WorldWideScience

Sample records for antecubital fossae rash

  1. Rashes

    Most simple rashes will improve with gentle skin care and by avoiding irritating substances. Follow these general guidelines: Avoid scrubbing your skin. Use as little soap as possible. Use gentle cleansers instead. ...

  2. Diaper Rash

    ... can thrive, causing a rash. Allergies. Babies with sensitive skin also can develop rashes. Certain types of detergent, ... dyes from diapers), or baby wipes can affect sensitive skin, causing a rash. Also, starting new foods can ...

  3. Mangala Fossa

    2002-01-01

    (Released 29 May 2002) The Science Today's THEMIS release captures Mangala Fossa. Mangala Fossa is a graben, which in geologic terminology translates into a long parallel to semi-parallel fracture or trough. Grabens are dropped or downthrown areas relative to the rocks on either side and these features are generally longer than they are wider. There are numerous dust devil trails seen in this image. In the lower portion of this image several dust devil tracks can be seen cutting across the upper surface then down the short stubby channel and finally back up and over to the adjacent upper surface. Some dust avalanche streaks on slopes are also visible. The rough material in the upper third of the image contains a portion of the rim of a 90 km diameter crater located in Daedalia Planum. The smooth crater floor has a graben (up to 7 km wide) and channel (2 km wide) incised into its surface. In the middle third and right of this image one can see ripples (possibly fossil dunes) on the crater floor material just above the graben. The floor of Mangala Fossa and the southern crater floor surface also have smaller linear ridges trending from the upper left to lower right. These linear ridges could be either erosional (yardangs) or depositional (dunes) landforms. The lower third of the scene contains a short stubby channel (near the right margin) and lava flow front (lower left). The floor of this channel is fairly smooth with some linear crevasses located along its course. One gets the impression that the channel floor is mantled with some type of indurated material that permits cracks to form in its surface. The Story In the Daedalia Plains on Mars, the rim of an old eroded crater rises up, a wreck of its former self (see context image at right). From the rough, choppy crater rim (top of the larger THEMIS image), the terrain descends to the almost smooth crater floor, gouged deeply by a trough, a channel, and the occasional dents of small, scattered craters. The deep trough running from southwest to northeast across the middle of this image is called 'Mangala Fossa.' Mangala Fossa is a graben, a land feature created by tectonic processes that worked to create a depression in the landscape. This graben is a little more than 4 miles wide at its maximum, but like most grabens, is much longer than it is wide. You can see from the context image that it runs across much of the width of the crater. Running southward from the graben (lower right-hand side of the larger THEMIS image) is a branching channel a little over a mile wide. The floor of this channel is fairly smooth with some linear crevasses along its course. These features suggest that the channel floor might be layered with some type of cemented material that permits cracks to form in its surface. Between the rough crater rim and the depressed graben, tiny crackles on the otherwise smooth surface appear. They might be the ripples of fossil dunes, hardened remains from a more active time. The floor of Mangala Fossa and the southern crater floor surface also feature small lines that seem to crease the surface. We know that they are ridges on the surface, but how did they form? Were higher surfaces carved away in grooves by the wind and scouring sand, forming ridges called yardangs? Or were dunes deposited on the smooth, lower terrain? No one knows for sure. Look closely for faint details as well. Do you see the subtle, scalloped pattern that laps at the lower left of the image, almost too muted to be seen? That's the sign of an ancient lava flow that stopped just there. And the shadowy gray streaks? Some are smudges caused by dust avalanches running down the slopes of the channel. Others are the tracks of dust devils that pass across the land, lifting and carrying away brighter dust to reveal the darker surface beneath. For a good example of a dust devil track, check out the faint gray line that cuts across the upper part of the channel, just below the point where it meets the graben.

  4. Tantalus Fossae

    2002-01-01

    (Released 25 June 2002) The Science Tantalus Fossae is a set of long valleys on the eastern side of Alba Patera. These valleys are referred to as grabens and are formed by extension of the crust and faulting. When large amounts of pressure or tension are applied to rocks on timescales that are fast enough that the rock cannot respond by deforming, the rock breaks along faults. In the case of a graben, two parallel faults are formed by extension of the crust and the rock in between the faults drops downward into the space created by the extension. Numerous sets of grabens are visible in this THEMIS image, trending from north-northeast to south-southwest. Because the faults defining the graben are formed parallel to the direction of the applied stress, we know that extensional forces were pulling the crust apart in the west-northwest/east-southeast direction. The large number of grabens around Alba Patera is generally believed to be the result of extensional forces associated with the uplift of Alba Patera. Also visible in this image are a series of linearly aligned pits, called a pit chain. The pits are not the result of impact cratering, but are similar to sinkholes on Earth. Sinkholes are typically formed by the removal of rock (commonly limestone) underground by groundwater -- when enough rock is removed, the overlying rock becomes too heavy to be supported, and it collapses, forming a pit. Unlike sinkholes, however, the pit chains near Alba Patera were likely formed when empty underground lava tubes collapsed, accounting for the presence and alignment of many pits. Numerous channel features are also observed in the image, and follow the local topographic slope, which is downhill to the east-southeast. One of these, a long channel in the center of the image, nicely demonstrates the complex relations possible between geologic features. The geologist's rule of superposition says that a feature on top of (superposing) another feature, or cutting across another feature is younger than the feature it covers or cuts. In one location, the channel cuts across the somewhat subdued fault defining a graben (near the right side of the image), indicating that the channel was carved after the graben was formed. But in other places (near the center of the image), the channel is clearly cut by a large fault defining one of the grabens, indicating that some faulting was occurring after the channel was carved. These relationships can be observed throughout this image. By mapping out superposition relationships in detail, geologists can establish a complex sequence of events that occurred long ago. The Story The first thing that catches your eye in the image above is a string of round pits that are strewn dramatically on the surface. Although they may look like craters, nothing came hurtling in from the sky to make them. Instead, collapses along a lava tube have created this long dotted line on the Martian surface. The lava tube, a hollow feature beneath the surface, can't always withstand the weight from above, and so collapses in places, forming pits like the ones seen here. Throughout the rest of the image are a series of depressed valleys known as grabens that run roughly from the northeast to the southwest. They formed when the crust of the Martian surface was stretched so fast that it broke along faults. When that happened, the rock in between fell downward into the space created by the extension, creating the long subtle streaks of lowered terrain. They were probably created when Alba Patera, the shield volcano of this area, was elevated or 'uplifted' through tectonic forces. This area of long valleys is named after Tantalus, a king of ancient Lydia who, according to legend, betrayed the gods and was sent to Hades. In this subterranean place, he was forced to stand in water up to his chin underneath the branches of fruit trees. Every time he tried to drink, the water would recede, and every time he tried to eat, the boughs would move the fruit just out of reach. You can easily see where the word 'tantalize' comes from. Scientists are intrigued so much by the history of this area that they seek to understand its elusive past. Luckily, their interests are much more in reach than those of poor Tantalus. A number of channels in this image (running downhill from the west-northwest to the east-southeast) help them understand the chain of events that worked to create the compelling features in this region. Take a look at the channels close-up and see if you can tell whether the channels or the grabens happened first. A rule of thumb is that if one feature is on top of another or cuts across it, it is younger than the feature it covers or cuts. One of the channels in the center of the image is great to study. Toward the right side of the image, the channel cuts across a fault, indicating it formed before the graben. Follow the channel westward, however, and you'll see that a large fault cuts the channel, indicating that this graben formed after the channel. That probably means this criss-crossed region went through a seeming eternity of torture itself, as the land kept tearing and stretching, as channels were carved and recarved, as lava tubes formed and then finally collapsed, only to have their walls erode in further streaks as well.

  5. Hot Tub Rash (Pseudomonas Folliculitis)

    ... clinical tools newsletter | contact Share | Hot Tub Rash ( Pseudomonas Folliculitis) Information for adults A A A This ... small pus-filled lesions. Overview Hot tub rash ( Pseudomonas folliculitis) is an infection of the hair follicle ...

  6. Miopericitoma em fossa nasal

    Medeiros, Arethusa Ingrid de Liz

    2009-06-01

    Full Text Available Introdução: Os miopericitomas representam cerca de 1 % dos tumores vasculares, sendo relativamente comum na região de cabeça e pescoço, 25% dos casos, e raro nas cavidades nasais e paranasais. Objetivo: Descrever um caso de miopericitoma em fossa nasal. Relato do Caso: Apresentamos um caso de paciente adulta, do sexo feminino, com queixas de obstrução nasal, dor em região de fossas nasais e epistaxe eventual em fossa nasal direita, apresentando massa angiomatosa e facilmente sangrante, não pulsátil, ocupando toda fossa nasal direita. Comentários Finais: Os mopericitomas são tumores vasculares incomuns, raramente localizados na cavidade nasal e nos seios paranasais. Devem ser incluídos no diagnóstico diferencial das massas bem delimitadas, vasculares e de crescimento lento à tomografia computadorizada.

  7. Drug Rash (Unclassified Drug Eruption) in Children

    ... rash and rashes clinical tools newsletter | contact Share | Drug Eruption, Unclassified (Pediatric) A parent's guide to condition ... lesions coming together into larger lesions typical of drug rashes (eruptions). Overview A drug eruption, also known ...

  8. Pediatric patient with a rash.

    Sutton, Jared; Walsh, Ryan; Franklin, Jillian

    2014-07-01

    A 2 year old fully immunized male with no personal history of chicken pox presented to the emergency department with a chief complaint of a rash for one week after returning from a hiking trip in a remote island in Canada. After initially being diagnosed with contact dermatitis, a diagnosis of herpes zoster was made by confirmatory viral polymerase chain reaction testing. The purpose of this case report is to examine the literature for the incidence and etiology of shingles in children without a prior history of a primary varicella rash outbreak. PMID:25035735

  9. Rash caused by Oryctes nasicornis.

    Veraldi, Stefano; Fanoni, Daniele; Nazzaro, Gianluca

    2016-02-01

    We report a case of rash caused by crushing of a male of Oryctes nasicornis (Linnaeus 1758) (Coleoptera, "http:// it. wikipedia. org/ wiki/ Scarabaeidae" \\o "Scarabaeidae" Scarabaeidae), popularly known as "European rhinoceros beetle", on the skin of an Italian tourist who developed the reaction during a trip to Turkey. The rash appeared one hour after the crushing of the insect on the skin. The patient was observed one day later, when she returned to Italy. To our knowledge, no similar cases have been reported in the literature. PMID:26858273

  10. Butterfly rash with periodontitis: A diagnostic dilemma

    Manvi Aggarwal; Mudit Mittal; Swati Dwivedi; Pallavi Vashisth; Deepesh Jaiswal

    2012-01-01

    Rashes can occur in any part of the body. But rash which appears on face has got both psychological and cosmetic effect on the patient. Rashes on face can sometimes be very challenging to physicians and dermatologists and those associated with oral manifestations pose a challenge to dentists. Butterfly rash is a red flat facial rash involving the malar region bilaterally and the bridge of the nose. The presence of a butterfly rash is generally a sign of lupus erythematosus (LE), but it can al...

  11. New Itchy Skin Rashes in Children

    ... an itchy rash. In children, viral infections and scabies are common, as are several types of skin ... are typical of hives (urticaria), viral infections, and scabies. Most skin rashes are not dangerous to others ...

  12. New Itchy Skin Rashes in Adults

    ... of drug reactions, hives (urticaria), viral infections, and scabies. Most skin rashes are not dangerous to others ... by an infectious disease, such as shingles or scabies. Many rashes go away on their own after ...

  13. Drug Rash (Unclassified Drug Eruption) in Adults

    ... trigger a drug rash include: Antibiotics, such as penicillin or sulfa drugs Anti-inflammatory medicines, such as ... Medical Care Whenever you are started on a new medication and develop a rash, you should immediately ...

  14. Pediatric Patient with a Rash

    Sutton, Jared; Walsh, Ryan; Franklin, Jillian

    2014-01-01

    A 2 year old fully immunized male with no personal history of chicken pox presented to the emergency department with a chief complaint of a rash for one week after returning from a hiking trip in a remote island in Canada. After initially being diagnosed with contact dermatitis, a diagnosis of herpes zoster was made by confirmatory viral polymerase chain reaction testing. The purpose of this case report is to examine the literature for the incidence and etiology of shingles in children withou...

  15. Butterfly rash with periodontitis: A diagnostic dilemma

    Manvi Aggarwal

    2012-01-01

    Full Text Available Rashes can occur in any part of the body. But rash which appears on face has got both psychological and cosmetic effect on the patient. Rashes on face can sometimes be very challenging to physicians and dermatologists and those associated with oral manifestations pose a challenge to dentists. Butterfly rash is a red flat facial rash involving the malar region bilaterally and the bridge of the nose. The presence of a butterfly rash is generally a sign of lupus erythematosus (LE, but it can also include a plethora of conditions. The case presented here is of a female with butterfly rash along with typical bright red discoloration of gingiva. The clinical, histopathological and biochemical investigations suggested the presence of rosacea.

  16. Medusae Fossae Formation

    2002-01-01

    (Released 10 April 2002) The Science This THEMIS visible image was acquired near 7o S, 172o W (188o E) and shows a remarkable martian geologic deposit known as the Medusae Fossae Formation. This Formation, seen here as the raised plateau in the upper two-thirds of the image, is a soft, easily eroded deposit that extends for nearly 1,000 km along the equator of Mars. In this region the deposit has been heavily eroded by the wind to produce a series of linear ridges called yardangs. These parallel ridges point in direction of the prevailing winds that carved them, and demonstrate the power of martian winds to sculpt the dry landscape of Mars. The Medusae Fossae Formation has been completely stripped from the surface in the lower third of the image, revealing a harder layer below that is more resistant to wind erosion. The easily eroded nature of the Medusae Fossae Formation suggests that it is composed of weakly cemented particles, and was most likely formed by the deposition of wind-blown dust or volcanic ash. Several ancient craters that were once completely buried by this deposit are being exposed, or exhumed, as the overlying Medusae Formation is removed. Very few impact craters are visible on this Formation, indicating that the surface seen today is relatively young, and that the processes of erosion are likely to be actively occurring. The Story Medusa of Greek mythology fame, the name-giver to this region, had snaky locks of hair that could turn a person to stone. Wild and unruly, this monster of the underworld could certainly wreak havoc on the world of the human imagination. As scary as she was, Medusa would have no advantage over the fierce, masterful winds blowing across Mars, which once carved the streaky, terrain at the top of this image. Wild and whipping, these winds have slowly eroded away the 'topsoil,' revealing ancient craters and other surface features they once covered. The loosely cemented particles of this 'topsoil' are likely made up of dust or volcanic ash, and are thus more susceptible to windblown erosion. The Martian winds have actually been strong and relentless enough over time to strip the land in the bottom of this image of the material that once covered it, leaving it hard and bare to the eye.

  17. Variations in the cubital fossa

    Biswas S

    2010-08-01

    Full Text Available The median nerve crosses in front of the brachial artery at the middle of the arm from lateral to medial side, and passes along its medial side. They appear in cubital fossa beneath bicipital aponeurosis and rest on brachialis muscle. In cubital fossa, structures lying from lateral to medial are tendon of biceps brachii, brachial artery and median nerve (TAN. No literature is available stating median nerve to be lateral to the brachial artery in the cubital fossa. In the present case, we found bilateral variations in the course of median nerve and brachial artery in the cubital fossa. The nerve was lateral to the artery. Both the structures passed deep to an accessory slip of brachialis muscle in the lower arm. It is a rare variation. Compression neuropathy of median nerve, vascular compression and injury to the median nerve during brachial catheterization can occur in such a case.

  18. Ron Rash: One Foot in Eden

    Bjerre, Thomas Ærvold

    An analysis of Ron Rash's novel One Foot in Eden, focusing on his attachment to place and his depiction of the internal conflicts between farmers and townspeople in a small Appalachian community. Rash depicts the contemporary Southerner’s struggle to maintain his or her roots in a time of rapid...

  19. Heat Rash or Prickly Heat (Miliaria Rubra)

    ... gland. Although this rash can be caused by fever, heat rash is more commonly seen in infants who are dressed too warmly (in the winter). ... humidity. Acetaminophen or ibuprofen can help to reduce fever. Remove any occlusive ... Most infants recover uneventfully within a matter of weeks. Young ...

  20. Skin rash during treatment with generic itraconazole

    Antonio De Vuono

    2014-01-01

    Full Text Available Generic drugs have the same active substance, the same pharmaceutical form, the same therapeutic indications and a similar bioequivalence with the reference medicinal product (branded. Although a similar efficacy is postulated, some cases of clinical inefficacy during treatment with generic formulations have been reported. In this case, we describe a woman with onychomycosis that developed a skin rash during treatment with a generic formulation of itraconazole. Drug administration and its re-challenge confirmed the association between itraconazole and skin rash. Both Naranjo probability scale and World Health Organization causality assessment scale documented a probable association between generic-itraconazole and skin rash. The switch from generic formulation to brand one induced an improvement of symptoms. Since we are unable to evaluate the role of each excipient in the development of skin rash, we cannot rule out their involvement. However, more data are necessary to better define the similarities or differences between branded and generic formulations.

  1. Approach to the Diseases with Rash

    Gönül Tan?r

    2009-05-01

    Full Text Available The differential diagnosis for febrile patients with a rash is extensive. Diseases that present with fever and rash are usually classified according to the morphology of the primary lesion. Rashes can be categorized as maculopapular and diffusely erythematous, vesiculobullous, purpuric, or petechial. A thorough history and a careful physical examination are essential to making a correct diagnosis. Certain exanthemas have fairly characteristic morphology, but in many cases an accurate diagnosis cannot be made on the basis of morphology alone. Historical factors may be helpful when evaluating these patients, specifically their disease contacts, immunization record, previous exanthematous illnesses, and associated prodromal symptoms. Although laboratory studies can be useful in confirming the diagnosis, test results often are not available immediately. Because the severity of these illnesses can vary from minor (roseola infantum to life-threatening (meningococcemia, the physician must make prompt management decisions regarding empiric therapy.

  2. Traumatic posterior fossa epidural hematoma

    In this paper three acute cases and two subacute cases are reported. CT findings in acute cases show two different types. ''Type I'' shows crescent or lenticular high density area which is not enhanced after contrast infusion. ''Type II'' shows lenticular low density area with membranous high density region in its medial side after contrast infusion. In subacute cases plain CT scan shows lenticular iso or low density area with membranous high density region in its medial side. Forty five cases of posterior fossa epidural hematoma in the review of literature of this country are discussed. Disturbances of the consciousness are the most predominant symptoms in acute cases, while in subacute cases cerebellar signs, vomiting, headache and choked disc are noted. Angiographical examinations may not always be valuable in collecting the direct information of the existence of the epidural hematoma. Liquor cavity in the posterior fossa which is thought to serve as a buffer action of hematoma is about 20 ml, so we discuss about the volume of hematoma, especially of 20 ml, associated with clinical course and prognosis. Volume of epidural hematoma is one of the most important factors affecting clinical course and prognosis. In summary of these our experiences, we again emphasize the value of CT scan as the rapid, noninvasive, accurate radiological examination in the diagnosis of traumatic posterior fossa epidural hematoma. (author)

  3. Posterior Fossa Tumor in Children

    Seyed Mahmoud TABATABAEI

    2012-06-01

    Full Text Available How to Cite this Article: Tabatabaei SM, Seddighi A, Seddighi AS. Posterior Fossa Tumor in Children. Iran. J. Child. Neurol 2012;6(2: 19-24. Objective Primary brain tumors are the most common solid neoplasms of childhood, representing 20% of all pediatric tumors. The best current estimates place the incidence between 2.76 and 4.28/100,000 children per year. Compared with brain tumors in adults, a much higher percentage of pediatric brain tumors arise in the posterior fossa. Infratentorial tumors comprise as many as two thirds of all pediatric brain tumors in some large series. Tumor types that most often occur in the posterior fossa include medulloblastoma, ependymoma, cerebellar astrocytoma and brainstem glioma. Materials & Methods All pediatric cases of posterior fossa tumor that were considered for surgery from 1981 to 2011 were selected and the demographic data including age, gender and tumor characteristics along with the location and pathological diagnosis were recorded. The surgical outcomes were assessed according to pathological diagnosis. Results Our series consisted of 84 patients (52 males, 32 females. Cerebellar symptoms were the most common cause of presentation (80.9% followed by headache (73.8% and vomiting (38.1%. The most common histology was medulloblastoma (42.8% followed by cerebellar astrocytoma (28.6%, ependymoma (14.3%, brainstem glioma (7.2% and miscellaneous pathologies (e.g., dermoid,  andtuberculoma (7.2%. Conclusion The diagnosis of brain tumors in the general pediatric population remains challenging. Most symptomatic children require several visits to a physician before the correct diagnosis is made. These patients are often misdiagnosed for gastrointestinal disorders. Greater understanding of the clinical presentation of these tumors and judicious use of modern neuroimaging techniques should lead to more efficacious therapies.References 1. Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ. Latency between symptom onset and diagnosis of  pediatric brain tumors: an Eastern Canadian geographic study. Neurosurgery 2002 Aug;51(2:365-73. 2. Mueller B, Gurney JG. Epidemiology of pediatric brain tumors. Neurosurg Clin N Am 1992 Oct;3(4:715-21. 3. Albright A, Wisoff JH, Zeltzer PM, Deutsch M, Finlay J, Hammond D. Current neurosurgical treatment of medulloblastomas in children. A report from the Children’s Cancer Study Group. Pediatr Neurosci 1989;15(6:276-82. 4. Albright AL. Posterior fossa tumors. Neurosurg Clin N Am. 1992 Oct;3(4:881-91. 5. Healey E, Barnes PD, Kupsky WJ, Scott RM, Sallan SE, Black PM. The prognostic significance of postoperative residual tumor in ependymoma. Neurosurgery 1991 May;28(5:666-71. 6. Park T, Hoffman HJ, Hendrick EB, Humphreys RP, Becker LE. Medulloblastoma: clinical presentation and management. Experience at the hospital for sick children, Toronto, 1950-1980. J Neurosurg 1983 Apr;58(4:543-52. 7. Allen LC. Childhood brain tumors. Current status of clinical trials in newly diagnosed and recurrent disease. Pediatr Clin North Am 1985 Jun;32(3:633-51. 8. Laurent JP,Cheek WR. Brain tumors in children. J Pediatr Neurosci 1985;1:15-32. 9. O’Brien DF, Caird J, Kennedy M, Roberts GA, Marks JC, Allcutt DA. Posterior fossa tumours in childhood: evaluation of presenting clinical features. Irish Med J 2001 Feb;94(2:52-3. 10. Bronstein KS. Epidemiology and classification of brain tumours. Cri Care Nurs Clin North Am 1995;7:79-89. 11. Lannering B, Marky I, Nordborg C. Brain tumors in children and adolescence in west Sweden 1970-1984. Epidemiology and survival Cancer. l990 Aug 1;66(3:604-9. 12. Cushing H. Experiences with cerebellar astrocytomas: a critical review of 26 cases. Surg Gynae Obstet 1931;52:129-204. 13. Geissinger JD. Astrocytomas of the cerebellum in children. Long-term study. Arch Neurol 1971 Feb;24(2:125-35. 14. Pascual - Castroviejo I, Raimondi AJ, Choux M, Di Rocco C. Functional basis of posterior fossa symptoms and signs. eds. Posterior fossa tumours. New York: Springer Verlag; 1993;12-21. 15. Cohen ME, Duner PK. Tumours of the brain and spinal cord including leukemic infiltrates. In: Swaiman KF, editor. Pediatric neurology principles and practice. St. Louis: Mosby; 1991. p. 94550. 16. Bronstein KS. Epidemiology and classification of brain tumors. Crit Care Nurs Clin North Am 1995 Mar;7(1:79-89. 17. GOL A. Cerebellar astrocytomas in children. Am J Dis Child 1963 Jul;106:21-4. 18. Hojer C, Hildebrandt G, Lanfermann H, Schroder R, Haupt WF. Pilocyticastrocytomas of the posterior fossa. A follow-up study in 33 patients. Acta Neurochir (Wien 1994;129(3-4:131-9. 19. Lassman LP, Arjona VE. Pontine gliomas of childhood. Lancet 1967 Apr 29;1(7496:913-5. 20. Reigel DH, Scarff TB, Woodford JE. Biopsy of pediatric brain stem tumors. Childs Brain. 1979;5(3:329-40. 21. Griwan MS, Sharma BS, Mahajan RK, Kak VK. Value of precraniotomy shunts in children with posterior fossa tumours. Childs Nerv Syst 1993 Dec;9(8:462-5. 22. Raimondi AJ, Tomita T. Hydrocephalus and infratentorial tumors. Incidence, clinical picture, and treatment. J Neurosurg 1981 Aug;55(2:17482. 23. Jamjoom AB, Jamjoom ZA, al-Rayess M. Intraventricular and leptomeningeal dissemination of a pilocytic cerebellar astrocytoma in a child with a ventriculoperitoneal shunt: case report Br J Neurosurg. 1998 Feb;12(1:568. 24. Vaquero J, Cabezudo JM, de Sola RG, Nombela L. Intratumoral hemorrhage in posterior fossa tumors after ventricular drainage. Report of two cases. J Neurosurg 1981 Mar;54(3:406-8. 25. Hoffman HJ, Hendrick EB, Humphreys RP. Metastasis via ventriculoperitoneal shunt in patients with medulloblastoma. J Neurosurg 1976 May;44(5:562-6. 26. Hirsch J, Renier D, Czernichow P, Benveniste L, PierreKahn A. Medulloblastoma in childhood: survival and functional results. Acta Neurochir 1979;48:1-15. 27. Abdollahzadeh-Hosseini SM, Rezaishiraz H, Allahdini F. Acta Medica Iranica 2006;44(2:89-94. 

  4. Methylenetetrahydrofolate reductase (MTHFR) deficiency presenting as a rash.

    Crushell, Ellen

    2012-09-01

    We report on the case of a 2-year-old girl recently diagnosed with Methylenetetrahydrofolate reductase (MTHFR) deficiency who originally presented in the neonatal period with a distinctive rash. At 11 weeks of age she developed seizures, she had acquired microcephaly and developmental delay. The rash deteriorated dramatically following commencement of phenobarbitone; both rash and seizures abated following empiric introduction of pyridoxine and folinic acid as treatment of possible vitamin responsive seizures. We postulate that phenobarbitone in combination with MTHFR deficiency may have caused her rash to deteriorate and subsequent folinic acid was helpful in treating the rash and preventing further acute neurological decline as commonly associated with this condition.

  5. Adult with morbilliform rash and tattoo bullae

    Borok, Jenna; Hau, Jennifer; Worswick, Scott

    2016-01-01

    A 34-year-old woman was diagnosed with Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), most likelyrelated to a reaction to allopurinol.The patient presented with a 2-week history of a painful pruritic rash that started on her back and progressed to the rest of her body over a five-day period. The eruption started after several new drugs were started, including allopurinol for hyperuricemia. On physical examination, the patient had a diffuse morbilliform eruption and geometric i...

  6. Leflunomide Induced Drug Rash And Hepatotoxicity

    Uppal Monica

    2004-01-01

    Full Text Available A 57 year old female presented with generalized erythematous scay plaques of 11/2 months duration and jaundice since 1 month. She was on leflunomide since 3 months for chronic rheumatoid arthritis. Investigations revealed positive ANA, rheumatoid factor and negative anti-DsDNA. Bilirubin and liver enzymes were markedly raised. Viral markers were negative. Direct immunoflourescence did not show lupus band. A diagnosis of drug induced hepatitis and skin rash was made. She was treated with cholestyramine but she died after ten days of hospitalization.

  7. Mature Teratoma Confined to the Posterior Fossa.

    Daugherty, Christopher; Ngo, Thang; Drehner, Dennis; Maugans, Todd

    2016-01-01

    Mature teratomas located solely in the posterior fossa are rare. We describe a girl who presented with hydrocephalus caused by a posterior fossa tumor that was ultimately diagnosed as a mature teratoma following complete extirpation. Unusual imaging characteristics which produced confusion preoperatively were, however, very consistent with mature teratomas that are encountered in the gonads. Immature elements were universally absent; therefore, extirpation was curative. Hydrocephalus is unlikely to resolve after tumor removal, and cerebrospinal fluid diversion may be required. PMID:26730985

  8. RASH D - A mercury programme for neutron shielding calculations

    An improved version of an earlier neutron shielding programme (RASH B) is described. The new programme is also written in Mercury Autocode and solves a set of multigroup diffusion equations in one dimension. It differs from RASH B in that distributed source terms may be introduced into all the groups if required. Some other improvements are also included. (author)

  9. Arachnoid cyst of the middle cranial fossa

    The middle cranial fossa is the most common site for intracranial arachnoid cysts. Galassi and his associates have provided a useful classification of middle fossa arachnoid cysts based on their computed tomographic appearances. The Type I cyst is a small lenticular lesion. The Type II cyst is quadrangular in shape, reflecting a completely open insula. The Type III cyst appears as a large area of smoothly rounded lucency, with a significant compression of the brain. We report a 2-year-old boy with a middle fossa arachnoid cyst. This cyst differed from the type of Galassi's classification in its extension. Computerized tomograms showed low-density lesions of the bilateral middle cranial fossa and suprasellar area, which was not enhanced with contrast medium. Magnetic Resonance Imaging (MRI) showed a CSF-like pattern (Kjos) and revealed delicate anatomical structures in the surrounding brain. Arachnoid cysts are usually single lesions. However, not infrequently these cystic cavities may be divided by membranous septa into two or more compartments. Bilateral, more or less symmetrical arachnoid cysts in the middle cranial fossa as seen in this patient, however, seem to be very rare. Only a few such cases have been reported previously. MRI was superior to X-ray CT in characterizing intracranial cystic lesions because of its ability to categorize cysts into Kjos's three groups on the basis of the intensity pattern of the cyst contents, thereby improving diagnostic specificity and patient management. (author)

  10. Radiographic imaging of the canine intercondylar fossa

    The intercondylar fossa is believed to play an important role in the pathology of cranial cruciate ligament rupture and therefore has received considerable attention in the last decade. Accurate radiographic imaging of the intercondylar fossa requires that the central x-ray beam pass through the center of the intercondylar “tunnel”. The anatomy of the canine intercondylar fossa is similar to humans, however, the orientations of the intercondylar fossa's differ. Consequently, the positioning techniques described for humans are not appropriate for the dog. To pass through the center of the dog, intercondylar fossa, the central x-ray beam should be 12° (S.D. 1.7°) caudal from the femoral diaphysis in the sagittal plane and obliqued caudolateral to craniomedial 7° (S.D. 0.60°) (caudo78°proximo7° lateralcraniodistomedial oblique). Cross table positioning was used with the hip flexed and the radiograph cassette placed on the cranial surface of the stifle. However, superimposition of the tuber ischii and soft tissues caudal to the femur made 15° to 20° the best angle obtainable. There was not a significant difference (p = 0.17) in the notch width index between a 12° versus 20° angle of the central x-ray beam caudal to the femoral diaphysis, both with 7° of external rotation of the stifle. The notch width index of 0.252 obtained from radiographic measurements was not significantly different from measurements obtained grossly of 0.254 (n = 26; p = 0.69). Failure to oblique the central x-ray beam caused a significant (p = 0.0008) decrease in the apparent fossa width radiographically

  11. Internal antecubital fold line: A new useful anatomical repair to identify the medial epicondyle and avoid iatrogenic ulnar nerve injury in patients with supracondylar fracture of the humerus Línea del pliegue antecubital interno: Un nuevo reparo anatómico útil para identificar la epitróclea y evitar lesiones iatrogénicas del nervio ulnar en pacientes con fractura supracondílea del humero

    Luis José Cespedes

    2012-12-01

    Full Text Available Introduction: The supracondylar fracture of the distal humerus is the most common pediatric fracture around the elbow. The currently accepted techniques of fixation are two lateral parallel wires , crosswiring technique from the lateral side, two divergent wires laterally and two retrograde crossed wires. The retrograde crossed wires provide the best mechanical stability. Many children with this fracture have swelling around the elbow, making difficult the feeling of the anatomic landmarks for percutaneous pinning, increasing the risk of ulnar nerve injury. Objective: To evaluate the correspondence of the internal antecubital fold line with the internal epicondyle in patients with supracondylar fracture and the incidence of iatrogenic ulnar nerve injuries . Methods: We conducted a series of clinical cases. In the first group we included 56 children with supracondylar fracture Gartland type III, from August 2000 to September 2007, who underwent closed reduction and crossed retrograde nail fixation. In the second group we included 241 (481 elbows outpatients with no anatomic abnormality. We used the extension of antecubital fold line to find the internal epicondyle in both groups. Results: The prolongation of the antecubital fold line intersected the medial epicondyle in all participants of the first group. In 96.3% of the participants in the second group, the extension of antecubital fold line intersected the internal epicondyle. None patient had iatrogenic ulnar nerve injury. Conclusions: The use of the antecubital internal fold line may be useful to identify the internal epicondyle and thus avoid iatrogenic ulnar nerve injury. Salud UIS 2012; 44 (2: 9-14La fractura supracondílea del húmero distal es la más común alrededor del codo en niños. Las técnicas actualmente aceptadas de fijación son dos clavos laterales paralelos, dos clavos cruzados laterales, dos clavos laterales divergentes y dos clavos retrógrados cruzados. Los clavos retrógrados cruzados, proporcionan la mejor estabilidad mecánica. La mayoría de los niños con fractura supracondílea presentan inflamación alrededor del codo, haciendo difícil la palpación de la epítroclea, aumentando el riesgo de lesión del nervio cubital. Objetivo: evaluar la correspondencia de la línea del pliegue antecubital interno con la epitróclea en pacientes con fractura supracondílea y la incidencia de las lesiones iatrogénicas del nervio cubital. Metodología: Realizamos una serie de casos clínicos. El primer grupo incluyó 56 niños con fractura supracondílea tipo III de Gartland, entre agosto de 2000 a septiembre de 2007, tratados con reducción cerrada y fijación con clavos cruzados retrógrados. El segundo grupo incluyó 241 (481 codos pacientes de consulta externa. En ambos grupos utilizamos la línea antecubital interna para identificar la epitróclea. Resultados: La prolongación de la línea del pliegue antecubital intersecó la epitróclea en todos los participantes del primer grupo. No hubo lesión iatrogénica del nervio cubital. En el segundo grupo la línea del pliegue antecubital intersecó la epitróclea en el 96.3% de los pacientes. Ningún paciente presentó lesión del nervio cubital. Conclusiones: La extensión de la línea de pliegue antecubital interno puede ser útil para la identificación de la epitróclea y así evitar lesiones iatrogénicas del nervio cubital. Salud UIS 2012; 44 (2: 9-14

  12. Not all that rashes is measles:

    Measles is a major cause of infant mortality in third world countries, leading to approximately one million deaths each year. The WHO aims to globally eradicate measles virus at the beginning of the next century, which will need a major effort in particular in countries like Sudan. To achieve goal epidemiological studies I am needed to estimate the magnitude of the problem for which accurate diagnostic test are needed. We therefore conducted a study in El hag Yousif area (population 500 000) in Khartoum North where measles is prevalent despite vaccination effort by EPI. We studied the accuracy of the WHO criteria for clinical diagnosis in comparison with laboratory diagnosis during a one-year period. A total of 145 under five suspected measles cases were identified by active, case finding and examined. 111 cases fully complied with the WHO criteria for diagnosis of clinical measles. Out of 103 clinical measles cases, tested using prototype rapid measles test IgM Elisa and Pcr, 77(75%) were measles positive. A battery of virus test was run on 21 sera out of the 26(25%) measles negatives: Herpes virus-6, Epstein-Bar and Dengue viruses were detected in five, one and one case, respectively. It was concluded that one out of every four cases diagnosed by the clinical as measles rash is probably caused by other viruses. (Author)

  13. Adult with morbilliform rash and tattoo bullae.

    Borok, Jenna; Hau, Jennifer; Worswick, Scott

    2016-01-01

    A 34-year-old woman was diagnosed with Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), most likelyrelated to a reaction to allopurinol.The patient presented with a 2-week history of a painful pruritic rash that started on her back and progressed to the rest of her body over a five-day period. The eruption started after several new drugs were started, including allopurinol for hyperuricemia. On physical examination, the patient had a diffuse morbilliform eruption and geometric intact bullae limited to the boundaries of tattoos.Most presentations of DRESS include a morbilliform eruption.  However, DRESS does not commonly present with bullae. There have been no known reported cases of bullae forming in the area of tattoos in cases of DRESS. This unique presentation suggests that a component of the tattoo or tattooing process alters the cutaneous immune response, creating an immunocompromiseddistrict. This alteration may promote a greater localized reaction in the setting of widespread skin involvement in DRESS. PMID:27136636

  14. Skin conditions: common skin rashes in infants.

    Zuniga, Ramiro; Nguyen, Tam

    2013-04-01

    Infants exhibit many skin rashes. Erythema toxicum neonatorum presents as erythematous macules, papules, and pustules on the face, trunk, and extremities; it typically resolves spontaneously within 1 week. Neonatal acne presents as comedones or erythematous papules on the face, scalp, chest, and back. Infantile acne is similar but starts after the neonatal period. Both conditions typically resolve spontaneously; failure to resolve within 1 year warrants evaluation for androgen excess. Neonatal cephalic pustulosis is an acne variant caused by hypersensitivity to Malassezia furfur. It is typically self-limited, but severe cases are managed with topical ketoconazole. Miliaria and milia are caused by sweat retention and present as tiny vesicles or papules; they resolve spontaneously. Contact diaper dermatitis is managed by keeping the diaper area clean and with open air exposure. Diaper dermatitis due to Candida albicans is managed with topical antifungals. Seborrheic dermatitis causes scaling on the scalp. Management involves shampooing and removing scales with a soft brush after applying mineral oil or petrolatum; severe cases are managed with tar or ketoconazole shampoo. Atopic dermatitis is related to food allergy in approximately one-third of children. Food allergy can be confirmed with oral food challenges or skin prick tests. Management includes elimination of irritants and triggers and use of low-potency topical steroids. PMID:23600337

  15. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    2010-04-01

    ...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the temporomandibular... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Glenoid fossa prosthesis. 872.3950 Section...

  16. Herniographic appearance of the lateral inguinal fossa

    Herniography frequently reveals clinically undetected groin hernia. Thereby herniography contributes to the clinical work-up in patients with obscure groin pain. However, the distinction between clinically important and unimportant abnormalities within the lateral inguinal fossa can be difficult. This study was therefore designed in order to elucidate the herniographic appearance of the lateral inguinal fossa in patients with obscure groin pain. Herniographic findings were compared with laterality of the patients' symptoms. The lateral umbilical fold was visible in only 47% of the groins. A triangular shaped outpouching from the lateral inguinal fossa and a patent processus vaginalis were found with equal frequency on the left and right side. They were five times as frequent in men as in women. Their presence did not correlate with laterality of the patients' symptoms. Indirect hernias were almost twice as common on the symptomatic side as compared with the asymptomatic side. On the left side they were found twice as often in men as in women while there was no significant sex difference on the right side. Our results show that neither a patent processus vaginalis nor a triangular outpouching from the lateral inguinal fossa correlate with the laterality of the patients' symptoms while true indirect hernias do. (orig.)

  17. Herniographic appearance of the lateral inguinal fossa

    Ekberg, O.; Kesek, P.

    Herniography frequently reveals clinically undetected groin hernia. Thereby herniography contributes to the clinical work-up in patients with obscure groin pain. However, the distinction between clinically important and unimportant abnormalities within the lateral inguinal fossa can be difficult. This study was therefore designed in order to elucidate the herniographic appearance of the lateral inguinal fossa in patients with obscure groin pain. Herniographic findings were compared with laterality of the patients' symptoms. The lateral umbilical fold was visible in only 47% of the groins. A triangular shaped outpouching from the lateral inguinal fossa and a patent processus vaginalis were found with equal frequency on the left and right side. They were five times as frequent in men as in women. Their presence did not correlate with laterality of the patients' symptoms. Indirect hernias were almost twice as common on the symptomatic side as compared with the asymptomatic side. On the left side they were found twice as often in men as in women while there was no significant sex difference on the right side. Our results show that neither a patent processus vaginalis nor a triangular outpouching from the lateral inguinal fossa correlate with the laterality of the patients' symptoms while true indirect hernias do.

  18. MORPHOMETRIC ANALYSIS OF GLENOID FOSSA OF SCAPULA

    Sangeeta

    2015-06-01

    Full Text Available The study was conducted on sixty scapulae obtained from the department of Anatomy, Government Medical College, Jammu. The shape of the glenoid cavity was observed in all the scapulae. It was inverted comma shaped, tear drop shaped, oval and round shaped. T he shape on the two sides was compared. Morphometry of the glenoid cavity was done and compared on right and left side. The dimensions of the glenoid fossa provide important information for designing and fitting of glenoid component for shoulder arthroplas ty. An understanding of variations of glenoid cavity is essential for evaluating pathological conditions like osseous Bankart lesions and osteochondral defects. INTRODUCTION: Shoulder arthroplasty is a common mode of treatment to treat shoulder pathologies like shoulder arthritis. Knowledge about the shape and morphological parameters is essential for success of shoulder arthroplasty as otherwise there would be loosening of the joint necessisitating the need for revision surgery. The articular surfaces for shoulder joint are the glenoid cavity (or fossa of scapula and head of humerus. The glenoid fossa is a shallow ovoid depression on the lateral angle of the scapula. It is also called as the glenoid cavity or the head of the scapula. There is variation in the shape of the glenoid fossa. The glenoid rim presents a small notch on its anterior and upper part . (1 The glenoid notch prevents the attachment of fibrocartilaginous glenoidal labrum to the glenoidal rim, which can be detach ed leading to Bankart, s les ion . (2 A knowledge of the shape and morphometry of glenoid fossa is essential for treat ing glenohumeral osteoarthritis . (3 Morphometric analysis of glenoid fossa is also essential when total shoulder prosthesis has to be used. It is also essential for eva luating Bankart lesion, osteochondral defects, shoulder instability etc. Thorough scanning of available literature revealed that there is dearth of literature regarding morphometry of glenoid fossa . Therefore a curious desire developed to conduct this stud y. Our study would provide morphometric data, providing an anatomical baseline, which will be of immense help to anthropologists, osteologists, anatomists, and orthopedicians.

  19. Side Effects of HIV Medicines: HIV and Rash

    ... medicine. In addition to rash, signs of a hypersensitivity reaction can include fever, fatigue, difficulty breathing, and kidney damage. Stevens-Johnson syndrome (SJS) is a rare but life-threatening ...

  20. Nappy (diaper) rash: what else besides irritant contact dermatitis?

    Carvalho, Vânia Oliveira; Robl, Renata; Uber, Marjorie; Abagge, Kerstin Taniguchi; Marinoni, Leide Parolin; Presa, Juliana Gomes Loyola

    2015-08-01

    Nappy (diaper) rash is a common cutaneous disorder of infancy, and diverse dermatoses may affect this region. To perform a differential diagnosis can be challenging. We present four cases to emphasise the importance of clinical diagnosis. PMID:25368136

  1. Vermian agenesis without posterior fossa cyst

    We report 11 cases of vermian partial agenesis without posterior fossa cyst or hemispheric abnormalities. Characteristic MR signs were: absence of the posterior lobe, hypoplasia of the anterior lobe, a narrow sagittal cleft separating the hemispheres (''buttocks sign'') and fourth ventricle deformity. The main clinical signs were complex oculomotor dysfunction and developmental delay. None of the patients had respiratory symptoms. Consideration is given to the relationship between Joubert syndrome and this entity as well as to embroyological data. (orig.)

  2. [Cochlear implantation through the middle fossa approach].

    Szyfter, W; Colletti, V; Pruszewicz, A; Kopeć, T; Szymiec, E; Kawczyński, M; Karlik, M

    2001-01-01

    The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding. PMID:11766315

  3. Benign neurilemmoma in the infratemporal fossa involving maxillary sinus and pterygopalatine fossa

    Choi, Jin Woo; Heo, Min Suk; Lee, Jin Koo; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of); An, Chang Hyeon [Kyungpook National University College of Medicine, Daegu (Korea, Republic of)

    2004-12-15

    Neurilemmoma is a benign tumor of the nerve sheath that arises on cranial and spinal nerve roots as well as along the course of peripheral nerves. A case of a neurilemmoma that arose in the left infratemporal fossa of a 29- year-old male was presented. Plain radiographs, enhanced computed tomography scan, and magnetic resonance imaging demonstrated a large, well-circumscribed, heterogeneously enhanced mass with extension into the pterygopalatine fossa. Displaced by the large mass, bowing-in of the posterior maxillary antral wall was noted and a provisional diagnosis of a benign soft tissue tumor was made. The mass was completely excised and a diagnosis of neurilemmoma was confirmed.

  4. Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa

    Tomomi Okamura; Masaru Abiko; Takanori Sakakura; Shigeki Nakano; Norio Ikeda; Takafumi Nishizaki

    2011-01-01

    Facial nerve schwannomas involving posterior and middle fossas are quite rare. Here, we report an unusual case of cerebellopontine angle facial schwannoma that involved the middle cranial fossa, two years after the first operation. A 53-year-old woman presented with a 3-year history of a progressive left side hearing loss and 6-month history of a left facial spasm and palsy. Magnetic resonance imaging (MRI) revealed 4.5 cm diameter of left cerebellopontine angle and small middle fossa tumor. ...

  5. Isotretinoin induced rash, urticaria, and angioedema: a case report

    Zonunsanga

    2015-10-01

    Full Text Available Isotretinoin is a vitamin A analogue, which is readily isomerized to tretinoin. It causes normalization of abnormal keratinisation. It also reduces sebum secretion. It also has anti-inflammatory as well as antibacterial properties. It has some adverse effects like teratogenecity, hypertriglyceridemia, pancreatitis, dryness of skin, cheilitis, altered liver functions etc. A 25 years old unmarried lady presented with acne vulgaris, who did not showed improvements with conventional (antibiotics therapy was given isotretinoin. She developed maculopapular rash, urticaria and angioedema Isotretinoin induced urticarial rashes and angioedema is rarely reported as far as our knowledge is concerned.

  6. Focal Encephalitis Following Varicella-Zoster Virus Reactivation without Rash

    J. Gordon Millichap; John J Millichap

    2014-01-01

    Staff members at the Mayo Clinic, Rochester, MN, and University of Iowa Children's Hospital, Iowa City, report a healthy 22-year-old man with a focal encephalitis following varicella-zoster virus (VZV) reactivation without rash, triggered by varicella vaccination required for employment in a hospital

  7. Posterior fossa involvement in a recurrent gliosarcoma

    Srikant Balasubramaniam

    2012-01-01

    Full Text Available Gliosarcoma (GSM is a WHO grade 4 tumor and a variant of glioblastoma multiforme with predilection for the temporal lobe. We record, perhaps the first case in literature, of a temporal lobe GSM with recurrence involving the posterior fossa. A 50-year-old man presented to us with headache, vomiting, and lethargy of relatively recent onset. Magnetic resonance imaging revealed a well-circumscribed lesion in the left temporal lobe for which left temporal craniotomy with radical excision of the tumor was performed. Histopathology was suggestive of GSM. He presented to us within a month of the first surgery with a large recurrence involving the temporal lobe. He underwent a second surgery with radical excision of the tumor. Histopathology was confirmatory of GSM. He was administered concomitant chemotherapy and radiotherapy. Within a fortnight of starting adjuvant therapy, the bone flap started bulging and a repeat computed tomography scan revealed a large recurrence extending into the posterior fossa. The patient′s relatives refused consent for third surgery and he finally succumbed on postoperative day 21. GSMs are aggressive tumors that have a temporal lobe predilection, but they may present anywhere in the brain. Detailed studies on larger cohort of cases are needed to understand the true nature of these biphasic tumors.

  8. Acute Spontaneous Posterior Fossa Subdural Hematoma

    Osama Shukir Muhammed Amin

    2014-02-01

    Full Text Available Acute posterior fossa subdural hematomas are rare and most of them are trauma-related. Non-traumatic ones have been reported in patients who had idiopathic thrombocytopenic purpura or those who had been receiving anticoagulant therapy. We report on the case of 57-year-old Iranian man who developed sudden severe occipital headache, drowsiness, repeated vomiting, and instability of stance and gait. He was neither hypertensive nor diabetic. No history of head trauma was obtained and he denied illicit drug or alcohol ingestion. A preliminary diagnosis of acute intra-cerebellar hemorrhage was made. His CT brain scan revealed an acute right-sided, extra-axial, crescent-shaped hyperdense area at the posterior fossa. His routine blood tests, platelets count, bleeding time, and coagulation profile were unremarkable. The patient had spontaneous acute infratentorial subdural hematoma. He was treated conservatively and discharged home well after 5 days. Since then, we could not follow-up him, clinically and radiologically because he went back to Iran. Our patient’s presentation, clinical course, and imaging study have called for conservative management, as the overall presentation was relatively benign. Unless the diagnosis is entertained and the CT brain scan is well-interpreted, the diagnosis may easily escape detection.

  9. A STUDY OF POSTERIOR FOSSA MALFORMATIONS: MR IMAGING

    Ravi

    2015-02-01

    Full Text Available AIMS AND OBJECTIVES: The aim of our study is to describe the imaging findings of various posterior fossa malformations and to evaluate the supratentorial abnormalities associated with posterior fossa malformations. MATERIALS AND METHODS: MR images of 30 patients wi th posterior fossa malformations detected in the department of Radiodiagnosis, BMCRI over a period of two years, from December 2012 to December 2014 were evaluated retrospectively. The various posterior fossa malformations were evaluated. Associated suprat entorial abnormalities were noted. RESULTS: 30 patients with posterior fossa malformations were included in the study. The age group of patients ranged from 1year to 53years. There were 18 males and 12 females. The various posterior fossa malformations det ected were Dandy Walker malformation (1 case, Dandy Walker variant (2 cases, mega cisterna magna (8 cases, arachnoid cysts (5 cases, Chiari 1 malformation (5 cases, Chairi 2 malformation (2 cases, Joubert malformation (1 case, lipoma (2 cases, verm ian and/or cerebellar hypoplasia without posterior fossa CSF collection or cyst (4 cases. Associated supratentorial abnormalities were seen in 8 cases . CONCLUSION: MRI is the imaging modality of choice in the evaluation of posterior fossa malformations. I t is very important to know the imaging findings of these malformations and to have knowledge about the various supratentorial and spinal abnormalities associated with them so as to provide an accurate diagnosis which is very essential for predicting the p rognosis and planning further management.

  10. Severe Imatinib-Associated Skin Rash in Gastrointestinal Stromal Tumor Patients: Management and Clinical Implications

    Park, Sook Ryun; Ryu, Min-Hee; Ryoo, Baek-Yeol; Beck, Mo Youl; Lee, In Soon; Choi, Mi Jung; Lee, Mi Woo; Kang, Yoon-Koo

    2015-01-01

    Purpose This study evaluated the incidence of imatinib-associated skin rash, the interventional outcomes of severe rash, and impact of severe rash on the outcomes of imatinib treatment in gastrointestinal stromal tumor (GIST) patients. Materials and Methods A total of 620 patients were administered adjuvant or palliative imatinib for GIST at Asan Medical Center between January 2000 and July 2012. This analysis focused on a group of 42 patients who developed a severe rash requiring major inter...

  11. Comparative results of infratemporal fossa approach with or without facial nerve rerouting in jugular fossa tumors.

    Llorente, J L; Obeso, S; López, F; Rial, J C; Coca, A; Suárez, C

    2014-04-01

    Jugular fossa tumors are uncommon diseases. During the surgery and due to the interposition of the facial nerve in the tumor approach, the facial nerve must be elevated from the fallopian canal and placed permanently into an anterior position. Although this maneuver provides a wide exposure, most of the patients suffer a long-term total or partial facial palsy. The purpose of this article is to check whether the infratemporal fossa approach without transposition of the facial nerve is equivalent to the approach with rerouting of the facial nerve regarding postsurgical morbidity. The clinical records of 52 patients who underwent an infratemporal fossa approach were reviewed in which 34 patients were segregated into two comparable groups regarding the presence or absence of transposition of the facial nerve. There were 19 women and 15 males. The majority of the patients (73%) had jugular paragangliomas. The mean follow-up of the full series was 66 months. It was statistically significant that the worst facial nerve function at hospital discharge was in the patients who underwent facial nerve transposition (p = 0.001). Equally the facial nerve function in the no-rerouting group 1 year after the surgery was significantly much better than in the rerouting group (p = 0.003). Regarding to survival, recurrence or complications no significant differences were observed between both groups. Our study suggests that most of cases avoiding facial nerve transposition allow significant better functional results thereof without affecting other parameters such as recurrence, complications or survival. PMID:23880925

  12. Management of posterior fossa gliomas in children

    K Sridhar

    2011-01-01

    Full Text Available Brain tumours form the most common type of solid tumour in children and more that 50% of these are infratentorial. Cerebellar astrocytomas and brain stem gliomas are the commonest posterior fossa glial tumours in children. Cerebellar astrocytomas represent up to 10% of all primary brain tumours and up to 25% of posterior fossa tumors in children, with Low grade gliomas forming the commonest of the cerebellar gliomas. They commonly present with symptoms and signs of raised intracranial pressure due to obstructive hydrocephalus. Radiologically they may be solid or cystic with or without a mural nodule. Surgical excision is the mainstay of treatment and forms the most consistent factor influencing progression free and long term survival. While majority of the tumours are pilocytic astrocytomas, they may also be fibrillary astrocytomas or even high grade tumours. Tumour histology does not appear to be an independent factor in the prognosis of these children, and therefore no palliative treatment after surgery is advocated. Brain stem gliomas account for approximately 10% of all pediatric brain tumours. Cranial nerve signs, ataxia and cerebellar signs with or without symptoms and signs of raised intracranial pressure are classically described symptoms and signs. Radiographic findings and clinical correlates can be used to categorize brain stem tumours into four types: diffuse, focal, exophytic and cervicomedullary. Histologically most brain stem gliomas are fibrillary astrocytomas. Diffuse brain stem gliomas are the most commonly seen tumour in the brain stem. These lesions are malignant high grade fibrillary astrocytomas. Focal tumours of the brain stem are demarcated lesions generally less than 2 cms in size, without associated edema. Most commonly seen in the midbrain or medulla, they form a heterogeneous pathological group, showing indolent growth except when the lesion is a PNET. Dorsally exophytic tumours lie in the fourth ventricle, while cervicomedullary lesions are similar to spinal intramedullary tumours. Expanding lesions are the only lesions amenable for excision while infiltrative and ventral lesions are not.

  13. A systematic approach to posterior fossa malformations

    Full text: Embryology of the cerebellum and classification of posterior fossa malformations: At the 28th-37th gestational day, the thin roof of the hindbrain (future fourth ventricle) is formed by an ependymal membrane coated by pia mater. The plica choroidea, a precursor of the future choroid plexus, divides the roof of the fourth ventricle into the anterior membranous area (AMA) lying cephalad, and the posterior membranous area (PMA) lying caudad. The cerebellum arises from dorsal rhombomere 1 of the anterior hindbrain, in a position along the anterior/posterior axis of the neural tube that is determined by genes expressing in the isthmic organizer at the mid-hindbrain junction, and is also influenced by genetic cues from the roof plate of the adjacent fourth ventricle. Studies in mice have shown that during early embryogenesis, the dorsal rhombomere 1 rotates to establish the mediolaterally-oriented bilateral cerebellar primordial, which are interposed by the AMA. As neurogenesis progresses, the bilateral primordia fuse on the dorsal midline over the fourth ventricle to establish the medial vermis and lateral cerebellar hemispheres, while the intervening AMA progressively involutes until its remnants are incorporated in the choroid plexus. Meanwhile, the PMA shows a transient posterior finger-like expansion, the Blake’s pouch, which extends below the vermis and eventually disappears as the foramen of Magendie opens. Cerebellar neurons are generated from two anatomically and molecularly distinct progenitor zones within the cerebellar primordium: the cerebellar ventricular zone (vZ), and the dorsally located rhombic lip (Rl). Newly differentiating neurons from the vZ, including cerebellar Purkinje cells, are postmitotic, and leave the vZ to migrate radially within the developing cerebellum; instead, cells exiting the Rl migrate over the primordium forming the external granule layer (eGl), where they proliferate and then migrate inward to form the internal granule layer. Malformations of the mid-hindbrain have been variably classified according to morphology, embryogenesis, and genetic information. One classical definition individuates cystic malformations, in which a collection resulting from active expansion of CSF spaces is found within the posterior cranial fossa, and non cystic malformations, which are mainly characterized by hypoplasia of the cerebellum and/or brainstem. Patients with infratentorial malformations usually show a variable combination of hypotonia, ataxia, abnormal eye movements, cranial nerve deficits, psychomotor delay, and cognitive impairment. the main malformations: the definition of Dandy-Walker malformation (DWM) classically includes partial or complete vermian agenesis associated with hypoplastic cerebellar hemispheres, cystic dilatation of the fourth ventricle, and expansion of the posterior fossa associated with high insertion of the tentorium, torcular Herophili and transverse sinuses. Vermian hypoplasia may be more or less severe; however, the hypoplastic superior vermis is constantly rotated in a counter-clockwise fashion, and often lies posterior to the quadrigeminal plate. Cerebellar hemispheres are also hypoplastic and abut the petrous ridges. The posterior fossa is occupied by a large cyst corresponding to a dilated fourth ventricle. Hydrocephalus develops in up to 80% of untreated cases. A megacisterna magna is characterized by dilatation of the cisterna magna with free communication with both the fourth ventricle and the adjacent subarachnoid spaces. The vermis, cerebellar hemispheres, and fourth ventricle are normal. Hydrocephalus is never associated and the anomaly is constantly clinically silent, being usually encountered during MRI for other indications. the persistent Blake’s pouch, or Blake’s pouch cyst, is characterized by a retrocerebellar CSF collection which, in itself, is similar to a mega cisterna magna. Persistence of the Blake’s pouch is, however, characterized by failed permeabilization of the Magendie foramen, resulting in tetraventricular hydrocephalus. Shunting of the retrocerebellar pouch restores normal CSF outflow, so that both the hydrocephalus and the pouch are resolved. The molar tooth malformation consists of the following triad: dysgenesis of the isthmic portion of the brainstem with elongation and thinning of the pontomesencephalic junction and elongation of the interpeduncular fossa; thickened superior cerebellar peduncles which project straight back, coursing perpendicular to the brainstem; and hypoplasia of the vermis. This malformation typically is found in patients with the Joubert syndrome, presenting clinically in the neonatal age with hyperpnoic-apnoic spells, ataxia, nystagmus, and developmental delay. Other entities in the so-called cerebello-oculo-renal syndrome spectrum (including Arima, Senior-loken, and Coach syndromes) may display a similar malformation. On MRI, the vermis is completely or partially absent with only the anterior lobules visible. The fourth ventricle is high riding with an umbrella shape on axial images. The superior cerebellar peduncles are elongated, thickened, and project straight back, running parallel with each other. Rhombencephalosynapsis is characterized by vermian agenesis, fused cerebellar hemispheres and peduncles, and apposed or fused dentate nuclei. MR detects the absence of the vermis and the midline fusion of the cerebellar hemispheres. On axial MR images, the folia and sulci are continuous throughout the midline; on sagittal MR images, the structure lying in the midsagittal plane is not the vermis but a monolobated cerebellum. The posterior fossa is small and the fourth ventricle has a characteristic «keyhole» shape. Associated supratentorial abnormalities may be found

  14. Nomenclature of drug-induced pityriasis rosea-like rashes

    Chuh AAT

    2015-10-01

    Full Text Available Antonio AT Chuh1Prince of Wales Hospital, Hospital Authority, 2The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong KongI read with admiration an article published in your prestigious journal on the rare adverse effects of clozapine (CLZ.1I write to address a specific issue in this article. In the second paragraph of the section “Dermatological adverse effects”, it was stated that a 54-year-old patient with schizophrenia treated for 28 days with CLZ developed a generalized rash compatible with pityriasis rosea (skin rash that usually begins as one large circular or oval spot on your chest, abdomen, or back.I wish to point out certain problems for coining pityriasis rosea (PR as the diagnostic label in the patient concerned.View original paper by De Fazio and colleagues.

  15. Autosomal dominant granulomatous arthritis, uveitis, skin rash, and synovial cysts.

    Pastores, G M; Michels, V V; Stickler, G B; Su, W P; Nelson, A M; Bovenmyer, D A

    1990-09-01

    In 1985, Blau reported a family with 11 members in four generations affected by granulomatous arthritis, iritis, skin rash, and periarticular synovial cysts. We report a second family with these abnormalities, thereby confirming this syndrome as a distinct familial entity with transmission compatible with autosomal dominant inheritance. Affected members in our family included a mother and two daughters. Disease onset was at 10 months to 8 years of age. Each had uveitis, symmetric polyarthritis, and synovial cysts overlying the ankle and wrist joints. In addition, both daughters had an intermittent generalized erythematous papular rash that on biopsy revealed noncaseating granulomatous infiltration. All three patients improved during alternate-day steroid therapy. Recognition of this disorder as distinct from other, more common causes of arthritis is important because of the apparent autosomal dominant transmission and because of the excellent responses to low-dose steroid therapy. PMID:2391595

  16. MORPHOMETRY OF GLENOID FOSSA IN ADULT EGYPTIAN SCAPULAE

    Gamal Hamed El-Sayed Hassanein

    2015-06-01

    Full Text Available Background: Knowledge of normal variations in shape and size of the glenoid fossa are required to improve efficacy and minimize failure rates in shoulder arthroplasty, particularly those involving the glenoid component of shoulder joint. Studies concerning glenoid morphometry among Egyptian population are scarce. The objective of the present study was to determine morphological types and diameters of glenoid fossa in adult Egyptian scapulae . Material and methods: A total of 68 dry adult unpaired scapulae of unknown age and sex were randomly selected. The shape and diameters of glenoid fossa in each specimen were recorded and collected data were statistically analyzed. Results : Glenoid fossa revealed a superior - inferior diameter of 3.31 ± 0.39 and 2.87 ± 0.41 centimeters and an anterior - posterior diameter of 2.44 ± 0.44 and 2.21 ± 0.44 centimeters on the right and left sides respectively. The anterior margin of glenoid fossa presented a notch in 76.47% of studied scapulae, and accordingly the fossa was classified into three morphological types; pear-shaped (45.59%, inverted comma-shaped (30.88% and oval – shaped (23.53%. Conclusion : The documented findings about glenoid fossa in the present study would help to decide the proper size of glenoid component in shoulder arthroplasty among Egyptians. Moreover, approximately one third of Egyptians are liable to Bankart lesion.

  17. Familial pellagra-like skin rash with neurological manifestations.

    Freundlich, E; Statter, M; Yatziv, S

    1981-01-01

    A 14-year-old boy of Arabic origin presented with a pellagra-like rash and neurological manifestations including ataxia, dysarthria, nystagmus, and coma. There was a striking response to oral nicotinamide. The laboratory findings were not typical of Hartnup disease: aminoaciduris and indicanuria were absent and there was no evidence of tryptophan malabsorption. Tryptophan loading did not induce tryptophanuria nor did it increase excretion of xanthurenic or kynurenic acids. These findings supp...

  18. Cefditoren pivoxil associated rash and arthralgia in a child

    Manab Nandy; Ananya Mandal; Tripathi, Santanu K.; Abhiram Chakrabarti

    2012-01-01

    Cefditoren pivoxil is an oral antimicrobial used increasingly in pediatric bacterial infections. We report a case of rash and arthralgia following administration of cefditoren pivoxil for lower respiratory tract infection in a four-year-old female child. On discontinuation of the antibiotic, the child recovered full function of the knee joint within seven days. The causality of the event assessed as per the WHO-UMC system for standardized case causality assessment criteria can be considered a...

  19. Asystole during posterior fossa surgery: Report of two cases.

    Goyal, Keshav; Philip, Frenny Ann; Rath, Girija Prasad; Mahajan, Charu; Sujatha, M; Bharti, Sachidanand Jee; Gupta, Nidhi

    2012-04-01

    Asystole during posterior fossa neurosurgical procedures is not uncommon. Various causes have been implicated, especially when surgical manipulation is carried out in the vicinity of the brain stem. The trigemino-cardiac reflex has been attributed as one of the causes. Here, we report two cases who suffered asystole during the resection of posterior fossa tumors. The vago-glossopharyngeal reflex and the direct stimulation of the brainstem were hypothesized as the causes of asytole. These episodes resolved spontaneously following withdrawal of the surgical stimulus emphasizing the importance of anticipation and vigilance during critical moments of tumor dissection during posterior fossa surgery. PMID:22870159

  20. Asystole during posterior fossa surgery: Report of two cases

    Goyal, Keshav; Philip, Frenny Ann; Rath, Girija Prasad; Mahajan, Charu; Sujatha, M; Bharti, Sachidanand Jee; GUPTA, Nidhi

    2012-01-01

    Asystole during posterior fossa neurosurgical procedures is not uncommon. Various causes have been implicated, especially when surgical manipulation is carried out in the vicinity of the brain stem. The trigemino-cardiac reflex has been attributed as one of the causes. Here, we report two cases who suffered asystole during the resection of posterior fossa tumors. The vago-glossopharyngeal reflex and the direct stimulation of the brainstem were hypothesized as the causes of asytole. These epis...

  1. Microsurgical Posterior Fossa Vestibular Neurectomy: An Evolution in Technique

    Silverstein, Herbert; Norrell, Horace; Wanamaker, Hayes; Flanzer, John

    1991-01-01

    Between 1925 and 1945, Walter Dandy and Kenneth McKenzie performed more than 700 posterior fossa eighth nerve sections and vestibular neurectomies, treating the intractable vertigo accompanying Meniere's disease. During the past 10 years, using microsurgical techniques and reaching the posterior fossa through the temporal bone, vestibular neurectomy has enjoyed a resurgence of popularity. When hearing is to be preserved, vestibular neurectomy is the surgical treatment of choice, if the patien...

  2. Transposition of the Pterygopalatine Fossa during Endoscopic Endonasal Transpterygoid Approaches.

    Pinheiro-Neto, Carlos D; Fernandez-Miranda, Juan C; Prevedello, Daniel M; Carrau, Ricardo L; Gardner, Paul A; Snyderman, Carl H

    2013-10-01

    Introduction Complete or partial removal of the pterygoid process provides lateral extension of the endonasal corridor necessary to approach the Meckel cave, infrapetrous skull base, and medial infratemporal fossa. This paper provides the anatomical foundations for the endoscopic endonasal transpterygoid approach with preservation of all neurovascular structures inside the pterygopalatine fossa. Methods Eight endoscopic transpterygoid approaches were performed in fresh cadaveric specimens. In all dissections the vidian nerve and the periosteal sac enclosing the pterygopalatine fossa were preserved. Results We reliably transposed the pterygopalatine fossa to approach the Meckel cave, infrapetrous skull base, and medial infratemporal region, preserving the neurovascular structures inside the pterygopalatine fossa in all specimens. Conclusions The transposition of the pterygopalatine fossa neurovascular structures for endoscopic endonasal approaches to the skull base is an alternative technique that is both feasible and desirable. The transposition requires no additional technical skills but requires comprehensive knowledge of its anatomy. The anatomical preservation of the neurovascular structures is potentially beneficial to the quality of life of patients. Clinical studies are necessary to prove the real benefits of this technique. PMID:24436922

  3. Nevirapine-induced rash with eosinophilia and systemic symptoms (DRESS

    Shaman Gill

    2013-01-01

    Full Text Available Drug rash with eosinophilia and systemic symptoms (DRESS syndrome is an adverse reaction commonly occurring with antiepileptic agents. It was earlier referred to by various names such as dilantin hypersensitivity syndrome and anticonvulsant hypersensitivity syndrome. It is characterized by the triad of fever, skin eruption, and systemic involvement. DRESS syndrome has also been reported with a number of other drugs including allopurinol, minocycline, terbinafine, sulfonamides, azathioprine, dapsone, and antiretroviral agents such as abacavir and nevirapine. We describe a rare case of nevirapine-induced hypersensitivity syndrome that was successfully treated with oral steroids.

  4. Respuesta anómala de anticuerpos de infecciones virales productoras de rash

    SONIA RESIK AGUIRRE

    1996-04-01

    Full Text Available Se estudiaron 20 pares de sueros provenientes del Sistema de Vigilancia Seroepidemiológica Nacional de la vacuna triple viral que llegaron al laboratorio con el diagnóstico de rash febril. Mediante la técnica de inhibición de la hemaglutinación se observó una respuesta anormal de nticuerpos, tanto a rubeola como a sarampión, manifiesta por una caída del título de anticuerpos a una o ambas entidades o a una de ellas con seroconversión a la otra. Con el objetivo de definir la respuesta de anticuerpos a la familia Herpesviridae (HSV, EBV, CMV, VZV, se encontró el 80 % de la respuesta a estos virus. Los resultados se presentan y se iscuten.

  5. Tocilizumab-induced psoriasiform rash in rheumatoid arthritis.

    Palmou-Fontana, Natalia; Sánchez Gaviño, Juan Antonio; McGonagle, Dennis; García-Martinez, Eva; Iñiguez de Onzoño Martín, Luis

    2014-01-01

    Tocilizumab (TCZ) is a humanized monoclonal antibody against the interleukin-6 (IL-6) receptor and has been approved for the treatment of rheumatoid arthritis (RA) patients who have had an inadequate response to previous biological therapies. Psoriasiform skin lesions, especially palmoplantar pustulosis lesions, are well described following anti-tumour necrosis factor therapy. We describe a 79-year-old woman with rheumatoid factor-positive, anti-citrullinated protein antibody-positive erosive RA, who developed a psoriasiform palmoplantar pustulosis reaction following treatment with TCZ therapy (IL-6 receptor). The rash showed histological features compatible with psoriasis and disappeared following discontinuation of TCZ. PMID:24942661

  6. Cefditoren pivoxil associated rash and arthralgia in a child

    Nandy, Manab; Mandal, Ananya; Tripathi, Santanu K.; Chakrabarti, Abhiram

    2012-01-01

    Cefditoren pivoxil is an oral antimicrobial used increasingly in pediatric bacterial infections. We report a case of rash and arthralgia following administration of cefditoren pivoxil for lower respiratory tract infection in a four-year-old female child. On discontinuation of the antibiotic, the child recovered full function of the knee joint within seven days. The causality of the event assessed as per the WHO-UMC system for standardized case causality assessment criteria can be considered as ‘probable’. Analyzed by the Naranjo's ADR probability scale, the score was 7, which also makes it a ‘probable’ event. PMID:22701261

  7. Cefditoren pivoxil associated rash and arthralgia in a child

    Manab Nandy

    2012-01-01

    Full Text Available Cefditoren pivoxil is an oral antimicrobial used increasingly in pediatric bacterial infections. We report a case of rash and arthralgia following administration of cefditoren pivoxil for lower respiratory tract infection in a four-year-old female child. On discontinuation of the antibiotic, the child recovered full function of the knee joint within seven days. The causality of the event assessed as per the WHO-UMC system for standardized case causality assessment criteria can be considered as ?probable?. Analyzed by the Naranjo?s ADR probability scale, the score was 7, which also makes it a ?probable? event.

  8. A measurement of the volume of the pituitary fossa in Korean adults

    The radiological measurement of the pituitary fossa provides an important clinical value in evaluation of the borderline cases of the intracranial disease, particularly in sellar and parasellar tumors. Normal volumes of the pituitary fossa is measured from antero-posterior and lateral projections of the skulls with focus-film distance of 30 inches. Following formula was used for calcification of the volume of the pituitary fossa. V=0.36 x L x H x W (L: length of the pituitary fossa H: height of the pituitary fossa W: width of the pituitary fossa). In 200 Korean adults, 103 males and 97 females, the mean volume of the pituitary fossa is 601 mm3 and the range of the volume of the pituitary fossa is 310 mm3 to 1236 mm3. The mean volume of the pituitary fossa is larger in females (mean:582 mm3) than in males (mean: 622 mm3)

  9. Skin Rashes on Leg in Brucellosis: a Rare Presentation.

    Seyed Hossein Shahcheraghi

    2015-06-01

    Full Text Available Brucellosis is the most widespread zoonotic infection in the world. The disease is endemic in countries bordering the Mediterranean Sea. It is an important re-emerging infectious disease. This disease is closely associated with the evolution of mankind as an agrarian society linked to the practice of shepherding and popularization of animal husbandry. The patients with this disease are typically present with chills, fever, asthenia and sweating. This paper describes a patient with brucellosis and skin rashes on the leg. A 41-year-old man presented with fever, ataxia, and dysarthria. He was a shepherd. The patient reported the loss of appetite, arthralgia and weight loss during previous five months. Finally, he was diagnosed with brucellosis by positive blood culture and high titer for Brucella agglutination test. The clinical manifestation of brucellosis is very broad, ranging from asymptomatic infection to serious debilitating disease. Current patient had skin rashes on his leg. Brucellosis must be considered in the differential diagnosis of acute infections, especially if there is a history of fresh milk product ingestion and living in an endemic region.

  10. The Age of the Medusae Fossae Formation

    Kerber, L.; Head, J. W.

    2008-09-01

    Introduction The Medusae Fossae Formation (MFF) is a complicated and discontinuous formation located in the southern parts of Elysium Planitia and Amazonis Planitia (130°-230°E and 12°S-12°N), covering an area of approximately 2.1 x 106 km2 and having an estimated volume of 1.4 x 106 km3 [1]. It is thought to have been deposited during the Amazonian period [2,3]. However, much of the cratering record may have been erased as friable units were eroded and long-buried terrains exhumed [4-6]. The formation is characterized by large accumulations of fine-grained, friable deposits and evidence of large amounts of erosion. There are many theories regarding the emplacement of this formation; recently the literature has focused on three possibilities: ignimbrites, ash fall, and aeolian dust. Some modified and inverted fluvial channels have been found within the deposit [7,8], (Fig. 1), indicating that there was some fluvial activity during or after the emplacement of the MFF. If the MFF is among the youngest surficial deposits on Mars [9], it is implied that meandering, channelized flow must have extended into the Amazonian, a significant constraint when considering the atmospheric evolution of the planet through time. Because of the wide implications that these findings have for the evolution of Mars and the Martian atmosphere, it is instructive to re-examine the evidence for the Amazonian age of the MFF. The initial conclusion comes from two main arguments: the relatively few superposed craters on the unit, and the superposition of the MFF on young lowland lava deposits [1, 9]. Using new high resolution data, we reexamine the relationships both within the MFF and with respect to adjacent units. Cratering Record The cratering record of the MFF and other easily eroded units has often been deemed unreliable [4, 10, 12], but it continues to be cited as evidence for the formation's young age. Throughout the MFF, pedestal craters, inverted craters, and remnant knobs can be found which trace the progression of crater erosion and suggest that a large number of craters originally superposed on the unit have been erased or degraded beyond recognition (Fig. 2). Stratigraphy Because lava units are emplaced in a geologically short period of time, cease to evolve after emplacement, and are relatively resistant to erosion, they are useful age markers for adjacent units such as the MFF which are more difficult to date. Early descriptions noted that lowland lava flows embay the formation in places [12], but later works have placed the MFF at the top of the stratigraphic column because it overlies lowland lavas [9]. We have observed that Cerberus lavas embay the formation in Northern Aeolis Planum and Zephyria Planum, though eroded Medusae Fossae Formation has been blown out onto the lava where it collects as sand dunes. In other places direct contacts are lacking, but ancient contacts may be recognized where lava units embayed the MFF after which the MFF was eroded from these areas, leaving irregular depressions and negative yardang patterns in the embaying lava units (Fig. 3). These boundaries are found in most places where there is a contact with a lava unit, including northwestern Aeolis Planum, north and east of Eumenides Dorsum, and in north-eastern Gordii Dorsum. In between Eumenides Dorsum and Amazonis Planum, several lobes of lava from Arsia Mons, mapped as Late Hesperian/Early Amazonian (AHt3) by [2], end abruptly in a negative yardang pattern, in close proximity to an eroding patch of MFF. Additionally, the large fan on the southeastern flank of Apollinaris Patera appears to embay the MFF yardangs at its base (Fig. 4). Discussion The Medusae Fossae Formation is a mobile unit which both erases craters on its own surface as well as sheltering nearby units from incoming projectiles, resulting in a misleadingly young age. The MFF appears to continuously erode into yardangs and reaccumulate as dunes and massive deposits. If it comes to a rest, the unconsolidated material gradually becomes indurated (perhaps through compression or interaction with the atmosphere) until it reaches a point where it can begin eroding into yardangs again. Lava flows, which remain relatively stable through time, make useful chronological markers for where the unit is and where it used to be. Recognition of remnant contacts between MFF and lava units is helpful in unravelling relationships between the MFF and lava units where direct contacts are not available. Lava unit contacts suggest that parts of the MFF may be older than previously hypothesized, perhaps Hesperian. This conclusion is consistent with the presence of fluvial channels within the deposit and relaxes the time constraint on its emplacement. References [1] Bradley, B.A. and Sakimoto, S.E.H. (2002) JGR, 107, E8. [2] Scott, D.H. and Tanaka, K.L. (1986) USGS Misc. Invest. Ser. Map I-1802-A. [3] Greeley, R. and Guest, J. (1987) USGS Misc. Inv. Series Map I-1802-B. [4] Schultz, P.H. and Lutz, A.B. (1988) Icarus 73, 91-141 [5] Schultz, P.H. (2006) Plan. Chron. Workshop, Abs. 6024. [6] Schultz, P.H. (2007) Science 318, 1080-1081. [7] Zimbelman, J.R. (2000) GSA Abs. Prog., 32(7), A303. [8] Edgett K.S. and Williams R.M.E. (2006) LPSC XXXVI, Abs. 1099. [9] Bradley, B.A. and Sakimoto, S.E.H. (2001) LPSC XXXII, Abs. 1335. [10] Tanaka, K.L. (2000) Icarus 144(2), 254-266. [11] Greeley et al. (2001) Space Sci. Rev. 96(1-4), 393-404. [12] Scott, D.H. and Tanaka, K.L. (1982) JGR 87(B2), 1179-1190.

  11. Incidence and Determinants of Nevirapine and Efavirenz-Related Skin Rashes in West Africans: Nevirapine's Epitaph?

    Sarfo, Fred Stephen; Sarfo, Maame Anima; Norman, Betty; Phillips, Richard; Chadwick, David

    2014-01-01

    Non-nucleoside reverse transcriptase inhibitor (NNRTI) associated rash is common and frequently leads to discontinuation of NNRTIs. This study assessed the risk of developing rashes and discontinuing NNRTIs and associated factors in a large clinic in central Ghana. In this retrospective cohort study, clinical data were obtained in patients starting efavirenz or nevirapine between 2004–2010. Factors associated with rashes were explored using a multivariate Cox proportional hazards regression m...

  12. Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa

    Takafumi Nishizaki

    2011-05-01

    Full Text Available Facial nerve schwannomas involving posterior and middle fossas are quite rare. Here, we report an unusual case of cerebellopontine angle facial schwannoma that involved the middle cranial fossa, two years after the first operation. A 53-year-old woman presented with a 3-year history of a progressive left side hearing loss and 6-month history of a left facial spasm and palsy. Magnetic resonance imaging (MRI revealed 4.5 cm diameter of left cerebellopontine angle and small middle fossa tumor. The tumor was subtotally removed via a suboccipital retrosigmoid approach. The tumor relapsed towards middle cranial fossa within a two-year period. By subtemporal approach with zygomatic arch osteotomy, the tumor was subtotally removed except that in the petrous bone involving the facial nerve. In both surgical procedures, intraoperative monitoring identified the facial nerve, resulting in preserved facial function. The tumor in the present case arose from broad segment of facial nerve encompassing cerebellopontine angle, meatus, geniculate/labyrinthine and possibly great petrosal nerve, in view of variable symptoms. Preservation of anatomic continuity of the facial nerve should be attempted, and the staged operation via retrosigmoid and middle fossa approaches using intraoperative facial monitoring, may result in preservation of the facial nerve.

  13. Fossa navicularis magna detection on cone-beam computed tomography

    Mupparapu, Mel

    2016-01-01

    Herein, we report and discuss the detection of fossa navicularis magna, a close radiographic anatomic variant of canalis basilaris medianus of the basiocciput, as an incidental finding in cone-beam computed tomography (CBCT) imaging. The CBCT data of the patients in question were referred for the evaluation of implant sites and to rule out pathology in the maxilla and mandible. CBCT analysis showed osseous, notch-like defects on the inferior aspect of the clivus in all four cases. The appearance of fossa navicularis magna varied among the cases. In some, it was completely within the basiocciput and mimicked a small rounded, corticated, lytic defect, whereas it appeared as a notch in others. Fossa navicularis magna is an anatomical variant that occurs on the inferior aspect of the clivus. The pertinent literature on the anatomical variations occurring in this region was reviewed. PMID:27051639

  14. Female with rash, acute kidney failure and rheumatoid arthritis

    M Atlani

    2012-01-01

    Full Text Available This case describes a 42-year-old female with longstanding history of rheumatoid arthritis (RA and Felty syndrome (FS. She presented with acute renal kidney failure, skin rash and hemoptysis. A clinical suspicion of small vessel vasculitis (SVV was thought, serology was also positive for various markers of SVV. However, these serology markers could be false-positive in a patient of rheumatoid arthritis. A renal biopsy was performed that led to the final diagnosis of cryoglobulinemic vasculitis. Patient was managed according to the standard guidelines for therapy (plasmafiltration and immunosuppression. It is challenging to manage a patient of RA, in the presence of Felty syndrome-related granulocytopenia and thrombocytopenia. Patient initially showed signs of improvement, but finally succumbed to complications of therapy. The case provides insight into the diagnosis and management of such cases.

  15. Dislocation of the mandibular condyle into the middle cranial fossa.

    Clauser, Luigi; Tieghi, Riccardo; Polito, Jessica; Galiè, Manlio

    2006-05-01

    Dislocation of the mandibular condyle into the middle cranial fossa is an uncommon event. A case report is presented based on a patient (32-year-old female) who sustained a traumatic left condyle fracture with superior dislocation into the middle cranial fossa due to a high-speed car accident. The diagnosis was done four months after trauma. Via a preauricular approach, left condylectomy and transposition of temporal muscle flap was performed. Postoperatively, the patient stayed for two weeks with intermaxillary fixation and four months of physical therapy. PMID:16770205

  16. A Case of Cerebellar Mutism after Posterior Fossa Surgery

    I??k GÖRKER

    2012-12-01

    Full Text Available Cerebellar mutism consisting of disruption speech output, hypotonia, ataxia, and emotional lability occurs after surgery for posterior fossa tumors. Although the mutism is transient, speech rarely normalizes and this condition is associated with adverse neurological, cognitive and psychiatric abnormalities. Possible mechanisms for its etiology include direct injury from surgical trauma, vasospasm, edema and hydrocephalus causing delayed injury to the cerebellar vermis, brainstem and dentate nuclei. In this study, the case of an adolescent patient, who had an astrocytoma and showed symptoms of cerebellar mutism, apathy, ataxi, hemiparesis and visual impairment after posterior fossa surgery, is presented. (Archives of Neuropsychiatry 2012; 49: 320-322

  17. Thoracic empyema with scarlatiniform rash and acral desquamation: a case report

    Baird, John Scott; Sediva, Ivona

    2009-01-01

    A 5 year old girl with thoracic empyema developed a scarlatiniform rash and acral desquamation. Cultures from blood, throat, and pleural fluid all grew Streptococcus pyogenes, a common etiologic agent of pediatric thoracic empyema. The presence of a scarlatiniform rash and acral desquamation in children with a thoracic empyema may help identify the causative organism.

  18. Management of EGFR-inhibitor associated rash: a retrospective study in 49 patients

    Gerber Peter

    2012-02-01

    Full Text Available Abstract Background In recent years inhibitors directed against the epidermal growth factor receptor (EGFR have evolved as effective targeting cancer drugs. Characteristic papulopustular exanthemas, often described as acneiform rashes, are the most frequent adverse effect associated with this class of novel cancer drugs and develop in > 90% of patients. Notably, the rash may significantly compromise the patients' quality of life, thereby potentially leading to incompliance as well as dose reduction or even termination of the anti-EGFR therapy. Yet, an effective dermatologic management of cutaneous adverse effects can be achieved. Whereas various case reports, case series or expert opinions on the management of EGFR-inhibitor (EGFRI induced rashes have been published, data on systematic management studies are sparse. Methods Here, we present a retrospective, uncontrolled, comparative study in 49 patients on three established regimens for the management of EGFRI-associated rashes. Results Strikingly, patients' rash severity improved significantly over three weeks of treatment with topical mometason furoate cream, topical prednicarbate cream plus nadifloxacin cream, as well as topical prednicarbate cream plus nadifloxacin cream plus systemic isotretinoin. Conclusions In summary our results demonstrate that EGFRI-associated rashes can be effectively managed by specific dermatologic interventions. Whereas mild to moderate rashes should be treated with basic measures in combination with topical glucocorticosteroids or combined regiments using glucocorticosteroids and antiseptics/antibiotics, more severe or therapy-resistant rashes are likely to respond with the addition of systemic retinoids.

  19. Surgical Management of a Functional Paraganglioma of the Infratemporal Fossa

    Tritter, Andrew G.; Selber, Jesse; Kupferman, Michael E.

    2015-01-01

    Background?Paragangliomas are rare neural crest tumors that can manifest in the head and neck as either functional or more commonly as nonfunctional lesions. Paragangliomas of the infratemporal fossa are exceedingly rare, with no more than a handful of documented cases. Like other tumors of this space, surgical management is challenging on account of complex anatomy and nearby critical structures.

  20. Transpterygoid Approach to a Dermoid Cyst in Pterygopalatine Fossa

    Ordones, Alexandre Beraldo

    2014-01-01

    Full Text Available Objective To describe a case of dermoid cyst arising from the pterygopalatine fossa and review the literature. Methods We report a case of a 23-year-old man who suffered a car accident 2 years before otolaryngologic attendance. He had one episode of generalized tonic-clonic seizure and developed a reduction of visual acuity of the left side after the accident. Neurologic investigation was performed and magnetic resonance imaging revealed an incidental finding of a heterogeneous ovoid lesion in the pterygopalatine fossa, hyperintense on T2-weighted imaging. Results Endoscopic sinus surgery with transpterygoid approach was performed. The ovoid lesion was noted in the pterygopalatine fossa. Puncture for intraoperative evaluation showed a transparent thick fluid. Surprisingly, hair and sebaceous glands were found inside the cyst capsule. The cyst was excised completely. Histologic examination revealed a dermoid cyst. The patient currently has no evidence of recurrence at 1 year postoperatively. Conclusion This unique case is a rare report of a dermoid cyst incidentally diagnosed. An endoscopic transnasal transpterygoid approach may be performed to treat successfully this kind of lesion. Although rare, it should be considered in the differential diagnosis of expansive lesions in the pterygopalatine fossa, including schwannoma, angiofibroma, esthesioneuroblastoma, osteochondroma, cholesterol granuloma, hemangioma, lymphoma, and osteoma.

  1. Ischiorectal fossa abscess after pelvic floor injection of botulinum toxin.

    Brueseke, Taylor J; Lane, Felicia L

    2012-03-01

    Botulinum toxin is used to treat pelvic floor tension myalgia; however, its safety profile is poorly understood. We report an ischiorectal fossa abscess after pelvic floor injections of botulinum toxin. Physicians need to be aware of this possible complication, consider alternate injection techniques and antiseptic preparation before injection. PMID:22381609

  2. Prenatal diagnosis of posterior fossa anomalies: An overview

    Novakov-Mikić Aleksandra

    2009-01-01

    Full Text Available Ultrasonography of the central nervous system is an integral part of a prenatal scan, and the development of imaging technologies has led to better diagnostic possibilities. Posterior fossa anomalies have traditionally been divided into Dandy Walke malformation, Dandy Walker variation and megacisterna magna, but this approach, due to diversity of the extensive number of possible disorders covered by this classification, unables accurate prognosis and therefore adequate counselling. An alternative approach to the classification of posterior fossa anomalies is to divide them into agenesis of the vermis, which could be partial or complete, cerebellar hypoplasia, pontocerebellar hypoplasia and cerebellar atrophy. Different ultrasonographic and magnetic resonance imagining of appearances of the posterior fossa anomalies in prenatal period are discussed in the article, as well as possible syndromes and prognosis of different entities. Diversity of anomalies of the central nervous system, and in particular, subtle differences in prenatal appearances of posterior fossa anomalies, which may have major impact on the prognosis, demand a multidisciplinary approach that encompasses two-dimensional and three-dimensional ultrasound scan, magnetic resonance imaging, infectious diseases and metabolic disorders work-ups as well as individual approach to every case involving of a team of experts in the field of perinatology, radiology, paediatrics, neurology and genetics.

  3. STUDY OF POSTERIOR FOSSA TUMORS BY HIGH RESOLUTION MRI

    Sree Hari

    2016-01-01

    Full Text Available INTRODUCTION Magnetic Resonance Imaging (MRI is the imaging modality used for the assessment of infratentorial neoplasms. Although Computed Tomography (CT provides better demonstration of small or subtle calcifications within tumors. OBJECTIVES Study is done to assess the potential of MRI in characterisation of different tumors in posterior fossa by evaluating various unenhanced and gadolinium enhanced sequences and to compare high resolution FSE MRI sequences with routine FSE MRI sequences in diagnosing posterior fossa brain tumors. Also correlate findings on Magnetic Resonance Imaging with Pathological diagnosis. MATERIALS AND METHODS A total of 52 patients were diagnosed by CT brain as having posterior fossa brain for a year of 2 years were included in the study. In all studies MR imaging was performed with a clinical 1.5 T system (General electrical medical systems. A dedicated phased-array coil was used. RESULTS The age group ranged from 1 year to 60 years, majority were between 1 to 20 years (39%. Slight male preponderance was seen (males 29, females 23. Commonest tumor encountered in our study was vestibular schwannoma. DWI alone can differentiate different pediatric posterior fossa brain tumors. One case of pilocytic astrocytoma showed solid lesion instead of typical cystic lesion with mural nodule. One case AT-RT showed 2 lesions one in cerebrum, one in CP angle. Common feature being intra-axial lesion involving cerebellum. MRI was able to predict diagnosis in 50 of the 52 tumors. CONCLUSION Magnetic Resonance Imaging was found to be a highly sensitive imaging procedure and method of choice for posterior fossa brain tumors.

  4. NATACIÓN (1915. SANTIAGO MESTRES FOSSAS (SWIMMING - 1915 - SANTIAGO MESTRES FOSSAS

    María Cuesta Salvador

    2010-04-01

    Full Text Available Resumen: Este artículo resume el libro de Santiago Mestres Fossas titulado “Natación”, escrito en 1915, apenas ocho años después del comienzo de la historia de la natación en España. Con este texto el autor no pretende enseñar a nadar, sino servir como soporte teórico y metodológico a aquellos que quieran acompañar a los que no saben nadar y a los nadadores más experimentados en su camino de aprendizaje y perfeccionamiento. Las cualidades esenciales de la natación, los estilos, los concursos, los juegos en el agua y una introducción al salvamento acuático son los temas que aborda el autor en este libro pionero en la natación española.Abstract: This article is a review of Santiago Mestres Fossas’ book intitled “Natación“ , published in1915, just eigth years after the beginning of Spanish swimming History. The book was notoriented to teach those who do not swim, but to support their teachers, as well as the proficience swimmers. The main focuses are: essential swimming qualities, stiles, competitions, water games and introduction to lifesaving.

  5. Rash: the only one clinical manifestation of dengue

    Sarah María Regueira Betancourt

    2015-12-01

    Full Text Available This is an unusual case of dengue without fever. This is a 23-year-old, white male patient who went to his family doctor in August, 2013 complaining of of a reddish exanthematous eruption in his upper chest, who despite of having measured his temperature several times at home, he did not have hyperthermia. He was referred to "Dr. Ernesto Guevara de la Serna" General Teaching Hospital, from where he was moved to "60 Anniversario del Moncada" field hospital for suspecting dengue. Throughout his hospital stay vital, his signs were measured every 3 hours, and fever was never detected. On the fourth day of his follow-up, loop test was positive. On sixth day, IgM for dengue was made and resulted positive. In situations of increasing the incidence of dengue, at the onset of rash without fever, this disease should be considered as a possible diagnosis, which is of paramount importance that has incidence on its transmission.

  6. Geologic Mapping of Mawrth Vallis and Nili Fossae, Mars

    Bleamaster, L. F.; Chuang, F.

    2010-12-01

    Mapping studies using traditional photogeologic and modern digital geologic mapping techniques of Mawrth Vallis (six MTM quads; 17.5-27.5N, 335-350E) and Nili Fossae (six MTM quads; 17.5-32.5N, 070-080E) at 1:1M-scale are being used to assess geologic materials and processes that shape the highlands along the Arabia Terra dichotomy boundary. Placing these landscapes, their material units, structural features, and unique compositional outcrops into broad spatial and temporal context may help to constrain: a) paleo-environments and climate conditions through time, b) fluvial-nival modification processes related to past and present volatile distribution and their putative reservoirs (aquifers, lakes and oceans, surface and ground ice) and c) the influences of nearby volcanic and tectonic features on hydrologic systems and processes, including possible hydrothermal alteration, across the region. Since the initial discovery of phyllosilicate-bearing materials by the OMEGA instrument (Poulet et al., 2005; Bibring et al., 2006], Mawrth Vallis and Nili Fossae have become areas of intense scrutiny by high-resolution cameras and spectrometers. The mineralogic diversity (a variety of clays, unaltered ferromagnesian silicates, sulfates, and small detections of carbonate) is unprecedented on the surface of Mars and requires stratigraphic sequencing to unlock their complex histories. Mapping to date has delineated 12 geologic units for Mawrth Vallis and 17 for Nili Fossae. Mawrth Vallis units include: Acidalia Planitia; Arabia Terra, members 1&2; Mawrth Vallis channel; Mawrth Vallis plains, members 1-4; and several crater facies. Nili Fossae units are: Arabia Terra plateau sequence, members 1-5, Arabia Plateau etched, members a-c; Borealis plains; Isisdis plains, members 1-3, Syrtis Major flows, members 1,2a,&2b, crater facies, and surficial deposits. It is our hope that the small-scale mapping being performed herein may provide regional context for larger-scale and more focused studies (e.g., MSL landing site surveys) investigating the distribution, stratigraphic position, and potential lateral continuity of compositionally distinct outcrops as identified by instruments in orbit. Geologic Map of Nili Fossae. Updated maps of Nili Fossae and Mawrth Vallis will be presented and available for digital distribution.

  7. Late epidermal growth factor receptor inhibitor-related papulopustular rash: a distinct clinical entity.

    Sibaud, V; Tournier, E; Roché, H; Del Giudice, P; Delord, J P; Hubiche, T

    2016-01-01

    We report four patients developing a late form of papulopustular rash induced by epidermal growth factor receptor inhibitors. These patients presented an unusual presentation of acneiform rash, characterized by late development (several months after treatment commenced), localization to the limbs with sparing of the face, and association with severe pruritus and Staphylococcus aureus superinfection in all cases. These clinical symptoms may suggest a distinct mechanism from the early acne-like rash frequently observed with these targeted anticancer therapies. Clinicians should be aware of this delayed adverse event, and we suggest the term 'late acneiform toxicity of EGFR inhibitors (LATE) syndrome' to permit better characterization of this clinical picture. PMID:25959005

  8. [Analysis and classification of Latin anatomical names of skeletal fossa in Terminologia Anatomica, and comparison with corresponding Japanese anatomical names].

    Shikano, Shun-ichi; Abe, Tatsuhiko; Terashima, Tatsuo

    2011-10-01

    For a better understanding of the structures comprising the human body and in view of the possible need for future revision of anatomical nomenclature, Latin anatomical names of skeletal fossa in Terminologia Anatomica were analyzed and classified, and compared with the corresponding Japanese anatomical names. The words following Fossa indicated: 1) the form of the fossa, 2) the structure to which the fossa belongs, 3) the position of the fossa, 4) the structure that exists near the fossa, 5) the structure that the fossa contains, 6) the structure attached to the fossa, 7) the structure that transmits the fossa, or 8) the structure with which the fossa articulates. The analysis of Latin names and comparison with Japanese names clarified some characteristics of both names and revealed some problems in them. PMID:22187883

  9. [A solitary neurofibroma arising from the temporal fossa].

    Tian, Xiaoyan; Luo, Gui; Zhu, Xinhua

    2014-07-01

    Neurofibromas are benign nerve sheath tumors that arise from the nonmyelinating Schwann cells. Generally, neurofibromas can be categorized into dermal and plexiform subtypes. The former subtype is usually associated with a lone peripheral nerve in the integumentary system, while plexiform tumors are associated with many nerve bundles and can originate internally. Rarely, the plexiform tumors can undergo malignant transformation. Neurofibromas are usually found in individuals with neurofibromatosis, which is an autosomal dominant disease. On occasion, an isolated neurofibroma can transpire without being associated with neurofibromatosis. Mostly, these solitary tumors tend to occur in the gastrointestinal system, and neurofibromas of the head and neck are not uncommon, but very rarely they have been reported to occur in the temporal fossa. In this report, we describe a case of a solitary neurofibroma arising from the temporal fossa. PMID:25248275

  10. Children's vomiting following posterior fossa surgery: A retrospective study

    Dundon Belinda

    2009-07-01

    Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

  11. Cerberus Fossae, Elysium, Mars: A source for lava and water

    Plescia, J.B.

    2003-01-01

    Cerberus Fossae, a long fracture system in the southeastern part of Elysium, has acted as a conduit for the release of both lava and water onto the surface. The southeastern portion of the fracture system localized volcanic vents having varying morphology. In addition, low shields occur elsewhere on the Cerberus plains. Three locations where the release of water has occurred have been identified along the northwest (Athabasca and Grjota' Vallis) and southeast (Rahway Vallis) portions of the fossae. Water was released both catastrophically and noncatastrophically from these locations. A fluvial system that extends more than 2500 km has formed beginning at the lower flank of the Elysium rise across the Cerberus plains and out through Matte Vallis into Amazonis Planitia. The timing of the events is Late Amazonian. ?? 2003 Elsevier Inc. All rights reserved.

  12. Petergopalatine Fossa A Key Area In Rhinocerebral Mucormycosis Extension

    Sadr-Hoseini S M

    2003-11-01

    Full Text Available Rhinocerebral mucormycosis is a rapidly progressive fungal infection that spreads from nose and sinuses to brain in short time. Cunent hypothesis about brain involvement explains that infection initiates in nose and progresses into orbit through ethmoidat sinuses via erosion of lamina papyranea. Then infection spreads from orbit apex to cavernous sinus and brain. Therefore, in addition to medical therapy surgical debridement of the sinuses plays a major role in treatment of these patients. The aim of this study is introduction of a new point of view about extension of mucor from the nose to orbit and brain. Also we discuss clinical implication of this perspective on surgery."nMaterials and Methods: Since 1997-2002 nine patients with mucormycosis involving nose. Sinuses and orbit were admitted in ENT ward of Imam Khomeini general hospital. 8 patients with positive pathology entered the study. Variable such as age, underlying diseases, symptoms, site of involvement, extent of debridement and its times, and outcome were studied."nResults: After review of the history, surgical reports and pathological results, we found these findings in almost all patients: 1 facial pain, facial anesthesia, paralysis of buccal branch of facial nerve, paralysis of extrocular muscles, chemosis, periorbital edema 2 involvement of cheek subcutaneous tissue, buccal fat pad, IOF, SOF, orbital apex, infraorbital and maxillary nerves 3 involvement of pterygoid fossa with or without infratemporal fossa extension. Three patients have survived. Causes of death in other five patients were pneumonia, hypokalemia, and arrythmis during anesthesia. Mucormycosis was under control in most of these patients."nConclusion: Pterygopalatine fossa is the main source for replication and extension of mucor. After entrance to the nose, mucor reaches this site and after involvement of IOF and SOF rapidly extends to retrobulbar portion of the orbit. Paranasal sinuses, buccal space, cheek, palate and infratemporal fossa may be secondarily involved. Exploration and debridment of this area has beneficial effect on surviving of these patients."n"n"n"n"n 

  13. Bone marrow aplasia and severe skin rash after a single low dose of methotrexate.

    Copur, S; Dahut, W; Chu, E; Allegra, C J

    1995-02-01

    A 64 year old man with recurrent metastatic squamous cell carcinoma of the head and neck developed severe skin rash and bone marrow aplasia 4 and 7 days, respectively, following a single dose of 40 mg/m2 methotrexate (MTX). Skin rash involved regions of the face, lower abdomen, back, buttocks and both upper thighs. Biopsy of the skin rash demonstrated superficial perivascular lymphocytic infiltrate and was consistent with a drug reaction. Peripheral blood count revealed pancytopenia and a bone marrow biopsy was consistent with aplasia. Blood counts returned to normal 6 days after institution of granulocyte colony stimulating factor therapy. In the absence of mucositis or diarrhea, severe dermatologic toxicity following a single low dose of the drug suggests an 'allergic' or acute hypersensitivity reaction to MTX in this patient. Development of an extensive skin rash following a single dose of MTX may be an early warning sign for life-threatening bone marrow aplasia. PMID:7538828

  14. Gamma Knife surgery for posterior fossa arteriovenous malformations

    The long-term outcomes after Gamma Knife surgery (GKS) were retrospectively analyzed in patients with posterior fossa arteriovenous malformations (AVMs) to evaluate the efficacy, safety, and indications for this procedure. The medical records were reviewed of 75 patients who underwent GKS between 1992 and 2005 in our institution. The rate of complete AVM obliteration was 57.3% at 3 years and 80.2% at 5 years after GKS. Multivariate analysis showed that the significant factors for higher obliteration rates were younger patient age, smaller nidus volume, and smaller nidus maximum/minimum diameter. Two patients suffered hemorrhages during the latency interval. Clinical deterioration was observed in 10 patients with radiation-induced edema after the GKS. Larger nidus volume and AVM located adjacent to eloquent areas were significantly associated with the risk of neuropathy after GKS. One patient developed radiation-induced necrosis 4 years after confirmation of complete AVM obliteration. GKS is an effective and safe modality for the treatment of posterior fossa AVMs, resulting in high AVM obliteration rate with low complication rates based on neuroimaging and neurological symptoms. Posterior fossa AVMs tend to occur adjacent to eloquent areas, so we recommend preparing a conformed dose plan that considers both obliteration of the AVM nidus and preservation of neurological function. (author)

  15. Venous anomalies and abnormalities of the posterior fossa

    The authors report a series of 16 patients with venous anomalies or abnormalities of the posterior fossa studied by angiography, CT and/or MRI. We believe that so-called 'venous angioma' are extreme anatomic variants that drain normal territories, and we prefer to call them developmental venous anomalies (DVA). Posterior fossa DVA, like the supra-tentorial ones are classified according to their drainage into deep and superficial type. They are exclusively located in the cerebellum or tectum. In 4 cases DVA was an incidental finding, in 3 an associated cerebral venous malformation (CVM) was found and felt to be the cause of the symptoms and only in one (Trigeminal pain) was a link between both suspected. Cavernous venous malformation (CVM) were found in frequent association with DVA (27%). 4 cases were single and 2 multiple. 5 CVM were located in the brain stem and 3 in the cerebellum. The clinical and radiological files were reviewed and a direct relationship between symptoms and localization was found in all patients with CVM. In 2 cases venous dysplasia was found: 1 Sturge-Weber and 1 First branchial arch syndrome. Both posterior fossa venous abnormalities were incidental findings. (orig.)

  16. Diffusion tensor imaging of midline posterior fossa malformations

    Diffusion tensor imaging and tractography have been used to evaluate a variety of brain malformations. However, these studies have focused mainly on malformations involving the supratentorial compartments. There is a paucity of data on diffusion tensor imaging of posterior fossa malformations. To describe the color vector maps and modified or abnormal tracts of midline posterior fossa malformations. Diffusion tensor imaging was performed in one patient with rhombencephalosynapsis and two with Joubert syndrome. Color vector maps of fractional anisotropy were used to place a region of interest for seed point of fiber tracking. The vermis was severely hypoplastic or absent in rhombencephalosynapsis and Joubert syndrome. In rhombencephalosynapsis, vertically oriented fibers were visualized in the midportion of the cerebellum. The location of the deep cerebellar nuclei could be inferred from the amiculum and were medially located in rhombencephalosynapsis. In the two patients with Joubert syndrome, the horizontally arranged superior cerebellar peduncles were well demonstrated on the color vector maps. Failure of the superior cerebellar peduncles to decussate in the mesencephalon was also well demonstrated on both color vector maps and tractography. The deep cerebellar nuclei were more laterally located in Joubert syndrome. The use of tractography in midline posterior fossa malformations expands our understanding of these malformations. (orig.)

  17. Skin rash as useful marker of erlotinib efficacy in NSCLC and its impact on clinical practice.

    Fiala, O; Pesek, M; Finek, J; Krejci, J; Ricar, J; Bortlicek, Z; Benesova, L; Minarik, M

    2013-01-01

    Erlotinib is an epidermal growth factor receptor tyrosine kinase inhibitor used in treatment of advanced NSCLC. Patients harboring EGFR or KRAS mutations represent minority of all patients in caucasian population and there is no available predictor for a predominant group of patients harboring the wild-type EGFR and wild-type KRAS genes. Skin rash is the most frequent manifestation of cutaneous toxicity of erlotinib. Rash is associated with a good therapeutic response. We aimed at the evaluation of rash as a predictor of therapeutic effect of erlotinib in patients harboring the wild-type EGFR and KRAS wild-type genes and to assess its possible usage in a clinical practice.Totally 184 patients with advanced stage NSCLC (IIIB, IV) harboring the wild-type EGFR and wild-type KRAS genes were analysed. Comparison of ORR, PFS and OS according to the occurrence of rash was performed. In order to assess the impact of rash in clinical practice it was conducted landmark analysis of the group of patients whose rash was observed during first month of treatment (n=124). Patients in whom progression was observed during the first month of treatment were excluded from the landmark analysis. The comparison of ORR was performed using Fisher's exact test, visualization of survival was performed using Kaplan-Meier survival curves and the differences in survival were tested using the log-rank test. Median PFS in patients who were observed with rash during the treatment was 3.0 vs. 1.2 months in patients with no rash (psurvival and ORR in patients harboring wild-type EGFR and wild-type KRAS genes. Occurrence of rash during the first month of treatment is a useful predictor of better effect of erlotinib after one month of treatment. Patients who were not observed with rash during the first month of treatment are in high risk of progression. Optimization of the treatment of these patients can contribute restaging after two months of treatment, assessment of plasma levels of erlotinib and eventually attempt to dose escalation. PMID:23067213

  18. A rare complication following maxillary third molar extraction: infratemporal fossa abscess

    Görkem Müftüo?lu

    2012-10-01

    Full Text Available

    Infratemporal fossa abscess formation is a very rare and life threatening condition and also its differential diagnosis is a very difficult process. Infratemporal fossa abscess following the non-infected, asymptomatic, erupted maxillary third molar extraction in a young and healthy patient is an unexpected and unusual complication.

    A 25 years old, male patient with a significant infratemporal fossa abscess and his treatment protocol was presented in this case report.

  19. Intensity-Modulated Arc Therapy for Pediatric Posterior Fossa Tumors

    Purpose: To compare intensity-modulated arc therapy (IMAT) to noncoplanar intensity-modulated radiation therapy (IMRT) in the treatment of pediatric posterior fossa tumors. Methods and Materials: Nine pediatric patients with posterior fossa tumors, mean age 9 years (range, 6–15 years), treated using IMRT were chosen for this comparative planning study because of their tumor location. Each patient’s treatment was replanned to receive 54 Gy to the planning target volume (PTV) using five different methods: eight-field noncoplanar IMRT, single coplanar IMAT, double coplanar IMAT, single noncoplanar IMAT, and double noncoplanar IMAT. For each method, the dose to 95% of the PTV was held constant, and the doses to surrounding critical structures were minimized. The different plans were compared based on conformity, total linear accelerator dose monitor units, and dose to surrounding normal tissues, including the entire body, whole brain, temporal lobes, brainstem, and cochleae. Results: The doses to the target and critical structures for the various IMAT methods were not statistically different in comparison with the noncoplanar IMRT plan, with the following exceptions: the cochlear doses were higher and whole brain dose was lower for coplanar IMAT plans; the cochleae and temporal lobe doses were lower and conformity increased for noncoplanar IMAT plans. The advantage of the noncoplanar IMAT plan was enhanced by doubling the treatment arc. Conclusion: Noncoplanar IMAT results in superior treatment plans when compared to noncoplanar IMRT for the treatment of posterior fossa tumors. IMAT should be considered alongside IMRT when treatment of this site is indicated.

  20. Tratamento cirúrgico da cisticircose da fossa craniana posterior

    Pedro Garcia Lopes

    1971-03-01

    Full Text Available A cisticercose, um dos mais sérios problemas parasitológicos do sistema nervoso, apresenta, quando localizada na fossa posterior, um quadro clínico dramático, no qual predomina a hipertensão intracraniana. Foram estudados neste trabalho, 70 pacientes com cisticercose de fossa craniana posterior, atendidos no Serviço de Neurocirurgia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo de 1945 a 1968. Considerando-se a grande diversidade existente em torno das técnicas de tratamento cirúrgico, foi objetivo deste trabalho o estudo dos resultados obtidos nestes pacientes, nos quais várias técnicas foram empregadas. As cirurgias paliativas que derivam o trânsito do líquido cefalorraqueano para regiões extracranianas, quando comparadas aos outros tipos de cirurgias utilizados, foram as que proporcionaram maior índice de recuperação, exigiram menos reoperações, além de terem sido acompanhadas de menor número de complicações, bem como de menor mortalidade pós-operatória. Por outro lado, a neurocisticercose geralmente é um processo difuso, encontrando-se parasitas em várias regiões do encéfalo e/ou aracnoidite, conforme comprovou-se, também, entre os casos ora reunidos e que vieram a falecer. Baseando-se nestes fatos, não se justificam as derivações intracranianas e, a não ser eventualmente, a abordagem direta do parasita. Os casos estudados permitem cone- tatar, portanto, que as derivações extracranianas, por sua simplicidade e eficácia, apresentam-se, atualmente, como a terapêutica cirúrgica mais propriada à cisticercose de fossa craniana posterior.

  1. Practical approach to prenatal posterior fossa abnormalities using MRI

    This review focuses on the optimum use of fetal MRI as an additional imaging tool to sonographic data in posterior fossa (PF) abnormalities in the second and third trimesters of gestation. We have chosen three particular situations to demonstrate the value of MRI as a complementary investigation to US: (1) the pattern of increased fluid-filled space of the PF, (2) decreased cerebellar sonographic biometry and (3) the diagnosis of focal echogenic lesions of the cerebellum. For increased fluid-filled space of the PF and decreased cerebellar sonographic biometry, a practical approach is proposed, largely based on prenatal imaging, especially MRI. (orig.)

  2. Large intradiploic growing skull fracture of the posterior fossa

    Hamamcioglu, M. Kemal; Hicdonmez, Tufan; Kilincer, Cumhur; Cobanoglu, Sebahattin [Trakya University, Department of Neurosurgery, Edirne (Turkey)

    2006-01-01

    Growing skull fractures (GSFs) are rare complications of head injury and mostly occur in infancy and early childhood. Location in the posterior fossa and intradiploic development of a GSF is very uncommon. We report a 7-year-old boy with a large, 9 x 7 x 4-cm, occipital intradiploic GSF. The lesion developed progressively over a period of 5 years following a documented occipital linear fracture. This case of a GSF developing from a known occipital linear fracture demonstrates that a GSF may reach a considerable size and, although uncommon, intradiploic development and occipital localization of a GSF is possible. (orig.)

  3. Posterior cranial fossa arteriovenous fistula with presenting as caroticocavernous fistula

    We report cases of posterior cranial fossa arteriovenous fistula (AVF) with presenting with exophthalmos, chemosis and tinnitus in 26- and 66-year-old men. The final diagnoses was vertebral artery AVF and AVF of the marginal sinus, respectively. The dominant venous drainage was the cause of the unusual presentation: both drained from the jugular bulb or marginal sinus, via the inferior petrosal and cavernous sinuses and superior ophthalmic vein. We used endovascular techniques, with coils and liquid adhesives to occlude the fistulae, with resolution of the symptoms and signs. (orig.)

  4. Posterior cranial fossa arteriovenous fistula with presenting as caroticocavernous fistula

    Liu, H.M.; Shih, H.C.; Huang, Y.C.; Wang, Y.H. [Dept. of Medical Imaging, National Taiwan University Hospital, Taipei (Taiwan)

    2001-05-01

    We report cases of posterior cranial fossa arteriovenous fistula (AVF) with presenting with exophthalmos, chemosis and tinnitus in 26- and 66-year-old men. The final diagnoses was vertebral artery AVF and AVF of the marginal sinus, respectively. The dominant venous drainage was the cause of the unusual presentation: both drained from the jugular bulb or marginal sinus, via the inferior petrosal and cavernous sinuses and superior ophthalmic vein. We used endovascular techniques, with coils and liquid adhesives to occlude the fistulae, with resolution of the symptoms and signs. (orig.)

  5. Azithromycin-Induced Rash in a Patient of Infectious Mononucleosis – A Case Report with Review of Literature

    Banerjee, Indranil; Mondal, Somnath; Sen, Sukanta; Tripathi, Santanu Kumar; Banerjee, Gautam

    2014-01-01

    Antibiotic induced skin rash in setting of infectious mononucleosis is often encountered in clinical practice. However, macrolides like azithromycin are considered relatively safe and till date only two cases of azithromycin induced rash in setting of infectious mononucleosis have been reported. The following report illustrates the case of a 23-year-old man suffering from infectious mononucleosis who exhibited a generalized cutaneous rash following treatment with azithromycin. Using the Naran...

  6. MRI diagnosis of muscle denervation from herpes zoster with discordant distribution of the skin rash

    Gupta, Amit; Sundaram, Murali [Cleveland Clinic, Section of Musculoskeletal Radiology, Imaging Institute, Cleveland, OH (United States); Winalski, Carl S. [Cleveland Clinic, Section of Musculoskeletal Radiology, Imaging Institute, Cleveland, OH (United States); Cleveland Clinic, Department of Biomedical Engineering, Lerner Research Institute, Cleveland, OH (United States)

    2014-10-15

    Herpes zoster is a common disorder characterized by a painful rash along a dermatome caused by reactivation of the varicella zoster virus (VZV). Muscle denervation injury from motor involvement is an uncommon phenomenon. Discordant distribution of the skin rash and motor nerve involvement, presenting as a skin rash in one body part and muscle weakness or pain from nerve involvement in another body part is an even more uncommonly reported finding. We present an unusual case of muscle denervation injury resulting from motor involvement of a peripheral nerve by VZV diagnosed by magnetic resonance imaging with cutaneous manifestations in a different dermatomal distribution. To the best of our knowledge, there has been no similar case reported in the English radiology literature. We suggest that whenever a radiologist notices MRI findings suggesting denervation injury and a cause not readily identified, VZV-related denervation injury should be included in the differential diagnosis, especially in an older immunocompromised patient. (orig.)

  7. Dependent heroin use and associated risky behaviour: the role of rash impulsiveness and reward sensitivity.

    Dissabandara, Lakal O; Loxton, Natalie J; Dias, Shavindra R; Dodd, Peter R; Daglish, Mark; Stadlin, Alfreda

    2014-01-01

    Impulsive temperament has long been considered as a risk factor for substance use disorders (SUD). Considering the heterogeneity of impulsivity, a biologically-based 2-factor model incorporating reward sensitivity and rash impulsiveness facets, has been proposed. Here we report how these two facets of impulsiveness could be associated with different aspects of dependent heroin use and associated risky behaviour. Two hundred and ninety three dependent heroin users and 232 non-users were assessed on reward sensitivity, rash impulsivity, and the related trait of punishment sensitivity. After adjusting for multiple comparisons, heroin users were found to be more rash-impulsive and reward-sensitive than non-users (pdrug use. While greater impulsivity is a common trait in drug users compared with non-users, the use of a 2-factor model of impulsivity provides additional information regarding specific aspects of drug initiation and maintenance that can be targeted in the prevention and treatment of heroin dependence. PMID:24112954

  8. MRI diagnosis of muscle denervation from herpes zoster with discordant distribution of the skin rash

    Herpes zoster is a common disorder characterized by a painful rash along a dermatome caused by reactivation of the varicella zoster virus (VZV). Muscle denervation injury from motor involvement is an uncommon phenomenon. Discordant distribution of the skin rash and motor nerve involvement, presenting as a skin rash in one body part and muscle weakness or pain from nerve involvement in another body part is an even more uncommonly reported finding. We present an unusual case of muscle denervation injury resulting from motor involvement of a peripheral nerve by VZV diagnosed by magnetic resonance imaging with cutaneous manifestations in a different dermatomal distribution. To the best of our knowledge, there has been no similar case reported in the English radiology literature. We suggest that whenever a radiologist notices MRI findings suggesting denervation injury and a cause not readily identified, VZV-related denervation injury should be included in the differential diagnosis, especially in an older immunocompromised patient. (orig.)

  9. Traumatic Posterior Fossa Epidural Hematomas and Their Complications

    Ali DALGIÇ

    2007-12-01

    Full Text Available Background: Traumatic posterior fossa epidural hematomas (TPFEDH occur infrequently however their mortality and morbidity are higher than supratentorial epidural hematomas. Signs and symptoms may be silent or nonspecific, even though they may show rapid progression and deterioration from consciousness to coma, thus they would cause fatal results. Recently, practice of computerized tomography (CT has grown up and replaced the use of direct X-ray to detect calvarial fractures and other traumatic pathologies, therefore patients with posterior fossa trauma were diagnosed earlier.Material and Methods: We presented eight cases who suffered from TPFEDHs treated in our clinics between the years 2002 and 2006. Five cases were operated immediately however 3 cases were treated conservatively. One of the operated cases died immediately after surgery. Postoperative complications of cerebral sinus thrombosis and pseudomeningocele were observed in two cases. Alive cases were discharged a few days after surgery.Conclusion: Mortality decreases in TPFEDHs since they could be diagnosed earlier with widespread use of CT and treated successfully. In addition, it is easier to decide whether conservative or surgical therapy is efficient because CT findings should correlate with clinical findings. However, few complications such as cerebral sinus thrombosis and pseudomeningocele occur infrequently. Furthermore these cases must be monitored carefully during postoperative period for a new neurological finding.

  10. Multidimensional analysis of fetal posterior fossa in health and disease.

    Vatansever, Deniz; Kyriakopoulou, Vanessa; Allsop, Joanna M; Fox, Matthew; Chew, Andrew; Hajnal, Joseph V; Rutherford, Mary A

    2013-10-01

    Fetal magnetic resonance imaging (MRI) is now routinely used to further investigate cerebellar malformations detected with ultrasound. However, the lack of 2D and 3D biometrics in the current literature hinders the detailed characterisation and classification of cerebellar anomalies. The main objectives of this fetal neuroimaging study were to provide normal posterior fossa growth trajectories during the second and third trimesters of pregnancy via semi-automatic segmentation of reconstructed fetal brain MR images and to assess common cerebellar malformations in comparison with the reference data. Using a 1.5-T MRI scanner, 143 MR images were obtained from 79 normal control and 53 fetuses with posterior fossa abnormalities that were grouped according to the severity of diagnosis on visual MRI inspections. All quantifications were performed on volumetric datasets, and supplemental outcome information was collected from the surviving infants. Normal growth trajectories of total brain, cerebellar, vermis, pons and fourth ventricle volumes showed significant correlations with 2D measurements and increased in second-order polynomial trends across gestation (Pearson r, p?MRI and confirm the advantages of utilizing advanced neuroimaging tools in clinical fetal research. PMID:23553467

  11. ["Fossa" carcinoma - a relapse or "rest" carcinoma of the kidney?].

    Panchev, P; Ianev, K; Georgiev, M; Kirilov, S; Kumanov, Kh

    2000-01-01

    The local relapse represents a unique variant of the advanced stage of a disease (A Esrig et 1992). Presumably, "fossa" carcinoma may result from incomplete resection or persisting tumor in the regional contiguous lymph nodes (JB D Kernion 1978). The average time interval for a relapse to occur is 31 months after nephrectomy, and in most patients it becomes manifest with symptoms, such as losing weight, fatigability and lumbar discomfort (D Esrig et al 1992). In cases with local recurrence a long-term survivorship may be attained by resorting to aggressive surgical intervention (S Tanguag et al 1996). This is a report on twenty-three patients with "fossa" carcinoma covering the period 1994 through 1999, with a total of 425 patients with renal carcinoma operated during the same period of time. All patients undergo operation--lumbar access is used in 22 cases, and transperitoneal--in one. In one patients resection of colon is necessitated, whereas in five the neoplastic mass hardly lends itself to complete excision, with enucleation alone being done. At follow-up study the survival terms are as follows: up to 1 year--18 patients, up to 3 year--16 patients, up to 5 year--12 patients. PMID:11692915

  12. Rash, disseminated intravascular coagulation and legionella: Episode 10 and a rewind into the past

    Prashanth M. Thalanayar

    2015-01-01

    Full Text Available Legionella pneumophila is the most common cause of legionellosis and is one of the organisms causing atypical pneumonia. We report the presentation of disseminated intravascular coagulation (DIC and skin rash in a single case of severe Legionella pneumonia. The unique clinical presentation of a diffuse rash diagnosed as purpura fulminans and the unpredictable variations encountered during the diagnostic work-up of the case make this write-up crucial. This article synthesizes all reported cases of L. pneumonia associated with cutaneous manifestations as well as cases presenting with DIC. Furthermore, this manuscript illustrates the correlation between cutaneous and coagulopathic manifestations, and morbidity and mortality from L. pneumonia.

  13. Epidermoid cyst of the posterior fossa: a case report Cisto epidermoide da fossa posterior: relato de caso

    Eduardo Cambruzzi

    2011-02-01

    Full Text Available Epidermoid cysts of the central nervous system are uncommon conditions, which are frequently located in the cerebellopontine angle and around the pons. They are covered with keratinized squamous epithelium and keratin lamella, which give its contents a soft, white-pearly appearance. Epidermoid cysts are mostly originated from malformations, presumably associated with surface elements of the nervous system ectoderm during the closure of the neural groove or formation of secondary cerebral vesicles. The authors describe a case of epidermoid cyst in the posterior fossa causing hydrocephalus and review morphologic and diagnostic criteria of this lesion.Os cistos epidermoides do sistema nervoso central (SNC são condições incomuns, estando localizados mais frequentemente no ângulo pontocerebelar e ao redor da ponte. Eles são revestidos por epitélio escamoso queratinizado e lamelas de queratina, tornando seu conteúdo branco-perolado e pastoso. Os cistos epidermoides são, na maioria das vezes, originados de malformações, possivelmente associados ao entremeio de elementos superficiais do ectoderma do SNC durante o fechamento da placa neural, ou formação das vesículas cerebrais secundárias. Os autores descrevem um caso de cisto epidermoide da fossa posterior determinando hidrocefalia e revisam critérios morfológicos e diagnósticos dessa lesão.

  14. Skin rash induced by ritonavir-boosted darunavir is common, but generally tolerable in an observational setting.

    Nishijima, Takeshi; Gatanaga, Hiroyuki; Teruya, Katsuji; Mizushima, Daisuke; Aoki, Takahiro; Watanabe, Koji; Kinai, Ei; Honda, Haruhito; Yazaki, Hirohisa; Tanuma, Junko; Tsukada, Kunihisa; Kikuchi, Yoshimi; Oka, Shinichi

    2014-04-01

    Ritonavir-boosted darunavir (DRV/r) is a protease inhibitor widely used in the treatment of HIV-1 infection. However, skin rash is a well-known adverse event of DRV, and limited data are available from observational settings. This observational study examined the characteristics of DRV-induced skin rash in treatment-naïve patients who commenced once-daily DRV/r-containing antiretroviral therapy (ART). Of the 292 study patients, DRV rashes developed in 31 (11%) patients with a median latency of 10 days (developing from 7 to 14 days in 93%) from initiation of ART. DRV skin rash was generally mild, as only one patient (3%) had grade 3 rash whereas 24 (77%) patients had grade 2 and 6 (19%) patients had grade 1. Only two patients (7%) discontinued DRV/r due to skin rash, and the other continued DRV/r and their rashes disappeared completely without any complications. Interestingly, DRV rash occurred more frequently to patients with less advanced HIV-1 infection than those with advanced infection. The incidence of DRV rash was not significantly different between patients with and without history of sulfonamide allergy (p = 0.201). Furthermore, when we exclude patients without history of sulfonamide use and only examine patients with sulfonamide use (n = 145), the result was similar (p = 0.548). In conclusion, DRV rashes were frequently observed but the prognosis was benign. Most patients tolerated DRV rashes with use of oral steroid or antihistamine without discontinuation of DRV. To date, there is no clear clinical evidence to suggest that DRV should be avoided in patients with history of sulfonamide allergy. PMID:24507978

  15. Bilateral suborbital rash: a dermatologic manifestation of neuropsychiatric disease in a pediatric patient.

    Tong, Lana X; Wang, Yen Tun; Beynet, David

    2014-05-01

    A 10-year-old girl presented with a new onset bilateral suborbital rash. Dermatologic examination revealed violaceous, non-tender, well-demarcated patches with an atypical distribution and pigmentation. After further investigation, a diagnosis of Munchausen syndrome was made and the patient was referred to her primary care provider for further management. PMID:24852783

  16. Posterior fossa malformations: main features and limits in prenatal diagnosis

    Garel, Catherine [Hopital d' Enfants Armand-Trousseau, Department of Radiology, Paris (France)

    2010-06-15

    Posterior fossa (PF) malformations are commonly observed during prenatal screening. Their understanding requires knowledge of the main steps of PF development and knowledge of normal patterns in US and MR imaging. The vast majority of PF malformations can be strongly suspected by acquiring a midline sagittal slice and a transverse slice and by systematically scrutinizing the elements of the PF: cerebellar vermis, hemispheres, brainstem, fourth ventricle, PF fluid spaces and tentorium. Analysis of cerebellar echogenicity and biometry is also useful. This review explains how to approach the diagnosis of the main PF malformations by performing these two slices and answering six key questions about the elements of the PF. The main imaging characteristics of PF malformations are also reviewed. (orig.)

  17. CT findings of dural arteriovenous malformation in the posterior fossa

    CT findings in eight cases of dural arteriovenous malformation, mainly involving the dura mater and the tentorium cerebelli of the posterior fossa, are reported. The main findings observed on CT scans may be summarized as follows: 1) patchy and vermiform enhancement after the intravenous injection of the contrast medium; 2) abnormal low-density area; 3) local mass effect; 4) hydrocephalus; 5) distention and aneurysmal dilatation of the major venous sinus system, and 6) dilated meningeal grooves of the skull inner table. These findings were commonly noted in the patients with Types II, III and IV in Djinjian's classification. The abnormal low density with or without patchy and vermiform enhancement and/or hydrocephalus are most likely caused by a disturbed venous return of the cerebral parenchyma and an impaired absorption of the cerebrospinal fluid due to the increased pressure of the venous sinus system. These findings were improved following artificial embolization or surgical excision of the dural arteriovenous malformation. (author)

  18. Posterior fossa malformations: main features and limits in prenatal diagnosis

    Posterior fossa (PF) malformations are commonly observed during prenatal screening. Their understanding requires knowledge of the main steps of PF development and knowledge of normal patterns in US and MR imaging. The vast majority of PF malformations can be strongly suspected by acquiring a midline sagittal slice and a transverse slice and by systematically scrutinizing the elements of the PF: cerebellar vermis, hemispheres, brainstem, fourth ventricle, PF fluid spaces and tentorium. Analysis of cerebellar echogenicity and biometry is also useful. This review explains how to approach the diagnosis of the main PF malformations by performing these two slices and answering six key questions about the elements of the PF. The main imaging characteristics of PF malformations are also reviewed. (orig.)

  19. Late-onset rash in patients with group A beta-hemolytic streptococcal pharyngitis treated with amoxicillin

    Masahiko Kimura

    2015-12-01

    Full Text Available We observed late-onset rashes in patients with group A beta-hemolytic streptococcal (GAS pharyngitis. Of 1028 patients with GAS pharyngitis, which was principally treated with amoxicillin, we evaluated those who developed a late-onset rash and excluded those with scarlet fever alone. Twenty-one patients developed a rash (2.0%, 95% confidence interval, 1.3- 3.1%, 7 to 20 days (median, 8 days after GAS pharyngitis onset. The rashes were characterized by maculopapules, which increased in size with coalescence and some developing into plaques, with a symmetrical distribution with a propensity for the extremities, including the palms and soles. The clinical courses of the patients were good, and the rashes subsided within 14 days. A non-immediate reaction to β-lactams, which usually manifests as a maculopapular rash, is a possible cause in our patients, however, repeated courses of amoxicillin in 3 patients did not induce the rash. The underlying mechanism of the late-onset rash after GAS pharyngitis with amoxicillin treatment remains unclear.

  20. [Neuralgias of the lower cranial nerves: microsurgical posterior fossa exploration].

    Antić, B; Perić, P; Ivanović, S; Spaić, M

    2004-01-01

    Neuralgias of the lower cranial nerves are trigeminal neuralgia (TN), glossopharingeal neuralgia (GphN), and geniculate neuralgia (GN). Microsurgical posterior fossa exploration with its variations microvascular decompression (MVD), partial sensory rhisotomy (PSR), and total sensory rhisotomy (TSR) is one of the most efficient ways of treating these neuralgias. It was performed 130 operations in 125 patients with TN, 3 in GphN patients, 1 in GN patient, 1 in GN/TN patients, 1 in GphN/GN patient, and 2 in GN/hemifacial spasm patients. Of total of 125 patients with TN, MVD was performed in 63, PSR in 18, and MVD+PSR in 44 cases. In 5 patients with recidivate TN PSR was performed. Of total 3 patients with GphN MVD was performed in 2 cases, and extirpation of a small meningeoma in 1 case (it was not seen on CT). In the patients with GN TSR of intermediate nerve was performed, in GN/TN patients TSR of intermediate nerve and PSR of trigeminal nerve was performed, in the GN/GphN patients MVD of glossopharingeal and TSR of intermediate nerve were performed, and in the GN/hemifacial spasm patients TSR of intermediate and MVD of facial nerve were performed. The results of TN patients are: excellent in 82.4%, good in 12%, and poor in 5.6% of patients. There is no difference in complete pain relief, rate of recurrence, and complications between MVD, MVD+PSR and PSR operative groups (p0.05). Among patients with other neuralgias the following results are noted: excellent in 4, good in 3, and poor in 1 patient. Microsurgical posterior fossa exploration is the method of choice in the treatment of the neuralgias of the lower cranial nerves. PMID:16018407

  1. Neuralgies of the lower cranial nerves: Microsurgical posterior fossa exploration

    Ivanović S.

    2004-01-01

    Full Text Available Neuralgias of the lower cranial nerves are trigeminal neuralgia (TN, glossopharingeal neuralgia (GphN, and geniculate neuralgia (GN. Microsurgical posterior fossa exploration with its variations microvascular decompression (MVD, partial sensory rhisotomy (PSR, and total sensory rhisotomy (TSR is one of the most efficient ways of treating these neuralgias. It was performed 130 operations in 125 patients with TN, 3 in GphN patients, 1 in GN patient, 1 in GN/TN patients, 1 in GphN/GN patient, and 2 in GN/hemifacial spasm patients. Of total of 125 patients with TN, MVD was performed in 63, PSR in 18, and MVD+PSR in 44 cases. In 5 patients with recidivate TN PSR was performed. Of total 3 patients with GphN MVD was performed in 2 cases, and extirpation of a small meningeoma in 1 case (it was not seen on CT. In the patients with GN TSR of intermediate nerve was performed, in GN/TN patients TSR of intermediate nerve and PSR of trigeminal nerve was performed, in the GN/GphN patients MVD of glossopharingeal and TSR of intermediate nerve were performed, and in the GN/hemifacial spasm patients TSR of intermediate and MVD of facial nerve were performed. The results of TN patients are: excellent in 82,4%, good in 12%, and poor in 5,6% of patients. There is no difference in complete pain relief, rate of recurrence, and complications between MVD, MVD+PSR and PSR operative groups (p>0,05. Among patients with other neuralgias the following results are noted: excellent in 4, good in 3, and poor in 1 patient. Microsurgical posterior fossa exploration is the method of choice in the treatment of the neuralgias of the lower cranial nerves.

  2. Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear

    From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Meniere's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiograhed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value. (orig.)

  3. Topographic relations of the high jugular fossa to the inner ear. A radioanatomic investigation

    Wadin, K.; Wilbrand, H.

    The radioanatomy of high jugular fossae and their topographic relations to the inner ear structures were investigated in 245 unselected temporal bones. One hundred and fifty specimens were submitted to multidirectional and 10 to computed tomography. After careful chemical and fermentative maceration plastic casts were made, using polyester resin and silicone rubber. With the use of vacuum, even minute structures became filled with the casting material. The specimens offered a three-dimensional view of the jugular fossae and surrounding structures. Fifty-eight (24%) of the total 245 specimens had high jugular fossae at a level above the lower border of the round window. Five casts showed a dehiscence of the peripheral portion of the vestibular aqueduct caused by the high jugular fossa. In 2 casts the proximal portion of the cochlear aqueduct was affected. In some casts the posterior semicircular canal, the facial canal, the stapedial muscle and the round window lay so close to the fossa that a dehiscence could not be excluded. In a clinical material of 102 high fossae the radiographic findings were in accordance with the experimental results. High jugular fossae were predominantly found in pyramids with low-grade mastoid bone pneumatization and sparse or no perilabyrinthine air cells.

  4. Rash after measles vaccination: laboratory analysis of cases reported in São Paulo, Brazil

    Oliveira Maria I

    2002-01-01

    Full Text Available OBJECTIVE: The clinical differential diagnosis of rash due to viral infections is often difficult, and misdiagnosis is not rare, especially after the introduction of measles and rubella vaccination. A study to determine the etiological diagnosis of exanthema was carried out in a group of children after measles vaccination. METHODS: Sera collected from children with rash who received measles vaccine were reported in 1999. They were analyzed for IgM antibodies against measles virus, rubella virus, human parvovirus B19 (HPV B19 using ELISA commercial techniques, and human herpes virus 6 (HHV 6 using immunofluorescence commercial technique. Viremia for each of those viruses was tested using a polimerase chain reaction (PCR. RESULTS: A total of 17 cases of children with exanthema after measles immunization were reported in 1999. The children, aged 9 to 12 months (median 10 months, had a blood sample taken for laboratory analysis. The time between vaccination and the first rash signs varied from 1 to 60 days. The serological results of those 17 children suspected of measles or rubella infection showed the following etiological diagnosis: 17.6% (3 in 17 HPV B19 infection; 76.5% (13 in 17 HHV 6 infection; 5.9% (1 in 17 rash due to measles vaccine. CONCLUSIONS: The study data indicate that infection due to HPV B19 or HHV 6 can be misdiagnosed as exanthema due to measles vaccination. Therefore, it is important to better characterize the etiology of rash in order to avoid attributing it incorrectly to measles vaccine.

  5. Rash after measles vaccination: laboratory analysis of cases reported in São Paulo, Brazil

    Maria I Oliveira

    2002-04-01

    Full Text Available OBJECTIVE: The clinical differential diagnosis of rash due to viral infections is often difficult, and misdiagnosis is not rare, especially after the introduction of measles and rubella vaccination. A study to determine the etiological diagnosis of exanthema was carried out in a group of children after measles vaccination. METHODS: Sera collected from children with rash who received measles vaccine were reported in 1999. They were analyzed for IgM antibodies against measles virus, rubella virus, human parvovirus B19 (HPV B19 using ELISA commercial techniques, and human herpes virus 6 (HHV 6 using immunofluorescence commercial technique. Viremia for each of those viruses was tested using a polimerase chain reaction (PCR. RESULTS: A total of 17 cases of children with exanthema after measles immunization were reported in 1999. The children, aged 9 to 12 months (median 10 months, had a blood sample taken for laboratory analysis. The time between vaccination and the first rash signs varied from 1 to 60 days. The serological results of those 17 children suspected of measles or rubella infection showed the following etiological diagnosis: 17.6% (3 in 17 HPV B19 infection; 76.5% (13 in 17 HHV 6 infection; 5.9% (1 in 17 rash due to measles vaccine. CONCLUSIONS: The study data indicate that infection due to HPV B19 or HHV 6 can be misdiagnosed as exanthema due to measles vaccination. Therefore, it is important to better characterize the etiology of rash in order to avoid attributing it incorrectly to measles vaccine.

  6. HLA-Cw*04 allele associated with nevirapine-induced rash in HIV-infected Thai patients

    Tunthanathip Preecha

    2009-10-01

    Full Text Available Abstract Background A high incidence of rash has been reported in HIV-1 patients who received the anti-retroviral drug nevirapine. In addition, several studies have suggested that polymorphisms of human leukocyte antigen (HLA genes may play important roles in nevirapine-induced rash. The aim of the present study was to evaluate the effects of different HLA-C alleles on rash associated with nevirapine in patients who started highly active anti-retroviral therapy (HAART containing nevirapine in Thailand. Results A case-control study was carried out involving HIV-1 patients under treatment at Bamrasnaradura Infectious Diseases Institute, Nonthaburi, Thailand between March 2007 and March 2008. The study included all HIV/AIDS patients being treated with nevirapine-containing regimens. The study population comprised 287 HIV/AIDS patients of whom 248 were nevirapine-tolerant and 39 developed rash after nevirapine treatment. From the nevirapine-tolerant patients, 60 were selected as the control group on the basis of age, sex, and therapy history matched for nevirapine-induced rash cases. We observed significantly more HLA-Cw*04 alleles in nevirapine-induced rash cases than in nevirapine-tolerant group, with frequencies of 20.51% and 7.50%, respectively (P = 0.009. There were no significant differences between the rash and tolerant groups for other HLA-C alleles except for HLA-Cw*03 (P = 0.015. Conclusion This study suggests that HLA-Cw*04 is associated with rash in nevirapine treated Thais. Future screening of patients' HLA may reduce the number of nevirapine-induced rash cases, and patients with alleles associated with nevirapine-induced rash should be started on anti-retroviral therapy without nevirapine.

  7. [Chondroblastoma of the Temporal Bone Removed Using a Middle Cranial Fossa Approach].

    Ishioka, Kaoru; Kanzaki, Jin; Harada, Tatsuhiko; Takanashi, Yoshihiro; Shinonaga, Masamichi; Kitamura, Hajime

    2015-03-01

    We report a case of chondroblastoma of the middle cranial fossa, probably arising from the (infra) mandibular fossa, and expanding to the attic and external auditory canal that was successfully removed using a middle cranial fossa approach. No recurrences occurred during an 8-year postoperative follow-up period. Initial biopsy findings suggested a pathological diagnosis of giant cell tumor that was later confirmed to be a chondroblastoma based on an immunohistochemical study of S-100. This case study suggests a profound understanding of the clinical features, histopathological characteristics, and possible treatment. of chondroblastoma. PMID:26349337

  8. Craniofacial access to the anterior and middle cranial fossae and skull base.

    Lello, G; Statham, P; Steers, J; McGurk, M

    1997-12-01

    A profusion of surgical approaches to gain access to the anterior and middle cranial fossa and skull base have been described. An attempt has been made to simplify the position by suggesting a classification of surgical approaches and to describe a standard approach (of at most 4 defined osteotomies, or at least 2) to give a craniofacial approach to the anterior and middle cranial fossae, the infratemporal fossa, the orbit and the superior nasal cavity. The full extent of the osteotomies have been likened to an ancient Corinthian face mask, or to the stylized face-mask worn by the comic book hero, Batman. PMID:9504303

  9. Phyllosilicate and Olivine around a Fracture in Nili Fossae

    2007-01-01

    The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) took this observation of part of the Nili Fossae region at the western margin of the Isidis impact basin at 3:07 (UTC) on December 12, 2006, near 21.9 degrees north latitude, 78.2 degrees east longitude. The image was taken in 544 colors covering 0.36-3.92 micrometers, and shows features as small as 18 meters (60 feet) across. The image is about 11 kilometers (7 miles) wide at its narrowest point. The Isidis basin resulted from a gigantic impact on the surface of Mars early in the planet's history. The image of the Isidis basin at the top left is the colored elevation data from the Mars Orbiter Laser Altimeter (MOLA) overlain on a digital image mosaic from the Viking mission. Reds represent higher elevations, and blue lower elevations. The western rim of the Isidis basin has numerous, concentric troughs (or 'fossae') which may have formed during faulting associated with the impact event. Since then, the Nili Fossae region has since been heavily eroded, and is one of the most mineralogically diverse spots on Mars. This CRISM image targets one of region's smaller fractures. The image is shown overlain on the Viking digital image mosaic at lower left. The lower right CRISM image was constructed from three visible wavelengths (0.71, 0.60 and 0.53 microns in the red, green and blue image planes, respectively) and is close to what the human eye would see. The blue on the right of the image is an artifact from light scattering in the atmosphere. The upper right image was constructed from three infrared channels (2.38, 1.80 and 1.15 microns in the red, green and blue image planes, respectively) to highlight the mineralogy of the area. The bright green areas are rich in 'phyllosilicates,' a category of minerals including clays. The purple material along the walls of the fracture likely contains small amounts of the iron- and magnesium-rich mineral pyroxene. The yellow-brown material contains the iron- and magnesium-rich mineral olivine. Olivine and pyroxene are minerals associated with igneous activity. Overlaying CRISM data with images from the High-Resolution Imaging Science Experiment (HiRISE) camera shows that the phyllosilicates are in small, eroded outcrops of rock. The olivine is most abundant in sand dunes on the surface. The use of these two instruments together reveals more about the history of the region: Olivine sands covered the area shown in the image after the interaction of water and rock formed the phyllosilicates and after the fracture formed. The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) is one of six science instruments on NASA's Mars Reconnaissance Orbiter. Led by The Johns Hopkins University Applied Physics Laboratory, the CRISM team includes expertise from universities, government agencies and small businesses in the United States and abroad.

  10. Nili Fossae in Natural Color and Across the Spectrum

    2007-01-01

    The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) took this image of the Nili Fossae region at 0643 UTC (2:43 a.m. EDT) on June 21, 2007, near 21.15 degrees north latitude, 74.24 degrees east longitude. CRISM's image was taken in 544 colors covering 0.36-3.92 micrometers, and shows features as small as 20 meters (66 feet) across. The region covered is just over 10 kilometers (6.2 miles) wide at its narrowest point, and is one of several dozen that CRISM has taken to map the minerals at candidate landing sites for the Mars Science Laboratory (MSL) mission, which will launch in 2010. The Nili Fossae region is critical to understanding the history of water on Mars and whether water ever formed environments suitable for life, because the region is underlain by a layer of phyllosilicate (clay) minerals. This type of mineralogy formed where water was in contact with Mars' crustal rocks for very long periods, altering the silicates in volcanic rocks. In addition, phyllosilicates can encapsulate and preserve organic chemicals associated with life (if life was present). Its rocky record of an ancient wet environment makes Nili Fossae a top contender among the 30-plus landing sites being considered for MSL, whose objectives include measuring the chemistry preserved in an ancient wet environment. This series of four different versions of the same 544-color image illustrates the mineral-mapping capability that comes from moving beyond the wavelength range of the human eye, and into infrared wavelengths where minerals leave distinct 'fingerprints' in reflected sunlight. At upper left, more than three dozen of the distinct wavelengths measured by CRISM were combined to mimic how the human eye would see the image. The subtle shading comes from the Sun's position high in Mars' sky when the image was taken, creating few shadows. The bland, butterscotch color comes from the dust coating nearly all of the Martian surface to some degree. At upper right, three infrared wavelengths (2.53, 1.50 and 1.08 micrometers) replace the red, green and blue image planes. These wavelengths are less sensitive to dust, and begin to show the spectral variations in the underlying rocks. The two bottom versions combine different wavelengths to show strength of absorption due to the different minerals that are present, providing indications of the minerals' presence and distribution. The lower left version combines measurements of the strength of iron mineral absorptions at 0.53, 0.86 and 1.0 microns in the red, green and blue image planes. Bluer areas have more pyroxene, a mineral found in volcanic basaltic rock, whereas reddish and especially orange areas have more oxidized iron minerals. The lower right version combines measurements of mineral absorptions at 1.0, 1.9 and 2.3 microns in the red, green and blue image planes. Redder areas are richer in pyroxene, and green and blue areas contain more phyllosilicate minerals. The combination of basaltic rocks and highly altered phyllosilicates in close proximity would allow MSL to make detailed measurements of rocks formed in two distinct environments. The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) is one of six science instruments on NASA's Mars Reconnaissance Orbiter. Led by The Johns Hopkins University Applied Physics Laboratory, the CRISM team includes expertise from universities, government agencies and small businesses in the United States and abroad.

  11. Facial herpes zoster infection precipitated by surgical manipulation of the trigeminal nerve during exploration of the posterior fossa: a case report

    Mansour Nassir

    2009-09-01

    Full Text Available Abstract Introduction We present a case of herpes zoster infection (shingles precipitated by surgical manipulation of the trigeminal nerve root during an attempted microvascular decompression procedure. The pathogenesis of this phenomenon, as well as the importance and role of prophylactic acyclovir in its management, are discussed. Case presentation A 54-year-old Caucasian man with a classical long-standing left-sided V2 and V3 division primary trigeminal neuralgia refractory to medical management, underwent posterior fossa exploration for microvascular decompression via a standard retromastoid craniectomy. The patient had immediate and complete relief from pain. Three days after the operation, he developed severely painful vesicles with V2 and V3 dermatomal distribution. Rather than the classical paroxysmal, lancinating type of trigeminal neuralgia, the pain experienced by the patient was of a constant burning nature. A clinical diagnosis of herpes zoster (shingles was made after smear confirmation from microbiological testing. The patient was commenced on antiviral treatment with acyclovir. His vesicular rash and pain gradually subsided over the next two weeks. He remains asymptomatic one year later. Conclusions Postoperative shingles precipitated by trigeminal nerve manipulation during surgery for trigeminal neuralgia can be a distressing and demoralizing experience for the patient. A careful preoperative history, early recognition, and prompt antiviral therapy is necessary.

  12. Posterior cranial fossa dimensions in the Chiari I malformation: relation to pathogenesis and clinical presentation

    Skull dimensions were measured on lateral skull radiographs in 33 adult patients with MRI-verified Chiari I malformations and in 40 controls. The posterior cranial fossa was significantly smaller and shallower in patients than in controls. In the patients, there was a positive correlation between posterior fossa size and the degree of the cerebellar ectopia, which might indicate that a posterior cranial fossa which was originally too small had been expanded by the herniation of hindbrain structures at an early stage. No special clinical presentation was associated with a very small posterior cranial fossa, which may indicate that a small posterior cranial per se has little or no clinical significance, although it may be the primary developmental anomaly. (orig./GD)

  13. Supratentorial Neurometabolic Alterations in Pediatric Survivors of Posterior Fossa Tumors

    Rueckriegel, Stefan M., E-mail: rueckriegel.s@nch.uni-wuerzburg.de [Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Driever, Pablo Hernaiz [Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Bruhn, Harald [Department of Radiology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Department of Radiology, Klinikum der Friedrich-Schiller-Universitaet, Erlanger (Germany)

    2012-03-01

    Purpose: Therapy and tumor-related effects such as hypoperfusion, internal hydrocephalus, chemotherapy, and irradiation lead to significant motor and cognitive sequelae in pediatric posterior fossa tumor survivors. A distinct proportion of those factors related to the resulting late effects is hitherto poorly understood. This study aimed at separating the effects of neurotoxic factors on central nervous system metabolism by using H-1 MR spectroscopy to quantify cerebral metabolite concentrations in these patients in comparison to those in age-matched healthy peers. Methods and Materials: Fifteen patients with World Health Organization (WHO) I pilocytic astrocytoma (PA) treated by resection only, 24 patients with WHO IV medulloblastoma (MB), who additionally received chemotherapy and craniospinal irradiation, and 43 healthy peers were investigated using single-volume H-1 MR spectroscopy of parietal white matter and gray matter. Results: Concentrations of N-acetylaspartate (NAA) were significantly decreased in white matter (p < 0.0001) and gray matter (p < 0.0001) of MB patients and in gray matter (p = 0.005) of PA patients, compared to healthy peers. Decreased creatine concentrations in parietal gray matter correlated significantly with older age at diagnosis in both patient groups (MB patients, p = 0.009, r = 0.52; PA patients, p = 0.006, r = 0.7). Longer time periods since diagnosis were associated with lower NAA levels in white matter of PA patients (p = 0.008, r = 0.66). Conclusions: Differently decreased NAA concentrations were observed in both PA and MB groups of posterior fossa tumor patients. We conclude that this reflects a disturbance of the neurometabolic steady state of normal-appearing brain tissue due to the tumor itself and to the impact of surgery in both patient groups. Further incremental decreases of metabolite concentrations in MB patients may point to additional harm caused by irradiation and chemotherapy. The stronger decrease of NAA in MB patients may correspond to the additional damage of combined irradiation and chemotherapy on neuroaxonal cell viability and number.

  14. The Radiological Spectrum of Orbital Pathologies that Involve the Lacrimal Gland and the Lacrimal Fossa

    Jung, Won Sang; Ahn, Kook Jin; Park, Mi Ra; KIM, Ji Young; Choi, Jae Jeong; Kim, Bum Soo; Hahn, Seong Tai

    2007-01-01

    CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. Although many diseases that affect the lacrimal gland and fossa are specifically diagnosed by imaging, it is frequently very difficult to differentiate each specific disease on the basis of image characteristics alone due to intrinsic similarities. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly wi...

  15. Condyle-fossa modifications and muscle interactions during Herbst treatment, Part 2. Results and conclusions.

    Voudouris, John C; Woodside, Donald G; Altuna, Gurkan; Angelopoulos, Gerassimos; Bourque, Paul J; Lacouture, Camilo Yamin; Kuftinec, Mladen M

    2003-07-01

    Herbst appliances were activated progressively in growing nonhuman primates, and the results were compared with primate and human controls. The methods and materials of this research are explained in Part 1 of this study. The results are discussed here in Part 2. All experimental subjects developed large super Class I malocclusions, the result of many factors including posterior movement of the maxilla and the maxillary teeth, an increased horizontal component of condylar growth, and anterior displacement of the mandible and the mandibular teeth. The growth modification measured in the glenoid fossa was in an inferior and anterior direction. Restriction of the downward and backward growth of the fossa observed in the control subjects might additionally contribute to the overall super Class I malocclusion. Clinically, these combined effects could be significant at the fossa. The restriction of local temporal bone (fossa) growth cannot be observed clinically; thus, these results might also clarify some Class II correction effects that cannot be explained with functional appliances. Differences in the area and maximum thickness of new bone formation in the glenoid fossa and in condylar growth were statistically significant. The bony changes in the condyle and the glenoid fossa were correlated with decreased postural electromyographic activity during the experimental period. Results from permanently implanted electromyographic sensors demonstrated that lateral pterygoid muscle hyperactivity was not associated with condyle-glenoid fossa growth modification with functional appliances, and that other factors, such as reciprocal stretch forces and subsequent transduction along the fibrocartilage between the displaced condyle and fossa, might play a more significant role in new bone formation. These results support the growth relativity concept. PMID:12867894

  16. Facial nerve neurinoma presenting as middle cranial fossa and cerebellopontine angle mass : a case report.

    Devi B

    2000-10-01

    Full Text Available Facial nerve neurinomas are rare. The tumours arising from the geniculate ganglion may grow anteriorly and superiorly and present as a mass in the middle cranial fossa. Only a few cases of facial nerve neurinomas presenting as middle cranial fossa mass have so far been reported. These tumours present with either long standing or intermittent facial palsy along with cerebellopontine angle syndrome.

  17. [Meningioma of the posterior fossa with extracranial expansion in a child: report of a case].

    de Moraes Júnior, L C; Wanderley, E C; Tamburus, W M; Haddad, F; de Andrade, A J

    1984-12-01

    A case of posterior fossa meningeoma with extracranial projection in a three years old female child is reported. The rarity of the process, its localization and the age group committed are emphasized. The radiological findings first suggesting an aneurismatic bone cyst like are commented. The surgical treatment with a posterior fossa approach and good results observed as well as the rarity of this pathology justify the report. PMID:6535559

  18. Traumatic Acute Subdural Hematoma Extending from the Posterior Cranial Fossa to the Cerebellopontine Angle

    Salih GULSEN; Sonmez, Erkin; Yilmaz, Cem; Nur ALTINORS

    2009-01-01

    Posterior cranial fossa subdural hematomas and extension of the subdural hematoma to the cerebellopontine angle is rarely seen and the concurrent development of acute peripheral facial palsy and the management strategy have not previously been reported in this pathology because of its rarity. We present this case to emphasize that minor head trauma may lead to a posterior cranial fossa hematoma extending to the cerebellopontine angle and cause peripheral facial palsy in patients using aspirin...

  19. Herpes Zoster Ophthalmicus Presenting as Acute Orbital Myositis Preceding a Skin Rash: A Case Report

    Herpes zoster ophthalmicus, in which orbital symptoms and signs appear before the onset of a skin rash, is very rare. We experienced such a case and therefore report on it via magnetic resonance imaging. A 48-year-old man with pain and swelling of left eye and headache presented 2 days before onset of a zoster skin rash. On orbit-al MRI, edematous thickening of the left lateral rectus muscle with high signal intensity was revealed. After contrast injection, the lateral rectus muscle demonstrated heterogenous enhancement. Also, diffuse contrast enhancement was noted at left preseptal space, lacrimal gland and periorbital soft tissue. The man was treated with antiviral agents and prednisolone. Two weeks later, he recovered from the skin manifestations and most of the orbital manifestations except for the diplopia and restricted lateral movement.

  20. Intravenous immunoglobulin in the treatment of drug rash eosinophilia and systemic symptoms caused by phenytoin

    Ponnusamy Santhamoorthy

    2012-01-01

    Full Text Available A 32 year old Asian female on 300 mg per day of phenytoin following meningioma excision developed a fever with a diffuse maculopapular rash, lymphadenopathy and splenomegaly after12 days. A diagnosis of DRESS (Drug Rash Eosinophilia and Systemic Symptoms syndrome was made. Patient was started on prednisolone at a dose of 1 mg/kg but since there was further deterioration in her condition, intravenous immunoglobulin was started. Clinical and blood parameters began to improve by the next day with liver functions returning to normal by the third week. DRESS syndrome is a drug hypersensitivity syndrome which can be fatal and therefore needs to be recognized early for the appropriate treatment to be started. The use of Intravenous immunoglobulins is anecdotal and the dramatic improvement noted in this case indicates that it is another treatment choice. The case and a brief review of the literature are discussed.

  1. Herpes Zoster Ophthalmicus Presenting as Acute Orbital Myositis Preceding a Skin Rash: A Case Report

    Oh, Ha Yeun; Cho, Seong Whi [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of); Kim, Sung Hun [Dept. of Neurology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2012-03-15

    Herpes zoster ophthalmicus, in which orbital symptoms and signs appear before the onset of a skin rash, is very rare. We experienced such a case and therefore report on it via magnetic resonance imaging. A 48-year-old man with pain and swelling of left eye and headache presented 2 days before onset of a zoster skin rash. On orbit-al MRI, edematous thickening of the left lateral rectus muscle with high signal intensity was revealed. After contrast injection, the lateral rectus muscle demonstrated heterogenous enhancement. Also, diffuse contrast enhancement was noted at left preseptal space, lacrimal gland and periorbital soft tissue. The man was treated with antiviral agents and prednisolone. Two weeks later, he recovered from the skin manifestations and most of the orbital manifestations except for the diplopia and restricted lateral movement.

  2. Cushingoid Syndrome Following of Local Steroid Administration for Diaper Rash; A Case Report

    Z Haghshenas

    2006-06-01

    Full Text Available Objective: Prolonged exogenous administration of ACTH or hydrocortisone or its analogs results in a clinical pattern identical to the spontaneous disorder and is frequently referred to as Cushingoid syndrome. This syndrome is generally reported as a result of oral or parenteral steroids administration. Case Report: Our report presents a five-month old baby with typical Cushingoid changes following local steroid application due to diaper rash. Clobetasol was used for diaper rash, but had not used systemic corticosteroid. Serum Cortical and ACTH was very low and no detectable. After discontinuation of local steroid, Skin complication recovered gradually and after 5 months, completely. Conclusion: Local corticosteroids may be high absorption and cause systemic complication such as Adrenal insufficiency and cushingoid syndrome.

  3. Protuberance or fossa on the lateral surface of the mandible in primates.

    Kondo, Shintaro; Naitoh, Munetaka; Matsuno, Masanobu; Kanazawa, Eisaku; Takai, Masanaru

    2016-01-01

    In order to clarify the morphological characteristics and function of the protuberance and/or fossa on the lateral surface of the mandible, we examined 778 mandibles of 9 genera, 19 species of non-human primates. Both protuberance and fossa were found in Macaca, Chlorocebus, and Cercocebus at frequencies ranging from 0% to 60%. The protuberance was composed of compact bone and was similar to the mandibular torus in humans. A well-developed protuberance extended from the fourth premolar to third molar region, and was situated at the central part of the mandibular body, or continued on the oblique line. Sometimes the protuberance localized on the mandibular base. A deep and large fossa was found in all individuals of Papio, Theropithecus, and Mandrillus, and the bone width was thin in the center of the fossa. The fossa extended from the third premolar to the second molar region, and the deepest area was the first molar region. In Macaca, Chlorocebus, and Cercocebus, the curvature of the external table of the mandible created a fossa. In Colobus, and Hylobates, the external surface of the mandible looked concave because of the thickened mandibular base. These concavo-convex structures have some biological functions and represent an adaptive change for mastication. PMID:25817174

  4. MRI tight posterior fossa sign for prenatal diagnosis of Chiari type II malformation

    Chiari type II malformation (CMII) is one of three hindbrain malformations that display hydrocephalus. We have observed that cerebrospinal fluid (CSF) signal in the posterior fossa, which is always apparent on normal fetal MR images, is not visible in a fetus with CMII. We use the term 'tight posterior fossa' for this MR imaging finding, and evaluate the diagnostic value of this finding on fetal MR images. Included in the study were 21 fetuses which underwent brain MR imaging at 1.5 T using two-dimensional balanced turbo-field-echo (2-D balanced-TFE) in the axial and sagittal planes. Postnatal diagnoses were CMII (n=5), CNS abnormalities other than CMII (n=8), and no abnormality (n=8). A tight posterior fossa was defined as an absent or slit-like water signal space around the hindbrain in the posterior fossa on both sagittal and axial MR images. All CMII fetuses displayed a tight posterior fossa on MR images. Hydrocephalus was visualized in all CMII fetuses and myelomeningocele in four fetuses, but hindbrain herniation was visualized only in two of five fetuses. The CSF signal surrounding the hindbrain was clearly visible in all the other 16 fetuses, including five with hydrocephalus not associated with CMII, although it was slightly narrower in a fetus with a cloverleaf skull than in the normal fetuses. Tight posterior fossa in the presence of hydrocephalus is a useful and characteristic finding of CMII on fetal MRI. (orig.)

  5. Paradoxical bronchospasm and cutaneous rash after metered-dose inhaled bronchodilators.

    Facchini, G; Antonicelli, L; Cinti, B; Bonifazi, F; Massei, V

    1996-06-01

    The authors describe a case of paradoxical bronchospasm with laryngospasm and cutaneous rash occurring in an asthmatic woman after the use, via metered-dose inhaler, of different bronchodilators containing soy-derived excipients. It is noteworthy that the patient was not affected by soy allergy. After a short review of the relevant literature, the authors consider the possible aetiopathogenetic factors and outline the importance of this rare adverse reaction in the care of asthmatic patients. PMID:8766194

  6. Carbamazepine-induced hepato-splenomegaly with erythematous rashes in a child

    Mittal, A.; Das, S.

    2012-01-01

    Carbamazepine is an antiepileptic drug. In clinical trials the total incidence of reported adverse reaction to this drug is 4.5 per million at defined daily doses, corresponding to 2.7 per million at prescribed daily doses. Among the adverse reactions of carbamazepine, most often reported are skin reactions (48%), hematological (14%), hepatic disorder (10%). Herein, we present a case with erythematous skin rashes and hepato-splenomegaly.

  7. Quality of life in children survivors of posterior fossa tumors

    We have created a numerical scale in order to measure the Quality of Life in children survivors of posterior fossa tumors. We evaluated the long-term sequelae in 39 patients seen during a 20 year period, with a medium follow-up of 9 years. They were 25 Cerebelar Astrocytoma (CA), 6 Medulloblastoma (MDB), 5 Brain-Stem Glioma (BSG) and 3 Ependymoma of IV ventricle (EPD). Sixty-six per cent of children showed neurologic and/or visual sequelae (Bloom's levels I-II in 66%). Psychointellectual dysfunctions were identified in 44%, with an IQ<90 in 39%. Endocrine disorders were found in 26%. Quality of Life (QL) was measured with our Scale, finding that 19 patients (49%) have a good or acceptable QL, eight (20%) a moderate QL that can be acceptable with adequate rehabilitation, and the remaining 12 (36%) a bad QL that can be improved slightly. Unfavorable outcomes were related to age less than 4 years at diagnosis, type of tumor (MDB, EPD, BSG), incomplete tumoral resection, and use of radiotherapy and/or chemotherapy. We consider that our scale is complete and adequate to measure the QL of children survivors of CNS tumors. (Author) 55 refs

  8. Middle cranial fossa anatomy and the origin of modern humans.

    Bastir, Markus; Rosas, Antonio; Lieberman, Daniel E; O'Higgins, Paul

    2008-02-01

    Anatomically, modern humans differ from archaic forms in possessing a globular neurocranium and a retracted face and in cognitive functions, many of which are associated with the temporal lobes. The middle cranial fossa (MCF) interacts during growth and development with the temporal lobes, the midface, and the mandible. It has been proposed that evolutionary transformations of the MCF (perhaps from modification of the temporal lobes) can have substantial influences on craniofacial morphology. Here, we use three-dimensional (3D) geometric morphometrics and computer reconstructions of computed tomography-scanned fossil hominids, fossil and recent modern humans and chimpanzees to address this issue further. Mean comparisons and permutation analyses of scaled 3D basicranial landmarks confirm that the MCF of Homo sapiens is highly significantly different (P heidelbergensis, and Pan troglodytes. Modern humans have a unique configuration with relatively more anterolateral projection of the MCF pole relative to the optic chiasm and the foramen rotundum. These findings are discussed in the context of evolutionary changes in craniofacial morphology and the origins of modern human autapomorphies. In particular, the findings of this study point to variations in the temporal lobe, which, through effects on the MCF and face, are central to the evolution of modern human facial form. PMID:18213701

  9. The results of radiosurgical management of 72 middle fossa meningiomas

    Of 812 patients with intracranial tumours treated by radiosurgery during the period 1984-1990, 129 had meningiomas. Of these latter, 72 had middle fossa meningiomas. Patients with meningiomas treated by us since March 1990 are not included in this report since we established the investigative principle of a minimum of 30 months follow-up. Seventeen of the 72 patients were treated after incomplete surgical resection, and 21 for tumour regrowth. In 34 patients, radiosurgery was the primary treatment. The tumour was calculated by the ellipsoid method. It ranged from 0.588-76.346ml. Radiosurgery was performed using the non-invasive stereotactic fixation head device (Greitz-Bergstroem) adapted to the Fixster frame, and dynamic irradiation performed with the linear accelerator, using especially designed collimators. The total tumour dose for each patient ranged from 15-45Gy. The minimum follow-up was 2.5 years and the maximum 8 years. In 50 patients there was tumour shrinkage ranging from 24-91% of the initial tumour volume. Shrinkage was associated with central tumour necrosis in 11 of these 50 patients. In 18 patients the tumour volume remained stable. In 2 patients there was tumour progression and in 2 there was regrowth after initial reduction of tumour volume. There were no significant treatment complications. Radiosurgery is preferable to re-operation in recurrent meningiomas and indicated after incomplete surgical removal. In high risk patients, as well as in 'unresectable' meningiomas, it is an obvious alternative to microsurgery. (authors)

  10. The management of right iliac fossa pain - is timing everything?

    McCartan, D P

    2012-01-31

    BACKGROUND: Right iliac fossa (RIF) pain remains the commonest clinical dilemma encountered by general surgeons. We prospectively audited the management of acute RIF pain, examining the relationship between symptom duration, use of pre-operative radiological imaging and patient outcome. METHODS: Over a six-month period, 302 patients, median age 18 years, 59% female, were admitted with RIF pain. Symptoms, clinical findings and laboratory results were documented. Patient management, timing of radiological investigations and operations, and outcome were recorded prospectively. RESULTS: Non-specific abdominal pain (26%), gynaecological (22%) and miscellaneous causes (14%) accounted for most admissions. Ultimately, 119 patients (39%) had appendicitis. Anorexia, tachycardia or rebound tenderness in the RIF significantly predicted a final diagnosis of appendicitis. Patients with perforated appendicitis (n = 29) had a longer duration of pre-hospital symptoms (median 50h) compared to those with simple appendicitis (median 17 h) (p<0.001). The use of pre-operative imaging resulted in an increased time to surgery but was not associated with increased post-operative morbidity or perforated appendicitis. CONCLUSION: The majority of patients presenting to hospital with RIF pain did not have appendicitis. Increased duration of pre-hospital symptoms was the main factor associated with perforated appendicitis. However, increased in-hospital time to theatre was not associated with perforated appendicitis or post-operative morbidity.

  11. Two family members with a syndrome of headache and rash caused by human parvovirus B19

    Antonio Carlos M. Pereira

    2001-02-01

    Full Text Available Human parvovirus B19 infection can cause erythema infectiosum (EI and several other clinical presentations. Central nervous system (CNS involvement is rare, and only a few reports of encephalitis and aseptic meningitis have been published. Here, we describe 2 cases of B19 infection in a family presenting different clinical features. A 30 year old female with a 7-day history of headache, malaise, myalgias, joint pains, and rash was seen. Physical examination revealed a maculopapular rash on the patient's body, and arthritis of the hands. She completely recovered in 1 week. Two days before, her 6 year old son had been admitted to a clinic with a 1-day history of fever, headache, abdominal pain and vomiting. On admission, he was alert, and physical examination revealed neck stiffness, Kerning and Brudzinski signs, and a petechial rash on his trunk and extremities. Cerebrospinal fluid analysis was normal. He completely recovered in 5 days. Acute and convalescent sera of both patients were positive for specific IgM antibody to B19. Human parvovirus B19 should be considered in the differential diagnosis of aseptic meningitis, particularly during outbreaks of erythema infectiosum. The disease may mimic meningococcemia and bacterial meningitis.

  12. First case of drug rash eosinophilia and systemic symptoms due to boceprevir.

    Samain, Agnès; Duval-Modeste, Anne-Bénédicte; Joly, Pascal; Leblanc, Céline; Massy, Nathalie; Courville, Philippe; Goria, Odile; Riachi, Ghassan

    2014-04-01

    Boceprevir and telaprevir are 2 specific inhibitors of the hepatitis C (HCV) serine protease 3. Cutaneous side effects have been reported with high frequency, essentially rash, and dry skin. We report a case of drug rash with eosinophilia and systemic symptoms (DRESS) due to boceprevir. A 56-year-old African woman with chronic hepatitis C complicated with cirrhosis and cryoglobulinemia received pegylated interferon alfa-2a (PegIFN) and ribavirin (RBV) for 4 weeks and then boceprevir was added. She was also co-infected with HIV state A2. Eight weeks after adding boceprevir she developed a generalized maculopapular exanthema with fever, facial oedema, apparition of lymph node and alteration of the general state. She presented an eosinophilia (up to 3.0 × 10(9)cells/L), no biological inflammatory syndrome. The computed tomography revealed several lymph nodes located in the abdominal and inguinal areas. The cutaneous biopsy was consistent with a drug rash reaction. The HCV treatment was stopped and the patient was treated with topical steroids. Cutaneous and systemic symptoms disappeared in few weeks. Boceprevir was considered the culprit drug. We report to our knowledge the first case of DRESS due to boceprevir. PMID:24333861

  13. Diaper Rash

    ... Notice This Site and third parties who place advertisements on this Site may collect and use information ... Site and other websites in order to provide advertisements about goods and services of interest to you. ...

  14. Red Rash.

    Banting, Joshua; Meriano, Tony

    2016-01-01

    The series objective is to review various clinical conditions/ presentations, including the latest evidence on management, and to dispel common myths. In the process, core knowledge and management principles are enhanced. A clinical case will be presented. Cases will be drawn from real life but phrased in a context that is applicable to the Special Operations Forces (SOF) or tactical emergency medical support (TEMS) environment. Details will be presented in such a way that the reader can follow along and identify how they would manage the case clinically depending on their experience and environment situation. Commentary will be provided by currently serving military medical technicians. The medics and author will draw on their SOF experience to communicate relevant clinical concepts pertinent to different operational environments including SOF and TEMS. Commentary and input from active special operations medical technicians will be part of the feature. PMID:27045501

  15. Analysis of sebum lipid composition and the development of acneiform rash before and after administration of egfr inhibitor

    Nakahara, T; Moroi, Y.; Takayama, K.; Y Nakanishi; M Furue

    2015-01-01

    Treatment with an epidermal growth factor receptor inhibitor (egfri) in patients having non-small-cell lung cancer can cause frequent and diverse skin toxicities, an acneiform rash being one of the commonest. Although the exact pathophysiology of this rash and its development mechanisms remain unknown, investigators have noted that egfri-induced skin toxicity might be partly associated with sebaceous gland function. Sebum is composed mainly of the lipids squalene (sq), wax ester (we), triglyc...

  16. Analysis of sebum lipid composition and the development of acneiform rash before and after administration of egfr inhibitor.

    Nakahara, T; Moroi, Y; Takayama, K; Nakanishi, Y; Furue, M

    2015-04-01

    Treatment with an epidermal growth factor receptor inhibitor (egfri) in patients having non-small-cell lung cancer can cause frequent and diverse skin toxicities, an acneiform rash being one of the commonest. Although the exact pathophysiology of this rash and its development mechanisms remain unknown, investigators have noted that egfri-induced skin toxicity might be partly associated with sebaceous gland function. Sebum is composed mainly of the lipids squalene (sq), wax ester (we), triglyceride, free fatty acid, and cholesterol, which are secreted mostly from the sebaceous glands and by keratinocytes. We therefore investigated the lipid composition of sebum before and after administration of egfri and whether sebum composition was associated with the development of acneiform rash. To investigate any associated changes in sebum gland activity, we focused especially on alterations in the amounts of sq and we, which are secreted solely from the sebaceous glands. In contrast to our expectations, we observed no substantial changes in the lipid composition of sebum before and after administration of egfri. Composition varies with the individual; however, the proportion of sq and we derived from the sebaceous glands was significantly lower in regions that did not develop acneiform rash than in regions that did. Our results suggest that development of an acneiform rash after administration of egfri could be related to sebaceous gland activity. Measurement of the lipid composition of sebum before therapy with egfri might predict which patients will be prone to acneiform rash. PMID:25908917

  17. Malignant melanoma of nasal fossae, a propos of a case

    Gómez-González JL

    2012-07-01

    Full Text Available Introduction: The melanoma of the nasal fossae represents a 4% of all sinonasal malignant tumors. The symptoms are unspecific, thus delaying diagnosis. We present a case of a woman of 80 years of age. She has hypertension and a degenerative heart disease, and presents nasal respiratory insufficiency, left otalgia and epistaxis of 8 months of evolution. Examination revealed a dark, polypoidal, fleshy mass. The CT revealed a mass that occupied that space, without bone erosion. A biopsy of the mass revealed that it was an amelanotic melanoma. Due to the age of the patient and her general pathology, endoscopic sinonasal surgery was applied. The pathological anatomic analysis confirmed that it was a malignant round cell melanoma with the following phenotype: positive for Vimentin, positive for nuclear S-100, focal positive for HMB-45, negative, melan A+ negative for HMB-45 with heterogeneous intensity, and negative for ENE and ALC. The patient did not present symptoms until a year later, when she discovered a small laterocervical adenopathy. A FNAP confirmed that the melanoma had metastatized. The patient underwent a radical neck dissection and remained 15 months without symptoms. She is currently going through monthly revisions. Discussion: The treatment of choice is surgery. Selective neck dissection is not justified. This tumor is radioresistant. Active immunotherapy (a combination of Interferon and Cimetidine and targeted chemotherapy have also been used, mainly in inoperable cases. Five-year survival ranges between 6.5% and 34%.Conclusion: We propose endoscopic surgery for non-infiltrating tumors or for patients who cannot undergo very aggressive surgery due to their general condition.

  18. Congenital cholesteatoma of the infratemporal fossa with congenital aural atresia and mastoiditis: a case report

    Abdel-Aziz Mosaad

    2012-06-01

    Full Text Available Abstract Background Congenital cholesteatoma may be expected in abnormally developed ear, it may cause bony erosion of the middle ear cleft and extend to the infratemporal fossa. We present the first case of congenital cholesteatoma of the infratemporal fossa in a patient with congenital aural atresia that has been complicated with acute mastoiditis. Case presentation A sixteen year old Egyptian male patient presented with congenital cholesteatoma of the infratemporal fossa with congenital aural atresia complicated with acute mastoiditis. Two weeks earlier, the patient suffered pain necessitating hospital admission, magnetic resonance imaging revealed a soft tissue mass in the right infratemporal fossa. On presentation to our institute, Computerized tomography was done as a routine, it proved the diagnosis of mastoiditis, pure tone audiometry showed an air-bone gap of 60 dB. Cortical mastoidectomy was done for treatment of mastoiditis, removal of congenital cholesteatoma was carried out with reconstruction of external auditory canal. Follow-up of the patient for 2 years and 3 months showed a patent, infection free external auditory canal with an air-bone gap has been reduced to 35db. One year after the operation; MRI was done and it showed no residual or recurrent cholesteatoma. Conclusions Congenital cholesteatoma of the infratemporal fossa in cases of congenital aural atresia can be managed safely even if it was associated with mastoiditis. It is an original case report of interest to the speciality of otolaryngology.

  19. Acute posterior fossa epidural hematoma in a newborn infant with Menkes disease.

    Takeuchi, Satoru; Horikawa, Masahiro; Wakamatsu, Hajime; Hashimoto, Jyunya; Nawashiro, Hiroshi

    2014-02-01

    Epidural hematoma (EDH) in newborn infants is rare compared with other types of intracranial hemorrhages. Furthermore, posterior fossa EDH is extremely rare. We present a case of posterior fossa EDH in an infant with Menkes disease with accessory bones in the occiput. A male infant with a condition diagnosed with Menkes disease by prenatal testing was born at 39 weeks via vacuum extraction. The patient presented with a mild tremor at 2 days after delivery. A brain computed tomography (CT) scan showed an acute EDH in the posterior fossa, extending into the occipitoparietal area. Three-dimensional CT and bone window CT scan revealed several accessory bones, diastasis of 1 accessory suture, a communicated fracture, and a linear fracture in the occipital bone. Furthermore, a bone fragment from a communicated fracture displaced toward the inside. The patient was treated conservatively for EDH because of his good general condition. The hematoma gradually resolved, and his tremor did not recur. We suggest the following mechanism of posterior fossa EDH development in our patient: (1) external force was applied to the occiput inside the birth canal during delivery, resulting in diastasis; (2) a communicated fracture occurred, and a bone fragment displaced toward the inside (linear fracture was caused indirectly by the force); (3) a transverse sinus was injured by the fragment; and (4) EDH developed in both the posterior fossa and supratentorial region. Copper deficiency can also cause fragility of connective tissues, vessels, and bones. PMID:24488163

  20. Clinical and Laboratory evaluation of measleslike rash in children and young adults

    Stewien Klaus Eberhard; Lima Lourdes Rehder de Andrade Vaz de; Botosso Viviane Fongaro; Oliveira Maria Isabel de; Fagundes Simone N.; Nogueira Meri B.; Ragazzi Selma Lopes Betta; Costa Maria Tereza Zuluni da; Ejzenberg Bernardo; Durigon Edison Luiz

    2000-01-01

    A clinical and laboratory evaluation of 11 children and young adults with measleslike rash was done during the measles outbreak in the Greater São Paulo Metropolitan area at the end of 1996 and spread over the country during 1997. Measles was laboratory confirmed in 07 patients by specific IgM detection in acute serum specimens using an IgM-capture EIA, by specific IgG seroconversion in serum pairs, and by reverse transcription PCR and virus isolation in peripheral blood lymphocytes. Clinical...

  1. Evaluation of patch test in identification of causative agent in drug rashes due to antiepileptics

    Vatve Maneesha

    2000-01-01

    Full Text Available Patch test was evaluated for the identification of causative agent in cutaneous eruptions due to antiepileptics. Patch tests were carried out in twenty patients and ten controls with carbamazepine, phenytoin sodium, phenobarbitone and sodium valproate. Sodium valproate was found tobe irritant in 1 and 5% concentration and further dilution is recommended for patch testing. Patch test was positive in 14 (70% patients and in 7 with suspected drug alone, and remaining 7 were positive with more than one antiepileptic drug. We recommended patch test for identification of causative drug in rashes due to antiepileptics.

  2. Concomitant boost radiotherapy for squamous carcinoma of the tonsillar fossa

    Purpose: To assess the efficacy of a concomitant boost fractionation schedule of radiotherapy for treating patients with squamous carcinoma of the tonsillar fossa. Patients and Methods: Between December 1983 and November 1992, 83 patients with squamous carcinoma of the tonsil were treated with concomitant boost fractionation. The distribution of American Joint Committee on Cancer T stages was TX-4, T1-5, T2-29, T3-41, T4-4; N stages were NX-1, N0-26, N1-13, N2-31, N3-12. Patients were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment consisted of a second daily 1.5 Gy fraction for 10-12 fractions, usually delivered during the final phase of treatment. The tumor dose was 69-72 Gy, given over 6 weeks. Twenty-one patients, who all had N2 or N3 regional disease, underwent neck dissections, either before (13 patients) or 6 weeks after radiotherapy (8 patients); the other patients were treated with radiotherapy alone. Results: The 5-year actuarial disease-specific survival and overall survival rates were 71 and 60%, respectively. Patients with T2 and T3 primary tumors had 5-year actuarial local control rates of 96 and 78%, respectively. Patients with T3 disease who received the final-phase boost had a 5-year actuarial local control rate of 82%. Actuarial 5-year regional disease control rates were N0, 92%; N1, 76%; N2, 89%; and N3, 89%. The 21 patients who had neck dissections all had their disease regionally controlled. Patients presenting with nodal disease or after a node excision who were treated with radiation alone had a 5-year actuarial regional disease control rate of 79%. All but five patients had confluent Grade 4 mucositis during treatment. Severe late complications attributable to radiation included mandibular necrosis, in-field osteosarcoma, and chronic dysphagia for solid foods. Conclusions: High rates of local and regional disease control were achieved with the concomitant boost fractionation schedule, with few cases of severe late morbidity. Patients with N2 and N3 neck disease were effectively treated with radiation and the selective use of neck dissections. The concomitant boost schedule is our preferred fractionation approach for treating patients with intermediate stage tonsil cancer who are not participating in our current research protocols

  3. Clival osteomyelitis resulting from spread of infection through the fossa navicularis magna in a child

    The fossa navicularis is a notch-like bone defect in the basiocciput that has been hitherto considered as an anatomical variant of the clivus and not previously described as a potential source of clival or skull base pathology. We report the imaging findings in a 5-year-old child who presented acutely with a retropharyngeal abscess and osteomyelitis of the clivus. Imaging after treatment revealed a ''notch-like'' defect in the anterior clivus consistent with a fossa navicularis. Based on these appearances, we postulate that the lymphoid tissue of the pharyngeal tonsil residing in the fossa navicularis served as a route through which infection spread and subsequently developed into clival osteomyelitis, which is a rare diagnosis. This case is unique, and we believe that the presence of this variant in young children may be important and is not merely an anatomical curiosity. (orig.)

  4. Hydrothermal formation of Clay-Carbonate alteration assemblages in the Nili Fossae region of Mars

    Brown, Adrian J; Baldridge, Alice M; Crowley, James K; Bridges, Nathan T; Thomson, Bradley J; Marion, Giles M; Filho, Carlos R de Souza; Bishop, Janice L

    2014-01-01

    The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) has returned observations of the Nili Fossae region indicating the presence of Mg- carbonate in small (<10km sq2), relatively bright rock units that are commonly fractured (Ehlmann et al., 2008b). We have analyzed spectra from CRISM images and used co-located HiRISE images in order to further characterize these carbonate-bearing units. We applied absorption band mapping techniques to investigate a range of possible phyllosilicate and carbonate minerals that could be present in the Nili Fossae region. We also describe a clay-carbonate hydrothermal alteration mineral assemblage in the Archean Warrawoona Group of Western Australia that is a potential Earth analog to the Nili Fossae carbonate-bearing rock units. We discuss the geological and biological implications for hydrothermal processes on Noachian Mars.

  5. CT evaluation of tumorous lesion extending in and into the infratemporal fossa

    Twenty patients with tumorous lesions extending in and into the infratemporal fossa were examined by CT at the Department of Dental Radiology, Kyusyu University Dental Hospital during the period from March, 1985 to September, 1988. They ranged in age from 6 to 75 years (mean, 52.7 years). Eleven were males. CT images of these patients were analyzed in detail and the results include: CT appearances of extension in and into the infratemporal fossa were classified into four types according to the primary site. Further, in cases of tumors originating in the oral cavity the appearances were subclassified into three types. In 17 of 20 patients (85%), bone involvement adjacent to the infratemporal fossa was detected by CT. The changes on CT images were considered to reflect clinical signs, such as trismus and sensory changes involving the fifth nerve (the second and the third division) and others. (author)

  6. The Radiological Spectrum of Orbital Pathologies that Involve the Lacrimal Gland and the Lacrimal Fossa

    Jung, Won Sang; Ahn, Kook Jin; Park, Mi Ra; Kim, Ji Young; Choi, Jae Jeong; Kim, Bum Soo; Hahn, Seong Tai [Catholic University College of Medicine, Seoul (Korea, Republic of)

    2007-08-15

    CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly with a well defined benign appearance, and a malignant adenoid cystic carcinoma is seen with a typical invasive malignant appearance. However, a malignant myoepithelial carcinoma is seen with a benign looking appearance. Lymphomatous lesions of the lacrimal gland include a broad spectrum ranging from reactive hyperplasia to malignant lymphoma. These lesions can be very difficult to differentiate both radiologically and pathologically. Generally, lymphomas tend to occur in older patients. The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a nonenhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass. However, masses of granulocytic sarcoma and xanthogranuloma, as well as vascular masses, such as a hemangiopericytoma, are difficult to diagnose correctly on the basis of preoperative imaging findings alone. Clinically, the lesions of the lacrimal gland and fossa are found as palpable masses in the superior lateral aspect of the orbit, and these lesions constitute about 5-13% of all of the orbital masses confirmed by biopsy. Many different pathological entities arise from the lacrimal gland and fossa, and as each of them requires a different therapeutic approach, the radiological characterization of each lesion is important. Approximately, half of the lacrimal gland masses are tumors of epithelial origin and the rest are lesions that arise from lymphoid or inflammatory diseases. Pseudotumors, metastatic masses and developmental cysts may also occur in the lacrimal fossa. This paper aims to discuss the radiologic findings of the lesions that are found in the lacrimal gland and fossa, and to aid physicians in the differential diagnoses of these various diseases.

  7. Anatomical relation between anterior ethmoidal sinus and lacrimal sac fossa on high resolution CT

    To evaluate the anatomical relation between anterior ethmoidal sinus and the lacrimal sac fossa, and thus help prevent complications during dacryocystorhinostomy. Fifty three people without previous history of trauma, surgery, or paranasal sinus disease were randomly selected, and the 106 lacrimal sac fossas of these subjects were evaluated by high resolution CT. A series of three 2-mm thick axial sections at least 2mm from the inferior orbital wall were obtained. The bony landmarks of the lacrimal sac fossa were established and the location of the most anterior ethmoid sinus was classified as one of three types. In type 1, no sinuses were anterior to the posterior lacrimal crest. While in type 2, sinuses extended anterior to this crest but remained behind the suture at the anterior edge of the lacrimal bone. In type 3, sinuses extended into the frontal process of the maxilla, anterior to the lacrimal bone suture. In addition, the category of both orbits of the same patient was compared. Among the 106 orbits examined, only seven (6.6%) were classified as type 1, with no ethmoid air cells postioned under the lacrimal sac fossa. Seventy six (71.7%) qualified as type 2, while the remaining 23 (21.7%) were type 3, demonstration anterior ethmoid air cells within the nasal process of the maxilla. The position of the air cells was symmetric in 41 of the 53 subjects (77.4%) and asymmetric in 12 (22.6%). In cases involving surgery of the lacrimal sac fossa, such as dacryocystorhinostomy, a knowledge of the consistent anatomic relationship between the anterior ethmoidal sinus and the lacrimal sac fossa is invaluable

  8. Evaluation of linear tomography accuracy in localization of nasal fossa and maxillary sinus

    Talaeipour AR.

    2007-07-01

    Full Text Available Background and Aim: Accurate measurement of bone height and width is essential prior to dental implant placement. The method of surgery as well as, the type and size of implants are determined according to dimensions of the residual bone. The purpose of this study was to evaluate the accuracy of linear tomography in localization of the floor of nasal fossa and maxillary sinus, and to determine the width of maxillary bone at the designated site for implant placement.Materials and Methods: In this test evaluation study, the vertical distances between the alveolar crest and the floor of nasal fossa and the floor of maxillary sinus was measured by the tomographic slices in 12 sites of three dry human skulls. In addition, the width of maxillary bone was measured at the same slices. The skulls were then sectioned through the marked places. Then the radiographic values were compared with the real values of bone sections.Results: After correction of tomographic values by the magnification factor of the unit, the mean absolute measurement error for vertical values at nasal fossa and maxillary sinus area in tomographic slices were 0.28 mm (SD= 0.24 and 1.1 mm (SD= 0.68 respectively. The mean absolute measurement error for maxillary width at the nasal fossa and maxillary sinus area were 0.65 mm (SD= 0.50 and 0.55 mm (SD= 0.45 respectively. 100 % of vertical values at nasal fossa area and 50 % of vertical values at maxillary sinus area were within ± 1 mm error limit. In addition, 50 % of width measurements at nasal fossa area and 83.3 % at maxillary sinus area were within ± 1 mm error limit.Conclusion: The linear tomography is more accurate in height estimation at nasal fossa area and in width estimation at maxillary sinus area. The accuracy of linear tomography in height and width estimation is within acceptable limits at both nasal fossa and maxillary sinus area.

  9. Unilateral abducens and bilateral facial nerve palsies associated with posterior fossa exploration surgery

    Khalil, Ayman; Clerkin, James; Mandiwanza, Tafadzwa; Green, Sandra; Javadpour, Mohsen

    2016-01-01

    Multiple cranial nerves palsies following a posterior fossa exploration confined to an extradural compartment is a rare clinical presentation. This case report describes a young man who developed a unilateral abducens and bilateral facial nerve palsies following a posterior fossa exploration confined to an extradural compartment. There are different theories to explain this presentation, but the exact mechanism remains unclear. We propose that this patient cranial nerve palsies developed following cerebrospinal fluid (CSF) leak, potentially as a consequence of rapid change in CSF dynamics.

  10. Spinal subdural haematoma mimicking tethered cord after posterior fossa open surgery

    We report the MRI findings in a girl aged 3 years and 10 months who developed a spinal subdural haematoma after posterior fossa open surgery for cerebellar malignant rhabdoid tumour. Emergency surgery was performed immediately because of increased intracranial pressure. Control MRI 48 h after surgery showed a spinal subdural haematoma without clinical signs of paresis or bladder dysfunction. Spinal subdural haematoma is rare, and only few cases have been reported, especially in children. This report suggests that ''silent'' (without clinical symptoms) postoperative spinal acute subdural haemorrhage can occur after posterior fossa surgery. (orig.)

  11. Unilateral abducens and bilateral facial nerve palsies associated with posterior fossa exploration surgery.

    Khalil, Ayman; Clerkin, James; Mandiwanza, Tafadzwa; Green, Sandra; Javadpour, Mohsen

    2016-01-01

    Multiple cranial nerves palsies following a posterior fossa exploration confined to an extradural compartment is a rare clinical presentation. This case report describes a young man who developed a unilateral abducens and bilateral facial nerve palsies following a posterior fossa exploration confined to an extradural compartment. There are different theories to explain this presentation, but the exact mechanism remains unclear. We propose that this patient cranial nerve palsies developed following cerebrospinal fluid (CSF) leak, potentially as a consequence of rapid change in CSF dynamics. PMID:26951144

  12. Computed tomographic evaluation due to ruptured intracranial aneurysms in the posterior fossa

    From April, 1978 through December, 1984, computed tomographic (CT) findings were carefully examined in 34 cases of initial subarachnoid bleeding due to a single ruptured aneurysm in the posterior fossa. All of the patients were hospitalized within 3 days of the onset of symptoms. High-density areas, which indicate the presence of subarachnoid clots, were evaluated in the interhemispheric and Sylvian fissures and the interpeduncular, prepontine, ambient, and quadrigeminal cisterns. The CT data suggest that hematomas in the four cisterns are thicker than those in the supratentorial subarachnoid spaces. Only one patient had an intracerebral hematoma. Hydrocephalus accompanied aneurysms of the posterior fossa more frequently than those of the anterior circulation. (author)

  13. Prophylactic supraclavicular fossa radiotherapy in early breast cancer: is it worthwhile?

    A total of 291 consecutive patients with early breast cancer who did not receive any supraclavicular prophylactic irradiation of the ipsilateral fossa have been followed for a minimum of 5 years. Isolated relapse in that site occurred in 4.5% of patients and was controlled by radical radiotherapy with a post-relapse 5-year survival of 33%. Relapse with co-existing distant metastases occurred in a further 7% and no patient survived to 3 years. Supraclavicular fossa irradiation contributes to morbidity, does not improve survival and should be abandoned in favour of delayed treatment for proven recurrence. (author)

  14. Magnetic resonance imaging textural evaluation of posterior cranial fossa tumors in childhood; Avaliacao textural por ressonancia magnetica dos tumores da fossa posterior em criancas

    Santos, Joelson Alves dos; Costa, Maria Olivia Rodrigues da; Otaduy, Maria Concepcion Garcia; Lacerda, Maria Teresa Carvalho de; Leite, Claudia da Costa [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: joelson_alves@ig.com.br; Matsushita, Hamilton [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Neurologia

    2004-08-01

    Objective: To distinguish healthy from pathological tissues in pediatric patients with posterior cranial fossa tumors using calculated textural parameters from magnetic resonance images. Materials And Methods: We evaluated 14 pediatric patients with posterior cranial fossa tumors using the software MaZda to define the texture parameters in selected regions of interest representing healthy and pathological tissues based on T2-weighted magnetic resonance images. Results: There was a statistically significant difference between normal and tumoral tissues as well as between supposedly normal tissues adjacent and distant from the tumoral lesion. Conclusion: Magnetic resonance textural evaluation is an useful tool for determining differences among various tissues, including tissues that appear apparently normal on visual analysis. (author)

  15. Posterior fossa vermian cystic schwannoma mimicking as pilocytic astrocytoma: A case report and literature review

    Alok Umredkar

    2011-01-01

    Full Text Available Intraparenchymal schwannomas are rare and most of the reported cases are in supratentorial region with frontal lobe being most common. Infratentorial location is very rare. We report a posterior fossa midline large cystic schwannoma with mural nodule mimicking as pilocytic astrocytoma. The pathogenesis and neuroradiological findings of intraparenchymal schwannomas are discussed with review of the related literature.

  16. A Cognitive and Affective Pattern in Posterior Fossa Strokes in Children: A Case Series

    Kossorotoff, Manoelle; Gonin-Flambois, Coralie; Gitiaux, Cyril; Quijano, Susana; Boddaert, Nathalie; Bahi-Buisson, Nadia; Barnerias, Christine; Dulac, Olivier; Brunelle, Francis; Desguerre, Isabelle

    2010-01-01

    Aim: Posterior fossa strokes account for about 10% of ischaemic strokes in children. Although motor and dysautonomic symptoms are common, to our knowledge cognitive and affective deficits have not been described in the paediatric literature. Our aim, therefore, was to describe these symptoms and deficits. Method: In a retrospective study, we…

  17. Relationship between external and histologic features of progressive stages of caries in the occlusal fossa

    Ekstrand, K R; Kuzmina, I; Bjørndal, L; Thylstrup, A

    1995-01-01

    The material comprised 140 extracted maxillary third molars. The central fossa area was examined with a stereomicroscope (SM) (x16) and macroscopically (M) under standardized conditions after cleaning and air-drying. Signs of caries were classified using a detailed scoring system involving 12 (SM...

  18. Orbital and infratemporal fossa metastasis: An unusual initial presentation of adenocarcinoma of lung

    Tamojit Chaudhuri; Kamlesh Yadava

    2013-01-01

    Orbital metastasis as initial presentation of adenocarcinoma of lung is an extremely rare phenomenon. Here, we report a 46-year-old non-smoker Asian woman, who presented with right eye proptosis due to right orbital and infratemporal fossa metastasis, as the first presentation of adenocarcinoma of right lung.

  19. High-resolution CT of the pterygopalatine fossa and its communications

    The pterygopalatine fossa is an important space because it communicates with the middle cranial fossa, orbit, nasal cavity, oral cavity, pharynx, foramen lacerum, and the infratemporal fossa via eight foramina and canals. We studied the pterygopalatine fossa, foramen rotundum, inferior orbital fissure, sphenopalatine foramen, pterygoid canal, greater and lesser palatine foramen, palatinovaginal canal, and the pterygomaxillary fissure with high-resolution CT to characterise the anatomy and variants of these structures. These structures were evaluated using axial and coronal planes. In the morphometric study, the distance between the foramina rotunda did not show statistically significant differences between the anterior and posterior segments. The pterygoid canal was slightly narrower in the anterior segment (23.9 mm) than in the posterior segment (25.2 mm). The pterygoid canal narrowed in the anterior (1.8 mm) to posterior (1.2 mm) direction (P < 0.01). The distance between the pterygoid canal and the lower wall of the sphenoid sinus was 2.2 mm anteriorly and 2.8 mm posteriorly (P < 0.01). The pterygoid canal showed various relationships with the sphenoid and ethmoid sinuses. In addition, a previously unreported situation, where the foramen rotundum was surrounded by the spheroid sinus, was observed. (orig.). With 4 figs., 2 tabs

  20. Omental infarction: An unusual cause of right iliac fossa pain in children

    Laxmikant Gupta

    2016-01-01

    Full Text Available Omental infarction is an uncommon cause of acute abdomen in the pediatric population. We report a case of a 4-year-old male child with right iliac fossa pain. The final diagnosis was made on ultrasound and computed tomography findings. This entity needs to be differentiated from acute conditions like appendicitis, avoiding surgery.

  1. Omental infarction: An unusual cause of right iliac fossa pain in children.

    Gupta, Laxmikant; Saxena, Akshay K; Sodhi, Kushaljit S; Mahajan, Jai K; Khandelwal, Niranjan

    2016-01-01

    Omental infarction is an uncommon cause of acute abdomen in the pediatric population. We report a case of a 4-year-old male child with right iliac fossa pain. The final diagnosis was made on ultrasound and computed tomography findings. This entity needs to be differentiated from acute conditions like appendicitis, avoiding surgery. PMID:26862293

  2. Bilateral hypertrophic olivary degeneration following surgical resection of a posterior fossa epidermoid cyst

    Vaidhyanath, R; Thomas, A; MESSIOS, N

    2010-01-01

    Hypertrophic olivary degeneration is a result of a primary lesion damaging the dento-rubro-olivary pathway. It is a transynaptic form of degeneration and is unique, causing hypertrophy rather than atrophy of the inferior olivary nucleus. We report a case of bilateral hypertrophic olivary degeneration following surgical excision of a posterior fossa epidermoid cyst and review the relevant literature.

  3. Abdominal Skin Rash After TACE Due to Non-Target Embolization of Hepatic Falciform Artery

    Bhalala, Mitesh; Vidholia, Aditi; Sao, Rahul; Sharma, Nisha; Mehta, Dhruv; McCabe, Sam; Bodin, Roxana

    2016-01-01

    Transcatheter arterial chemoembolization (TACE) is a well-recognized procedure for management of hepatocellular carcinoma. We present a 54-year-old man who presented with a periumbilical maculopapular skin rash that developed after an otherwise uneventful TACE procedure. A retrospective review of imaging was consistent with non-target embolization of the hepatic falciform artery (HFA). He was treated with oral non-steroidal antiinflammatory medication for 3 weeks with improvement, but had slight skin induration and an excoriated papule at 6-month follow-up. Non-target embolization of HFA is very rare, but clinicians and interventionalists should be aware of this complication, especially in patients predisposed to enlargement of HFA. PMID:27144210

  4. Fever with Rash, an Alarm to the Physicians - A Case Report of Atypical Measles.

    Raman, Prabhakaran; Hussaini, Syed Bahavudeen; Saravanan, Paramasivam; Jeyaram, Kuttuva

    2016-02-01

    Measles is a highly contagious disease caused by Paramyxovirus group. It has been estimated that globally deaths occurs out of measles. The disease still remains as one of the leading cause of death among young children and adults despite the effective vaccination. The outbreak of measles is on rise in recent years with serologically confirmed cases in India. The incidence and complications of atypical measles is usually severe among older age groups even prior immunization. We report a case of 15-year-old male with symptoms of fever and rash with possible differential diagnosis and emphasize on the clinical presentation of atypical measles among adolescent age group with an additional evidence of investigations. PMID:27042506

  5. Treatment and survival of supratentorial and posterior fossa ependymomas in adults.

    Nuño, Miriam; Yu, Jeffrey J; Varshneya, Kunal; Alexander, Julia; Mukherjee, Debraj; Black, Keith L; Patil, Chirag G

    2016-06-01

    Ependymoma is a rare primary brain or spinal cord tumor that arises from the ependyma, a tissue of the central nervous system. This study analyzed a large cohort of adult supratentorial and posterior fossa ependymoma tumors in order to elucidate factors associated with overall survival. We utilized the USA National Cancer Database to study adult World Health Organization grade II/III supratentorial and posterior fossa ependymoma patients treated between 1998 and 2011. Overall survival was estimated by the Kaplan-Meier method and factors associated with survival were determined using a multivariate Cox proportional hazards model. Among 1318 patients, 1055 (80.0%) had grade II and 263 (20.0%) anaplastic tumors located in the posterior fossa (64.3%) and supratentorial region (35.7%). Overall average age was 44.3years, 48.0% of patients were female, 86.5% were Caucasian, and 36.8% underwent near/gross total surgical resection. Radiotherapy was given to 662 patients (50.8%) and 75 (5.9%) received chemotherapy. Older age at diagnosis (hazard ratio [HR] 1.51, p<0.0001), high tumor grade (HR 1.82, p=0.005), and large tumor size (HR 1.66, p=0.008) were associated with poor survival. Females compared to males (HR 0.67, p=0.03) and patients with posterior fossa tumors versus supratentorial (HR 0.64, p=0.04) had a survival advantage. Our study showed that older patients, with supratentorial tumors, and high histological grade had an increased risk of mortality. A survival benefit was captured in females and patients with posterior fossa tumors. Adjuvant radiotherapy and chemotherapy did not confer a survival benefit among all patients, even after stratification by tumor grade or anatomical location. PMID:26810473

  6. The significance of the pterygopalatine fossa angiography before endoscopic sinus surgery

    Hong-yu XING

    2013-11-01

    Full Text Available Objective?To investigate the value of pterygopalatine fossa angiography in fresh cadaveric heads, so as to provide a useful guidance and an individualized operative procedure for endoscopic sinus surgery. Methods?Three fresh cadaveric heads were used in the present study. After injection with 10%, 5% iodine fluorine into carotid artery, 3D vascular structure of the pterygopalatine fossa was constructed. The posterior wall of the maxillary sinus was dissected by gently removing the fat tissue with sinus forceps. All anatomical structures, such as vascular, nerve and muscle structures were then exposed. The anatomical characteristics of vasculature in the pterygopalatine fossa and the imaging data were compared. Results?The pterygopalatine segment at the third portion of the MA was well shown in the imaging system. According to Morton and Khan morphologic classification of the third portion of the internal maxillary artery, the proportion of Y type, M type, and intermediate type was 33.3%, 16.7% and 50.0%, respectively. Using an endoscopic endonasal approach, the PPF was exposed through its anteromedial surface. The first visible structures would be the branches of the MA. It appeared that the anatomical land-markers of the pterygopalatine fossa area was well shown by both intranasal endoscopic view and imaging data. Conclusion?CTA is a useful technique for pterygopalatine fossa imaging before surgical dissection. The terminal segment of MA provides direct anatomical topography features of the PPF. This technique provides useful information for the individual surgery in this area. DOI: 10.11855/j.issn.0577-7402.2013.11.013

  7. 'There are no significant side-effects from a bone scan injection' - a rash statement

    Full text: Adverse reactions to radiopharmaceuticals are very uncommon, mild and generally occur a few hours post-injection. For these reasons they are poorly documented and rarely seen in nuclear medicine departments. Diphosphonates produce the most reports and the annual incidence is reputed to be between 0.3 and 33 events per 100,000 administrations. Very few of these require medical intervention and appear to resolve quickly. We report a case of a 78-year-old retired medical practitioner who underwent a staging whole body bone scan for renal cell carcinoma. 880 MBq of Tc-HDP was injected intravenously without extravasation and routine whole body images obtained 2 hours later. He awoke next morning with a macular rash and intense pruritis involving his chest, which over one week spread to involve his whole trunk, arms and then legs. The rash remained symptomatic for three months requiring continuous topical therapy. The patient was already on regular anti-histamine tablets. Dermatological review confirmed a drug reaction. There is a history of chronic renal failure requiring peritoneal dialysis. While multiple medications were being ingested, including phenergan for pruritus, there were no changes to his usual regime around this time and no other obvious causal agents. A previous bone scan 5 years ago passed uneventfully. Review of the literature provides scanty information as therapy is seldom required and when indicated is purely symptomatic. There are no reports of a prolonged adverse event. This case almost certainly represents a hypersensitivity reaction to a common bone radio-pharmaceutical and reminds us that very rarely these may be quite severe and prolonged. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  8. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  9. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M. [University of Arkansas for Medical Sciences, Pediatric Radiology, Little Rock, AR (United States)

    2016-01-15

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  10. Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear. A clinical and radiologic investigation

    Wadin, K.; Thomander, L.; Wilbrand, H.

    From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Meniere's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiograhed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value.

  11. Measles Vaccine Strain Genotype A from the Skin Rash of a DiGeorge Patient on a TNF Inhibitor

    Tam, Pui-Ying Iroh; Hanisch, Benjamin R.; Klammer, Kate; DeVries, Aaron S.

    2014-01-01

    Isolation of measles virus is typically from respiratory, blood or urine specimens. We describe the first known case of measles vaccine-associated disease in a patient on TNF inhibitor therapy in which genotype A Edmonston vaccine strain virus was identified from skin scrapings of the patient’s rash.

  12. Is there a dural wall between the cavernous sinus and the pituitary fossa? Anatomical and MRI findings

    Dietemann, J.L.; Diniz, R.; Reis, M. Jr.; Neugroschl, C.; Vinclair, L. [Univ. Hospital, Strasbourg (France). Dept. of Radiology 2; Kehrli, P. [Department of Neurosurgery, University Hospital of Strasbourg, Strasbourg (France); Maillot, C. [Institute of Anatomy, University Hospital of Strasbourg, Strasbourg (France)

    1998-10-01

    We compared MRI studies of the sellar area and embryological and adult histological studies of the cavernous sinuses and pituitary fossa. MRI studies were performed in 50 normal subjects with coronal sections using a fast inversion-recovery sequence to demonstrate the dural walls of the cavernous sinus and pituitary fossa. With this sequence, dura mater appears as a high-signal linear structure. The lateral and superior walls of the cavernous sinus was easily identified on all studies, but demonstration of a dural wall separating the cavernous sinus from the pituitary fossa was not possible. These results correlated well with embryological and adult histological studies obtained from 14 specimens. The absence of a strong separation between the pituitary fossa and the cavernous sinus explains the high incidence of extension of pituitary tumours to the cavernous sinuses and vice versa. (orig.) (orig.) With 2 figs., 21 refs.

  13. Carbonate in Nili Fossae at the Noachian-Hesperian Boundary: Importance of post-Syrtis Hydrological Systems

    Mustard, J. F.; Wiseman, S. M.; Goudge, T. A.

    2014-07-01

    Exceptionally well-exposed mineral-bearing strata in Nili Fossae show reactants (olivine) and products (magnesite) in close proximity. Association with surface and subsurface hydrology point a promising Noachian-Hesperian habitable environment.

  14. Posterior fossa boost in medulloblastoma: an analysis of dose to surrounding structures using 3-dimensional (conformal) radiotherapy

    Purpose: The purpose of this study was to compare three different techniques of delivering the posterior fossa boost in patients with medulloblastoma. Methods and Materials: Five patients underwent CT simulation for treatment planning of the posterior fossa boost. For each slice, the posterior fossa was contoured in addition to the cochlea, non-posterior fossa brain, pituitary gland, mandible, parotid glands, thyroid gland, pharynx, and cervical spinal cord. For each patient, plans for three techniques of delivering the posterior fossa boost were compared. Technique A utilized parallel-opposed lateral fields using bony landmarks (2-dimensional radiotherapy); the other two techniques were planned using 3-dimensional radiotherapy. Technique B utilized a pair of coplanar wedged posterior oblique beams, whereas Technique C utilized a pair of posterior oblique fields and a vertex field. Dose-volume histograms (DVH) were obtained for each of the organs contoured and for each technique and patient. The maximum, minimum, and mean dose to each organ were determined using the DVH program in our treatment planning system. Results: In 3 of 5 patients, the planning target volume (PTV) was not included in the treatment field with Technique A. The cochlea received 100%, 50%, and 42% of the prescribed posterior fossa dose using Techniques A, B, and C respectively. The mean dose to the non-posterior fossa brain was highest with Technique C, intermediate with Technique A, and lowest for Technique B. The mean dose to the non-posterior fossa brain with Technique B was comparable to the mean non-posterior fossa brain dose delivered using parallel-opposed lateral fields based on the CT definition of the PTV. Likewise, mean dose to the pituitary gland was lowest for Technique B. Both Techniques B and C were associated with a higher mean dose to the thyroid gland, mandible, parotid glands, and pharynx. Conclusions: The use of Technique B minimized the radiotherapy dose to the cochlea, pituitary gland, and non-posterior fossa brain. Contrary to what one may expect, conformal radiotherapy using Technique B did not deliver a higher dose to the non-posterior fossa brain over standard parallel-opposed lateral fields. Other advantages of conformal techniques B and C over 2-dimensional radiotherapy are the inclusion of the PTV in all patients and a lower mean dose to the pituitary gland. The main disadvantage of conformal Techniques B and C employed in our patients is a higher mean dose to the thyroid gland and other tissues in the neck

  15. Magnetic resonance imaging textural evaluation of posterior cranial fossa tumors in childhood

    Objective: To distinguish healthy from pathological tissues in pediatric patients with posterior cranial fossa tumors using calculated textural parameters from magnetic resonance images. Materials And Methods: We evaluated 14 pediatric patients with posterior cranial fossa tumors using the software MaZda to define the texture parameters in selected regions of interest representing healthy and pathological tissues based on T2-weighted magnetic resonance images. Results: There was a statistically significant difference between normal and tumoral tissues as well as between supposedly normal tissues adjacent and distant from the tumoral lesion. Conclusion: Magnetic resonance textural evaluation is an useful tool for determining differences among various tissues, including tissues that appear apparently normal on visual analysis. (author)

  16. Facial Nerve Schwannoma Involving Middle Cranial Fossa: When the Unilateral Sensorineural Hearing Loss Guide to the Correct Diagnosis

    De Stefano, Alessandro; Dispenza, Francesco; Kulamarva, Gautham

    2011-01-01

    The Facial Nerve Schwannoma is a rare tumor and it seldom involved the middle cranial fossa. Facial nerve schwannoma has various manifestations, including facial palsy but unfortunately facial nerve is very resistant to compression and often facial nerve paralysis or a facial weakness are not present. We present a case of giant facial nerve schwannoma involved the middle cranial fossa without facial nerve paralysis. In these cases the unilateral hearing loss (if present) guide to a correct di...

  17. Triad of torticollis, photophobia and epiphora in a child with a posterior fossa tumor

    Buijsrogge, Michiel

    2014-11-01

    Full Text Available [english] A 7-month-old Caucasian girl presented with an acquired, spasmodic torticollis to the right side with the head tilted downwards, photophobia and epiphora. Diagnostic work-out revealed a posterior fossa pilocytic astrocytoma. The symptoms improved after surgical resection. There is evidence of internuclear connections between cranial nerves II, V and VII acting as important mechanisms in this triad (Okamoto et al. 2010.

  18. Assessment of Condyle and Glenoid Fossa Morphology Using CBCT in South-East Asians

    Al-koshab, May; Nambiar, Phrabhakaran; John, Jacob

    2015-01-01

    Introduction Proper imaging allows practitioners to evaluate an asymptomatic tempormandibular joint (TMJ) for potential degenerative changes prior to surgical and orthodontic treatment. The recently developed cone-beam computed tomography (CBCT) allows measurement of TMJ bony structures with high accuracy. A study was undertaken to determine the morphology, and its variations, of the mandibular condyle and glenoid fossa among Malay and Chinese Malaysians. Methods CBCT was used to assess 200 j...

  19. Clinical studies of photodynamic therapy for malignant brain tumors: facial nerve palsy after temporal fossa photoillumination

    Muller, Paul J.; Wilson, Brian C.; Lilge, Lothar D.; Varma, Abhay; Bogaards, Arjen; Fullagar, Tim; Fenstermaker, Robert; Selker, Robert; Abrams, Judith

    2003-06-01

    In two randomized prospective studies of brain tumor PDT more than 180 patients have been accrued. At the Toronto site we recognized two patients who developed a lower motor neuron (LMN) facial paralysis in the week following the PDT treatment. In both cases a temporal lobectomy was undertaken and the residual tumor cavity was photo-illuminated. The surface illuminated included the temporal fossa floor, thus potentially exposing the facial nerve to the effect of PDT. The number of frontal, temporal, parietal, and occipital tumors in this cohort was 39, 24, 12 and 4, respectively. Of the 24 temporal tumors 18 were randomized to Photofrin-PDT. Of these 18 a temporal lobectomy was carried out exposing the middle fossa floor as part of the tumor resection. In two of the 10 patients where the lobectomy was carried out and the fossa floor was exposed to light there occurred a postoperative facial palsy. Both patients recovered facial nerve function in 6 and 12 weeks, respectively. 46 J/cm2 were used in the former and 130 J/cm2 in the latter. We did not encounter a single post-operative LMN facial plasy in the 101 phase 2 patients treated with Photofrin-PDT. Among 688 supratentorial brain tumor operations in the last decade involving all pathologies and all locations no case of early post-operative LMN facial palsy was identified in the absence of PDT. One further patient who had a with post-PDT facial palsy was identified at the Denver site. Although it is possible that these patients had incidental Bell's palsy, we now recommend shielding the temporal fossa floor during PDT.

  20. Unusual presentation of a dermoid cyst in the ischiorectal fossa. Magnetic resonance imaging and ultrasound appearances

    Choudur, H.N. [Hamilton General Hospital, Department of Radiology, Hamilton, ON (Canada); Hamilton General Hospital, McMaster University, Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, Ontario (Canada); Hunjan, J.S.; Howey, J.M. [Hamilton General Hospital, McMaster University, Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, Ontario (Canada); DeNardi, F. [Henderson General Hospital, McMaster University, Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, Ontario (Canada)

    2009-09-15

    The ischiorectal fossa may give rise to a wide variety of pathological entities, although it is composed of relatively few structures. Developmental cysts are included among the list. Large epidermoid cysts in the ischiorectal fossa have been previously described (Fujimoto et al., Clin Imaging 17:146-148, 1993; Ng et al., Can J Surg 49:435-436, 2006). However, to the best of our knowledge, there is no published case in the English literature of a dermoid cyst within the ischiorectal fossa. Using magnetic resonance (MR) imaging and a subsequent ultrasound-guided biopsy, we were able to offer a focused differential that included a dermoid cyst within the ischiorectal fossa in a 55-year-old man presenting with a painful mass on the buttocks. Hair and fatty components were obtained by targeted ultrasound-guided biopsy. On MR imaging, the mass was seen to be well circumscribed and registered a heterogeneous T1-weighted signal that corresponded to layers of fat and debris on short-tau inversion recovery (STIR) imaging. A well-defined ball of fat was noted centrally within the lesion, with a speckled low T1 and low T2 signal within it. Hair admixed with fat was obtained from it by targeted ultrasound-guided biopsy. There was no enhancement of the lesion after administration of gadolinium. On ultrasound, the lesion was well circumscribed and heterogeneous; the echogenic area corresponded to the fat signal seen on magnetic resonance imaging (MRI). The lower level echoes within the lesion corresponded to the debris seen on MRI. The central rounded area of speckling, registering fine posterior shadowing corresponded to the hairy contents obtained by the targeted ultrasound-guided biopsy. A differential diagnosis of all lipomatous lesions was included in the pre-biopsy report: fat necrosis within a lipoma; well-differentiated liposarcoma; myxoid liposarcoma and dermoid cyst. Histopathological diagnosis following complete surgical resection was that of a dermoid cyst. (orig.)

  1. Unusual presentation of a dermoid cyst in the ischiorectal fossa. Magnetic resonance imaging and ultrasound appearances

    The ischiorectal fossa may give rise to a wide variety of pathological entities, although it is composed of relatively few structures. Developmental cysts are included among the list. Large epidermoid cysts in the ischiorectal fossa have been previously described (Fujimoto et al., Clin Imaging 17:146-148, 1993; Ng et al., Can J Surg 49:435-436, 2006). However, to the best of our knowledge, there is no published case in the English literature of a dermoid cyst within the ischiorectal fossa. Using magnetic resonance (MR) imaging and a subsequent ultrasound-guided biopsy, we were able to offer a focused differential that included a dermoid cyst within the ischiorectal fossa in a 55-year-old man presenting with a painful mass on the buttocks. Hair and fatty components were obtained by targeted ultrasound-guided biopsy. On MR imaging, the mass was seen to be well circumscribed and registered a heterogeneous T1-weighted signal that corresponded to layers of fat and debris on short-tau inversion recovery (STIR) imaging. A well-defined ball of fat was noted centrally within the lesion, with a speckled low T1 and low T2 signal within it. Hair admixed with fat was obtained from it by targeted ultrasound-guided biopsy. There was no enhancement of the lesion after administration of gadolinium. On ultrasound, the lesion was well circumscribed and heterogeneous; the echogenic area corresponded to the fat signal seen on magnetic resonance imaging (MRI). The lower level echoes within the lesion corresponded to the debris seen on MRI. The central rounded area of speckling, registering fine posterior shadowing corresponded to the hairy contents obtained by the targeted ultrasound-guided biopsy. A differential diagnosis of all lipomatous lesions was included in the pre-biopsy report: fat necrosis within a lipoma; well-differentiated liposarcoma; myxoid liposarcoma and dermoid cyst. Histopathological diagnosis following complete surgical resection was that of a dermoid cyst. (orig.)

  2. Facial reflex examination for assessment of trigeminal nerve involvement in pituitary fossa tumours.

    Bynke, O

    1985-01-01

    Sixteen patients with pituitary fossa tumours with different intrasellar extension have been studied by facial reflex examination, a neurophysiological test for the trigemino-facial pathway. Impaired transmission along the reflex path was shown in patients with proved encroachments on the flexible walls of the cavernous sinuses, but with no tumour spread to the brain stem and facial nerve. The findings were consistent with a subclinical involvement of the first trigeminal division. Tumour rem...

  3. Spontaneous bilateral subdural haematomas in the posterior cranial fossa revealed by MRI

    A 52-year-old woman treated for acute myeloproliferative disease developed progressive stupor. CT showed obstructive hydrocephalus resulting from unexplained mass effect on the fourth ventricle. MRI revealed bilateral extra-axial collections in the posterior cranial fossa, giving high signal on T1- and T2-weighted images, suggesting subacute subdural haematomas. Subdural haematomas can be suspected on CT when there is unexplained mass effect. MRI may be essential to confirm the diagnosis and plan appropriate treatment. (orig.)

  4. Slit-like jugular foramen due to abnormal bone growth at jugular fossa

    Budhiraja V; Rastogi R

    2010-01-01

    An abnormal unilateral blockage of the jugular foramen by a bone growth converting it into a slit was noted in a skull during osteology demonstration classes for medical undergraduates. The left jugular foramen was narrowed by a thick bony projection filling the jugular fossa. This kind of narrowing of the foramen might results in neurovascular symptoms as it transmits important cranial nerves and internal jugular vein. Injury of ninth, tenth and eleventh cranial nerves can occur due to narro...

  5. Temporal fossa arachnoid cyst presenting with bilateral subdural hematoma following trauma: two case reports

    Pillai Promod; Menon Sajesh K; Manjooran Raju P; Kariyattil Rajiv; Pillai Ashok B; Panikar Dilip

    2009-01-01

    Abstract Introduction Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hemat...

  6. Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus

    Goncalves, Fabricio Guimaraes; Lamb, Leslie; Del Carpio-O' Donovan, Raquel, E-mail: goncalves.neuroradio@gmail.com [McGill University Health Center Montreal General Hospital (Canada)

    2011-11-15

    Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

  7. Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus

    Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

  8. Influence of occlusal splints on TMJ condyle-fossa relationship and disc shape

    Braun, Barbara Victoria

    2012-01-01

    Background. Occlusal splints are nowadays commonly used in dentistry to treat symptoms of myoarthropathies of the masticatory system, but also to treat simple occlusal parafunctions. Still, the exact mechanism by which the treatment works is unknown. The aim of this study was to find out the answers to following questions: 1. is there an immediate change of the minimum condyle-fossa distance and accompanying disc thickness by inserting a Michigan splint and 2. is it possible to displace the m...

  9. Declarative and procedural learning in children and adolescents with posterior fossa tumours

    Casares Encarnación; Gómez Carlos M; Quintero-Gallego Eliana A; Márquez Javier; Pérez-Santamaría Fco

    2006-01-01

    Abstract Background This quasi-experimental study was designed to assess two important learning types – procedural and declarative – in children and adolescents affected by posterior fossa tumours (astrocytoma vs. medulloblastoma), given that memory has an important impact on the child's academic achievement and personal development. Methods We had three groups: two clinical (eighteen subjects) and one control (twelve subjects). The learning types in these groups were assessed by two experime...

  10. Management of the stricture of fossa navicularis and pendulous urethral strictures

    Singh, Shrawan K.; Agrawal, Santosh K.; Mavuduru, Ravimohan S.

    2011-01-01

    Objective: Management of distal anterior urethral stricture is a common problem faced by practicing urologists. Literature on urethral stricture mainly pertains to bulbar urethral stricture and pelvic fracture urethral distraction defect. The present article aims to review the management of the strictures of fossa navicularis and pendulous urethra. Materials and Methods: The literature in English language was searched from the National Library of Medicine database, using the appropriate key w...

  11. Posterior fossa tuberculoma in a Huichol native Mexican child: a case report

    Escobedo-Meléndez, Griselda; Portillo-Gómez, Leopoldo; Andrade-Ramos, Miguel A; Bocanegra, David; Mercado-Pimentel, Rodrigo; Arredondo, Luis; Torres, Dara; Caniza, Miguela A.

    2014-01-01

    Background Tuberculosis is a major health concern in Mexico, especially among the native population. Tuberculomas are a frequent and severe complication of pediatric tuberculosis, these are observed as tumors in neuroimaging studies but are often not diagnosed adequately. Case presentation We present a case of a 12-year-old native Mexican girl Huichol ethnicity diagnosed with a large posterior fossa tuberculoma found by imaging. This tuberculoma was surgically removed. Histopathologic examina...

  12. The use of wavelet filters for reducing noise in posterior fossa Computed Tomography images

    Wavelet transform based de-noising like wavelet shrinkage, gives the good results in CT. This procedure affects very little the spatial resolution. Some applications are reconstruction methods, while others are a posteriori de-noising methods. De-noising after reconstruction is very difficult because the noise is non-stationary and has unknown distribution. Therefore, methods which work on the sinogram-space don’t have this problem, because they always work over a known noise distribution at this point. On the other hand, the posterior fossa in a head CT is a very complex region for physicians, because it is commonly affected by artifacts and noise which are not eliminated during the reconstruction procedure. This can leads to some false positive evaluations. The purpose of our present work is to compare different wavelet shrinkage de-noising filters to reduce noise, particularly in images of the posterior fossa within CT scans in the sinogram-space. This work describes an experimental search for the best wavelets, to reduce Poisson noise in Computed Tomography (CT) scans. Results showed that de-noising with wavelet filters improved the quality of posterior fossa region in terms of an increased CNR, without noticeable structural distortions

  13. The use of wavelet filters for reducing noise in posterior fossa Computed Tomography images

    Pita-Machado, Reinado [Centro de Ingeniería Clínica. Guacalote y Circunvalación, Santa Clara 50200 (Cuba); Perez-Diaz, Marlen, E-mail: mperez@uclv.edu.cu; Lorenzo-Ginori, Juan V., E-mail: mperez@uclv.edu.cu; Bravo-Pino, Rolando, E-mail: mperez@uclv.edu.cu [Centro de Estudios de Electrónica y Tecnologías de la Información (CEETI), Universidad Central Marta Abreu de las Villas, Carretera a Camajuaní, km. 5 1/2 Santa Clara 54830 (Cuba)

    2014-11-07

    Wavelet transform based de-noising like wavelet shrinkage, gives the good results in CT. This procedure affects very little the spatial resolution. Some applications are reconstruction methods, while others are a posteriori de-noising methods. De-noising after reconstruction is very difficult because the noise is non-stationary and has unknown distribution. Therefore, methods which work on the sinogram-space don’t have this problem, because they always work over a known noise distribution at this point. On the other hand, the posterior fossa in a head CT is a very complex region for physicians, because it is commonly affected by artifacts and noise which are not eliminated during the reconstruction procedure. This can leads to some false positive evaluations. The purpose of our present work is to compare different wavelet shrinkage de-noising filters to reduce noise, particularly in images of the posterior fossa within CT scans in the sinogram-space. This work describes an experimental search for the best wavelets, to reduce Poisson noise in Computed Tomography (CT) scans. Results showed that de-noising with wavelet filters improved the quality of posterior fossa region in terms of an increased CNR, without noticeable structural distortions.

  14. Packing of renal fossa: Useful technique for intractable bleeding after open pyelolithotomy surgery

    Mohinder Kumar Malhotra

    2012-01-01

    Full Text Available There is no documented study to indicate the role of prolonged packing of renal fossa (24 to 48 hours to control bleeding in life threating haemorrhage following open pyelolithotomy without compromise in the renal functions. On the contrary emergency nephrectomy was performed for intractable bleeding during renal stone surgery in peripheral hospitals. Several studies have shown the usefulness of temporary packing to control bleeding in liver injuries and following open heart operations. Packing of the renal fossa with laparotomy pads in unstable patients, and transferring the patient to the surgical intensive care unit (ICU is also described in trauma but not in controlling bleeding after open pyelolithotomy .This study comprises of three such patients whose kidneys were salvaged by a simple procedure of temporary packing of renal fossa for period of 24-48 hours who had developed life threatening haemorrhage after open pyelolithotomy. This technique is simple and worth trying especially for surgeons who are contemplating nephrectomy as prolonged packing has not lead to any compromise in renal functions. The aim of this manuscript is very limited and clear. Packing is not a licence to carry out open pyelolithotomy without proper expertise and local backup or resources. Principles of safe and ethical surgical practice should never be violated as it can lead to medico legal complications.

  15. BIOGENIC AMINE CONTENT AND CHEMICAL AND PHYSICAL FEATURES OF ITALIAN FORMAGGIO DI FOSSA

    N. Mascaro

    2010-06-01

    Full Text Available Formaggio di Fossa is an Italian traditional cheese of the Montefeltro area (Emilia Romagna and Marche regions characterized by a particular step of ripening that is carried out into pits (infossamento borne in the sandstone. Since the XIV century, the inhabitants were used to set food, especially cereals and cheese, into pits to preserve them during winter and to protect them from invaders. The aim of the present work is to study physical and chemical features of this product with particular reference to the presence of the most important biogenic amines ( -Phenylethylamine, putrescine, cadaverine, histamine, tyramine, spermine and spermidine, compared with a control cheese fully ripened in factory. Formaggio di Fossa showed higher values of Aw, pH, humidity, proteins, pH 4,6-soluble nitrogen (NCN and water soluble nitrogen (NPN and much lower amounts of fat. Much higher amounts of total biogenic amines were detected in Formaggio di Fossa than in control cheese, where their concentration was very low. Cadaverine, putrescine and tyramine were the most concentrated biogenic amines. Nevertheless, thyramine was present at levels suggested as compatible with GMPs. Histamine was detected at low amounts, far from potentially toxic levels.

  16. Chronic Expanding Hematoma in the Popliteal Fossa after Pseudoaneurysm Surgery because of Nail Puncture

    Deveci, Alper; Ozkurt, Bulent; Simsek, Mehmet Emin; Tabak, Abdullah Yalcin; Bozkurt, Murat

    2014-01-01

    Hematomas caused by surgery or trauma that persist and expand slowly for more than a month are defined as chronic expanding hematomas (CEH). Magnetic resonance imaging (MRI) is useful for the diagnosis. Total excision with the pseudocapsule is the treatment method. Pseudoaneurysms result from arterial wall disruptions and can be mistaken for CEH. We present a rare case report of a 45-year-old man with a large, painful swelling in his left popliteal fossa. He had a puncture wound by a nail 11 years ago and a gradually expanding mass occurred in his popliteal fossa. A pseudoaneurysm was detected and operated a year later. After surgery, a gradually expanding mass recurred in his popliteal fossa. On the arteriography, the popliteal artery was occluded and the blood flow was maintained with collateral vessels. On MRI, an enormous swelling of 115 × 107 × 196 cm in diameter was seen. It was diagnosed as CEH and was excised completely protecting the collateral vessels and there was no recurrence after a year from the surgery. PMID:25610684

  17. Analysis of mandibular condylar and glenoid fossa fractures with computed tomography

    Ogura, Ichiro; Sasaki, Yusuke; Kaneda, Takashi [Nihon University School of Dentistry at Matsudo, Department of Radiology, Matsudo, Chiba (Japan)

    2014-04-15

    The purpose of this study was to investigate the prevalence of glenoid fossa and condylar fractures in patients with mandibular fractures using multidetector computed tomography (MDCT). A prospective study was performed in 227 patients with mandibular fractures who underwent 64-MDCT. Mandibular fractures were classified into four types: median, paramedian, angle and condylar. Statistical analysis of the relationship between prevalence of condylar fractures and mandibular fracture locations was performed using ?{sup 2} test with Fisher's exact test. A P value less than 0.05 was considered statistically significant. The prevalence of condylar fracture was 64.8 % of all patients with mandibular fractures, 66.7 % of median type (P = 0.667), 45.5 % of paramedian type (P = 0.001) and 12.3 % of angle type (P = 0.000), respectively. Furthermore, glenoid fossa fracture was seen in 1.4 % of patients with condylar fractures. The results of the presented study suggest focusing also on incidental findings such as glenoid fossa fractures. (orig.)

  18. Evaluation of peritumoral area associated with brain tumor in posterior cranial fossa using three dimensional SPECT

    We measured peritumoral hypoperfusion volume associated with brain tumor in posterior cranial fossa using SPECT and compared the result with volumes of tumor and peritumoral edema on MRI. Seventeen patients with brain tumor in posterior cranial fossa, who underwent 123 I-IMP SPECT and MRI before operation, were studied. The SPECT images were performed in three dimension using a panning visualization software (application visualization system medical viewer: AVS-MV). The peritumoral hypoperfusion area on three dimensional SPECT was larger than the volume of edema on MRI with a statistical different (p<0.001). Acoustic tumor cases showed a good correlation between the volume of peritumoral hypoperfusion area on three dimensional SPECT and the volume of edema on MRI. These results suggest tumor volume in posterior cranial fossa affects cerebral circulation. It is assumed that pressure exerted by the tumor may contribute to the reduction in cerebral blood flow. The large amount of data provided by three dimensional SPECT images, gives reliable results and furthermore, makes objective evaluation possible because it eliminates the need to set region of interest (ROI) in the analysis. The application of SPECT to assess the extent of hypoperfusion volume, is considered a new and clinically useful tool. (author)

  19. Neurinomas of the facial nerve extending to the middle cranial fossa

    Three cases with neurinomas of the facial nerve are reported, especially with regard to the computerized tomographic (CT) findings. All of them had a long history of facial-nerve dysfunction, associated with hearing loss over periods from several to twenty-five years. Intraoperative findings demonstrated that these tumors arose from the intrapetrous portion, the horizontal portion, or the geniculate portion of the facial nerve and that they were located in the middle cranial fossa. The histological diagnoses were neurinomas. CT scans of three cases demonstrated round and low-density masses with marginal high-density areas in the middle cranial fossa, in one associated with diffuse low-density areas in the left temporal and parietal lobes. The low-density areas on CT were thought to be cysts; this was confirmed by surgery. Enhanced CT scans showed irregular enhancement in one case and ring-like enhancement in two cases. High-resolution CT scans of the temporal bone in two cases revealed a soft tissue mass in the middle ear, a well-circumscribed irregular destruction of the anterior aspect of the petrous bone, and calcifications. These findings seemed to be significant features of the neurinomas of the facial nerve extending to the middle cranial fossa. We emphasize that bone-window CT of the temporal bone is most useful in detecting a neurinoma of the facial nerve in its early stage in order to preserve the facial- and acoustic-nerve functions. (author)

  20. Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report

    Kamal Kataria

    2012-05-01

    Full Text Available Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature.

  1. Clinical and Laboratory evaluation of measleslike rash in children and young adults

    Stewien Klaus Eberhard

    2000-01-01

    Full Text Available A clinical and laboratory evaluation of 11 children and young adults with measleslike rash was done during the measles outbreak in the Greater São Paulo Metropolitan area at the end of 1996 and spread over the country during 1997. Measles was laboratory confirmed in 07 patients by specific IgM detection in acute serum specimens using an IgM-capture EIA, by specific IgG seroconversion in serum pairs, and by reverse transcription PCR and virus isolation in peripheral blood lymphocytes. Clinical presentations were not always classic; one of the 07 cases had received measles vaccine and corresponded to modified clinical case of measles. The 4 remaining cases were negative for measles and were diagnosed as exanthem subitum (2 cases, scarlet fever and Kawasaki disease. The present study reinforces the view that clinical features alone are not sufficient for establishing an accurate diagnosis in the post-vaccine era, and a surveillance system based on sensitive laboratory results is needed so that it can confirm IgM-negative measles cases.

  2. Genetic linkage of familial granulomatous inflammatory arthritis, skin rash, and uveitis to chromosome 16

    Tromp, G.; Kuivaniemi, H.; Ala-Kokko, L. [Thomas Jefferson Univ., Philadelphia, PA (United States)] [and others

    1996-11-01

    Blau syndrome (MIM 186580), first described in a large, three-generation kindred, is an autosomal, dominantly inherited disease characterized by multiorgan, tissue-specific inflammation. Its clinical phenotype includes granulomatous arthritis, skin rash, and uveitis and probably represents a subtype of a group of clinical entities referred to as {open_quotes}familial granulomatosis.{close_quotes} It is the sole human model with recognizably Mendelian inheritance for a variety of multisystem inflammatory diseases affecting a significant percentage of the population. A genomewide search for the Blau susceptibility locus was undertaken after karyotypic analysis revealed no abnormalities. Sixty-two of the 74-member pedigree were genotyped with dinucleotide-repeat markers. Linkage analysis was performed under dominant model of inheritance with reduced penetrance. The marker D16S298 gave a maximum LOD score of 3.75 at {theta} = .04, with two-point analysis. LOD scores for flanking markers were consistent and placed the Blau susceptibility locus within the 16p12-q21 interval. 46 refs., 3 figs., 3 tabs.

  3. Real-world analysis of the Celgene Global Drug Safety database: early discontinuation of lenalidomide in patients with myelodysplastic syndromes due to non-serious rash

    Weiss L

    2015-09-01

    Full Text Available Lilia Weiss,1 Dianna Gary,1 Arlene S Swern,2 John Freeman,1 Mary M Sugrue3 1Global Drug Safety, Celgene Corporation, Summit, 2Biometrics, Celgene Corporation, Berkeley Heights, 3Medical Affairs, Celgene Corporation, Summit, NJ, USA Background: Lenalidomide is approved for treating transfusion-dependent anemia due to lower-risk del(5q myelodysplastic syndromes (MDS. In clinical trials, rash was common, although severe rash was infrequent. To examine rash in patients with MDS treated with lenalidomide in the real world, the Celgene Global Drug Safety database was analyzed and compared with clinical trials.Materials and methods: Adverse event reports in the post-marketing setting and in the MDS-003/004 clinical trials were analyzed by action taken with lenalidomide, seriousness/grade, time to onset, and treatment duration.Results: Globally, 16,942 reports representing 36,793 adverse events from the post-marketing setting were submitted to the Global Drug Safety database between December 27, 2005 and June 13, 2013. Most rash adverse events were non-serious (Global Drug Safety database, 91% or grade 1/2 (MDS-003/004 trials, 87%–93%. Unexpectedly, rash, occurring at a median of 9 days after treatment initiation, was the leading cause of permanent discontinuation of lenalidomide. Seventy-two percent of non-serious rash adverse events led to early permanent discontinuation within two cycles, while in the MDS-003/004 pivotal clinical trials, only 2%–3% of rash adverse events led to permanent discontinuation.Conclusion: Non-serious rash was the most common reason for permanent discontinuation of lenalidomide in real-world settings. Managing lenalidomide-related rash using published recommendations might improve treatment duration and optimize patient outcomes. Keywords: adverse events, safety, post-marketing setting 

  4. [The comparative characteristic of cytokine production in serum and whole blood in patients with chronic autoimmune nettle rash].

    Aschina, L A; Baranova, N I; Kojenkova, S V

    2015-03-01

    The sampling of 100 patients with chronic autoimmune nettle rash and control group of 30 healthy donors was analyzed for identification of level of interleukin (IL)-4, IL-10, IL-17, IL-18 and γ-interferon (IFN) in serum of patients. The same sampling was examined using method ex vivo for spontaneous and induced production by cells of immune system. In patients with chronic autoimmune nettle rash increasing of spontaneous production of IL-4 and spontaneous and induced production of IL-17 and IFN was identified. The decreasing of spontaneous and induced production of IL-18 was detected too. These occurrences indicate to simultaneous activation of Th1, Th2 and Th17-population of T-lymphocytes. The analysis of level of cytokines in blood serum established only decreasing of level of IL-4 in patients with chronic autoimmune nettle rash as compared with healthy individuals. The level of other analyzed cytokines had no reliable differences that demonstrate both low informativeness of detection ofcontent of cytokines in blood serum and advantage of application of method ex vivo with detection of level of cytokines in whole blood. PMID:26031163

  5. Itch and skin rash from chocolate during fluoxetine and sertraline treatment: Case report

    Svenson Svante

    2004-11-01

    Full Text Available Abstract Background The skin contains a system for producing serotonin as well as serotonin receptors. Serotonin can also cause pruritus when injected into the skin. SSRI-drugs increase serotonin concentrations and are known to have pruritus and other dermal side effects. Case presentation A 46-year-old man consulted his doctor due to symptoms of depression. He did not suffer from any allergy but drinking red wine caused vasomotor rhinitis. Antidepressive treatment with fluoxetine 20 mg daily was initiated which was successful. After three weeks of treatment an itching rash appeared. An adverse drug reaction (ADR induced by fluoxetine was suspected and fluoxetine treatment was discontinued. The symptoms disappeared with clemastine and betametasone treatment. Since the depressive symptoms returned sertraline medication was initiated. After approximately two weeks of sertraline treatment he noted an intense itching sensation in his scalp after eating a piece of chocolate cake. The itch spread to the arms, abdomen and legs and the patient treated himself with clemastine and the itch disappeared. He now realised that he had eaten a chocolate cake before this episode and remembered that before the first episode he had had a chocolate mousse dessert. He had never had any reaction from eating chocolate before and therefore reported this observation to his doctor. Conclusions This case report suggests that there may be individuals that are very sensitive to increases in serotonin concentrations. Dermal side reactions to SSRI-drugs in these patients may be due to high activity in the serotonergic system at the dermal and epidermo-dermal junctional area rather than a hypersensitivity to the drug molecule itself.

  6. Avian cerebellar floccular fossa size is not a proxy for flying ability in birds.

    Walsh, Stig A; Iwaniuk, Andrew N; Knoll, Monja A; Bourdon, Estelle; Barrett, Paul M; Milner, Angela C; Nudds, Robert L; Abel, Richard L; Sterpaio, Patricia Dello

    2013-01-01

    Extinct animal behavior has often been inferred from qualitative assessments of relative brain region size in fossil endocranial casts. For instance, flight capability in pterosaurs and early birds has been inferred from the relative size of the cerebellar flocculus, which in life protrudes from the lateral surface of the cerebellum. A primary role of the flocculus is to integrate sensory information about head rotation and translation to stabilize visual gaze via the vestibulo-occular reflex (VOR). Because gaze stabilization is a critical aspect of flight, some authors have suggested that the flocculus is enlarged in flying species. Whether this can be further extended to a floccular expansion in highly maneuverable flying species or floccular reduction in flightless species is unknown. Here, we used micro computed-tomography to reconstruct "virtual" endocranial casts of 60 extant bird species, to extract the same level of anatomical information offered by fossils. Volumes of the floccular fossa and entire brain cavity were measured and these values correlated with four indices of flying behavior. Although a weak positive relationship was found between floccular fossa size and brachial index, no significant relationship was found between floccular fossa size and any other flight mode classification. These findings could be the result of the bony endocranium inaccurately reflecting the size of the neural flocculus, but might also reflect the importance of the flocculus for all modes of locomotion in birds. We therefore conclude that the relative size of the flocculus of endocranial casts is an unreliable predictor of locomotor behavior in extinct birds, and probably also pterosaurs and non-avian dinosaurs. PMID:23825638

  7. The incidence of left iliac fossa uptake of 99mTc-DTPA in renal scanning

    In rare cases, extrarenal uptake of technetium-99m diethylenetriamine penta-acetic acid (99mTc-DTPA) has been reported, e.g. in tumours or abscesses. Although in our experience a relatively common occurrence, increased uptake in the left iliac fossa (LIF) and its incidence have not been described. This retrospective study set out to establish the incidence of this phenomenon and to exclude malignancy as the cause. All patients who had a renal 99mTc-DTPA scan between 1 January 1996 and 31 December 1997 had their scans reviewed. Presence and grade of increase in iliac fossa activity were determined by consensus agreement of three observers. The list of patients with increased uptake was cross-referenced against the New South Wales (Australia) Cancer Council database to exclude the possibility of a neoplastic lesion in this region. Increased LIF uptake was noted in 41 of the 231 (18%) consecutive patients (18 men, 23 women; mean age 43 years, range 20-83). Among these 41 patients, uptake was severe in 2 (5%), moderate in 12 (29%) and mild in 27 (66%). No patient had increased uptake in the right iliac fossa. Only one patient had a malignant lesion but this was excluded as being the cause of LIF uptake. No other patient developed malignancy (mean follow-up time 4.1 years; range 3.2-5.1). Increase in LIF uptake is a common, benign finding most likely due to activity within the descending colon. It occurs in approximately 18% of the population, and it is important to recognise such uptake in order to avoid misdiagnoses. (orig.)

  8. Distinct disease-risk groups in pediatric supratentorial and posterior fossa ependymomas

    Godfraind, Catherine; Kaczmarska, Joanna M.; Kocak, Mehmet; Dalton, James; Wright, Karen D.; Sanford, Robert A.; Boop, Fredrick A.; Gajjar, Amar J.; Merchant, Thomas E.; Ellison, David W.

    2012-01-01

    Purpose No reliable classification exists for the therapeutic stratification of children with ependymoma, such that disease-risk might be identified and patients treated to ensure a combination of maximal cure rates and minimal adverse therapeutic effects. This study examined associations between clinicopathological and cytogenetic variables and outcome in a trial cohort of children with ependymoma, with the aim of defining a practical scheme for grading this heterogeneous tumor. Methods Intracranial ependymomas (n=146) from children treated on the RT1 trial at St. Jude Children’s Research Hospital were evaluated for the status of multiple pathological features. Interphase FISH (iFISH) defined the status of chromosomes 1q, 6q (LATS1), and 9p21 (CDKN2A). Data relating to these variables were compared with survival data in order to model disease-risk groups. Results Extent of surgical resection was a significant determinant of outcome. Tumor cell density and mitotic count were associated with outcome among children with posterior fossa ependymomas (n=119). Among pathologic factors, only brain invasion was associated with outcome in children with supratentorial ependymomas (n=27). Gain of 1q was independently associated with outcome and in combination with clinicopathological variables defined a three-tier system of disease-risk for posterior fossa tumors. Conclusions Among children developing posterior fossa ependymomas treated with maximal surgical resection and conformal radiotherapy, key clinicopathological variables and chromosome 1q status can be used to define tiers of disease-risk. In contrast, risk factors for pediatric supratentorial tumors are limited to subtotal resection and brain invasion. PMID:22526017

  9. Preoperative irradiation of an extracerebral cavernous hemangioma in the middle fossa

    This is a report of case with the extracerebral cavernous hemangioma in the middle fossa in which total removal was carried out after radiotherapy. Follow-up study with computed tomography during and after irradiation are presented. A 44-year-old house-wife complained of a decreased vision of the both eyes and paresis of the left upper and lower limbs. CT scan revealed a slightly high density area in the right middle cranial fossa which was markedly enhanced with contrast media. Right carotid angio-graphy demonstrated a large avascular mass in the right middle fossa and no feeding artery or draining vein was visualized except a faint irregular stain in the venous phase. An attempt to total removal of the tumor had failed to success because of extensive hemorrhage from the tumor. Histological examination revealed a cavernous hemangioma. Irradiation with a total dose of 5000 rads was delivered. After irradiation. CT scan revealed a marked decrease of size and EMI number of the tumor. At this stage, hypervascular mass lesion with feeding arteries was noted in conventional angiography. Tumor stain in prolonged injection angiography was also visualized. In the second operation, removal of the tumor was performed without any difficulty and hemorrhage was controlled easily by electrocoagulation. Histology revealed a marked narrowing of vessels with an increase in the connective tissues. In the central part of specimen, there noted findings of coagulation necrosis, intraluminal thrombus formations and so on, which were attributed to the influence of radiation. It is concluded that in case of a extracerebral cavernous hemangioma with massive hemorrhage, radiation of up to 3000 - 5000 rads was a method of choice. The treatment results in an increase of probability of total removal of the tumor. (author)

  10. Long-term Outcomes of Gamma Knife Surgery for Posterior Fossa Arteriovenous Malformations

    Matsunaga, Shigeo; Shuto, Takashi

    2014-01-01

    The long-term outcomes of gamma knife surgery (GKS) in patients with posterior fossa arteriovenous malformations (AVMs) were retrospectively analyzed in 82 patients followed up for more than 5 years to evaluate the efficacy and safety. The median AVM volume at GKS was 0.95 cm3. The prescribed dose to the AVM margin was median 18 Gy with 1–18 isocenters. The actual complete AVM obliteration rate was 58.5% at 3 years and 78.0% at 5 years. The significant factors for higher complete obliteration...

  11. Mudez após cirurgia para tumor da fossa posterior relato de dois casos

    Roberto da Cunha Wagner; Pasquale Gallo; Paulo P. Oppitz

    1995-01-01

    Os autores descrevem episódios de mutismo após cirurgia para tumores da fossa posterior em pacientes jovens. São apresentados dois casos e é feita análise da ausência de expressão verbal que estabeleceu após a cirurgia. Também é feita análise do mutismo do ponto de vista de suas conotações neurológicas e psicológicas, ao mesmo tempo em que é revista a literatura sobre o assunto.

  12. Unusual Presentation of Hepatocellular Carcinoma into Right iliac fossa: A Rare Entity.

    Uthamalingam, Murali; Periyasamy, Karthikumaran

    2015-11-01

    Hepatocellular carcinoma (HCC) is the most common primary malignant hepatic tumour. Hepatocellular carcinoma presenting itself or extending into the right iliac fossa (RIF) is a very rare entity. We report on a rare case of hepatocellular carcinoma in a 60-year-old lady, presented with a mobile mass in the lower abdomen without cirrhosis, with normal ?-feto protein levels (AFP) or any known risk factors for liver disease. HCC in this case was unusual in its presentation both in the patient as well as a disease. PMID:26672490

  13. Parameters of infiltration in posterior fossa tumours of childhood using a high resolution CT scanner

    The computed tomographic changes in 23 posterior fossa tumours of childhood scanned on a GE 8800 scanner have been compared with the detailed operative reports in order to evaluate morphological features indicative of infiltration. The study indicated that the cyst wall of a cystic astrocytoma was always easily enucleated and was free from infiltration and that a sharp enhancing edge of a medulloblastoma or centrally necrotic astrocytoma was usually also not the site of infiltration. Other features however were found to be unreliable. (orig.)

  14. Congenital piriform fossa sinus tract presenting as an asymptomatic neck mass in an infant

    A 5-month-old girl with an asymptomatic left-sided neck mass was demonstrated by ultrasound and upper gastrointestinal series (UGI), and confirmed at surgery, to have a congenital piriform fossa sinus tract (CPFST) that communicated with an intrathyroidal cyst. To demonstrate a case of CPFST presenting as an asymptomatic neck mass. Nearly all cases of CPFST present with infection or pain, making this case unique. Case report and review of the literature. CPFST with an associated cyst should be added to the differential diagnosis of asymptomatic cystic neck masses in infants, especially if the cyst is intrathyroidal by ultrasound. (orig.)

  15. Resection of sphenoidal crest, orbit and infratemporal fossa communicative meningioma through fronto-tempo-preauricular approach

    Wu, Yue; Song, Xueming; An, Yihua; Hu, Shaoshan; Shi, Huaizhang; Wu, Huailan; Yang, Guoming; Cao, Xiangyi

    1999-09-01

    We reported our experience using diode laser under microscope to resect a sphenoidal crest, orbit and infratemporal fossa communicative meningioma through fronto-tempo-preauricular approach. We used contacting, un-contacting and inserting methods and the power was in the range of 5 - 30 watt. The tumor was totally removed and the patient received radiotherapy post- operation. Follow up showed that the patient survived for two years after operation. The result showed that combination of laser application during surgery and radiotherapy post-operation was an effective method to delay or prevent tumor recurrence.

  16. Invasive intracranial aspergillosis spread by the pterygopalatine fossa in an immunocompetent patient.

    Xiao, Anqi; Jiang, Shu; Liu, Yi; Deng, Kaihong; You, Chao

    2012-01-01

    Aspergillosis of the central nervous system (CNS) is an uncommon infection, mainly found in immunocompromised patients but rarely seen among immunocompetent patients. Herein we describe a 57 year-old immunocompetent man who suffered intracranial aspergillosis spread by the pterygopalatine fossa (PPF) following a tooth extraction. Based on magnetic resonance imaging (MRI) characteristics, in this report we focus on the spreading routes of CNS aspergillosis via communicative structures of the PPF, the relationship between clinical manifestations and the locations of the lesion, and propose a therapeutic strategy to improve the prognosis. PMID:22552465

  17. Invasive intracranial aspergillosis spread by the pterygopalatine fossa in an immunocompetent patient

    Anqi Xiao

    2012-04-01

    Full Text Available Aspergillosis of the central nervous system (CNS is an uncommon infection, mainly found in immunocompromised patients but rarely seen among immunocompetent patients. Herein we describe a 57 year-old immunocompetent man who suffered intracranial aspergillosis spread by the pterygopalatine fossa (PPF following a tooth extraction. Based on magnetic resonance imaging (MRI characteristics, in this report we focus on the spreading routes of CNS aspergillosis via communicative structures of the PPF, the relationship between clinical manifestations and the locations of the lesion, and propose a therapeutic strategy to improve the prognosis.

  18. Recurrent inverted papilloma with intracranial and temporal fossa involvement: A case report and review of the literature

    Inverted papilloma (I.P.) is a rare naso-sinusal benign tumour, with epithelium surface inversion to inside the stroma. Extension to intracranial temporal fossa and middle ear has been reported in few cases in the literature. This involvement may be derived from either direct extension from sino-nasal cavity via the Eustachian tube or primary middle ear involvement secondary to meta-plastic changes of the middle ear mucosa. Here, we report a case of inverted papilloma in a male patient, with multiple recurrences, middle ear and intracranial involvement into the temporal fossa with posterior development of malignancy. This patient had received multiple surgeries and radiotherapy but despite of that, his disease recurred several times. As a conclusion, inverted papilloma is a benign tumour with an aggressive course, tendency to recurrence and progression to malignancy. Intracranial and temporal fossa involvements are rare and the treatment depends of the symptoms and the severity of the disease. (authors)

  19. Surgical exposure of the internal auditory canal by the middle cranial fossa approach. Using CT and MRI fluoroscopic image

    Surgical exposure of the internal auditory canal by the middle cranial fossa approach for acoustic neurinoma is much more difficult than by the trans labyrinthine approach, because there are so few surgical landmarks in the middle cranial fossa to approach to the internal auditory canal. We developed a new method to identify the internal auditory canal easily and accurately by the following techniques. Tracing bilateral internal auditory canal and external auditory canal from high-resolution CT in several slice levels and a tumor from enhanced MRI and the fluoroscopic image was composed. Determination of the drilling line on the middle cranial fossa which showed the relationship of the external auditory canal and internal auditory canal. As the result, among 6 tumor excisions operated on with this new method, the internal auditory canal was easily reached without causing damage to the inner ear structure. (author)

  20. Posterior fossa abnormalities in high-risk term infants: comparison of ultrasound and MRI

    We aimed to assess the characteristics of posterior fossa (PF) abnormalities in a cohort of high-risk term neonates, as well as the diagnostic performance of cranial ultrasound (CUS) with additional mastoid fontanelle (MF) views for the detection of these abnormalities, with magnetic resonance imaging (MRI) being the reference standard. In this retrospective study, 113 term neonates with CUS and subsequent MRI were included. Sensitivity, specificity, and predictive values of routine CUS and CUS with MF views were calculated. Posterior fossa abnormalities were diagnosed on CUS in 46 of 113 infants. MRI confirmed these findings in 43 and showed additional abnormalities in 32 infants. The sensitivity and specificity of anterior fontanelle views for major PF abnormalities as seen on MRI were 16 % and 99 %. Adding MF views increased the sensitivity of US to 82 %. The sensitivity and specificity of MF views for the detection of any (major or minor) PF abnormality were 57 % and 95 %. Especially acute hypoxic-ischemic injury and small subdural and punctate cerebellar haemorrhage remained undetected by CUS. PF abnormalities are frequent in high-risk term infants. MF-CUS enables early diagnosis of major PF abnormalities. We therefore advocate to perform MF-CUS in high-risk term neonates. (orig.)

  1. MR imaging of the posterior fossa structures of human embryos and fetuses

    There have been few reports on MR imaging of the developing human fetal brain. The aim of this article is to establish a standard atlas of developing fetal brain, focusing in particular on posterior fossa structures. Eighty-eight formalin-fixed embryos and fetuses were examined using 1.5 Tesla MR units. Specimens ranged from Carnegie stage 17 to 28 gestational weeks. The morphologic changes in developing cerebellum, cerebellar fissures, pontine flexure, fourth ventricle, and cerebral aqueduct were observed in each developmental period. The height of the fourth ventricle and cerebral aqueduct and the thickness of the tectum and the tegmentum of the midbrain were measured. We obtained detailed MR images of the developmental changes in posterior fossa structures and produced an atlas of these images. Our study showed that the period of visualization of cerebellar structures and fissures was later on MR imaging than described in past anatomical and embryological studies. In addition, the sudden decrease in height of the fourth ventricle and the cerebral aqueduct found in our study might reflect the presence of communication between the fourth ventricle and subarachnoid space. (author)

  2. Functional and neuropsychological late outcomes in posterior fossa tumors in children.

    Lassaletta, Alvaro; Bouffet, Eric; Mabbott, Donald; Kulkarni, Abhaya V

    2015-10-01

    Tumors of the posterior fossa (PF) account for up to 60 % of all childhood intracranial tumors. Over the last decades, the mortality rate of children with posterior fossa tumors has gradually decreased. While survival has been the primary objective in most reports, quality of survival increasingly appears to be an important indicator of a successful outcome. Children with a PF tumor can sustain damage to the cerebellum and other brain structures from the tumor itself, concomitant hydrocephalus, the consequences of treatment (surgery, chemotherapy, radiotherapy), or a combination of these factors. Together, these contribute to long-term sequelae in physical functioning, neuropsychological late outcomes (including academic outcome, working memory, perception and estimation of time, and selective attention, long-term neuromotor speech deficits, and executive functioning). Long-term quality of life can also be affected by endocrinological complication or the occurrence of secondary tumors. A significant proportion of survivors of PF tumors require long-term special education services and have reduced rates of high school graduation and employment. Interventions to improve neuropsychological functioning in childhood PF tumor survivors include (1) pharmacological interventions (such as methylphenidate, modafinil, or donepezil), (2) cognitive remediation, and (3) home-based computerized cognitive training. In order to achieve the best possible outcome for survivors, and ultimately minimize long-term complications, new interventions must be developed to prevent and ameliorate the neuro-toxic effects experienced by these children. PMID:26351237

  3. A morphometric CT study of Down's syndrome showing small posterior fossa and calcification of basal ganglia

    We report characteristic and morphometric changes of cranial computed tomography (CT) with increasing age in 56 patients with Down's syndrome aged from 0 month to 37 years. Patients were compared with 142 normal controls aged 0 to 59 years. Width of ventricles, Sylvian fissures, posterior fossa, pons and cisterna magna were measured on CT. The incidences of the cavum septi pellucidi, cavum vergae and cavum veli interpositi and high density in the basal ganglia were examined. There was high incidence (10.7%) of bilateral calcification of basal ganglia in Down's syndrome, although that of pineal body and choroid plexus calcification was similar in Down's syndrome and controls. Basal ganglia calcification is more frequently seen in young Down's syndrome and may be related to the premature aging characteristic of Down's syndrome. The CT in Down's syndrome showed relatively small posterior fossa, small cerebellum, small brain stem and relatively large Sylvian fissures in those under one year of age. There was a high frequency of midline cava and large cisterna magna. There were no significant atrophic changes on CT except after the fifth decade comparing with controls. (orig.)

  4. Pathology, treatment and management of posterior fossa brain tumors in childhood

    Brain tumors are the second most common childhood malignancy. Between 1975 and 1985, 462 newly diagnosed patients were treated at the Children's Hospital of Philadelphia; 207 (45%) tumors arose in the posterior fossa and 255 (55%) appeared supratentorially. A wide variety of histological subtypes were seen, each requiring tumor-specific treatment approaches. These included primitive neuroectodermal tumor (n = 86, 19%), astrocytoma (n = 135, 30%), brainstem glioma (n = 47, 10%), anaplastic astrocytoma (n = 32, 7%), and ependymoma (n = 30, 6%). Because of advances in diagnostic abilities, surgery, radiotherapy, and chemotherapy, between 60% and 70% of these patients are alive today. Diagnostic tools such as computed tomography and magnetic resonance imaging allow for better perioperative management and follow-up, while the operating microscope, CO2 laser, cavitron ultrasonic aspirator and neurosurgical microinstrumentation allow for more extensive and safer surgery. Disease specific treatment protocols, utilizing radiotherapy and adjuvant chemotherapy, have made survival common in tumors such as medulloblastoma. As survival rates increase, cognitive, endocrinologic and psychologic sequelae become increasingly important. The optimal management of children with brain tumors demands a multidisciplinary approach, best facilitated by a neuro-oncology team composed of multiple subspecialists. This article addresses incidence, classification and histology, clinical presentation, diagnosis, pre-, intra- and postoperative management, long-term effects and the team approach in posterior fossa tumors in childhood. Management of specific tumor types is included as well. 57 references

  5. Long-term outcomes of gamma knife surgery for posterior fossa arteriovenous malformations

    The long-term outcomes of gamma knife surgery (GKS) in patients with posterior fossa arteriovenous malformations (AVMs) were retrospectively analyzed in 82 patients followed up for more than 5 years to evaluate the efficacy and safety. The median AVM volume at GKS was 0.95 cm3. The prescribed dose to the AVM margin was median 18 Gy with 1-18 isocenters. The actual complete AVM obliteration rate was 58.5% at 3 years and 78.0% at 5 years. The significant factors for higher complete obliteration rate were younger patient age and smaller maximum/minimum nidus diameter ratio. Two patients experienced hemorrhage caused by residual AVM rupture at 4 and 49 months. Twenty patients developed peri-nidal edema as an adverse radiation-induced reaction at median 13 months. One patient developed radiation-induced necrosis at 6.8 years. Neurological complication was observed in 12 patients and 6 patients remained with neurological dysfunction permanently. Larger nidus volume and location adjacent to an eloquent area significantly increased the risk of neurological complication. Pittsburgh radiosurgery-based AVM grading scale was significantly correlated with the outcome of neurological symptoms after GKS. GKS achieved acceptable and complete obliteration rate for posterior fossa AVM with relatively low risk of morbidity on neuroimaging and neurological symptoms for the long-term period after treatment. We recommend conformable and selective treatment planning to achieve both obliteration of the AVM nidus and preservation of neurological function. (author)

  6. Posterior fossa abnormalities in high-risk term infants: comparison of ultrasound and MRI

    Steggerda, S.J.; Smits-Wintjens, V.E.H.J.; Verbon, P.; Walther, F.J. [Leiden University Medical Centre, Department of Neonatology, Leiden (Netherlands); Bruine, F.T. de [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Wezel-Meijler, G. van [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Isala Hospital, Department of Neonatology, Zwolle (Netherlands)

    2015-09-15

    We aimed to assess the characteristics of posterior fossa (PF) abnormalities in a cohort of high-risk term neonates, as well as the diagnostic performance of cranial ultrasound (CUS) with additional mastoid fontanelle (MF) views for the detection of these abnormalities, with magnetic resonance imaging (MRI) being the reference standard. In this retrospective study, 113 term neonates with CUS and subsequent MRI were included. Sensitivity, specificity, and predictive values of routine CUS and CUS with MF views were calculated. Posterior fossa abnormalities were diagnosed on CUS in 46 of 113 infants. MRI confirmed these findings in 43 and showed additional abnormalities in 32 infants. The sensitivity and specificity of anterior fontanelle views for major PF abnormalities as seen on MRI were 16 % and 99 %. Adding MF views increased the sensitivity of US to 82 %. The sensitivity and specificity of MF views for the detection of any (major or minor) PF abnormality were 57 % and 95 %. Especially acute hypoxic-ischemic injury and small subdural and punctate cerebellar haemorrhage remained undetected by CUS. PF abnormalities are frequent in high-risk term infants. MF-CUS enables early diagnosis of major PF abnormalities. We therefore advocate to perform MF-CUS in high-risk term neonates. (orig.)

  7. Surgical safety distances in the infratemporal fossa: three-dimensional measurement study.

    Guo, Y X; Sun, Z P; Liu, X J; Bhandari, K; Guo, C B

    2015-05-01

    The wedge-shaped infratemporal fossa is a constricted space and has long been a surgical challenge, mainly due to difficulties in access. Three-dimensional (3D) reconstruction of the skull, internal carotid artery (ICA), and internal jugular vein (IJV) was carried out using enhanced computed tomography (CT) data, to measure the safety distances in relation to infratemporal fossa surgery. Fifty enhanced CT datasets were selected to reconstruct 3D images by segmentation technique. The anatomical routes of the ICA, IJV, and the styloid process (SP) were observed. The following were measured: SP length, height of the pterygoid plates (PP height), distances from the pterygoid process (antero-inferior and anterosuperior border) to the leading edge of the ICA (PP-ICA (inferior), PP-ICA (superior)), and distance between the most prominent point of the zygomatic arch and the medial pterygoid plate (Zyg-MPP). The mean measurements of SP length, PP height, and the distances PP-ICA (inferior), PP-ICA (superior), and Zyg-MPP were 30.64 mm, 26.61 mm, 31.16 mm, 34.37 mm, and 51.37 mm, respectively. No significant differences were observed by age group, except the distance of PP-ICA (inferior) on the left side. In centres without intraoperative navigation facilities, proper knowledge of the anatomy, particularly of bony landmarks and the safe distances to nearby neurovascular structures, can provide useful information to ensure safe operations. PMID:25441861

  8. Life-threatening posterior fossa cyst induced by pseudomeningocele after operation for acoustic neuroma

    Chiang, Jung-Ying; Lin, Hung-Lin

    2015-01-01

    Background: Pseudomeningocele is the term used to describe fluid accumulation due to the leakage of cerebrospinal fluid into the surrounding soft tissue. It may cause complications such as cosmetic deformities, chronic meningitis, and/or impingement on vital structures resulting in neurological deficits; nevertheless, life-threatening posterior fossa cyst formation is a rare event. Case Description: We report a case of posterior fossa cyst formation induced by pseudomeningocele with brain stem compression leading to coma with pupillary dilation. These symptoms occurred after an operation for left acoustic neuroma. After emergent decompression and dural repair, the patient recovered well without experiencing any further neurological deficits. Conclusion: We discuss the clinical features, possible pathophysiological mechanisms, and treatment options for pseudomeningocele. Although most cases of pseudomeningocele follow a benign course and need only conservative treatment, the potential attendant complications, such as an enlarged cyst, may still have fatal consequences. We believe that it is beneficial to take an aggressive attitude toward this condition and to consider the possibility of surgical interventions more seriously. PMID:25883852

  9. High precision locations of long-period events at La Fossa Crater (Vulcano Island, Italy

    Salvatore Rapisarda

    2009-06-01

    Full Text Available Since the last eruption in 1888-90, the volcanic activity on Vulcano Island (Aeolian Archipelago, Italy has been limited to fumarolic degassing. Fumaroles are mainly concentred at the active cone of La Fossa in the northern sector of the island and are periodically characterized by increases in temperature as well as in the amount of both CO2 and He. Seismic background activity at Vulcano is dominated by micro-seismicity originating at shallow depth (<1-1.5 km under La Fossa cone. This seismicity is related to geothermal system processes and comprises long period (LP events. LPs are generally considered as the resonance of a fluid-filled volume in response to a trigger. We analyzed LP events recorded during an anomalous degassing period (August-October 2006 applying a high precision technique to define the shape of the trigger source. Absolute and high precision locations suggest that LP events recorded at Vulcano during 2006 were produced by a shallow focal zone ca. 200 m long, 40 m wide and N30-40E oriented. Their occurrence is linked to magmatic fluid inputs that by modifying the hydrothermal system cause excitation of a fluid-filled cavity.

  10. Late effects of treatment on the intelligence of children with posterior fossa tumors

    This retrospective pilot study was undertaken to evaluate the late effects of treatment on intelligence in a population of children with posterior fossa tumors. Ten children with posterior fossa tumors treated with radiation and chemotherapy received intellectual evaluations at least one year following diagnosis. Six children had medulloblastomas, one child had a fourth ventricular ependymoma, two children had brainstem gliomas, and one child had a recurrent cerebellar astrocytoma. Children with supratentorial tumors were specifically excluded from the study in order to eliminate the possible influence of the tumor on intellectual functioning. Four children had had intelligence testing in school prior to treatment of their tumor. In each case results following treatment revealed a deterioration of full scale IQ of at least 25 points. Six children did not have prior testing; of these, two had IQ's less than 20. Overall, 50% of the patients had IQ's of less than 80 and 20% had IQ's of greater than 100. Furthermore, four children with normal intelligence (IQ greater than 80) have learning problems requiring special classes. Thus, of the ten children evaluated, all have either dementia, learning disabilities, or evidence of intellectual retardation. This study suggests that aggressive treatment of children with brain tumors may improve survivals but may be associated with significant long-term disabilities

  11. Extramedullary Plasmacytoma Presenting as a Solitary Mass in the Intracranial Posterior Fossa

    A patient with a 3-month history of headache refractory to pain medication was admitted. The CT scan and MRI showed evidence of a posterior fossa mass. This was pathologically confirmed as an extra medullary plasmacytoma (EMP). He had a pathologic fracture of the left humerus 7 years ago while the radiologist was unaware at the time of diagnosis. A solitary bone plasmacytoma (SBP) was the cause of the pathologic fracture. This report includes the first description of MRI findings in a patient with a rare-incidence intracranial solitary extra medullary plasmacytoma (SEP) in Iran. There is a striking similarity between the features of intracranial SEP and meningiomas. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise. The MRI findings and differential diagnosis of plasmacytoma are reviewed. Before this case report, only few cases have been reported in the literature. Nonetheless, this is the first report of posterior fossa EMP from Iran

  12. Changes in sebum levels and the development of acneiform rash in patients with non–small cell lung cancer after treatment with EGFR inhibitors

    Nakahara T

    2015-01-01

    Full Text Available Takeshi Nakahara,1,2 Yoichi Moroi,2 Koichi Takayama,3 Eriko Itoh,1,2 Makiko Kido-Nakahara,2 Yoichi Nakanishi,3 Masutaka Furue2 1Division of Skin Surface Sensing, 2Department of Dermatology, 3Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan Background: It has recently been shown that patients treated with epidermal growth factor receptor (EGFR inhibitors often develop various cutaneous adverse events. While the pathogenesis underlying these events remains unclear, the relationship between skin toxicity induced by EGFR inhibitors and the sebaceous glands that express EGFR has been previously reported. Objectives: The primary aim of this study was to determine the relationship between cutaneous sebum levels and acneiform rash, a typical skin toxicity of EGFR inhibitors, by measuring the sebum levels before and after EGFR inhibitor treatment. Methods: Eight patients diagnosed with non–small cell lung cancer (NSCLC (three men and five women with an average age of 69.3 years who were initiated on treatment with EGFR inhibitors (either gefitinib [Iressa®] or erlotinib [Tarceva®] were enrolled. Using a Sebumeter®, sebum levels in the face, chest, and back of each patient were measured before and after EGFR inhibitor treatment. The development of acneiform rash in each skin region was also assessed. Results: Changes in sebum level along with the development of an acneiform rash were observed after patients were started on EGFR inhibitor treatment. Patients who developed an EGFR inhibitor–induced acneiform rash tended to have higher pretreatment sebum levels (baseline than did patients who did not experience an acneiform rash. At each time point measurement, sebum levels were found to be significantly higher in patients who had developed an acneiform rash at that time. Patients who developed rash during treatment showed greater differences in sebum level compared with pretreatment baseline. Conclusion: Patients who had increased levels of sebum or whose sebum levels showed greater change from pretreatment baseline developed an acneiform rash, suggesting that sebaceous gland activity may be involved in the mechanism underlying the development of acneiform rash, in patients treated with EGFR inhibitors. Keywords: skin toxicity, cutaneous adverse event, gefitinib, erlotinib

  13. Topographic Constraints on the Mode of Formation of an Enigmatic Flow in Cerberus Fossae, Mars

    Mouginis-Mark, P. J.; Wilson, L.

    2013-12-01

    We use a digital elevation model (DEM), derived from stereo Context Camera (CTX) images referenced to Mars Orbiter Laser Altimeter (MOLA) data, and shadow length measurements made from High Resolution Imaging Science Experiment (HiRISE) images, to investigate the geometry of a young enigmatic flow in S.W. Cerberus Fossae, Mars. The flow originates from an almost circular (1.2 x 1.5 km) pit within a remnant of a yardang at 0o 35'N, 155o 17'E, within the lower unit of the Medusae Fossae Formation. The flow is ~42 km long and 0.5 to 2.0 km wide, and MOLA data indicate that the flow falls ~50 m along its length. The flow has a broad distal fan of material ~8 x 14 km in size that has a platey surface texture. The source area of the flow displays several sets of semi-concentric ridges with different centers of curvature, and the CTX DEM shows this depression is ~20 m deep, implying a volume of ~0.03 km3 for the removed material. Measurements made from the DEM of the height of the bounding walls of several 160 - 200 m wide constrictions, where 'over-spill' from the flow forms a clear disrupted margin to the flow on the adjacent hills, indicate that the flow was never more than ~8 - 10 m thicker than it currently appears. The total surface area of the flow is ~153 km2 and 25 shadow length measurements made from HiRISE images of the flow margins at 16 different places along the flow give a typical thickness of ~4 m. These measurements imply a volume for the flow of ~0.6 km3, which is 20 times larger than the volume of the flow's source area, thereby demonstrating that a significant amount of new material was erupted to form the flow. The available morphologic and topographic data raise the intriguing probability that the flow is most likely not a lava flow, but is instead a mud flow produced by water reaching the surface within the yardang materials and the subsequent mobilization of the unconsolidated material that comprised the yardang. This proposed mud flow origin consequently raises the possibility that other similar young platey-textured flows in Cerberus Fossae are also non-volcanic.

  14. Anatomical aspects of posterior fossa affecting lateral suboccipital approach. Evaluation by bone-window CT

    The high-resolution 1.5 mm-slice bone-window CT images of the posterior fossa in 40 patients with the cerebello-pontine angle tumor were reviewed regarding three anatomical aspects: the internal occipital crest (IOC), the posterior surface of the petrous bone, and the 'petrous angle'. The IOC was sometimes prominent and protruded profoundly into the posterior fossa. The height of IOC from the inner table of the occipital bone was 9.6±3.3 mm. The posterior surface of the petrous bone was convex to the posterior fossa in the most cases; the zenith of the prominence was the porus acusticus. The convexity of the posterior surface in the CT image was objectively evaluated by the 'porus angle' made by two lines of A and B; the line A was the posterior half of the posterior surface of the petrous bone, and the line B was the anterior half of it. The 'porus angle' in 40 cases was 28±14deg in the left side, and 28±12deg in the right side. The 'petrous angle', made by the cranial sagittal line and (the posterior half of ) the posterior surface of the petrous bone, was 61.8±5.8deg and 62.7±7.0deg, respectively. In the patient with a prominent IOC, the lateral suboccipital approach (LSA) with a unilateral suboccipital craniotomy may induce the compression of the cerebellar hemisphere by the brain retractor and the prominent IOC, and develop cerebellar contusion. Such a postoperative cerebellar complication can be avoided by a large suboccipital craniotomy with the resection of the prominent IOC extending contralaterally. The severe convexity of the posterior surface of the petrous bone, i.e. the large 'porus angle', makes it difficult to get the view of the petroclival region in the LSA. The larger is the 'petrous angle', the less cerebellar compression is necessary for the approach to the cerebello-pontine angle by the LSA; the large 'petrous angle' is advantageous to the approach. (H.O.)

  15. Microsurgical localization of the cochlea in the extended middle fossa approach.

    Forbes, Jonathan A; Rivas, Alejandro; Tsai, Betty; Ehtesham, Moneeb; Zuckerman, Scott; Wanna, George; Weaver, Kyle

    2012-12-01

    Objective In the extended middle fossa approach, a portion of the petrous bone known as Kawase's rhomboid can be drilled to expose the posterior fossa through a middle fossa corridor. During this bony resection, the cochlea is placed at risk. The objective of this study was to objectively detail the position of the cochlea in relation to reliable surgical landmarks. Methods Eleven cadaveric specimens were dissected-including six cadaveric heads and five dry temporal bones by means of an anterior petrosectomy with skeletonization of the cochlea. Three anatomic measurements describing the location of the cochlea in relation to the extrapolated intersection of the greater superficial petrosal nerve (GSPN) and facial nerve were recorded. These measurements were then correlated with thin-cut temporal bone computed tomography scans from 25 patients with morphologically normal inner ears. Results In the cadaveric specimens, the anterior border of the membranous basal turn of the cochlea was located an average of 7.56 mm (6.4 to 8.9 mm) anterior to the extrapolated junction of the GSPN and facial nerve, as measured along the course of the GSPN. The medial border of the membranous cochlea (medial margin of basal turn) was located an average of 8.2 mm (6.9 to 8.9 mm) medial to the extrapolated junction of the GSPN and facial nerve, as measured along the course of the facial nerve. The average maximum distance from the extrapolated junction of the GSPN and facial nerve to the membranous cochlea was 9.3 mm (8.2 to 10.3 mm). These anatomic measurements correlated well with radiologic measurements of the same parameters. Conclusion When drilling Kawase's rhomboid, it is useful to locate the extrapolated junction of the GSPN and the facial nerve. Drilling of the anteromedial petrous bone outside of a radius of 12.5 mm from the extrapolated junction of GSPN and facial nerve appears to be associated with a low degree of risk to the cochlear apparatus. PMID:24294559

  16. Role of Cerebellum in Fine Speech Control in Childhood: Persistent Dysarthria after Surgical Treatment for Posterior Fossa Tumour

    Morgan, A. T.; Liegeois, F.; Liederkerke, C.; Vogel, A. P.; Hayward, R.; Harkness, W.; Chong, K.; Vargha-Khadem, F.

    2011-01-01

    Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen…

  17. Bone changes in the condylar head and mandibular fossa in patients with temporomandibular disorders. Helical CT observation

    In the present study, we investigated whether bone changes are present in sites impossible to observe by panoramic X-ray and Schuller's X-ray examination, namely the medial of the condylar head and mandibular fossa, in patients with type IV temporomandibular joint disorders. We observed the articular fossa using computed tomography, which is able to obtain detailed 3-dimensional information, in patients with type IV temporomandibular disorders. We examined 120 joints of 60 patiens who visited the Department of Oral Surgery, Osaka Medical College Hospital. Each condylar head was clearly visualized in panoramic X-ray and Schuller's X-ray examination findings, and shown to have possible changes unilaterally. Each joint was diagnosed as type IV, according to the diagnostic guidelines set by Japanese Society for Temporomandibular Joint, and further examined using helical CT. Changes in condylar head; We concluded that bone changes were present with considerable probability in the medial of condylar head in a manner similar to those found in the lateral and center of joints with type IV temporomandibular disorders. Changes in mandibular fossa; The bone changes occurred in various locations of the mandibular fossa, while they appeared significantly more frequently in the condylar head. We think that our finding will contribute to development of treatment strategies for temporomandibular disorders, as they clarify bone changes in sites previously unreported. (author)

  18. Contribution of sup(99m)Tc pertechnetate brain scintigraphy in the diagnosis of tumours of posterior fossa

    The present work concerns 38 posterior cranial fossa tumour cases subjected to sup(99m)Tc pertechnetate brain scintigraphy between May 1974 and June 1976. 33 of these patients have undergone an anatomical check while for the remaining 5, the existence of a posterior fossa tumour is established from the conjunction of clinical signs and other paraclinical examinations. The procedure was the same for all these 38 patients: after a 300 μC/kg injection of tracer, an immediate angioscintigraphic period, an early set of pictures (half an hour after the tracer injection) then delayed set (4 to 5 hours later) taken from 4 angles: front, back and two profiles. The examination was performed with an OHIO NUCLEAR SIEMENS gamma camera and sometimes a conventional scanner as well (the latter giving no better a diagnosis than the former). In 75% of the cases a hyperfixation of the injected tracer was observed and its site located quite accurately in the posterior fossa tumour. The etiology of the lesion could be diagnosed in 'most probable' or 'least probable' terms. Examination of work by other authors, who obtained similar results, leads to the conclusion that this method is very helpful in the diagnosis of posterior fossa tumours when used as a means of early detection, before the undertaking of more complex neuroradiological explorations

  19. Role of Cerebellum in Fine Speech Control in Childhood: Persistent Dysarthria after Surgical Treatment for Posterior Fossa Tumour

    Morgan, A. T.; Liegeois, F.; Liederkerke, C.; Vogel, A. P.; Hayward, R.; Harkness, W.; Chong, K.; Vargha-Khadem, F.

    2011-01-01

    Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen…

  20. Infraorbital nerve block within the Pterygopalatine fossa of the horse: anatomical landmarks defined by computed tomography

    In order to provide anaesthesia of the equine maxillary cheek teeth, a local nerve block of the infraorbital nerve in the pterygopalatine fossa had been proposed, which is referred to as the 'Palatine Bone Insertion' (PBI). As several complications with this method were reported, our study was designed to recommend a modified injection technique which avoids the risk of puncturing of relevant anatomical structures. Five cadaver heads and two living horses were examined by contrast medium injections and subsequent computed tomography (CT). Spinal needles were inserted using two different insertion techniques: The above mentioned (PBI), and a modification called 'Extraperiorbital Fat Body Insertion' (EFBI). Both techniques (PBI and EFBI) provide a consistent distribution of contrast medium around the infraorbital nerve. However, only the EFBI technique is appropriate to minimize the risk of complications. This study is an example for the permanent challenge of anatomists to supply a basis for clinical and surgical procedures

  1. Cholecystokinin-Assisted Hydrodissection of the Gallbladder Fossa during FDG PET/CT-guided Liver Ablation

    Tewari, Sanjit O., E-mail: tewaris@mskcc.org [Memorial Sloan-Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Petre, Elena N., E-mail: petree@mskcc.org [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States); Osborne, Joseph, E-mail: osbornej@mskcc.org [Memorial Sloan-Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Sofocleous, Constantinos T., E-mail: sofoclec@mskcc.org [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States)

    2013-12-15

    A 68-year-old female with colorectal cancer developed a metachronous isolated fluorodeoxyglucose-avid (FDG-avid) segment 5/6 gallbladder fossa hepatic lesion and was referred for percutaneous ablation. Pre-procedure computed tomography (CT) images demonstrated a distended gallbladder abutting the segment 5/6 hepatic metastasis. In order to perform ablation with clear margins and avoid direct puncture and aspiration of the gallbladder, cholecystokinin was administered intravenously to stimulate gallbladder contraction before hydrodissection. Subsequently, the lesion was ablated successfully with sufficient margins, of greater than 1.0 cm, using microwave with ultrasound and FDG PET/CT guidance. The patient tolerated the procedure very well and was discharged home the next day.

  2. Giant posterior fossa arachnoid cyst causing tonsillar herniation and cervical syringomyelia

    Vijay P Joshi

    2013-01-01

    Full Text Available Acquired cerebellar tonsillar herniation and syringomyelia associated with posterior fossa mass lesions is an exception rather than the rule. In the present article, we describe the neuroimaging findings in a case of 28-year-old female patient presented with a history of paraesthesia involving right upper limb of 8-month duration. Magnetic resonance imaging showed a giant retrocerebellar arachnoid causing tonsillar herniation with cervical syringomyelia. The findings in the present case supports that the one of the primary mechanism for the development of syringomyelia may be the obstruction to the flow of cerebrospinal fluid causing alterations in the passage of extracellular fluid in the spinal cord and leading to syringomyelia.

  3. Cholecystokinin-Assisted Hydrodissection of the Gallbladder Fossa during FDG PET/CT-guided Liver Ablation

    A 68-year-old female with colorectal cancer developed a metachronous isolated fluorodeoxyglucose-avid (FDG-avid) segment 5/6 gallbladder fossa hepatic lesion and was referred for percutaneous ablation. Pre-procedure computed tomography (CT) images demonstrated a distended gallbladder abutting the segment 5/6 hepatic metastasis. In order to perform ablation with clear margins and avoid direct puncture and aspiration of the gallbladder, cholecystokinin was administered intravenously to stimulate gallbladder contraction before hydrodissection. Subsequently, the lesion was ablated successfully with sufficient margins, of greater than 1.0 cm, using microwave with ultrasound and FDG PET/CT guidance. The patient tolerated the procedure very well and was discharged home the next day

  4. Posterior cranial fossa box expansion leads to resolution of symptomatic cerebellar ptosis following Chiari I malformation repair.

    Heller, Justin B; Lazareff, Jorge; Gabbay, Joubin S; Lam, Sandi; Kawamoto, Henry K; Bradley, James P

    2007-03-01

    Chiari I malformation occurs when the cerebellar tonsils herniate downward through the foramen magnum into the upper cervical spinal canal. If the posterior fossa craniectomy during corrective surgery leads to excessive enlargement of the foramen magnum, the complication of cerebellar ptosis may result. To treat this difficult problem a posterior cranial fossa box expansion was devised and studied. Patients who developed symptomatic cerebellar ptosis (confirmed by MRI) following cranial vault decompression for Chiari I malformations underwent a posterior fossa box expansion (n=7). This procedure involved coverage of posterior aspect of the enlarged foramen magnum with a split-thickness calvarial bone graft box. The box reconstruction provided separation between the neck musculature, soft tissues from the neural tissue; prevention of cerebellar prolapse; and expansion of the posterior cranial vault. Patients had a mean of 12+/-1 months between initial suboccipital craniectomy and confirmation of symptomatic cerebellar ptosis. Mean age at the time of posterior fossa box reconstruction was 31+/-9 years (range of 14 to 44 years). Preoperative symptoms of headache (7/7, 100%), upper extremity numbness (5/7, 71%) or paresthesias (3/7, 43%), respiratory disturbance (2/7, 29%) and inability to walk (2/7, 29%) improved in all patients postoperatively. At more than 12 month follow-up 6/7 patients (86%) were both disease-free (MRI confirmation) and symptom-free. One out of seven patients had return of headache in a more mild form. Thus, in our patient group the posterior fossa box reconstruction led to resolution of symptomatic cerebellar ptosis following Chiari I malformation repair. PMID:17414275

  5. Magnetic resonance imaging (MRI) of neurosurgical disorders in the posterior fossa

    Since July, 1985, we have studied 247 patients with neurosurgical disorders using the superconductive magnetic resonance imaging (MRI) system (Philips Gyroscan S5). The lesions were in the posterior fossa in 31 cases, including nine intramedullary and 11 extramedullary tumors, five vascular malformations, two hemorrhages, two infarctions, and two congenital malformations. Each examination involved the use of T1-weighted (SE400/30), proton-density-weighted (SE1200 - 1500/50), T2-weighted (SE1200 - 1500/100, 150, 200), and inversion-recovery images (IR1400 - 1800/400/30). In general, the tumors showed a high intensity in the T2-weighted images and a low intensity in the T1-weighted images. With the T2-weighted images, perifocal edema was most clearly detectable, but the interface between tumor and edema became less clear. Contrast enhancement with Gadolinium-DTPA (0.1 mmol/kg, I.V.) was performed in five out of the twenty patients with tumors. After the administration of Gd-DTPA, an increased signal intensity from the tumor was observed in all five patients. The differentiation of the tumor from the perifocal edema was best in the postcontrast, T1-weighted images. In the patient with a cerebellar venous angioma, an enlarged draining vein showed a low signal intensity on the first-spin echo image and an increased signal intensity on the second-spin echo image. A comparison of the MRI and X-ray CT findings showed that the MRI indicated more precisely the extent and nature of lesions. It is concluded that MRI could be the first screening procedure in patients with a suspected neurosurgical disorder in the posterior fossa. (author)

  6. Incidence, Risks, and Sequelae of Posterior Fossa Syndrome in Pediatric Medulloblastoma

    Purpose: To investigate the incidence, risks, severity, and sequelae of posterior fossa syndrome (PFS) in children with medulloblastoma. Methods and Materials: Between 1990 and 2007, 63 children with medulloblastoma at Emory University and Children's Healthcare of Atlanta were treated with craniectomy followed by radiation. Fifty-one patients were assigned to a standard-risk group, and 12 patients were assigned to a high-risk group. Five patients had 2 residual tumor, 4 had ≥1.5-cm2 residual tumor, and the remainder had no residual tumor. Eleven patients had disseminated disease. Patients received craniospinal irradiation at a typical dose of 23.4 Gy or 36 Gy for standard- or high-risk disease, respectively. The posterior fossa was given a total dose of 54 or 55.8 Gy. Nearly all patients received chemotherapy following cooperative group protocols. Results: Median follow-up was 7 years. PFS developed in 18 patients (29%). On univariate analysis, brainstem invasion, midline tumor location, younger age, and the absence of radiographic residual tumor were found to be predictors of PFS; the last two variables remained significant on multivariate analysis. From 1990 to 2000 and from 2001 to 2007, the proportions of patients with no radiographic residual tumor were 77% and 94%, respectively. During the same eras, the proportions of patients with PFS were 17% and 39%. Only 4 patients had complete recovery at last follow-up. Conclusions: The incidence of PFS increased in the latter study period and is proportional to more aggressive surgery. Children with midline tumors exhibiting brainstem invasion are at increased risk. With the increased incidence of PFS and the permanent morbidity in many patients, the risks and benefits of complete tumor removal in all patients need to be reexamined.

  7. Treatment and diagnosis of middle fossa arachnoid cyst. Ventriculofiberscopy and cine-MRI

    The treatment of intracranial arachnoid cysts is controversial regarding its surgical indication and operative procedures. Conventional surgical approaches such as fenestration, membranectomy, and shunting operation are invasive. Also CT cisternography and/or RI cisternography are invasive, when it has been performed to evaluate the possible CSF communications between the arachnoid cyst and subarachnoid space. Between July 1994 and February 1997, 10 patients with intracranial middle fossa arachnoid cysts were treated with a newly developed ventriculofiberscope which is characterized by splendid mechanical flexibility and high resolution. The cine-MRI, which is a non-invasive diagnostic tool, is used to evaluate the CSF circulation around the cyst fenestration. The patients' ages ranged from 4 months to 10 years, with a mean of 4.46 years. The cyst locations were left middle fossa (9), and right (1). Eight patients presented with macrocrania, 4 with developmental delay, three with seizure, two with headache, and one with subdural hematoma. The patients were preoperatively evaluated by means of MRI and cine-MR images. In all patients ventriculofiberscopic procedures including cyst fenestration, membranous dissection, cyst puncture and shriveling were successfully performed. Postoperative MR and cine-MR studies have shown reduction of the cyst size and appropriate CSF circulation. Neuroendoscopic procedures seem to be the first choice for children with arachnoid cysts and the ventriculofiberscope proved to be very useful not only for cyst fenestration but also for cyst dissection. In addition, the non-invasive cine-MR studies are useful for long follow-up at OPD. (author)

  8. Treatment and diagnosis of middle fossa arachnoid cyst. Ventriculofiberscopy and cine-MRI

    Kamikawa, Shuji; Kuwamura, Keiichi [Hyogo Prefectural Awaji Hospital, Sumoto (Japan); Tamaki, Norihiko

    1998-07-01

    The treatment of intracranial arachnoid cysts is controversial regarding its surgical indication and operative procedures. Conventional surgical approaches such as fenestration, membranectomy, and shunting operation are invasive. Also CT cisternography and/or RI cisternography are invasive, when it has been performed to evaluate the possible CSF communications between the arachnoid cyst and subarachnoid space. Between July 1994 and February 1997, 10 patients with intracranial middle fossa arachnoid cysts were treated with a newly developed ventriculofiberscope which is characterized by splendid mechanical flexibility and high resolution. The cine-MRI, which is a non-invasive diagnostic tool, is used to evaluate the CSF circulation around the cyst fenestration. The patients` ages ranged from 4 months to 10 years, with a mean of 4.46 years. The cyst locations were left middle fossa (9), and right (1). Eight patients presented with macrocrania, 4 with developmental delay, three with seizure, two with headache, and one with subdural hematoma. The patients were preoperatively evaluated by means of MRI and cine-MR images. In all patients ventriculofiberscopic procedures including cyst fenestration, membranous dissection, cyst puncture and shriveling were successfully performed. Postoperative MR and cine-MR studies have shown reduction of the cyst size and appropriate CSF circulation. Neuroendoscopic procedures seem to be the first choice for children with arachnoid cysts and the ventriculofiberscope proved to be very useful not only for cyst fenestration but also for cyst dissection. In addition, the non-invasive cine-MR studies are useful for long follow-up at OPD. (author)

  9. Anatomic study of the lacrimal fossa and lacrimal pathway for bypass surgery with autogenous tissue grafting

    Hai Tao

    2014-01-01

    Full Text Available Purpose: To study the microsurgical anatomy of the lacrimal drainage system and to provide anatomical evidence for transnasal endoscopic lacrimal drainage system bypass surgery by autogenous tissue grafting. Materials and Methods: A total of 20 Chinese adult cadaveric heads in 10% formaldehyde, comprising 40 lacrimal ducts were used. The middle third section of the specimens were examined for the following features: the thickness of the lacrimal fossa at the anterior lacrimal crest, vertical middle line, and posterior lacrimal crest; the cross section of the upper opening, middle part, and lower opening of the nasolacrimal canal; the horizontal, 30° oblique, and 45° oblique distances from the lacrimal caruncle to the nasal cavity; the distance from the lacrimal caruncle to the upper opening of the nasolacrimal duct; and the included angle between the lacrimal caruncle-nasolacrimal duct upper opening junction and Aeby?s plane. Results: The middle third of the anterior lacrimal crest was significantly thicker than the vertical middle line and the posterior lacrimal crest (P > 0.05. The horizontal distance, 30° oblique distance, and 45° oblique distance from the lacrimal caruncle to the nasal cavity exhibited no significant differences (P > 0.05. The included angle between the lacrimal caruncle and the lateral wall middle point of the superior opening line of the nasolacrimal duct and Aeby?s plane was average (49.9° ± 1.8°. Conclusion: The creation of the bony tunnel should start from the middle or posterior middle part of the lacrimal fossa, extending toward the anterior inferior region with an optimal downward oblique angle of 45°.

  10. Comments on Mohammed Abouelleil Rashed's "A critical perspective on second-order empathy in understanding psychopathology: phenomenology and ethics".

    Schlimme, Jann E; Wiggins, Osborne P; Schwartz, Michael A

    2015-04-01

    Understanding the mental life of persons with psychosis/schizophrenia has been the crucial challenge of psychiatry since its origins, both for scientific models as well as for every therapeutic encounter between persons with and without psychosis/schizophrenia. Nonetheless, a preliminary understanding is always the first step of phenomenological as well as other qualitative research methods addressing persons with psychotic experiences in their life-world. In contrast to Rashed's assertions, in order to achieve such understanding, phenomenological psychopathologists need not necessarily adopt the transcendental-phenomenological attitude, which, however, is often required if performing phenomenological philosophy. Additionally, in the course of these (non-philosophical) scientific endeavors, differences between persons with psychosis/schizophrenia and so-called normal people seem to have a methodological function and value driving the scientist in her enterprise. Yet, these differences do not extend to ethical dimensions, and therefore, do not by any means touch ethical equality. PMID:25820145

  11. Incidence and risk factors of skin rashes and hepatotoxicity in HIV-infected patients receiving nevirapine-containing combination antiretroviral therapy in Taiwan

    Yu-Tzu Tseng

    2014-12-01

    Conclusions: Abnormal liver function at baseline was significantly associated with skin rashes, while a higher CD4 count and the concurrent use of trimethoprim/sulfamethoxazole were associated with hepatotoxicity after the initiation of nevirapine-containing cART in HIV-infected Taiwanese patients.

  12. Curative analysis of different surgical treatments for non-solid hemangioblastoma in posterior cranial fossa

    Yu-xiang MA

    2015-07-01

    Full Text Available Objective  The article analyzed the curative effect of different surgical treatments for non-solid hemangioblastoma in posterior cranial fossa to explore reasonable operation method.  Methods  Clinical data of 61 patients with non-solid hemangioblastoma who underwent surgeries in Tianjin Huanhu Hospital during July 2007 and June 2014 were retrospectively analyzed. According to surgical approaches and the situation of foramen magnum and atlas, these patients were divided into 5 groups: midline approach opening foramen magnum and atlas (Group A, midline approach without opening foramen magnum and atlas (Group B, paramedian approach opening foramen magnum and atlas (Group C, paramedian approach without opening foramen magnum and atlas (Group D, retrosigmoid approach (Group E. By collecting clinical symptoms, imaging findings, surgical records and postoperative complications, the surgical results and occurrence of postoperative complications were summarized and reasonable operation method was discussed.  Results  Among 61 patients, total resection was achieved in 56 cases (91.80%, and partial resection was achieved in 5 cases (8.20% . The postoperative remission rate of 43 cases with hydrocephalus was 79.07% (34/43. Intracranial infection was the most common postoperative complication, accounting for 22.95% (14/61. There was significant difference in occurrence rate of intracranial infection among 4 subgroups: opening or not opening the foramen magnum and atlas with or without restoring bone flap (Z = 16.269, P = 0.001. In the subgroup of not opening foramen magnum and atlas with restoring bone flap, the infection rate, which accounted for 6.90% (2/29, was the lowest.  Conclusions  The surgical treatment options for non-solid hemangioblastoma in posterior fossa should be done according to patients' condition, and performed by a professional group. If conditions allow, not to open the foramen magnum and atlas, as well as intraoperative restoring bone flap should be chosen as far as possible, so as to reduce the occurrence of postoperative complications. DOI: 10.3969/j.issn.1672-6731.2015.06.013

  13. Evaluation of articular cartilage thickness of the humeral head and the glenoid fossa by MR arthrography: anatomic correlation in cadavers

    To evaluate the accuracy of MR arthrography in determining the thickness of articular cartilage of the humeral head and glenoid fossa. Results. The correlation coefficients for MR arthrographic measurement versus anatomic measurement of the cartilage thickness were 0.7324 and 0.8757 for humeral head and glenoid fossa, respectively. With regard to the humeral head, there was a tendency to overestimate regions of thin cartilage and underestimate regions of thick cartilage. This tendency was not found in the assessment of glenoid cartilage. The mean of the absolute value of MR-anatomic differences was similar on the glenoid side (0.27 mm) and the humeral side (0.29 mm). The accuracy of measurement was significantly better on the glenoid side (Fisher's r-to-Z transformation: Z=5.21, P=0.000001). (orig.)

  14. Clinical validity of MR based program for analysis of fluid/brain index of posterior cranial fossa structures in patients with spinocerebellar ataxia

    Spinocerebellar ataxia type 1 (SCA1) and type 2 (SCA2) belong to the group of neurodegenerative disorders of autosomal dominant inheritance, genetically and clinically heterogeneous, caused by CAG trinucleotide repeat expansion, which leads to productions of protein carrying the abnormal polyglutamine chain (polyQ). Molecular abnormalities cause degenerative changes - atrophy of posterior cranial fossa structures. The clinical symptoms typical of this disorder include progressive gait and limb ataxia, dysarthria, occulomotor disturbances, pyramidal tract and peripheral nerves involvement. The aim of the study is to evaluate the usefulness of a computer program prepared in our department for volumetric measurements of posterior cranial fossa structures (the pons, vermis and cerebellar hemispheres) in a group of SCA patients. MR examinations of 22 patients suffering from SCA were used to calculate the value of fluid/brain index of posterior cranial fossa structures and compared with the results of group of 10 healthy volunteers. The degree of atrophy of posterior cranial fossa structures can be objectively evaluated by special volumetric measurements. We found fluid/brain index (FBI) of posterior cranial fossa structures in group of SCA patients to vary from 0.1411 to 0.3929 (mean 0.2456 SD±0.601). 1. MR-based calculation of fluid/brain index of posterior fossa structures is a valuable tool for morphological assessment of SCA-related changes in brain structures. 2. The presented software enables objective evaluation of the course and stage of posterior fossa structures atrophy. 3. Our self-made computer program to calculate the fluid/brain index of posterior cranial fossa structures is easy to use on a personal computer- it is a good tool in everyday radiological practice. (author)

  15. AB96. The first clinical research in the world of combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation in highly sensitized recipients

    Yuan, Jianlin; Zhang, Geng; Qin, Weijun; Yu, Lie

    2014-01-01

    Objective To study the clinical effect of combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation to treat highly sensitized recipients. Methods Combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation from the same donor was used to treat a highly sensitized recipient with panel reactive antibodies (PRA) >50% and pre-existing donor specific antibodies (DSA). The hyperacute rejection and the function of renal after the...

  16. A comparison in 101 dairy cows of right paralumbar fossa omentopexy and right paramedian abomasopexy for treatment of left displacement of the abomasum

    Fubini, Susan L.; Ducharme, Norm G.; Erb, Hollis N.; Sheils, Robin L.

    1992-01-01

    Right paramedian abomasopexy and right paralumbar fossa omentopexy appear to be the most widely used means of correcting left displacement of the abomasum in dairy cattle. We compared these two procedures in a prospective study of 101 cows with uncomplicated left displaced abomasum. The surgical treatment (right paramedian abomasopexy, n = 48; or right paralumbar fossa omentopexy, n = 53) was assigned randomly. Follow-up information was obtained, at regular intervals, from one week through si...

  17. Appendicular endometriosis as a cause of chronic abdominal pain alone in the right iliac fossa: case report and literature review

    Marcelo Pandolfi Basso; Adriana Borgonovi Christiano; André Luís Cozetto de Oliveira; Geni Satomi Cunrath; João Gomes Netinho

    2012-01-01

    Endometriosis is a disease characterized by the presence of ectopic endometrial glands and stroma. Although its etiology is undefined, it is suggested to be a result of coelomic metaplasia, retrograde menstruation, to provide a genetic component, or to be one that occurs due to blood or lymphatic spread. The involvement of the gastrointestinal tract is common. However, appendicular endometriosis is a rare condition. It is usually asymptomatic. Recurrent pain in the right iliac fossa is an unu...

  18. COMPARISON OF LOCAL INFILTRATION OF ROPIVACAINE, BUPIVACAINE, TOPICAL APPLICATION OF SUCRALFATE IN THE TONSILLAR FOSSA ON POST-TONSILLECTOMY PAIN

    MK Gautham; Ravishankara, S.; Naik, Sudhir M.; P. Sathya; Mohan Appaji; Shankarnarayan Bhat

    2014-01-01

    Background: Tonsillectomy is one of the most common surgeries performed in paediatric otorhinolaryngology. The most common morbidity of the surgery is the post operative pain. As there is increase in trend of tonsillectomy as day care surgery adequate postoperative analgesia becomes a very important issue. Objective: To compare the efficacy of infiltration of ropivacaine 0.2% and bupivacaine 0.25% and topical application of sucralfate in to the tonsillar fossa in postoperative pain ma...

  19. COMPARISON OF LOCAL INFILTRATION OF ROPIVACAINE, BUPIVACAINE, TOPICAL APPLICATION OF SUCRALFATE IN THE TONSILLAR FOSSA ON POST-TONSILLECTOMY PAIN

    MK Gautham

    2014-10-01

    Full Text Available Background: Tonsillectomy is one of the most common surgeries performed in paediatric otorhinolaryngology. The most common morbidity of the surgery is the post operative pain. As there is increase in trend of tonsillectomy as day care surgery adequate postoperative analgesia becomes a very important issue. Objective: To compare the efficacy of infiltration of ropivacaine 0.2% and bupivacaine 0.25% and topical application of sucralfate in to the tonsillar fossa in postoperative pain management. Method: 120 patients aged 5–12 years, undergoing tonsillectomy were enrolled in the study. They were randomized into 4 groups. In group A (n=30 cases were infiltrated with ropivacaine into the tonsillar fossa; in group B (n=30, bupivacaine was infiltrated and in group C (n=30, the fossa was painted with sucralfate solution after the surgery; group D (n=30 was the control group where normal saline was infiltrated to the fossa following surgery. Visual analogue scale & Wong Baker facial pain scale were used to measure the intensity of pain postoperatively. Results: At 4h postoperatively, the pain scores of all 3 study groups were significantly lesser (p<0.05 than control group (Group A - 3.53, B – 3.70, C- 3.80, D- 5.20. The VAS & facial pain scores over the entire postoperative period were consistently lower in the study groups than in the control. The reduction of throat pain was significantly lower in the ropivacaine & sucralfate group compared with bupivacaine & control groups. Conclusion: Our study demonstrates that topical sucralfate and ropivacaine are equally effective and safe and improves post tonsillectomy analgesia. They provide better analgesia compared to bupivacaine.

  20. Longitudinal MRI assessment: the identification of relevant features in the development of Posterior Fossa Syndrome in children

    Spiteri, M.; Lewis, E.; Windridge, D.; Avula, S.

    2015-03-01

    Up to 25% of children who undergo brain tumour resection surgery in the posterior fossa develop posterior fossa syndrome (PFS). This syndrome is characterised by mutism and disturbance in speech. Our hypothesis is that there is a correlation between PFS and the occurrence of hypertrophic olivary degeneration (HOD) in lobes within the posterior fossa, known as the inferior olivary nuclei (ION). HOD is exhibited as an increase in size and intensity of the ION on an MR image. Intra-operative MRI (IoMRI) is used during surgical procedures at the Alder Hey Children's Hospital, Liver- pool, England, in the treatment of Posterior Fossa tumours and allows visualisation of the brain during surgery. The final MR scan on the IoMRI allows early assessment of the ION immediately after the surgical procedure. The longitudinal MRI data of 28 patients was analysed in a collaborative study with Alder Hey Children's Hospital, in order to identify the most relevant imaging features that relate to the development of PFS, specifically related to HOD. A semi-automated segmentation process was carried out to delineate the ION on each MRI. Feature selection techniques were used to identify the most relevant features amongst the MRI data, demographics and clinical data provided by the hospital. A support vector machine (SVM) was used to analyse the discriminative ability of the selected features. The results indicate the presence of HOD as the most efficient feature that correlates with the development of PFS, followed by the change in intensity and size of the ION and whether HOD occurred bilaterally or unilaterally.

  1. Microarray-based gene expression profiling and DNA copy number variation analysis of temporal fossa arachnoid cysts

    Helland Christian A; Aarhus Mads; Lund-Johansen Morten; Wester Knut; Knappskog Per M

    2010-01-01

    Abstract Background Intracranial arachnoid cysts (AC) are membranous sacs filled with CSF-like fluid that are commonly found in the temporal fossa. The majority of ACs are congenital. Typical symptoms are headache, dizziness, and dyscognition. Little is known about genes that contribute to the formation of the cyst membranes. Methods In order to identify differences in gene expression between normal arachnoid membrane (AM) and cyst membrane, we have performed a high-resolution mRNA microarray...

  2. Cranial CT with 64-, 16-, 4- and single-slice CT systems-comparison of image quality and posterior fossa artifacts in routine brain imaging with standard protocols

    Posterior fossa artifacts constitute a characteristic limitation of cranial CT. To identify practical benefits and drawbacks of newer CT systems with reduced collimation in routine cranial imaging, we aimed to investigate image quality, posterior fossa artifacts and parenchymal delineation in non-enhanced CT (NECT) with 1-, 4-, 16- and 64-slice scanners using standard scan protocols. We prospectively enrolled 25 consecutive patients undergoing NECT on a 64-slice CT. Three groups with 25 patients having undergone NECT on 1-, 4- and 16-slice CT machines were matched regarding age and sex. Standard routine CT parameters were used on each CT system with helical acquisition in the posterior fossa; the parameters varied regarding collimation and radiation dose. Three blinded readers independently assessed the cases regarding image quality, infra- and supratentorial artifacts and delineation of brain parenchymal structures on a five-point ordinal scale. Reading orders were randomized. A proportional odds model that accounted for the correlated nature of the data was fit using generalized estimating equations. Posterior fossa artifacts were significantly reduced, and the delineation of infratentorial brain structures was significantly improved with the thinner collimation used for the newer CT systems (p0.5). The thinner collimation available on modern CT systems leads to reduced posterior fossa artifacts and to a better delineation of brain parenchyma in the posterior fossa. (orig.)

  3. Johann Christian Rosenmüller (1771-1820): A Historical Perspective on the Man behind the Fossa

    Amene, Chiazo; Cosetti, Maura; Ambekar, Sudheer; Guthikonda, Bharat; Nanda, Anil

    2013-01-01

    Introduction The fossa of Rosenmüller, also known as the lateral pharyngeal recess, is a well-established site of origin of nasopharyngeal carcinoma. It is located in the lateral pharyngeal wall behind the cartilaginous portion of the Eustachian tube, the torus tubarius, and is named after Johann Christian Rosenmüller (JCR). Objective We present a history on the life and extensive works of Johann Christian Rosenmüller, a German physician and anatomist. Results Johann Christian Rosenmüller was a dedicated anatomist. In addition to identifying the fossa of Rosenmüller, his influence extends to various other anatomic subjects, including the Rosenmüller gland, the palpebral portion of the lacrimal gland, and the organ of Rosenmüller (i.e., the caudal remnant of the mesonephric duct). He was also an avid speleologist, studying the composition of caves and their life forms. For his contributions to this field, he had a cave in Germany and an extinct species named after him—Rosenmüllerhöhle and Ursus spelaeus Rosenmüller, respectively. Conclusion The fossa of Rosenmüller plays an important role in the growth and surgical treatment of nasopharyngeal carcinoma. We present a brief glimpse into the life of Johann Christian Rosenmüller, for whom it was named. PMID:24436911

  4. Diffusion tensor imaging in evaluation of posterior fossa tumors in children on a 3T MRI scanner

    Zarina Abdul Assis

    2015-01-01

    Full Text Available Context: Primary intracranial tumors in children are commonly located in the posterior fossa. Conventional MRI offers limited information regarding the histopathological type of tumor which is essential for better patient management. Aims: The purpose of the study was to evaluate the usefulness of advanced MR imaging techniques like diffusion tensor imaging (DTI in distinguishing the various histopathological types of posterior fossa tumors in children. Settings and Design: DTI was performed on a 3T MRI scanner in 34 untreated children found to have posterior fossa lesions. Materials and Methods: Using third party software, various DTI parameters [apparent diffusion coefficient (ADC, fractional anisotropy (FA, radial diffusivity, planar index, spherical index, and linear index] were calculated for the lesion. Statistical Analysis Used: Data were subjected to statistical analysis [analysis of variance (ANOVA] using SPSS 15.0 software. Results: We observed significant correlation (P < 0.01 between ADC mean and maximum, followed by radial diffusivity (RD with the histopathological types of the lesions. Rest of the DTI parameters did not show any significant correlation in our study. Conclusions: The results of our study support the hypothesis that most cellular tumors and those with greater nuclear area like medulloblastoma would have the lowest ADC values, as compared to less cellular tumors like pilocytic astrocytoma.

  5. Estenose da fossa intercondilar após estabilização articular com retalho de fáscia lata em cães Intercondylar fossa stenosis after joint stabilization using a fascial strip in dogs

    André Luis Selmi

    2012-01-01

    Full Text Available Determinaram-se os índices de largura da fossa intercondilar (FI, após transecção do ligamento cruzado cranial em nove cães adultos submetidos à estabilização articular com retalho de fáscia lata. Os joelhos foram alocados em dois grupos, sendo o joelho direito (GI submetido à incisuroplastia troclear (ITR e posterior estabilização articular, e o joelho esquerdo submetido somente à substituição ligamentar (GC. Cada grupo foi dividido em três subgrupos correspondentes aos momentos de eutanásia aos 30, 90 e 180 dias de pós-operatório. Os índices de largura da FI foram determinados, macroscópica e radiograficamente, pela mensuração da abertura cranial da FI nos terços cranial, médio e caudal, e indexados em relação à largura epicondilar. Observou-se aumento significativo dos índices macroscópicos e radiográficos nas articulações do GI, sendo estes estatisticamente diferentes daqueles das articulações de GC. Não foi observada estenose intercondilar nos joelhos de GC após a estabilização articular. Conclui-se que a estabilização articular com retalho de fáscia lata preveniu a estenose da fossa intercondilar, e que a ITR promoveu o alargamento permanente dessa estrutura.Intercondylar fossa width indexes (IFWI were determined in nine adult dogs submitted to intercondylar notchplasty (IN after transection of the cranial cruciate ligament (CCL followed by a fascial strip stabilization. The right stifle was submitted to IN followed by fascial strip reconstruction of the CCL (GI while in the left stifle IN was not performed (GC. Each group was then divided into three subgroups which corresponded to time of euthanasia at 30, 90 and 180 days after surgery. IFWI were determined, both macroscopically and radiographically, by measuring the cranial outlet of the intercondylar fossa in relation to the epicondylar width. A significant increase was observed in indexes of GI following IN, and these differed from indexes of GC throughout the evaluation period. It was concluded that articular repair using a fascia strip prevented stenosis of the intercondylar fossa, and that IN caused a permanent widening of it.

  6. Developmental venous anomalies of the posterior fossa with transpontine drainage: report of 3 cases

    Developmental venous anomalies (DVA) are considered as variant patterns of cerebral venous drainage. Although generally not rare in the cerebellum, DVA of the brain stem or of the cerebellum with drainage through the brain stem are exceptional findings. Because it is not clear whether DVA may sometimes be of clinical significance, we try to correlate the clinical findings of the patients with the course of the variant vessels. We reviewed the literature and report three additional cases. All patients were examined by MRI and digital subtraction angiography. In particular, we discuss the drainage route as compared with the established patterns of posterior fossa blood drainage, which is directed to the dural sinuses, the petrosal vein or the vein of Galen. In one of our patients suffering from trigeminal neuralgia, the close topical relation of the DVA and the trigeminal nucleus and trigeminal nerve entry zone suggests a causal relationship. In a second case the brain stem symptoms were due to haemorrhage of a concomitant cavernoma. It remains unclear if the occurrence of dysarthria and dysaesthesia in the third patient with brain stem DVA was purely coincidental. The only clinical symptom directly attributable to a DVA with transpontine drainage in our series was trigeminal neuralgia. (orig.). With 3 figs., 1 tab

  7. Developmental venous anomalies of the posterior fossa with transpontine drainage: report of 3 cases

    Kueker, W. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany); Mull, M. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany); Thron, A. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany)

    1997-08-01

    Developmental venous anomalies (DVA) are considered as variant patterns of cerebral venous drainage. Although generally not rare in the cerebellum, DVA of the brain stem or of the cerebellum with drainage through the brain stem are exceptional findings. Because it is not clear whether DVA may sometimes be of clinical significance, we try to correlate the clinical findings of the patients with the course of the variant vessels. We reviewed the literature and report three additional cases. All patients were examined by MRI and digital subtraction angiography. In particular, we discuss the drainage route as compared with the established patterns of posterior fossa blood drainage, which is directed to the dural sinuses, the petrosal vein or the vein of Galen. In one of our patients suffering from trigeminal neuralgia, the close topical relation of the DVA and the trigeminal nucleus and trigeminal nerve entry zone suggests a causal relationship. In a second case the brain stem symptoms were due to haemorrhage of a concomitant cavernoma. It remains unclear if the occurrence of dysarthria and dysaesthesia in the third patient with brain stem DVA was purely coincidental. The only clinical symptom directly attributable to a DVA with transpontine drainage in our series was trigeminal neuralgia. (orig.). With 3 figs., 1 tab.

  8. Progressive tumefactive fibroinflammatory lesion of the infratemporal fossa treated by radiation therapy

    Brian O’Sullivan

    2012-01-01

    Full Text Available Tumefactive fibroinflammatory lesion (TFIL is a rare benign tumor in the head and neck region. We present a case of a 40-year-old female with a benign but progressive lesion of the infratemporal fossa, which was diagnosed as TFIL. Patient responded briefly to a course of steroid treatment but eventually showed progression and was unresponsive to further steroids. She was then treated with external beam radiation to a dose of 60 Gy in 30 fractions. After radiation a slow, gradual decrease in tumor size was noted over the course of years and she is free of disease after more than 11 years of follow-up. The major longterm side effect this patient developed was an expected unilateral radiation-induced retinopathy, due to the close proximity of the lesion to the orbit. The dilemma of treatment of benign disease with radiation with potential long-term complications is discussed and a review of the literature on TFIL is presented.

  9. Posterior Cranial Fossa Crowdedness Is Related to Age and Sex: an Magnetic Resonance Volumetric Study

    Purpose: To measure 3-dimensional (3D) posterior cranial fossa (PCF) crowdedness and to evaluate the effect of age, sex, and body height on PCF. Material and Methods: Fifty-two healthy volunteers (24 M and 28 F; mean age 55.4±17.2 years; range 24-82 years) were recruited. Using a semi-automated magnetic resonance technique, we calculated a PCF crowdedness index (CI) as the ratio of hindbrain (HB) volume to PCF volume x100% and correlated this index with age, sex, body height, and other crowdedness parameters. Results: The mean PCF CI was 93.7±2.7%. Women had a more crowded PCF than men (95.0±1.7% versus 92.1±2.7%; P <0.001). PCF CI declined with age for both men ( r = -0.61; P = 0.002) and women ( r = -0.68; P <0.001). The association with age - but not HB volume - was maintained after we controlled for sex and body height. On multiple regression, both age and sex accounted for 57.5% of the PCF CI variance. Conclusion: Our study shows that PCF CI is associated with age and sex, and can therefore be used as a surrogate to assess hindbrain atrophy in a cross-sectional sample. Moreover, sex- and age-specific normal ranges may be needed to evaluate the PCF CI in clinical practice

  10. Sleep Apnea Syndrome after Posterior Fossa Surgery: A Case of Acquired Ondine's Curse

    Elnaz Faraji rad

    2015-01-01

    Full Text Available Introduction: Ondine’s Curse is a catastrophic but rare condition in adults. It is referred to as a congenital or acquired condition, in which the patient cannot breathe automatically while asleep. Acquired causes of this disease can be any cause affecting the ventrolateral part of the medulla, which is considered to be the breathing center in humans.    Case Report:   A 51-year-old woman, with ataxia and the symptoms and signs of rising Intra-Cranial Pressure, who underwent ventriculoperitoneal shunting and removal of tumour, developed episodic apnea during sleep after surgery and hypercapnia when awake. In her post-operative CT scan, some fine spots of hypodensity in the left lateral part of the medulla were observed. She was managed pharmacologically and underwent tracheotomy. After 50 days, she was discharged from the hospital when she was able to breathe normally.   Conclusion:  Having experience with this condition after resection of a fourth ventricle tumor, it was found that Ondine’s Curse can be considered as one of the complications of  posterior fossa surgery and is curable by proper management.

  11. Effect of radiation therapy on extracerebral cavernous hemangioma in the middle fossa

    We report three cases of extracerebral cavernous hemangiomas in the middle fossa all of which had received radiotherapy. Follow-up study with serial computed tomography during and after irradiation were presented. In Case 1, radiotherapy after partial removal of the tumor reduced the tumor's size and CT number, and facilitated total removal. In Case 2 as well, irradiation was started before the operation. The tumor responded very well to irradiation and showed significant reduction in the size and CT number of the tumor with a dose of about 3,000 rads. Subtotal romoval was possible. In Case 3, the tumor responded very well clinically to irradiation, and vertigo were much improved with a dose of about 3,000 rads, and CT scan at that time showed significant reduction in the size and CT number of the tumor, therefore she only received radiation therapy, no surgical intervention. It is concluded that in cases of extracerebral cavernous hemangioma with massive hemorrhage, radiation of up to 3,000 rads was a method of choice. The treatment results in an increased probability of total removal of the tumor, and moreover the possibility of eliminating surgery. (author)

  12. Hypophyseal fossa aspergillosis mimicking a pituitary macro adenoma with bleed: A case report

    Background: Aspergillus infection of the sinuses is a common condition in those predisposed due to immunosuppression. However, its intracranial extension is rare, with sellar extension being even rarer and therefore is difficult to diagnose on imaging. Case Report: A case of sellar and sinusal aspergillosis mimicking a pituitary macroadenoma with bleed is presented. The initial CT examination of head of a diabetic patient revealed a hyperdense lesion in the hypophyseal fossa and in the sphenoid sinus with extension into the right cavernous sinus, showing foci of calcification. The differential diagnosis included fungal disease or meningioma and MRI was advised. Unfortunately, the imaging was done after a five months delay when CT and MRI revealed interval growth of the lesion. Although, the MRI presentation was highly suggestive of pituitary macroadenoma with bleeding, the diagnosis of invasive aspergillosis was made when clinical data became available. The diagnosis of aspergillosis was proven by histology. Conclusions: The diagnosis of hypophyseal extension of aspergillosis is difficult, because of its rarity. It is important to consider possibility of fungal infection in those predisposed to it. The judgment based only on MRI findings and incomplete clinical data could easily lead into false diagnosis of an invasive pituitary macroadenoma with bleed. (authors)

  13. Lumbar meningeal enhancement after surgery in the posterior cranial fossa: a normal finding in children?

    Purpose: Spinal meningeal Gd-DTPA enhancement after cranial surgery is a known observation of a not well understood underlying mechanism. This paper demonstrates that this MRI finding is a normal meningeal reaction to subarachnoid hemorrhage, which should not be mistaken for metastatic spread. Material and methods: Three pediatric patients were examined by MRI for metastatic spread of malignant infratentorial tumors along the spinal canal two to nine days after the removal of the primary cerebral lesion. The findings were compared with a control group that underwent cranial surgery (cyst resection or fenestration of the posterior cranial fossa) without major bleeding into the subarachnoid space. Unenhanced and enhanced sequences were obtained to prove that the high singal within the CSF is caused by an abnormal Gd-DTPA uptake and not by methemoglobin. Results: Meningeal enhancement was observed in all patients with intraoperative bleeding resembling subarachnoid masses on enhanced T1-weighted images. This was not present in any patient of the control group. This finding lasts for approximately two weeks. Conclusion: The meningeal enhancement renders immediate postoperative studies inconclusive for the detection of metastatic spread. Consequently, the obligatory tumor staging along the spinal canal should ideally be done prior to the resection of a cerebral tumor. (orig.)

  14. Developmental changes in the posterior cranial fossa of children studied by CT

    Although CT is widely used, it has not been employed in the study of the development of the normal PF during childhood. We reviewed 181 brain CT examinations, with no abnormal findings, to determine normative data for the posterior cranial fossa (PF) in children. The volume of the PF and the supratentorial cranial cavity (SC) was assessed by summing consecutive CT cross-sectional areas. Linear mesurements of the PF structures - cerebellum, vermis, brain stem and fourth ventricle - were also performed. The PF grows rapidly during the first 3 years of life and thereafter a smaller increase in size is observed. All the PF structures showed a positive correlation with the PF volume. The PF volume increased in parallel with that of the SC and the PF/SC volume ratio remained relatively constant during childhood. The establishment of normative data for the volume of the PF and its contents may be of value in the CT study of diseases associated with morphological alterations in the PF. (orig.)

  15. A branchial cyst of the pyriform fossa transoral laser resection: a case report.

    Abdelfattah, Hesham Mostafa; Ahmed, Mohammed Elrabie; El-Rabie Ahmed, Mona; Ahmed, Mohamed Abd El-Kader; Moussa, Abd-Elmateen

    2016-02-01

    Pyriform sinus malformations represent rare third and fourth branchial anomalies. Fistulae at the latter site were initially described and make up less than 1 % of all brachial anomalies. They may be discovered incidentally, or may present as a neck mass with recurrent infection, dysphagia, or airway compromise, and can be an unusual cause of dysphonia in infant and children. Here, we present a case of third branchial cyst located in pharyngeal wall of the left pyriform sinus which presented with dysphonia since birth in a 6-year-old girl. Transoral CO2 laser excision was carried out successfully with no communicating tract. The patient's dysphonia showed progressive regression at 1-year follow-up. Third branchial cyst in the left pyriform sinus (Bailey's type IV) is an unusual cause of dysphonia in pediatric. Our present case report is the first brachial cyst to be reported in the pyriform fossa and the second branchial anomalies to be excised transorally with CO2 laser. PMID:25740470

  16. Revision muduloblastoma and treatment of posterior fossa ependinoma analysis of new therapeutic strategies

    Fulltext: In general the primary tumors of S.n.c. required at some stage in their treatment, use of radiotherapy, usually as postoperative treatment or exclusively in the case that the surgery is not possible, in turn for treatment of some of these tumors association with chemotherapy has shown to be beneficial. In the case of medulloblastomas, ependymomas of the posterior fossa tumors of the choroid plexus and the pineal gland, irradiation technique that used for their particular spread is the total craniospinal irradiation. In this paper a review of the treatment techniques are performed, the overall survival and disease-free survival and complications treatments, in patients with medulloblastoma and ependymomas treated in the Department. Oncology Hospital and Clinics in INDO period of approximately 30 years. Results were compared with the international literature and analysis was performed new perspectives on the therapeutic radiation treatment (radiotherapy 3D shaped for example) and its association with chemotherapy. The results will be analyzed in Congress

  17. A report of the anesthesia in posterior fossa operations in the sitting position in 55 patients

    Jahanguiri B

    1994-04-01

    Full Text Available In this survey, 55 patients were studied in a period of six years for having the anesthesia in the sitting position. In this position, the surgeon will had a better access to the location, whose damages have been sustained, so less damages would be given to the healthy tissues. For the patients, due to their critical general conditions, one week prior to giving anesthesia to the posterior fossa, operation in the sitting position the right ventriculoatiral shunt was placed. For preventing the fall of blood pressure, a bandage was placed in the lower limbs after inducing anesthesia and changing supine position to sitting position. Before the induction, central venous pressure was measured for treating the air embolism. The head of catheter was placed inside the right atrial. Premedications such as atropine, pethidine, and inductive agents like thiopenton, and muscle relaxants, maintained with halothane and nitrous oxide. All of the patients endured this condition without the fall of blood pressure and air embolism

  18. Total spine and posterior fossa MRI screening in adolescent idiopathic scoliosis (177 cases

    MR Etemadifar

    2005-05-01

    Full Text Available Background: MRI screening for idiopathic scoliosis is controversial. Considering our clinical experiences, the results of MRI in all patients with idiopathic scoliosis were evaluated. Methods: In a prospective clinical study, all neurologically normal patients with idiopathic scoliosis screened by posterior fossa and total spine MRI. Results: After excluding 9 patients for mild neurological findings, in other 177 patients (132 female, 45 male, the average age and curve angle was 15±2 years and 59±17º (30 to 135º, respectively. Convexity was to right in 146 and to left in 31 cases. MRI was positive in 12 cases (6.8%. In 5 cases (2.8%, neurosurgical intervention was necessary prior to scoliosis surgery. There was no relation between age, sex, presence of pain or curve angle and positive MRI findings (P>0.05. Left convexity was significantly related to positive MRI findings (P=0.013. In males with left convex curves, the probability of positive MRI findings was 8.8 folds other patients. Conclusion: Considering our results and other reported articles, it seems that routine MRI screening of all patients presenting as idiopathic scoliosis is necessary for detection of underlying pathologies. Key words: Idiopathic Scoliosis, MRI, Spine Syrinx, Chiari

  19. Cerberus Fossae and Elysium Planitia Lavas, Mars: Source Vents, Flow Rates, Edifice Styles and Water Interactions

    Sakimoto, S. E. H.; Gregg, T. K. P.

    2004-01-01

    The Cerberus Fossae and Elysium Planitia regions have been suggested as some of the youngest martian surfaces since the Viking mission, although there was doubt whether the origins were predominantly volcanic or fluvial. The Mars Global Surveyor and Mars Odyssey Missions have shown that the region is certainly young in terms of the topographic preservation and the youthful crater counts (e.g. in the tens to a few hundred million yrs.). Numerous authors have shown that fluvial and volcanic features share common flow paths and vent systems, and that there is evidence for some interaction between the lava flows and underlying volatiles as well as the use by lavas and water of the same vent system. Given the youthful age and possible water-volcanism interaction environment, we'd like constraints on water and volcanic flux rates and interactions. Here, we model ranges of volcanic flow rates where we can well-constrain them, and consider the modest flow rate results results in context with local eruption styles, and track vent locations, edifice volumes, and flow sources and data.

  20. Radar Sounding of the Medusae Fossae Formation Mars: Equatorial Ice or Dry, Low-Density Deposits?

    Watters, Thomas R.; Campbell, Bruce; Carter, Lynn; Leuschen, Carl J.; Plaut, Jeffrey J.; Picardi, Giovanni; Orosei, Roberto; Safaeinili, Ali; Clifford, Stephen M.; Farrell, William M.; Ivanov, Anton B.; Phillips, Roger J.; Stofan, Ellen R.

    2007-11-01

    The equatorial Medusae Fossae Formation (MFF) is enigmatic and perhaps among the youngest geologic deposits on Mars. They are thought to be composed of volcanic ash, eolian sediments, or an ice-rich material analogous to polar layered deposits. The Mars Advanced Radar for Subsurface and Ionospheric Sounding (MARSIS) instrument aboard the Mars Express Spacecraft has detected nadir echoes offset in time-delay from the surface return in orbits over MFF material. These echoes are interpreted to be from the subsurface interface between the MFF material and the underlying terrain. The delay time between the MFF surface and subsurface echoes is consistent with massive deposits emplaced on generally planar lowlands materials with a real dielectric constant of ~2.9 ± 0.4. The real dielectric constant and the estimated dielectric losses are consistent with a substantial component of water ice. However, an anomalously low-density, ice-poor material cannot be ruled out. If ice-rich, the MFF must have a higher percentage of dust and sand than polar layered deposits. The volume of water in an ice-rich MFF deposit would be comparable to that of the south polar layered deposits.

  1. Minimally Invasive Supraorbital Key-hole Approach for the Treatment of Anterior Cranial Fossa Meningiomas

    IACOANGELI, Maurizio; NOCCHI, Niccolò; NASI, Davide; DI RIENZO, Alessandro; DOBRAN, Mauro; GLADI, Maurizio; COLASANTI, Roberto; ALVARO, Lorenzo; POLONARA, Gabriele; SCERRATI, Massimo

    2016-01-01

    The most important target of minimally invasive surgery is to obtain the best therapeutic effect with the least iatrogenic injury. In this background, a pivotal role in contemporary neurosurgery is played by the supraorbital key-hole approach proposed by Perneczky for anterior cranial base surgery. In this article, it is presented as a possible valid alternative to the traditional craniotomies in anterior cranial fossa meningiomas removal. From January 2008 to January 2012 at our department 56 patients underwent anterior cranial base meningiomas removal. Thirty-three patients were submitted to traditional approaches while 23 to supraorbital key-hole technique. A clinical and neuroradiological pre- and postoperative evaluation were performed, with attention to eventual complications, length of surgical procedure, and hospitalization. Compared to traditional approaches the supraorbital key-hole approach was associated neither to a greater range of postoperative complications nor to a longer surgical procedure and hospitalization while permitting the same lesion control. With this technique, minimization of brain exposition and manipulation with reduction of unwanted iatrogenic injuries, neurovascular structures preservation, and a better aesthetic result are possible. The supraorbital key-hole approach according to Perneckzy could represent a valid alternative to traditional approaches in anterior cranial base meningiomas surgery. PMID:26804334

  2. Shape and Symmetry of Human Condyle and Mandibular Fossa / Forma y Simetría del Cóndilo Humano y Fosa Mandibular

    Eduardo Cotecchia, Ribeiro; Monique Lalue, Sanches; Luis Garcia, Alonso; Ricardo Luiz, Smith.

    2015-04-01

    Full Text Available El objetivo del estudio fue determinar y clasificar la forma de la fosa mandibular y cóndilo correspondiente en diferentes tipos, relacionándolos con el sexo y la simetría en cráneos humanos adultos en perspectivas laterales, posteriores y superiores. La muestra incluyó 50 cráneos humanos de 32 homb [...] res y 18 mujeres entre 23 a 82 años. Fueron fotografiados el cóndilo y moldes de silicona de la fosa para evaluar la forma en los tres puntos. Se clasificaron las formas, validadas por el análisis intra e inter-evaluador, la frecuencia, distribución por sexo y simetría verificada. Las formas fueron clasificadas como redondeada, en ángulo, aplanada y mixtas en las vistas lateral y posterior; y como biconvexa, convexo-plana, y mixta en la vista superior. En las vistas laterales el cóndilo y la fosa redondeada fueron más frecuentes (57% y 66%, respectivamente), mientras que en la vista posterior (53% y 83%). En la vista superior, la forma mixta presentó mayor frecuencia en el cóndilo (59%), mientras que en la fosa la forma biconvexa (46%) fue más común. No hubo diferencia significativa en la distribución de laforma por sexo. La misma forma (simétrica o no-simétrica) en el cóndilo lateral derecho e izquierdo y la fosa fueron evaluadas por separado, y se observaron varias combinaciones. Abstract in english The aim of the study was to determine and classify the shape of the mandibular fossa and the corresponding condyle in different types, relating them to sex and symmetry, in adult human skulls, from lateral, posterior and superior views. The sample included 50 human skulls from 23 to 82 years old, 32 [...] males and 18 females. The condyle and silicone casting molds of the fossa were photographed to assess shape in the three views. Shapes were classified, validated by intra- and inter-rater analysis and frequency, sex distribution and symmetry verified. Shapes were classified as rounded, angled, flattened and mixed types in the lateral and posterior views; and as biconvex, flat-convex, biflattened and mixed in the superior view. Rounded condyle and fossa were more frequent in the lateral (57% and 66% respectively) and posterior (53% and 83%) views. In the superior view, mixed shape presented higher frequency in condyle (59%) while in fossa the biconvex shape (46%) was most common. There was no significant difference in shape distribution by sex. The same shape (symmetry) or otherwise (non-symmetry) in right and left side condyle and fossa were separately assessed and showed various combinations.

  3. Interlaboratory comparison of the CB6F1-Tg rasH2 rapid carcinogenicity testing model.

    Maronpot, R R; Mitsumori, K; Mann, P; Takaoka, M; Yamamoto, S; Usui, T; Okamiya, H; Nishikawa, S; Nomura, T

    2000-05-01

    Several genetically engineered mouse models are currently being examined for potential use in cancer hazard identification. We have undertaken an interlaboratory comparison of the performance of the CB6F1-Tg rasH2 transgenic mouse in cancer bioassays concurrently conducted in the United States and Japan. Chemicals selected for study included known human carcinogens (melphalan and cyclosporin A) and known rodent carcinogens (p-cresidine and vinyl carbamate) tested at carcinogenic doses, and non-carcinogens (p-anisidine and resorcinol) tested at appropriate high doses. Because of abdominal adhesions caused by the intraperitoneal dosing vehicle, melphalan was excluded from the study results. The remaining five studies showed similar results between the two laboratories conducting each study. Vinyl carbamate gave the strongest positive response inducing lung adenomas and carcinomas and splenic hemangiosarcomas. p-Cresidine was considered positive for urinary bladder transitional neoplasia. Cyclosporin A, p-anisidine, and resorcinol were negative in all studies. Although only five chemicals were successfully tested in this interlaboratory comparison, there was good concordance in outcome for the strong carcinogens and for the non-carcinogens. Successful testing of chemicals with less carcinogenic potential may require modifications in study design to include more animals and longer study duration. PMID:10814847

  4. Numerical modelling of gravel unconstrained flow experiments with the DAN3D and RASH3D codes

    Sauthier, Claire; Pirulli, Marina; Pisani, Gabriele; Scavia, Claudio; Labiouse, Vincent

    2015-12-01

    Landslide continuum dynamic models have improved considerably in the last years, but a consensus on the best method of calibrating the input resistance parameter values for predictive analyses has not yet emerged. In the present paper, numerical simulations of a series of laboratory experiments performed at the Laboratory for Rock Mechanics of the EPF Lausanne were undertaken with the RASH3D and DAN3D numerical codes. They aimed at analysing the possibility to use calibrated ranges of parameters (1) in a code different from that they were obtained from and (2) to simulate potential-events made of a material with the same characteristics as back-analysed past-events, but involving a different volume and propagation path. For this purpose, one of the four benchmark laboratory tests was used as past-event to calibrate the dynamic basal friction angle assuming a Coulomb-type behaviour of the sliding mass, and this back-analysed value was then used to simulate the three other experiments, assumed as potential-events. The computational findings show good correspondence with experimental results in terms of characteristics of the final deposits (i.e., runout, length and width). Furthermore, the obtained best fit values of the dynamic basal friction angle for the two codes turn out to be close to each other and within the range of values measured with pseudo-dynamic tilting tests.

  5. Characteristic findings of metrizamide CT cisternography in an epidermoid in the posterior fossa

    A case of epidermoid cyst in the posterior fossa showing a characteristic finding upon metrizamide CT cisternography is reported. A 42-year-old man was admitted with gait disturbance. The abnormal signs were trunucal ataxia, gait ataxia, left cerebellar sign and nystagmus. A CT scan revealed a large, low-density area and the fourth ventricle could not be seen clearly. Absorption values were in the range of 5 - 18 Hounsfield units. There was no change in the absorption values of the lesion following intravenous injection of contrast medium. Metrizamide CT cisternography was performed No remarkable change was seen 1 hour after intrathecal injection of metrizamide. However, metrizamide irregularly surrounded the left margin of the low-density area 3 hours after intrathecal injection. Moreover, metrizamide stained the area heterogeneously like a honeycomb or sponge at 6 hours. Finally, only a small amount of metrizamide remained in this area after 24 hours. Suboccipital craniectomy revealed a pearly tumor in the cisterna magna, wrapped in a thin white capsule and partially adherent to the cerebellomedullary junction. The tumor was totally removed. Histopathological investigation showed stratified squamous epithelium with keratinous material. A honeycomb- or sponge-like image seems to be a characteristic finding in metrizamide CT cisternography of the epidermoid cyst. This finding has not been previously reported. However, pneumoencephalographical findings in some cases of epidermoid were reported as crumb- or sponge-like images. These images were thought to be caused by air covering the surface of the pearly tumor. These images should be similar to the one found in the present study using CT cisternography. (author)

  6. ROLE OF ULTRASONOGRAPHY IN PRE - OPERATIVE EVALUATION OF RIGHT ILIAC FOSSA MASS

    Madhushankar

    2013-11-01

    Full Text Available Mass in the Right Iliac Fossa (RIF is clinica lly difficult to differentiate, ultrasonography a quick non - invasive investigation has bridged the gap between clinical examination and direct visualization. The study was done to know the efficacy of ultrasonography in pre operative evaluation of RIF mass . MATERIALS AND METHODS: The data for this prospective study was obtained from 300 patients admitted/ attending OPD with a clinical diagnosis of RIF mass. Ultrasonography was done and a provisional diagnosis was obtained. The final diagnosis was obtained w ith histopathological examination[HPE] or by other standard methods. The sonological diagnosis was compared with final diagnosis. RESULTS: Out of 300 patients studied 236 were operable. Ultrasonography was able to diagnose 228 out of the 236 (Sensitivity o f 96.7% as operable cases and the remaining eight were inconclusive report. Ultrasonography was able to rule out all non operable cases with 100% specificity. The final diagnosis correlated with sonological diagnosis in 284 cases with sensitivity of 94.6% while clinical diagnosis correlated with final diagnosis in 232 cases with sensitivity of 77.3%.The most common conditions being appendicular mass followed by appendicular abscess and ileocaecal TB. DISCUSSION: Thus ultrasonography in experienced hands is an invaluable tool for preoperative evaluation of RIF mass. It has favorable sensitivity and specificity in differentiating RIF mass and 100% sensitivity and specificity in detecting cases which needs emergency intervention. In countries like India where other radiological investigation modalities are present only in higher center, ultrasonography becomes an invaluable tool in diagnosis and evaluation of RIF mass for practitioners in semi - urban and rural settings.

  7. Clock face model applied to tibial intraneural ganglia in the popliteal fossa

    Spinner, Robert J. [Mayo Clinic, Department of Neurologic Surgery, Rochester, MN (United States); Mayo Clinic, Department of Orthopedics, Rochester, MN (United States); Mayo Clinic, Rochester, MN (United States); Hebert-Blouin, Marie-Noelle [Mayo Clinic, Department of Neurologic Surgery, Rochester, MN (United States); Maniker, Allen H. [Beth Israel Hospital, Department of Neurosurgery, New York, NY (United States); Amrami, Kimberly K. [Mayo Clinic, Department of Neurologic Surgery, Rochester, MN (United States); Mayo Clinic, Department of Radiology, Rochester, MN (United States)

    2009-07-15

    Tibial intraneural ganglia occurring in the popliteal fossa are often misdiagnosed because of their relative rarity. Their joint connection is typically not recognized and therefore not treated, leading to recurrence. This is a retrospective clinical study. Magnetic resonance images (MRIs) of six patients with confirmed tibial intraneural ganglia arising from the superior tibiofibular joint were analyzed and were compared to ten individuals with normal tibial nerves who were imaged with MRI. All studies were interpreted as left-sided. A previously designed clock face model introduced for peroneal intraneural ganglia was used to describe the superior tibiofibular joint connection (tail sign). A single axial image was sought to determine the normal anatomic and pathologic relationships of the tibial nerve and tibial articular branch to the superior tibiofibular joint. In all patients with intraneural ganglia, a single conventional axial image at the mid-fibular head level could reliably demonstrate: (1) intraneural cyst within the articular branch at the superior tibiofibular joint connection (tail sign) between 8 and 9 o'clock and intraneural cyst within the tibial nerve, (2) the central location of the tibial nerve posterior to the tibia, and (3) popliteus muscle denervation changes and atrophy (popliteus sign). This technique can provide radiologists and surgeons with rapid and reproducible information for diagnosis and treatment planning of tibial intraneural ganglia. Similar to its use with the clock face model in peroneal intraneural ganglia, a standard axial image at the mid-fibular head level can be used to interpret key features of tibial intraneural ganglia and identify the joint connection. Improved identification of the presence of a joint connection will change the therapeutic approach of this pathology and reduce cyst recurrences. (orig.)

  8. A review of the treatment options for skin rash induced by EGFR-targeted therapies: Evidence from randomized clinical trials and a meta-analysis

    Agents targeting the epidermal growth factor receptor (EGFR) are amongst the most extensively used of the targeted agents in the therapy of some of the most common solid tumors. Although they avoid many of the classic side effects associated with cytotoxic chemotherapy, they are associated with unpleasant cutaneous toxicities which can affect treatment compliance and impinge on patient quality of life. To date, despite a plethora of consensus recommendations, expert opinions and reviews, there is a paucity of evidence-based guidance for the management of the skin rash that occurs in the treatment of patients receiving EGFR-targeted therapies. A literature search was conducted as a first step towards investigating not only an evidence-based approach to the management of skin rash, but also with a view to designing future randomized trials. The literature search identified seven randomized trials and a meta-analysis was conducted using the data from four of these trials involving oral antibiotics. The meta-analysis of the data from these four trials suggests that prophylactic antibiotics might reduce the relative risk of severe rash associated with EGFR-targeted agents by 42–77%. Vitamin K cream was also identified as having a potential role in the management EGFR-targeted agent induced rash. This review and meta-analysis clearly identify the need for further randomized studies of the role of oral antibiotics in this setting. The results of the ongoing randomized trials of the topical application of vitamin K cream plus or minus doxycycline and employing prophylactic versus reactive strategies are eagerly awaited

  9. Severe toxicity of skin rash, fever and diarrhea associated with imatinib: case report and review of skin toxicities associated with tyrosine kinase inhibitors

    Delong Liu

    2008-10-01

    Full Text Available Xuan Huang1, Samir Patel2, Nasir Ahmed2, Karen Seiter2, Delong Liu21Department of Medicine, Richmond University Medical Center, New York, NY, USA; 2Division of Oncology and Hematology, New York Medical College and Westchester Medical Center, New York, NY, USAAbstract: Chronic myeloid leukemia (CML is characterized by a Philadelphia chromosome which contains an oncogene, bcr-abl. This oncogene encodes a tyrosine kinase which is constitutively activated. Imatinib, a tyrosine kinase inhibitor (TKI, has been widely used in the treatment of CML. Dasatinib and nilotinib were recently approved for the treatment of CML. Other TKIs, such as bosutinib, erlotinib, and sunitinib, are under study for the treatment of CML as well as other hematologic and solid malignancies. Skin rash has been reported as one of the most common side effects of the TKIs. Here we present a case of severe skin rash together with unusual symptoms of high fever and diarrhea induced by imatinib in a CML patient. The dermatologic toxicities from a variety of tyrosine kinase inhibitors are reviewed and general principles of management are also discussed.Keywords: chronic myeloid leukemia, skin rash, tyrosine kinase inhibitor, imatinib

  10. Analysis by computed tomography of bone changes in the mandibular head and mandibular fossa in relation to clinical findings in patients with temporomandibular joint (TMJ) disorders

    Hamamoto, Yoshioki; Nakajima, Tamio; Hayashi, Takafumi [Niigata Univ. (Japan). School of Dentistry

    1994-12-01

    Bone changes in the mandibular head and mandibular fossa in 33 patients with temporomandibular joint (TMJ) disorders were studied with axial computed tomography in relation to clinical findings to clarify possible factors leading to bone changes in this phenomenon. Bone changes of the mandibular head were observed in 45 (68%) of the 66 TMJs. The mandibular head was juxtaposed to the mandibular fossa in 13 (29%) of the 45 joints in centric occlusion and in 29 joints (64%) in the anterior position on CT, whereas the mandibular head with no pathological bone change was juxtaposed to the mandibular fossa in none of the 21 joints in centric occlusion and in only 1 joint (5%) in the anterior position. In the two groups of patients with and without juxtaposition of the mandibular head and mandibular fossa with bone changes, the incidence of the initial symptoms such as pain, crepitus, and difficulty in opening the mouth was increased compared with the symptoms at presentation. However, the former group had severer symptoms than the latter group. These findings suggest that bony degeneration of the TMJ is accelerated by juxtaposition of the head and fossa. (author).

  11. Analysis by computed tomography of bone changes in the mandibular head and mandibular fossa in relation to clinical findings in patients with temporomandibular joint (TMJ) disorders

    Bone changes in the mandibular head and mandibular fossa in 33 patients with temporomandibular joint (TMJ) disorders were studied with axial computed tomography in relation to clinical findings to clarify possible factors leading to bone changes in this phenomenon. Bone changes of the mandibular head were observed in 45 (68%) of the 66 TMJs. The mandibular head was juxtaposed to the mandibular fossa in 13 (29%) of the 45 joints in centric occlusion and in 29 joints (64%) in the anterior position on CT, whereas the mandibular head with no pathological bone change was juxtaposed to the mandibular fossa in none of the 21 joints in centric occlusion and in only 1 joint (5%) in the anterior position. In the two groups of patients with and without juxtaposition of the mandibular head and mandibular fossa with bone changes, the incidence of the initial symptoms such as pain, crepitus, and difficulty in opening the mouth was increased compared with the symptoms at presentation. However, the former group had severer symptoms than the latter group. These findings suggest that bony degeneration of the TMJ is accelerated by juxtaposition of the head and fossa. (author)

  12. The acetabular fossa hot spot on {sup 18}F-FDG PET/CT: epidemiology, natural history, and proposed etiology

    Kubicki, Shelby L. [Trinity University, San Antonio, TX (United States); Richardson, Michael L. [University of Washington, Department of Radiology, Seattle, WA (United States); Martin, Thomas [X-Ray Associates of New Mexico, Department of Radiology, Albuquerque, NM (United States); Rohren, Eric [The University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, Division of Nuclear Medicine, Houston, TX (United States); Wei, Wei [The University of Texas M.D. Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States); Amini, Behrang [The University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, Division of Musculoskeletal Radiology, Houston, TX (United States)

    2015-01-15

    To describe a benign focus of increased activity in the acetabular fossa (the acetabular fossa hot spot, AFHS) on {sup 18}F-FDG PET/CT that can mimic a neoplasm. {sup 18}F-FDG PET/CT images from four patient populations were examined. Group 1 (n = 13) was collected from a search of radiology reports and used to define the AFHS and for hypothesis generation. Group 2 (n = 1,150) was used for prevalence of AFHS. Group 3 (n = 1,213) had PET/CT and MRI pelvis within a week of each other and was used to correlate metabolic and anatomic findings. Group 4 (n = 100) was used to generate the control group. Data were collected on demographics, common comorbidities, underlying cancer diagnosis and status, and hip symptoms. Prevalence of AFHS was 0.36 % (95 % CI 0.10-0.91 %). None progressed to malignancy or was associated with cancer status. The majority (71 %) were on the left, and 6 % were bilateral. Mean SUV{sub max} of the AFHS was 4.8 (range, 2.7-7.8). Male patients were more likely to have the AFHS (OR = 8.69, 95 % CI 1.88-40.13). There was no difference with respect to other collected data, including hip symptoms. Average minimum duration of AFHS was 346 days (range, 50-1,010 days). Readers did not detect corresponding hip abnormalities on MRIs. AFHS is a benign finding that may be caused by subclinical ligamentum teres injury, focal synovitis, or degeneration of acetabular fossa fat. Despite uncertainty regarding its etiology, recognition of AFHS as a benign finding can prevent morbidity associated with unnecessary biopsy or initiation of therapy. (orig.)

  13. Survival of very young children with medulloblastoma (primitive neuroectodermal tumor of the posterior fossa) treated with craniospinal irradiation

    Purpose: Very young children with medulloblastoma are considered to have a worse prognosis than older children. As radiotherapy remains an important part of the treatment, the adverse prognosis could be due to inadequate radiation treatment rather than biological factors. We analyzed the published literature to examine the impact of radiotherapy on survival in this group. Methods and Materials: A Medline search was performed and we reviewed studies of treatment of medulloblastoma where radiotherapy was delivered using megavoltage equipment and the minimum follow-up allowed the calculation of 5-year survival rates. Results: Thirty-nine studies were published between 1979 and 1996 with a treatment including craniospinal irradiation and boost to the posterior fossa. Eleven studies comprising 1366 patients analyzed survival by age at diagnosis. Eight of 11 studies showed a worse 5-year survival for the younger patient group which reached statistical significance in two. There is also a suggestion of a higher proportion of children with metastatic disease at presentation in the very young age group. The usual policy in younger children was to give a lower dose of radiotherapy to the craniospinal axis (CSA) and posterior fossa (PF) with reduction of dose in the range of 15 to 25% compared to standard treatment. As dose reduction to the posterior fossa is associated with worse survival and local recurrence is the predominant site of failure, the major determinant of worse survival in very young children with medulloblastoma may be suboptimal radiotherapy. Protocols including postoperative chemotherapy with delayed, omitted, or only local tumor irradiation do not reach survival rates of protocols with standard radiotherapy, also suggesting a continued importance for irradiation. Conclusion: Very young children with medulloblastoma have a worse prognosis than older children. Inadequate radiation dose and technique to the primary tumor region may be a major contributing factor. Current chemotherapeutic regimes alone are not sufficient to compensate for reduced radiation doses and volumes

  14. The acetabular fossa hot spot on 18F-FDG PET/CT: epidemiology, natural history, and proposed etiology

    To describe a benign focus of increased activity in the acetabular fossa (the acetabular fossa hot spot, AFHS) on 18F-FDG PET/CT that can mimic a neoplasm. 18F-FDG PET/CT images from four patient populations were examined. Group 1 (n = 13) was collected from a search of radiology reports and used to define the AFHS and for hypothesis generation. Group 2 (n = 1,150) was used for prevalence of AFHS. Group 3 (n = 1,213) had PET/CT and MRI pelvis within a week of each other and was used to correlate metabolic and anatomic findings. Group 4 (n = 100) was used to generate the control group. Data were collected on demographics, common comorbidities, underlying cancer diagnosis and status, and hip symptoms. Prevalence of AFHS was 0.36 % (95 % CI 0.10-0.91 %). None progressed to malignancy or was associated with cancer status. The majority (71 %) were on the left, and 6 % were bilateral. Mean SUVmax of the AFHS was 4.8 (range, 2.7-7.8). Male patients were more likely to have the AFHS (OR = 8.69, 95 % CI 1.88-40.13). There was no difference with respect to other collected data, including hip symptoms. Average minimum duration of AFHS was 346 days (range, 50-1,010 days). Readers did not detect corresponding hip abnormalities on MRIs. AFHS is a benign finding that may be caused by subclinical ligamentum teres injury, focal synovitis, or degeneration of acetabular fossa fat. Despite uncertainty regarding its etiology, recognition of AFHS as a benign finding can prevent morbidity associated with unnecessary biopsy or initiation of therapy. (orig.)

  15. Entrapped Catheter across the Fossa Ovalis in an Adult with Pulmonary Stenosis - A Case Report of Surgical Relief

    Vithalkumar Malleshi Betigeri

    2014-03-01

    Full Text Available Percutaneous pulmonary balloon valvuloplasty as a procedure of choice in adults has been established since the last three decades. Even though the complications are rare, they are scarcely reported in the literature. We report such a case in an adult female patient of severe pulmonary valular stenosis in whom, entrapped catheter across the fossa ovalis was noted in chest x-ray and echocardiogram following unsuccessful percutaneous pulmonary balloon valvuloplasty. Our case emphasizes this rare complication and its successful surgical outcome.

  16. Unexpected rare complication of the facial paralysis in a patient with an antrochoanal polyp following canine fossa puncture.

    Kim, Ah-Young; Choi, Myoung Su

    2015-01-01

    Canine fossa puncture (CFP) combined with endoscopic sinus surgery is a simple and effective method for treating antrochoanal polyps, particularly those that originate in the anterior, inferior or medial aspect of the antrum. Several complications can occur following CFP, including facial paraesthesia and dental numbness. However, facial palsy is extremely rare after CFP. We postulated that a possible mechanism of facial palsy is pressure injury to the soft tissues adjacent to the puncture site, which can damage the buccal branch of the facial nerve during CFP. PMID:25976190

  17. Spinal level of myelomeningocele lesion as a contributing factor in posterior fossa volume, intracranial cerebellar volume, and cerebellar ectopia.

    Sweeney, Kieron J

    2013-02-01

    McLone and Knepper\\'s unified theory of Chiari malformation Type II (CM-II) describes how the loss of CSF via the open posterior neuropore fails to create adequate distending pressure for the developing rhomboencephalic vesicle. The authors of the present article describe the relationship between the posterior fossa volume and intracranial cerebellar volume as being related to the distance from the obex of the fourth ventricle to the myelomeningocele lesion using a common mathematical model, the Hagen-Poiseuille law.

  18. Meningeoma de fossa posterior com expansão extracraniana em criança: registro de um caso

    Lamartine Corrêa de Moraes Jr.

    1984-12-01

    Full Text Available Os autores relatam caso de meningeoma de fossa posterior com projeção extracraniana em criança de 3 anos de idade, submetido a terapêutica cirúrgica com boa evolução e remissão completa dos sinais e sintomas neurológicos apresentados. A raridade do tipo e localização do tumor nessa faixa etária justificam a apresentação e registro do caso.

  19. Meningeoma de fossa posterior com expansão extracraniana em criança: registro de um caso

    Lamartine Corrêa de Moraes Jr.; Eliana C. F. O. Wanderley; Wander Miguel Tamburus; Fahd Haddad; Aparecido José de Andrade

    1984-01-01

    Os autores relatam caso de meningeoma de fossa posterior com projeção extracraniana em criança de 3 anos de idade, submetido a terapêutica cirúrgica com boa evolução e remissão completa dos sinais e sintomas neurológicos apresentados. A raridade do tipo e localização do tumor nessa faixa etária justificam a apresentação e registro do caso.

  20. The value of MRT during radiotherapy of tumours in the posterior fossa and in the pineal region in children

    MRT is a highly sensitive method for the diagnosis of childhood tumours in the posterior fossa. Since it demonstrates tumour extent better than does CT, MRT is the method of choice for radiotherapy planning. The result of treatment can be judged morphologically and by measuring relaxation times. Changes due to treatment can be recognised more easily than by CT. A disadvantage of MRT is lack of specificity, since various processes may lead to an equal increase in T1 and T2 times. (orig.)

  1. Chloramphenicol induced maculopapular rashes

    Prashant Wadagbalkar; Poonam Patel

    2015-01-01

    Chloramphenicol is a broad spectrum antibiotic that acts by inhibiting protein synthesis. Though systemic use is rare, their topical preparations are commonly used. Allergic reaction due to chloramphenicol ear drops are less reported. Here, we have reported a maculopapular exanthema due to use of chloramphenicol ear drops. [Int J Basic Clin Pharmacol 2015; 4(1.000): 179-180

  2. Dark-toned dunes in the western Medusae Fossae Formation: Characteristics, distribution, and source

    Burr, D. M.; Zimbelman, J. R.; Brown, A. J.; Qualls, F. B.; Michaels, T. I.; Chojnacki, M.

    2010-12-01

    Aeolian bedforms are nearly ubiquitous on Mars but the origin of the sediments remains unidentified. Dark-toned Martian sand may originate as volcaniclastic sediment (Edgett and Lancaster 1993). The Medusae Fossae Formation (MFF) has been hypothesized to be a volcaniclastic deposit. The two lobes of the western-most MFF (westMFF) host dark -toned sediments (Fig. 1) categorized here as aeolian based on morphologies, surface textures, and locations within lows. These sediments are bright in both day and night infrared (IR) images, indicating a large grain size and low albedo, and are concentrated along the westMFF southern margin, below the highland-lowland boundary (HLB) scarp. Indications of an MFF origin for this dark-toned dune sediment include: 1) gradation of tone: the dark sediments frequently grade into lighter toned MFF slope materials. 2) morphology and location: The dark dune morphologies indicate emplacement by a northerly (toward the south) wind regime (Fig. 1), for which the westMFF immediately to the north provides a sediment origin. 3) composition: Limited spectral data of the dark dunes indicate an olivine-poor composition, in contrast to the olivine-rich spectra of dunes in southern highland (SH) and Cerberus plains (Cp) craters, indicating a different source for those SH or Cp dunes than for the westMFF dunes. Thus, while minor amounts of sediment have likely been contributed from elsewhwere, we hypothesize that the dark-toned dunes in the westMFF originate(d) from the breakdown of MFF sediments, winnowing of bright fines, and concentration of dark, coarse sand into dunes. Given the putative origin of the MFF as volcaniclastic, this identification of the origin of the westMFF dark-toned dunes supports the paradigm of dark aeolian sediments on Mars originating as volcaniclastic material. Portion of P07_003769_1742_XN_05S209W, showing gradation between lighter- and dark-toned sediments (upper portion of image), and echo dune morphology (white oval) indicative of transport from the north (top).

  3. Formações venosas superficiais da fossa cubital: aspectos de interesse para a prática da Enfermagem

    Nilton Alves

    2012-12-01

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA.

  4. Morphometric CT study of Down's syndrome showing small posterior fossa and calcification of basal ganglia

    Ieshima, A.; Yoshino, K.; Takashima, S.; Takeshita, K.; Kisa, T.

    1984-11-01

    We report characteristic and morphometric changes of cranial computed tomography (CT) with increasing age in 56 patients with Down's syndrome aged from 0 month to 37 years. Patients were compared with 142 normal controls aged 0 to 59 years. Width of ventricles, Sylvian fissures, posterior fossa, pons and cisterna magna were measured on CT. The incidences of the cavum septi pellucidi, cavum vergae and cavum veli interpositi and high density in the basal ganglia were examined. There was high incidence (10.7%) of bilateral calcification of basal ganglia in Down's syndrome, although that of pineal body and choroid plexus calcification was similar in Down's syndrome and controls. Basal ganglia calcification is more frequently seen in young Down's syndrome and may be related to the premature aging characteristic of Down's syndrome. The CT in Down's syndrome showed relatively small posterior fossa, small cerebellum, small brain stem and relatively large Sylvian fissures in those under one year of age. There was a high frequency of midline cava and large cisterna magna. There were no significant atrophic changes on CT except after the fifth decade comparing with controls.

  5. Ultrasonographic and magnetic resonance imaging findings of transitional ceII carcinoma arising at penile fossa navicularis: case report

    Lee, Seung Woo; Cho, Jae Ho; Jang, Han Won; Kim, Dong Sug; Moon, Gi Hak [College of Medicine, Yeungnam Univ., Daegu (Korea, Republic of)

    2004-08-01

    Primary carcinoma of the male urethra are rare. Among the malignant tumors of the male urethra, squamous cell carcinoma is the most common. Transitional cell carcinoma is very rare, particularly in the distal urethra. We experienced a case of distal urethral transitional cell carcinoma, arising at the fossa navicuIaris of the penis, which we report here with a review of the literature. A 68-year-old male patient presented with bloody discharge from the prepuce for 1 month. Ultrasonography showed a poorly marginating, heterogeneous mass, invading the glans penis and the corpus spongiosum. The mass encircled the glandular urethra of the penis glans, and obstructed the glandular urethra and the fossa navicularis. A Doppler ultrasonogram revealed hypervascularity in this mass. The mass was isointense to the corpus carvernosum on the T1-weighted images and slightly hypointense to the corpus carvernosum on the T2-weighted images. Contrast-enhanced MR imaging showed a poorly enhancing mass in the glans penis. This mass was confirmed as a transitional cell carcinoma by histologic study and a partial penectomy was performed.

  6. Ultrasonographic and magnetic resonance imaging findings of transitional ceII carcinoma arising at penile fossa navicularis: case report

    Primary carcinoma of the male urethra are rare. Among the malignant tumors of the male urethra, squamous cell carcinoma is the most common. Transitional cell carcinoma is very rare, particularly in the distal urethra. We experienced a case of distal urethral transitional cell carcinoma, arising at the fossa navicuIaris of the penis, which we report here with a review of the literature. A 68-year-old male patient presented with bloody discharge from the prepuce for 1 month. Ultrasonography showed a poorly marginating, heterogeneous mass, invading the glans penis and the corpus spongiosum. The mass encircled the glandular urethra of the penis glans, and obstructed the glandular urethra and the fossa navicularis. A Doppler ultrasonogram revealed hypervascularity in this mass. The mass was isointense to the corpus carvernosum on the T1-weighted images and slightly hypointense to the corpus carvernosum on the T2-weighted images. Contrast-enhanced MR imaging showed a poorly enhancing mass in the glans penis. This mass was confirmed as a transitional cell carcinoma by histologic study and a partial penectomy was performed

  7. The intranasal endoscopic removal of schwannoma of the pterygopalatine and infratemporal fossae via the prelacrimal recess approach.

    Zhou, Bing; Huang, Qian; Shen, Ping-Hung; Cui, Shun-Jiu; Wang, Cheng-Shuo; Li, Yun-Chuan; Yu, Zhen-Kun; Chen, Xiao-Hong; Ye, Ting

    2016-04-01

    OBJECT This study was undertaken to analyze the results of a novel surgical method-the endoscopic prelacrimal recess approach (PLRA)-in patients with tumors involving the pterygopalatine fossa (PPF) and infratemporal fossa (ITF). The surgical technique and indications for this approach are also discussed. METHODS The authors analyzed data from 7 cases involving patients who underwent resection of PPF and ITF tumors by means of the endoscopic PLRA from 2004 to 2013. Preoperative and postoperative imaging studies were available in all cases and were reviewed. The surgical specimens were all confirmed to be schwannomas. RESULTS All tumors were completely resected via endoscopic PLRA. There were no recurrences noted over a 28-month follow-up period. In 4 cases, the patients experienced postoperative facial numbness during the first two weeks after surgery, which gradually lessened thereafter. One patient continued to have mild facial numbness at most recent follow-up. The numbness had fully resolved in the other 3 cases. CONCLUSIONS The intranasal endoscopic removal of schwannoma from PPF and ITF via PLRA can spare the whole lateral nasal wall, resulting in a reduction in morbidity. This is a novel minimally invasive surgical method for PPF and ITF tumors. PMID:26339855

  8. Mesenteric Fibromatosis Presenting as a Diagnostic Dilemma: A Rare Differential Diagnosis of Right Iliac Fossa Mass in an Eleven Year Old—A Rare Case Report

    Abhinav Mahajan; Mohinder Singh; Anoop Varma; Gunjeet Singh Sandhu; Malwinder Singh; Rupesh Nagori

    2013-01-01

    An eleven-year-old boy presented with a mass in the right iliac fossa for the last 21 days associated with pain, fever, anorexia, and nausea. The patient was thoroughly investigated and contrast-enhanced CT abdomen revealed a well-defined mass in the region of right iliac fossa. Exploratory laparotomy was done and a mass measuring 10?cm in diameter arising from mesentery of proximal ileum and adherent with the wall of ileum was seen. Resection and anastomosis were done. Histopathological exam...

  9. Hydralazine-induced anti-neutrophil cytoplasmic antibody-positive renal vasculitis presenting with a vasculitic syndrome, acute nephritis and a puzzling skin rash: a case report

    Keasberry Justin

    2013-01-01

    Full Text Available Abstract Introduction Anti-neutrophil cytoplasmic antibody-associated vasculitis has been associated with many drugs and it is a relatively rare side effect of the antihypertensive drug hydralazine. The diagnosis and management of patients who have anti-neutrophil cytoplasmic antibody-associated vasculitis may be challenging because of its relative infrequency, variability of clinical expression and changing nomenclature. The spectrum of anti-neutrophil cytoplasmic antibody-associated vasculitis is wide and can be fatal. This case documents a 62-year-old woman who presented with hydralazine-induced anti-neutrophil cytoplasmic antibody-positive renal vasculitis with a puzzling cutaneous rash. Case presentation We report a rare case of hydralazine-induced anti-neutrophil cytoplasmic antibody-associated vasculitis in a 62-year-old Caucasian woman who presented with a vasculitic syndrome with a sore throat, mouth ulcers and otalgia after several months of constitutional symptoms. She then proceeded to develop a rash over her right lower limb. Clinically, the rash had features to suggest Sweet’s syndrome, but also had some appearances consistent with embolic phenomena and did not have the appearance of palpable purpure usually associated with cutaneous vasculitis. Differential diagnoses were hydralazine-associated Sweet’s syndrome, streptococcal-induced cutaneous eruption or an unrelated contact dermatitis. A midstream urine sample detected glomerular blood cells in the setting of anti-neutrophil cytoplasmic antibody-positive renal vasculitis and Streptococcus pyogenes bacteremia. A renal biopsy revealed a pauci-immune, focally necrotizing glomerulonephritis with small crescents. Her skin biopsy revealed a heavy neutrophil infiltrate involving the full thickness of the dermis with no evidence of a leucocytoclastic vasculitis, but was non-specific. She was initially commenced on intravenous lincomycin for her bloodstream infection and subsequently commenced on immunosuppression after cessation of hydralazine. The patient was subsequently discharged from hospital after a rapid clinical improvement. Conclusion Hydralazine-induced anti-neutrophil cytoplasmic antibody-positive renal vasculitis is a rare adverse effect and can present with a severe vasculitic syndrome with multiple organ involvement. Features of this association include the presence of high titres of anti-myeloperoxidase-anti-neutrophil cytoplasmic antibody with multi-antigenicity, positive anti-histone antibodies and the lack of immunoglobulin and complement deposition histopathogically. A rash that is characteristic of Sweet’s syndrome has also been described as an association. Prompt cessation of hydralazine may be sufficient to reverse disease activity but immunosuppression may be needed for definite treatment.

  10. Clinical and Laboratory evaluation of measleslike rash in children and young adults Avaliação clínica e laboratorial de exantema semelhante ao sarampo em crianças e jovens adultos

    Klaus Eberhard Stewien; Lourdes Rehder de Andrade Vaz de Lima; Viviane Fongaro Botosso; Maria Isabel de Oliveira; Simone N. Fagundes; Nogueira, Meri B.; Selma Lopes Betta Ragazzi; Maria Tereza Zuluni da Costa; Bernardo Ejzenberg; Edison Luiz Durigon

    2000-01-01

    A clinical and laboratory evaluation of 11 children and young adults with measleslike rash was done during the measles outbreak in the Greater São Paulo Metropolitan area at the end of 1996 and spread over the country during 1997. Measles was laboratory confirmed in 07 patients by specific IgM detection in acute serum specimens using an IgM-capture EIA, by specific IgG seroconversion in serum pairs, and by reverse transcription PCR and virus isolation in peripheral blood lymphocytes. Clinical...

  11. A linha dividida: uma abordagem matemática à filosofia platônica, de Glenn Erickson e John Fossa

    Jorge dos Santos Lima

    2007-06-01

    Full Text Available Resenha do livro "A linha dividida: uma abordagem matemática à filosofia platônica", de Erickson, Glenn W.; e Fossa, John A. Rio de Janeiro: Relume Dumará, 2006. 186 páginas. [Coleção Metafísica, n. 4].

  12. Uncommon evolution of probable central nervous system histoplasmosis: from leptomeningitis to posterior fossa granuloma. A case report with magnetic resonance images

    We report a case of a young immunocompetent patient with probable central nervous system histoplasmosis with evolutive peculiar findings seen on magnetic resonance imaging. Leptomeningeal thickening was initially observed which subsequently became a posterior fossa granuloma. The diagnosis of fungal infection was only reached by histopathological study and the treatment was based on long term therapy with fluconazole wth good initial response. (author)

  13. RADIATION THERAPY QUALITY IN CCG/POG INTERGROUP 9961: IMPLICATIONS FOR CRANIOSPINAL IRRADIATION AND THE POSTERIOR FOSSA BOOST IN FUTURE MEDULLOBLASTOMA TRIALS

    BernadineDonahue

    2012-12-01

    Results: Of the 308 patients who were evaluable for volume deviations, 101 patients (33% did not have any. Of the remaining 207 patients, 50% had only minor deviations, 29% had only major deviations, and 21% had both minor and major deviations. Of the patients with major deviations, 73% had a single major deviation. The most common major deviation was in the cribriform plate region, followed by the posterior fossa; posterior fossa deviations resulted from treating less than whole posterior fossa. There were no significant differences in PFS or OS between patients with deviations and those without. There was no evidence of associations of deviations with patient age. Conclusions: Approximately one-third of patients had major volume deviations. There was no evidence of a significant association between these and outcome. This lack of correlation likely reflects the current high quality of radiation therapy delivered in COG institutions, our strict definition of volume deviations, and the relatively few instances of multiple major deviations in individual patients. In is noteworthy that the types of posterior fossa volume deviations observed in this study were not adversely associated with outcome. As we move forward, quality assurance will continue to play an important role to ensure that deviations on study do not influence study outcome.

  14. Delayed migration of K-wire into popliteal fossa used for tension band wiring of patellar fracture

    Meena Sanjay

    2013-06-01

    Full Text Available 【Abstract】Breakage of K-wires and stainless steel wires which are used for fracture fixation is not uncommon, but migration is rare. We report a case of migration of bro-ken K-wire used for patella tension band wiring to the popliteal fossa. The broken hardware was removed surgically. We would like to suggest that K-wire and wire fixation used for treatment of patellar fractures can migrate into the posterior compartment of the knee and cause clini-cal symptoms. Close clinical and radiological follow-up af-ter internal fixation to identify the presence of hardware breakage or movement and removal of wires once fracture has united can avert such complications. Key words: Patella; Fracture fixation, internal; Bone wires

  15. Anterior and middle cranial fossa in traumatic brain injury: relevant neuroanatomy and neuropathology in the study of neuropsychological outcome.

    Bigler, Erin D

    2007-09-01

    The frontal and temporal lobe regions of the brain have a high vulnerability to injury as a consequence of cerebral trauma. One reason for this selective vulnerability is how the frontal and temporal regions are situated in the anterior and cranial fossa of the skull. These concavities of the skull base cup the frontal and temporal lobes which create surface areas of contact between the dura, brain, and skull where mechanical deformation injures the brain. In particular, the sphenoid ridge and the free-edge of the tentorium cerebelli are uniquely situated to facilitate injury to the posterior base of the frontal lobe and the anterior pole and medial surface area of the temporal lobe. Three-dimensional image reconstruction with computerized tomography and magnetic resonance imaging are used to demonstrate the vulnerability of these regions. How neuropsychological deficits result from damage to these areas is reviewed and discussed. PMID:17784800

  16. Pedicled Gastrocnemius Flap: Clinical Application in Limb Sparing Surgical Resection of Sarcoma Around the Knee Region and Popliteal Fossa

    To highlight on the versatility of superiorly based pedicled gastrocnemius muscle flap in the limb-sparing surgery for bone or soft tissue sarcoma around the knee and popliteal fossa. Patients and Methods: A total of 30 patients with localized bone or soft tissue sarcoma around the knee and popliteal fossa were treated with limb-salvage procedure. The study included 5 cases with bone sarcoma of the distal femur, 15 cases having bone sarcoma of proximal tibia and 10 cases having soft tissue sarcoma around the knee region and popliteal fossa. Routine preoperative staging studies were done for every patient and included local plain radiography, local MRI, isotopic bone scan and CT chest. Local MRA or angiography was done in selected cases. According to the Enneking staging system, 19 patients had stage IIB and 11 had stage IIA. Patients having bone sarcoma of the proximal tibia were subjected to wide resection, endo prosthetic reconstruction and reconstruction of the extensor mechanism by the medial gastrocnemius muscle flap. Patients having bone sarcoma of the distal femur were subjected to wide resection, endo prosthetic reconstruction and coverage of the prosthesis and re balance of the patellar tendon by the medial gas-trocnemius flap. Patients having soft tissue sarcoma were subjected to wide resection and soft tissue coverage with either medial or lateral myocutaneous gastrocnemius flap or muscle flap with grafting. Limb function was evaluated according to MSTS functional scores. Adjuvant chemotherapy or radiotherapy was given according to nationally agreed protocols. Results: There were 18 males and 12 females with a mean age of 29 years at the time of surgery (range 11-44 years). The mean follow-up period was 52 months (range 25-72 months). Resection with a negative bony and soft tissue margins could be achieved in all cases. A total of 30 flaps were used and included medial gastrocnemius muscle flaps in 21 cases (15 cases had proximal tibia endoprothesis, 5 cases had distal femur endoprothesis, 2 cases had soft tissue sarcoma infiltrating the chin of tibia myocutaneous gastrocnemius flaps in 8 cases having, tissue sarcoma (5 had medial head flap and 3 cases 1 head flap). Flap survival was 100%. The success rate of limb salvage was 96.6% with high score functional result according to MSTS functional scores. The area of the skin island harvested in cases of myocutaneous flaps ranged from 11 to 18 cm in length and from 5 to 8 cm in width and all these cases required grafting of the donor sit Complications included partial wound dehiscence in case, revision of the prosthesis in one case, amputatjf due to local recurrence in one case and significant extension lag in 2 cases. Conclusion: The unique vascularisation of the ga trocnemius muscle (one pedicle to each head), the size of the muscle belly, the fact that it is situated in the dissection field and that its transfer does not affect the function, the spared limb too adversely, makes it particularly suita for limb sparing procedures for sarcoma in the region of the knee and popliteal fossa. The medial head is workhorse muscle flap for soft tissue coverage of knee endoprothesis and reconstruction of extensor mechanism This decreases the rate of complications and improves I functional outcome. Reconstruction of the soft issue defect improves wound healing, protects exposed deep structures and subsequently prevents wound problems, delays adjauvant therapy and secondary amputation.

  17. Analysis on the diagnosis and treatment of the fractures of the anterior cranial fossa in the 26 cases

    Objective: To study the diagnosis and treatment of anterior cranial fossa fracture. Methods: The medical records of 26 patients treated were reviewed retrospectively. All cases were examined by CT imaging scans preoperatively. The total cases were divided into three types. The types of operation such as acute decompress, skull base reconstruction, dural repairement, optical canaldompress were performed. Results: Only one case developed postoperative cerebrospinal fluid leakage in the chronic period. After using repair operation, the patient recovered. Three cases visual impairement did not recover postoperativaly. Two patients died. Conclusion: Verification of the fracture types and initial necerological systemic impairments by means of CT scanning is important preoperatively. It is very effective to prevent cerebrospinal fluid leakage if the dura is repaired and the skull base recons-tructed in primury operation

  18. Investigating the role of the Itoigawa-Shizuoka tectonic line towards the evolution of the Northern Fossa Magna rift basin

    Panayotopoulos, Yannis; Hirata, Naoshi; Sato, Hiroshi; Kato, Aitaro; Imanishi, Kazutoshi; Kuwahara, Yasuto; Cho, Ikuo; Takeda, Tetsuya; Asano, Youichi

    2014-03-01

    The Itoigawa-Shizuoka tectonic line (ISTL) fault system is considered to have one of the highest probabilities for a major inland earthquake occurrence in the whole of Japan. It is a complex fault system with the dip directions of the local fault segments changing from north to south between an east-dipping low-angle thrust fault, a strike slip fault and a west-dipping thrust fault. The tectonic relations between the different parts of the fault system and the surrounding geological units are yet to be fully explained. This study aims to reveal the juncture of the northern and central parts of the ISTL and investigate its contribution towards the shaping of the Northern Fossa Magna rift basin. We conducted 3 deployments of 1 or 2 linear arrays of seismic stations across the central and northern ISTL regions and observed local micro-earthquakes for a period of 3 years. Each deployment recorded continuous waveform data for approximately 3 months. Using arrival times of 1193 local earthquakes, we jointly determined earthquake locations and a 3D velocity model, applying the tomography method. We were able to image the regional crustal structures from the surface to a depth of 20 km with a spatial resolution of 5 km. Subsequently, we used the obtained 3D velocity model to relocate the background local seismicity from 2003 to 2009. The juncture of the northern and central parts of the ISTL was well constrained by our results. The depth extension of the northern parts of the ISTL fault segments follows the bottom of the Miocene Northern Fossa Magna rift basin (NFM) and forms an east-dipping low-angle fault. In contrast, the central parts of the ISTL fault segments are estimated to lie along the eastern boundary of the Matsumoto basin forming an oblique strike slip fault (Fig. 1).

  19. Deep seismic reflection profiling across the northern Fossa Magna, central Japan: opening and closure of back-arc basin

    Sato, Hiroshi; Shiraishi, Kazuya; Ishiyama, Tatsuya; Kato, Naoko; Kurashimo, Eiji; Abe, Susumu; Inaba, Mitsuru; Iwasaki, Takaya; Kawamoto, Tomihisa

    2013-04-01

    The northern Fossa Magna (NFM) is a back-arc rift basin produced in the final stages of the opening of the Sea of Japan. It divides the major structure of Japan into two regions, NE and SW Japan. The Itoigawa-Shizuoka Tectonic Line (ISTL) bounds the western part of the northern Fossa Magna and forms an active fault system that displays one of the largest slip rates in the Japanese islands. The eastern rim is bounded by the western boundary fault of the Nagano basin (WNB), which produced the Zenkoji earthquake of 1847 (M7.4). We carried out deep seismic reflection and refraction/wide-angle reflection profiling across the northern part of NFM in order to delineate structures in the crust, and the deep geometry of the active fault systems. The seismic data were acquired using four viboseis trucks, explosives (4 locations, 100 kg). We further applied refraction tomography analysis to distinguish between previously undifferentiated syn-rift volcanics and pre-rift Mesozoic rock based on P-wave velocity. The 60-km-long velocity profile suggests 6-km-thick Miocene basin fill beneath in the NFM basin. The thick argillaceous basin fill was strongly deformed by compression since the Pliocene. The shortening deformation is marked by fault-related folds and detachment folds. The middle Miocene over pressured mudstone forms detachments within a basin fill. Geologic reconstruction based on the seismic section suggests that the NFM basin was formed by east dipping normal fault systems. Due to reactivation of normal faults as reverse faults, Miocene major normal faults forms seismogenic source faults. Observed tectonic geomorphological features accords well to the subsurface geologic structures with a flat-and-ramp geometry. The deeper extension of the WNB fault is interpreted as the Miocene normal fault dipping 40 degrees.

  20. The overcrowding of osteal posterior cranial fossa in adults: multi-slice CT measurements and clinical significance

    Objective: To assess the clinical value of MSCT in diagnosing the overcrowding of osteal posterior cranial fossa (PCF) in adults. Methods: MSCT images of a cohort of 52 adult patients with foramen magnum osteal malformation confirmed by surgery (diseased group), and 100 healthy adults (control group) were retrospectively reviewed. Images post-processing techniques included multi-planer reformation (MPR) and volume rendering (VR). The posterior cranial fossa volume (PCFV), posterior cranial fossa height (PCFH), clivus length (CL), clivus gradient (CG), supraocciput length (SL), and 100 normal adults. Independent-sample student's t test was used to compare the differences between patients and normal adults. Results: The results of PCFV, PCFH, CL, SL, FMD and CG, male of control group were (168.2 ± 12.3) cm3, (38.2 ± 1.2), (47.1 ± 2.8), (41.1 ± 1.8), (36.6 ± 4.9)mm, (51.5 ± 3.6)degree, female of control group were (157.5 ± 10.2) cm3, (36.5 ± 1.4), (46.2 ± 2.2), (39.7 ± 1.3), (35.2 ± 3.8), (49.6 ± 3.1)degree; diseased group were (128.7 ± 11.7) cm3, (30.6 ± 1.9), (36.2 ± 1.4), (37.3 ± 0.9), (33.9 ± 3.5)mm, (44.5 ± 2.8)degree. There was significant sex difference in PCFV, PCFH, CL, SL and CG in control group (t=4.70, 6.44, 4.84, 4.43 and 2.81 respectively, P<0.01), but FMD was not significant (t=1.97, P<0.05); the results of PCFV, PCFH, CL, CG and SL were significant different between diseased group and male of control group (t=16.62, 24.04, 25.01, 14.17 and 10.99 respectively, P<0.01); the results of PCFV, PCFH, CL, CG and SL were significant different between diseased group and female of control group (t=13.23, 17.80, 27.50, 11.67 and 8.73 respectively, P<0.01); but there were no significant differences of FMD between diseased group and control group, both male and female (t=2.96, 2.07, P<0.05). Conclusions: The overcrowding of PCF can be accurately measured by MCST. As a routine preoperative examination, MSCT is helpful in the therapeutic selection and the anatomic and pathologic study of PCF. (authors)

  1. Appendicular endometriosis as a cause of chronic abdominal pain alone in the right iliac fossa: case report and literature review

    Marcelo Pandolfi Basso

    2012-03-01

    Full Text Available Endometriosis is a disease characterized by the presence of ectopic endometrial glands and stroma. Although its etiology is undefined, it is suggested to be a result of coelomic metaplasia, retrograde menstruation, to provide a genetic component, or to be one that occurs due to blood or lymphatic spread. The involvement of the gastrointestinal tract is common. However, appendicular endometriosis is a rare condition. It is usually asymptomatic. Recurrent pain in the right iliac fossa is an unusual clinical manifestation. There are no non-invasive complementary tests to confirm the diagnosis. Laparoscopy is the main option for research, due to its diagnostic and therapeutic features. A histopathological examination is necessary for the diagnosis. Although surgical and drug therapies have special indications, the combination therapy showed lower symptom recurrence. This study reports a case of appendicular endometriosis that was diagnosed and treated in the service of Coloproctology of the Base Hospital at Faculdade de Medicina of São Jose do Rio Preto. There is also a literature review about this situation.Endometriose é uma doença caracterizada pela presença de estroma e glândulas endometriais ectópicas. Apesar de sua etiologia não definida, sugere-se que seja decorrente de metaplasia celômica, menstruação retrógada, apresente componente genético, ou ocorra devido à disseminação linfática ou sanguínea. O acometimento do trato gastrointestinal é comum; no entanto, a endometriose apendicular é condição rara e se apresenta com maior frequência de forma assintomática. Dor recorrente em fossa ilíaca direita é uma manifestação clínica incomum. Não há exames complementares não invasivos que confirmem o diagnóstico. A laparoscopia é a principal opção durante a investigação, por sua característica diagnóstica e terapêutica. O diagnóstico pode ser feito apenas após um exame histopatológico. Embora as terapias medicamentosa e cirúrgica apresentem indicações particulares, a terapêutica combinada mostra menor recorrência dos sintomas. O objetivo do trabalho é relatar um caso de endometriose apendicular diagnosticado e tratado na Disciplina de Coloproctologia do Hospital de Base da Faculdade de Medicina de São José do Rio Preto, além de revisar a literatura acerca dessa situação.

  2. [Postnatal developmental changes in the posterior cranial fossa area. I. Facies posterior partis petrosae (porus et meatus acusticus internus, fossa subarcuata, apertura externa aqueductus vestibuli, apertura externa canaliculi cochleae)].

    Lang, J; Hofmann, S; Maier, R; Schafhauser, O

    1981-01-01

    1. In the newborn the lateral edge of the internal acoustic pore is located about 13.3 mm, in the 2-year-old about 22.5 mm and in the adults about 28.5 (22 to 34) mm from the paramedian plane of the skull. Also the mean distance from the lateral wall of the skull increases from about 13 to 30 mm in the postnatal period. 2. Without the postnatal development of height and width of the internal acoustic pore the postnatal extension (from a mean value of 5 mm in the newborn to about 10 mm in the 15- to 17-year-old) also the postnatal development of height and width of the internal acoustic meatus were measured. 3. Size, width and position of the subarcuata fossa, the external aperture of the aqueduct of the vestibulum just as the external aperture of the cochlear canaliculus were determined. The results were discussed in detail with the datas of former investigators. PMID:7286595

  3. Uncommon evolution of probable central nervous system histoplasmosis: from leptomeningitis to posterior fossa granuloma. A case report with magnetic resonance images; Evolucao incomum de provavel histoplasmose de sistema nervoso central: de leptomeningite para granuloma da fossa posterior. Relato de caso com imagens por ressonancia magnetica

    Carrilho, Paulo Eduardo Mestrinelli; Alves, Orival [Universidade Estadual do Oeste do Parana - UNIOESTE, Cascavel, PR (Brazil). Curso de Medicina. Disciplina de Neurologia e Neurocirurgia]. E-mail: carrilho@certto.com.br; Budant, Manfredo [UNITOM - Unidade de Diagnostico por Imagem, Cascavel, PR (Brazil). Centro de Tomografia; Bozo, Marlon K.; Meirelles, Noel [Universidade Estadual do Oeste do Parana - UNIOESTE, Cascavel, PR (Brazil). Curso de Medicina; Bueno, Alexandre Galvao [ANATOM - Instituto de Anatomia Patologica de Cascavel, PR (Brazil)

    2006-01-15

    We report a case of a young immunocompetent patient with probable central nervous system histoplasmosis with evolutive peculiar findings seen on magnetic resonance imaging. Leptomeningeal thickening was initially observed which subsequently became a posterior fossa granuloma. The diagnosis of fungal infection was only reached by histopathological study and the treatment was based on long term therapy with fluconazole wth good initial response. (author)

  4. Evaluation of Single Photon Emission Computerised Tomography (SPECT using Tc99m-Tetrofosmin as a Diagnostic Modality for Recurrent Posterior Fossa Tumours

    Barai S

    2003-01-01

    Full Text Available BACKGROUND: Brain Single Photon Emission Computerised Tomography (SPECT has been established as a potentially useful tool for the assessment of recurrent brain tumours. Though brain SPECT is exquisitely sensitive in detecting viable tumour tissue in the supratentorial region, its efficacy has not been evaluated till date in case of infratentorial posterior fossa tumours. AIM OF THE STUDY: To evaluate the diagnostic utility of brain SPECT in differentiating recurrence of tumour from post-radiation gliosis in the posterior fossa of the brain. SUBJECTS AND METHODS: Twenty-one patients with primary malignant posterior fossa brain tumour were evaluated by brain SPECT with Tc99m-Tetrofosmin as the tumour-seeking agent. Clinical behaviour of the tumour observed for a minimum period of one year after the SPECT study was taken as the gold standard. STATISTICAL ANALYSIS: The Chi-square test has been used to note the significance of the association between the clinical outcome and the SPECT finding. In addition, the sensitivity and specificity of brain SPECT were also calculated. RESULT: Brain SPECT in 4 patients revealed increased tracer concentration over the primary tumour bed, which was consistent with recurrent tumour. The clinical course was consistent with tumour recurrence in 13 of the 21 patients, which included 3 patients with positive SPECT study and 10 patients with negative SPECT study. Brain SPECT revealed recurrent tumour in 4 patients whereas clinical follow-up suggested recurrence in 13 patients. The clinical course was consistent with radiation necrosis in the remaining 8 patients. In 1 brain SPECT positive patient the clinical course was consistent with post-radiation gliosis. CONCLUSION: This study demonstrates that brain SPECT is not a sensitive diagnostic modality to differentiate recurrent tumour from post-radiation gliosis in the posterior fossa of the brain.

  5. A Lateral Transzygomatic-Transtemporal Approach to the Infratemporal Fossa: Technical Note for Mobilization of the Second and Third Branches of the Trigeminal Nerve

    Terasaka, Shunsuke; Sawamura, Yutaka; Goto, Shin; Fukushima, Takanori

    1999-01-01

    This report describes an alternative approach to the infratemporal fossa lesions through a lateral zygomato-temporal craniotemy, which modifies the extradural temporopolar technique for cavernous sinus surgery. First, an L-shaped osteotomy of the zygoma from the frontozygomatic suture attaching the zygomatre arch and low positioned temporal cramotomy are made. Through this zygomato-temporal craniotomy and orbitotemporal drilling, leaving the lateral orbital rim and orbital roof intact, skelet...

  6. Body mass index and patient CT measurements as a predictor of benefit of intensity-modulated radiotherapy to the supraclavicular fossa

    Koh V; Tang JI; Choo BA; Tan CW; BK Lim; Shen L; Lu JJ

    2013-01-01

    Vicky Koh,1 Johann I Tang,1 Bok Ai Choo,1 Chek Wee Tan,1 Boon Keat Lim,2 Liang Shen,3 Jiade Jay Lu1 1Department of Radiation Oncology, National University Cancer Institute, Singapore; 2Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore; 3Department of Biostatistics, National University of Singapore, Singapore Background: Irradiation of the supraclavicular fossa is commonly used as part of adjuvant breast radiotherapy. Intensity-modulated radiotherapy (IMRT) may be used to ...

  7. Progressive Multifocal Leucoencephalopathy Isolated to Posterior Fossa in a Patient with AIDS: DWI and 1H-MRS Features

    We report a case of progressive multifocal leukoencephalopathy (PML) isolated to the posterior fossa in a 55-year-old male with acquired immune deficiency syndrome (AIDS). Initial MR images revealed a few foci of patchy increased signal intensity (SI) on a T2-weighted image and a diffusion weighted image (DWI) at the pons, right middle cerebellar peduncle, and right cerebellar hemisphere, with no enhancement. After anti-retroviral therapy, follow-up MR images revealed the more prominent extent of previously-seen lesions and newly discovered newly developed focal increased SI on T2-weighted images located left of the inferior cerebellar hemisphere. Proton MR spectroscopy (1H-MRS) showed a slightly increased choline peak (3.2 ppm) and lactate peak (1.35 ppm), as well as a decreased N-acetylaspartate (NAA) peak (2.0 ppm), which suggests active demyelinating disease. DWI and 1H-MRS may support the diagnosis of PML in patients with AIDS

  8. Long-term intellectual outcome in children with posterior fossa tumors according to radiation doses and volumes

    Purpose: To analyze the relationship between craniospinal irradiation (CSI) and intellectual outcome in children with posterior fossa (PF) tumors. Methods and Materials: A neuropsychological evaluation was performed retrospectively in 31 children, aged 5-15 years, who had received radiotherapy for PF tumors, and who had been off therapy for at least 1 year. Factors evaluated for impact on intellectual outcome were: socioeconomic status, disease presentation, histology, complications, chemotherapy, age at radiotherapy, interval between radiotherapy and testing, and radiation doses and volumes. Patients were divided into 3 subgroups according to the CSI doses (0 Gy [i.e., PF irradiation only], 25 Gy, and 35 Gy), with 11, 11, and 9 patients, respectively. Results: Long-term cognitive impairment occurred in most of the patients, even after PF irradiation only. Moreover, there was a significant correlation between the full-scale IQ score (FSIQ) and the CSI dose, with mean FSIQ scores at 84.5 (SD = 14.0), 76.9 (SD = 16.6), and 63.7 (SD = 15.4) for 0 Gy, 25 Gy, and 35 Gy of CSI, respectively. A marked drop in verbal comprehension scores was noted in children who had received the higher dose. Conclusion: This preliminary study further supports the rationale for de-escalation of CSI doses and volumes in standard-risk PF tumors

  9. Middle infratemporal fossa less invasive approach for radical resection of parapharyngeal tumors: surgical microanatomy and clinical application.

    Nonaka, Yoichi; Fukushima, Takanori; Watanabe, Kentaro; Sakai, Jun; Friedman, Allan H; Zomorodi, Ali R

    2016-01-01

    Surgery of the infratemporal fossa (ITF) and parapharyngeal area presents a formidable challenge to the surgeon due to its anatomical complexity and limited access. Conventional surgical approaches to these regions were often too invasive and necessitate sacrifice of normal function and anatomy. To describe a less invasive transcranial extradural approach to ITF parapharyngeal lesions and to determine its advantages, 17 patients with ITF parapharyngeal neoplasms who underwent tumor resection via this approach were enrolled in the study. All lesions located in the ITF precarotid parapharyngeal space were resected through a small operative corridor between the trigeminal nerve third branch (V3) and the temporomandibular joint (TMJ). Surgical outcomes and postoperative complications were evaluated. Pathological diagnosis included schwannoma in eight cases, paraganglioma in two cases, gangliocytoma in two cases, carcinosarcoma in one case, giant cell tumor in one case, pleomorphic adenoma in one case, chondroblastoma in one case, and juvenile angiofibroma in one case. Gross total resection was achieved in 12 cases, near-total and subtotal resection were in 3 and 2 cases, respectively. The most common postoperative complication was dysphagia. Surgical exposure can be customized from minimal (drilling of retrotrigeminal area) to maximal (full skeletonization of V3, removal of all structures lying lateral to the petrous segment of internal carotid artery) according to tumor size and location. Since the space between the V3 and TMJ is the main corridor of this approach, the key maneuver is the anterior translocation of V3 to obtain an acceptable surgical field. PMID:26160680

  10. The relation of catastrophic flooding of Mangala Valles, Mars, to faulting of Memnonia Fossae and Tharsis volcanism

    Detailed stratigraphic relations indicate two coeval periods of catastrophic flooding and Tharsis-centered faulting (producing Memnonia Fossae) in the Mangala Valles region of Mars. Major sequences of lava flows of the Tharsis Montes Formation and local, lobate plains flows were erupted during and between these channeling and faulting episodes. First, Late Hesperian channel development overlapped in time the Tharsis-centered faulting that trends north 75 degree to 90 degree E. Next, Late Hesperian/Early Amazonian flooding was coeval with faulting that trends north 55 degree to 70 degree E. In some reaches, resistant lava flows filled the early channels, resulting in inverted channel topography after the later flooding swept through. Both floods likely originated from the same graben, which probably was activated during each episode of faulting. Faulting broke through groundwater barriers and tapped confined aquifers in higher regions west and east of the point of discharge. The minimum volume of water required to erode Mangala Valles (about 5 x 1012 m3) may have been released through two floods that drained a few percent pore volume from a relatively permeable aquifer. The peak discharges of the floods may have lasted from days to weeks. The perched water discharged from the aquifer may have been produced by hydrothermal groundwater circulation induced by Tharsis magmatism, tectonic uplift centered at Tharsis Montes, and compacting of saturated crater ejecta due to loading by lava flows

  11. Progressive Multifocal Leucoencephalopathy Isolated to Posterior Fossa in a Patient with AIDS: DWI and 1H-MRS Features

    Park, Byung Sa; Yu, In Kyu; Lee, Byung Hee [Eulji University Hospital, College of Medicine, Daejeon (Korea, Republic of)

    2010-11-15

    We report a case of progressive multifocal leukoencephalopathy (PML) isolated to the posterior fossa in a 55-year-old male with acquired immune deficiency syndrome (AIDS). Initial MR images revealed a few foci of patchy increased signal intensity (SI) on a T2-weighted image and a diffusion weighted image (DWI) at the pons, right middle cerebellar peduncle, and right cerebellar hemisphere, with no enhancement. After anti-retroviral therapy, follow-up MR images revealed the more prominent extent of previously-seen lesions and newly discovered newly developed focal increased SI on T2-weighted images located left of the inferior cerebellar hemisphere. Proton MR spectroscopy (1H-MRS) showed a slightly increased choline peak (3.2 ppm) and lactate peak (1.35 ppm), as well as a decreased N-acetylaspartate (NAA) peak (2.0 ppm), which suggests active demyelinating disease. DWI and 1H-MRS may support the diagnosis of PML in patients with AIDS

  12. Parasitic copepods in the nasal fossae of five fish species (Characiformes from the upper Paraná river floodplain, Paraná, Brazil = Copépodes parasitos de fossas nasais de cinco espécies de peixes (Characiformes da planície de inundação do alto rio Paraná, Paraná, Brasil

    Ana Carolina Figueiredo Lacerda

    2007-10-01

    Full Text Available The present work had the objective to study parasitic copepods in thenasal fossae of fish from the upper Paraná river floodplain. Fish were captured in different locations of the floodplain in March, June and September, 2004. A total of 73 specimens (Characiformes were collected, belonging to 4 distinct families and 5 species: Acestrorhynchus lacustris (Acestrorhynchidae, Schizodon borellii (Anostomidae, Prochilodus lineatus (Prochilodontidae, Serrasalmus marginatus and Serrasalmus maculatus (Serrasalmidae. Among 73 fishes examined, 53 were parasitized by nasal fossae copepods, varying from 1 to 146 parasites per host. Parasites found belonged to 3 known species: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984; and Rhinergasilus piranhus Boeger & Thatcher, 1988. There were differences in parasite corporal measurements and in the quantity of parasites per host in relation to copepod parasites from the Amazon region. The present study constitutes one of the few studies of identification of copepod parasites in the nasal fossae of fish from the Southern region of Brazil.O presente trabalho teve como objetivo o estudo de copépodes parasitos de fossas nasais de peixes da planície de inundação do alto Rio Paraná. As coletas foram realizadas em diversos pontos da planície nos meses de março, junho e setembro de 2004. Foram coletados 73 exemplares de peixes da ordem Characiformes, de quatrofamílias distintas, pertencentes a cinco espécies: Acestrorhynchus lacustris, Prochilodus lineatus, Schizodon borellii, Serrasalmus maculatus e Serrasalmus marginatus. Dentre os 73 peixes examinados, 53 encontravam-se parasitados por copépodes de fossas nasais,variando de 1 a 146 parasitos por peixe. Os parasitos encontrados pertenciam a três espécies conhecidas: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984 e Rhinergasilus piranhus Boeger & Thatcher, 1988. Diferenças foram observadas nas medidas corporais dos parasitos e na quantidade de espécies de parasitos por espécie de peixe em relação aos copépodes encontrados em estudos anteriores na região amazônica. O presente estudo constitui um dos poucos trabalhos de identificação de copépodes parasitos de fossas nasais de peixes da região Sul do Brazil.

  13. Cerebellar and posterior fossa malformations in patients with autism-associated chromosome 22q13 terminal deletion.

    Aldinger, Kimberly A; Kogan, Jillene; Kimonis, Virginia; Fernandez, Bridget; Horn, Denise; Klopocki, Eva; Chung, Brian; Toutain, Annick; Weksberg, Rosanna; Millen, Kathleen J; Barkovich, A James; Dobyns, William B

    2013-01-01

    The 22q13.3 deletion causes a neurodevelopmental syndrome, also known as Phelan-McDermid syndrome (MIM #606232), characterized by developmental delay and severe delay or absence of expressive speech. Two patients with hemizygous chromosome 22q13.3 telomeric deletion were referred to us when brain-imaging studies revealed cerebellar vermis hypoplasia (CBVH). To determine whether developmental abnormalities of the cerebellum are a consistent feature of the 22q13.3 deletion syndrome, we examined brain-imaging studies for 10 unrelated subjects with 22q13 terminal deletion. In seven cases where the availability of DNA and array technology allowed, we mapped deletion boundaries using comparative intensity analysis with single nucleotide polymorphism (SNP) microarrays. Approximate deletion boundaries for three additional cases were derived from clinical or published molecular data. We also examined brain-imaging studies for a patient with an intragenic SHANK3 mutation. We report the first brain-imaging data showing that some patients with 22q13 deletions have severe posterior CBVH, and one individual with a SHANK3 mutation has a normal cerebellum. This genotype-phenotype study suggests that the 22q13 deletion phenotype includes abnormal posterior fossa structures that are unlikely to be attributed to SHANK3 disruption. Other genes in the region, including PLXNB2 and MAPK8IP2, display brain expression patterns and mouse mutant phenotypes critical for proper cerebellar development. Future studies of these genes may elucidate their relationship to 22q13.3 deletion phenotypes. PMID:23225497

  14. Reversibility of dopamine receptor antagonist-induced hyperprolactinemia and associated histological changes in Tg RasH2 wild-type mice.

    Krishna, Gopala; Ganiger, Shivaputhrappa; Kannan, Kamala; Gopalakrishnan, Gopa; Goel, Saryu

    2015-12-01

    The purpose of this study was to better understand the biological effects of increased prolactin levels induced in mice by dopamine D2 receptor antagonist molindone treatment. Toxicokinetics, prolactin levels, and reproductive tissue histology were evaluated in Tg rasH2 wild-type mice treated orally with molindone at 0, 5, 15, and 50mg/kg/day for 6 months, followed by a 2-month posttreatment recovery period. A greater than dose-proportional increase in molindone exposure ([AUC]0‒24) was observed on Day 180 for both sexes. Statistically significant (Ptreatment groups compared with controls at 0.5h postdose on Days 1 and 180. Prolactin levels returned to baseline levels during the recovery period. Microscopic changes attributable to hyperprolactinemia, including corpora lutea enlargement and interstitial cell atrophy in the ovaries, and atrophy of the uterus and vagina were observed on Day 180. These changes were reversed during the recovery period in the 5- and 15-mg/kg/day treatment groups. Mice receiving molindone at 50mg/kg/day also showed signs of reversal on histologic examination. PMID:26327279

  15. Evaluation of osteal posterior cranial fossa in adults by multi-slice CT measurements before and after operation in basilar invagination patients

    Objective: To evaluate the clinical effect of MSCT measurements in the pre- and post- operational osteal posterior cranial fossa for the adult patients of basilar invagination. Methods: We reviewed the images of a cohort of 31 adult patients with basilar invagination, which were treated by surgical operation. According to the presence of atlantoaxial dislocation, the patients were divided into groups A and B. The basion-dens interval (BDI), atlanto-dental interval (ADI), space available of the spinal cord (SAC), clivus-canal angle (CCA), Highly index (HI), and Chamberlian line (CBL) of the posterior cranial fossa were obtained in all the patients. Independent-sample Student's t test was used to compare the differences between groups A and groups B. Spearman correlations were analyzed between CT measurement data and effects of operations. Results: In Group A, the BDI, ADI, SAC, CCA, HI, CBL before and after surgery were 12.6 mm, 8.3 mm, 4.5 mm, 3.3 mm; 18.2 mm, 20.8 mm, 138.3°, 150.4°, 28.7 mm, 43.4 mm, 6.3 mm, 3.3 mm respectively. There were significant differences (t=5.603, 2.323, 3.124, 5.531, 4.278 and 2.375, respectively, P0.05). The preoperative JOA score in groups B was 11 points, and the postoperative score was 16 points. JOA scores before and after surgery were significantly different (t=2.874, P 0.05), and CBL, SAC and CCA were correlated (r=-0.756, -0.728; 0.651, 0.672; 0.726, 0.695, P< 0.05). Conclusion: MSCT measurements for basilar invagination before and after surgery are helpful for understanding changes of osteal posterior fossa anatomy and comprehensive evaluation of surgical treatment. (authors)

  16. Parasitic copepods in the nasal fossae of five fish species (Characiformes) from the upper Paraná river floodplain, Paraná, Brazil = Copépodes parasitos de fossas nasais de cinco espécies de peixes (Characiformes) da planície de inundação do alto rio Paraná, Paraná, Brasil

    Ana Carolina Figueiredo Lacerda; Ricardo Massato Takemoto; Maria de los Angeles Perez Lizama; Gilberto Cezar Pavanelli

    2007-01-01

    The present work had the objective to study parasitic copepods in thenasal fossae of fish from the upper Paraná river floodplain. Fish were captured in different locations of the floodplain in March, June and September, 2004. A total of 73 specimens (Characiformes) were collected, belonging to 4 distinct families and 5 species: Acestrorhynchus lacustris (Acestrorhynchidae), Schizodon borellii (Anostomidae), Prochilodus lineatus (Prochilodontidae), Serrasalmus marginatus and Serrasalmus macula...

  17. Recurrent inverted papilloma with intracranial and temporal fossa involvement: A case report and review of the literature;Papillome inverse recidivant avec extension temporale et intracranienne: cas clinique et revue de la litterature

    Acevedo-Henao, C.M.; Pradier, O. [Department of Radiotherapy, Morvan Hospital, CHU de Brest, Brest University, 29 - Brest (France); Talagas, M. [Department of Pathology, Morvan Hospital, CHU de Brest, 29 - Brest (France); Marianowski, R. [Department of Head and Neck Surgery, Morvan Hospital, CHU de Brest, 29 - Brest (France)

    2010-06-15

    Inverted papilloma (I.P.) is a rare naso-sinusal benign tumour, with epithelium surface inversion to inside the stroma. Extension to intracranial temporal fossa and middle ear has been reported in few cases in the literature. This involvement may be derived from either direct extension from sino-nasal cavity via the Eustachian tube or primary middle ear involvement secondary to meta-plastic changes of the middle ear mucosa. Here, we report a case of inverted papilloma in a male patient, with multiple recurrences, middle ear and intracranial involvement into the temporal fossa with posterior development of malignancy. This patient had received multiple surgeries and radiotherapy but despite of that, his disease recurred several times. As a conclusion, inverted papilloma is a benign tumour with an aggressive course, tendency to recurrence and progression to malignancy. Intracranial and temporal fossa involvements are rare and the treatment depends of the symptoms and the severity of the disease. (authors)

  18. Bilateral lipoma arborescens of the bicipitoradial bursa

    A 37-year-old military mechanic presented to our institution with a chronic history of a slowly enlarging left elbow antecubital fossa mass. There was no history of other chronic illness or trauma. Magnetic resonance imaging (MRI) and excisional biopsy revealed fatty villi and synovial inflammation within the left bicipitoradial bursa, consistent with lipoma arborescens. Four years later the patient presented with a 6-month history of swelling at the antecubital fossa of the opposite elbow. Diagnostic computed tomography and MRI examinations were performed. The surgical and pathologic findings confirmed the imaging diagnosis of lipoma arborescens at the right bicipitoradial bursa. (orig.)

  19. Differences in Supratentorial Damage of White Matter in Pediatric Survivors of Posterior Fossa Tumors With and Without Adjuvant Treatment as Detected by Magnetic Resonance Diffusion Tensor Imaging

    Purpose: To elucidate morphologic correlates of brain dysfunction in pediatric survivors of posterior fossa tumors by using magnetic resonance diffusion tensor imaging (DTI) to examine neuroaxonal integrity in white matter. Patients and Methods: Seventeen medulloblastoma (MB) patients who had received surgery and adjuvant treatment, 13 pilocytic astrocytoma (PA) patients who had been treated only with surgery, and age-matched healthy control subjects underwent magnetic resonance imaging on a 3-Tesla system. High-resolution conventional T1- and T2-weighted magnetic resonance imaging and DTI data sets were obtained. Fractional anisotropy (FA) maps were analyzed using tract-based spatial statistics, a part of the Functional MRI of the Brain Software Library. Results: Compared with control subjects, FA values of MB patients were significantly decreased in the cerebellar midline structures, in the frontal lobes, and in the callosal body. Fractional anisotropy values of the PA patients were not only decreased in cerebellar hemispheric structures as expected, but also in supratentorial parts of the brain, with a distribution similar to that in MB patients. However, the amount of significantly decreased FA was greater in MB than in PA patients, underscoring the aggravating neurotoxic effect of the adjuvant treatment. Conclusions: Neurotoxic mechanisms that are present in PA patients (e.g., internal hydrocephalus and damaged cerebellar structures affecting neuronal circuits) contribute significantly to the alteration of supratentorial white matter in pediatric posterior fossa tumor patients.

  20. Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications

    Kalifa Chantal

    2008-01-01

    Full Text Available Abstract Background To investigate the neuropsychological outcome of children treated with surgery and posterior fossa irradiation for localized infratentorial ependymoma. Methods 23 patients (age 0.3 – 14 years at diagnosis who were treated with local posterior fossa irradiation (54 Gy underwent one (4 patients or sequential (19 patients neuropsychologic evaluation. The last evaluation was performed at a median of 4.5 (1 to 15.5 years after RT. Results Mean last full scale IQ (FSIQ, verbal IQ (VIQ and PIQ were 89.1, 94.0, and 86.2 respectively. All patients had difficulties with reading, and individual patients showed deficits in visuospatial, memory and attentional tasks. There was no trend for deterioration of intellectual outcome over time. All 5 children with IQ scores ? 75 were under the age of four at diagnosis. There was a significant association between the presence of cerebellar deficits and impaired IQ (72.0 vs 95.2, p Conclusion Within the evaluated cohort, intellectual functions were moderately impaired. Markedly reduced IQ scores were only seen with early disease manifestation and treatment, and postoperative neurological deficits had a strong impact on intellectual outcome.

  1. [Surface of the floor of the anterior cranial fossa and orbital roof as well as angles and measurements of the orbits].

    Lang, J; Roth, C

    1984-01-01

    With the aid of diagraphic drawings the floor-space of the anterior cranial fossa and of that orbital roof area of adults which is adjacent to the floor of the anterior cranial fossa (separated by the paranasal sinuses) were investigated. On the right side there is a mean of 730 mm2 and on the left side 717 mm2. The paries medialis orbitae on the right side runs by about 1 degree more to the rostral and medial side as left. The angle on the right side between frontomolare orbitale , the lateral end of the fissura orbitalis superior and the mediansagittal plane is somewhat bigger (35 degrees) than on the left side (33.9 degrees). Different angles inside the orbita, the extension of the orbita behind the frontozygomatic suture, the depth of the orbita, right-left-differences of the apertura orbitae canalis optici and the greater retardation of the laterally border of the orbita on the right side were investigated. The medical importance for neurosurgeons and ophthalmologists is demonstrated. PMID:6721209

  2. Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications

    To investigate the neuropsychological outcome of children treated with surgery and posterior fossa irradiation for localized infratentorial ependymoma. 23 patients (age 0.3 – 14 years at diagnosis) who were treated with local posterior fossa irradiation (54 Gy) underwent one (4 patients) or sequential (19 patients) neuropsychologic evaluation. The last evaluation was performed at a median of 4.5 (1 to 15.5) years after RT. Mean last full scale IQ (FSIQ), verbal IQ (VIQ) and PIQ were 89.1, 94.0, and 86.2 respectively. All patients had difficulties with reading, and individual patients showed deficits in visuospatial, memory and attentional tasks. There was no trend for deterioration of intellectual outcome over time. All 5 children with IQ scores ≤ 75 were under the age of four at diagnosis. There was a significant association between the presence of cerebellar deficits and impaired IQ (72.0 vs 95.2, p < 0,001). The absence of hydrocephalus was an indicator of better neuropsychologic outcome (mean FSIQ of 102.6 vs 83.9, p = 0.025). Within the evaluated cohort, intellectual functions were moderately impaired. Markedly reduced IQ scores were only seen with early disease manifestation and treatment, and postoperative neurological deficits had a strong impact on intellectual outcome

  3. Arteriovenous synovial hemangioma of the popliteal fossa diagnosed in an adolescent with history of unilateral congenital clubfoot: case report and a single-institution retrospective review.

    Derzsi, Zoltán; Gurzu, Simona; Jung, Ioan; László, Ileana; Golea, Mircea; Nagy, Örs; Pop, Tudor Sorin

    2015-01-01

    Synovial hemangioma (SH) is a very rare soft tissue tumor; in our department, SH represented 0.07% from all soft tissue tumors (one case from 1311 soft tissue tumors), and 0.78% from all excised hemangiomas (one case from 128 hemangiomas) diagnosed over a five-year period. The aim of this paper was to present the clinicopathologic characteristics of hemangiomas and particularities of one SH of the popliteal fossa diagnosed in an athletic adolescent with previously corrected congenital clubfoot. To our knowledge, this is the 275 case of reported SH. A 13-year-old trick cyclist presented with two-year history of slowly growing mass of the left posterior fossa. The magnetic resonance imaging of the left knee showed a juxta-articular mass with intramuscular component. Open excision of the tumor and partial removal of the synovial membrane was the therapy of choice. Histopathological examination revealed clusters of large arteries and veins embedded in a fibrotic tissue, the tumor mass being lined by synovial membrane. Intramuscular growing was also confirmed. Without any other postoperative therapies, no recurrence or functional disorders were noted after 21 months of follow-up. SH of the knee should be excised as soon as possible to avoid complications such as muscle invasion and risk of recurrence. PMID:26193227

  4. Diaper Rash: How to Treat

    ... benefits Become a member DermCare Team Professionalism and ethics My account Member directory Publications JAAD JAAD Case ... AAD publications Make a difference Career planning Media Relations Toolkit Dermatology issues ... in Dermatology JAAD Mohs AUC Psoriasis Patient ...

  5. Skin Rashes and Other Changes

    ... your elbows and knees? Yes This could be PSORIASIS, a condition caused by the overproduction of skin cells. See your doctor. Keep the skin moisturized. Your doctor may prescribe ointments, oral medications and/or light therapy, also called phototherapy, to treat the symptoms. No ...

  6. Rash - child under 2 years

    ... creams may help reduce friction and protect the baby's skin from irritation. Powders such as cornstarch or talc should be used cautiously, as they can be inhaled by the infant and may cause lung injury. If your baby ...

  7. A study of sup(81m)Kr perfusion images before and after vascular reconstructive surgery in the posterior fossa by using single-photon emission computed tomography

    sup(81m)Kr perfusion images obtained by means of single-photon emission computed tomography (SPECT) were studied in 8 patients with occlusive lesions of the vertebrobasilar system. Seven of these patients had occlusions or stenoses of one or both vertebral arteries, and one had a kink of the vertebral artery. Superficial temporal-superior cerebellar artery (STA-SCA) anastomosis and the occipital-posterior inferior cerebellar artery anastomosis were performed on three and one patients respectively. In three other patients, endarterectomy of the vertebral artery was performed, while the repair of the kink in the vertebral artery was done in one patient. In the preoperative perfusion images after sup(81m)Kr infusion into the ascending aorta, an irregular distribution in the posterior fossa was found in 3 out of 6 patients. Among these three patients, a low perfusion was observed in the brain stem of two and in the cerebellar hemisphere of one patient. One patient with a low perfusion in the brain stem had a low-density lesion in X-ray computed tomographic scans, but the other two patients had no obvious low-density lesions. The irregular distribution of perfusion after sup(81m)Kr infusion into the ascending aorta was improved in the resting state of one patient after STA-SCA anastomosis. In all four patients, after the bypass surgery, a marked reduction in the perfusion in the posterior fossa was found by compression of the donar artery. By the reduction of the perfusion, not only the patency of the anastomosis, but also the area perfused by the donar and the degree of the dependence on the donar were disclosed. After STA-SCA anastomosis in one patient, the perfusion images after sup(81m)Kr infusion into the external carotid artery revealed the perfused area through STA in the posterior fossa. sup(81m)Kr perfusion images by SPECT seemed to be useful for learning of cerebral hemodynamics easily. (J.P.N.)

  8. Implante coclear via fossa craniana média: uma nova técnica para acesso ao giro basal da cóclea Cochlear implantation through the middle cranial fossa: a novel approach to access the basal turn of the cochlea

    Aline Gomes Bittencourt

    2013-04-01

    Full Text Available A técnica clássica para o implante coclear é realizada através de mastoidectomia e timpanotomia posterior. A abordagem pela fossa craniana média provou ser uma alternativa valiosa, embora venha sendo usada para o implante coclear apenas esporadicamente e sem normatização. OBJETIVO: Descrever uma nova abordagem para expor o giro basal da cóclea para o implante coclear através da fossa craniana média. MÉTODO: Cinquenta ossos temporais foram dissecados. A cocleostomia foi realizada através de uma abordagem via fossa craniana média, na parte mais superficial do giro basal da cóclea, usando o plano meatal e seio petroso superior como pontos de reparo. A parede lateral do meato acústico interno foi dissecada após o broqueamento e esqueletização do ápice petroso. A parede dissecada do meato acústico interno foi acompanhada longitudinalmente até a cocleostomia. Design: Estudo anatômico de osso temporal. RESULTADOS: Em todos os ossos temporais, apenas a parte superficial do giro basal da cóclea foi aberta. A exposição do giro basal da cóclea permitiu que as escalas timpânica e vestibular fossem visualizadas. Assim, não houve dificuldade na inserção do feixe de eletrodos através da escala timpânica. CONCLUSÃO: A técnica proposta é simples e permite exposição suficiente do giro basal da cóclea.The classic approach for cochlear implant surgery includes mastoidectomy and posterior tympanotomy. The middle cranial fossa approach is a proven alternative, but it has been used only sporadically and inconsistently in cochlear implantation. OBJECTIVE: To describe a new approach to expose the basal turn of the cochlea in cochlear implant surgery through the middle cranial fossa. METHOD: Fifty temporal bones were dissected in this anatomic study of the temporal bone. Cochleostomies were performed through the middle cranial fossa approach in the most superficial portion of the basal turn of the cochlea, using the meatal plane and the superior petrous sinus as landmarks. The lateral wall of the internal acoustic canal was dissected after the petrous apex had been drilled and stripped. The dissected wall of the inner acoustic canal was followed longitudinally to the cochleostomy. RESULTS: Only the superficial portion of the basal turn of the cochlea was opened in the fifty temporal bones included in this study. The exposure of the basal turn of the cochlea allowed the visualization of the scala tympani and the scala vestibuli, which enabled the array to be easily inserted through the scala tympani. CONCLUSION: The proposed approach is simple to use and provides sufficient exposure of the basal turn of the cochlea.

  9. Formações venosas superficiais da fossa cubital: aspectos de interesse para a prática da Enfermagem / Superficial venous formation of the cubital fossa: aspects of interest for nursing practice / Formaciones venosas superficiales de la fosa cubital: aspectos de interés para la práctica de Enfermería

    Nilton, Alves.

    2012-12-01

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma [...] revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA. Abstract in spanish El objetivo de esta investigación es contribuir al conocimiento que auxilie al profesional de enfermería en la identificación de los tipos más comunes de formaciones venosas de la fosa cubital, además de advertir sobre la importancia de fijar la atención a los casos poco comunes, como lo aquí report [...] ado. A través de la revisión bibliográfica, clasificamos las formaciones venosas de esta región en cinco tipos más comunes, siendo lo más frecuente el Tipo II. La utilización de la VICo se recomienda como el mejor sitio de punción, seguido por la VIB. Además, describimos una variación anatómica, donde se observó la ausencia de comunicación entre VC y VB a nivel de fosa cubital y VIA drenando en VB, con presencia de la VCA. Abstract in english The aim of this study is to contribute to the knowledge to assists the nursing staff to identify the most common types of venous formations of the cubital fossa region, and also focus on the importance of always being alert to unusual cases as that reported here. Through a literature review, we foun [...] d that the venous formations of this region can be classified into five common types, bring the Type II the was most frequent. We also found that MCV is considered the best puncture site, followed by MBV. We also describe an anatomical variation, in which we observed the absence of communication between BV and CV at the level of cubital fossa draining into BV and MVF, with the presence of the ACV.

  10. An Unusual Case of Large Posterior Fossa Neurenteric Cyst Involving Bilateral Cerebellopontine Angle Cisterns: Report of a Rare Case and Review of Literature

    Intracranial neurenteric cysts are rare cystic masses of endodermal origin lined with mucin producing low columnar or cuboidal epithelium. Approximately 141 cases have been reported so far. Most of the posterior fossa neurenteric cysts are typically small, located anteriorly to the brainstem in the midline or in the cerebellopontine angle cistern area. We present a rare, histologically proven case of a large lobulated intracranial neurenteric cyst measuring 4.2 centimeters in the maximal transverse dimension and involving bilateral cerebellopontine angle cisterns. We also present a review of the literature on this uncommon finding. Imaging features of neurenteric cyst are non-specific and it should be considered in the differential diagnosis for any intracranial extraaxial cystic lesion

  11. Biorremediação vegetal do esgoto domiciliar: o caso da fossa verde em comunidades rurais do Alto Sertão Alagoano

    Antonio Oliveira Netto

    2015-12-01

    Full Text Available O imenso déficit de atendimento referente a cobertura de coleta e tratamento do esgoto requer desenvolvimento de sistemas que combinam destinação adequada dos efluentes e baixos custos de construção e operação. Nesse contexto surge a biorremediação vegetal, através da fossa verde, tecnologia social sustentável e de baixo custo, apresentando-se como alternativa viável principalmente para a zona rural de municípios. Essa tecnologia social objetiva contribuir para o enfrentamento da problemática do esgoto domiciliar e das suas consequências para a saúde coletiva da comunidade e o meio ambiente; sendo alternativa de destinação do esgoto doméstico, além de possibilitar o cultivo de algumas espécies frutíferas. Mediante parceria estabelecida com o projeto Renas-Ser que atua na linha de gestão de corpos hídricos superficiais e subterrâneos, três unidades de fossa verde encontram-se construídas em comunidades rurais de municípios do alto sertão alagoano, contemplando o condicionamento adequado dos efluentes domésticos. Os primeiros resultados da observação pontual de redução de matéria orgânica são bastante animadores, tendo em vista a remoção de aproximadamente 38% da DQO já na primeira camada suporte. A etapa seguinte consiste na definição dos demais parâmetros a serem monitorados e verificar a aprovação dos usuários da tecnologia.

  12. Two case series reports: 8 cases of arachnoid Temporoparietal cysts (middle fossa & sylvian fissure) and 2 cases of chronic subdural hematoma

    Meshkini, Ali; Meshkini, Mohammad

    2012-01-01

    Abstract: Background: Arachnoid cysts are common intracranial space-occupying lesions which are often found in middle fossa and temporal regions of the skull. Many of these lesions are asymptomatic but some might appear as space-occupying lesions. Almost arachnoid cyst rupture, either following a trauma or spontaneously can result in intracystic hemorrhage, subdural hematoma and hygroma. The present study presents two case series including 8 cases of arachnoid cysts in temporal region and 2 cases of subdural hemorrhage. Methods: Demographic data and clinical and neuroimaging features of 8 patients were evaluated. Results: A total of 8 patients with arachnoid cysts in temporal region were assessed: age range 3 to 27 years old, 5 male and 3 female. The most important complains of the patients during their visit were seizure (3 cases), headache (4 cases), increased head circumference (1 case), parietotemporal arachnoid cyst in right (4 cases) and left hemisphere (4 cases). The conservative treatment and follow-up were performed in 6 out of 8 patients. In the other 2 patients, for craniotomy surgery with hematoma evacuation was performed. Furthermore, in the surgery the fenestration of arachnoid cyst wall into the basal cisterns as well as low pressure cysto-peritoneal shunt was performed. Conclusions: The risk of annual hemorrhage for patients with arachnoid cyst is very low. However, when the hemorrhage occurs it is treated by hematoma evacuation in most cases, but sometimes there is a need for fenestration of the cyst into basal cisterns under endoscopy, microsurgical or cystoperitoneal shunt. Keywords: Arachnoid cyst, Middle fossa, Chronic subdural hematoma

  13. Hydrocephaly management in patients with tumors in the posterior fossa. Manejo de la hidrocefalia en pacientes con tumores de fosa posterior.

    Omar López Arbolay.

    2005-11-01

    Full Text Available Introduction: Preoperative hydrocephalus is reported in about 80 % of posterior fossa tumor patients and in 15-40% of cases postoperative treatment for persistent or progressive hydrocephalus is required. There is no consensus on the way hydrocephalus should be managed before, during, and after PF surgery. Objective: To determine the presence of hidrocephalia in the tumors of the PF and the therapeutic focus in our means. Methods: We report a descriptive, retrospective study of 10 adult patients with posterior fossa mass lesions and obstructive hydrocephalus who were managed medically for compensate intracranial hypertension plus observation and were operated through posterior fossa craniectomy and tumor excision as unique method of surgical treatment. Results: In all 10 cases clinical improvement was obtained immediately after medical treatment. Circulation of cerebrospinal fluid (CSF was totally restored only by tumor excision in 9 patients. The other case had progression of hydrocephalus after surgery and a ventriculoperitoneal shunt was inserted. Radiological normal sized ventricles was obtained between one and two months of surgery Conclusions: Surgical elimination of CFS circulation obstacle helped by medical treatment for lower intracranial pressure should be considered as a safe option in adult patients, reserving endoscopic ventriculostomy and shunt insertion for cases with persistent or progressive hydrocephalus after treatment. Prospective multicenters randomized trials are needed to obtain stronger evidences. Fundamento: La hidrocefalia preoperatoria se reporta en el 80 % de los pacientes con tumores de fosa posterior y en 15-40 % de los casos se necesita tratamiento postoperatorio para hidrocefalia persistente o progresiva. No existe consenso en cuanto a la forma en que la hidrocefalia debe ser tratada antes, durante, o después de la cirugía de fosa posterior. Objetivo: Determinar la presencia de hidrocefalia en los tumores de la fosa posterior y el enfoque terapéutico en nuestro medio. Método: Se analizan los resultados obtenidos en 10 pacientes adultos con hidrocefalia obstructiva por lesiones de masa de fosa posterior a los cuales se les realizó tratamiento medicamentoso para compensar la hipertensión endocraneana, más observación rigurosa y exéresis de la lesión como único método de tratamiento quirúrgico. Resultados: En los 10 casos se logró mejoría clínica inmediatamente después del tratamiento medicamentoso. En 9 pacientes se restauró totalmente la circulación del líquido cefalorraquídeo después de la exéresis tumoral, progresando después de la operación la hidrocefalia solamente en un caso, al cual se le colocó un shunt ventrículo-peritoneal como tratamiento definitivo. La desaparición radiológica de la dilatación ventricular se logró entre el mes y los dos meses de operados. Conclusiones: La eliminación del obstáculo a la circulación del líquido cefalorraquídeo en los adultos con tumores de fosa posterior como único tratamiento quirúrgico para la hidrocefalia apoyado en un esquema de tratamiento medicamentoso intensivo puede considerarse como una opción segura, reservando la ventriculostomía endoscópica o la colocación de un shunt para los pacientes en que persista o se desarrolle después de la cirugía la hidrocefalia. Se necesitan estudios aleatorizados, multicéntricos para apoyar esta afirmación.

  14. Avaliação da implantação de fossas sépticas na melhoria na qualidade de águas superficiais em comunidades rurais

    Raphael de Vicq

    2014-12-01

    Full Text Available Na maioria dos municípios brasileiros, as comunidades rurais são núcleos populacionais agrupados em torno de córregos que fornecem a água e recebem seus efluentes. Buscou-se nesta pesquisa avaliar as condições dos corpos d'água na bacia hidrográfica do córrego Pau Grande, Ouro Branco, Minas Gerais, antes e depois da instalação de 20 fossas sépticas na comunidade de Castiliano, construídas em 2006. O monitoramento da bacia foi realizado entre 2005 e 2009, em 6 pontos amostrais, onde foram medidos vazão, oxigênio dissolvido, demanda bioquímica de oxigênio, fósforo total, coliformes fecais totais, turbidez e pH. Os pontos a jusante das fossas apresentaram um aumento de mais de 100% nos valores de oxigênio dissolvido e redução em mais de 800% na quantidade de coliformes fecais. Investimentos relativamente baixos, como a construção das fossas, podem trazer melhorias à qualidade dos recursos hídricos em áreas rurais.

  15. Formações venosas superficiais da fossa cubital: aspectos de interesse para a prática da Enfermagem Formaciones venosas superficiales de la fosa cubital: aspectos de interés para la práctica de Enfermería Superficial venous formation of the cubital fossa: aspects of interest for nursing practice

    Nilton Alves

    2012-12-01

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA.El objetivo de esta investigación es contribuir al conocimiento que auxilie al profesional de enfermería en la identificación de los tipos más comunes de formaciones venosas de la fosa cubital, además de advertir sobre la importancia de fijar la atención a los casos poco comunes, como lo aquí reportado. A través de la revisión bibliográfica, clasificamos las formaciones venosas de esta región en cinco tipos más comunes, siendo lo más frecuente el Tipo II. La utilización de la VICo se recomienda como el mejor sitio de punción, seguido por la VIB. Además, describimos una variación anatómica, donde se observó la ausencia de comunicación entre VC y VB a nivel de fosa cubital y VIA drenando en VB, con presencia de la VCA.The aim of this study is to contribute to the knowledge to assists the nursing staff to identify the most common types of venous formations of the cubital fossa region, and also focus on the importance of always being alert to unusual cases as that reported here. Through a literature review, we found that the venous formations of this region can be classified into five common types, bring the Type II the was most frequent. We also found that MCV is considered the best puncture site, followed by MBV. We also describe an anatomical variation, in which we observed the absence of communication between BV and CV at the level of cubital fossa draining into BV and MVF, with the presence of the ACV.

  16. Remote Sensing and Geodetic Measurements for Volcanic Slope Monitoring: Surface Variations Measured at Northern Flank of La Fossa Cone (Vulcano Island, Italy

    Alessandro Bonforte

    2013-05-01

    Full Text Available Results of recent monitoring activities on potentially unstable areas of the NW volcano flank of La Fossa cone (Vulcano Island, Italy are shown here. They are obtained by integration of data by aerial photogrammetry, terrestrial laser scanning (TLS and GPS taken in the 1996–2011 time span. A comparison between multi-temporal models built from remote sensing data (photogrammetry and TLS highlights areas characterized by ~7–10 cm/y positive differences (i.e., elevation increase in the upper crown of the slope. The GPS measurements confirm these results. Areas characterized by negative differences, related to both mass collapses or small surface lowering, also exist. The higher differences, positive and negative, are always observed in zones affected by higher fumarolic activity. In the 2010–2012 time span, ground motions in the northern part of the crater rim, immediately above the upper part of observed area, are also observed. The results show different trends for both vertical and horizontal displacements of points distributed along the rim, with a magnitude of some centimeters, thus revealing a complex kinematics. A slope stability analysis shows that the safety factors estimated from these data do not indicate evidence of possible imminent failures. Nevertheless, new time series are needed to detect possible changes with the time of the stability conditions, and the monitoring has to go on.

  17. Formaciones Venosas de la Fosa Cubital en el Individuo Mapuche: Estudio Bioscópico Venous Formations in the Cubital Fossa of Mapuche: Bioscopy Study

    Mariano del Sol

    2007-12-01

    Full Text Available Las venas superficiales de la fosa cubital constituyen uno de los sitios más importantes para punción venosa. La disposición de esas venas presenta numerosas variaciones y, la disposición de ellas no ha sido estudiada en el grupo étnico mapuche. Debido a esto, y considerando a este grupo como el mayor conglomerado étnico de América del Sur, efectuamos este estudio. Fueron analizadas las venas superficiales de la fosa cubital, en 300 miembros superiores (150 derechos y 150 izquierdos de individuos de ambos sexos (30 hombres y 120 mujeres, chilenos del grupo étnico mapuche, con edades entre 15 y 84 años. El estudio fue realizado en las postas rurales adyacentes a la ciudad de Temuco. Basados en la clasificación de del Sol et al. (1988 para las formaciones venosas de la fosa cubital, obtuvimos los siguientes resultados: Tipo I (38,7%, la vena cefálica (VC se divide en vena intermedia basílica (VIB y vena intermedia cefálica (VIC, uniéndose a la vena basílica (VB y vena cefálica accesoria (VCA, respectivamente. La VIB era de mayor calibre y la vena intermedia del antebrazo (VIA drenaba, generalmente, en la VB; Tipo II (28,3%, la VC origina la vena intermedia del codo (VICo, que se une a la VB. No existe VCA, siendo la VICo de mayor calibre y la VIA drena en la VB; Tipo III (24%, no existe comunicación entre la VB y VC a nivel de la fosa cubital. La VIA drena en la VB; Tipo IV (4,3%, la VC drena en la VB y la VIA drena en la VC; Tipo V otras disposiciones, donde se incluye la M clásica (1% que resulta de la división de la VIA. La utilización de las VIC y VC se recomienda cuando ellas tienen un calibre semejante a la VIB o a la VICo ya que los riesgos de punción de otras estructuras anatómicas importantes, como ramos anteriores del nervio cutáneo medial del antebrazo o arteria braquial, son mínimosThe superficial veins of the cubital fossa constitute one of the most important sites for vein puncture. The availability of those veins present numerous variations, and the availability of these has not been studied in the Mapuche ethnic group. In view of the above, and considering this group as the greatest ethnic conglomerate in South America the study took place. The superficial veins of the cubital fossa were analized in 300 superior members (150 right and 150 left in subjects of both sexes (30 men and 120 women Chileans of the Mapuche ethnic group between 15 and 84 years of age. The study was realized in rural clinics near the city of Temuco. Based on the classification of del Sol et al. (1988 for the vein formation of the cubital fossa, the following results were obtained: type I (38.7%, the cephalic vein (VC is divided in the intermediate basilic vein (VIB and intermediate cephalic vein (VIC, joining thebasilic vein (VBand accessory cephalic vein (VCA respectively. The VIB was of a major caliber and the intermediate vein of the forearm (VIA generally drained in the VB, Type II (28,3%, the VC originates the intermediate vein of the elbow (VICo, that joins the VB. VCA does not exist, th VICo being of a mayor caliber and the VIA drains in to VB, Type III (24% no communication exists between the VB and VC at the level of the cubital fossa, the VIA drains into VB, Type IV (4,3%, the VC drains in the VB and VIA drins in the VC; Type V other dispositions where the classic M is included (1% which results in the division of the VIA. The use of the VIC and VC is recommended when they have a similar caliber to that of the VIB of VICo. Because the puncture risks of other important anatomic structures, such as anterior branches of the medial cutaneous nerve of the forearm or brachial artery are minimal

  18. Radiation therapy quality in CCG/POG intergroup 9961: implications for craniospinal irradiation and the posterior fossa boost in future medulloblastoma trials

    Donahue, Bernadine; Marymont, Mary A. H.; Kessel, Sandra; Iandoli, Matthew K.; FitzGerald, Thomas; Holmes, Emiko; Kocak, Mehmet; Boyett, James M.; Gajjar, Amar; Packer, Roger J.

    2012-01-01

    Purpose: Associations of radiation therapy (RT) deviations and outcomes in medulloblastoma have not been defined well, particularly in the era of reduced-dose craniospinal irradiation and chemotherapy. The aim of this study is to evaluate the quality of RT on Children’s Cancer Group/Pediatric Oncology Group 9961 and analyze associations of RT deviations with outcome. Materials and Methods: Major volume deviations were assessed based on the distance from specified anatomical region to field edge. We investigated associations of RT deviations with progression-free survival (PFS), overall survival (OS), and explored associations with demographics and clinical variables. Results: Of the 308 patients who were evaluable for volume deviations, 101 patients (33%) did not have any. Of the remaining 207 patients, 50% had only minor deviations, 29% had only major deviations, and 21% had both minor and major deviations. Of the patients with major deviations, 73% had a single major deviation. The most common major deviation was in the cribriform plate region, followed by the posterior fossa (PF); PF deviations resulted from treating less than whole PF. There were no significant differences in PFS or OS between patients with deviations and those without. There was no evidence of associations of deviations with patient age. Conclusions: Approximately one-third of patients had major volume deviations. There was no evidence of a significant association between these and outcome. This lack of correlation likely reflects the current high quality of RT delivered in Children’s Oncology Group institutions, our strict definition of volume deviations, and the relatively few instances of multiple major deviations in individual patients. In is noteworthy that the types of PF volume deviations observed in this study were not adversely associated with outcome. As we move forward, quality assurance will continue to play an important role to ensure that deviations on study do not influence study outcome. PMID:23316474

  19. VARIACIONES DE LAS COMUNICACIONES LINFATICO-VENOSAS EN LA FOSA SUPRACLAVICULAR IZQUIERDA DEL HOMBRE VARIATIONS OF THE LYMPHATIC-VENOUS COMMUNICATIONS IN THE HUMAN LEFT SUPRACLAVICULAR FOSSA

    C.F.S. Rodrigues

    1997-01-01

    Full Text Available Considerando la importancia clínica y quirúrgica de las comunicaciones linfáticovenosas, poco descritas en la región cervical, presentamos y analizamos variaciones de estas comunicaciones, las que fueron observadas después de la disección de la fosa supraclavicular izquierda de 34 cadáveres en la Disciplina de Anatomía Descriptiva y Topográfica de la Universidade Federal de São Paulo-Escola Paulista de Medicina, Brasil. Encontramos dos casos (5,9 % de vasos linfáticos que desembocaban en la vena subclavia izquierda, próximo del ángulo yúgulo-subclavio. En ambos casos, estaba presente el conducto torácico desembocando en el lugar habitual. Los estudios anatómicos de estas variaciones son importantes, ya que su conocimiento ayuda a evitar secuelas después de la realización de procedimientos quirúrgicos en la región cervical permitiendo, además, aportar detalles sobre las vías linfáticas de esa regiónConsidering the clinical and surgical importance of lymphaticovenous communications, little described in cervical region, we presented and discussed the variations of these communications observed after the left supraclavicular fossa dissection of 34 adult cadavers used in the Descriptive and Topographic Anatomy of the Universidade Federal de São Paulo - Escola Paulista de Medicina, Brazil. We found two cases (5,9% of lymphatic vessels that reach the left subclavian vein, near of the jugulosubclavian angle. In both cases, the thoracic duct was present and reach the usual local. Anatomical studies of these variations are important due to it knowledge help to avoid consequences after chirurgical proceedings in the cervical region. Besides, the findings of these studies contribute with more details on the lymphatic ways in this region

  20. Rash after measles vaccination: laboratory analysis of cases reported in São Paulo, Brazil Exantema após vacinação do sarampo: análise laboratorial de casos notificados em São Paulo

    Maria I Oliveira

    2002-04-01

    Full Text Available OBJECTIVE: The clinical differential diagnosis of rash due to viral infections is often difficult, and misdiagnosis is not rare, especially after the introduction of measles and rubella vaccination. A study to determine the etiological diagnosis of exanthema was carried out in a group of children after measles vaccination. METHODS: Sera collected from children with rash who received measles vaccine were reported in 1999. They were analyzed for IgM antibodies against measles virus, rubella virus, human parvovirus B19 (HPV B19 using ELISA commercial techniques, and human herpes virus 6 (HHV 6 using immunofluorescence commercial technique. Viremia for each of those viruses was tested using a polimerase chain reaction (PCR. RESULTS: A total of 17 cases of children with exanthema after measles immunization were reported in 1999. The children, aged 9 to 12 months (median 10 months, had a blood sample taken for laboratory analysis. The time between vaccination and the first rash signs varied from 1 to 60 days. The serological results of those 17 children suspected of measles or rubella infection showed the following etiological diagnosis: 17.6% (3 in 17 HPV B19 infection; 76.5% (13 in 17 HHV 6 infection; 5.9% (1 in 17 rash due to measles vaccine. CONCLUSIONS: The study data indicate that infection due to HPV B19 or HHV 6 can be misdiagnosed as exanthema due to measles vaccination. Therefore, it is important to better characterize the etiology of rash in order to avoid attributing it incorrectly to measles vaccine.OBJETIVO: O diagnóstico diferencial de doenças exantemáticas causadas por vírus é geralmente difícil, e equívocos não são raros, especialmente depois da introdução da vacina contra o sarampo e a rubéola. Um estudo laboratorial foi conduzido com o objetivo de estabelecer o diagnóstico etiológico de casos de exantema em crianças que receberam a vacina contra o sarampo. MÉTODOS: Soros de casos de exantema em crianças que receberam vacina contra o sarampo, em 1999, foram analisados para anticorpos IgM contra os vírus do sarampo, da rubéola e do parvovírus humano B19 (HPV B19, por técnicas comerciais de Elisa, e o herpes vírus humano tipo 6 (HHV 6, por técnica comercial de imunofluorecência. A viremia para cada um desses vírus foi testada pela reação em cadeia da polimerase (PCR. RESULTADOS: Foram notificados, em 1999, 17 casos de crianças com exantema pós-vacinal. A idade das crianças era de nove a 12 meses (mediana, dez meses. Uma amostra de sangue colhida para investigação laboratorial foi obtida para cada criança. O tempo decorrido entre a aplicação da vacina e o aparecimento do exantema variou de um a 60 dias. Os resultados da sorologia das 17 crianças sugeriram o seguinte diagnóstico etiológico para o exantema: 17,6% (três em 17 infecção pelo HPV B19; 76,5% (13 em 17 infecção pelo HHV 6; 5,9% (um em 17 exantema originado pela vacina do sarampo. CONCLUSÃO: Os resultados indicaram que a infecção pelo HPV B19 ou pelo HHV 6 pode ser diagnosticada como sarampo de origem vacinal. Portanto, é fundamental incluir esses vírus no diagnóstico laboratorial para corretamente apontar a etiologia das doenças exantemáticas, evitando, assim, atribuir à vacina do sarampo efeito colateral.

  1. Avaliação da implantação de fossas sépticas na melhoria na qualidade de águas superficiais em comunidades rurais / Evaluation of the implementation of septic tanks improving the quality of surface waters in rural communities

    Raphael de, Vicq; Mariangela Garcia Praça, Leite.

    2014-12-01

    Full Text Available Na maioria dos municípios brasileiros, as comunidades rurais são núcleos populacionais agrupados em torno de córregos que fornecem a água e recebem seus efluentes. Buscou-se nesta pesquisa avaliar as condições dos corpos d'água na bacia hid [...] rográfica do córrego Pau Grande, Ouro Branco, Minas Gerais, antes e depois da instalação de 20 fossas sépticas na comunidade de Castiliano, construídas em 2006. O monitoramento da bacia foi realizado entre 2005 e 2009, em 6 pontos amostrais, onde foram medidos vazão, oxigênio dissolvido, demanda bioquímica de oxigênio, fósforo total, coliformes fecais totais, turbidez e pH. Os pontos a jusante das fossas apresentaram um aumento de mais de 100% nos valores de oxigênio dissolvido e redução em mais de 800% na quantidade de coliformes fecais. Investimentos relativamente baixos, como a construção das fossas, podem trazer melhorias à qualidade dos recursos hídricos em áreas rurais. Abstract in english In most Brazilian cities, rural communities are clustered in the surroundings of streams that supply water and receive their effluents. The aim of this study was to evaluate the conditions of the quality water in Pau Grande catchment, located [...] in Ouro Branco, Minas Gerais, Brazil, before and after the construction of 20 septic tanks in the community of Castiliano, build in 2006. The monitoring of the basin was conducted between February 2005 and November 2009, using 6 control points. Several water parameters were evaluated: river flow, dissolved oxygen, biochemical oxygen demand, total phosphorus, total coliform, turbidity and pH. Monitoried points downstream of the construction sites showed an increase of more than 100% in dissolved oxygen and a decrease of fecal coliform bacteria (over 800%). Relatively small investments can bring major improvements to the quality of water resources in rural communities areas.

  2. Radiation dose to the lens of the eye during computerised tomography examinations of the orbit, the pituitary fossa and the brain on a general electric 9800 Quick C.T. scanner

    A phantom simulating the lens of the eye has been used to estimate the radiation dose to the lens of the eye during C.T. scanning of the orbit, pituitary fossa and brain. Routine scanning will deliver a dose to the lens which is many times less than the threshold for cataracts. However the potential exists to use techniques which will increase the dose substantially. Repeat examinations of this sort could theoretically exceed the threshold dose required to induce cataracts in the lens. A dramatic elevation of radiation dose was reported with overlapping slices and increased scan duration.. 12 refs., 8 tabs., 5 figs

  3. Fractionated high-dose-rate and pulsed-dose-rate brachytherapy: first clinical experience in squamous cell carcinoma of the tonsillar fossa and soft palate

    Purpose: Fractionated high-dose-rate (fr.HDR) and pulsed-dose-rate (PDR) brachytherapy (BT) regimens, which simulate classical continuous low-dose-rate (LDR) interstitial radiation therapy (IRT) schedules, have been developed for clinical use. This article reports the initial results using these novel schedules in squamous cell carcinoma (SCC) of the tonsillar fossa (TF) and/or soft palate (SP). Methods and Materials: Between 1990 and 1994, 38 patients with TF and SP tumors (5 T1, 22 T2, 10 T3, and 1 T4) were treated by fr.HDR or PDR brachytherapy, either alone or in combination with external irradiation (ERT). Half of the patients were treated with fr.HDR, which entailed twice-daily fractions of ?3 Gy. The other 19 patients were administered PDR, which consisted of pulses of ?2 Gy delivered 4-8 times/day. The median cumulative dose of IRT ± ERT series was 66 Gy (range 55-73). The results in these patients treated by brachytherapy were compared to 72 patients with similar tumors treated in our institute with curative intent, using ERT alone. The median cumulative dose of ERT-only series was 70 Gy (range 40-77). Results: Excellent locoregional control was achieved with the use of IRT ± ERT, with only 13% (5 of 38) developing local failure, and salvage surgery being possible in three of the latter (60%). Neither BT scheme (fr.HDR vs. PDR) nor tumor site (TF vs. SP) significantly influenced local control rates. The type and severity of the side effects observed are comparable to those reported in the literature for LDR-IRT. These results contrast sharply with our ERT-only series, in which 39% of patients (28 of 72) developed local failure, with surgical salvage being possible only in three patients (11%). Taking the data set of 110 patients, in a univariate analysis IRT, T stage, N stage, overall treatment time (OTT), and BEDcor10 (biological effective dose with a correction for the OTT) were significant prognostic factors for local relapse-free survival (LRFS) and overall survival (OS) at 3 years. Using Cox proportional hazard analysis, only T stage and BEDcor10 remained significant for LRFS (p 10 (p = 0.03). Conclusion: The 3-year LRFS of approximately 90% for TF and SP tumors reported here is comparable with the best results in the literature, particularly given the fact that 30% of the patients (11 of 38) presented with T3/4 tumors. When compared with our historical (ERT-only) controls, the patients treated with IRT had superior local control. A dose-response relationship was established for the BEDcor10

  4. Dolor recurrente en fosa iliaca derecha en niños: reporte de dos casos asociados a alergia alimentaria / Recurrent right iliac fossa pain in children: two cases report related to food allergy

    Ana, Muñoz-Urribarri; Aderbal, Sabrá; Isaac, Tenorio; Selma, Sabrá; Javier Arias-Stella, Castillo.

    2015-01-01

    Full Text Available Objetivo: Presentar dos casos de alergia alimentaria de presentación poco común y discutir el enfoque diagnóstico de DAR en niños Casos: Caso N° 1: Niña de 11 años, aqueja dolor en fosa iliaca derecha hace 3 meses. Antecedentes: Prematuridad, atopía (dermatitis, rinitis, cólicos). Hermana y madre at [...] ópicas. Al examen físico: Dolor exquisito a la palpación de fosa iliaca derecha, cuerda cólica bilateral. Piel seca. Laboratorio: Hematobiometría sin alteraciones. Examen de orina normal, parasitológico seriado (-). EDN (neurotoxina derivada de eosinófilos) fecal >3210 ng/ml (V.N. Abstract in english Objective: To present two cases of food allergy of uncommon presentation and discuss the diagnostic approach to give in these cases: Case N° 1: 11-year-old girl, afflicting pain in the right iliac fossa 3 months ago. Background: Prematurity, atopy (dermatitis, rhinitis, cramping). Sister and mother [...] are atopic too. The physical exam show exquisite pain on right iliac fossa at palpation. Laboratory: Urine normal, parasitological serial negative. EDN (neurotoxin derived from eosinophils) fecal >3210 ng/ml (V. N.

  5. Associação singular de síndrome de Kallmann e cisto aracnóide da fossa média: relato de caso Singular association of Kallmann's syndrome and arachnoid cyst of middle fossa: case report

    Yvens B. Fernandes

    1995-09-01

    Full Text Available O hipogonadismo hipogonadotrófico pode resultar de diferentes anomalias do sistema nervoso central, apresentando sinais clínicos que dependem da idade de aparecimento, bem como do grau de deficiência gonadotrófica e de sua associação com outras deficiências hipofisárias. Relatamos o caso de um rapaz de 18 anos com atraso puberal, retardo de crescimento estatural a partir de 10 anos e história de dificuldade de aprendizado escolar. Ao exame apresentava discreto aspecto eunucóide, 162 cm de altura (z score = -2,17, estadiamento puberal GII, PII, testículos de 4 cm³. A avaliação complementar demonstrou níveis pré-puberais de testosterona, megateste com resposta normal, exceto ao teste de estímulo com GnRH agudo e prolongado. CT de crânio mostrou cisto aracnóide da fossa média esquerda com extensão supra-selar. Foi feito o diagnóstico de hipogonadismo hipogonadotrófico provavelmente secundário à compressão pelo cisto aracnóide e por isso, optou-se por derivação cisto-peritoneal. Após a cirurgia não houve retomada do desenvolvimento puberal, sendo então verificada anosmia bilateral e, portanto, diagnosticada Síndrome de Kallmann, que foi confirmada pelos achados da RNM, embora os resultados hormonais não sejam totalmente compatíveis com a referida síndrome. Não encontramos na literatura descrição da associação entre Síndrome de Kallmnann e cisto aracnóide e acreditamos que neste caso os resultados da avaliação hormonal possam ser devidos a tal associação que provocou adicionalmente uma disfunção hipofisária.Hypogonadotrophic hypogonadism can result from different abnormalities in the central nervous system. The clinical picture depends upon the time of onset the deficiency, the magnitude of the gonadotropins deficiency and whether there are other pituitary hormone deficiencies as well. We report on a 18-year-old boy, who was investigated because of pubertal and growth delay. He also had learning disabilities. On physical examination he exhibited mild eunuchoid aspect, 162 cm height (z score = -2,17, pubertal development on stage G II, P II, and 4 cm5 testis. Laboratory investigation revealed pre-pubertal levels of testosterone and normal results of the combined test of anterior pituitary function, except for in GnRH acute and prolonged test. Brain CT showed an arachnoid cyst on left middle fossa with expansion to suprasellar cisterna. He was diagnosed as having hypogonadotrophic hypogonadism secondary to compression by the cyst, and a cyst-peritoneal derivation was performed. After surgery there was no improvement of the pubertal state and bilateral anosmia was discovered, so Kallmann's syndrome was then diagnosed and was confirmed by MRI, even though the hormonal results are not totally matched with the refered syndrome. We did not find in the literature any description of the association between Kallmann's syndrome and arachnoid cyst and we believe that in this case the results of the hormonal measurement may be due to such association that provoked an additional hypophysis dysfunction.

  6. Copépodes parasitos de fossas nasais de cinco espécies de peixes (Characiformes da planície de inundação do alto rio Paraná, Paraná, Brasil - DOI: 10.4025/actascibiolsci.v29i4.887 Parasitic copepods in the nasal fossae of five fish species (Characiformes from the upper Paraná river floodplain, Paraná, Brazil - DOI: 10.4025/actascibiolsci.v29i4.887

    Maria de los Angeles Perez Lizama

    2008-02-01

    Full Text Available O presente trabalho teve como objetivo o estudo de copépodes parasitos de fossas nasais de peixes da planície de inundação do alto Rio Paraná. As coletas foram realizadas em diversos pontos da planície nos meses de março, junho e setembro de 2004. Foram coletados 73 exemplares de peixes da ordem Characiformes, de quatro famílias distintas, pertencentes a cinco espécies: Acestrorhynchus lacustris, Prochilodus lineatus, Schizodon borellii, Serrasalmus maculatus e Serrasalmus marginatus. Dentre os 73 peixes examinados, 53 encontravam-se parasitados por copépodes de fossas nasais, variando de 1 a 146 parasitos por peixe. Os parasitos encontrados pertenciam a três espécies conhecidas: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984 e Rhinergasilus piranhus Boeger & Thatcher, 1988. Diferenças foram observadas nas medidas corporais dos parasitos e na quantidade de espécies de parasitos por espécie de peixe em relação aos copépodes encontrados em estudos anteriores na região amazônica. O presente estudo constitui um dos poucos trabalhos de identificação de copépodes parasitos de fossas nasais de peixes da região Sul do Brazil.The present work had the objective to study parasitic copepods in the nasal fossae of fish from the upper Paraná river floodplain. Fish were captured in different locations of the floodplain in March, June and September, 2004. A total of 73 specimens (Characiformes were collected, belonging to 4 distinct families and 5 species: Acestrorhynchus lacustris (Acestrorhynchidae, Schizodon borellii (Anostomidae, Prochilodus lineatus (Prochilodontidae, Serrasalmus marginatus and Serrasalmus maculatus (Serrasalmidae. Among 73 fishes examined, 53 were parasitized by nasal fossae copepods, varying from 1 to 146 parasites per host. Parasites found belonged to 3 known species: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984; and Rhinergasilus piranhus Boeger & Thatcher, 1988. There were differences in parasite corporal measurements and in the quantity of parasites per host in relation to copepod parasites from the Amazon region. The present study constitutes one of the few studies of identification of copepod parasites in the nasal fossae of fish from the Southern region of Brazil.

  7. The sweet Christmas rash (case series)

    Gyldenløve, Mette; Nepper-Christensen, Steen; Thyssen, Jacob P; Faurschou, Annesofie

    2013-01-01

    Christmas tree hypersensitivity is a rare condition, which has so far obtained scarce attention in the medical literature. We present two clinical cases of hypersensitivity associated with Christmas tree exposure, a 51-year-old woman with allergic contact dermatitis and a 41-year-old man with all...... allergic rhinitis. The female patient had a positive patch test reaction to colophony, and the male patient had a positive skin prick test reaction to alternaria mould. Both were successfully advised to avoid prolonged exposure to Christmas trees and buy artificial trees for Christmas....

  8. Skin Rashes Due to Bed-Wetting

    ... KEEP Healthy Event at Hartford Boys & Girls Club Sat, 05/21/2016 - 11:00am Hartford, CT 2016 San Diego Kidney Walk Sun, 05/22/2016 - 8:00am San Diego, CA Register Now Central New Jersey Kidney Walk Sun, 05/22/2016 - 8: ...

  9. Heat Rash (Miliaria or Prickly Heat)

    ... help you stay cool and dry. Avoid using baby powders and creams. They can block your pores and actually make your skin warmer. ... Is there a treatment that will help? What can I do at home to make myself more comfortable? Should I let my baby go without a diaper to help clear up ...

  10. Chronic Itchy Skin Rashes in Children

    ... bumps that appear and disappear anywhere on the body. An individual lesion of hives typically lasts a few hours before fading… ... Notice This Site and third parties who place advertisements on this Site may collect and use information ...

  11. Hot Tub Rash (Pseudomonas Dermatitis/Folliculitis)

    ... Skin, Ear, & Eye Illness Respiratory Illness Neurologic Illness Wound Infections Other Illnesses Swimming Pool Operation & Disinfection Microbial Testing & Disinfection Swimming Pool Chemicals Injuries & Outdoor ...

  12. Heat Rash or Prickly Heat (Miliaria Rubra)

    ... Notice This Site and third parties who place advertisements on this Site may collect and use information ... Site and other websites in order to provide advertisements about goods and services of interest to you. ...

  13. Estudio de las Venas de la Fosa Cubital a través de la Tomografía Computada Helicoidal y su Aplicación Clínica Study of the Veins of the Cubital Fossa by Helical Computed Tomography and its Clinical Application

    Mariano del Sol

    2012-03-01

    Full Text Available Las venas superficiales de la fosa cubital, constituyen uno de los sitios más importantes de punción venosa. La disposición de estas venas presenta numerosas variaciones. Su anatomía no ha sido estudiada aplicando los avances tecnológicos en el campo de la medicina, como la tomografía computada helicoidal. Fueron analizadas mediante tomografía axial computada helicoidal, las formaciones venosas de la fosa cubital en 60 individuos chilenos de ambos sexos, de edades entre 10 y 86 años, de la IX Región de La Araucanía, Chile. El estudio fue realizado en un tomógrafo General Electric, modelo CT/e, perteneciente al Centro de Imagenología del Hospital del Trabajador, Temuco, Chile, en individuos ambulatorios. Basados en la clasificación de del Sol et al. (1988 para las formaciones venosas de la fosa cubital, se obtuvo los siguientes resultados: Tipo I (46,7%, la vena cefálica del antebrazo (VCA, se divide en vena mediana basílica (VMB y vena mediana cefálica (VMC, las que se unen a la vena basílica del antebrazo (VBA y vena cefálica del accesoria del antebrazo (VCAA, respectivamente. Tipo II (13,3%, la VCA originó la vena mediana del codo (VMCo, que se une a la VBA. Tipo III (20%, no existe comunicación entre la VBA y VCA a nivel de la fosa cubital. Tipo IV (8,3%, la VCA drenaba en la VBA. Tipo V (11,7%. Otras disposiciones, donde se incluye la "M" clásica, que resulta de la división de la vena mediana del antebrazo. La utilización de la VMC o de la VCA, se recomienda ya que previene los riesgos de punción de otras estructuras anatómicas importantes como el ramo anterior del nervio cutáneo antebraquial medial.The superficial veins of the cubital fossa, is one of the most important sites of venipunctures. There are many variations in the arrangement of these veins. Their anatomy has not been studied using technology available in the field of medicine such, as helical computed tomography. The vein formation of the cubital fossa in 60 Chilean subjects of both sexes, between 10 and 86 years of age of the IX Region of Araucania, Chile, were analyzed by helical computed tomography. The study was realized on a General Electric scanner, model CT / e, belonging to the Imaging Center of the Hospital del Trabajador, Temuco, Chile, in ambulatory subjects. Based on the classification of del Sol et al. (1988 for the vein formation of the cubital fossa, we obtained the following results: Type I (46.7%, the cephalic vein of forearm (CVF, is divided into median basilic vein (MBV and median cephalic vein (MCV, then anastomosis the basilic vein of forearm (BVF and cephalic vein accessory (CVA, respectively. Type II (13.3%, the CVA originates at the median cubital vein (MCuV, which anastomoses to the BVF. Type III (20%, there is no communication between BVF and CVF at the cubital fossa. Type IV (8.3%, CVF drains into the BVF. Type V (11.7% - Other disposition, which include the "M" classical, resulting from the division of the median antebrachial vein. Using the MCV or CVF, is recommended, since there are risks of puncture of other important anatomical structures such as the anterior branch of the medial antebrachial cutaneous nerve.

  14. Delayed presentation of a traumatic brachial artery pseudoaneurysm.

    Forde, James C

    2009-09-01

    Delayed presentation of a brachial artery pseudoaneurysm following penetrating trauma is infrequently reported. We report the case of a 23-year-old male who presented three months following a penetrating trauma to his antecubital fossa with a sudden exacerbation of swelling and tenderness of his elbow. Doppler ultrasound and computed tomography arteriography confirmed the presence of a large pseudoaneurysm. Surgical reconstruction was performed using the long saphenous vein as an interposition vein graft, restoring normal arterial circulation.

  15. [Potentialities of blocking osteosynthesis for metaphyseal fractures of the humeral bone].

    Neverov, V A; Khromov, A A; Cherniaev, S N; Egorov, K S

    2008-01-01

    A method of blocking intramedullary osteosynthesis of metaphyseal fractures of the humeral bone is proposed. Its special features are: retrograde implantation of a nail from the antecubital fossa of the humeral bone, blocking the nail with distal blocking screws and proximal blocking screws which are fixed in the nail at the expense of threaded connection. This method gives exact reposition, absolute stability of fixation, possibility of early load and rehabilitation. PMID:19241817

  16. Use of short prosthesis segments for brachiocephalic arteriovenous fistulas in elderly hemodialysis population

    Głowiński, Jerzy; Małyszko, Jolanta; Głowińska, Irena; Myśliwiec, Michał

    2014-01-01

    Introduction The autogenous brachiocephalic fistula is a recognized secondary access for hemodialysis. However, veins in the antecubital fossa are often damaged, due to repeated venipunctures and subsequent scarring. Sometimes their anatomy does not enable successful arteriovenous fistula creation. In cases when the proximal part of the cephalic vein seemed patent, during ultrasound Doppler examination, we decided to use a short segment of 6 mm polytetrafluoroethylene graft to connect the vei...

  17. Lateral Antebrachial Cutaneous Nerve injury induced by phlebotomy

    Azadi Arezoo

    2007-03-01

    Full Text Available Abstract Background Phlebotomy is one of the routine procedures done in medical labs daily. Case presentation A 52 yr woman noted shooting pain and dysesthesia over her right side anterolateral aspect of forearm, clinical examination and electrodiagnostic studies showed severe involvement of right side lateral antebrachial cutaneous nerve. Conclusion Phlebotomy around lateral aspect of antecubital fossa may cause lateral antebrachial cutaneous nerve injury, electrodiagnostic studies are needed for definite diagnosis.

  18. An approach to acanthosis nigricans

    Meghana Madhukar Phiske

    2014-01-01

    Acanthosis nigricans (AN) is characterized by dark, coarse and thickened skin with a velvety texture, being symmetrically distributed on the neck, the axillae, antecubital and popliteal fossae, and groin folds, histopathologically characterized by papillomatosis and hyperkeratosis of the skin. A high prevalence of AN has been observed recently. Different varieties of AN include benign, obesity associated, syndromic, malignant, acral, unilateral, medication-induced and mixed AN. Diagnosis is l...

  19. Tortícolis recurrente como forma de presentación de un tumor de la fosa posterior del cerebro Recurrent torticollis as a form of presenting a tumor in the posterior fossa brain

    Isael Olazábal Armas

    2012-09-01

    Full Text Available La tortícolis se presenta como una manifestación focal del sistema nervioso central, y es una afección poco frecuente, aunque puede ser el síntoma inicial en patologías de la fosa posterior del cerebro. Se presenta el caso de un paciente masculino de cuatro años de edad, con antecedentes de dolor, lateralización y torsión del cuello con nueve meses de evolución, cuyos síntomas se mantuvieron progresando. Gradualmente se asocian cefalea, náuseas e inestabilidad a la marcha. Al realizar el examen físico se encontraron elementos clínicos de una tortícolis y un síndrome cerebeloso de hemicuerpo derecho. Se realizó una resonancia magnética nuclear de cráneo, la cual evidenció una lesión sólida que ocupaba todo el piso del IV ventrículo, y se extendía hasta el segundo segmento medular cervical. Se efectuó abordaje quirúrgico de la fosa posterior del cerebro y exeresis de la lesión. El diagnóstico histológico fue el de un ependimoma. Aunque la tortícolis la mayoría de las ocasiones es una condición benigna, cuando se presenta secundariamente en los niños, uno de los diagnósticos diferenciales que deben tenerse en cuenta, son los tumores de la fosa posterior del cerebro, como ocurrió en este caso.Torticollis is presented as a focal demonstration of the central nervous system, and it is a rare condition, but it may be the initial symptom in diseases of the posterior fossa brain. We report the case of a male patient aged four, with a history of pain, lateralization and twisted neck with nine months of evolution, whose symptoms were progressing. Gradually, headache, nausea and gait instability are associated. When performing the physical examination, we found clinical elements of a stiff neck and a right hemisphere cerebellar syndrome. We performed a cranial MRI, which showed a solid lesion occupying the entire floor of the fourth ventricle, and it extended to the second cervical spinal segment. Surgical approach was performed in the posterior fossa and brain tumor excision. Ependymoma was the histological diagnosis. Though most occasions, torticollis is a benign condition, when it occurs secondarily in children, one of the differential diagnoses that should be considered is the posterior fossa tumors of the brain, as in this case.

  20. Bilateral Supernumerary Sternocleidomastoid Heads with Critical Narrowing of the Minor and Major Supraclavicular Fossae: Clinical and Surgical Implications Cabezas Supernumerarias Bilaterales del Músculo Esternocleidomastoídeo con Estrechamiento Crítico de las Fosas Supraclavicular Menor y Mayor: Implicancias Clínicas y Quirúrgicas

    Athanasios Raikos

    2012-09-01

    Full Text Available Anatomical variations of the sternocleidomastoid muscle are rare and concern its origin, insertion, and the number of heads. We report on a rare bilateral variant of the sternocleidomastoid muscle with aberrant and supernumerary muscular heads, observed in a cadaveric subject. On the right side of the neck, a typical sternomastoid head of the sternocleidomastoid muscle, and three aberrant clavicular heads of variable thickness, origin, and termination were noticed. On the left side, two sternomastoid heads were present; the medial one was of typical pattern, while the lateral was supernumerary. The cleidomastoid portion of the left sternocleidomastoid muscle was fused with the double sternomastoid segment. A strap-like muscle originating from the middle third of the clavicle and inserting onto the transverse process of the C3 vertebra was noticed. This is known as the cleidocervical muscle. On the right side of the neck, the posterior cervical triangle was diminished, the minor supraclavicular fossa was considerably narrow, whereas on the left, it was diminished in addition to a bilateral shortening of the major supraclavicular fossa minimizing space needed for potential surgical access. These findings are of prominent significance for anesthetists in ultrasound guided needle positioning in brachial plexus block, as well as in subclavian or external jugular vein catheterization, and in surgical interventions involving structures lying under the sternocleidomastoid muscle.Las variaciones anatómicas del músculo esternocleidomastoideo son poco frecuentes y se refieren a su origen, inserción, y número de cabezas. Se presenta una rara variante del músculo esternocleidomastoideo con cabezas musculares aberrantes y supernumerarias bilateralmente en un cadáver. En el lado derecho del cuello, se observaron la cabeza esternomastoidea típica del músculo esternocleidomastoideo, y tres cabezas claviculares aberrantes de origen, espesor y terminación variable. En el lado izquierdo, se observaron dos cabezas esternomastoídeas, la medial con su patrón típico, mientras que el lateral fue supernumeraria. La porción cleidomastoídea del músculo esternocleidomastoideo izquierdo se fusionó con el segmento esternocleidomastoideo doble. Un músculo acintado similar procedentes del tercio medio de la clavícula e inserción en el proceso transverso de la vértebra C3 fue observado. Éste se conoce como el músculo cleidocervical. En el lado derecho del cuello, el triángulo cervical posterior fue disminuido, la fosa supraclavicular menor fue considerablemente estrecha, mientras que en el lado izquierdo, se disminuyó además a un acortamiento bilateral del espacio fosa supraclavicular importante reducir al mínimo necesario para el acceso quirúrgico potencial. Estos hallazgos tienen una importancia destacada para los anestesistas en el posicionamiento de aguja guiada por ecografía en el bloqueo del plexo braquial, así como en la cateterización de la vena subclavia o yugular externa, y en las intervenciones quirúrgicas que afecta las estructuras situadas debajo del músculo esternocleidomastoideo.

  1. Relationship Between Volume of Pterygopalatine Fossa and Block Anesthesia of Maxillary Nerve: A Pilot Study / Relación entre el Volumen de la Fosa Pterigopalatina y la Anestesia Troncular del Nervio Maxilar: Un Estudio Piloto

    Pedro, Aravena Torres; Nicole, Cresp Sinning; Katherine, Büchner Sagredo; Carlos, Muñoz Rocha; Ricardo, Cartes-Velásquez.

    2011-09-01

    Full Text Available El bloqueo troncular del nervio maxilar (BTNM) se logra depositando anestesia vía canal palatino mayor en la fosa pterigopalatina. Los autores difieren en la cantidad de anestesia a depositar y la tasa de complicaciones asociadas (diplopía y hematomas). Coronado et al. (2008) midió el volumen de la [...] fosa pterigopalatina encontrando un promedio de 1,2ml, sugiriendo dicha cantidad de anestesia para el BTNM. El objetivo del presente trabajo es comparar la eficacia de dosis bajas de 1,2ml (DB) versus dosis tradicional de 1,8ml (DT) de anestesia para el BTNM y sus efectos adversos. Se realizó un estudio clínico cuasiexperimental de carácter exploratorio, participaron 82 pacientes donde la técnica anestésica estaba indicada para un procedimiento de exodoncia, los que fueron aleatorizados en los grupos DB y DT, administrándoles lidocaína al 2% con 1:50.000 de epinefrina. Se registraron variables demográficas (sexo y edad), clínicas (pieza a extraer y dosis administrada) y anatómicas (índices facial superior y craneal). El éxito anestésico (EA) se definió como la posibilidad de realizar la exodoncia con nulo o mínimo dolor, medido con escala visual análoga (EVA). En el análisis estadístico se utilizaron los tests de chi cuadrado y t de student (p Abstract in english Block anesthesia of maxillary nerve 9BAMN) is achieved by depositing anesthesia through greater palatine canal into the pterygopalatine fossa. Authors differ in the amount of anesthesia to be administered and the rate of complications (diplopia and hematomas), Coronado et al., (2008), measured the s [...] ize of the pterygopalatine fossa finding an average of 1.2 ml, suggesting that amount of anesthesia for BAMN. The aim of this study is to compare the effectiveness of low doses of 1.2 ml (LD)versus traditional dose of 1.8 m. (TD) of anesthesia for BAMN and its adverse effects. A quasi experimental exploratory clinical study was performed involving 82 patients where the anesthetic technique was suitable for tooth extraction procedure; patients were randomized in LD and TD groups, 2% lidocaine with 1:50.000 epinephrine was used. Demographic (sex and age), clinical (tooth for extraction and anesthetic dose) as well as anatomical variables (upper facial and cranial index) were recorded. The anesthetic success (AS) was defined as the possibility to perform the tooth extraction with no pain or minimal pain as measured by visual analogue scale (VAS). For statistical analysis chi-square and t test (p

  2. Copépodes parasitos de fossas nasais de cinco espécies de peixes (Characiformes) da planície de inundação do alto rio Paraná, Paraná, Brasil - DOI: 10.4025/actascibiolsci.v29i4.887 Parasitic copepods in the nasal fossae of five fish species (Characiformes) from the upper Paraná river floodplain, Paraná, Brazil - DOI: 10.4025/actascibiolsci.v29i4.887

    Maria de los Angeles Perez Lizama; Ricardo Massato Takemoto; Ana Carolina Figueiredo Lacerda; Gilberto Cezar Pavanelli

    2008-01-01

    O presente trabalho teve como objetivo o estudo de copépodes parasitos de fossas nasais de peixes da planície de inundação do alto Rio Paraná. As coletas foram realizadas em diversos pontos da planície nos meses de março, junho e setembro de 2004. Foram coletados 73 exemplares de peixes da ordem Characiformes, de quatro famílias distintas, pertencentes a cinco espécies: Acestrorhynchus lacustris, Prochilodus lineatus, Schizodon borellii, Serrasalmus maculatus e Serrasalmus marginatus. Dentre ...

  3. Relationship Between Volume of Pterygopalatine Fossa and Block Anesthesia of Maxillary Nerve: A Pilot Study Relación entre el Volumen de la Fosa Pterigopalatina y la Anestesia Troncular del Nervio Maxilar: Un Estudio Piloto

    Pedro Aravena Torres

    2011-09-01

    Full Text Available Block anesthesia of maxillary nerve 9BAMN is achieved by depositing anesthesia through greater palatine canal into the pterygopalatine fossa. Authors differ in the amount of anesthesia to be administered and the rate of complications (diplopia and hematomas, Coronado et al., (2008, measured the size of the pterygopalatine fossa finding an average of 1.2 ml, suggesting that amount of anesthesia for BAMN. The aim of this study is to compare the effectiveness of low doses of 1.2 ml (LDversus traditional dose of 1.8 m. (TD of anesthesia for BAMN and its adverse effects. A quasi experimental exploratory clinical study was performed involving 82 patients where the anesthetic technique was suitable for tooth extraction procedure; patients were randomized in LD and TD groups, 2% lidocaine with 1:50.000 epinephrine was used. Demographic (sex and age, clinical (tooth for extraction and anesthetic dose as well as anatomical variables (upper facial and cranial index were recorded. The anesthetic success (AS was defined as the possibility to perform the tooth extraction with no pain or minimal pain as measured by visual analogue scale (VAS. For statistical analysis chi-square and t test (p El bloqueo troncular del nervio maxilar (BTNM se logra depositando anestesia vía canal palatino mayor en la fosa pterigopalatina. Los autores difieren en la cantidad de anestesia a depositar y la tasa de complicaciones asociadas (diplopía y hematomas. Coronado et al. (2008 midió el volumen de la fosa pterigopalatina encontrando un promedio de 1,2ml, sugiriendo dicha cantidad de anestesia para el BTNM. El objetivo del presente trabajo es comparar la eficacia de dosis bajas de 1,2ml (DB versus dosis tradicional de 1,8ml (DT de anestesia para el BTNM y sus efectos adversos. Se realizó un estudio clínico cuasiexperimental de carácter exploratorio, participaron 82 pacientes donde la técnica anestésica estaba indicada para un procedimiento de exodoncia, los que fueron aleatorizados en los grupos DB y DT, administrándoles lidocaína al 2% con 1:50.000 de epinefrina. Se registraron variables demográficas (sexo y edad, clínicas (pieza a extraer y dosis administrada y anatómicas (índices facial superior y craneal. El éxito anestésico (EA se definió como la posibilidad de realizar la exodoncia con nulo o mínimo dolor, medido con escala visual análoga (EVA. En el análisis estadístico se utilizaron los tests de chi cuadrado y t de student (p<0,05. Los resultados muestran que el dolor y el EA en el grupo DB fueron de 2,93 y 61,67% y en el DT de 3,09 y 59,09% respectivamente, hubo 6 casos de diplopía sin diferencias estadísticamente significativas entre ambos grupos.

  4. Multi-Institution Prospective Trial of Reduced-Dose Craniospinal Irradiation (23.4 Gy) Followed by Conformal Posterior Fossa (36 Gy) and Primary Site Irradiation (55.8 Gy) and Dose-Intensive Chemotherapy for Average-Risk Medulloblastoma

    Purpose: Limiting the neurocognitive sequelae of radiotherapy (RT) has been an objective in the treatment of medulloblastoma. Conformal RT to less than the entire posterior fossa (PF) after craniospinal irradiation might reduce neurocognitive sequelae and requires evaluation. Methods and Materials: Between October 1996 and August 2003, 86 patients, 3-21 years of age, with newly diagnosed, average-risk medulloblastoma were treated in a prospective, institutional review board-approved, multi-institution trial of risk-adapted RT and dose-intensive chemotherapy. RT began within 28 days of definitive surgery and consisted of craniospinal irradiation (23.4 Gy), conformal PF RT (36.0 Gy), and primary site RT (55.8 Gy). The planning target volume for the primary site included the postoperative tumor bed surrounded by an anatomically confined margin of 2 cm that was then expanded with a geometric margin of 0.3-0.5 cm. Chemotherapy was initiated 6 weeks after RT and included four cycles of high-dose cyclophosphamide, cisplatin, and vincristine. Results: At a median follow-up of 61.2 months (range, 5.2-115.0 months), the estimated 5-year event-free survival and cumulative incidence of PF failure rate was 83.0% ± 5.3% and 4.9% ± 2.4% (± standard error), respectively. The targeting guidelines used in this study resulted in a mean reduction of 13% in the volume of the PF receiving doses >55 Gy compared with conventionally planned RT. The reductions in the dose to the temporal lobes, cochleae, and hypothalamus were statistically significant. Conclusion: This prospective trial has demonstrated that irradiation of less than the entire PF after 23.4 Gy craniospinal irradiation for average-risk medulloblastoma results in disease control comparable to that after treatment of the entire PF

  5. The effect of M-stage on patterns of failure in posterior fossa primitive neuroectodermal tumors treated on CCG-921: a phase III study in a high-risk patient population

    Purpose: To analyze patterns of failure in patients (pts) with high-risk posterior fossa primitive neuroectodermal tumors (PF-PNETs) treated with combined modality therapy on a large, randomized multiinstitutional study. Methods and Materials: One hundred eighty-eight prospectively staged pts with PF-PNET confirmed by central pathology review, with high-risk features, were treated on Children's Cancer Group Study 921 (CCG-921), comparing two chemoradiotherapy regimens. Patterns of initial sites of failure were analyzed, specifically evaluating the impact of Chang M-stage. Results: Progression-free survival (PFS) correlated with the presence or absence of metastatic disease (p < 0.001), with 5-year PFS of 68 ± 5.8% for M0 vs. 43 ± 6.8% for M+ pts. The cumulative incidence functions (CIF) of recurrence were different (p = 0.005) and at 5 years were 29 ± 4.7% for M0 pts and 48 ± 5.5% for M+ pts. Involvement of the PF at time of initial failure as measured by CIF correlated with M-stage (p = 0.047) and occurred in 18 ± 3.9% of M0 pts and 8 ± 2.9% of M+ pts overall; PF as the only site of relapse also correlated with M-stage (p = 0.019) and was seen in 6 ± 2.5 and 0% of M0 and M+ pts, respectively, at 5 years. Relapse in the spine and/or cerebrospinal fluid (CSF) at initial recurrence was correlated with M-stage (p < 0.002), with 5-year cumulative incidences of 14 ± 3.7%, 26 ± 8.2%, 40 ± 15%, and 40 ± 7.7% for M0, M1, M2, and M3 pts, respectively. Isolated spine/CSF recurrence correlated with M-stage (p 0.034) and occurred in 2 ± 1.5% of M0 and 9 ± 3.2% of M+ pts by 5 years. The median time to relapse for pts who failed was 1.2 years (range 0.2-5.3). Ninety percent of all relapses occurred by 3 years. Conclusions: Original sites of disease are at the highest risk for relapse, but the entire neuraxis remains at significant risk, despite combined-modality treatment. M-Stage was prognostic for spine/CSF relapse as well as PFS and may be an important tool in guiding therapy. A more aggressive approach to local control in the neuraxis is warranted, especially in M+ patients

  6. Analysis of the Condyle, Articular Fossa and Mandibular Ramus in Subjects with Active Condylar Hyperplasia / Análisis del Cóndilo, Fosa Articular y Rama Mandibular de Sujetos con Hiperplasia Condilar Activa

    Pablo, Muñoz; Douglas Rangel, Goulart; Sergio, Olate; Márcio, de Moraes; Pablo, Navarro; Rodrigo, Fariña.

    2014-09-01

    Full Text Available La asimetría facial es relativamente común, transformándose en enfermedad cuando se asocia hiperplásia condilar. El objetivo de esta investigación fue describir y comparar las características morfológicas de los cóndilos hiperplásico con su contralateral no hiperplásico. Quince sujetos de entre 14 y [...] 29 años de edad, con asimetría facial e hiperplasia condilar unliateral diagnosticada, fueron estudiados mediante tomografía computarizada Cone-Beam. Se determinaron mediciones lineales de la morfología condilar en vista coronal y sagital, estableciendo tamaños de la fosa articular, rama mandibular, entre otras. Las mediciones condilares sagitales mostraron diferencias significativas (p=0,028) entre los grupos (lado hiperplásico vs. lado no hiperplásico); las mediciones de longitud de rama mostraron diferencias significativas (p=0,034) entre ambos lados. No se observó diferencias significativas (p=0,155) en la relación de distancia medio lateral (imagen coronal) de cóndilos hiperplásico y no hiperplásicos. Concluimos que existe un aumento del tamaño hemimandibular y de la ATM del lado hiperplásico, aunque investigaciones con mayor número de pacientes son necesarios para establecer una tendencia mas exacta. Abstract in english Facial asymmetry is relatively common, but it becomes a disease when condylar hyperplasia is involved. The purpose of this investigation was to describe and compare the morphological characteristics of hyperplastic condyles to their non-hyperplastic contralateral side. Fifteen subjects aged between [...] 14 and 29 years with facial asymmetry and diagnosed with unilateral condylar hyperplasia were studied using cone-beam computerized tomography. Linear measurements were taken of the condylar morphology on the sagittal and coronal planes, establishing the size of the articular fossa, mandibular ramus, and other aspects. Sagittal condylar measurements showed significant differences (p=0.028) between the groups (hyperplastic side v/s non-hyperplastic side); ramus measurements showed significant differences (p=0.034) between the two sides. No significant differences were observed (p=0.155) in the relation of the mean lateral distance (coronal image) of hyperplastic and non-hyperplastic condyles. It can be concluded that there is an increase in the size of the hemimandible and TMJ on the hyperplastic side, although research with a greater number of patients is needed to establish a more precise trend.

  7. Oblique rifting at Tempe Fossae, Mars

    Fernández, Carlos; Anguita, Francisco

    2007-01-01

    This work shows the results of a structural study of the faults observed at the Tempe Rift (northeastern Tharsis region), Mars. A new, detailed map of faults and fault systems was used to geometrically characterize the fracture architecture of the Tempe Rift and to measure fault length, displacement, and spacing data, to analyze the spatial distribution of fault centroids, and to investigate the fractal nature of fault trace maps. A comparison with analog models and the use of ...

  8. Temporal fossa intra-extracranial dumbbell schwannoma.

    Wong, Limy

    2011-02-01

    Intra-extracranial schwannomas arising unrelated to major cranial nerves are exceedingly rare neoplasms. We report the case of a 23-year-old male who presented with a 9 month history of progressive temporal swelling which was excised and found histologically to be a schwannoma. A succinct review of the relevant literature is presented.

  9. Temporal fossa intra-extracranial dumbbell schwannoma.

    Wong, Limy

    2012-02-01

    Intra-extracranial schwannomas arising unrelated to major cranial nerves are exceedingly rare neoplasms. We report the case of a 23-year-old male who presented with a 9 month history of progressive temporal swelling which was excised and found histologically to be a schwannoma. A succinct review of the relevant literature is presented.

  10. Estudo morfométrico da fossa intercondilar femoral em joelhos com e sem lesão do ligamento cruzado anterior (L.C.A., através da aplicação de um software sobre imagens radiográficas digitalizadas Morphometric study of the femoral intercondylar notch of knees with and without injuries of anterior cruciate ligament (A.C.L., by the use of software in digitalized radiographic images

    Rita di Cássia de Oliveira Angelo

    2004-09-01

    Full Text Available Os autores sugerem a aplicação de um software sobre imagens radiográficas digitalizadas para análise morfométrica da fossa intercondilar e dos côndilos femorais. O programa permite o tracejamento de linhas guias que facilitam a mensuração da extremidade distal do fêmur. Foram analisadas 39 radiografias simples da fossa intercondilar femoral dos joelhos direito e esquerdo, obtidas de indivíduos do sexo masculino reunidos em grupo normal (n=23 e grupo lesionado (n=16. A média de idade da amostra foi de 26,56 anos. As variáveis analisadas foram largura bicondilar femoral, larguras da fossa intercondilar ao nível do sulco poplíteo e da base da fossa, a altura da fossa intercondilar e a largura do côndilo femoral lateral. A fossa intercondilar foi classificada quanto ao formato em cônica, circular e retangular. Os resultados encontrados sugerem que a largura da base da fossa e a largura do côndilo femoral lateral seriam fatores de risco importantes na lesão do L.C.A. Os valores médios das variáveis analisadas aproximam-se dos descritos na literatura especializada em mensurações diretas em peças cadavéricas e ressonância nuclear magnética e demonstram que a aplicação de um software sobre as imagens radiográficas digitalizadas proporciona uma mensuração confiável, mesmo utilizando-se de imagens radiográficas simples e de baixo custo.The authors suggest the use of software in digitalized radiographic images to morphometric analysis of the intercondylar notch and the femoral condyles. The software allows the draw of guide lines which facilitate the measurement of the distal extremity of femur. Thirty-nine radiographic simple has been analyzed of femoral intercondylar notch of right and left knees, of male sex individuals collected into normal (n=23 and injured (n=16 groups. The age average was 26-56 years old.The analyzed variable had been femoral bicondylar width, widths of intercondylar notch to the level of the popliteal groove and the notch base, intercondylar notch height and the width of lateral femoral condyle. The intercondylar notch was classified according to its shape into conical , circular and rectangular. The results suggest that the base width of the notch and the width of the femoral condyle would be important risk factors of the injury of A.C.L. The average range of analyzed variables are near to the ones described in the specialized literature in direct measurements in corpse pieces and magnetic resonance imaging and demonstrate that the use of a software in digitalized radiographic images provides a realiable measurement, even if simple and low cost radiographic images are used.

  11. Hyper-Immunoglobulin E Syndrome

    Gnanraj Pushpa

    2004-01-01

    Full Text Available A case of hyper-IgE syndrome in a 6 year old boy with bronchial asthma is reported here with the various manifestations of multiple tender abscesses of the scalp, recurrent dermatophyte infections of his face and right thigh, eczematous lesions of his neck, shoulders and antecubital fossae, candidiasis of the tongue, angular cheilitis and total dystrophy of his right bit toe nail. Laboratory investigations revealed staphylococcus aureus infection of the scalp, Trichophyton rubrum infection of the face and the thigh and candidal onychomycosis. Immunological survey revealed markedly elevated serum lgE level.

  12. The 'sparing phenomenon' of purpuric rash over tattooed skin.

    Pinal-Fernandez, Iago; Solans-Laqué, Roser

    2014-01-01

    Cutaneous complications associated with decorative tattooing are well known. However, the inhibition of a purpuric reaction by a tattoo is a fact that, as far as the authors know, has not been described before, fitting the definition of a 'sparing phenomenon', the absence of manifesting a particular skin disease in an area previously affected by another condition. From the clinical observation of purpuric lesions apparently inhibited by a tattoo in a 26-year-old patient, we performed an exact binomial test on the observed and expected proportion of purpuric lesions inside (0%, 95% confidence interval, CI, 0-2.6%) and outside (100%, 95% CI 97.4-100%) the tattooed skin, demonstrating a nonrandom distribution respecting the tattooed area (p tattoo (color pigment, glycerine, Hamamelis virginiana extract, water and alcohol). Moreover, we reviewed the cases of sparing phenomenon described in the literature. In conclusion this is the first report of a sparing phenomenon of purpuric lesions over tattooed skin. PMID:24356492

  13. Spot diagnosis: An ominous rash in a newborn

    Wong William

    2009-04-01

    Full Text Available Abstract Purpura fulminans (PF is an ominous cutaneous condition usually associated with meningococcemia. PF in the newborn is rarely reported. We report the case of a female preterm infant with extensive PF due to group B streptococcus (GBS septicemia. She developed multi-organ system failure despite neonatal intensive care support and succumbed 9 days later. GBS, sensitive to penicillin, was isolated from the blood cultures of the mother and the infant. Invasive early GBS infection is common in the newborn and is empirically treated with prompt institution of intravenous antibiotics. PF associated with GBS is a rare cutaneous sign that must not be missed. Mortality remains high despite aggressive treatment and ICU support.

  14. Erysipeloid rash: A rare adverse event induced by gemcitabine

    Ana Ruiz-Casado; David Gutiérrez; Ignacio Juez

    2015-01-01

    Some rare cases of erysipelas-like or pseudocellulitis have been reported in relation to gemcitabine. This rare adverse event is more frequent in the presence of edema. Here, we report a case of pseudocellulitis after adjuvant treatment for pancreatic cancer. Oncologists should be aware of this infrequent and non-well understood adverse event. They should be especially careful when administering gemcitabine in the presence of lymphedema.

  15. Red, Itchy Rash? Get the Skinny on Dermatitis

    ... In this condition, the water-tight barrier between skin cells gets weak, which lets moisture out and other things in. That’s why people with atopic dermatitis have to moisturize their skin, and they’re more susceptible to skin infections. ...

  16. Isotretinoin induced rash, urticaria, and angioedema: a case report

    Zonunsanga

    2015-01-01

    Isotretinoin is a vitamin A analogue, which is readily isomerized to tretinoin. It causes normalization of abnormal keratinisation. It also reduces sebum secretion. It also has anti-inflammatory as well as antibacterial properties. It has some adverse effects like teratogenecity, hypertriglyceridemia, pancreatitis, dryness of skin, cheilitis, altered liver functions etc. A 25 years old unmarried lady presented with acne vulgaris, who did not showed improvements with conventional (antibiotics)...

  17. Erysipeloid rash: A rare adverse event induced by gemcitabine.

    Ruiz-Casado, Ana; Guti Rrez, David; Juez, Ignacio

    2015-01-01

    Some rare cases of erysipelas-like or pseudocellulitis have been reported in relation to gemcitabine. This rare adverse event is more frequent in the presence of edema. Here, we report a case of pseudocellulitis after adjuvant treatment for pancreatic cancer. Oncologists should be aware of this infrequent and non-well understood adverse event. They should be especially careful when administering gemcitabine in the presence of lymphedema. PMID:26881588

  18. Erysipeloid rash: A rare adverse event induced by gemcitabine

    Ana Ruiz-Casado

    2015-01-01

    Full Text Available Some rare cases of erysipelas-like or pseudocellulitis have been reported in relation to gemcitabine. This rare adverse event is more frequent in the presence of edema. Here, we report a case of pseudocellulitis after adjuvant treatment for pancreatic cancer. Oncologists should be aware of this infrequent and non-well understood adverse event. They should be especially careful when administering gemcitabine in the presence of lymphedema.

  19. A case of Hymenolepis diminuta in a young male from Odisha.

    Karuna, T; Khadanga, Sagar

    2013-07-01

    Hymenolepis diminuta also known as rat tapeworm rarely causes hymenolepiasis in humans. We report a case of H. diminuta infection in an 18-year-old male farmer who presented with intermittent pruritic maculopaular rashes and dull aching left iliac fossa pain for 6 months. Patient was cured with 2 doses of praziquantel 20 mg/kg on day 0 and 7. PMID:24471000

  20. A case of Hymenolepis diminuta in a young male from Odisha

    Karuna, T; Khadanga, Sagar

    2013-01-01

    Hymenolepis diminuta also known as rat tapeworm rarely causes hymenolepiasis in humans. We report a case of H. diminuta infection in an 18-year-old male farmer who presented with intermittent pruritic maculopaular rashes and dull aching left iliac fossa pain for 6 months. Patient was cured with 2 doses of praziquantel 20 mg/kg on day 0 and 7.

  1. Detection of tumoral lesions in the posterior fossa, in brain computerized tomography scans for various conditions of acquiring a preliminary approach; Deteccion de lesiones tumorales en fosa posterior en imagenes de Tomografia Computarizada cerebral para diversas condiciones de adquisicion: un enfoque preliminar

    Perez, M.; Carvalho-Filho, A. E.; Khoury, H. J.; Casas, M. C.; Andrade, M. E.; Paz, J. E.

    2010-07-01

    The present work performs a study over 13 tomographic images, using an anthropomorphic head phantom. It contains small lesions in the posterior fossa. Tube current (I [mA]), slice thickness (E [mm]), were the parameters changed among studies, looking for the best acquisition conditions, which permit good lesion detectability, and applying the lowest dose. Air Kerma in air [mGy] was calculated. Image quality was analyzed by both expert criterion and some merit figures. Two of them were global: contrasts to noise ratio (RCR [dB]) and signal to noise ratio (RSR). The rest of the measures used were relatives to the maximum dose condition: The gain in signal to noise ratio (SNR [dB]) and the maximum signal to noise ratio (PSNR [dB]), the normalized mean squared error (NMSE) and the structural similarity index (SSIM). Objective and subjective results were correlated. It is shown that it is possible to reduce the dose using lower values of mAs without affecting lesion detectability and keeping good image quality for the scanner used. An optimized protocol is also proposed for the technology used. (Author) 27 refs.

  2. Aneurisma infectado de artéria braquial após endocardite infecciosa de valva mitral Infected aneurysm of brachial artery after mitral valve infective endocarditis

    Heraldo Guedis Lobo Filho

    2011-03-01

    Full Text Available Apresentamos um caso de aneurisma infectado de artéria braquial em paciente com endocardite infecciosa por Streptococcus bovis. Homem de 49 anos de idade se apresentou com febre, dispnéia e sopro regurgitativo em foco mitral com irradiação para axila. O ecocardiograma demonstrou vegetação em valva mitral nativa. Após troca valvar mitral com implante de prótese biológica, observou-se massa pulsátil de cinco centímetros de diâmetro em fossa antecubital direita. Foi feito o diagnóstico de aneurisma infectado de artéria braquial, e o tratamento cirúrgico foi realizado com sucesso. O objetivo desse relato de caso é apresentar uma complicação pouco comum após endocardite infecciosa.We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitral valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis.

  3. Brachial artery pseudoaneurysm arising from the stump of a ligated arteriovenous fistula.

    Cox, Nicola; Sahnan, Kapil; Yee, Chris Pui Yan; Sritharan, Kaji

    2015-01-01

    An 85-year-old man presented to A&E department with a bleeding, pulsatile mass within the left antecubital fossa. He reported a 3-month history of an increasing, painless swelling. He had a history of end-stage renal failure secondary to antiglomerular basement membrane disease. 14 years prior, he had a left brachiocephalic fistula created, which was ligated shortly after its creation due to Steal syndrome. Examination revealed a 10×15×10 cm pulsatile, non-tender mass with overlying ulceration in the left antecubital fossa. Arterial duplex demonstrated a pseudoaneurysm arising from the left distal brachial artery with a 9 mm neck. The patient underwent surgical exploration and repair. At surgery, a large brachial artery pseudoaneurysm at the site of the previous fistula ligation was found. The overlying ulcerated skin and pseudoaneurysm were excised en mass, and the arterial defect repaired by transection and end-to-end anastomosis. This is the first reported case of a brachial artery pseudoaneurysm occurring following arteriovenous fistula ligation. PMID:26063109

  4. PH- Mapping Of Prepubertal Skin Of Indian Subjects

    Gupta A B

    1995-01-01

    Full Text Available PH- mapping of skin was made by measuring the skin surface pH in 61 normal Indian subjects (35M, 26F in the prepubertal age group at 21 different sites from scalp to sole at an ambient temperature 25-32C and a relative humidity 60-65%. The pH values at axilla, umbilicus, palm, fingerfolds, foot, sole, and cheek were found to be consistently higher than those at scalp, forehead, retroauricular folds, antecubital and popliteal fossae, anterior arm, anterior the mean pH of male skin appeared to be lower than that of female. The highest pH recorded was in axilla (5.98 for male, 6.00 for female, irrespective of sex. The lowest value however was in anterior neck (4.59 for male and in antecubital fossa (4.83 for female. While the origin of the skin pH is yet to be definitely known, it was observed that a high density of both sweat gland and bacteria flora leads to a high pH, and high concentration of sebaceous gland and of bacterial flora to a lower pH.

  5. Producción y calidad sanitaria de la lechuga fertilizada con efluente de fosa séptica biodigestora Produção e qualidade sanitária de alface adubada com efluente de fossa séptica biodigestora

    Miréia Aparecida Bezerra Pereira

    2012-04-01

    Full Text Available

    Se evaluó la producción y los aspectos sanitarios de la lechuga fertilizada con aguas residuales de efluente humano derivada de fosa séptica biodigestora en Assentamento Rural Vale Verde, Gurupi, Estado de Tocantins, Brasil. Fueron realizadas evaluaciones morfofisiológicas y microbiológicas en plantas y microbiológicas en muestras de agua del suelo, de la lechuga y del efluente de la fosa séptica biodigestora. Por el número de hojas, altura de planta y peso fresco se observó que las plantas que recibieron la dosis de 60 L de efluente tuvieron valores más altos que los demás. Hubo un aumento del área foliar de las plantas con el aumento de la dosis de efluente. Las plantas que recibieron 60 L de efluentes fueron las que produjeron más clorofila total, y las que recibieron 20 L presentaran valores cerca de éstos. El rendimiento de la producción fue significativamente mayor en las plantas que recibieron 20, 40 y 60 L de efluente, y menor para los demás (0 y 80 L. En este estudio, no hubo contaminación por coliformes fecales a 45 º C en las muestras 1, 3, 4, 5 y 7. De las plantas de las parcelas fertilizadas con efluente del tanque séptico, sólo una muestra presentó contaminación, sin embargo, el valor se ha considerado como adecuado por estar dentro de los límites de 95% de la prueba. Se trata de una alternativa sostenible que contribuye a maximizar los recursos disponibles dentro de la agricultura familiar, sin comprometer el nivel de calidad sanitaria de consumo humano de la lechuga en las condiciones estudiadas y con incremento de la productividad.

    Avaliou-se a produção e os aspectos sanitários de alface adubada com efluente humano de fossa séptica biodigestora no Assentamento Rural Vale Verde, Gurupi-TO. Foram realizadas avaliações morfofisiológicas e análises microbiológicas de amostras de água do solo, alface e do efluente de fossa séptica biodigestora. Para número de folhas, altura de plantas e peso fresco foi observado que as plantas que receberam a dose de 60 L de efluente tiveram maiores valores que as demais. Houve um aumento na área foliar para as plantas a medida que se aumentou a dose de efluente. As plantas que receberam 60 L de efluente foram as que mais produziram clorofila total, sendo que as que receberam 20 L obteve valores próximos a estas. O rendimento de produção foi, acentuadamente, maior nas plantas que receberam 20, 40 e 60 L de efluente, e menor para as demais (0 e 80 L. Neste trabalho, não foi observada contaminação por coliformes fecais a 45 ºC nas amostras 1, 3, 4, 5 e 7. Das plantas provenientes das parcelas adubadas com efluente de fossa séptica, apenas uma amostra apresentou contaminação, no entanto o valor foi considerado adequado por estar dentro dos limites de confiança de 95% do teste. Trata-se de uma alternativa sustentável que contribui para maximização dos recursos disponíveis no âmbito da agricultura familiar sem comprometer a qualidade sanitária ao nível do consumo humano da alface nas condições analisadas e com incremento de produtividade.

  6. Investigation of measles IgM-seropositive cases of febrile rash illnesses in the absence of documented measles virus transmission, State of São Paulo, Brazil, 2000-2004 Investigação dos casos de doenças febris exantemáticas com IgM reagente contra o sarampo na ausência de transmissão documentada do vírus do sarampo, Estado de São Paulo, 2000-2004

    Flávia Helena Ciccone

    2010-06-01

    Full Text Available INTRODUCTION: To review measles IgM-positive cases of febrile rash illnesses in the State of São Paulo, Brazil, over the five-year period following interruption of measles virus transmission. METHODS: We reviewed 463 measles IgM-positive cases of febrile rash illness in the State of São Paulo, from 2000 to 2004. Individuals vaccinated against measles INTRODUÇÃO: Revisar os casos de doenças febris exantemáticas com IgM reagente contra o sarampo, no Estado de São Paulo, Brasil, durante os cinco anos seguidos a interrupção da transmissão do vírus do sarampo. MÉTODOS: Nós revisamos 463 casos de doenças febris exantemáticas com IgM reagente contra o sarampo, no Estado de São Paulo, Brasil, de 2000 a 2004. Indivíduos vacinados contra o sarampo 56 dias antes da coleta de amostra foram considerados expostos à vacina. Soros da fase aguda e de convalescença foram testados para a evidência de infecção de sarampo, rubéola, parvovírus B19 e herpes vírus 6. Na ausência de soroconversão para imunoglobulina G contra o sarampo, casos com IgM reagente contra o sarampo foram considerados falsos positivos em pessoas com evidência de outras infecções virais. RESULTADOS: Entre as 463 pessoas com doenças febris exantemáticas que testaram positivo para anticorpos IgM contra o sarampo durante o período, 297 (64% pessoas foram classificadas como expostas à vacina. Entre os 166 casos não expostos à vacina, 109 (66% foram considerados falsos positivos baseado na ausência de soroconversão, dos quais 21 (13% tiveram evidência de infecção por vírus da rubéola, 49 (30% parvovírus B19 e 28 (17% infecção por herpes vírus humano 6. CONCLUSÕES: Após a interrupção da transmissão do vírus do sarampo é necessária exaustiva investigação dos casos com IgM reagente contra o sarampo, especialmente dos casos não expostos à vacina. Testes laboratoriais para etiologias das doenças febris exantemáticas ajudam na interpretação destes casos.

  7. Uncommon posterior cranial fossa anomalies: MRI with clinical correlation

    Demaerel, P. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Kendall, B.E. [Lysholm Radiological Dept., National Hospital for Neurology and Neurosurgery, London (United Kingdom); Wilms, G. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Halpin, S.F.S. [Lysholm Radiological Dept., National Hospital for Neurology and Neurosurgery, London (United Kingdom); Casaer, P. [Dept. of Paediatrics, University Hospitals, Leuven (Belgium); Baert, A.L. [Dept. of Radiology, University Hospitals, Leuven (Belgium)

    1995-01-01

    The clinical and MRI findings in two cases of rhombencephalosynapsis (RS) and two of tectocerebellar dysraphia (TCD) with an associated occipital encephalocele were studied to elucidate the clinical picture and embryogenesis of these rare anomalies. To our knowledge, only one case of TCD [1] and four of RS [2, 3] examined by MRI during life have been reported. The clinical picture in the cases of RS was rather constant and there were similarities with TCD. Consideration of the embryogenesis of the neural tube suggests a temporal proximity of the abnormalities, with TCD arising at a slightly earlier time. (orig.)

  8. Chondroblastoma of the Temporal Bone: Consistent Middle Fossa Involvement

    Selesnick, Samuel H.; Jennifer M. Levine

    1999-01-01

    The objective of this study is to describe the presentation and clinical course of two patients with temporal bone chondroblastoma, and to review the literature on temporal bone chondroblastoma to identify characteristic clinical and radiological presentations, and optimal treatment regimens. MEDLINE literature searches covering the period from 1966 to January 1998, in all languages, were performed as well as a review of the bibliographies of the identified studies. Strict inclusion criteria ...

  9. Infarto agudo do cerebelo simulando tumor da fossa posterior

    José Alberto Gonçalves da Silva; Erasmo Barros da Silva; Carlos Agripino Branco

    1992-01-01

    Um homem de 58 anos foi acometido subitamente de cefaléia, vômitos, vertigens e incoordenação das extremidades esquerdas. A tomografia computadorizada do crânio evidenciou área hipodensa no hemisfério cerebelar esquerdo, cujo exame anátomo-patológica mostrou tratar-se de infarto cerebelar.

  10. Arthroscopy-assisted percutaneous fixation of glenoid fossa fracture

    Yallapragada Rahikiran

    2007-01-01

    Full Text Available We are reporting an interesting case of glenoid fracture in a 46-year-old male which was fixed with the help of arthroscopy. At present, anterior or posterior glenoid rim fractures and some greater tuberosity fractures are widely treated arthroscopically. We report the arthroscopically assisted fixation of a transverse articular glenoid fracture. Arthroscopic reduction and percutaneous fixation of glenoid fractures not only allows anatomic reduction with minimal surgical trauma but provides a valid diagnostic and treatment alternative for associated capsular, ligamentous, labral or tendon injuries as well as joint irrigation. The principle portals are discussed. We suggest fixation with cannulated screws for better stability of fracture fragments and advise K-wires for fractures that are comminuted and not amenable to cannulated screw fixation. However, arthroscopic fixation of shoulder fractures is associated with a learning curve depending on surgeon?s experience in shoulder arthroscopy.

  11. Arthroscopy-assisted percutaneous fixation of glenoid fossa fracture

    Yallapragada Rahikiran; Patel Kuntal; Davuluri Pardhasaradhi; Sloan Andy; Marynissen Hans

    2007-01-01

    We are reporting an interesting case of glenoid fracture in a 46-year-old male which was fixed with the help of arthroscopy. At present, anterior or posterior glenoid rim fractures and some greater tuberosity fractures are widely treated arthroscopically. We report the arthroscopically assisted fixation of a transverse articular glenoid fracture. Arthroscopic reduction and percutaneous fixation of glenoid fractures not only allows anatomic reduction with minimal surgical trauma but provides a...

  12. Lesão de nervo cutâneo antebraquial lateral relacionada à venipuntura: o que saber?

    Juan A. Ramos

    2014-04-01

    Full Text Available Justificativa e objetivos: a venipuntura é um dos procedimentos mais comuns na prática anestésica cotidiana. Embora geralmente inócuas, lesões de nervos periféricos com sequelas graves foram descritas após venipuntura. Apresentamos um caso de lesão de nervo cutâneo antebraquial lateral relacionada à venipuntura, juntamente com as informações de diagnóstico e prognóstico essenciais para a prática cotidiana. Relato de caso: paciente do sexo masculino, 27 anos, submetido à venipuntura de fossa antecubital direita, com uma agulha de calibre 20, para avaliação metabólica de rotina. O paciente sofreu uma dor aguda, tipo choque elétrico, que percorreu a face lateral do antebraço desde a fossa antecubital proximal até o pulso lateral direito e a base do polegar direito. Após 24 horas, o paciente ainda sentia a dor semelhante a choque elétrico que foi classificada como 8/10 no braço distal lateral direito, no pulso lateral direito e na base do polegar, acompanhada de parestesia. Fizemos uma revisão da literatura e o paciente recebeu orientação sobre os resultados publicados a respeito desse tipo de lesão. Durante o acompanhamento, o paciente relatou que a disestesia diminuiu cerca de 3-4 semanas após a lesão inicial e que não restou déficit neurológico. Conclusões: lesões de nervos periféricos foram descritas pós-venipuntura, mas a literatura é limitada. Os nervos da fossa antecubital estão classicamente localizados em um plano logo abaixo - e muito próximos - das veias, o que os torna susceptíveis a lesões durante a flebotomia; além disso, sabe-se que existe uma extensa variação anatômica, o que sugere que mesmo uma venipuntura satisfatória não traumática pode danificar diretamente esses nervos. O anestesiologista deve estar ciente dessa possível complicação e também do diagnóstico e prognóstico para orientar os pacientes de forma adequada, caso essa complicação ocorra.

  13. Assessment and comparison of anemia of chronic disease in healthy subjects and chronic periodontitis patients: A clinical and hematological study

    Rajashri A Kolte

    2014-01-01

    Full Text Available Background: Bacteremia is associated with periodontal diseases whose extent is related to the severity of inflammation in periodontal tissues. The purpose of this study was to assess and compare the various blood parameters in healthy subjects and severe chronic periodontitis patients. Materials and Methods: 100 patients with severe chronic periodontitis (test group and 100 periodontally healthy subjects (control group in the age group 35-60 years participated in the study. Blood parameters were recorded with blood samples drawn from the antecubital fossa by venous puncture. Results: Periodontitis group showed lower erythrocyte count and mean corpuscular hemoglobin concentration (MCHC, and increased total leukocyte count (TLC and neutrophil, lymphocyte, and eosinophil count, compared to the healthy control group. Conclusions: To conclude, periodontitis may tend toward anemia and there is marked leukocytosis due to increased number of circulating neutrophils and lymphocytes.

  14. Catheter fracture- A rare complication of Peripherally Inserted Central Catheter (PICC .

    Yasir Bashir

    2014-09-01

    flexible catheter made of biocompatible material, either silicone or polyurethane, inserted percutaneously into the basilic or cephalic vein in the forearm or the antecubital fossa, often with the help of ultrasound or fluoroscopy guidance. The catheter is then advanced into the central circulation with tip of the catheter most often placed in the superior vena cava or at the caval-atrial junction. Although peripherally inserted central catheters (PICCs offer advantages over traditional central venous approaches, PICC lines are associated with a number of insertion and maintenance problems .We present a case of Acute lymphoblastic leukemia(ALL on modified Berlin Frankfurt and ndash; Munster (BFM protocol with a rare complication of catheter fracture. [Natl J Med Res 2014; 4(3.000: 262-263

  15. An approach to acanthosis nigricans

    Meghana Madhukar Phiske

    2014-01-01

    Full Text Available Acanthosis nigricans (AN is characterized by dark, coarse and thickened skin with a velvety texture, being symmetrically distributed on the neck, the axillae, antecubital and popliteal fossae, and groin folds, histopathologically characterized by papillomatosis and hyperkeratosis of the skin. A high prevalence of AN has been observed recently. Different varieties of AN include benign, obesity associated, syndromic, malignant, acral, unilateral, medication-induced and mixed AN. Diagnosis is largely clinical with histopathology needed only for confirmation. Other investigations needed are fasting lipoprotein profile, fasting glucose, fasting insulin, hemoglobin and alanine aminotransferase for obesity associated AN and radiological investigations (plain radiography, ultrasonography, magnetic resonance imaging/computerized tomography for malignancy associated AN. The most common treatment modalities include retinoids and metformin.

  16. An approach to acanthosis nigricans.

    Phiske, Meghana Madhukar

    2014-07-01

    Acanthosis nigricans (AN) is characterized by dark, coarse and thickened skin with a velvety texture, being symmetrically distributed on the neck, the axillae, antecubital and popliteal fossae, and groin folds, histopathologically characterized by papillomatosis and hyperkeratosis of the skin. A high prevalence of AN has been observed recently. Different varieties of AN include benign, obesity associated, syndromic, malignant, acral, unilateral, medication-induced and mixed AN. Diagnosis is largely clinical with histopathology needed only for confirmation. Other investigations needed are fasting lipoprotein profile, fasting glucose, fasting insulin, hemoglobin and alanine aminotransferase for obesity associated AN and radiological investigations (plain radiography, ultrasonography, magnetic resonance imaging/computerized tomography) for malignancy associated AN. The most common treatment modalities include retinoids and metformin. PMID:25165638

  17. Subcutaneous Venous Port Implantation in Patients with Bilateral Breast Surgery

    The purpose of this study was to evaluate the long-term follow-up results of subcutaneous venous ports implanted in patients with bilateral mastectomies. We retrospectively reviewed the hospital charts and the electronic database of 17 patients with bilateral mastectomies whom had venous port implantation in our interventional radiology suit. A total of 17 ports were implanted to the paramedian (n = 3) and anterolateral (standard; n = 12) chest wall, on the trapezius muscle (n = 1), and to the antecubital fossa (n = 1). The mean age was 48.29 years (range: 35-60 years). The mean time interval from time of surgery to port implantation was 34 months (range: 1-84 months). The mean follow-up time was 15 months (range: 7-39 months). Follow-up parameters and classification of the complications was defined according to the SIR guidelines. No procedure-related complication occurred. A single case of mild late infection was noted and the infection rate was 0.19/1000 catheter days. Infusion chemotherapy administration was still going on in eight patients. Two patients died during the follow-up and four patients were lost after 6 months. Port removal was performed in three patients at follow-up because of the end of treatment. One trapezius port and one paramedian port weres among the removed ports without any problem. Although we have a limited number of patients, port placement to the anterior chest wall, either paramedian or anterolateral, on the trapezius muscle or to the antecubital fossa depending on the extent of the bilateral breast surgeries that can be performed with low complication rates by a careful patient and anatomical location selection by involving the patients in the decision-making process. We believe that patient education and knowledge of possible complications have high importance in follow-up

  18. Skin rash, headache and abnormal behaviour: unusual presentation of intracranial haemorrhage in dengue fever

    Wani, Abdul Majid; Mejally, Mousa Ali Al; Hussain, Waleed Mohd; Maimani, Wail Al; Hanif, Sadia; Khoujah, Amer Mohd; Siddiqi, Ahmad; Akhtar, Mubeena; Bafaraj, Mazen G; Fareed, Khurram

    2010-01-01

    Dengue viral infections are one of the most important mosquito borne diseases in the world. The dengue virus is a single stranded RNA virus belonging to the Flaviviridae family. There are four serotypes (DEN 1–4) classified according to biological and immunological criteria. Patients may be asymptomatic or their condition may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF), or dengue shock syndrome. Annually, 100 million cases of dengue fever and half a mill...

  19. Itch and skin rash from chocolate during fluoxetine and sertraline treatment: Case report

    Svenson Svante; Knight Stefan; Cederberg Jonas; Melhus HÃ¥kan

    2004-01-01

    Abstract Background The skin contains a system for producing serotonin as well as serotonin receptors. Serotonin can also cause pruritus when injected into the skin. SSRI-drugs increase serotonin concentrations and are known to have pruritus and other dermal side effects. Case presentation A 46-year-old man consulted his doctor due to symptoms of depression. He did not suffer from any allergy but drinking red wine caused vasomotor rhinitis. Antidepressive treatment with fluoxetine 20 mg daily...

  20. Anti-fungal resistance in candida isolated from oral and diaper rash candidiasis in neonates

    Mohamadi, Jasem; Motaghi, Mahsa; Panahi, Jafar; Havasian, Mohamad Reza; Ali DELPISHEH; Azizian, Mitra; PAKZAD, Iraj

    2014-01-01

    The purpose of the present study is to evaluate the sensitivity of Candida species isolated from oral candidiasis and diaper dermatitis infections in children. The children referring to private and public clinics in Ilam, Iran were exmined for oral candidiasis and diaper dermatitis. In this study, 248 oral candidiasis and diaper dermatitis samples were collected and cultured.Candida species were identified by using standard methods. Resistance and sensitivity to amphotericin B, nystatin, keto...

  1. Robot Assisted Laparoscopic Repair of Sciatic Hernia (RASH): A Case Report.

    Singh, Iqbal; Hudson, Jon E; Richards, Kyle A; Hemal, Ashok K

    2011-12-01

    Sciatic hernia is a surgical rarity. One such hernia was incidentally diagnosed in a 79-year-old woman who underwent Robot assisted laparoscopic radical cystectomy for locally invasive bladder cancer. Intra-operatively, a patent hernia sac was noted in the sciatic notch. The hernia was successfully repaired during the same operation by using robot assisted laparoscopic technique. This appears to be the first robot assisted sciatic hernia repair in the world literature although it was done incidentally during another procedure. The technical descriptions of the operation are also applicable when isolated sciatic hernia repair is intended. A robot assisted laparoscopic repair is safe, feasible and well suited to the repair of sciatic hernias in women. The surgeon needs to be aware of this uncommon surgical pathology that may occur in women presenting with persistent chronic pelvic discomfort. PMID:23204714

  2. October 2014 critical care case of the month: a skin rash in the ICU

    Raschke RA

    2014-10-01

    Full Text Available No abstract available. Abstract truncated after first page. History of Present Illness: A 28 year old man was admitted to an outside hospital with an ethylene glycol overdose in an apparent suicide attempt. At that time the patient was delirious and vomiting. He had a severe metabolic acidosis and a creatinine of 2.1 mg/dL. He was intubated, a nasogastric tube was placed, and he was transferred to the toxicology service. PMH, FH, SH: There was no significant past medical history. Family history was noncontributory. He was a nonsmoker who recently had a fight with his girlfriend prompting the suicide attempt. Physical Examination: Vital signs were stable and he was sedated and nasally intubated receiving mechanical ventilation. There were no other significant findings on physical examination. Which of the following can be used for ethylene glycol poisoning? 1. Ethanol; 2. Fomezipole; 3. Hemodialysis; 4. Pyridoxine; 5. All of the above ...

  3. Clopidogrel induced urticarial rash in a patient with left main stem percutaneous coronary intervention: management issues

    Khambekar, S K; Kovac, J.; Gershlick, A. H.

    2004-01-01

    Clopidogrel, an ideal treatment for prevention of subacute stent thrombosis, may not be feasible to use in every patient. Ticlopidine (plus aspirin) is a very good alternative, although the risks of life threatening neutropenia should mandate regular monitoring of blood counts. It is proposed that patients undergoing angioplasty and stenting should carry a warning card in an effort to make the public and general practitioners aware that antiplatelet treatment after angioplasty plays an import...

  4. Mucocutaneous Leishmaniasis/HIV Coinfection Presented as a Diffuse Desquamative Rash

    Guilherme Almeida Rosa da Silva; Daniel Sugui; Rafael Fernandes Nunes; Karime de Azevedo; Marcelo de Azevedo; Alexandre Marques; Carlos Martins; Fernando Raphael de Almeida Ferry

    2014-01-01

    Leishmaniasis is an infectious disease that is endemic in tropical areas and in the Mediterranean. This condition spreads to 98 countries in four continents, surpassing 12 million infected individuals, with 350 million people at risk of infection. This disease is characterized by a wide spectrum of clinical syndromes, caused by protozoa of the genus Leishmania, with various animal reservoirs, such as rodents, dogs, wolves, foxes, and even humans. Transmission occurs through a vector, a sandfl...

  5. Rash with DERMABOND PRINEO Skin Closure System Use in Bilateral Reduction Mammoplasty: A Case Series

    Knackstedt, R. W.; J. A. Dixon; P. J. O’Neill; Herrera, F. A.

    2015-01-01

    Background. Bilateral reduction mammoplasty is a common plastic surgery procedure that can be complicated by unfavorable scar formation along incision sites. Surgical adhesives can be utilized as an alternative or as an adjunct to conventional suture closures to help achieve good wound tension and provide an adequate barrier with excellent cosmesis. The recently introduced DERMABOND PRINEO Skin Closure System Skin Closure System combines the skin adhesive 2-octyl cyanoacrylate with a self-adh...

  6. Simian varicella virus infection of Chinese rhesus macaques produces ganglionic infection in the absence of rash

    Ouwendijk, Werner J. D.; Mahalingam, Ravi; Traina-Dorge, Vicki; Amerongen, Geert van; Wellish, Mary; Osterhaus, Albert D. M. E.; Gilden, Don; Verjans, Georges M.G.M.

    2012-01-01

    Varicella-zoster virus (VZV) causes varicella (chickenpox), becomes latent in ganglia along the entire neuraxis, and may reactivate to cause herpes zoster (shingles). VZV may infect ganglia via retrograde axonal transport from infected skin or through hematogenous spread. Simian varicella virus (SVV) infection of rhesus macaques provides a useful model system to study the pathogenesis of human VZV infection. To dissect the virus and host immune factors during acute SVV infection, we analyzed ...

  7. A 25-year-old Man with Acute Maculo-Papular Rash and Target Lesions

    Vitorino Modesto dos SANTOS

    2012-01-01

    Full Text Available A 25-year-old student had an erythematous eruption on his face, trunk and upper extremity. Initial maculo-papules evolved to target lesions with a vesicular center surrounded by alternating pale and dark rings. The eruption appeared at the dorsum of the hand and progressed proximally, four days after a flu-like episode, without use of drugs or medicines for a minimum of six-months. The changes were restricted to the skin, painless and mildly itching. More conspicuous lesions appeared on his right scapula, left shoulder, and the dorsum of the left hand (Figure 1. Previously, he was in good health, without a history of allergy or skin or mucosal disturbances. He denied alcoholism, tobacco smoking, use of illicit drugs, and vaccination. His girl friend had fever, fatigue, pharyngitis and lymphadenopathy shortly before the onset of his actual disease. Physical examination revealed the aforementioned skin changes, in addition to discrete bilateral posterior cervical lymphadenopathy, and a moderate nontender liver and spleen enlargement. The patient was eutrophic and afebrile, with no ocular, oral, nasal, genital or anal lesions. In addition to routine laboratory tests, he underwent a skin biopsy aiming to clear the diagnosis. Blood determinations revealed leukocytosis, lymphocytosis and 12% reactive lymphocytes. Except for a transient elevation of the aminotransferase levels, biochemical data were normal. Hepatosplenomegaly and lymph node enlargement rapidly regressed to normal, as well as the lymphocyte count. The skin lesions improved gradually and healed in about two weeks.

  8. May 2015 pulmonary case of the month: pneumonia with a rash

    Robbins RA

    2015-05-01

    Full Text Available No abstract available. Article truncated at 150 words. History of Present Illness: A 77-year-old man underwent a thoracic CT scan for follow up of a known thoracic aneurysm. However, he had been feeling tired for about a week with a cough, night sweats and fever. He had no shortness of breath, wheezing or known history of lung disease. Past Medical History, Social History and Family History: He has a history of hypertension and a known thoracic aortic aneurysm. There was a surgical repair of his right clavicle after a motor vehicle accident. He is single and has lived in Arizona for over 50 years. He just returned from a trip to California where he visited Disneyland. He does not smoke. Family history is noncontributory. Current Medications: dutasteride, levothyroxine, atorvastatin. Physical Examination: His physical examination was reported as unremarkable. SpO2 was 95% on room air. Which of the following is appropriate at this time? 1. Begin empiric antibiotics; 2. ...

  9. May 2015 pulmonary case of the month: pneumonia with a rash

    Robbins RA

    2015-01-01

    No abstract available. Article truncated at 150 words. History of Present Illness: A 77-year-old man underwent a thoracic CT scan for follow up of a known thoracic aneurysm. However, he had been feeling tired for about a week with a cough, night sweats and fever. He had no shortness of breath, wheezing or known history of lung disease. Past Medical History, Social History and Family History: He has a history of hypertension and a known thoracic aortic aneurysm. There was a surgical repair ...

  10. Pseudoxanthoma Elasticum: A Pediatric Case

    Melis Çoban

    2015-12-01

    Full Text Available Pseudoxanthoma elasticum (PXE is a multisystemic, metabolic and autosomal recessive inherited disorder affecting especially elastic fibers of skin, retina and blood vessels. The prevalence varies from 1:25,000 to 1:100,000. The average age of onset is 13.5 years. Yellowish papules 1-3 mm in diameter and plaques merging as linear or reticular pattern are mostly on antecubital fossae, popliteal fossae, inguinal region, lower clavicle, neck, axilla, flexural regions as umbilicus and trauma sites. Of the patients, 85% have eye involvement. The first symptom of eye involvement is spot retinal pigmentation. Cardiovascular complications occur usually in adults. The most common and early cardiovascular complication is intermittent claudication. There is no specific treatment for skin signs. Lifestyle changes may have important effects on prognosis. A male patient with 3-year history of yellowish papules on his neck and 1-year history of yellowish papules on his groins, was presented in this case report. This 7-year-old patient received a diagnosis of PXE based on medical story, clinical examination and histopathological findings. This case was presented as PXE is a rare disease and should be diagnosed by the clinician at early ages.

  11. Posterior fossa gangliocytoma with facial nerve invasion: case report Gangliocitoma de fossa posterior com invasão de nervo facial: relato de caso

    Andrei Koerbel; Daniel Monte-Serrat Prevedello; Cláudio Esteves Tatsui; Luciano Nassar Pellegrino; Ricardo Alexandre Hanel; Luiz Fernando Bleggi-Torres; João Cândido de Araújo

    2003-01-01

    A 5 year-old boy with a cerebellar gangliocytoma with a peripheral right facial paresis and ataxia is presented. His MRI showed a heterogenous, diffuse lesion, isointense on T1 and hyperintense on T2-weigthed sequences, involving the right cerebellar hemisphere with direct extension into the right facial nerve. The present case is the first description of a gangliocytoma with direct facial nerve invasion, as demonstrated for the facial nerve paresis and supported by MRI and surgical inspectio...

  12. Angioplasty of communicating veins to the brachial vein in haemodialysis patients with obliterated superficial veins of the upper arm

    Aim: To evaluate the outcomes of angioplasty of the communicating veins when superficial veins of the upper arm were almost totally obliterated in haemodialysis patients. Materials and methods: Twenty-one angioplasties of the communicating veins that were performed for failing haemodialysis fistulas in patients with almost totally obliterated superficial veins of the upper arm from December 2006 to March 2011 were retrospectively reviewed. Fistulas were of the following types: native radiocephalic fistulas (n = 20) and radio-antecubital fistulas (n = 1). All angioplasties were performed using 5–8 mm conventional balloons. Cutting balloon angioplasty was additionally performed in five patients. The primary, secondary, and target lesion patency rate was calculated using Kaplan–Meier analysis. Results: The communicating vein was located in the antecubital fossa. Technical and clinical success rates were 100% and 95.2%, respectively. Follow-up duration was 1–52 months (mean 20 months). The primary patency rates were 76%, 43%, and 29% at 3, 6, and 12 months, respectively, and target lesion patency rates were 81%, 62%, and 43% at 3, 6, and 12 months, respectively. The secondary patency rates were 81%, 76%, and 57% at 3, 6, and 12 months, respectively. There were no major or minor complications. Conclusion: Angioplasty of the communicating vein is effective in restoring function in failing haemodialysis fistula in patients with obliterated superficial veins of the upper arm. - Highlights: • Lack of patent superficial veins of upper arm is challenging condition for endovascular recanalization in haemodialysis patients. • This paper is to introduce angioplasty technique of communicating veins as an alternative pathway in the setting of totally obliterated superficial veins of upper arms. • The technical and clinical success rate of this technique were 100% and 95.2% and there was no major or minor complication

  13. Miliaria-rash after neutropenic fever and induction chemotherapy for acute myelogenous leukemia Miliária 'rash' após neutropenia febril e quimioterapia de indução para a leucemia mielóide aguda

    Tuyet A Nguyen

    2011-08-01

    Full Text Available Miliaria is a disorder of the eccrine sweat glands which occurs in conditions of increased heat and humidity. It can be associated with persistent febrile states as well as with certain drugs. We presented a 40 year-old female with myelodysplastic syndrome and progression to acute myelogenous leukemia who was admitted to the hospital for chemotherapy induction. The patient was treated with idarubicin and cytarabine. She became pancytopenic and developed neutropenic fever and was started on vancomycin and cefepime, but was persistently febrile with night sweats. Five days into her fevers, she developed diffuse, nonpruritic and fragile vesicles together with drenching nightsweats. The patient's exanthem was diagnosed as Miliaria crystallina, most probably induced by neutropenic fever and idarubucin exposureMiliária é uma desordem das glândulas sudoríparas écrinas, que ocorre em condições de aumento de calor e umidade. Miliária pode ser associada com estados febris persistentes bem como com certos medicamentos. Apresentamos o caso de uma mulher de 40 anos com síndrome mielodisplásica e progressão para leucemia mielóide aguda que foi admitida no hospital para quimioterapia de indução. A paciente foi tratada com idarrubicina e citarabina. Ela se tornou pancitopênica e desenvolveu neutropenia febril. Iniciou tratamento com vancomicina e cefepime, mas a febre com sudorese noturna continou. Cinco dias depois a paciente desenvolveu vesículas difusas, não pruríticas e frágeis juntamente com a persistência de sudorese noturna. O exantema do paciente foi diagnosticado como Miliária cristalina, provavelmente induzida por neutropenia febril e exposição a idarubucin

  14. Epidermoid cysts of the posterior fossa and petroclival region. Treatment and outcome

    Kwiek, SJ; Bazowski, P; Slusarczyk, W; Kukier, W; Luszawski, J; Wójcikiewicz, T; Wolwender, A; Namyslowski, G; Lisowska, G; Zymon-Zagórska, A

    2009-01-01

    Objectives: Surgical management of epidermoid cysts is still a challenge. One of the most important goals in epidermoids management is total tumor removal, but its tendency to adhere to cranial nerves and to the brain stem make technical problems in their complete removal. Approach to epidermal cysts of CPA and petroclival region is determined by tumor extension. Patients and methods: Since 1988 to 2004 among 226 operations of cerebellopontine angle (CPA) tumors (retrosigmoid approach ...

  15. Cerebral salt wasting syndrome in the posterior fossa surgery post-operative period: Case report

    Rosana Guerrero-Domínguez

    2015-02-01

    Full Text Available Hyponatremia is the most common electrolyte disorder following intracranial surgery. Its aetiology is multifactorial. We present a case of a patient taken to microvascular decompression (Janetta surgery for the treatment of trigeminal neuralgia who developed a symptomatic magnification of basal hyponatremia in the immediate post-operative period. Cerebral salt wasting syndrome was diagnosed. The management of this condition poses a challenge for physicians involved in postoperative neurosurgical care.

  16. Radiotherapy of posterior cerebral fossa medulloblastomas: comparison of conformational approaches by photons and protons

    It exists an indisputable advantage in favour of protons according to the homogeneity, conformity and tissues protection that should manifest by a significant decrease of neurological, cognitive, and endocrinal delayed aftereffects. (N.C.)

  17. Ileocolic mucormycosis – an unusual cause of a mass in the right iliac fossa

    Chethan, Kishanchand; Prasad, Seetharam; Ramachandra, Lingadakai

    2012-01-01

    Mucormycosis is a relatively uncommon, aggressive and lethal mycosis. Fungi from the order Mucorales are the etiological agents of mucormycosis. The condition is more common among the immunocompromised, diabetic patients with ketoacidosis and people with iron overload syndromes. Diagnosis of mucormycosis requires a high index of suspicion regarding the possibility of the condition in high-risk individuals. Timely diagnosis is critical to survival and minimization of morbidity. A favourable ou...

  18. Cisternal abnormalities produced by clinical tumours in the posterior cranial fossa. II

    A detailed analysis of the distortion of the subarachnoid cisterns produced by intraventricular tumours of the fourth ventricle was carried out on a clinical material of 30 patients examined with pneumography. The cisternal distortions in cases with a tumour originating from the roof of the ventricle have been compared with those in tumours originating from the floor, and the typical appearances for each group of tumours are recorded. The results should be applicable when analysing cisterns examined not only with pneumography but also with other radiologic methods, such as computer tomography and cisternography with positive contrast media. (Auth.)

  19. Acoustic Schwannoma Presenting as Acute Posterior Fossa Hematoma: Case Report and Review of the Literature

    Ghobashy, Ashraf; Loveren, Harry van

    1993-01-01

    Acoustic schwannomas usually present with gradually progressive unilateral sensorineural hearing loss. As the tumor enlarges, symptoms and signs develop when the adjacent cranial nerves, cerebelhim, and/or brainstem become compressed. Rarely, acoustic tumors present with acute subarachnoid or intratumoral hemorrhage. Of the 12 cases of acoustic schwannoma with tumoral hemorrhage presented in the literature of which we are aware, this is the third such case of a patient presenting with spontan...

  20. An Unusual Cause of Right Iliac Fossa Pain: Caecal Diverticulum Perforation.

    Butt, Usman Ismat; Mansoor, Rashid; Khan, Ahsan; Siddique, Sumera; Khan, Huma Sabir; Iftikhar, Muhammad Adil; Ayyaz, Mahmood

    2015-10-01

    Caecal diverticulum perforation is a rare condition. It mimics acute appendicitis and is seldom suspected pre-operatively. Commonly it is discovered during exploration. Ultrasonography and computed tomography are helpful in the diagnosis of the condition. There is controversy regarding the surgical treatment. We are presenting the case of a 44-year male who underwent exploration for suspected acute appendicitis but was found to have a perforated solitary caecal diverticulum. Patient underwent diverticulectomy and made an uneventful recovery. PMID:26522193

  1. The use of laparoscopy in the management of right iliac fossa pain.

    Clarke, P.J.; Hands, L. J.; Gough, M. H.; Kettlewell, M G

    1986-01-01

    Fourty-six patients with a clinical diagnosis of acute appendicitis were laparoscoped before exploration. As a result the diagnosis was revised in 10 patients (22%). With experience the laparoscopic features of appendicitis can be recognised confidently so reducing the number of normal appendices removed.

  2. Towards a Proactive Risk Mitigation Strategy at La Fossa Volcano, Vulcano Island

    Biass, S.; Gregg, C. E.; Frischknecht, C.; Falcone, J. L.; Lestuzzi, P.; di Traglia, F.; Rosi, M.; Bonadonna, C.

    2014-12-01

    A comprehensive risk assessment framework was built to develop proactive risk reduction measures for Vulcano Island, Italy. This framework includes identification of eruption scenarios; probabilistic hazard assessment, quantification of hazard impacts on the built environment, accessibility assessment on the island and risk perception study. Vulcano, a 21 km2 island with two primary communities host to 900 permanent residents and up to 10,000 visitors during summer, shows a strong dependency on the mainland for basic needs (water, energy) and relies on a ~2 month tourism season for its economy. The recent stratigraphy reveals a dominance of vulcanian and subplinian eruptions, producing a range of hazards acting at different time scales. We developed new methods to probabilistically quantify the hazard related to ballistics, lahars and tephra for all eruption styles. We also elaborated field- and GIS- based methods to assess the physical vulnerability of the built environment and created dynamic models of accessibility. Results outline the difference of hazard between short and long-lasting eruptions. A subplinian eruption has a 50% probability of impacting ~30% of the buildings within days after the eruption, but the year-long damage resulting from a long-lasting vulcanian eruption is similar if tephra is not removed from rooftops. Similarly, a subplinian eruption results in a volume of 7x105 m3 of material potentially remobilized into lahars soon after the eruption. Similar volumes are expected for a vulcanian activity over years, increasing the hazard of small lahars. Preferential lahar paths affect critical infrastructures lacking redundancy, such as the road network, communications systems, the island's only gas station, and access to the island's two evacuation ports. Such results from hazard, physical and systemic vulnerability help establish proactive volcanic risk mitigation strategies and may be applicable in other island settings.

  3. Avian Cerebellar Floccular Fossa Size Is Not a Proxy for Flying Ability in Birds

    Walsh, Stig A.; Iwaniuk, Andrew N.; Knoll, Monja A.; Bourdon, Estelle; Barrett, Paul M.; Milner, Angela C.; Nudds, Robert L.; Abel, Richard L.; Sterpaio, Patricia Dello

    2013-01-01

    Extinct animal behavior has often been inferred from qualitative assessments of relative brain region size in fossil endocranial casts. For instance, flight capability in pterosaurs and early birds has been inferred from the relative size of the cerebellar flocculus, which in life protrudes from the lateral surface of the cerebellum. A primary role of the flocculus is to integrate sensory information about head rotation and translation to stabilize visual gaze via the vestibulo-occular reflex...

  4. Hepatitis C eradication and improvement of cryoglobulinemia-associated rash and membranoproliferative glomerulonephritis with interferon and ribavirin after kidney transplantation

    Zeman, Marilyn; Campbell, Patricia; BAIN, VINCENT G.

    2006-01-01

    Postrenal transplant hepatitis C is increasing in frequency due to the high prevalence of hepatitis C among patients with renal failure. Despite this, there is still no standard hepatitis C treatment available for renal transplanted recipients. Combination antiviral hepatitis C therapy, the standard of care in the nontransplant population, is generally avoided because of documented renal graft rejection secondary to interferon treatment. A case of a male patient with postrenal transplant hepa...

  5. Management of imatinib-associated skin rash in a patient with metastatic gastrointestinal stromal tumor: a case report

    Blay Jean-Yves

    2012-01-01

    Abstract Purpose Long-term continuous imatinib is recommended for adult patients with unresectable and/or metastatic KIT+ gastrointestinal stromal tumors (GIST) as long as the patient continues to benefit. In the adjuvant setting, recent findings indicate that patients at considerable risk of recurrence should receive at least 3 years of imatinib. Because imatinib is often administered for prolonged periods, proper management of imatinib-associated adverse events is crucial. Case report We re...

  6. VZV multifocal vasculopathy with ischemic optic neuropathy, acute retinal necrosis and temporal artery infection in the absence of zoster rash.

    Mathias, Marc; Nagel, Maria A; Khmeleva, Nelly; Boyer, Philip J; Choe, Alexander; Durairaj, Vikram D; Bennett, Jeffrey L; Mandava, Naresh; Gilden, Don

    2013-02-15

    We describe a 54-year-old diabetic woman who developed ischemic optic neuropathy followed by acute retinal necrosis and multiple areas of focal venous beading. Vitreous fluid contained amplifiable VZV DNA but not HSV-1, CMV or toxoplasma DNA. The clinical presentation was remarkable for jaw claudication and intermittent scalp pain, prompting a temporal artery biopsy that was pathologically negative for giant cell arteritis, but notable for VZV antigen. The current case adds to the clinical spectrum of multifocal VZV vasculopathy. The development of acute VZV retinal necrosis after ischemic optic neuropathy supports the notion that vasculitis is an important additional mechanism in the development of VZV retinal injury. PMID:23312850

  7. Skin mucormycosis presenting as an erythema-nodosum-like rash in a renal transplant recipient: a case report

    Nouri-Majalan Nader; Moghimi Mansour

    2008-01-01

    Abstract Introduction Cutaneous mucormycosis is a rare entity related to kidney transplantation. It usually presents with ecthyma-like lesions and black necrotic cellulitis. We report an unusual case of primary cutaneous mucormycosis presenting as erythema-nodosum-like lesions in a woman who had received a renal transplant. Case presentation A 49-year-old woman with diabetes received a living-unrelated kidney transplant. Her clinical course was uneventful for the first six months after transp...

  8. Pentobarbital Toxicity after Self-Administration of Euthasol Veterinary Euthanasia Medication.

    Crellin, Steven Jason; Katz, Kenneth D

    2016-01-01

    Suicide attempt via sodium pentobarbital is uncommon. A 48-year-old woman with a history of depression and prior suicide attempt was found unresponsive by her veterinarian spouse near a syringe containing pink solution. Upon EMS' arrival, the patient was experiencing apnea, hypoxemia, and miotic pupils; her blood glucose level measured 73?mg/dL. She was bradycardic and administered atropine with transient improvement in heart rate and transported to an emergency department; 2?mg of intravenous naloxone was administered without effect. She was endotracheally intubated via rapid sequence intubation. Rapid urine drug screening detected both benzodiazepines and barbiturates. The patient was transferred to an intensive care unit where she demonstrated a nearly absent radial pulse. Emergent fasciotomy to the left forearm and carpal tunnel was performed for acute compartment syndrome; "Euthasol" had been self-administered into the antecubital fossa. Expanded toxicological analysis via liquid chromatography/mass spectroscopy detected caffeine, atropine, 7-aminoclonazepam, phenytoin, citalopram, and naproxen. The patient's coma resolved over 48 hours and she was successfully extubated without complication. Emergency physicians must closely monitor patients exposed to veterinary euthanasia agents who develop central nervous system and respiratory depression, hypothermia, bradycardia, hypotension, or skin injury. Consultation with a regional poison center and medical toxicologist is recommended. PMID:26881149

  9. Emergency Stent Grafting After Unsuccessful Surgical Repair of a Mycotic Common Femoral Artery Pseudoaneurysm in a Drug Abuser

    Mycotic false aneurysm caused by local arterial injury from attempted intravenous injections in drug addicts remains a challenging clinical problem. The continued increase in drug abuse has resulted in an increased incidence of this problem, particularly in high-volume urban centres. In the drug-abusing population, mycotic arterial pseudoaneurysms most often occur because of missed venous injection and are typically seen in the groin, axilla, and antecubital fossa. Mycotic aneurysms may lead to life-threatening haemorrhage, limb loss, sepsis, and even death. Any soft-tissue swelling in the vicinity of a major artery in an intravenous drug abuser should be suspected of being a false aneurysm until proven otherwise and should prompt immediate referral to a vascular surgeon for investigation and management. We report a case of rupturing mycotic pseudoaneurysm of the left common femoral artery treated by surgical resection followed by vessel reconstruction with autologous material. Unfortunately, at the time of discharge a sudden leakage from the vein graft anastomosis occurred, with subsequent massive bleeding, and required emergent endovascular covered stenting. To the best of our knowledge, this is the first reported case of femoral artery bleeding in a drug abuser treated by stent graft placement.

  10. Clinical report: the joint obstetric and psychiatric management of phobic anxiety disorders in pregnancy.

    Patel, Roshni R; Hollins, Kathryn

    2015-01-01

    Women who struggle with distressing pregnancy-related phobic anxiety disorders are regularly encountered in maternity services, and their management poses particular challenges. Early identification is crucial in order to offer an opportunity to treat and manage their fears and enable a positive birth experience. In this article, women with different phobias (tokophobia, emetophobia and ante-cubital fossa phobia) describe their first pregnancy experience, and the ways in which the Chelsea and Westminster Hospital offered them joint maternity and psychiatric care. A multidisciplinary hospital-based approach can be effective in managing mental health problems in pregnancy. Despite maternal preconceptions and professional misgivings, this approach can work for women with phobias and enable a good birth experience and successful mother and infant bonding. The lead obstetrician for mental health and perinatal psychiatrist describe their roles in enabling successful outcomes for both the current and subsequent pregnancies. The case is made for training of maternity staff in both the identification of severe pregnancy phobias and the prompt referral for shared psychiatric and maternity care. Even if previous treatments have failed, adequate coping strategies for childbirth may be achieved in a short time frame. Long-term improvements in the phobia itself may also be found. PMID:25547323

  11. The enigma of post-radiation oedema and residual or recurrent carcinoma of the larynx and pyriform fossa

    Persistence of significant laryngeal oedema following radiotherapy presents the surgeon with a diagnostic dilemma. Though the oedema may represent a prolonged response to irradiation, the possibility of residual carcinoma must be considered. Several authors have commented upon it and have suggested frequent biopsies to prove the presence of residual or recurrent neoplasm (Ward et al., 1975; Lederman, 1970; Calcaterra et al., 1972). Some reluctance to laryngeal biopsy has been exercised to avoid inciting a fulminant perichondritis. However, the difficulty of obtaining a positive biopsy in a post-irradiated case is well known, and repeated negative biopsies do not exclude the presence of a residual tumour. The present paper studies 52 histopathologically proven cases of carcinoma of the larynx and laryngopharynx which had received radiotherapy earlier. These cases underwent salvage radical surgery on clinical suspicion of residual/recurrent tumour, manifested by persistence of significant laryngeal oedema and/or fixation of the larynx. No positive biopsies have been obtained following radiotherapy. (author)

  12. Remote multiple intracranial hemorrhage in multiple metastatic lung adenocarcinoma following decompression of posterior fossa lesion: Unknown cause

    Subhas Konar

    2015-01-01

    Full Text Available Cerebral metastasis can present with hemorrhage. However, multiple hemorrhages in metastatic lesions following surgical decompression of a single lesion are never reported. We report a case of cerebral metastasis from lung cancer that developed multiple hemorrhages in supratentorial metastatic lesions following surgical resection of an infratentorial lesion.

  13. Rupture of a small middle cerebral artery aneurysm into middle fossa arachnoid cyst presenting as a chronic subdural haematoma.

    Kocaeli, H; Korfali, E

    2008-04-01

    The rupture of an aneurysm into an arachnoid cyst and subdural space is unusual. A 25-year-old man was admitted 2 weeks after having undergone a burr hole drainage for a chronic subdural haematoma elsewhere. An angiogram revealed a small aneurysm at the bifurcation of the middle cerebral artery. The aneurysm was clipped and the cyst communicated with the basal cisterns. To the best of our knowledge, this is the first report of an association of an aneurysm of the middle cerebral artery with an arachnoid cyst presenting as a chronic subdural haematoma. PMID:18311525

  14. Utility of abdominal ultrasonography in acute painful tables of right iliac Fossa with appendicitis acute suspicion. Maciel Hospital Experience

    Acute appendicitis is one of the most frequent causes of consultation and of indication of emergency laparotomy in most western countries. Despite its diagnostic being based mainly on clinical examination, there is a certain percentage of patients whose clinical presentation is atypical. In these cases image methods such as the abdominal ultrasound are particularly useful as diagnostic auxiliaries.The objective of this work is to compare the echographic with the Anatomopathological diagnosis in 80 patients who consulted the Hospital Maciel emergency service with episodes of acute appendicitis

  15. Endovascular treatment of arteriovenous fistula with pseudoaneurysm at popliteal fossa using a PTFE stent-graft: a case report

    Choi, Jeong Yeol; Kim, Dong Hyun; Oh, Hyung Woo; Jang, Jeong Hwan; Oh, Jae Hee; Kim, Young Suk; Byun, Joo Nam; Kim, Young Cheol [Chosun University Hospital, Gwangju (Korea, Republic of)

    2005-07-15

    We report the successful treatment of a postoperative pseudoaneurysm of a popliteal artery, which was associated with an arteriovenous fistula to the popliteal vein using an endovascular placement of a PTFE-covered stent graft. After a one-month follow-up, there was an in-stent stenosis, which was managed by balloon angioplasty. The patient was well with mild leg discomfort after a 3-month follow-up.

  16. Endovascular treatment of arteriovenous fistula with pseudoaneurysm at popliteal fossa using a PTFE stent-graft: a case report

    We report the successful treatment of a postoperative pseudoaneurysm of a popliteal artery, which was associated with an arteriovenous fistula to the popliteal vein using an endovascular placement of a PTFE-covered stent graft. After a one-month follow-up, there was an in-stent stenosis, which was managed by balloon angioplasty. The patient was well with mild leg discomfort after a 3-month follow-up

  17. Suggestion for the prostatic fossa clinical target volume in adjuvant or salvage radiotherapy after a radical prostatectomy

    Background and purpose: To assess the location of recurrent tumors and suggest the optimal target volume in adjuvant or salvage radiotherapy (RT) after a radical prostatectomy (RP). Material and methods: From January 2000 to December 2012, 113 patients had been diagnosed with suspected recurrent prostate cancer by MRI scan and received salvage RT in the Samsung Medical Center. This study assessed the location of the suspected tumor recurrences and used the inferior border of the pubic symphysis as a point of reference. Results: There were 118 suspect tumor recurrences. The most common site of recurrence was the anastomotic site (78.8%), followed by the bladder neck (15.3%) and retrovesical area (5.9%). In the cranial direction, 106 (87.3%) lesions were located within 30 mm of the reference point. In the caudal direction, 12 lesions (10.2%) were located below the reference point. In the transverse plane, 112 lesions (94.9%) were located within 10 mm of the midline. Conclusions: A MRI scan acquired before salvage RT is useful for the localization of recurrent tumors and the delineation of the target volume. We suggest the optimal target volume in adjuvant or salvage RT after RP, which includes 97% of suspected tumor recurrences

  18. Re-Growth of a Posterior Inferior Cerebellar Artery Aneurysm after Resection of the Associated Posterior Fossa Arteriovenous Malformation

    Al-Jehani, Hosam; Tampieri, Donatella; Cortes, Maria; Melançon, Denis

    2014-01-01

    Arteriovenous malformation (AVM)-related aneurysms have been described in the literature. Their behavior varies based on their location in relation to and the activity of the shunting through the index AVM. The intuitive expectation supported by numerous reports is that these aneurysms should regress if the AVM is excluded from the circulation.

  19. A 46-year-old female presenting with worsening headache, nuchal rigidity and a skin rash in varicella zoster virus meningitis: a case report

    Kushawaha, Anurag; Mobarakai, Neville; Tolia, Jill

    2009-01-01

    Varicella zoster virus causes two distinct clinical diseases. Varicella is the primary infection and results from exposure of a person susceptible to the virus. The virus remains latent in cranial nerve ganglia, dorsal root ganglia, and autonomic ganglia along the entire neuraxis. Years later, in association with a decline in cell-mediated immunity in the elderly and immuno-compromised, varicella zoster virus reactivates and can cause a wide range of neurologic disease, including herpes zoste...

  20. Dermatitis irritativa del pañal: Tratamiento local con productos barrera y calidad de vida Diaper rash: Local treatment with barrier products and quality of life

    Justo Rueda López

    2012-03-01

    Full Text Available Los trastornos cutáneos son derivados, en la mayoría de las ocasiones, de agresiones continuas por elementos externos que tiene como respuesta reacciones como la pérdida de lípidos epidérmicos por efecto de la humedad, cambios en el pH cutáneo (alcalinización y aumento del coeficiente de fricción (denudación junto al desequilibrio de la flora saprofita de la piel, que se traducen en procesos irritativos y en un aumento de la infecciones fúngicas y bacterianas en la zona expuesta a humedad. Dada la importancia de evaluar la calidad de vida de los pacientes con dermatitis que son tratados con productos barrera no irritantes (PBNI se ha desarrollado un estudio multicéntrico, con el objetivo de evaluar los aspectos relacionados con la mejora en la calidad de cuidados a pacientes tratados con Cavilon® que presentaban dermatitis por incontinencia mediante la escala ESCLI. Los pacientes incluidos en el estudio fueron 25. Los resultados muestran una mejora importante de los aspectos evaluados mediante la escala ESCLI sobre la evolución de la dermatitis. Esta escala valora aspectos como el área afectada por el enrojecimiento y la severidad, presentan una reversión del 47% de los casos. La denudación de la piel en la zona del pañal desaparece en el 56% de los casos y la severidad de la denudación que presenta una mejoría del 47%. La valoración del dolor en la zona de incontinencia se reduce en un 76% en la zona de incontinencia y en un 73% al realizar la limpieza de la zona. Las conclusiones del presente estudio ponen de manifiesto que la aplicación de productos formadores de una película barrera no irritante (PBNI en los pacientes que presentan dermatitis por incontinencia representa una alternativa a los tratamientos convencionales como son las cremas o ungüentos de óxido de cinc o pastas al agua. La reversión y reducción de la dermatitis es un aspecto que presenta una mejoría importante. Los resultados obtenidos que podemos relacionar con la calidad de vida o más concretamente con la mejora del dolor son destacables.The skin disorders are derived in most cases continuous injuries by external factors that have how responses the loss of epidermal lipids by the effect of moisture, derived of changes in skin pH (alkalinization, an increased coefficient of friction (denudation and the imbalance of the saprophytic flora of the skin, give how a result an increase to the irritative processes and the fungal and bacterian infections in the area exposed to moisture. Given the importance of assessing the quality of life of patients with dermatitis who are treated with No Sting Barrier Film (NSBF CavilonTM has developed a multicenter study, in order to evaluate the related to improving the quality of care that patients Incontinence Dermatitis with ESCLI scale. Patients included in the study were 25. The results show a significant improvement aspects ESCLI assessed by the scale of the evolution of the dermatitis. This scale assesses aspects such as the area affected by the redness and severity. Show a reversal 47% of cases. The denudation of the skin in the diaper area disappears in 56% of cases and the severity of the denudation which has a 47% improvement. The assessment of pain in the area of incontinence, is reduced by 76% in the area of incontinence and a 73% when cleaning the area. The findings of this study prove indicates that the application of forming products of a No Sting Barrier Film (NSBF in patients with incontinence dermatitis is an alternative to conventional treatments such as creams or ointments or zinc oxide paste water. The reversal and reduction of dermatitis is an aspect that has improved important. The results that we can relate to quality of life or longer specifically with the improvement of pain are significant.

  1. Hydralazine-induced anti-neutrophil cytoplasmic antibody-positive renal vasculitis presenting with a vasculitic syndrome, acute nephritis and a puzzling skin rash: a case report

    Keasberry Justin; Frazier Jeremy; Isbel Nicole M; van Eps Carolyn L; Oliver Kimberley; Mudge David W

    2013-01-01

    Abstract Introduction Anti-neutrophil cytoplasmic antibody-associated vasculitis has been associated with many drugs and it is a relatively rare side effect of the antihypertensive drug hydralazine. The diagnosis and management of patients who have anti-neutrophil cytoplasmic antibody-associated vasculitis may be challenging because of its relative infrequency, variability of clinical expression and changing nomenclature. The spectrum of anti-neutrophil cytoplasmic antibody-associated vasculi...

  2. A hospital in Ilkh?nid Iran: toward a socio-economic reconstruction of the Rab‘-i Rash?d?.

    Khafipour, Hani

    2012-01-01

    In the first decade of the fourteenth century, Rashid al-D?n Fazl Allah penned a remarkable endowment deed in which he meticulously detailed his plans for the creation of a utopian community. He named it the Rab'-i Rashid. In this document, he provides socio-economic data concerning the day-to-day operations of this settlement unparalleled in comparable texts. This article focuses on the hospital ward of the Rab'-i Rashid, and provides a broader historical context for this medieval hospital and its personnel by examining the financial and monetary information in the endowment deed in order to piece together the inner workings of this community. In so doing, we are granted a rare opportunity to explore the daily lives of ordinary people whose endeavors, however significant, often went unnoticed. PMID:22334946

  3. Changes in sebum levels and the development of acneiform rash in patients with non–small cell lung cancer after treatment with EGFR inhibitors

    Nakahara T; Moroi Y; Takayama K; Itoh E; Kido-Nakahara M; Nakanishi Y; Furue M

    2015-01-01

    Takeshi Nakahara,1,2 Yoichi Moroi,2 Koichi Takayama,3 Eriko Itoh,1,2 Makiko Kido-Nakahara,2 Yoichi Nakanishi,3 Masutaka Furue2 1Division of Skin Surface Sensing, 2Department of Dermatology, 3Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan Background: It has recently been shown that patients treated with epidermal growth factor receptor (EGFR) inhibitors often develop various cutaneous adverse events. While the pa...

  4. Significance of the site of injection in unexpected right-to-left shunting

    Lung perfusion scintigraphy, with Tc-99m MAA injected into a left antecubital vein, revealed extensive uptake in the myocardium, kidneys, spleen, thyroid, and brain. After a right antecubital injection, a normal pulmonary perfusion pattern was found. This finding is specific for right-to-left shunting due to anomalous systemic venous drainage into the left atrium

  5. Pain assessment in children undergoing venipuncture: the Wong–Baker faces scale versus skin conductance fluctuations

    Francesco Savino

    2013-02-01

    Full Text Available The aim of this study was to evaluate the efficacy of the subjective Wong–Baker faces pain rating scale (WBFS and of the objective skin conductance fluctuation (SCF test in assessing pain in children undergoing venipuncture. One-hundred and fifty children (aged 5–16 years entered the study. All underwent venipuncture at the antecubital fossa to collect blood specimens for routine testing in the same environmental conditions. After venipuncture, the children indicated their pain intensity using the WBFS, whereas the number of SCFs was recorded before, during and after venipuncture. So, pain level was measured in each child with WBFS and SCF. We found that the level of WBFS-assessed pain was lower in all children, particularly those above 8 years of age, than SCF-assessed pain (p < 0.0001. Moreover, the number of SCFs was significantly higher during venipuncture than before or after venipuncture (p < 0.0001. At multivariate regression analysis, age and previous experience of venipuncture influenced the WBFS (β = −1.81, p < 0.001, and β = −0.86, p < 0.001, respectively but not SCFs. In conclusion, although both procedures can be useful for research and clinical practice, our findings show that WBFS was affected by age and previous venipuncture, whereas SCF produced uniform data. If verified in other studies, our results should be taken into account when using these tools to evaluate pain in children.

  6. Effects of disturbed blood flow during exercise on endothelial function: a time course analysis.

    Paiva, F M; Vianna, L C; Fernandes, I A; Nóbrega, A C; Lima, R M

    2016-01-01

    This study aimed to examine the time course of endothelial function after a single handgrip exercise session combined with blood flow restriction in healthy young men. Nine participants (28±5.8 years) completed a single session of bilateral dynamic handgrip exercise (20 min with 60% of the maximum voluntary contraction). To induce blood flow restriction, a cuff was placed 2 cm below the antecubital fossa in the experimental arm. This cuff was inflated to 80 mmHg before initiation of exercise and maintained through the duration of the protocol. The experimental arm and control arm were randomly selected for all subjects. Brachial artery flow-mediated dilation (FMD) and blood flow velocity profiles were assessed using Doppler ultrasonography before initiation of the exercise, and at 15 and 60 min after its cessation. Blood flow velocity profiles were also assessed during exercise. There was a significant increase in FMD 15 min after exercise in the control arm compared with before exercise (64.09%±16.59%, P=0.001), but there was no change in the experimental arm (-12.48%±12.64%, P=0.252). FMD values at 15 min post-exercise were significantly higher for the control arm in comparison to the experimental arm (P=0.004). FMD returned to near baseline values at 60 min after exercise, with no significant difference between arms (P=0.424). A single handgrip exercise bout provoked an acute increase in FMD 15 min after exercise, returning to near baseline values at 60 min. This response was blunted by the addition of an inflated pneumatic cuff to the exercising arm. PMID:26909789

  7. Effects of disturbed blood flow during exercise on endothelial function: a time course analysis

    F.M. Paiva

    2016-01-01

    Full Text Available This study aimed to examine the time course of endothelial function after a single handgrip exercise session combined with blood flow restriction in healthy young men. Nine participants (28±5.8 years completed a single session of bilateral dynamic handgrip exercise (20 min with 60% of the maximum voluntary contraction. To induce blood flow restriction, a cuff was placed 2 cm below the antecubital fossa in the experimental arm. This cuff was inflated to 80 mmHg before initiation of exercise and maintained through the duration of the protocol. The experimental arm and control arm were randomly selected for all subjects. Brachial artery flow-mediated dilation (FMD and blood flow velocity profiles were assessed using Doppler ultrasonography before initiation of the exercise, and at 15 and 60 min after its cessation. Blood flow velocity profiles were also assessed during exercise. There was a significant increase in FMD 15 min after exercise in the control arm compared with before exercise (64.09%±16.59%, P=0.001, but there was no change in the experimental arm (-12.48%±12.64%, P=0.252. FMD values at 15 min post-exercise were significantly higher for the control arm in comparison to the experimental arm (P=0.004. FMD returned to near baseline values at 60 min after exercise, with no significant difference between arms (P=0.424. A single handgrip exercise bout provoked an acute increase in FMD 15 min after exercise, returning to near baseline values at 60 min. This response was blunted by the addition of an inflated pneumatic cuff to the exercising arm.

  8. Vibration and skin blood flow changes in subjects with restless legs syndrome

    Mitchell UH

    2014-02-01

    Full Text Available Ulrike H Mitchell, Paula K Johnson Department of Exercise Sciences, Brigham Young University, Provo, UT, USA Objective: Vascular disturbances leading to tissue hypoxia have been named as one of the possible causes of restless legs syndrome (RLS. Whole body vibration (WBV in healthy individuals results in nitric oxide (NO generation, which then leads to increased blood flow. The purpose of this investigation was to determine if WBV can: 1 improve skin blood flow, as measured in flux, in individuals with RLS, and 2 induce increases in NO blood concentration. The data were compared to healthy age-matched subjects. Design: Repeated measures, using two groups (RLS and control that underwent two treatments (WBV and sham (no vibration. Setting: Data collection occurred in an institutional setting. Patients: Ten subjects with RLS and ten controls. Methods: Subjects underwent a ten bout, 30-second per bout WBV and one sham treatment session. Blood drawn for NO analysis and flux measurements with laser Doppler were performed before, immediately after, and 5 minutes after the sessions. Main outcome measurements: The dependent variables, measured at three time intervals, were skin blood flow (flux as determined by laser Doppler imaging and blood nitric oxide concentration. Results: Baseline flux was significantly higher in the RLS group compared to control (P<0.001; flux in the RLS group immediately after WBV was significantly higher compared to baseline (P<0.05, sham treatment (P<0.05, and control group (P<0.05. There was no difference in NO concentration within subjects and between groups. Conclusion: Subjects with RLS have higher skin blood flow than controls and a greater increase in flux with WBV without concurrent increases in NO concentration from blood drawn at the antecubital fossa. Keywords: restless legs syndrome, flux, SBF, WBV, vascular disturbance

  9. Treatment of a complex posterior fossa aneurysm in a child using side-to-side posterior inferior cerebellar artery-posterior inferior cerebellar artery bypass.

    Chandela, Sid; Alzate, Juan; Sen, Chandranath; Song, Joon; Nimi, Yasunari; Berenstein, Alejandro; Langer, David

    2008-01-01

    Endovascular and cerebral bypass therapies are rarely used in children. The authors describe the treatment of a partially coiled giant distal vertebral artery (VA)-posterior inferior cerebellar artery (PICA) aneurysm in a child. They performed a side-to-side PICA-PICA anastomosis followed by endovascular VA aneurysm deconstruction with PICA preservation. A healthy 11-year-old boy developed progressive holocephalic headaches over the course of 2 months. Magnetic resonance imaging and magnetic resonance angiography revealed a large right PICA aneurysm causing brainstem compression. In November 2005, 2 Neuroform stents and Guglielmi detachable coils and Matrix were placed in the aneurysm at an outside institution. In 2006, angiography demonstrated aneurysm enlargement from which the PICA originated, coil compaction, and increased mass effect. The patient underwent a PICA-PICA bypass with intraoperative flow measurements followed by endovascular embolization of the aneurysm and parent VA. An angiogram obtained after the procedure demonstrated filling of the right PICA medullary branch through the bypass and obliteration of the aneurysm. The patient remained neurologically intact. Giant aneurysms of the posterior circulation are rare but do occur in children. With the aid of combined surgical and endovascular strategies the authors were able to safely eliminate the aneurysm from circulation with good outcome. Cerebral bypass and endovascular deconstructive therapies can be used safely in children but should be reserved for cases in which direct treatment carries significant risk. Careful surgical and endovascular planning with intraoperative flow assessment is essential for good outcome. PMID:18352808

  10. Formaciones Venosas de la Fosa Cubital en el Individuo Mapuche: Estudio Bioscópico Venous Formations in the Cubital Fossa of Mapuche: Bioscopy Study

    Mariano del Sol; Miguel Lagos Mardones; Edison Torres Bustos

    2007-01-01

    Las venas superficiales de la fosa cubital constituyen uno de los sitios más importantes para punción venosa. La disposición de esas venas presenta numerosas variaciones y, la disposición de ellas no ha sido estudiada en el grupo étnico mapuche. Debido a esto, y considerando a este grupo como el mayor conglomerado étnico de América del Sur, efectuamos este estudio. Fueron analizadas las venas superficiales de la fosa cubital, en 300 miembros superiores (150 derechos y 150 izquierdos) de indiv...

  11. Partial MEF2C deletion in a Cypriot patient with severe intellectual disability and a jugular fossa malformation: review of the literature.

    Tanteles, George A; Alexandrou, Angelos; Evangelidou, Paola; Gavatha, Marina; Anastasiadou, Violetta; Sismani, Carolina

    2015-03-01

    Deletions or intragenic mutations involving the MEF2C gene on chromosome 5q14.3 have generally been associated with a relatively uniform phenotype characterized by severe developmental delay, absent speech, stereotypies, absent or limited gait abilities, lack of a typical facial gestalt and scarcity of major malformations. We report on a patient of Cypriot descent with a de novo, approximately 147 kb in size, partial MEF2C deletion removing exons 1 to 3. He had a history of severe intellectual disability with absent speech, poor eye contact, hand stereotypies and a wide-based gait. A broad-based, shallow jugular pit with an overlying vascular malformation was also present. Partial MEF2C deletions have only been reported in a very small number of patients and have on occasion been associated with relatively milder phenotypes. We present a patient of Cypriot descent with such a deletion and review previously published literature on partial MEF2C gene deletions postulating a key role of the first few exons in the pathogenesis of the disease. PMID:25691421

  12. Facial herpes zoster infection precipitated by surgical manipulation of the trigeminal nerve during exploration of the posterior fossa: a case report

    Mansour Nassir; Kaliaperumal Chandrasekaran; Choudhari Kishor A

    2009-01-01

    Abstract Introduction We present a case of herpes zoster infection (shingles) precipitated by surgical manipulation of the trigeminal nerve root during an attempted microvascular decompression procedure. The pathogenesis of this phenomenon, as well as the importance and role of prophylactic acyclovir in its management, are discussed. Case presentation A 54-year-old Caucasian man with a classical long-standing left-sided V2 and V3 division primary trigeminal neuralgia refractory to medical man...

  13. RADIATION THERAPY QUALITY IN CCG/POG INTERGROUP 9961: IMPLICATIONS FOR CRANIOSPINAL IRRADIATION AND THE POSTERIOR FOSSA BOOST IN FUTURE MEDULLOBLASTOMA TRIALS

    BernadineDonahue; MaryAnneH.Marymont; SandraKessel; EmikoHolmes; MehmetKocak; RogerJ.Packer

    2012-01-01

    Purpose: Associations of radiation therapy (RT) deviations and outcomes in medulloblastoma have not been defined well, particularly in the era of reduced-dose craniospinal irradiation and chemotherapy. The aim of this study is to evaluate the quality of RT on Children’s Cancer Group/Pediatric Oncology Group 9961 and analyze associations of RT deviations with outcome. Materials and Methods: Major volume deviations were assessed based on the distance from specified anatomical region to field ed...

  14. FDG dose extravasations in PET/CT: frequency and impact on SUV measurements

    MedhatMOsman

    2011-11-01

    Full Text Available Objectives: PET/CT with 18F-FDG has proven to be effective in detecting and assessing various types of cancers. However, due to cancer and/or its therapy, intravenous (IV FDG injection may be problematic resulting in dose extravasations. In the most frequently used field of view (FOV, arms-up and base of skull to upper-thigh (limited Whole Body (LWB, the injection site may not be routinely imaged. The purpose of this study was to evaluate the frequency of dose extravasations in FDG PET and the potential impact on SUV measurements. Methods: True Whole Body (TWB FDG-PET/CT scans (including all extremities of 400 patients were retrospectively reviewed. A log recorded cases of IV dose extravasations. When possible, SUVs were measured in two frequently used reference locations: mediastinum and liver. The SUVs were obtained in the same patients who had studies with and without FDG extravasations within an average of 3 months without interval therapy. Results: Of the 400 scans, 42 (10.5% had extravasations on the maximum intensity projections (MIP images. In scans with or without dose infiltration, FDG injection site was at or distal to the antecubital fossa in 97% of studies. Of those 42 cases, dose infiltration was within the LWB FOV in 29/42 (69% and outside in the remaining 13/42 (31%. Of those 42 patients, 5 had repeat PET studies with no interval therapy. For those 5 patients, liver maximum SUV was 11.7% less in patients with infiltration than those without (2.22 ± 0.54 vs. 2.48 ± 0.6. Mediastinum SUVmax was 9.3% less in patients with infiltration than those without (1.72 ± 0.54 vs. 1.88 ± 0.49. Conclusion: We conclude dose extravasations were commonly encountered (10.5% in PET/CT. However, it is underreported by at least 31% due to omitting injection site from the FOV. When present, extravasations may lead to underestimation of SUVmax. Therefore, it should not only be avoided but also reported in order to avoid false interpretations of the exam.

  15. Mild episodes of tourniquet-induced forearm ischaemia-reperfusion injury results in leukocyte activation and changes in inflammatory and coagulation markers

    Bastawrous Salah S

    2007-05-01

    Full Text Available Abstract Background Monocytes and neutrophils are examples of phagocytic leukocytes, with neutrophils being considered as the 'chief' phagocytic leukocyte. Both monocytes and neutrophils have been implicated to play a key role in the development of ischaemia-reperfusion injury, where they are intrinsically involved in leukocyte-endothelial cell interactions. In this pilot study we hypothesised that mild episodes of tourniquet induced forearm ischaemia-reperfusion injury results in leukocyte activation and changes in inflammatory and coagulation markers. Methods Ten healthy human volunteers were recruited after informed consent. None had any history of cardiovascular disease with each subject volunteer participating in the study for a 24 hour period. Six venous blood samples were collected from each subject volunteer at baseline, 10 minutes ischaemia, 5, 15, 30, 60 minutes and 24 hours reperfusion, by means of a cannula from the ante-cubital fossa. Monocyte and neutrophil leukocyte sub-populations were isolated by density gradient centrifugation techniques. Leukocyte trapping was investigated by measuring the concentration of leukocytes in venous blood leaving the arm. The cell surface expression of CD62L (L-selectin, CD11b and the intracellular production of hydrogen peroxide (H2O2 were measured via flow cytometry. C-reactive protein (CRP was measured using a clinical chemistry analyser. Plasma concentrations of D-dimer and von Willebrand factor (vWF were measured using enzyme-linked fluorescent assays (ELFA. Results During ischaemia-reperfusion injury, there was a decrease in CD62L and an increase in CD11b cell surface expression for both monocytes and neutrophils, with changes in the measured parameters reaching statistical significance (p =2O2 production by leukocyte sub-populations, which was measured as a marker of leukocyte activation. Intracellular production of H2O2 in monocytes during ischaemia-reperfusion injury reached statistical significance (p = 0.014, although similar trends were observed with neutrophils these did not reach statistical significance. CRP was measured to assess the inflammatory response following mild episodes of ischaemia-reperfusion injury and resulted in a significant increase in the CRP concentration (p = Conclusion Tourniquet induced forearm ischaemia-reperfusion injury results in increased adhesiveness, trapping and activation of leukocytes. We report that, even following a mild ischaemic insult, this leukocyte response is immediately followed by evidence of increased inflammatory response, coagulation activity and endothelial damage. These results may have important implications and this pilot study may lead to a series of trials that shed light on the mechanisms of ischaemia-reperfusion injury, including potential points of therapeutic intervention for pathophysiological conditions.

  16. Impaired hyperemic response is predictive of early access failure.

    Wall, L Philipp; Gasparis, Antonios; Callahan, Susan; van Bemmelen, Paul; Criado, Enrique; Ricotta, John

    2004-03-01

    The aim of this study was to demonstrate that hyperemic response is a predictor of access failure. We conducted a review of a prospective database of dialysis access patients with preoperative hyperemia studies from June 1998 to August 2002. These consisted of bilateral brachial artery pressures followed by flow velocity measurements of the brachial artery and radial artery at rest and after 3 min of arm ischemia. Measurements were taken by using a cuff placed above the antecubital fossa and inflated to 20 mmHg above systolic pressure. There were no differences recorded in brachial artery pressures for the bilateral studies. Hyperemic response was entered into a stepwise Cox regression to determine its effect on access failure. Access failure was defined as failure to mature or thrombosis. Accesses were placed according to Dialysis Outcome Quality Intiatives (DOQI) guidelines. Kaplan-Meier survival analysis was performed. Log-rank testing was used to compare patency results. Censored end points were death, renal transplant, and access survival to the end of the study period. Fistulas that failed to mature were considered failures at 3 months. Arteries with a <5 cm/sec increase in peak systolic velocity were defined as nonresponders. The 59 arteries used for dialysis access were divided into two groups on the basis of their hyperemic response in cm/sec. The nonresponders were compared with the remainder of accesses performed. Accesses based on arteries with absent or minimal hyperemic response had significantly lower (p < 0.0005) secondary patencies by Kaplan-Meier analysis. Upon further stratification into radial and brachial arteries, the significant difference in secondary patency remained for radial artery--based accesses (p = 0.024) and approached statistical significance for brachial artery--based accesses (p = 0.057). A significant difference was not seen in primary patencies, indicating that accesses based on arteries with an acceptable hyperemic response are more likely to be salvaged by revisions. A nonresponsive radial artery was not a significant predictor of a nonresponsive brachial artery in the same extremity by binary logistic regression (p = 0.111), and a nonresponsive artery was not a significant predictor of nonresponsiveness in the corresponding artery in the contralateral extremity (p = 0.137). Cox regression analysis revealed that the hyperemic response is a significant predictor of failure to mature or thrombosis. Hyperemic testing is a useful means of evaluating adequate arterial inflow for dialysis access. Reduced or absent hyperemic response is an independent predictor of access failure. PMID:15253251

  17. NECROLISIS EPIDERMICA TOXICA. DESCRIPCION DE DOS CASOS. ERUPCIÓN CUTÁNEA SEVERA PRODUCIDA POR FÁRMACOS COMUNES TOXICAL EPIDERMAL NECROLYSIS. REPORT OF TWO CASES. SEVERE SKIN RASH CAUSED BY COMMON DRUGS

    Liz Lezcano

    2013-10-01

    Full Text Available Reacción adversa a medicamentos (RAM es definida por la OMS como cualquier respuesta a un medicamento, que sea nociva e inesperada, que ocurre a dosis normalmente utilizadas en el ser humano para profilaxis, diagnóstico, terapia de enfermedad o para modificación de la función fisiológica. Cuando RAM compromete a la piel se denomina farmacodermia, dermatosis medicamentosa o toxicodermia, la cual ocurre en el 1% de pacientes ambulatorios y 2-5 % de pacientes hospitalizados. La OMS acepta que el 2% de todas las reacciones adversas a fármacos (RAM son severas (Farmacodermia grave=FG. Son más frecuentes en mujeres, ancianos y pacientes con SIDA. La mayoría de las farmacodermias son leves, pero éstas pueden de inicio ser reacciones severas. 1 de cada 1.000 pacientes hospitalizados sufre una FG, dentro de las cuales se incluyen al síndrome de Stevens Johnson (SSJ y la Necrolisis Epidérmica Tóxica (NET. El Síndrome de Stevens Johnson (SSJ y la Necrolisis Epidérmica Tóxica (NET son reacciones cutáneas graves, con un potencial de morbilidad y mortalidad elevadas, ocurre en 0.4-2 casos por millón de habitantes por año para el SSJ y para la NET en 1.2-6.0 casos millón de habitantes por año. Se presenta en pacientes de todas las edades, razas y sexo. Estas patologías constituyen una verdadera emergencia dermatológica, donde su cuidado y manejo deben ser multidisciplinarios.

  18. Eritema infeccioso: un exantema infantil a considerar en la práctica diaria Fifth disease or infectious erythema: a childhood rash to consider in the daily medical practice

    AD Pérez-Elizondo

    Full Text Available Se presenta el caso de un escolar con febrícula y leve ataque del estado general, quien desarrolla una erupción maculosa en mejillas, pocos días después un exantema en "encaje" o reticulado en tronco posterior y parte proximal de extremidades inferiores, compatible con la quinta enfermedad y confirmado por la morfología lesional característica y la inmuno-serología (IgM.We present a five years old child with a mild fever and malaise, a maculoedematous eruption on cheeks and a "lace" exanthema located on posterior aspect of the trunk and lower limbs, developed after a few days. A fifth disease was diagnosticated based on characteristic morphological presentation and immunoserological studies.

  19. Estudio de las Venas de la Fosa Cubital a través de la Tomografía Computada Helicoidal y su Aplicación Clínica Study of the Veins of the Cubital Fossa by Helical Computed Tomography and its Clinical Application

    Mariano del Sol; Eugenio Lillo; Leonardo Lobos; Bélgica Vásquez

    2012-01-01

    Las venas superficiales de la fosa cubital, constituyen uno de los sitios más importantes de punción venosa. La disposición de estas venas presenta numerosas variaciones. Su anatomía no ha sido estudiada aplicando los avances tecnológicos en el campo de la medicina, como la tomografía computada helicoidal. Fueron analizadas mediante tomografía axial computada helicoidal, las formaciones venosas de la fosa cubital en 60 individuos chilenos de ambos sexos, de edades entre 10 y 86 años, de la IX...

  20. Radiotherapy of posterior cerebral fossa medulloblastomas: comparison of conformational approaches by photons and protons; Radiotherapie de la fosse cerebrale posterieure des medulloblastomes: comparaison d'approches conformationnelles par photons et par protons

    Chaurin, P.; Abdulkarim, B.; Beaudre, A.; Le Pechoux, C.; Biron, B.; Ibrahim, M.; Habrand, J.L. [Institut Gustave Roussy, Dept. de Radiotherapie, 94 - Villejuif (France); Chaurin, P. [Hopital d' Instruction des Armees du Val-de-Grace, Clinique de Radiotherapie et Oncologie, 75 - Paris (France); Hartman, O. [Institut Gustave Roussy, Dept. de Pediatrie, 94 - Villejuif (France); Ferrand, R.; Habrand, J.L. [Paris-11 Univ., Centre de Protontherapie d' Orsay, CPO, 91 - Orsay (France)

    2000-12-01

    It exists an indisputable advantage in favour of protons according to the homogeneity, conformity and tissues protection that should manifest by a significant decrease of neurological, cognitive, and endocrinal delayed aftereffects. (N.C.)