WorldWideScience
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"CEPHALIC VEIN ANATOMY IN ANTECUBITAL FOSSA DURING THE CONSTRUCTION OF ARTERIOVENOUS FISTULA"  

Directory of Open Access Journals (Sweden)

Full Text Available In order to create an effective arteriovenous fistula (AVF in patients with sustained chronic renal failure (CRF, surgeons need to become familiar with various anatomical variations of venous structures in the operating field. Because of variety and different types of cubital venous anatomies, there is more than a 90% possibility of creating suitable AVFs in the cubital fossa , but in the wrist and forearm, due to old injections and thrombophlebitis, there is less chance to do so. Since cephalic vein is the main venous conduit for constructing an AVF in the antecubital region, this study focuses on the various anatomical variations of cephalic vein and its communicating branches. We studied the cubital cephalic anatomy of 103 patients with CRF during construction of an AVF from July 1999 to June 2001. Five types of cephalic vein anatomy were seen: type A (44.66%, type B (30.1%, type C (18.44%, type D (3.88% and type E (2.29% in 39 right and 64 left arms. Seventy-six anastomoses were performed to brachial trunk, 25 to the radial and 2 to the ulnar artery. Eleven cases with progressive swelling after AVF were uneventfully cured by hand elevation. No infection, false aneurysm, venous hypertension or steal syndrome was detected. In order to obtain the best results and select appropriate operative technique for reliable vascular access in CRF, it is necessary to understand the anatomical variety of cephalic vein.

S. M. Alamshah

2004-08-01

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"CEPHALIC VEIN ANATOMY IN ANTECUBITAL FOSSA DURING THE CONSTRUCTION OF ARTERIOVENOUS FISTULA"  

OpenAIRE

In order to create an effective arteriovenous fistula (AVF) in patients with sustained chronic renal failure (CRF), surgeons need to become familiar with various anatomical variations of venous structures in the operating field. Because of variety and different types of cubital venous anatomies, there is more than a 90% possibility of creating suitable AVFs in the cubital fossa , but in the wrist and forearm, due to old injections and thrombophlebitis, there is less chance to do so. Since cep...

Alamshah, S. M.

2004-01-01

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Colgajo de perforantes de la arteria colateral cubital inferior para defectos por quemadura eléctrica en fosa cubital / Inferior ulnar collateral perforators flap to cover defects on antecubital fossa after electrical burn  

Scientific Electronic Library Online (English)

Full Text Available Las quemaduras eléctricas producen lesiones profundas, especialmente las debidas a la entrada y salida de la corriente y al arco voltaico, que pueden dejar expuestas estructuras nobles y afectar áreas de flexo-extensión, como la fosa antecubital. Los defectos resultantes pueden cubrirse mediante col [...] gajos libres o pediculados de brazo y antebrazo. Entre las distintas opciones quirúrgicas, el colgajo medial del brazo evita la interrupción de los ejes vasculares mayores y la secuela en la zona donante es discreta. Sin embargo, su uso está poco extendido por considerarse un colgajo de difícil disección debido a la variabilidad anatómica de las arterias colaterales cubitales superior e inferior que lo irrigan. Presentamos la cobertura para un defecto secundario a quemadura eléctrica en la fosa antecubital mediante un colgajo medial del brazo basado en las ramas perforantes de la arteria colateral cubital inferior. Aunque confirmamos en este caso la variabilidad vascular, la disección resultó sencilla y el resultado estético y funcional fue excelente. Abstract in english Electrical burns result in deep injury to tissues, especially those lesions produced by entrance and exit of electric flow and voltaic arc, that expose structures such as tendons, nerves or vessels when it happens at the antecubital fossa. Defects produced by electrical burns can be covered using fr [...] ee flaps or local pedicled flaps from arm and forearm. Among different surgical procedures, medial arm flap is a useful one, as it avoids interruption of main vascular axis of the arm and donor site sequelae are minimal. Never the less, its use is not extended due to its difficult dissection, as because the pedicle of the flap has a highly variable anatomical vascularity (superior and inferior ulnar collateral artery). We present a defect produced by electrical burn and its coverage using a local flap based on perforator branches from inferior ulnar collateral artery. Although vascular variability was confirmed, dissection was easy and an aesthetical and functional outcome was achieved.

I., González-Alaña; J.V., Torrero-López; M., Llop-Adrián; P., Martín-Playá; F.J., Gabilondo Zubizarreta.

2014-09-01

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Severe, traumatic soft-tissue loss in the antecubital fossa and proximal forearm associated with radial and/or median nerve palsy: nerve recovery after coverage with a pedicled latissimus dorsi muscle flap.  

Science.gov (United States)

A total of 6 patients with complex, traumatic wounds of the antecubital fossa and proximal forearm were included in this study. All patients presented with radial and/or median nerve palsies in addition to their soft-tissue defect. Except for 1 patient with a 15-cm defect of the radial nerve, all other traumatized nerves appeared in-continuity at the time of surgery. However, the nerve injury was severe enough to induce Wallerian degeneration (i.e., axonotmesis in traumatized nerves in-continuity). Three patients required brachial artery reconstruction with a reverse saphenous vein graft. Wound coverage was accomplished using a pedicled latissimus dorsi muscle flap, which was covered with a split-thickness skin graft. Successful reconstruction was obtained in all patients. Follow-up ranged from 2 to 6 years. The range of motion at the elbow and forearm was considered excellent in 5 patients and good in the remaining patient who had an intra-articular fracture. Motor recovery of traumatized nerves in-continuity was observed in all but 1 patient who had persistent partial anterior interosseous nerve palsy. The grip strength of the injured hand measured 70% to 85% of the contralateral uninjured hand. Median nerve sensory recovery was excellent in all patients. The versatility of the pedicled latissimus dorsi muscle flap for coverage of these complex wounds with traumatized neurovascular bundles around the elbow is discussed. PMID:11216605

Al-Qattan, M M

2001-02-01

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Preventing Diaper Rash  

Science.gov (United States)

... on this page, please enable JavaScript. Preventing Diaper Rash Dermatologist shares tips for protecting your baby's skin (* ... Infant and Newborn Problems Infant and Newborn Care Rashes WEDNESDAY, Dec. 31, 2014 (HealthDay News) -- Diaper rash ...

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Claritas Fossae  

Science.gov (United States)

(Released 20 June 2002) The Science The eastern rim of this unnamed crater in Claritas Fossae is very degraded. This indicates that this crater is very ancient and has been subjected to erosion and subsequent bombardment from other impactors such as asteroids and comets. One of these later (younger) craters is seen in the upper right of this image superimposed upon the older crater rim material. Note that this smaller younger crater rim is sharper and more intact than the older crater rim. This region is also mantled with a blanket of dust. This dust mantle causes the underlying topography to take on a more subdued appearance. The Story Not every crater on Mars has a name. The one in this image doesn't. What would you name it if you could? That's what planetary scientists ask themselves when they come across such features. If they think of a good name, they can submit it for approval to a group of world astronomers who are members of the International Astronomical Union. There are special rules, though, so not any name can be selected. The selection committee especially wants to make sure that all world cultures are represented. While this crater may not have a name, the region it lies in does. It is called Claritas Fossae. 'Claritas' is the Latin word for 'bright.' 'Fossae' are long, narrow, shallow depressions that mark the region. You can see these best in the context image to the right. You can tell just by looking at this crater that it is very ancient. Its rim is very degraded from erosion and bombardment from other impactors such as asteroids and comets. Compare its roughened rim to the smoother outline of the small crater on the rim's edge (upper right). The smoother rim of the small one means that it is considerably younger than its older, choppier neighbor. You know it was certainly created after the large crater because it lies on top of the rim. Other than the old and young generations of craters, the surface looks pretty uniform in hue and perhaps even a little dull. That's because a coating of dust lies over the area, masking some of the contrasts in terrain that might lie beneath.

2002-01-01

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Olmesartan: induced maculopapular rash.  

Science.gov (United States)

Olmesartan medoxomil is an angiotensin receptor blocker (ARB) which is shown to be effective and well tolerated in hypertensive patients. It is a frequently prescribed antihypertensive as it is considered safe. Here, we report the case of a patient who developed maculopapular rash during the course of the treatment with olmesartan medoxomil. PMID:23716904

Bhushan, Aruna; Ved Bhushan, S T

2013-01-01

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Posterior fossa malformations.  

Science.gov (United States)

Understanding embryologic development of the cerebellum and the 4th ventricle is essential for understanding posterior fossa malformations. Posterior fossa malformations can be conveniently classified into those that have a large posterior fossa and those with normal or small posterior fossa. Disorders associated with a large posterior fossa include classic Dandy-Walker malformation, Blake's pouch cyst, mega cisterna magna, and posterior fossa arachnoid cyst. Disorders associated with normal or small posterior fossa include Dandy-Walker variant, Joubert syndrome, tecto-cerebellar dysraphia, rhombencephalosynapsis, the neocerebellar hypoplasias, and cerebellar atrophy. Neuro-imaging features should enable the imager to provide the referring physician a logical approach to these complex posterior fossa malformations. PMID:21596278

Shekdar, Karuna

2011-06-01

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A purpuric rash.  

Science.gov (United States)

Kelly is 28 years of age and a recreational sea swimmer and surfer. He presented with a rash on both arms of 6 months duration. Kelly said a similar eruption occurred 12 months previously and resolved in a few weeks with 1% hydrocortisone cream. He has no significant past history, is not on any medication, and there is no recent history of trauma or contact with insects or animals. Physical examination revealed multiple, flat, nonblanching dark red lesions on the medial aspect of both arms (Figure 1, 2). The rest of the physical examination was unremarkable. Full blood examination revealed normal levels of haemoglobin, white cells and platelets, and coagulation studies are normal. PMID:19893836

Aguayo-Leiva, Ingrid; Vano-Galvan, Sergio; Arrazola, Jose-Maria

2009-11-01

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Posterior fossa epidural hematoma  

International Nuclear Information System (INIS)

CT demonstrated posterior fossa epidural hematoma in three patients with head trauma in whom this diagnosis was not clinically apparent. No patient was in stupor or coma and no patient experienced a lucid interval. Only one patient had signs referable to the posterior fossa. Two patients had occipital skull fracture disclosed by plain radiographs. CT revealed a unilateral biconvex hematoma in two cases, and a bilateral hematoma with supratentorial extension in the third. All patients underwent suboccipital craniectomy and recovered. Therapeutic success in these cases was facilitated by early CT and the rapid disclosure of the unsuspected posterior fossa lesions. CT showing contiguous hematoma below and above the tentorium cerebelli after posterior head trauma is highly suggestive of epidural hematoma arising from the posterior fossa. (orig.)

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Allergic Rash: Does It Exist?  

OpenAIRE

IgE-mediated urticaria and angioedema, serum sickness and idiosyncratic mechanisms all cause rashes. However, only mechanisms involving IgE should be labelled allergic, and they are the only ones with potentially fatal results. The most common type of rash seen by an allergy specialist is urticaria, acute and chronic. Acute urticaria lasts less than six to eight weeks and is most often caused by infection, medication and some foods. Chronic urticaria is caused by animal dander, ASA, certain f...

Greenbaum, Joseph

1982-01-01

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New Itchy Skin Rashes in Children  

Science.gov (United States)

newsletter | contact Share | New Itchy Skin Rashes in Children A A A There are many types of skin rashes. A rash is an outbreak of many red bumps or ... the skin. Many conditions can cause an itchy rash. In children, viral infections and scabies are common, ...

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A Chinese New Year rash  

Directory of Open Access Journals (Sweden)

Full Text Available A 28-year-old man presented with a chief complaint of rashes all over his body. He had a history of a trip to Langkawi Island, a famous island resort off the west coast of Malaysia, over the Chinese New Year’s weekend. According to him, he had a lot of fun with a group of friends at the sunny beach and the beautiful sea. There were no untoward incidents and they were perfectly well when they returned home after a 2-day trip. On the evening of the second day after his return, he noticed rashes appearing over his body, notably on shoulders and trunk. These rashes were little painful in nature.

Keah SH

2013-10-01

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A Chinese New Year rash  

OpenAIRE

A 28-year-old man presented with a chief complaint of rashes all over his body. He had a history of a trip to Langkawi Island, a famous island resort off the west coast of Malaysia, over the Chinese New Year’s weekend. According to him, he had a lot of fun with a group of friends at the sunny beach and the beautiful sea. There were no untoward incidents and they were perfectly well when they returned home after a 2-day trip. On the evening of the second day after his return, he noticed rash...

Sh, Keah; Ks, Chng

2013-01-01

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"Hot Tub Rash" and "Swimmer's Ear" (Pseudomonas)  

Science.gov (United States)

... Tub Rash” and “Swimmer’s Ear” (Pseudomonas) What is Pseudomonas and how can it affect me? Pseudomonas (sue- ... a health care provider for treatment. How is Pseudomonas spread? Hot tub rash can occur if contaminated ...

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Rashes  

Science.gov (United States)

... Jr. Plant-induced dermatitis. In: Auerbach PS, ed. Wilderness Medicine . 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007: ... Elsevier; 2011:chap 444. Werth VP. Principles of therapy of skin diseases. In: Goldman L, Ausiello D, ...

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Rash  

Science.gov (United States)

... possible desensitization therapy. You also may need a bee-sting kit, which contains emergency medication to prevent potentially life-threatening reactions. Make sure you know where the kit is at home and consider getting an extra one if you ...

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Heat Rash or Prickly Heat (Miliaria Rubra)  

Science.gov (United States)

... heat rash consist of controlling heat and humidity. Acetaminophen or ibuprofen can help to reduce fever, which ... may be given. Dehydration may be treated with intravenous fluids, especially if there is vomiting. Heat stroke ...

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Drug Rash (Unclassified Drug Eruption) in Adults  

Science.gov (United States)

newsletter | contact Share | Drug Eruption, Unclassified Information for adults A A A Acute drug eruption with numerous red, raised lesions. Overview A drug rash (drug eruption), also known as a drug ...

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Epidural hematomas of posterior fossa  

Directory of Open Access Journals (Sweden)

Full Text Available Background. Posterior fossa epidural hematomas represent 7-14% of all traumatic intracranial epidural hematomas. They are most frequently encountered posttraumatic mass lesions in the posterior fossa. The aim of this study was to identify clinical features that could lead to the early diagnosis of posterior fossa epidural hematoma. Methods. Between 1980 and 2002, 28 patients with epidural hematoma of the posterior fossa were operated on at the Institute for Neurosurgery, Belgrade. Clinical course neuroradiological investigations, and the results of surgical treatment of the patients with posterior fossa epidural hematomas were analyzed retrospectively. Results. Almost two thirds of patients were younger than 16 years of age. In 20 cases injury was caused by a fall, in 6 cases by a traffic accident, and in 2 by the assault. Clinical course was subacute or chronic in two thirds of the patients. On the admission Glasgow Coma Scale was 7 or less in 9 injured, 8-14 in 14 injured, and 15 in 5 injured patients. Linear fracture of the occipital bone was radiographically evident in 19 patients, but was intraoperatively encountered in all the patients except for a 4-year old child. In 25 patients the diagnosis was established by computer assisted tomography (CAT and in 3 by vertebral angiography. All the patients were operated on via suboccipital craniotomy. Four injured patients who were preoperatively comatose were with lethal outcome. Postoperatively, 24 patients were with sufficient neurologic recovery. Conclusion. Posterior fossa epidural hematoma should be suspected in cases of occipital injury, consciousness disturbances, and occipital bone fracture. In such cases urgent CAT-scan is recommended. Early recognition early diagnosis, and prompt treatment are crucial for good neurological recovery after surgery.

Radulovi? Danilo

2004-01-01

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Erythema Gyratum Repens: A Rare Paraneoplastic Rash  

Directory of Open Access Journals (Sweden)

Full Text Available Erythema gyratum repens (EGR is a rare, and characteristic, paraneoplastic rash associated with a variety of malignancies, most notably lung, esophageal, and breast cancers. This case report details the appearance, epidemiology, diagnosis, and treatment of EGR. Prompt identification of EGR is essential, as the rash often precedes the diagnosis of malignancy by several months. Urgent patient referral to evaluate for malignancy is crucial, as this may lead to decreased morbidity and mortality. [West J Emerg Med. 2011;12(4:556–558.

Michael E Winters

2011-05-01

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Traumatic posterior fossa epidural hematoma  

International Nuclear Information System (INIS)

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)

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Methylenetetrahydrofolate reductase (MTHFR) deficiency presenting as a rash.  

LENUS (Irish Health Repository)

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.

Crushell, Ellen

2012-09-01

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21 CFR 872.3950 - Glenoid fossa prosthesis.  

Science.gov (United States)

...2010-04-01 false Glenoid fossa prosthesis. 872.3950 Section 872.3950...Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to...

2010-04-01

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Clonazepam induced maculopapular rash: a case report  

OpenAIRE

Clonazepam is a benzodiazepine with prominent anticonvulsant action than other members of the group at equisedating doses. It especially blocks pentylenetetrazole-induced seizures. Other important actions include anxiolysis. Common adverse effects to Clonazepam include drowsiness and lethargy. In this submission we report a case of Clonazepam induced maculopapular rash in a 30 year old female treated for panic disorder. [Int J Basic Clin Pharmacol 2013; 2(5.000): 647-649

Mabu Shareef, S.; Sai Krishna, P.; Tadvi, Naser A.; Naidu, C. Dinesh M.

2013-01-01

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Clonazepam induced maculopapular rash: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Clonazepam is a benzodiazepine with prominent anticonvulsant action than other members of the group at equisedating doses. It especially blocks pentylenetetrazole-induced seizures. Other important actions include anxiolysis. Common adverse effects to Clonazepam include drowsiness and lethargy. In this submission we report a case of Clonazepam induced maculopapular rash in a 30 year old female treated for panic disorder. [Int J Basic Clin Pharmacol 2013; 2(5.000: 647-649

S. Mabu Shareef

2013-10-01

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Pathology Case Study: Skin Rash and Proteinuria  

Science.gov (United States)

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 8-year-old boy has a history of skin rash with concurrent hematuria and proteinuria. Visitors are given the microscopic and gross descriptions, immunoflourescent and electron microscopy findings, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in renal pathology.

Dickman, Paul S.

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Leflunomide Induced Drug Rash And Hepatotoxicity  

Directory of Open Access Journals (Sweden)

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.

Uppal Monica

2004-01-01

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Geometric morphometrics of hominoid infraspinous fossa shape.  

Science.gov (United States)

Recent discoveries of early hominin scapulae from Ethiopia (Dikika, Woranso-Mille) and South Africa (Malapa) have motivated new examinations of the relationship between scapular morphology and locomotor function. In particular, infraspinous fossa shape has been shown to significantly differ among hominoids. However, this region presents relatively few homologous landmarks, such that traditional distance and angle-based methods may oversimplify this three-dimensional structure. To more thoroughly assess infraspinous fossa shape variation as it relates to function among adult hominoid representatives, we considered two geometric morphometric (GM) approaches--one employing five homologous landmarks ("wireframe") and another with 83 sliding semilandmarks along the border of the infraspinous fossa. We identified several differences in infraspinous fossa shape with traditional approaches, particularly in superoinferior fossa breadth and scapular spine orientation. The wireframe analysis reliably captured the range of shape variation in the sample, which reflects the relatively straightforward geometry of the infraspinous fossa. Building on the traditional approach, the GM results highlighted how the orientation of the medial portion of the infraspinous fossa differed relative to both the axillary border and spine. These features distinguished Pan from Gorilla in a way that traditional analyses had not been able to discern. Relative to the wireframe method, the semilandmark approach further distinguished Pongo from Homo, highlighting aspects of infraspinous fossa morphology that may be associated with climbing behaviors in hominoid taxa. These results highlight the ways that GM methods can enhance our ability to evaluate complex aspects of shape for refining and testing hypotheses about functional morphology. PMID:25339150

Green, David J; Serrins, Jesse D; Seitelman, Brielle; Martiny, Amy R; Gunz, Philipp

2015-01-01

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RASH D - A mercury programme for neutron shielding calculations  

International Nuclear Information System (INIS)

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)

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Late presentation of sorafenib-associated rash: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Sorafenib, an oral multitargeted tyrosine kinase inhibitor, is licensed for the treatment of hepatocellular carcinoma. Rash is one of the most common side effects of its use, generally appearing within days to a few weeks of commencing treatment. We report the first case of rash appearing nine months after starting treatment with sorafenib. Case presentation A 75-year-old Caucasian man initially presented with asymptomatic transient jaundice. He was diagnosed with Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma after extensive investigation. He tolerated sorafenib 400 mg twice a day before presenting nine months later with a rash, confirmed to be drug-induced. Conclusions Sorafenib is a drug of choice in Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma. It can cause protracted rash quite late into treatment. Successful management of the rash could contribute to achieving stable disease in hepatocellular carcinoma over a significant period of time.

Ross Paul

2010-10-01

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Arachnoid cyst of the middle cranial fossa  

International Nuclear Information System (INIS)

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 specificits, thereby improving diagnostic specificity and patient management. (author)

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Not all that rashes is measles:  

International Nuclear Information System (INIS)

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)

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Rash y anemia aplásica inducidos por fenitoína: caso clínico Phenytoin-induced rash and aplastic anemia: case report  

Directory of Open Access Journals (Sweden)

Full Text Available El rash es un efecto secundario común asociado al uso de fármacos antiepilépticos. La frecuencia de rash con fenitoína se ha estimado en un 5,9% y asciende a un 25% en pacientes que han presentado rash con otro fármaco antiepiléptico. La anemia aplásica es una anomalía adquirida de las células madre hematopoyéticas caracterizada por pancitopenia de la sangre periférica y médula ósea hipocelular. Los pacientes tratados con fenitoína presentan un riesgo 3,5 veces mayor de desarrollar anemia aplásica. Presentamos el caso de una mujer de 70 años que desarrolló dos reacciones adversas severas y simultáneas a la fenitoína: un exantema maculopapular pruriginoso con compromiso de mucosas y una anemia aplásica. Ambas condiciones se resolvieron completamente con la suspensión del fármaco.Rash is a common side effect associated with antiepileptic drugs. The rate of a phenytoin rash is 5.9% and increases to 25% in those with another antiepileptic drug rash. Aplastic anemia is an adquired hematopoietic stem-cell disorder characterized by pancytopenia of the peripheral blood and hypocellular bone marrow. The use of phenytoin is associated with a 3.5 fold increased risk of aplastic anemia. We report a case of a 70-year-old woman who developed two severe adverse reactions simultaneously with phenytoin: a maculopapular pruritic rash with involvement of mucous and an aplastic anemia. Both conditions normalized after phenytoin withdrawal.

Álvaro Soto V

2011-01-01

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Rash y anemia aplásica inducidos por fenitoína: caso clínico / Phenytoin-induced rash and aplastic anemia: case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish El rash es un efecto secundario común asociado al uso de fármacos antiepilépticos. La frecuencia de rash con fenitoína se ha estimado en un 5,9% y asciende a un 25% en pacientes que han presentado rash con otro fármaco antiepiléptico. La anemia aplásica es una anomalía adquirida de las células madre [...] hematopoyéticas caracterizada por pancitopenia de la sangre periférica y médula ósea hipocelular. Los pacientes tratados con fenitoína presentan un riesgo 3,5 veces mayor de desarrollar anemia aplásica. Presentamos el caso de una mujer de 70 años que desarrolló dos reacciones adversas severas y simultáneas a la fenitoína: un exantema maculopapular pruriginoso con compromiso de mucosas y una anemia aplásica. Ambas condiciones se resolvieron completamente con la suspensión del fármaco. Abstract in english Rash is a common side effect associated with antiepileptic drugs. The rate of a phenytoin rash is 5.9% and increases to 25% in those with another antiepileptic drug rash. Aplastic anemia is an adquired hematopoietic stem-cell disorder characterized by pancytopenia of the peripheral blood and hypocel [...] lular bone marrow. The use of phenytoin is associated with a 3.5 fold increased risk of aplastic anemia. We report a case of a 70-year-old woman who developed two severe adverse reactions simultaneously with phenytoin: a maculopapular pruritic rash with involvement of mucous and an aplastic anemia. Both conditions normalized after phenytoin withdrawal.

Álvaro, Soto V; Manuel, Lavados M; Fernando, Araya D.

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Radiographic imaging of the canine intercondylar fossa  

International Nuclear Information System (INIS)

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

37

[Posterior fossa extradural and extracranial hydatid cyst].  

Science.gov (United States)

Hydatidosis is an endemic disease in Morocco. Cerebral echinococcosis is a relatively rare entity accounting for only 1-2% of all hydatid cysts in humans. Extradural hydatid cyst of the posterior fossa is a very uncommon site for the disease: only four cases have been reported in the literature. We report the case of a 37-year-old admitted for high intracranial pressure. Brain MRI showed an extradural and extracranial posterior fossa cyst without enhancement after contrast medium injection. Multiple hydatid cysts were removed and the histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole postoperatively with good follow-up 6 months later. PMID:20138319

Lakhdar, F; Arkha, Y; Bougrine, M; Derraz, S; El Ouahabi, A; El Khamlichi, A

2010-10-01

38

Decompressive Craniectomy in Posterior Fossa Ischemic Stroke  

Directory of Open Access Journals (Sweden)

Full Text Available Ischemic damage produced in the posterior cerebral territory causes significant morbidity and urgently must be considered if the patient need a surgical attitude. Surgical decompression by suboccipital craniectomy seams to be effective to treat secondary edema due to cerebellar damage or in posterior fossa, when medical treatment is not able to control side effects. We report a clinical case of a patient with a subacute ischemic infarction in the vertebro-basilar territory, with perilesional edema, and a posterior fossa decompressive craniectomy (DC was carried out.

Manuel Sánchez-Palacios

2012-07-01

39

Red, Itchy Rash? Get the Skinny on Dermatitis  

Science.gov (United States)

... External link, please review our exit disclaimer . Subscribe Red, Itchy Rash? Get the Skinny on Dermatitis You’ ... unusual. Why does your skin break out in red blotches like that? More important, is there anything ...

40

A Case Report on Allergic Rash Caused by Icodextrin  

Science.gov (United States)

Icodextrin may be used as an alternative to glucose as the osmotic agent in peritoneal dialysis with ultrafiltration failure. In general, icodextrin is known to be safe and well tolerated, but it can also cause hypersensitivity reactions such as skin rashes. Allergic rashes are generally defined as erythematous, itchy and maculopapular, visible over the trunk and the extremities. When a rash occurs, it generally develops early in therapy, is self-limited, and resolves without sequelae after the discontinuation of icodextrin. Although the safety and efficacy of icodextrin peritoneal dialysis solution is well documented, clinicians should be aware of the possibility of severe adverse cutaneous reactions to it. We report the case of a 23-year-old female who developed a skin rash following the use of icodextrin.

Cevher, ?imal Köksal; Ozkayar, Nihal; Dede, Fatih

2015-01-01

41

Painful and petechial rash after injecting black tar heroin.  

Science.gov (United States)

Abstract A painful petechial rash developed in a patient after the subcutaneous or intravenous injection of reported black tar heroin. Additional history and the appearance of the skin lesion suggested otherwise. PMID:25597468

Hendrickson, R G

2015-02-01

42

Contact Dermatitis: Tips for Getting Rid of the Rash  

Science.gov (United States)

... Many things can cause a rash, including your wedding ring, glasses, clothing, and cell phone. Sometimes you ... metal found in many pieces of jewelry. A wedding ring can cause this problem. In fact, this ...

43

Ceftriaxone induced drug rash with eosinophilia and systemic symptoms  

Science.gov (United States)

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a drug reaction commonly occurring in association with aromatic anticonvulsants and allopurinol. It is characterized by triad of fever, skin eruption, and systemic involvement. DRESS is rare with beta-lactam antibiotics and even rarer with ceftriaxone. We describe a case of pneumonia who developed ceftriaxone-induced rash, bicytopenia, eosinophilia, transaminitis and was eventually diagnosed and managed successfully as a case of DRESS. PMID:25114941

Guleria, Vivek S.; Dhillon, Mukesh; Gill, Shaman; Naithani, Nardeep

2014-01-01

44

Ceftriaxone induced drug rash with eosinophilia and systemic symptoms  

OpenAIRE

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a drug reaction commonly occurring in association with aromatic anticonvulsants and allopurinol. It is characterized by triad of fever, skin eruption, and systemic involvement. DRESS is rare with beta-lactam antibiotics and even rarer with ceftriaxone. We describe a case of pneumonia who developed ceftriaxone-induced rash, bicytopenia, eosinophilia, transaminitis and was eventually diagnosed and managed successfully as a ca...

Guleria, Vivek S.; Dhillon, Mukesh; Gill, Shaman; Naithani, Nardeep

2014-01-01

45

Acneiform rash during lung cancer therapy with erlotinib (Tarceva®)  

OpenAIRE

Tyrosine kinase inhibitors are currently applied in the treatment of non-small cell lung cancer with overexpressed epidermal growth factor receptor (EGFR). Acneiform rash is the earliest and most characteristic side effect of EGFR inhibition. The incidence may be as high as 50-100% of cases. We report a case of a 47-year-old patient who developed acneiform rash after 1.5 weeks of treatment with erlotinib.

Owczarczyk-saczonek, Agnieszka; Witmanowski, Henryk; Placek, Waldemar

2013-01-01

46

An insidious skin rash without itch.  

Science.gov (United States)

A 74-year-old female with a 5-year medical history of breast infiltrating lobular carcinoma was admitted to our Rehabilitation Unit ward for left hemiparesis secondary to neurosurgical removal of frontal and right parietal metastatic lesions. After the intervention, prophylactic treatment with the antiepileptic diphenylhydantoin 100 mg/tid was started. On 38th day of drug administration an erythema without itch appeared in jugular and parasternal region and absent in the clothing covered areas, suggesting a contact dermatitis. Next day, the erythema extended to the neck with poorly delineated red plaques. During the following 4 days the patient presented oral stomatitis with fetid breath, atypical targetoid and erythematous confluenced macules. The clinical picture rapidly worsened with vesiculate, bullate lesions and frank skin erosions. The patient was sent to a Dermatology Burn Unit where a therapy with corticosteroids, antibiotics, fluids, albumin and immunoglobulins was administrated. Complete clinical resolution was observed after 1 month without long-term sequelae. Toxic epidermal necrolysis (TEN) is a rare (incidence about 0.01%) adverse drug reaction related to idiosyncratic mechanism, burdened by a mortality rate ranging from 3.2 to 90%. In our patient, TEN covered 63% of body surface, a condition associated with a death risk of 58.3% according to the specific severity illness scale SCORTEN. The disease onset may be insidious, and it could appear as a skin rash without itch; the cutaneous manifestations appear quite lately, then the disease quickly progresses. Early recognition of the disease, especially in oncologic patients, is critical for effective management of this condition in terms of mortality reduction. PMID:22224932

Lonati, Davide; Zancan, Arturo; Giampreti, Andrea; Sparpaglione, Diego; Locatelli, Carlo Alessandro; Manzo, Luigi

2012-02-01

47

Cerebellar tuberculoma mimicking posterior cranial fossa tumour.  

Science.gov (United States)

A young girl presented with history of prolonged fever, vomiting and headache. CT scan of brain revealed a space occupying lesion in posterior cranial fossa with moderate hydrocephalus. Surgery was performed and histopathology report confirmed the lesion as tuberculous. Patient showed smooth postoperative recovery and complete remission of complaints on antituberculous treatment for one year and regular follow-up. PMID:18182146

Afzal, Muhammad; Qureshi, Shaukat Mahmood; Ghaffar, Abdul; Lutafullah, Muhammad; Khan, Shoaib Ali; Iqbal, Mudassir; Sultan, Mehboob

2007-12-01

48

Management of posterior fossa arteriovenous malformations  

Science.gov (United States)

Background: Posterior fossa arteriovenous malformations (AVMs) are rare vascular lesions, representing 7–15% of all intracranial AVMs. Although less frequent than supratentorial AVMs, they present higher rupture, morbidity, and mortality rates. Microsurgery, radiosurgery, and endovascular neurosurgery are treatment options for obliteration of those lesions. In this paper, we present a critical review of the literature about the management of posterior fossa AVM. Methods: A MEDLINE-based search of articles published between January 1960 and January 2014 was performed. The search terms: “Posterior fossa arteriovenous malformation,” “microsurgery,” “radiosurgery,” and “endovascular” were used to identify the articles. Results: Current data supports the role of microsurgery as the gold standard treatment for cerebellar AVMs. Brainstem AVMs are usually managed with radiotherapy and endovascular therapy; microsurgery is considered in cases of pial brainstem AVMs. Conclusions: Succsseful treatment of posterior fossa AVMs depend on an integrated work of neurosurgeons, radiosurgeons, and endovascular neurosurgery. Although the development of radiosurgery and endovascular techniques is remarkable, microsurgery remains as the gold standard treatment for most of those lesions. PMID:25745586

Almeida, Joao Paulo; Medina, Roberto; Tamargo, Rafael J.

2015-01-01

49

Herniographic appearance of the lateral inguinal fossa  

Energy Technology Data Exchange (ETDEWEB)

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.

Ekberg, O.; Kesek, P.

50

Herniographic appearance of the lateral inguinal fossa  

International Nuclear Information System (INIS)

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.)

51

Cerebellar tuberculoma mimicking posterior cranial fossa tumour  

International Nuclear Information System (INIS)

A young girl presented with history of prolonged fever, vomiting and headache. CT scan of brain revealed a space occupying lesion in posterior cranial fossa with moderate hydrocephalus. Surgery was performed and histopathology report confirmed the lesion as tuberculous. Patient showed smooth postoperative recovery and complete remission of complaints on antituberculous treatment for one year and regular follow-up. (author)

52

Contralateral hearing disturbance following posterior fossa surgery.  

Science.gov (United States)

A 53-year-old man suffered contralateral hearing disturbance one day after acoustic neuroma surgery. Hearing function gradually recovered after steroid and hyperbaric therapy. Contralateral hearing disturbance after acoustic neuroma surgery is an extremely rare complication that can also occur after other posterior fossa surgery. The mechanism of this rare phenomenon remains unclear, but the patent cochlear aqueduct may be involved. PMID:21701108

Shuto, Takashi; Matsunaga, Shigeo; Suenaga, Jun

2011-01-01

53

A woman with a post-vacation rash.  

Science.gov (United States)

A 52-year-old woman was admitted to the hospital with a rash, periorbital edema, dysphagia, and muscle weakness. The rash had appeared on the back of her neck nine months earlier, and because she had recently returned from a wildlife preserve on Assateague Island, Maryland, she assumed that it was due to tick bites. Over the next two months, the rash spread to her forehead, back, chest, and upper extremities, and scaly lesions appeared over metacar-pophalangeal joints. Initial laboratory tests indicated that her creatine kinase level was elevated. She was given prednisone and the level decreased. The rash also improved, but in the next two months the muscle weakness worsened. She became feverish and increasingly fatigued, depressed, and irritable. These later symptoms were attributed to the medication, but when she was weaned from it, her rash, weakness, and dysphagia increased. Over the ensuing months, she was given intramuscular injections of methotrexate (up to 25 mg/wk), followed by oral doses of hydroxychloroquine and azathioprine, but the symptoms persisted. PMID:9109805

Rosenbach, K; Brown, M; Matfin, G; Adelman, H M

1997-04-15

54

Martian Variety Exhibited by the Olympica Fossae  

Science.gov (United States)

The Olympica Fossae are a collection of troughs and depressions located in northern Tharsis, south of the Alba Patera volcano. The Mars Global Surveyor Mars Orbiter Camera has been sending back unprecedented, spectacular views of this region. The Olympica Fossae are especially interesting because they show landforms that run the entire range of things seen elsewhere on Mars. This picture shows many examples, including layered outcrops in canyon walls, evenly-spaced dunes on the canyon floors, dark landslide streaks on the canyon walls, pits formed by ground collapse, and streamlined forms related to the flow of water, mud, or lava. Malin Space Science Systems and the California Institute of Technology built the MOC using spare hardware from the Mars Observer mission. MSSS operates the camera from its facilities in San Diego, CA. The Jet Propulsion Laboratory's Mars Surveyor Operations Project operates the Mars Global Surveyor spacecraft with its industrial partner, Lockheed Martin Astronautics, from facilities in Pasadena, CA and Denver, CO.

1999-01-01

55

Erlotinib-induced rash spares previously irradiated skin  

International Nuclear Information System (INIS)

Erlotinib is an epidermal growth factor receptor inhibitor prescribed to patients with locally advanced or metastasized non-small cell lung carcinoma after failure of at least one earlier chemotherapy treatment. Approximately 75% of the patients treated with erlotinib develop acneiform skin rashes. A patient treated with erlotinib 3 months after finishing concomitant treatment with chemotherapy and radiotherapy for non-small cell lung cancer is presented. Unexpectedly, the part of the skin that had been included in his previously radiotherapy field was completely spared from the erlotinib-induced acneiform skin rash. The exact mechanism of erlotinib-induced rash sparing in previously irradiated skin is unclear. The underlying mechanism of this phenomenon needs to be explored further, because the number of patients being treated with a combination of both therapeutic modalities is increasing. The therapeutic effect of erlotinib in the area of the previously irradiated lesion should be assessed. (orig.)

56

Erlotinib-induced rash spares previously irradiated skin  

Energy Technology Data Exchange (ETDEWEB)

Erlotinib is an epidermal growth factor receptor inhibitor prescribed to patients with locally advanced or metastasized non-small cell lung carcinoma after failure of at least one earlier chemotherapy treatment. Approximately 75% of the patients treated with erlotinib develop acneiform skin rashes. A patient treated with erlotinib 3 months after finishing concomitant treatment with chemotherapy and radiotherapy for non-small cell lung cancer is presented. Unexpectedly, the part of the skin that had been included in his previously radiotherapy field was completely spared from the erlotinib-induced acneiform skin rash. The exact mechanism of erlotinib-induced rash sparing in previously irradiated skin is unclear. The underlying mechanism of this phenomenon needs to be explored further, because the number of patients being treated with a combination of both therapeutic modalities is increasing. The therapeutic effect of erlotinib in the area of the previously irradiated lesion should be assessed. (orig.)

Lips, Irene M.; Vonk, Ernest J.A. [Radiotherapeutisch Instituut Stedendriehoek en Omstreken (RISO), Deventer (Netherlands). Dept. of Radiation Oncology; Koster, Mariska E.Y. [Deventer Hospital (Netherlands). Dept. of Lung Diseases; Houwing, Ronald H. [Deventer Hospital (Netherlands). Dept. of Dermatology

2011-08-15

57

Computed tomography of lacrimal fossa tumors  

International Nuclear Information System (INIS)

The lacrimal fossa can be involved by a wide spectrum of orbital pathology. The correct diagnosis is important to avoid unnecessary procedure and to do appropriate management. 14 patients with mass lesions in the lacrimal fossa were evaluated with computed tomography (CT) and clinical findings. The results were as follows: 1. Final diagnosis of 14 cases with lacrimal fossa tumors was pleomorphic adenoma in 3 cases, adenoid cystic carcinoma in 1 case, pseudotumor in 5 cases, lymphoma in 2 cases, neurofibroma in 1 case, chloroma in 1 case and metastatic adenocarcinoma in 1 case. 2. The duration of symptoms of pleomorphic adenoma was more than 1 year and characteristic CT findings were globular masses with pressure erosion of the adjacent bone. Patient with adenoid cystic carcinoma had a short history of symptoms. CT showed a fusiform mass but intracranial extension with frank destruction of sphenoid bone. 3. Patients with pseudotumor and lymphoma had symptoms for less than 1 year. The CT findings were ill-defined infiltrative patterns with scleral thickening and the differential diagnosis of them was difficult. 4. The margins of neurofibroma and chloroma were well defined while that of the metastic adenocarcinoma was ill-defined. 5. The degree and the extent of the contrast enhancement gave no benefit in the differential diagnosis of each disease entities and even of the benign and malignant lesions

58

Computed tomography of lacrimal fossa tumors  

Energy Technology Data Exchange (ETDEWEB)

The lacrimal fossa can be involved by a wide spectrum of orbital pathology. The correct diagnosis is important to avoid unnecessary procedure and to do appropriate management. 14 patients with mass lesions in the lacrimal fossa were evaluated with computed tomography (CT) and clinical findings. The results were as follows: 1. Final diagnosis of 14 cases with lacrimal fossa tumors was pleomorphic adenoma in 3 cases, adenoid cystic carcinoma in 1 case, pseudotumor in 5 cases, lymphoma in 2 cases, neurofibroma in 1 case, chloroma in 1 case and metastatic adenocarcinoma in 1 case. 2. The duration of symptoms of pleomorphic adenoma was more than 1 year and characteristic CT findings were globular masses with pressure erosion of the adjacent bone. Patient with adenoid cystic carcinoma had a short history of symptoms. CT showed a fusiform mass but intracranial extension with frank destruction of sphenoid bone. 3. Patients with pseudotumor and lymphoma had symptoms for less than 1 year. The CT findings were ill-defined infiltrative patterns with scleral thickening and the differential diagnosis of them was difficult. 4. The margins of neurofibroma and chloroma were well defined while that of the metastic adenocarcinoma was ill-defined. 5. The degree and the extent of the contrast enhancement gave no benefit in the differential diagnosis of each disease entities and even of the benign and malignant lesions.

Park, Chan Sup; Kim, Young Goo; Chang, Kee Hyun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1985-12-15

59

[Cochlear implantation through the middle fossa approach].  

Science.gov (United States)

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

Szyfter, W; Colletti, V; Pruszewicz, A; Kope?, T; Szymiec, E; Kawczy?ski, M; Karlik, M

2001-01-01

60

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

61

Classification of middle fossa floor dehiscence syndromes.  

Science.gov (United States)

OBJECT Middle fossa floor dehiscence (MFFD) can present as multiple syndromes depending on dehiscence location, tissue herniation, and dural integrity. The authors propose a classification system for MFFD with the potential to guide clinical decision making. METHODS A retrospective analysis of the electronic medical records (years 1995-2012) of patients who had undergone temporal craniotomy for the surgical repair of an MFFD syndrome at a single institution was undertaken. Reviewed data included demographic, operative, presentation, and outcome details. Middle fossa floor dehiscence was classified as follows: Class A, bony dehiscence without herniation of the brain and/or meninges; Class B, herniation of the brain and/or meninges through the middle fossa floor without CSF leakage; Class C, dehiscence with CSF leakage without meningitis; or Class D, dehiscence with meningitis. RESULTS Fifty-one patients, 22 males and 29 females, were included in the analysis. The mean age was 48.7 ± 15.5 years, mean body mass index was 32.65 ± 6.86 kg/m(2), and mean symptom duration was 33 ± 42 months. Seven patients underwent repeat surgery for symptomatic recurrence; therefore, there were 58 surgical encounters. Repair included bony reconstruction with hydroxyapatite with or without resection of encephaloceles and/or repair of a dural defect. According to the MFFD classification system described, 15, 8, 27, and 8 cases were categorized as Class A, B, C, and D, respectively. The prevalence of hearing loss was 87%, 63%, and 70% in Classes A, B, and C, respectively. Vestibular symptoms were more prevalent in Class A. Seven patients reported persistent symptoms at the last follow-up. Transient complications were similar in each classification (13%-25%), and a single permanent complication related to anesthesia was observed. There were no mortalities or severe neurological morbidities in the series. CONCLUSIONS Middle fossa floor dehiscence has a spectrum of clinical presentations. A classification system may help to clarify the diagnosis and guide therapy. Surgery, the mainstay of treatment, is safe and well tolerated. PMID:25554855

Gupta, Kunal; Sabry, Hatem A; Dogan, Aclan; Coppa, Nicholas D; McMenomey, Sean; Delashaw, Johnny B; Raslan, Ahmed M

2015-03-01

62

Acute Spontaneous Posterior Fossa Subdural Hematoma  

Directory of Open Access Journals (Sweden)

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.

Osama Shukir Muhammed Amin

2014-02-01

63

An itchy rash on the fingertips - a case study.  

Science.gov (United States)

A case study A previously healthy woman, aged 37 years, presented with a 4-week history of pruritic periungual rash and subungual pain. Physical examination revealed scaly, fissured, erythematous plaques around her fingernails (Figure 1). Underneath the acrylic artificial nails that she had been wearing for 6 weeks, onycholysis and nail bed hyperkeratosis were evident. Oral terbinafine and amorolfine nail polish were prescribed by the general practitioner but had no clinical benefit. PMID:24563892

Machado, Patricia; Pereira, Diogo; Morais, Paulo

2014-01-01

64

Nevirapine-induced rash with eosinophilia and systemic symptoms (DRESS)  

OpenAIRE

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, ...

Gill, Shaman; Sagar, Amitabh; Shankar, S.; Nair, Velu

2013-01-01

65

Cefditoren pivoxil associated rash and arthralgia in a child  

OpenAIRE

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...

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

2012-01-01

66

Nevirapine-induced rash with eosinophilia and systemic symptoms (DRESS)  

Science.gov (United States)

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. PMID:24014920

Gill, Shaman; Sagar, Amitabh; Shankar, S.; Nair, Velu

2013-01-01

67

Cefditoren pivoxil associated rash and arthralgia in a child.  

Science.gov (United States)

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

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

2012-05-01

68

Solitary fibrous tumor of the infratemporal fossa: A case report  

OpenAIRE

First described as a pleural neoplasm, the solitary fibrous tumor (fibrous mesothelioma) has been reported in a number of extrapulmonary sites, including the Head-Neck region. In the Head-Neck region, it has been described in the sinonasal tract, epiglottis, parapharyngeal, retropharyngeal spaces, parotid and infratemporal fossa. We present the second case of solitary fibrous tumor of infratemporal fossa described in world literature. A complete excision was achieved by transmaxillary approach.

Naresh, K. Panda; Parida Pradipta, K.; Mahesha, V.; Ashim, Das

2007-01-01

69

MANAGEMENT OF HYDROCEPHALUS IN POSTERIOR CRANIAL FOSSA TUMORS  

OpenAIRE

Treatment of hydrocephalus in posterior fossa tumors in children is still a matter of controversy and different centers have their own routines. In this regard, hospital records of all children with posterior fossa tumors treated in our center during the interval of 1985-1995 were reviewed. Patients’ demographic and diagnostic data were analyzed and the frequencies of shunting procedures were determined. Fisher exact test was employed to compare the frequency of postoperative complications ...

Abdollahzadeh-hosseini, S. M.; Allahdini, H. Rezaishiraz F.

2006-01-01

70

Microsurgical Posterior Fossa Vestibular Neurectomy: An Evolution in Technique  

OpenAIRE

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...

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

1991-01-01

71

Asystole during posterior fossa surgery: Report of two cases  

OpenAIRE

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...

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

2012-01-01

72

Infratemporal fossa approaches to the lateral skull base.  

Science.gov (United States)

The infra-temporal fossa approach is one of the lateral approaches to the skull base. It is indicated for the treatment of tumors such as glomus tumor, petrous apex cholesteatoma, chondroma, lower cranial nerve neuroma and nasopharyngeal cancer. In the present paper, we described the surgical anatomy of the lateral skull base and the indications for the infra-temporal fossa approach with its variants. We showed the hints and pitfalls in the procedures. Five illustrative cases are also presented. PMID:10638143

Sanna, M; De Donato, G; Taibah, A; Russo, A; Falcioni, M; Mancini, F

1999-12-01

73

Mineral Spectra from Nili Fossae, Mars  

Science.gov (United States)

Spectra collected by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) indicate the presence of three distinct minerals. The graphed information comes from an observation of terrain in the Nili Fossae area of northern Mars. CRISM is one of six science instruments on NASA's Mars Reconnaissance Orbiter. Iron-magnesium smectite clay is formed through alteration of rocks by liquid water and is characterized by distinctive absorptions at 1.4, 1.9, and 2.3 micrometers due to water (H2O) and OH in the atomic structure of the mineral. Olivine is an iron magnesium silicate and primary igneous mineral, and water is not in its structure. Its spectrum is characterized by a strong and broad absorption at 1.0 micrometer due to ferrous iron (Fe2+). Carbonate is an alteration mineral identified by the distinctive paired absorptions at 2.3 and 2.5 micrometers. The precise band positions at 2.31 and 2.51 micrometers identify the carbonate at this location as magnesium carbonate. The broad 1.0 micrometer band indicates some small amount of ferrous iron is also present and the feature at 1.9 micrometers indicates the presence of water. CRISM researchers believe the magnesium carbonate found in the Nili Fossae region formed from alteration of olivine by water. The data come from a CRISM image catalogued as FRT00003E12. The spectra shown here are five-pixel-by-five-pixel averages of CRISM L-detector spectra taken from three different areas within the image that have then been ratioed to a five-pixel-by-five-pixel common denominator spectrum taken from a spectrally unremarkable area with no distinctive mineralogic signatures. This technique highlights the spectral contrasts between regions due to their unique mineralogy. The spectral wavelengths near 2.0 micrometers are affected by atmospheric absorptions and have been removed for clarity. NASA's Jet Propulsion Laboratory, a division of the California Institute of Technology, Pasadena, manages the Mars Reconnaissance Orbiter for the NASA Science Mission Directorate, Washington. Lockheed Martin Space Systems, Denver, is the prime contractor for the project and built the spacecraft. The Johns Hopkins University Applied Physics Laboratory led the effort to build the CRISM instrument and operates CRISM in coordination with an international team of researchers from universities, government and the private sector.

2008-01-01

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Unilateral Heliotrope Rash in Juvenile Dermatomyositis: An Unusual Presentation of an Underlying Serious Disease  

OpenAIRE

Background. Heliotrope rash is one of the characteristic skin manifestations of juvenile dermatomyositis. It is a reddish-purple rash on the upper eyelids that is usually bilateral. Case Presentation. We report a boy who presented with unilateral heliotrope rash, Gottron's papules, and muscle weakness. Muscle biopsy was consistent with inflammatory myositis. Patient was started on prednisolone and methotrexate with an excellent response in both the skin and muscles. Conclusion. Unilateral hel...

Al-janobi, Ghada; Alkhalidi, Hisham; Omair, Mohammed A.

2014-01-01

75

Allergic skin rash with lamotrigine and concomitant valproate therapy: evidence for an increased risk / Rash cutâneo com lamotrigina e concomitante uso de valproato: evidências de maior risco  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Rash cutâneo é um dos efeitos adversos mais comuns associados ao início de tratamento com lamotrigina, uma nova medicação antiepiléptica. Avaliamos se esse risco é maior em pacientes medicados concomitantemente com valproato em 103 pacientes adultos com epilepsia refratária, que tiveram lamotrigina [...] adicionada a seu tratamento. Dez dos 33 pacientes (30%) que faziam uso de valproato e 6 (8%) dos 70 pacientes que não usaram valproato desenvolveram rash. Isto sugere que existe maior risco de desenvolver rash cutâneo quando se adiciona lamotrigina em pacientes em uso de valproato (p Abstract in english Cutaneous rash is one of the commonest adverse events associated with lamotrigine. We assessed whether the risk is increased in patients receiving concomitant valproate therapy in a population of 103 adult patients with intractable epilepsy, who had lamotrigine added to their treatment. Of the 33 pa [...] tients taking valproate, 10 (30%) developed a rash, whilst of the 70 not taking valproate, only 6 (8%) developed a rash. This suggests a significantly higher risk of cutaneous rash when starting lamotrigine in patients already taking valproate (p

L. M., Li; M., Russo; M. F., O' Donoghue; J. S., Duncan; J. W. A. S., Sander.

1996-03-01

76

Estudo eletrencefalográfico das afecções cirúrgicas da fossa posterior / Electroencephalography in posterior fossa lesions  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os resultados eletrencefalográficos em 22 casos verificados de afecção cirúrgica da fossa posterior, obtidos com uma rotina de exame detalhado como preconiza Bagchi, são relatados de modo sintético, em quadros comparativos entre dados eletrencefalográficos e neurocirúrgicos. Dessa análise podem-se d [...] eduzir as seguintes idéias conclusivas: 1. Dos 22 casos estudados, 9 foram normais e 13 anormais. Entre as anormalidades eletrencefalográficas destacamos: a) surtos de ondas bilaterais e síncronas, substituindo o ritmo de base, de potencial ligeiramente superior ao de base e de freqüência 4 a 7 c/s (ritmo ?) : b) ondas lentas e irregulares, difusas ou localizadas (ondas ?), mas sempre com sensível dispersão temporal em relação às áreas de predominante projeção. 2. As alterações eletrencefalográficas não diferiram em casos de tumores das de lesão de tipo inflamatorio (quadro 1). 3. Os surtos de ritmo 4 a 7 c/s bilateral síncrono não diferençaram afecções da linha mediana das paramedianas (quadro 4). 4. Os casos de EEG normal apareceram preferentemente entre afecções extraparenquimatosas, comparativamente com as de lesão intraparen-quimatosa (quadro 3). 5. Nos casos em que houve nítida lateralização das ondas ?;, o processo era contralateral na fossa posterior (quadro 2). 6. Os surtos de ondas ? difusas apareceram mais freqüentemente nos casos de afecção mediana da fossa posterior (quadro 4). Abstract in english The authors have analysed 22 cases of verified infratentorial surgical lesions and found: 1. In 9 cases the EEG was normal and in 13 abnormal. The predominant EEG modifications were: outbursts of bilateral synchronous waves, 4 to 7 c/s. (? rhythm) and ? waves, diffuse or localized, with temporal dis [...] persion in relation to predominant projection areas. 2. The EEG changes did not differentiate the inflammatory lesions from the tumors. 3. The outbursts of 4 to 7 c/s. bilateral synchronous waves did not differentiate the midline lesions from the lateral lesions. 4. The normal EEG was dominant in the cases of extraencephalic lesions in relation to the intraparenchymatous lesions. 5. In the cases of definite localized ? waves the lesions were contralateral in the posterior fossa. 6. The outburst of diffuse ? waves were more frequent in the midline lesions.

Aloysio Mattos, Pimenta; Paulo Pinto, Pupo; Eliova, Zukerman.

1954-09-01

77

Unilateral heliotrope rash in juvenile dermatomyositis: an unusual presentation of an underlying serious disease.  

Science.gov (United States)

Background. Heliotrope rash is one of the characteristic skin manifestations of juvenile dermatomyositis. It is a reddish-purple rash on the upper eyelids that is usually bilateral. Case Presentation. We report a boy who presented with unilateral heliotrope rash, Gottron's papules, and muscle weakness. Muscle biopsy was consistent with inflammatory myositis. Patient was started on prednisolone and methotrexate with an excellent response in both the skin and muscles. Conclusion. Unilateral heliotrope rash can occur in patients with juvenile dermatomyositis. Being a paraneoplastic condition caution should be taken not to miss any underlying malignancy. PMID:25587479

Al-Janobi, Ghada; Alkhalidi, Hisham; Omair, Mohammed A

2014-01-01

78

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

International Nuclear Information System (INIS)

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)

79

Magnetic resonance imaging in posterior fossa lesions  

International Nuclear Information System (INIS)

Magnetic resonance imaging (MRI) using 0.15 Tesla was performed on more than 240 patients with suspected diseases of the brain and the spinal cord over a two-year period. Among them, 27 patients with various disorders of the CNS in the posterior fossa were selected for evaluation by means of comparing the MRI results with those of X-ray CT (CT). The subjects consisted of 16 patients with ischemic infarctions, 4 with demyelinating diseases, and 7 with craniovertebral junction anomalies in whom abnormalities could be detected only by MRI, while the CT was normal or equivocal. (1) Ischemic infarctions. In 10 cases of midbrain or pontine infarct, MRI was able to locate lesions compatible with the signs and symptoms. In 4 cases of the lateral medullary syndrome, MRI showed the lesions in two cases, but in the others only a lack of symmetry in the medullar was noted. In cases of cerebellar infarct, MRI was obviously superior to CT for detecting not only clinically responsible lesions, but also silent ones. (2) Demyelinating diseases. In 4 cases of multiple sclerosis, MRI successfully detected demyelinating plaques, regardless of the stage, while none were detected by CT alone. Spin-echo images seemed superior over inversion recovery in detection sensitivity. (3) Craniovertebral junction pathology. In this category, 5 cases of Arnold-Chiari malformations and two others were included. A sagittal section of MRI was found most useful for detecting these anomalies and was considr detecting these anomalies and was considered the first choice for tests because of its non-invasive and accurate characteristics. (author)

80

MRI of the fetal posterior fossa  

International Nuclear Information System (INIS)

MRI is a useful tool to complement US for imaging of the fetal posterior fossa (PF). In France, the discovery of a PF malformation in the fetus frequently leads to termination of pregnancy (80% in a personal series). However, despite improved accuracy in the diagnosis of PF abnormalities, prognosis remains uncertain. The first objective of this review is to document the normal MRI landmarks of the developing fetal PF. Because of their thinness, the visibility of the cerebellar fissures is dramatically delayed on MRI compared to macroscopic data. An important landmark is identification of the primary fissure of the vermis, normally seen at around 25-26 weeks' gestation (WG) on the sagittal slice, separating the larger posterior lobe from the anterior lobe (volume ratio around 2:1). The prepyramidal and secondary fissures are usually only identifiable after 32 WG and the hemispheric fissures are difficult to see until the end of pregnancy. Considering the signal changes, high signal on T2-weighted (T2-W) sequences is seen from 25 WG in the posterior part of the brain stem (tegmentum and ascending sensory tracts) related to myelination. The low signal intensities seen within the cerebellum on T2-W images correspond to high cellularity of grey matter (deep nuclei), as there is no myelination within the white matter before 38 WG. The second objective is to highlight the signs highly predictive of a poor neurological prognosis. Lack of pontine curvature or vermian agenesis of pontine curvature or vermian agenesis without a PF cyst (small volume of PF) is greatly associated with poor neurological status. The third objective is to propose a diagnostic strategy in difficult cases where prognosis is important, e.g. the Dandy Walker continuum. (orig.)

81

Respuesta anómala de anticuerpos de infecciones virales productoras de rash  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish 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.

SONIA, RESIK AGUIRRE; CARLOS A, SARIOL CURBELO; MARITZA, ALVAREZ VEGA; MIGUEL, MARRERO SUAREZ.

1996-04-01

82

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

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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.

Gerber Peter

2012-02-01

83

Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa  

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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.

Tomomi Okamura

2011-04-01

84

An orbital lymphoma involving the pterygopalatine and infratemporal fossae. A case report.  

Science.gov (United States)

Lymphoma is the most common malignant orbital tumor. We describe the imaging features of diffuse orbital follicular lymphoma with extension into the pterygopalatine fossa and infratemporal fossa without bony infiltration. PMID:24059901

Conte, G; D'Amore, A; Viglianesi, A; Chiaramonte, R; Puzzo, L; Caltabiano, R; Lanzafame, S; Pero, G; Chiaramonte, I

2011-12-30

85

Posterior fossa neoplasm and PHACES syndrome: a case report.  

Science.gov (United States)

A 4-year-old girl with PHACES syndrome (posterior fossa brain malformations, hemangiomas, arterial anomalies, cardiac anomalies/coarctation of the aorta, eye abnormalities, and sternal clefting/supraumbilical raphe) developed a cerebellar pilocytic astrocytoma 18 months after resolution of her neck, ear, and thoracic hemangiomas. Because cutaneous hemangiomas may have involuted by the time a patient is diagnosed with a central nervous system neoplasm, it seems possible that in other such patients the association may have gone unrecognized. Cerebellar pilocytic astrocytoma may be a rare manifestation of the posterior fossa malformations of PHACES. PMID:19262249

Wallen, Katharine E; Hadar, Eldad J; Perry, Victor; Bouldin, Thomas W; Loehr, James; Blatt, Julie

2009-03-01

86

Subarachnoid pouches of the posterior fossa with syringomyelia  

International Nuclear Information System (INIS)

Three men are presented, all of whom were born with difficulty and later developed severe syringomyelia with collapsing cords on air myelography. Each had hydrocephalus and a sizable subarachnoid pouch in the posterior fossa. The clinical features and investigations are presented with a discussion of the aetiology and possible mechanisms concerned in pathogenesis and treatment. All three men had posterior fossa exploration over fifty years after birth, and the first two were also treated by valved ventriculo-atrial shunts. Each patient has improved a little since operation, but no certainly that this was due to surgery has been proved in any case; none has progressed since the last operation. (author)

87

BILATERAL ANOMALOUS MUSCLE IN THE POPLITEAL FOSSA & ITS CLINICAL SIGNIFICANCE  

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Full Text Available Muscle variation may occur due to genetic or developmental causes. Some variations may compromise the vascular, muscular or nervous system in the region. Bilateral muscle variation in popliteal fossa is very rare. In present study an instance of bilateral muscle variation in popliteal fossa, arising from different muscles like gastrocnemius and from biceps femoris is recorded. There is no report of such variations. These observations are rare of its kind because of bilateral asymmetrical presence and difference in the origins in different legs. This is the first report as for the literatures available. Clinical and functional importance of such variation is discussed with the morphological aspects of this anomalous muscle.

Sowmya S

2014-10-01

88

Transpterygoid Approach to a Dermoid Cyst in Pterygopalatine Fossa  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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 develope [...] d 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.

Alexandre Beraldo, Ordones; Marco Aurélio, Fornazieri; Fábio de Rezende, Pinna; Thiago Freire Pinto, Bezerra; Richard Louis, Voegels; Luiz Ubirajara, Sennes.

2014-01-01

89

Evaluation of the Origin Hypotheses of Pantheon Fossae, Mercury  

Science.gov (United States)

By means of a detailed study of the graben pattern on MESSENGER image PIA10397, a strain analysis along five concentric traverses, and an analysis of the loading of the mercurian lithosphere, different origin hypotheses of the Pantheon Fossae structure are evaluated.

Klimczak, C.; Nahm, A. L.; Schultz, R. A.

2009-03-01

90

Posterior fossa hemorrhage in the newborn - diagnosis and management  

International Nuclear Information System (INIS)

Two cases of posterior fossa hemorrhage in full-term newborns are presented. Because of possible sonographic misinterpretations computer tomographic (CT) scans are advocated for a reliable diagnosis. Regarding the management of the primary hemorrhage as well as the posthemorrhagic hydrocephalus a conservative approach is recommended. (orig.)

91

Severe chronic diarrhea and maculopapular rash: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Systemic mastocytosis (SM is a heterogeneous disease of the bone marrow characterized by abnormal growth, accumulation and activation of clonal mast cells (MCs. We report a case of SM with multi-organ involvement. A 30-year-old man presented with diarrhea, flushing, maculopapular rash with itching and weight loss. The upper and lower gastrointestinal endoscopies showed macroscopic involvement of stomach and duodenum; mucosal samples from stomach, duodenum, colon and distal ileum showed mucosal infiltration by large, spindle-shaped MCs with abnormal surface molecule expression (CD2 and CD25, a picture fully consistent with SM, according to the World Health Organization diagnostic criteria. A computed tomography scan showed diffuse lymphadenopathy, hepatosplenomegaly and diffuse small bowel involvement. Bone marrow aspirate and biopsy were diagnostic for SM; serum tryptase levels were increased (209 ng/mL, normal values < 20 ng/mL. The conclusive diagnosis was smouldering SM. There were no therapeutic indications except for treatment of symptoms. The patient was strictly followed up because of the risk of aggressive evolution.

Alessandra Elvevi

2011-01-01

92

Henoch–Schonlein purpura presenting sequentially as nodular rash, erythema nodosum, and palpable purpura  

OpenAIRE

We describe a 26-year-old woman who presented with a nodular rash on the elbows following an insect bite. Two days later, she developed erythema nodosum. Both these lesions were treated symptomatically. One week later, she had purpura, abdominal pain, hematuria, and arthralgias, following which steroids were administered. Her investigations revealed only microscopic hematuria that disappeared with therapy. This pattern of sequential appearance of rash and a nodular morphology are both unique ...

Balamurugesan, Kandan; Viswanathan, Stalin

2014-01-01

93

A 62-year-old man with skin rash and an abnormal chest radiograph.  

Science.gov (United States)

A 62-year-old man developed a scalp rash 2 months ago, followed by bilateral eyelid swelling. The nonpruritic rash then spread to involve most of his skin. He also had fatigue, muscle weakness, mild muscle soreness with activity, and dysphagia for solid foods for the last 3 weeks. He had no other symptoms. He had a 50 pack-year history of smoking and drank two to three shots of alcohol daily. PMID:25732478

Albert, Tyler J; Bastawrous, Sarah; Raugi, Gregory J; Hirschmann, Jan V

2015-03-01

94

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

OpenAIRE

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 vir...

Oliveira Maria I.; Curti Suely P.; Figueiredo Cristina A; Ms, Afonso Ana; Theobaldo Márcia; Azevedo Raymundo S; Durigon Edison L

2002-01-01

95

Severe skin rash with lamivudine in HIV infected patients: Some unusual case reports  

OpenAIRE

Lamivudine (3TC) is a nucleoside reverse transcriptase inhibitor (NRTI) licensed for as a first line drug in Human immunodeficiency virus (HIV) infection and also in the treatment of hepatitis B. It is relatively nontoxic in nature and potentiates the antiviral effects of other NRTIs like zidovudine. Although lamivudine is well-tolerated, certain dermatological side effects like severe skin rash may appear. We report a case series of severe skin rashes in four HIV-infected patients, probably ...

Modak, Dolanchampa; Guha, Subhasish Kamal

2013-01-01

96

Sulfasalazine-induced DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) / Síndrome DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) induzida por sulfasalazina  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese CONTEXTO: A síndrome DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) é um tipo de reação a drogas comumente confundida com uma infecção viral. Deve ser prontamente reconhecida devido a sua alta morbidade e taxa de mortalidade de 10%. Poucos casos de síndrome DRESS induzida por sulfasalazin [...] a foram relatados na literatura. RELATO DE CASO: É relatado o caso de uma mulher branca, brasileira, de 47 anos, que desenvolveu a síndrome DRESS oito semanas após iniciar tratamento com sulfasalazina para artrite soronegativa. A paciente apresentou rash maculopapular, febre, hepatite, linfadenomegalia, eosinofilia e linfocitose atípica. A medicação foi suspensa imediatamente no início dos sintomas, mas só houve melhora clínica após tratamento com prednisona. Abstract in english CONTEXT: DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a type of drug reaction commonly mistaken for a viral infection. It must be recognized promptly due to its high morbidity and 10% mortality rate. Few cases of DRESS syndrome induced by sulfasalazine have been reported in [...] the literature. CASE REPORT: The case of a 47-year-old white Brazilian woman who developed DRESS syndrome eight weeks after starting a course of sulfasalazine for treatment of seronegative arthritis is reported. She presented a skin rash, fever, hepatitis, lymphadenopathy, eosinophilia and atypical lymphocytes. The causative drug was discontinued immediately, but she only improved after treatment with prednisone.

Renata Telles Rudge de, Aquino; Carmen Silvia Vieitas, Vergueiro; Maria Elisa Ruffolo, Magliari; Thais Helena Proença de, Freitas.

2008-07-01

97

Hematoma extradural da fossa posterior: relato de sete casos  

Directory of Open Access Journals (Sweden)

Full Text Available Hematomas da fossa posterior são complicação incomum de traumatismo cra-nioencefálico. Quase invariavelmente eles ocorrem após traumatismo da região occipital e estão associados com fraturas de crânio. O diagnóstico e tratamento dessa patologia tem sido grandemente favorecido pela tomografia computadorizada. Na presente série, a maioria dos pacientes teve evolução aguda, indicando o risco potencial de um tratamento conservador. Nossos resultados (29% de mortalidade são similares àqueles previamente relatados para outras séries dessas lesões.Hematomas of the posterior fossa are an uncommon complication of head injury. Almost invariably they occur after trauma of the occiput, and are associated with skull fracture. Their diagnosis and management have been greatly improved by CT scanning. In the present series ,the majority of patients had acute evolution indicating the potential hazard of conservative treatment. Our results (29% mortality are similar to those previously reported in other series.

Mauro A. Oliveira

1993-06-01

98

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

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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.

Dundon Belinda

2009-07-01

99

Extramedullary plasmacytoma imitating neoplasm of the gallbladder fossa after cholecystectomy.  

Science.gov (United States)

Extramedullary plasmacytomas are plasma cell tumors that arise outside of the bone marrow. They account for approximately 3% of plasma cell neoplasms and are most frequently located in the head and neck region. Five months after undergoing cholecystectomy, a 69-year-old patient presented with the pain under the right costal margin and a 12 kg weight loss. Computed tomography of the abdomen demonstrated irregular, vascular mass in the gallbladder fossa that dents towards the duodenum and the pylorus and lowers caudally to the hepatic flexure. His laboratory tests indicated normocytic anemia and showed elevated sedimentation rate. During operative procedure, a tumorous mass in the gallbladder fossa was found, inseparable of the peritoneum of the hepatoduodenal ligament and the IVb liver segment. Histopathological examination and immunohistochemical staining determined the diagnosis of the plasmacytoma. Total resection of the tumor was achieved and after 24-month follow-up patient showed no signs of local recurrence or dissemination of the disease. PMID:22816242

Majerovi?, Matea; Bogdani?, Branko; Drinkovi?, Niksa; Kinda, Sandra Basi?; Jaki?-Razumovi?, Jasminka; Gasparovi?, Vladimir

2012-03-01

100

A bullet in the maxillary antrum and infratemporal fossa.  

Science.gov (United States)

A young male patient was shot from a revolver on his left temple from a close range, but surprisingly he survived. On imaging, a complete bullet was found occupying his left maxillary sinus and infratemporal fossa. The bullet, after hitting and breaking the neck of the mandible on the left side, ricocheted and entered the left maxillary sinus through its posterior wall. It was removed safely by a combination of sublabial antrotomy and endoscopic approach. PMID:23852256

Goswami, Saileswar

2013-01-01

101

Petergopalatine Fossa A Key Area In Rhinocerebral Mucormycosis Extension  

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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 

Sadr-Hoseini S M

2003-11-01

102

Extensive Supratentorial Hemorrhages Following Posterior Fossa Meningioma Surgery  

OpenAIRE

Remote supratentorial hematoma soon after posterior fossa surgery for the removal of a space-occupying lesion is a rare but dramatic and dreaded complication, carrying significant morbidity and mortality. A 47-year-old woman presented with headache of 1-year duration that worsened over last 2 months, progressive ataxia of 2 months’ duration, blurring and diminution of vision of 2 months’ duration and forgetfulness of 2 months’ duration. Fundus showed bilateral papille dema, and visual a...

Agrawal, Amit; Kakani, Anand; Ray, Kaushik

2010-01-01

103

Cardiorespiratory Fitness in Survivors of Pediatric Posterior Fossa Tumor  

OpenAIRE

Advances in medical therapies have greatly improved survivorship rates in children diagnosed with brain tumor; as a result, morbidities associated with survivorship have become increasingly important to identify and address. In general, pediatric posterior fossa tumor survivors tend to be less physically active than peers. This may be related to late effects of diagnosis and treatment, including cardiovascular, endocrine, psychological, and neurocognitive difficulties. Exercise has been shown...

Wolfe, Kelly R.; Hunter, Gary R.; Madan-swain, Avi; Reddy, Alyssa T.; Ban?os, James; Kana, Rajesh K.

2012-01-01

104

MANAGEMENT OF HYDROCEPHALUS IN POSTERIOR CRANIAL FOSSA TUMORS  

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Full Text Available Treatment of hydrocephalus in posterior fossa tumors in children is still a matter of controversy and different centers have their own routines. In this regard, hospital records of all children with posterior fossa tumors treated in our center during the interval of 1985-1995 were reviewed. Patients’ demographic and diagnostic data were analyzed and the frequencies of shunting procedures were determined. Fisher exact test was employed to compare the frequency of postoperative complications in different groups. A total of 108 patients with age ranging from 3 months to 18 years and a male to female ratio of 1.5 comprised the study population. Ninety-nine cases had hydrocephalus at the time of diagnosis and 81 patients underwent preoperative shunting. Of the remaining 18 patients, 13 underwent external ventricular drainage at tumor operation session plus preoperative corticosteroid therapy. The rest of the patients got no primary treatment for hydrocephalus. Three of these 5 patients had postoperative shunting after tumor removal, but the other 2 remained shunt free. The rate of postoperative complications including cerebrospinal fluid leakage and septic meningitis were significantly lower in patients with preoperative shunting. The results of this study are in favor of those that approve the effect of preoperative shunting in decreasing postoperative complications. This is well established when the tumor size is big or when the diagnosis of posterior fossa tumor is made in later stages or when hydrocephalus is severe. It could be concluded that preoperative shunting can decrease the rate of postoperative complications.

S. M. Abdollahzadeh-Hosseini

2006-06-01

105

Posterior fossa cysts: clinical, neuroradiological and surgical features.  

Science.gov (United States)

Various types of neuroimaging investigations were performed in 26 patients with posterior fossa cysts. The results were retrospectively analyzed to facilitate differential diagnosis and clarify indications for surgery. Four major findings were obtained in this study. First, posterior fossa intra-arachnoid cysts were encountered more frequently than expected and were found to be surgically treatable. Second, although IV ventricular cysts were categorized as Dandy-Walker malformation, Dandy-Walker variant, and persistent Blake's pouch in this study, the distinctions of neuroimaging findings between these three types are uncertain. Third, the diagnostic criteria for mega cisterna magna were established, and it was found to be a surgically untreatable condition. Finally, in cases with the following neuroimaging findings, surgery appears to be indicated: (1) occipital bossing or petrosal scalloping with distortion or obliteration of cerebrospinal fluid (CSF) cisterns of the posterior fossa; (2) compression and deformity of the brain surrounding the cyst; (3) radioisotope and/or computed tomography cisternographic findings suggestive of disturbance of intracystic CSF circulation; (4) a non-communicating cyst. PMID:1878871

Arai, H; Sato, K

1991-06-01

106

Diffusion tensor imaging of midline posterior fossa malformations  

International Nuclear Information System (INIS)

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.)ons. (orig.)

107

Computed tomography in diagnosis of acute traumatic epidural hematoma in posterior fossa  

International Nuclear Information System (INIS)

Acute epidural hematoma in the posterior fossa is considerably rare and considered to be difficult to diagnose. In this paper, two cases of posterior fossa epidural hematoma were reported and these cases were diagnosed by computed tomography (CT). CT is the most useful of neuroradiological procedure in diagnosis of the posterior fossa hematoma and provides much more precise informations such as the deviation of the brain stem and ascending transtentorial herniation. (author)

108

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

International Nuclear Information System (INIS)

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.)

109

Delayed skin rash following administration of technetium-99m diphosphonate: A case report  

International Nuclear Information System (INIS)

The authors report a case of a 48-yr-old woman who developed a delayed skin rash following intravenous (i.v.) administration of technetium-99m hydroxymethylene diphosphonate (99mTc-HDP). The rash was characterized by skin biopsy, and it was concluded that the reaction was due to the diphosphonate compound. The rash resolved spontaneously without treatment. With most 99mTc-based agents, adverse reactions are considered rare and are usually allergic in nature, but the delayed nature of this reaction is more common with diphosphonate compounds than with other radiopharmaceuticals. If a repeat examination is required, alternative agents (such as 99mTc-pyrosphosphate) or any other diagnostic modality (magnetic resonance imaging) may be considered. An intradermal skin test may be helpful to determine the safest alternative bone agent

110

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

Energy Technology Data Exchange (ETDEWEB)

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.)

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

111

An infant with human parechovirus type 3 infection with a distinctive rash on the extremities.  

Science.gov (United States)

Human parechovirus type 3 (HPeV3) is known to cause sepsis-like syndrome and meningoencephalitis in neonates and young infants. We herein report a neonatal case of sepsis-like syndrome due to HPeV3 infection, diagnosed using polymerase chain reaction (PCR), with a distinctive erythematous rash present mainly on the soles and palms that helped in the diagnosis of the disease. Combining the unique characteristics of rash and confirmation by PCR at the early stage of the disease led to the diagnosis of HPeV3, distinguishing it from sepsis and other critical disease conditions, and allowing for appropriate, rapid management. PMID:22938181

Shoji, Kensuke; Komuro, Hisako; Kobayashi, Yoshinori; Shike, Tatsuhiko; Funaki, Takanori; Katsuta, Tomohiro; Miyata, Ippei; Saitoh, Akihiko

2014-01-01

112

Posterior fossa cystic lesions--magnetic resonance imaging manifestations.  

Science.gov (United States)

Cystic lesions of the posterior fossa remain a controversial subject as to clinical classification and diagnosis, especially for those in combination with other intracranial abnormalities. During the period of November 1985 to June 1991, 16 patients with cystic lesions of the posterior fossa were retrospectively reviewed on neuroradiological evaluation with MR images. The patients were 9 males and 7 females aged from 5 days to 15 years old (medium 1 year old). They were classified into three groups as Dandy-Walker cyst (group A, 5 patients), mega cisterna magna (group B, 4) and retrocerebellar pouch or cyst (group C, 7). Nine patients had associated intracranial anomalies, holoprosencephaly in 3 (group A, 3), dysgenesis of the corpus callosum in 4 (group A, 2; group C, 2), and occipital meningoceles in 2 (group C, 2). Hydrocephalus or ventricular enlargement was found in 10 patients (group A, 5; group B, 2; group C, 3). Surgical treatment (cyst-peritoneal shunt or cystectomy) was performed for 10 patients with clinical symptoms due to cyst. Postoperatively, clinical symptoms due to increased intracranial pressure or hydrocephalus improved in 7 patients. For long-term results, the cyst was reduced in 1 of 5 patients of group A and 2 of 5 of group C. Most of our patients have a poor prognosis because of the associated intracranial anomalies or atrophy of the cerebellum. Multiplanar MR images may provide sufficient evidence for the diagnosis of posterior fossa cysts, especially in the case of rotation or upward displacement of the cerebellar vermis. However, the cyst membrane, and the communication of fluid between the cyst and the cistern, cannot be demonstrated on MR images. Further investigation on these subjects and indications for surgical intervention is highly necessary. PMID:8747420

Tan, E C; Takagi, T; Karasawa, K

1995-01-01

113

Computed tomography of the nasopharynx and fossa pterygopalatina  

Energy Technology Data Exchange (ETDEWEB)

CT is -especially since the introduction of thin slice technique - the method of choice for the diagnosis of nasopharyngeal tumors. This method provides better results than the conventional film tomography in determining intracranial tumor extension, osseous destruction of the base of the skull, and involvement of the orbit. Tumor infiltration into the pterygoid fossa is also well seen by the third generation of CT. In particular CT scans are superior to conventional tomography in delineating tumor extension to the parapharyngeal and retromaxillary space as well as in recognition of cervical lymph node involvement.

Moedder, U.; Bertram, G.

1982-06-01

114

A strange lupus-like malar rash with renal involvement: an angioimmunoblastic T-cell lymphoma - A case report.  

Science.gov (United States)

Cutaneous malar rash and kidney involvement has not previously been reported as presenting symptoms of an angioimmunoblastic T-cell lymphoma (AITL). We report a case of a woman with erythematous rash. A PET-CT revealed a lymphadenopathy and splenomegaly. An inguinal lymph node biopsy showed an AITL. There was clinical improvement after prednisone. PMID:25678974

Dalbeni, Andrea; Gomarasca, Luca; Bellocchi, Maria C; Nuvolari, Roberta; Bertagnin, Matteo; Imbalzano, Egidio; Fondrieschi, Luigi; Minuz, Pietro

2015-01-01

115

Posterior fossa dermoid in association with Klippel-Feil syndrome--a short report.  

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Full Text Available A posterior fossa dermoid cyst in association with the Klippel-Feil syndrome, in a 4 year old child is reported. Early diagnosis to prevent complications like neural compression, cyst rupture and staphylococcal meningitis justifies investigation for posterior fossa dermoids in cases of Klippel-Feil syndrome. Their embryological basis is discussed.

Sharma M

2001-04-01

116

Resection in the popliteal fossa for metastatic melanoma  

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Full Text Available Abstract Background Traditionally metastatic melanoma of the distal leg and the foot metastasize to the lymph nodes of the groin. Sometimes the first site of nodal disease can be the popliteal fossa. This is an infrequent event, with rare reports in literature and when it occurs, radical popliteal node dissection must be performed. Case presentation We report a case of a 36-year old man presented with diagnosis of 2 mm thick, Clark's level II-III, non ulcerated melanoma of the left heel, which developed during the course of the disease popliteal node metastases, after a superficial and deep groin dissection for inguinal node involvement. Five months after popliteal lymph node dissection he developed systemic disease, therefore he received nine cycles of dacarbazine plus fotemustine. To date (56 months after prior surgery and 11 months after chemotherapy he is alive with no evidence of disease. Conclusion In case of groin metastases from melanoma of distal lower extremities, clinical and ultrasound examination of ipsilateral popliteal fossa is essential. When metastatic disease is found, radical popliteal dissection is the standard of care. Therefore knowledge of anatomy and surgical technique about popliteal lymphadenectomy are required to make preservation of structures that if injured, can produce a permanent, considerable disability.

Botti Gerardo

2007-01-01

117

Ependymomas of the posterior cranial fossa: CT and MRI findings  

International Nuclear Information System (INIS)

We studied nine children with posterior cranial fossa ependymomas to identify specific neuroradiological features. Patients were studied preoperatively with CT and MRI; T1-, T2- and proton-density (PD)-weighted images were obtained. All children underwent surgery and a definite histopathological diagnosis was made. All the tumours grew into the fourth ventricle and caused dilatation of its upper part, which resembled a cap. All but one were separated from the vermis by a cleavage plane. In eight cases there was desmoplastic development through the foramina of the fourth ventricle, and five were heterogeneous due to necrosis and cystic change; one had a haemorrhagic area. In most cases the solid portion was isointense with grey matter on T1-weighted images, hyperintense on PD weighting, and isointense on T2-weighted images. On CT the tumour was isodense in six cases and calcification was detected in four. The presence of both desmoplastic development and a tumour/vermis cleavage plane in a posterior cranial fossa tumour isodense on CT is highly suggestive of ependymoma. (orig.)

118

[Access to the anterior cranial fossa through the frontal sinus].  

Science.gov (United States)

In 1998 to 2001, the Academician N. N. Burdenko Research Institute of Neurosurgery operated on 15 patients aged 20 to 65 years who had bulky processes in the base of the skull and paranasal sinuses by applying an access through the frontal sinus. Most patients (n = 7) had meningiomas. The others had osteoma of the base of anterior cranial fossa (n = 2), chondroma (n = 2), angiofibroma (n = 1), fibroma (n = 1), esthesioneuroepithelioma (n = 1), and neurinoma (n = 1). The main criteria for choosing this access were the site and extent of a process, the sizes of the frontal sinus, and no signs of acute or chronic rhinosinusitis. The length of frontal sinuses in the most measurement was 3.5 to 5.0 cm, their width was 7 to 10 cm. All patients showed no progression of neurological symptoms. Three patients had a decrease in visual acuity from 1.0 to 0.8; with vascular therapy, visual disorders regressed during 2 months. Olfaction became worse in 4 cases, there was anosmia in 2 cases. Nasal liquorrhea was not observed. When there were tumors in the anterior cranial fossa, an access through the anterior wall of the frontal sinus permits radical removal of both intra- and extracranial parts of a tumor with closure of the defect with a periostal flap. PMID:12214504

Cherekaev, V A; Kornienko, V N; Bekiashev, A Kh; Belov, A I; Vinokurov, A G; Pronin, I N

2002-01-01

119

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

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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.

Tunthanathip Preecha

2009-10-01

120

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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 ci [...] stos 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. Abstract in english 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.

Eduardo, Cambruzzi; Karinelli, Presa; Luciano Carvalho, Silveira; Gerson Evandro, Perondi.

2011-02-01

121

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

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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.

Wadin, K.; Wilbrand, H.

122

The topographic relations of the high jugular fossa to the inner ear  

International Nuclear Information System (INIS)

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. (orig.)

123

Hairy Polyp of the Supratonsillar Fossa Causing Intermittent Airway Obstruction  

Scientific Electronic Library Online (English)

Full Text Available Introduction Dermoids frequently called "hairy polyps" and their nature have not been completely clarified. Objectives To discuss the unusual presentation, symptoms, incidence, histology, and perioperative management of hairy polyps in the light of a case and current literature. Resumed Report A 3- [...] year-old boy presented with intermittent respiratory distress since birth. Oropharyngeal examination revealed a nasopharyngeal mass originating from the supratonsillar fossa. The mass was so mobile that it moved between the oropharynx and the nasopharynx during swallowing. The radiologic and pathologic examinations confirmed the mass as a hairy polyp. Conclusion In a pediatric age group with airway obstruction, hairy polyps of the oropharyngeal region must also be included in the differential diagnosis.

124

Dural arteriovenous malformation in the anterior cranial fossa.  

Science.gov (United States)

Two cases of dural arteriovenous malformation (AVM) at the base of the anterior cranial fossa are described. In both cases an intracerebral hematoma following the rupture of the AVM was the first indication of the disease. In one case, the malformation was supplied both by the anterior ethmoidal artery and frontopolar artery draining into the superior sagittal sinus. In the second case, the right anterior ethmoidal artery with draining veins into the superior sagittal sinus and sphenoparietal sinus was the feeding vessel. Surgical evacuation of the hematoma and excision of the malformation was performed on both patients. The typical clinical signs and radiological findings are described. A review of the pertinent literature is given. PMID:10350203

Gliemroth, J; Nowak, G; Arnold, H

1999-03-01

125

Intraosseous meningioma of the posterior fossa--Case report.  

Science.gov (United States)

A 62-year-old male presented with a rare intraosseous meningioma with intradural extension manifesting as frequent vomiting and floating sensation that had persisted for 3 months. Neuroimaging detected a mass lesion that was mainly located extradurally in the right posterior fossa with a daughter lesion inside the dura. He underwent surgical excision of the mass lesion. Craniectomy exposed the main lesion of the tumor just beneath the thinned outer table of the skull, and in the extradural space, with the daughter lesion penetrating the dura. Both portions of the tumor were resected. There was no attachment to the adjacent dura mater. Histological examination showed meningotheliomatous meningioma containing scattered bony tissue. This intraosseous meningioma probably originated from the occipital bone with a small intradural extension caused by mechanical compression. PMID:11372560

Yamazaki, T; Tsukada, A; Uemura, K; Satou, H; Tsuboi, K; Nose, T

2001-03-01

126

Neuralgies of the lower cranial nerves: Microsurgical posterior fossa exploration  

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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.

Ivanovi? S.

2004-01-01

127

Magnetic resonance properties of hydrogen: imaging the posterior fossa  

International Nuclear Information System (INIS)

Posterior fossa scans were performed on five healthy volunteers using a nuclear magnetic resonance (NMR) machine constructed by Thorn-EMI Ltd. Three different NMR scanning sequences were used. In the first, a type of saturation-recovery technique was used to produce images strongly dependent on the density of hydrogen nuclei, but with some dependence on the spin-lattice relaxation time (T1). In the second, an inversion-recovery technique was used to produce images with a stronger dependence on the spin-lattice relaxation time. In the third, a spin-echo technique was used to obtain images with a dependence on the spin-spin relaxation time (T2). All three types of NMR image were unaffected by bone artifact. Visualization of brain adjacent to the skull base was obtained without loss of detail due to partial-volume effect from bone. The saturation-recovery images highlighted arteries and veins that were clearly visible without the use of contrast agents. The inversion-recovery images showed remarkable gray-white matter differentiation enabling internal structure to be seen within the brainstem and cerebellum. The trigeminal nerve and ganglion were also seen outside the brain. Experience with the spin-echo technique is limited, but the images at the base of the brain show considerable soft-tissue detail. The NMR images of the posterior fossa in this study were comparable in quality to those obtained from a new rotate-rotate x-ray computed tomography m rotate-rotate x-ray computed tomography machine and were superior in several respects

128

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

Directory of Open Access Journals (Sweden)

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.

Mansour Nassir

2009-09-01

129

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

130

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

International Nuclear Information System (INIS)

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.

131

Occupational injury in a fishmonger with a macular rash, hepatosplenomegaly and pancytopenia  

OpenAIRE

A 47?year?old fishmonger presented with a history of weight loss and lethargy. On investigation he was found to have myeloma. He presented again before follow up, with a 3?day history of fever and a maculopapular rash. He was admitted to the haematology ward and treated with broad?spectrum antibiotics. Blood cultures were found to be positive for Erysipelothrix rhusiopathiae. Penicillin treatment was given, and he made a good recovery. The importance of occupational illness in an alre...

Cooke, L. J.; Bowles, K. M.; Craig, J. I. O.; Sule, O.

2006-01-01

132

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

OpenAIRE

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.

Mittal, A.; Das, S.

2012-01-01

133

First Culture Isolation of Borrelia lonestari, Putative Agent of Southern Tick-Associated Rash Illness  

OpenAIRE

Southern tick-associated rash illness (STARI) is a Lyme disease-like infection described in patients in the southeastern and south-central United States, where classic Lyme disease is relatively rare. STARI develops following the bite of a lone star tick (Amblyomma americanum) and is thought to be caused by infection with an “uncultivable” spirochete tentatively named Borrelia lonestari. In this study, wild lone star ticks collected from an area where B. lonestari is endemic were cocultur...

Varela, Andrea S.; Luttrell, M. Page; Howerth, Elizabeth W.; Moore, Victor A.; Davidson, William R.; Stallknecht, David E.; Little, Susan E.

2004-01-01

134

Association between gold induced skin rash and remission in patients with rheumatoid arthritis.  

OpenAIRE

The coincidence of skin eruption and remission induced by gold has not previously been reported. In 50 out of 247 patients with rheumatoid arthritis treated with gold salts (Solganal) between 1977 and 1987 treatment was stopped owing to adverse reactions. Skin rashes were present in 31 patients, 10 had nephropathy, and nine patients had aphthous stomatitis. All 31 patients who developed skin eruption entered a concomitant clinical and laboratory remission. The remission satisfied the American...

Caspi, D.; Tishler, M.; Yaron, M.

1989-01-01

135

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

Directory of Open Access Journals (Sweden)

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.

Antonio Carlos M. Pereira

2001-02-01

136

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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 pre [...] senting 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.

Antonio Carlos M., Pereira; Roberto Alexandre Q., Barros; Jussara Pereira do, Nascimento; Solange Artimos de, Oliveira.

2001-02-01

137

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

International Nuclear Information System (INIS)

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)

138

Geomorphology and structural geology of Saturnalia Fossae and adjacent structures in the northern hemisphere of Vesta  

Science.gov (United States)

Vesta is a unique, intermediate class of rocky body in the Solar System, between terrestrial planets and small asteroids, because of its size (average radius of ?263 km) and differentiation, with a crust, mantle and core. Vesta's low surface gravity (0.25 m/s2) has led to the continual absence of a protective atmosphere and consequently impact cratering and impact-related processes are prevalent. Previous work has shown that the formation of the Rheasilvia impact basin induced the equatorial Divalia Fossae, whereas the formation of the Veneneia impact basin induced the northern Saturnalia Fossae. Expanding upon this earlier work, we conducted photogeologic mapping of the Saturnalia Fossae, adjacent structures and geomorphic units in two of Vesta's northern quadrangles: Caparronia and Domitia. Our work indicates that impact processes created and/or modified all mapped structures and geomorphic units. The mapped units, ordered from oldest to youngest age based mainly on cross-cutting relationships, are: (1) Vestalia Terra unit, (2) cratered highlands unit, (3) Saturnalia Fossae trough unit, (4) Saturnalia Fossae cratered unit, (5) undifferentiated ejecta unit, (6) dark lobate unit, (7) dark crater ray unit and (8) lobate crater unit. The Saturnalia Fossae consist of five separate structures: Saturnalia Fossa A is the largest (maximum width of ?43 km) and is interpreted as a graben, whereas Saturnalia Fossa B-E are smaller (maximum width of ?15 km) and are interpreted as half grabens formed by synthetic faults. Smaller, second-order structures (maximum width of medium-scale impacts (diameters of medium-scale impacts, is interpreted to form minor ridges because seismic shaking induces flow of regolith, which subsequently accumulates as minor ridges that are roughly parallel to the regional slope. In this work we expand upon the link between impact processes and structural features on Vesta by presenting findings of a photogeologic, structural mapping study which highlights how impact cratering and impact-related processes are expressed on this unique, intermediate Solar System body.

Scully, Jennifer E. C.; Yin, A.; Russell, C. T.; Buczkowski, D. L.; Williams, D. A.; Blewett, D. T.; Ruesch, O.; Hiesinger, H.; Le Corre, L.; Mercer, C.; Yingst, R. A.; Garry, W. B.; Jaumann, R.; Roatsch, T.; Preusker, F.; Gaskell, R. W.; Schröder, S. E.; Ammannito, E.; Pieters, C. M.; Raymond, C. A.

2014-12-01

139

Microanatomy and Surgical Approaches to the Infratemporal Fossa: An Anaglyphic Three-Dimensional Stereoscopic Printing Study  

OpenAIRE

Objective: The infratemporal fossa (ITF) is a continuation of the temporal fossa between the internal surface of the zygoma and the external surface of the temporal bone and greater wing of the sphenoid bone that is sitting deep to the ramus of the mandible. The principal structure to understanding its relationships is the lateral pterygoid muscle. Other important structures are the medial pterygoid muscle, the maxillary artery, the pterygoid venous plexus, the otic ganglion, the chorda tympa...

Isolan, Gustavo Rassier; Rowe, Richard; Al-mefty, Ossama

2007-01-01

140

Oncogenic osteomalacia associated with mesenchymal tumor in the middle cranial fossa: a case report  

OpenAIRE

Abstract Introduction Tumor-induced osteomalacia is a paraneoplastic syndrome of hypophosphatemia. Osteomalacia causes multiple bone fractures and severe pain. Case presentation We report the case of a 57-year-old Japanese man with tumor-induced osteomalacia associated with a middle cranial fossa bone tumor. The tumor was successfully resected by using a middle fossa epidural approach. His phosphate level recovered to a normal range immediately after the surgery. Conclusions It is rare that t...

Chokyu Isao; Ishibashi Kenichi; Goto Takeo; Ohata Kenji

2012-01-01

141

Results of radiotherapy with cobalt-60 of malignant tumors of the tonsillar fossa  

International Nuclear Information System (INIS)

From 1963 to 1978 119 patients with a carcinoma of the tonsillar fossa received cobalt-60-therapy from 60 to 70 Gy to the primary lesion and the lymph nodes. The 5-year-survival-rate was 34%, with a combined therapy of surgery and irradiation it was 43.6%. For 44 patients with a sarcoma of the tonsillar fossa the 5-year-survival was 32%. For the patients with a carcinoma chemotherapy was only given for palliation. (orig.)

142

Recurrent ameloblastoma of the infratemporal fossa: diagnostic implications and a review of the literature.  

Science.gov (United States)

It is unusual for odontogenic tumours such as ameloblastoma to occur in the infratemporal fossa. Although these odontogenic tumours usually arise in jaws, they can infiltrate into the infratemporal region, pterygomaxillary space or fissure, invading soft tissues by way of extension. A case of recurrent ameloblastoma in the infratemporal fossa region arising from an extension of the lesion from the site of previous occurrence in the right mandibular body is reported. PMID:17881602

Auluck, A; Shetty, S; Desai, R; Mupparapu, M

2007-10-01

143

Synovial chondromatosis of the temporomandibular joint with extension to the middle cranial fossa  

OpenAIRE

A rare case of synovial chondromatosis with extension to the middle cranial fossa is reported. Synovial chondromatosis, a benign disorder characterized by multiple cartilaginous, free-floating nodules that originate from the synovial membrane is not exclusive to the temporomandibular joint (TMJ). This condition is commonly seen in the axial skeleton and can involve multiple joints. In this case, synovial chondromatosis of the TMJ led to complete bony erosion of the glenoid fossa extending int...

Mupparapu M

2005-01-01

144

Reconciling the convergence of supraspinous fossa shape among hominoids in light of locomotor differences.  

Science.gov (United States)

Differences in scapular morphology between modern humans and the African and lesser apes are associated with the distinct locomotor habits of these groups. However, several traits, particularly aspects of the supraspinous fossa, are convergent between Homo and Pongo-an unexpected result given their divergent locomotor habits. Many morphological assessments of the scapula rely on the limited number of static landmarks available, and traditional approaches like these tend to oversimplify scapular shape. Here, we present the results of two geometric morphometric (GM) analyses of hominoid supraspinous fossa shape-one employing five homologous landmarks and another with 83 sliding semilandmarks-alongside those of traditional methods to evaluate if three-dimensional considerations of fossa shape afford more comprehensive insights into scapular shape and functional morphology. Traditional measures aligned Pongo and Homo with narrow and transversely oriented supraspinous fossae, whereas African ape and Hylobates fossae are broader and more obliquely situated. However, our GM results highlight that much of the convergence between Homo and Pongo is reflective of their more medially positioned superior angles. These approaches offered a more complete assessment of supraspinous shape and revealed that the Homo fossa, with an intermediate superior angle position and moderate superoinferior expansion, is actually reminiscent of the African ape shape. Additionally, both Pongo and Hylobates were shown to have more compressed fossae, something that has not previously been identified through traditional analyses. Thus, the total morphological pattern of the Pongo supraspinous fossa is unique among hominoids, and possibly indicative of its distinctive locomotor habits. Am J Phys Anthropol 156:498-510, 2015. © 2015 Wiley Periodicals, Inc. PMID:25607373

Green, David J; Sugiura, Yui; Seitelman, Brielle C; Gunz, Philipp

2015-04-01

145

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

International Nuclear Information System (INIS)

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.)

146

Supratentorial Neurometabolic Alterations in Pediatric Survivors of Posterior Fossa Tumors  

International Nuclear Information System (INIS)

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 = ite 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.

147

Supratentorial Neurometabolic Alterations in Pediatric Survivors of Posterior Fossa Tumors  

Energy Technology Data Exchange (ETDEWEB)

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.

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

148

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

LENUS (Irish Health Repository)

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.

McCartan, D P

2012-01-31

149

Middle cranial fossa anatomy and the origin of modern humans.  

Science.gov (United States)

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

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

2008-02-01

150

Desmoid Tumor of the Popliteal Fossa during Pregnancy.  

Science.gov (United States)

Desmoid tumors are fibroblastic neoplasms that have an intermediate behavior with a highly aggressive infiltrative growth arising from deep muscle or aponeurosis. We present the case of a 34-year-old woman that developed a painless mass in the right popliteal fossa during pregnancy after intracytoplasmic sperm injection and hormonal therapy. The MRI scan showed a hyperintense mass of 6,7?cm?×?4,7?cm?×?3,8?cm surrounding the lateral head of the gastrocnemius muscle. The open biopsy was done one week after delivery, and the histology showed a desmoid tumor. We performed the resection one week later and found the common peroneal nerve completely surrounded by the tumor. The close resection due to the neurolysis was the reason why an adjuvant radiation with 56?Gy was done. The last clinical examination, 18 month later, did not show any signs of recurrence and an excellent functional outcome. This case demonstrates the possible influences of pregnancy and hormonal therapy on the evolution of desmoid tumors. PMID:25734019

Weschenfelder, Wolfram; Lindner, Robert; Spiegel, Christian; Hofmann, Gunther Olaf; Vogt, Matthias

2015-01-01

151

Quality of life in children survivors of posterior fossa tumors  

International Nuclear Information System (INIS)

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

152

Hemangioblastoma of the posterior fossa: the role of multimodality treatment / Hemangioblastoma da fossa posterior: papel do tratamento multimodal  

Scientific Electronic Library Online (English)

Full Text Available Os autores fazem revisão de uma série de pacientes com hemangioblastomas da fossa posterior tratados entre 1973 e 1993: 32 pacientes foram analisados com 24 deles recebendo ressecção, 8 recebendo radiocirurgia e 2 recebendo radioterapia convencional. A mortalidade dos pacientes submetidos a ressecçã [...] o foi considerada aceitável com 2 mortes (8%) c com morbidade de outros 3 pacientes (12,5%). A revisão de literatura sugere que a radioterapia convencional com altas doses (45-60 Gy) pode ter um papel no controle pós-operatório dos hemangioblastomas e em alguns casos pode ser empregada mesmo antes da ressecção com o objetivo de facilitar a cirurgia. O tratamento radiocirúrgico é considerado coadjuvante. Resultados ruins foram obtidos com a radiocirurgia em tumores grandes em que doses baixas (menos que 20 Gy) foram utilizadas. Devido a raridade e complexidade destes tumores, principalmente quando associados com a doença de von Hippel-Lindau, um estudo multicêntrico pode ser útil na avaliação da combinação e otimização dessas modalidades de tratamento. Abstract in english The authors made a review of a series of patients with hemangioblastomas of the posterior fossa treated between 1973 and 1993. A total of 32 patients were analyzed with 24 patients receiving resection, 8 patients receiving radiosurgery and 2 patients receiving conventional radiotherapy. The mortalit [...] y in the patients with a resection was considered acceptable with 2 deaths (8%) and with a morbidity of 3 patients (12.5%). A review of the literature suggests that conventional radiotherapy with high doses (45-60 Gy) may have a role in the post-operative control of hemangioblastomas and in some cases could be employed even before the resection in order to facilitate the surgery. The radiosurgical treatment is regarded like adjuvant. Poor results were obtained with radiosurgery in large tumors where low doses (less than 20 Gy) were used. Because of the rarity and complexity of these tumors, mainly when associated with von Hippel-Lindau disease, a multicenter study could be useful with the assessment of the optimal utilization and combination of these treatment modalities.

Alvaro E., Georg; L. Dade, Lunsford; Douglas, Kondziolka; John C., Flickinger; Ann, Maitz.

1997-06-01

153

Diaper Rash  

Science.gov (United States)

... any area that is not covered by the diaper. Treatments Your Physician May Prescribe The doctor may suggest ... Self-Care Guidelines When to Seek Medical Care Treatments Your Provider May Prescribe ... (Candidiasis) View all diseases Community: Discussion Forum ...

154

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

International Nuclear Information System (INIS)

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 dacryocystohe 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

155

Drug Rash with Eosinophilia and Systemic Symptoms Syndrome Due to Anti-TB Medication.  

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Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, idiosyncratic, multi-system reaction characterized by the clinical triad of fever, rash, and internal organ involvement. The mortality rate is estimated to be 8%, especially among patients with liver involvement, so early recognition is imperative. Drugs commonly associated with the development of DRESS syndrome include anticonvulsants, long-acting sulfonamides, and anti-inflammatory medications; however, there are no reported cases implicating anti-tuberculosis (anti-TB) medications. We report a case of DRESS syndrome from anti-TB therapy. A 68-year-old male with pulmonary TB presented with pruritic skin eruption and sore throat, 8 weeks after starting Rifampin, Isoniazid, Pyrazinamide, and Ethambutol (RIPE) therapy. He takes metformin and glyburide for diabetes. Physical exam was significant for diffuse, exfoliative erythematous macules with target lesions involving the entire skin surface, without mucosal involvement. Laboratory data was significant for mild transaminitis and new onset eosinophilia. Given suspicion of drug eruption, RIPE therapy was discontinued. Skin biopsy confirmed erythema multiforme. Despite discontinuation of the implicated medications, eosinophilia and transaminitis continued to worsen, and so systemic corticosteroids were started. After 4 weeks of discontinuation of RIPE therapy, the cutaneous eruption resolved and laboratory data returned to normal. The patient is finishing course of anti-TB with cycloserine and moxifloxacin. Upon follow up as outpatient, the rash was resolving and disappeared in 1 month. DRESS syndrome is always considered when there is high eosinophil counts and multisystem involvement with skin eruptions. It can be potentially life threatening with certain drugs and infectious agents in predisposed individuals. It is imperative to discontinue the causative medication and avoid re-exposure. PMID:24479051

Kaswala, Dharmesh H

2013-01-01

156

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  

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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.

André Luis Selmi

2012-01-01

157

A case of cyst hydatid rupture presented with rashes to the emergency department  

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Full Text Available Hydatid cyst is a disease caused by Echinococcus Granulosus. The cystic form of Echinoccocus granulosus (Cyst Hydatid is usually seen in the liver (60%. Hydatid cyst rupture may cause with a wide range of allergic reactions, from urticaria to anaphylactic shock. Erythema, puffiness and pruritus may be the only findings of cyst hydatid rupture in some cases. In the present study, we report a case of 22 year old man presented with skin rashes and diagnosed as cyst hydatid rupture. And we also discussed the cyst hydatid rupture in the light of the medical literature.

Hayati KANDIS

2009-01-01

158

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

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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.

Vatve Maneesha

2000-01-01

159

Posterior fossa arachnoid cysts in adults: Surgical strategy: Case series  

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Introduction and Aim: The management of posterior fossa arachnoid cyst (PFAC) in adults is controversial. To review our cases and literature, propose a practically useful surgical strategy, which gives excellent long-term outcome in management of PFAC. Materials and Methods: We analyzed our case records of 26 large intracranial arachnoid cysts in adults treated over 12 years. Of them, we had 7 patients with symptomatic PFAC. Reviewed the literature of 174 PFAC cases (1973–2012) and added 7 of our new cases with a follow-up ranging from 3 to 12 years. Results: In 6 cases the PFAC was located in the midline. In the 7th case, it was located laterally in the cerebello-pontine (CP) angle. All patients were treated surgically. Excision of the cyst was performed in 5 of these cases. Among the two intra-fourth ventricular cysts, in both the cases cysto-peritoneal shunt was performed. Postoperative computed tomography/magnetic resonance imaging showed variable decrease in size of the cyst even though clinically all patients improved. We propose a surgical strategy for the management of these cases which would aid the surgeon in decision making. Discussion: We observed that these PFACs can occur either in the midline within the fourth ventricle or retroclival region or extra-fourth ventricular region. It can also develop laterally in the CP angle or behind the cerebellum or as intracerebellar cyst. Importance of this is except for Midline Intra-fourth ventricular cyst/retroclival cyst, the rest all can be safely excised with excellent long term outcome. The treatment strategy for Midline Intra-fourth ventricular cyst/retroclival cyst can be either cysto-peritoneal shunt or endoscopic fenestration of the cyst.

Srinivasan, Uddanapalli Sreeramulu; Lawrence, Radhi

2015-01-01

160

Defining the superior border of posterior fossa radiation treatment fields  

International Nuclear Information System (INIS)

Purpose: Lateral posterior fossa treatment fields are usually defined on traditional simulation films based on bony landmarks. The superior field border, intended to include the apex of the tentorium cerebelli, is frequently difficult to define. While sagittal magnetic resonance imaging (MRI) images or three-dimensional treatment planning tools are good means to locate the tentorial apex, these are not always available. We herein describe a method for locating the tentorial apex based on bony landmarks. Methods and Materials: Midsagittal magnetic resonance images of 53 patients were reviewed. Using a Cartesian grid, the geometric relationship between the tentorial apex and several bony landmarks was assessed. Two lines were defined: the first connected the posterior clinoid and the internal occipital protuberance (AB). The second was perpendicular to the first, included the tentorial apex, and extended from the base of the skull inferiorly to the 'crown' of the skull superiorly (DE). Relationships between measurements were made using linear regression and least square fits. Results: Line DE was within 5 mm of the perpendicular bisector of line AB in 83% (44/53) of patients. The tentorial apex was located within 10 mm of the midpoint of DE in 91% (48/53) of patients. Conclusion: In the majority of patients, the location of the tentorial apex can be estimated based on bony landmarks, to within approximately 10 mm. The technique described is a useful means of estimating described is a useful means of estimating the location of the tentorial apex in patients where sagittal MRI imaging or three-dimensional treatment planning tools are not available

161

Malignant melanoma of nasal fossae, a propos of a case  

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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.

Gómez-González JL

2012-07-01

162

Evaluation of CSF flow patterns of posterior fossa cystic malformations using CSF flow MR imaging  

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Differential radiologic diagnosis of cystic malformations of the posterior fossa is often difficult with conventional imaging techniques because of overlapping features of these entities. Posterior fossa cystic malformations occupy the cerebrospinal fluid (CSF) spaces. They may create secondary dynamic effects on the movements of CSF. The aim of this study was to investigate CSF flow alterations in posterior fossa cystic malformations with CSF flow MR imaging. The study included 40 patients with cystic malformations of the posterior fossa. The patients underwent cardiac-gated phase-contrast cine MR imaging. CSF flow was qualitatively evaluated using an in-plane phase-contrast sequence in the midsagittal plane. The MR images were displayed in a closed-loop cine format. Twelve of the patients had communicating arachnoid cyst, seven had non-communicating arachnoid cyst, ten had mega cisterna magna, six had Dandy-Walker malformation, two had Dandy-Walker variant, and three had Blake's pouch cyst. CSF flow MR imaging indicated the regions of no, slow or higher flow, direction of flow, and abnormal cystic fluid motion. Each malformation displayed a distinct CSF flow pattern. Phase-contrast cine MR imaging for CSF flow evaluation may be a useful adjunct to routine MR imaging in the evaluation of the cystic malformations of the posterior fossa because it can improve the specificity in differentiating such malformations. (orig.)

Yildiz, Harun; Yazici, Zeynep; Hakyemez, Bahattin; Erdogan, Cuneyt; Parlak, Mufit [University of Uludag, Department of Radiology, School of Medicine, Bursa (Turkey)

2006-09-15

163

Inflammatory pseudotumor of the infratemporal fossa leading to orbital apex syndrome.  

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An inflammatory pseudotumor is a rare benign disease presenting with non-specific chronic inflammation, and reported occurrences involving the skull base are relatively rare. A 65-year-old man became aware of pain around the right temporomandibular joint and mild trismus, and palsies of the cranial nerves III, IV, V, and VI were observed. A biopsy was performed under general anesthesia with an infratemporal fossa approach, and he was diagnosed with inflammatory pseudotumor of the infratemporal fossa. There was a rapid improvement in symptoms after the start of steroid administration, and 29 months after the initial consultation, the patient remained under strict observation. The 3 criteria in our department for confirming progression of the disease are (1) clinical symptoms, (2) C-reactive protein levels in blood tests, and (3) contrast effect of the tumor on magnetic resonance imaging. This is a rare case report to demonstrate the inflammatory pseudotumor of the infratemporal fossa leading to orbital apex syndrome. PMID:24943507

Nishio, Naoki; Fujimoto, Yasushi; Nakashima, Tsutomu

2014-07-01

164

DEMOGRAPHIC DATA COMPARISON OF PREVALENCE OF MASS IN RIGHT ILIAC FOSSA: A PROSPECTIVE HOSPITAL BASED STUDY  

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Full Text Available Mass in the right iliac fossa is one of the commonest problems faced in surgical practice. The present study was conducted to find the incidence of mass in patients attending surgery department. A total of 50 cases were included in the study. Their demographic data was collected and analysed to find the incidence of mass in right iliac fossa. The results showed a high incidence of appendicular mass (44% with male preponderance; followed by ileocaecal tuberculosis and carcinoma of caecum. The incidence of appendicular mass was highest in the age of 21-30 years. Appendicular abscess and ileocaecal tuberculosis showed highest incidence in the age group of 31-40 years. In the age group of 51-60 years carcinoma of caecum was observed the most. Several factors like age, gender, food habits and occupation caused the development of mass in the abdomen. Coolies and agriculturists were more prone to development of mass in the right iliac fossa.

Sunil Kumar M*, Mohan, Sarath Babu K, Deepak Hongaiah, Pradeep Kumar T and Balakrishna MA

2014-03-01

165

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

International Nuclear Information System (INIS)

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)

166

Synovial chondromatosis of the temporomandibular joint with extension to the middle cranial fossa.  

Science.gov (United States)

A rare case of synovial chondromatosis with extension to the middle cranial fossa is reported. Synovial chondromatosis, a benign disorder characterized by multiple cartilaginous, free-floating nodules that originate from the synovial membrane is not exclusive to the temporomandibular joint (TMJ). This condition is commonly seen in the axial skeleton and can involve multiple joints. In this case, synovial chondromatosis of the TMJ led to complete bony erosion of the glenoid fossa extending into the middle cranial fossa. Although plain radiographs showed the involvement of the joint, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) provided more detailed information about the lesion in all three dimensions. This case demonstrates the value of CT and MRI in both the diagnosis and treatment planning. A review of previously reported cases of synovial chondromatosis with cranial extensions is included. PMID:16006705

Mupparapu, M

2005-01-01

167

Synovial chondromatosis of the temporomandibular joint with extension to the middle cranial fossa  

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Full Text Available A rare case of synovial chondromatosis with extension to the middle cranial fossa is reported. Synovial chondromatosis, a benign disorder characterized by multiple cartilaginous, free-floating nodules that originate from the synovial membrane is not exclusive to the temporomandibular joint (TMJ. This condition is commonly seen in the axial skeleton and can involve multiple joints. In this case, synovial chondromatosis of the TMJ led to complete bony erosion of the glenoid fossa extending into the middle cranial fossa. Although plain radiographs showed the involvement of the joint, Computed Tomography (CT and Magnetic Resonance Imaging (MRI provided more detailed information about the lesion in all three dimensions. This case demonstrates the value of CT and MRI in both the diagnosis and treatment planning. A review of previously reported cases of synovial chondromatosis with cranial extensions is included.

Mupparapu M

2005-01-01

168

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

International Nuclear Information System (INIS)

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 entit 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

169

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

Energy Technology Data Exchange (ETDEWEB)

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.

Park, Sang Woo; Seol, Hae Young; Yong, Hwan Seok; Kim, Dae Hyun; Kang, Hyo Jun; Kim, Baek Hyun [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

2000-12-01

170

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

171

[A temporal bone study of the jugular fossa].  

Science.gov (United States)

This study was performed to elucidate the anatomic variations of the jugular fossa (JF) on the basis of examination of 120 human temporal bones. Observations were made of temporal bones sectioned along a plane including the cochlea, the JF, and long axis of the internal auditory canal. The position of the upper margin of the JF was classified according to its relation to the tympanic cavity, the cochlea, and the internal auditory canal. The height of the upper margin of the JF was classified as follows. Low type; inferior to the level of the external auditory canal. Middle type; between the level of the external auditory canal and the cochlea. High type; superior to the level of the cochlea. The results revealed that 58 ears were of low type, 46 middle type, and 16 high type. Middle and high type comprised 62 ears, thus in 52% of ears the upper margin of the JF was situated superior to the external auditory canal. The relation between the JF and the cochlea was classified as follows. Medial type; medial to the medial margin of the cochlea. Lateral type; lateral to the medial margin of the cochlea. The results showed that 74 ears were of medial type, and 46 lateral type. Therefore, in 62% of ears the upper margin of the JF was situated medial to the medial margin of the cochlea. Forty-seven ears of medial type were of middle or high type. Ears of lateral type included none of high type. The jugular bulb diverticulum was observed in 32 ears, which consisted of 3 of low type, 13 middle type, 16 high type. When the upper margin of the JF was positioned higher, the JF was in a more medial position. However, no defect of the bony labyrinth was observed. In conclusion, it is considered that protrusion of the jugular bulb into the tympanic cavity was not caused by the abnormally high position of the JF, but by its lateral displacement. Distances from the JF to the surrounding structures were as follows; to the tympanic membrane 5.58 +/- 2.43mm (mean +/- S.D.), to the tympanic cavity 2.94 +/- 1.92mm, to the cochlea 4.93 +/- 2.20mm, and the internal auditory canal 5.82 +/- 2.38mm. PMID:1634992

Yagi, M

1992-06-01

172

Concomitant boost radiotherapy for squamous carcinoma of the tonsillar fossa  

International Nuclear Information System (INIS)

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 nody 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

173

Executive Dysfunction in Pediatric Posterior Fossa Tumor Survivors: A Systematic Literature Review of Neurocognitive Deficits and Interventions  

OpenAIRE

Improved medical therapies have increased survivorship rates for children with posterior fossa tumors; resultantly, morbidities associated with survivorship, such as executive function deficits, have become increasingly important to identify and address. Executive dysfunction can impact academic achievement as well as functional outcomes. We summarize studies describing executive functioning deficits in pediatric posterior fossa tumor survivors who received cranial radiation therapy and inter...

Wolfe, Kelly R.; Madan-swain, Avi; Kana, Rajesh K.

2012-01-01

174

A case of recurrent rash and leg numbness mimicking systemic rheumatic disease: the occurrence of leprosy in a nonendemic area.  

Science.gov (United States)

Leprosy, a rare chronic granulomatous communicable disease caused by Mycobacterium leprae, is classically known to have cutaneous and neurologic sequelae. As a result of immigration, the disease, endemic in Brazil, India, Nepal, Madagascar, Myanmar, and Indonesia, has been recognized to be present in North America and the Caribbean. We describe a case of a woman presenting with a long history of a recurrent rash and leg numbness, initially diagnosed with systemic lupus, who was later proven to have lepromatous leprosy. It is a reminder that this underappreciated disease should still be considered in the differential diagnosis of skin rash and neuropathy, even in nonendemic regions. PMID:17551381

Flower, Cindy; Gaskin, David; Marquez, Sean

2007-06-01

175

Chololesterol granuloma in the middle cranial fossa: report of two cases  

International Nuclear Information System (INIS)

We report two cases of cholesterol granuloma in the middle cranial fossa. On CT the lesions appeared as a nonspecific, nonenhancing soft-tissue mass with bone erosion. On MRI they were seen as areas of high signal intensity surrounded by a low-intensity peripheral zone on both T1- and T2-weighted images. Cholesterol granuloma is thought to occur when pneumatised cells in the temporal bone become obstructed. Although this lesion usually occurs in the petrous bone, it can extend to the middle cranial fossa. The diagnosis and surgical management are discussed. (orig.)

176

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

International Nuclear Information System (INIS)

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)

177

Klippel-Feil syndrome in association with posterior fossa suboccipital dermoid cyst  

International Nuclear Information System (INIS)

We present the second case of Klippel-Feil syndrome in association with a posterior fossa dermoid cyst extending through the occipital bone and presenting as a suboccipital subcutaneous mass. We describe its radiographic, CT, and MRI appearances as well as on MRI diffusion-weighted images. Posterior cranial fossa dermoid cysts and sinuses should be added to the list of congenital abnormalities which must be sought in patients with Klippel-Feil syndrome. Diffusion-weighted images of brain may differentiate these masses from cerebral spinal fluid collections. (orig.)

178

Klippel-Feil syndrome in association with posterior fossa suboccipital dermoid cyst  

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We present the second case of Klippel-Feil syndrome in association with a posterior fossa dermoid cyst extending through the occipital bone and presenting as a suboccipital subcutaneous mass. We describe its radiographic, CT, and MRI appearances as well as on MRI diffusion-weighted images. Posterior cranial fossa dermoid cysts and sinuses should be added to the list of congenital abnormalities which must be sought in patients with Klippel-Feil syndrome. Diffusion-weighted images of brain may differentiate these masses from cerebral spinal fluid collections. (orig.)

Aksoy, F.G. [Turkish Ministry of Health-Ankara (Turkey). Dept. of Radiology; Aksoy, O.G. [Ankara Training and Research Hospital (Turkey). Dept. of Orthopedics; Gomori, J.M. [Hadassah Univ. Hospital, Jerusalem (Israel). Dept. of Radiology

2001-01-01

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

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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)

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

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Revised classification of posterior fossa cysts and cystlike malformations based on the results of multiplanar MR imaging.  

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MR and clinical data on 31 patients with posterior fossa CSF collections were analyzed. A clear separation of these patients into classical categories was not possible because of new information obtained from the MR images. We present a new classification of these disorders. The Dandy-Walker malformation, Dandy-Walker variant, and mega-cisterna magna seem to represent a continuum of developmental anomalies of the posterior fossa. A possible embryologic basis for this continuum is suggested. Discrete posterior fossa CSF collections that are clearly separate from the fourth ventricle and vallecula are classified as posterior fossa cysts. Posterior fossa CSF collections that communicate with the fourth ventricle and are associated with cerebellar atrophy are classified as prominent cisterna magna. Both the Dandy-Walker complex and posterior fossa cysts can cause enlargement of the posterior fossa and scalloping of the inner table of the occipital bone. The Dandy-Walker complex presents with seizures, developmental delay, and enlarging head size; it requires CSF diversion when associated with hydrocephalus. Posterior fossa cysts present with symptoms of a posterior fossa mass; they generally require surgical resection. Prominent cisterna magna is a result of degenerative disorders and requires no surgical therapy. This new classification facilitates both diagnosis and therapy of these disorders. MR revealed that disorders previously referred to as the Dandy-Walker malformation, the Dandy-Walker variant, and the mega-cisterna magna actually are not separate entities, but appear to represent steps on a continuum of developmental anomalies of the posterior fossa. Because of this, we suggest a new term, the Dandy-Walker complex, be used to describe this continuum. PMID:2816648

Barkovich, A J; Kjos, B O; Norman, D; Edwards, M S

1989-12-01

181

A 62-year-old women with persistent severe asthma, skin rash, and eosinophilia.  

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A 62-year-old white woman was admitted with shortness of breath, wheezing, and cough. While in the hospital a generalized pruritic skin rash developed on her trunk and upper and lower extremities. She did not have any fevers, chills, or night sweats. The patient was known to have chronic, difficult-to-control asthma despite being compliant with a treatment regimen consisting of inhaled albuterol, high-dose inhaled steroids, salmeterol, and montelukast. Her medical history was significant for hypertension and gout. She had no family history of asthma. The patient was a life-long nonsmoker and did not drink alcohol. During this hospitalization, she was started on prednisone 40 mg/d po in addition to her home medications. PMID:25091763

Lataifeh, Abdel Rahman; Deas, Steven; Shalin, Sara C; Khasawneh, Khaled R

2014-08-01

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

International Nuclear Information System (INIS)

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 reportss 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

183

Skin rash and arthritis a simplified appraisal of less common associations.  

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Skin and joint manifestations are part of the clinical spectrum of many disorders. Well-known associations include psoriatic arthritis and arthritis associated with autoimmune connective tissue diseases. This review focuses on less common associations where skin lesions can provide easily accessible and valuable diagnostic clues, and directly lead to the specific diagnosis or limit the list of possibilities. This may also affect health care resources as diagnostic tests are often low-specific, highly expensive and poorly available. This group of diseases can be divided into two subsets, based on the presence/absence of fever, and then further classified according to elementary skin lesions (macular, urticarial, maculo-papular, vesico-bullous, pustular, petechial and nodular). In most instances joint involvement occurs as peripheral migrating polyarthritis. Erythematosus macular or urticarial rashes occur in most febrile disorders such as monogenic autoinflammatory syndromes, Schnitzler's syndrome, Still's disease and rheumatic fever and afebrile diseases as urticarial vasculitis. Pustular rash may be observed in chronic recurrent multifocal osteomyelitis (CRMO) and pyogenic arthritis with pyoderma gangrenosum and acne (PAPA) syndrome (both febrile) as well as in Behcet's disease and Synovitis, acne, pustulosis, hyperostosis and osteitis syndrome (both non-febrile). Papular lesions are typical of secondary syphilis, sarcoidosis, interstitial granulomatous dermatitis, papular petechial of cutaneous small-vessel vasculitis and nodular lesions of polyarteritis nodosa and multicentric reticulohistiocytosis all of which are afebrile. Differential diagnosis includes infections and drug reactions which may mimic several of these conditions. To biopsy the right skin lesion at the right time it is essential to obtain relevant histological information. PMID:23980929

Cozzi, A; Doria, A; Gisondi, P; Girolomoni, G

2014-06-01

184

Thalidomide-induced hemorrhagic rash in a patient with myelofibrosis and delta-granule storage pool disease.  

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Thalidomide is one of the immunomodulating agents used in current oncology practice. We present a case of hemorrhagic rash induced by thalidomide in a patient with delta granule storage pool disease. The patient was getting thalidomide for underlying myelofibrosis. PMID:24105355

Taj, Asma; Abbi, Kamal; Skeel, Roland T

2015-01-01

185

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

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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. PMID:24346604

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

2015-01-01

186

Role of squamosal suture as a consistent landmark for middle fossa approach craniotomy: an anatomical study.  

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Objective?To establish a consistent surface bony landmark for a middle fossa approach (MFA) lateral craniotomy represented by the squamosal suture (SS). Methods?In 60 dried skulls, we assessed the relation between the SS and the external auditory canal (EAC). The lateral portion of the middle cranial fossa floor was also assessed for a possible relation with the anteroposterior diameter (APD) of the squama temporalis (ST). Clinically, we applied our findings on the SS in MFA for different lesions. Results?A vertical line at the EAC divided the ST into the anterior part constituting 61% of the APD (i.e., two thirds) and the posterior part forming 39% (i.e., one third). The average ST height was 35.92 mm. The SS posterior limit at the supramastoid crest was located just anterior to the external projection of the petrous ridge in 35 skulls (58%) and exactly corresponded to it in 25 skulls (42%). The APD of the ST equals on average 97% of the APD of the lateral middle cranial fossa. Optimum exposure of the middle fossa was obtained without any further craniotomy extension. Conclusion?The SS serves as a consistent natural surface bony landmark for MFA. Optimum craniotomy, two thirds anterior to the EAC and one third posterior, is obtained following SS as a landmark. PMID:25685647

Alkhalili, Kenan; Tantawy, Mohammed; Nageeb, Mohab M; Ragaee, Mohamed A; Alshyal, Gasser H; Alcindor, Dunbar S; Chen, Douglas A; Aziz, Khaled M Abdel

2015-02-01

187

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

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Full Text Available 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 hematomas in patients with temporal fossa arachnoid cysts has rarely been observed and is reported less frequently in the medical literature. Case presentation We report two cases of people (a 23-year-old man and a 41-year-old man with temporal fossa arachnoid cysts complicated by a subdural hematoma following head injury. Both patients developed a subdural hematoma contralateral to the side of a temporal fossa arachnoid cyst. It is likely that lack of adequate intracranial cushioning in the presence of an intracranial arachnoid cyst may result in injury not only to ipsilateral but also to contralateral bridging veins, following head trauma. Conclusion It is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma.

Pillai Promod

2009-02-01

188

Using acetabular fossa as a guide for anticipated inclination of uncemented cup in total hip replacement.  

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Positions of acetabular implant generally are considered to be major causative factors of dislocation. Accurate and consistent achievement of the preoperatively anticipated orientation of the acetabular cup is a great challenge in total hip replacement (THR). In the present study, we investigated the surgical application of acetabular fossa as a guide for anticipated inclination of uncemented cup, and evaluated its accuracy as an anatomic reference for achieving the preoperatively anticipated abduction of the acetabular cup in comparison with traditional device method on cadaveric specimens. Sixteen normal adult pelvic cadaveric specimens were collected. On each of the sixteen normal adult pelvic cadaveric specimens, acetabular fossa related anatomic sites were marked and studied on pelvic radiographs. Our results showed that there is close correlation between most medial aspect of acetabular sourcil and central axis of the acetabular cup at anticipated inclination of 40° ± 5°. And the fossa group can achieve the preoperatively anticipated cup abduction more accurately than the device group. The current results demonstrated that acetabular fossa can be a reasonable alternative, or as a complement to the currently used methods guiding total hip replacement. PMID:25784987

Li, Junwei; Gao, Xu; Yang, Guanghui; Zhang, Yanru

2015-01-01

189

Therapeutic approach of posterior fossa tumours in adults. A retrospective study.  

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The authors present a review of their experience with posterior fossa tumours in adults during a period of 20 years. Symptoms, physical findings, tumour histology, operative treatment and results are reviewed in 109 cases. The value of preoperative normalization of intracranial pressure by insertion of a ventriculo-subcutaneous drainage is discussed. PMID:2163804

Claesen, P; Plets, C; D'Haen, B; Van den Bergh, R

1990-01-01

190

A Rare Case of Metastatic Renal Cell Carcinoma in Posterior Fossa  

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Full Text Available Renal cell carcinoma (RCC is a tumor with high degree of potentiality for distant metastasis. Intracranial metastasis is a very rare location for this tumor. Here is presented a 47-year-old female with history of RCC and cerebellar metastasis. Key Words: Renal Cell Carcinoma, Metastasis, Posterior Fossa

H Moin

2005-09-01

191

Posterior fossa midline cryptococcoma in a patient with idiopathic CD4 lymphocytopenia.  

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Idiopathic CD4 lymphocytopenia (ICL) is a rare disorder which is often diagnosed as HIV-negative AIDS in the light of poor immunity and AIDS-defining illnesses. We present a case of a 50-year-old male who presented with a midline posterior fossa tumour with ICL diagnosed as cerebellar cryptococcoma. PMID:22885213

Rai, S; Marak, R S K; Jain, S; Dhole, T N

2012-01-01

192

A dural arteriovenous fistula of the anterior cranial fossa angiographically mimicking an anterior ethmoidal artery aneurysm.  

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Venous aneurysm or varix at the venous side of the fistula commonly exist in dural arteriovenous fistula (DAVF) of the anterior cranial fossa, which may be initially mistaken with aneurysm on computed tomography and magnetic resonance imaging, but always identified by angiography. We report a very unusual case of anterior cranial fossa DAVF angiographically mimicking an anterior ethmoidal artery aneurysm, which was ultimately corrected by surgery. A 41-year-old male presented with right frontal intraparenchymal hematoma with intraventricular extension. Angiography revealed a vascular lesion adjacent to the anterior fossa mimicking an anterior ethmoidal artery aneurysm, which was surgically proven to be a partially thrombosed venous varix of drainaging vein originated from the cribriform plate. A diagnosis of anterior cranial fossa DAVF was made, and venous varix was excised. Follow-up angiography after the operation revealed complete disappearance of the lesion. Our case illustrates a unique occasion that a proximal venous varix without obvious outflow angiographically in DAVF might be mistaken with an aneurysm. PMID:19555408

Chen, Zhi; Tang, Weihua; Liu, Zhi; Li, Fei; Feng, Hua; Zhu, Gang

2010-10-01

193

Chronic arachnoiditis in the posterior fossa: a study of 82 cases  

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Arachnoiditis in the posterior fossa is not a rare disorder in China. Eighty-two cases seen in a three year period were studied with reference to symptomatology, aetiology and treatment. The presentation was contrasted with that of increased intracranial pressure caused by tumour. The efficacy of treatment by direct exploration and shunt surgery was emphasised.

Rongxun, Zhang

1982-01-01

194

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

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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…

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

195

The intercondylar fossa of the normal canine stifle: an anatomic and radiographic study  

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The intercondylar fossa (ICF) in dogs consists of a cranial outlet, intercondylar shelf, caudal arch, caudal outlet, a medial wall, and a lateral wall. The normal cranial outlet is bell-shape and, in mixed-breed dogs (mean body weight 19.2 kg, N = 21), measured 5.8 mm cranially, 8.1 mm centrally, and 10.3 mm caudally. The ICF is oriented 12 degree from the dorsal plane of the femoral diaphysis and obliqued 7 degree , proximolateral to distomedial, in the sagittal plane. To adjust for dog size, a fossa width index (FWI) was calculated by dividing the cranial outlet width by the distance between epicondyles. The normal FWI as determined in this study was 0.18 cranially, 0.25 centrally, and 0.32 caudally. The fossa height index was 0.31. Contact between the ICF and the cranial cruciate ligament began at about 115 degree of extension. The contact area moved cranially in the intercondylar fossa as the stifle was extended. Evaluation of the ICF can be performed radiographically but positioning is critical

196

Predictors of functional outcome following treatment of posterior fossa arteriovenous malformations.  

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Posterior fossa arteriovenous malformations (AVM) present particular therapeutic challenges. Studies aimed at clarifying risk of hemorrhage focus on obliteration rates, but few have addressed functional outcomes in these patients. In this study, we aim to explore the predictors of good functional outcome for posterior fossa AVM after treatment. A retrospective review of patients diagnosed with posterior fossa AVM at our institution from 1990 to 2013 was performed, and 61 patients met the inclusion criteria. Functional outcomes were assessed using the modified Rankin Scale (mRS), and mRS ? 1 was defined as good outcome. Within our cohort, 39 patients presented with hemorrhage (64.0%). Spetzler-Martin grades were I (n = 9, 14.8%), II (n = 20, 32.8%), III (n = 22, 36.1%), IV (n = 8, 13.1%), and V (n = 2, 3.3%). Patients were treated with surgery (n = 8), radiosurgery (n = 34), embolization (n = 2) or multimodal therapies (n = 8). Nine patients did not undergo treatment. Average follow-up was 41.9 months. Obliteration of AVM was confirmed in 44.3% of patients (n = 27). Forty-three patients (70.5%) achieved good functional outcomes (mRS ? 1). The absence of pre-treatment symptoms (p < 0.01) and AVM obliteration (p = 0.04) were predictive of good functional outcomes. In contrast, non-hemorrhagic presentation was not a significant predictor (p = 0.60). Asymptomatic presentation and AVM obliteration are associated with good functional outcomes in patients with posterior fossa AVM. Non-hemorrhagic presentation does not necessarily predict good functional outcome. Therefore treatment should not be considered only for those who present with hemorrhage. Posterior fossa AVM should be considered for definitive treatment in order to prevent future hemorrhages and subsequent poor functional outcomes. PMID:25439748

Yang, Wuyang; Wang, Joanna Y; Caplan, Justin M; Braileanu, Maria; Shang, Hanbing; Upadhyay, Urvashi; Zenonos, Georgios A; Rigamonti, Daniele; Colby, Geoffrey P; Coon, Alexander L; Tamargo, Rafael J; Huang, Judy

2015-02-01

197

The significance of the pterygopalatine fossa angiography before endoscopic sinus surgery  

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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

Hong-yu XING

2013-11-01

198

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

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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 Menière'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 radiographed 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. PMID:3101406

Wadin, K; Thomander, L; Wilbrand, H

1986-01-01

199

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

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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.

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

200

Stereotactic conformal radiotherapy for posterior fossa tumours: a modelling study for potential improvement in therapeutic ratio  

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Purpose: To investigate the optimal technique of stereotactic conformal radiotherapy (SCRT) for posterior fossa tumours. Material and methods: SCRT planning image data sets of four patients with posterior fossa tumours constituted the study material. Based on the operative notes and preoperative imaging, a clinical target volume (CTV) was drawn for each patient. An additional CTV representative of a typical posterior fossa tumour was also drawn on each patient's localisation scans. Therefore a total of eight CTVs differing in their size and location were used for further work. A margin of 5 mm was grown in three dimensions to result in a final planning target volume (PTV). Beam arrangements studied were conformal bilateral parallel pair, a three-field coplanar arrangement with two bilateral and a vertex beam, two three-field non-coplanar techniques and a six-field non-coplanar technique with conformation achieved by micromultileaf collimator (mMLC). Normal structures contoured included normal posterior fossa brain (excluding PTV), brain stem, cochleae, optic apparatus, pituitary-hypothalamic axis (PHA), supratentorial brain and the temporal lobes. Comparative evaluation of plans was done with dose volume histograms (DVH), conformity index (CI) and dose heterogeneity (DH). Results: In all plans, the 95% isodose line covered at least 99% of the PTV with acceptable dose heterogeneity. As compared to the baseline bilateral conformal parallel pair plan, all other plans achal parallel pair plan, all other plans achieved significantly more sparing of the normal posterior fossa brain at the 95 and 80% dose prescription levels with superior CI (at 95% isodose). The six-field technique resulted in maximum sparing as compared to the bilateral plan with a mean additional sparing of 74% (46.2 cm3) and 55% (33.83) at 95 and 80% dose prescription level, respectively (P<0.0001). Among the three field plans, the technique of bilateral and vertex fields resulted in least doses to cochlea and also irradiated the least volume of brain stem and PHA. Comparison of this technique to the six-field technique did not show any significant difference in sparing of normal structures in the posteriorly placed tumours. In anteriorly placed tumours, the six-field technique was the most optimal irrespective of the size of the target volumes. Conclusions: A six-field plan SCRT achieves the most significant sparing of the normal tissues for localised irradiation in posterior fossa tumours, particularly for anteriorly located tumours. A relatively simpler three-field plan with bilateral and a vertex beam is equally good for tumours that are placed posteriorly and away from the brain stem

201

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

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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. PMID:25670908

Nakahara, Takeshi; Moroi, Yoichi; Takayama, Koichi; Itoh, Eriko; Kido-Nakahara, Makiko; Nakanishi, Yoichi; Furue, Masutaka

2015-01-01

202

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

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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.

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

2014-07-01

203

Chronic subdural hematoma of the posterior fossa associated with cerebellar hemorrhage: report of rare disease with MRI findings Hematoma subdural crônico de fossa posterior associado a hemorragia cerebelar espontânea: relato de doença rara com achados de RNM  

Directory of Open Access Journals (Sweden)

Full Text Available Chronic subdural hematoma of the posterior fossa is an uncommon entity, and spontaneous lesions are very rarely described, occurring mostly during anticoagulation therapy. The association of the posterior fossa chronic subdural hematoma with spontaneous parenchymal hemorrhage without anticoagulation therapy was never related in the literature, to our knowledge. We describe a case of a 64 year-old woman who suffered a spontaneous cerebellar hemorrhage, treated conservatively, and presented 1 month later with a chronic subdural posterior fossa hematoma.Hematomas subdurais da fossa posterior são lesões raras, mais comumente relacionadas com traumas graves. A ocorrência de hematomas subdurais crônicos na fossa posterior é muito rara, sendo descritos 15 casos até o momento, boa parte relacionada ao uso de anticoagulantes. Em nossa revisão da literatura, não pudemos encontrar nenhum relato da associação entre hematoma subdural crônico da fossa posterior e hemorragia cerebelar espontânea. Relatamos o caso de paciente de 64 anos com hematoma intraparenquimatoso cerebelar tratado conservadoramente e hematoma subdural crônico, tratado cirurgicamente, cerca de 1 mês após o acidente vascular cerebelar.

Leodante B. Costa Jr

2004-03-01

204

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

Directory of Open Access Journals (Sweden)

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.

Stewien Klaus Eberhard

2000-01-01

205

Diagnóstico virológico de un brote de fiebre y rash producido por Parvovirus B19, Cuba, 1995  

Directory of Open Access Journals (Sweden)

Full Text Available Se reportan los resultados obtenidos en el estudio de un brote de fiebre y rash ocurrido en Ciudad de La Habana en marzo de 1995. En las muestras de 35 pacientes se descartaron dengue, sarampión, rubéola, herpes simple y Epstein Barr como agentes causales del brote. Mediante la detección de anticuerpos IgM y la técnica de reacción en cadena de la polimerasa (RCP se identificó al Parvovirus B19 como agente causal del brote. En 14/18 muestras (77,7 % se comprobó la infección por este agente por alguna de las técnicas empleadas. Este estudio se refiere al primer brote confirmado de Parvovirus B19 en Cuba.The results obtained in the study of an aoutbreak of fever and reash ocurred in Havana City in March, 1995, are reported. Dengue, measles, rubella, herpes simplex, and Epstein Barr were discarded as causal agents of the outbreak in the samples of 35 patients. Parvovirus B19 was identified as the causing agent of the outbreak by the detection of IgM antibodies and the polymerase chain reaction technique (PCR. The infection produced by this agent was confirmed in 14/18 samples (77,7 % by some of the techniques used. This study makes reference to the first outbreak of Parvovirus B19 that was proved in Cuba.

MARÍA G GUZMÁN

1997-04-01

206

Diagnóstico virológico de un brote de fiebre y rash producido por Parvovirus B19, Cuba, 1995  

Scientific Electronic Library Online (English)

Full Text Available Se reportan los resultados obtenidos en el estudio de un brote de fiebre y rash ocurrido en Ciudad de La Habana en marzo de 1995. En las muestras de 35 pacientes se descartaron dengue, sarampión, rubéola, herpes simple y Epstein Barr como agentes causales del brote. Mediante la detección de anticuer [...] pos IgM y la técnica de reacción en cadena de la polimerasa (RCP) se identificó al Parvovirus B19 como agente causal del brote. En 14/18 muestras (77,7 %) se comprobó la infección por este agente por alguna de las técnicas empleadas. Este estudio se refiere al primer brote confirmado de Parvovirus B19 en Cuba. Abstract in english The results obtained in the study of an aoutbreak of fever and reash ocurred in Havana City in March, 1995, are reported. Dengue, measles, rubella, herpes simplex, and Epstein Barr were discarded as causal agents of the outbreak in the samples of 35 patients. Parvovirus B19 was identified as the cau [...] sing agent of the outbreak by the detection of IgM antibodies and the polymerase chain reaction technique (PCR). The infection produced by this agent was confirmed in 14/18 samples (77,7 %) by some of the techniques used. This study makes reference to the first outbreak of Parvovirus B19 that was proved in Cuba.

MARÍA G, GUZMÁN; DELFINA, ROSARIO; MARÍA E., RODRÍGUEZ; MAYLING, ÁLVAREZ; ROSMARI, RODRÍGUEZ; SUSET, OROPESA; JOSÉ, LAFERTÉ; SONIA, RESIK.

1997-04-01

207

[Enlargement of the fetal posterior fossa--what is the significance?].  

Science.gov (United States)

The posterior fossa may be enlarged due to: mega cisterna magna, arachnoid cyst or Dandy Walker malformation. These anomalies can be identified during routine ultrasound screening performed in the beginning of the second half of pregnancy (22nd week). The outcome of these findings is not clear. Therefore, it is difficult to advise the parents how to manage the pregnancy after the discovery of this anomaly. Most of the studies report a good prognosis in cases of mega cisterna magna or arachnoid cyst, as long as this finding is isolated. A Dandy-Walker malformation or non-isolated enlargement of the posterior fossa entail a guarded prognosis. Further studies are needed in order to enable better counseling. PMID:19264007

Dror, Raheli; Malinger, Gustavo; Ben-Sira, Liat; Lev, Dorit; Pick, Chaim; Lerman-Sagie, Tally

2008-11-01

208

Oncogenic osteomalacia associated with mesenchymal tumor in the middle cranial fossa: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Tumor-induced osteomalacia is a paraneoplastic syndrome of hypophosphatemia. Osteomalacia causes multiple bone fractures and severe pain. Case presentation We report the case of a 57-year-old Japanese man with tumor-induced osteomalacia associated with a middle cranial fossa bone tumor. The tumor was successfully resected by using a middle fossa epidural approach. His phosphate level recovered to a normal range immediately after the surgery. Conclusions It is rare that tumor-induced osteomalacia originates from the middle skull base. This report suggests that, if patients have a clinical and biochemical picture suggestive of tumor-induced osteomalacia, it is crucial to perform a meticulous examination to detect the tumor or the lesion responsible for the tumor. The serum level of fibroblast growth factor 23 is the most reliable marker for evaluating the treatment outcome of tumor-induced osteomalacia.

Chokyu Isao

2012-07-01

209

Extremely weak tumor-promoting effect of troglitazone on splenic hemangiosarcomas in rasH2 mice induced by urethane  

Energy Technology Data Exchange (ETDEWEB)

To examine the tumor-promoting effect of troglitazone (TRG), a novel thiazolidinedione insulin-sensitizing agent, on splenic hemangiosarcomas in rasH2 mice, histopathological and molecular analyses were performed in the spleen of female rasH2 mice fed a diet containing 6,000 or 0 ppm TRG for 16 weeks after 1,000 or 0 mg/kg urethane (UR) initiation. Histopathologically, splenic hemangiosarcomas were observed in the UR-alone and UR+TRG groups, but there was no significant difference in the incidence of splenic hemangiosarcomas between the UR-alone and UR+TRG groups. There were increasing tendencies in the number of positive cells for anti-PCNA antibody and gene expression in the UR+TRG group, but such a change was not statistically significant as compared to that in the UR-alone group. The gene expressions of VEGF, VEGFR1, VEGFC, VEGFR2 and Tie2 related to angiogenesis; c-fos related to MAPK cascade activation; and cyclin D1 related to cell cycle in the UR-alone and UR+TRG groups were significantly higher than those in the untreated control group. However, only the Tie2 gene in the UR+TRG group was significantly increased as compared to that in the UR-alone group. These results suggest that the vascular tumor-promoting activity of TRG in rasH2 mice is extremely low in the present experimental condition and a part of the gene related to angiogenesis probably contributes to the promotion of splenic hemangiosarcomas in rasH2 mice given TRG. (orig.)

Jin, Meilan [Tokyo University of Agriculture and Technology, Laboratory of Veterinary Pathology, Tokyo (Japan); Tokyo University of Agriculture and Technology, Department of Applied Biological Science, United Graduate School of Agricultural Sciences, Tokyo (Japan); Matsumoto, Sayaka; Saekusa, Yukie; Mitsumori, Kunitoshi [Tokyo University of Agriculture and Technology, Laboratory of Veterinary Pathology, Tokyo (Japan); Dewa, Yasuaki; Nishimura, Jihei [Tokyo University of Agriculture and Technology, Laboratory of Veterinary Pathology, Tokyo (Japan); Gifu University, Pathogenetic Veterinary Science, United Graduate School of Veterinary Sciences, Gifu (Japan); Hasumi, Keiji [Tokyo University of Agriculture and Technology, Department of Applied Biological Science, United Graduate School of Agricultural Sciences, Tokyo (Japan)

2008-10-15

210

MS Plaque Demonstration in the Posterior Fossa: T2W Imaging is Better Than FLAIR  

Directory of Open Access Journals (Sweden)

Full Text Available Background/Objective: For imaging diagnosis of multiple sclerosis, axial FLAIR, T2W and Sagittal T2W are commonly obtained and FLAIR is known as the best pulse in showing the plaques. According to our daily observation and corresponding to an investigation, T2W is better for posterior fossa and FLAIR is better for supra-tentorial plaque diagnosis."nMaterials and Methods: Four-hundred patients in a series of brain MRIs were investigated by ROI (region of interest signal intensity assessment. All images are obtained by a 1.5 tesla machine. Patients were men and women and we used the mean signal intensity of ROI in the MRI machine."nResults: On T2W and FLAIR images, the mean signal intensity of the pontine white matter was measured as 306 and 294; the centrum semiovalae as 295 and 286; the brachium cerebella as 311 and 309; the cerebral penduncle as 247 and 238; the CSF as 820 and 134; the MS plaque in the supratentorial as 616 and 434 and the MS plaque in the posterior fossa as 407 and 344."nConclusion: The background in T2 images is darker than it is in FLAIR. Supra-tentorial background signal intensity suppression is due to the free CSF signal in the FLAIR pulse."nThe amount of CSF is larger in the supratentorial cisternal regions compared to the less gyral pattern in the infratentorial region. These problems and findings in the background and high signal T2 value of MS plaque in T2 show the following mentioned results:"nFor supra-tentorial area plaques, FLAIR is more sensitive and for plaques in the posterior fossa, T2W is better than FLAIR (visual and by ROI signal assessment."nBy better T2W demonstration of the posterior fossa plaques, their water density was higher than supra-tentorial plaques.

Dariush Etemadi

2010-05-01

211

The Vulnerability of the Vein of Labbé During Combined Craniotomies of the Middle and Posterior Fossae  

OpenAIRE

During combined middle and posterior cranial fossae (“petrosal”) approaches to the skull base, the anastamotic vein of Labbe, which bridges between the inferior surface of the temporal lobe and the transverse sinus is placed at risk. Occlusion of this vein, which may drain a large section of the temporal and parietal lobes, may lead to speech, memory, and/or other cognitive disorders. Labbe may be injured along its course on the inferior aspect of the temporal lobe where it may be lacerae...

Lustig, Lawrence R.; Jackler, Robert K.

1998-01-01

212

Subdural enhancement on postoperative spinal MRI after resection of posterior cranial fossa tumours  

International Nuclear Information System (INIS)

In malignant brain tumours which may disseminate staging, usually by cranial and spinal MRI is necessary. If MRI is performed in the postoperative period pitfalls should be considered. Nonspecific subdural contrast enhancement on spinal staging MRI is rarely reported after resection of posterior fossa tumours, which may be mistaken for dissemination of malignancy. We investigated the frequency of spinal subdural enhancement after posterior cranial fossa neurosurgery in children. We reviewed 53 postoperative spinal MRI studies performed for staging of paediatric malignant brain tumours, mainly infratentorial primitive neuroectodermal tumours 2-40 days after surgery. There was contrast enhancement in the spinal subdural space in seven cases. This was not seen in any of eight patients who had been operated upon for a supratentorial tumour. After resection of 45 posterior cranial fossa tumours the frequency of subdural enhancement was 15.5%. MRI showing subdural enhancement was obtained up to 25 days postoperatively. No patient with subdural enhancement had cerebrospinal fluid (CSF) examinations positive for tumour cells or developed dissemination of disease in the CSF. Because the characteristic appearances of subdural contrast enhancement, appropriate interpretation is possible; diagnosis of neoplastic meningitis should rarely be impeded. Because of the striking similarity to that in patients with a low CSF-pressure syndrome and in view of the fact that only resection o in view of the fact that only resection of tumours of the posterior cranial fossa, usually associated with obstructive hydrocephalus, was followed by this type of enhancement one might suggest that rapid changes in CSF pressure are implicated, rather the effects of blood introduced into the spinal canal at surgery. (orig.)

213

Endoscopic Endonasal Transturbinate Approach to the Pterygopalatine Fossa in the Management of Juvenile Nasopharyngeal Angiofibromas  

OpenAIRE

Pterygopalatine fossa (PPF) is a difficult-to-access anatomic area located behind the posterior wall of the maxillary sinus. Juvenile nasopharyngeal angiofibroma (JNA) often affects this area, and the management of feeding artery to the tumor is important in the surgery. Endoscopic endonasal approach to the PPF without endangering all other nasal structures is useful in the management of JNA. We describe a new approach to the PPF, endoscopic transturbinate approach, which is effective in the ...

Satoru Kodama; Hideaki Mabuchi; Masashi Suzuki

2012-01-01

214

Increased use of laparoscopy in acute right iliac fossa pain - is it good for patients?  

OpenAIRE

AIM: The use of laparoscopy, with or without appendicectomy, is becoming more common in the management of acute right iliac fossa (RIF) pain, but little is known of the 'unintended' consequences of this change. This study aimed to evaluate the impact of increased use of laparoscopy on the number and type of patients treated surgically and on the rate of negative appendicectomy. METHOD: A prospective audit was carried out of admissions to a teaching hospital over two, 3-month periods during 20...

Jones, Ge; Kreckler, S.; Shah, A.; Stechman, Mj; Handa, A.

2012-01-01

215

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

International Nuclear Information System (INIS)

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)

216

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

Energy Technology Data Exchange (ETDEWEB)

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)

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

217

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

Directory of Open Access Journals (Sweden)

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.

Buijsrogge, Michiel

2014-11-01

218

Extradural middle fossa approach. Proposal of a learning method: the 'rule of two fans.' technical note  

OpenAIRE

The extradural middle fossa approach is used to access lesions of the petroclival and cavernous sinus regions. It may be included in combined petrosal and anterolateral transcavernous approaches. Technically, it is a demanding exposure that provides a wide extradural corridor between the 5th, 7th, and 8th cranial nerves. Its major advantages are that it offers extradural dissection, limits temporal lobe retraction, and avoids the transposition of nerves or vessels. Its disadvantages are prima...

Mastronardi, Luciano; Sameshima, Tetsuro; Ducati, Alessandro; Waele, Luc F.; Ferrante, Luigi; Fukushima, Takanori

2006-01-01

219

Hyperplastic Luschka Ducts: A Mimic of Adenocarcinoma in the Gallbladder Fossa  

OpenAIRE

Ducts of Luschka are a developmental abnormality found within the gallbladder fossa in up to 10% of cholecystectomy specimens. They are most often encountered by surgeons when injured during laparoscopic or open cholecystectomy, leading to bile leakage and subsequent peritonitis. Histologically, they are typically composed of lobular aggregates of small ductules lined by bland, cuboidal-to-columnar biliary-type epithelium, associated with centrally located, larger ductules surrounded by conce...

Singhi, Aatur D.; Adsay, Nazmi Volkan; Swierczynski, Sharon L.; Torbenson, Michael; Anders, Robert A.; Hruban, Ralph H.; Argani, Pedram

2011-01-01

220

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

OpenAIRE

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...

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

2009-01-01

221

Giant posterior fossa arachnoid cyst causing tonsillar herniation and cervical syringomyelia  

OpenAIRE

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 suppo...

Joshi, Vijay P.; Valsangkar, Ashwin; Nivargi, Satish; Vora, Nitant; Dekhne, Anish; Agrawal, Amit

2013-01-01

222

Agenesis of the vermis cerebelli and malformations of the posterior fossa in childhood and adolescence.  

Science.gov (United States)

Three cases of cerebellar vermis agenesis are reported and the relevant literature (19 other cases) is reviewed. Other posterior fossa malformations, such as a mega-cisterna magna, arachnoid cyst and Dandy-Walker syndrome, are discussed both from the pathological and clinical view point. We put forward a hypothesis that agenesis of the cerebellar vermis and Dandy-Walker syndrome could be regarded as two different stages of the same malformation. PMID:503277

Mercuri, S; Curatolo, P; Giuffrè, R; Di Lorenzo, N

1979-09-01

223

[On the practical-medical mean distances of the fossa cranialis media].  

Science.gov (United States)

The postnatal growth from different structures would be investigated at 61 skulls of children and 87 skulls of adults. The mean distance between the Foramen caecum and the Protuberantia occipitalis interna (internal length of the skull) increases from 9.7 cm to 14.0 cm. The greatest internal width of the skull grows up in the mean from 6.8 cm to 12.9 cm. The mean surface area of the Fossa cranialis media includes 7.6 cm2 by newborns and 22.4 cm2 by adults. The surface area of the right Fossa cranialis media is significantly more extensive than the left one. The mean radius of the curvature of the Ala minor ossis sphenoidalis increases from 11.8 mm to about 26,0 mm. The side angle of the Ala minor ascends from 75.7 degrees to about 84 degrees in a detour way. The bight to be found underneath for the Polus temporalis has a mean surface area of 24 mm2 in the newborns and 64 mm2 in the adults. The deepest zone of the floor of the Fossa cranialis media is to be located in newborns in the mean 2 mm and in adults in the mean 0.4 mm below the Frankfort plane and 6.4 mm dorsal of the Tuberculum articulare. The mean distance to the Processus zygomaticus cornes to 4.5 mm in newborns and 0.9 mm in adults. The Fossa temporalis deepens in all measured zones during the postnatal development. Apart from the right-left-differences the acceleration during the last 150 years and the sexual dimorphismus of the skull will be discussed. PMID:7137573

Lang, J; Götzfried, H P

1982-01-01

224

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

Directory of Open Access Journals (Sweden)

Full Text Available Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyomavirus (JCV, an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppresed 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.

Fabrício Guimarães Gonçalves

2011-12-01

225

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyomavirus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppresed patients and rarely associated with systemic lupus erythematosus. I [...] n 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.

Fabrício Guimarães, Gonçalves; Leslie, Lamb; Raquel, Del Carpio-O' Donovan.

2011-12-01

226

Emptiness of the left iliac fossa: a new clinical sign of sigmoid volvulus  

OpenAIRE

BACKGROUND—Diagnostic difficulties are common in sigmoid volvulus. This diagnostic delay contributes to high morbidity and mortality.?AIM—This paper recognises visible or palpable emptiness of the left iliac fossa as a new clinical sign of sigmoid volvulus. Predictive accuracy of the sign was assessed in this study.?METHODS—519 patients with acute abdomen of non-traumatic origin were prospectively studied.?RESULTS—The new sign was present in 24 out of 86 patients (28%) with si...

Raveenthiran, V.

2000-01-01

227

Middle Cranial Fossa Transtemporal Approach to the Intrapetrous Internal Carotid Artery  

OpenAIRE

Diseases involving the proximity of the internal carotid artery at the skull base require identification of this vessel in the temporal bone to gain vascular control for any maneuver in its vicinity. This article details the technique of surgical dissection and exposure of the internal carotid artery within the skull base through a transtemporal middle cranial fossa approach. The anatomic landmarks important in utilizing this procedure include the greater superficial petrosal nerve, the mandi...

Andrews, James C.; Martin, Neil A.; Black, Keith; Honrubia, Vincent F.; Becker, Donald P.

1991-01-01

228

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

International Nuclear Information System (INIS)

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 withinaging (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.)

229

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

Energy Technology Data Exchange (ETDEWEB)

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.)

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

230

Analysis of mandibular condylar and glenoid fossa fractures with computed tomography  

Energy Technology Data Exchange (ETDEWEB)

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.)

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

2014-04-15

231

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

DEFF Research Database (Denmark)

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) and 8 (M) classification criteria, ranging from 'sound' to 'cavitation with dentine involvement'. Six radiographic scores were used in the classification. Sections 250 microns in thickness were cut in buccolingual direction through the central fossa, and the fossa section with the most extensive stereomicroscopic changes was selected for histologic examination (x16). The histologic enamel and dentine changes were classified independently using 9 and 7 scores, respectively. The correlation between SM and the histologic enamel changes (HE scores) in terms of progressive demineralization and destruction were highly correlated (rs = 0.90). Dentinal changes were also highly correlated with enamel changes (rs = 0.85). Thehistologic classifications in conjunction with the macroscopical observations made it possible to demonstrate a clear relationship between the external degree of caries progression and the internal enamel and dentine reactions. The data did not support routine usage of radiographic examination for occlusal caries diagnosis.

Ekstrand, K R; Kuzmina, I

1995-01-01

232

Analysis of mandibular condylar and glenoid fossa fractures with computed tomography  

International Nuclear Information System (INIS)

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 ?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.)

233

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

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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.

Kamal Kataria

2012-05-01

234

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

Science.gov (United States)

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.

Pita-Machado, Reinado; Perez-Diaz, Marlen; Lorenzo-Ginori, Juan V.; Bravo-Pino, Rolando

2014-11-01

235

Cystic malformations of the posterior fossa: differential diagnosis clarified through embryologic analysis.  

Science.gov (United States)

Cystic or cyst-like malformations of the posterior fossa represent a spectrum of disorders, including the Dandy-Walker malformation, vermian-cerebellar hypoplasia, mega cisterna magna, and arachnoid cyst. Differentiation of these lesions may be difficult with routine cross-sectional imaging; however, an accurate diagnosis is essential for proper treatment planning and genetic counseling. Dandy-Walker malformation is easily diagnosed on the basis of the classic triad: complete or partial agenesis of the vermis, cystic dilatation of the fourth ventricle, and enlarged posterior fossa. Vermian-cerebellar hypoplasia is a general classification that describes congenital malformations with a normal-sized posterior fossa, varying degrees of vermian and cerebellar hypoplasia, and a prominent retrocerebellar cerebrospinal fluid space that communicates freely with a normal or dilated fourth ventricle. Mega cisterna magna can be asymmetric and can manifest apparent mass effect, simulating the appearance of an arachnoid cyst; therefore, ventriculography or cisternography may be needed to demonstrate communication of the cystic mass with the subarachnoid space. A careful review of the embryologic development is essential in understanding these malformations and in making a more accurate radiologic diagnosis. PMID:8031352

Kollias, S S; Ball, W S; Prenger, E C

1993-11-01

236

Hip arthroscopy: intra-articular saucerization of the acetabular cotyloid fossa.  

Science.gov (United States)

Hip arthroscopy is increasingly recognized as a treatment option for patients with hip pain and labral tears. When emphasis is placed on labral tears as a primary clinical finding in the peripheral compartment, a broader view of the pathophysiology of these tears may be missed. Therefore, it is imperative to gain arthroscopic surgical access to the central compartment and determine if its contents affect the congruency of the hip joint. Abnormal bone and fibro-fatty tissue in the cotyloid fossa decrease the space available for the ligamentum teres, leading to lateral subluxation of the femoral head and rim loading of the acetabulum at the chondrolabral junction. Rim loading of the acetabulum may induce articular-sided labral tears due to hip incongruency. Although these labral tears may require refixation, the congruency of the hip joint should be restored to the best extent possible. Arthroscopic intra-articular saucerization and debridement of space-occupying lesions in the cotyloid fossa increase the space available for the ligamentum teres, improve the congruency of the hip joint, and mitigate against acetabular rim loading. This article describes a case of arthroscopic intra-articular saucerization of the cotyloid fossa in a 25-year-old man with chronic hip pain. PMID:22310417

Brannon, James K

2012-02-01

237

Delayed effect of radiation therapy on extracerebral cavernous angioma in the middle fossa  

International Nuclear Information System (INIS)

This is a report of a case with extracerebral cavernous angioma in the middle fossa which had received radiation therapy. Follow-up study with serial computed tomography during and after irradiation were presented. A 62-year-old housewife complained of vertigo. CT scan revealed a slightly high density area in the left middle cranial fossa which was markedly enhanced with contrast media. Left carotid angiography demonstrated a large avascular mass in the left middle fossa and no feeding artery or draining vein was visualized except a faint irregular stain in the venous phase. Irradiation with a total dose of 50 Gy was delivered. At the end of radiation, CT scan revealed a slight decrease in size and CT number of the tumor. Follow-up CT scans 5 months later showed 50 % regression of the tumor and 19 months later were negative for tumor. It is concluded that in case of an extracerebral cavernous angioma with massive hemorrhage, radiation of up to 30 - 50 Gy was a method of choice. The treatment results in the possibility of eliminating surgery and the benefit of irradiation may not become evident until the first year. (author)

238

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

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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.

S Rea

2010-06-01

239

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  

OpenAIRE

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 vir...

Oliveira, Maria I.; Curti, Suely P.; Figueiredo, Cristina A.; Ms, Ana Afonso; Márcia Theobaldo; Azevedo, Raymundo S.; Durigon, Edison L.

2002-01-01

240

Absence of HLA-B*1502 and HLA-A*3101 Alleles in 9 Korean Patients With Antiepileptic Drug-Induced Skin Rash: A Preliminary Study  

OpenAIRE

There have been a number of studies about correlations between HLA genotypes in various ethnic groups and occurrence of various cutaneous adverse drug reactions, ranging in intensity from mild to severe, caused by antiepileptic drugs (AEDs). This is the first report analyzing the HLA genotypes of 9 Korean patients with skin rashes induced by various AEDs. The AEDs that induced skin rash were lamotrigine (n=3), carbamazepine (n=3), oxcarbazepine (n=1), phenobarbital (n=1), and phenytoin (n=1)....

Song, Ju Sun; Kang, Eun-suk; Joo, Eun Yeon; Hong, Seung Bong; Seo, Dae-won; Lee, Soo-youn

2014-01-01

241

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

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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.

Svenson Svante

2004-11-01

242

Titanium Mesh Reconstruction to Maintain Scalp Contour after Temporalis Musculofascial Flap Reconstruction of the Floor of the Middle Cranial Fossa: A Technical Note and Report of Two Cases  

OpenAIRE

Objective: Temporalis musculofascial rotational flaps can provide excellent tissue for reconstruction of defects in the floor of the middle cranial fossa. This technique can, however, result in cosmetic deformity of the temporal fossa with an asymmetric contour of the head. We report a technique that uses titanium mesh and autologous abdominal adipose to maintain a normal scalp contour. Clinical Presentation: Two patients, one with a large middle cranial fossa and infratemporal schwannoma, an...

Lipira, Angelo; Limbrick, David; Haughey, Bruce; Custer, Phillip; Chicoine, Michael R.

2009-01-01

243

Does Sunscreen Prevent Epidermal Growth Factor Receptor (EGFR) Inhibitor–Induced Rash? Results of a Placebo-Controlled Trial from the North Central Cancer Treatment Group (N05C4)  

Science.gov (United States)

Purpose. Rash occurs in >50% of patients prescribed epidermal growth factor receptor (EGFR) inhibitors. This study was undertaken to determine whether sunscreen prevents or mitigates these rashes. Methods. This placebo-controlled, double-blinded trial enrolled rash-free patients starting an EGFR inhibitor. Patients were randomly assigned to sunscreen with a sun protection factor of 60 applied twice a day for 28 days versus placebo. They were then monitored for rash and quality of life (Skindex-16) during the 4-week intervention and for an additional 4 weeks. Results. Fifty-four patients received sunscreen, and 56 received placebo; the arms were balanced at baseline. During the 4-week intervention, physician-reported rash occurred in 38 (78%) and 39 (80%) sunscreen-treated and placebo-exposed patients, respectively (p = 1.00); no significant differences in rash rates emerged over the additional 4 weeks. There were no significant differences in rash severity, and patient-reported outcomes of rash yielded similar conclusions. Adjustment for sun intensity by geographical zone, season, and use of photosensitivity medications did not yield a significant difference in rash across study arms (p = .20). Quality of life scores declined but remained comparable between arms. Conclusions. Sunscreen, as prescribed in this trial, did not prevent or attenuate EGFR inhibitor–induced rash. PMID:20798191

Thrower, Abby; Sloan, Jeff A.; Flynn, Patrick J.; Wentworth-Hartung, Nicole Lea; Dakhil, Shaker R.; Mattar, Bassam I.; Nikcevich, Daniel A.; Novotny, Paul; Sekulic, Aleksandar; Loprinzi, Charles L.

2010-01-01

244

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

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No reliable classification is in clinical use 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 has examined associations between clinicopathologic and cytogenetic variables and outcome in a trial cohort of children with ependymoma, with the aim of defining a practical scheme for stratifying this heterogeneous tumor. 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 loci on chromosomes 1q (EXO1), 6q (LATS1) and 9, including 9p21 (CDKN2A). Data relating to these clinicopathological and cytogenetic variables were compared with survival data in order to model disease risk groups. Extent of surgical resection was a significant determinant of outcome in both supratentorial and infratentorial compartments. Tumor cell density and mitotic count were associated with outcome among children with posterior fossa ependymomas (n = 119). Among pathologic features, only brain invasion was associated with outcome in children with supratentorial ependymomas (n = 27). For posterior fossa tumors, gain of 1q was independently associated with outcome and in combination with clinicopathological variables defined both a two-tier and three-tier system of disease risk. 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 sub-total resection and brain invasion. PMID:22526017

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

2012-08-01

245

Report on Active Faults map and Vertical Displacements in the Northern Fossa Magna, Central Japan  

Science.gov (United States)

The Fossa Magna (FM) is one of the most major active tectonic zones with the highest seismic risk and the largest slip rates (4-9 mm/yr), which crosses the Japan Islands north and south. The FM is divided into the Northern Fossa Magna (NFM) and the Southern Fossa Magna by the differences of the tectonic settings. The NFM was formed as a Miocene rift basin in final stages of the opening of the Sea of Japan (ex. Sato and Ikeda, 1999, Sato et al., 2004). The rift zone is filled with the thick Neogene fill composed of the abundant volcanic products and sedimentary deposits. The western margin and eastern margin of the NFM is bounded by active reverse faults of the Itoigawa Shizuoka Tectonic Line (ISTL) and Shibata Koide Tectonic Line (SKTL), respectively. ISTL strikes NS and dips to the east. SKTL strikes NNE-SSW and dips to the west. Therefore, the fold and thrust zone is formed in association with the both movements of ISTL and SKTL within the NFM region. However, the behavior segment of active faults is not clarified in detail within the NFM region. We reconstructed the active fault map based on the deformation of the marine terraces and fluvial terraces using the air photographs in the NFM and examined the geometry relationship between the geological structure of the Neogene and displacements distribution estimated from the terrace deformation in the northern part of the NFM. In addition, we tried to understand the tectonic movement along the fault trace based on the time and space changes of slip rates in the northern part of NFM. The length of the active fault is evaluated as a result.

Kim, H.; Iwasaki, T.

2008-12-01

246

Condyle-fossa modifications and muscle interactions during herbst treatment, part 1. New technological methods.  

Science.gov (United States)

Changes in the condyle, the glenoid fossa, and the muscles of mastication were investigated in subjects undergoing continuous orthopedic advancement of the mandible with a Herbst-block appliance. The total sample consisted of 56 subjects and included 15 nonhuman primates (in the middle mixed, early permanent, and permanent dentitions), 17 human Herbst patients in the early permanent dentition, and 24 human controls from the Burlington Growth Center. The 8 nonhuman primates in the middle mixed dentition were the focus of this study. Mandibular advancement was obtained progressively in 5 animals by adding stops to the telescopic arms of fixed functional Herbst appliances with occlusal coverage; activations of 5.0 mm, 7.0 mm, and 8.0 mm were achieved. Two primates served as controls, and the third was a sham control. Two experimental animals and the 2 controls also wore surgically implanted electromyographic electrodes in the superior and inferior heads of the lateral pterygoid muscles and in the superficial masseter and anterior digastric muscles. Changes in condylar growth direction and amount were assessed with the Björk method from measurements made on serial cephalometric tracings superimposed on metallic implants. Undecalcified sections, treated with intravenous tetracycline vital staining, were viewed with fluorescence microscopy to examine histologic changes in the condyle and the glenoid fossa. New bone formation in the fossa associated with continuous mandibular protrusion was quantified by using computerized histomorphometric analysis of decalcified histological sections and polarized light. The unique combination of permanently implanted electromyographic electrodes, tetracycline vital staining, and histomorphometry represents a significant technological advancement in methods and materials. Together, they demonstrated different muscle-bone interaction results for functional appliances than those reported in previous studies. In Part 1 of this study, we describe and discuss the techniques used in this research and give a brief overview of the findings; in Part 2 (to be published next month), we offer a more in-depth discussion of the results and the implications of our findings. PMID:12806337

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

2003-06-01

247

Preoperative irradiation of an extracerebral cavernous hemangioma in the middle fossa  

International Nuclear Information System (INIS)

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, intraluminndings 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)

248

Avian Cerebellar Floccular Fossa Size Is Not a Proxy for Flying Ability in Birds  

Science.gov (United States)

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

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

249

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

International Nuclear Information System (INIS)

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.)

250

Surgical resection of ulcer of the popliteal fossa and myoplasty by using a gastrocnemius muscle flap  

International Nuclear Information System (INIS)

In a 71-year-old female patient, radiation-induced ulcer of the popliteal fossa was resected, and a flap of the gastrocnemius muscle was planted. Anatomy of the region and the method of the operation were shown. This kind of flap can cover the space of 14 x 14 cm, and sequelae of auto-transplantation of the muscle are very rare. Since the operative technique is rather simple and the muscular flap survives well, this operation may succeed in many cases, if they are selected. (Ueda, J.)

251

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

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Full Text Available 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 narrowing of jugular foramen know as Vernet’s syndrome is discussed along with case.

Budhiraja V

2010-05-01

252

Computer-assisted-endoscopic Surgery of a Large Trigeminal Schwannoma in the Pterygopalatine Fossa  

OpenAIRE

Case Report: A 33 year-old woman presented with a history of many years of a tumor in the pterygopalatine fossa. The tumor (5x 4.5 cm) extended to the sphenoid and maxillary sinuses, the nasal cavity, the skull base with an erosion of the cavernous sinus and the orbit with a close contact with the ophthalmic nerve. The patient had first refused to undergo the surgery because only an external approach through a paranasal and Caldwell-Luc incision had been proposed to her. We proposed a strictl...

Ghanooni, Rose; Delpierre, Isabelle; Witte, Olivier; Choufani, Georges; Hassid, Sergio

2009-01-01

253

Hip arthroscopy for space-occupying lesions within the acetabular cotyloid fossa.  

Science.gov (United States)

Standard hip arthroscopy emphasizes access to disease within the peripheral compartment. The author describes precise access to the central compartment for removal of space-occupying lesions within the cotyloid fossa. These lesions can compromise the space available for the ligamentum teres and possibly contribute to the development of cam/pincer lesions and articular-sided labral tears by altering the congruency of the hip joint. Importantly, this novel approach does not impair the ability to complete the more widely known surgical techniques used within the peripheral compartment. PMID:24992051

Brannon, James K

2014-07-01

254

Congenital intra-extracranial dumbbell schwannoma of temporal fossa unassociated with any major cranial nerve.  

Science.gov (United States)

Intracranial schwannomas commonly arise from the vestibular nerve and less commonly from other cranial nerves. On rare occasions, they may be intraparenchymatous, intraventricularor intrasellar. However, the occurrence of a congenital solitary intracranial extradural schwannoma unrelated to any cranial nerve in the absence of von Recklinghausan's syndrome is exceptional. The authors report a unique, heretofore unreported case of a congenital temporal extradural schwannoma, unassociated with any known cranial nerve and with a transcranial extension presenting as a temporal fossa mass since birth in a 16-year-old female patient. Total resection of this tumour was uncomplicated. A brief review of the relevant literature is presented. PMID:11749032

Sharma, Rewati Raman; Netalkar, Audumbar S; Pawar, Sanjay J; Lad, Santosh D; Musa, Mohammed M; Mahapatra, Ashok Kumar

2002-01-01

255

Hemangiopericytoma of popliteal fossa as a multichambered cystic mass : a case report  

Energy Technology Data Exchange (ETDEWEB)

Hemangiopericytoma is an uncommon mesenchymal neoplasm that may occur anywhere in the body but is most common in the lower extremities and retroperitoneum. Radiologically, the tumor is mainly a solid hypervascular mass, and when large, has some cystic and necrotic portions. It can compress or displace adjacent tissue and organs, and may cause related symptoms. The authors encountered a case of hemangiopericytoma of the popliteal fossa as a multichambered cystic mass containing various-staged hemorrhagic fluid, and report this case together with its MR imaging findings. (author). 7 refs., 1 fig.

Kim, Ki Jun; Lee, Jae Hee; Lee, Sung Yong; Sohn, Kyung Myung; Sohn, Jong Min [Catholic University of Korea, Incheon (Korea, Republic of). Our Lady of Mercy Hospital

1998-06-01

256

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

International Nuclear Information System (INIS)

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.)

257

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

Scientific Electronic Library Online (English)

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.

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

2012-04-01

258

[Personal experience with establishment of arteriovenous anastomoses for dialysis using blood vessels in the cubital fossa].  

Science.gov (United States)

The authors use, when establishing secondary arteriovenous anastomoses for haemodialysis, the blood vessels of the cubital fossa. If it is possible from the anatomical and functional aspect, they connect the superficial venous vessels to the arterial ones by means of a perforating vein. If the blood vessels of the forearm are of poor quality, they use this procedure as the primary approach. After two years the group of 38 established fistulas comprises 87% which can be completely used and none of them had to be modified. PMID:8768966

Utíkal, P; Bachleda, P; Sekanina, Z; Král, V

1996-02-01

259

Subdural hygroma in association with middle fossa arachnoid cyst: acetazolamide therapy.  

Science.gov (United States)

Intracranial arachnoid cysts are cerebrospinal fluid-filled collections between arachnoid layers. While many are silent, arachnoid cysts can become symptomatic if there is sudden expansion, haemorrhage or rupture with the development of subdural hygroma or subdural hematoma. Several studies have demonstrated the association of arachnoid cysts with subdural hygroma and subdural hematoma. We describe a 9-year-old girl with a moderate-sized middle-fossa arachnoid cyst and bilateral frontal subdural hygroma presenting with raised intracranial pressure. She was treated with acetazolamide which resulted in resolution of the subdural hygroma and relief of symptomatology. PMID:9761002

Choong, C T; Lee, S H

1998-08-01

260

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

International Nuclear Information System (INIS)

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)

261

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

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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

Nakahara T

2015-01-01

262

Pseudolesions around the gallbladder fossa: comparison of frequency and radiological characteristics in multiphasic CT, CTAP, and CTHA  

International Nuclear Information System (INIS)

The purpose of this study is to compare the frequency with which pseudolesions around the gallbladder (GB) fossa are revealed by multiphasic CT, by CT during arterial portography (CTAP), and by CT during hepatic arteriography (CTHA) and to determine their radiological characteristics. Multiphasic CT, CTAP, and CTHA examinations of 81 patients without pathology of the GB and around the GB fossa were evaluated for pseudolesion around the GB fossa. The definition of pseudolesion was as follows: 1) hyperattenuation during the arterial phase and isoattenuation during the delayed phase of multiphasic CT, or perfusion defect on CTAP and hyperattenuation on CTHA; 2) no Lipiodol tagging on Lipiodol CT, 3) all findings observed adjacent to the gallbladder fossa; and 4) no interval change on follow-up CTAP and CTHA. We compared the frequency of pseudolesions around the GB fossa, as seen on multiphasic CT, CTAP, and CTHA, and determined their size, location, and shape, as revealed by CTHA. The frequency of pseudolesion was 2.5% (2/81) on multiphasic CT, while on CTAP or CTHA, the frequency was 53.1% (43/81), and 58 pseudolesions were identified. Of 58 pseudolesions, 56 were revealed by CTAP and 57 by CTHA. Forty-nine of 58 pseudolesions were larger and all pseudolesions showed more contrast to parenchyma on CTHA than on CTAP. The location of pseudolesions was segment V (32 of 58), IV (25 of 58), and VI (1 of 58), and their size ranged from 5 to 30 (mean, 17.5) mm. Pseudolesions wm 5 to 30 (mean, 17.5) mm. Pseudolesions were wedge-shaped (48 of 58), oval (6 of 58), bandlike (3 of 58), or round (1 of 58). CTAP and CTHA frequently revealed pseudolesion around the GB fossa. The radiological characteristics of these modalities help differentiate pseudolesions from true tumoral hepatic lesions. (author)

263

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

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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.

Salvatore Rapisarda

2009-06-01

264

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

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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 30.64mm, 26.61mm, 31.16mm, 34.37mm, and 51.37mm, 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

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

2015-05-01

265

A possible biomechanical role of occlusal cusp-fossa contact relationships.  

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Biomechanical features of occlusal contacts are important in understanding the role of the occlusion contributing to masticatory function. Cusp-fossa contact is the typical pattern of occlusion between upper and lower teeth. This includes static relations, such as that during clenching, and dynamic relations when mandibular teeth contact in function along the maxillary occlusal pathways, as during mastication. During clenching in the maximum intercuspal position (ICP), cuspal inclines may take the role of distributing the occlusal forces in multi-directions thus preventing excessive point pressures on the individual tooth involved. During chewing movement on the functional side, the mandible moves slightly from buccal through the maximum ICP to the contralateral side. The part of the chewing cycle where occlusal contacts occur and the pathways taken by the mandible with teeth in occlusal contacts are determined by the morphology of the teeth. The degree of contact is associated with the activity of the jaw muscles. To obtain repeatable static and dynamic occlusal contact information provided by the morphology of the teeth, maximum voluntary clenching and chewing movements with maximum range are needed. In conclusion, in addition to the standard occlusal concepts of centric relation/centric occlusion and group function/cuspid protection relation, biomechanics in static and dynamic cusp-fossa relationships should be included to develop an understanding of occlusal harmony which includes no interfering or deflective contacts in functional occlusal contact. PMID:22882571

Wang, M; Mehta, N

2013-01-01

266

A modified retromaxillary approach to the infratemporal fossa: three case studies.  

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The infratemporal fossa (ITF) is an anatomically complex region with multiple neural and vascular structures entering and exiting through foramina in the skull base. The main obstacles to approaching the ITF are the zygomatic arch, the parotid gland, the facial nerve, and the ascending ramus AND condylar head of the mandible. Different surgical approaches to the ITF exist and the best approach should provide optimal visibility, minimal impairment of temporomandibular joint function, and preservation of motor and sensory nerve integrity. This report describes a modified Obwegeser retromaxillary approach to access lesions within the ITF. A multidisciplinary team was involved, which included an oral and maxillofacial surgery team, a neurosurgery team, and an otolaryngology team. Three patients with large skull base lesions, including an aneurysmal bone cyst, a giant cell tumor of the bone, and an invasive melanoma, underwent resection using this approach and were followed postoperatively. Excellent exposure of the floor of the middle cranial fossa and ITF was achieved with this approach. Functional status remained unchanged with respect to mastication, speech, swallowing, and cosmesis. Given the severity of the patients' conditions and extent of involvement of the skull base, outcomes were favorable, with minimal morbidity. This experience suggests that this approach provides safe access to an anatomically complex region and lessens challenges associated with more conventional approaches. PMID:25631866

Woodford, Rebecca; Chaudhary, Navjot; Wolf, Amparo; Lownie, Stephen; Armstrong, Jerrold E

2015-04-01

267

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

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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. PMID:23408237

Daghighi, Mohammad Hossein; Poureisa, Masoud; Shimia, Mohammad; Mazaheri-Khamene, Ramin; Daghighi, Shadi

2012-01-01

268

Comparison of outcomes following complex posterior fossa surgery performed in the sitting versus lateral position.  

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The sitting position during surgery is thought to provide important advantages, yet it remains controversial. We compared surgical and neurological outcomes for patients operated on in the sitting versus lateral position. Technically difficult procedures performed from the years 2001-2008 for complex lesions in the posterior fossa (vestibular schwannomas, other cerebellopontine angle tumors, foramen magnum meningiomas, brainstem cavernomas, pineal region tumors) were included. Outcomes in the two surgical positions were compared for all 243 patients (93 sitting, 38.3%; 150 lateral, 61.7%) and for 130/243 patients with vestibular schwannomas (50 sitting, 38.5%; 80 lateral, 61.5%). Sitting and lateral patient subgroups were clinically comparable. There were no surgical mortalities. The extent of removal and surgical and neurological outcomes were comparable. We found no advantage in surgical or neurological outcomes for use of the sitting or lateral surgical positions in technically difficult posterior fossa procedures. In vestibular schwannoma surgeries facial nerve preservation (House-Brackmann score 1-2) was related to extent of resection but not to surgical position. The choice of operative position should be based on lesion characteristics and the patient's preoperative medical status as well as the experience and preferences of the surgeons performing the procedure. PMID:25752232

Spektor, Sergey; Fraifeld, Shifra; Margolin, Emil; Saseedharan, Sanjith; Eimerl, Daniel; Umansky, Felix

2015-04-01

269

Fractura de cavidad glenoidea: reporte de un caso / Glenoid fossa fracture: case report  

Scientific Electronic Library Online (English)

Full Text Available Las fracturas del componente craneofacial aumentan su frecuencia y severidad día con día en las salas de urgencias. Las disrupciones de la mandíbula pueden clasificarse de acuerdo a su localización anatómica, siendo más frecuentes las del ángulo (36.3%) y el cuerpo (21.2%) y poco comunes las de apóf [...] isis coronoides (0.25%).¹ Las fracturas de coronoides, condilares y de arco cigomático, pueden enmascarar un fractura de cavidad glenoidea, ya que clínicamente existe restricción de la motricidad mandibular. Presentamos el caso de un paciente de 38 años, con fracturas de complejo cigomaticomaxilar, apófisis coronoides y cavidad glenoidea derecho. Abstract in english Emergency rooms have seen a gradual increase of patients afflicted by craniofacial fractures. Mandible fractures can be classified according to their anatomical location. The most frequent fractures are angle fractures (36.3%) and body of the mandible fractures (21.2%). Coronoid process fractures ar [...] e uncommon (0.25%)¹ Zygomatic arch, condylar or coronoid process fractures can mask a fracture of the glenoid fossa, since, clinically, there is restriction of mandibular movements. The case here presented is that of a 38 year patient afflicted with fractures of the maxillary-zygomatic complex, coronoid process as well as right glenoid fossa.

Carlos Alain, Rodríguez Piña; José Ernesto, Miranda Villasana.

2013-09-01

270

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

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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 e, 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

271

Primary non-Hodgkin's lymphoma of the infratemporal fossa: a rare case report  

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Background The head and neck are two of the most common sites of extranodal non-Hodgkin's lymphoma (NHL). However, primary tumors of the infratemporal fossa are infrequent, and NHL in this region is extremely rare. Case presentation We present a case of a 41-year-old female that presented with swelling in the right preauricular region that had persisted for the past two years. The patient was diagnosed as having a small lymphocytic NHL. She initially underwent chemo-radiation but reported relapse. The tumor was excised and again the patient underwent chemotherapy. The patient remained symptomatic and developed a second primary squamous cell carcinoma in the right retromolar trigone. Discussion and conclusion We discussed NHL with an emphasis on extranodal manifestations. Extranodal NHL that is limited to a single site can be managed by surgery and regular follow up. To the best of our knowledge, this is only the second case of primary NHL of the infratemporal fossa to be reported in the literature. PMID:19545392

Thakur, Jagdeep S; Minhas, Ravinder S; Mohindroo, Narinder K; Sharma, Dev R; Mohindroo, Shobha; Thakur, Anamika

2009-01-01

272

Evaluation of the origin hypotheses of Pantheon Fossae, central Caloris basin, Mercury  

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The origin of Pantheon Fossae, a complex structure consisting of radial graben in the center of the Caloris basin, Mercury, has been debated since the structure was first imaged by the MESSENGER spacecraft. Three different formation hypotheses have been suggested, i.e. an origin associated with the Apollodorus impact into a previously domed Caloris basin floor, graben formation as surface expressions of dike intrusions and basin-interior uplift alone. In order to test the scenarios, detailed observations from the currently available imagery were compared to the proposed formation mechanisms. We evaluate these origin hypotheses by means of detailed interpretations of the graben characteristics and patterns, by comparing to radial structures from Earth and Venus, and by mechanical analyses for each formation hypothesis. Results indicate that the formation of Pantheon Fossae as the result of doming in the central part of the Caloris basin is more likely than it having formed in association with a radially symmetric stress field centered at or near the Apollodorus crater, that would have been created by a magma chamber or been superimposed on a pre-existing dome due to impact mechanics.

Klimczak, Christian; Schultz, Richard A.; Nahm, Amanda L.

2010-09-01

273

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

International Nuclear Information System (INIS)

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.)

274

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

International Nuclear Information System (INIS)

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

275

Estudo da anatomia endoscópica da fossa lacrimal guiado por transiluminacão / Transillumination-guided study of the endoscopic anatomy of the lacrimal fossa  

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Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese A dacriocistorrinostomia é o tratamento de escolha para a obstrução do aparelho lacrimal. No final do século passado, o desenvolvimento da instrumentação endoscópica em cirurgia nasossinusal tornou viável sua realização por via endonasal. Entretanto, variações anatômicas tornam difícil a reprodutibi [...] lidade de uma técnica de abordagem endonasal. OBJETIVO: Estudar a anatomia endoscópica da fossa lacrimal através da transiluminação do canalículo comum. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Foram dissecadas 40 vias lacrimais de 20 cadáveres humanos, constando três etapas: 1 - identificação e dilatação do canalículo lacrimal. 2 - introdução do feixe de fibra óptica; 3 - dissecção endoscópica do saco lacrimal, descrevendo sua posição. RESULTADOS: A posição mais frequente do saco lacrimal foi entre a borda livre do corneto médio e sua inserção e imediatamente abaixo desta. A linha maxilar foi visualizada em 95% dos casos. A septoplastia foi necessária em 12,5%, uncifectomia em 35% e turbinectomia média em 7,5%. CONCLUSÃO: embora o saco lacrimal tenha mostrado uma localização mais frequente, sua posição variou consideravelmente. A transiluminação do canalículo comum mostrou-se útil, resolvendo o problema da variabilidade anatômica. Abstract in english Dacryocystorhinostomy is the treatment of choice for the obstruction of the lachrymal apparatus. At the end of last century, the development of the endoscopic instruments for nasosinusal surgery has made it possible to do it through the endoscopic pathway. Nonetheless, anatomical variations make it [...] difficult to have reproducibility endonasaly. AIM: study the endoscopic anatomy of the lachrymal fossa through transillumination of the common canaliculus. STUDY DESIGN: experimental. MATERIALS AND METHODS: we dissected 40 lachrymal pathways from 20 human cadavers, in three stages: 1. identification and dilation of the lachrymal canaliculus. 2 - Optic fiber beam introduction; 3 - endoscopic dissection of the lachrymal sac, describing its position. RESULTS: the most frequent position of the lachrymal sac was between the free border of the middle turbinate and its insertion immediately underneath it. The maxillary line was seen in 95% of the cases. Septoplasty was needed in 12.5%, unicifectomy in 35% and middle turbinectomy in 7.5%. CONCLUSION: Although the lachrymal sac has a more frequent location, its position varied considerably. The transillumination of the common canaliculus proved useful, solving the problem of the anatomical variability.

Luiz Artur Costa, Ricardo; Marcio, Nakanishi; Antonio Sérgio, Fava.

2010-02-01

276

Estudo da anatomia endoscópica da fossa lacrimal guiado por transiluminacão Transillumination-guided study of the endoscopic anatomy of the lacrimal fossa  

Directory of Open Access Journals (Sweden)

Full Text Available A dacriocistorrinostomia é o tratamento de escolha para a obstrução do aparelho lacrimal. No final do século passado, o desenvolvimento da instrumentação endoscópica em cirurgia nasossinusal tornou viável sua realização por via endonasal. Entretanto, variações anatômicas tornam difícil a reprodutibilidade de uma técnica de abordagem endonasal. OBJETIVO: Estudar a anatomia endoscópica da fossa lacrimal através da transiluminação do canalículo comum. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Foram dissecadas 40 vias lacrimais de 20 cadáveres humanos, constando três etapas: 1 - identificação e dilatação do canalículo lacrimal. 2 - introdução do feixe de fibra óptica; 3 - dissecção endoscópica do saco lacrimal, descrevendo sua posição. RESULTADOS: A posição mais frequente do saco lacrimal foi entre a borda livre do corneto médio e sua inserção e imediatamente abaixo desta. A linha maxilar foi visualizada em 95% dos casos. A septoplastia foi necessária em 12,5%, uncifectomia em 35% e turbinectomia média em 7,5%. CONCLUSÃO: embora o saco lacrimal tenha mostrado uma localização mais frequente, sua posição variou consideravelmente. A transiluminação do canalículo comum mostrou-se útil, resolvendo o problema da variabilidade anatômica.Dacryocystorhinostomy is the treatment of choice for the obstruction of the lachrymal apparatus. At the end of last century, the development of the endoscopic instruments for nasosinusal surgery has made it possible to do it through the endoscopic pathway. Nonetheless, anatomical variations make it difficult to have reproducibility endonasaly. AIM: study the endoscopic anatomy of the lachrymal fossa through transillumination of the common canaliculus. STUDY DESIGN: experimental. MATERIALS AND METHODS: we dissected 40 lachrymal pathways from 20 human cadavers, in three stages: 1. identification and dilation of the lachrymal canaliculus. 2 - Optic fiber beam introduction; 3 - endoscopic dissection of the lachrymal sac, describing its position. RESULTS: the most frequent position of the lachrymal sac was between the free border of the middle turbinate and its insertion immediately underneath it. The maxillary line was seen in 95% of the cases. Septoplasty was needed in 12.5%, unicifectomy in 35% and middle turbinectomy in 7.5%. CONCLUSION: Although the lachrymal sac has a more frequent location, its position varied considerably. The transillumination of the common canaliculus proved useful, solving the problem of the anatomical variability.

Luiz Artur Costa Ricardo

2010-02-01

277

Absence of HLA-B*1502 and HLA-A*3101 alleles in 9 Korean patients with antiepileptic drug-induced skin rash: a preliminary study.  

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There have been a number of studies about correlations between HLA genotypes in various ethnic groups and occurrence of various cutaneous adverse drug reactions, ranging in intensity from mild to severe, caused by antiepileptic drugs (AEDs). This is the first report analyzing the HLA genotypes of 9 Korean patients with skin rashes induced by various AEDs. The AEDs that induced skin rash were lamotrigine (n=3), carbamazepine (n=3), oxcarbazepine (n=1), phenobarbital (n=1), and phenytoin (n=1). None of the patients' HLA genotypes was either HLA-B*1502 or HLA-A*3101. Based on these series of cases, AED-induced skin rash can occur independently of HLA-B*1502 or HLA-A*3101 genotypes in the Korean patients. PMID:25187890

Song, Ju Sun; Kang, Eun-Suk; Joo, Eun Yeon; Hong, Seung Bong; Seo, Dae-Won; Lee, Soo-Youn

2014-09-01

278

Inhibitory effect of yogurt on aberrant crypt foci formation in the rat colon and colorectal tumorigenesis in RasH2 mice.  

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The inhibitory effects of yogurt consisting of milk fermented by Lactobacillus delbrueckii subsp. bulgaricus strain 2038 and Streptococcus salivarius subsp. thermophilus strain 1131 on formation of colonic aberrant crypt foci (ACF) in rats and also on development of colorectal tumors in transgenic mice harboring human prototype c-Ha-ras genes (rasH2 mice) were examined. F344 rats and rasH2 mice were fed commercial diet containing freeze-dried yogurt or starter medium (non-fermented milk). Rats were inoculated orally with heterocyclic amine 2-amino-methyl-6-phenylimidazo[4,5-b]pyridine hydrochloride (PhIP) for two weeks. The rats were necropsied 14 days after the PhIP treatment, and ACF in the colon and rectum were counted. RasH2 mice were injected with 1,2-dimethylhydrazine dihydrochloride (DMH) for 20 weeks. Three weeks after the last injection of DMH, rasH2 mice were necropsied to determine the number and the size of colorectal tumors. Yogurt supplementation in diet significantly reduced the number of ACF and aberrant crypts (ACs) in rats fed control diet (P<0.01), but not in rats fed non-fermented milk diet. On the other hand, rasH2 mice receiving the yogurt-supplemented diet had significantly reduced numbers of tumors induced by DMH compared with those fed the non-fermented milk-supplemented diet (P<0.05). These results demonstrate that the yogurt used in this study appears to have tumor-suppressing properties, and rasH2 mice are a useful model for the evaluation of antitumor activities of foods. PMID:20660995

Narushima, Seiko; Sakata, Tadashi; Hioki, Kyoji; Itoh, Toshio; Nomura, Tatsuji; Itoh, Kikuji

2010-01-01

279

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

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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…

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

2011-01-01

280

Basement-involved tectonics in North Fossa Magna, central Japan: The significance of the northern Itoigawa-Shizuoka Tectonic Line  

Science.gov (United States)

The Toyama Trough and Fossa Magna basin are major transverse tectonic depressions located between northeast Japan (NEJ) and southwest Japan (SWJ). Itoigawa-Shizuoka Tectonic Line (ISTL), the western margin of Fossa Magna is a boundary between two tectonic provinces along the inner side of NEJ and SWJ. Abrupt lateral variations in thickness of the Middle to Upper Miocene strata are quite significant among these provinces in the North Fossa Magna. The development of the thrust/fold belt is attributed not only to horizontal compression but also to vertical block movements as basement-involved tectonics. In response to the Pliocene and later compression regime, the old fault-block boundaries were reactivated and produced differential block movement such as the tilting of the Central Upheaval Zone and uplifting of the Nishikubiki Belt. One possible model for the deeper geologic structure is presented that high-angled block faults on the surface among tectonic provinces originate in vertical weak zones in the deep seismogenic zone under the sedimentary layer. The folded Neogene system comprises the present-day thrust-fault province of the North Fossa Magna and the stress regime of strikeslip faulting occupies the basement, as inferred from focal mechanism solutions for small events. In order to account for the apparent discrepancy, a duplex stress field is possible for the active tectonics in the region.

Takeuchi, Akira

2004-12-01

281

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

International Nuclear Information System (INIS)

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 ?C/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

282

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

International Nuclear Information System (INIS)

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

283

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

International Nuclear Information System (INIS)

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

284

Tumors in posterior cranial fossa: diagnostic by CT and MR, 103 cases  

International Nuclear Information System (INIS)

This article deals with the incidence and epidemiology, as well as the CT and MR findings, in 103 tumors located in posterior cranial fossa. The series included primary neoplasms and metastases, whether axial or extra-axial, providing they were solitary in the intracranial region. Ninety-one confirmed histologically. Their statistical incidence among intracranial neoplasms is high; moreover, they present considerable histological and epidemiological difference with respect to their supratentorial homonyms. The sample discloses the behavior of a random population, 20% of which were children. In the latter group, the most common lesions were glioma and medulloblastoma. Among adult patients, the most prevalent lesion was solitary axil metastasis. The analysis of the data demonstrates the importance of the anatomic site in the differential diagnosis. (Author)

285

Computer-assisted-endoscopic Surgery of a Large Trigeminal Schwannoma in the Pterygopalatine Fossa  

Directory of Open Access Journals (Sweden)

Full Text Available Case Report: A 33 year-old woman presented with a history of many years of a tumor in the pterygopalatine fossa. The tumor (5x 4.5 cm extended to the sphenoid and maxillary sinuses, the nasal cavity, the skull base with an erosion of the cavernous sinus and the orbit with a close contact with the ophthalmic nerve. The patient had first refused to undergo the surgery because only an external approach through a paranasal and Caldwell-Luc incision had been proposed to her. We proposed a strictly endoscopic surgery after embolisation that allowed the diagnosis and the complete removal of this extended trigeminal schwannoma. The computer-assisted endoscopic surgery allowed the preservation of the intracranial structures, the internal carotid artery and the ophthalmic nerve; the morbidity was minimal and the patient was totally free of pain after surgery. There was no recurrence of the tumor after a follow-up of 2 years.

Ghanooni, Rose

2009-12-01

286

Contrast-enhanced magnetic resonance imaging of the internal auditory canals and posterior fossa.  

Science.gov (United States)

A retrospective review of 314 cases of contrast-enhanced magnetic resonance imaging (MRI) of the posterior fossa and internal auditory canals was carried out correlating the presenting symptoms with the scan findings. 7.2% of the cases showed findings on the MRI which could account for the patients' symptoms. Patients with sensorineural hearing loss were more likely to have a positive scan than those presenting with vertigo and/or tinnitus without hearing loss. Acoustic schwannoma was the most common lesion detected. Labyrinthine lesions e.g. cochlear schwannoma, labyrinthitis, congenital labyrinthine abnormality, and central lesions e.g. multiple sclerosis, brainstem glioma were some of the other lesions detected. PMID:9663303

Tan, T Y; Teh, H S

1998-03-01

287

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

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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.

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

288

Primary choroid plexus papilloma in the pituitary fossa: case report and literature review.  

Science.gov (United States)

Choroid plexus papillomas are rare tumors of the central nervous system and are usually confined to the ventricular system. We illustrated a primary choroid plexus papilloma in the pituitary fossa. A 31-year-old female presented with amenorrhea and intermittent galactorrhoea, with no visual complaints in the last 2 years. Endocrine testing showed no hormone excess or deficiency of the pituitary and target glands, except for a higher prolactin level (56 ng/ml). A sharply circumscribed regular mass in the sellar region occupying the entire sella turcica and extending into the suprasellar cistern was demonstrated on MR imaging with gadolinium diethylenetriamine pentaacetic acid. The patient underwent an endonasal trans-sphenoidal approach. Complete microsurgical excision and complete preservation of the normal pituitary gland was achieved, with normal prolactin level. The histopathology showed that the lesion was a choroid plexus papilloma. Theories of the origin, the differential diagnosis, and treatment of the rare tumor are discussed. PMID:21140177

Bian, Liu-Guan; Sun, Qing-Fang; Wu, Hua-Cheng; Jiang, Hong; Sun, Yue-Hao; Shen, Jian-Kang

2011-04-01

289

Fractured inlet connecting tube of the flat bottom flushing device of a posterior fossa cystoperitoneal shunt  

Science.gov (United States)

Background: There are well-known complications for shunt procedures. Shunt fracture or disconnection is the second most frequent cause of shunt malfunction in children. Shunt disconnection is not a common cause of shunt malfunction in the early period after installation, especially in the adulthood. Case Description: Fracture of the proximal (inlet) connector of a flat-based shunt installed for decompression of a large posterior fossa arachnoid cyst in a 31-year-old female with signs of increased intracranial pressure led to recurrence of her symptoms 6 months after surgery. Conclusion: Awareness of the possibility of fracture site in the junction of the inlet connector of flat bottom shunt systems is warranted and can be diagnosed by three-dimensional computed tomography (3D CT) imaging without performing shunt series study. PMID:25789198

Amirjamshidi, Abbas; Abbasioun, Kazem; Ghassemi, Babak

2015-01-01

290

A 41-year-old woman with shortness of breath and history of rash and recurrent laryngeal edema.  

Science.gov (United States)

A 41-year-old Hispanic woman with a 20 pack-year smoking history presented with worsening shortness of breath on exertion that gradually started 2 years ago, then significantly deteriorated over the last 4 months. She was diagnosed with COPD 2 months prior to her presentation and started on treatment with fluticasone propionate and albuterol. Her medical history was relevant for undifferentiated connective tissue disorder diagnosed 5 years prior due to a positive antinuclear antibody test, arthralgia, recurrent urticarial skin rash, peripheral neuropathy, abdominal pain, and diffuse body swelling. She was started on treatment with prednisone and azathioprine at the time and had substantial improvement in the occurrence of her urticaria. She also had a history of recurrent laryngeal edema of unclear etiology. She had no history of IV drug abuse, no exposure to animals, was not sexually active, and had no recent travel outside of Florida. There was no significant family history of lung diseases. PMID:25644915

Ataya, Ali; Faruqi, Ibrahim; Salgado, Juan C

2015-02-01

291

Emerging zoonoses in the southern United States: toxocariasis, bovine tuberculosis and southern tick-associated rash illness.  

Science.gov (United States)

The majority of emerging diseases in humans have been linked to zoonotic pathogens originating in domestic animals or wildlife. This is a public health concern because zoonotic infections affect several aspects of the society. The complex interactions among pathogen, host and environment also pose challenges in estimating the true burden of those infections. However, the recent development of new molecular diagnostic tools has allowed for better diagnosis of zoonotic infections. This review focuses on 3 emerging zoonoses, namely toxocariasis, bovine tuberculosis and southern tick-associated rash illness, and demonstrates that these infections may be more prevalent in the southern United States than previously recognized. This review places special emphasis on the recent epidemiologic trends, intra/interspecies transmission and clinical features of each of these zoonoses. In addition, treatment and prevention for each zoonotic pathogen are discussed. Clinicians working in the southern United States should be aware of the presence of those zoonotic infections. PMID:20697261

Clinton, Rachel M; Carabin, Hélène; Little, Susan E

2010-09-01

292

Herpes zoster with motor involvement: discordance between the distribution of skin rash and localization of peripheral nervous system dysfunction.  

Science.gov (United States)

Herpes zoster viral infection (shingles) frequently appears in the thoracic dermatomes with no detectable weakness. We describe three patients who exhibited classic symptoms of herpes zoster infection of the upper limb with various neuropathic findings, including multiple mononeuropathies, radiculopathy, and brachial plexopathy. The distribution of weakness and electrodiagnostic findings was not limited to the involved dermatomes. Furthermore, the electrodiagnostic studies in one patient show evidence of acquired demyelination; hence, the infectious process may include the axon and/or the myelin sheath of the peripheral nerves. In the upper limb, we suggest that a mismatch between the distribution of the vesicular herpetic rash and weakness, as corroborated by the clinical examination and the electrodiagnostic studies, may occur. PMID:21321495

Alshekhlee, Amer; Tay, Edward; Buczek, Marek; Shakir, Zaid A; Katirji, Bashar

2011-03-01

293

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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. Abstract in english 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 1 [...] 8-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.

Yvens B., Fernandes; Gil, Guerra Jr; Sofia H. V., Lemos; Maria T., Matias; Benito P., Damasceno; Osmi, Hamamoto; Ary, Marconi Jr; Donizetti C., Honorato; José L. C., Marins.

1995-09-01

294

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  

Directory of Open Access Journals (Sweden)

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.

Yvens B. Fernandes

1995-09-01

295

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  

Scientific Electronic Library Online (English)

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 nov [...] a 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. Abstract in english 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.

Aline Gomes, Bittencourt; Robinson Koji, Tsuji; João Paulo Ratto, Tempestini; Alfredo Luiz, Jacomo; Ricardo Ferreira, Bento; Rubens de, Brito.

2013-04-01

296

Leiomyosarcoma of the ischiorectal fossa: report of a novel sphincter and sciatic nerve sparing simultaneous trans-abdominal and trans-gluteal resection and review of the literature.  

Science.gov (United States)

Leiomyosarcomas are rare tumours of smooth muscle origin, and there have been no reported cases of such tumours arising within the ischiorectal fossa. Surgical resection with clear margins remains the gold standard treatment; however, there is limited literature on surgical approaches to the ischiorectal fossa for such tumours. We report a case of a high-grade leiomyosarcoma in a 59-year-old lady, occurring within the ischiorectal fossa that was managed using a novel simultaneous sphincter and sciatic nerve preserving trans-abdominal and trans-gluteal technique. This novel approach could be utilized not only for sarcomas but also for other tumours of the ischiorectal fossa extending into the gluteal region. PMID:25759172

Mehta, Nisarg; Konarski, Alastair; Rooney, Paul; Chandrasekar, Coonoor

2015-01-01

297

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

International Nuclear Information System (INIS)

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. Thelated 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)

298

Carcinoma of the tonsillar fossa: prognostic factors and long-term therapy outcome  

International Nuclear Information System (INIS)

Purpose: To identify prognostic parameters and evaluate the therapeutic outcomes for patients with carcinoma of the tonsillar fossa treated with three treatment modalities. Methods and Materials: The results of therapy are reported in 384 patients with histologically proven epidermoid carcinoma of the tonsillar fossa; 154 were treated with irradiation alone (55-70 Gy), 144 with preoperative radiation therapy (20-40 Gy), and 86 with postoperative irradiation (50-60 Gy). The operation in all but four patients in the last two groups consisted of an en bloc radical tonsillectomy with ipsilateral lymph node dissection. Results: Treatment modality and total irradiation doses had no impact on survival. Actuarial 10-year disease-free survival rates were 65% for patients with T1 tumors, 60% for T2, 60% for T3, and 30% for T4 disease. Patients with no cervical lymphadenopathy or with a small metastatic lymph node (N1) had better disease-free survival (60% and 70%, respectively) at 5 years than those with large or fixed lymph nodes (30%). Primary tumor recurrence (local, marginal) rates in the T1, T2, and T3 groups were 20-25% in patients treated with irradiation and surgery and 31% for those treated with irradiation alone (difference not statistically significant). In patients with T4 disease treated with surgery and postoperative irradiation, the local failure rate was 32% compared with 86% with low-dose preoperative irradiation and 47% with irradiation alone (p 0.03). The ove% with irradiation alone (p 0.03). The overall recurrence rates in the neck were 10% for N0 patients, 25% for N1 and N2, and 35-40% for patients with N3 cervical lymph nodes, without significant differences among the various treatment groups. The incidence of contralateral neck recurrences was 8% with the various treatment modalities. On multivariate analysis the only significant factors for local tumor control and disease-free survival were T and N stage (p = 0.04-0.001). Fatal complications were noted in 7 of 144 (5%) patients treated with preoperative irradiation and surgery, 2 of 86 (2%) of those receiving postoperative irradiation, and 2 of 154 (1.3%) patients treated with radiation therapy alone. Other moderate or severe nonfatal sequelae were noted in 30% of the patients treated with preoperative irradiation and surgery, in 53% treated with postoperative irradiation, and in 19% receiving radiation therapy alone. Conclusion: Primary tumor and neck node stage are the only significant prognostic factors influencing locoregional tumor control and disease-free survival. Treatment modality had no significant impact on outcome. Radiation therapy remains the treatment of choice for patients with stage T1-T2 carcinoma of the tonsillar fossa. In patients with T3-T4 tumors and good general condition, combination surgery and postoperative irradiation offers better tumor control than single-modality and preoperative irradiation procedures, but with greater morbidity

299

Ultrasound Imaging of the Sciatic Nerve Division in the Popliteal Fossa: A Volunteer Study  

Directory of Open Access Journals (Sweden)

Full Text Available The Background and Objectives: A sciatic nerve block at the level of the popliteal fossa is frequently administered for post-operative analgesia for surgery below the knee. While ultrasound continues to gain popularity as the technique of choice for guiding needle positioning during peripheral nerve blocks, practitioners can begin to utilize ultrasound to look for patterns of anatomical significance. Recognizing anatomical variations among different demographic populations can help practitioners improve in performing nerve blocks. We aim to determine if predictable variability exists in sciatic nerve bifurcation location and depth at the level of the popliteal fossa. Methods: After IRB approval, eligible subjects were screened for ASA I or II status and demographic data was collected. Fifty subjects were enrolled. The SonoSite MicroMaxx® with 38-mm broadband linear array, 13-6 MHz probe with color Doppler and image capturing capabilities was used for ultrasound measurements. With subject lying prone, the location of the sciatic nerve in relation to the popliteal crease and skin-to-nerve distance were assessed via ultrasound. Two independent investigators confirmed nerve location for measurements. Analyses were performed with SAS version 9.1 using Pearson Correlation Coefficients and regression analysis. Results: Gender stratification revealed that, while males were both taller and heavier, skin-nerve measurements for depth were consistently deeper in females (p-value 0.02. Independent of the right or left leg, male gender and increased height decreases the skin-nerve distance, while increased weight increases the distance. There was no correlation between patient characteristics and crease-nerve distance. In some subjects, variability of crease-nerve distance even existed between their right and left leg. Conclusion: We show that significant variability exists for actual sciatic nerve bifurcation location, or target injection site, with consistently deeper skin depth values for female patients when compared to male patients, accounting for height and weight. These findings suggest visualization techniques such as ultrasound may lead to better localization of ideal injection sites.

Eric P. Chiang

2013-07-01

300

White matter integrity is associated with cognitive processing in patients treated for a posterior fossa brain tumor  

OpenAIRE

Children treated for posterior fossa tumors experience reduced cognitive processing speed and, after imaging, show damage to white matter (WM) tracts in the brain. This study explores relationships between white matter microstructure, assessed by fractional anisotropy (FA), and speed of cognitive processing using tract-based spatial statistics (TBSS). At 36 months after treatment with radiotherapy and chemotherapy, 40 patients completed an MRI examination and neuropsychological evaluation. Pa...

Palmer, Shawna L.; Glass, John O.; Li, Yimei; Ogg, Robert; Qaddoumi, Ibrahim; Armstrong, Gregory T.; Wright, Karen; Wetmore, Cynthia; Broniscer, Alberto; Gajjar, Amar; Reddick, Wilburn E.

2012-01-01

301

Primary extraparenchymal hemorrhage of the posterior cranal fossa as a premonitory symptom of atlanto-axial instability  

International Nuclear Information System (INIS)

The contribution discusses the cases of five patients with cranio-cerebral trauma, (four children and one adult patient), where CT examination revealed extraparenchymal hemorrhage of the posterior cranal fossa, which did not fit into their pattern of intracranial trauma and therefore gave reason to suspect a lesion of the upper cervical spine. The various types of hemorrhage found are explained, as well as the underlying cervical spine lesions, and the choice of respective therapies which proved to be successful. (orig./CB)

302

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

OpenAIRE

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...

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

2014-01-01

303

Deep Venous Reflux Associated with a Dilated Popliteal Fossa Vein Reversed with Endovenous Laser Ablation and Sclerotherapy  

OpenAIRE

Objective. To report an incidence of reflux in the deep venous system reversed by ablation of a popliteal fossa vein (PFV). Method. A 40-year-old man with pain and swelling in the medial upper calf was found to have an incompetent PFV. Results. Reflux in the femoral and popliteal veins was reversed utilizing endovenous laser ablation and foam sclerotherapy, documented on Duplex studies before and after the intervention. There was also resolution of symptoms. Conclusion. A PFV can be associate...

Link, Daniel P.; Jennifer Feneis; John Carson

2013-01-01

304

Volume-artifact reduction modality by helical CT of the anterior, middle and posterior carnial fossae. Comparison with conventional CT  

International Nuclear Information System (INIS)

Purpose: The object of this study was to determine the extent to which a new volume-artifact reduction (VAR) modality using helical CT was able to reduce artifacts in the anterior, middle and posterior fossae in comparison with conventional CT (sequential mode). Methods: In a prospective, randomized trial, 50 patients underwent helical CT (VAR) and 50 underwent sequential CT. The results were evaluated by three radiologists; influences on image quality where scaled between 1 (no artifact) and 4 (not assessable). Eight regions of the anterior, middle and posterior fossae were evaluated. Results: On average, artifacts were scaled at 2.5 in helical CT (VAR) and 3.1 in conventional CT. Significant differences were seen at the eyeball, anterior to the petrosol bone, at the internal occipital crest, and at the level of the transverse sinus (p<0.005). Conclusions: Helical CT with the VAR modality is superior to conventional, sequential CT in the area of the anterior, middle and posterior fossae. (orig.)

305

Impacted cisterna magna without syringomyelia associated with lancinating headache, throbbed nuchal pain and paraparesis treated byposterior fossa decompression Cisterna magna impactada sem siringomielia associada a cefaléia lancinante, dor na nuca terebrante e paraparesia tratadas com descompressão da fossa posterior  

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Full Text Available A 29-year-old woman with acute lancinating headache, throbbed nuchal pain and subacute paraparesis underwent brain MRI in supine position that depicted: the absence of the cisterna magna, filled by non herniated cerebellar tonsils and compression of the brain stem and cisternae of the posterior fossa, which are aspects of the impacted cisterna magna without syringomyelia and without hydrocephalus. During eight days, pain was constant and resistant to drug treatment. Osteodural-neural decompression of the posterior fossa, performed with the patient in sitting position, revealed: compression of the brainstem, fourth ventricle and foramen of Magendie by herniated cerebellar tonsils, which were aspirated. Immediately after surgery, the headache and nuchal pain remmited. MRI depicted the large created cisterna magna and also that the cerebellar tonsils did not compress the fourth ventricle, the foramen of Magendie and the brainstem, besides the enlargement of posterior fossa cisternae. Four months after surgery, headache, nuchal pain and paraparesis had disappeared but hyperactive patellar and Achilles reflexes remained.Uma paciente de 29 anos de idade com quadro agudo de cefaléia lancinante, dor terebrante na nuca e paraparesia subaguda foi submetida a RM do encéfalo, em posição supina, que revelou: ausência da cisterna magna, preenchida por tonsilas cerebelares não herniadas e compressão do tronco encefálico e das cisternas da fossa posterior, compatíveis com o diagnóstico de cisterna magna impactada sem siringomielia e sem hidrocefalia. Por oito dias a dor foi constante e resistente aos analgésicos. Com a paciente em posição sentada, foi realizada descompressão osteodural-neural da fossa posterior associada a aspiração das tonsilas cerebelares. Os achados perioperatórios foram caracterizados por herniação das tonsilas cerebelares que comprimiam o tronco cerebral, o quarto ventrículo e o forame de Magendie. No pós-operatório imediato houve remissão da cefaléia e da dor na nuca. A RM evidenciou a cisterna magna recém-criada, alargamento do quarto ventrículo e das cisternas do tronco encefálico. Quatro meses depois, a paciente continuava sem cefaléia, sem dor na nuca e sem paraparesia. Entretanto, permaneceu a hiperatividade dos reflexos patelares e aquileus.

José Alberto Gonçalves da Silva

2007-12-01

306

Geology of Hebrus Valles and Hephaestus Fossae, Mars: evidence for basement control of fluvial patterns  

Energy Technology Data Exchange (ETDEWEB)

Hebrus Valles (HV) and Hephaestus Fossae (HF) are valley systems located SW of Elysium Mons in the low northern plains of Mars. HV share many of their characteristics with other martian outflow channels--widely interpreted as having formed by catastrophic flooding. The NW-trending HV system is 250 km long and begins in an elongate depression. Individual channels are less than 1 km wide; a braided reach is about 10 km wide. Streamlined islands are abundant in the middle reach. HV terminate as a series of narrow distributaries. No sedimentary deposits are obviously related to the development of the channel. HV cut across a broad expanse of older plains dotted by irregular mesas and smaller knobs. HF are a connected series of linear valley segments which branch and cross downslope but have high junction angles. Locally, the channel pattern is polygonal. HF are parallel to HV but are considerably deeper and longer (600 km). HF also originate in a depression, but to the NW they terminate near the gradational boundary between the knobby plains and polygonally fractured terrain of Utopia Planitia. The valley pattern has led some to suggest that HF are tectonic features. It is suggested that like HV, HF are also of fluvial origin. Downcutting to, or subsurface flow at this pre-existing surface red to a channel pattern that was strongly controlled by the polygonal troughs buried beneath the younger knobby plains materials.

Christiansen, E.H.

1985-01-01

307

Endoscopic endonasal transturbinate approach to the pterygopalatine fossa in the management of juvenile nasopharyngeal angiofibromas.  

Science.gov (United States)

Pterygopalatine fossa (PPF) is a difficult-to-access anatomic area located behind the posterior wall of the maxillary sinus. Juvenile nasopharyngeal angiofibroma (JNA) often affects this area, and the management of feeding artery to the tumor is important in the surgery. Endoscopic endonasal approach to the PPF without endangering all other nasal structures is useful in the management of JNA. We describe a new approach to the PPF, endoscopic transturbinate approach, which is effective in the management of JNA. Submucous inferior turbinoplasty was performed, and sphenopalatine artery, the feeder to the tumor, was identified at the sphenopalatine foramen. The posterior wall of maxillary sinus was removed. Internal maxillary artery was identified in the PPF and was ligated with a hemoclip. The tumor in the PPF was pushed into the nasal cavity. These procedures were all performed via submucous turbinate tunnel. Then, the tumor was successfully removed in en bloc from the nasal cavity by transnasal approach without ethmoidectomy. This approach improves accessibility and visualization in the PPF and potential to reduce intraoperative bleeding due to ligation of the feeder safely without touching the tumor. Endoscopic transturbinate approach is effective in the management of early stage of JNA. PMID:22953122

Kodama, Satoru; Mabuchi, Hideaki; Suzuki, Masashi

2012-01-01

308

Analogue Modeling of the Neogene North Fossa Magna Basin, Central Japan  

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The North Fossa Magna (NFM) is a Miocene basin developed during the final stage of the Sea of Japan. This basin is bounded in the west by the Itoigawa-Shizuoka Tectonic Line (ISTL) from the Pre-Neogene basement rocks. Previous seismic reflection analysis of the claimed active faults transecting this area, revealed that (1) the ISTL is a thrusting fault system dipping eastward. (2) The West Nagano Basin fault (WNBF) is a reverse active fault dipping westward. The idea to simulate the extension phase of the NFM (since 14 Ma.) is based on to visualize the real-time developing structures on a scale model similar to the natural prototype (NFM) and to better understand the tectonic processes created this basin. These geological processes are still manipulating the active tectonic in this area. Similarity condition between the scale model and natural prototype has been considered. The pre-Neogene basement rocks were represented in the sandbox experiments by sand of relatively high internal-friction angle (about 42 degree). The Miocene and Pliocene sedimentary rocks were modeled using less internal-friction angle sand (tectonic rather than other factors during the Miocene to Early Pliocene period. Extension tectonic influences started to weaken from Late Pliocene, announcing the beginning of the inversion. This tectonic inversion made the whole system of the NFM under compression during the Quaternary and still active nowadays.

Elouai, D.; Yamada, Y.; Zhang, M.; Nakajima, H.; Matsuoka, T.

2005-12-01

309

Evaluation of axillary fossa lymph nodes metastasis with mammography in patients with breast cancer  

International Nuclear Information System (INIS)

Objective: To investigate X-ray characteristics of axillary fossa lymph nodes (ALNs)metastases in patients with breast cancer. Methods: 11 cases of breast cancer confirmed by operation were performed with mammography. The breast, the samples of the breast and the ALNs were all detected. The X-ray characteristics of ALNs were compared with pathologic findings. Results: There were 46 metastatic lymph nodes and 52 non-metastatic nodes. There were 10 metastaic and 8 non-metastic lymph nodes among 18 lymph nodes with maximum diameter larger than 10mm. There were 42 metastatic and 5 non-metastatic lymph nodes among 42 high density solid ymph nodes. Only 4 out of 46 metastatic lymph nodes showed normal density. Conclusion: The metastases of ALNs had poor correlation with the size. The high density, irregular cortex and adjacent fat tissue change of the ALNs in patients with breast cancer are probably indicative of metastases. Molybdenum target mammography is amodality of choice for the assessment of ALNs in patients with breast cancer. (authors)

310

Imaging of lesions in the posterior cranial fossa using single photon emission computed tomography  

Energy Technology Data Exchange (ETDEWEB)

Lesions in the posterior cranial fossa were visualized by single photon emission computed tomography (SPECT) with /sup 123/I-IMP (N-isopropyl-p-/sup 123/I-iodoamphetamine) and /sup 99m/Tc-HM-PAO (/sup 99m/Tc-hexametylpropyleneamine oxime). It is generally held that these radiopharmaceuticals penetrate the walls of cerebral blood vessels and that their accumulations in the brain tissue may reflect the cerebral blood flow. Six patients with lesions in the central nervous system all showed wider areas of abnormality in SPECT than in X-ray CT, indicating a larger lesion of blood flow disturbance. In the next series of 11 patients with vertigo or dizziness of unknown etiology, eight had abnormal findings in the scan with /sup 123/I-IMP as did four of the nine in the scan with /sup 99m/Tc-HM-PAO. Thus, most patients with dizziness of unknown etiology may have some vertebral blood flow disorder, which in some cases is not clearly diagnosed by conventional vestibular examinations or even by X-ray CT scan. The accuracy of the diagnostic measures for otoneurological problems awaits further studies of their sensitivity and specificity.

Kawakami, Michiro; Uesugi, Yasuo; Higashikawa, Masahiko; Ochi, Mari; Makimoto, Kazuo; Takahashi, Hiroaki; Shin, Akinori; Utsunomiya, Keita; Akagi, Hiroaki

1988-10-01

311

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

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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

MR Etemadifar

2005-05-01

312

Imaging of lesions in the posterior cranial fossa using single photon emission computed tomography  

International Nuclear Information System (INIS)

Lesions in the posterior cranial fossa were visualized by single photon emission computed tomography (SPECT) with 123I-IMP (N-isopropyl-p-123I-iodoamphetamine) and 99mTc-HM-PAO (99mTc-hexametylpropyleneamine oxime). It is generally held that these radiopharmaceuticals penetrate the walls of cerebral blood vessels and that their accumulations in the brain tissue may reflect the cerebral blood flow. Six patients with lesions in the central nervous system all showed wider areas of abnormality in SPECT than in X-ray CT, indicating a larger lesion of blood flow disturbance. In the next series of 11 patients with vertigo or dizziness of unknown etiology, eight had abnormal findings in the scan with 123I-IMP as did four of the nine in the scan with 99mTc-HM-PAO. Thus, most patients with dizziness of unknown etiology may have some vertebral blood flow disorder, which in some cases is not clearly diagnosed by conventional vestibular examinations or even by X-ray CT scan. The accuracy of the diagnostic measures for otoneurological problems awaits further studies of their sensitivity and specificity. (author)

313

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

International Nuclear Information System (INIS)

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)

314

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

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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.

Brian O’Sullivan

2012-01-01

315

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

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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

Jahanguiri B

1994-04-01

316

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

International Nuclear Information System (INIS)

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

317

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

International Nuclear Information System (INIS)

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

318

Long-lasting "christmas tree rash" in an adolescent: isotopic response of indeterminate cell histiocytosis in pityriasis rosea?  

Science.gov (United States)

A 13-year-old girl developed a non-pruritic pityriasis rosea-like rash, which did not respond to topical corticosteroids or UV therapy but persisted for 2 years. The lymphohistiocytic infiltrate in the upper dermis showed mononuclear cells immunoreactive with S100, CD68, factor XIIIa and CD1a. Electron microscopic evaluation of these cells demonstrated lamellated dense bodies but no Birbeck granules, lipid vacuoles or cholesterol crystals. Two diagnoses were made: a primarily clinical diagnosis of generalized eruptive histiocytosis and a more cell-biology-based diagnosis of an indeterminate cell histiocytosis. Three years later, the lesions are showing spontaneous resolution, with loss of erythema and flattening. Our patient's indeterminate cells fulfil Rowden's classical definition (dendritically shaped epidermal non-keratinocytes without identifying cytoplasmic features), as well as Zelger's newer definition (cells with features of both macrophages and dendritic cells). A Christmas tree pattern has not been previously described in indeterminate cell histiocytosis. Development of indeterminate cell histiocytosis in the lesions of a healing pityriasis rosea might explain the unusual distribution pattern. The development of a skin disorder at the site of an unrelated, already healed skin disease is known as an isotopic response. Key PMID:12361135

Wollenberg, Andreas; Burgdorf, Walter H C; Schaller, Martin; Sander, Christian

2002-01-01

319

Reconstrução tridimensional da face nos tumores avançados com invasão da fossa craniana anterior / Tridimensional facial reconstruction following major resection of tumors involving the anterior cranial fossa  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Analisar as indicações cirúrgicas e o seguimento pós operatório, ressaltando as complicações e efetividade da abordagem multidisciplinar, para os tumores avançados da base do crânio. MÉTODO: Análise retrospectiva de 46 prontuários de pacientes submetidos à ressecção de tumores invadindo a [...] fossa craniana anterior e reconstruídos com retalhos microcirúrgicos, operados entre março de 1990 e julho de 2002. Todos os pacientes foram operados pelo núcleo de cirurgia de base do crânio do INCA. RESULTADOS: As estruturas mais envolvidas na ressecção foram por ordem: a órbita (76,5%), seio maxilar (76,5%), seio esfenoidal (63,8%), paredes da cavidade nasal (59,5%) e palato (42,5%). A dura-máter estava acometida em 32,6% dos casos. A reconstrução microcirúrgica utilizando os retalhos do músculo reto abdominal foi empregada em 93,5 % dos casos. A taxa de sucesso dos transplantes livres foi de 97,8%. As complicações ocorreram em 58,6% dos pacientes e as mais freqüentes foram: infecções locais (21,7%), fístulas liquóricas (15,2%), meningite (6,5%) e hematoma (6,5%). CONCLUSÕES: A reconstrução com técnica microcirúrgica permite que se realizem ressecções alargadas destes tumores com limites seguros e índices de complicações aceitáveis, permitindo a estes pacientes uma melhoria da qualidade de vida e da sobrevida, com baixo índice de recidiva. Abstract in english BACKGROUND: The analysis of the surgical indications and the follow-up, stressing the surgical complications and efficiency of a team approach for the advanced tumors involving the anterior skull base are the purpose of the present study. METHODS: The authors present a retrospective evaluation of 46 [...] patients who underwent resections of advanced tumors involving the anterior skull base, which were reconstructed with free flaps from May, 1990 to July, 2002. Those patients have been treated by the skull base surgical team of INCA. RESULTS: The commonest resected structures were: the orbit (76.5%), maxilar sinus (76.5%), sphenoidal sinus (63.8%), nasal cavity walls (59.5%) and palate (42.5%). The dura-mater was involved in 32,6% of the patients. Free-flap reconstructions employing the rectus abdominis muscle flaps were the leading procedure in 93.5% of patients. The successful rate of the free-tissue transfer was 97.8%. Complications occurred in 58,6% of patients, the most frequent were: local infection (21.7%), cerebrospinal fluid leakage (15.3%), meningitis(6.5%) and hematoma (6.5%). CONCLUSIONS: The microvascular free-tissue transfer reconstruction allows more extensive resections of those tumors with safety borders, presenting acceptable complication rates, offering the patients a better quality of life, longer life expectance with low incidence of recurrent disease.

Mario Sergio Lomba, Galvão; Geraldo Mattos de, Sá; Terence, Farias; Rafael, Anlicoara; Fernando Luiz, Dias; Juliano Carlos, Sbalchiero.

2004-04-01

320

Incidence of rubella IgM antibodies in individuals with febrile rash illness attending clinics in Akwa Ibom State, Nigeria, 2006-2009  

OpenAIRE

Background: Rubella is an infectious disease of public health importance because infection ac-quired during early pregnancy often results in foetal abnormalities that are classified as con-genital rubella syndrome (CRS). The burden of rubella infection in most developing countries is however not well documented because of lim-ited epidemiological data. Methods: Between 2006 and 2009, 781individuals with febrile rash illness seen in clinics in Akwa Ibom State were screened for rubella specific...

Bassey Enya; Moses Anietie Effiong; Udo Sunde Moffat; Bassey Emem

2011-01-01

321

Reduced CYP2D6 function is associated with gefitinib-induced rash in patients with non-small cell lung cancer  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Rash, liver dysfunction, and diarrhea are known major adverse events associated with erlotinib and gefitinib. However, clinical trials with gefitinib have reported different proportions of adverse events compared to trials with erlotinib. In an in vitro study, cytochrome P450 (CYP 2D6 was shown to be involved in the metabolism of gefitinib but not erlotinib. It has been hypothesized that CYP2D6 phenotypes may be implicated in different adverse events associated with gefitinib and erlotinib therapies. Methods The frequency of each adverse event was evaluated during the period in which the patients received gefitinib or erlotinib therapy. CYP2D6 phenotypes were determined by analysis of CYP2D6 genotypes using real-time polymerase chain reaction techniques, which can detect single-nucleotide polymorphisms. The CYP2D6 phenotypes were categorized into 2 groups according to functional or reduced metabolic levels. In addition, we evaluated the odds ratio (OR of the adverse events associated with each factor, including CYP2D6 activities and treatment types. Results A total of 232 patients received gefitinib therapy, and 86 received erlotinib therapy. Reduced function of CYP2D6 was associated with an increased risk of rash of grade 2 or more (OR, 0.44; 95% confidence interval [CI], 0.21–0.94; *p = 0.03, but not diarrhea ? grade 2 (OR, 0.49; 95% CI, 0.17–1.51; *p = 0.20 or liver dysfunction ? grade 2 (OR, 1.08; 95% CI, 0.52–2.34; *p = 0.84 in the gefitinib cohort. No associations were observed between any adverse events in the erlotinib cohort and CYP2D6 phenotypes (rash: OR, 1.77; 95% CI, 0.54–6.41; *p = 0.35/diarrhea: OR, 1.08; 95% CI, 0.21–7.43; *p = 0.93/liver dysfunction: OR, 0.93; 95% CI, 0.20–5.07; *p = 0.93. Conclusions The frequency of rash was significantly higher in patients with reduced CYP2D6 activity who treated with gefitinib compared to patients with functional CYP2D6. CYP2D6 phenotypes are a risk factor for the development of rash in response to gefitinib therapy.

Suzumura Tomohiro

2012-12-01

322

Geological Structure of the Itoigawa - Shizuoka Tectonic Line, Northern Fossa Magna, Central Japan  

Science.gov (United States)

Geological structure of two different natures is recognized in the Northern Fossa Magna (NFM). NFM is situated near the zone where the central Japan Island bent geographically and a graben zone formed between the North Alps and the Kanto highland. NFM is characterized by thick Neogene deposits and with active tilting of the crustal blocks and active folding bloc. At the present the sedimentary basin is the Saigawa hill due to the active faulting and folding in the Fossa Magna. Active fault system of Itoigawa-Shizuoka Tectonic Line (ISTL) is an eastward - dip of reverse fault which strikes N-S along the western margin of the NFM. The vertical displacement rate of ISTL is estimated to be maximum 9 mm/yr from the offset amount and the formation age of flexure scarp which appeared in the fluvial terrace [ex. Ikeda et al., (2002)]. Besides, the last event and the reccurrence interval are presumed to be about about 1,500 years aga and 2,000 years, respectively [Okumura (2001)]. In addition the western margin fault of the Nagano basin (NBF) strikes NNE-SSW along the east edge of NFM. The NBF is an eastward-dip of reverse fault, and the Zenkoji earthquake (M7.4) in 1847 was occurred. The purpose of present study is to discuss the geometry of ISTL and geological process of NFM based on the geomorphological and geological survey using the geological dip and strike already obtained at the more than 1,500 data points. Based on these geological data, the geological structure provinceis divided into two types those are a tilt block and a folding belt at west and east sides, respectively. The Western tilting block and an Eastern folding belt trend NS strike and NNE-SSW strike, respectively. As a result of the geomorphic decipherment in alignment with ISTL using the air photograph, flexure scarp of east side upheaval is formed in the fluvial terrace side and it is difficult for the terrace riser which crosses flexure scarp and a valley to observe lateral offset. The tilt block, ‘Omine belt’, exists along east side of ISTL. The Omine belt is exposed of the Omine formation which is mainly composed of alluvial conglomerate with several tuff layers. The Omine formation is inferred to contact with the ISTL from the situated. The dips of bedding surface are ranged in 20 - 50 degrees east. The ISTL, thus, is an emergent thrust with a low angle fault plane. The eruption age of the upper tuff layer, which was observed in the uppermost member, are presumed to be ca. 1.65 Ma from the stratigraphy and K-Ar age measurement. The Otari-Nakayama Fault (ONF) is already mapped near the boundary between the Omine belt and the folding belt [ex. Saito (1962), Kato et al. 1989]. The fault plane is almost vertical. The Omine formation (Plio-Pleistocene ) is distributed over its west side and the Aoki and Ogawa formations (Miocene) is over the east side. The Omine formation is crushed [ex. Saito (1962), Kato et al. 1989]. The activity stage of this fault is still unknown. The large-scale folding structures are appeared in the Miocene zone. Folding structures strike NNE-SSW and different from the Omine belt.The slip partitioning is recognized by the different mode of several faults which are distributed in and around the NFM.

Kim, H.; Iwasaki, T.

2009-12-01

323

La Verbena azul en el tratamiento del niño con salpullido / The blue Verbena to treat the child with rash  

Scientific Electronic Library Online (English)

Full Text Available Introducción: la miliaria es una enfermedad inflamatoria de la piel, usualmente conocida como salpullido, es muy frecuente en niños pequeños sobre todo en los meses de verano. Objetivo: valorar la eficacia de la infusión de Verbena azul en el control de la miliaria común. Métodos: se realizó un ensa [...] yo clínico fase II, a partir de la preparación de una infusión de hojas frescas o secas molidas, que se vertieron en 12 litros de agua hirviente, se tapó y se separó del fuego después de añadirle la planta, se dejó reposar y se coló. Fue aplicada tibia en todo el cuerpo durante 21 días, en dos secciones, al levantarse, y en la tarde luego del baño diario. El estudio se realizó en 30 lactantes de raza blanca, que acudieron con esta patología a la consulta de Medicina Natural y Tradicional, en el consultorio 6 del poblado de Altagracia, en el periodo entre junio del 2004 y junio del 2005, los cuales pertenecían al Policlínico Comunitario Docente "Carlos J. Finlay" de la Ciudad de Camagüey. Los datos se recogieron mediante una encuesta, confeccionada de acuerdo con los objetivos planteados en la investigación. Resultados: el grupo más afectado fue el de 3 a 6 meses, todos los pacientes fueron blancos, no se encontraron diferencias significativas en cuanto al sexo. La variedad clínica más frecuente fue la cristalina, y los meses en que más se presentó fueron entre junio y agosto. Conclusiones: este tratamiento presentó una alta eficacia en el control de la sintomatología de la miliaria común; se curaron 9 de cada 10 pacientes. Abstract in english Introduction: miliaria is an skin inflammatory disease known as rash and is very frequent in small children mainly during summer months. Objective: assessing the efficacy of the infusion of blue Verbena in controlling common heat rash. Methods: a phase II clinical trial was conducted from the prepar [...] ation of an infusion of fresh leaves or dry grinded poured out in 12 liters of boiling water, was covered and removed from fire after adding the plant, it was doughed and strained. It was applied warm in whole body for 21 days in t wo sessions, to stand up and at evening after daily bath. A study was conducted in 30 white infants presenting with this pathology who came to the Natural and Traditional Medicine Service in the No.6 consulting room of the Altagracia settlement from June, 2004 to June, 2005 of "Carlos J. Finlay" Teaching Community polyclinic of the Camagüey city. Data were collected by survey, designed according to the objectives proposed in research. Results: the more involved group was that aged 3-6 months, all patients were white; there were not significant differences as regards sex. The more frequent clinical variety was the crystalline one and more prevalent months were June and August. Conclusions: present treatment was highly effective in the control of symptomatology of the common miliaria; nine of ten patients were cured.

Roberto, Galiano Piquet; Bárbaro, Usatorres Rodríguez.

2012-03-01

324

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

Energy Technology Data Exchange (ETDEWEB)

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.

Murayama, K.; Chen, M.N.; Kuzuhara, M.; Shimura, T.; Yajima, K.; Nakazawa, S. (Nippon Medical School, Tokyo)

1982-05-01

325

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

International Nuclear Information System (INIS)

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 ofcephalographical 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)

326

Effective shunt-independent treatment for primary middle fossa arachnoid cyst.  

Science.gov (United States)

The results of a prospective study on excision of the outer and inner membrane for symptomatic primary middle fossa arachnoid cysts in children are presented. During the period 1982-1989, among 48 cases of cyst in various locations, 18 symptomatic patients were treated by excision of both the outer and inner membranes with an opening to the basal cistern. The mean patient age was 3.2 years. All patients were evaluated by examinations, including magnetic resonance imaging (MRI), X-ray computed tomography (CT), quantitative CT cisternography (CTC), digital subtraction angiography (DSA), N-isopropyl-p[123]iodoamphetamine single-photon emission CT (IMP-SPECT) and IQ. All showed abnormal cerebrospinal fluid flow dynamics. Significant complications included massive subdural effusion in two patients and transient pulmonary edema in one. There were no recurrences during the follow-up period (mean 4.7 years). Two morphological types were noted: type I, the classical anteromedial type where the cysts are attached directly to the adjacent parasellar cisterns, and type II, the anterolateral type, where the diagonally concave anterior temporal lobe covers the adjacent cisterns, making wide opening difficult. Type I accounted for 78% of all cases, and the reduction of the cyst volume with clinical improvement was remarkable within 6 months after surgery. Angiographically, 22% of cases showed tapering and retrograde filling of the superficial middle cerebral vein. This pattern is not included in Hacker's normal variations [18] and suggests mild but chronic compression of the developing brain. Even in patients with hemispheric cyst, the reconstituted brain showed sufficient cerebral perfusion on SPECT, suggesting that the nature of this disease entity is reversible developmental arrest.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1794117

Sato, H; Sato, N; Katayama, S; Tamaki, N; Matsumoto, S

1991-11-01

327

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

International Nuclear Information System (INIS)

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 gangliment 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.)

328

Amyloidoma Involving the Orbit, Meckel's Cave and Infratemporal Fossa: 3T MRI Findings.  

Science.gov (United States)

Amyloidoma is a rare lesion characterized by tissue deposition of an abnormal fibrillary protein (amyloid). It is the focal and localized counterpart of systemic amyloidosis, where the deposition of amyloid diffusely involves several organs. The few literature reports of intracranial amyloidomas include lesions involving the pituitary gland, orbit, cerebral hemispheres, temporal bone, cerebellopontine angle and jugular foramen. We describe the case of a 27-year-old woman presenting with painless slowly progressive proptosis of the right eye. The patient underwent a contrast-enhanced CT study of the head, followed by 3T MRI which disclosed a homogeneous mass in the right Meckel's cave and cavernous sinus, extending through an enlarged foramen ovale to the infratemporal fossa. The right optic nerve and ocular muscles were enlarged and infiltrated along with the retrobulbar fat by contrast-enhancing tissue. Thin contrast-enhanced MRI scans through the area of interest showed the mass to extend posterior to the gasserian ganglion, involving the cerebellopontine angle cistern, where the intracisternal parts of the III, V, and VI nerves bilaterally appeared enlarged and showed perineural enhancement. The lesion closely mimicked a malignant tumor with perineural tumor infiltration, so we performed fine needle biopsy of the portion of the lesion near the right foramen ovale under fluoroscopic guidance. Histopathology revealed that the lesion was an amyloidoma. Further clinical and blood examinations, serum chemistry, followed by biopsy of the periumbilical fat showed no signs of systemic amyloidosis or an underlying inflammatory or neoplastic disorder. No further treatment was instituted, follow-up MRI six months later showed no enlargement of the mass. PMID:24206952

Menetti, F; Bartolomei, I; Ambrosini-Spaltro, A; Salvi, F; Agati, R; Leonardi, M

2009-03-23

329

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

Energy Technology Data Exchange (ETDEWEB)

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.)

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

330

Molecular sub-group-specific immunophenotypic changes are associated with outcome in recurrent posterior fossa ependymoma.  

Science.gov (United States)

Better understanding of ependymoma (EPN) biology at relapse is needed to improve therapy at this critical event. Convincing data exist defining transcriptionally distinct posterior fossa (PF) sub-groups A and B at diagnosis. The clinical and biological consequence of these sub-groups at recurrence has not yet been defined. Genome and transcriptome microarray profiles and clinical variables of matched primary and first recurrent PF EPN pairs were used to identify biologically distinct patterns of progression between EPN sub-groups at recurrence. Key findings were validated by histology and immune function assays. Transcriptomic profiles were partially conserved at recurrence. However, 4 of 14 paired samples changed sub-groups at recurrence, and significant sub-group-specific transcriptomic changes between primary and recurrent tumors were identified, which were predominantly immune-related. Further examination revealed that Group A primary tumors harbor an immune gene signature and cellular functionality consistent with an immunosuppressive phenotype associated with tissue remodeling and wound healing. Conversely, Group B tumors develop an adaptive, antigen-specific immune response signature and increased T-cell infiltration at recurrence. Clinical distinctions between sub-groups become more apparent after first recurrence. Group A tumors were more often sub-totally resected and had a significantly shorter time to subsequent progression and worse overall survival. Minimal tumor-specific genomic changes were observed for either PF Groups A or B at recurrence. Molecular sub-groups of PF EPN convey distinct immunobiologic signatures at diagnosis and recurrence, providing potential biologic rationale to their disparate clinical outcomes. Immunotherapeutic approaches may be warranted, particularly in Group A PF EPN. PMID:24240813

Hoffman, Lindsey M; Donson, Andrew M; Nakachi, Ichiro; Griesinger, Andrea M; Birks, Diane K; Amani, Vladimir; Hemenway, Molly S; Liu, Arthur K; Wang, Michael; Hankinson, Todd C; Handler, Michael H; Foreman, Nicholas K

2014-05-01

331

Double saloon door tectonics in the Japan Sea, Fossa Magna, and the Japanese Island Arc  

Science.gov (United States)

A number of criteria considered diagnostic of double saloon door rifting and seafloor spreading are matched by data from the Japanese Arc. These include: a pair of terranes, SW and NE Honshu, which rotated in opposite directions from 22-21 Ma to 14-11 Ma; rotated terranes which comprise a retro-arc fold/thrust belt attached to an accretionary wedge intruded by a magmatic arc; contemporaneous backarc extension from 24 to 21 Ma which is brought to a halt by progressive collision of the Izu-Bonin and Japan Arcs from 15 to 5 Ma; isolation of blocks of thicker continental crust by areas of thin continental or oceanic crust, during backarc rifting; such isolation may be due to simultaneous rifting or to progressively seaward rifts, associated with ridge jumps towards the subduction zone; opposite rotations are accommodated by subduction rollback demonstrated by seaward migration of the volcanic front from 30-26 Ma to 16-15 Ma; concurrent development of a major arc-orthogonal rift, the Fossa Magna, from 23-18 Ma to 14 Ma, which was thereafter inverted from 15 Ma to the Recent; a northeast propagating rift in the northern Japan Basin demonstrated by the relationship of linear magnetic anomalies to the mapped continent ocean boundary. Driving mechanisms for double saloon door tectonics are discussed in relation to various reconstructions of the northwest Pacific. Opposite rotational torques, leading to opposite terrane rotations, may be caused by rollback of a curved trench hingeline, or by the divergent slab sinking forces of the Pacific and Philippine Sea Plates.

Martin, A. K.

2011-01-01

332

Phenocrysts Crystallisation Pressures and Temperatures and Melts Evolution at La Fossa Volcano (Vulcano Island, Italy)  

Science.gov (United States)

La Fossa Volcano (Vulcano Isl., Aeolian Arch., Italy) erupted last, explosively, in 1888-1890. Its eruptive history includes at least four eruptive cycles of mixed eruptions with strombolian and hydromagmatic phases followed generally by small lava flows ranging in composition from latites to trachytes and rhyolites. Crystallisation temperatures and pressures of phenocrysts and melts chemical evolution, have been modeled via thermochemical calculations and HP-HT laboratory experiments. The crystallisation temperatures and pressures of olivine and clinopyroxene phenocrysts of latitic and trachitic lavas (Punte Nere, Grotte dei Palizzi) were obtained via the empirical olivine-clinopyroxene-liquid thermobarometer of Sugawara (2000) and the olivine geothermometer of Ariskin et al. (1993) which gave consistent values of 1120°C - 60 MPa and 1080°C - 50 MPa. For the trachytic lava of Grotte dei Palizzi and the rhyolitic blocks of 1888-90 eruption, T - P of 1030°C - 50 MPa and 1000°C - 40 MPa were obtained using the two feldspars thermochemical equilibrium model of Green and Usdansky (1986). The %(H2O)m of trachytic and rhyolitic melts, in the range of 1.7 - 2.7% and 2.4 - 2.7% respectively, was obtained after the experimental calibration at P = 100 MPa and T = 1000-1020°C of X(An)plg against the %(H2O)m. The phase relations and melts composition under the above indicated conditions were finally investigated by the MELTS code (Ghiorso and Sack, 1995), allowing us to show how the more primitive latitic melt can evolve toward the more evolved trachytic and rhyolitic compositions.

Masotta, M.; Trigila, R.

2008-12-01

333

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  

International Nuclear Information System (INIS)

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)

334

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

International Nuclear Information System (INIS)

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 sufailure, 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

335

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

Energy Technology Data Exchange (ETDEWEB)

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.)

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

336

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

International Nuclear Information System (INIS)

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.)

337

Could Pantheon Fossae be the result of the Apollodorus crater-forming impact within the Caloris basin, Mercury?  

Science.gov (United States)

The ~ 40-km-diameter Apollodorus impact crater lies near the center of Pantheon Fossae, a complex of radiating linear troughs itself at the approximate center of the 1500-km-diameter Caloris basin on Mercury. Here we use a series of finite element models to explore the idea that the Apollodorus crater-forming impact induced the formation of radially oriented graben by altering a pre-existing extensional stress state. Graben in the outer portions of the Caloris basin, which display predominantly circumferential orientations, have been taken as evidence that the basin interior was in a state of horizontal extensional stress as a result of uplift. If the Apollodorus crater formed at the time of such a stress state, impact-induced damage to basin fill material would have caused basin material to move radially outward, leading to a decrease in the radial extensional stress and an increase in the circumferential stress. If this change in differential stress was sufficient to induce failure, the predicted style of faulting would be radial graben extending outward from the exterior crater rim. The ~ 230-km radial extent of Pantheon Fossae implies, by this scenario, that the Apollodorus impact generated a large damage zone, extending to perhaps three crater radii (~ 60 km) or more. The calculations also suggest, under this scenario, that the Caloris basin fill had greater strength than the surrounding crust and that the basin uplift and extensional stress field prior to the Apollodorus impact were close to azimuthally symmetric. The location of Pantheon Fossae very near the center of the Caloris basin appears to be coincidental; any crater similar in size to Apollodorus and located within ~ 300 km of the basin center could have produced a radiating set of graben by the mechanism explored here.

Freed, Andrew M.; Solomon, Sean C.; Watters, Thomas R.; Phillips, Roger J.; Zuber, Maria T.

2009-08-01

338

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

LENUS (Irish Health Repository)

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.

Sweeney, Kieron J

2013-02-01

339

Chloramphenicol induced maculopapular rashes  

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Full Text Available 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

Prashant Wadagbalkar

2015-02-01

340

Rash after visiting Tucson.  

Science.gov (United States)

Cactus dermatitis is a common problem among harvesters of cactus fruit. The smaller spines (glochidia) are responsible for most of the dermatitis. Easily separated from the body of the plant, the glochidia may be transferred to bystanders through contact with clothing or pets exposed to these cacti. Removal of the glochidia from the skin is key to treatment, and household glue may aid in this extraction. PMID:12165226

Goodheart, H P; Huntley, A C

2001-12-01

341

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

Science.gov (United States)

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).

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

2010-12-01

342

Evaluation of Pneumatization in the Articular Eminence and Roof of the Glenoid Fossa with Cone-Beam Computed Tomography  

Science.gov (United States)

Background: Detection of air cavities, so called pneumatizations, nearby to the temporomandibular joint (TMJ) area is important, as they represent sites of minimal resistance and facilitate the spread of various pathologies into the joint as inflammation, tumor or fractures and serve as a possible complicating factor in TMJ surgery. Aims: To determine the prevalence of pneumatization of the articular eminence (PAT) and roof of the glenoid fossa (PRGF) using cone-beam computed tomography (CBCT). Study Design: Cross-sectional study. Methods: Acquired images of 111 patients (222 TMJs) were evaluated. The presence of pneumatization was recorded at the articular eminence and roof of the glenoid fossa. Age and gender were recorded for all patients and type (unilocular or multilocular) and laterality were noted for the cases of pneumatization. Results: The mean age of the study group was 48.86±18.31 years. Among all the patients, 73 (65.8%) had PAT, while 13 (11.7%) had PRGF. Forty-two (37.8%) of the patients had PAT bilaterally; whereas 3 of them (2.7%) presented PRGF bilaterally. The percentage of PAT was higher for females (73.6%) than males (51.3%) (p<0.05). Conclusion: CBCT images are an accurate and reliable means of detection of the exact size and type of pneumatization and the relationship of pneumatization to the adjacent tissues. This is especially significant before a surgical intervention is planned in this region, in order to make a sound diagnosis. PMID:25759774

?lgüy, Mehmet; Döleko?lu, Semanur; Fi?ekçio?lu, Erdo?an; Ersan, Nilüfer; ?lgüy, Dilhan

2015-01-01

343

A case of symptomatic mass in the right iliac fossa a Bermuda Triangle which often lies the right diagnosis.  

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Disease of the iliac fossa can often be accompanied by non-specific symptoms and some of these are exclusively caused by the compression of bulky masses of other neighboring structures. In young women a differential diagnosis is a non trivial task as several possible causes have to be taken into account. Thus, intraligamentary tumors, which are extremely rare finding, are frequently confused with uterus, ovary or intestinal tumors. Even if myomas are the most benign tumors of the female genital tract, broad ligament leiomyomas are an unusual finding in women of reproductive age. These tumors are often asymptomatic until they reach a volume likely to cause symptoms related to the mass pressure. An accurate patient's anamnesis and examination serve as a guide to further examinations. Ultrasound is the first line imaging as it can show ovarian or other pelvic mass and doesn't involve exposure to radiations in young patients, who can be pregnant. We describe the clinical presentation and imaging features of a broad ligament leiomyoma, which presented as an inguinal mass in a patient with a right iliac fossa pain. We also report our diagnostic process performing the differential diagnosis with other potential pathologies of RIF. In these cases, a preoperative disease classification discriminating the benign or malignant tumor nature is closely linked to the proper patient management. PMID:24566476

Panarese, Alessandra; Pironi, Daniele; Pontone, Stefano; Vendettuoli, Maurizio; De Cristofaro, Flaminia; Antonelli, Manila; Romani, Annamaria; Filippini, Angelo

2014-01-01

344

Pleistocene volcanic activities in the Fossa Magna region, central Japan - K-Ar age studies of the Yatsugatake volcanic chain  

International Nuclear Information System (INIS)

Pleistocene volcanic rocks of the Yatsugatake volcanic chain were dated by the K-Ar method in order to study the geochronological significance of the Quaternary volcanic activities along the Fossa Magna, the most remarkable tectonic structure in central Japan. One of the prophyrites of Mt. Nakadake, which are regarded to have formed the root of the Yatsugatake volcanoes shows a K-Ar age of about 1.3Ma. An andesite of Kasuga volcanic rocks from the northern area of the Yatsugatake volcanic chain indicates a K-Ar age of about 1.0Ma. K-Ar ages for seven andesites from four different lava units of the southern area range from 0.23 to 0.38Ma. These results are concordant with those estimated stratigraphically. Present results suggest that the volcanic activities to form the present Yatsugatake volcanic chain probably started about 1 - 1.5Ma ago. This might have been related to some tectonic effects which triggered volcanic activities around the area like Kirigamine Volcano in central Japan. Furthermore, available radiometric age data together with present results suggest that some volcanic activities already occurred about 1.5 - 2Ma ago along the present volcanic front, at least in the Fossa Magna region. (author)

345

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  

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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. Clinica...

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

2000-01-01

346

Anatomical Examination of the Foramens of the Middle Cranial Fossa / Examinación Anatómica de los Forámenes de la Fosa Craneal Media  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: English Abstract in spanish Tres forámenes pueden ser identificados en el ala mayor del esfenoides: El foramen redondo (FR), foramen oval (FO) y el foramen espinoso (FS). Puede además existir otro foramen llamado foramen oval accesorio o foramen de Vesalio (FV), que conecta la fosa craneal media a la fosa pterigoidea. Se descr [...] ibe como una abertura con paredes lisas por anterior y medial al foramen oval, que conduce a un canal oblicuo dirigido hacia la fosa pterigoidea. FV estuvo presente entre FO y FR en 14 (31,8%) de 44 cráneos secos y 6 (33,3%), en 18 lados en la base de cráneos de cadáveres (total 20 (32,3%) de 62). El diámetro de los forámenes en los lados derecho e izquierdo se observó casi simétricos. Las distancias de FR desde la línea mediana en el lado izquierdo fue mayor que en el lado derecho. Además, la distancia entre FO y el vértice de la porción petrosa y la distancia entre el FS y el vértice porción petrosa fueron mayores en el lado izquierdo. En el lado derecho la distancia entre A y FR, así como la distancia entre A y FS fueron mayores. Por otra parte, la distancia entre los FR y el vértice del porción petrosa fue mayor en el lado derecho. Las variaciones anatómicas en el tamaño de la apariencia y la distancia de FR, DE, FS y FV son de gran importancia quirúrgica. Podemos inferir que la información proporcionada en este estudio puede ayudar al neurocirujano y anatomista para aumentar el conocimiento sobre la anatomía de la fosa craneal media. Abstract in english Three foramina can be identified in the greater wing of the sphenoid bone: The foramen rotundum (FR), foramen ovale (FO) and foramen spinosum (FS). In addition, there may be another foramen called foramen ovale accessorium or foramen vesalius (FV) which connects the middle cranial fossa to the fossa [...] pterygoidea (pterygoid fossa). It is described as an opening with smooth walls in front and medial to foramen ovale which leads to an oblique channel directed towards the fossa pterygoidea. FV was present between FO and FR in 14 (31.8%) of 44 dry and 6 (33.3%) of 18 cadaver skullbase sides (total 20 (32.3%) of 62). The diameter values of foramens on both the right and the left side were observed to be almost symmetrical. FR's distance from the midline on the left side was greater than the right side. Also, the distance between FO and the petrous apex and the distance between FS and the petrous apex were greater on the left side. On the right side the distance between FO and FR, and the distance between FO and FS were greater. Also, the distance between FR and the petrous apex was greater on the right side. Anatomical variations in appearance size and distance of FR, FO, FS and FV are of great surgical importance. In conclusion, we can infer that the information provided with this study can help the neurosurgeon and anatomist to increase the knowledge about anatomy of middle cranial fossa.

Nadire, Unver Dogan; Zeliha, Fazliogullari; Ismihan Ilknur, Uysal; Muzaffer, Seker; Ahmet Kagan, Karabulut.

2014-03-01

347

Deformation of lacrimal fossa and nasolacrimal canal after paranasal sinus operation and in chronic sinusitis  

International Nuclear Information System (INIS)

As have been already described in the literature, the bony wall of maxillary antrum is thickened and sclerotic, and antral contraction may occur in chronic sinusitis and after paranasal sinus operation. However, bony nasolacrimal canal (NLC) is also deformed, but no quantitative data have been published on bony NLC in patients with postoperative status and chronic sinusitis. In the present study, I have measured the diameter and the wall thickness of lacrimal fossa (LF) and NLC. Eighty-nine post-operative cases of paranasal sinuses (bilateral 66 cases, unilateral 23 cases, mean 60.1 years; male/female 59/30), 48 cases with chronic paranasal sinusitis (mean 52.9 years; male/female=32/16,) and 40 normal subjects (mean 44.7 years, male/female=18/22) were measured. The diameter of NLC (upper and lower portions), medial wall thickness of LF and NLC were measured. The outer distance between distal end of bilateral NLC and angle of inclination of NLC were also measured. CT examination was performed with multidetector CT with 0.5 mm collimation and measurement was performed on Exavision (Ziosoft), with reconstruction. The mean diameter of NLC in the post-operative group (upper; 5.6 mm, lower; 6.0 mm) was statistically enlarged as compared with that of normal subjects (4.4 mm both). The chronic sinusitis group (4.7 mm, 4.9 mm, respectively) showed no statistical deference from the normal group in upper diameter of NLC. The wall thickness of LF and upper NLC in post-operative gss of LF and upper NLC in post-operative groups were statistically thick (post-operative; 0.63, 0.64, normal; 0.37, 0.44 mm, respectively), however, those in chronic sinusitis group were not (chronic sinusitis; 0.40, 0.45 mm, respectively). The angle of the inclination of NLC showed outer deviation in the postoperative group and inner deviation in the chronic sinusitis group. After the operation of paranasal sinuses, dilatation of NLC and thickening of bony wall of LF and NLC occurred definitely, and these phenomena were confirmed statistically. It is said that both postoperative sinus and chronic sinusitis have sclerotic and thickened bony wall of maxillary antrum, however, consequence of statistical deformation of LF and upper NLC occurs only in the former. Currently, dacryocystorhinostomy and sinus surgery have been performed endoscopically. This technique can reduce surgical invasion dramatically, but there is no information on bony structure. The structural change of lacrimal drainage apparatus should be considered and ensured before these operations. Evaluation of postoperative NLC and LF with CT scan is an adequate technique which will avoid technical trouble during the operation and complications. (author)

348

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

International Nuclear Information System (INIS)

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)

349

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

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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.

BernadineDonahue

2012-12-01

350

Ultrasound and magnetic resonance imaging findings in Schistosomiasis mansoni: expanded gallbladder fossa and fatty hilum signs / Achados da ultrassonografia e da ressonância magnética na esquistossomose mansônica: sinais da expansão da fossa da vesícula e do hilo gorduroso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese INTRODUÇÃO: Não existem estudos que correlacionam os achados da ressonância magnética (RM) aos da ultrassonografia (US) em pacientes com esquistossomose mansônica. O objetivodeste estudo foi descrever os achados da imagem por RM em pacientes com doença hepática esquistossomótica identificada por US. [...] MÉTODOS: Selecionaram-se 54 pacientes com idade média de 41,6±13,5 anos, provenientes de área endêmica para a esquistossomose mansônica. Todos apresentavam US indicativa de fibrose hepática esquistossomótica, e foram avaliados com imagens por RM, realizadas com uma unidade magnética supercondutora de 1,5-T(Sigma). RESULTADOS: Quarenta e sete (87%) entre 54 pacientes com sinais ultrassonográficosde fibrose periportal esquistossomótica tiveram este diagnóstico confirmado pela RM. Nos sete(13%) casos discordantes, a RM revelou tecido adiposo preenchendo o espaço periportal hilaronde a US indicava espessamento isolado da parede da veia porta em seu ponto de entrada no fígado. Este achado foi nomeado sinal do hilo gorduroso. Um dos 47 pacientes com evidência de fibrose periportal RM era colecistectomizado. Trinta e quatro (76,1%) dos 46 pacientes restantes apresentavam expansão da fossa da vesícula, que se encontrava preenchida portecido adiposo. Nos outros sete, a RM revelou sinais de fibrose pericolecística. CONCLUSÕES: Os espessamentos ecogênicos central da parede da veia porta, e da parede da vesícula biliar, até o momento, atribuídos à fibrose, foram frequentemente identificados como tecido adiposopela RM. Entretanto, o espessamento da parede da vesícula identificado pela US (expansão da fossa da vesícula na RM) é provavelmente secundário a alterações morfológicas hepáticas na esquistossomose, e representa comprometimento grave do fígado. Abstract in english INTRODUCTION: There is no study relating magnetic resonance imaging (MRI) to ultrasound (US) findings in patients with Schistosomiasis mansoni. Our aim was to describe MRI findings inpatients with schistosomal liver disease identified by US. METHODS: Fifty-four patients (mean age 41.6±13.5years) fro [...] m an area endemic for Schistosomiasis mansoni were selected for this study.All had US indicating liver schistosomal fibrosis and were evaluated with MRI performed witha 1.5-T superconducting magnet unit (Sigma). RESULTS: Forty-seven (87%) of the 54 patientsshowing signs of periportal fibrosis identified through US investigation had confirmed diagnosesby MRI. In the seven discordant cases (13%), MRI revealed fat tissue filling in the hilar periportalspace where US indicated isolated thickening around the main portal vein at its point of entryto the liver. We named this the fatty hilum sign. One of the 47 patients with MRI evidence ofperiportal fibrosis had had his gallbladder removed previously. Thirty-five (76.1%) of the other46 patients had an expanded gallbladder fossa filled with fat tissue, whereas MRI of the remainingeleven showed pericholecystic signs of fibrosis. CONCLUSIONS: Echogenic thickening of thegallbladder wall and of the main portal vein wall heretofore attributed to fibrosis were frequentlyidentified as fat tissue in MRI. However, the gallbladder wall thickening shown in US (expandedgallbladder fossa in MRI) is probably secondary to combined hepatic morphologic changes inschistosomiasis, representing severe liver involvement.

Luciana Cristina dos Santos, Silva; Luciene Mota, Andrade; Ivie Braga de, Paula; Leonardo Campos de, Queiroz; Carlos Maurício Figueiredo, Antunes; José Roberto, Lambertucci.

2012-08-01

351

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  

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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.

Maria I Oliveira

2002-04-01

352

Posterior fossa decompression with tonsillectomy in 104 cases of basilar impression, Chiari malformation and/or syringomyelia Descompressão da fossa posterior com tonsilectomia em 104 casos de impressão basilar, malformação de Chiari e/ou siringomielia  

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Full Text Available The prime objective in the surgical treatment of basilar impression (BI, Chiari malformation (CM and/or syringomyelia (SM is based on the restoration of the normal cerebrospinal fluid (CSF dynamics at the craniovertebral junction through the creation of a large artificial cisterna magna. A small suboccipital craniectomy has been emphasized to avoid caudal migration of the hindbrain structures into the vertebral canal. Nevertheless, the results showed downward migration of the hindbrain related to that type of craniectomy. The authors present, otherwise, the results of 104 cases of BI, CM and/or SM, whose surgical treatment was characterized by a large craniectomy with the patient in the sitting position, tonsillectomy, large opening of the fourth ventricle and duraplasty with creation of a large artificial cisterna magna. A significant upward migration of the posterior fossa structures was detected by postoperative magnetic resonance imaging.O principal objetivo no tratamento cirúrgico da impressão basilar, malformação de Chiari e/ou siringomielia fundamenta-se na restauração dinâmica do líquido cefalorraqueano ao nível da transição craniovertebral e criação de ampla cisterna magna. Uma craniectomia suboccipital de pequenas dimensões foi proposta para evitar a migração caudal de estruturas rombencefálicas no canal vertebral. Entretanto, os resultados evidenciaram migração caudal do rombencéfalo. Os autores apresentam, por outro lado, os resultados de 104 casos de malformação de Chiari e/ou siringomielia, nos quais o tratamento cirúrgico se baseou em ampla craniectomia com o paciente em posição sentada, tonsilectomia, abertura ampla do quarto ventrículo e enxerto dural com consequente criação de ampla cisterna magna. Uma significante migração cranial das estruturas da fossa posterior foi detectada pelo emprego pós-operatório da ressonância magnética.

José Alberto Gonçalves da Silva

2011-10-01

353

Posterior fossa decompression with tonsillectomy in 104 cases of basilar impression, Chiari malformation and/or syringomyelia / Descompressão da fossa posterior com tonsilectomia em 104 casos de impressão basilar, malformação de Chiari e/ou siringomielia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese O principal objetivo no tratamento cirúrgico da impressão basilar, malformação de Chiari e/ou siringomielia fundamenta-se na restauração dinâmica do líquido cefalorraqueano ao nível da transição craniovertebral e criação de ampla cisterna magna. Uma craniectomia suboccipital de pequenas dimensões fo [...] i proposta para evitar a migração caudal de estruturas rombencefálicas no canal vertebral. Entretanto, os resultados evidenciaram migração caudal do rombencéfalo. Os autores apresentam, por outro lado, os resultados de 104 casos de malformação de Chiari e/ou siringomielia, nos quais o tratamento cirúrgico se baseou em ampla craniectomia com o paciente em posição sentada, tonsilectomia, abertura ampla do quarto ventrículo e enxerto dural com consequente criação de ampla cisterna magna. Uma significante migração cranial das estruturas da fossa posterior foi detectada pelo emprego pós-operatório da ressonância magnética. Abstract in english The prime objective in the surgical treatment of basilar impression (BI), Chiari malformation (CM) and/or syringomyelia (SM) is based on the restoration of the normal cerebrospinal fluid (CSF) dynamics at the craniovertebral junction through the creation of a large artificial cisterna magna. A small [...] suboccipital craniectomy has been emphasized to avoid caudal migration of the hindbrain structures into the vertebral canal. Nevertheless, the results showed downward migration of the hindbrain related to that type of craniectomy. The authors present, otherwise, the results of 104 cases of BI, CM and/or SM, whose surgical treatment was characterized by a large craniectomy with the patient in the sitting position, tonsillectomy, large opening of the fourth ventricle and duraplasty with creation of a large artificial cisterna magna. A significant upward migration of the posterior fossa structures was detected by postoperative magnetic resonance imaging.

José Alberto Gonçalves da, Silva; Adailton Arcanjo dos, Santos Jr; Luiz Ricardo Santiago, Melo; Antônio Fernandes de, Araújo; Giseuda Pessoa, Regueira.

2011-10-01

354

Retrospective analysis of the use of amniotic membranes and xenografts in spinal surgery and anterior cranial fossa operations  

International Nuclear Information System (INIS)

To determine the suitability of amniotic membrane an bovine bone xenografts for the use in spinal surgery and anterior cranial for a generations. Fifteen patients with anterior cranial fossa defects and spinal bone fractures received bovine bone xenografts and 10 patients with meningomyeloceles received amniotic membranes (produced by the Malaysian National Tissue Bank) were analysed retrospectively. Clinical criterias like fever, signs of inflammation, breakdown of graft implant, non specific reaction to the nervous tissue were analysed haematological and radiologically. All patients who received the bovine grafts and amniotic membranes did not show any evidence of inflammation or fever. There were no graft implant breakdowns. There was no radiological or clinical evidence of specific or non specific reaction to the nervous tissue after 12-36 months followup Amniotic membranes and bovine xenografts may be used in the healing and reconstruction of spinal and cranial defects. Despite no evidence of rejection and infection after 36 months, a long term followup is still needed

355

Transient asystole during surgery for posterior fossa meningioma caused by activation of the trigeminocardiac reflex: three case reports.  

Science.gov (United States)

Three patients undergoing surgery for cerebello-pontine angle meningioma suffered transient episodes of asystole. All patients exhibited return to the previous heart rate with cessation of surgical manipulations and administration of anticholinergic agents. These reactions were apparently elicited by activation of the trigeminocardiac reflex (TCR) by direct stimulation of the trigeminal nerve or branches in the dura mater or cerebellar tentorium. Remifentanil was used in all three cases as an anesthetic agent, so may be a cause of the TCR. The possibility of activation of the TCR should be considered during surgical manipulation around the trigeminal nerve or the distribution of the trigeminal nerve branches. Transient bradycardia, hypotension, or asystole can occur regardless of whether there is pressure on the brainstem during posterior fossa meningioma surgery. PMID:20448432

Usami, Kenichi; Kamada, Kyousuke; Kunii, Naoto; Tsujihara, Hiroko; Yamada, Yoshitsugu; Saito, Nobuhito

2010-01-01

356

Laparoscopic repair for a previously unreported form of ventral hernia on the right iliac fossa in an elderly emaciated woman.  

Science.gov (United States)

An 81-year-old emaciated woman was admitted to our hospital with a one-year history of recurrent bilateral inguinal swellings. Palpable lumps were observed not only in bilateral groin areas, but also on the right iliac fossa (RIF) of her abdomen. During a planned transabdominal preperitoneal laparoscopic herniorrhaphy, a previously unreported form of ventral hernia was observed at a position lateral and cranial to the right internal inguinal ring, which probably corresponded to the palpable lump on the RIF. The hernia orifice was 2 cm in diameter, and a vascular structure ran through the orifice. The contents of the hernia consisted of fatty tissue arising from the retroperitoneal tissue. Routine exploration revealed orifices of the following hernias: left indirect, right direct, bilateral femoral, bilateral obturator, and right Spigelian hernia. Her postoperative course was uneventful and a mass on the right lower quadrant disappeared after operation. PMID:24218077

Yokoyama, T; Kobayashi, A; Shimizu, A; Motoyama, H; Miyagawa, S

2013-11-12

357

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

International Nuclear Information System (INIS)

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.

358

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

Science.gov (United States)

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.

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

2013-04-01

359

Intraoperative somatosensory evoked potential recovery following opening of the fourth ventricle during posterior fossa decompression in Chiari malformation: case report.  

Science.gov (United States)

The most appropriate surgical technique for posterior fossa decompression in Chiari malformation (CM) remains a matter of debate. Intraoperative electrophysiological studies during posterior fossa decompression of Type I CM (CM-I) aim to shed light on the entity's pathomechanism as well as on the ideal extent of decompression. The existing reports on this issue state that significant improvement in conduction occurs after craniotomy in all cases, but additional durotomy contributes a further improvement in only a minority of cases. This implies that craniotomy alone might suffice for clinical improvement without the need of duraplasty or even subarachnoid manipulation at the level of the craniocervical junction. In contrast to published data, the authors describe the case of a 32-year-old woman who underwent surgery for CM associated with extensive cervicothoracic syringomyelia and whose intraoperative somatosensory evoked potentials (SSEPs) did not notably improve after craniotomy or following durotomy; rather, they only improved after opening of the fourth ventricle and restoration of CSF flow through the foramen of Magendie. Postoperatively, the patient recovered completely from her preoperative neurological deficits. To the authors' knowledge, this is the first report of significant SSEP recovery after opening the fourth ventricle in the decompression of a CM-I. The electrophysiological and operative techniques are described in detail and the findings are discussed in the light of available literature. The authors conclude that there might be a subset of CM-I patients who require subarachnoid dissection at the level of the craniocervical junction to benefit clinically. Prospective studies with detailed electrophysiological analyses seem warranted to answer the question regarding the best surgical approach in CM-I decompression. PMID:25526275

Grossauer, Stefan; Koeck, Katharina; Vince, Giles H

2015-03-01

360

Saneamento rural no Brasil: impacto da fossa séptica biodigestora / Rural sanitation in Brazil: impact analysis of the septic tank digester  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O Brasil tem mais de 23 milhões de pessoas na zona rural sem coleta ou tratamento de esgoto, o que corresponde a 75% da população rural. Este estudo teve como objetivo mensurar os impactos social, ambiental e econômico decorrente da atual falta de saneamento rural no país em relação à implementação [...] de uma proposta tecnológica de tratamento do esgoto, a fossa séptica biodigestora. Foi observado que, ao ano, a construção desse sistema de saneamento poderia evitar cerca de 250 mortes e 5,5 milhões de infecções causados por doenças diarreicas; reduzir a poluição dos cursos d'água em cerca de 129 mil toneladas de resíduos; e que cada R$ 1,00 investido na implementação da alternativa tecnológica avaliada poderia causar um retorno para a sociedade de R$ 1,6 em renda interna bruta. Além disto, a construção da fossa séptica biodigestora promoveria a geração de cerca de 39 mil empregos. Abstract in english Brazil has more than 23 million rural people with unimproved sanitation, which corresponds to about 75% of rural population. This study aimed to measure the social, environmental and economic impacts caused by the implementation of a technological proposal for sanitation, the septic cesspool biodige [...] ster. It was observed that, per year, the implementation of this technology in rural homes with unimproved sanitation could reduce about 250 deaths and 5.5 million infections caused by diarrheal diseases; reduce pollution of waterways by about 129 thousand tons of sediment; and that every R$ 1.00 invested in the implementation of the alternative technology evaluated could cause a return to the society of R$ 1.6 in gross domestic product. Moreover, the implementation of septic cesspool biodigesters would promote the creation of 39 thousand jobs.

Cinthia Cabral da, Costa; Joaquim José Martins, Guilhoto.

361

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

Science.gov (United States)

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).

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

2014-03-01

362

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  

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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.

Maria de los Angeles Perez Lizama

2008-02-01

363

Cystic malformations of the posterior cranial fossa originating from a defect of the posterior membranous area. Mega cisterna magna and persisting Blake's pouch: two separate entities.  

Science.gov (United States)

Cystic malformations of the posterior cranial fossa are all but arachnoid cysts contained within the general context of the Dandy-Walker complex and may be further classified in two groups on the basis of their embryological origin: anomalies of the anterior membranous area (AMA) and anomalies of the posterior membranous area (PMA). Whether the latter group of malformations can be regarded as separate entities is still quite controversial. The present authors give a detailed account of the various embryological stages in the formation of the posterior cranial fossa and its contents and propose the identification of two anomalies derived from a defect of the PMA: the mega cisterna magna (MCM) and the persisting Blake's pouch, a new entity with different MRI features from MCM. Criteria for their recognition are discussed, stressing the capital importance of a differential diagnosis in view of the radically different therapeutic approach. PMID:8816293

Tortori-Donati, P; Fondelli, M P; Rossi, A; Carini, S

1996-06-01

364

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  

Energy Technology Data Exchange (ETDEWEB)

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)

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

365

Age determination of linear surface features using the Buffered Crater Counting approach - Case studies of the Sirenum and Fortuna Fossae graben systems on Mars  

Science.gov (United States)

Buffered Crater Counting (BCC) offers a possibility to determine ages of linear/curvilinear surface features that provide no or only very limited surface areas for the conventional crater counting approach. In this study we applied the BCC analysis to two tectonic fault systems, Fortuna Fossae and a subsection of Sirenum Fossae. We compared BCC results with age estimates derived from conventional crater counting on the surrounding geologic units and investigated to what extent crater ejecta blankets can be used for determining the stratigraphic placement of craters pre- or post-dating the formation of linear features. Furthermore, we introduce a new functionality of the CraterTools software for ArcGIS which allows for a user-friendly semi-automatic application of the otherwise time-consuming procedure of BCC analysis. The software provides the resulting crater size-frequency data in a standard format, which can be read and analyzed in the CraterStats analysis software. Our case studies showed that the BCC approach provides equivalent or even more precise age results compared to the conventional stratigraphic approach. Here, we found that the investigated section of Sirenum Fossae is younger than previously thought. The derived formation age from the BCC analysis is 3.44-0.25+0.1Ga which corresponds to Late instead of Early Hesperian. Fortuna Fossae formed shortly after the emplacement of its now-fractured geologic host unit (Late Hesperian). Ages derived from BCC analysis vary between 3.53-0.11+0.06Ga and 3.50-0.11+0.07Ga . Furthermore, we recommend the use of crater ejecta blankets to position them in the stratigraphic sequence in order to improve crater statistics. However, the accuracy of the results depends on the extent and preservation state of the continuous ejecta blankets in the region of interest. Thus, the applied buffer width has to be chosen carefully according to investigated crater sizes and local observations.

Kneissl, T.; Michael, G. G.; Platz, T.; Walter, S. H. G.

2015-04-01

366

Remote Sensing and Geodetic Measurements for Volcanic Slope Monitoring: Surface Variations Measured at Northern Flank of La Fossa Cone (Vulcano Island, Italy)  

OpenAIRE

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 u...

Alessandro Bonforte; Massimo Fabris; Giuseppe Casula; Giordano Teza; Arianna Pesci

2013-01-01

367

ESR dating of fault movement using various defect centres in quartz; the case in the western South Fossa Magna, Japan  

Science.gov (United States)

The dates of movements of the Itoigawa-Shizuoka Tectonic Line (I-S T.L.)and Minobu Fault in the western South Fossa Magna have been obtained by ESR dating. Measurements were made on various lattice defects of the OHC, Ge, Al and E' centres in quartz grains of fault clay and quartz veins intruded at the time of movement. All the dates obtained from these centres in quartz grains from two localities of the I-S T.L. and IWO localities of the Minobu Fault fall in the range of 0.30-0.55 Ma; this suggests that all the centres were annihilated completely. and that the obtained age can be admitted as the actual data of the latest fault movement. Meanwhile, ESR dates of quartz vein and fault clay in other localities (locations 3, 6, 7) are divided into 0.30-0.55 Ma and 1.5 -2.0 Ma, which suggest incomplete resetting. The dates of 0.30-0.55 and 1.5-2.0 Ma might correspond to the clino- unconformities observed in Plio-Pleistocene sequence of this region.

Fukuchi, Tatsuro; Imai, Noboru; Shimokawa, Koichi

1986-05-01

368

Seismological and geological characterization of the crust in the southern part of northern Fossa Magna, central Japan  

Science.gov (United States)

The northern Fossa Magna (NMF) is a Miocene rift basin formed in the final stages of the opening of the Sea of Japan. The northern part of Itoigawa-Shizuoka Tectonic Line (ISTL) bounds the western part of the NMF and forms an active fault system that displays one of the largest slip rates in the Japanese islands. Reflection and refraction/wide-angle reflection profiling and earthquake observations by a dense array were undertaken across the northern part of ISTL in order to delineate structures in the crust, and deep geometry of the active fault systems. The ISTL active fault system at depth (ca. 2 km) shows east-dipping low-angle in Omachi and Matsumoto and is extended beneath the Central Uplift Zone and Komoro basin keeping the same dip-angle down to ca. 15 km. The upper part of the crust beneath the Central Uplift Zone is marked by the high Vp and high resistivity zone. Beneath the folded zone of the NMF, the middle to lower crust shows low Vp, low resistivity and more reflective features. The balanced geologic cross-section based on the reflection profiles suggests that the shortening deformation since the late Neogene was produced by the basin inversion of the Miocene low-angle normal fault.

Sato, Hiroshi; Iwasaki, Takaya; Ikeda, Yasutaka; Takeda, Tetsuya; Matsuta, Nobuhisa; Imai, Tomoko; Kurashimo, Eiji; Hirata, Naoshi; Sakai, Sin'ichi; Elouai, Driss; Kawanaka, Taku; Kawasaki, Shinji; Abe, Susumu; Kozawa, Takeshi; Ikawa, Takeshi; Arai, Yoshimasa; Kato, Naoko

2004-12-01

369

Crustal structure in the northern Fossa Magna region, central Japan, modeled from refraction/wide-angle r reflection data  

Science.gov (United States)

The northern Fossa Magna (NFM) is a back-arc rift basin filled with thick Tertiary sediments, which show strong NW-SE shortening deformation. In the NFM, there exist two major active fault systems, the Itoigawa-Shizuoka Tectonic Line active fault system (ISTL) and the Western Nagano Basin active fault system (WNB), both of which have great potentials to cause destructive earthquakes. By reanalyzing five sets of refraction/wide-angle reflection data, we successfully obtained detailed and consistent models of the crustal structure in the NFM region. It was a very effective modeling procedure to incorporate vicinal seismic reflection data and geologic information. The geometries of the active faults in the NFM region were revealed. The ISTL is east dipping, and the WNB is northwest dipping. The Tertiary sedimentary layer (<4.0 km/sec) west and adjacent to the ISTL extends to a depth of 4-5 km. The basement rocks below the Central Uplift Belt (CUB) form a wedge structure, which suggests the westward movement of the CUB basement rocks.

Takeda, Tetsuya; Sato, Hiroshi; Iwasaki, Takaya; Matsuta, Nobuhisa; Sakai, Shin'ichi; Iidaka, Takashi; Kato, Aitaro

2004-12-01

370

Topographical relationships between the brainstem auditory and somatosensory evoked potentials and the location of lesions in posterior fossa stroke  

International Nuclear Information System (INIS)

The topographical relationships between the location of brainstem lesions detected by magnetic resonance imaging and abnormality of brainstem auditory evoked potentials (BAEPs) and short-latency somatosensory evoked potentials (SSEPs) were studied in 57 patients with stroke in the posterior fossa. Abnormal BAEPs or SSEPs were associated with lesions involving the pontine tegmentum, and abnormal BAEPs also with lesions at the cerebellar peduncle. Absence of the V wave in BAEPs and N20 in SSEPs was associated with a localized overlapping area in the pontine tegmentum contralateral to stimulation. The overlapping area associated with loss of N20 coincided with the location of the medial lemniscus. Lesions widely involving the pontine tegmentum caused the disappearance of multiple waves in the BAEPs and SSEPs. Patients who entered prolonged coma or died had total loss of the III, IV, and V waves, bilateral absence to the contralateral response in BAEPs, or loss of N18 in SSEPs. The loss of N18 in SSEPs had a statistically significant correlation with bad outcome, which suggests the superiority of SSEPs for predicting the outcome of stroke and indicates the involvement of some system excluding the medial lemniscus in the generation of N18. (author)

371

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

International Nuclear Information System (INIS)

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

372

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

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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

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

2010-11-15

373

Dynamic studies of arachnoid cysts in the middle cranial fossa by computed tomography (CT) and radioisotope (RI) cisternography  

International Nuclear Information System (INIS)

The dynamics of cerebrospinal fluid in twelve cases of arachnoid cysts in the middle cranial fossa was examined by using CT-cisternography. RI-cisternography was also performed in nine patients combined with CT-cisternography. According to the results of CT-cisternography obtained from twelve cases, the cysts were classified into four types. Type I showed early filling of Metrizamide into the cyst and early clearance from it. Type II showed early filling of Metrizamide and delayed clearance. Type III showed delayed filling of Metrizamide and delayed clearance. Type IV demonstrated no intracystic filling of Metrizamide. In Type I, II and III, there existed communication between the cyst and its adjacent subarachnoid space. Namely they were communicating cysts. Type IV were non-communicating cyst. Type I and II were all clinically asymptomatic. All cases with intracranial hypertension belonged to Type IV. Accordingly, there were close correlations between CT-cisternographic results and the clinical findings. On the other hand, RI-cisternography demonstrated communicating cysts in all nine cases. Thus there was no clear relationship between RI-cisternographic findings and clinical symptoms. Thus, it can be concluded that CT-cisternography is very useful in determining the surgical indication and is also of great value in detecting a possible recurrence of the cyst. (J.P.N.)

374

Bilateral lipoma arborescens of the bicipitoradial bursa  

International Nuclear Information System (INIS)

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.)

375

Carcinoma of the tonsillar fossa: A nonrandomized comparison of irradiation alone or combined with surgery: Long-term results  

Energy Technology Data Exchange (ETDEWEB)

The results of therapy are reported in 296 patients with histologically proven epidermoid carcinoma of the tonsillar fossa; 127 were treated with irradiation alone (5,500 to 7,000 cGy), 133 with preoperative radiotherapy (2,000 to 3,000 cGy) or were initially planned for preoperative irradiation but treated with radiotherapy alone, and 36 with postoperative irradiation (5,000 to 6,000 cGy). The operation in all but 4 patients consisted of an en bloc radical tonsillectomy with ipsilateral lymph node dissection. Actuarial 5-year no evidence of disease (NED) was as follows: survival rates for patients with T1 tumors, 76%; T2, 54%; T3, 45%; and T4, 20%. Patients with no cervical lymphadenopathy or with a small metastatic lymph node (N1) had better relapse-free survival (60% to 70% at 5 years) than those with large or fixed lymph nodes (30% to 40%). Primary tumor recurrence rate in the T1-T2 groups was about 20% in patients treated with irradiation and surgery and 30% for those treated with irradiation alone (difference not statistically significant), 30% in patients with stage T3 lesions in all treatment groups, and 33% in patients with T4 disease treated with surgery and postoperative irradiation compared to 52% with irradiation alone (p = 0.03). The overall recurrence rate in the neck was about 20% for the N0 patients, 25% for N1, and 30% for those with N2 and N3 cervical lymph nodes in the 4 treatment groups. The incidence of contralateral neck recurrences was about 8% with the various treatment modalities.

Perez, C.A.; Carmichael, T.; Devineni, V.R.; Simpson, J.R.; Frederickson, J.; Sessions, D.; Spector, G.; Fineberg, B. (Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (USA))

1991-07-01

376

Carcinoma of the tonsillar fossa: A nonrandomized comparison of irradiation alone or combined with surgery: Long-term results  

International Nuclear Information System (INIS)

The results of therapy are reported in 296 patients with histologically proven epidermoid carcinoma of the tonsillar fossa; 127 were treated with irradiation alone (5,500 to 7,000 cGy), 133 with preoperative radiotherapy (2,000 to 3,000 cGy) or were initially planned for preoperative irradiation but treated with radiotherapy alone, and 36 with postoperative irradiation (5,000 to 6,000 cGy). The operation in all but 4 patients consisted of an en bloc radical tonsillectomy with ipsilateral lymph node dissection. Actuarial 5-year no evidence of disease (NED) was as follows: survival rates for patients with T1 tumors, 76%; T2, 54%; T3, 45%; and T4, 20%. Patients with no cervical lymphadenopathy or with a small metastatic lymph node (N1) had better relapse-free survival (60% to 70% at 5 years) than those with large or fixed lymph nodes (30% to 40%). Primary tumor recurrence rate in the T1-T2 groups was about 20% in patients treated with irradiation and surgery and 30% for those treated with irradiation alone (difference not statistically significant), 30% in patients with stage T3 lesions in all treatment groups, and 33% in patients with T4 disease treated with surgery and postoperative irradiation compared to 52% with irradiation alone (p = 0.03). The overall recurrence rate in the neck was about 20% for the N0 patients, 25% for N1, and 30% for those with N2 and N3 cervical lymph nodes in the 4 treatment groups. The incidence of contralateral neck recurrences was about 8%ontralateral neck recurrences was about 8% with the various treatment modalities

377

A Two-Dimensional, Linear-Elastic Model to Explain Radial Extensional Fractures, Pantheon Fossae, Caloris Basin, Mercury  

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In this study, two-dimensional linear elasticity theory is used to model the lithospheric stress field that produces radial extensional fractures observed at Pantheon Fossae in the Caloris Basin of Mercury. These fractures were imaged by the MESSENGER mission flyby of Mercury on January 14, 2008 and show radial fractures extending outward from a 40-kilometer impact crater named Apollodorus. Recent studies have proposed several different mechanisms to explain these fractures, including magmatic processes, central basin uplift, and stresses produced by the formation of the impact crater itself. The model presented here attempts to describe the state of the stress field, independent of the physical mechanism that produced it. The first part of the analysis uses a model with azimuthal symmetry, consisting of a two-dimensional infinite plate with a hole in the center to represent the crater and a constant horizontal pressure applied along the crater wall. This model produces a stress field with compressive stresses in the radial direction and tensional stresses in the azimuthal direction, which is consistent with the formation of radial extensional fractures. However, this simple model cannot explain the observed asymmetry of the fractures distribution, where fractures extend further and are more abundant along a preferred azimuth of approximately N30E. The second part of the analysis superposes a regional stress field, with the maximum horizontal compressive stress aligned with this direction of maximum fracture extent. This analysis shows that the yield strength of the lithosphere is minimal along the direction of the maximum compressive stress. Therefore, a stress field with constant pressure applied horizontally along the crater wall superimposed upon a regional stress field with maximum horizontal compressive stress aligned along a N30E azimuth can adequately explain the observed fracture distribution.

Cicerone, R. D.; McDonough, B. M.

2009-12-01

378

Carcinoma of the tonsillar fossa. A nonradomized comparison of preoperative radiation and surgery or irradiation alone: long-term results  

International Nuclear Information System (INIS)

The results of therapy in 218 patients with epidermoid carcinoma of the tonsillar fossa are reported. Ninety-eight patients were treated with irradiation alone (5500-7000 rad). One hundred twenty patients were treated with preoperative radiation (2000-3000 rad) and en bloc radical tonsillectomy with ipsilateral lymph node dissection. The actuarial three year survival on patients with T1 tumors was 76%; T2, 40%; T3, 42%; and T4, 25%. The patients with no cervical lymphadenopathy or with a small metastatic lymph node (N1,N2) had better survival (50% at five years) than those with fixed lymph nodes (20%-30%). The primary tumor recurrence rate in the T1-T2 groups was about 20% in the patients treated with preoperative radiation and surgery in contrast to 35% to 40% for those treated with radiation alone. The local recurrences in the patients with T3 lesions were 30% with both treatment groups; with T4 lesions recurrences noted in 50% of the patients receiving irradiation alone and 75% in the patients treated with preoperative radiation and surgery. The local recurrence rate in the neck was about 10% for the NO patients, 30% for N1, and 30% for the patients with N2 and N3 cervical lymph node stage groups. There was no significant difference in the survival or in the frequency of recurrences in the primary or neck in the patients treated with radiation alone or preoperative radiation and surgery. Fatal major complications were noted in eight of the 120mplications were noted in eight of the 120 patients treated with preoperative radiation and surgery (6.6%) in contrast to only one in the 98 patients treated with radiation alone. Other less severe complications were noted in 40% of the patients treated with preoperative radiation and surgery and in 32.6% of those treated with radiation therapy alone

379

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

International Nuclear Information System (INIS)

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)

380

Assessment of relationship between the facial height and sagittal position of the glenoid fossa in subjects with Class II malocclusion associated with mandibular retrusion  

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Full Text Available Introduction: The relationship of the mandible to the cranial base influences both sagittal and vertical facial disharmonies. The aim of the present study was to analyze the relationship between facial height and sagittal position of the glenoid fossa in subjects with Class II malocclusion associated with mandibular retrusion.Materials and Methods: This descriptive-analytical study was carried out on 60 subjects (21 males and 39 females, aged 7?12 years, with Class II malocclusion associated with mandibular retrusion, who had different facial heights (normal, short, long. The cephalometric measurements were carried out based on three parameters of GF-S on FH, GF-PTM on FH and GF-FMN. Data were analyzed by SPSS16 using one-way ANOVA and Duncan analysis (? = 0.05.Results: The means of GF-FMN distances in subjects with short, normal and long faces were 72.6 mm, 70.4 mm and 69 mm, respectively. The means of GF-S distances on FH in the three groups were 11.6 mm, 12.7 mm and 11.27 mm, respectively and the means of GF-PTM distances on FH were 30.09 mm, 28.6 mm and 28 mm, respectively. There were no statistically significant differences in the sagittal position of glenoid fossa between the three groups (p values < 0.05. There were significant differences between long and short faces in the GF-FMN distance (p value = 0.048.Conclusion: Under the limitations of this study there was no significant relationship between facial height and the sagittal position of glenoid fossa in subjects with Class II malocclusion associated with mandibular retrusion. Key words: Face, Malocclusion, Mandible

Roshanak Ghafari

2013-01-01

381

Corpos estranhos de fossas nasais: descrição de tipos e complicações em 420 casos Nasal foreign bodies: description of types and complications in 420 cases  

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Full Text Available Corpos estranhos de fossas nasais são acidentes comuns em crianças, podendo, de acordo com a literatura, levar a complicações supurativas e bronco-aspiração do corpo estranho. O diagnóstico é feito quase sempre pela rinoscopia anterior, mas a nasofibroscopia e exames radiológicos podem ser úteis. OBJETIVO: Analisar um total de 420 casos de corpos estranhos de fossas nasais removidos no serviço de ORL-EPO do Hospital Municipal Souza Aguiar quanto a vários parâmetros como sexo, idade, tipo e complicações. MATERIAL E MÉTODO: 420 casos de corpos estranhos de fossas nasais removidos no serviço de Otorrinolaringologia e Endoscopia Per-oral (ORL-EPO do Hospital Municipal Souza Aguiar, no período de dezembro de 1992 a dezembro de 1998, quanto aos parâmetros acima referidos. RESULTADOS: Foi encontrada uma maior incidência na faixa etária de 0 a 4 anos, sendo os mais comuns, pela ordem fragmentos de espuma, fragmentos de material plástico, grãos de feijão e fragmentos de papel. As complicações ocorreram em 9,05% dos casos, sendo as mais comuns a epistaxe e a vestibulite. CONCLUSÃO: Os corpos estranhos de fossas nasais são acidentes encontrados principalmente na faixa etária de 0 a 4 anos, sendo os mais comuns, em nossa casuística, os fragmentos de espuma e pequenos artefatos de plástico. Complicações não são freqüentes, sendo as mais encontradas a epistaxe e vestibulite nasal.Nasal cavities foreign bodies are common accidents in children, sometimes leading, in accordance with the literature, to complications such as epistaxis and bronchoaspiration. Diagnosis is often made with anterior rhinoscopy, but sometimes nasal fibroendoscopy and imaging may be useful. AIM: To evaluate 420 cases of nasal foreign bodies removed in ENT Service of Souza Aguiar Hospital, Rio de Janeiro, as related to sex, age, type of foreign body and complications. MATERIALS AND METHOD: 420 cases of nasal foreign bodies removed in the ENT service of Souza Aguiar Hospital between December 1992 and December 1998 were evaluated according to the parameters related above. RESULTS: We found higher incidence between 0 and 4 years of age, and the most frequently found foreign bodies were foam fragments, plastic pieces of little toys, beans and paper fragments. Complications occurred in 9.05% of the cases, epistaxis and vestibulitis being the commonest. CONCLUSION: Nasal foreign bodies are especially found between the ages of 0 and 4 years. In our study, foam fragments and small plastic objects were the most frequent foreign bodies found. Complications were found in 9.05% of the cases, headed by epistaxis and nasal vestibulitis.

Ricardo Rodrigues Figueiredo

2006-02-01

382

Corpos estranhos de fossas nasais: descrição de tipos e complicações em 420 casos / Nasal foreign bodies: description of types and complications in 420 cases  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese Corpos estranhos de fossas nasais são acidentes comuns em crianças, podendo, de acordo com a literatura, levar a complicações supurativas e bronco-aspiração do corpo estranho. O diagnóstico é feito quase sempre pela rinoscopia anterior, mas a nasofibroscopia e exames radiológicos podem ser úteis. OB [...] JETIVO: Analisar um total de 420 casos de corpos estranhos de fossas nasais removidos no serviço de ORL-EPO do Hospital Municipal Souza Aguiar quanto a vários parâmetros como sexo, idade, tipo e complicações. MATERIAL E MÉTODO: 420 casos de corpos estranhos de fossas nasais removidos no serviço de Otorrinolaringologia e Endoscopia Per-oral (ORL-EPO) do Hospital Municipal Souza Aguiar, no período de dezembro de 1992 a dezembro de 1998, quanto aos parâmetros acima referidos. RESULTADOS: Foi encontrada uma maior incidência na faixa etária de 0 a 4 anos, sendo os mais comuns, pela ordem fragmentos de espuma, fragmentos de material plástico, grãos de feijão e fragmentos de papel. As complicações ocorreram em 9,05% dos casos, sendo as mais comuns a epistaxe e a vestibulite. CONCLUSÃO: Os corpos estranhos de fossas nasais são acidentes encontrados principalmente na faixa etária de 0 a 4 anos, sendo os mais comuns, em nossa casuística, os fragmentos de espuma e pequenos artefatos de plástico. Complicações não são freqüentes, sendo as mais encontradas a epistaxe e vestibulite nasal. Abstract in english Nasal cavities foreign bodies are common accidents in children, sometimes leading, in accordance with the literature, to complications such as epistaxis and bronchoaspiration. Diagnosis is often made with anterior rhinoscopy, but sometimes nasal fibroendoscopy and imaging may be useful. AIM: To eval [...] uate 420 cases of nasal foreign bodies removed in ENT Service of Souza Aguiar Hospital, Rio de Janeiro, as related to sex, age, type of foreign body and complications. MATERIALS AND METHOD: 420 cases of nasal foreign bodies removed in the ENT service of Souza Aguiar Hospital between December 1992 and December 1998 were evaluated according to the parameters related above. RESULTS: We found higher incidence between 0 and 4 years of age, and the most frequently found foreign bodies were foam fragments, plastic pieces of little toys, beans and paper fragments. Complications occurred in 9.05% of the cases, epistaxis and vestibulitis being the commonest. CONCLUSION: Nasal foreign bodies are especially found between the ages of 0 and 4 years. In our study, foam fragments and small plastic objects were the most frequent foreign bodies found. Complications were found in 9.05% of the cases, headed by epistaxis and nasal vestibulitis.

Ricardo Rodrigues, Figueiredo; Andréia A., Azevedo; Arthur Octávio de Ávila, Kós; Shiro, Tomita.

2006-02-01

383

Spigelian hernia with Richter-type herniation of the ileum: A rare cause of right iliac fossa pain mimicking acute appendicitis  

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Full Text Available We report a case of a sixty-two-year-old man who presented to the emergency department with severe right iliac fossa pain. The patient was clinically diagnosed as having acute appendicitis and was referred for an abdominal CT scan. Abdominal CT revealed a Spigelian hernia with Richter-type herniation of the small bowel without any significant bowel obstruction. The patient underwent immediate surgical repair and the postoperative course was uneventful. This is a rare association of two rare conditions mimicking a common disease such as appendicitis.

Arif Nelliyulla Parambath

2012-05-01

384

Tratamento cirúrgico na recidiva retroperitoneal tardia por carcinoma renal de células claras após nefrectomia radical Surgical treatment for late renal cell carcinoma recurrence in the renal fossa after radical nephrectomy  

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Full Text Available Late renal cell carcinoma recurrence in the renal fossa is a rare event. This condition occurs in 1 to 2% of radical nephrectomies. We reported a late recurrence at the renal fossa about four and half years after radical nephrectomy due to a renal cell carcinoma (RCC without metastasis elsewhere. Diagnosis in an outpatient follow-up was made during an abdominal computed tomography and we observed a retroperitoneal mass in the renal fossa. The excision at the recurrence area was made through a subcostal transversal incision without any difficulty. After 6 months from this second procedure, there was no evidence of recurrence. The surgical aggressive treatment for late retroperitoneal RCC recurrence is a good method in this rare situation. Abdominal computed tomography must be done during long periods of follow-up for patients with radical nephrectomy for RCC to search for late retroperitoneal recurrences.

Carlos Márcio Nóbrega de Jesus

2007-12-01

385

Tratamento cirúrgico na recidiva retroperitoneal tardia por carcinoma renal de células claras após nefrectomia radical / Surgical treatment for late renal cell carcinoma recurrence in the renal fossa after radical nephrectomy  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese [...] Abstract in english Late renal cell carcinoma recurrence in the renal fossa is a rare event. This condition occurs in 1 to 2% of radical nephrectomies. We reported a late recurrence at the renal fossa about four and half years after radical nephrectomy due to a renal cell carcinoma (RCC) without metastasis elsewhere. D [...] iagnosis in an outpatient follow-up was made during an abdominal computed tomography and we observed a retroperitoneal mass in the renal fossa. The excision at the recurrence area was made through a subcostal transversal incision without any difficulty. After 6 months from this second procedure, there was no evidence of recurrence. The surgical aggressive treatment for late retroperitoneal RCC recurrence is a good method in this rare situation. Abdominal computed tomography must be done during long periods of follow-up for patients with radical nephrectomy for RCC to search for late retroperitoneal recurrences.

Carlos Márcio Nóbrega de, Jesus; Filemón Anastásio Silva, Casafus; Aparecido Donizetti, Agostinho.

2007-12-01

386

Incidence of rubella IgM antibodies in individuals with febrile rash illness attending clinics in Akwa Ibom State, Nigeria, 2006-2009  

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Full Text Available Background: Rubella is an infectious disease of public health importance because infection ac-quired during early pregnancy often results in foetal abnormalities that are classified as con-genital rubella syndrome (CRS. The burden of rubella infection in most developing countries is however not well documented because of lim-ited epidemiological data. Methods: Between 2006 and 2009, 781individuals with febrile rash illness seen in clinics in Akwa Ibom State were screened for rubella specific IgM antibodies using the ELISA technique. Statistical analysis was done using Graph prime version 5.3 statis-tical package at 95% confidence interval. The level of significance was established at P = 0.05 using Fisher’s exact two-tailed values. Results: Of 781 individuals screened for rubella specific IgM antibodies, 94 (12% were found to be posi-tive. Incidence of 8.7% recorded in 2006 gradu-ally rose to 9.3% in 2007, 11.6% in 2008 and 14.3% in 2009. Those in the reproductive age group (> 16 years were most affected (51.7%. However, this was not statistically significant (P = 0.228. Females (17.4% were more suscepti-ble than males (6.2% (P < 0.0001 an rural dwellers (12.8% more susceptible than urban dwellers (10.5% (P = 0.416. Conclusion: The study shows that the incidence of rubella in Akwa Ibom State, Nigeria is high. The lowest incidence was however found among individu-als below the reproductive age. Thus, the find-ings of this study can be used by policy makers to model the introduction of routine rubella vaccination into the country’ Expanded Program on Immunization Schedule (EPI.

Bassey Enya

2011-06-01

387

Skull-base foramina of the middle cranial fossa : assessment of normal variation with high-resolution CT  

International Nuclear Information System (INIS)

To recognize foraminal variants of the foraminae of the skull base in the middle cranial fossa, and to thus understand and distinguish normal and potentially abnormal structures. We analysed 163 patients without intracranial disease who had undergone CT scanning. These comprised 82 men and 81 women with a mean age of 39 years (range, 4-73 years). HRCT was performed, using a GE 9800 scanner. All CT scans were obtained 6-7 slices at the base of the skull, with 1.5mm collimation at 1.5mm intervals parallel to the infraorbital line. We analysed the foraminae by closesly correlating imaging findings and established anatomic knowledge. In 45 cases (27.6%) the foramen ovale was 5-10mm in diameter and asymmetrical. Deficiency of the medial bony wall including persistent foramen lacerum medius was seen in five cases (3.1%). Confluence of the foramen ovale and the foramen spinosum was seen in 13 cases (8%) and confluence of the foramen ovale and the foramen of Vesalius in 23 (14.1%). Posterolateral groove for the accessory meningeal artery was observed in 36 cases (22%). The foramen spinosum was asymmetrical in 42 cases (25.8%). A small or absent foramen spinosum with a larger ipsilateral foramen ovale was observed in 11 cases (6.7%). Medial bony defect was seen in 16 cases (9.8%). The foramen spinosum was absent in four cases (2.5%). In 74 cases (45.4%), the foramen of Vesalius was absent; it was present unilaterally and bilaterally in 55 (33.7%) and 34 cases (20.9%), respecti 55 (33.7%) and 34 cases (20.9%), respectively. Five cases showed duplicated foramina. Canaliculus innominatus was seen in 14 cases (8.9%) and was present bilaterally in three (1.8%). HRCT clearly delineates bony structure and is well able to display the rich spectrum of anatomic variation found in the base of the skull. The recognition of these normal variants will result in a better understanding of skull base neurovascular anatomy and diminish speculation as to their true nature during the interpretation of CT images

388

Skull-base foramina of the middle cranial fossa : assessment of normal variation with high-resolution CT  

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To recognize foraminal variants of the foraminae of the skull base in the middle cranial fossa, and to thus understand and distinguish normal and potentially abnormal structures. We analysed 163 patients without intracranial disease who had undergone CT scanning. These comprised 82 men and 81 women with a mean age of 39 years (range, 4-73 years). HRCT was performed, using a GE 9800 scanner. All CT scans were obtained 6-7 slices at the base of the skull, with 1.5mm collimation at 1.5mm intervals parallel to the infraorbital line. We analysed the foraminae by closesly correlating imaging findings and established anatomic knowledge. In 45 cases (27.6%) the foramen ovale was 5-10mm in diameter and asymmetrical. Deficiency of the medial bony wall including persistent foramen lacerum medius was seen in five cases (3.1%). Confluence of the foramen ovale and the foramen spinosum was seen in 13 cases (8%) and confluence of the foramen ovale and the foramen of Vesalius in 23 (14.1%). Posterolateral groove for the accessory meningeal artery was observed in 36 cases (22%). The foramen spinosum was asymmetrical in 42 cases (25.8%). A small or absent foramen spinosum with a larger ipsilateral foramen ovale was observed in 11 cases (6.7%). Medial bony defect was seen in 16 cases (9.8%). The foramen spinosum was absent in four cases (2.5%). In 74 cases (45.4%), the foramen of Vesalius was absent; it was present unilaterally and bilaterally in 55 (33.7%) and 34 cases (20.9%), respectively. Five cases showed duplicated foramina. Canaliculus innominatus was seen in 14 cases (8.9%) and was present bilaterally in three (1.8%). HRCT clearly delineates bony structure and is well able to display the rich spectrum of anatomic variation found in the base of the skull. The recognition of these normal variants will result in a better understanding of skull base neurovascular anatomy and diminish speculation as to their true nature during the interpretation of CT images.

Kim, Hyae Young [Ewha Woman' s Univ. Hospital, Seoul (Korea, Republic of); Chung, Eun Chul [Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Suh, Jeong Soo; Choi, Hye Young [Ewha Woman' s Univ. College of Medicine, Seoul (Korea, Republic of); Ko, Eun Joo [Eulgi Medical Center, Seoul (Korea, Republic of); Lee, Myung Sook [Samsung Cheil Hospital, Seoul (Korea, Republic of)

1997-05-01

389

A modified frontal-nasal-orbital approach to midline lesions of the anterior cranial fossa and skull base: technical note with case illustrations.  

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The frontal-nasal-orbital craniotomy has been utilized for craniofacial abnormalities and resection of tumors involving the anterior skull base. We describe modifications of this technique to approach extra-axial and intradural midline lesions of the anterior fossa with or without involvement of the skull base. A craniotomy was planned with an endoscope and image guidance. A modified frontal-nasal-orbital craniotomy encompassing the entire frontal sinus complex was performed in conjunction with osteotomies incorporating the bilateral superior orbital ridges and nasal septum. Removal of the posterior wall of the frontal sinus was completed if necessary. Dural repair and final reconstruction are detailed. Our initial experience using this approach in five patients harboring lesions of the anterior skull base resulted in adequate exposure of the targeted pathology. There were no complications of the procedure. Cosmetic results were acceptable. We present a detailed account of this procedure via photographs and a video. The frontal-nasal-orbital craniotomy provides access to the floor of the anterior fossa while avoiding excessive brain retraction associated with facial incisions. In addition, this approach is associated with a lower incidence of complications, such as CSF leak, brain retraction edema, or infection. The frontal-nasal-orbital craniotomy is a useful technique for midline lesions of the anterior skull base, and it should be in the armamentarium of neurological surgeons. PMID:19727873

Raza, Shaan M; Conway, James E; Li, Khan W; Attenello, Frank; Boahene, Kofi; Subramanian, Prem; Quinones-Hinojosa, Alfredo

2010-01-01

390

Deep seismic reflection profiling across the Northern Fossa Magna: The ERI 1997 and the JNOC 1996 seismic lines, active faults and geological structures  

Science.gov (United States)

The Northern Fossa Magna is a Miocene failed rift and due to subsequent shortening, its basin-fill forms a fold-belt associated with active faults. Seismic reflection data across the middle part of the northern Fossa Magna acquired in late 1990s were reprocessed to reveal the deep geometry of active faults. The reprocessed seismic sections portray the folded and faulted structure of the Neogene basin-fill. The deeper extension of the Western Nagano Basin active Fault (WNBF), which has been revealed for the first time, can be traced down to 4 km, as a reverse fault dipping 40° westward. In the western part, the Itoigawa-Shizuoka Tectonic Line (ISTL) active fault is presented as an emergent thrust dipping 30-35° eastward. Based on the seismic profiles, surface geology and well data, the balanced geologic cross section was constructed. Using simple-shear model of the basin formation, the total amount of Miocene extension is calculated to be ca. 27 km and the total amount of late Neogene to Quaternary shortening is ca. 11 km. The basin formation and shortening deformation are well explained by the tectonic inversion model and fault reactivation.

Elouai, Driss; Sato, Hiroshi; Hirata, Naoshi; Kawasaki, Shinji; Takeshita, Toru; Kato, Naoko; Takeda, Tetsuya

2004-12-01

391

Low V p and V p/ V s zone beneath the northern Fossa Magna basin, central Japan, derived from a dense array observation  

Science.gov (United States)

The northern Fossa Magna (NFM) basin is a Miocene rift system formed in the final stage of the opening of the Japan Sea. The northern part of the Itoigawa-Shizuoka Tectonic Line (ISTL) bounds the western part of the northern Fossa Magna. In order to understand the active tectonics in these areas, it is essential to explain the seismic velocity structures, deep structures of active faults, and microseismicity near the active faults. In the autumn of 2002, we conducted a seismic array observation across the northern part of the ISTL and the NFM to obtain a structural image beneath the NFM. Arrival times of local earthquakes and explosive shots were used in a joint inversion for earthquake locations and 3-D V p and V p/ V s structures. P- and S-wave arrival time data were obtained from 73 events including 4 explosive shots, and 3809 P- and 2659 S-wave arrival times were used for the inversion analysis. We obtained a seismic velocity model revealing good correlations with the surface geology along the profile. In particular, we found thick low-velocity zones beneath the NFM and the Komoro basin and a high-velocity zone beneath the Central Uplift Zone. Beneath the NFM, a low-velocity zone with low-to-moderate V p/ V s extends to a depth of approximately 10 km. The low-velocity suggests the existence of aqueous fluid-filled pores with high aspect ratios.

Kurashimo, Eiji; Hirata, Naoshi

2004-12-01

392

Pattern recognition methods in (1)H MRS monitoring in vivo of normal appearing cerebellar tissue after treatment of posterior fossa tumors.  

Science.gov (United States)

The objective of this study was to investigate the metabolic responses of normal appearing cerebellar tissue after posterior fossa tumor treatment, and to identify characteristics of the particular treatment method. Moreover, this work examined the metabolic alterations of normal appearing tissue induced by a particular tumor state including resection, stagnation, progression, and recurrence. The studied group consisted of 29 patients treated for posterior fossa tumors. All of them were irradiated with a total dose of 54 Gy at 1.8 Gy/fraction (median values). In addition, 13 underwent chemotherapy, 25 underwent total tumor resection, 18 were tumor-free in control examinations, 5 had a stable disease, and tumor progression or recurrence was observed in 2 and 4 cases, respectively. The 69 spectra, acquired using a MRI/MRS 2T system, were analyzed using Partial Least Squares Discriminant Analysis (PLS-DA) with orthogonal signal correction (OSC) spectral filtering. A significantly elevated spectral region (0.97-1.55 ppm) was observed in patients after total resection in comparison to non-operated subjects. Patients treated with chemotherapy showed an elevated band between 1.15-1.75 and 2.7-3.0 ppm and had decreases in the remaining parts of the spectra. Increases in lactate and decreases in the remaining metabolites were characteristic for the tumor progression/recurrence group. Pattern recognition methods coupled with MRS revealed significant treatment-dependent alterations in normal appearing cerebellar tissue, as well as metabolic changes induced by tumor progression/recurrence. PMID:19812943

Boguszewicz, Lukasz; Blamek, S?awomir; Sokó?, Maria

2010-01-01

393

Avaliação dos selantes de fossas e fissuras aplicados por estudantes de Odontologia / Evaluation of pit and fissure sealants applied by dental students  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: Selantes de fossas e fissuras são indicados para prevenir lesão de cárie em superfícies oclusais. OBJETIVO: O objetivo deste estudo foi avaliar os selantes de fossas e fissuras aplicados por estudantes do Curso de Graduação em Odontologia da Universidade Regional de Blumenau (FURB), Sant [...] a Catarina. MATERIAL E MÉTODO: O estudo descritivo retrospectivo desenvolveu-se em três etapas: na primeira, procedeu-se à análise dos prontuários do Setor de Triagem, tendo como critério de inclusão a existência de radiografias dos dentes selados. Na segunda etapa, analisaram-se as radiografias dos prontuários selecionados e a história clínica da criança. A terceira etapa foi realizada por meio de exames clínicos e radiográficos, pelos quais eram verificadas as condições dos selantes de fossas e fissuras. RESULTADO: Foram analisados 800 prontuários, sendo selecionados 131 (16,37%) para a segunda etapa, quando se observou que 321 selantes de fossas e fissuras foram aplicados. Compareceram à consulta de controle 119 (90,84%) crianças, ocasião em que se confirmou a aplicação de 160 (49,85%) selantes resinosos, 126 (39,25%) com cimento de ionômero de vidro e 35 (10,90%) com resina flow. Foram observados 296 (92,21%) selantes em dentes permanentes. Ao exame clínico, verificou-se que 114 (35,51%) selantes haviam sido perdidos totalmente em diferentes períodos de tempo. Nenhuma lesão de cárie foi observada em 294 (91,59%) dentes selados. CONCLUSÃO: Verificou-se que os selantes de fossas e fissuras, aplicados por estudantes do Curso de Odontologia da FURB, foram eficazes na manutenção da maioria das superfícies dentárias livres de lesão de cárie, mesmo quando foram perdidos parcial ou totalmente. Abstract in english INTRODUCTION: Pit and fissure sealants are indicated to prevent caries in occlusal surfaces. OBJECTIVE: The aim of this study was to evaluate pit and fissure sealants applied by Dentistry undergraduate students of the Regional University of Blumenau (FURB), Santa Catarina. MATERIAL AND METHOD: The r [...] etrospective descriptive study was developed in three stages: the analysis of the records of the Department of Screening, being used as an inclusion criterion the existence of X-rays of the sealed teeth. In the second step we analyzed the radiographs of selected records and medical history of the child. The third step was performed by clinical and radiographic examinations, when conditions of pit and fissure sealants were verified. RESULT: We analyzed 800 medical records, and selected 131 (16.37%) for the second step, where it was observed that 321 pit and fissure sealants were applied. 119 (90.84%) children attended the control dental appointment, when confirmed the application of 160 (49.85%) resin, 126 (39.25%) glass ionomer cement and 35 (10.90%) flowable composite. We observed 296 (92.21%) sealants in permanent teeth. The clinical examination revealed that 114 (35.51%) of the sealants were completely lost at different periods of time. No caries lesion was observed in 294 (91.59%) teeth sealed. CONCLUSION: It was found that the pit and fissure sealants applied by students of the FURB School of Dentistry were effective in maintaining the majority of tooth surfaces free of caries, even when they were partially or totally lost.

Márcio Cristiano de Souza, Rastelli; Stella Maria Glaci, Reinke; Marcos, Scalabrin; Fábio André dos, Santos.

2012-10-01

394

Hot Tub Rash (Pseudomonas Folliculitis)  

Science.gov (United States)

... swimming pool, or hot tub Using a contaminated loofah sponge Wearing a contaminated diving suit Signs and ... spas, and hot tubs is essential. Sponges and loofahs should be completely dried between uses in order ...

395

How to Treat Diaper Rash  

Science.gov (United States)

... meetings archive Derm Exam Prep Course Epiphanies in Dermatology Legislative Conference Education and quality care AAD professional education Online Learning Center Clinical guidelines PQRS DataDerm State melanoma ...

396

Skin Rashes and Other Changes  

Science.gov (United States)

... you have a painful red bump or a cluster of painful red bumps? Yes This could be a BOIL. A cluster of boils is called a CARBUNCLE. These occur ... away. No 45. Is there a fleshy, growing mass on or near your nose, eyes or other ...

397

Poison ivy - oak - sumac rash  

Science.gov (United States)

... spend time outdoors. The plant has three shiny green leaves and a red stem. Poison ivy typically ... oils may remain for a long time on clothing, pets, tools, shoes, and other surfaces. Contact with ...

398

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Apresenta-se um estudo sobre a avaliação clínica e laboratorial de crianças e adultos jovens com exantema semelhante ao sarampo, durante a ocorrência do surto epidêmico de sarampo na região metropolitana da Grande São Paulo no final de 1996 que se alastrou por todo o país durante o ano de 1997. O di [...] agnóstico laboratorial de sarampo foi firmado em 7 dos 11 pacientes examinados, por detecção direta de IgM específico em amostras de soro da fase aguda da doença, por soroconversão de IgG em um par de amostras da fase aguda e convalescente, pelo isolamento do vírus em culturas de linhagem B95a e pela detecção do RNA viral por PCR em linfócitos do sangue periférico e na urina. O quadro clínico apresentado pelos pacientes nem sempre correspondeu à forma clássica do sarampo. Um jovem adulto, que havia sido vacinado contra o sarampo, apresentou um quadro clínico modificado. Os 4 casos restantes foram negativos em todas as provas laboratoriais para o sarampo, tendo diagnóstico final de exantema súbito (2 casos), escarlatina e Doença de Kawasaki. O presente estudo reforça o ponto de vista de que os sinais e sintomas clínicos são geralmente insuficientes para estabelecer um diagnóstico preciso de sarampo na era pós-vacinal, sendo indispensável um sistema de vigilância baseado em resultados laboratoriais que confirmam todos os casos suspeitos, inclusive os casos de sarampo com sorologia IgM-negativa Abstract in english 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 detec [...] tion 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.

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

2000-10-01

399

Hemangiopericitoma de la fosa posterior: a propósito de un caso / Hemangiopericytoma of the posterior fossa: case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish El hemangiopericitoma es un tumor mesenquimal infrecuente originado de los pericitos de Zimmerman, que habitualmente asienta en tejidos blandos. Su variante meníngea supone menos del 1% de todos los tumores intracraneales. Característicamente presenta un comportamiento agresivo, con marcada tendenci [...] a a recurrir localmente y a lo largo del neuroeje, así como a metastatizar en localizaciones extraneurales. Presentamos el caso de una paciente de 74 años que debutó con clínica inespecífica, observándose durante la exploración física una masa retroauricular no dolorosa a la palpación, adherida a la piel. El estudio de neuroimagen demostró una lesión de gran tamaño localizada en la fosa posterior que realzaba intensamente tras la administración de contraste, asociada a llamativa osteolisis occípito-mastoidea y cuya vascularización provenía exclusivamente de ramas de la arteria carótida externa. La paciente se sometió a la resección quirúrgica completa de la lesión, administrándose radioterapia inicial adyuvante una vez confirmado histológicamente el diagnóstico de hemangiopericitoma. Dieciséis meses después de la intervención, la paciente se encuentra libre de enfermedad. El tratamiento de elección del hemangiopericitoma intracraneal es su resección quirúrgica completa, siempre que sea técnicamente posible, seguida de radioterapia adyuvante con dosis superiores a los 50 Gy. Esta combinación ha demostrado aumentar el intervalo de tiempo libre de recurrencia. Un estrecho seguimiento a largo plazo de estos pacientes es esencial para detectar recurrencias o metástasis a distancia precozmente, pudiendo aparecer incluso décadas después del adecuado tratamiento inicial. Abstract in english Hemangiopericytoma is an uncommon mesenchymal neoplasm arising from Zimmerman 's pericytes, which usually locates in soft tissues. Meningeal hemangiopericytoma accounts for less than 1% of all intracranial tumours. Typically, it behaves aggressively, showing distinct tendency to recur locally or dis [...] tantly along the neural axis and to present extraneural metastases. We describe a 74-year-old patient who presented unspecific symptoms and whose physical exam revealed a painless retroauricular mass which was adhered to skin. Neuroimaging studies showed a large posterior fossa tumour with intense enhancement after contrast infusion that caused striking occipital-mastoid osteolisis and which was exclusively fed by external carotid artery branches. The patient underwent gross total resection of the tumour, and once the histological diagnosis of hemangiopericytoma was confirmed, she underwent initial adjuvant radiotherapy. Sixteen months after surgery, the patient remains recurrence free. The treatment of choice of intracranial hemangiopericytoma is gross total resection, which must be attempted when technically feasible, followed by adjuvant radiotherapy providing total doses over 50 Gy. This combination has demonstrated increasing recurrence-free interval in these patients. Close and longterm follow-up is mandatory in order to achieve early diagnosis of recurrence or metastases in these patients, since they can appear several years, even decades, after initial proper treatment.

R., Gutiérrez-González; G.R., Boto; Á., Pérez-Zamarrón; M., Rivero-Garvía.

2008-10-01

400

Skin rash in the hypogastric region during a regional chemotherapy for bladder carcinoma: CT and scintigraphic demonstration of a potential collateral pathway between the internal iliac and inferior epigastric arteries  

Energy Technology Data Exchange (ETDEWEB)

A 70-year-old man developed a skin rash in his right lower abdominal wall after an intra-arterial infusion chemotherapy for carcinoma of the bladder. A CT with a direct infusion of contrast material via the implanted reservoir showed a marked enhancement of the right inferior epigastric artery and a significantly large artery in the right inguinal region. Radionuclide imaging with a direct infusion of Tc-99m macroaggregated albumin (MAA) revealed an abnormal accumulation in the right anterior abdominal wall. These findings implied a collateral pathway from the right internal iliac artery to the right inferior epigastric artery, i.e., the corona mortis. (orig.)

Fujimoto, H. [Dept. of Radiology, Numazu City Hospital (Japan); Naito, H. [Dept. of Urology, Numazu City Hospital (Japan); Terauchi, M. [Dept. of Plastic Surgery, Numazu City Hospital (Japan)

2001-09-01

401

Skin rash in the hypogastric region during a regional chemotherapy for bladder carcinoma: CT and scintigraphic demonstration of a potential collateral pathway between the internal iliac and inferior epigastric arteries  

International Nuclear Information System (INIS)

A 70-year-old man developed a skin rash in his right lower abdominal wall after an intra-arterial infusion chemotherapy for carcinoma of the bladder. A CT with a direct infusion of contrast material via the implanted reservoir showed a marked enhancement of the right inferior epigastric artery and a significantly large artery in the right inguinal region. Radionuclide imaging with a direct infusion of Tc-99m macroaggregated albumin (MAA) revealed an abnormal accumulation in the right anterior abdominal wall. These findings implied a collateral pathway from the right internal iliac artery to the right inferior epigastric artery, i.e., the corona mortis. (orig.)

402

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  

Directory of Open Access Journals (Sweden)

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.

Nilton Alves

2012-12-01

403

Tumors in posterior cranial fossa: diagnostic by CT and MR, 103 cases. Neoplasias solitarias de la fosa posterior: diagnostico por TC y RM, a proposito de 103 casos  

Energy Technology Data Exchange (ETDEWEB)

This article deals with the incidence and epidemiology, as well as the CT and MR findings, in 103 tumors located in posterior cranial fossa. The series included primary neoplasms and metastases, whether axial or extra-axial, providing they were solitary in the intracranial region. Ninety-one confirmed histologically. Their statistical incidence among intracranial neoplasms is high; moreover, they present considerable histological and epidemiological difference with respect to their supratentorial homonyms. The sample discloses the behavior of a random population, 20% of which were children. In the latter group, the most common lesions were glioma and medulloblastoma. Among adult patients, the most prevalent lesion was solitary axil metastasis. The analysis of the data demonstrates the importance of the anatomic site in the differential diagnosis. (Author)

Olier, J.; Atondo, T.; Yubero, M.L.; Gil, J.L.; Guridi, J.; Zubieta, J.L. (Clinica Universitaria de Navarra, Hospital de Navarra, Pamplona (Spain))

1994-01-01

404

Quantitative radio-isotope cisternography for the investigation of CSF circulation in the posterior fossa and basal cisterns--a preliminary report.  

Science.gov (United States)

In the absence of hydrocephalus there is an inclination to overlook enlargement of CSF spaces. In theory such enlargement might be the pathological basis for unexplained diseases seemingly related to disorders in CSF dynamics. By using Indium-111-DTPA in scinti-cisternography for 66 hours an attempt was made to identify such disorders by quantification of CSF circulation in the posterior fossa. The experimental data were fitted by means of two successive least square logarithmic regression analyses in order to make possible differentiation between "known" CSF disturbances and "external hydrocephalus". Theoretically, a biexponential curve would be expected. If therefore a monoexponential "best fit" is found, disturbances of CSF circulation may be taken to be present. For a definition of the features of normality in the case of a biexponential curve, however, further data on normal volunteers are needed. PMID:3736896

Wolbers, J G; van Halderen, P; van Lingen, A; Gelsema, E S; van Alphen, H A

1986-01-01

405

Deep Seismic Reflection Profiling Across the Northern Fossa Magna: the ERI 1997 and the JNOC 1996 Seismic Lines, Active Faults and Geological Structure  

Science.gov (United States)

View the fact that Japan is situated on a puzzle of tectonic plate boundaries; it is considered one of the most countries threatened by hazardous phenomena, mainly volcano and earthquakes. The Itoigawa-Shizuoka tectonic line (ISTL) is one of these boundaries, which separate the NE Japan from the SW Japan. In between these parts of Japan, the Neogene Fossa magna basin has been developed since the Miocene and is considered an active tectonic area, thus it has attracted different research groups. Our research group has conducted this research in order to investigate the geometry of the active faults and to get a better understanding of the relationship between the Pre-Neogene basement and the subsequent thick package of the sediments and the accompanied igneous rocks. Reprocessing the NF-97 line (17km in length) of the Earth Research Institute of Tokyo University (ERI) and the NS96-A line (19km) of the Japan National Oil Company (JNOC), has improved the quality of these lines. Despite of the difference in their strikes, EW for the former and NE-SW for the latter, we could merge both of them in a single line. Applying the migration process, we could partially filled in the 4km gap in between the two lines. Thus we could visualize the main structures, faults and folds existing in this area with their extension in the deep part. In the western part of the seismic line, the Itoigawa-Shizuoka active fault and the Otari-Nakayama fault appear as thrusting faults. These thrusts are dipping towards the East, with a westward vergence. The ISTL constitute a detachment fault system, which probably has played a key role of the tectonic evolution of the whole Fossa magna. In the East part of the seismic line, two backward reverse faults have been observed, the active fault of the West Nagano Basin and the Saigawa fault.

Elouai, D.; Sato, H.; Hirata, N.; Kawasaki, S.; Takeshita, T.

2003-12-01