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Sample records for antecubital fossae rash

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

    Directory of Open Access Journals (Sweden)

    S. M. Alamshah

    2004-08-01

    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.

  2. Rash

    Science.gov (United States)

    ... zoster, herpes or shingles Bacterial infections, such as impetigo, scarlet fever or Lyme disease Fungal infections, such ... may last for an extended period of time. Prevention Prevention depends on the cause of the rash: ...

  3. 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)

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

    2014-09-01

    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.

  4. Physiologically based pharmacokinetic modeling of arterial – antecubital vein concentration difference

    Directory of Open Access Journals (Sweden)

    Levitt David G

    2004-02-01

    Full Text Available Abstract Background Modeling of pharmacokinetic parameters and pharmacodynamic actions requires knowledge of the arterial blood concentration. In most cases, experimental measurements are only available for a peripheral vein (usually antecubital whose concentration may differ significantly from both arterial and central vein concentration. Methods A physiologically based pharmacokinetic (PBPK model for the tissues drained by the antecubital vein (referred to as "arm" is developed. It is assumed that the "arm" is composed of tissues with identical properties (partition coefficient, blood flow/gm as the whole body tissues plus a new "tissue" representing skin arteriovenous shunts. The antecubital vein concentration depends on the following parameters: the fraction of "arm" blood flow contributed by muscle, skin, adipose, connective tissue and arteriovenous shunts, and the flow per gram of the arteriovenous shunt. The value of these parameters was investigated using simultaneous experimental measurements of arterial and antecubital concentrations for eight solutes: ethanol, thiopental, 99Tcm-diethylene triamine pentaacetate (DTPA, ketamine, D2O, acetone, methylene chloride and toluene. A new procedure is described that can be used to determine the arterial concentration for an arbitrary solute by deconvolution of the antecubital concentration. These procedures are implemented in PKQuest, a general PBPK program that is freely distributed http://www.pkquest.com. Results One set of "standard arm" parameters provides an adequate description of the arterial/antecubital vein concentration for ethanol, DTPA, thiopental and ketamine. A significantly different set of "arm" parameters was required to describe the data for D2O, acetone, methylene chloride and toluene – probably because the "arm" is in a different physiological state. Conclusions Using the set of "standard arm" parameters, the antecubital vein concentration can be used to determine the whole body PBPK model parameters for an arbitrary solute without any additional adjustable parameters. Also, the antecubital vein concentration can be used to estimate the arterial concentration for an arbitrary input for solutes for which no arterial concentration data is available.

  5. ANSWER: A characteristic rash.

    Directory of Open Access Journals (Sweden)

    Vui Heng CHONG

    2011-02-01

    Full Text Available Answer: Dengue fever with Herman’srash.Dengue presents as classic dengue fever orhaemorrhagic dengue. It is caused byFlavivirus, transmitted to humans by theAedes aegypti mosquito.Dengue rash or also known as Herman’srash (Panel A appears as a maculopapularerythematous rash with islands ofnormal skin sparing or scarlatiniform (likeScarlet fever rash: it blanches upon pressure,Panel B. The clinical feature of denguerash is classically described as “Islands ofwhite in a sea of red”. The erythematousrash (red appearance is due to an increasein capillary permeability and fluid leakage asa result of damaged capillary walls from animmune complex reaction secondary due tothe infection. The islands of white describedin the rash (the spots of skin that are not erythematousare areas where there is moreoedema than the surrounding area as a resultof a greater increase in fluid leakage.

  6. First Aid: Rashes

    Science.gov (United States)

    ... Ivy Shingles Fungal Infections Rashes: The Itchy Truth Impetigo Word Find: Skin Your Skin Poison Ivy Flash ... purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995- The Nemours Foundation. All ...

  7. How to Treat Diaper Rash

    Science.gov (United States)

    ... pus that drains from the rash, and a rash that does not go away after treatment or worsens. Another sign of a skin infection is if the baby is in pain or is hard to console. Babies have very delicate ... best effort, diaper rash still occurs. If your baby’s diaper rash is ...

  8. Hot Tub Rash (Pseudomonas Dermatitis/Folliculitis)

    Science.gov (United States)

    ... Do I Protect Myself and My Family? "Hot Tub Rash" ( Pseudomonas Dermatitis / Folliculitis) Below are answers to ... tub rash and healthy swimming. What is Hot Tub Rash? Hot tub rash, or dermatitis, is an ...

  9. Tantalus Fossae

    Science.gov (United States)

    2002-01-01

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

  10. Posterior fossa tumor

    Science.gov (United States)

    ... can block the flow of spinal fluid and cause increased pressure on the brain and spinal cord. Most tumors of the posterior fossa are primary brain cancers . They start in the brain, rather than spreading ...

  11. Miopericitoma em fossa nasal

    Directory of Open Access Journals (Sweden)

    Medeiros, Arethusa Ingrid de Liz

    2009-06-01

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

  12. A Chinese New Year rash

    OpenAIRE

    SH Keah; KS Chng

    2013-01-01

    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...

  13. Skin Rashes and Other Changes

    Science.gov (United States)

    ... adult? Yes This could be a sign of SEBORRHEIC DERMATITIS, a condition in which the sebaceous glands overproduce. ... weeks. Pityriasis rosea doesn't usually respond to treatment. No 17. Do you have an intensely itchy rash with red bumps and blisters, and does it ...

  14. New Itchy Skin Rashes in Children

    Science.gov (United States)

    ... viral exanthem is a rash caused by a viral infection. Many viruses can cause a similar-appearing rash, so it ... This Site and third parties who place advertisements on this Site may collect and use information ...

  15. Vena cava filter placement via the antecubital access: a report of 6 cases

    International Nuclear Information System (INIS)

    Objective: To study the methods and skill of vena cava filter placement via the antecubital access. Methods: Six patients with DVT (4 males and 2 females, mean age of 62) underwent vena cava filter placement via the antecubital access in Huashan Hospital from Oct. 2004 to May. 2006. The right basilic vein was punctured with the use of micropuncture technique. SNF(Simon nitinol filter, Bard)was inserted through its carrier into the 90-cm-long sheath. The filter was then deployed with a standard fashion in the IVC, 5 cm inferior to the renal vein. Results: The filter was once placed successfully in all six patients within average time of 25 min without complications, but with good healing, exclusion of bleeding and no phlebitis. The position of filter was accurate without deviation and no occurrence of pulmonary embolism. Conclusions: vena cava filter placement via antecubital access is easy, minimal invasive, no need of lying in bed postoperatively. It is beneficial for DVT patients as an alternative for the contra-indication to femoral venous access. (authors)

  16. Rashes

    Science.gov (United States)

    ... and along the scalp. Fingernails may be affected. Impetigo -- common in children, this infection is from bacteria ... doctor You may have a tick bite Home treatment doesn't work, or your symptoms get worse

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

    Science.gov (United States)

    Facts About “Hot Tub Rash” and “Swimmer’s Ear” (Pseudomonas) What is Pseudomonas and how can it affect me? Pseudomonas (sue-doh-MOH-nass) ... major cause of infections commonly known as “hot tub rash” and “swimmer’s ear.” This germ is commonly ...

  18. 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 ...

  19. Southern Tick-Associated Rash Illness (STARI)

    Science.gov (United States)

    ... been described in humans following bites of the lone star tick, Amblyomma americanum . The rash may be accompanied by ... to expect from your physician... Geographic Distribution Where lone star ticks are found... STARI or Lyme Disease? Learn how ...

  20. New Itchy Skin Rashes in Adults

    Science.gov (United States)

    ... widespread distribution is typical of drug reactions, hives (urticaria), viral infections, and scabies. Most skin rashes are ... is the culprit. Your age, duration of… Hives (Urticaria) Hives (urticaria), also known as welts, is a ...

  1. Memnonia Fossae (Enhanced Color)

    Science.gov (United States)

    1995-01-01

    Tharsis-centered volcanic and tectonic activity resulted in the formation of radial grabens of Memnonia Fossae, which cut materials of the ancient cratered highlands and the relatively young, highland-embaying lava flows from the Tharsis volcanoes. Center of picture is at latitude 16 degrees S., longitude 142 degrees W. The enhanced color version (following decorrelation stretch) reveals a diversity of subtle color variations; many of the color variations may be due to different lava flow units and variable amounts of weathering, possible alteration by water, and eolian redistributions. Viking Orbiter Picture Numbers 41B52 (green) 41B54 (red), and 41B56 (blue) at 198 m/pixel resolution. Picture width is 206 km. North is 119 degrees counter-clockwise from top.

  2. Variations in the cubital fossa

    Directory of Open Access Journals (Sweden)

    Biswas S

    2010-08-01

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

  3. Epidural hematomas of posterior fossa

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    Radulovi? Danilo

    2004-01-01

    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.

  4. Oxcarbazepine Induced Maculopapular Rash - A Case Report

    Science.gov (United States)

    Mitra, Ritabrata; Sen, Sukanta; Pal, Agnik; Tripathi, Santanu Kumar

    2015-01-01

    Unlike carbamazepine, newer anti epileptic drug like oxcarbazepine, reports fewer side effects. In this report we describe a case of oxcarbazepine induced maculopapular rash probably happened because of a drug interaction with isoniazid, and a brief review of the existing literature is presented herewith. A 40-year-old male patient received oxcarbazepine 300mg twice daily along with other anti-tubercular drugs including isoniazid (300mg) once daily since two days. Extensive cutaneous rash with intense itching developed which subsided on discontinuation of oxcarbazepine. This case highlights the fact that there is a potential possibility of drug-drug interaction between oxcarbazepine and isoniazid and concomitant use of these two drugs should better be avoided during clinical practice. PMID:25738002

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

    LENUS (Irish Health Repository)

    Crushell, Ellen

    2012-09-01

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

  6. Lamotrigine overdose cause skin rash and angioedema

    OpenAIRE

    Mohammad Alkayem; Hussein Assallum

    2013-01-01

    A 23 years old female presented to Lincoln Medical and Mental Health center with skin rash and angioedema after she received 20 pills of lamotrigine 25 mg, and the patient used to take this medication before two tables a day for many months, after she received the appropriate management she improved. After reviewing MEDLINE we found a few cases reported life threatening complications related to lamotrigine intoxication and sudden increase the dose, so we should be aware about these complicat...

  7. Diseases of the optic fossa

    International Nuclear Information System (INIS)

    By using a whole body CT unit for coronal tomography, it is possible to observe the extraocular muscles at the same time. Diseases of the optic fossa that can be investigated by CT include muscular hypertrophy due to toxic goiter, calcification of the sclera in hyperparathyroidismus, foreign bodies, inflammatory pseudotumor, retrobulbar tumor, tumor of the retina, tumor of the choroidea, and tumor of the sclera

  8. Lamotrigine overdose cause skin rash and angioedema

    Directory of Open Access Journals (Sweden)

    Mohammad Alkayem

    2013-05-01

    Full Text Available A 23 years old female presented to Lincoln Medical and Mental Health center with skin rash and angioedema after she received 20 pills of lamotrigine 25 mg, and the patient used to take this medication before two tables a day for many months, after she received the appropriate management she improved. After reviewing MEDLINE we found a few cases reported life threatening complications related to lamotrigine intoxication and sudden increase the dose, so we should be aware about these complications before prescribing this medication.

  9. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Science.gov (United States)

    2010-04-01

    ...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...

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

    Directory of Open Access Journals (Sweden)

    María Cuesta Salvador

    2010-04-01

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

  11. Posterior Fossa Tumor in Children

    Directory of Open Access Journals (Sweden)

    Seyed Mahmoud TABATABAEI

    2012-06-01

    Full Text Available How to Cite this Article: Tabatabaei SM, Seddighi A, Seddighi AS. Posterior Fossa Tumor in Children. Iran. J. Child. Neurol 2012;6(2: 19-24. Objective Primary brain tumors are the most common solid neoplasms of childhood, representing 20% of all pediatric tumors. The best current estimates place the incidence between 2.76 and 4.28/100,000 children per year. Compared with brain tumors in adults, a much higher percentage of pediatric brain tumors arise in the posterior fossa. Infratentorial tumors comprise as many as two thirds of all pediatric brain tumors in some large series. Tumor types that most often occur in the posterior fossa include medulloblastoma, ependymoma, cerebellar astrocytoma and brainstem glioma. Materials & Methods All pediatric cases of posterior fossa tumor that were considered for surgery from 1981 to 2011 were selected and the demographic data including age, gender and tumor characteristics along with the location and pathological diagnosis were recorded. The surgical outcomes were assessed according to pathological diagnosis. Results Our series consisted of 84 patients (52 males, 32 females. Cerebellar symptoms were the most common cause of presentation (80.9% followed by headache (73.8% and vomiting (38.1%. The most common histology was medulloblastoma (42.8% followed by cerebellar astrocytoma (28.6%, ependymoma (14.3%, brainstem glioma (7.2% and miscellaneous pathologies (e.g., dermoid,  andtuberculoma (7.2%. Conclusion The diagnosis of brain tumors in the general pediatric population remains challenging. Most symptomatic children require several visits to a physician before the correct diagnosis is made. These patients are often misdiagnosed for gastrointestinal disorders. Greater understanding of the clinical presentation of these tumors and judicious use of modern neuroimaging techniques should lead to more efficacious therapies.References 1. Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ. Latency between symptom onset and diagnosis of  pediatric brain tumors: an Eastern Canadian geographic study. Neurosurgery 2002 Aug;51(2:365-73. 2. Mueller B, Gurney JG. Epidemiology of pediatric brain tumors. Neurosurg Clin N Am 1992 Oct;3(4:715-21. 3. Albright A, Wisoff JH, Zeltzer PM, Deutsch M, Finlay J, Hammond D. Current neurosurgical treatment of medulloblastomas in children. A report from the Children’s Cancer Study Group. Pediatr Neurosci 1989;15(6:276-82. 4. Albright AL. Posterior fossa tumors. Neurosurg Clin N Am. 1992 Oct;3(4:881-91. 5. Healey E, Barnes PD, Kupsky WJ, Scott RM, Sallan SE, Black PM. The prognostic significance of postoperative residual tumor in ependymoma. Neurosurgery 1991 May;28(5:666-71. 6. Park T, Hoffman HJ, Hendrick EB, Humphreys RP, Becker LE. Medulloblastoma: clinical presentation and management. Experience at the hospital for sick children, Toronto, 1950-1980. J Neurosurg 1983 Apr;58(4:543-52. 7. Allen LC. Childhood brain tumors. Current status of clinical trials in newly diagnosed and recurrent disease. Pediatr Clin North Am 1985 Jun;32(3:633-51. 8. Laurent JP,Cheek WR. Brain tumors in children. J Pediatr Neurosci 1985;1:15-32. 9. O’Brien DF, Caird J, Kennedy M, Roberts GA, Marks JC, Allcutt DA. Posterior fossa tumours in childhood: evaluation of presenting clinical features. Irish Med J 2001 Feb;94(2:52-3. 10. Bronstein KS. Epidemiology and classification of brain tumours. Cri Care Nurs Clin North Am 1995;7:79-89. 11. Lannering B, Marky I, Nordborg C. Brain tumors in children and adolescence in west Sweden 1970-1984. Epidemiology and survival Cancer. l990 Aug 1;66(3:604-9. 12. Cushing H. Experiences with cerebellar astrocytomas: a critical review of 26 cases. Surg Gynae Obstet 1931;52:129-204. 13. Geissinger JD. Astrocytomas of the cerebellum in children. Long-term study. Arch Neurol 1971 Feb;24(2:125-35. 14. Pascual - Castroviejo I, Raimondi AJ, Choux M, Di Rocco C. Functional basis of posterior fossa symptoms and signs. eds. Posterior fossa tumours. New York: Springer Verlag; 1993;12-21. 15. Cohen ME, Duner PK. Tumours of the brain and

  12. Memnonia Fossae, Approximately Natural Color

    Science.gov (United States)

    1995-01-01

    Tharsis-centered volcanic and tectonic activity resulted in the formation of radial grabens of Memnonia Fossae, which cut materials of the ancient cratered highlands and the relatively young, highland-embaying lava flows from the Tharsis volcanoes. Center of picture is at latitude 16 degrees S., longitude 142 degrees W. Natural color version shows albedo variations and uniform colors. The enhanced color version (PIA00151, following decorrelation stretch), however, reveals a diversity of subtle color variations; many of the color variations may be due to different lava flow units and variable amounts of weathering, possible alteration by water, and eolian redistributions. Viking Orbiter Picture Numbers 41B52 (green), 41b54 (red), and 41B56 (blue) at 198 m/pixel resolution. Picture width is 206 km. North is 119 degrees counter-clockwise from top.

  13. Arachnoid cysts of the posterior fossa.

    Science.gov (United States)

    Vaquero, J; Carrillo, R; Cabezudo, J M; Nombela, L; Bravo, G

    1981-08-01

    A series of 6 patients with arachnoid cysts of the posterior fossa who were treated surgically is presented. The diagnosis of the nature of the lesion and of the exact location within the posterior fossa could not be established on a clinical basis. CT scanning is the best method for diagnosing the lesion and for observing the postoperative evolution. Treatment consisted of removing the cyst walls, shunting the cyst to the peritoneum, or both. The differential diagnosis of arachnoid cysts of the posterior fossa from other cerebrospinal fluid collections, such as the megacisterna magna or the Dandy-Walker malformation, are discussed. PMID:6974408

  14. Computed tomography of posterior fossa tumor

    Energy Technology Data Exchange (ETDEWEB)

    Suh, J. H.; Suh, C. O.; Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1980-06-15

    58 case of proven primary posterior fossa tumor examined by CT scanner were analyzed. The CT appearance in acoustic neurinoma, trigeminal neurinoma, meningioma, dermoid, astrocytoma, hemangioblastoma, medulloblastoma, and ependymoma are described and the differential diagnosis are discussed.

  15. Computed tomography of posterior fossa tumor

    International Nuclear Information System (INIS)

    58 case of proven primary posterior fossa tumor examined by CT scanner were analyzed. The CT appearance in acoustic neurinoma, trigeminal neurinoma, meningioma, dermoid, astrocytoma, hemangioblastoma, medulloblastoma, and ependymoma are described and the differential diagnosis are discussed.

  16. 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)

  17. Computer tomography of posterior cranial fossa

    International Nuclear Information System (INIS)

    The problems and possibilities are presented of computer tomography examinations of the posterior cranial fossa. The apparatus used was Somatom 2 by Siemens. Such examinations make it possible to introduce specific measurements and evaluations of pathological processes. Computer tomography in itself, however, may not always be successful in this respect and in the examination of the posterior cranial fossa invasive methods, suitably used, will make the diagnosis more accurate and adequate therapy possible. (J.O.)

  18. Geometric morphometrics of hominoid infraspinous fossa shape.

    Science.gov (United States)

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

    2015-01-01

    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

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

    Scientific Electronic Library Online (English)

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

    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. 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.

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

    Directory of Open Access Journals (Sweden)

    Luis José Cespedes

    2012-12-01

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

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

    Scientific Electronic Library Online (English)

    Luis José, Cespedes; Camilo, Turriago; Jairo, Goyeneche.

    2012-12-01

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

  2. [Adult-onset Still's disease and its characteristic rash].

    Science.gov (United States)

    Sunderkötter, C; Frieling, U; Nashan, D; Metze, D

    1998-12-01

    Still's disease was originally described as one form of rheumatoid arthritis in children beginning with fever and other systemic symptoms. In rare cases it may also begin in the adult and is then referred to as adult-onset Still's disease. The diagnostic criteria include typical rash, arthralgias, bouts of fever, and leukocytosis, as well as lymphadenopathy or splenomegaly, liver dysfunctions, noninfectious angina, and absence of rheumatoid factor and antinuclear antibodies. We report two adult patients with longstanding disease whose exanthema guided us to the correct diagnosis. The rash is a finding with high sensitivity. It is characterized by red macules with distinct borders and is evanescent. During an acute flare of the rash, gentle friction induces erythematous, isomorphic (Koebner) phenomena, which, as we describe here for the first time, may persist longer than the remainder of the fleeting rash. PMID:9914890

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

    Science.gov (United States)

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

    2014-11-01

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

  4. Contact Dermatitis: Tips for Getting Rid of the Rash

    Science.gov (United States)

    ... nickel, which is a common cause of allergic contact dermatitis. Brief direct contact with an eyelash curler or tweezers can cause ... yourself rubbing your eyes, try to stop. Indirect contact with an allergen can cause a rash on ...

  5. The nature and distribution of daffodil pickers' rash.

    Science.gov (United States)

    Julian, C G; Bowers, P W

    1997-12-01

    The rash associated with picking daffodils has long been recognized, but the distribution and differing types of lesions have not been explained. This study, from observations in the field, attempts to clarify the position. The method of picking and then gathering the flowers explains the development of the rash at the points of contact of plant sap with skin. Crystals of calcium oxalate in the sap, in conjunction with alkaloids, act as an irritant, and also cause the characteristic sores. PMID:9455627

  6. Ceftriaxone induced drug rash with eosinophilia and systemic symptoms

    OpenAIRE

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

    2014-01-01

    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...

  7. Direct sagittal CT scanning in the diagnosis of pituitary fossa tumours and posterior fossa pathology

    International Nuclear Information System (INIS)

    Two independent methods are presented for multidirectional CT scanning of the brain using the Philips Tomoscan 300. The advantages in scanning pituitary fossa tumours and pathology of the posterior fossa are discussed. No additional software or modifications are required. Direct sagittal scanning is particularly advantageous for accurate assessment of the size of pituitary tumours and intrasellar lesions requiring surgical intervention or radiation therapy. (Auth.)

  8. 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

  9. Erlotinib-induced rash spares previously irradiated skin

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  10. Widespread skin rash following travel to South-East Asia.

    Science.gov (United States)

    Creamer, Andrew

    2014-01-01

    A 21-year-old man presented with a widespread, intensely pruritic skin rash, which developed acutely 5 days after returning from a backpacking holiday in Thailand. On initial presentation to his general practitioner, an erythematous, papular rash was noted in the upper right back, with smaller clusters of lesions on the buttocks and right arm. Based on the anatomical distribution of the lesions, a preliminary diagnosis of shingles was made. Over the following 2 weeks, the lesions failed to improve, and new snake-like lesions appeared. A dermatologist made the diagnosis of cutaneous larva migrans. The skin lesions rapidly resolved following oral albendazole therapy. PMID:24557477

  11. 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.)

  12. Large epidermoid cyst in the posterior fossa

    International Nuclear Information System (INIS)

    An extensive epidermoid cyst in the posterior fossa was diagnosed in a 59 year old male patient. The most valuable indicator for differential diagnosis was given by plain skull X-ray showing a peripheral zone of sclerosis as the leading X-ray sign of epidermoids. CT and MRI complemented the preoperative diagnostic measurements. (orig.)

  13. Herniographic appearance of the lateral inguinal fossa

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Kesek, P.

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

  14. Neurological Disease Produced by Varicella Zoster Virus Reactivation Without Rash

    OpenAIRE

    Gilden, Don; Cohrs, Randall J.; Mahalingam, Ravi; Nagel, Maria A.

    2010-01-01

    Reactivation of varicella zoster virus (VZV) from latently infected human ganglia usually produces herpes zoster (shingles), characterized by dermatomal distribution pain and rash. Zoster is often followed by chronic pain (postherpetic neuralgia or PHN) as well as meningitis or meningoencephalitis, cerebellitts, isolated cranial nerve palsies that produce ophthalmoplegia or the Ramsay Hunt syndrome, multiple cranial nerve palsies (polyneuritis cranialis), vasculopathy. myelopathy, and various...

  15. Shampoo-Clay Heals Diaper Rash Faster Than Calendula Officinalis

    Science.gov (United States)

    Adib-Hajbaghery, Mohsen; Mahmoudi, Mansoreh; Mashaiekhi, Mahdi

    2014-01-01

    Background: Diaper rash is one of the most common skin disorders of infancy and childhood. Some studies have shown that Shampoo-clay was effective to treat chronic dermatitis. Then, it is supposed that it may be effective in diaper rash; however, no published studies were found in this regard. Objectives: This study aimed to compare the effects of Shampoo-clay (S.C) and Calendula officinalis (C.O) to improve infantile diaper rash. Patients and Methods: A randomized, double blind, parallel controlled, non-inferiority trial was conducted on 60 outpatient infants referred to health care centers or pediatric clinics in Khomein city and diagnosed with diaper rash. Patients were randomly assigned into two treatment groups including S.C group (n = 30) and C.O group (n = 30) by using one to one allocation ratio. The rate of complete recovery in three days was the primary outcome. Data was collected using a checklist and analyzed using t-test, Chi-square and Fisher’s exact tests and risk ratio. Results: Totally, 93.3% of lesions in the S.C group healed in the first 6 hours, while this rate was 40% in C.O group (P < 0.001). The healing ratio for improvement in the first 6 hours was 7 times more in the S.C group. In addition, 90% of infants in the SC group and 36.7% in the C.O group were improved completely in the first 3 days (P < 0.001). Conclusions: S.C was effective to heal diaper rash, and also had faster effects compared to C.O. PMID:25414900

  16. Allergic skin rash with lamotrigine and concomitant valproate therapy - Evidence for an increased risk

    OpenAIRE

    Li, L. M.; Russo, M.(Department of Physics and Astronomy, University of Catania, 95123 Catania, Italy); ODonoghue, M. F.; Duncan, J.S.; Sander, JWAS

    1996-01-01

    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 patients 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 la...

  17. Posterior fossa lesions associated with neuropsychiatric symptomatology.

    Science.gov (United States)

    Pollak, L; Klein, C; Rabey, J M; Schiffer, J

    1996-11-01

    We reviewed 7 cases with posterior fossa structural abnormalities (3 tumors, 2 megacisterna magna and 2 Dandy-Walker syndrome) presenting with neuropsychiatric symptomatology. Derangement in the balance of dopamine, serotonin and noradrenergic networks has been implicated in the pathogenesis of schizophrenia, affective and even personality disorders. Disruption of the cerebellar output to mesial dopaminergic areas, locus coeruleus and raphe nuclei, or deafferentation of the thalamolimbic circuits by a cerebellar lesion may lead to behavioral changes. Seven patients (pts) (comprising 4 men and 3 women with mean age 22 years) were diagnosed as suffering from psychosis (2 pts), major depression (1 pt), personality disorders (2 pts) and somatoform disorders (2 pts) (DSM-IV criteria). Brain CT scan (7 pts) and MRI (4 pts) revealed tumors of the posterior fossa (2 pts), megacisterna magna (2 pts) and Dandy-Walker variant (2 pts). In one patient a IVth ventricle tumor was removed in childhood. PMID:9003973

  18. Treatment of posterior fossa tumors in children.

    Science.gov (United States)

    Muzumdar, Dattatraya; Ventureyra, Enrique C G

    2010-04-01

    The most common posterior fossa tumors in children are medulloblastoma, astrocytoma and ependymoma. Atypical rhabdoid teratoid tumors and brain stem gliomas are relatively rare. As the posterior fossa is a limited space, the tumors presenting in this region cause symptoms early on and require prompt treatment to avoid potential morbidity and mortality. Early detection and diagnosis of these tumors and prompt neurosurgical consultation is crucial in the optimum management of pediatric infratentorial brain tumors. Surgery is the mainstay of treatment, as it provides biopsy and decompression of the tumor. Adjuvant therapy is required in the majority of cases. Recent advances in the field of radiation biology and pharmacology have improved dose and delivery techniques of chemoradiation therapy. In the current era, advances in translational research and molecular genetics have assumed a major role in the pursuit of achieving a 'cure' for these potentially malignant tumors. PMID:20367206

  19. Mammary-type myofibroblastoma of popliteal fossa

    International Nuclear Information System (INIS)

    Mammary-type myofibroblastoma is a very rare, benign, spindle cell lesion, arising mainly in the inguinal region. This clinical entity strictly duplicates the features of its breast counterpart. To our knowledge, this is the first report of this particular lesion occurring in the popliteal fossa. We discuss the clinical, radiological and histopathological features of this case, emphasizing the role of incisional biopsy in such an unusual neoplasia. (orig.)

  20. Ancient schwannoma of the infratemporal fossa

    OpenAIRE

    Balasubramaniam, Saravanan; Balasubramanian, Sethurajan; Thirunavukkarasu, Rohini

    2014-01-01

    Schwannomas are benign tumors of neurogenic origin arising from the Schwann cells of peripheral, cranial, and autonomic nerves. Schwannomas in spite of constituting 25-40% of head and neck tumors the percentage of intraoral schwannomas is merely 1%. Among the intraoral schwannoma the occurrence of the variant “ancient schwannoma of the infratemporal fossa with an intraoral presentation is very rare. The purpose of this presentation is to highlight the rarity of this lesion, to stress the im...

  1. 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

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

    Science.gov (United States)

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

    2001-01-01

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

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

    International Nuclear Information System (INIS)

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

  4. [A case of disseminated gonococcal infection without typical skin rash].

    Science.gov (United States)

    Yokota, Kazuhisa; Gomi, Harumi; Morisawa, Yuji

    2011-07-01

    Few case reports have been published on disseminated gonococcal infection in Japan. We report such a non-HIV case without typical skin rash. A 49-year-old Japanese man living in Thailand on business was seen for fever and multiple arthralgia after returning to Japan. Given the travel history, differential diagnoses included endemic viral infection such as human immunodeficiency virus (HIV), dengue fever, and chikungunya. Diagnosis was based on right-knee arthrocentesis, and synovial fluid culture followed by Neisseria gonorrhoeae polymerase chain reaction (PCR). The isolated strain was sensitive to penicillin. The man was treated with intravenous ceftriaxone and oral levofloxacin. Disseminated gonococcal infection should thus be considered when examining those with classical polyarthralgia symptoms even without a typical skin rash. PMID:21861441

  5. Poison Ivy Taking the Itch Out of the Rash

    Science.gov (United States)

    Rosemary H. Ford

    2011-01-01

    A longstanding belief that has it roots in Native American folklore is that the crushed leaves of jewelweed (Impatiens capensis) relieve the skin's allergic reaction to the toxin of poison ivy (Toxicodendron radicans). This case was developed for an introductory majors or non-majors biology or plant class. It first examines students' conceptions about the rash of poison ivy, what in the plant causes the rash, and how the body responds to the toxin. Then students in small groups plan an experiment using the scientific method to test the ability of jewelweed to reduce the reaction. Following a comparison of experimental designs from different groups, data from a scientific paper is presented for interpretation and analysis. An important outcome of this case is that students recognize the need for evaluating myths and misconceptions using scientific evidence.

  6. Rash decisions-dermatological manifestations preceding a progressive neurological syndrome.

    OpenAIRE

    Doherty, G.; Vincent, A.; Cox, A.

    2013-01-01

    We describe the case of a 72 year old woman who presented with sequential cranial nerve palsies preceded by irritation, pain and a vesicular rash in the sensory distributions of the affected nerves. She had signs and symptoms suggestive of aphagia and Ramsey-Hunt syndrome. Further vesicular eruptions roughly obeying dermatomal boundaries on the limbs and trunk were observed. She was initially thought to have disseminated VZV/HZV infection and was commenced on IV aciclovir. Investigations seek...

  7. The Measurement of Dispositions to Rash Action in Children

    OpenAIRE

    Zapolski, Tamika C. B.; Stairs, Agnes M.; Settles, Regan Fried; Combs, Jessica L.; Smith, Gregory T.

    2009-01-01

    Among adolescents and adults, there appear to be at least four different personality traits that dispose individuals to rash or ill-advised action: sensation seeking, negative urgency, lack of planning, and lack of perseverance. The four are only moderately correlated and they appear to play different roles in dysfunction. It is important to determine whether the traits are present among preadolescents, because of their possible influence on subsequent development. We developed assessments of...

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

    OpenAIRE

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

    2013-01-01

    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, ...

  9. Ancient schwannoma of the infratemporal fossa.

    Science.gov (United States)

    Balasubramaniam, Saravanan; Balasubramanian, Sethurajan; Thirunavukkarasu, Rohini

    2014-01-01

    Schwannomas are benign tumors of neurogenic origin arising from the Schwann cells of peripheral, cranial, and autonomic nerves. Schwannomas in spite of constituting 25-40% of head and neck tumors the percentage of intraoral schwannomas is merely 1%. Among the intraoral schwannoma the occurrence of the variant "ancient schwannoma of the infratemporal fossa with an intraoral presentation is very rare. The purpose of this presentation is to highlight the rarity of this lesion, to stress the importance of an accurate diagnosis and to consider neurogenic lesions in the differential diagnosis of head and neck lesions. PMID:25593881

  10. Extended Middle Cranial Fossa Approach for Acoustic Neuroma Surgery

    OpenAIRE

    Wigand, Malte E.; Haid, Toni; Berg, Michael; Schuster, Bernd; Goertzen, Winfried

    1991-01-01

    The enlarged middle cranial fossa approach was used for removal of acoustic neuromas in 209 cases. Complete tumor removal was accomplished in 96% of cases. Hearing was preserved in 51% of cases, with better results in smaller tumors. Our experience with the enlarged middle fossa approach has led us to discard the translabyrinthine approach for removal of acoustic neuromas.

  11. BAER suppression during posterior fossa dural opening

    Science.gov (United States)

    Shields, Christopher B.; Shields, Lisa B. E.; Jiang, Yi Dan; Yao, Tom; Zhang, Yi Ping; Sun, David A.

    2015-01-01

    Background: Intraoperative monitoring with brainstem auditory evoked responses (BAER) provides an early warning signal of potential neurological injury and may avert tissue damage to the auditory pathway or brainstem. Unexplained loss of the BAER signal in the operating room may present a dilemma to the neurosurgeon. Methods: This paper documents two patients who displayed a unique mechanism of suppression of the BAER apparent within minutes following dural opening for resection of a posterior fossa meningioma. Results: In two patients with anterior cerebellopontine angle and clival meningiomas, there was a significant deterioration of the BAER soon after durotomy but prior to cerebellar retraction and tumor removal. Intracranial structures in the posterior fossa lying between the tumor and dural opening were shifted posteriorly after durotomy. Conclusion: We hypothesized that the cochlear nerve and vessels entering the acoustic meatus were compressed or stretched when subjected to tissue shift. This movement caused cochlear nerve dysfunction that resulted in BAER suppression. BAER was partially restored after the tumor was decompressed, dura repaired, and bone replaced. BAER was not suppressed following durotomy for removal of a meningioma lying posterior to the cochlear complex. Insight into the mechanisms of durotomy-induced BAER inhibition would allay the neurosurgeon's anxiety during the operation. PMID:25883849

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

    Science.gov (United States)

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

    2013-01-01

    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

  13. 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

    Directory of Open Access Journals (Sweden)

    L. M. Li

    1996-03-01

    Full Text Available 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 patients 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 (pRash 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<0,02.

  14. 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)

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

    1996-03-01

    Full Text Available 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

  15. Outbreak of pruritic rashes associated with mites--Kansas, 2004.

    Science.gov (United States)

    2005-09-30

    In late August 2004, the Kansas Department of Health and Environment (KDHE) received reports from the Crawford County Health Department (CCHD) of approximately 300 residents of Pittsburg, Kansas (2000 population: 19,243), seeking care for a pruritic rash of unknown etiology. In early September, three neighboring counties in Kansas and two neighboring states (Missouri and Nebraska) also reported such cases. These events prompted KDHE to request assistance from CDC. Additional cases subsequently were reported in Oklahoma and Texas. This report describes the investigation in Crawford County, Kansas, by public health agencies and entomologists to identify the etiology of the pruritic rash and to assess the extent of the outbreak. A microscopic itch mite (Pyemotes herfsi) was identified as the likely cause of the outbreak, which affected an estimated 54% of the Crawford County population (2000 population: 38,242). Entomologists confirmed the return of P. herfsi in Kansas in August 2005 and have recommended prevention measures, such as use of DEET-containing products, to help minimize exposure for persons outdoors. PMID:16195693

  16. Facial rash with scarring due to granulomatous vasculitis in rheumatoid disease.

    OpenAIRE

    White, R; Wegman, A.; Bulpitt, P; Wood, G.; Fleming, A

    1986-01-01

    A 60-year-old man with destructive rheumatoid disease, multiple nodules, and vasculitis developed a facial rash with ulceration and scarring. Histology showed granulomatous vasculitis. The rash was rapidly controlled with oral corticosteroids. Granulomatous vasculitis has not previously been reported as causing this clinical picture in the absence of concomitant necrobiosis and palisading.

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

    Directory of Open Access Journals (Sweden)

    Gerber Peter

    2012-02-01

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

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

    OpenAIRE

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

    1991-01-01

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

  19. Mineral Spectra from Nili Fossae, Mars

    Science.gov (United States)

    2008-01-01

    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.

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

    Scientific Electronic Library Online (English)

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

    1954-09-01

    Full Text Available 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.

  1. Malignant Fibrous Histiocytoma in the Infratemporal Fossa

    International Nuclear Information System (INIS)

    Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in late adult life, but its incidence in oral and maxillofacial region is extremely rare. We report a case of malignant fibrous histiocytoma which occurred in the infratemporal fossa. Conventional radiograph of this case showed an ill-defined radiolucent lesion in the alveolar bone of the right maxillary first molar area, the lateral wall of the maxillary sinus, and the ascending ramus of mandible. MRI demonstrated well defined mass of intermediate signal intensity in T1 weighted images but T2 weighted images showed two distinctive regions of different characteristics. Infratemporal portion of the lesion was of hyperintense signal but under that region, the signal intensity decreased clearly, which might mean this case composed of two different subtypes, though it couldn't be confirmed by histopathological examination. Biopsy was taken in the only soft tissue of the maxillary posterior alveolar region and confirmed the lesion as the storiform-pleomorphic type of malignant fibrous histiocytoma. Histopathological subtype was well consistent with the relatively aggressive imaging findings of that region. We expect more detailed analysis of the nature of malignant fibrous histiocytoma with improvement of the imaging modality and the identification of the relationship between diagnostic imaging and histopathologic findings.

  2. 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.)

  3. Drug Rash with Eosinophilia and Systemic Symptoms: Two Emergency Department Cases

    Directory of Open Access Journals (Sweden)

    Adam Landman

    2011-05-01

    Full Text Available Drug rash with eosinophilia and systemic symptoms (DRESS is a rare, severe adverse drug event that appears with a generalized rash, fevers, and dysfunction of 1 or more organ systems. We describe 2 patients (1 adult and 1 pediatric seen in the emergency department with DRESS, and review the clinical presentations, potential complications, and management of DRESS. Although rare, it can be associated with significant morbidity, including liver failure and death, and should be considered in the differential diagnosis of patients with diffuse rash and systemic symptoms. [West J Emerg Med. 2011;12(4:559–562.

  4. Fatal intratumoral hemorrhage in posterior fossa tumors following ventriculoperitoneal shunt.

    Science.gov (United States)

    Santhanam, R; Balasubramaniam, Anandh; Chandramouli, B A

    2009-01-01

    We report on two patients with rare major intratumoral hemorrhage following ventriculoperitoneal shunt in posterior fossa tumors. A 28-year-old woman with a midline posterior fossa lesion, whose imaging features suggested a fourth ventricular ependymoma with obstructive hydrocephalus, was subjected to a right ventriculoperitoneal shunt. Her consciousness deteriorated, and she experienced massive intratumoral hemorrhage and later died. An eight-year-old girl presented with raised intracranial pressure and ataxia caused by vermian astrocytoma with obstructive hydrocephalus. She also developed a massive tumor bleed following a ventriculoperitoneal shunt and was subjected to emergency decompression of the tumor with the bleeding. She remained vegetative at discharge and died 18 months later. Intratumoral hemorrhage is a rare but important cause of morbidity and mortality in patients with posterior fossa tumors who undergo ventriculoperitoneal shunt. PMID:19013806

  5. Visual diagnosis: 12-month-old boy with persistent rash and lymphadenopathy.

    Science.gov (United States)

    Sears, William; Hodge, Bethany; Jones, Brooke; Thompson, Matthew; Vidwan, Navjyot

    2014-10-01

    Gianotti-Crosti syndrome (GCS) is a self-limiting, papular or papulovesicular, symmetric, acral exanthem that typically presents subsequent to viral infection, bacterial infection, or immunization in a child 1 to 4 years old. The rash can persist for 2 to 10 weeks. Recent infection with Epstein-Barr virus is the most common serologic finding in patients who have developed GCS. The diagnosis is often made after the child has been unsuccessfully treated for a more common cause of an acral rash (eg, scabies). There are no pathognomonic laboratory or histopathologic findings. GCS, therefore, is still a clinical diagnosis of exclusion. The rash is self-limited, and treatment is usually not necessary. However, topical corticosteroids are anecdotally reported to reduce duration of rash. Oral antihistamines can be used to treat pruritus. Parents should be assured that resolution is almost always complete, scarring seldom occurs, and recurrence is rare. PMID:25274975

  6. A Case of Cerebellar Mutism after Posterior Fossa Surgery

    Directory of Open Access Journals (Sweden)

    I??k GÖRKER

    2012-12-01

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

  7. Allopurinol causing drug rash with eosinophilia and systemic symptoms syndrome: a challenging diagnosis

    OpenAIRE

    Hassan S.; Wetz R; Zouein E

    2011-01-01

    Samer Hassan, Robert Wetz, Elie ZoueinStaten Island University Hospital, New York, NY, USABackground: Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by cutaneous drug eruption, eosinophilia, and systemic symptoms. The syndrome is difficult to diagnose due to its clinical heterogeneity and long latency period(2–6 weeks).Case report: This paper describes a 73-year-old man who presented with a rash that started 1 week prior to his presentation. The ...

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

    OpenAIRE

    Gerber Peter; Meller Stephan; Eames Tatiana; Buhren Bettina; Schrumpf Holger; Hetzer Sonja; Ehmann Laura; Budach Wilfried; Bölke Edwin; Matuschek Christiane; Wollenberg Andreas; Homey Bernhard

    2012-01-01

    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 re...

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

    OpenAIRE

    Kaswala, Dharmesh H.

    2013-01-01

    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 ar...

  10. Drug Rash With Eosinophilia and Systemic Symptoms Syndrome Induced by Chloral Hydrate in Early Childhood

    OpenAIRE

    Yoo, Suk Dong; Kim, Su Gon; Kim, Seong Heon; Kim, Hye-young

    2013-01-01

    Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, also known as drug-induced hypersensitivity syndrome (DIHS), is a rare, acute and severe life-threatening systemic disease. DRESS syndrome is characterized by fever, lymphadenopathy, rash, hypereosinophilia and involvement of systemic organs. The most commonly implicated drugs are anticonvulsants, sulfonamides and allopurinol. Chloral hydrate is a sedative and hypnotic drug frequently used in pediatric patients. We first repo...

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

    OpenAIRE

    Santhamoorthy, Ponnusamy; Alexander, K. John; Alshubaili, Asmahan

    2012-01-01

    A 32 year old Asian female on 300 mg per day of phenytoin following meningioma excision developed a fever with a diffuse maculopapular rash, lymphadenopathy and splenomegaly after12 days. A diagnosis of DRESS (Drug Rash Eosinophilia and Systemic Symptoms) syndrome was made. Patient was started on prednisolone at a dose of 1 mg/kg but since there was further deterioration in her condition, intravenous immunoglobulin was started. Clinical and blood parameters began to improve by the next day wi...

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

    OpenAIRE

    Balamurugesan, Kandan; Viswanathan, Stalin

    2014-01-01

    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 ...

  13. 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)

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

    2008-07-01

    Full Text Available 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.

  14. Transpterygoid Approach to a Dermoid Cyst in Pterygopalatine Fossa

    Scientific Electronic Library Online (English)

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

    2014-01-01

    Full Text Available Objective? To describe a case of dermoid cyst arising from the pterygopalatine fossa and review the literature. Methods? We report a case of a 23-year-old man who suffered a car accident 2 years before otolaryngologic attendance. He had one episode of generalized tonic-clonic seizure and 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.

  15. Prenatal diagnosis of posterior fossa anomalies--an overview.

    Science.gov (United States)

    Novakov-Miki?, Aleksandra; Koprivsek, Katarina; Luci?, Milos; Belopavlovi?, Zoran; Stoji?, Sinisa; Sekuli?, Slobodan

    2009-01-01

    Ultrasonography of the central nervous system is an integral part of a prenatal scan, and the development of imaging technologies has led to better diagnostic possibilities. Posterior fossa anomalies have traditionally been divided into Dandy Walke malformation, Dandy Walker variation and megacisterna magna, but this approach, due to diversity of the extensive number of possible disorders covered by this classification, unables accurate prognosis and therefore adequate counselling. An alternative approach to the classification of posterior fossa anomalies is to divide them into agenesis of the vermis, which could be partial or complete, cerebellar hypoplasia, pontocerebellar hypoplasia and cerebellar atrophy. Different ultrasonographic and magnetic resonance imagining of appearances of the posterior fossa anomalies in prenatal period are discussed in the article, as well as possible syndromes and prognosis of different entities. Diversity of anomalies of the central nervous system, and in particular, subtle differences in prenatal appearances of posterior fossa anomalies, which may have major impact on the prognosis, demand a multidisciplinary approach that encompasses two-dimensional and three-dimensional ultrasound scan, magnetic resonance imaging, infectious diseases and metabolic disorders work-ups as well as individual approach to every case involving of a team of experts in the field of perinatology, radiology, paediatrics, neurology and genetics. PMID:19623847

  16. Unusual tumors of the posterior fossa skull base.

    Science.gov (United States)

    Kumar, Raj; Wani, Abrar Ahad

    2006-05-01

    Five unusual cases of posterior skull base tumors were treated through different skull base approaches. Two or more staged operations were required to achieve total or near-total excision and decompression of two extensive tumors. Total excision of an extensive en plaque meningioma of the foramen magnum that encircled the brain stem and cervical spinal cord could not be achieved through the extreme lateral and suboccipital craniectomy approach. However, the vital structures were decompressed and the patient's postoperative morbidity was acceptable. An extended middle fossa approach was required to excise a hemangiopericytoma of the middle and posterior fossae in a 12-year-old. Extension of the tumor into the posterior fossa precluded a retromastoid approach because the mass draped the lower cranial nerves posteriorly. Two men had undifferentiated adenocarcinomas involving the jugular foramen and middle to posterior fossa, respectively. The origin of one was renal in a 37-year-old man. A 63-year-old man survived 1.5 years after a good decompression of his extensive tumor and irradiation. The histological diagnosis of paraganglioma of the occipital bone was a surprise in a 25-year-old man with pure bony involvement. These cases indicate that the appropriate selection of skull base approaches and their combination can provide the needed access to achieve adequate excision or decompression of masses located in challenging anatomical regions of the skull base. Furthermore, good surgical excision improves palliation in radioresistant metastatic tumors of the skull base. PMID:17077871

  17. Prenatal diagnosis of posterior fossa anomalies: An overview

    Directory of Open Access Journals (Sweden)

    Novakov-Miki? Aleksandra

    2009-01-01

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

  18. Allopurinol causing drug rash with eosinophilia and systemic symptoms syndrome: a challenging diagnosis

    Directory of Open Access Journals (Sweden)

    Hassan S

    2011-11-01

    Full Text Available Samer Hassan, Robert Wetz, Elie ZoueinStaten Island University Hospital, New York, NY, USABackground: Drug rash with eosinophilia and systemic symptoms (DRESS syndrome is characterized by cutaneous drug eruption, eosinophilia, and systemic symptoms. The syndrome is difficult to diagnose due to its clinical heterogeneity and long latency period(2–6 weeks.Case report: This paper describes a 73-year-old man who presented with a rash that started 1 week prior to his presentation. The rash was associated with fever, dyspnea, and cough. He was admitted for pneumonia and started on intravenous antibiotics. After 3 days, he became confused and developed multiorgan dysfunction. Work-up for possible hematologic disorders, autoimmune diseases, and pneumonia was negative. One month prior to the onset of the rash, allopurinol had been prescribed for asymptomatic hyperuricemia. The allopurinol was stopped and corticosteroids were started; 2 days later, the patient became afebrile and the dyspnea resolved. He was diagnosed with DRESS syndrome, which is associated with high mortality.Conclusion: The recent introduction of a drug followed by a rash, multiorgan dysfunction, and eosinophilia should raise the suspicion of DRESS syndrome. Early cessation of the introduced drug is key to survival. Clinicians should be aware of this potential adverse reaction when prescribing any new drug, including allopurinol.Keywords: DRESS syndrome, eosinophilia, drug reaction, allopurinol, multiorgan failure, hyperuricemia

  19. Getting to the bottom of nappy rash. ALSPAC Survey Team. Avon Longitudinal Study of Pregnancy and Childhood.

    OpenAIRE

    Philipp, R.; Hughes, A.; Golding, J.

    1997-01-01

    BACKGROUND: Nappy rash accounts for 20% of dermatology consultations in childhood, but its causes are poorly understood. AIM: To determine the incidence of nappy rash during the first four weeks of life in a geographically defined United Kingdom (UK) population, and to study the factors associated with developing the rash. METHOD: The data are derived from self-completed questionnaires of parents in the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). The response rate to a questi...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-15

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

  1. 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.)

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

    Directory of Open Access Journals (Sweden)

    Dundon Belinda

    2009-07-01

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

  3. Endovascular treatment of anterior cranial fossa dural arteriovenous fistula

    International Nuclear Information System (INIS)

    We describe the technique and results of the endovascular treatment of anterior cranial fossa dural arteriovenous fistulas (DAVF) in four symptomatic patients. Catheterization was via the superior sagittal sinus in two patients and via the ophthalmic artery in two patients. Embolization was performed using detachable platinum coils in the former two patients and a liquid embolic system (Onyx-18, MTI) in the latter. We were able to reach the fistula site and to embolize the arteriovenous shunting zone in all of the patients. The final angiogram showed complete occlusion of the DAVFs, and all patients recovered completely. No complications related to either approach were observed. Endovascular treatment of anterior cranial fossa DAVFs is feasible by either transvenous or transarterial access. (orig.)

  4. Paediatric intra-axial posterior fossa tumours: pictorial review.

    Science.gov (United States)

    Rasalkar, Darshana D; Chu, Winnie Chiu-Wing; Paunipagar, Bhawan K; Cheng, Frankie W T; Li, C K

    2013-01-01

    Paediatric brain tumours commonly arise in the posterior cranial fossa. Early diagnosis is often challenging due to initial non-specific clinical symptoms, especially in very young children. The typical MR features of tumours in this region including medulloblastoma, ependymoma, juvenile pilocytic subtype of cerebellar astrocytoma, brain stem glioma and atypical teratoid-rhabdoid tumour are illustrated. Diffusion-weighted imaging and apparent diffusion coefficient values combined with signal characteristics on conventional MR sequences can usually differentiate low-grade from high-grade tumours. Prompt diagnosis is crucial as total surgical resection, which is only possible in localised disease, improves prognosis. A practical MR flow chart is introduced for differentiating different types of posterior cranial fossa tumours, which might be useful in clinical practice. PMID:22977284

  5. Drug rash with eosinophilia and systemic symptoms syndrome induced by chloral hydrate in early childhood.

    Science.gov (United States)

    Yoo, Suk Dong; Kim, Su Gon; Kim, Seong Heon; Kim, Hye-Young

    2014-05-01

    Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, also known as drug-induced hypersensitivity syndrome (DIHS), is a rare, acute and severe life-threatening systemic disease. DRESS syndrome is characterized by fever, lymphadenopathy, rash, hypereosinophilia and involvement of systemic organs. The most commonly implicated drugs are anticonvulsants, sulfonamides and allopurinol. Chloral hydrate is a sedative and hypnotic drug frequently used in pediatric patients. We first report a case of DRESS syndrome induced by chloral hydrate in a 14-month-old female. PMID:24843805

  6. The treatment of trigeminal neuralgia by posterior fossa microsurgery.

    OpenAIRE

    Adams, C. B.; Kaye, A H; Teddy, P J

    1982-01-01

    Between 1972 and 1981 57 patients underwent posterior fossa exploration in Oxford by a single surgeon for the treatment of trigeminal neuralgia. Fifty-four of these had either partial or total section of the trigeminal sensory root, 2 had microvascular decompression operations and one had both a partial sensory root section and microvascular decompression. There was no mortality and no significant morbidity. Fifty-four patients were followed up for a mean period of 4 . 5 years. Fifty-two pati...

  7. Imaging in neurenteric cysts of the posterior cranial fossa

    International Nuclear Information System (INIS)

    Neurenteric cysts are cystic masses lined by a columnar epithelium of endodermal origin. They are rare in the central nervous system. We report two neurenteric cysts in the posterior cranial fossa and describe their neuroradiological features. The lesions were of low density on CT and more accurately delineated on MRI. They gave the same signal as cerebrospinal fluid on all sequences. There was no contrast enhancement. (orig.)

  8. Endoscopic Removal of a Bullet Penetrating the Middle Cranial Fossa

    OpenAIRE

    Hatch, Neal U.; Riley, Kristen O.; Woodworth, Bradford A.

    2011-01-01

    Reports of intracranial retained foreign bodies are relatively rare in the literature. Such objects can cause numerous complications requiring removal, such as infection, persistent cerebrospinal fluid (CSF) leak, or new-onset seizures. The transnasal endoscopic approach provides an excellent alternative to craniotomy for repairing middle cranial fossa (MCF) defects. We describe a case of a 57-year-old woman with a self-inflicted bullet piercing the MCF, creating a persistent CSF leak. The de...

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

    OpenAIRE

    Dundon Belinda; Schopflocher Donald; Newburn-Cook Christine V; Neufeld Susan M; Yu Herta; Drummond Jane E

    2009-01-01

    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 qu...

  10. CT and MRI diagnosis of posterior fossa atypical ependymoma

    International Nuclear Information System (INIS)

    Objective: To analyse the CT and MRI features of posterior fossa atypical ependymoma. Methods: Sixteen cases of posterior fossa atypical ependymoma proved by surgery and pathology had CT and (or) MRI scanning. There were 11 males and 5 females. The age ranged from 17 to 46 (mean, 31.2). Twelve cases ranged from 20 to 40 years old. the main symptoms of all cases were dizziness, unsteady walking and vomiting. Results: The locations of all cases were cerebellum (12 cases), vermis (3 cases) and cerebellopontile angle (1 cases). Fifteen cases were solid with multiple cystic changes and 1 case in the cerebellopontile angle was cystic. The tumor was usually close to the surface of cerebellum with rather extensive connection with dura mater or tentorium. Calcifications were shown in 3 cases. The tumors revealed inhomogeneous density on CT scan and inhomogeneous intensity on MRI. Mild inhomogeneous enhancement was shown in most cases, while intense irregular enhancement in the others. Conclusions: The characteristic findings of the posterior fossa atypical ependymoma ependymoma were cerebellar intraparenchymatous multiple small cystic changes within solid tumor in most cases and inhomogeneous density and intensity on CT and MRI. The differential diagnosis is meningioma, metastasis and acoustic schwannoma

  11. A dorsally located giant posterior fossa neurenteric cyst in a Chinese woman.

    Science.gov (United States)

    Gu, Jianwen; Yang, Tao; Xing, Xuemin; Kuang, Yongqin; Cheng, Gangge; Zhang, Junhai; Huang, Yongan; Zhang, Baoguo; Dong, Lianqiang; Mao, Qinwen

    2015-05-01

    Neurenteric cysts (NC) are rare, endodermal-derived intracranial lesions, commonly located anteriorly in the posterior cranial fossa. We describe a rare case of a giant posterior fossa NC (6.5×5.9×4.3cm) located dorsal to the brain stem in a Chinese woman with a 1week history of cerebellar symptoms. To our knowledge, this is the largest documented cyst of this type and the third dorsally located NC in the posterior fossa. PMID:25800145

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

    Directory of Open Access Journals (Sweden)

    Görkem Müftüo?lu

    2012-10-01

    Full Text Available

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

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

  13. Varicella Zoster Virus Pneumonitis and Brainstem Encephalitis Without Skin Rash in an Immunocompetent Adult

    Science.gov (United States)

    Nandhagopal, Ramachandiran; Khmeleva, Nelly; Jayakrishnan, B.; White, Teresa; Al Azri, Faisal; George, Jojy; Heintzman, Anna; Al Zeedy, Khalfan; Rorke-Adams, Lucy; Gujjar, Arunodaya R.; Schmid, D. Scott; Al-Asmi, Abdullah; Nagel, Maria A.; Jacob, Poovathoor Chacko; Gilden, Don

    2014-01-01

    Varicella zoster virus (VZV) pneumonitis and brainstem encephalitis developed in an immunocompetent adult without rash. Chest computed tomography exhibited nodularity; lung biopsy revealed multinucleated giant cells, Cowdry A inclusions, VZV antigen, and DNA. Varicella zoster virus central nervous system disease was verified by cerebrospinal fluid (CSF) anti-VZV IgG antibody with reduced serum/CSF ratios. PMID:25734134

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

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    Tunthanathip Preecha

    2009-10-01

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

  15. Unusual CT features of dermoid cyst in the posterior fossa

    International Nuclear Information System (INIS)

    A dermoid cyst of the posterior fossa in a 73-year-old man is reported. The presentation of the cyst was unusual because of the age of the patient, the spontaneously hyperdense aspect of the mass on CT, the partial rim enhancement of the lesion, and the presence of perilesional edema. On pathologic examination, the cyst contained small amount of fat, hairs, necrosis, and small areas of hemorrhage. The amount of hemorrhage found could not explain the spontaneous hyperdensity of the lesion found on CT. The hyperdensity may be related to high protein content of the lesion. (orig.)

  16. CT findings of hydatid cyst with unusual location: infratemporal fossa

    International Nuclear Information System (INIS)

    Hydatid disease has a high incidence in the countries of the temperate zones such as Turkey. Only few cases in the head and neck region have been reported in the literature. Our case, an unusual localization of hydatidosis, i. e. hydatid disease of the infratemporal fossa of a 9-year-old male patient suffering from a swelling of the left maxillary region which was diagnosed by CT, is presented. The lesion visualized on CT images was compressing the neighbouring structures. The possible diagnosis was made based on the images obtained from CT examination. (orig.)

  17. Resection in the popliteal fossa for metastatic melanoma

    OpenAIRE

    Botti Gerardo; Chiofalo Maria; Caracò Corrado; Marone Ugo; Mozzillo Nicola

    2007-01-01

    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, whic...

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

    International Nuclear Information System (INIS)

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

  19. Improved visualization of posterior fossa with clivoaxial CT scanning plane

    International Nuclear Information System (INIS)

    Eighteen patients clinically suspected of having acoustic neurinoma were studied in both orbitomeatal and clivoaxial (CA) (the plane perpendicular to clivus) CT scanning planes during the same sessions. On the CA cuts there were highly significantly less (p<0.001) artifacts. Also, the tentorium was highly significantly (p<0.001) better visualized on the CA cuts. CA cuts could be recommended in cases when artifacts disturb the diagnostics of posterior fossa pathology or when detailed topographic information about pathologic anatomy round the tentorium is needed. (orig.)

  20. Extracranial propagation of glioblastoma with extension to pterygomaxillar fossa

    Directory of Open Access Journals (Sweden)

    Grahovac Gordan

    2011-05-01

    Full Text Available Abstract Background Glioblastoma multiforme is a highly malignant primary brain tumor that shows marked local aggressiveness, but extracranial spread is not a common occurrence. We present an unusual case of recurrent glioblastoma in 54-year old male that spread through the scull base to the ethmoid and sphenoid sinuses, to the orbita, pterygomaxillar fossa, and to the neck. Methods A 54-year old male underwent left temporal resection because of brain tumor of his left temporal lobe. Operation was followed by external beam radiation combined with temozolomide. The tumor recurred eight months after first surgery. The patient developed swelling of left temporal region, difficult swallowing and headache. MRI of head showed recurrent tumor, which invaded orbita, ethmoid and sphenoid sinuses, nasal cavity, pterygomaxillar fossa. Results The patient died ten months after initial diagnosis of glioblastoma multiforme, and two months after his second operation. Conclusions The aggressive surgical operation helped to downsize the tumor mass as much as possible, but did not prolonged significantly the life or improved the life quality of the patient. The current literature is reviewed, and the diagnostic approaches as well as therapeutic options are discussed.

  1. Resection in the popliteal fossa for metastatic melanoma

    Directory of Open Access Journals (Sweden)

    Botti Gerardo

    2007-01-01

    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.

  2. Ependymomas of the posterior cranial fossa: CT and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Tortori-Donati, P. [Dept. of Neuroradiology, Children`s Hospital ``Giannina Gaslini``, Genoa (Italy); Fondelli, M.P. [Dept. of Neuroradiology, Children`s Hospital ``Giannina Gaslini``, Genoa (Italy); Cama, A. [Dept. of Neurosurgery, Children`s Hospital ``Giannina Gaslini``, Genoa (Italy); Garre, M.L. [Dept. of Neurooncology, Children`s Hospital ``Giannina Gaslini``, Genoa (Italy); Rossi, A. [Dept. of Neuroradiology, Children`s Hospital ``Giannina Gaslini``, Genoa (Italy); Andreussi, L. [Dept. of Neurosurgery, Children`s Hospital ``Giannina Gaslini``, Genoa (Italy)

    1995-04-01

    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.)

  3. 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.)

  4. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

  6. Carcinogenicity evaluation for the application of carbon nanotubes as biomaterials in rasH2 mice

    Science.gov (United States)

    Takanashi, Seiji; Hara, Kazuo; Aoki, Kaoru; Usui, Yuki; Shimizu, Masayuki; Haniu, Hisao; Ogihara, Nobuhide; Ishigaki, Norio; Nakamura, Koichi; Okamoto, Masanori; Kobayashi, Shinsuke; Kato, Hiroyuki; Sano, Kenji; Nishimura, Naoyuki; Tsutsumi, Hideki; Machida, Kazuhiko; Saito, Naoto

    2012-07-01

    The application of carbon nanotubes (CNTs) as biomaterials is of wide interest, and studies examining their application in medicine have had considerable significance. Biological safety is the most important factor when considering the clinical application of CNTs as biomaterials, and various toxicity evaluations are required. Among these evaluations, carcinogenicity should be examined with the highest priority; however, no report using transgenic mice to evaluate the carcinogenicity of CNTs has been published to date. Here, we performed a carcinogenicity test by implanting multi-walled CNTs (MWCNTs) into the subcutaneous tissue of rasH2 mice, using the carbon black present in black tattoo ink as a reference material for safety. The rasH2 mice did not develop neoplasms after being injected with MWCNTs; instead, MWCNTs showed lower carcinogenicity than carbon black. Such evaluations should facilitate the clinical application and development of CNTs for use in important medical fields.

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

    OpenAIRE

    Mittal, A; Das, S.

    2012-01-01

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

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

    OpenAIRE

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

    2004-01-01

    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...

  9. An unusual presentation of acute brucellosis with thrombocytopenia and maculopapular rash

    OpenAIRE

    O Alici, B. Kasapoglu

    2007-01-01

    Human brucellosis is common in developing countries and a multi-system disease with a broad spectrum of clinical manifestations. Cutaneous lesions associated with brucellosis have been rarely reported in the world literature. Here we present the case of a 69-year-old woman with history of consumption of cheese made from raw milk seen with occurrence of thrombocytopenia and diffuse maculopapular rash during the course of Brucella infection. Physical examination showed a pruritic maculopapular ...

  10. Drug rash with eosinophilia and systemic symptoms syndrome following cholestatic hepatitis A: a case report

    OpenAIRE

    An, Jihyun; Lee, Joo Ho; Lee, Hyojeong; Yu, Eunsil; Lee, Dan Bi; Shim, Ju Hyun; Yoon, Sunyoung; Lee, Yumi; Park, Soeun; Lee, Han Chu

    2012-01-01

    Hepatitis A virus (HAV) infections occur predominantly in children, and are usually self-limiting. However, 75-95% of the infections in adults are symptomatic (mostly with jaundice), with the illness symptoms usually persisting for a few weeks. Atypical manifestations include relapsing hepatitis, prolonged cholestasis, and complications involving renal injury. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, drug-induced hypersensitivity reaction characterized b...

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

    Directory of Open Access Journals (Sweden)

    Eduardo Cambruzzi

    2011-02-01

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

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

    Scientific Electronic Library Online (English)

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

    2011-02-01

    Full Text Available 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.

  13. Southern Tick-Associated Rash Illness (STARI) in the North: STARI following a tick bite in Long Island, New York.

    Science.gov (United States)

    Feder, Henry M; Hoss, Diane M; Zemel, Lawrence; Telford, Sam R; Dias, Feliciano; Wormser, Gary P

    2011-11-01

    The most common clinical manifestation of Lyme disease is the characteristic rash, erythema migrans (EM). In the 1980s EM-like eruptions were reported in Missouri and other southeastern states. The EM-like eruptions, which were of unknown etiology, often followed the bite of the Lone Star tick (Amblyomma americanum) and the rash is called STARI (southern tick-associated rash illness). Although the Lone Star tick is found in the Lyme disease-endemic areas of New England and Mid-Atlantic regions of the United States, STARI has been reported only once from the Northeast and Mid-Atlantic regions. We report a child from Connecticut who visited Long Island, New York, and developed a rash that was thought to be EM. Because the patient failed to respond to antibiotics used to treat Lyme disease, an investigation ensued, and the diagnosis of STARI was established. PMID:21940418

  14. Liver transplantation in a child with acute liver failure resulting from drug rash with eosinophilia and systemic symptoms syndrome

    OpenAIRE

    Seung Min Song; Min Sung Cho; Seak Hee Oh; Kyung Mo Kim; Young Seo Park; Dae Yeon Kim; Sung Gyu Lee

    2013-01-01

    Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by a severe idiosyncratic reaction including rash and fever, often with associated hepatitis, arthralgias, lymph-node enlargement, or hematologic abnormalities. The mortality rate is approximately 10%, primarily owing to liver failure with massive or multiple disseminated focal necrosis. Here, we report a case of a 14-year-old girl treated with vancomycin because of a wound infection by methicillin-resista...

  15. Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Induced by Celecoxib and Anti-tuberculosis Drugs

    OpenAIRE

    Lee, Joo Ho; Park, Hye-kyung; Heo, Jeong; Kim, Tae Oh; Kim, Gwang Ha; Kang, Dae Hwan; Song, Geun Am; Cho, Mong; Kim, Dae Sung; Kim, Hwal Woong; Lee, Chang Hun

    2008-01-01

    Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome reflects a serious hypersensitivity reaction to drugs, characterized by skin rash, fever, lymph node enlargement, and internal organ involvement. So far, numerous drugs such as sulfonamides, phenobarbital, sulfasalazine, carbamazepine, and phenytoin have been reported to cause the DRESS syndrome. We report a case in a 29-yr-old female patient who had been on celecoxib and anti-tuberculosis drugs for one month to treat knee joi...

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

    Science.gov (United States)

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

    2015-01-01

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

  17. 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)

    Mansour Nassir

    2009-09-01

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

  18. 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.)

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

    International Nuclear Information System (INIS)

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

  20. Hairy Polyp of the Supratonsillar Fossa Causing Intermittent Airway Obstruction

    Scientific Electronic Library Online (English)

    Onur, & #304; smi; Kemal, Görür; Rabia Bozdo& #287; an, Arpac& #305; ; Yusuf, Vayisoglu; Cengiz, Özcan.

    2015-03-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-06-15

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

  2. Rosette-forming glioneuronal tumors of the posterior fossa.

    Science.gov (United States)

    Shah, Manish N; Leonard, Jeffrey R; Perry, Arie

    2010-01-01

    Rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle is a rare, recently described WHO Grade I neoplasm. The authors report 6 examples of RGNT arising primarily from the cerebellar vermis. All the patients were female, and the mean age of presentation was 24.8 years. The original diagnoses included pilocytic astrocytoma, ependymoma, cerebellar dysembryoplastic neuroepithelial tumor (DNT), and oligodendroglioma. The cases showed classic pathological characteristics, although in 2 cases the lesions included DNT-like "floating neurons" involving Purkinje cells, a feature which has not been previously reported to the authors' knowledge. The clinical outcome was excellent with no recurrences after complete resection. These cases expand the known clinical and histological spectrum of this rare tumor type. Given the lack of fourth ventricle involvement in most of these cases, the authors suggest revising the name to RGNT of the posterior fossa. PMID:20043744

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

    Directory of Open Access Journals (Sweden)

    Ivanovi? S.

    2004-01-01

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

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

    Science.gov (United States)

    Kaswala, Dharmesh H

    2013-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Vatve Maneesha

    2000-01-01

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

  6. Malar rash in a painting by Jean-Baptiste Siméon Chardin (1699-1779

    Directory of Open Access Journals (Sweden)

    M. Vicarioto

    2011-09-01

    Full Text Available In the present report we describe a typical malar rash, as painted by Jean-Baptiste Siméon Chardin (1699-1779, French painter, one of the greatest of the 18th century, on the face of a child in “Le Bénédicité” (Hermitage, St. Petersburg. Three versions of this theme were more completed by Chardin, in various times of his life, but the malar eruption can be seen solely on the painting at the Hermitage. In the attempt to clarify, on a diagnostic ground, such a cutaneous abnormality, the relationships between systemic lupus erythematosus and parvovirus B19 infection, i.e. the causative agent of fifth disease, are briefly discussed.

  7. A papulopustular, vesicular, crusted rash in a 4-week-old neonate.

    Science.gov (United States)

    Subramaniam, Sathyaseelan; Rutman, Maia S; Wenger, Jodi K

    2013-11-01

    Scabies is commonly seen worldwide, in its usual classic form when afflicting older children and adults. However, neonatal scabies is described as its own entity in the literature. We present a case of a 4-week-old infant with a generalized papulopustular, vesicular, and crusted rash who was diagnosed with scabies. We contrast the differing clinical features of neonatal and classic scabies, describe possible mimickers of this diagnostic dilemma, and review current treatment options available for scabies in this very young age group. PMID:24196092

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

    Directory of Open Access Journals (Sweden)

    Hayati KANDIS

    2009-01-01

    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.

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

    OpenAIRE

    Gulsen, Salih; Sonmez, Erkin; Cem YILMAZ; Nur ALTINORS

    2009-01-01

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

  10. CT and MRI diagnosis of tumor originating in the pterygopalatine fossa

    International Nuclear Information System (INIS)

    Objective: To investigate the CT and MRI findings of tumors originating in the pterygopalatine fossa so as to promote the diagnostic accuracy. Methods: All 11 patients with tumors arising from the pterygopalatine fossa were confirmed by pathology and surgery. CT and MRI appearances were analyzed retrospectively. Results: The tumors included 3 neurilemmomas, 2 neurofibromas, 3 angiofibromas, 2 adenoid cystic carcinomas, and 1 melanoma, and they all extended through communicating pathways of the pterygopalatine fossa. On HRCT, neurogenic tumors caused enlargement of the pterygopalatine fossa with thinning of their bony walls, while MRI demonstrated isointense signal to brain on T1WI and hyperintense signal on T2WI. Two neurofibromas showed homogeneous enhancement after administration of contrast medium while 3 neurilemmomas showed heterogeneous enhancement. On HRCT scans, angiofibroma caused enlargement of the pterygopalatine fossa, eroding their bony walls. On MR imaging, the lesions were isointense compared to muscle on T1WI, hyperintense on T2WI with marked postcontrast enhancement. One case of angiofibroma showed scattered stippling or stria-shaped signal voids and inhomogeneous postcontrast enhancement. On CT scans, adenoid cystic carcinoma revealed moth-eaten bony wall of the pterygopalatine fossa with poorly defined margins and irregular shapes. Adenoid cystic carcinoma showed hypointense signal compared to muscle on T1WI, inhomogeneous hyperintense signal on T2WI and heterogeneous postcontrast enhancement. One case of melanoma showed enlargement of pterygopalatine fossa and destruction of the bony walls except for the anterior wall by invading adjacent structures with well-defined border and irregular shape. On MR imaging, the lesion showed isointense signal compared to muscle on T1WI and hyperintense signal on T2WI with discrete mottled or linear signal voids and inhomogeneous postcontrast enhancement. Conclusion: HRCT can depict bony changes clearly and MRI can demonstrate optimally the extent of the lesion in pterygopalatine fossa. Both imaging modalities can contribute to the diagnosis of neurogenic tumor and angiofibroma and can provide information for therapeutic procedure and surgical planning

  11. The Microscopic Surgical Treatment for Tumor of Posterior Cranial Fossa in Children

    OpenAIRE

    Chen, Duo; Xiangtai WEI; Yin, Qiang

    2009-01-01

    OBJECTIVE To analyze and discuss about the clinical characteristics, pathological types, surgical modalities and techniques, and postoperative complications in children with tumor of posterior cranial fossa .METHODS Retrospective study was conducted on 102 cases of pediatric tumor of posterior cranial fossa, admi? ed and treated in our hospital during the period of January 1996 to January 2007. All patients underwent microscopic surgical treatment. Fifty-eight were male and 44 cases wer...

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

    OpenAIRE

    Sunil Kumar M, Mohan

    2014-01-01

    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...

  13. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-01

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

  15. 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

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

    LENUS (Irish Health Repository)

    McCartan, D P

    2012-01-31

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

  17. Microsurgical Anatomy for Lateral Approaches to the Foramen Magnum with Special Reference to Transcondylar Fossa (Supracondylar Transjugular Tubercle) Approach

    OpenAIRE

    Matsushima, Toshio; Natori, Yoshihiro; Katsuta, Toshiro; Ikezaki, Kiyonobu; Fukui, Masashi; Rhoton, Albert L.

    1998-01-01

    Microsurgical anatomy for lateral approaches to the foramen magnum, especially for transcondylar fossa (supracondylar transjugular tubercle) approach, was studied using cadavers. The transcondylar fossa approach is an approach in which extradural removal of the posterior portion of the jugular tubercle through the condylar fossa is added to the far lateral approach. Some differences between this approach and the transcondylar approach are demonstrated. The atlanto-occipital joint and the jugu...

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

    Science.gov (United States)

    Flower, Cindy; Gaskin, David; Marquez, Sean

    2007-06-01

    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

  19. 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

  20. 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

    Scientific Electronic Library Online (English)

    André Luis, Selmi; João Guilherme, Padilha Filho; Bruno Testoni, Lins; Andrigo Barboza, De Nardi; Bianca Mota, Penteado.

    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 troc [...] lear (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. Abstract in english 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.

  1. 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

    Directory of Open Access Journals (Sweden)

    André Luis Selmi

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gómez-González JL

    2012-07-01

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

  3. Rash with DERMABOND PRINEO Skin Closure System Use in Bilateral Reduction Mammoplasty: A Case Series.

    Science.gov (United States)

    Knackstedt, R W; Dixon, J A; O'Neill, P J; Herrera, F A

    2015-01-01

    Background. Bilateral reduction mammoplasty is a common plastic surgery procedure that can be complicated by unfavorable scar formation along incision sites. Surgical adhesives can be utilized as an alternative or as an adjunct to conventional suture closures to help achieve good wound tension and provide an adequate barrier with excellent cosmesis. The recently introduced DERMABOND PRINEO Skin Closure System Skin Closure System combines the skin adhesive 2-octyl cyanoacrylate with a self-adhering polyester-based mesh. Proposed benefits of wound closure with DERMABOND PRINEO Skin Closure System, used with or without sutures, include its watertight seal, easy removal, microbial barrier, even distribution of tension, and reduction in wound closure time. Although allergic reactions to 2-octyl cyanoacrylate have been reported, few allergic reactions to DERMABOND PRINEO Skin Closure System have been noted in the literature. This case series describes three patients who experienced an allergic reaction to DERMABOND PRINEO Skin Closure System after undergoing elective bilateral reduction mammoplasties at our institution to further explore this topic. Methods. Retrospective chart review of bilateral reduction mammoplasty patients who received DERMABOND PRINEO Skin Closure System dressing at our institution was performed. Results. Three patients were identified as having a rash in reaction to DERMABOND PRINEO Skin Closure System after bilateral reduction mammoplasty. All three patients required systemic steroid treatment to resolve the rash. One patient was identified as having a prior adhesive reaction. Conclusions. DERMABOND PRINEO Skin Closure System has demonstrated its efficacy in optimizing scar healing and appearance. However, as we demonstrate these three allergic reactions to DERMABOND PRINEO Skin Closure System, caution must be utilized in its usage, namely, in patients with a prior adhesive allergy and in sites where moisture or friction may be apparent. PMID:25922607

  4. '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

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

    Directory of Open Access Journals (Sweden)

    Abdel-Aziz Mosaad

    2012-06-01

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

  6. Clinical analysis of surgical treatment of traumatic hematomas of the posterior cranial fossa

    International Nuclear Information System (INIS)

    Objective: To discuss the clinical features and surgical outcome of the traumatic hematomas posterior cranial fossa. Methods: Fifteen patients with traumatic hematomas posterior cranial fossa in authors' hospital during the period from 1995 to 1998 were reviewed. Results: Thirteen patients had an occipital skull fracture, 11 pure epidural hematomas among whom 4 had cerebellar contusion and hematomas 4 posterior cranial fossa hematoma with associated cerebral hematoma or contusion, and 5 acute hydrocephalus. Fifteen patients were treated by emergency surgery, 9 had good recovery and 1 had severe disability in GCS between 9 and 15 marking, 1 had good recovery, 1 had severe disability and 3 died in GCS between 3 and 8. Nine patients had good recovery in 11 patient having pure epidural hematoma of posterior cranial fossa. Conclusions: The clinical course of the traumatic hematomas posterior cranial fossa was acute and severe. The GCS value below 9 predicts the poor out-come for patients. Early diagnosis and appropriately and promptly treatment are crucial for achieving good results

  7. Radiographic and computed tomographic evaluation of the canine intercondylar fossa in normal stifles and after notchplasty in stable and unstable stifles

    International Nuclear Information System (INIS)

    The role of the intercondylar fossa in cranial cruciate ligament injury has gained notable attention in humans and it's role is now being questioned in animals. Controversy exists regarding the accuracy of radiographs and computed tomography (CT) in evaluating the intercondylar fossa. This study compared radiographic and CT evaluation with gross evaluation of the intercondylar fossa. Six greyhounds were evaluated before notchplasty, immediately after notchplasty and 6 months after notchplasty in stable and unstable stifles. A fossa width index was used for comparison because it negates the effects of patient size and radiographic magnification. The fossa width index is calculated by dividing the width of the intercondylar fossa by the total condylar width. The fossa width indices of dogs determined from radiographs and CT were not significantly different before notchplasty except for the cranial fossa width indices which were more inconsistent and tended to underestimate the size when compared to gross measurements. At six months, both stable and unstable stifles had refilling of the notchplasty, but the unstable stifles had significantly greater refilling resulting in no significant enlargement in intercondylar fossa size as compared to the prenotchplasty size. Osteophytes that occurred within the intercondylar fossa were less radiopaque and more easily visualized by computed tomography. Computed tomography provided several advantages, including clearer visualization of the intercondylar fossa, avoiding superimposition of the intercondylar fossa by caudal thigh muscles or tuber ischii and the ability to analyze the cranial and caudal components of the intercondylar fossa separately

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

    CERN Document Server

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

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

    2014-03-01

    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.

  10. Primitive neuroectodermal tumors in the posterior fossa: excluding medulloblastoma based on pathology

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Kyung Jin; Kim, Tae Hun; Kim, Yong Joo; Kang, Duk Sik; Shon, Youn Kyung [College of Medicine, Kyungpook National University, Daegu (Korea, Republic of); Kim, Sun Young [College of Medicine, Youngnam University, Daegu (Korea, Republic of)

    1992-01-15

    Four children, with histopathologically confirmed posterior fossa primitive neuroectodermal tumors, were examined by plain radiography, computed tomography (CT) and cerebral angiography. The homogeneously well enhanced solid mass in the midline of the posterior fossa and hydrocephalus of various degree were seen on all CT scans. One case had calcifications and another case had low density areas in the tumor mass. Three cerebral angiograms showed vascular displacement without tumor vascularities. Unfortunately, these CT and angiography findings are not specific for primitive neuroectodermal tumors, as similar findings are seen in medulloblastoma, ependymoma and other tumors. Therefore, we think that the primitive neuroectodermal tumors should be included in the differential diagnosis when a well enhanced solid mass in the midline posterior fossa is seen on CT scan in children.

  11. Primitive neuroectodermal tumors in the posterior fossa: excluding medulloblastoma based on pathology

    International Nuclear Information System (INIS)

    Four children, with histopathologically confirmed posterior fossa primitive neuroectodermal tumors, were examined by plain radiography, computed tomography (CT) and cerebral angiography. The homogeneously well enhanced solid mass in the midline of the posterior fossa and hydrocephalus of various degree were seen on all CT scans. One case had calcifications and another case had low density areas in the tumor mass. Three cerebral angiograms showed vascular displacement without tumor vascularities. Unfortunately, these CT and angiography findings are not specific for primitive neuroectodermal tumors, as similar findings are seen in medulloblastoma, ependymoma and other tumors. Therefore, we think that the primitive neuroectodermal tumors should be included in the differential diagnosis when a well enhanced solid mass in the midline posterior fossa is seen on CT scan in children

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

    International Nuclear Information System (INIS)

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

  13. Venous hemodynamics of arteriovenous meningeal fistulas in the posterior cranial fossa

    Energy Technology Data Exchange (ETDEWEB)

    Brainin, M.; Samec, P.

    1983-06-01

    The etiology of arteriovenous meningeal fistulas (AVMFs) of the posterior fossa often remains unclear. Analyses of three personal cases, however, suggest a change in venous hemodynamics due to a primary lesion, the cases being of sinus thrombosis, intracerebral abcess with oedema and arteriovenous malformation. It is suggested that increase of venous pressure in the posterior fossa leads to increased drainage and, consequently, to dilatation of infratentorial veins and of meningeal branches of the external carotid and vertebral artery. Clinical findings and anatomical facts underlying AVMF lesions tend to confirm the view that the concept of a congenital malformation decompensating with age cannot be upheld for all AVMFs, especially when located in the posterior fossa and when clinical symptoms arise in middle age. It is proposed that a pressure activated mechanism of growth results in widening of normally insignificantly small dural vessels.

  14. 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)

    OpenAIRE

    Jatoi, Aminah; 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

    This study assessed whether sunscreen prevents or mitigates rashes in patients prescribed epidermal growth factor receptor inhibitors, and found that sunscreen as prescribed in the study did not prevent or attenuate these rashes.

  15. Incisive Fossa Case Report / Fosa Incisiva - Reporte de un Caso

    Scientific Electronic Library Online (English)

    Nilton, Alves.

    2010-09-01

    Full Text Available La importancia de los conocimientos de anatomía radiográfica en la interpretación de las patologías es innegable. La base de este conocimiento es familiarizarse con la anatomía de la región que va a ser evaluada. Por tanto, es importante reconocer lo que se considera normal, así como las variaciones [...] anatómicas y, de esta manera, identificar lo que es patológico. En este caso clínico, se describe un hallazgo radiológico en un paciente leucodérmico, de 13 años y un mes de edad, quiense realizó, para la evaluación de los terceros molares, una radiografía panorámica en una clínica privada en São Paulo - Brasil. Durante la lectura radiológica, se pudo observar en la región entre las raíces de los dientes incisivos laterales y caninos superiores una zona radiolúcida bilateral con una forma de lágrima invertida. Aunque era una imagen que sugería rarefacción ósea, la integridad de la lámina dura se hizo evidente en ambos lados. Durante la exploración clínica del paciente, no se observó una asimetría bilateral, así como cualquier tipo de sintomatología. En este caso, de acuerdo con los hallazgos clínicos y radiográficos, se concluye que el diagnóstico es la presencia de una fosa incisiva bilateral. Abstract in english The importance of the radiographic anatomy knowledge in the interpretation of the pathologies is undeniable. The base of this knowledge is a great familiarity with the anatomy of the region that is going to be evaluated. Thus, it is important to recognize what is considered normal, as well as the an [...] atomical variations, so that one can identify what is pathologic. In this case report we describe a radiographic finding in leucoderm patient, 13 years old and one month, submitted to a panoramic radiography in a private clinic in São Paulo - Brazil, for evaluation of the third molars. During the radiographic reading, a bilateral radiolucid area with an inverted tear shape could be observed in the region between the roots of the lateral incisive teeth and upper canines. Although it was an image that suggested bone rarefaction, the integrity of the hard lamina was evident in both sides. During the patient's clinical examination, a bilateral asymmetry was not observed, as well as any kind of sintomatology. In our case report, according to the clinical and radiographic findings, we conclude that the diagnosis was bilateral incisive fossa.

  16. Incisive Fossa Case Report Fosa Incisiva - Reporte de un Caso

    Directory of Open Access Journals (Sweden)

    Nilton Alves

    2010-09-01

    Full Text Available The importance of the radiographic anatomy knowledge in the interpretation of the pathologies is undeniable. The base of this knowledge is a great familiarity with the anatomy of the region that is going to be evaluated. Thus, it is important to recognize what is considered normal, as well as the anatomical variations, so that one can identify what is pathologic. In this case report we describe a radiographic finding in leucoderm patient, 13 years old and one month, submitted to a panoramic radiography in a private clinic in São Paulo - Brazil, for evaluation of the third molars. During the radiographic reading, a bilateral radiolucid area with an inverted tear shape could be observed in the region between the roots of the lateral incisive teeth and upper canines. Although it was an image that suggested bone rarefaction, the integrity of the hard lamina was evident in both sides. During the patient's clinical examination, a bilateral asymmetry was not observed, as well as any kind of sintomatology. In our case report, according to the clinical and radiographic findings, we conclude that the diagnosis was bilateral incisive fossa.La importancia de los conocimientos de anatomía radiográfica en la interpretación de las patologías es innegable. La base de este conocimiento es familiarizarse con la anatomía de la región que va a ser evaluada. Por tanto, es importante reconocer lo que se considera normal, así como las variaciones anatómicas y, de esta manera, identificar lo que es patológico. En este caso clínico, se describe un hallazgo radiológico en un paciente leucodérmico, de 13 años y un mes de edad, quiense realizó, para la evaluación de los terceros molares, una radiografía panorámica en una clínica privada en São Paulo - Brasil. Durante la lectura radiológica, se pudo observar en la región entre las raíces de los dientes incisivos laterales y caninos superiores una zona radiolúcida bilateral con una forma de lágrima invertida. Aunque era una imagen que sugería rarefacción ósea, la integridad de la lámina dura se hizo evidente en ambos lados. Durante la exploración clínica del paciente, no se observó una asimetría bilateral, así como cualquier tipo de sintomatología. En este caso, de acuerdo con los hallazgos clínicos y radiográficos, se concluye que el diagnóstico es la presencia de una fosa incisiva bilateral.

  17. The purpose of this study is to determine the clinical usefulness of Valsalva maneuver (VM) to evaluate piriform-fossae lesions on helical CT

    International Nuclear Information System (INIS)

    Forty-four patients who were suspected hypopharyngeal carcinoma underwent both conventional CT under quiet breath holding and helical CT under Valsalva maneuver (VMCT). All patients successfully performed Valsalva maneuver during image acquisition. Normal piriform fossae were dilated well under VM. Five fossae involved by hypopharyngeal carcinoma were poorly dilated on VMCT. In conclusion VMCT is a supportive method to evaluate piriform fossae. If piriform fossae lesions were suspected on conventional CT, VMCT should be performed. (author)

  18. 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.)

  19. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-08-01

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

  1. Osteoma of anterior cranial fossa complicated by intracranial mucocele with emphasis on its radiological diagnosis

    OpenAIRE

    Ye Jinhu; Sun Hui; Li Xin de; Dai Jianping

    2008-01-01

    We present a 43-year-old female patient who had recurrent headache for one year. An intracranial bony lesion surrounded by a cyst in the anterior cranial fossa was found on imaging. Postoperative histological examination confirmed the diagnosis of osteoma and mucocele.

  2. Osteoma of anterior cranial fossa complicated by intracranial mucocele with emphasis on its radiological diagnosis

    Directory of Open Access Journals (Sweden)

    Ye Jinhu

    2008-01-01

    Full Text Available We present a 43-year-old female patient who had recurrent headache for one year. An intracranial bony lesion surrounded by a cyst in the anterior cranial fossa was found on imaging. Postoperative histological examination confirmed the diagnosis of osteoma and mucocele.

  3. Large-cell lymphoma of the infratemporal fossa presenting as myofacial pain.

    Science.gov (United States)

    Schreiber, A; Kinney, L A; Salman, R

    1991-01-01

    Patients with temporomandibular joint or myofascial pain are often subjected to rigid protocols of diagnosis and treatment. This tendency to generalize patient care can result in overlooking occult pathology. A case of large-cell lymphoma of the infratemporal fossa causing facial pain is presented. PMID:1814971

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

    International Nuclear Information System (INIS)

    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

  5. Teratoma of the posterior fossa CT and MR aspects A case

    International Nuclear Information System (INIS)

    The CT and MR findings are reported for a patient diagnosed as having teratoma of the posterior fossa with onset in the form of intracranial hypertension. The objective of this article is to report the detection of the lesion, as well as its origin in the closure defect of the cranial cavity with the formation of a cutaneous fistula, and review the recent literature

  6. Delineation of Two Clinically and Molecularly Distinct Subgroups of Posterior Fossa Ependymoma

    OpenAIRE

    Witt, Hendrik; Mack, Stephen C.; Ryzhova, Marina; Bender, Sebastian; Sill, Martin; Isserlin, Ruth; Benner, Axel; Hielscher, Thomas; Milde, Till; Remke, Marc; Jones, David T.W.; Northcott, Paul A.; Garzia, Livia; Bertrand, Kelsey C.; Wittmann, Andrea

    2011-01-01

    Despite the histological similarity of ependymomas from throughout the neuroaxis, the disease likely comprises multiple independent entities, each with a distinct molecular pathogenesis. Transcriptional profiling of two large independent cohorts of ependymoma reveals the existence of two demographically, transcriptionally, genetically, and clinically distinct groups of posterior fossa (PF) ependymomas. Group A patients are younger, have laterally located tumors with a balanced genome, and are...

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

    OpenAIRE

    Rongxun, Zhang

    1982-01-01

    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.

  8. A Rare Case of Metastatic Renal Cell Carcinoma in Posterior Fossa

    Directory of Open Access Journals (Sweden)

    H Moin

    2005-09-01

    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

  9. Migration of a Kirschner wire from the wrist to the cubital fossa

    Scientific Electronic Library Online (English)

    AH, Botha; AB, du Toit.

    Full Text Available A patient presented with a distal radius and ulna fracture which was treated with closed reduction and Kirschner wires. The patient presented after an extended time period with elbow pain and associated loss of function. Examination revealed that the Kirschner wires migrated to his cubital fossa. Re [...] moval of the Kirschner wire resulted in complete functional recovery.

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

    Directory of Open Access Journals (Sweden)

    Stewien Klaus Eberhard

    2000-01-01

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

  11. An unusual presentation of acute brucellosis with thrombocytopenia and maculopapular rash

    Directory of Open Access Journals (Sweden)

    O. Alici,1 B. Kasapoglu,2 R. Alkan,2 E. Sarifakioglu,3 R. Akgedik,4 R. Bozalan,2 A. Kosar,5 H. Sahin6

    2007-10-01

    Full Text Available Human brucellosis is common in developing countries and a multi-system disease with a broad spectrum of clinical manifestations. Cutaneous lesions associated with brucellosis have been rarely reported in the world literature. Here we present the case of a 69-year-old woman with history of consumption of cheese made from raw milk seen with occurrence of thrombocytopenia and diffuse maculopapular rash during the course of Brucella infection. Physical examination showed a pruritic maculopapular exanthema over the trunk, arms and legs. Laboratory tests revealed severe thrombocytopenia with platelet count of 15x109/L. Body temperature was normal. Parasitic examinations and serologic tests for syphilis, salmonellosis, rickettsiae, toxoplasma, Epstein-Barr virus, human immunodeficiency virus, and hepatitis B and C viruses were negative. The Brucella agglutination test titer was 1/2.560 and the skin lesions were interpreted as brucellar dermatitis. The patient was subsequently treated with oral doxycycline and rifampicin and was discharged in good health. If there is suspicion of exposure to infected food products, brucellosis should be included in the differential diagnosis of thrombocytopenia in Brucella-endemic areas; there may be skin lesions other than purpura that can accompany thrombocytopenia.

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

    Scientific Electronic Library Online (English)

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

    1997-04-01

    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.

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

    Directory of Open Access Journals (Sweden)

    MARÍA G GUZMÁN

    1997-04-01

    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.

  14. Case report of drug rash with eosinophilia and systemic symptoms demonstrating human herpesvirus-6 reactivation.

    Science.gov (United States)

    Ferrero, Natalie A; Pearson, Kelly C; Zedek, Daniel C; Morrell, Dean S

    2013-01-01

    Drug rash with eosinophilia and systemic symptoms (DRESS) is a severe drug-induced hypersensitivity syndrome that presents with diffuse cutaneous eruptions, fever, and multiorgan involvement. Here we present a pediatric case of DRESS complicated by human herpesvirus (HHV)-6 reactivation. After 1 week of sulfasalazine, our patient developed a diffuse morbilliform eruption. Sulfasalazine was discontinued. The patient presented to the emergency department soon thereafter with worsening eruption, fever, rigors, facial edema, and lymphadenopathy. Methylprednisolone was initiated. Peripheral smear did not demonstrate eosinophilia but showed toxic granulation with atypical lymphocytes. Transaminase levels and white blood cell count quickly became elevated, with increased eosinophils, suggesting DRESS. During the methylprednisolone taper, our patient experienced symptom exacerbation, acute hepatitis, and HHV-6 seroconversion, indicating HHV-6 reactivation as the cause. As demonstrated by our patient, a decelerated methylprednisone taper is important because of potential symptom flaring during taper. Additionally, in the care of individuals with DRESS, HHV-6 is often tested for upon admission and not repeated. Delay in the rise of titers necessitates repeat testing. PMID:24016284

  15. Acute kidney injury in patients with severe rash on vemurafenib treatment for metastatic melanomas.

    Science.gov (United States)

    Regnier-Rosencher, E; Lazareth, H; Gressier, L; Avril, M F; Thervet, E; Dupin, N

    2013-10-01

    Vemurafenib, a selective BRAF (v-raf murine sarcoma viral oncogene homologue B1) kinase inhibitor, is a new targeted biotherapy that improves survival in patients with metastatic melanomas harbouring the BRAF V600E mutation. However, this drug has significant dermatological adverse effects. We report a new severe cutaneous reaction to this drug associated with acute kidney injury (AKI). Four patients presented a generalized grade 3 (Common Terminology Criteria for Adverse Events) erythematous eruption with hyperkeratosis pilaris, 5-14 days after the introduction of vemurafenib. These symptoms were associated with AKI in all cases and transitory hypereosinophilia in two cases. Vemurafenib treatment was stopped in three patients and the dose was reduced in the fourth, leading to a gradual improvement of skin symptoms and renal function. Positron-emission tomography scans showed a complete response in three cases and a major response in one case. Vemurafenib was reintroduced at a lower dose, without a relapse of the rash, but renal function again deteriorated. Thus, we report a cluster of four cases of AKI associated with similar, severe, grade 3 cutaneous drug reactions related to vemurafenib. PMID:23909652

  16. Liver transplantation in a child with acute liver failure resulting from drug rash with eosinophilia and systemic symptoms syndrome

    Directory of Open Access Journals (Sweden)

    Seung Min Song

    2013-05-01

    Full Text Available Drug rash with eosinophilia and systemic symptoms (DRESS syndrome is characterized by a severe idiosyncratic reaction including rash and fever, often with associated hepatitis, arthralgias, lymph-node enlargement, or hematologic abnormalities. The mortality rate is approximately 10%, primarily owing to liver failure with massive or multiple disseminated focal necrosis. Here, we report a case of a 14-year-old girl treated with vancomycin because of a wound infection by methicillin-resistant Staphylococcus aureus , who presented with non-specific symptoms, which progressed to acute liver failure, displaying the hallmarks of DRESS syndrome. With the presence of aggravated hepatic encephalopathy and azotemia, the patient was refractory to medical treatments, she received a living-donor liver transplantation, and a cure was achieved without any sign of recurrence. Vancomycin can be a cause of DRESS syndrome. A high index of suspicion and rapid diagnosis are necessary not to miss this potentially lethal disease.

  17. Liver transplantation in a child with acute liver failure resulting from drug rash with eosinophilia and systemic symptoms syndrome.

    Science.gov (United States)

    Song, Seung Min; Cho, Min Sung; Oh, Seak Hee; Kim, Kyung Mo; Park, Young Seo; Kim, Dae Yeon; Lee, Sung Gyu

    2013-05-01

    Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by a severe idiosyncratic reaction including rash and fever, often with associated hepatitis, arthralgias, lymph node enlargement, or hematologic abnormalities. The mortality rate is approximately 10%, primarily owing to liver failure with massive or multiple disseminated focal necrosis. Here, we report a case of a 14-year-old girl treated with vancomycin because of a wound infection by methicillin-resistant Staphylococcus aureus, who presented with non-specific symptoms, which progressed to acute liver failure, displaying the hallmarks of DRESS syndrome. With the presence of aggravated hepatic encephalopathy and azotemia, the patient was refractory to medical treatments, she received a living-donor liver transplantation, and a cure was achieved without any sign of recurrence. Vancomycin can be a cause of DRESS syndrome. A high index of suspicion and rapid diagnosis are necessary not to miss this potentially lethal disease. PMID:23741237

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

    Energy Technology Data Exchange (ETDEWEB)

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

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

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

    Science.gov (United States)

    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

    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

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

    Directory of Open Access Journals (Sweden)

    Hong-yu XING

    2013-11-01

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

  1. Another Look at Impulsivity: A Meta- Analytic Review Comparing Specific Dispositions to Rash Action in their Relationship to Bulimic Symptoms

    OpenAIRE

    Fischer, Sarah; Smith, Gregory T.; Cyders, Melissa A.

    2008-01-01

    Recent advances in personality theory indicate that there are distinct constructs that dispose individuals to rash action and risky behavior, as opposed to one broad trait of impulsivity. Two are emotion based, two represent deficits in conscientiousness, and one is sensation seeking. Previous studies of impulsivity and its relationship to bulimia nervosa have yielded mixed findings. The authors applied this advance in personality theory to the study of bulimia nervosa (BN) to test the hypoth...

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

    Directory of Open Access Journals (Sweden)

    Svenson Svante

    2004-11-01

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

  3. Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas / Minicraniotomia supra-orbitária superciliar no tratamento de meningiomas na fossa craniana anterior e para-selares

    Scientific Electronic Library Online (English)

    Manoel Antonio de, Paiva-Neto; Oswaldo Inácio de, Tella-Jr.

    2010-06-01

    Full Text Available A evolução técnica e a introdução de instrumentais cirúrgicos mais delicados proporcionaram o uso de craniotomias menores no tratamento de patologias intracranianas. Avaliamos os aspectos técnicos da minicraniotomia supra-orbitária superciliar, considerando as indicações, limitações e complicações n [...] o tratamento de meningiomas na fossa craniana anterior e para-selares. Vinte e quarto pacientes (21 mulheres; idade média, 53±8,6 anos) operados entre 2002 e 2006 foram estudados. O diâmetro tumoral máximo variou de 1,6 a 6 cm. Ressecção total foi obtida em 20 (83,3%). Todos os tumores eram histologicamente benignos. Dois pacientes (8%) apresentaram fistula liquórica pós-operatória e outros dois diabetes insipido transitórioa (8%). Um paciente evoluiu com hemiparesia transitória. Houve um caso de meningite e um de evolução fatal. O seguimento variou de 6 a 66 meses (média 31,5±20,1 meses), não houve recidiva. A minicraniotomia supra-orbitária superciliar é uma via de abordagem eficaz para o tratamento de meningiomas da fossa craniana anterior e para-selares selecionados. Abstract in english The improvement of surgical techniques as well as the introduction of new surgical instruments promoted the use of keyhole craniotomies in neurosurgery. We evaluated the technical aspects of the supra-orbital keyhole approach considering the indications, limitations, and complications of this approa [...] ch to treat anterior cranial fossa and parasellar meningiomas. Twenty-four patients (21 females; mean age, 53±8.6 years) operated on between 2002 and 2006 through a supra-orbital eyebrow approach were studied. Maximal tumor diameter ranged from 1.6 to 6 cm. Gross total resection was done in 20 (83.3%). All tumors were histologically benign. Two patients (8%) experienced CSF rinorhea and another two patients suffered transitory diabetes insipidus (8%). One patient experienced transitory hemiparesis. There was one case of meningitis and one mortality. Follow-up ranged between 6 to 66 months (mean 31.5±20.1 months), with no recurrence. The supra-orbital keyhole craniotomy is a useful minimally invasive approach to treat selected anterior fossa and parasellar meningiomas.

  4. Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas Minicraniotomia supra-orbitária superciliar no tratamento de meningiomas na fossa craniana anterior e para-selares

    Directory of Open Access Journals (Sweden)

    Manoel Antonio de Paiva-Neto

    2010-06-01

    Full Text Available The improvement of surgical techniques as well as the introduction of new surgical instruments promoted the use of keyhole craniotomies in neurosurgery. We evaluated the technical aspects of the supra-orbital keyhole approach considering the indications, limitations, and complications of this approach to treat anterior cranial fossa and parasellar meningiomas. Twenty-four patients (21 females; mean age, 53±8.6 years operated on between 2002 and 2006 through a supra-orbital eyebrow approach were studied. Maximal tumor diameter ranged from 1.6 to 6 cm. Gross total resection was done in 20 (83.3%. All tumors were histologically benign. Two patients (8% experienced CSF rinorhea and another two patients suffered transitory diabetes insipidus (8%. One patient experienced transitory hemiparesis. There was one case of meningitis and one mortality. Follow-up ranged between 6 to 66 months (mean 31.5±20.1 months, with no recurrence. The supra-orbital keyhole craniotomy is a useful minimally invasive approach to treat selected anterior fossa and parasellar meningiomas.A evolução técnica e a introdução de instrumentais cirúrgicos mais delicados proporcionaram o uso de craniotomias menores no tratamento de patologias intracranianas. Avaliamos os aspectos técnicos da minicraniotomia supra-orbitária superciliar, considerando as indicações, limitações e complicações no tratamento de meningiomas na fossa craniana anterior e para-selares. Vinte e quarto pacientes (21 mulheres; idade média, 53±8,6 anos operados entre 2002 e 2006 foram estudados. O diâmetro tumoral máximo variou de 1,6 a 6 cm. Ressecção total foi obtida em 20 (83,3%. Todos os tumores eram histologicamente benignos. Dois pacientes (8% apresentaram fistula liquórica pós-operatória e outros dois diabetes insipido transitórioa (8%. Um paciente evoluiu com hemiparesia transitória. Houve um caso de meningite e um de evolução fatal. O seguimento variou de 6 a 66 meses (média 31,5±20,1 meses, não houve recidiva. A minicraniotomia supra-orbitária superciliar é uma via de abordagem eficaz para o tratamento de meningiomas da fossa craniana anterior e para-selares selecionados.

  5. Posterior fossa abnormalities in major depression: a controlled magnetic resonance imaging study.

    Science.gov (United States)

    Shah, S A; Doraiswamy, P M; Husain, M M; Escalona, P R; Na, C; Figiel, G S; Patterson, L J; Ellinwood, E H; McDonald, W M; Boyko, O B

    1992-06-01

    High-field magnetic resonance (MR) images were used to study posterior fossa morphology in 27 patients with major depression and 36 normal control subjects. Depressed patients demonstrated smaller brain stem and cerebellar vermis than controls. These differences were highly significant for the anterior cerebellar vermis and medulla. There was also a striking age-related decline in midbrain size in depressed patients as well as in controls. Our results are consistent with several lines of evidence implicating a role for the cerebellar vermis in affective disorders and, in addition, provide the first MR documentation of the differential effects of aging on posterior fossa morphology in normal subjects compared with patients with major depression. PMID:1642132

  6. Dose Attenuation in the Mid-Cranial Fossa with 6 MV photon Beam Irradiations

    International Nuclear Information System (INIS)

    In X-ray irradiation, dose distribution depends on multiple parameters, one of them being tissue inhomogeneity to change the dose significantly. Considerable dose attenuation through the mid-cranial fossa is expected because of various bony structures in it. Dose distribution around the mid-cranial fossa, following irradiation with 6 MV photon beam, was measured with LiF TLD micro-rod, and compared with the expected dose in the same sites. In our calculation with Cf(correction factor), the expected dose attenuation revealed about 3.74% per 1 cm thickness of bone tissue. And the differences between the expected dose with correction for bone tissue and the measured dose by TLD was small, agreeing within an average variation of ±0.21%

  7. History and morphology of faulting in the Noctis Labyrinthus-Claritas Fossae Region of Mars

    International Nuclear Information System (INIS)

    The topographically high areas cut by Noctis Labyrinthus, Noctis Fossae, and Claritas Fossae were subjected to only minor resurfacing during and following local tectonic activity. Principal resurfacing materials consist of lava flows from Syria Planum and Tharsis Montes. Thus, these areas preserve much of the fault record produced by tectonism in this region. Although recent geologic maps of the area have been produced from Viking images, the only detailed fault histories available until now were described from Mariner 9 images. Much of the faulting in the Tharsis tectonic province was centered in Syria Planum; therefore, understanding the fault history in this region is critical to understanding the stress history and tectonism of Tharsis as a whole

  8. A Middle Cranial Fossa Dermoid Cyst Treated by an Endonasal Endoscopic Approach.

    Science.gov (United States)

    Durmaz, Abdullah; Yildizo?lu, Üzeyir; Polat, Bahtiyar; Binar, Murat

    2015-06-01

    Dermoid cysts are rare, benign, congenital ectodermal inclusion cysts in the skull base, comprising skin supplements surrounded by squamous epithelium. In the period of embryological development, the cysts originate from ectodermal cells left behind in the cranial region by the closure of the neural tube and are primarily located at the midline, especially in the subarachnoid spaces. These lesions are usually asymptomatic and diagnosed incidentally. When the cysts reach large sizes, they can be symptomatic due to infection, rupture, or mass effect around neurovascular tissue. The cysts typically demonstrate accurate radiological diagnostic features. In this case report, we present a rare dermoid cyst in the middle cranial fossa, treated by an endonasal endoscopic approach. The endonasal endoscopic management of appropriate middle cranial fossa is discussed as a recent advance in the extended applications of endoscopic sinus surgery. PMID:26080254

  9. Tectonic history of the Alba Patera-Ceraunius Fossae region of Mars

    International Nuclear Information System (INIS)

    The structural history of Alba Patera and Ceraunius Fossae is presented in the context of regional and local tectonic controls. Detailed mapping of fault patterns and determination of stratigraphic relations among faults and geologic units in the region identify four main stages of faulting from Noachian to Late Amazonian time. It is shown that the broad pattern of volcanism and tectonism at Alba Patera is similar to those of Syria Planum and Tempe Terra; this pattern may reflect a style characteristic of intermediate-age volcano tectonic centers in heavily fractured areas of the Tharsis region. Lahars and channels associated with Ceraunius Fossae indicate episodic release of ground water during fracturing of the last two stages. The extension of northeast-trending faults for over 1000 km from Alba Patera and Ascraeus Mons may have been governed by a crustal weakness along the highland/lowland boundary. 29 refs

  10. Meningoencefalitis aséptica como manifestación de un síndrome de rash con eosinofilia y síntomas sistémicos asociados a drogas por lamotrigina / Aseptic meningoencephalitis as infectation of a sindrome of rash with eosinophilia and systemic symptoms associated with drugs caused by lamotrigine

    Scientific Electronic Library Online (English)

    Pablo, Reyes S; Paulina, Silva P.

    2014-03-01

    Full Text Available La meningitis aséptica (MA) se define por la presencia de hallazgos en el líquido cefalorraquídeo compatibles con una meningitis, sin que se logre aislar una bacteria que la produzca. Las causas de MA son diversas, entre las que se encuentran las drogas. Entre los fármacos que más frecuentemente se [...] han asociado a MA, se encuentran los antiinflamatorios no esteroidales, antibióticos, inmunoglobulinas y anticonvulsivantes aromáticos. Cuando la MA forma parte de una respuesta sistémica que acompaña a una manifestación cutánea, puede tratarse de un rash con eosinofilia y síntomas sistémicos asociado a drogas (DRESS, acrónimo derivado del inglés DrugRash with Eosinophilia and Systemic Symptoms), considerada una reacción adversa grave a medicamentos. La lamotrigina es un anticonvulsivante no aromático ampliamente utilizado para el tratamiento de la epilepsia y el trastorno bipolar que ha sido asociada con MA. Comunicamos un caso de meningoencefalitis aséptica como manifestación de DRESS asociado al uso de lamotrigina. Abstract in english Aseptic meningitis (AM) is defined by the presence of cerebrospinal fluid findings consistent with meningitis, without achieving the isolation of a bacterium that produces it. Drugs are one of the diverse causes of AM. Drugs frequently associated with AM include immunoglobulin's, nonsteroidal anti-i [...] nflammatory, antibiotics, and aromatic anticonvulsants. When AM is part of a systemic response accompanying a cutaneous manifestation it may be a DRESS (Drug Rash with Eosinophilia and Systemic Symptoms), considered a serious adverse reaction to drugs. Lamotrigine is a non-aromatic anticonvulsant widely used for the treatment of epilepsy and bipolar disorder, which has been associated with AM. We report a case of aseptic meningoencephalitis as a manifestation of DRESS associated to lamotrigine.

  11. The supraclavicular fossa ultrasound view for central venous catheter placement and catheter change over guidewire.

    Science.gov (United States)

    Kim, Se-Chan; Klebach, Christian; Heinze, Ingo; Hoeft, Andreas; Baumgarten, Georg; Weber, Stefan

    2014-01-01

    The supraclavicular fossa ultrasound view can be useful for central venous catheter (CVC) placement. Venipuncture of the internal jugular veins (IJV) or subclavian veins is performed with a micro-convex ultrasound probe, using a neonatal abdominal preset with a probe frequency of 10 Mhz at a depth of 10-12 cm. Following insertion of the guidewire into the vein, the probe is shifted to the right supraclavicular fossa to obtain a view of the superior vena cava (SVC), right pulmonary artery and ascending aorta. Under real-time ultrasound view, the guidewire and its J-tip is visualized and pushed forward to the lower SVC. Insertion depth is read from guidewire marks using central venous catheter. CVC is then inserted following skin and venous dilation. The supraclavicular fossa view is most suitable for right IJV CVC insertion. If other insertion sites are chosen the right supraclavicular fossa should be within the sterile field. Scanning of the IJVs, brachiocephalic veins and SVC can reveal significant thrombosis before venipuncture. Misplaced CVCs can be corrected with a change over guidewire technique under real-time ultrasound guidance. In conjunction with a diagnostic lung ultrasound scan, this technique has a potential to replace chest radiograph for confirmation of CVC tip position and exclusion of pneumothorax. Moreover, this view is of advantage in patients with a non-p-wave cardiac rhythm were an intra-cardiac electrocardiography (ECG) is not feasible for CVC tip position confirmation. Limitations of the method are lack of availability of a micro-convex probe and the need for training. PMID:25548874

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

    OpenAIRE

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

    2012-01-01

    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...

  13. Transzygomatic Approach with Intraoperative Neuromonitoring for Resection of Middle Cranial Fossa Tumors*

    OpenAIRE

    Son, Byung Chul; Lee, Sang Won; Kim, Sup; Hong, Jae Taek; Sung, Jae Hoon; Yang, Seung-ho

    2012-01-01

    The authors reviewed the surgical experience and operative technique in a series of 11 patients with middle fossa tumors who underwent surgery using the transzygomatic approach and intraoperative neuromonitoring (IOM) at a single institution. This approach was applied to trigeminal schwannomas (n?=?3), cavernous angiomas (n?=?3), sphenoid wing meningiomas (n?=?3), a petroclival meningioma (n?=?1), and a hemangiopericytoma (n?=?1). An osteotomy of the zygoma, a low-position...

  14. 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)

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

    OpenAIRE

    Budhiraja V; Rastogi R

    2010-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Warmuth-Metz, M.; Solymosi, L. [Abteilung fuer Neuroradiologie, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Kuehl, J. [Paediatric Oncology, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Krauss, J. [Paediatric Neurosurgery, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany)

    2004-03-01

    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 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.)

  17. Ilioinguinal nerve entrapment: a little-known cause of iliac fossa pain.

    OpenAIRE

    Knockaert, D. C.; D Heygere, F. G.; Bobbaers, H. J.

    1989-01-01

    The ilioinguinal nerve entrapment syndrome is an abdominal muscular pain syndrome, characterized by the clinical triad of muscular type iliac fossa pain with a characteristic radiation pattern, an altered sensory perception in the ilioinguinal nerve cutaneous innervation area, and a well-circumscribed trigger point medial and below the anterosuperior iliac spine. Relief of pain by infiltration of a local anaesthetic confirms the diagnosis. This report describes retrospectively the clinical pi...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-11-15

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

  19. Accessing escalators: a central vestibular disorder after posterior fossa tumor removal.

    Science.gov (United States)

    Archer, Hilary A; Faldon, Mary E; Davies, Rosalyn; Bronstein, Adolfo

    2012-08-01

    About 20% of childhood tumors originate within the central nervous system. Progress in assessment and treatment of these lesions has led to improved survival rates. We describe a patient with a posterior fossa ependymoma who despite a remarkable recovery following treatment has been frustrated by difficulty in using escalators. Such symptom selectivity is explained by specific vertical visuomotor and high-frequency vestibular deficits disrupting the execution of this complex motor act. PMID:22447846

  20. General considerations on posterior fossa arteriovenous malformations (clinics, imaging and therapy)

    OpenAIRE

    Neacsu, A.; Ciurea, Av

    2010-01-01

    The posterior fossa arteriovenous malformation (AVM) is uncommon and different from other intracranial AVM in its natural history, diagnosis, treatment, prognosis, and other features. Authors present a review of the actual procedures of diagnosis and treatment in the field of infratentorial cerebral arterio–venous malformations, based on the actual literature data. Pre–therapeutic considerations, such as clinical presentation and diagnostic evaluation, are initially di...

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

    DEFF Research Database (Denmark)

    Ekstrand, K R; Kuzmina, I

    1995-01-01

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

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

    Directory of Open Access Journals (Sweden)

    S Rea

    2013-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Kamal Kataria

    2012-05-01

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

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

    Science.gov (United States)

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

    2014-11-01

    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.

  5. Bare spot of the glenoid fossa in children: incidence and MRI features

    International Nuclear Information System (INIS)

    The bare spot of the glenoid fossa is a normal cartilage defect seen frequently in adults. It has been used on arthroscopy as a landmark for the center of the glenoid fossa. There are no reports of this variant in children, but we have noted it on some pediatric clinical shoulder MRI studies. Our main purpose is to evaluate the incidence of the bare spot in children and define location and MRI features. Shoulder MRI studies (total 570) from 2004 to 2008 were reviewed. Children were divided into two age groups: group 1, 0-10 years (n=200), group 2, 11-20 years (n=370). A total of 12 bare spots (2.1%) were identified; all were seen in group 2. Eight (67%) were central and four were eccentric in the glenoid fossa. All showed a well-marginated focal cartilage defect containing hyperintense joint fluid or contrast agent. Three also had air. The bare spot is seen in children. The absence in children younger than 10 years and the low incidence in the second decade support the proposed acquired nature. Familiarity with this finding is important so as not to misinterpret it as a pathologic condition. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-04-15

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

  7. Pattern of recurrence in children with midline posterior fossa malignant neoplasms

    International Nuclear Information System (INIS)

    Background. Surveillance imaging of the brain and spinal neuraxis in patients with posterior fossa malignant tumors is commonly performed, with the assumption that early detection of tumor recurrence will improve outcome. However, the benefit of this imaging has not been proven. To evaluate the usefulness of spinal surveillance imaging in children with nonmetastatic (at diagnosis, M0) posterior fossa ependymoma and medulloblastoma. Materials and methods. This retrospective study included 65 children (3 months to 16 years, mean 5.7 years) treated between 1985 and 1997 for ependymoma (22) and medulloblastoma (43). Medical records were reviewed for pathology and treatment data. Serial imaging of the head and spine was reviewed for evidence of tumor recurrence. Results. Twenty-four patients (37 %) had tumor recurrence, including 13 with ependymoma and 11 with medulloblastoma. Of the 17/24 recurrent patients initially diagnosed as M0 (6 medulloblastoma and 11 ependymoma), 13 (76 %) had a cranial recurrence only, and 4 (24 %) presented with concomitant cranial and spinal recurrence. No M0 patient presented solely with spinal metastases at recurrence. Conclusion. This study suggests that spinal surveillance imaging in patients with posterior fossa ependymoma or medulloblastoma initially staged as M0 may not be useful, as these patients initially recur intracranially. Thus, until an intracranial recurrence is detected, these patients may be spared the time, expense and sedatimay be spared the time, expense and sedation risk necessary for spinal imaging. (orig.)

  8. Pattern of recurrence in children with midline posterior fossa malignant neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Wootton-Gorges, S.L.; Foreman, N.K.; Albano, E.A.; Dertina, D.M.; Nein, P.K.; Shukert, B.; Cesario, K.B.; Gage, S.; Rumack, C.M.; Strain, J.D. [Children' s Hospital, Department of Radiology, Denver, CO (United States)

    2000-02-01

    Background. Surveillance imaging of the brain and spinal neuraxis in patients with posterior fossa malignant tumors is commonly performed, with the assumption that early detection of tumor recurrence will improve outcome. However, the benefit of this imaging has not been proven. To evaluate the usefulness of spinal surveillance imaging in children with nonmetastatic (at diagnosis, M0) posterior fossa ependymoma and medulloblastoma. Materials and methods. This retrospective study included 65 children (3 months to 16 years, mean 5.7 years) treated between 1985 and 1997 for ependymoma (22) and medulloblastoma (43). Medical records were reviewed for pathology and treatment data. Serial imaging of the head and spine was reviewed for evidence of tumor recurrence. Results. Twenty-four patients (37 %) had tumor recurrence, including 13 with ependymoma and 11 with medulloblastoma. Of the 17/24 recurrent patients initially diagnosed as M0 (6 medulloblastoma and 11 ependymoma), 13 (76 %) had a cranial recurrence only, and 4 (24 %) presented with concomitant cranial and spinal recurrence. No M0 patient presented solely with spinal metastases at recurrence. Conclusion. This study suggests that spinal surveillance imaging in patients with posterior fossa ependymoma or medulloblastoma initially staged as M0 may not be useful, as these patients initially recur intracranially. Thus, until an intracranial recurrence is detected, these patients may be spared the time, expense and sedation risk necessary for spinal imaging. (orig.)

  9. Infratemporal fossa cellulitis caused by a remnant iatrogenic foreign body after a bimaxillary operation.

    Science.gov (United States)

    Park, Do Yang; Choo, Oak-Sung; Hong, Sang Young; Kim, Hyun Jun

    2015-05-01

    Infratemporal fossa cellulitis is rare and mostly occurs because of sinusitis and dental procedures. Furthermore, cellulitis caused by iatrogenic foreign bodies is very rare.A 28-year-old woman who had previously undergone cosmetic bimaxillary operation visited our hospital complaining of left facial swelling, oppressive pain, and nasal obstruction since 2 years. She had been attending another clinic, but despite having additional procedures and taking medications, her symptoms persisted. A subsequent operation was performed, during which we found a remnant surgical gauze from the previous operation, which was decomposed and trapped around the necrotic soft tissue and had eroded the bony structure around the pterygoid fossa. The material was successfully removed by endoscopic surgery, and the necrotic tissue was debrided. After the operation, all symptoms disappeared, and the patient was discharged without sequelae.During any procedure, surgeons must meticulously check for remnant material. Additionally, physicians must carefully note patient history and perform a physical examination, even in patients without serious symptoms. We report a case of advanced infratemporal fossa cellulitis due to remnant gauze material during a previous operation that was undetected. PMID:25950522

  10. A combined administration of Aragv?d?di ka??yam and Syrup Talekt induced skin rashes

    OpenAIRE

    Ajanal, Manjunath; Prasad, B. S.

    2014-01-01

    It is a common notion among people in India that herbal or Ayurvedic products are safe and do not produce any adverse effect. This is not true since Ayurveda has evaded many adverse effects which occur by combination of herbs. This axiom is potentiated by our report that occurs in the form of skin rashes. A 20-year-old South Indian female of Pittakapha prak?ti (constitution) after beginning therapy with Aragv?d?di ka??yam (ARK) (poly-herbal formulation) and Syrup Talekt (poly-herbal pa...

  11. Isoniazid-induced Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Presenting as Acute Eosinophilic Myocarditis.

    Science.gov (United States)

    Zhang, Sai-Nan; He, Qiu-Xiang; Yang, Nai-Bin; Ni, Shun-Lan; Lu, Ming-Qin

    2015-01-01

    It has been reported that hypereosinophilic syndrome may be induced by antituberculosis drugs. We herein report the case of a 43-year-old man who had been on antituberculosis drugs for two months to treat tuberculous meningitis. During therapy, he suffered from drug rash with eosinophilia and systemic symptoms (DRESS) presenting as acute eosinophilic myocarditis, as confirmed on a histopathologic examination. According to the patient's medication history, clinical features and accessory examination findings, the eosinophilic myocarditis was thought to be possibly induced by isoniazid. Although further investigations are needed to confirm causality, isoniazid may be added to the list of drugs with the potential to cause DRESS syndrome. PMID:25986261

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

    Directory of Open Access Journals (Sweden)

    Nakahara T

    2015-01-01

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

  13. 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)

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

    Science.gov (United States)

    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

    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

  15. Interstitial radiotherapy using phosphorus-32 for giant posterior fossa cystic craniopharyngiomas.

    Science.gov (United States)

    Yu, Xin; Zhang, Jianning; Liu, Rui; Wang, Yaming; Wang, Hongwei; Wang, Peng; Chen, Jinhui; Liu, Song

    2015-05-01

    OBJECT The treatment for giant posterior fossa cystic craniopharyngiomas remains an important challenge in neurosurgery. The authors evaluated the effects of treating 20 patients with giant posterior fossa cystic craniopharyngiomas using phosphorus-32 (P-32) interstitial radiotherapy at their hospital. METHODS The patients included 11 boys and 9 girls with an age range of 3 to 168 months. Before treatment, the tumor volumes ranged from 65 to 215 ml. The intracranial pressure was increased in 16 patients, and optic nerve damage had occurred in 18. The patients received P-32 interstitial radiotherapy following stereotactic cyst-fluid aspiration or drainage and were followed up for 7-138 months. RESULTS The treatment immediately relieved the intracranial hypertension symptoms in all patients. At the end of follow-up, imaging examinations revealed that the cystic tumors had disappeared, but some residual calcification remained in 12 patients, and had decreased by more than 75% of the initial volume in 8 patients. The damaged optic nerve recovered in 3 cases, improved in 12 cases, remained unchanged in 1 case, and was aggravated in 2 cases. No other severe complications related to surgery or interstitial radiation occurred. During the follow-up period, 7 new cysts appeared in 5 patients who had received additional interstitial radiotherapies with a dose of P-32 that was calculated using the same formula as for the initial treatment. The new tumors then disappeared in 2 patients, significantly shrank in 2 patients, and progressed in 1 patient. CONCLUSIONS For treating giant posterior fossa cystic craniopharyngiomas, P-32 interstitial radiation after stereotactic cyst-fluid aspiration or drainage can achieve a high tumor control rate and has relatively satisfactory clinical effects and quality of life outcomes with few complications. PMID:25679384

  16. Hearing Preservation by the Extended and Nonextended Middle Cranial Fossa Approach for Acoustic Neuroma

    OpenAIRE

    Kanzaki, Jin; O-Uchi, Toshiaki; OGAWA, KAORU; Shiobara, Ryuzo; Toya, Shigeo

    1994-01-01

    The results of 248 cases of acoustic neuroma surgery carried out mainly by the extended middle cranial fossa approach during a 16-year period from 1976 to 1991 are analyzed. Hearing preservation was attempted in 69 cases and successfully achieved in 35 (51%) cases. Hearing was preserved in 24 (57%) of 42 cases in which a tumor was 20 mm or smaller in diameter, pure-tone hearing level was 50 dB or lower, and speech discrimination score was 50% or higher. The hearing preservation rate (76%) in ...

  17. 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.)

  18. The Microscopic Surgical Treatment for Tumor of Posterior Cranial Fossa in Children

    Directory of Open Access Journals (Sweden)

    Duo CHEN

    2009-04-01

    Full Text Available OBJECTIVE To analyze and discuss about the clinical characteristics, pathological types, surgical modalities and techniques, and postoperative complications in children with tumor of posterior cranial fossa .METHODS Retrospective study was conducted on 102 cases of pediatric tumor of posterior cranial fossa, admi? ed and treated in our hospital during the period of January 1996 to January 2007. All patients underwent microscopic surgical treatment. Fifty-eight were male and 44 cases were female. The age ranged from 9 months to 14 years old, with an average of 6.1 ± 0.5 of age. Cranial CT or MRI examination was conducted before and after the surgery on all patients.RESULTS The primary manifestations for this group of patients were increased intracranial pressure and/or ataxia. Postoperative pathological diagnoses showed: 46 cases of medulloblastoma, 43 cases of astrocytoma, 11 cases of ependymoma (including 1 case of degenerative ependymoma, 1 case of dermoid cyst, and 1 case of teratoma. In this group of the patients, radical surgery was used in 68 cases and subtotal surgical removal used in 31 cases, while surgical removal of large section was performed on 3 cases. There were no deaths from surgery reported. Ninety-one cases showed significant symptomatic improvement when compared with preoperative conditions, while 11 cases showed either no improvement or more severely affected afterward. For 6 cases, postoperative ventriculoperitoneal shunt was performed within 7 days to 2 months after the surgery. Sixty-three patients gained follow-up for 3 to 60 months in duration. Thirty-nine patients regained normal life and were able to learn well, while there were 7 patients who could not live normally on their own. During the follow-up period, there were 17 cases of recurrence and 7 cases of death. In 23 cases of medulloblastoma in children with age of 3 years old or above, 2 cases who underwent surgical removal of intracranial ependymoma received small dosage of postoperative X-ray radiotherapy on the the brain and spinal cord. Nine cases of medulloblastoma in children under age of 3 and 17 cases of astrocytoma diagnosed after the surgery received chemotherapy of Carmustine.CONCLUSION Medulloblastomas and astrocytomas were the most common types of pediatric tumor of posterior cranial fossa, right followed by ependymoma, and dermoid cysts and teratomas were rare. Early correct diagnosis, proper selection of appropriate surgical modality and the surgical margin, proper treatment of postoperative complications, and the selecting right radiotherapy or chemotherapy were the key factors in infl uencing the prognostic outcome of children with tumor of posterior cranial fossa.

  19. Rod Migration into the Posterior Fossa after Harms Operation : Case Report and Review of Literatures

    OpenAIRE

    Chun, Hyoung-Joon; Bak, Koang Hum; Kang, Tae Hoon; Yi, Hyeong-Joong

    2010-01-01

    C1 lateral mass and C2 pedicle (C1LM-C2P) fixation is a relatively new technique for atlantoaxial stabilization. Complications from C1LM-C2P fixation have been rarely reported. The authors report unilateral rod migration into the posterior fossa as a rare complication after this posterior C1-C2 stabilization technique. A 23-year-old man suffered severe head trauma and cervical spine injury after vehicle accident. He was unconscious for 2 months and regained consciousness. He underwent C1LM-C2...

  20. Spontaneous resolution of a flow-related ophthalmic-segment aneurysm after treatment of anterior cranial fossa dural arteriovenous fistula

    Science.gov (United States)

    Reinard, Kevin; Basheer, Azam; Pabaney, Aqueel; Marin, Horia; Malik, Ghaus

    2014-01-01

    Background: The natural history of proximal, feeding-artery aneurysms after successful obliteration of high-grade, anterior cranial fossa dural arteriovenous fistulas (dAVFs) has not been well documented. Case Description: A 52-year-old Caucasian male presented with an unruptured anterior cranial fossa (dAVF) and an associated aneurysm. Cerebral angiography revealed a large, contralateral, carotid-ophthalmic segment aneurysm, enlarged feeding ophthalmic arteries, as well as cortical venous drainage. Successful surgical obliteration of the dAVF was undertaken to eliminate the risk of hemorrhage. Conclusion: The carotid-ophthalmic aneurysm regressed significantly after surgical obliteration of the dAVF and a follow-up, planned coiling procedure to address the carotid-ophthalmic aneurysm was abandoned. This represents the first reported case of a near complete, spontaneous resolution of an unruptured carotid-ophthalmic aneurysm associated with a high-grade anterior cranial fossa dAVF. PMID:25525558

  1. MORPHOLOGICAL AND MORPHOMETRICAL ANALYSIS OF THE VERMIAN FOSSA IN DRY ADULT SKULLS OF WESTERN UTTAR PRADESH POPULATION: AN OSTEOLOGICAL STUDY

    Directory of Open Access Journals (Sweden)

    Arvind Yadav

    2014-09-01

    Full Text Available Aim: The internal occipital crest (IOC occasionally diverges at the lower end around the foramen magnum, giving rise to roughly triangular shaped vermian fossa. Variations occur in the vermian fossa in the form of shape and size. There is paucity of such study in the available literature, hence the present study was undertaken to evaluate the incidence, morphology and morphometry of the VF in the adult population of Western Uttar Pradesh. Material and method: Adult human 30 cranial bases (vault removed and 25 occipital bones of both the sexes, which were obtained from the osteology section of department of anatomy in LLRM Medical College, Meerut (UP, formed the basis for this study. The fossa were macroscopically examined and classified into Type1 (triangular shape, Type 2 (quadrangular shape, and Type 3or atypical type (fossa shape was other than the above said. Result: Out of the 55 specimens the VF was observed in 40(72.7% specimens, and was found absent in the remaining 15(27.2% specimens. The VF was triangular shaped in 29(72.5% specimens and quadrangular in 4(10.0% specimens. In 7(17.5% specimens it was having unusual morphology and considered as atypical. Among the atypical types, two specimens were having deep fossa, one was having partitioned VF, and four of them had widened VF. The average length and width of the fossa were 14.2 mm and 12.1 mm respectively. Conclusion: The incidence is higher in our study as compared to the previous studies and it might be because of racial variations. Accurate knowledge of the variability of the human morphology and morphometry improves the diagnosis and therapeutic performance and also helpful in the study of the diseases that cause alterations of size and morphology of inferior vermis of cerebellum and clinician who operates intracranially or interprets radiological imaging. Hence this study is enlightening for the neuroanatomists and morphologists.

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

    Science.gov (United States)

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

    2015-04-01

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

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

    Science.gov (United States)

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

    2015-04-01

    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

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

    Science.gov (United States)

    Chiang, Jung-Ying; Lin, Hung-Lin

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

    Introduction Proper imaging allows practitioners to evaluate an asymptomatic tempormandibular joint (TMJ) for potential degenerative changes prior to surgical and orthodontic treatment. The recently developed cone-beam computed tomography (CBCT) allows measurement of TMJ bony structures with high accuracy. A study was undertaken to determine the morphology, and its variations, of the mandibular condyle and glenoid fossa among Malay and Chinese Malaysians. Methods CBCT was used to assess 200 joints in 100 subjects (mean age, 30.5 years). i-CAT CBCT software and The Mimics 16.0 software were employed to measure the volume, metrical size, position of each condyle sample and the thickness of the roof of the glenoid fossa (RGF). Results No significant gender differences were noted in thickness of the RGF and condylar length; however condylar volume, width, height and the joint spaces were significantly greater among males. With regards to comparison of both TMJs, the means of condylar volume, width and length of the right TMJ were significantly higher, while the means of the left condylar height and thickness of RGF were higher. When comparing the condylar measurements and the thickness of RGF between the two ethnic groups, we found no significant difference for all measurements with exception of condylar height, which is higher among Chinese. Conclusion The similarity in measurements for Malays and Chinese may be due to their common origin. This information can be clinically useful in establishing the diagnostic criteria for condylar volume, metrical size, and position in the Malaysian East Asians population. PMID:25803868

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

    International Nuclear Information System (INIS)

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

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

    Scientific Electronic Library Online (English)

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

    2013-09-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Duffner, P.K.; Cohen, M.E.; Thomas, P.

    1983-01-15

    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.

  9. Posterior fossa tumor with distinct choroid plexus papilloma and ependymoma components.

    Science.gov (United States)

    Cai, Chunyu; Stephens, Bradley H; Leonard, Jeffrey R; Dahiya, Sonika

    2015-05-01

    Synchronous occurrence of multiple primary central nervous system (CNS) tumors of different histological types is uncommon in patients without radiation history or genetic syndrome association. We herein report a sporadic case of posterior fossa tumor with synchronous choroid plexus papilloma (CPP) and ependymoma (EP) components. A 7-year-old girl with no significant past or familial medical history presented with 2 years of migraine type headaches. Brain magnetic resonance imaging showed a cystic mass with a mural enhancing nodule centered within the cerebellar vermis. The patient underwent gross total resection of the tumor. Histologic examination showed a tumor with two distinct components. The predominant component demonstrated classic morphological and immunohistochemical characteristics of choroid plexus papilloma CPP, WHO grade I. However, there were a few discrete foci, where tumor cells showed architectural, cytological, and immunohistochemical features characteristic of an ependymoma, WHO grade II. In addition, there was exuberant piloid gliosis secondary to infiltration of the CPP component into the adjacent brain parenchyma. Followup brain imaging at 14 months after surgery showed no evidence of residual or recurrent tumor. To the best of our knowledge, this is the first reported case of synchronous CPP and EP in the posterior fossa. PMID:25601059

  10. 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

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    Bonner, K.; Siegel, K.R.

    1988-04-01

    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, CO/sub 2/ laser, cavitron ultrasonic aspirator and neurosurgical microinstrumentation allow for more extensive and safer surgery. Disease specific treatment protocols, utilizing radiotherapy and adjuvant chemotherapy, have made survival common in tumors such as medulloblastoma. As survival rates increase, cognitive, endocrinologic and psychologic sequelae become increasingly important. The optimal management of children with brain tumors demands a multidisciplinary approach, best facilitated by a neuro-oncology team composed of multiple subspecialists. This article addresses incidence, classification and histology, clinical presentation, diagnosis, pre-, intra- and postoperative management, long-term effects and the team approach in posterior fossa tumors in childhood. Management of specific tumor types is included as well. 57 references.

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

    Scientific Electronic Library Online (English)

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

    2010-02-01

    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 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.

  14. Establishing a laboratory animal model from a transgenic animal: RasH2 mice as a model for carcinogenicity studies in regulatory science.

    Science.gov (United States)

    Urano, K; Tamaoki, N; Nomura, T

    2012-01-01

    Transgenic animal models have been used in small numbers in gene function studies in vivo for a period of time, but more recently, the use of a single transgenic animal model has been approved as a second species, 6-month alternative (to the routine 2-year, 2-animal model) used in short-term carcinogenicity studies for generating regulatory application data of new drugs. This article addresses many of the issues associated with the creation and use of one of these transgenic models, the rasH2 mouse, for regulatory science. The discussion includes strategies for mass producing mice with the same stable phenotype, including constructing the transgene, choosing a founder mouse, and controlling both the transgene and background genes; strategies for developing the model for regulatory science, including measurements of carcinogen susceptibility, stability of a large-scale production system, and monitoring for uniform carcinogenicity responses; and finally, efficient use of the transgenic animal model on study. Approximately 20% of mouse carcinogenicity studies for new drug applications in the United States currently use transgenic models, typically the rasH2 mouse. The rasH2 mouse could contribute to animal welfare by reducing the numbers of animals used as well as reducing the cost of carcinogenicity studies. A better understanding of the advantages and disadvantages of the transgenic rasH2 mouse will result in greater and more efficient use of this animal model in the future. PMID:22146850

  15. 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

  16. Effect of Texture, Shape, and Intensity Feature Fusion for Posterior-Fossa Tumor Segmentation in MRI

    Directory of Open Access Journals (Sweden)

    Channu Kokila, K. Ramesh

    2013-04-01

    Full Text Available In this study, we systematically investigate efficacy of using several different image features such as intensity, fractal texture, and level-set shape in segmentation of posterior-fossa (PF tumor for pediatric patients. We explore effectiveness of using four different feature selection and three different segmentation techniques, respectively, to discriminate tumor regions from normal tissue in multimodal brain MRI. We further study the selective fusion of these features for improved PF tumor segmentation. We further study the selective fusion of these features for improved PF tumor segmentation. Our result suggests that Kullback–Leibler divergence measure for feature ranking and selection and the expectation maximization algorithm for feature fusion and tumor segmentation offer the best results for the patient data in this study.

  17. Outcome in children with space-occupying posterior fossa arachnoid cysts.

    Science.gov (United States)

    Boltshauser, E; Martin, F; Altermatt, S

    2002-06-01

    While prognostic information for Dandy-Walker syndrome and non-progressive cerebellar ataxia/cerebellar hypoplasia is available, surprisingly scant literature reports are found for space-occupying posterior fossa arachnoid cysts (PFAC). We describe the outcome of patients with symptomatic PFAC shunted as infants. Only 11 children were seen over a 20-year period (1980-1999). Cyst location was retrocerebellar (n = 8), supravermian (n = 2) and in the cerebellopontine angle (n = 1). Motor and cognitive impairments in one child were interpreted as the result of neurosurgical complications (intraventricular and intracerebral haemorrhage). One 6-year-old boy had mild truncal ataxia and mild cognitive delay. The 9 other patients had no evidence of ataxia or clumsiness and had average, some even above average, cognitive ability and scholastic achievements. Epilepsy was not a feature. We conclude that the prognosis of PFAC for cognitive development and neurological signs is favourable. PMID:12200740

  18. Survey of radiotherapy planning and treatment of the supraclavicular fossa in breast cancer

    International Nuclear Information System (INIS)

    Full text: A survey of radiation oncologists (RO) in Australia and New Zealand was undertaken to determine how they would plan and treat the supraclavicular fossa (SCF) in women with breast cancer. From the 259 surveys sent in February to March 2007 there were 168 responses (65%) and 124 of these were from RO who managed breast cancer. The study demonstrated a wide variation in placement of the SCF field and differences in the treatment prescription. With widespread availability of CT for simulation it would be worthwhile to explore the routine voluming of SCF lymph nodes (LN) to ensure the radiation field is accurately determined and targeted. This would also allow more individualized prescription parameters and overcome the variation in the ICRU dose point found in the present survey.

  19. Acoustic neurinoma and posterior fossa meningioma - clinical and CT radiologic findings

    International Nuclear Information System (INIS)

    Clinical and computed tomography (CT) findings of twenty-three patients with acoustig neurinoma (AN) and eleven patients with posterior fossa meningioma (PFM) are described. AN frequently (94%) presents with the complaint of hearing loss, while PFM often (60%) presents with non-specific pains in the head or neck. The CT characteristics of AN and PFM in this series were similar to those found in most previous publications. The maximal measured mean diamter of PFM (40.2 mm) was significantly larger than that of AN (26.4 mm). Hydrocephalus was apparently influenced by tumor location rather than by its size. It is concluded that diagnostic ability has been improved in cases of CPA tumors, but not in those of non-CPA PFM, probably because of the earlier clinical presentation of the former. Clinical efforts are still necessary to detect the smaller tumors. (orig.)

  20. 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

  1. Middle cranial fossa epidermoid cyst: a case report of unusual CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Na, Hyoung Il; Lee, Yong Chul; Kwon, Jeong Tek; Kang, Seok Hyung; Yoo, Seung Min; Lee, Hwa Yeon; Song, In Sup; Kim, Yang Soo [College of Medicine, Chungang Univ., Seoul (Korea, Republic of); Yu, Hyoen [Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2004-11-01

    Intracranial epidermoid cysts usually show homogeneous hypodensity on CT scans, hypointensity on T1-weighted MR images and hyperintensity on T2-weighted MR images. Most of them arise in the cerebellopontine angle and parasellar areas. We report a case of middle cranial fossa epidermoid tumor with unusual image findings. The entire tumor mass showed inhomogeneous low density, without any enhancing solid portion on the CT scans. The lateral portion of the tumor showed homogeneous T1 low signal intensity and T2 high signal intensity. The medial portion of the tumor showed heterogeneous T1 and T2 intermediate to high signal intensity. On the gadolinium enhanced MR images, enhancement of the thickened dura was observed behind the tumor. Surgery and pathologic examination revealed the presence of an extradural epidermoid cyst.

  2. Delineation of two clinically and molecularly distinct subgroups of posterior fossa ependymoma.

    Science.gov (United States)

    Witt, Hendrik; Mack, Stephen C; Ryzhova, Marina; Bender, Sebastian; Sill, Martin; Isserlin, Ruth; Benner, Axel; Hielscher, Thomas; Milde, Till; Remke, Marc; Jones, David T W; Northcott, Paul A; Garzia, Livia; Bertrand, Kelsey C; Wittmann, Andrea; Yao, Yuan; Roberts, Stephen S; Massimi, Luca; Van Meter, Tim; Weiss, William A; Gupta, Nalin; Grajkowska, Wiesia; Lach, Boleslaw; Cho, Yoon-Jae; von Deimling, Andreas; Kulozik, Andreas E; Witt, Olaf; Bader, Gary D; Hawkins, Cynthia E; Tabori, Uri; Guha, Abhijit; Rutka, James T; Lichter, Peter; Korshunov, Andrey; Taylor, Michael D; Pfister, Stefan M

    2011-08-16

    Despite the histological similarity of ependymomas from throughout the neuroaxis, the disease likely comprises multiple independent entities, each with a distinct molecular pathogenesis. Transcriptional profiling of two large independent cohorts of ependymoma reveals the existence of two demographically, transcriptionally, genetically, and clinically distinct groups of posterior fossa (PF) ependymomas. Group A patients are younger, have laterally located tumors with a balanced genome, and are much more likely to exhibit recurrence, metastasis at recurrence, and death compared with Group B patients. Identification and optimization of immunohistochemical (IHC) markers for PF ependymoma subgroups allowed validation of our findings on a third independent cohort, using a human ependymoma tissue microarray, and provides a tool for prospective prognostication and stratification of PF ependymoma patients. PMID:21840481

  3. Extensive cartilaginous metaplasia of recurrent posterior fossa ependymoma: case report and review of the literature.

    Science.gov (United States)

    Boukas, Alexandros; Joshi, Abhijit; Jenkins, Alistair; Holliman, Damian

    2013-01-01

    Cartilaginous metaplasia in ependymomas is extremely rare and only few cases have been reported in the literature. We describe a case of a 5-year-old patient with a 5th recurrence of 4th ventricle ependymoma. He was previously treated with 4 resections, chemotherapy and radiotherapy. Histopathology revealed well-differentiated chondroid tissue occupying almost the entire lesion. Near total resection was achieved for the 5th time, but the patient died 3 months later achieving a total survival of 48 months, the 3rd longest reported in literature. Multiple resections of tumour recurrence provided a new insight in this very rare tumour, as it gave us the opportunity to observe the progression of tumour aggressiveness from grade II to grade III and finally to chondroid metaplasia. Cartilaginous metaplasia in posterior fossa ependymomas is a very atypical and challenging tumour with poor overall prognosis. PMID:24401698

  4. Molecular Sub-Group Specific Immunophenotypic Changes are Associated with Outcome in Recurrent Posterior Fossa Ependymoma

    Science.gov (United States)

    Hoffman, Lindsey; 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.

    2013-01-01

    Background 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. Methods 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. Results 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 PMID:24240813

  5. Herniography: A prospective, randomized study between midline and left iliac fossa puncture techniques

    International Nuclear Information System (INIS)

    AIM: To determine whether an optimal site of injection exists for herniography. MATERIALS AND METHODS: This was a prospective, randomized study of 93 consecutive patients who were referred for herniography over a period of 9 months. Patients underwent either a left iliac fossa (LIF) or midline puncture. Parameters assessed included initial adequate needle placement, complications, pain scores and body mass index (BMI). The groups were compared using Chi-squared test for categorical data, Student's t-test for continuous data and the Mann-WhitneyU-test for skewed data, withP 6 ml resulted in significantly more pain. More frequent initial adequate needle placement was observed in thin patients (BMI 2) with experienced operators. Conversely, increased body mass index resulted in more difficult needle placement. CONCLUSION: Herniography is a safe procedure with few complications. There was no significant difference comparing the midline and LIF approaches. Nadkarni, S. et al. (2001)

  6. Arachnoid cysts of the middle fossa predispose to subdural haematoma formation fact or fiction?

    Science.gov (United States)

    Page, A C; Mohan, D; Paxton, R M

    1988-01-01

    An association between arachnoid cysts of the middle fossa (ACMF) and complicating subdural haematoma (SDH) has been previously noted. More recently it has been hypothesized that ACMF may predispose to SDH formation. The Plymouth Neurosurgical Unit has treated twenty patients with ACMF between 1976-1985, seven of these being complicated by SDH. There was an age range of 11-56 years in those with SDH. Six of the seven patients with ACMF and SDH gave no significant trauma history. Four of these were males aged 11 to 20 years. The presenting histories, clinical findings and subsequent management of these patients were compared with the age-matched males with SDH alone (twelve patients). In the SDH alone group 100% suffered major skull trauma and 80% had demonstrable skull fractures. In addition the patients with ACMF were compared with patients presenting with other supratentorial arachnoid cysts in Plymouth. Only ACMF were associated with the development of SDH in our study. Three patients demonstrated total masking of the ACMF by isodense intracystic haematoma on computed tomography. In two of these patients the presence of an ACMF was suspected due to plain radiographic and CT enlargement of the middle fossa. It is advocated that with special reference to young males, in the absence of major skull trauma an ACMF should be suspected as a predisposing factor to SDH. Postoperative CT scans for at least one year are advisable in young patients with SDH as demonstration of the presence of an ACMF and SDH affects future management. PMID:3189011

  7. 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)

    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

    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. 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.

  8. 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)

    Yvens B. Fernandes

    1995-09-01

    Full Text Available O hipogonadismo hipogonadotrófico pode resultar de diferentes anomalias do sistema nervoso central, apresentando sinais clínicos que dependem da idade de aparecimento, bem como do grau de deficiência gonadotrófica e de sua associação com outras deficiências hipofisárias. Relatamos o caso de um rapaz de 18 anos com atraso puberal, retardo de crescimento estatural a partir de 10 anos e história de dificuldade de aprendizado escolar. Ao exame apresentava discreto aspecto eunucóide, 162 cm de altura (z score = -2,17, estadiamento puberal GII, PII, testículos de 4 cm³. A avaliação complementar demonstrou níveis pré-puberais de testosterona, megateste com resposta normal, exceto ao teste de estímulo com GnRH agudo e prolongado. CT de crânio mostrou cisto aracnóide da fossa média esquerda com extensão supra-selar. Foi feito o diagnóstico de hipogonadismo hipogonadotrófico provavelmente secundário à compressão pelo cisto aracnóide e por isso, optou-se por derivação cisto-peritoneal. Após a cirurgia não houve retomada do desenvolvimento puberal, sendo então verificada anosmia bilateral e, portanto, diagnosticada Síndrome de Kallmann, que foi confirmada pelos achados da RNM, embora os resultados hormonais não sejam totalmente compatíveis com a referida síndrome. Não encontramos na literatura descrição da associação entre Síndrome de Kallmnann e cisto aracnóide e acreditamos que neste caso os resultados da avaliação hormonal possam ser devidos a tal associação que provocou adicionalmente uma disfunção hipofisária.Hypogonadotrophic hypogonadism can result from different abnormalities in the central nervous system. The clinical picture depends upon the time of onset the deficiency, the magnitude of the gonadotropins deficiency and whether there are other pituitary hormone deficiencies as well. We report on a 18-year-old boy, who was investigated because of pubertal and growth delay. He also had learning disabilities. On physical examination he exhibited mild eunuchoid aspect, 162 cm height (z score = -2,17, pubertal development on stage G II, P II, and 4 cm5 testis. Laboratory investigation revealed pre-pubertal levels of testosterone and normal results of the combined test of anterior pituitary function, except for in GnRH acute and prolonged test. Brain CT showed an arachnoid cyst on left middle fossa with expansion to suprasellar cisterna. He was diagnosed as having hypogonadotrophic hypogonadism secondary to compression by the cyst, and a cyst-peritoneal derivation was performed. After surgery there was no improvement of the pubertal state and bilateral anosmia was discovered, so Kallmann's syndrome was then diagnosed and was confirmed by MRI, even though the hormonal results are not totally matched with the refered syndrome. We did not find in the literature any description of the association between Kallmann's syndrome and arachnoid cyst and we believe that in this case the results of the hormonal measurement may be due to such association that provoked an additional hypophysis dysfunction.

  9. 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

    Directory of Open Access Journals (Sweden)

    Aline Gomes Bittencourt

    2013-04-01

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

  10. 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)

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

    2013-04-01

    Full Text Available A técnica clássica para o implante coclear é realizada através de mastoidectomia e timpanotomia posterior. A abordagem pela fossa craniana média provou ser uma alternativa valiosa, embora venha sendo usada para o implante coclear apenas esporadicamente e sem normatização. OBJETIVO: Descrever uma 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.

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2011-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    Delong Liu

    2008-10-01

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

  14. Pesquisa de Staphylococcus aureus enterotoxigênico nas fossas nasais de manipuladores de alimentos em hospitais, São Paulo, 1976 Staphylococcus aureus in the anterior portion of nasal fossae of hospital food handlers, São Paulo, Brazil, 1976

    OpenAIRE

    Sebastião Timo laria; Furlanetto, Sirde?ia M. P.; Campos, Maria Lu?cia C.

    1980-01-01

    Foi realizada a verificação da presença de Staphylococcus aureus enterotoxigênico, em manipuladores de alimentos, em cozinhas hospitalares. Foi colhido material da porção anterior das fossas nasais de 34 pessoas que trabalhavam em três hospitais da cidade de São Paulo. Dentre os indivíduos examinados, 12 (35,3%) revelaram-se portadores de S. aureus e, destes 2 (16,7%) foram positivos para cepas produtoras de enterotoxina estafilocócica do tipo C. Das 12 cepas isoladas, 9 (75%) foram...

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

    OpenAIRE

    Kalifa Chantal; Habrand Jean-Louis; Kieffer Virginie; von Hoff Katja; Dellatolas Georges; Grill Jacques

    2008-01-01

    Abstract Background To investigate the neuropsychological outcome of children treated with surgery and posterior fossa irradiation for localized infratentorial ependymoma. Methods 23 patients (age 0.3 – 14 years at diagnosis) who were treated with local posterior fossa irradiation (54 Gy) underwent one (4 patients) or sequential (19 patients) neuropsychologic evaluation. The last evaluation was performed at a median of 4.5 (1 to 15.5) years after RT. Results Mean last full scale IQ (FSIQ), ve...

  16. 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)

  17. Pesquisa de Staphylococcus aureus enterotoxigênico nas fossas nasais de manipuladores de alimentos em hospitais, São Paulo, 1976 Staphylococcus aureus in the anterior portion of nasal fossae of hospital food handlers, São Paulo, Brazil, 1976

    Directory of Open Access Journals (Sweden)

    Sebastião Timo laria

    1980-03-01

    Full Text Available Foi realizada a verificação da presença de Staphylococcus aureus enterotoxigênico, em manipuladores de alimentos, em cozinhas hospitalares. Foi colhido material da porção anterior das fossas nasais de 34 pessoas que trabalhavam em três hospitais da cidade de São Paulo. Dentre os indivíduos examinados, 12 (35,3% revelaram-se portadores de S. aureus e, destes 2 (16,7% foram positivos para cepas produtoras de enterotoxina estafilocócica do tipo C. Das 12 cepas isoladas, 9 (75% foram fagotipáveis; das duas cepas enterotoxigênicas, uma foi não fagotipável e a outra foi Usada por fagos do grupo III.The presence of enterotoxic S. aureus in the nasal fossae of hospital food handlers was investigated. Material was collected from the anterior portion of fossae of 34 food handlers in the kitchens of three hospitals in the city of S. Paulo, Brazil. Of these 34 persons, 12 (35.3% were positive for S. aureus, of these same 12, two (16.7% showed positive for type C staphylococcal enterotoxin producing strains. Of the 12 strains isolated, nine (75% could be phagetyped; of the enterotoxic strains, one was lysed by Group III phage; the other was non-typeable.

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Roberto Galiano Piquet

    2012-03-01

    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 ensayo 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.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 preparation 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.

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

    Scientific Electronic Library Online (English)

    Roberto, Galiano Piquet; Bárbaro, Usatorres Rodríguez.

    2012-03-01

    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.

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

    Link, Daniel P.; Jennifer Feneis; John Carson

    2013-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    Eric P. Chiang

    2013-07-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Brian O’Sullivan

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jahanguiri B

    1994-04-01

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

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

    International Nuclear Information System (INIS)

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

  7. Improved Treatment of the Breast and Supraclavicular Fossa Based on a Simple Geometrical Principle

    International Nuclear Information System (INIS)

    In breast cancer, nodal irradiation has become routine, but adds time and creates concerns for field overlap if the “match” is not accurate. We developed a technique to address these issues by using only one isocenter for both areas. Tangents are designed at simulation. The isocenter is then shifted to the upper border of the breast using a straightforward geometrical calculation. After determining the new isocenter, fields are recreated wherein the tangents are treated with a quarter beam and the supraclavicular field fashioned with a half-beam block. The gantry, collimator, and couch angles of the supraclavicular field are adjusted to achieve an accurate match. Ten patients were evaluated. Doses to the spinal cord and brachial plexus were lowered relative to conventional techniques. The hot spots were not augmented. In comparison with standard arrangements, setup time decreased. Accurate matching was consistently achieved and verified by portal imaging. A new approach for treating the supraclavicular fossa is easily executed. Advantages include negligible doses to the critical neural structures (i.e., spinal cord and brachial plexus), optimized matchline, and reduced setup time.

  8. 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

  9. Subtemporal-anterior transtentoral approach to middle cranial fossa microsurgical anatomy.

    Science.gov (United States)

    Xu, Zhiming; Wang, Weimin; Zhang, Jingjing; Liu, Wei; Feng, Yugong; Li, Gang

    2014-11-01

    This study aimed to describe the topography of inferior and external dura mater of the middle cranial fossa through subtemporal-anterior transpetrosal approach and discuss the feasibility of improving the approach. Eight formalin-fixed adult cadaveric heads were studied, with the bones milled away in the lateral triangle region of the petrous bone, Kawase rhombus region, and inner triangle region of the petrous apex. The distances between the targets in these regions, as well as the angles after the dissection of zygomatic arch, were measured, and then the exposed petroclival and retrochiasmatic areas were observed under the microscope. There were significant variations in the distances between targets in the 3 milled regions among the specimens. After the dissection of zygomatic arch, the surgical view got an average increase of 12 degrees. The subtemporal anterior transpetrosal approach, as an improved subtemporal approach, can expose the lesions optimally, causing no injury to the hearing and reducing injuries to temporal lobe. On the other hand, the lateral bone of the petrous parts of the temporal bone is removed so as to improve the view to the retrochiasmatic area and expand the operative field. PMID:25377976

  10. Visualization of the angio-architecture in the posterior fossa using image fusion

    International Nuclear Information System (INIS)

    Recently, the authors reported a novel image fusion technique, which combines three-dimensional digital subtraction angiography (3D DSA) and magnetic resonance (MR) images, to produce DSA-MR fusion. This technique visualizes both angioarchitecture imaged by 3D DSA and soft tissues imaged by MR. The goal of this study was to evaluate the utility of DSA-MR fusion in visualizing arteries and veins, as well as intracranial lesions, brain tissues, and cranial nerves, in the posterior fossa. Thirty-seven consecutive patients (10 with neurovascular compression syndrome, 24 with brain tumors and 3 with cerebrovascular diseases) underwent preoperative DSA-MR fusion. The authors compared the DSA-MR fusion images with intraoperative findings. Image fusion was performed within 20 minutes and the registration error was insignificant in all cases. Image fusion successfully and clearly visualized the 3D relationships between arteries or veins, cranial nerves, brain tissues and lesions; furthermore, specific vessels were easily identified. The findings of DSA-MR fusion images were surgically confirmed in all patients. Using this advanced image fusion technique with its reasonable post-processing time, neurosurgeons may more easily and precisely understand the surgical anatomy preoperatively than by analyzing 3D DSA and MR images separately. (author)

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

    Directory of Open Access Journals (Sweden)

    MR Etemadifar

    2005-05-01

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

  12. 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)

  13. 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)

  14. Malignant giant cell tumor in the posterior fossa of a neonate.

    Science.gov (United States)

    Karamanakos, Petros N; Jaaskelainen, Juha E; Alafuzoff, Irina; Pirinen, Elina; Vanninen, Ritva; Silvennoinen, Sanna; Sankilampi, Ulla; Immonen, Arto

    2010-03-01

    Giant cell tumors (GCTs) of the bone are rare, usually benign but locally aggressive neoplasms that primarily occur in the epiphyses of long bones. They seldom develop in the cranium; when they do, they involve principally the sphenoid and temporal bones. These tumors usually affect young adults, and few reports in children have been published. Primary malignant GCTs of the skull are even more uncommon. The 3 published cases all involved adults over 40 years of age. Herein, the authors present a case of a highly aggressive primary malignant GCT of the posterior fossa in a 5-week old preterm infant. One month after the gross-total resection of the tumor found in the bone, the infant's condition rapidly deteriorated and she died. Magnetic resonance imaging and postmortem examination revealed a tumor larger than it had been before the operation, with expansion toward the brain. To the best of the authors' knowledge, this is the youngest patient reported with a primary malignant GCT of the skull, and actually the first case in a pediatric patient. In addition, the extremely high growth rate of the tumor in the postoperative period renders this case the most aggressive primary malignant GCT of the cranium described so far. PMID:20192645

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

    Scientific Electronic Library Online (English)

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

    2015-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Keasberry Justin

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-15

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

  18. 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.)

  19. Changes in cerebrospinal fluid flow assessed using intraoperative MRI during posterior fossa decompression for Chiari malformation.

    Science.gov (United States)

    Bond, Aaron E; Jane, John A; Liu, Kenneth C; Oldfield, Edward H

    2015-05-01

    OBJECT The authors completed a prospective, institutional review board-approved study using intraoperative MRI (iMRI) in patients undergoing posterior fossa decompression (PFD) for Chiari I malformation. The purpose of the study was to examine the utility of iMRI in determining when an adequate decompression had been performed. METHODS Patients with symptomatic Chiari I malformations with imaging findings of obstruction of the CSF space at the foramen magnum, with or without syringomyelia, were considered candidates for surgery. All patients underwent complete T1, T2, and cine MRI studies in the supine position preoperatively as a baseline. After the patient was placed prone with the neck flexed in position for surgery, iMRI was performed. The patient then underwent a bone decompression of the foramen magnum and arch of C-1, and the MRI was repeated. If obstruction was still present, then in a stepwise fashion the patient underwent dural splitting, duraplasty, and coagulation of the tonsils, with an iMRI study performed after each step guiding the decision to proceed further. RESULTS Eighteen patients underwent PFD for Chiari I malformations between November 2011 and February 2013; 15 prone preincision iMRIs were performed. Fourteen of these patients (93%) demonstrated significant improvement of CSF flow through the foramen magnum dorsal to the tonsils with positioning only. This improvement was so notable that changes in CSF flow as a result of the bone decompression were difficult to discern. CONCLUSIONS The authors observed significant CSF flow changes when simply positioning the patient for surgery. These results put into question intraoperative flow assessments that suggest adequate decompression by PFD, whether by iMRI or intraoperative ultrasound. The use of intraoperative imaging during PFD for Chiari I malformation, whether by ultrasound or iMRI, is limited by CSF flow dynamics across the foramen magnum that change significantly when the patient is positioned for surgery. PMID:25699415

  20. Posterior cranial fossa single-hole arteriovenous fistulae in children: 14 consecutive cases

    International Nuclear Information System (INIS)

    We report 14 consecutive children with 23 posterior cranial fossa arteriovenous fistula (AVF); six had multifocal lesions, involving the supratentorial brain in three and the spinal cord in one. There were two boys and four girls with a family history compatible with hereditary haemorrhagic telangiectasia. The diagnosis was made in infancy in eight cases and in a further six before the age of 12 years; mean age at diagnosis was 3.5 years. The male-to-female ratio was 1.8:1. Presenting features were macrocrania in four cases, haemorrhage or headache in three and nonhaemorrhagic neurological deficits or and cardiac overload in two. Dominant supply to the symptomatic fistula arose from the posterior inferior cerebellar artery in five cases, anterior inferior cerebellar artery in two and the upper basilar artery system in seven. All children were primarily treated by transarterial embolisation. We treated thirteen children (93%) by transarterial embolisation alone; one older child with a history of haemorrhage also underwent radiosurgery. We obtained 100% exclusion of the fistula(e) in six children, 95-80% in five, 80-50% in one and <50% in one. Of the incompletely treated cases, three had conservative management, and two with 80% and one with 60% reduction of their lesion are scheduled for elective treatment; two partially treated case died. There was no morbidity due to the endovascular procedures. Follow-up since referral is 6 months-10 years (mean 4.5 years). Ten chilmonths-10 years (mean 4.5 years). Ten children are neurologically normal, two have persistent (pre-existing) neurological deficits and two are dead. (orig.)

  1. Clear-cell meningioma of the anterior cranial fossa. Case report and review of the literature.

    Science.gov (United States)

    Pizzoni, C; Sarandria, C; Pierangeli, E

    2009-09-01

    Clear-cell meningioma (CCM) is a rare subtype of meningioma which occurs at a younger age and has a higher recurrence rate than other subtypes (WHO grade II). CCM usually occur in younger patients and is located in the posterior fossa and spine. The authors report the first case of olfactory groove mixed clear-cell meningioma. A 66-year-old woman was admitted to the SS. Annunziata Hospital (Taranto, Italy) in January 2007 with a two-year history of subtle changes in personality and mental function. On neurologic examination she presented a loss of sense of smell. The magnetic resonance imaging (MRI) showed an olfactory groove meningioma. The computed tomography (CT) and MRI features of CCM are not different from those of common meningiomas. The tumor was totally removed by frontolateral approach on January 24, 2007). Histological examination showed that the tumor was composed of sheet-like uniform and polygonal cells, with abundant clear cytoplasm, and small and bland nuclei. The cytoplasm was heavily laden with granular periodic acid Schiff-positive and diastase-sensitive material representing glycogen. There were no rich vascular networks but scattered collagen bundles within the tumour, little foci areas of necrosis and whorls of meningothelial cells. The neoplastic cells were positive for epithelial membrane antigen (EMA) and vimentin, and negative for glial fibrillary acidic protein (GFAP)? S-100?chromogranin A; Ki-67 labelling showed an index of 1%. The final diagnosis was mixed clear-cell meningioma. Until now only 38 intracranial CCM cases had been reported in English language literature. Different diagnoses for CCM include lesions with clear cell appearance such metastases of renal cell carcinoma and sarcoma, hemangioblastoma, ependymoma, oligodendroglioma, germinoma, chordoma, pleomorphic xanthoastrocytoma, lipid-rich glioblastoma, microcystic and lipomatous meningioma. PMID:20075823

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

    Science.gov (United States)

    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

    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

  3. 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

    Scientific Electronic Library Online (English)

    José Alberto Gonçalves da, Silva; Maria do Desterro Leiros da, Costa; Luiz Ricardo Santiago, Melo; Antônio Fernandes de, Araújo; Everardo Bandeira de, Almeida.

    1228-12-01

    Full Text Available 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 da [...] s 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. Abstract in english 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 foss [...] a, 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.

  4. 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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-12-01

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

  5. 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)

  6. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-01-15

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

  8. Divergent ependymal tumor (ependymoblastoma/anaplastic ependymoma) of the posterior fossa: an uncommon case observed in a child.

    Science.gov (United States)

    Ortiz, Javier; Otero, Alvaro; Bengoechea, Oscar; Gonçalves, Jesús; Sousa, Pablo; Figols, Javier; Bullón, Agustín

    2008-09-01

    We report a divergent ependymal tumor of the posterior fossa (ependymoblastoma/anaplastic ependymoma) observed in an 8-year-old boy. The tumor showed the histological pattern typical of an ependymoblastoma (tubular-papillary fetaloid architecture with stratification of the tumor cells) next to areas in which findings typical of an anaplastic ependymoma were detected. The immunohistochemical study confirmed our diagnostic suspicion, allowing us to establish a differential diagnosis with other entities such as medulloblastoma, medulloepithelioma, atypical rhabdoid/teratoid tumor, or metastases. PMID:18827270

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

    LENUS (Irish Health Repository)

    Sweeney, Kieron J

    2013-02-01

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

  10. Schwannoma trigeminal intracraneal con extensión a la fosa infratemporal, espacio parafaríngeo, órbita, seno maxilar y fosa nasal: A propósito de un caso / Intracraneal trigeminal schwannoma with extension to infratemporal fossa, parapharingeal space, orbit, maxillary sinus and nasal fossa

    Scientific Electronic Library Online (English)

    J.A., Santos-Franco; A., Barragán; R., Mercado-Pimentel; I., Ortiz-Velásquez; C., García-Pastor; E.I., Barquet-Platón; C., Pane-Pianesse; S., Gómez-Llata.

    2005-02-01

    Full Text Available Los schwannomas constituyen del 8 al 10% de los tumores intracraneales. Su asiento principal es la rama vestibular del VIII nervio craneal, siendo los trigeminales de escasa frecuencia. Presentamos el caso de una paciente admitida en el Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco [...] Suárez" de la ciudad de México con una masa en la fosa infratemporal con extensión importante a estructuras vecinas. Los schwannomas con extensión a la fosa infratemporal son raros. Revisamos la anatomía de la fosa infratemporal, los accesos quirúrgicos hacia dicha región, analizamos la serie de casos junto al nuestro y proponemos una modalidad quirúrgica distinta. Abstract in english Schwannomas reach 8 to 10% of all intracranial tumors. Most originate at the vestibular root of VIII cranial nerve, but trigeminal tumors are infrequent. We present the case of a patient admitted at the National Institute of Neurology and Neurosurgery "Manuel Velasco Suárez" (Mexico City) with a mas [...] s occupying the infratemporal fossa with involvement of nearby structures. Schwannomas with extension to the infratemporal fossa are rare. We review the anatomy of this region, the surgical approaches, which have been used and propose a different approach.

  11. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-08-01

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

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

    International Nuclear Information System (INIS)

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

  14. Patterns of failure following treatment for medulloblastoma: is it necessary to treat the entire posterior fossa?

    International Nuclear Information System (INIS)

    Purpose: Craniospinal radiation (CSRT) followed by a boost to the entire posterior fossa (PF) is standard postoperative therapy for patients with medulloblastoma. A large proportion of recurrences after treatment are local, with approximately 50-70% of recurrences occurring in the PF. It is unclear, however, whether these failures are occurring in the original tumor bed or outside the tumor bed, but still within the PF. With improved diagnostic imaging, better definition of tumor volumes, and the use of three-dimensional conformal therapy (3D CRT), we may be able to restrict the boost volume to the tumor bed plus a margin without compromising local control. This retrospective study analyzes the patterns of failure within the PF in a series of patients treated with radiation therapy (RT). Methods: From July 1986 through February 1996, 114 patients >18 months and <18 years with medulloblastoma were treated at the University of Michigan and Children's Hospital of Philadelphia, with RT following surgical resection. Of 114, 27 (24%) were found to have a recurrence and form the basis for this study. RT consisted of CSRT followed by a boost to the entire posterior fossa. Some patients received adjuvant chemotherapy. Patient's preoperative magnetic resonance imaging (MRI) and/or computerized tomography (CT) studies were used to compare the original tumor volume with the specific region of local relapse. Failure was defined as MRI or CT evidence of recurrence or positive cerebT evidence of recurrence or positive cerebrospinal fluid cytology. Relapse was scored as local, if it was within the original tumor bed, and regional if it was outside of the tumor bed but still within the PF. Results: The median age of the 27 patients who relapsed was 8.6 years. Three patients were <3 years old. Of 27, 21 had disease localized to the PF. Of 26, 22 patients received chemotherapy during their treatment regimen; 1 patient did not have information on systemic treatment. The median dose of RT to the craniospinal axis was 32.5 Gy and to the PF was 55.2 Gy. The median time to recurrence was 19.5 months. Local failure within the tumor bed as any component of first failure occurred in 52% (14 of 27) of all failures, but as the solitary site of first failure in only 2 of 27 failures. Of 14 patients who failed in the tumor bed, 11 also failed in the spine, 8 of 14 also failed within the PF but outside the tumor bed, and 7 of 14 failed in all three locations. Local failure within the PF but outside the tumor bed as any component of first failure occurred in 41% (11 of 27) of all failures, but as the solitary site of first failure in only 1 of 27 failures. Of 11 patients who failed in the PF but outside the tumor bed, 9 also failed in the spine, 8 also failed within the tumor bed, and 7 failed in the all three locations. Of the failures outside the tumor bed but still within the PF, 7 of 11 failed in the leptomeninges, 1 in the brainstem parenchyma, and 3 in the PF parenchyma. Of 7 who failed in the PF leptomeninges, 6 also failed within the spine. Failure within the spine as any component of first failure occurred in 70% (19 of 27) of all failures and as the only site of first failure in 5 of 27 patients. Of 19 patients who failed in the spine, 11 also failed in the tumor bed, 9 also failed within the PF but outside the tumor bed, and 9 failed in the all three locations. Conclusions: Leptomeningeal failure is a common component of failure and occurs in the leptomeninges of the PF, as well as the spine. Isolated tumor bed failure is a rarely observed event and occurred in only 2 of 27 failures described here. Similarly, parenchymal (nonleptomeningeal) failures in the PF but outside of the tumor bed were rare: 4 patients recurred in this manner, only 1 of whom was an isolated event without other sites of recurrence. Our data suggest that, when the entire PF is treated, very few failures develop in isolation in the PF outside the tumor bed. Further studies will be necessary to determine if RT to the tumor bed alone will suffice as opposed to a boost to th

  15. Patterns of failure following treatment for medulloblastoma: is it necessary to treat the entire posterior fossa?

    International Nuclear Information System (INIS)

    Purpose: Craniospinal radiation (CSRT) followed by a boost to the entire posterior fossa (PF) is standard post-operative therapy for patients with medulloblastoma. A large proportion of recurrences after treatment are local with approximately 50-70% of recurrences occurring in the PF. It is unclear, however, whether these failures are occurring in the original tumor bed, or outside the tumor bed but still within the PF. With improved diagnostic imaging, better definition of tumor volumes, and the use of 3D conformal therapy, we may be able to restrict the boost volume to the tumor bed plus a margin without compromising local control. This retrospective study analyzes the patterns of failure within the PF of a series of patients treated with radiation therapy (RT). Methods: From (7(86)) through (2(96)), 27 of 114 (24%) patients > 18 mo and < 18 yr with medulloblastoma, who were treated at the University of Michigan and Children's Hospital of Philadelphia, with RT following surgical resection were found to have a recurrence. RT consisted of CSRT followed by a boost to the entire posterior fossa. Patient's preoperative MRI and/or CT studies were used to compare the original tumor volume with the specific region of local relapse. Failure was defined as MRI or CT evidence of recurrence or positive cerebrospinal fluid cytology. Relapse was scored as local, if it was within the original tumor bed and regional, if it was outside of the tumor bed but still within the PF. Resule tumor bed but still within the PF. Results: The median age of the patients was 8.6 years. Three patients were < 3 years old. (21(27)) had disease localized to the PF. (19(21)) patients received chemotherapy during their treatment regimen; 6 patients did not have information on systemic treatment. The median dose of RT to the craniospinal axis was 32.5 Gy and to the PF was 55.2 Gy. The median time to recurrence was 19.5 months. Local failure within the tumor bed as any component of first failure occurred in 52% ((14(27))) of all failures but as the solitary site of first failure in only (1(27)) failures. (11(14)) patients who failed in the tumor bed also failed in the spine, (8(14)) also failed within the PF but outside the tumor bed, and (7(14)) failed in the all three locations. Local failure within the PF but outside the tumor bed as any component of first failure occurred in 41% ((11(27))) of all failures but as the solitary site of first failure in only (1(27)) failures. Nine of 11 patients who failed in the PF but outside the tumor bed also failed in the spine, (8(11)) also failed within the tumor bed, and (7(11)) failed in the all three locations. Of the failures outside the tumor bed but still within the PF, (7(11)) failed in the leptomeninges, (1(11)) in the brainstem parenchyma, and (3(11)) in the PF parenchyma. (6(7)) who failed in the PF leptomeninges also failed within the spine. Failure within the spine as any component of first failure occurred in 70% ((19(27))) of all failures and as the only site of first failure in (5(27)) patients. (11(19)) patients who failed in the spine also failed in the tumor bed, (9(19)) also failed within the PF but outside the tumor bed, and (9(19)) failed in the all three locations. Conclusions: Leptomeningeal failure is a common component of failure and occurs in the leptomeninges of the PF as well as the spine. Isolated tumor bed failure is a rarely observed event and occurred in only (1(27)) failures here described. Similarly, parenchymal (non-leptomengingeal) failures in the PF but outside of the tumor bed were rare: 4 patients recurred in this manner, only 1 of which was an isolated event without other sites of recurrence. These data suggest that when the entire PF is treated, very few failures develop in the PF outside the tumor bed. Further studies will be necessary to determine whether RT the tumor bed alone will suffice as opposed to a boost to the entire PF. The former approach using 3D conformal therapy may minimize the ototoxicity and other morbidity associated with full PF irradiation

  16. 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)

  17. 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)

  18. Hematoma within the Outer Membrane of the Arachnoid Cyst Located in the Middle Fossa: A Mechanism of Development of Chronic Subdural Hematoma Associated with Arachnoid Cysts

    Directory of Open Access Journals (Sweden)

    Yasuhiko Hayashi

    2014-04-01

    Full Text Available It is well known that chronic subdural hematoma (CSDH occasionally arises in patients harboring an arachnoid cyst (AC located in the middle fossa. Although the pathogenesis of CSDH associated with ACs remains unknown, several possible mechanisms have been proposed. In many reported cases, the patients with ACs in the middle fossa would be symptomatic according to development of CSDH. A 9-year-old girl presenting with a headache, nausea, and diplopia was referred to our department. Magnetic resonance imaging showed an AC in the left-side middle fossa and ipsilateral CSDH with a remarkable mass effect. Irrigation of the CSDH, partial removal of the outer membrane of the AC and CSDH, and endoscopic cystocisternostomy were performed to relieve her symptoms. Postoperative clinical course was excellent. Histopathological examination of the outer membrane of the CSDH demonstrated an arachnoid cell layer and hemorrhage from the granulation inside the membrane, and collagen fibers outside the membrane. These findings strongly suggested that the membrane and the content of the CSDH were derived from the outer membrane of the AC, and the CSF including the hemorrhage within the membrane, respectively. Laceration and hemorrhage from granulation tissue within the outer membrane of the AC are considered as one of the developmental mechanisms of the CSDH associated with AC in the middle fossa.

  19. 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

    Directory of Open Access Journals (Sweden)

    Luciana Cristina dos Santos Silva

    2012-08-01

    Full Text Available 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 from 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.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.

  20. 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)

    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

    Full Text Available 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.

  1. 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)

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

    2011-10-01

    Full Text Available 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.

  2. 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

  3. 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.

  4. Value and limitations of diffusion-weighted imaging in grading and diagnosis of pediatric posterior fossa tumors.

    Science.gov (United States)

    Jaremko, J L; Jans, L B O; Coleman, L T; Ditchfield, M R

    2010-10-01

    DWI reportedly accurately differentiates pediatric posterior fossa tumors, but anecdotal experience suggests limitations. In 3 years, medulloblastoma and JPA were differentiated by DWI alone in 23/26 cases (88%). Ependymoma (n = 5) could not be reliably differentiated from medulloblastoma or JPA. A trend toward increased diffusion restriction in higher grade tumors (1/14 grade I, 7%; 9/12 grade IV, 75%) had too much overlap to predict the grade of individual cases. The overlap in ADC between tumor types appeared partly due to technical factors (in small, heterogeneous, calcific, or hemorrhagic tumors) but also likely reflected true histologic variability, given that our 3 overlap cases included a desmoplastic medulloblastoma, an anaplastic ependymoma, and a JPA with restricted diffusion in its nodule. Simple structural features (macrocystic tumor, location off midline) aided in distinguishing JPA from the other tumors in these cases. PMID:20538820

  5. 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)

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

    Full Text Available 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.

  6. Copépodes parasitos de fossas nasais de cinco espécies de peixes (Characiformes da planície de inundação do alto rio Paraná, Paraná, Brasil - DOI: 10.4025/actascibiolsci.v29i4.887 Parasitic copepods in the nasal fossae of five fish species (Characiformes from the upper Paraná river floodplain, Paraná, Brazil - DOI: 10.4025/actascibiolsci.v29i4.887

    Directory of Open Access Journals (Sweden)

    Maria de los Angeles Perez Lizama

    2008-02-01

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

  7. 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)

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

    2006-01-15

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

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

    Directory of Open Access Journals (Sweden)

    Barai S

    2003-01-01

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

  9. Delayed Airway Obstruction in Posterior Fossa Craniotomy with Park-Bench Position—A Case Report and Review of the Literatures

    OpenAIRE

    Szu-Kai Hsu; Cheng-Ta Hsieh; Chih-Ta Huang; Jing-Shan Huang

    2012-01-01

    Background: Park-bench position is a commonly used position in patients operated with cerebellopontine tumor, microvascular decompression, or lesions of cerebellar hemisphere and vertebral artery. Several complications associated with this positioning have been described. However, the delayed airway complication resulting from park-bench position has been rarely reported in the literatures. Herein, we report a rare case of delayed airway obstruction after a posterior-fossa craniotomy with par...

  10. Georeferenced cartography dataset of the La Fossa crater fumarolic field at Vulcano Island (Aeolian Archipelago, Italy): conversion and comparison of data from local to global positioning methods

    OpenAIRE

    Carmelo Sammarco; Giovannella Pecoraino; Paolo Madonia

    2011-01-01

    The present study illustrates the procedures applied for the coordinate system conversion of the historical fumarole positions at La Fossa crater, to allow their comparison with newly acquired global positioning system (GPS) data. Due to the absence of ground control points in the field and on both the old Gauss Boaga and the new UTM WGS 1984 maps, we had to model the transformation errors between the two systems using differential GPS techniques. Once corrected, the maps show a residual East...

  11. Exposure of the Petrous Segment of the Internal Carotid Artery Through the Extradural Subtemporal Middle Cranial Fossa Approach: A Systematic Anatomical Study

    OpenAIRE

    Mortini, Pietro; Mandelli, Carlo; Gerevini, Simonetta; Giovanelli, Massimo

    2001-01-01

    The relationships between the horizontal segment of the internal carotid artery (ICA) and other petrous apex structures was studied in 14 anatomical specimens obtained from routine autopsies and on 10 magnetic resonance images obtained from healthy volunteers. The dissection was performed under an operating microscope using the middle fossa transpetrous approach. A pentagonshaped area of 67.91 mm2 posterior to the trigeminal nerve and bordered by anatomical structures was identified inside th...

  12. 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)

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

    2015-04-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Marcelo Pandolfi Basso

    2012-03-01

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

  14. A branching, positive relief network in the middle member of the Medusae Fossae Formation, equatorial Mars—Evidence for sapping?

    Science.gov (United States)

    Harrison, S. K.; Balme, M. R.; Hagermann, A.; Murray, J. B.; Muller, J.-P.; Wilson, A.

    2013-09-01

    The Medusae Fossae Formation (MFF) is a geological formation comprising three geological units (members) spread across five principal lobes. It dominates a quarter of the longitudinal extent of the equatorial region of Mars. Positive relief features referred to as ‘sinuous ridges’ (commonly interpreted as inverted paleoflow channel or valley fills) have been observed in the lowest member of the western MFF, but have not been identified within the central and eastern portions of the formation, in the middle and upper members. This paper presents the identification and analysis of a branching, positive relief system which occurs in the central lobe of the MFF in what appears to be an exposure of the middle member. A simple geomorphological map of the system is presented, from which we have adopted the working hypothesis that this is an inverted fill of a branching fluvial channel or valley system. A suite of morphological and topographic evidence supporting this hypothesis is presented, including analysis of the network using a ?15 m/pixel digital terrain model derived from a Context Imager (CTX) stereo image pair. The evidence supporting this hypothesis includes: (1) the local slope and topography of the upper surface of the network are consistent with a contributory network; (2) the braided, fan-like form at the termination of the branching network is consistent in morphology with it being a depositional fan at the end of a fluvial system; (3) the terminal fan and surrounding deposits show layering and polygonization; and (4) there is strong association between the lower order branches and amphitheater shaped scarps in the depression walls. We evaluate the possible origins of this fluvial system and suggest that seepage sapping is the most probable. Two possible models for the evolution of the network and related features are presented; both require melt of ice within the MFF to form liquid water. We conclude that at least some portions of the Medusae Fossae Formation, if not the entire formation, were once volatile-rich. Finally, we note that our observations do not rule out the case that this network formed before MFF emplacement, and has since been exhumed. However, this conclusion would suggest that much of the surrounding terrain, currently mapped as middle-member MFF, is not in fact MFF material at all.

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

    Scientific Electronic Library Online (English)

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

    2012-03-01

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

  16. Posterior fossa dural arteriovenous fistulas: diagnosis and follow-up with time-resolved imaging of contrast kinetics (TRICKS) at 1.5T

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    Pekkola, Johanna; Kangasniemi, Marko (Helsinki Medical Imaging Center, Helsinki Univ. Central Hospital, Helsinki (Finland)), email: johanna.pekkola@hus.fi

    2011-05-15

    Background Time-of-flight MR angiography (TOF MRA) is currently the most widely used non-invasive imaging tool to diagnose dural arteriovenous fistula (DAVF). It is, however, not as sensitive as invasive digital subtraction angiography (DSA) for detecting the arteriovenous shunting inherent in DAVF. Dynamic contrast-enhanced MR angiography allows separation of arterial and venous phases of contrast passage though the brain and can thus demonstrate early venous filling through the arteriovenous shunt. Purpose To compare the diagnostic value of TOF MRA and a commercially available dynamic contrast-enhanced MR angiography sequence (TRICKS) at 1.5T in detecting posterior fossa DAVF. Material and Methods We retrospectively collected image data for 19 patients who underwent TOF MRA, TRICKS, and DSA either for primary diagnosis or for follow-up of posterior fossa DAVF and assessed the performance of TOF MRA and TRICKS in demonstrating the arteriovenous shunt, with DSA as the reference standard. Results TRICKS detected early arterial filling at 94.4% sensitivity and 83.3% specificity. TOF MRA detected high flow-related signal within venous structures at 64.7% sensitivity and 80% specificity. Conclusion The commercially available dynamic MR angiography sequence TRICKS with fully automatic vendor postprocessing at 1.5T is more sensitive than TOF MRA in detecting the arteriovenous shunt in posterior fossa DAVF

  17. 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)

  18. Detection of tumors lesions in posterior fossa in CT brain images for different conditions acquisition and dose

    International Nuclear Information System (INIS)

    The posterior fossa brain area is likely to be the seat of tumors young of many types and origins. These lesions are sometimes beyond the level of detectability of routine CT of the skull, where conditions acquisition and processing are not the most appropriate. This paper provides a study of tomographic images acquired with a new anthropomorphic skull phantom showing minor tumor lesions in the above mentioned area. 13 axial CT were performed. The acquisition parameters were varied tube current, time exposure, slice thickness and collimation, looking for better conditions allowing good detectability of lesions under study by applying lower doses. We measured the air kerma at the entrance of the phantom. We studied the quality of imagery expert observer approach, investigating the detectability of lesions, as well as from 4 figures of merit: Value Contrast-Noise, Signal to Noise Ratio, Mean Square Error and Index Structural similarity with respect to the reference condition in each type of acquisition. It shows that it is possible to reduce doses from applying under MAS values without affecting the detectability of such injuries in the CT skull, with good in image quality. Are also proposed, optimized acquisition protocols for technology acquisition employed. (author)

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Bassey Enya

    2011-06-01

    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.

  1. Hot Tub Rash (Pseudomonas Folliculitis)

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    ... Your doctor may wish to obtain a bacterial culture of one of the pus-filled bumps in ... 2006-2013 Logical Images, Inc. All rights reserved. Advertising Notice This Site and third parties who place ...

  2. Poison ivy - oak - sumac rash

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    ... away if: The person is suffering a severe allergic reaction, such as swelling or difficulty breathing, or has had a severe reaction in the past. The person has been exposed to the smoke of a burning poison ivy, oak or sumac. ...

  3. Rash - child under 2 years

    Science.gov (United States)

    ... creams because they tend to keep the skin warmer and block the pores. Erythema toxicum is normal ... that has caused irritation in the past (including foods) should be avoided. Apply a moisturizing cream or ...

  4. Reversible dyscognition in patients with a unilateral, middle fossa arachnoid cyst revealed by using a laptop based neuropsychological test battery (CANTAB).

    Science.gov (United States)

    Torgersen, Johan; Helland, Christian; Flaatten, Hans; Wester, Knut

    2010-11-01

    The aim of this study was to evaluate and validate the Cambridge Neuropsychological Test Automated Battery (CANTAB) in a Norwegian group of patients undergoing surgery for middle fossa arachnoid cysts (AC). We also wanted to assess health related quality of life (HRQOL) in these patients to see if it could be improved by decompression of the AC. Adult patients (>18 years) with unilateral middle fossa AC and no previous history of neurological disease, head injury, or a psychiatric disorder were eligible for inclusion. We used four tests from CANTAB to assess the level of neuropsychological performance: paired associate learning (PAL) and delayed matching to sample (DMS) assessed temporal lobe functions, while Stockings of Cambridge (SOC) and intra-extra dimensional (IED) shift focused on frontal lobe functions. Patients with postoperative cerebral complications were reported, but excluded from neuropsychological follow-up. In addition to the CANTAB data, pre- and postoperative clinical and radiological data were collected. HRQOL was assessed using Short Form 36 (SF-36) pre- and postoperatively. We found significant improvement in the two temporal tests assessing memory, but no improvement in the two frontal tests assessing executive function. HRQOL was significantly reduced preoperatively in two of eight SF-36 domains and improved significantly in four domains postoperatively. CANTAB facilitates detection of cognitive improvements after decompression of the cyst in patients with AC in the middle fossa. The improvements were detected on the tests sensitive to temporal lobe problems only, not on the tests more sensitive to frontal lobe affection. This establishes construct validity for CANTAB for the first time in this population. PMID:20602236

  5. 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)

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

    Directory of Open Access Journals (Sweden)

    Arif Nelliyulla Parambath

    2012-05-01

    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.

  7. 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)

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

    2006-02-01

    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. 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.

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

    Directory of Open Access Journals (Sweden)

    Ricardo Rodrigues Figueiredo

    2006-02-01

    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.

  9. Discordant K-Ar ages between hornblende and biotite from the Tanzawa tonalitic pluton in the southern Fossa Magna, central Japan

    International Nuclear Information System (INIS)

    K-Ar ages were determined for hornblende and biotite in three tonalites from the Tanzawa pluton in the southern Fossa Magna, central Japan. The two minerals show discordant ages of 10.1 and 10.7 Ma for hornblende and 4.6 - 5.1 Ma for biotite. The age data and field evidence indicate that the pluton was emplaced in the Tanzawa Group in Middle Miocene time and its slow cooling (ca. 50 deg C/Ma in average) resulted in younger ages of boitites than hornblendes due to lower closure temperature for biotite. (author)

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

    Scientific Electronic Library Online (English)

    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

    Full Text Available 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.

  11. 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

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

    Scientific Electronic Library Online (English)

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

    2008-10-01

    Full Text Available 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.

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

    Directory of Open Access Journals (Sweden)

    Kalifa Chantal

    2008-01-01

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

  14. 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)

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

    2012-10-01

    Full Text Available 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.

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

    International Nuclear Information System (INIS)

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

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

    Scientific Electronic Library Online (English)

    Nilton, Alves.

    1030-10-01

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma [...] revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA. Abstract in spanish El objetivo de esta investigación es contribuir al conocimiento que auxilie al profesional de enfermería en la identificación de los tipos más comunes de formaciones venosas de la fosa cubital, además de advertir sobre la importancia de fijar la atención a los casos poco comunes, como lo aquí report [...] ado. A través de la revisión bibliográfica, clasificamos las formaciones venosas de esta región en cinco tipos más comunes, siendo lo más frecuente el Tipo II. La utilización de la VICo se recomienda como el mejor sitio de punción, seguido por la VIB. Además, describimos una variación anatómica, donde se observó la ausencia de comunicación entre VC y VB a nivel de fosa cubital y VIA drenando en VB, con presencia de la VCA. Abstract in english The aim of this study is to contribute to the knowledge to assists the nursing staff to identify the most common types of venous formations of the cubital fossa region, and also focus on the importance of always being alert to unusual cases as that reported here. Through a literature review, we foun [...] d that the venous formations of this region can be classified into five common types, bring the Type II the was most frequent. We also found that MCV is considered the best puncture site, followed by MBV. We also describe an anatomical variation, in which we observed the absence of communication between BV and CV at the level of cubital fossa draining into BV and MVF, with the presence of the ACV.

  17. 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)

    Nilton Alves

    2012-12-01

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA.El objetivo de esta investigación es contribuir al conocimiento que auxilie al profesional de enfermería en la identificación de los tipos más comunes de formaciones venosas de la fosa cubital, además de advertir sobre la importancia de fijar la atención a los casos poco comunes, como lo aquí reportado. A través de la revisión bibliográfica, clasificamos las formaciones venosas de esta región en cinco tipos más comunes, siendo lo más frecuente el Tipo II. La utilización de la VICo se recomienda como el mejor sitio de punción, seguido por la VIB. Además, describimos una variación anatómica, donde se observó la ausencia de comunicación entre VC y VB a nivel de fosa cubital y VIA drenando en VB, con presencia de la VCA.The aim of this study is to contribute to the knowledge to assists the nursing staff to identify the most common types of venous formations of the cubital fossa region, and also focus on the importance of always being alert to unusual cases as that reported here. Through a literature review, we found that the venous formations of this region can be classified into five common types, bring the Type II the was most frequent. We also found that MCV is considered the best puncture site, followed by MBV. We also describe an anatomical variation, in which we observed the absence of communication between BV and CV at the level of cubital fossa draining into BV and MVF, with the presence of the ACV.

  18. Endoscopic prelacrimal recess approach adjunct with vestibular sulcus incision: case report of a minimally invasive access to remove infratemporal fossa tumor.

    Science.gov (United States)

    Chen, Hai-Hong; Wang, Feng; Weng, Bin-Qi; Wang, Shen-Qing

    2015-07-01

    To remove tumor located at anterolateral-inferior of infratemporal fossa (ITF) with purely transnasal approach is still a great challenge because of the over lateral angulation. The aim of this study is to present our initial experience-endoscopic prelacrimal recess approach adjunct with vestibular sulcus incision as a simple and minimally invasive approach to remove tumor in this area. Tumor in anterolateral ITF can be well explored via endoscopic prelacrimal recess approach; a simple vestibular sulcus incision provides a second access for two-surgeon co-operation, so tumor can be removed conveniently with minimal invasion. It is a viable alternative to endoscopic extended medial maxillectomy approach or open approaches to this area. PMID:25557004

  19. The prognostic value of histological grading of posterior fossa ependymomas in children: a Children's Oncology Group study and a review of prognostic factors.

    Science.gov (United States)

    Tihan, Tarik; Zhou, Tianni; Holmes, Emi; Burger, Peter C; Ozuysal, Sema; Rushing, Elisabeth J

    2008-02-01

    We performed a retrospective analysis of 96 pediatric posterior fossa ependymomas in order to determine the prognostic value of histological grade based on the current WHO grading scheme. The patients were selected among Children's Oncology Group (previously Pediatric Oncology Group-POG) patients enrolled in clinical trials, and on the basis of central pathology review, location, and age. We excluded entities such as sub-ependymoma, myxopapillary, or clear-cell ependymoma, after a consensus diagnosis by three neuropathologists. A total of 66 males and 30 females with a median age of 48 months were identified. The group was analyzed to determine the effects of histological grade, age, gender, and extent of resection on event-free and overall survival. Our results showed that extent of resection, age, and histological grade were independent prognostic variables for event-free survival. The relative risk for extent of resection and histological grade was calculated as 3.59 (Pependymomas in the English language between 1990 and 2005. Selection criteria identified 32 manuscripts involving 1444 patients. Extent of resection was a significant factor in 21, age in 12, and histological grading in nine of these studies. Other factors reported to be significant by more than one study included tumor location and radiation treatment. Our findings suggest that histological grade (WHO Grade II vs III) is an independent prognostic indicator for event-free survival, but may not be so for overall survival in pediatric posterior fossa ependymomas. We believe that an accurate assessment of the prognostic value of histological grade depends on the selection of a well-characterized clinical cohort of sufficient size, and the inclusion of relevant histological criteria as outlined in the WHO classification scheme. PMID:18084249

  20. Delayed removal of maxillary third molar displaced into the infratemporal fossa / Extracción diferida del tercer molar maxilar desplazado a la fosa infratemporal

    Scientific Electronic Library Online (English)

    Bruno, Tochetto Primo; Diego José, Stringhini; Leandro, Eduardo Klüppel; Delson João, Da Costa; Nelson Luis, Barbosa Rebellato; Rafaela, Scariot de Moraes.

    2014-06-01

    Full Text Available La extracción del tercer molar es un procedimiento habitual que pocas veces se asocia a complicaciones. Una posible complicación asociada es el desplazamiento de la pieza dental a la fosa infratemporal, una estructura anatómica que contiene el músculo temporal, el músculo pterigoideo interno y exter [...] no, el plexo pterigoideo, la arteria maxilar y sus ramas, el nervio mandibular y sus ramas y la cuerda del tímpano (una rama del nervio facial). El caso descrito en este manuscrito ilustra la extracción quirúrgica diferida de un tercer molar maxilar que se había desplazado a la fosa infratemporal, a través de un acceso intraoral y con anestesia local. A pesar de que es una complicación excepcional, el cirujano experto en cirugía oral y maxilofacial debe conocer su tratamiento y seleccionar la técnica óptima, teniendo en cuenta los signos y síntomas manifestados por el paciente, y en función de sus conocimientos y experiencia. Abstract in english Third molar extraction is a common procedure and it is rarely associated with complications. One complication that may be associated with this procedure is displacement of the tooth into the infratemporal fossa, an anatomical structure that contains the temporalis muscle, medial and lateral pterygoi [...] d muscles, the pterygoid plexus, the maxillary artery and its branches, the mandibular nerve and its branches, and the chorda tympani. The present case report illustrates delayed surgical removal of a maxillary third molar that was displaced into the infratemporal fossa, via the intraoral access and under local anesthesia. Despite the rarity of this complication, oral and maxillofacial surgeons should be aware of its management and able to choose the optimal technique, taking into account the patient's signs and symptoms as well as the knowledge and experience of the surgeon.

  1. Estudo morfométrico da fossa intercondilar femoral em joelhos com e sem lesão do ligamento cruzado anterior (L.C.A.), através da aplicação de um software sobre imagens radiográficas digitalizadas Morphometric study of the femoral intercondylar notch of knees with and without injuries of anterior cruciate ligament (A.C.L.), by the use of software in digitalized radiographic images

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    Rita di Cássia de Oliveira Angelo; Sílvia Regina Arruda de Moraes; Luciano Carvalho Suruagy; Tetsuo Tashiro; Helena Medeiros Costa

    2004-01-01

    Os autores sugerem a aplicação de um software sobre imagens radiográficas digitalizadas para análise morfométrica da fossa intercondilar e dos côndilos femorais. O programa permite o tracejamento de linhas guias que facilitam a mensuração da extremidade distal do fêmur. Foram analisadas 39 radiografias simples da fossa intercondilar femoral dos joelhos direito e esquerdo, obtidas de indivíduos do sexo masculino reunidos em grupo normal (n=23) e grupo lesionado (n=16). A média de id...

  2. Hydrocephaly management in patients with tumors in the posterior fossa. Manejo de la hidrocefalia en pacientes con tumores de fosa posterior.

    Directory of Open Access Journals (Sweden)

    Omar López Arbolay.

    2005-11-01

    Full Text Available Introduction: Preoperative hydrocephalus is reported in about 80 % of posterior fossa tumor patients and in 15-40% of cases postoperative treatment for persistent or progressive hydrocephalus is required. There is no consensus on the way hydrocephalus should be managed before, during, and after PF surgery. Objective: To determine the presence of hidrocephalia in the tumors of the PF and the therapeutic focus in our means. Methods: We report a descriptive, retrospective study of 10 adult patients with posterior fossa mass lesions and obstructive hydrocephalus who were managed medically for compensate intracranial hypertension plus observation and were operated through posterior fossa craniectomy and tumor excision as unique method of surgical treatment. Results: In all 10 cases clinical improvement was obtained immediately after medical treatment. Circulation of cerebrospinal fluid (CSF was totally restored only by tumor excision in 9 patients. The other case had progression of hydrocephalus after surgery and a ventriculoperitoneal shunt was inserted. Radiological normal sized ventricles was obtained between one and two months of surgery Conclusions: Surgical elimination of CFS circulation obstacle helped by medical treatment for lower intracranial pressure should be considered as a safe option in adult patients, reserving endoscopic ventriculostomy and shunt insertion for cases with persistent or progressive hydrocephalus after treatment. Prospective multicenters randomized trials are needed to obtain stronger evidences. Fundamento: La hidrocefalia preoperatoria se reporta en el 80 % de los pacientes con tumores de fosa posterior y en 15-40 % de los casos se necesita tratamiento postoperatorio para hidrocefalia persistente o progresiva. No existe consenso en cuanto a la forma en que la hidrocefalia debe ser tratada antes, durante, o después de la cirugía de fosa posterior. Objetivo: Determinar la presencia de hidrocefalia en los tumores de la fosa posterior y el enfoque terapéutico en nuestro medio. Método: Se analizan los resultados obtenidos en 10 pacientes adultos con hidrocefalia obstructiva por lesiones de masa de fosa posterior a los cuales se les realizó tratamiento medicamentoso para compensar la hipertensión endocraneana, más observación rigurosa y exéresis de la lesión como único método de tratamiento quirúrgico. Resultados: En los 10 casos se logró mejoría clínica inmediatamente después del tratamiento medicamentoso. En 9 pacientes se restauró totalmente la circulación del líquido cefalorraquídeo después de la exéresis tumoral, progresando después de la operación la hidrocefalia solamente en un caso, al cual se le colocó un shunt ventrículo-peritoneal como tratamiento definitivo. La desaparición radiológica de la dilatación ventricular se logró entre el mes y los dos meses de operados. Conclusiones: La eliminación del obstáculo a la circulación del líquido cefalorraquídeo en los adultos con tumores de fosa posterior como único tratamiento quirúrgico para la hidrocefalia apoyado en un esquema de tratamiento medicamentoso intensivo puede considerarse como una opción segura, reservando la ventriculostomía endoscópica o la colocación de un shunt para los pacientes en que persista o se desarrolle después de la cirugía la hidrocefalia. Se necesitan estudios aleatorizados, multicéntricos para apoyar esta afirmación.

  3. Producción y calidad sanitaria de la lechuga fertilizada con efluente de fosa séptica biodigestora Produção e qualidade sanitária de alface adubada com efluente de fossa séptica biodigestora

    Directory of Open Access Journals (Sweden)

    Miréia Aparecida Bezerra Pereira

    2012-04-01

    Full Text Available

    Se evaluó la producción y los aspectos sanitarios de la lechuga fertilizada con aguas residuales de efluente humano derivada de fosa séptica biodigestora en Assentamento Rural Vale Verde, Gurupi, Estado de Tocantins, Brasil. Fueron realizadas evaluaciones morfofisiológicas y microbiológicas en plantas y microbiológicas en muestras de agua del suelo, de la lechuga y del efluente de la fosa séptica biodigestora. Por el número de hojas, altura de planta y peso fresco se observó que las plantas que recibieron la dosis de 60 L de efluente tuvieron valores más altos que los demás. Hubo un aumento del área foliar de las plantas con el aumento de la dosis de efluente. Las plantas que recibieron 60 L de efluentes fueron las que produjeron más clorofila total, y las que recibieron 20 L presentaran valores cerca de éstos. El rendimiento de la producción fue significativamente mayor en las plantas que recibieron 20, 40 y 60 L de efluente, y menor para los demás (0 y 80 L. En este estudio, no hubo contaminación por coliformes fecales a 45 º C en las muestras 1, 3, 4, 5 y 7. De las plantas de las parcelas fertilizadas con efluente del tanque séptico, sólo una muestra presentó contaminación, sin embargo, el valor se ha considerado como adecuado por estar dentro de los límites de 95% de la prueba. Se trata de una alternativa sostenible que contribuye a maximizar los recursos disponibles dentro de la agricultura familiar, sin comprometer el nivel de calidad sanitaria de consumo humano de la lechuga en las condiciones estudiadas y con incremento de la productividad.

    Avaliou-se a produção e os aspectos sanitários de alface adubada com efluente humano de fossa séptica biodigestora no Assentamento Rural Vale Verde, Gurupi-TO. Foram realizadas avaliações morfofisiológicas e análises microbiológicas de amostras de água do solo, alface e do efluente de fossa séptica biodigestora. Para número de folhas, altura de plantas e peso fresco foi observado que as plantas que receberam a dose de 60 L de efluente tiveram maiores valores que as demais. Houve um aumento na área foliar para as plantas a medida que se aumentou a dose de efluente. As plantas que receberam 60 L de efluente foram as que mais produziram clorofila total, sendo que as que receberam 20 L obteve valores próximos a estas. O rendimento de produção foi, acentuadamente, maior nas plantas que receberam 20, 40 e 60 L de efluente, e menor para as demais (0 e 80 L. Neste trabalho, não foi observada contaminação por coliformes fecais a 45 ºC nas amostras 1, 3, 4, 5 e 7. Das plantas provenientes das parcelas adubadas com efluente de fossa séptica, apenas uma amostra apresentou contaminação, no entanto o valor foi considerado adequado por estar dentro dos limites de confiança de 95% do teste. Trata-se de uma alternativa sustentável que contribui para maximização dos recursos disponíveis no âmbito da agricultura familiar sem comprometer a qualidade sanitária ao nível do consumo humano da alface nas condições analisadas e com incremento de produtividade.

  4. Suboccipital craniectomy with opening of the fourth ventricle and duraplasty: study of 192 cases of craniovertebral malformations / Descompressao da fossa posterior sem tonsilectomia em 192 casos de impressao basilar, malformacao de Chiari e/ou siringomielia

    Scientific Electronic Library Online (English)

    Jose Alberto Goncalves da, Silva; Adailton Arcanjo dos, Santos Jr.; Maria do Desterro Leiros da, Costa; Everardo Bandeira de, Almeida.

    2013-09-01

    Full Text Available O principal objetivo no tratamento cirúrgico da impressão basilar, malformação de Chiari e/ou siringomielia fundamenta-se na restauração da dinâmica do líquido cefalorraqueano ao nível da transição craniovertebral e criação de cisterna magna ampla. Isto é fator importante para evitar a migração caud [...] al das estruturas da fossa posterior. A craniectomia ampla facilita a migração cranial dessas estruturas. Existem várias técnicas cirúrgicas para descomprimir a fossa posterior, mas não há evidência sobre qual a melhor.. Os autores apresentam os resultados de 192 casos de impressão basilar, malformação de Chiari e siringomielia, operados entre 1975 e 2008, nos quais o tratamento cirúrgico se baseou em ampla craniectomia com o paciente em posição sentada, sem tonsilectomia, abertura ampla do quarto ventrículo e enxerto dural. Abstract in english The prime objective in the surgical treatment of basilar impression (BI), Chiari malformation (CM), and/or syringomyelia (SM) is based on restoration of the normal cerebrospinal fluid (CSF) dynamics at the craniovertebral junction and creation of a large artificial cisterna magna, avoiding the cauda [...] l migration of the hindbrain. It is observed that a large craniectomy might facilitate an upward migration of the posterior fossa structures. There are many surgical techniques to decompress the posterior fossa; however, a gold standard approach remains unclear. The authors present the results of 192 cases of BI, CM, and SM treated between 1975 and 2008 and whose surgical treatment was characterized by a large craniectomy without tonsillectomy with the patient in the sitting position, large opening of the fourth ventricle, and duraplasty.

  5. Tumor mesenquimatoso fosfatúrico de fosa nasal con compromiso intracraneano: Reporte de un caso y revisión de la literatura / Nasal fossa phosphaturic mesenchymal tumor with intracraneal compromise: case report and review of the literature

    Scientific Electronic Library Online (English)

    Tomás, Andrade D; Fernando, Slater R; Claudia, González G; Rodrigo, Cabezón A.

    2013-04-01

    Full Text Available El tumor mesenquimatoso fosfatúrico (TMF) es una enfermedad extremadamente rara. Según evidencia reciente es causado por la sobreexpresión del factor de crecimiento fibroblástico 23 (FGF23), el cual genera hipofosfemia y osteomalacia. A continuación presentamos el caso de un paciente de 42 años con [...] un tumor mesenquimatoso fosfatúrico de fosa nasal izquierda con extenso compromiso intracraneano. Cabe destacar que hasta la fecha hay 142 casos reportados de TMF en la literatura de los cuales solo 11 se ubican en fosa nasaly cavidades sinusales, y sólo dos de ellos ubicados en fosa nasal¹. El paciente tuvo una exitosa resolución quirúrgica con la consecuente normalización de parámetros analíticos (incluido el FGF23), mejoría sintomática y ausenia de recidiva hasta la fecha. Abstract in english The phosphaturic mesenchymal tumor (PMT) is an extremely rare disease. According to recent evidence is caused by overexpression of fibroblast growth factor 23 (FGF23) which generates hypophosphatemia and osteomalacia. We report the case of a 42 year old patient with a left nasal fossa phosphaturic m [...] esenchymal tumor with intracranial involvement. Should be noted that to date there are 142 reported cases of PMT in the literature of which only 11 are located in nasal fossa and sinus cavities, two of them located in nasal fossa¹. The patient had a successful surgical resolution with consequent normalization of analytical parameters (including FGF23), absence of symptoms and no recurrence to date.

  6. Bloqueio dos nervos tibial e fibular comum em fossa poplítea com punção única utilizando o estimulador percutâneo de nervos: considerações anatômicas e descrição ultrassonográfica Bloqueo de los nervios tibial y fibular común en fosa poplítea con punción única utilizando el estimulador percutáneo de nervios: consideraciones anatómicas y descripción ultrasonográfica Tibial and common fibular nerveblock in the popliteal fossa with single puncture using percutaneous nerve stimulator: anatomical considerations and ultrasound description

    OpenAIRE

    Viviane de Oliveira Rangel; Raphael de Almeida Carvalho; Beatriz Lemos da Silva Mandim; Rodrigo Rodrigues Alves; Roberto Araújo Ruzi; Neuber Martins da Fonseca

    2011-01-01

    JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios de nervos periféricos têm ganhado popularidade nas últimas duas décadas, tornando-se crescente opção anestésica para a cirurgia de membros. Este estudo propõe uma técnica de abordagem dos nervos tibial e fibular comum na fossa poplítea por punção única e utilizando o estimulador percutâneo de nervos, considerando a correlação com estudo anatômico e ultrassonográfico. MÉTODO: Estudo prospectivo, observacional e aleatório ...

  7. Formaciones Venosas de la Fosa Cubital en el Individuo Mapuche: Estudio Bioscópico / Venous Formations in the Cubital Fossa of Mapuche: Bioscopy Study

    Scientific Electronic Library Online (English)

    Mariano, del Sol; Miguel, Lagos Mardones; Edison, Torres Bustos.

    2007-12-01

    Full Text Available Las venas superficiales de la fosa cubital constituyen uno de los sitios más importantes para punción venosa. La disposición de esas venas presenta numerosas variaciones y, la disposición de ellas no ha sido estudiada en el grupo étnico mapuche. Debido a esto, y considerando a este grupo como el may [...] or conglomerado étnico de América del Sur, efectuamos este estudio. Fueron analizadas las venas superficiales de la fosa cubital, en 300 miembros superiores (150 derechos y 150 izquierdos) de individuos de ambos sexos (30 hombres y 120 mujeres), chilenos del grupo étnico mapuche, con edades entre 15 y 84 años. El estudio fue realizado en las postas rurales adyacentes a la ciudad de Temuco. Basados en la clasificación de del Sol et al. (1988) para las formaciones venosas de la fosa cubital, obtuvimos los siguientes resultados: Tipo I (38,7%), la vena cefálica (VC) se divide en vena intermedia basílica (VIB) y vena intermedia cefálica (VIC), uniéndose a la vena basílica (VB) y vena cefálica accesoria (VCA), respectivamente. La VIB era de mayor calibre y la vena intermedia del antebrazo (VIA) drenaba, generalmente, en la VB; Tipo II (28,3%), la VC origina la vena intermedia del codo (VICo), que se une a la VB. No existe VCA, siendo la VICo de mayor calibre y la VIA drena en la VB; Tipo III (24%), no existe comunicación entre la VB y VC a nivel de la fosa cubital. La VIA drena en la VB; Tipo IV (4,3%), la VC drena en la VB y la VIA drena en la VC; Tipo V otras disposiciones, donde se incluye la M clásica (1%) que resulta de la división de la VIA. La utilización de las VIC y VC se recomienda cuando ellas tienen un calibre semejante a la VIB o a la VICo ya que los riesgos de punción de otras estructuras anatómicas importantes, como ramos anteriores del nervio cutáneo medial del antebrazo o arteria braquial, son mínimos Abstract in english The superficial veins of the cubital fossa constitute one of the most important sites for vein puncture. The availability of those veins present numerous variations, and the availability of these has not been studied in the Mapuche ethnic group. In view of the above, and considering this group as th [...] e greatest ethnic conglomerate in South America the study took place. The superficial veins of the cubital fossa were analized in 300 superior members (150 right and 150 left) in subjects of both sexes (30 men and 120 women) Chileans of the Mapuche ethnic group between 15 and 84 years of age. The study was realized in rural clinics near the city of Temuco. Based on the classification of del Sol et al. (1988) for the vein formation of the cubital fossa, the following results were obtained: type I (38.7%), the cephalic vein (VC) is divided in the intermediate basilic vein (VIB) and intermediate cephalic vein (VIC), joining thebasilic vein (VB)and accessory cephalic vein (VCA) respectively. The VIB was of a major caliber and the intermediate vein of the forearm (VIA) generally drained in the VB, Type II (28,3%), the VC originates the intermediate vein of the elbow (VICo), that joins the VB. VCA does not exist, th VICo being of a mayor caliber and the VIA drains in to VB, Type III (24%) no communication exists between the VB and VC at the level of the cubital fossa, the VIA drains into VB, Type IV (4,3%), the VC drains in the VB and VIA drins in the VC; Type V other dispositions where the classic M is included (1%) which results in the division of the VIA. The use of the VIC and VC is recommended when they have a similar caliber to that of the VIB of VICo. Because the puncture risks of other important anatomic structures, such as anterior branches of the medial cutaneous nerve of the forearm or brachial artery are minimal

  8. Formaciones Venosas de la Fosa Cubital en el Individuo Mapuche: Estudio Bioscópico Venous Formations in the Cubital Fossa of Mapuche: Bioscopy Study

    Directory of Open Access Journals (Sweden)

    Mariano del Sol

    2007-12-01

    Full Text Available Las venas superficiales de la fosa cubital constituyen uno de los sitios más importantes para punción venosa. La disposición de esas venas presenta numerosas variaciones y, la disposición de ellas no ha sido estudiada en el grupo étnico mapuche. Debido a esto, y considerando a este grupo como el mayor conglomerado étnico de América del Sur, efectuamos este estudio. Fueron analizadas las venas superficiales de la fosa cubital, en 300 miembros superiores (150 derechos y 150 izquierdos de individuos de ambos sexos (30 hombres y 120 mujeres, chilenos del grupo étnico mapuche, con edades entre 15 y 84 años. El estudio fue realizado en las postas rurales adyacentes a la ciudad de Temuco. Basados en la clasificación de del Sol et al. (1988 para las formaciones venosas de la fosa cubital, obtuvimos los siguientes resultados: Tipo I (38,7%, la vena cefálica (VC se divide en vena intermedia basílica (VIB y vena intermedia cefálica (VIC, uniéndose a la vena basílica (VB y vena cefálica accesoria (VCA, respectivamente. La VIB era de mayor calibre y la vena intermedia del antebrazo (VIA drenaba, generalmente, en la VB; Tipo II (28,3%, la VC origina la vena intermedia del codo (VICo, que se une a la VB. No existe VCA, siendo la VICo de mayor calibre y la VIA drena en la VB; Tipo III (24%, no existe comunicación entre la VB y VC a nivel de la fosa cubital. La VIA drena en la VB; Tipo IV (4,3%, la VC drena en la VB y la VIA drena en la VC; Tipo V otras disposiciones, donde se incluye la M clásica (1% que resulta de la división de la VIA. La utilización de las VIC y VC se recomienda cuando ellas tienen un calibre semejante a la VIB o a la VICo ya que los riesgos de punción de otras estructuras anatómicas importantes, como ramos anteriores del nervio cutáneo medial del antebrazo o arteria braquial, son mínimosThe superficial veins of the cubital fossa constitute one of the most important sites for vein puncture. The availability of those veins present numerous variations, and the availability of these has not been studied in the Mapuche ethnic group. In view of the above, and considering this group as the greatest ethnic conglomerate in South America the study took place. The superficial veins of the cubital fossa were analized in 300 superior members (150 right and 150 left in subjects of both sexes (30 men and 120 women Chileans of the Mapuche ethnic group between 15 and 84 years of age. The study was realized in rural clinics near the city of Temuco. Based on the classification of del Sol et al. (1988 for the vein formation of the cubital fossa, the following results were obtained: type I (38.7%, the cephalic vein (VC is divided in the intermediate basilic vein (VIB and intermediate cephalic vein (VIC, joining thebasilic vein (VBand accessory cephalic vein (VCA respectively. The VIB was of a major caliber and the intermediate vein of the forearm (VIA generally drained in the VB, Type II (28,3%, the VC originates the intermediate vein of the elbow (VICo, that joins the VB. VCA does not exist, th VICo being of a mayor caliber and the VIA drains in to VB, Type III (24% no communication exists between the VB and VC at the level of the cubital fossa, the VIA drains into VB, Type IV (4,3%, the VC drains in the VB and VIA drins in the VC; Type V other dispositions where the classic M is included (1% which results in the division of the VIA. The use of the VIC and VC is recommended when they have a similar caliber to that of the VIB of VICo. Because the puncture risks of other important anatomic structures, such as anterior branches of the medial cutaneous nerve of the forearm or brachial artery are minimal

  9. Quality of life in children survivors of posterior fossa tumors. Calidad de vida en nios supervivientes de tumores de fosa craneal posterior

    Energy Technology Data Exchange (ETDEWEB)

    Martinez-Climent, J.A.; Castel Sanchez, V.; Esquembre Menor, C.; Ferris Tortajada, J.; Verdeguer Miralles, A.

    1994-01-01

    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.

  10. Aneurysm of antecubital vein: an unusual complication of peripheral intravenous cannulation

    Directory of Open Access Journals (Sweden)

    Mylona Evangelia

    2007-06-01

    Full Text Available Abstract Background Intravenous cannulation is a very common procedure. Venous aneurysm secondary to peripheral intravenous cannulation is extremely rare. Moreover, venous aneurysm can mimic other conditions and may confuse the issue. Case presentation We describe a case of a 45-year-old woman who was referred with the diagnosis of varicose vein of right arm. A history of intravenous cannulation at the same site was noted that raised suspicion. The swelling was compressible and turned out to be a venous aneurysm. The lesion was completely excised. Postoperative recovery was uneventful. Histology findings were in conformity with the preoperative diagnosis. Conclusion Caution should be exercised in diagnosing varicose vein at a site that bears a history of intravenous cannulation. The case also raises an important issue regarding consent. Should patients undergoing peripheral intravenous cannulation be warned of this rare complication?

  11. Aneurysm of antecubital vein: an unusual complication of peripheral intravenous cannulation

    OpenAIRE

    Mylona Evangelia; Wallace Stuart; Debnath Debasish; Myint Fiona

    2007-01-01

    Abstract Background Intravenous cannulation is a very common procedure. Venous aneurysm secondary to peripheral intravenous cannulation is extremely rare. Moreover, venous aneurysm can mimic other conditions and may confuse the issue. Case presentation We describe a case of a 45-year-old woman who was referred with the diagnosis of varicose vein of right arm. A history of intravenous cannulation at the same site was noted that raised suspicion. The swelling was compressible and turned out to ...

  12. VARIACIONES DE LAS COMUNICACIONES LINFATICO-VENOSAS EN LA FOSA SUPRACLAVICULAR IZQUIERDA DEL HOMBRE / VARIATIONS OF THE LYMPHATIC-VENOUS COMMUNICATIONS IN THE HUMAN LEFT SUPRACLAVICULAR FOSSA

    Scientific Electronic Library Online (English)

    C.F.S., Rodrigues; N., Wafae; E., Olave; C., Gabrielli; E.A., Sgrott; M.T.T, Braga.

    Full Text Available Considerando la importancia clínica y quirúrgica de las comunicaciones linfáticovenosas, poco descritas en la región cervical, presentamos y analizamos variaciones de estas comunicaciones, las que fueron observadas después de la disección de la fosa supraclavicular izquierda de 34 cadáveres en la Di [...] sciplina de Anatomía Descriptiva y Topográfica de la Universidade Federal de São Paulo-Escola Paulista de Medicina, Brasil. Encontramos dos casos (5,9 %) de vasos linfáticos que desembocaban en la vena subclavia izquierda, próximo del ángulo yúgulo-subclavio. En ambos casos, estaba presente el conducto torácico desembocando en el lugar habitual. Los estudios anatómicos de estas variaciones son importantes, ya que su conocimiento ayuda a evitar secuelas después de la realización de procedimientos quirúrgicos en la región cervical permitiendo, además, aportar detalles sobre las vías linfáticas de esa región Abstract in english Considering the clinical and surgical importance of lymphaticovenous communications, little described in cervical region, we presented and discussed the variations of these communications observed after the left supraclavicular fossa dissection of 34 adult cadavers used in the Descriptive and Topogr [...] aphic Anatomy of the Universidade Federal de São Paulo - Escola Paulista de Medicina, Brazil. We found two cases (5,9%) of lymphatic vessels that reach the left subclavian vein, near of the jugulosubclavian angle. In both cases, the thoracic duct was present and reach the usual local. Anatomical studies of these variations are important due to it knowledge help to avoid consequences after chirurgical proceedings in the cervical region. Besides, the findings of these studies contribute with more details on the lymphatic ways in this region

  13. Chemical compositions and Sr, Nd isotope ratios of gabbroic xenoliths in calc-alkali andesites of Naeba and Torikabuto volcanoes, North Fossa Magna, central Japan

    International Nuclear Information System (INIS)

    Gabbroic, doleritic and basaltic xenoliths found in calc-alkali andesites of Naeba and Torikabuto volcanoes are geochemically divided into three groups. Gabbro A of the group 1 from Naeba is rich in MgO and Ni, poor in alkalis, and shows depleted REE pattern resembling those of Ichinomegata (Sp. No.2232) and Hakone (HKG1, HKG2) volcanoes. On the basis the REE pattern and high AlIV contents in clinopyroxenes, gabbro A is interpreted to have been cumulate from a primary magma generated by partial melting of upper mantle. From REE pattern, gabbros of the group 2 from Ichinomegata (Sp. No.2218) may have derived from low alkali tholeiite magma which have been formed by removal of material such as the group 1 gabbro at shallow depth. Doleritic and basaltic xenoliths of the group 3 from Naeba, gabbroic xenoliths from Torikabuto and Umikawa are poorer in MgO and richer in alkalis than those of the group 1 and show enriched pattern in REE resembling that of high alkali tholeiite and contain clinopyroxenes having low AlIV. Therefore, these rocks are considered to be differentiates of high alkali tholeiite magma at shallow depth. On ?Nd-87Sr/86Sr diagram, isotope data of gabbro A of the group 1 plot near those of andesites from Asama and Myoko volcanoes of the North Fossa Magna. It is interpreted that these rocks have derived from the same mantle source as the Asama and Myoko volcanoes which are richer in incompatible elements than the richer in incompatible elements than those of MORB. (author)

  14. Venas Superficiales de la Fosa Cubital: Aspectos Anátomo-Clínicos y Antropológicos / Superficial Veins of the Cubital Fossa: Anatomical, Clinical and Anthropological Aspects

    Scientific Electronic Library Online (English)

    Mariano, del Sol; Bélgica, Vásquez.

    2009-06-01

    Full Text Available Es bastante frecuente el acceso a las venas superficiales de la fosa cubital, siendo uno de los sitios más utilizados para punción venosa. Aunque es un procedimiento simple, es invasivo y a veces doloroso. La disposición de las venas superficiales de la región cubital ha sido descrita por numerosos [...] autores y en diversos grupos étnicos, describiéndose variaciones y diversas padronizaciones. Las venas superficiales de la fosa cubital se han descrito formando una M, N, Y y W. Numerosos estudios, en distintas razas y grupos étnicos han demostrado similitudes y diferencias en la disposición de las venas superficiales de la fosa cubital. En 1908 Berry & Newton determinaron que en el 83% de los hombres británicos la vena cefálica del antebrazo (VCA) y la vena basílica del antebrazo (VB A) eran conectadas por la vena mediana del codo (VMCo). Okamoto (1922) en hombres japoneses, determinó 3 Tipos de padrones venosos: Tipo I donde la VCA origina la VMCo, no existe la vena cefálica accesoria del antebrazo (VCAA), y la VCA no se duplica; Tipo II, caracterizado por la duplicación de la VCA y un Tipo III, que incluye la VCAA que drena en la VCA. En hombres blancos y negros Charles (1932) señaló que la distribución más frecuente (cerca de 70% de los casos), era aquella donde la VCA y la VB A eran conectadas por la VMCo. Soller et al. (1962, 1964) en africanos de África Occidental, distinguiron tres tipos de formaciones venosas. Grupo I. Disposición clásica, tipos en M o aparentes (38,1%). Grupos II y III descritas como disposiciones de tipo embrionario constituyen el 62% de los casos. Halim & Abdi (1974) en hindúes, observaron tres tipos: 1) Tipo I. La VCA y la VBA son conectadas por la VMCo; Tipo II. La VCA drena en la VBA; la vena mediana del antebrazo (VMA) drena en la VCA. Tipo III. No existe comunicación entre la VCA y la VBA en la fosa cubital y la subdividen en Tipos IIIA y III B. Wasfi et al. (1986) describieron seis tipos de formaciones venosas en iraquíes, indicando que dos de ellas no habían sido mencionadas anteriormente. El tipo más común era la división de la VMA en dos venas, una de las cuales se unía a la VBA y la otra a la VCA. Del Sol et al. (1988) clasificaron las formaciones venosas de la fosa cubital en cinco Tipos: I la VCA se divide en vena mediana basílica (VMB) y vena mediana cefálica (VMC), uniéndose a la VBA y VCAA, respectivamente. Tipo II, la VCA origina la vena VMCo, que se une a la VB, no existe VCAA. Tipo III, no existe comunicación entre la VBAy VCA a nivel de la fosa cubital, Tipo TV, la VCA drena en la VBA y la VMA drena en la VCA. Tipo V otras disposiciones, donde se incluye la M clásica que resulta de la división de la VMA. Con respecto al diámetro de las venas parece ser de consenso que dependiendo del tipo de formación la VMB y la VMCo son las de mayor diámetro, La utilización de la VMC se recomienda cuando ella presenta un diámetro semejante a la VMB o a la VIMo ya que los riesgos de punción de otras estructuras anatómicas, como los ramos anteriores del nervio cutáneo medial del antebrazo o arteria braquial, son mínimos. Abstract in english Access ofthe cubital fossa to the superficial veins is very frequent, this being one ofthe most frequent vein puncture sites. Although it is a simple procedure, it is invasive and at times painful. The disposition ofthe superficial veins ofthe cubital area has been described by numerous authors and [...] in diverse ethnic groups, describing many variations and various patterning. The superficial veins ofthe ofthe cubital fossa have been independently described, forming an M, N, Y or W. Numerous studies in different races and ethnic groups have demonstrated similarities and differences in the disposition ofthe superficial veins ofthe cubital fossa. In 1908 Berry & Newton determined that in 83% of British men the cephalic vein ofthe forearm (CVF) and the basilic vein ofthe forearm (BVF) were connected by the median cubital vein (MCV) Okamoto (1922) in Japanese men, determined 3 types of venous

  15. Avaliação da implantação de fossas sépticas na melhoria na qualidade de águas superficiais em comunidades rurais / Evaluation of the implementation of septic tanks improving the quality of surface waters in rural communities

    Scientific Electronic Library Online (English)

    Raphael de, Vicq; Mariangela Garcia Praça, Leite.

    2014-12-01

    Full Text Available Na maioria dos municípios brasileiros, as comunidades rurais são núcleos populacionais agrupados em torno de córregos que fornecem a água e recebem seus efluentes. Buscou-se nesta pesquisa avaliar as condições dos corpos d'água na bacia hid [...] rográfica do córrego Pau Grande, Ouro Branco, Minas Gerais, antes e depois da instalação de 20 fossas sépticas na comunidade de Castiliano, construídas em 2006. O monitoramento da bacia foi realizado entre 2005 e 2009, em 6 pontos amostrais, onde foram medidos vazão, oxigênio dissolvido, demanda bioquímica de oxigênio, fósforo total, coliformes fecais totais, turbidez e pH. Os pontos a jusante das fossas apresentaram um aumento de mais de 100% nos valores de oxigênio dissolvido e redução em mais de 800% na quantidade de coliformes fecais. Investimentos relativamente baixos, como a construção das fossas, podem trazer melhorias à qualidade dos recursos hídricos em áreas rurais. Abstract in english In most Brazilian cities, rural communities are clustered in the surroundings of streams that supply water and receive their effluents. The aim of this study was to evaluate the conditions of the quality water in Pau Grande catchment, located [...] in Ouro Branco, Minas Gerais, Brazil, before and after the construction of 20 septic tanks in the community of Castiliano, build in 2006. The monitoring of the basin was conducted between February 2005 and November 2009, using 6 control points. Several water parameters were evaluated: river flow, dissolved oxygen, biochemical oxygen demand, total phosphorus, total coliform, turbidity and pH. Monitoried points downstream of the construction sites showed an increase of more than 100% in dissolved oxygen and a decrease of fecal coliform bacteria (over 800%). Relatively small investments can bring major improvements to the quality of water resources in rural communities areas.

  16. Resolution of syringomyelia in ten cases of "up-and-down Chiari malformation" after posterior fossa decompression / Resolução de siringomielia em dez casos de malformação de Chiari observada apenas com o paciente em posição sentada durante a descompressão da fossa posterior

    Scientific Electronic Library Online (English)

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

    2010-10-01

    Full Text Available Os autores descrevem 10 casos de siringomielia sem herniação do rombencéfalo, observada na ressonância magnética realizada em decúbito dorsal. Por outro lado, a herniação foi observada em todos os pacientes durante a operação com o paciente em posição sentada. A ressonância magnética pós-operatória [...] evidenciou redução da cavidade siringomiélica nos dez pacientes, bem como foi observada melhora clínica em todos os casos. O tratamento cirúrgico consistiu de craniectomia ampla da fossa posterior, tonsilectomia, abertura ampla do quarto ventrículo e duroplastia com a criação de ampla cisterna magna. Abstract in english The authors describe ten cases of syringomyelia without hindbrain herniation depicted by preoperative magnetic resonance imaging (MRI) in supine position. However, the herniation was observed in all cases during the operation with the patient in sitting position. The postoperative MRI revealed an in [...] tense reduction of the syrinx in all patients, as well as it was also observed a clinical amelioration in all cases. The surgical treatment was based on a large craniectomy with the patient in sitting position, tonsillectomy, large opening of the fourth ventricle and duraplasty with creation of a large cisterna magna.

  17. Skin Rashes Due to Bed-Wetting

    Science.gov (United States)

    ... Sign up for our FREE magazine, Kidney Living Organ Donation & Transplantation Be an Organ Donor Living Donation Donor ... Gift Primary menu Home Prevention Kidney Disease Patients Organ Donation & Transplantation Professionals Events Advocacy Donate Search Search Header ...

  18. Photos of Slapped-Cheek Rash

    Science.gov (United States)

    ... Search The CDC Cancel Submit Search The CDC Parvovirus B19 and Fifth Disease Note: Javascript is disabled ... message, please visit this page: About CDC.gov . Parvovirus Home About Parvovirus B19 Fifth Disease Pregnancy and ...

  19. The sweet Christmas rash (case series)

    DEFF Research Database (Denmark)

    GyldenlØve, Mette; Nepper-Christensen, Steen

    2013-01-01

    Christmas tree hypersensitivity is a rare condition, which has so far obtained scarce attention in the medical literature. We present two clinical cases of hypersensitivity associated with Christmas tree exposure, a 51-year-old woman with allergic contact dermatitis and a 41-year-old man with allergic rhinitis. The female patient had a positive patch test reaction to colophony, and the male patient had a positive skin prick test reaction to alternaria mould. Both were successfully advised to avoid prolonged exposure to Christmas trees and buy artificial trees for Christmas.

  20. A painful rash in an austere environment.

    Science.gov (United States)

    Hellums, John S; Klapperich, Kyle

    2015-01-01

    Dermatologic complaints are common in the deployed environment. Preventive medicine and knowledge of indigenous flora and fauna are cornerstones for forward deployed medical personnel. This article describes a case of Paederus dermatitis in an austere environment, reviews dermatologic terminology, and provides a reminder of the importance of exercising good preventive medicine procedures. PMID:25770808

  1. A Life Threatening Rash, an Unexpected Cause

    OpenAIRE

    Dhiraj Jain; Stalin Viswanathan; Chandramohan Ramasamy

    2014-01-01

    We describe a 74-year-old man with purpura fulminans and altered sensorium following an acute febrile illness. Intensive sepsis management was to no avail, until institution of doxycycline therapy following confirmation of scrub typhus. Empirical doxycycline needs to be considered in endemic areas for patients presenting with purpura fulminans.

  2. Chronic Itchy Skin Rashes in Children

    Science.gov (United States)

    ... areas of the skin, while scabies and hives (urticaria) are often widespread, covering the entire body. Click ... people by prolonged skin-to-skin contact. Hives (Urticaria) Hives (urticaria), also known as welts, is a ...

  3. Dolor recurrente en fosa iliaca derecha en niños: reporte de dos casos asociados a alergia alimentaria / Recurrent right iliac fossa pain in children: two cases report related to food allergy

    Scientific Electronic Library Online (English)

    Ana, Muñoz-Urribarri; Aderbal, Sabrá; Isaac, Tenorio; Selma, Sabrá; Javier Arias-Stella, Castillo.

    2015-01-01

    Full Text Available Objetivo: Presentar dos casos de alergia alimentaria de presentación poco común y discutir el enfoque diagnóstico de DAR en niños Casos: Caso N° 1: Niña de 11 años, aqueja dolor en fosa iliaca derecha hace 3 meses. Antecedentes: Prematuridad, atopía (dermatitis, rinitis, cólicos). Hermana y madre at [...] ópicas. Al examen físico: Dolor exquisito a la palpación de fosa iliaca derecha, cuerda cólica bilateral. Piel seca. Laboratorio: Hematobiometría sin alteraciones. Examen de orina normal, parasitológico seriado (-). EDN (neurotoxina derivada de eosinófilos) fecal >3210 ng/ml (V.N. Abstract in english Objective: To present two cases of food allergy of uncommon presentation and discuss the diagnostic approach to give in these cases: Case N° 1: 11-year-old girl, afflicting pain in the right iliac fossa 3 months ago. Background: Prematurity, atopy (dermatitis, rhinitis, cramping). Sister and mother [...] are atopic too. The physical exam show exquisite pain on right iliac fossa at palpation. Laboratory: Urine normal, parasitological serial negative. EDN (neurotoxin derived from eosinophils) fecal >3210 ng/ml (V. N.

  4. Incidence of Thrombophlebitis in Humans with the Diazepam Vehicle

    OpenAIRE

    Parkes, Roger Brown; Blanton, Patricia L.; Thrash, William J.

    1982-01-01

    Forty-one adult males volunteered for a study designed to investigate the thrombogenicity of the Valium® vehicle. Utilizing a standardized protocol, each subject received a sedative dose of Injectable Valium® in the antecubital fossa of one arm and an equivalent volume of vehicle in the contralateral arm. Both were administered with a continuous infusion drip of 5 per cent dextrose in water. Post-operative evaluation extended over 10 weeks and included clinical observation and palpation. Ul...

  5. Impact of Donor Arm Cleaning with Different Aseptic Solutions for Prevention of Contamination in Blood Bags

    OpenAIRE

    Patel, Tanvi G.; Shukla, Rinku V.; Gupte, Snehalata C.

    2012-01-01

    Transfusion associated sepsis cases are encountered occasionally and bacterial transmission remains the major cause. The goal of our study was to compare the efficacy of disinfectants in phlebotomy site preparation. After selection of donor the antecubital fossa area of the arm was disinfected with different types of disinfectants namely sprit (70% isopropyl alcohol), povidone iodine (0.5% w/v available iodine in distilled water), savlon (1.5% v/v chlorhexidine gluconate solution and 3.0% cet...

  6. Lateral Antebrachial Cutaneous Nerve injury induced by phlebotomy

    Directory of Open Access Journals (Sweden)

    Azadi Arezoo

    2007-03-01

    Full Text Available Abstract Background Phlebotomy is one of the routine procedures done in medical labs daily. Case presentation A 52 yr woman noted shooting pain and dysesthesia over her right side anterolateral aspect of forearm, clinical examination and electrodiagnostic studies showed severe involvement of right side lateral antebrachial cutaneous nerve. Conclusion Phlebotomy around lateral aspect of antecubital fossa may cause lateral antebrachial cutaneous nerve injury, electrodiagnostic studies are needed for definite diagnosis.

  7. Delayed presentation of a traumatic brachial artery pseudoaneurysm.

    LENUS (Irish Health Repository)

    Forde, James C

    2009-09-01

    Delayed presentation of a brachial artery pseudoaneurysm following penetrating trauma is infrequently reported. We report the case of a 23-year-old male who presented three months following a penetrating trauma to his antecubital fossa with a sudden exacerbation of swelling and tenderness of his elbow. Doppler ultrasound and computed tomography arteriography confirmed the presence of a large pseudoaneurysm. Surgical reconstruction was performed using the long saphenous vein as an interposition vein graft, restoring normal arterial circulation.

  8. Decorrelation Stretch Near Cerberus Fossae

    Science.gov (United States)

    2004-01-01

    [figure removed for brevity, see original site] Released July 25, 2004 On this image you can see two infrared frames of the same area on Mars. One of the images (in black and white) represents a single wavelength or band of the THEMIS IR instrument, while the other image (in false color) represents 3 different bands. The image with the various colors was created with a technique called Decorrelation Stretch (DCS). In this technique individual bands of the THEMIS IR instrument are stretched to better show compositional variations throughout the whole range. After the bands are stretched they are overlayed on one another and colors are assigned to each band. This makes up the colors in the image. As you can see, there is a difference in what is noticable in the single band IR image versus the false-colored one. On the color image the pink/magenta colors usually represent basaltic content, cyan often indicates the presence of water ice clouds, while green can represent dust. The bright purple and pink colors associated with the valley are due to basalt. There may be a thin veneer of dust present in the region (it was a dark colored region during the Viking mission in the 1970's) through which the basaltic material pokes out along the edges of the valley and the nearby knobby terrain. Image information: IR instrument. Latitude 10.7, Longitude 163 East (197 West). 100 meter/pixel resolution. Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time. NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  9. Tortícolis recurrente como forma de presentación de un tumor de la fosa posterior del cerebro / Recurrent torticollis as a form of presenting a tumor in the posterior fossa brain

    Scientific Electronic Library Online (English)

    Isael, Olazábal Armas; Katia, Pereira Jiménez.

    2012-09-01

    Full Text Available La tortícolis se presenta como una manifestación focal del sistema nervioso central, y es una afección poco frecuente, aunque puede ser el síntoma inicial en patologías de la fosa posterior del cerebro. Se presenta el caso de un paciente masculino de cuatro años de edad, con antecedentes de dolor, l [...] ateralización y torsión del cuello con nueve meses de evolución, cuyos síntomas se mantuvieron progresando. Gradualmente se asocian cefalea, náuseas e inestabilidad a la marcha. Al realizar el examen físico se encontraron elementos clínicos de una tortícolis y un síndrome cerebeloso de hemicuerpo derecho. Se realizó una resonancia magnética nuclear de cráneo, la cual evidenció una lesión sólida que ocupaba todo el piso del IV ventrículo, y se extendía hasta el segundo segmento medular cervical. Se efectuó abordaje quirúrgico de la fosa posterior del cerebro y exeresis de la lesión. El diagnóstico histológico fue el de un ependimoma. Aunque la tortícolis la mayoría de las ocasiones es una condición benigna, cuando se presenta secundariamente en los niños, uno de los diagnósticos diferenciales que deben tenerse en cuenta, son los tumores de la fosa posterior del cerebro, como ocurrió en este caso. Abstract in english Torticollis is presented as a focal demonstration of the central nervous system, and it is a rare condition, but it may be the initial symptom in diseases of the posterior fossa brain. We report the case of a male patient aged four, with a history of pain, lateralization and twisted neck with nine m [...] onths of evolution, whose symptoms were progressing. Gradually, headache, nausea and gait instability are associated. When performing the physical examination, we found clinical elements of a stiff neck and a right hemisphere cerebellar syndrome. We performed a cranial MRI, which showed a solid lesion occupying the entire floor of the fourth ventricle, and it extended to the second cervical spinal segment. Surgical approach was performed in the posterior fossa and brain tumor excision. Ependymoma was the histological diagnosis. Though most occasions, torticollis is a benign condition, when it occurs secondarily in children, one of the differential diagnoses that should be considered is the posterior fossa tumors of the brain, as in this case.

  10. Tortícolis recurrente como forma de presentación de un tumor de la fosa posterior del cerebro Recurrent torticollis as a form of presenting a tumor in the posterior fossa brain

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    Isael Olazábal Armas

    2012-09-01

    Full Text Available La tortícolis se presenta como una manifestación focal del sistema nervioso central, y es una afección poco frecuente, aunque puede ser el síntoma inicial en patologías de la fosa posterior del cerebro. Se presenta el caso de un paciente masculino de cuatro años de edad, con antecedentes de dolor, lateralización y torsión del cuello con nueve meses de evolución, cuyos síntomas se mantuvieron progresando. Gradualmente se asocian cefalea, náuseas e inestabilidad a la marcha. Al realizar el examen físico se encontraron elementos clínicos de una tortícolis y un síndrome cerebeloso de hemicuerpo derecho. Se realizó una resonancia magnética nuclear de cráneo, la cual evidenció una lesión sólida que ocupaba todo el piso del IV ventrículo, y se extendía hasta el segundo segmento medular cervical. Se efectuó abordaje quirúrgico de la fosa posterior del cerebro y exeresis de la lesión. El diagnóstico histológico fue el de un ependimoma. Aunque la tortícolis la mayoría de las ocasiones es una condición benigna, cuando se presenta secundariamente en los niños, uno de los diagnósticos diferenciales que deben tenerse en cuenta, son los tumores de la fosa posterior del cerebro, como ocurrió en este caso.Torticollis is presented as a focal demonstration of the central nervous system, and it is a rare condition, but it may be the initial symptom in diseases of the posterior fossa brain. We report the case of a male patient aged four, with a history of pain, lateralization and twisted neck with nine months of evolution, whose symptoms were progressing. Gradually, headache, nausea and gait instability are associated. When performing the physical examination, we found clinical elements of a stiff neck and a right hemisphere cerebellar syndrome. We performed a cranial MRI, which showed a solid lesion occupying the entire floor of the fourth ventricle, and it extended to the second cervical spinal segment. Surgical approach was performed in the posterior fossa and brain tumor excision. Ependymoma was the histological diagnosis. Though most occasions, torticollis is a benign condition, when it occurs secondarily in children, one of the differential diagnoses that should be considered is the posterior fossa tumors of the brain, as in this case.

  11. Estudo morfométrico da fossa intercondilar femoral em joelhos com e sem lesão do ligamento cruzado anterior (L.C.A., através da aplicação de um software sobre imagens radiográficas digitalizadas Morphometric study of the femoral intercondylar notch of knees with and without injuries of anterior cruciate ligament (A.C.L., by the use of software in digitalized radiographic images

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    Rita di Cássia de Oliveira Angelo

    2004-09-01

    Full Text Available Os autores sugerem a aplicação de um software sobre imagens radiográficas digitalizadas para análise morfométrica da fossa intercondilar e dos côndilos femorais. O programa permite o tracejamento de linhas guias que facilitam a mensuração da extremidade distal do fêmur. Foram analisadas 39 radiografias simples da fossa intercondilar femoral dos joelhos direito e esquerdo, obtidas de indivíduos do sexo masculino reunidos em grupo normal (n=23 e grupo lesionado (n=16. A média de idade da amostra foi de 26,56 anos. As variáveis analisadas foram largura bicondilar femoral, larguras da fossa intercondilar ao nível do sulco poplíteo e da base da fossa, a altura da fossa intercondilar e a largura do côndilo femoral lateral. A fossa intercondilar foi classificada quanto ao formato em cônica, circular e retangular. Os resultados encontrados sugerem que a largura da base da fossa e a largura do côndilo femoral lateral seriam fatores de risco importantes na lesão do L.C.A. Os valores médios das variáveis analisadas aproximam-se dos descritos na literatura especializada em mensurações diretas em peças cadavéricas e ressonância nuclear magnética e demonstram que a aplicação de um software sobre as imagens radiográficas digitalizadas proporciona uma mensuração confiável, mesmo utilizando-se de imagens radiográficas simples e de baixo custo.The authors suggest the use of software in digitalized radiographic images to morphometric analysis of the intercondylar notch and the femoral condyles. The software allows the draw of guide lines which facilitate the measurement of the distal extremity of femur. Thirty-nine radiographic simple has been analyzed of femoral intercondylar notch of right and left knees, of male sex individuals collected into normal (n=23 and injured (n=16 groups. The age average was 26-56 years old.The analyzed variable had been femoral bicondylar width, widths of intercondylar notch to the level of the popliteal groove and the notch base, intercondylar notch height and the width of lateral femoral condyle. The intercondylar notch was classified according to its shape into conical , circular and rectangular. The results suggest that the base width of the notch and the width of the femoral condyle would be important risk factors of the injury of A.C.L. The average range of analyzed variables are near to the ones described in the specialized literature in direct measurements in corpse pieces and magnetic resonance imaging and demonstrate that the use of a software in digitalized radiographic images provides a realiable measurement, even if simple and low cost radiographic images are used.

  12. Estudo morfométrico da fossa intercondilar femoral em joelhos com e sem lesão do ligamento cruzado anterior (L.C.A.), através da aplicação de um software sobre imagens radiográficas digitalizadas / Morphometric study of the femoral intercondylar notch of knees with and without injuries of anterior cruciate ligament (A.C.L.), by the use of software in digitalized radiographic images

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    Rita di Cássia de Oliveira, Angelo; Sílvia Regina Arruda de, Moraes; Luciano Carvalho, Suruagy; Tetsuo, Tashiro; Helena Medeiros, Costa.

    2004-09-01

    Full Text Available Os autores sugerem a aplicação de um software sobre imagens radiográficas digitalizadas para análise morfométrica da fossa intercondilar e dos côndilos femorais. O programa permite o tracejamento de linhas guias que facilitam a mensuração da extremidade distal do fêmur. Foram analisadas 39 radiograf [...] ias simples da fossa intercondilar femoral dos joelhos direito e esquerdo, obtidas de indivíduos do sexo masculino reunidos em grupo normal (n=23) e grupo lesionado (n=16). A média de idade da amostra foi de 26,56 anos. As variáveis analisadas foram largura bicondilar femoral, larguras da fossa intercondilar ao nível do sulco poplíteo e da base da fossa, a altura da fossa intercondilar e a largura do côndilo femoral lateral. A fossa intercondilar foi classificada quanto ao formato em cônica, circular e retangular. Os resultados encontrados sugerem que a largura da base da fossa e a largura do côndilo femoral lateral seriam fatores de risco importantes na lesão do L.C.A. Os valores médios das variáveis analisadas aproximam-se dos descritos na literatura especializada em mensurações diretas em peças cadavéricas e ressonância nuclear magnética e demonstram que a aplicação de um software sobre as imagens radiográficas digitalizadas proporciona uma mensuração confiável, mesmo utilizando-se de imagens radiográficas simples e de baixo custo. Abstract in english The authors suggest the use of software in digitalized radiographic images to morphometric analysis of the intercondylar notch and the femoral condyles. The software allows the draw of guide lines which facilitate the measurement of the distal extremity of femur. Thirty-nine radiographic simple has [...] been analyzed of femoral intercondylar notch of right and left knees, of male sex individuals collected into normal (n=23) and injured (n=16) groups. The age average was 26-56 years old.The analyzed variable had been femoral bicondylar width, widths of intercondylar notch to the level of the popliteal groove and the notch base, intercondylar notch height and the width of lateral femoral condyle. The intercondylar notch was classified according to its shape into conical , circular and rectangular. The results suggest that the base width of the notch and the width of the femoral condyle would be important risk factors of the injury of A.C.L. The average range of analyzed variables are near to the ones described in the specialized literature in direct measurements in corpse pieces and magnetic resonance imaging and demonstrate that the use of a software in digitalized radiographic images provides a realiable measurement, even if simple and low cost radiographic images are used.

  13. Estudio de las Venas de la Fosa Cubital a través de la Tomografía Computada Helicoidal y su Aplicación Clínica / Study of the Veins of the Cubital Fossa by Helical Computed Tomography and its Clinical Application

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    Mariano, del Sol; Eugenio, Lillo; Leonardo, Lobos; Bélgica, Vásquez.

    2012-03-01

    Full Text Available Las venas superficiales de la fosa cubital, constituyen uno de los sitios más importantes de punción venosa. La disposición de estas venas presenta numerosas variaciones. Su anatomía no ha sido estudiada aplicando los avances tecnológicos en el campo de la medicina, como la tomografía computada heli [...] coidal. Fueron analizadas mediante tomografía axial computada helicoidal, las formaciones venosas de la fosa cubital en 60 individuos chilenos de ambos sexos, de edades entre 10 y 86 años, de la IX Región de La Araucanía, Chile. El estudio fue realizado en un tomógrafo General Electric, modelo CT/e, perteneciente al Centro de Imagenología del Hospital del Trabajador, Temuco, Chile, en individuos ambulatorios. Basados en la clasificación de del Sol et al. (1988) para las formaciones venosas de la fosa cubital, se obtuvo los siguientes resultados: Tipo I (46,7%), la vena cefálica del antebrazo (VCA), se divide en vena mediana basílica (VMB) y vena mediana cefálica (VMC), las que se unen a la vena basílica del antebrazo (VBA) y vena cefálica del accesoria del antebrazo (VCAA), respectivamente. Tipo II (13,3%), la VCA originó la vena mediana del codo (VMCo), que se une a la VBA. Tipo III (20%), no existe comunicación entre la VBA y VCA a nivel de la fosa cubital. Tipo IV (8,3%), la VCA drenaba en la VBA. Tipo V (11,7%). Otras disposiciones, donde se incluye la "M" clásica, que resulta de la división de la vena mediana del antebrazo. La utilización de la VMC o de la VCA, se recomienda ya que previene los riesgos de punción de otras estructuras anatómicas importantes como el ramo anterior del nervio cutáneo antebraquial medial. Abstract in english The superficial veins of the cubital fossa, is one of the most important sites of venipunctures. There are many variations in the arrangement of these veins. Their anatomy has not been studied using technology available in the field of medicine such, as helical computed tomography. The vein formatio [...] n of the cubital fossa in 60 Chilean subjects of both sexes, between 10 and 86 years of age of the IX Region of Araucania, Chile, were analyzed by helical computed tomography. The study was realized on a General Electric scanner, model CT / e, belonging to the Imaging Center of the Hospital del Trabajador, Temuco, Chile, in ambulatory subjects. Based on the classification of del Sol et al. (1988) for the vein formation of the cubital fossa, we obtained the following results: Type I (46.7%), the cephalic vein of forearm (CVF), is divided into median basilic vein (MBV) and median cephalic vein (MCV), then anastomosis the basilic vein of forearm (BVF) and cephalic vein accessory (CVA), respectively. Type II (13.3%), the CVA originates at the median cubital vein (MCuV), which anastomoses to the BVF. Type III (20%), there is no communication between BVF and CVF at the cubital fossa. Type IV (8.3%), CVF drains into the BVF. Type V (11.7%) - Other disposition, which include the "M" classical, resulting from the division of the median antebrachial vein. Using the MCV or CVF, is recommended, since there are risks of puncture of other important anatomical structures such as the anterior branch of the medial antebrachial cutaneous nerve.

  14. Relationship Between Volume of Pterygopalatine Fossa and Block Anesthesia of Maxillary Nerve: A Pilot Study / Relación entre el Volumen de la Fosa Pterigopalatina y la Anestesia Troncular del Nervio Maxilar: Un Estudio Piloto

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    Pedro, Aravena Torres; Nicole, Cresp Sinning; Katherine, Büchner Sagredo; Carlos, Muñoz Rocha; Ricardo, Cartes-Velásquez.

    2011-09-01

    Full Text Available El bloqueo troncular del nervio maxilar (BTNM) se logra depositando anestesia vía canal palatino mayor en la fosa pterigopalatina. Los autores difieren en la cantidad de anestesia a depositar y la tasa de complicaciones asociadas (diplopía y hematomas). Coronado et al. (2008) midió el volumen de la [...] fosa pterigopalatina encontrando un promedio de 1,2ml, sugiriendo dicha cantidad de anestesia para el BTNM. El objetivo del presente trabajo es comparar la eficacia de dosis bajas de 1,2ml (DB) versus dosis tradicional de 1,8ml (DT) de anestesia para el BTNM y sus efectos adversos. Se realizó un estudio clínico cuasiexperimental de carácter exploratorio, participaron 82 pacientes donde la técnica anestésica estaba indicada para un procedimiento de exodoncia, los que fueron aleatorizados en los grupos DB y DT, administrándoles lidocaína al 2% con 1:50.000 de epinefrina. Se registraron variables demográficas (sexo y edad), clínicas (pieza a extraer y dosis administrada) y anatómicas (índices facial superior y craneal). El éxito anestésico (EA) se definió como la posibilidad de realizar la exodoncia con nulo o mínimo dolor, medido con escala visual análoga (EVA). En el análisis estadístico se utilizaron los tests de chi cuadrado y t de student (p Abstract in english Block anesthesia of maxillary nerve 9BAMN) is achieved by depositing anesthesia through greater palatine canal into the pterygopalatine fossa. Authors differ in the amount of anesthesia to be administered and the rate of complications (diplopia and hematomas), Coronado et al., (2008), measured the s [...] ize of the pterygopalatine fossa finding an average of 1.2 ml, suggesting that amount of anesthesia for BAMN. The aim of this study is to compare the effectiveness of low doses of 1.2 ml (LD)versus traditional dose of 1.8 m. (TD) of anesthesia for BAMN and its adverse effects. A quasi experimental exploratory clinical study was performed involving 82 patients where the anesthetic technique was suitable for tooth extraction procedure; patients were randomized in LD and TD groups, 2% lidocaine with 1:50.000 epinephrine was used. Demographic (sex and age), clinical (tooth for extraction and anesthetic dose) as well as anatomical variables (upper facial and cranial index) were recorded. The anesthetic success (AS) was defined as the possibility to perform the tooth extraction with no pain or minimal pain as measured by visual analogue scale (VAS). For statistical analysis chi-square and t test (p

  15. Bilateral Supernumerary Sternocleidomastoid Heads with Critical Narrowing of the Minor and Major Supraclavicular Fossae: Clinical and Surgical Implications / Cabezas Supernumerarias Bilaterales del Músculo Esternocleidomastoídeo con Estrechamiento Crítico de las Fosas Supraclavicular Menor y Mayor: Implicancias Clínicas y Quirúrgicas

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    Athanasios, Raikos; George K, Paraskevas; Stefanos, Triaridis; Panagiota, Kordali; George, Psillas; Beate, Brand-Saberi.

    2012-09-01

    Full Text Available Las variaciones anatómicas del músculo esternocleidomastoideo son poco frecuentes y se refieren a su origen, inserción, y número de cabezas. Se presenta una rara variante del músculo esternocleidomastoideo con cabezas musculares aberrantes y supernumerarias bilateralmente en un cadáver. En el lado d [...] erecho del cuello, se observaron la cabeza esternomastoidea típica del músculo esternocleidomastoideo, y tres cabezas claviculares aberrantes de origen, espesor y terminación variable. En el lado izquierdo, se observaron dos cabezas esternomastoídeas, la medial con su patrón típico, mientras que el lateral fue supernumeraria. La porción cleidomastoídea del músculo esternocleidomastoideo izquierdo se fusionó con el segmento esternocleidomastoideo doble. Un músculo acintado similar procedentes del tercio medio de la clavícula e inserción en el proceso transverso de la vértebra C3 fue observado. Éste se conoce como el músculo cleidocervical. En el lado derecho del cuello, el triángulo cervical posterior fue disminuido, la fosa supraclavicular menor fue considerablemente estrecha, mientras que en el lado izquierdo, se disminuyó además a un acortamiento bilateral del espacio fosa supraclavicular importante reducir al mínimo necesario para el acceso quirúrgico potencial. Estos hallazgos tienen una importancia destacada para los anestesistas en el posicionamiento de aguja guiada por ecografía en el bloqueo del plexo braquial, así como en la cateterización de la vena subclavia o yugular externa, y en las intervenciones quirúrgicas que afecta las estructuras situadas debajo del músculo esternocleidomastoideo. Abstract in english Anatomical variations of the sternocleidomastoid muscle are rare and concern its origin, insertion, and the number of heads. We report on a rare bilateral variant of the sternocleidomastoid muscle with aberrant and supernumerary muscular heads, observed in a cadaveric subject. On the right side of t [...] he neck, a typical sternomastoid head of the sternocleidomastoid muscle, and three aberrant clavicular heads of variable thickness, origin, and termination were noticed. On the left side, two sternomastoid heads were present; the medial one was of typical pattern, while the lateral was supernumerary. The cleidomastoid portion of the left sternocleidomastoid muscle was fused with the double sternomastoid segment. A strap-like muscle originating from the middle third of the clavicle and inserting onto the transverse process of the C3 vertebra was noticed. This is known as the cleidocervical muscle. On the right side of the neck, the posterior cervical triangle was diminished, the minor supraclavicular fossa was considerably narrow, whereas on the left, it was diminished in addition to a bilateral shortening of the major supraclavicular fossa minimizing space needed for potential surgical access. These findings are of prominent significance for anesthetists in ultrasound guided needle positioning in brachial plexus block, as well as in subclavian or external jugular vein catheterization, and in surgical interventions involving structures lying under the sternocleidomastoid muscle.

  16. Bilateral Supernumerary Sternocleidomastoid Heads with Critical Narrowing of the Minor and Major Supraclavicular Fossae: Clinical and Surgical Implications Cabezas Supernumerarias Bilaterales del Músculo Esternocleidomastoídeo con Estrechamiento Crítico de las Fosas Supraclavicular Menor y Mayor: Implicancias Clínicas y Quirúrgicas

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    Athanasios Raikos

    2012-09-01

    Full Text Available Anatomical variations of the sternocleidomastoid muscle are rare and concern its origin, insertion, and the number of heads. We report on a rare bilateral variant of the sternocleidomastoid muscle with aberrant and supernumerary muscular heads, observed in a cadaveric subject. On the right side of the neck, a typical sternomastoid head of the sternocleidomastoid muscle, and three aberrant clavicular heads of variable thickness, origin, and termination were noticed. On the left side, two sternomastoid heads were present; the medial one was of typical pattern, while the lateral was supernumerary. The cleidomastoid portion of the left sternocleidomastoid muscle was fused with the double sternomastoid segment. A strap-like muscle originating from the middle third of the clavicle and inserting onto the transverse process of the C3 vertebra was noticed. This is known as the cleidocervical muscle. On the right side of the neck, the posterior cervical triangle was diminished, the minor supraclavicular fossa was considerably narrow, whereas on the left, it was diminished in addition to a bilateral shortening of the major supraclavicular fossa minimizing space needed for potential surgical access. These findings are of prominent significance for anesthetists in ultrasound guided needle positioning in brachial plexus block, as well as in subclavian or external jugular vein catheterization, and in surgical interventions involving structures lying under the sternocleidomastoid muscle.Las variaciones anatómicas del músculo esternocleidomastoideo son poco frecuentes y se refieren a su origen, inserción, y número de cabezas. Se presenta una rara variante del músculo esternocleidomastoideo con cabezas musculares aberrantes y supernumerarias bilateralmente en un cadáver. En el lado derecho del cuello, se observaron la cabeza esternomastoidea típica del músculo esternocleidomastoideo, y tres cabezas claviculares aberrantes de origen, espesor y terminación variable. En el lado izquierdo, se observaron dos cabezas esternomastoídeas, la medial con su patrón típico, mientras que el lateral fue supernumeraria. La porción cleidomastoídea del músculo esternocleidomastoideo izquierdo se fusionó con el segmento esternocleidomastoideo doble. Un músculo acintado similar procedentes del tercio medio de la clavícula e inserción en el proceso transverso de la vértebra C3 fue observado. Éste se conoce como el músculo cleidocervical. En el lado derecho del cuello, el triángulo cervical posterior fue disminuido, la fosa supraclavicular menor fue considerablemente estrecha, mientras que en el lado izquierdo, se disminuyó además a un acortamiento bilateral del espacio fosa supraclavicular importante reducir al mínimo necesario para el acceso quirúrgico potencial. Estos hallazgos tienen una importancia destacada para los anestesistas en el posicionamiento de aguja guiada por ecografía en el bloqueo del plexo braquial, así como en la cateterización de la vena subclavia o yugular externa, y en las intervenciones quirúrgicas que afecta las estructuras situadas debajo del músculo esternocleidomastoideo.

  17. Investigation of measles IgM-seropositive cases of febrile rash illnesses in the absence of documented measles virus transmission, State of São Paulo, Brazil, 2000-2004 / Investigação dos casos de doenças febris exantemáticas com IgM reagente contra o sarampo na ausência de transmissão documentada do vírus do sarampo, Estado de São Paulo, 2000-2004

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    Flávia Helena, Ciccone; Telma Regina Marques Pinto, Carvalhanas; Ana Maria Sardinha, Afonso; Brendan, Flannery; Eliseu Alves, Waldman.

    2010-06-01

    Full Text Available INTRODUÇÃO: Revisar os casos de doenças febris exantemáticas com IgM reagente contra o sarampo, no Estado de São Paulo, Brasil, durante os cinco anos seguidos a interrupção da transmissão do vírus do sarampo. MÉTODOS: Nós revisamos 463 casos de doenças febris exantemáticas com IgM reagente contra o [...] sarampo, no Estado de São Paulo, Brasil, de 2000 a 2004. Indivíduos vacinados contra o sarampo 56 dias antes da coleta de amostra foram considerados expostos à vacina. Soros da fase aguda e de convalescença foram testados para a evidência de infecção de sarampo, rubéola, parvovírus B19 e herpes vírus 6. Na ausência de soroconversão para imunoglobulina G contra o sarampo, casos com IgM reagente contra o sarampo foram considerados falsos positivos em pessoas com evidência de outras infecções virais. RESULTADOS: Entre as 463 pessoas com doenças febris exantemáticas que testaram positivo para anticorpos IgM contra o sarampo durante o período, 297 (64%) pessoas foram classificadas como expostas à vacina. Entre os 166 casos não expostos à vacina, 109 (66%) foram considerados falsos positivos baseado na ausência de soroconversão, dos quais 21 (13%) tiveram evidência de infecção por vírus da rubéola, 49 (30%) parvovírus B19 e 28 (17%) infecção por herpes vírus humano 6. CONCLUSÕES: Após a interrupção da transmissão do vírus do sarampo é necessária exaustiva investigação dos casos com IgM reagente contra o sarampo, especialmente dos casos não expostos à vacina. Testes laboratoriais para etiologias das doenças febris exantemáticas ajudam na interpretação destes casos. Abstract in english INTRODUCTION: To review measles IgM-positive cases of febrile rash illnesses in the State of São Paulo, Brazil, over the five-year period following interruption of measles virus transmission. METHODS: We reviewed 463 measles IgM-positive cases of febrile rash illness in the State of São Paulo, from [...] 2000 to 2004. Individuals vaccinated against measles

  18. Bloqueio dos nervos tibial e fibular comum em fossa poplítea com punção única utilizando o estimulador percutâneo de nervos: considerações anatômicas e descrição ultrassonográfica / Tibial and common fibular nerveblock in the popliteal fossa with single puncture using percutaneous nerve stimulator: anatomical considerations and ultrasound description / Bloqueo de los nervios tibial y fibular común en fosa poplítea con punción única utilizando el estimulador percutáneo de nervios: consideraciones anatómicas y descripción ultrasonográfica

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    Viviane de Oliveira, Rangel; Raphael de Almeida, Carvalho; Beatriz Lemos da Silva, Mandim; Rodrigo Rodrigues, Alves; Roberto Araújo, Ruzi; Neuber Martins da, Fonseca.

    2011-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios de nervos periféricos têm ganhado popularidade nas últimas duas décadas, tornando-se crescente opção anestésica para a cirurgia de membros. Este estudo propõe uma técnica de abordagem dos nervos tibial e fibular comum na fossa poplítea por punção ú [...] nica e utilizando o estimulador percutâneo de nervos, considerando a correlação com estudo anatômico e ultrassonográfico. MÉTODO: Estudo prospectivo, observacional e aleatório realizado com 28 pacientes escalados para cirurgias no pé. Após localização dos nervos tibial e fibular comum por meio de estimulação percutânea, realizou-se punção no ponto de estímulo do nervo tibial com agulha de 5 cm (B.Braun, Stimuplex 50) e foram injetados 10 mL de levobupivacaína. A agulha foi recuada e redirecionada para o ponto de estímulo do nervo fibular comum em busca da resposta motora correspondente, injetando-se 10 mL do anestésico. Realizado estudo fotográfico da região poplítea por ultrassonografia para correlação da anatomia com a técnica utilizada. RESULTADOS: Obteve-se anestesia adequada em todos os casos. O tempo médio para a localização dos nervos tibial e fibular comum, utilizando o estimulador percutâneo de nervos, foi de 57,1 e 32,8 segundos, respectivamente, e com o estimulador de nervos foi de 2,22 e 1,79 minutos. A profundidade média da agulha para o nervo tibial foi de 10,7 mm. CONCLUSÕES: A abordagem dos nervos tibial e fibular comum com punção única na fossa poplítea utilizando o estimulador percutâneo de nervos é uma boa opção para anestesia e analgesia para cirurgias do pé. Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: Las técnicas de bloqueos de nervios periféricos ha venido obteniendo popularidad en las últimas de los décadas, y convirtiéndose cada vez más en una opción anestésica para la cirugía de los miembros. Este estudio propone una técnica de abordaje de los nervios tibial y fibu [...] lar común en la fosa poplítea por punción única y utilizando el estimulador percutáneo de nervios, considerando la correlación con el estudio anatómico y ultrasonográfico. MÉTODO: Estudio prospectivo, observacional y aleatorio realizado con 28 pacientes selecionados para cirugías en el pie. Después de la localización de los nervios tibial y fibular común a través de la estimulación percutánea, se realizó una punción en el punto de estímulo del nervio tibial con la aguja de 5 cm (B.Braun, Stimuplex 50), y fueron inyectados 10 mL de levobupivacaína. La aguja se echó hacia atrás y fue redirigida hacia el punto de estímulo del nervio fibular común en busca de la respuesta motora correspondiente, inyectando 10 mL del anestésico. Se realizó el estudio fotográfico de la región poplítea por ultrasonografía para la correlación de la anatomía con la técnica utilizada. RESULTADOS: En todos los casos se obtuvo la anestesia adecuada. El tiempo promedio para la localización de los nervios tibial y fibular común, utilizando el estimulador percutáneo de nervios, fue de 57,1 y 32,8 segundos respectivamente y con el estimulador de nervios fue de 2,22 y 1,79 minutos. La profundidad promedio de la aguja para el nervio tibial fue de 10,7 mm. CONCLUSIONES: El abordaje de los nervios tibial y fibular común con punción única en la fosa poplítea utilizando el estimulador percutáneo de nervios, es una buena opción para la anestesia y la analgesia en cirugías del pie. Abstract in english BACKGROUND AND OBJECTIVES: Techniques of peripheral nerve block have gained popularity over the last two decades becoming a growing anesthetic option for limb surgeries. This study proposes a technical approach of the tibial and common fibular nerves in the popliteal fossa with single puncture using [...] percutaneous nerve stimulator, considering the correlation with an anatomical and ultrasound study. METHODS: This prospective, observational, randomized study was performed with 28 patients scheduled for foot surgeries. After localizing the

  19. Temporomandibular joint prostheses: an alternative for impacted mandibular condyle in middle cranial fossa / Prótesis de la articulación temporomandibular: una alternativa para la impactación del cóndilo mandibular en la fosa craneal media

    Scientific Electronic Library Online (English)

    Henry, Garcia-Guevara; Joao, Gavranich; Thais, Araujo-Moreira; Valquiria, Vasconcellos; Luiz L., Leandro.

    2013-12-01

    Full Text Available La luxación del cóndilo mandibular con impactación en la fosa craneal media es un proceso poco frecuente -apenas se dispone de estudios publicados. Los autores describen el primer caso publicado de luxación y fractura unilateral combinadas, tratado y reconstruido con la implantación de una prótesis [...] temporomandibular. Se describen la conducta prequirúrgica y la postura médica de los equipos de neurocirugía, radiología y cirugía oral y maxilofacial. Se proporcionan detalles de las evaluaciones de los 2 primeros años postoperatorios, incluidos la abertura máxima interincisal, función articular, habla, sintomatología dolorosa y alimentación del paciente. Abstract in english The dislocation of the mandibular condyle in the middle cranial fossa is a rare condition with few reports in the literature. The authors described the first case reported of unilateral dislocation and fracture treated and reconstructed with a Temporo mandibular joint prostheses. Pre-surgical conduc [...] t, medical positions of the Neurosurgery, Radiology and Oral and Maxillofacial teams are described. Also, two years post-operative evaluations are detailed, including information regarding maximum interincisal opening, function, speech, pain and diet of the patient.

  20. Relationship Between Volume of Pterygopalatine Fossa and Block Anesthesia of Maxillary Nerve: A Pilot Study Relación entre el Volumen de la Fosa Pterigopalatina y la Anestesia Troncular del Nervio Maxilar: Un Estudio Piloto

    Directory of Open Access Journals (Sweden)

    Pedro Aravena Torres

    2011-09-01

    Full Text Available Block anesthesia of maxillary nerve 9BAMN is achieved by depositing anesthesia through greater palatine canal into the pterygopalatine fossa. Authors differ in the amount of anesthesia to be administered and the rate of complications (diplopia and hematomas, Coronado et al., (2008, measured the size of the pterygopalatine fossa finding an average of 1.2 ml, suggesting that amount of anesthesia for BAMN. The aim of this study is to compare the effectiveness of low doses of 1.2 ml (LDversus traditional dose of 1.8 m. (TD of anesthesia for BAMN and its adverse effects. A quasi experimental exploratory clinical study was performed involving 82 patients where the anesthetic technique was suitable for tooth extraction procedure; patients were randomized in LD and TD groups, 2% lidocaine with 1:50.000 epinephrine was used. Demographic (sex and age, clinical (tooth for extraction and anesthetic dose as well as anatomical variables (upper facial and cranial index were recorded. The anesthetic success (AS was defined as the possibility to perform the tooth extraction with no pain or minimal pain as measured by visual analogue scale (VAS. For statistical analysis chi-square and t test (p El bloqueo troncular del nervio maxilar (BTNM se logra depositando anestesia vía canal palatino mayor en la fosa pterigopalatina. Los autores difieren en la cantidad de anestesia a depositar y la tasa de complicaciones asociadas (diplopía y hematomas. Coronado et al. (2008 midió el volumen de la fosa pterigopalatina encontrando un promedio de 1,2ml, sugiriendo dicha cantidad de anestesia para el BTNM. El objetivo del presente trabajo es comparar la eficacia de dosis bajas de 1,2ml (DB versus dosis tradicional de 1,8ml (DT de anestesia para el BTNM y sus efectos adversos. Se realizó un estudio clínico cuasiexperimental de carácter exploratorio, participaron 82 pacientes donde la técnica anestésica estaba indicada para un procedimiento de exodoncia, los que fueron aleatorizados en los grupos DB y DT, administrándoles lidocaína al 2% con 1:50.000 de epinefrina. Se registraron variables demográficas (sexo y edad, clínicas (pieza a extraer y dosis administrada y anatómicas (índices facial superior y craneal. El éxito anestésico (EA se definió como la posibilidad de realizar la exodoncia con nulo o mínimo dolor, medido con escala visual análoga (EVA. En el análisis estadístico se utilizaron los tests de chi cuadrado y t de student (p<0,05. Los resultados muestran que el dolor y el EA en el grupo DB fueron de 2,93 y 61,67% y en el DT de 3,09 y 59,09% respectivamente, hubo 6 casos de diplopía sin diferencias estadísticamente significativas entre ambos grupos.

  1. Bloqueio dos nervos tibial e fibular comum em fossa poplítea com punção única utilizando o estimulador percutâneo de nervos: considerações anatômicas e descrição ultrassonográfica Bloqueo de los nervios tibial y fibular común en fosa poplítea con punción única utilizando el estimulador percutáneo de nervios: consideraciones anatómicas y descripción ultrasonográfica Tibial and common fibular nerveblock in the popliteal fossa with single puncture using percutaneous nerve stimulator: anatomical considerations and ultrasound description

    Directory of Open Access Journals (Sweden)

    Viviane de Oliveira Rangel

    2011-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios de nervos periféricos têm ganhado popularidade nas últimas duas décadas, tornando-se crescente opção anestésica para a cirurgia de membros. Este estudo propõe uma técnica de abordagem dos nervos tibial e fibular comum na fossa poplítea por punção única e utilizando o estimulador percutâneo de nervos, considerando a correlação com estudo anatômico e ultrassonográfico. MÉTODO: Estudo prospectivo, observacional e aleatório realizado com 28 pacientes escalados para cirurgias no pé. Após localização dos nervos tibial e fibular comum por meio de estimulação percutânea, realizou-se punção no ponto de estímulo do nervo tibial com agulha de 5 cm (B.Braun, Stimuplex 50 e foram injetados 10 mL de levobupivacaína. A agulha foi recuada e redirecionada para o ponto de estímulo do nervo fibular comum em busca da resposta motora correspondente, injetando-se 10 mL do anestésico. Realizado estudo fotográfico da região poplítea por ultrassonografia para correlação da anatomia com a técnica utilizada. RESULTADOS: Obteve-se anestesia adequada em todos os casos. O tempo médio para a localização dos nervos tibial e fibular comum, utilizando o estimulador percutâneo de nervos, foi de 57,1 e 32,8 segundos, respectivamente, e com o estimulador de nervos foi de 2,22 e 1,79 minutos. A profundidade média da agulha para o nervo tibial foi de 10,7 mm. CONCLUSÕES: A abordagem dos nervos tibial e fibular comum com punção única na fossa poplítea utilizando o estimulador percutâneo de nervos é uma boa opção para anestesia e analgesia para cirurgias do pé.JUSTIFICATIVA Y OBJETIVOS: Las técnicas de bloqueos de nervios periféricos ha venido obteniendo popularidad en las últimas de los décadas, y convirtiéndose cada vez más en una opción anestésica para la cirugía de los miembros. Este estudio propone una técnica de abordaje de los nervios tibial y fibular común en la fosa poplítea por punción única y utilizando el estimulador percutáneo de nervios, considerando la correlación con el estudio anatómico y ultrasonográfico. MÉTODO: Estudio prospectivo, observacional y aleatorio realizado con 28 pacientes selecionados para cirugías en el pie. Después de la localización de los nervios tibial y fibular común a través de la estimulación percutánea, se realizó una punción en el punto de estímulo del nervio tibial con la aguja de 5 cm (B.Braun, Stimuplex 50, y fueron inyectados 10 mL de levobupivacaína. La aguja se echó hacia atrás y fue redirigida hacia el punto de estímulo del nervio fibular común en busca de la respuesta motora correspondiente, inyectando 10 mL del anestésico. Se realizó el estudio fotográfico de la región poplítea por ultrasonografía para la correlación de la anatomía con la técnica utilizada. RESULTADOS: En todos los casos se obtuvo la anestesia adecuada. El tiempo promedio para la localización de los nervios tibial y fibular común, utilizando el estimulador percutáneo de nervios, fue de 57,1 y 32,8 segundos respectivamente y con el estimulador de nervios fue de 2,22 y 1,79 minutos. La profundidad promedio de la aguja para el nervio tibial fue de 10,7 mm. CONCLUSIONES: El abordaje de los nervios tibial y fibular común con punción única en la fosa poplítea utilizando el estimulador percutáneo de nervios, es una buena opción para la anestesia y la analgesia en cirugías del pie.BACKGROUND AND OBJECTIVES: Techniques of peripheral nerve block have gained popularity over the last two decades becoming a growing anesthetic option for limb surgeries. This study proposes a technical approach of the tibial and common fibular nerves in the popliteal fossa with single puncture using percutaneous nerve stimulator, considering the correlation with an anatomical and ultrasound study. METHODS: This prospective, observational, randomized study was performed with 28 patients scheduled for foot surgeries. After localizing the tibial and common fibular nerves through percutaneous stimulatio

  2. Analysis of the Condyle, Articular Fossa and Mandibular Ramus in Subjects with Active Condylar Hyperplasia / Análisis del Cóndilo, Fosa Articular y Rama Mandibular de Sujetos con Hiperplasia Condilar Activa

    Scientific Electronic Library Online (English)

    Pablo, Muñoz; Douglas Rangel, Goulart; Sergio, Olate; Márcio, de Moraes; Pablo, Navarro; Rodrigo, Fariña.

    1064-10-01

    Full Text Available La asimetría facial es relativamente común, transformándose en enfermedad cuando se asocia hiperplásia condilar. El objetivo de esta investigación fue describir y comparar las características morfológicas de los cóndilos hiperplásico con su contralateral no hiperplásico. Quince sujetos de entre 14 y [...] 29 años de edad, con asimetría facial e hiperplasia condilar unliateral diagnosticada, fueron estudiados mediante tomografía computarizada Cone-Beam. Se determinaron mediciones lineales de la morfología condilar en vista coronal y sagital, estableciendo tamaños de la fosa articular, rama mandibular, entre otras. Las mediciones condilares sagitales mostraron diferencias significativas (p=0,028) entre los grupos (lado hiperplásico vs. lado no hiperplásico); las mediciones de longitud de rama mostraron diferencias significativas (p=0,034) entre ambos lados. No se observó diferencias significativas (p=0,155) en la relación de distancia medio lateral (imagen coronal) de cóndilos hiperplásico y no hiperplásicos. Concluimos que existe un aumento del tamaño hemimandibular y de la ATM del lado hiperplásico, aunque investigaciones con mayor número de pacientes son necesarios para establecer una tendencia mas exacta. Abstract in english Facial asymmetry is relatively common, but it becomes a disease when condylar hyperplasia is involved. The purpose of this investigation was to describe and compare the morphological characteristics of hyperplastic condyles to their non-hyperplastic contralateral side. Fifteen subjects aged between [...] 14 and 29 years with facial asymmetry and diagnosed with unilateral condylar hyperplasia were studied using cone-beam computerized tomography. Linear measurements were taken of the condylar morphology on the sagittal and coronal planes, establishing the size of the articular fossa, mandibular ramus, and other aspects. Sagittal condylar measurements showed significant differences (p=0.028) between the groups (hyperplastic side v/s non-hyperplastic side); ramus measurements showed significant differences (p=0.034) between the two sides. No significant differences were observed (p=0.155) in the relation of the mean lateral distance (coronal image) of hyperplastic and non-hyperplastic condyles. It can be concluded that there is an increase in the size of the hemimandible and TMJ on the hyperplastic side, although research with a greater number of patients is needed to establish a more precise trend.

  3. Hyper-Immunoglobulin E Syndrome

    Directory of Open Access Journals (Sweden)

    Gnanraj Pushpa

    2004-01-01

    Full Text Available A case of hyper-IgE syndrome in a 6 year old boy with bronchial asthma is reported here with the various manifestations of multiple tender abscesses of the scalp, recurrent dermatophyte infections of his face and right thigh, eczematous lesions of his neck, shoulders and antecubital fossae, candidiasis of the tongue, angular cheilitis and total dystrophy of his right bit toe nail. Laboratory investigations revealed staphylococcus aureus infection of the scalp, Trichophyton rubrum infection of the face and the thigh and candidal onychomycosis. Immunological survey revealed markedly elevated serum lgE level.

  4. Global Hepatic Uptake of {sup 99m}Tc-MAA During VQ Scintigraphy Secondary to Synchronous Superior and Inferior Vena Caval Obstruction: a Demonstraion of Trans-Portal Venous Collateral Pathways

    Energy Technology Data Exchange (ETDEWEB)

    Conway, Oliver; Lloyd, Simon; Gruening, Thomas [Derriford Hospital, Plymouth (United States)

    2013-12-15

    A 38-year-old woman underwent lung scintigraphy. Injection of technetium-99m macroaggregated albumin ({sup 99m}Tc-MAA) via the left antecubital fossa revealed global hepatic uptake. Review of contemporary computed tomography (CT) imaging demonstrated synchronous superior and inferior vena cava (SVC and IVC) obstruction, with formation of systemic-portal venous collateral pathways. Systemic-portal venous collateralisation can in rare circumstances lead to focal hepatic uptake of {sup 99m}Tc-MAA during lung scintigraphy. This case of global hepatic uptake, secondary to synchronous SVC and IVC obstruction, demonstrates the trans-portal venous collateral pathways leading to this unusual imaging outcome.

  5. Temporal fossa intra-extracranial dumbbell schwannoma.

    LENUS (Irish Health Repository)

    Wong, Limy

    2011-02-01

    Intra-extracranial schwannomas arising unrelated to major cranial nerves are exceedingly rare neoplasms. We report the case of a 23-year-old male who presented with a 9 month history of progressive temporal swelling which was excised and found histologically to be a schwannoma. A succinct review of the relevant literature is presented.

  6. Temporal fossa intra-extracranial dumbbell schwannoma.

    LENUS (Irish Health Repository)

    Wong, Limy

    2012-02-01

    Intra-extracranial schwannomas arising unrelated to major cranial nerves are exceedingly rare neoplasms. We report the case of a 23-year-old male who presented with a 9 month history of progressive temporal swelling which was excised and found histologically to be a schwannoma. A succinct review of the relevant literature is presented.

  7. Distribución de los Patrones Venosos de la Fosa Cubital en una Muestra de Personas Nacidas en Bucaramanga, Colombia / Distribution Pattern of the Veins of the Cubital Fossa in a Sample of People Born in Bucaramanga, Colombia

    Scientific Electronic Library Online (English)

    Edgar Giovanni, Corzo Gómez; Olga Lucía, Gómez Díaz; María Eugenia, Niño Mantilla; Ruby Jackeline, Rey Triana; Leidy Johanna, Pedraza Díaz.

    1011-10-01

    Full Text Available El uso racional del acceso a las venas superficiales en la fosa cubital es de especial relevancia en pacientes pediátricos, con fístulas para diálisis, en quimioterapia, o como vías para acceso venoso central. Se han descrito varios patrones venosos con sus beneficios o riesgos. Se determinó la frec [...] uencia de los patrones venosos en una población de ambos sexos nacida en Bucaramanga, Colombia, en 800 miembros superiores (200 hombres y 200 mujeres), conforme a la clasificación propuesta por del Sol et al. (1988, 2007). El análisis descriptivo para variables cualitativas nominales y ordinales mediante porcentajes, las cuantitativas con media y desviación estándar en el caso de variables con distribución normal y las no paramétricas identificadas con número mediante mediana y rango intercuartil. Se comparó género y patrón venoso mediante la prueba de Kwallis y chi cuadrado. El patrón predominante fue el III, 297 casos (37%) determinado por una alta frecuencia en mujeres (54%), seguido del II 190 casos (24%). En el lado derecho para ambos géneros el patrón más frecuente fue el III, 141 casos (35%), seguidos del II, 89 casos (22%). En el lado izquierdo para ambos géneros predominó el patrón III, 156 casos (39%), seguido por el II con 101 casos (25%). El patrón II fue el mayor en hombres (28%), seguido del III (21%). En mujeres predominó el patrón III, seguido del II (19%). En el lado derecho en hombres, predominó el II (24%) seguido del IV (23%). En el lado derecho en mujeres predominó el III (51%) seguido del II (20%). En el lado izquierdo en hombres, predominó el patrón II (32%) seguido del III (21%). En el lado izquierdo en mujeres predominó III (57%) seguido del II (18%). El patrón que en más ocasiones se presentó al mismo tiempo en ambos lados en la misma persona fue el III (23,5%). Abstract in english The rational use of access to the superficial veins in the cubital fossa is particularly important in pediatric patients, with fistulas for dialysis, chemotherapy, or central venous access routes. Several venous patterns have been described for their benefits or risks. The prevalence of venous patte [...] rns in a population of both sexes born in Bucaramanga, Colombia, in 800 upper limbs (200 men and 200 women), according to the classification proposed by del Sol et al. (1988, 2007). The descriptive analysis for nominal and ordinal qualitative variables with percentages, the quantitative mean and standard deviation for normally distributed variables and nonparametric identified by number using median and interquartile range, was compared by gender and venous pattern through test and chi square Kwallis. The predominant pattern was III, 297 cases (37%) determined by a high frequency in women (54%), followed by II 190 cases (24%). On the right side for both sexes the most common pattern was III, 141 cases (35%), followed by II, 89 cases (22%). On the left side for both genders predominant pattern III, 156 cases (39%), followed by the second with 101 cases (25%). Pattern II was greater in men (28%), followed by III (21%). In women the pattern III predominated, followed by II (19%). On the right side in men, II predominated (24%) followed by IV (23%). On the right side III predominated in women (51%) followed by II (20%). On the left side in men, the predominant pattern II (32%) followed by III (21%). On the left side in women predominated III (57%) followed by II (18%). The pattern appeared more often at the same time on both sides in the same person was III (16.6%).

  8. Distribución de los Patrones Venosos de la Fosa Cubital en una Muestra de Personas Nacidas en Bucaramanga, Colombia Distribution Pattern of the Veins of the Cubital Fossa in a Sample of People Born in Bucaramanga, Colombia

    Directory of Open Access Journals (Sweden)

    Edgar Giovanni Corzo Gómez

    2010-12-01

    Full Text Available El uso racional del acceso a las venas superficiales en la fosa cubital es de especial relevancia en pacientes pediátricos, con fístulas para diálisis, en quimioterapia, o como vías para acceso venoso central. Se han descrito varios patrones venosos con sus beneficios o riesgos. Se determinó la frecuencia de los patrones venosos en una población de ambos sexos nacida en Bucaramanga, Colombia, en 800 miembros superiores (200 hombres y 200 mujeres, conforme a la clasificación propuesta por del Sol et al. (1988, 2007. El análisis descriptivo para variables cualitativas nominales y ordinales mediante porcentajes, las cuantitativas con media y desviación estándar en el caso de variables con distribución normal y las no paramétricas identificadas con número mediante mediana y rango intercuartil. Se comparó género y patrón venoso mediante la prueba de Kwallis y chi cuadrado. El patrón predominante fue el III, 297 casos (37% determinado por una alta frecuencia en mujeres (54%, seguido del II 190 casos (24%. En el lado derecho para ambos géneros el patrón más frecuente fue el III, 141 casos (35%, seguidos del II, 89 casos (22%. En el lado izquierdo para ambos géneros predominó el patrón III, 156 casos (39%, seguido por el II con 101 casos (25%. El patrón II fue el mayor en hombres (28%, seguido del III (21%. En mujeres predominó el patrón III, seguido del II (19%. En el lado derecho en hombres, predominó el II (24% seguido del IV (23%. En el lado derecho en mujeres predominó el III (51% seguido del II (20%. En el lado izquierdo en hombres, predominó el patrón II (32% seguido del III (21%. En el lado izquierdo en mujeres predominó III (57% seguido del II (18%. El patrón que en más ocasiones se presentó al mismo tiempo en ambos lados en la misma persona fue el III (23,5%.The rational use of access to the superficial veins in the cubital fossa is particularly important in pediatric patients, with fistulas for dialysis, chemotherapy, or central venous access routes. Several venous patterns have been described for their benefits or risks. The prevalence of venous patterns in a population of both sexes born in Bucaramanga, Colombia, in 800 upper limbs (200 men and 200 women, according to the classification proposed by del Sol et al. (1988, 2007. The descriptive analysis for nominal and ordinal qualitative variables with percentages, the quantitative mean and standard deviation for normally distributed variables and nonparametric identified by number using median and interquartile range, was compared by gender and venous pattern through test and chi square Kwallis. The predominant pattern was III, 297 cases (37% determined by a high frequency in women (54%, followed by II 190 cases (24%. On the right side for both sexes the most common pattern was III, 141 cases (35%, followed by II, 89 cases (22%. On the left side for both genders predominant pattern III, 156 cases (39%, followed by the second with 101 cases (25%. Pattern II was greater in men (28%, followed by III (21%. In women the pattern III predominated, followed by II (19%. On the right side in men, II predominated (24% followed by IV (23%. On the right side III predominated in women (51% followed by II (20%. On the left side in men, the predominant pattern II (32% followed by III (21%. On the left side in women predominated III (57% followed by II (18%. The pattern appeared more often at the same time on both sides in the same person was III (16.6%.

  9. Rash, fever and proteinuria after amoxicillin in a SLE patient

    OpenAIRE

    Couto, M.; Duarte, C; Geraldes, A; Medeiros, C; Inês, L; Malcata, AB

    2009-01-01

    We report a case of severe type IV hypersensitivity reaction to amoxicillin, which occurred in a person with a 12-year history of SLE. The present case illustrates the wide differential diagnosis in a SLE patient who presents with an allergic drug reaction. The attribution of the presenting symptoms to the underlying SLE and/or to the drugs used to treat SLE and coexisting conditions is a major challenge.

  10. Rash of Hacker Attacks Knock Out Major Websites

    Science.gov (United States)

    Missner, Emily D.

    On February 7, 2000, and continuing in the following days, six of the most popular sites on the World Wide Web were brought to a stand-still by a concerted effort of computer hackers. The attack started with Yahoo! on Monday. Buy.com, Ebay, CNN.com, and Amazon.com were hit on Tuesday, and ZDNet reported that it was the latest victim of the hackers on Wednesday morning. Each of the sites has suffered from what is called a "Denial of Service" (DoS) attack. In a DoS hack, the hacker does not need to gain access to the computer server; instead hackers send a huge volume of fake traffic, which blocks actual users from accessing the site. Yahoo!, for example, was hit with 800 megabytes of data per second, "more than 24 times the normal flow of data." Each of the sites was unable to be accessed by users for several hours. Buy.com was an unfortunate victim on the day of its IPO. It was, however, able to recover, closing that day at 25-1/8, though it peaked earlier that day at 35-7/16. Although the FBI has been brought in to investigate, this type of attack is very difficult to trace.

  11. Spot diagnosis: An ominous rash in a newborn

    Directory of Open Access Journals (Sweden)

    Wong William

    2009-04-01

    Full Text Available Abstract Purpura fulminans (PF is an ominous cutaneous condition usually associated with meningococcemia. PF in the newborn is rarely reported. We report the case of a female preterm infant with extensive PF due to group B streptococcus (GBS septicemia. She developed multi-organ system failure despite neonatal intensive care support and succumbed 9 days later. GBS, sensitive to penicillin, was isolated from the blood cultures of the mother and the infant. Invasive early GBS infection is common in the newborn and is empirically treated with prompt institution of intravenous antibiotics. PF associated with GBS is a rare cutaneous sign that must not be missed. Mortality remains high despite aggressive treatment and ICU support.

  12. Sarcoidosis presenting with an unusual erythematous rash and persistent hypercalcemia.

    Science.gov (United States)

    Barney, B. L.

    1992-01-01

    Sarcoidosis is a multisystem disease that often presents with constitutional symptoms and ocular and skin manifestations. The chest roentgenogram may show no abnormalities or only diffuse interstitial disease. The serum calcium level is uncommonly persistently elevated and responds rapidly to low-dose corticosteroid therapy. The level of 1,25-dihydroxyvitamin D is often elevated, and the level of parathyroid hormone is almost always suppressed. Skin manifestations vary considerably and may appear in an unusual fashion. A skin biopsy may often be essential in the diagnosis of sarcoidosis. Images PMID:1595285

  13. Sarcoidosis presenting with an unusual erythematous rash and persistent hypercalcemia.

    OpenAIRE

    Barney, B. L.

    1992-01-01

    Sarcoidosis is a multisystem disease that often presents with constitutional symptoms and ocular and skin manifestations. The chest roentgenogram may show no abnormalities or only diffuse interstitial disease. The serum calcium level is uncommonly persistently elevated and responds rapidly to low-dose corticosteroid therapy. The level of 1,25-dihydroxyvitamin D is often elevated, and the level of parathyroid hormone is almost always suppressed. Skin manifestations vary considerably and may ap...

  14. Aneurisma infectado de artéria braquial após endocardite infecciosa de valva mitral / Infected aneurysm of brachial artery after mitral valve infective endocarditis

    Scientific Electronic Library Online (English)

    Heraldo Guedis, Lobo Filho; Eduardo Rebouças, Carvalho; José Glauco, Lobo Filho; Patrícia Leal Dantas, Lobo.

    2011-03-01

    Full Text Available Apresentamos um caso de aneurisma infectado de artéria braquial em paciente com endocardite infecciosa por Streptococcus bovis. Homem de 49 anos de idade se apresentou com febre, dispnéia e sopro regurgitativo em foco mitral com irradiação para axila. O ecocardiograma demonstrou vegetação em valva m [...] itral nativa. Após troca valvar mitral com implante de prótese biológica, observou-se massa pulsátil de cinco centímetros de diâmetro em fossa antecubital direita. Foi feito o diagnóstico de aneurisma infectado de artéria braquial, e o tratamento cirúrgico foi realizado com sucesso. O objetivo desse relato de caso é apresentar uma complicação pouco comum após endocardite infecciosa. Abstract in english We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitr [...] al valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis.

  15. Aneurisma infectado de artéria braquial após endocardite infecciosa de valva mitral Infected aneurysm of brachial artery after mitral valve infective endocarditis

    Directory of Open Access Journals (Sweden)

    Heraldo Guedis Lobo Filho

    2011-03-01

    Full Text Available Apresentamos um caso de aneurisma infectado de artéria braquial em paciente com endocardite infecciosa por Streptococcus bovis. Homem de 49 anos de idade se apresentou com febre, dispnéia e sopro regurgitativo em foco mitral com irradiação para axila. O ecocardiograma demonstrou vegetação em valva mitral nativa. Após troca valvar mitral com implante de prótese biológica, observou-se massa pulsátil de cinco centímetros de diâmetro em fossa antecubital direita. Foi feito o diagnóstico de aneurisma infectado de artéria braquial, e o tratamento cirúrgico foi realizado com sucesso. O objetivo desse relato de caso é apresentar uma complicação pouco comum após endocardite infecciosa.We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitral valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis.

  16. Lesão de nervo cutâneo antebraquial lateral relacionada à venipuntura: o que saber? / Venipuncture-related lateral antebrachial cutaneous nerve injury: what to know? / Lesión del nervio cutáneo antebraquial lateral relacionada con la venopunción: ¿qué debemos saber?

    Scientific Electronic Library Online (English)

    Juan A., Ramos.

    2014-04-01

    Full Text Available Justificativa e objetivos: a venipuntura é um dos procedimentos mais comuns na prática anestésica cotidiana. Embora geralmente inócuas, lesões de nervos periféricos com sequelas graves foram descritas após venipuntura. Apresentamos um caso de lesão de nervo cutâneo antebraquial lateral relacionada [...] à venipuntura, juntamente com as informações de diagnóstico e prognóstico essenciais para a prática cotidiana. Relato de caso: paciente do sexo masculino, 27 anos, submetido à venipuntura de fossa antecubital direita, com uma agulha de calibre 20, para avaliação metabólica de rotina. O paciente sofreu uma dor aguda, tipo choque elétrico, que percorreu a face lateral do antebraço desde a fossa antecubital proximal até o pulso lateral direito e a base do polegar direito. Após 24 horas, o paciente ainda sentia a dor semelhante a choque elétrico que foi classificada como 8/10 no braço distal lateral direito, no pulso lateral direito e na base do polegar, acompanhada de parestesia. Fizemos uma revisão da literatura e o paciente recebeu orientação sobre os resultados publicados a respeito desse tipo de lesão. Durante o acompanhamento, o paciente relatou que a disestesia diminuiu cerca de 3-4 semanas após a lesão inicial e que não restou déficit neurológico. Conclusões: lesões de nervos periféricos foram descritas pós-venipuntura, mas a literatura é limitada. Os nervos da fossa antecubital estão classicamente localizados em um plano logo abaixo - e muito próximos - das veias, o que os torna susceptíveis a lesões durante a flebotomia; além disso, sabe-se que existe uma extensa variação anatômica, o que sugere que mesmo uma venipuntura satisfatória não traumática pode danificar diretamente esses nervos. O anestesiologista deve estar ciente dessa possível complicação e também do diagnóstico e prognóstico para orientar os pacientes de forma adequada, caso essa complicação ocorra. Abstract in spanish Justificación y objetivos: la venopunción es uno de los procedimientos más comunes en la práctica anestésica cotidiana. Aunque en general es inocua, se han descrito lesiones de los nervios periféricos con secuelas graves después de la venopunción. Presentamos un caso de lesión de nervio cutáneo an [...] tebraquial lateral relacionada con la venopunción, conjuntamente con la información de diagnóstico y pronóstico que son esenciales para la práctica cotidiana. Caso: paciente del sexo masculino, de 27 años, sometido a venopunción de la fosa antecubital derecha con una aguja de calibre 20 para evaluación metabólica de rutina. El paciente sufrió un dolor agudo de tipo descarga eléctrica, recorriendo el lateral del antebrazo desde la fosa antecubital proximal hasta la muñeca derecha y la base del pulgar derecho. Después 24 h, el paciente todavía sentía un dolor parecido a una descarga eléctrica que fue clasificado como 8/10 en el brazo distal lateral derecho, en la muñeca derecha y en la base del pulgar, acompañado de parestesia. Hicimos una revisión de la literatura y el paciente recibió orientación sobre los resultados publicados respecto a ese tipo de lesión. Durante el seguimiento, el paciente relató que la disestesia disminuyó aproximadamente 3-4 semanas después de la lesión inicial y no informó déficit neurológico. Conclusiones: se han descrito lesiones de nervios periféricos tras venopunción, pero la literatura es limitada. Los nervios de la fosa antecubital están clásicamente localizados en un plano inmediatamente inferior (y muy cercanos) a las venas, lo que los hace susceptibles a lesiones durante la flebotomía. Además, se sabe que existe una extensa variación anatómica, sugiriendo que incluso una venopunción satisfactoria no traumática puede perjudicar directamente esos nervios. El anestesiólogo debe ser consciente de esa posible complicación y también del diagnóstico y del pronóstico para orientar a los pacientes de forma adecuada en el caso de que ocurra esa complicación. Abstract in english Backgro

  17. Dolor a la inyección de propofol en sedación para colonoscopia: rol que desempeña el sitio de cateterización venosa Propofol injection pain during sedation for colonoscopy: the role of venous catheterization site

    Directory of Open Access Journals (Sweden)

    Roberto Rodríguez-Miranda

    2013-03-01

    Full Text Available Justificación: la mayor área de crecimiento en el uso de propofol ha sido para sedación en salas de operaciones y centros diagnósticos. El dolor a la inyección de propofol es un problema clínico común. Ha habido muchos intentos para reducir el dolor, sin embargo, la inhibición completa no se ha logrado. Métodos: se diseñó una fórmula para la recolección de datos, la cual se aplicó a los pacientes sedados para colonoscopia en la Sala de Endoscopia del Hospital San Juan de Dios. En la citada fórmula se incluyó la escala de dolor a la inyección de propofol, según lo establecido por McCrirrick, y se registraron las variables demográficas, localización y calibre del catéter venoso utilizado, así como los fármacos administrados concomitantemente. Los datos de la fórmula fueron completados por el médico anestesiólogo a cargo de la sedación, y revisados por el investigador. Resultados: un 58% de los pacientes no presentó dolor a la inyección de propofol; un 24,8% presentó dolor leve; un12,8%, dolor moderado, y un 1,7%, dolor intenso. Estadísticamente, el grupo de pacientes al que se le administró propofol en una vía colocada en fosa antecubital, presentó menos dolor que aquellos pacientes a los cuales se les colocó vía en dorso de mano, muñeca o cara anterior de antebrazo (p=0,006. Conclusión: la mejor forma de reducir el dolor a la inyección de propofol, consiste en utilizar una cánula venosa en la fosa antecubital para su administración.Background: The use of propofol has seen its greatest growth in the operating room and diagnostic centers. Pain associated with propofol injection is a common clinical issue. There have been many attempts to reduce pain, however, complete inhibition has not been achieved. Methods: Data was colected from patients sedated with propofol in the Endoscopy room at San Juan de Dios Hospital. The data obtained included the McCrirrick pain on propofol injection scale, demographic variables, caliber and location of venous catheters, as well as concomitant medications. The data was recorded by the treating anesthesiologist and reviewed by the researcher. Results: 58% of patients did not experience pain on propofol injection; 24,8% experienced mild pain, 12,8% moderate pain, and 1,7% severe pain. Statistically, the group of patients that received propofol through a venous catheter in the antecubital fossa, experienced less pain than those with a venous catheter placed in the hand, wrist, or anterior forearm. (p=0,006. Conclusion: The best way to reduce pain on propofol injection is to place the venous catheter in the antecubital fossa.

  18. Acute Appendicitis in Henoch-Schönlein Purpura : A Case Report

    OpenAIRE

    Kim, Chan Jong; Chung, Hae Yul; Kim, So Youn; Kim, Young OK; Ryu, Seong Yeob; Kim, Jung Chul; Chung, Jae Hun

    2005-01-01

    Common complications of Henoch-Schönlein purpura (HSP) that lead to surgical intervention include intussusception, perforation, necrosis, and massive gastrointestinal bleeding. Acute appendicitis is rarely seen as a complication of HSP. A seven-year-old boy was admitted for arthralgia, abdominal pain, hematochezia, melena, and purpuric rash on the lower extremities. On admission day abdominal ultrasonography was normal, but on day 5, he became pyrexial and developed right iliac fossa pain an...

  19. Miliaria-rash after neutropenic fever and induction chemotherapy for acute myelogenous leukemia Miliária 'rash' após neutropenia febril e quimioterapia de indução para a leucemia mielóide aguda

    Directory of Open Access Journals (Sweden)

    Tuyet A Nguyen

    2011-08-01

    Full Text Available Miliaria is a disorder of the eccrine sweat glands which occurs in conditions of increased heat and humidity. It can be associated with persistent febrile states as well as with certain drugs. We presented a 40 year-old female with myelodysplastic syndrome and progression to acute myelogenous leukemia who was admitted to the hospital for chemotherapy induction. The patient was treated with idarubicin and cytarabine. She became pancytopenic and developed neutropenic fever and was started on vancomycin and cefepime, but was persistently febrile with night sweats. Five days into her fevers, she developed diffuse, nonpruritic and fragile vesicles together with drenching nightsweats. The patient's exanthem was diagnosed as Miliaria crystallina, most probably induced by neutropenic fever and idarubucin exposureMiliária é uma desordem das glândulas sudoríparas écrinas, que ocorre em condições de aumento de calor e umidade. Miliária pode ser associada com estados febris persistentes bem como com certos medicamentos. Apresentamos o caso de uma mulher de 40 anos com síndrome mielodisplásica e progressão para leucemia mielóide aguda que foi admitida no hospital para quimioterapia de indução. A paciente foi tratada com idarrubicina e citarabina. Ela se tornou pancitopênica e desenvolveu neutropenia febril. Iniciou tratamento com vancomicina e cefepime, mas a febre com sudorese noturna continou. Cinco dias depois a paciente desenvolveu vesículas difusas, não pruríticas e frágeis juntamente com a persistência de sudorese noturna. O exantema do paciente foi diagnosticado como Miliária cristalina, provavelmente induzida por neutropenia febril e exposição a idarubucin

  20. Miliaria-rash after neutropenic fever and induction chemotherapy for acute myelogenous leukemia / Miliária 'rash' após neutropenia febril e quimioterapia de indução para a leucemia mielóide aguda

    Scientific Electronic Library Online (English)

    Tuyet A, Nguyen; Alex G, Ortega-Loayza; Michael P, Stevens.

    2011-08-01

    Full Text Available Miliária é uma desordem das glândulas sudoríparas écrinas, que ocorre em condições de aumento de calor e umidade. Miliária pode ser associada com estados febris persistentes bem como com certos medicamentos. Apresentamos o caso de uma mulher de 40 anos com síndrome mielodisplásica e progressão para [...] leucemia mielóide aguda que foi admitida no hospital para quimioterapia de indução. A paciente foi tratada com idarrubicina e citarabina. Ela se tornou pancitopênica e desenvolveu neutropenia febril. Iniciou tratamento com vancomicina e cefepime, mas a febre com sudorese noturna continou. Cinco dias depois a paciente desenvolveu vesículas difusas, não pruríticas e frágeis juntamente com a persistência de sudorese noturna. O exantema do paciente foi diagnosticado como Miliária cristalina, provavelmente induzida por neutropenia febril e exposição a idarubucin Abstract in english Miliaria is a disorder of the eccrine sweat glands which occurs in conditions of increased heat and humidity. It can be associated with persistent febrile states as well as with certain drugs. We presented a 40 year-old female with myelodysplastic syndrome and progression to acute myelogenous leukem [...] ia who was admitted to the hospital for chemotherapy induction. The patient was treated with idarubicin and cytarabine. She became pancytopenic and developed neutropenic fever and was started on vancomycin and cefepime, but was persistently febrile with night sweats. Five days into her fevers, she developed diffuse, nonpruritic and fragile vesicles together with drenching nightsweats. The patient's exanthem was diagnosed as Miliaria crystallina, most probably induced by neutropenic fever and idarubucin exposure

  1. Intraoperative Facial Nerve Monitoring in Posterior Fossa Surgery: Prognostic Value

    OpenAIRE

    Berges, C; Fraysse, B.; Yardeni, E (Eyal); Rugiu, G.

    1993-01-01

    A retrospective study was done of 43 patients operated on for acoustic neuroma by a translabyrinthine approach with intraoperative facial nerve monitoring. Direct stimulation of the facial nerve at the level of the cerebellopontine angle (CPA) and the internal auditory canal (IAC) permits the calculation of a R ratio that has a predictive value for postoperative facial function: R = R?/R?, where R? is the ratio of the minimal intensity (I) of stimulation capable of inducing a response after d...

  2. Posterior fossa infarct following Viper bite: a paradox

    Directory of Open Access Journals (Sweden)

    D Deepu

    2011-01-01

    Full Text Available Cerebral infarction after a viper bite is relatively uncommon. A combination of factors has been implicated in the pathophysiology of infarct following snakebite. In this case report, the clinical outcome after a posterior circulation infarct and various possibilities that could lead to such a catastrophic event are discussed. The present study stresses the need to keep hydration, blood pressure and central venous pressure optimal in all snakebite patients. Cerebral infarction should be considered a differential diagnosis, in any patient with neurological deterioration following snakebite. Prognosis of such patients with posterior circulation stroke remains poor and decompressive craniectomy has not been found to be helpful.

  3. Posterior fossa infarct following Viper bite: a paradox

    Scientific Electronic Library Online (English)

    D, Deepu; S, Hrishikesh; MT, Suma; V, Zoya.

    Full Text Available Cerebral infarction after a viper bite is relatively uncommon. A combination of factors has been implicated in the pathophysiology of infarct following snakebite. In this case report, the clinical outcome after a posterior circulation infarct and various possibilities that could lead to such a catas [...] trophic event are discussed. The present study stresses the need to keep hydration, blood pressure and central venous pressure optimal in all snakebite patients. Cerebral infarction should be considered a differential diagnosis, in any patient with neurological deterioration following snakebite. Prognosis of such patients with posterior circulation stroke remains poor and decompressive craniectomy has not been found to be helpful.

  4. Unusual Tumors of the Posterior Fossa Skull Base

    OpenAIRE

    Kumar, Raj; Wani, Abrar Ahad

    2006-01-01

    Five unusual cases of posterior skull base tumors were treated through different skull base approaches. Two or more staged operations were required to achieve total or near-total excision and decompression of two extensive tumors. Total excision of an extensive en plaque meningioma of the foramen magnum that encircled the brain stem and cervical spinal cord could not be achieved through the extreme lateral and suboccipital craniectomy approach. However, the vital structures were decompressed ...

  5. An enigmatic brainstem posterior fossa ganglioglioma in an adult.

    Science.gov (United States)

    Qin, BaiJing; Tabbara, Abdul Kader; Delalle, Ivana; Holsapple, James; Hohler, Anna

    2014-09-01

    Ganglioglioma is a rare central nervous system neoplasm representing 0.4% to 1.7% of all brain tumors and most frequently occurs in the pediatric population with an incidence of 7.6%. These tumors are usually slow-growing and well-circumscribed solid or cystic lesions. Gangliogliomatosis infrequently occurs in the frontal lobe, pineal gland, basal ganglia, hypothalamus, and optic chiasm, with very few reports of brainstem ganglioglioma. We report a case of a 35-year-old female who initially presented with headache, vertigo, ataxia, saccadic dysfunction, dysarthria, and dysmetria for several years due to an unknown etiology. Her brain imaging showed multiple lesions in the pons and the cerebellum with cystic changes and size reduction and enlargement over the next few years while her neurological symptoms continued to worsen. The patient received courses of steroid treatment that improved her neurological symptoms, suggesting an inflammatory component of her disease. Extensive workup for an inflammatory or infectious etiology was unfruitful and two brain biopsies were inconclusive. A third biopsy showed atypical glial nuclei, binucleated cells, and Rosenthal fibers and the presence of BRAF V600E mutation was detected. The diagnosis of gangliogliomatosis was consequently established. This case illustrates that gangliogliomatosis may present with the waxing-and-waning neurological signs and symptoms. It can masquerade inflammatory processes in the central nervous system on brain imaging and deserves careful consideration in the diagnosis of patients with an indolent course of neurological deterioration. PMID:24405263

  6. Surveillance imaging in children with medulloblastoma (posterior fossa PNET)

    International Nuclear Information System (INIS)

    Background. The use of surveillance imaging in children with medulloblastoma has been criticised. The aim of this study was to determine what proportion of relapses are detected by surveillance and whether these are found at a relatively favourable stage. Methods. This study was a retrospective review of the medical charts and imaging studies of 89 patients treated at a single children's cancer centre. Relapse was defined as evidence of an increase in volume of residual tumour of greater than 25% or the presence of metastases, or new onset of positive CSF cytology. Relapse was termed symptomatic if it was diagnosed by tests performed because of new symptoms that occurred in the interval between surveillance examinations. Asymptomatic relapse was diagnosed solely on the basis of surveillance imaging. Survival time to relapse was calculated from the date of the first surgical procedure. Results. Surveillance imaging detected 17 (71%) of the 24 relapses that occurred later than 6 months after diagnosis. All seven patients who presented with symptoms between scans have died, with a median survival from relapse of 5 months. Median survival from relapse in the patients detected by surveillance was 44 months, and four remain alive at 44-75 months. The patients detected by surveillance tended to have less advanced disease, which was more amenable to salvage therapy. Conclusion. This type of study cannot prove that surveillance imaging improves survival in children with medull improves survival in children with medulloblastoma because of the effects of lead time and length biases. Despite this, surveillance does appear to be effective in detecting potentially curable medulloblastoma relapses and should be offered to all patients. (orig.)

  7. Ewing sarcoma of the posterior fossa in an adolescent girl.

    Science.gov (United States)

    Stark, Andreas M; Leuschner, Ivo; Mehdorn, H Maximilian; Claviez, Alexander

    2014-01-01

    Medulloblastoma, astrocytoma, and ependymoma represent the most common infratentorial tumors in childhood, while Ewing sarcomas in that localization are extremely rare. A large left infratentorial space-occupying lesion was diagnosed in a 12-year-old girl with signs of increased intracranial pressure. Following total tumor resection, histological and molecular examination revealed Ewing sarcoma with rearranged EWSR-1 gene. The patient achieved complete remission following adjuvant chemotherapy and radiotherapy according to Euro-EWING 2008 treatment protocol. Intracranial Ewing sarcoma, although rare, should be an important differential diagnosis of intracranial tumors in childhood which requires aggressive multimodal treatment. PMID:25614743

  8. Uncommon posterior cranial fossa anomalies: MRI with clinical correlation

    International Nuclear Information System (INIS)

    The clinical and MRI findings in two cases of rhombencephalosynapsis (RS) and two of tectocerebellar dysraphia (TCD) with an associated occipital encephalocele were studied to elucidate the clinical picture and embryogenesis of these rare anomalies. To our knowledge, only one case of TCD [1] and four of RS [2, 3] examined by MRI during life have been reported. The clinical picture in the cases of RS was rather constant and there were similarities with TCD. Consideration of the embryogenesis of the neural tube suggests a temporal proximity of the abnormalities, with TCD arising at a slightly earlier time. (orig.)

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

    OpenAIRE

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

    2011-01-01

    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 vesi...

  10. Stroke and skin rash: A rare case of Henoch-Schonlein purpura

    OpenAIRE

    Ghosh, Kaushik; Chatterjee, Atri; Sau, Jyoti Tanmay; Dey, Sandip

    2012-01-01

    Henoch-Schonlein purpura (HSP) is a small vessel vasculitis that is rare in adults. Here, we present a case of a woman who presented with palpable purpura, abdominal pain, arthritis and ischemic stroke. The patient met the diagnostic criteria of HSP. However, cerebrovascular disease is reported as an uncommon, yet fatal, complication of HSP. The patient responded to aggressive immunosuppression with pulses of corticosteroids and cyclophosphamide. In the absence of an established protocol of t...

  11. Stroke and skin rash: A rare case of Henoch-Schonlein purpura.

    Science.gov (United States)

    Ghosh, Kaushik; Chatterjee, Atri; Sau, Jyoti Tanmay; Dey, Sandip

    2012-10-01

    Henoch-Schonlein purpura (HSP) is a small vessel vasculitis that is rare in adults. Here, we present a case of a woman who presented with palpable purpura, abdominal pain, arthritis and ischemic stroke. The patient met the diagnostic criteria of HSP. However, cerebrovascular disease is reported as an uncommon, yet fatal, complication of HSP. The patient responded to aggressive immunosuppression with pulses of corticosteroids and cyclophosphamide. In the absence of an established protocol of treatment of such neurologic emergency in HSP patients, this report demonstrates a successful outcome. PMID:23349600

  12. A 25-year-old Man with Acute Maculo-Papular Rash and Target Lesions

    Directory of Open Access Journals (Sweden)

    Vitorino Modesto dos SANTOS

    2012-01-01

    Full Text Available A 25-year-old student had an erythematous eruption on his face, trunk and upper extremity. Initial maculo-papules evolved to target lesions with a vesicular center surrounded by alternating pale and dark rings. The eruption appeared at the dorsum of the hand and progressed proximally, four days after a flu-like episode, without use of drugs or medicines for a minimum of six-months. The changes were restricted to the skin, painless and mildly itching. More conspicuous lesions appeared on his right scapula, left shoulder, and the dorsum of the left hand (Figure 1. Previously, he was in good health, without a history of allergy or skin or mucosal disturbances. He denied alcoholism, tobacco smoking, use of illicit drugs, and vaccination. His girl friend had fever, fatigue, pharyngitis and lymphadenopathy shortly before the onset of his actual disease. Physical examination revealed the aforementioned skin changes, in addition to discrete bilateral posterior cervical lymphadenopathy, and a moderate nontender liver and spleen enlargement. The patient was eutrophic and afebrile, with no ocular, oral, nasal, genital or anal lesions. In addition to routine laboratory tests, he underwent a skin biopsy aiming to clear the diagnosis. Blood determinations revealed leukocytosis, lymphocytosis and 12% reactive lymphocytes. Except for a transient elevation of the aminotransferase levels, biochemical data were normal. Hepatosplenomegaly and lymph node enlargement rapidly regressed to normal, as well as the lymphocyte count. The skin lesions improved gradually and healed in about two weeks.

  13. October 2014 critical care case of the month: a skin rash in the ICU

    Directory of Open Access Journals (Sweden)

    Raschke RA

    2014-10-01

    Full Text Available No abstract available. Abstract truncated after first page. History of Present Illness: A 28 year old man was admitted to an outside hospital with an ethylene glycol overdose in an apparent suicide attempt. At that time the patient was delirious and vomiting. He had a severe metabolic acidosis and a creatinine of 2.1 mg/dL. He was intubated, a nasogastric tube was placed, and he was transferred to the toxicology service. PMH, FH, SH: There was no significant past medical history. Family history was noncontributory. He was a nonsmoker who recently had a fight with his girlfriend prompting the suicide attempt. Physical Examination: Vital signs were stable and he was sedated and nasally intubated receiving mechanical ventilation. There were no other significant findings on physical examination. Which of the following can be used for ethylene glycol poisoning? 1. Ethanol; 2. Fomezipole; 3. Hemodialysis; 4. Pyridoxine; 5. All of the above ...

  14. Beyond "diaper rash": Incontinence-associated dermatitis: does it have you seeing red?

    Science.gov (United States)

    Junkin, Joan; Selekof, Joan Lerner

    2008-11-01

    Incontinence-associated dermatitis (IAD) results from frequent exposure to urine or feces. Consistent preventive skin care or treatment may reduce the incidence of IAD. The authors propose using an IAD classification and intervention tool (IADIT) to make detecting and treating IAD easier and more consistent. PMID:19020456

  15. May 2015 pulmonary case of the month: pneumonia with a rash

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2015-05-01

    Full Text Available No abstract available. Article truncated at 150 words. History of Present Illness: A 77-year-old man underwent a thoracic CT scan for follow up of a known thoracic aneurysm. However, he had been feeling tired for about a week with a cough, night sweats and fever. He had no shortness of breath, wheezing or known history of lung disease. Past Medical History, Social History and Family History: He has a history of hypertension and a known thoracic aortic aneurysm. There was a surgical repair of his right clavicle after a motor vehicle accident. He is single and has lived in Arizona for over 50 years. He just returned from a trip to California where he visited Disneyland. He does not smoke. Family history is noncontributory. Current Medications: dutasteride, levothyroxine, atorvastatin. Physical Examination: His physical examination was reported as unremarkable. SpO2 was 95% on room air. Which of the following is appropriate at this time? 1. Begin empiric antibiotics; 2. ...

  16. From "Rash Promises" to a Broadsheet: A Colorado Staff Finds an Easier Way.

    Science.gov (United States)

    Dixon, Dick

    1980-01-01

    Traces the development of a high school newspaper from a mimeographed publication to a monthly six-page supplement in the local daily newspaper. Lists some advantages in the new arrangement: improved writing by students due to increased motivation, reduced printing costs, "real world" experience for student writers, and lower costs of production.…

  17. Carcinogenicity evaluation for the application of carbon nanotubes as biomaterials in rasH2 mice

    OpenAIRE

    Seiji Takanashi; Kazuo Hara; Kaoru Aoki; Yuki Usui; Masayuki Shimizu; Hisao Haniu; Nobuhide Ogihara; Norio Ishigaki; Koichi Nakamura; Masanori Okamoto; Shinsuke Kobayashi; Hiroyuki Kato; Kenji Sano; Naoyuki Nishimura; Hideki Tsutsumi

    2012-01-01

    The application of carbon nanotubes (CNTs) as biomaterials is of wide interest, and studies examining their application in medicine have had considerable significance. Biological safety is the most important factor when considering the clinical application of CNTs as biomaterials, and various toxicity evaluations are required. Among these evaluations, carcinogenicity should be examined with the highest priority; however, no report using transgenic mice to evaluate the carcinogenicity of CNTs ...

  18. Analyzing Process Quality of Early Childhood Education with Many Facet Rash Measurement Model

    Science.gov (United States)

    Basturk, Ramazan; Isikoglu, Nesrin

    2008-01-01

    Quality of early childhood education institutions specifically, dimensions of process quality should be evaluated. Purpose of this study is to analyze process quality of early childhood education by using many-facet Rasch measurement model (MFRM). In this study, data were collected from twelve early childhood education institutions by four…

  19. 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

    OpenAIRE

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

    1995-01-01

    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 alt...

  20. Evaluation of the Tetracore Orthopox BioThreat® antigen detection assay using laboratory grown orthopoxviruses and rash illness clinical specimens.

    Science.gov (United States)

    Townsend, Michael B; MacNeil, Adam; Reynolds, Mary G; Hughes, Christine M; Olson, Victoria A; Damon, Inger K; Karem, Kevin L

    2013-01-01

    The commercially available Orthopox BioThreat® Alert assay for orthopoxvirus (OPV) detection is piloted. This antibody-based lateral-flow assay labels and captures OPV viral agents to detect their presence. Serial dilutions of cultured Vaccinia virus (VACV) and Monkeypox virus (MPXV) were used to evaluate the sensitivity of the Tetracore assay by visual and quantitative determinations; specificity was assessed using a small but diverse set of diagnostically relevant blinded samples from viral lesions submitted for routine OPV diagnostic testing. The BioThreat® Alert assay reproducibly detected samples at concentrations of 10(7)pfu/ml for VACV and MPXV and positively identified samples containing 10(6)pfu/ml in 4 of 7 independent experiments. The assay correctly identified 9 of 11 OPV clinical samples and had only one false positive when testing 11 non-OPV samples. Results suggest applicability for use of the BioThreat® Alert assay as a rapid screening assay and point of care diagnosis for suspect human monkeypox cases. PMID:22981983

  1. Clinical report: the joint obstetric and psychiatric management of phobic anxiety disorders in pregnancy.

    Science.gov (United States)

    Patel, Roshni R; Hollins, Kathryn

    2015-03-01

    Women who struggle with distressing pregnancy-related phobic anxiety disorders are regularly encountered in maternity services, and their management poses particular challenges. Early identification is crucial in order to offer an opportunity to treat and manage their fears and enable a positive birth experience. In this article, women with different phobias (tokophobia, emetophobia and ante-cubital fossa phobia) describe their first pregnancy experience, and the ways in which the Chelsea and Westminster Hospital offered them joint maternity and psychiatric care. A multidisciplinary hospital-based approach can be effective in managing mental health problems in pregnancy. Despite maternal preconceptions and professional misgivings, this approach can work for women with phobias and enable a good birth experience and successful mother and infant bonding. The lead obstetrician for mental health and perinatal psychiatrist describe their roles in enabling successful outcomes for both the current and subsequent pregnancies. The case is made for training of maternity staff in both the identification of severe pregnancy phobias and the prompt referral for shared psychiatric and maternity care. Even if previous treatments have failed, adequate coping strategies for childbirth may be achieved in a short time frame. Long-term improvements in the phobia itself may also be found. PMID:25547323

  2. Pain assessment in children undergoing venipuncture: the Wong–Baker faces scale versus skin conductance fluctuations

    Directory of Open Access Journals (Sweden)

    Francesco Savino

    2013-02-01

    Full Text Available The aim of this study was to evaluate the efficacy of the subjective Wong–Baker faces pain rating scale (WBFS and of the objective skin conductance fluctuation (SCF test in assessing pain in children undergoing venipuncture. One-hundred and fifty children (aged 5–16 years entered the study. All underwent venipuncture at the antecubital fossa to collect blood specimens for routine testing in the same environmental conditions. After venipuncture, the children indicated their pain intensity using the WBFS, whereas the number of SCFs was recorded before, during and after venipuncture. So, pain level was measured in each child with WBFS and SCF. We found that the level of WBFS-assessed pain was lower in all children, particularly those above 8 years of age, than SCF-assessed pain (p < 0.0001. Moreover, the number of SCFs was significantly higher during venipuncture than before or after venipuncture (p < 0.0001. At multivariate regression analysis, age and previous experience of venipuncture influenced the WBFS (? = ?1.81, p < 0.001, and ? = ?0.86, p < 0.001, respectively but not SCFs. In conclusion, although both procedures can be useful for research and clinical practice, our findings show that WBFS was affected by age and previous venipuncture, whereas SCF produced uniform data. If verified in other studies, our results should be taken into account when using these tools to evaluate pain in children.

  3. Emergency Stent Grafting After Unsuccessful Surgical Repair of a Mycotic Common Femoral Artery Pseudoaneurysm in a Drug Abuser

    International Nuclear Information System (INIS)

    Mycotic false aneurysm caused by local arterial injury from attempted intravenous injections in drug addicts remains a challenging clinical problem. The continued increase in drug abuse has resulted in an increased incidence of this problem, particularly in high-volume urban centres. In the drug-abusing population, mycotic arterial pseudoaneurysms most often occur because of missed venous injection and are typically seen in the groin, axilla, and antecubital fossa. Mycotic aneurysms may lead to life-threatening haemorrhage, limb loss, sepsis, and even death. Any soft-tissue swelling in the vicinity of a major artery in an intravenous drug abuser should be suspected of being a false aneurysm until proven otherwise and should prompt immediate referral to a vascular surgeon for investigation and management. We report a case of rupturing mycotic pseudoaneurysm of the left common femoral artery treated by surgical resection followed by vessel reconstruction with autologous material. Unfortunately, at the time of discharge a sudden leakage from the vein graft anastomosis occurred, with subsequent massive bleeding, and required emergent endovascular covered stenting. To the best of our knowledge, this is the first reported case of femoral artery bleeding in a drug abuser treated by stent graft placement.

  4. The morphology of synovial grooves (Fossae synoviales) in joints of cattle of different age groups

    DEFF Research Database (Denmark)

    Wegener, K. M.; Heje, N. I.

    1993-01-01

    The joint cartilage of the head of the radius, the metacarpal bone, the tibial cochlea, the proximal trochlea of the talus and the metatarsal bone of 26 cattle in the age groups fetuses, 0 days, 2-5 weeks, 2-5 months, 7-13 months, 2-3.5 years, and 5-7 years were examined macroscopically and histologically. Synovial grooves developed on all joint surfaces examined, but at different times. At some locations the development of the grooves began prenatally. During the groove development the same features were in principle observed on all joint surfaces: Degeneration and progressive thinning of the joint cartilage, invasion of connective tissue into the cartilage, cessation of the endochondral ossification, and depression of the groove area into the subchondral bone. The findings indicated that the synovial grooves should be considered as being part of the normal morphology of the joints. In 4 animals aged from 3 weeks to 13 months dyschondroplastic (osteochondrotic) lesions were observed in the joint cartilage both inside and outside the groove areas on one or more joint surfaces.

  5. MR imaging in the evaluation of epidermoid cysts and cholesterol granulomas of the posterior fossa

    International Nuclear Information System (INIS)

    This paper reports on MR imaging and CT examination of ten patients with epidermoid cysts and six patients with cholesterol granulomas of the cerebellopontine region. MR imaging proved superior to CT for the assessment as well as differentiation of these lesions. Most epidermoid tumors had long T1 and long T2 signal characteristics. Cholesterol granulomas, except one case, demonstrated short T1 and long T2 signal characteristics. Short-repetition time, short TE-echo time, MR images with maximum excitations (eight) showed characteristic serpiginous structures in epidermoids that were thought to be due to macromolecule of the keratin in keratoma. In two epidermoid cysts, in vivo H-1 spectroscopy was performed. The spectra of these cysts did not show any specific resonance marker related to keratin or lipid

  6. Litiasis fosa navicular de uretra / Urinary calculus in the fossa navicularis

    Scientific Electronic Library Online (English)

    Edgar Antonio, Granados Loarca; Carlos, Salazar Monterroso; Carlos, Robles.

    1070-10-01

    Full Text Available OBJETIVO: Evaluar el tratamiento de la litiasis del meato uretral. MÉTODO/RESULTADOS: Se informa el caso de un paciente masculino de 52 años con un gran cálculo en el meato uretral. Paciente: varón que consultó por síndrome miccional, disuria y dificultad al orinar, en quien se palpo induración del [...] glande y se observo una fístula por donde orinaba el paciente. El diagnóstico se efectuó con la observación y por la palpación del glande. Se le extrajo mediante meatoplastia con buenos resultados. CONCLUSIONES: El tratamiento de la litiasis gigante del meato uretral que causa obstrucción es la meatoplastia. Abstract in english OBJETIVE: Evaluate the treatment of the meatus urethral lithiasis. METHODS/RESULTS: A case of a 52 year-old male patient is reported with a big stone in the urethral meatus. Male patient that consults for Micturitional Syndrome, disury and difficulty when urinating, in whom felt induration of the gl [...] ans and observed a water-pipe where the patient urinated. The Diagnoses was made by the observation and the palpation of the glans. It was extracted by meatoplasthy with good results. CONCLUSIONS: The treatment of the meatus urethral big lithiasis that causes obstruction is the meatoplasthy.

  7. [Rare benign tumors of the nasal fossae and sinuses of the face (benign schwannoma, fibromyxoma].

    Science.gov (United States)

    Mahé, E; Poncet, P; Basset, J M; Le Doussal, V

    1983-01-01

    The authors report the observation of two cases of benign schwannomas, one in the nasal cavities, the other in the maxillary sinus and a case of odontogenous fibromyxoma of the ethmoïdo-maxillary sinus. After a study of the observations, a literature review determines the benign character of these tumours, the possibilities of recurring in case of incomplete operation, the importance of computerized tomography to precise their extension, the histological difficulty of the diagnosis and the importance of ultrastructural study to identify them. Taking the cases of schwannomas, we settle two forms A and B (ie) Antoni, because of the myxoïde degeneration which predominate in the second type. Concerning the fibromyxomas histochemicals and ultrastructural studies allow us to definite the character of "myxoblast" or "fibroblast", Cells. Treatment of these lesions is essentially surgical and a long term prognosis is favourable. PMID:6881823

  8. Transfrontal sinus approach for an anterior cranial fossa, ethmoidal, dural arteriovenous fistula

    Science.gov (United States)

    Magro, Elsa; Engel, Doortje; Bojanowski, Michel W.

    2014-01-01

    Background: Ethmoidal dural arteriovenous fistulas (eDAVFs) are usually approached via a pterional or a frontal craniotomy. A more direct route to the fistula is possible through a purely transfrontal sinus approach. The aim of this report is to illustrate the interest of transsinus frontal approach for eDAVFs. Case Description: The transfrontal sinus approach is described and illustrated in a case of an ethmoidal arteriovenous fistula. This approach is the most direct when treating an eDAVF surgically, allowing preserving neural structures with minimal to no brain manipulation. Conclusion: For eDAVFs, the purely transfrontal sinus approach is highly worth considering in cases of large frontal sinuses. PMID:25593756

  9. Twelfth nerve paresis induced by an unusual posterior fossa arachnoid cyst: case report and literature review.

    Science.gov (United States)

    Tarantino, Roberto; Marruzzo, Daniele; Colistra, Davide; Mancarella, Cristina; Delfini, Roberto

    2014-08-01

    There are only three cases of arachnoid cysts inducing twelfth nerve paresis described in English medical literature. We herein report one more instance. Six weeks after surgery, the patient has almost fully recovered. This case underlines the importance of considering the arachnoid cyst as a possible cause of twelfth nerve paresis. PMID:24138685

  10. Primary medulla oblongata germinoma--an unusual posterior fossa tumors in young adults.

    Science.gov (United States)

    Akimoto, Jiro; Murakami, Mamoru; Fukami, Shinjiro; Ikeda, Yukio; Haraoka, Jo

    2009-05-01

    We encountered 2 patients with germinoma arising from the medulla oblongata in whom preoperative radiological diagnosis was difficult. A 30-year-old woman presented due to aspiration pneumonia caused by bilateral lower cranial nerve palsies, and a 24-year-old man presented with headache caused by obstructive hydrocephalus. In both patients, there was a midline tumor that extended from the lower part of the fourth ventricle to the C1 lamina level. It was well-demarcated and homogeneously enhanced tumor with a slightly high density on plain CT scan. The preoperative diagnosis for both patients was ependymoma. The former patient had persistent lower cranial nerve palsies due to brain stem injury after tumor resection. Both patients achieved complete remission with adjuvant therapy. Fewer than 10 cases of germinoma affecting the medulla oblongata have been reported. Radiological findings resembling those of the pineal region germinoma were observed in the two patients reported here. We would like to stress the importance of remembering germinoma when making a preoperative differential diagnosis of fourth ventricular tumors in young adults. PMID:19282178

  11. Recurrent posterior fossa anaplastic ependymoma with prominent chondroid metaplasia: a case report and review of literature.

    Science.gov (United States)

    Ghosal, Nandita; Murthy, Ganesh; Dadlani, Ravi; Hegde, Alangar Sathya; Singh, Devendra

    2010-01-01

    We report an unusual case of a recurrent fourth ventricular anaplastic ependymoma with prominent chondroid metaplasia in a 16-year-old male. On initial presentation, the patient had a WHO Grade II tumor. However, at recurrence 1 year later, the tumor progressed to WHO Grade III tumor with more cellularity, necrosis and brisk mitotic activity. Chondroid metaplasia was present in both the initial and recurrent tumors. PMID:21045418

  12. Recurrent posterior fossa anaplastic ependymoma with prominent chondroid metaplasia: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Ghosal Nandita

    2010-10-01

    Full Text Available We report an unusual case of a recurrent fourth ventricular anaplastic ependymoma with prominent chondroid metaplasia in a 16-year-old male. On initial presentation, the patient had a WHO Grade II tumor. However, at recurrence 1 year later, the tumor progressed to WHO Grade III tumor with more cellularity, necrosis and brisk mitotic activity. Chondroid metaplasia was present in both the initial and recurrent tumors.

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

    OpenAIRE

    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

    2012-01-01

    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. In...

  14. Recurrent posterior fossa anaplastic ependymoma with prominent chondroid metaplasia: A case report and review of literature

    OpenAIRE

    Ghosal Nandita; Murthy Ganesh; Dadlani Ravi; Hegde Alangar; Singh Devendra

    2010-01-01

    We report an unusual case of a recurrent fourth ventricular anaplastic ependymoma with prominent chondroid metaplasia in a 16-year-old male. On initial presentation, the patient had a WHO Grade II tumor. However, at recurrence 1 year later, the tumor progressed to WHO Grade III tumor with more cellularity, necrosis and brisk mitotic activity. Chondroid metaplasia was present in both the initial and recurrent tumors.

  15. Dosimetry and field matching for radiotherapy to the breast and supraclavicular fossa

    International Nuclear Information System (INIS)

    Purpose: Early breast cancer radiotherapy aims for local disease control and reduced recurrence. Treatment is directed to breast or chest wall alone using tangential fields, or includes regional lymph nodes with a separate anterior field. The complex geometry of this region necessitates matching adjacent radiation fields in three-dimensions. Potential exists for overdosage or underdosage and cosmetic results may be compromised if fields are not accurately aligned. Methods and materials: A study of dosimetry across the match line region using different techniques, as reported in the multicentre START Trial Quality Assurance programme, was undertaken. A custom-made anthropomorphic phantom assessed dose distribution in three-dimensions using film dosimetry. Results: Methods with varying degrees of complexity were employed for field matching. Techniques combined half beam blocking and machine rotations to achieve geometric alignment. Asymmetric beam matching allowed use of a single isocentre technique. Where field matching was not undertaken a gap between tangential and nodal fields was employed. Results demonstrated differences between techniques and variations for similar techniques in different centres. Geometric alignment techniques produced more homogenous dose distributions in the match region than gap techniques or those techniques not correcting for field divergence. Conclusions: Field matching techniques during the START trial varied between centres. Film dosimettrial varied between centres. Film dosimetry used in conjunction with a breast-shaped phantom provided relative dose information. The study highlighted difficulties in matching treatment fields to achieve homogenous dose distribution through the region of the match plane and the degree of inhomogeneity as a consequence of a gap between treatment fields.

  16. Towards a Proactive Risk Mitigation Strategy at La Fossa Volcano, Vulcano Island

    Science.gov (United States)

    Biass, S.; Gregg, C. E.; Frischknecht, C.; Falcone, J. L.; Lestuzzi, P.; di Traglia, F.; Rosi, M.; Bonadonna, C.

    2014-12-01

    A comprehensive risk assessment framework was built to develop proactive risk reduction measures for Vulcano Island, Italy. This framework includes identification of eruption scenarios; probabilistic hazard assessment, quantification of hazard impacts on the built environment, accessibility assessment on the island and risk perception study. Vulcano, a 21 km2 island with two primary communities host to 900 permanent residents and up to 10,000 visitors during summer, shows a strong dependency on the mainland for basic needs (water, energy) and relies on a ~2 month tourism season for its economy. The recent stratigraphy reveals a dominance of vulcanian and subplinian eruptions, producing a range of hazards acting at different time scales. We developed new methods to probabilistically quantify the hazard related to ballistics, lahars and tephra for all eruption styles. We also elaborated field- and GIS- based methods to assess the physical vulnerability of the built environment and created dynamic models of accessibility. Results outline the difference of hazard between short and long-lasting eruptions. A subplinian eruption has a 50% probability of impacting ~30% of the buildings within days after the eruption, but the year-long damage resulting from a long-lasting vulcanian eruption is similar if tephra is not removed from rooftops. Similarly, a subplinian eruption results in a volume of 7x105 m3 of material potentially remobilized into lahars soon after the eruption. Similar volumes are expected for a vulcanian activity over years, increasing the hazard of small lahars. Preferential lahar paths affect critical infrastructures lacking redundancy, such as the road network, communications systems, the island's only gas station, and access to the island's two evacuation ports. Such results from hazard, physical and systemic vulnerability help establish proactive volcanic risk mitigation strategies and may be applicable in other island settings.

  17. Eritema infeccioso: un exantema infantil a considerar en la práctica diaria / Fifth disease or infectious erythema: a childhood rash to consider in the daily medical practice

    Scientific Electronic Library Online (English)

    AD, Pérez-Elizondo; E, Pérez-Campos; JF, García-Hernández.

    2013-03-30

    Full Text Available Se presenta el caso de un escolar con febrícula y leve ataque del estado general, quien desarrolla una erupción maculosa en mejillas, pocos días después un exantema en "encaje" o reticulado en tronco posterior y parte proximal de extremidades inferiores, compatible con la quinta enfermedad y confirm [...] ado por la morfología lesional característica y la inmuno-serología (IgM). Abstract in english We present a five years old child with a mild fever and malaise, a maculoedematous eruption on cheeks and a "lace" exanthema located on posterior aspect of the trunk and lower limbs, developed after a few days. A fifth disease was diagnosticated based on characteristic morphological presentation and [...] immunoserological studies.

  18. Eritema infeccioso: un exantema infantil a considerar en la práctica diaria Fifth disease or infectious erythema: a childhood rash to consider in the daily medical practice

    Directory of Open Access Journals (Sweden)

    AD Pérez-Elizondo

    Full Text Available Se presenta el caso de un escolar con febrícula y leve ataque del estado general, quien desarrolla una erupción maculosa en mejillas, pocos días después un exantema en "encaje" o reticulado en tronco posterior y parte proximal de extremidades inferiores, compatible con la quinta enfermedad y confirmado por la morfología lesional característica y la inmuno-serología (IgM.We present a five years old child with a mild fever and malaise, a maculoedematous eruption on cheeks and a "lace" exanthema located on posterior aspect of the trunk and lower limbs, developed after a few days. A fifth disease was diagnosticated based on characteristic morphological presentation and immunoserological studies.

  19. Wegener’s granulomatosis in a middle-aged woman presenting with dyspnea, rash, hemoptysis and recurrent eye complaints: a case report

    Directory of Open Access Journals (Sweden)

    Cardenas-Garcia Jose

    2012-10-01

    Full Text Available Abstract Introduction Wegener’s granulomatosis presenting as diffuse alveolar hemorrhage is uncommon. However, the recognition of multisystem disease involving joints, kidney, eye and lung is critical for diagnosing Wegener's vasculitis. This is not the first report of this kind in the literature. Case presentation A 51-year-old Croatian woman presented to our Emergency Department with a history of progressively worsening productive cough and shortness of breath, epistaxis and two episodes of hemoptysis. She developed respiratory failure due to diffuse alveolar hemorrhage, which was successfully treated with high-dose steroids, cyclophosphamide and plasmapheresis. Her clinical course was complicated with methicillin-resistant Staphyloccocus aureus pneumonia, which has been associated with Wegener’s granulomatosis flares. Conclusion The recognition of multisystem disease is critical for diagnosing Wegener's vasculitis. Diffuse alveolar hemorrhage can be a fulminant manifestation of Wegener’s granulomatosis, in which case immediate and aggressive treatment with pulse steroids, high-dose cyclophosphamide and plasma exchange can be life-saving.

  20. Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease

    OpenAIRE

    Cameron, Daniel J; Johnson, Lorraine B; Maloney, Elizabeth L

    2014-01-01

    Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions – the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease. Healthcare providers who evaluate and manage patients with Lyme disease are the ...

  1. NECROLISIS EPIDERMICA TOXICA. DESCRIPCION DE DOS CASOS. ERUPCIÓN CUTÁNEA SEVERA PRODUCIDA POR FÁRMACOS COMUNES TOXICAL EPIDERMAL NECROLYSIS. REPORT OF TWO CASES. SEVERE SKIN RASH CAUSED BY COMMON DRUGS

    Directory of Open Access Journals (Sweden)

    Liz Lezcano

    2013-10-01

    Full Text Available Reacción adversa a medicamentos (RAM es definida por la OMS como cualquier respuesta a un medicamento, que sea nociva e inesperada, que ocurre a dosis normalmente utilizadas en el ser humano para profilaxis, diagnóstico, terapia de enfermedad o para modificación de la función fisiológica. Cuando RAM compromete a la piel se denomina farmacodermia, dermatosis medicamentosa o toxicodermia, la cual ocurre en el 1% de pacientes ambulatorios y 2-5 % de pacientes hospitalizados. La OMS acepta que el 2% de todas las reacciones adversas a fármacos (RAM son severas (Farmacodermia grave=FG. Son más frecuentes en mujeres, ancianos y pacientes con SIDA. La mayoría de las farmacodermias son leves, pero éstas pueden de inicio ser reacciones severas. 1 de cada 1.000 pacientes hospitalizados sufre una FG, dentro de las cuales se incluyen al síndrome de Stevens Johnson (SSJ y la Necrolisis Epidérmica Tóxica (NET. El Síndrome de Stevens Johnson (SSJ y la Necrolisis Epidérmica Tóxica (NET son reacciones cutáneas graves, con un potencial de morbilidad y mortalidad elevadas, ocurre en 0.4-2 casos por millón de habitantes por año para el SSJ y para la NET en 1.2-6.0 casos millón de habitantes por año. Se presenta en pacientes de todas las edades, razas y sexo. Estas patologías constituyen una verdadera emergencia dermatológica, donde su cuidado y manejo deben ser multidisciplinarios.

  2. Case Records of the Mass General Hospital. Case 7-2015: A 25-year-old man with oral ulcers, rash, and odynophagia.

    Science.gov (United States)

    Unizony, Sebastian H; Kim, Nancy D; Hoang, Mai P

    2015-02-26

    A 25-year-old man presented with oral ulcers and odynophagia. On examination, there were scattered pink papules and plaques on the trunk, thighs, and buttocks and multiple raised, erythematous nodules on both shins. A diagnostic procedure was performed. PMID:25714165

  3. Dermatitis irritativa del pañal: Tratamiento local con productos barrera y calidad de vida Diaper rash: Local treatment with barrier products and quality of life

    Directory of Open Access Journals (Sweden)

    Justo Rueda López

    2012-03-01

    Full Text Available Los trastornos cutáneos son derivados, en la mayoría de las ocasiones, de agresiones continuas por elementos externos que tiene como respuesta reacciones como la pérdida de lípidos epidérmicos por efecto de la humedad, cambios en el pH cutáneo (alcalinización y aumento del coeficiente de fricción (denudación junto al desequilibrio de la flora saprofita de la piel, que se traducen en procesos irritativos y en un aumento de la infecciones fúngicas y bacterianas en la zona expuesta a humedad. Dada la importancia de evaluar la calidad de vida de los pacientes con dermatitis que son tratados con productos barrera no irritantes (PBNI se ha desarrollado un estudio multicéntrico, con el objetivo de evaluar los aspectos relacionados con la mejora en la calidad de cuidados a pacientes tratados con Cavilon® que presentaban dermatitis por incontinencia mediante la escala ESCLI. Los pacientes incluidos en el estudio fueron 25. Los resultados muestran una mejora importante de los aspectos evaluados mediante la escala ESCLI sobre la evolución de la dermatitis. Esta escala valora aspectos como el área afectada por el enrojecimiento y la severidad, presentan una reversión del 47% de los casos. La denudación de la piel en la zona del pañal desaparece en el 56% de los casos y la severidad de la denudación que presenta una mejoría del 47%. La valoración del dolor en la zona de incontinencia se reduce en un 76% en la zona de incontinencia y en un 73% al realizar la limpieza de la zona. Las conclusiones del presente estudio ponen de manifiesto que la aplicación de productos formadores de una película barrera no irritante (PBNI en los pacientes que presentan dermatitis por incontinencia representa una alternativa a los tratamientos convencionales como son las cremas o ungüentos de óxido de cinc o pastas al agua. La reversión y reducción de la dermatitis es un aspecto que presenta una mejoría importante. Los resultados obtenidos que podemos relacionar con la calidad de vida o más concretamente con la mejora del dolor son destacables.The skin disorders are derived in most cases continuous injuries by external factors that have how responses the loss of epidermal lipids by the effect of moisture, derived of changes in skin pH (alkalinization, an increased coefficient of friction (denudation and the imbalance of the saprophytic flora of the skin, give how a result an increase to the irritative processes and the fungal and bacterian infections in the area exposed to moisture. Given the importance of assessing the quality of life of patients with dermatitis who are treated with No Sting Barrier Film (NSBF CavilonTM has developed a multicenter study, in order to evaluate the related to improving the quality of care that patients Incontinence Dermatitis with ESCLI scale. Patients included in the study were 25. The results show a significant improvement aspects ESCLI assessed by the scale of the evolution of the dermatitis. This scale assesses aspects such as the area affected by the redness and severity. Show a reversal 47% of cases. The denudation of the skin in the diaper area disappears in 56% of cases and the severity of the denudation which has a 47% improvement. The assessment of pain in the area of incontinence, is reduced by 76% in the area of incontinence and a 73% when cleaning the area. The findings of this study prove indicates that the application of forming products of a No Sting Barrier Film (NSBF in patients with incontinence dermatitis is an alternative to conventional treatments such as creams or ointments or zinc oxide paste water. The reversal and reduction of dermatitis is an aspect that has improved important. The results that we can relate to quality of life or longer specifically with the improvement of pain are significant.

  4. Dermatitis irritativa del pañal: Tratamiento local con productos barrera y calidad de vida / Diaper rash: Local treatment with barrier products and quality of life

    Scientific Electronic Library Online (English)

    Justo, Rueda López; A., Guerrero Palmero; T., Segovia Gómez; A. M., Muñoz Bueno; M., Bermejo Martínez; C., Rosell Moreno.

    2012-03-01

    Full Text Available Los trastornos cutáneos son derivados, en la mayoría de las ocasiones, de agresiones continuas por elementos externos que tiene como respuesta reacciones como la pérdida de lípidos epidérmicos por efecto de la humedad, cambios en el pH cutáneo (alcalinización) y aumento del coeficiente de fricción ( [...] denudación) junto al desequilibrio de la flora saprofita de la piel, que se traducen en procesos irritativos y en un aumento de la infecciones fúngicas y bacterianas en la zona expuesta a humedad. Dada la importancia de evaluar la calidad de vida de los pacientes con dermatitis que son tratados con productos barrera no irritantes (PBNI) se ha desarrollado un estudio multicéntrico, con el objetivo de evaluar los aspectos relacionados con la mejora en la calidad de cuidados a pacientes tratados con Cavilon® que presentaban dermatitis por incontinencia mediante la escala ESCLI. Los pacientes incluidos en el estudio fueron 25. Los resultados muestran una mejora importante de los aspectos evaluados mediante la escala ESCLI sobre la evolución de la dermatitis. Esta escala valora aspectos como el área afectada por el enrojecimiento y la severidad, presentan una reversión del 47% de los casos. La denudación de la piel en la zona del pañal desaparece en el 56% de los casos y la severidad de la denudación que presenta una mejoría del 47%. La valoración del dolor en la zona de incontinencia se reduce en un 76% en la zona de incontinencia y en un 73% al realizar la limpieza de la zona. Las conclusiones del presente estudio ponen de manifiesto que la aplicación de productos formadores de una película barrera no irritante (PBNI) en los pacientes que presentan dermatitis por incontinencia representa una alternativa a los tratamientos convencionales como son las cremas o ungüentos de óxido de cinc o pastas al agua. La reversión y reducción de la dermatitis es un aspecto que presenta una mejoría importante. Los resultados obtenidos que podemos relacionar con la calidad de vida o más concretamente con la mejora del dolor son destacables. Abstract in english The skin disorders are derived in most cases continuous injuries by external factors that have how responses the loss of epidermal lipids by the effect of moisture, derived of changes in skin pH (alkalinization), an increased coefficient of friction (denudation) and the imbalance of the saprophytic [...] flora of the skin, give how a result an increase to the irritative processes and the fungal and bacterian infections in the area exposed to moisture. Given the importance of assessing the quality of life of patients with dermatitis who are treated with No Sting Barrier Film (NSBF) CavilonTM has developed a multicenter study, in order to evaluate the related to improving the quality of care that patients Incontinence Dermatitis with ESCLI scale. Patients included in the study were 25. The results show a significant improvement aspects ESCLI assessed by the scale of the evolution of the dermatitis. This scale assesses aspects such as the area affected by the redness and severity. Show a reversal 47% of cases. The denudation of the skin in the diaper area disappears in 56% of cases and the severity of the denudation which has a 47% improvement. The assessment of pain in the area of incontinence, is reduced by 76% in the area of incontinence and a 73% when cleaning the area. The findings of this study prove indicates that the application of forming products of a No Sting Barrier Film (NSBF) in patients with incontinence dermatitis is an alternative to conventional treatments such as creams or ointments or zinc oxide paste water. The reversal and reduction of dermatitis is an aspect that has improved important. The results that we can relate to quality of life or longer specifically with the improvement of pain are significant.

  5. A 46-year-old female presenting with worsening headache, nuchal rigidity and a skin rash in varicella zoster virus meningitis: a case report

    OpenAIRE

    Kushawaha, Anurag; Mobarakai, Neville; Tolia, Jill

    2009-01-01

    Varicella zoster virus causes two distinct clinical diseases. Varicella is the primary infection and results from exposure of a person susceptible to the virus. The virus remains latent in cranial nerve ganglia, dorsal root ganglia, and autonomic ganglia along the entire neuraxis. Years later, in association with a decline in cell-mediated immunity in the elderly and immuno-compromised, varicella zoster virus reactivates and can cause a wide range of neurologic disease, including herpes zoste...

  6. NECROLISIS EPIDERMICA TOXICA. DESCRIPCION DE DOS CASOS. ERUPCIÓN CUTÁNEA SEVERA PRODUCIDA POR FÁRMACOS COMUNES TOXICAL EPIDERMAL NECROLYSIS. REPORT OF TWO CASES. SEVERE SKIN RASH CAUSED BY COMMON DRUGS

    OpenAIRE

    Liz Lezcano; Beatriz Di Martino Ortiz; Mirtha Rodríguez Masi; Oilda Knopfelmacher; Lourdes Bolla de Lezcano

    2013-01-01

    Reacción adversa a medicamentos (RAM) es definida por la OMS como cualquier respuesta a un medicamento, que sea nociva e inesperada, que ocurre a dosis normalmente utilizadas en el ser humano para profilaxis, diagnóstico, terapia de enfermedad o para modificación de la función fisiológica. Cuando RAM compromete a la piel se denomina farmacodermia, dermatosis medicamentosa o toxicodermia, la cual ocurre en el 1% de pacientes ambulatorios y 2-5 % de pacientes hospitalizados. La OMS acepta ...

  7. Vibration and skin blood flow changes in subjects with restless legs syndrome

    Directory of Open Access Journals (Sweden)

    Mitchell UH

    2014-02-01

    Full Text Available Ulrike H Mitchell, Paula K Johnson Department of Exercise Sciences, Brigham Young University, Provo, UT, USA Objective: Vascular disturbances leading to tissue hypoxia have been named as one of the possible causes of restless legs syndrome (RLS. Whole body vibration (WBV in healthy individuals results in nitric oxide (NO generation, which then leads to increased blood flow. The purpose of this investigation was to determine if WBV can: 1 improve skin blood flow, as measured in flux, in individuals with RLS, and 2 induce increases in NO blood concentration. The data were compared to healthy age-matched subjects. Design: Repeated measures, using two groups (RLS and control that underwent two treatments (WBV and sham (no vibration. Setting: Data collection occurred in an institutional setting. Patients: Ten subjects with RLS and ten controls. Methods: Subjects underwent a ten bout, 30-second per bout WBV and one sham treatment session. Blood drawn for NO analysis and flux measurements with laser Doppler were performed before, immediately after, and 5 minutes after the sessions. Main outcome measurements: The dependent variables, measured at three time intervals, were skin blood flow (flux as determined by laser Doppler imaging and blood nitric oxide concentration. Results: Baseline flux was significantly higher in the RLS group compared to control (P<0.001; flux in the RLS group immediately after WBV was significantly higher compared to baseline (P<0.05, sham treatment (P<0.05, and control group (P<0.05. There was no difference in NO concentration within subjects and between groups. Conclusion: Subjects with RLS have higher skin blood flow than controls and a greater increase in flux with WBV without concurrent increases in NO concentration from blood drawn at the antecubital fossa. Keywords: restless legs syndrome, flux, SBF, WBV, vascular disturbance

  8. Utility of abdominal ultrasonography in acute painful tables of right iliac Fossa with appendicitis acute suspicion. Maciel Hospital Experience

    International Nuclear Information System (INIS)

    Acute appendicitis is one of the most frequent causes of consultation and of indication of emergency laparotomy in most western countries. Despite its diagnostic being based mainly on clinical examination, there is a certain percentage of patients whose clinical presentation is atypical. In these cases image methods such as the abdominal ultrasound are particularly useful as diagnostic auxiliaries.The objective of this work is to compare the echographic with the Anatomopathological diagnosis in 80 patients who consulted the Hospital Maciel emergency service with episodes of acute appendicitis

  9. Subacute phase treatment of subperiosteal hematoma of the orbit with epidural hematoma in the frontal cranial fossa: Case report

    Directory of Open Access Journals (Sweden)

    Mikami Taro

    2012-06-01

    Full Text Available Abstract Background Subperiosteal hematoma of the orbit is one of the rare lesions that cause exophthalmos after craniomaxillofacial trauma. Presently, there is no consensus for how to treat this disease. Although some reports have suggested a conservative type of therapy, others have recommended surgical treatments be done during the early stages. Case presentation This case report provides details on the clinical course of a 9-year-old girl with subperiosteal hematoma of the orbit. In this particular patient, a rare case of ipsilateral subfrontal extradural hematoma was also observed. Due to our performing the surgical intervention during the subacute stage, functional complications as well as cosmetic problems were avoided. Conclusion Our results demonstrate that surgical treatments for subperiosteal hematoma of the orbit should be delayed until it can be confirmed that a patient has no other complications. On the other hand, once it has been confirmed that the patient has no other existing problems, immediate surgical therapy with a small skin incision followed by the setting of a drain is recommended in order to achieve an early resolution and avoid complications.

  10. What Is Shingles?

    Medline Plus

    Full Text Available ... three stages -- severe pain or tingling, possibly itchy rash and blisters that look like chicken pox but ... Adriana Marques M.D.: The location of the rash is a clue if the rash is shingles ...

  11. Red blood cell deformability and aggregation in chronic venous disease patients with varicose veins

    Directory of Open Access Journals (Sweden)

    Karolina S?oczy?ska

    2013-07-01

    Full Text Available Introduction: Red blood cells’ (RBC rheological properties are disturbed in chronic venous disease (CVD. The aim of the study was to compare deformability and aggregation of erythrocytes taken from the varicose vein and the antecubital vein of patients with chronic venous disease.Materials and Methods: Blood samples were taken from twelve CVD patients presenting clinical, aetiological, anatomical and pathological elements (CEAP stages II and III. Blood was sampled from varicose veins and antecubital veins of patients (as control. Deformability and aggregation of RBC were analysed with a Laser-assisted Optical Rotational Cell Analyser (LORCA.Results: A significant increase in deformability was found in varicose vein RBC for shear stress values 4.24, 8.23 and 15.96 Pa as compared to RBC from the antecubital vein. The aggregation index was significantly lower and aggregation halftime was significantly increased for RBC taken from antecubital veins than for RBC from varicose veins.Discussion: In conclusion, RBC taken from varicose and antecubital veins of CVD patients are not entirely rheologically comparable and show different deformability and aggregation. Varicose vein RBC are more deformable and show a higher tendency for aggregation than antecubital vein RBC. Perhaps the deformability of varicose vein RBC has been increased as a compensation mechanism in subjects with CVD, due to increased resistance in their microcirculation.

  12. A novel hybrid aspirin-NO-releasing compound inhibits TNFalpha release from LPS-activated human monocytes and macrophages

    Directory of Open Access Journals (Sweden)

    Fox Sarah

    2008-07-01

    Full Text Available Abstract Background The cytoprotective nature of nitric oxide (NO led to development of NO-aspirins in the hope of overcoming the gastric side-effects of aspirin. However, the NO moiety gives these hybrids potential for actions further to their aspirin-mediated anti-platelet and anti-inflammatory effects. Having previously shown that novel NO-aspirin hybrids containing a furoxan NO-releasing group have potent anti-platelet effects, here we investigate their anti-inflammatory properties. Here we examine their effects upon TNF? release from lipopolysaccharide (LPS-stimulated human monocytes and monocyte-derived macrophages and investigate a potential mechanism of action through effects on LPS-stimulated nuclear factor-kappa B (NF-?B activation. Methods Peripheral venous blood was drawn from the antecubital fossa of human volunteers. Mononuclear cells were isolated and cultured. The resultant differentiated macrophages were treated with pharmacologically relevant concentrations of either a furoxan-aspirin (B8, B7; 10 ?M, their respective furazan NO-free counterparts (B16, B15; 10 ?M, aspirin (10 ?M, existing nitroaspirin (NCX4016; 10 ?M, an NO donor (DEA/NO; 10 ?M or dexamethasone (1 ?M, in the presence and absence of LPS (10 ng/ml; 4 h. Parallel experiments were conducted on undifferentiated fresh monocytes. Supernatants were assessed by specific ELISA for TNF? release and by lactate dehydrogenase (LDH assay for cell necrosis. To assess NF-?B activation, the effects of the compounds on the loss of cytoplasmic inhibitor of NF-?B, I?B? (assessed by western blotting and nuclear localisation (assessed by immunofluorescence of the p65 subunit of NF-?B were determined. Results B8 significantly reduced TNF? release from LPS-treated macrophages to 36 ± 10% of the LPS control. B8 and B16 significantly inhibited monocyte TNF? release to 28 ± 5, and 49 ± 9% of control, respectively. The B8 effect was equivalent in magnitude to that of dexamethasone, but was not shared by 10 ?M DEA/NO, B7, the furazans, aspirin or NCX4016. LDH assessment revealed none of the treatments caused significant cell lysis. LPS stimulated loss of cytoplasmic I?B? and nuclear translocation of the p65 NF-?B subunit was inhibited by the active NO-furoxans. Conclusion Here we show that furoxan-aspirin, B8, significantly reduces TNF? release from both monocytes and macrophages and suggest that inhibition of NF-?B activation is a likely mechanism for the effect. This anti-inflammatory action highlights a further therapeutic potential of drugs of this class.

  13. Mild episodes of tourniquet-induced forearm ischaemia-reperfusion injury results in leukocyte activation and changes in inflammatory and coagulation markers

    Directory of Open Access Journals (Sweden)

    Bastawrous Salah S

    2007-05-01

    Full Text Available Abstract Background Monocytes and neutrophils are examples of phagocytic leukocytes, with neutrophils being considered as the 'chief' phagocytic leukocyte. Both monocytes and neutrophils have been implicated to play a key role in the development of ischaemia-reperfusion injury, where they are intrinsically involved in leukocyte-endothelial cell interactions. In this pilot study we hypothesised that mild episodes of tourniquet induced forearm ischaemia-reperfusion injury results in leukocyte activation and changes in inflammatory and coagulation markers. Methods Ten healthy human volunteers were recruited after informed consent. None had any history of cardiovascular disease with each subject volunteer participating in the study for a 24 hour period. Six venous blood samples were collected from each subject volunteer at baseline, 10 minutes ischaemia, 5, 15, 30, 60 minutes and 24 hours reperfusion, by means of a cannula from the ante-cubital fossa. Monocyte and neutrophil leukocyte sub-populations were isolated by density gradient centrifugation techniques. Leukocyte trapping was investigated by measuring the concentration of leukocytes in venous blood leaving the arm. The cell surface expression of CD62L (L-selectin, CD11b and the intracellular production of hydrogen peroxide (H2O2 were measured via flow cytometry. C-reactive protein (CRP was measured using a clinical chemistry analyser. Plasma concentrations of D-dimer and von Willebrand factor (vWF were measured using enzyme-linked fluorescent assays (ELFA. Results During ischaemia-reperfusion injury, there was a decrease in CD62L and an increase in CD11b cell surface expression for both monocytes and neutrophils, with changes in the measured parameters reaching statistical significance (p =2O2 production by leukocyte sub-populations, which was measured as a marker of leukocyte activation. Intracellular production of H2O2 in monocytes during ischaemia-reperfusion injury reached statistical significance (p = 0.014, although similar trends were observed with neutrophils these did not reach statistical significance. CRP was measured to assess the inflammatory response following mild episodes of ischaemia-reperfusion injury and resulted in a significant increase in the CRP concentration (p = Conclusion Tourniquet induced forearm ischaemia-reperfusion injury results in increased adhesiveness, trapping and activation of leukocytes. We report that, even following a mild ischaemic insult, this leukocyte response is immediately followed by evidence of increased inflammatory response, coagulation activity and endothelial damage. These results may have important implications and this pilot study may lead to a series of trials that shed light on the mechanisms of ischaemia-reperfusion injury, including potential points of therapeutic intervention for pathophysiological conditions.

  14. Potential Mars Surveyor 2001 Landing Sites: Low-Elevation Cratered "Highlands" in Central and Eastern Sinus Meridiani and Near Amenthes Fossae

    Science.gov (United States)

    Edgett, K. S.; Parker, T. J.; Huntwork, S. N.

    1998-01-01

    The main scientific goal for the Mars Surveyor Program 2001 (MSP 01) landed mission is to collect and characterize 91 rock and 13 soil core samples using an integrated instrument suite onboard the Athena Rover. If possible, these samples will be retrieved and returned to Earth via a MSP 05 or MSP 07 mission. Preliminary engineering constraints for the MSP 01 landing site call for a location that lies between 15 S and 30 N, and below about 2 km elevation (based on Viking-era topography). Desirable landing sites for MSP 01 are to be located "in the ancient highlands where the environmental conditions may have been favorable to the preservation of evidence of possible prebiotic or biotic processes including the emergence (and, potentially, the persistence) of life". We interpret this to mean that the desirable sites include those that have evidence of aqueous sediments that might have been deposited during the Noachian and/or Hesperian Epochs of Mars' history. In addition to the search for subaqueous sedimentary deposits, we took into consideration the fact that the rover, Athena, will need to be able to access these materials. Thus, a site where aeolian deflation has occurred might be desirable because it might expose, in situ, layered sedimentary deposits. Deflated areas, of course, might include potential landing hazards in the form of meterscale buttes and mesas (e.g., Christmas Lake Valley, OR), thus careful study of such sites with high resolution images will be required before a decision is made to land. We have been examining three regions that have potential to be considered for MSP 01 landing sites. This work is based on Viking (VIS, IRTM) and Phobos 2 (Termoskan) observations and should be regarded as preliminary because we believe that the final site selection should also be based upon analysis of Mars Global Surveyor observations that help constrain mineralogy (TES) and local geomorphology (MOC, MOLA). (1) Eastern Sinus Meridiani Region (proposed by K. S. Edgett) Sinus Meridiani is a persistent low-albedo (inertias are 3.2-7.0 x 10(exp -3) cal /sq cm s(exp -0.5)/K; and rock abundances are around 2-6%. The site at 7.6 S, 346.9 W is at the southern end of the smooth, medium-albedo unit that might have a lacustrine origin. At this location, numerous channels appear to have drained toward the smooth unit. Viking images from orbit 747A show this area at about 15 m/pixel ground resolution. The images reveal that aeolian deflation has occurred along the deposit's margins. Bright (i.e., albedo >= 0.21) aeolian dunes are present on the channel floors and in some of the depressions on the smooth unit. The bright, apparently active dunes might consist of material (perhaps lakedeposited sands) that has been eroded from the smooth unit. The site at approximately 0.8 S, 349 W is selected because it offers an opportunity to solve a long-standing puzzle about Mars remote sensing. There are three main "color" units on Mars: "dark red, dark gray, and bright red". This landing site would allow the Athena rover an opportunity to investigate all three materials within close proximity (the best place on Mars to do so). There are no high resolution (better than 100 m/pixel) Viking or Mariner images of this site.

  15. Adubação do milho: IX - Ensaio com lôdo de fossas sépticas "OMS" Fertilizer experiments with corn: IX - Trial with dried sewage sludge

    Directory of Open Access Journals (Sweden)

    G. P. Viégas

    1956-01-01

    Full Text Available No presente artigo os autores apresentam os resultados de um ensaio conduzido em terra roxa misturada, na Estação Experimental Central, Campinas, para estudar o efeito, na cultura do milho, do adubo OMS completado ou não com fósforo e potássio. O adubo OMS é um pó resultante da decantação, em tanques sépticos, do material de esgotos das cidades, contendo aproximadamente 10% de umidade, 45% de matéria orgânica, 2,5% de N, 0,7% de P2O5 e 0,2% de K2O. O ensaio constou de 16 tratamentos compreendendo tôdas as combinações de: 1 0, 2,5, 5 e 10 t/ha de adubo OMS; 2 0 e 80 kg/ha de P2O5 na forma de farinha de ossos e 3 0 e 50 kg/ha de K.,0 na forma de cinzas de café (que também forneceram 20 kg/ha de P2O5. Os adubos foram empregados somente no primeiro ano, 1943-44, mas o ensaio foi conduzido durante três anos. O efeito do fósforo foi muito pequeno (provavelmente porque a terra havia sido adubada com adubos fosfatados nas culturas anteriores ao ensaio, ao passo que o potássio aumentou extraordinariamente a produção no primeiro ano e teve magnífico efeito residual nos dois anos seguintes. O efeito do adubo OMS foi pequeno na ausência do potássio, mas elevou-se substancialmente na presença dêsse nutriente. As doses de 5 e 10 t/ha deram resultados satisfatórios; contudo, aumentaram relativamente mais a produção de colmos que a de grãos. O efeito do nitrogênio de OMS foi rápido, mas aparentemente pouco duradouro. Para melhor aproveitamento do seu nitrogênio, a aplicação do adubo OMS deveria ser feita com freqüência (talvez anualmente e em doses moderadas, completadas, conforme a terra, com fósforo e potássio.This paper reports the results of an experiment conducted in "terra roxa misturada" soil at the Central Experiment Station, Campinas, to study mainly the effect of dried sewage sludge as a fertilizer for corn. The product contained approximately 10% water, 45% organic matter, 2.5% N, 0.7% P2O5, and 0.2% K2O and was used at the dosages of 2.5, 5 and 10 metric tons to the hectare, either alone or supplementd with phosphorus (bone meal, potassium (coffee beans ash, or both. All the fertilizers were applied only in the first year, 1943-44, but corn was planted in the same plots for three consecutive yars. The yield increase due to phosphorus was small, apparently because the area used for the experiment had been fertilized with phosphates in the previous crops. Potassium increased considerably the yield in the first year and showed excellent residual effect in the two succeeding years. In the absence of potash the sludge product acted poorly, but in the presence of that nutrient its effect increased appreciably. The 5 and 10 tons rates gave satisfactory results; however, they increased comparatively more the production of stover than the grain yield. The nitrogen of the sludge product acts fairly quickly, but apparently little of it remains in the soil for the succeeding crops. For better utilization of its nitrogen, the sludge product should be applied frequently (perhaps annually and at moderate rates, supplemented with potash and phosphate, according to the soil.

  16. Resolution of syringomyelia in ten cases of "up-and-down Chiari malformation" after posterior fossa decompression Resolução de siringomielia em dez casos de malformação de Chiari observada apenas com o paciente em posição sentada durante a descompressão da fossa posterior

    OpenAIRE

    José Alberto Gonçalves da Silva; Luiz Ricardo Santiago Melo; Antônio Fernandes de Araújo; Adailton Arcanjo dos Santos Jr

    2010-01-01

    The authors describe ten cases of syringomyelia without hindbrain herniation depicted by preoperative magnetic resonance imaging (MRI) in supine position. However, the herniation was observed in all cases during the operation with the patient in sitting position. The postoperative MRI revealed an intense reduction of the syrinx in all patients, as well as it was also observed a clinical amelioration in all cases. The surgical treatment was based on a large craniectomy with the patient in sitt...

  17. Arm vein uptake of thallium-201 during exercise: incidence and clinical significance

    International Nuclear Information System (INIS)

    We prospectively analyzed several clinical and technical variables that might be associated with arm vein uptake of 201Tl during stress thallium scintigraphy in 63 patients. The influence of site (medial antecubital vs. other vein) and technique (with or without a 15-cc saline flush) were examined. Arm vein uptake was not seen after medial antecubital injections except in one case injected through a 24-hr-old indwelling catheter. Arm vein uptake was seen in 24/45 (53%) of cases injected into veins other than the medial antecubital. A saline flush did not reduce the incidence of arm uptake. In patients with normal myocardial studies, those with positive arm uptake had 33% lower net myocardial counts on the postexercise images (p = 0.00008) and 20% lower net myocardial counts on the delayed images (p = 0.04). Myocardial washout of thallium was significantly (p = 0.009) slower in those with arm uptake

  18. Mohs Surgery

    Medline Plus

    Full Text Available ... question & answer discussion forum widgets for professionals dermatology education rash and rashes clinical tools newsletter | contact Share | ... process takes a couple hours. Dr. Jodi Markus Education • Assistant Professor of Dermatology and Dermatologic Surgery – Baylor ...

  19. Side Effects of Smallpox Vaccination

    Science.gov (United States)

    ... of the body away from the vaccination site (generalized vaccinia). A toxic or allergic rash in response to ... threatening reactions. These reactions require immediate medical attention: Eczema vaccinatum. Serious skin rashes caused by widespread infection of ...

  20. Ketoconazole Topical

    Science.gov (United States)

    ... is used to treat tinea corporis (ringworm; fungal skin infection that causes a red scaly rash on different ... diaper rash, eczema (skin irritation caused by allergies), impetigo (blisters caused by a bacterial infection), and psoriasis ( ...

  1. Scabies: Frequently Asked Questions (FAQs)

    Science.gov (United States)

    ... vesicles) and scales. Scratching the rash can cause skin sores; sometimes these sores become infected by bacteria. Tiny ... or rash continue to appear. How soon after treatment will I feel better? If itching continues more ...

  2. Pityriasis Rosea

    Science.gov (United States)

    ... relatives have a similar rash Your recent sexual history Your medication history (make sure you know the names of any ... Links MedlinePlus: Rashes References Bolognia, Jean L., ed. Dermatology , pp.158-160. New York: Mosby, 2003. Freedberg, ...

  3. 75 FR 71491 - Designation of Biobased Items for Federal Procurement

    Science.gov (United States)

    2010-11-23

    ...of scratches, cuts, bruises, abrasions, sun damaged skin, tattoos, rashes and other skin conditions...of scratches, cuts, bruises, abrasions, sun damaged skin, tattoos, rashes and other skin conditions. (b) Minimum biobased...

  4. Mohs Surgery

    Medline Plus

    Full Text Available ... answer discussion forum widgets for professionals dermatology education rash and rashes clinical tools newsletter | contact Share | Mohs Surgery A ... history of chronic sun exposure. Although it requires treatment to prevent it from becoming too invasive, basal ...

  5. Mohs Surgery

    Medline Plus

    Full Text Available research skin condition finder disease list trusted search trusted links explore resource centers health articles health topics community skinmatters blog question & answer discussion forum widgets for professionals dermatology education rash and rashes clinical tools newsletter | contact ...

  6. Mohs Surgery

    Medline Plus

    Full Text Available ... answer discussion forum widgets for professionals dermatology education rash and rashes clinical tools newsletter | contact Share | Mohs Surgery A ... the Daily Green Tweet Top Rated Forum Topics eczema I am in pain 4.5 undiagnosed skin ...

  7. If I Had - A Child with a Food Allergy

    Medline Plus

    Full Text Available ... could include skin symptoms like itchy skin, skin rash, hives (which look like mosquito bite), and flaring of pre-existing rash like eczema. It can also include stomach problems ...

  8. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... Dizziness Vomiting A headache A red, donut-shaped rash that develops after a tick bite: This could ... A fever with a red or black, spotty rash that spreads: This could be a sign of ...

  9. Biotin

    Science.gov (United States)

    ... hair loss, brittle nails, skin rash in infants (seborrheic dermatitis), diabetes, and mild depression. ... cause mild biotin deficiency.Skin rash in infants (seborrheic dermatitis).Hair loss. There is some preliminary evidence that ...

  10. Wound Care: Preventing Infection

    Science.gov (United States)

    ... TO HAVE CLEARED UP . Problem — Allergic reaction (itchy rash or swelling). Treatment — If the rash is mild, it may help ... the problem persists. Problem — Fungal infection (itchy, burning rash similar to athlete’s foot). Treatment — Topical antifungal creams or diaper cream may work. ...

  11. Osteogenesis imperfecta with joint contractures: Bruck syndrome

    International Nuclear Information System (INIS)

    We describe an Egyptian boy with osteogenesis imperfecta who was born with thumb contractures and bilateral antecubital pterygia. He was seen at 16 months of age with femur and tibial fractures, thoracic vertebral compression fractures, scoliosis and Wormian bones. The findings are consistent with a diagnosis of Bruck syndrome. (orig.)

  12. Pituitary function with a solitary intrasellar plasmacytoma.

    OpenAIRE

    Evans, P. J.; Jones, M. K.; Hall, R.; Scanlon, M. F.

    1985-01-01

    A solitary intrasellar plasmacytoma with marked pituitary fossa destruction and yet near normal pituitary gland function is described. We suggest that a minimal disturbance of endocrine function together with a radiologically abnormal pituitary fossa indicates that the primary lesion may lie outside the pituitary fossa.

  13. Cerebral salt wasting syndrome in the posterior fossa surgery post-operative period: Case report / Síndrome pierde sal en el postoperatorio de cirugía de fosa posterior: reporte de caso

    Scientific Electronic Library Online (English)

    Rosana, Guerrero-Domínguez; Gemma, González-González; Jesús, Acosta-Martínez; Rafael, Rubio-Romero; Ignacio, Jiménez.

    2015-02-01

    Full Text Available La hiponatremia es el trastorno electrolítico más frecuente después de la cirugía intracraneal. Su etiología es multifactorial. A continuación presentamos un caso de un paciente sometido a una descompresión microvascular (cirugía de Janetta) como tratamiento de la neuralgia del trigémino que en el p [...] ostoperatorio inmediato desarrolló una magnificación sintomática de su hiponatremia basal. Se diagnosticó un síndrome pierde sal cuyo manejo supone un reto para los médicos implicados en los cuidados neuroquirúrgicos postoperatorios. Abstract in english Hyponatremia is the most common electrolyte disorder following intracranial surgery. Its aetiology is multifactorial. We present a case of a patient taken to microvascular decompression (Janetta surgery) for the treatment of trigeminal neuralgia who developed a symptomatic magnification of basal hyp [...] onatremia in the immediate post-operative period. Cerebral salt wasting syndrome was diagnosed. The management of this condition poses a challenge for physicians involved in postoperative neurosurgical care.

  14. Estudio de las Venas de la Fosa Cubital a través de la Tomografía Computada Helicoidal y su Aplicación Clínica Study of the Veins of the Cubital Fossa by Helical Computed Tomography and its Clinical Application

    OpenAIRE

    Mariano del Sol; Eugenio Lillo; Leonardo Lobos; Bélgica Vásquez

    2012-01-01

    Las venas superficiales de la fosa cubital, constituyen uno de los sitios más importantes de punción venosa. La disposición de estas venas presenta numerosas variaciones. Su anatomía no ha sido estudiada aplicando los avances tecnológicos en el campo de la medicina, como la tomografía computada helicoidal. Fueron analizadas mediante tomografía axial computada helicoidal, las formaciones venosas de la fosa cubital en 60 individuos chilenos de ambos sexos, de edades entre 10 y 86 años, ...

  15. Bilateral Supernumerary Sternocleidomastoid Heads with Critical Narrowing of the Minor and Major Supraclavicular Fossae: Clinical and Surgical Implications Cabezas Supernumerarias Bilaterales del Músculo Esternocleidomastoídeo con Estrechamiento Crítico de las Fosas Supraclavicular Menor y Mayor: Implicancias Clínicas y Quirúrgicas

    OpenAIRE

    Athanasios Raikos; Paraskevas, George K.; Stefanos Triaridis; Panagiota Kordali; George Psillas; Beate Brand-Saberi

    2012-01-01

    Anatomical variations of the sternocleidomastoid muscle are rare and concern its origin, insertion, and the number of heads. We report on a rare bilateral variant of the sternocleidomastoid muscle with aberrant and supernumerary muscular heads, observed in a cadaveric subject. On the right side of the neck, a typical sternomastoid head of the sternocleidomastoid muscle, and three aberrant clavicular heads of variable thickness, origin, and termination were noticed. On the left side, two stern...

  16. Folliculitis after smallpox vaccination: a report of two cases.

    Science.gov (United States)

    Oh, Robert C

    2005-02-01

    Rashes are frequent and potentially serious adverse consequences of smallpox vaccination. Life-threatening rashes must be differentiated from benign, self-limiting ones. Generalized vaccinia, erythema multiforme, and folliculitis are distinct self-limiting entities but may be difficult to differentiate from one another. Two cases of folliculitis after smallpox vaccination are described. Both patients received anthrax vaccination within 2 weeks before smallpox vaccination. Both presented with a papulopustular rash 9 days after smallpox vaccination. Although the rashes were initially diagnosed as erythema multiforme, the clinical features were more consistent with folli