WorldWideScience

Sample records for antecubital fossae rash

  1. %178200 PTERYGIUM, ANTECUBITAL [OMIM

    Lifescience Database Archive (English)

    Full Text Available FIELD NO 178200 FIELD TI %178200 PTERYGIUM, ANTECUBITAL FIELD TX DESCRIPTION Antecubital pterygi ... osomal dominant disorder characterized by a fleshy web ... extending across the anterior aspect of the cubita ... here was 1 instance of a 'skipped generation.' The web ... extended across the cubital fossa from the distal ...

  2. Rashes

    Science.gov (United States)

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

  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. Diaper Rash

    Science.gov (United States)

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

  5. Babies and heat rashes

    Science.gov (United States)

    Heat rashes and babies; Prickly heat rash; Red miliaria ... To avoid heat rash , keep your baby cool and dry during warm weather. Some helpful suggestions: During the hot season, dress your baby in lightweight, soft, cotton clothing. Cotton ...

  6. Herpetic neonatal pustular rash

    OpenAIRE

    Meda, Manjula; Godden, Charles; Irish, Dianne

    2009-01-01

    Pustular rash in a neonate is very common and is usually associated with staphylococcal infection. The present report describes the case of a 12-day-old neonate with a pustular rash, secondary to herpes simplex infection. A high index of suspicion is necessary in neonates presenting with suggestive signs, especially with negative bacterial cultures. Prompt initiation of aciclovir treatment after obtaining diagnostic samples may be life-saving.

  7. Mangala Fossa

    Science.gov (United States)

    2002-01-01

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

  8. Olmesartan: Induced maculopapular rash

    Directory of Open Access Journals (Sweden)

    Aruna Bhushan

    2013-01-01

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

  9. Hot Tub Rash (Pseudomonas Folliculitis)

    Science.gov (United States)

    newsletter | contact Share | Hot Tub Rash ( Pseudomonas Folliculitis) Information for adults A A A This image displays follicular elevations of the skin and small pus-filled lesions. Overview Hot tub rash ( ...

  10. Empty glenoid fossa sign.

    Science.gov (United States)

    Penna, Kevin J; Mirra, Richard M; Cusumano, Francis J

    2007-01-01

    Routine CT studies of suspected closed head injury encompass the calvaria to the cranial base. It is at the cranial base that the glenoid fossa appears. An "empty glenoid fossa" sign is when there is no condyle associated within the fossa. This is suggestive of a condylar neck fracture. PMID:17378320

  11. 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

  12. 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.

  13. [Antecubital flap: advantages in elbow coverage. An anatomical study and experience of five clinical cases].

    Science.gov (United States)

    Duteille, F; Rocchi, L; Dautel, G; Merle, M

    2001-02-01

    The antecubital flap is a fasciocutaneous strip that has its blood supply provided by the first proximal collateral of the radial artery. This flap was described for the first time in 1983 by Lamberty and Cormack, but it has not been widely used and there have been only a few reports in the literature concerning this procedure. The aim of the present investigation was to demonstrate via an anatomical study and a report on five cases the viability of the various anatomical features of this cutaneous flap, and also its positive contribution to elbow reconstruction. The anatomical study involved eight fresh cadavers (eight upper limbs). An injection of colored prevulcanized latex was made in the humeral artery in the lower third of the arm. The aim was to determine which artery provided blood supply to the flap, its anatomical location, and also to look for possible distal anastomoses which would permit a distal pedicled flap to be removed. Contrary to the findings of other authors, in the present study it was found that the vessel providing blood to the antecubital flap always branched off from the radial artery. However, no anastomoses with distal vascularization were detected, which would have permitted a distal pedicled flap to be obtained. The use of the antecubital flap for elbow coverage was then illustrated by five clinical cases of soft tissue defects of the elbow. This method was found to be reliable, practical, and the flap could be rapidly dissected. Moreover, this particular technique is sensitive, and has an interesting rotational arc. The distal cutaneous island flap has the advantage of limiting scar tissue. A comparison between the antecubital flap and other pedicled flaps has then been made. In conclusion, it appears that this little-known procedure has definite advantages, and that it should be included in the range of surgical techniques that are available for soft tissue reconstruction in the case of elbow defects. PMID:11233730

  14. Rash caused by Oryctes nasicornis.

    Science.gov (United States)

    Veraldi, Stefano; Fanoni, Daniele; Nazzaro, Gianluca

    2016-02-01

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

  15. Pediatric patient with a rash.

    Science.gov (United States)

    Sutton, Jared; Walsh, Ryan; Franklin, Jillian

    2014-07-01

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

  16. New Itchy Skin Rashes in Children

    Science.gov (United States)

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

  17. New Itchy Skin Rashes in Adults

    Science.gov (United States)

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

  18. Pediatric Patient with a Rash

    OpenAIRE

    Sutton, Jared; Walsh, Ryan; Franklin, Jillian

    2014-01-01

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

  19. Posterior fossa tumours

    International Nuclear Information System (INIS)

    The results of magnetic resonance imaging, using a 0.5 Tesla superconductive magnet in 6 patients with clinical (6), angiographic (6) and histologic (4) diagnosis of posterior fossa tumors were reviewed and compared with X-ray computed tomography. Optimal visualization of normal and abnormal anatomic relationships and the possibility and value of calculated T1- and T2-pictures with the aid of spin-echo-technique are discussed. (orig.)

  20. Butterfly rash with periodontitis: A diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Manvi Aggarwal

    2012-01-01

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

  1. Rash associated with Pregabalin: A case report

    Directory of Open Access Journals (Sweden)

    Burak Uz

    2013-03-01

    Full Text Available A 48-year-old man with erythematous, maculopapularrash localized to his extremities and lumbar region thathe had been receiving oral pregabalin 300 mg per day for2 months to treat his neuropathy was applied. The Naranjoprobability scale indicates a probable relationship betweenthe development of rash and use of pregabalin byour patient. Pregabalin was discontinued and antihistaminictreatment, oral methyprednisolone and topical steroidcream were given to treat the rash. The rash almostcompletely resolved one week after pregabalin was discontinued.Pregabalin-induced rash was rarely reportedin Phase 3 clinical trials, and there is currently only oneavailable report on the development of a rash coincidingwith the use of pregabalin. No clear mechanisms reportedfor rash associated with pregabalin. It is usually recommendedto start pregabalin with low doses and slow increasesmight prevent the incidence of side effects. J ClinExp Invest 2013; 4 (1: 107-109Key words: pregabalin, rash, multiple myelom

  2. Medusae Fossae Formation

    Science.gov (United States)

    2002-01-01

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

  3. Ron Rash: One Foot in Eden

    DEFF Research Database (Denmark)

    Bjerre, Thomas Ærvold

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

  4. Posterior fossa arteriovenous malformations

    International Nuclear Information System (INIS)

    Classically, posterior fossa arteriovenous malformations (PF-AVMs) have been considered as lesions with high tendency to bleed. However, careful analysis of clinical and autopsy data from the literature demonstrate that in fact the incidence of hemorrhage is similar in infratentorial and supratentorial locations. The clinical perception that most of the diagnosed PF-AVMs had bled does not mean that they have a high risk of hemorrhage. It suggests that bleeding is the dominant way of expression, since other symptoms are uncommon. Furthermore, angioarchitectural analysis is similar in supra- an intratentorial locations. The causes of hemorrhage are probably related to venous anatomic and hemodynamic changes or associated aneurysms as in other intracranial AVMs. (orig.)

  5. 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.

  6. Skin rash during treatment with generic itraconazole

    Directory of Open Access Journals (Sweden)

    Antonio De Vuono

    2014-01-01

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

  7. Epidural hematomas of posterior fossa

    Directory of Open Access Journals (Sweden)

    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.

  8. Approach to the Diseases with Rash

    Directory of Open Access Journals (Sweden)

    Gönül Tan?r

    2009-05-01

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

  9. The Rough South of Ron Rash

    DEFF Research Database (Denmark)

    Bjerre, Thomas Ærvold

    2016-01-01

    While Ron Rash is not a direct heir to the “Southern Redneck and White Trash” tradition that Erik Bledsoe discusses in his seminal essay, his fiction is full of people whose lives are firmly embedded in the so-called Rough South. In his introduction to the anthology Grit Lit: A Rough South Reader, Brian Carpenter defines the people of Rough South literature as “mostly poor, white, rural, and unquestionably violent” (xxvii). Based on this definition, Rash belongs firmly in that category. He peoples his fiction with mostly lower class whites from the Appalachian regions of North and South Carolina. In a 2006 television interview with Rash, William Gay, and Barry Hannah titled “Renegade Writers,” interviewer Gene Edwards opened the show by dividing southern writing into the same two groups as Tony Early has done previously: those on the right side of the tracks (the heirs of Eudora Welty) and those on the wrong side of the tracks (the hell raising, hard-drinking, violent group). Asked if he feels he is from theother side of the tracks, Rash answers affirmative: “Yeah, in the sense of the kind of world that I depict and the language of that world as well. And also just being outdoors, being out there among the mayhem at times” (“Renegade Writers”). Through his body of work, then, Rash illustrates his concern with working class characters and their struggles. He clearly depicts poor whites and their struggles with violence. Rash writes both out of and against the southern Agrarian tradition; he uses his own experience of escaping the Rough South through education to mirror the experiences of several of his characters.

  10. The Rough South of Ron Rash

    DEFF Research Database (Denmark)

    Bjerre, Thomas Ærvold

    2016-01-01

    While Ron Rash is not a direct heir to the “Southern Redneck and White Trash” tradition that Erik Bledsoe discusses in his seminal essay, his fiction is full of people whose lives are firmly embedded in the so-called Rough South. In his introduction to the anthology Grit Lit: A Rough South Reader, Brian Carpenter defines the people of Rough South literature as “mostly poor, white, rural, and unquestionably violent” (xxvii). Based on this definition, Rash belongs firmly in that category. He peopl...

  11. Cadaveric study of fossa ovalis

    Directory of Open Access Journals (Sweden)

    Kanani SD

    2014-12-01

    Full Text Available Introduction: The interatrial septum of heart presents the fossa ovale, an oval depression above and to the left of the orifice of the inferior vena cava. Atrial septal defect is one of the most common but least severe congenital heart diseases in adult. Patent foramen ovale is a hemodynamically insignificant interatrial communication present in >25% of the adult population. Material and Methods: This cross sectional study was conducted on 40 cadavers with age range of 60 to 80 years in the dissection laboratory of various medical colleges of ahmedabad, Gujarat, India. Standard dissection method was used and foramen ovale was observed after opening up the right atrium and data about the situation, shape, floor and margin of foramen ovale was noted. Result and Observation: Commonest position of fossa ovalis was the middle of the interatrial wall followed by mouth of the inferior caval vein and mouth of the superior caval vein. In 33 hearts the fossa was oval and in 07 hearts it was round. The floor was very thick 19, moderately thick in 13 and thin in 08. Two hearts had fenestrated floor. Conclusion: Patients with isolated atrial septal defects (ASD have benefited from important recent advances in the diagnosis, evaluation, & management of their conditions. More studies are necessary to address several unresolved issues related to patent foramen ovale for benefit of patients.

  12. 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.

  13. 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.

  14. Leflunomide Induced Drug Rash And Hepatotoxicity

    Directory of Open Access Journals (Sweden)

    Uppal Monica

    2004-01-01

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

  15. Mature Teratoma Confined to the Posterior Fossa.

    Science.gov (United States)

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

    2016-01-01

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

  16. 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

  17. 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

  18. Skin conditions: common skin rashes in infants.

    Science.gov (United States)

    Zuniga, Ramiro; Nguyen, Tam

    2013-04-01

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

  19. 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)

  20. 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.

  1. 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

  2. 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 ...

  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

    2015-08-01

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

  4. Piriformis Fossa – An Anatomical and Orthopedics Consideration

    OpenAIRE

    O. P. Lakhwani; Mittal, P.S.; Naik, D.C.

    2014-01-01

    Introduction: Piriformis fossa is an important anatomical landmark having significant clinical value in orthopedic surgery; but its location and anatomical relationship with surrounding structures are not clearly defined. Hence it is necessary to clearly describe it in respect to anatomical and orthopedic aspect.

  5. 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.)

  6. 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.

  7. MORPHOMETRIC ANALYSIS OF GLENOID FOSSA OF SCAPULA

    Directory of Open Access Journals (Sweden)

    Sangeeta

    2015-06-01

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

  8. 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.)

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

    Directory of Open Access Journals (Sweden)

    Zonunsanga

    2015-10-01

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

  10. Vermian agenesis without posterior fossa cyst

    Energy Technology Data Exchange (ETDEWEB)

    Adamsbaum, C. [Dept. of Pediatric Radiology, Saint Vincent de Paul Hospital, 75 Paris (France); Moreau, V. [Dept. of Pediatric Radiology, Saint Vincent de Paul Hospital, 75 Paris (France); Bulteau, C. [Dept. of Pediatric Neurology, Saint Vincent de Paul Hospital, 75 Paris (France); Burstyn, J. [Dept. of Pediatric Ophthalmology, Saint Vincent de Paul Hospital, 75 Paris (France); Lair Milan, F. [Dept. of Pediatric Radiology, Saint Vincent de Paul Hospital, 75 Paris (France); Kalifa, G. [Dept. of Pediatric Radiology, Saint Vincent de Paul Hospital, 75 Paris (France)

    1994-12-01

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

  11. Vermian agenesis without posterior fossa cyst

    International Nuclear Information System (INIS)

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

  12. [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

  13. Congenital candidiasis presenting as septic shock without rash

    OpenAIRE

    Carmo, Kathryn Browning; Evans, Nick; Isaacs, David

    2007-01-01

    Congenital candidiasis is rare and often benign. This report describes the case of twins born at 32 weeks of gestation with different manifestations of congenital candidiasis. One twin was born well though neutropenic, and died from overwhelming sepsis with septic shock at 22 h. The other twin presented with a delayed onset of rash at 2 days, remained well and survived.

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

    OpenAIRE

    J. Gordon Millichap; John J Millichap

    2014-01-01

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

  15. Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa

    OpenAIRE

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

    2011-01-01

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

  16. Post-traumatic osteochondral ''loose body'' of the olecranon fossa

    International Nuclear Information System (INIS)

    Three cases of intra-articular osteochondral bodies with the olecranon fossa are reported. All patients had had severe trauma to the elbow, and in each case an osteochondral fragment, nourished by the synovial fluid, became enlarged and finally lodged within the fossa. The radiological and pathological features and presumed pathogenesis are described

  17. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Glenoid fossa prosthesis. 872.3950 Section 872.3950 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a)...

  18. Acute Spontaneous Posterior Fossa Subdural Hematoma

    Directory of Open Access Journals (Sweden)

    Osama Shukir Muhammed Amin

    2014-02-01

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

  19. 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...

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

    OpenAIRE

    Freundlich, E; Statter, M; Yatziv, S

    1981-01-01

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

  1. 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...

  2. Cefditoren pivoxil associated rash and arthralgia in a child

    OpenAIRE

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

    2012-01-01

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

  3. DNA methylation patterns in naïve CD4+ T cells identify epigenetic susceptibility loci for malar rash and discoid rash in systemic lupus erythematosus

    Science.gov (United States)

    Renauer, Paul; Coit, Patrick; Jeffries, Matlock A; Merrill, Joan T; McCune, W Joseph; Maksimowicz-McKinnon, Kathleen; Sawalha, Amr H

    2015-01-01

    Objective Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterised by heterogeneous clinical manifestations, autoantibody production and epigenetic dysregulation in T cells. We sought to investigate the epigenetic contribution to the development of cutaneous manifestations in SLE. Methods We performed genome-wide DNA methylation analyses in patients with SLE stratified by a history of malar rash, discoid rash or neither cutaneous manifestation, and age, sex and ethnicity matched healthy controls. We characterised differentially methylated regions (DMRs) in naïve CD4+ T cells unique to each disease subset, and assessed functional relationships between DMRs using bioinformatic approaches. Results We identified 36 and 37 unique DMRs that contribute to the epigenetic susceptibility to malar rash and discoid rash, respectively. These DMRs were primarily localised to genes mediating cell proliferation and apoptosis. Hypomethylation of MIR886 and TRIM69, and hypermethylation of RNF39 were specific to patients with SLE with a history of malar rash. Hypomethylation of the cytoskeleton-related gene RHOJ was specific to patients with SLE with a history of discoid rash. In addition, discoid rash-specific hypomethylated DMRs were found in genes involved in antigen-processing and presentation such as TAP1 and PSMB8. Network analyses showed that DMRs in patients with SLE with but not without a history of cutaneous manifestations are associated with TAP-dependent processing and major histocompatibility-class I antigen cross-presentation (p=3.66×10?18 in malar rash, and 3.67×10?13 in discoid rash). Conclusions We characterised DNA methylation changes in naïve CD4+ T cells specific to malar rash and discoid rash in patients with SLE. These data suggest unique epigenetic susceptibility loci that predispose to or are associated with the development of cutaneous manifestations in SLE. PMID:26405558

  4. A systematic approach to posterior fossa malformations

    International Nuclear Information System (INIS)

    Full text: Embryology of the cerebellum and classification of posterior fossa malformations: At the 28th-37th gestational day, the thin roof of the hindbrain (future fourth ventricle) is formed by an ependymal membrane coated by pia mater. The plica choroidea, a precursor of the future choroid plexus, divides the roof of the fourth ventricle into the anterior membranous area (AMA) lying cephalad, and the posterior membranous area (PMA) lying caudad. The cerebellum arises from dorsal rhombomere 1 of the anterior hindbrain, in a position along the anterior/posterior axis of the neural tube that is determined by genes expressing in the isthmic organizer at the mid-hindbrain junction, and is also influenced by genetic cues from the roof plate of the adjacent fourth ventricle. Studies in mice have shown that during early embryogenesis, the dorsal rhombomere 1 rotates to establish the mediolaterally-oriented bilateral cerebellar primordial, which are interposed by the AMA. As neurogenesis progresses, the bilateral primordia fuse on the dorsal midline over the fourth ventricle to establish the medial vermis and lateral cerebellar hemispheres, while the intervening AMA progressively involutes until its remnants are incorporated in the choroid plexus. Meanwhile, the PMA shows a transient posterior finger-like expansion, the Blake’s pouch, which extends below the vermis and eventually disappears as the foramen of Magendie opens. Cerebellar neurons are generated from two anatomically and molecularly distinct progenitor zones within the cerebellar primordium: the cerebellar ventricular zone (vZ), and the dorsally located rhombic lip (Rl). Newly differentiating neurons from the vZ, including cerebellar Purkinje cells, are postmitotic, and leave the vZ to migrate radially within the developing cerebellum; instead, cells exiting the Rl migrate over the primordium forming the external granule layer (eGl), where they proliferate and then migrate inward to form the internal granule layer. Malformations of the mid-hindbrain have been variably classified according to morphology, embryogenesis, and genetic information. One classical definition individuates cystic malformations, in which a collection resulting from active expansion of CSF spaces is found within the posterior cranial fossa, and non cystic malformations, which are mainly characterized by hypoplasia of the cerebellum and/or brainstem. Patients with infratentorial malformations usually show a variable combination of hypotonia, ataxia, abnormal eye movements, cranial nerve deficits, psychomotor delay, and cognitive impairment. the main malformations: the definition of Dandy-Walker malformation (DWM) classically includes partial or complete vermian agenesis associated with hypoplastic cerebellar hemispheres, cystic dilatation of the fourth ventricle, and expansion of the posterior fossa associated with high insertion of the tentorium, torcular Herophili and transverse sinuses. Vermian hypoplasia may be more or less severe; however, the hypoplastic superior vermis is constantly rotated in a counter-clockwise fashion, and often lies posterior to the quadrigeminal plate. Cerebellar hemispheres are also hypoplastic and abut the petrous ridges. The posterior fossa is occupied by a large cyst corresponding to a dilated fourth ventricle. Hydrocephalus develops in up to 80% of untreated cases. A megacisterna magna is characterized by dilatation of the cisterna magna with free communication with both the fourth ventricle and the adjacent subarachnoid spaces. The vermis, cerebellar hemispheres, and fourth ventricle are normal. Hydrocephalus is never associated and the anomaly is constantly clinically silent, being usually encountered during MRI for other indications. the persistent Blake’s pouch, or Blake’s pouch cyst, is characterized by a retrocerebellar CSF collection which, in itself, is similar to a mega cisterna magna. Persistence of the Blake’s pouch is, however, characterized by failed permeabilization of the Magendie foramen, resulting in tetraventricular hyd

  5. MORPHOMETRY OF GLENOID FOSSA IN ADULT EGYPTIAN SCAPULAE

    Directory of Open Access Journals (Sweden)

    Gamal Hamed El-Sayed Hassanein

    2015-06-01

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

  6. Role of cerebrospinal fluid diversion in posterior fossa tumor surgery

    International Nuclear Information System (INIS)

    Objective: To assess the role of cerebrospinal fluid diversion in posterior fossa tumor surgery. Results: There were 48 patients who were operated for posterior fossa tumors. Mean age was 23 years. Male to female ratio was 1.2:1. VPS was done in 14 patients (29%) pre-operatively, in one patient (2%) per-operatively and in 2 patients (4%) postoperatively. EVD was done in 33 patients out of whom 2 patients were shunted post-operatively. Sixty-five percent of the patients remained shunt-free. Conclusion: Although management of hydrocephalus secondary to posterior fossa tumors is controversial, majority of the patients need temporary cerebrospinal fluid diversion. (author)

  7. Gallbladder Fossa Abscess Masquerading as Cholecystitis After Cholecystectomy.

    Science.gov (United States)

    Rodrigue, Paul; Fakhri, Asif; Baumgartner, Andrew

    2015-12-01

    We present a case of a 59-y-old woman who had undergone cholecystectomy and was subsequently found to have an abscess within the gallbladder fossa. A hepatobiliary scan using (99m)Tc-diisopropyliminodiacetic acid demonstrated the characteristic rim sign, a photopenic defect surrounded by a rim of mildly increased activity immediately adjacent to the gallbladder fossa. The rim sign was thought to be the result of reactive inflammation in the hepatic tissue adjacent to a postoperative abscess within the gallbladder fossa. PMID:26111711

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

    Directory of Open Access Journals (Sweden)

    Shaman Gill

    2013-01-01

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

  9. Tocilizumab-induced psoriasiform rash in rheumatoid arthritis.

    Science.gov (United States)

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

    2014-01-01

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

  10. Cefditoren pivoxil associated rash and arthralgia in a child

    Science.gov (United States)

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

    2012-01-01

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

  11. Cefditoren pivoxil associated rash and arthralgia in a child

    Directory of Open Access Journals (Sweden)

    Manab Nandy

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    SONIA RESIK AGUIRRE

    1996-04-01

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

  13. PHACE syndrome in antenatally diagnosed posterior fossa anomaly

    Directory of Open Access Journals (Sweden)

    Seema Pavaman Sindgikar

    2014-01-01

    Full Text Available PHACE is a neurocutaneous syndrome, an acronym to describe patients with facial segmental hemangiomas and other malformations. We describe a newborn antenatally diagnosed to have posterior fossa anomaly and subsequently as PHACE syndrome.

  14. 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.

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

    Science.gov (United States)

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

    2013-10-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  18. CT findings of posterior fossa venous angiomas

    International Nuclear Information System (INIS)

    Three cases of posterior fossa venous angiomas were reported, with some comments on the CT findings. Case 1: A 53-year-old woman was admitted for the further examination of a viral meningitis which had appeared three months before. Neurological examination revealed no abnormality. Vertebral angiography, however, demonstrated numerous fine medullary veins, with an enlarged intraparenchymal draining vein, in the right cerebellum; they drained into the petrosal vein, which was characteristic of venous angioma. On the plain CT, part of the draining vein was identified as a slightly high-density node. A curvilinear draining vein was demonstrated by the enhanced CT. Case 2: A 29-year-old man was admitted complaining of headache, vomiting, and atxia. Neurological examination disclosed truncal ataxia. The enhanced CT demonstrated two distinct nodules on the anterior border of the hematoma in the deep median cerebellum, probably corresponding to the draining veins. On the angiogram, a venous angioma was found in the bilateral cerebellum; it drained into the precentral cerebellar veins and ultimately joined the straight sinus via the precentro-vermo-rectal vein. Case 3: A 4-year-old boy was admitted suffering from headache, vomiting, and ataxia. Neurological examination disclosed a co-ordination disturbance of the left side. The enhanced CT demonstrated a curvilinear structure inside the hematoma. Angiography showed a venous angioma in the left cerebellum which drained into the petrosal vein. Computerized angiotomography delineated the characteristic venous structure on the angiogram as many fine, high-density lines (medullary veins) converging to a large intraparenchymal linear structure (central medullary vein) and then to a superficial cortical vein. In all cases, large intraparenchymal draining veins were identified by the conventional CT. (J.P.N.)

  19. Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa

    Directory of Open Access Journals (Sweden)

    Takafumi Nishizaki

    2011-05-01

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

  20. 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.

  1. Radionuclide studies of posterior fossa lesions in children

    International Nuclear Information System (INIS)

    A series of 480 children was investigated by scintiscanning using the radionuclide (99m-Tc) Technetium pertechnetate. Of this group 39 were reported abnormal in the posterior fossa region - 10 were reported as normal but were found subsequently by other investigations or by operation to have a lesion in this region. Of the 39 reported abnormal 37 were subsequently found to have a lesion either benign or malignant. There were 2 false positives. The overall accuracy of the diagnosis in the posterior fossa was 75.5%. The value of cerebral radionuclide imaging in the study of posterior fossa lesions in children has been upheld. The investigation is non evasive, safe and reasonably accurate and is an important screening test in this area. (author)

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

    Science.gov (United States)

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

    2006-05-01

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

  3. 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

  4. Larger urethral catheter size leads to fossa navicularis stricture formation in robotic radical prostatectomy

    OpenAIRE

    Yee, David S.; Gelman, Joel; Skarecky, Douglas W.; Thomas E. Ahlering

    2007-01-01

    Fossa navicularis strictures following radical prostatectomy are reported infrequently. We recently experienced a series of fossa strictures following robotic-assisted laparoscopic prostatectomy (RLP). We describe herein our experience to prevent fossa strictures and to determine its etiologic factors. From June 2002 to May 2006, 424 patients underwent robotic-assisted laparoscopic prostatectomy with the da Vinci surgical system. Fossa strictures were diagnosed based on the acute onset of obs...

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

    Science.gov (United States)

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

    2016-01-01

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

  6. 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.

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

    OpenAIRE

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

    2015-01-01

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

  8. Kidney Retransplantation in the Ipsilateral Iliac Fossa: A Surgical Challenge.

    Science.gov (United States)

    Ooms, L S S; Roodnat, J I; Dor, F J M F; Tran, T C K; Kimenai, H J A N; Ijzermans, J N M; Terkivatan, T

    2015-11-01

    The aim of this study is to review the surgical outcome of kidney retransplantation in the ipsilateral iliac fossa in comparison to first kidney transplants. The database was screened for retransplantations between 1995 and 2013. Each study patient was matched with 3 patients with a first kidney transplantation. Just for graft and patient survival analyses, we added an extra control group including all patients receiving a second transplantation in the contralateral iliac fossa. We identified 99 patients who received a retransplantation in the ipsilateral iliac fossa. There was significantly more blood loss and longer operative time in the retransplantation group. The rate of vascular complications and graft nephrectomies within 1 year was significantly higher in the study group. The graft survival rates at 1 year and 3, 5, and 10 years were 76%, 67%, 61%, and 47% in the study group versus 94%, 88%, 77%, and 67% (p?fossa is surgically challenging and associated with more vascular complications and graft loss within the first year after transplantation. Whenever feasible, the second renal transplant (first retransplant) should be performed contralateral to the prior failed one. PMID:26153103

  9. Spatiotemporal Evolution of Erythema Migrans, the Hallmark Rash of Lyme Disease

    OpenAIRE

    Vig, Dhruv K.; Wolgemuth, Charles W.

    2014-01-01

    To elucidate pathogen-host interactions during early Lyme disease, we developed a mathematical model that explains the spatiotemporal dynamics of the characteristic first sign of the disease, a large (?5-cm diameter) rash, known as an erythema migrans. The model predicts that the bacterial replication and dissemination rates are the primary factors controlling the speed that the rash spreads, whereas the rate that active macrophages are cleared from the dermis is the principle determinant of ...

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

    OpenAIRE

    Z Haghshenas; Kh Daneshjou

    2006-01-01

    Objective: Prolonged exogenous administration of ACTH or hydrocortisone or its analogs results in a clinical pattern identical to the spontaneous disorder and is frequently referred to as Cushingoid syndrome. This syndrome is generally reported as a result of oral or parenteral steroids administration. Case Report: Our report presents a five-month old baby with typical Cushingoid changes following local steroid application due to diaper rash. Clobetasol was used for diaper rash, but had not u...

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

    Science.gov (United States)

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

    2011-10-01

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

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

    Science.gov (United States)

    Bleamaster, L. F.; Chuang, F.

    2010-12-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    Plescia, J.B.

    2003-01-01

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

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

    Science.gov (United States)

    Tian, Xiaoyan; Luo, Gui; Zhu, Xinhua

    2014-07-01

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

  16. 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.

  17. Petergopalatine Fossa A Key Area In Rhinocerebral Mucormycosis Extension

    Directory of Open Access Journals (Sweden)

    Sadr-Hoseini S M

    2003-11-01

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

  18. 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...

  19. 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...

  20. Venous anomalies and abnormalities of the posterior fossa

    International Nuclear Information System (INIS)

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

  1. 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.

  2. 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.)

  3. 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.)

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

    Directory of Open Access Journals (Sweden)

    Prashanth M. Thalanayar

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

  6. Tratamento cirúrgico da cisticircose da fossa craniana posterior

    Directory of Open Access Journals (Sweden)

    Pedro Garcia Lopes

    1971-03-01

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

  7. Large intradiploic growing skull fracture of the posterior fossa

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-01-01

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

  8. Synovial sarcoma of the infratemporal fossa: A case report

    OpenAIRE

    Wushou, Alimujiang; ZHAO, YA-JUN; Shao, Zhi-ming

    2014-01-01

    Synovial sarcomas (SS) are high-grade soft-tissue sarcomas, predominantly found in the deep soft tissues of the lower extremities, with only 3–5% occurring in the head and neck region. Primary SS of the infratemporal fossa (ITF) is exceptionally uncommon. The present study reports the case of a 23-year-old female with an SS arising in the ITF. To the best of our knowledge, this case is only the second patient with intracranial involvement recorded in the literature. The patient was treated pr...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-05-01

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

  10. 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.)

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

    Science.gov (United States)

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

    2014-04-01

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

  12. Post-traumatic osteochondral ''loose body'' of the olecranon fossa

    Energy Technology Data Exchange (ETDEWEB)

    Bassett, L.W.; Mirra, J.M.; Forrester, D.M.; Gold, R.H.; Bernstein, M.L.; Rollins, J.S.

    1981-12-01

    Three cases of intra-articular osteochondral bodies with the olecranon fossa are reported. All patients had had severe trauma to the elbow, and in each case an osteochondral fragment, nourished by the synovial fluid, became enlarged and finally lodged within the fossa. The radiological and pathological features and presumed pathogenesis are described.

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

    Directory of Open Access Journals (Sweden)

    Masahiko Kimura

    2015-12-01

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

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

    Science.gov (United States)

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

    2013-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Oliveira Maria I

    2002-01-01

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

  16. 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.

  17. 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.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  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. Fractures of the nasolacrimal fossa and canal: CT findings and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chae Kyung; Lee, Hyeon Kyeong; Lee, Jong Hwa; Ku, Kwan Min; Choi, Dae Seob; Oh, Yeon Hee; Kim, Seung Hyeon; Lee, Sung Woo; Han, Jae Sik; Kim, Mi Woon [Dongguk Univ., College of Medicine, Seoul (Korea, Republic of)

    1998-09-01

    This study was aimed to determine the CT findings of nasolacrimal fossa and their clinical significance. Twenty-nine of 116 patients who underwent facial CT scanning after trauma showed evidence of nasolacrimal fracture. We retrospectively analyzed CT findings to evaluate fracture patterns of the nasolacrimal fossa and canal and associated facial fractures. To determine the frequency of associated complications, clinical records were reviewed were reviewed. Three types of fracture were identified: avulsion, comminuted,and linear. Forty-one nasolacrimal fractures, 20 of which involved the nasolacrimal fossa and 21 the nasolacrimal canal, were found in the 29 patients. Of the 20 fractures involving the nasolacrimal fossa, ten were avulsion, eight were linear, and two were comminuted. Seventeen of 21 fractures involving the nasolacrimal canal were comminuted and four were linear;all nasolacrimal fractures were associated with other facial fractures. Twenty-five of 29 fractures were the complex midfacial-type (naso-ethmoid);the remaining four were simple and unilateral. Nasolacrimal sac and duct-related complications were documented in only two patients; they experienced epiphora associated with avulsion fracture of the nasolacrimal fossa, though the probvlem was resolvced by conservative treatment without surgery. Fractures of the nasolacrimal fossa and canal were accompanied by simple or complex facial fractures. Injury-associated complications were rare, and all were associated with avulsion fractures of the nasolacrimal fossa.=20.

  2. 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.)

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

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    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. Infratemporal Fossa Fasciae: Anatomical and Clinical-Surgical Study.

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    Menéndez, José María

    2012-12-01

    Full Text Available The lack of thoroughness that characterizes the anatomical description of pterygo-temporo-mandibular and interpterygoid fasciae is indisputable; this shortcoming is not only found in classical but also in contemporary bibliography. Likewise, these are not contemplated in International Anatomical Terminology. This paper aims to provide a detailed description of the aforementioned fasciae and the ligaments that depend of them, thus as the bony bridges. Similarly, a correlation among these anatomical structures and trigeminal neuralgia will be developed, placing particular emphasis on its role as the possible etiological agents. In the process of performing this task, skulls (n=200, cadavers without previous fixing (n=10 and cadavers fixed in a 5% aqueous formaldehyde solution (n=20 were used. Following a standardized procedure, using appropriate instrumental and magnifying devices, the dissections were performed. It should be stressed that both, conventional and unconventional approaches, were executed. During each stage of this research pertinent photographic recording was taken. The distinctive anatomical characteristics of these fasciae have been precisely exhibited, detailing its shapes, limits, insertions and relations within infratemporal fossa. A meticulous description of pterygoalar and pterygospinosous ligament was attained and its relations with the colateral branches of mandibular nerve bear special highlighting. Indeed, the role played by these ligaments in the constitution of bony bridges surrounding the oval foramen was widely analyzed. After profound reflexion on the obtained results, a thorough description of pterygo-temporo-mandibular and interpterygoid fasciae and its ligaments was achieved allowing to drawing a parallel between its disposition in the infratemporal fossa and its possible ossification and the compression the nervous branches might undergo so that a trigeminal neuralgia befalls.

  5. 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.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Z Haghshenas

    2006-06-01

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

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

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    Ponnusamy Santhamoorthy

    2012-01-01

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

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

    Science.gov (United States)

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

    1997-12-01

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

  10. 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.

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

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    Antonio Carlos M. Pereira

    2001-02-01

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

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

    Science.gov (United States)

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

    2014-04-01

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

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

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    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.

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

    International Nuclear Information System (INIS)

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

  15. Middle cranial fossa tumors of rare and a typical CT features

    International Nuclear Information System (INIS)

    Six different brain tumors in middle cranial fossa are presented which are studied by CT and proved pathologically. The authors experienced rare tumors in middle cranial fossa such as cavernous hemangioma, cystic meningioma, Schwannoma, Masson's vegetant intravascular hemangioendothelioma and other tumors (arteriovenous malformation and metastatic adenoid cystic carcinoma) whose CT findings were atypical. The results are as follows; 1. In case of tumors in middle cranial fossa, basal and coronal sections are necessary for further evaluation of the relations with dura and adjancent bone change. 2. In suspicion of metastasis, bone setting should be done to find out bone involvement. 3. Internal carotid angiography gave little help in the differential diagnosis of tumors in middle cranial fossa

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

    Directory of Open Access Journals (Sweden)

    Jorge dos Santos Lima

    2007-06-01

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

  17. Phyllosilicate and Olivine around a Fracture in Nili Fossae

    Science.gov (United States)

    2007-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Devi B

    2000-10-01

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

  20. An unusual case of a pituitary fossa aspergilloma in an immunocompetent patient mimicking infiltrative tumour

    OpenAIRE

    Ahmadzai, Hasib; Raley, Darryl Alan; Masters, Lynette; Davies, Mark

    2013-01-01

    Sellar aspergillosis is a rare infection commonly mistaken for a pituitary tumour. We present a rare case of pituitary fossa Aspergillus fumigatus mycetoma in an immunocompetent 90-year-old female, who presented with headaches. Magnetic resonance imaging scans demonstrated an enhancing pituitary fossa mass that appeared to infiltrate the sphenoid sinus, suggestive of an invasive tumour. Stereotactic trans-sphenoidal resection confirmed localized A. fumigatus infection. The abscess was debride...

  1. 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

  2. Eyebrow incision using tattoo for anterior fossa lesions: technical case reports.

    Science.gov (United States)

    Ko, Y; Yi, H J; Kim, Y S; Oh, S H; Kim, K M; Oh, S J

    2001-03-01

    Some Korean women draw tattoo in their eyebrow to cover the scant hair. If a patient has a tattoo in her eyebrow, lesions of anterior cranial fossa can be easily managed with this small eyebrow skin incision through a small unilateral supraorbital craniotomy. By this technique, 7 cases of anterior cranial fossa lesions were successfully treated without any major complications. This leads to less facial scar, less operation time and an earlier return to social adaptation. PMID:11409306

  3. 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.

  4. 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

    2015-04-01

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

  5. 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.)

  6. Acoustic interaction between the right and left piriform fossae in generating spectral dips.

    Science.gov (United States)

    Takemoto, Hironori; Adachi, Seiji; Mokhtari, Parham; Kitamura, Tatsuya

    2013-10-01

    It is known that the right and left piriform fossae generate two deep dips on speech spectra and that acoustic interaction exists in generating the dips: if only one piriform fossa is modified, both the dips change in frequency and amplitude. In the present study, using a simple geometrical model and measured vocal tract shapes, the acoustic interaction was examined by the finite-difference time-domain method. As a result, one of the two dips was lower in frequency than the two independent dips that appeared when either of the piriform fossae was occluded, and the other dip was higher in frequency than the two dips. At the lower dip frequency, the piriform fossae resonated almost in opposite phase, while at the higher dip frequency, they resonated almost in phase. These facts indicate that the piriform fossae and the lower part of the pharynx can be modeled as a coupled two-oscillator system whose two normal vibration modes generate the two spectral dips. When the piriform fossae were identical, only the higher dip appeared. This is because the lower mode is not acoustically coupled to the main vocal tract enough to generate an absorption dip. PMID:24116431

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

    Science.gov (United States)

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

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

  9. 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

  10. 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.

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

    Scientific Electronic Library Online (English)

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

    1997-06-01

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

  12. 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.

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

    OpenAIRE

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

    2000-01-01

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

  14. 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.

  15. 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.

  16. 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.)

  17. Hypertensive posterior reversible encephalopathy syndrome causing posterior fossa edema and hydrocephalus.

    Science.gov (United States)

    Grossbach, Andrew J; Abel, Taylor J; Hodis, Brendan; Wassef, Shafik N; Greenlee, Jeremy D W

    2014-02-01

    Posterior reversible encephalopathy syndrome (PRES) is a well characterized entity resulting from the inability of cerebral autoregulation to adequately protect the brain from uncontrolled hypertension. It primarily affects the occipital lobes, but can also involve the structures in the posterior fossa including the brainstem and cerebellum. Treatment usually consists of strict blood pressure control, but more aggressive management may be indicated with acutely worsening neurological status. We present a patient with hypertensive encephalopathy that resulted in hydrocephalus and brainstem compression necessitating surgical decompression requiring ventriculostomy and suboccipital craniectomy. In rare cases, PRES can present with severe brainstem compression requiring emergent posterior fossa decompression. When brainstem signs are present on exam, emergent posterior fossa decompression may be safer than ventriculostomy alone. PMID:24126039

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

    International Nuclear Information System (INIS)

    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. (orig.)

  19. 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.

  20. Avaliação da implantação de fossas sépticas na melhoria na qualidade de águas superficiais em comunidades rurais

    Directory of Open Access Journals (Sweden)

    Raphael de Vicq

    2014-12-01

    Full Text Available Na maioria dos municípios brasileiros, as comunidades rurais são núcleos populacionais agrupados em torno de córregos que fornecem a água e recebem seus efluentes. Buscou-se nesta pesquisa avaliar as condições dos corpos d'água na bacia hidrográfica do córrego Pau Grande, Ouro Branco, Minas Gerais, antes e depois da instalação de 20 fossas sépticas na comunidade de Castiliano, construídas em 2006. O monitoramento da bacia foi realizado entre 2005 e 2009, em 6 pontos amostrais, onde foram medidos vazão, oxigênio dissolvido, demanda bioquímica de oxigênio, fósforo total, coliformes fecais totais, turbidez e pH. Os pontos a jusante das fossas apresentaram um aumento de mais de 100% nos valores de oxigênio dissolvido e redução em mais de 800% na quantidade de coliformes fecais. Investimentos relativamente baixos, como a construção das fossas, podem trazer melhorias à qualidade dos recursos hídricos em áreas rurais.

  1. 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.

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

    International Nuclear Information System (INIS)

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

  3. 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 dacryocystorhinostomy, a knowledge of the consistent anatomic relationship between the anterior ethmoidal sinus and the lacrimal sac fossa is invaluable

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

    Science.gov (United States)

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

    2016-01-01

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

  5. An unusual case of a pituitary fossa aspergilloma in an immunocompetent patient mimicking infiltrative tumour.

    Science.gov (United States)

    Ahmadzai, Hasib; Raley, Darryl Alan; Masters, Lynette; Davies, Mark

    2013-01-01

    Sellar aspergillosis is a rare infection commonly mistaken for a pituitary tumour. We present a rare case of pituitary fossa Aspergillus fumigatus mycetoma in an immunocompetent 90-year-old female, who presented with headaches. Magnetic resonance imaging scans demonstrated an enhancing pituitary fossa mass that appeared to infiltrate the sphenoid sinus, suggestive of an invasive tumour. Stereotactic trans-sphenoidal resection confirmed localized A. fumigatus infection. The abscess was debrided and the dura was left intact. Her headaches resolved post-operatively and she was treated with voriconazole. This indicates that aspergilloma should be considered as a differential for an unexplained pituitary lesion even in elderly immunocompetent patients. PMID:24964429

  6. An unusual case of a pituitary fossa aspergilloma in an immunocompetent patient mimicking infiltrative tumour

    Science.gov (United States)

    Ahmadzai, Hasib; Raley, Darryl Alan; Masters, Lynette; Davies, Mark

    2013-01-01

    Sellar aspergillosis is a rare infection commonly mistaken for a pituitary tumour. We present a rare case of pituitary fossa Aspergillus fumigatus mycetoma in an immunocompetent 90-year-old female, who presented with headaches. Magnetic resonance imaging scans demonstrated an enhancing pituitary fossa mass that appeared to infiltrate the sphenoid sinus, suggestive of an invasive tumour. Stereotactic trans-sphenoidal resection confirmed localized A. fumigatus infection. The abscess was debrided and the dura was left intact. Her headaches resolved post-operatively and she was treated with voriconazole. This indicates that aspergilloma should be considered as a differential for an unexplained pituitary lesion even in elderly immunocompetent patients. PMID:24964429

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

    Directory of Open Access Journals (Sweden)

    Talaeipour AR.

    2007-07-01

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

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

    International Nuclear Information System (INIS)

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

  9. Arachnoid cyst of the middle fossa and subdural hygroma: an uncommon association

    International Nuclear Information System (INIS)

    The middle fossa is the most common site for arachnoid cysts and the presence of subdural hematomas has been well-established. Occasionally, as a consequence of mild cranial trauma, or even spontaneously, the capsule of the cyst can be damaged, allowing part of the contents to empty into the extra cerebral compartment. We present two cases of congenital arachnoid cysts of middle fossa media complicated by subdural hygroma and intracranial hypertension, and we discuss the possible mechanisms involved in this uncommon association. 9 refs

  10. 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)

  11. Maculopapular skin rash due to amoxicillin tri-hydrate hypersensitivity reaction: a case report

    Directory of Open Access Journals (Sweden)

    Walli Mohammed

    2015-02-01

    Full Text Available Amoxicillin tri-hydrate (AMT is a commonly used penicillin group of antibacterial agent to combat various bacterial infections. Penicillin group of drugs are known to cause cutaneous drug eruptions as a hypersensitivity reaction. Most of the time, these eruptions are mild in nature, however, sometimes they represent the early manifestation of rare and severe drug-induced cutaneous reactions, such as; Stevens and ndash;Johnson syndrome and toxic epidermal necrolysis. Here, we report a case of maculopapular skin rash developed due to AMT hypersensitivity reaction in a 48-year-old Indian male patient. Pheniramine maleate, hydrocortisone and skin protecting lotion were prescribed to manage the situation. This case is being reported to emphasize the need for reporting of drug induced complications and their management procedures. [Int J Basic Clin Pharmacol 2015; 4(1.000: 175-178

  12. '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 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

  13. 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

  14. 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

    OpenAIRE

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

    2012-01-01

    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 eutan...

  15. Edema agudo de pulmão secundário a tumor de fossa posterior: registro de um caso Pulmonary edema secondary to posterior fossa tumor: a case report

    OpenAIRE

    Antonio Cesar G. Borges; Gastão Duval-Neto; Rodinei R. Festugato; Alfredo D. Zauk; Mauro Aquini

    1982-01-01

    É relatada a observação de uma paciente de 44 anos de idade com quadro clínico de edema de pulmão secundário a meningioma situado na fossa posterior. São feitos comentários sobre a importância da gasometria arterial realizada no período pré e pós-operatório e especialmente sobre o gradiente alvéolo-arterial de oxigênio que serve de guia na avaliação clínica do paciente neurocirúrgico, particularmente nos casos de edema pulmonar não cardiogênico.A case of a 44-year-old woman presenting pulmona...

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

    DEFF Research Database (Denmark)

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

    1995-01-01

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

  17. 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

  18. 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.

  19. 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.

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

    Science.gov (United States)

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

    2010-01-01

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

  1. 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

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    Weiss L

    2015-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-10-01

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

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

    Science.gov (United States)

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

    2014-07-01

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

  6. A 26-week carcinogenicity study of 2-amino-3-methylimidazo[4,5-f]quinoline in rasH2 mice.

    OpenAIRE

    Okamura, Miwa; Moto, Mitsuyoshi; Muguruma, Masako; Ito, Tadashi; Jin, Meilan; Kashida, Yoko; Mitsumori, Kunitoshi

    2006-01-01

    To evaluate the carcinogenic susceptibility of rasH2 mice to 2-amino-3-methylimidazo[4,5-f]quinoline (IQ), 7-week-old rasH2 mice and their wild-type littermates (non-Tg mice) of both the sexes were fed a diet containing 0 or 300 ppm IQ for 26 weeks. Microscopical examinations revealed that the proliferative lesions of the forestomach, including squamous cell hyperplasias, papillomas, and carcinomas, were frequently encountered in male and female rasH2 mice fed with IQ. In non-Tg mice, no sign...

  7. 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...

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

    OpenAIRE

    Stefano, Alessandro; Dispenza, Francesco; Kulamarva, Gautham

    2011-01-01

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

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

    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.

  10. Closure of endoscopic third ventriculostomy after surgery for posterior cranial fossa tumor: The "snow globe effect".

    Science.gov (United States)

    Tamburrini, Gianpiero; Frassanito, Paolo; Bianchi, Federico; Massimi, Luca; Di Rocco, Concezio; Caldarelli, Massimo

    2015-06-01

    The management of obstructive hydrocephalus associated to posterior cranial fossa tumor remains a controversial issue. In this context, the role of endoscopic third ventriculostomy (ETV) performed before tumor removal (the so-called preoperative ETV) is debated and its success rate is reported as being largely variable in the literature. We describe two children who experienced the closure of a preoperatively performed ETV after the surgical resection of their posterior fossa tumor. In both cases tumor removal was performed in the prone position. Radiological investigations and intraoperative evidence documented that the failure of the ETV was due to a blood clot which directly occluded the stoma. We speculate that the prone position favored the migration of blood, through the aqueduct, thereafter, clotting on the most declivous part of the third ventricle once the patient assumed the upright position, with the consequent occlusion of the stoma. Based on a gravitational hypothesis, we named this mechanism the "snow globe effect." PMID:25470245

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

    OpenAIRE

    Channu Kokila, K. Ramesh

    2013-01-01

    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 tum...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-09-15

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

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

    Science.gov (United States)

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

    2003-06-01

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

  14. Middle Cranial Fossa Transtemporal Approach to the Intrapetrous Internal Carotid Artery

    OpenAIRE

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

    1991-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Dariush Etemadi

    2010-05-01

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

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

    OpenAIRE

    Braun, Barbara Victoria

    2012-01-01

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

  19. 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)

  20. 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)

  1. Edema agudo de pulmão secundário a tumor de fossa posterior: registro de um caso

    Directory of Open Access Journals (Sweden)

    Antonio Cesar G. Borges

    1982-06-01

    Full Text Available É relatada a observação de uma paciente de 44 anos de idade com quadro clínico de edema de pulmão secundário a meningioma situado na fossa posterior. São feitos comentários sobre a importância da gasometria arterial realizada no período pré e pós-operatório e especialmente sobre o gradiente alvéolo-arterial de oxigênio que serve de guia na avaliação clínica do paciente neurocirúrgico, particularmente nos casos de edema pulmonar não cardiogênico.

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

    International Nuclear Information System (INIS)

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

  3. 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.

  4. Arthroscopically assisted percutaneous fixation and bone grafting of a glenoid fossa fracture nonunion.

    Science.gov (United States)

    Sears, Benjamin W; Lazarus, Mark D

    2012-08-01

    Arthroscopy is commonly used for evaluating intra-articular fracture patterns and assessing postfixation reduction; however, the use of arthroscopy for the definitive treatment of articular fracture nonunion has not been reported. This article describes a case of symptomatic glenoid fossa fracture nonunion that was successfully treated with arthroscopically assisted percutaneous screw fixation and bone grafting. A 48-year-old laborer sustained a glenoid fossa fracture following a fall from a height. An initial period of nonoperative management was attempted; however, the patient reported continued shoulder pain during his rehabilitation course. Imaging 5 months after injury showed no osseous union at the fracture. Using an arthroscopically assisted technique, percutaneous fixation and bone grafting of the nonunion with cancellous allograft was performed. Postoperatively, the patient progressed through a structured therapy program, and his pain improved. A computed tomography scan 4 months postoperatively showed osseous union at the fracture site. To the authors' knowledge, this is the first report in the literature of definitive arthroscopically assisted bone grafting and percutaneous fixation of a diarthrodial joint nonunion. Advantages of arthroscopic fixation of glenoid fossa fracture nonunion include avoiding potential axillary nerve injury and preserving the native subscapularis insertion, which may be important if subsequent procedures require access to the anterior access to the joint. PMID:22868621

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-11-07

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

  6. 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.)

  7. Posterior fossa swelling and hydrocephalus resulting from hypertensive encephalopathy: case report and review of the literature

    Science.gov (United States)

    Wang; Escott; Breeze

    1999-06-01

    OBJECTIVE AND IMPORTANCE: Brain stem and cerebellar edema rarely have been described as the principal manifestation of hypertensive encephalopathy. In addition, secondary hydrocephalus has been described in only a few cases in the literature. We present an unusual case of posterior fossa swelling and hydrocephalus resulting from hypertensive encephalopathy. CLINICAL PRESENTATION: A 53-year-old man presented with increased shortness of breath, headache, and visual changes, which had been worsening for several months. Blood pressure on presentation was 253/140 mm Hg. Neuroradiological studies revealed brain stem swelling predominantly affecting the pons, with compression of the adjacent cisterns and fourth ventricle and resultant hydrocephalus. The diagnosis of brain stem glioma was briefly entertained. INTERVENTION: The patient's blood pressure was brought under control with medical management, and he was treated with dexamethasone for 48 hours. Subsequent neuroradiological studies revealed decreased posterior fossa edema as well as marked improvement in the hydrocephalus. CONCLUSION: Hypertensive encephalopathy can present principally in the posterior fossa and can give rise to obstructive hydrocephalus. Invasive treatment of the hydrocephalus is not necessarily required in this clinical setting because reduction of the blood pressure may result in rapid improvement of the hydrocephalus. PMID:10371634

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

    Directory of Open Access Journals (Sweden)

    Mohinder Kumar Malhotra

    2012-01-01

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

  9. 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.

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

    International Nuclear Information System (INIS)

    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

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    N. Mascaro

    2010-06-01

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

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

    International Nuclear Information System (INIS)

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

  14. 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.)

  15. 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.

  16. 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

  17. 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, 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)

  18. 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 J.; Merchant, Thomas E.; Ellison, David W.

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Uthamalingam, Murali; Periyasamy, Karthikumaran

    2015-11-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Anqi Xiao

    2012-04-01

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

  3. 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.)

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    1995-01-01

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

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

    International Nuclear Information System (INIS)

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

  7. 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

  8. 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

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    Salvatore Rapisarda

    2009-06-01

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

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

    International Nuclear Information System (INIS)

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

  12. 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)

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

    International Nuclear Information System (INIS)

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

  14. Schwanoma de la fosa pterigopalatina: Abordaje endoscópico / Pterygopalatine fossa schwannoma: Endoscopic approach

    Scientific Electronic Library Online (English)

    L., Rosique-López; M., Rosique-Arias; F.J., Sánchez-Celemin.

    2010-10-01

    Full Text Available Exponemos las características anatómicas de la fosa pterigopalatina (FPP) y la patología que se puede originar en ella. A continuación se muestra la experiencia quirúrgica en un caso de schwanoma de FPP de cinco centímetros de diámetro que pudo ser extirpada por cirugía endoscópica transnasal, evita [...] ndo así un abordaje externo. Los schwanomas constituyen del 8 al 10% de los tumores intracraneales. Su asiento principal es la rama vestibular del VIII nervio craneal, siendo los trigeminales a nivel de FPP de escasa frecuencia. Abstract in english We expose the anatomical characteristics of the pterygopalatine fossa (FPP) and the pathology that can cause it. Below is the surgical experience in a case of schwannoma of FPP five centimeters in diameter that could be removed by transnasal endoscopic surgery, being unnecessary an external surgery. [...] Schwannomas constitute the 8-10% of intracranial tumors, normally localized in the vestibular branch of the VIII cranial nerve. A schwannoma of a branche of the trigeminal lnerve in the pterigopalatine fossa is exceptional.

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

    International Nuclear Information System (INIS)

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

  16. 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 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

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

    Science.gov (United States)

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

    2015-10-01

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

  18. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-15

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

  20. 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.

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2013-12-01

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

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

    International Nuclear Information System (INIS)

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

  4. 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 μC/kg injection of tracer, an immediate angioscintigraphic period, an early set of pictures (half an hour after the tracer injection) then delayed set (4 to 5 hours later) taken from 4 angles: front, back and two profiles. The examination was performed with an OHIO NUCLEAR SIEMENS gamma camera and sometimes a conventional scanner as well (the latter giving no better a diagnosis than the former). In 75% of the cases a hyperfixation of the injected tracer was observed and its site located quite accurately in the posterior fossa tumour. The etiology of the lesion could be diagnosed in 'most probable' or 'least probable' terms. Examination of work by other authors, who obtained similar results, leads to the conclusion that this method is very helpful in the diagnosis of posterior fossa tumours when used as a means of early detection, before the undertaking of more complex neuroradiological explorations

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

    Science.gov (United States)

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

    2011-01-01

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

  6. MR-Guided Laser-Induced Thermotherapy of the Infratemporal Fossa and Orbit in Malignant Chondrosarcoma via a Modified Technique

    International Nuclear Information System (INIS)

    A 76-year-old patient presented with a recurrent mass of a malignant chondrosarcoma in the right infratemporal fossa and in the left maxillary sinus with orbital invasion. The patient was treated with a palliative intention with MR-guided laser-induced thermotherapy using a modified applicator technique. Following treatment clinical symptoms improved and MRI revealed complete laser-induced tumor necrosis

  7. 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

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

    Science.gov (United States)

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

    2007-03-01

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

  9. Cine-magnetic resonance imaging evaluation of communication between middle cranial fossa arachnoid cysts and cisterns

    International Nuclear Information System (INIS)

    Cine-magnetic resonance (MR) imaging examinations were performed in 10 patients with middle cranial fossa arachnoid cysts to evaluate communication between the cysts and the normal cerebrospinal fluid (CSF) space. Eight of 10 patients were evaluated by time of flight cine-MR imaging, and two by phase contrast cine-MR imaging. Two patients underwent membranectomy of the cysts, and were evaluated both pre-and postoperatively. Computed tomography cisternography was used to confirm communication between the cysts and the surrounding cisterns. Pulsatile fluid motion within the cysts was present in all patients. However, marked fluid motion and jet flow between the cysts and the surrounding cisterns were only observed in communicating cysts. In the two patients who underwent membranectomy, postoperative examination found greater fluid motion and jet flow not previously present. Cine-MR imaging demonstration of marked pulsatile fluid motion accompanied by jet flow suggests that a cyst communicates with the normal CSF space. (author)

  10. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-15

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

  12. 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

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

    Directory of Open Access Journals (Sweden)

    Vijay P Joshi

    2013-01-01

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

  14. Spontaneous Rupture of the Middle Fossa Arachnoid Cyst into the Subdural Space: Case Report

    Science.gov (United States)

    Bora, Ayd?n; Yoku?, Adem; Batur, Abdussamet; Bulut, Mehmet Deniz; Yavuz, Alpaslan; Gül?en, ?smail; Özgökçe, Mesut; Arslan, Mehmet

    2015-01-01

    Summary Background Arachnoid cysts are congenital, benign and intra-arachnoidal lesions. A great majority of arachnoid cysts are congenital. However, to a lesser extent, they are known to develop after head trauma and brain inflammatory diseases. Arachnoid cysts are mostly asymptomatic and they can develop anywhere in the brain along the arachnoid membrane. Case Report Arachnoid cysts form 1% of the non-traumatic lesions which occupy a place and it is thought to be a congenital lesion developed as a result of meningeal development abnormalities or a lesion acquired after trauma and infection. There is a male dominance at a rate of 3/1 in arachnoid cysts which locate mostly in the middle fossa. Our patient was a 2-years-old boy. Conclusions As a conclusion, spontaneous subdural hygroma is a rare complication of the arachnoid cysts. Surgical intervention could be required in acute cases. PMID:26150904

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

    Directory of Open Access Journals (Sweden)

    Hai Tao

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  18. 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.

  19. 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.

  20. 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.

  1. Deliberate soft tissue injection of petrol.

    Science.gov (United States)

    Wiper, Jonathan D; Grant, Ian; Kay, Simon P

    2011-04-01

    We present a case report of self-inflicted injection of petrol into the antecubital fossa and buttocks. The presentation and subsequent management of these difficult and rare injuries is discussed. PMID:21220220

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

    International Nuclear Information System (INIS)

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

  3. 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. 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)

  4. 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.)

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

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    Yu-xiang MA

    2015-07-01

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

  6. The clinical utility of ultra-low field (0. 02 T) MRI for the diagnosis of posterior fossa lesions

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    Kurihara, Yoshiko (St. Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine)

    1989-10-01

    It is clear that high and middle field MRI be superior to CT on evaluation of neurological diseases. However, the clinical utility of ultra-low magnetic field (0.02 T) MRI has not been established yet. In this article, the usefulness of ultra-low field MRI in the diagnosis of posterior fossa lesions is studied as comparison with that of CT. We reviewed 128 patients who had both ultra-low magnetic field MRI and CT examinations. In these cases, 87 patients had posterior fossa lesion and 41 patients didn't. The specificity of MRI and CT were the same as 85.4%. Sensitivity of MRI and CT were 96.8% and 78.9%, respectively. Accuracy of MRI and CT were 93.4% and 80.9%. Superiority of MRI was well demonstrated in the pathology of medulla oblongata, pons and lower portion of cerebellar hemisphere, because of lack of beam-hardening artifacts, that often exist on CT. In the true-positive cases of CT, MRI had one false-negative case (dolicho-ectatic basilar artery). Infarction and demyelinization were more accurately detected by MRI than CT. T2 weighted image was more sensitive in the evaluation of posterior fossa lesions than T1 weighted image. Short T1 IR (STIR) image was proved to be a good method for evaluation of small lesions adjacent to CSF space. As conclusion, it is warranted to say that ultra-low magnetic field MRI be superior to CT in the evaluation of posterior fossa lesions and is a good modality for screening. (author).

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

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    MK Gautham

    2014-10-01

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

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

    OpenAIRE

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

    2014-01-01

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

  9. 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...

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

    Science.gov (United States)

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

    2015-03-01

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

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

    OpenAIRE

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

    2010-01-01

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

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

    International Nuclear Information System (INIS)

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

  13. MR spectroscopy in the evaluation of recurrent contrast-enhancing lesions in the posterior fossa after tumor treatment

    International Nuclear Information System (INIS)

    Recurrent contrast-enhancing lesions arising within foci of prior brain neoplasms treated with chemotherapy and/or radiation therapy pose a significant diagnostic dilemma, as they may represent recurrent or residual tumor, treatment-related changes, or a combination of both. Those lesions specifically in the posterior fossa are even more difficult to assess, given the technical limitations of 2D CSI in the infratentorial compartment. We explored the feasibility of 2D-CSI MR spectroscopy in the evaluation of recurrent contrast-enhancing lesions in eight consecutive patients who had undergone treatment for posterior fossa or brainstem tumors. Mean Cho/Cr (choline/creatine) ratios obtained by 2D-CSI in recurrent tumor, treatment-related changes, and normal white matter were 2.93, 1.62, and 0.97, respectively, mean Cho/NAA (choline/N-Acetyl aspartate) ratios were 4.34, 1.74, and 0.93, and mean NAA/Cr (N-acetyl aspartate/creatine) ratios were 0.74, 0.92, and 1.26, respectively. In conclusion, also in the posterior fossa, MR spectroscopy is likely to be useful as an adjunct to conventional imaging characteristics in distinguishing recurrent tumor from treatment-related changes, irrespectively of the MRS technique used. In most cases spectra of diagnostic quality can be obtained using 2D-CSI to include coverage of both the lesion and its vicinity. (orig.)

  14. MR spectroscopy in the evaluation of recurrent contrast-enhancing lesions in the posterior fossa after tumor treatment

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    Weybright, P.; Maly, P.; Gomez-Hassan, D.; Blaesing, C.; Sundgren, P.C. [Department of Radiology, Neuroradiology Division, University of Michigan Hospitals, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0030 (United States)

    2004-07-01

    Recurrent contrast-enhancing lesions arising within foci of prior brain neoplasms treated with chemotherapy and/or radiation therapy pose a significant diagnostic dilemma, as they may represent recurrent or residual tumor, treatment-related changes, or a combination of both. Those lesions specifically in the posterior fossa are even more difficult to assess, given the technical limitations of 2D CSI in the infratentorial compartment. We explored the feasibility of 2D-CSI MR spectroscopy in the evaluation of recurrent contrast-enhancing lesions in eight consecutive patients who had undergone treatment for posterior fossa or brainstem tumors. Mean Cho/Cr (choline/creatine) ratios obtained by 2D-CSI in recurrent tumor, treatment-related changes, and normal white matter were 2.93, 1.62, and 0.97, respectively, mean Cho/NAA (choline/N-Acetyl aspartate) ratios were 4.34, 1.74, and 0.93, and mean NAA/Cr (N-acetyl aspartate/creatine) ratios were 0.74, 0.92, and 1.26, respectively. In conclusion, also in the posterior fossa, MR spectroscopy is likely to be useful as an adjunct to conventional imaging characteristics in distinguishing recurrent tumor from treatment-related changes, irrespectively of the MRS technique used. In most cases spectra of diagnostic quality can be obtained using 2D-CSI to include coverage of both the lesion and its vicinity. (orig.)

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

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    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.

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

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    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

  17. Efficacy of texture, shape, and intensity features for robust posterior-fossa tumor segmentation in MRI

    Science.gov (United States)

    Ahmed, S.; Iftekharuddin, K. M.; Ogg, R. J.; Laningham, F. H.

    2009-02-01

    Our previous works suggest that fractal-based texture features are very useful for detection, segmentation and classification of posterior-fossa (PF) pediatric brain tumor in multimodality MRI. In this work, we investigate and compare efficacy of our texture features such as fractal and multifractional Brownian motion (mBm), and intensity along with another useful level-set based shape feature in PF tumor segmentation. We study feature selection and ranking using Kullback -Leibler Divergence (KLD) and subsequent tumor segmentation; all in an integrated Expectation Maximization (EM) framework. We study the efficacy of all four features in both multimodality as well as disparate MRI modalities such as T1, T2 and FLAIR. Both KLD feature plots and information theoretic entropy measure suggest that mBm feature offers the maximum separation between tumor and non-tumor tissues in T1 and FLAIR MRI modalities. The same metrics show that intensity feature offers the maximum separation between tumor and non-tumor tissue in T2 MRI modality. The efficacies of these features are further validated in segmenting PF tumor using both single modality and multimodality MRI for six pediatric patients with over 520 real MR images.

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

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    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.

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2007-11-01

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

  1. 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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  4. 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)

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

    Science.gov (United States)

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

    2004-01-01

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

  6. 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

  7. 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)

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

    Science.gov (United States)

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

    2016-02-01

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

  9. 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.

  10. Sorafenib Induced Hand Foot Skin Rash in FLT3 ITD Mutated Acute Myeloid Leukemia-A Case Report and Review of Literature

    OpenAIRE

    Senapati, Jayastu; Devasia, Anup J.; Ganapule, Abhijeet; George, Leni; Viswabandya, Auro

    2014-01-01

    Sorafenib is a novel small molecule multiple kinase inhibitor which has been used for metastatic renal cancer, hepatocellular cancer. Sorafenib induced skin rash has been discussed as a side effect in trials in both, FLT3 wild type and mutated acute myeloid leukemia (AML), as monotherapy or as combination with other chemotherapeutic agents. We describe a patient with FLT 3 ITD mutated AML, who was started on adjunctive Sorafenib therapy. Skin reactions manifested as NCI Grade III palmoplantar...

  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. 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

  13. 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.

  14. Multifractal modeling, segmentation, prediction, and statistical validation of posterior fossa tumors

    Science.gov (United States)

    Islam, Atiq; Iftekharuddin, Khan M.; Ogg, Robert J.; Laningham, Fred H.; Sivakumar, Bhuvaneswari

    2008-03-01

    In this paper, we characterize the tumor texture in pediatric brain magnetic resonance images (MRIs) and exploit these features for automatic segmentation of posterior fossa (PF) tumors. We focus on PF tumor because of the prevalence of such tumor in pediatric patients. Due to varying appearance in MRI, we propose to model the tumor texture with a multi-fractal process, such as a multi-fractional Brownian motion (mBm). In mBm, the time-varying Holder exponent provides flexibility in modeling irregular tumor texture. We develop a detailed mathematical framework for mBm in two-dimension and propose a novel algorithm to estimate the multi-fractal structure of tissue texture in brain MRI based on wavelet coefficients. This wavelet based multi-fractal feature along with MR image intensity and a regular fractal feature obtained using our existing piecewise-triangular-prism-surface-area (PTPSA) method, are fused in segmenting PF tumor and non-tumor regions in brain T1, T2, and FLAIR MR images respectively. We also demonstrate a non-patient-specific automated tumor prediction scheme based on these image features. We experimentally show the tumor discriminating power of our novel multi-fractal texture along with intensity and fractal features in automated tumor segmentation and statistical prediction. To evaluate the performance of our tumor prediction scheme, we obtain ROCs and demonstrate how sharply the curves reach the specificity of 1.0 sacrificing minimal sensitivity. Experimental results show the effectiveness of our proposed techniques in automatic detection of PF tumors in pediatric MRIs.

  15. Dosimetry and field matching for radiotherapy to the breast and superclavicular fossa

    Science.gov (United States)

    Winfield, Elizabeth

    Radiotherapy for early breast cancer aims to achieve local disease control and decrease loco-regional recurrence rates. Treatment may be directed to breast or chest wall alone or, include regional lymph nodes. When using tangential fields to treat the breast a separate anterior field directed to the axilla and supraclavicular fossa (SCF) is needed to treat nodal areas. The complex geometry of this region necessitates matching of adjacent radiation fields in three dimensions. The potential exists for zones of overdosage or underdosage along the match line. Cosmetic results may be compromised if treatment fields are not accurately aligned. Techniques for field matching vary between centres in the UK. A study of dosimetry across the match line region using different techniques, as reported in the multi-centre START Trial Quality Assurance (QA) programme, was undertaken. A custom-made anthropomorphic phantom was designed to assess dose distribution in three dimensions using film dosimetry. Methods with varying degrees of complexity were employed to match tangential and SCF beams. Various techniques combined half beam blocking and machine rotations to achieve geometric alignment. Matching of asymmetric beams allowed a single isocentre technique to be used. Where field matching was not undertaken a gap between tangential and SCF fields was employed. Results demonstrated differences between techniques in addition to variations within the same technique between 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. For this multi-centre assessment of match plane techniques film dosimetry used in conjunction with a breast shaped phantom provided relative dose information. This study has highlighted the difficulties of 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. ROLE OF ULTRASONOGRAPHY IN PRE - OPERATIVE EVALUATION OF RIGHT ILIAC FOSSA MASS

    Directory of Open Access Journals (Sweden)

    Madhushankar

    2013-11-01

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

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

    International Nuclear Information System (INIS)

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

  18. 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.)

  19. 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.

    2007-12-01

    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.

  20. 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)

  1. Prevalence, associations, and predictors of apathy in adult survivors of infantile (<5 years of age) posterior fossa brain tumors†

    Science.gov (United States)

    Carroll, Cliodhna; Watson, Peter; Spoudeas, Helen A.; Hawkins, Michael M.; Walker, David A.; Clare, Isabel C. H.; Holland, Anthony J.; Ring, Howard A.

    2013-01-01

    Background Apathy is associated with pervasive and disadvantageous effects on daily functioning. It has been observed transiently in some children after surgery for posterior fossa tumors. In this study, our objective was to examine prevalence, associations, and predictors of apathy in adult survivors of an infantile posterior fossa brain tumor (PFT). Methods One hundred seventeen adult survivors of a childhood PFT diagnosed before age 5 years and 60 of their siblings were assessed in a cross-sectional study a mean of 32 years (range, 18–53 years) after survivors' initial tumor diagnoses, using the Marin Apathy Evaluation Scale (AES), the Weschler Abbreviated Scale of Intelligence and the Composite International Diagnostic Interview for psychiatric disorders. Results Marin Apathy Evaluation Scale, the Weschler Abbreviated Scale of Intelligence reached or exceeded a criterion score for clinically significant apathy in 35% of survivors, compared with 18% in a sibling comparison group. In both siblings and survivors, apathy was associated with lower verbal and full-scale IQ and, among survivors, with having undergone partial rather than total tumor resection (independent of irradiation status). Apathy was not related to presence of concurrent International Classification of Diseases, 10th Revision, depression. Female sex was associated with late apathy after a PFT, with increased likelihood of women reaching the apathy criterion relative to men if they were survivors. Conclusions Clinically significant and potentially treatable apathy occurs relatively commonly in adult survivors of an infantile childhood PFT, particularly women. Clinicians, including those managing posterior fossa pathology in very young children, should be aware of this association, and future research should clarify whether specific treatment-related variables are implicated in increasing this risk of apathy. PMID:23502428

  2. 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.)

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

    International Nuclear Information System (INIS)

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

  4. 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.)

  5. Normobaric Hyperoxia for Treatment of Pneumocephalus after Posterior Fossa Surgery in the Semisitting Position: A Prospective Randomized Controlled Trial

    Science.gov (United States)

    Hong, Bujung; Biertz, Frank; Raab, Peter; Scheinichen, Dirk; Ertl, Philipp; Grosshennig, Anika; Nakamura, Makoto; Hermann, Elvis J.; Lang, Josef M.; Lanfermann, Heinrich; Krauss, Joachim K.

    2015-01-01

    Background Supratentorial pneumocephalus after posterior fossa surgery in the semisitting position may lead to decreased alertness and other symptoms. We here aimed to prove the efficacy of normobaric hyperoxia on the absorption of postoperative pneumocephalus according to a standardized treatment protocol. Methods and Findings We enrolled 44 patients with postoperative supratentorial pneumocephalus (> 30 ml) after posterior fossa surgery in a semisitting position. After randomisation procedure, patients received either normobaric hyperoxia at FiO2 100% over an endotracheal tube for 3 hours (treatment arm) or room air (control arm). Routine cranial CT scans were performed immediately (CT1) and 24 hours (CT2) after completion of surgery and were rated without knowledge of the therapy arm. Two co-primary endpoints were assessed: (i) mean change of pneumocephalus volume, and (ii) air resorption rate in 24 hours. Secondary endpoints were subjective alertness (Stanford Sleepiness Scale) postoperatively and attention (Stroop test), which were evaluated preoperatively and 24 hours after surgery. The mean change in pneumocephalus volume was higher in patients in the treatment arm as compared to patients in the control arm (p = 0.001). The air resorption rate was higher in patients in the treatment arm as compared to patients in the control arm (p = 0.0015). Differences were more pronounced in patients aged 52 years and older. No difference between patients in treatment arm and control arm was observed for the Stroop test. The distribution of scores in the Stanford Sleepiness Scale differed in the treatment arm as compared to the control arm, and there was a difference in mean values (p = 0.015). Conclusions Administration of normobaric hyperoxia at FiO2 100% via an endotracheal tube for 3 hours is safe and efficacious in the treatment of pneumocephalus after posterior fossa surgery in the semisitting position. Largest benefit was found in elderly patients and particularly in older men. Trial Registration German Clinical Trials Register DRKS00006273 PMID:25992622

  6. Ameloblastoma de fossa nasal: revisão bibliográfica e relato de dois casos / Nasal ameloblastoma: literature review and report of two cases

    Scientific Electronic Library Online (English)

    Washington L. C., Almeida; Alex C., Costa; Carlos R. T., Góis; Marcelo C. C., Almeida; Milton P. C., Moura; Achiléa A. L., Bittencourt.

    2001-09-01

    Full Text Available O ameloblastoma é um tumor bastante incomum na cavidade nasal. Surge a partir do epitélio odontogênico, podendo estender-se ao seio maxilar, órbitas e base de crânio. Apresentamos dois casos de ameloblastoma em fossa nasal direita, associados a sintomas nasossinusais e seus principais achados, clíni [...] cos e cirúrgicos. Abstract in english Ameloblastoma is a very unusual tumor in the nasal cavity. It arises from the odontogenic epithelium and extends up to the maxillary sinus, orbits and skull base. We have presented two cases of ameloblastoma, both in the right nasal cavity, associated with nasal and sinusal symptoms, and reported th [...] e main surgical and clinical findings.

  7. 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.

  8. Localization of the Internal Maxillary Artery for Extracranial-to-Intracranial Bypass through the Middle Cranial Fossa: A Cadaveric Study*

    OpenAIRE

    Eller, Jorge L.; Sasaki-Adams, Deanna; Sweeney, Justin M.; Abdulrauf, Saleem I.

    2012-01-01

    The internal maxillary artery (IMAX) is a promising arterial pedicle to function as a donor vessel for extracranial-to-intracranial (EC-IC) bypass procedures. The access to the IMAX through the anterior portion of the middle cranial fossa floor allows a much shorter interposition graft to be used to create a bypass to the ipsilateral middle cerebral artery and prevents a second incision in the neck. One of the challenges of this technique, however, is the difficulty to find the IMAX through a...

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

    Science.gov (United States)

    Kim, Ah-Young; Choi, Myoung Su

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Vithalkumar Malleshi Betigeri

    2014-03-01

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

  11. 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.

  12. 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 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)

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

    Science.gov (United States)

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

    2010-12-01

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

  14. 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

    OpenAIRE

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

    2000-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

    The purpose of this study was to better understand the biological effects of increased prolactin levels induced in mice by dopamine D2 receptor antagonist molindone treatment. Toxicokinetics, prolactin levels, and reproductive tissue histology were evaluated in Tg rasH2 wild-type mice treated orally with molindone at 0, 5, 15, and 50mg/kg/day for 6 months, followed by a 2-month posttreatment recovery period. A greater than dose-proportional increase in molindone exposure ([AUC]0?24) was observed on Day 180 for both sexes. Statistically significant (Pmolindone at 50mg/kg/day also showed signs of reversal on histologic examination. PMID:26327279

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

    OpenAIRE

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

    2013-01-01

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

  17. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-11-01

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

  19. 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

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

    Scientific Electronic Library Online (English)

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

    2014-03-01

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

  1. Rash after measles vaccination: laboratory analysis of cases reported in São Paulo, Brazil Exantema após vacinação do sarampo: análise laboratorial de casos notificados em São Paulo

    Directory of Open Access Journals (Sweden)

    Maria I Oliveira

    2002-04-01

    Full Text Available OBJECTIVE: The clinical differential diagnosis of rash due to viral infections is often difficult, and misdiagnosis is not rare, especially after the introduction of measles and rubella vaccination. A study to determine the etiological diagnosis of exanthema was carried out in a group of children after measles vaccination. METHODS: Sera collected from children with rash who received measles vaccine were reported in 1999. They were analyzed for IgM antibodies against measles virus, rubella virus, human parvovirus B19 (HPV B19 using ELISA commercial techniques, and human herpes virus 6 (HHV 6 using immunofluorescence commercial technique. Viremia for each of those viruses was tested using a polimerase chain reaction (PCR. RESULTS: A total of 17 cases of children with exanthema after measles immunization were reported in 1999. The children, aged 9 to 12 months (median 10 months, had a blood sample taken for laboratory analysis. The time between vaccination and the first rash signs varied from 1 to 60 days. The serological results of those 17 children suspected of measles or rubella infection showed the following etiological diagnosis: 17.6% (3 in 17 HPV B19 infection; 76.5% (13 in 17 HHV 6 infection; 5.9% (1 in 17 rash due to measles vaccine. CONCLUSIONS: The study data indicate that infection due to HPV B19 or HHV 6 can be misdiagnosed as exanthema due to measles vaccination. Therefore, it is important to better characterize the etiology of rash in order to avoid attributing it incorrectly to measles vaccine.OBJETIVO: O diagnóstico diferencial de doenças exantemáticas causadas por vírus é geralmente difícil, e equívocos não são raros, especialmente depois da introdução da vacina contra o sarampo e a rubéola. Um estudo laboratorial foi conduzido com o objetivo de estabelecer o diagnóstico etiológico de casos de exantema em crianças que receberam a vacina contra o sarampo. MÉTODOS: Soros de casos de exantema em crianças que receberam vacina contra o sarampo, em 1999, foram analisados para anticorpos IgM contra os vírus do sarampo, da rubéola e do parvovírus humano B19 (HPV B19, por técnicas comerciais de Elisa, e o herpes vírus humano tipo 6 (HHV 6, por técnica comercial de imunofluorecência. A viremia para cada um desses vírus foi testada pela reação em cadeia da polimerase (PCR. RESULTADOS: Foram notificados, em 1999, 17 casos de crianças com exantema pós-vacinal. A idade das crianças era de nove a 12 meses (mediana, dez meses. Uma amostra de sangue colhida para investigação laboratorial foi obtida para cada criança. O tempo decorrido entre a aplicação da vacina e o aparecimento do exantema variou de um a 60 dias. Os resultados da sorologia das 17 crianças sugeriram o seguinte diagnóstico etiológico para o exantema: 17,6% (três em 17 infecção pelo HPV B19; 76,5% (13 em 17 infecção pelo HHV 6; 5,9% (um em 17 exantema originado pela vacina do sarampo. CONCLUSÃO: Os resultados indicaram que a infecção pelo HPV B19 ou pelo HHV 6 pode ser diagnosticada como sarampo de origem vacinal. Portanto, é fundamental incluir esses vírus no diagnóstico laboratorial para corretamente apontar a etiologia das doenças exantemáticas, evitando, assim, atribuir à vacina do sarampo efeito colateral.

  2. 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.

  3. Sagittal reconstruction computed tomography in metrizamide cisternography. Useful diagnostic procedure for malformations in craniovertebral junction and posterior fossa

    Energy Technology Data Exchange (ETDEWEB)

    Mochizuki, H.; Okita, N.; Fujii, T.; Yoshioka, M.; Saito, H. (Tohoku Univ., Sendai (Japan). School of Medicine)

    1982-08-01

    We studied the sagittal reconstruction technique in computed tomography with metrizamide. Ten ml of metrizamide, 170 mg iodine/ml in concentration, were injected by lumbar puncture. After diffusion of the injected metrizamide, axial computed tomograms were taken by thin slice width (5 mm) with overlapped technique. Then electrical sagittal reconstruction was carried out by optioned software. Injection of metrizamide, non-ionic water soluble contrast media, made clear contrasts among bone, brain parenchyma and cerebrospinal fluid with computed tomography. Sagittal reconstruction technique could reveal more precise details and accurate anatomical relations than ordinary axial computed tomography. This technique was applied on 3 cases (Arnold-Chiari malformation, large cisterna magna and partial agenesis cerebellar vermis), which demonstrated a useful diagnostic procedure for abnormalities of craniovertebral junction and posterior fossa. The adverse reactions of metrizamide were negligible in our series.

  4. 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.

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

    Science.gov (United States)

    Bigler, Erin D

    2007-09-01

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

  6. Evidence for the episodic erosion of the Medusae Fossae Formation preserved within the youngest volcanic province on Mars

    Science.gov (United States)

    Morgan, Gareth A.; Campbell, Bruce A.; Carter, Lynn M.; Plaut, Jeffrey J.

    2015-09-01

    We use orbital SHAllow RADar (SHARAD) sounder data to three-dimensionally visualize the subsurface structure of Elysium Planitia, the youngest volcanic province on Mars. Our results reveal an emplacement history consisting of multiple groups of overlapping lava flow units, originating from different sources. The uniquely complex "radar stratigraphy" of Elysium Planitia, relative to other volcanic regions, requires a distinct mechanism to generate the numerous reflectors observed in SHARAD data. Sedimentary deposits interbedded with successive batches of lava flows could account for the elaborate pattern of reflectors. We infer that widespread, rapidly emplaced material sourced from the enigmatic Medusae Fossae Formation (MFF) creates these sedimentary layers. This implies that episodes of atmospheric activity, perhaps linked with the obliquity of Mars, periodically erode and redeposit material from the MFF across a large region.

  7. 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.

  8. 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.

  9. Sorafenib induced Hand Foot Skin Rash in FLT3 ITD mutated Acute Myeloid leukemia- A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Jayastu Senapati

    2014-02-01

    Full Text Available Sorafenib is a novel small molecule multiple kinase inhibitor which has been used for metastatic renal cancer, hepatocellular cancer. Sorafenib induced skin rash has been discussed as a side effect in trials in both FLT3 wild type and mutated acute myeloid leukemia (AML as monotherapy or as combination with other chemotherapeutic agents . We describe a patient with FLT 3 ITD mutated AML who was started on adjunctive Sorafenib therapy. Skin reactions manifested as NCI Grade III palmoplantar erythrodysesthesia (PPE, requiring drug discontinuation. Several pathogenic mechanisms have been implicated in Sorafenib induced skin reactions, but none has been conclusively proven. While treatment options are varied for early stage skin reactions, drug discontinuation remains the only possible therapy presently for severe grade skin reaction. 

  10. 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.

  11. 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.

  12. 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)

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

    Science.gov (United States)

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

    1981-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  15. 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.

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

    International Nuclear Information System (INIS)

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

  17. 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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  20. Potentials recorded from neck and supraclavicular fossa during a rapid voluntary contraction of the triceps brachii muscle.

    Science.gov (United States)

    Tanii, K; Tsuji, S

    1993-06-01

    Two experiments were performed in order to study whether it is possible to record potentials related to the voluntary movement from electrodes placed on the skin overlying the spinous process of the 2nd and 6th cervical vertebrae and at Erb's point ipsilateral to the movement. In the first series of experiments (Experiment I) the subject initiated spontaneously an arm movement accompanying a contraction of the right triceps brachii muscle. Rapid extension of the right 5 fingers was also performed self paced. Recordings of the potentials were referential to the left knee. The morphology of the potentials from the neck and Erb's point did not differ among time constants, between experimental days, among subjects and between the arm movement and the finger movement. A negative deflection of the cervical potential started preceding the onset of the electromyogram (EMG). This negativity was followed by a positive deflection after the EMG onset. The positive potential was followed by a negative deflection during the rising phase of the EMG. In the second series of experiments the subject performed both reaction and self-paced arm movements. The prime mover was the same as the agonist in Experiment I. Morphology of the potentials recorded with monopolar and bipolar derivations did not differ between the differently initiated movements and among the subjects. The morphology of the potentials from the neck and Erb's point was the same as the morphology of the potentials recorded in Experiment I. The present results indicate that it is possible to record the potentials related to the voluntary movement from neck and supraclavicular fossa. PMID:8359125

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

    Directory of Open Access Journals (Sweden)

    Roshanak Ghafari

    2013-01-01

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

  2. Bilateral lipoma arborescens of the bicipitoradial bursa

    International Nuclear Information System (INIS)

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

  3. 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.

  4. 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.

  5. Rash - child under 2 years

    Science.gov (United States)

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

  6. Poison ivy - oak - sumac rash

    Science.gov (United States)

    ... spend time outdoors. The plant has three shiny green leaves and a red stem. Poison ivy typically ... B. Dermatologic presentations. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts ...

  7. Skin Rashes and Other Changes

    Science.gov (United States)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-06-15

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

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

    Directory of Open Access Journals (Sweden)

    Carlos Márcio Nóbrega de Jesus

    2007-12-01

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

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

    Science.gov (United States)

    Lang, J; Roth, C

    1984-01-01

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

  11. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

  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. Hematoma de fosa posterior no traumático: consideraciones clínicas y terapéuticas / Non-traumatic Posterior Fossa Hematomas: Clinical and Therapeutical issues

    Scientific Electronic Library Online (English)

    Patricio, Tagle; Luis Carlos, Vintimilla; Sergio, Del Villar; Gonzalo, Torrealba; Pablo, Villanueva; Jorge, Méndez; Sergio, Rey.

    2002-04-01

    Full Text Available Se analizan 52 pacientes portadores de hematoma de fosa posterior no traumático. Correspondieron a 28 hombres y 24 mujeres, con una media de edad de 60 años. Diez (19,2%) fueron secundarios a malformación arteriovenosa (5), cavernomas (3), angioma venoso (1) y hemangioblastoma (1). Cuarenta y dos (8 [...] 0,7%) fueron catalogados como primarios, encontrándose el antecedente de hipertensión arterial en 31, trastornos de coagulación en 5 y en 6 no se demostró un factor predisponente. Hipertensión intracraneana fue el cuadro clínico de presentación en la mayoría (84%). La Tomografía Computarizada demostró el hematoma en todos los casos. Cuatro de ellos medían menos de 2 cm., 24 entre 2 y 3 cm. y 24 eran mayores de 3 cm. Hidrocefalia estuvo presente en 22 casos (42,3%). Angiografía digital se realizó en 12 pacientes, siendo positiva en 7 (5 malformaciones arteriovenosas, 1 angioma venoso y 1 hemangioblastoma). Resonancia Magnética fue practicada en 2 enfermos, demostrando en uno angioma cavernoso. Treinta y un pacientes fueron operados realizándose vaciamiento del hematoma en 24, 14 de ellos con drenaje de LCR. En los restantes solo se trató la hidrocefalia. Se observó buenos resultados en el 67,3% y la mortalidad global fue de 9,6%. La mortalidad quirúrgica fue de 12,5%. Incide en los resultados el estado de conciencia inicial y el tamaño. Las cisternas troncales no fueron evaluadas en nuestra casuística. Sin embargo, creemos que el tratamiento debiera ser evaluado en cada caso en particular, ya que ningún factor influyen en forma absoluta en la evolución Abstract in english Fifty two patients (28 male and 24 female) with non-traumatic posterior fossa hematomas were analyzed. Average age of the patients was 60 years old. In ten cases (19.2%), the hematomas were secondary to arteriovenous malformations (5), cavernomas (3), venous angiomas (1) and hemangioblastoma (1). Fo [...] rty two (80.7%) were considered primary, with a history of high blood pressure in 31 patients and coagulation disorders in 5. Six cases had no predisposing factors. Most subjects also had intercraneal hypertension (84%). Computerized tomography showed hematomas in all cases, of which four were under 2 cm in size, 24 were between 2 and 3 cm, and 24 were larger than 3 cm. Hydrocephalus was present in 22 cases (42.3%). Twelve patients underwent digital angiography, with favorable results in seven (5 arteriovenous malformations, 1 venous angioma and 1 hemangioblastoma). Magnetic resonance imaging was done with two patients, and showed one cavernous angioma. Thirty-one patients underwent surgery; the hematoma was drained in 24 cases, 14 of which involved LCR draining. The remaining cases were treated for hydrocephalus only. Favorable results were seen in 67.3% of the cases, and the overall mortality rate was 9.6%. Surgical mortality was 12.5%. The initial state of consciousness and size had a bearing on results. We believe that treatment must be evaluated on a case-by-case basis, since no single factor has an absolute effect on a patient's outcome

  16. Customized rapid subtraction hybridization (RaSH) gene microarrays identify overlapping expression changes in human fetal astrocytes resulting from human immunodeficiency virus-1 infection or tumor necrosis factor-alpha treatment.

    Science.gov (United States)

    Su, Zao-zhong; Chen, Yinming; Kang, Dong-chul; Chao, Wei; Simm, Malgorzata; Volsky, David J; Fisher, Paul B

    2003-03-13

    Genes displaying altered expression as a function of human immunodeficiency virus (HIV)-1 infection of cultured primary human fetal astrocytes (PHFA) were previously identified using a rapid subtraction hybridization (RaSH) method. This scheme identified both known and novel genes displaying elevated expression, astrocyte elevated genes (AEG), and decreased expression, astrocyte suppressed genes (ASG), in PHFA as a consequence of infection with HIV-1 or treatment with HIV-1 envelope glycoprotein (gp120). RaSH also identified both known and novel genes displaying enhanced (HR) or reduced (HS) expression in HIV-1 resistant versus HIV-1 susceptible human T-cell clones. In the present study, a customized microarray approach employing these RaSH-derived genes was used to distinguish overlapping gene expression changes occurring in PHFA as a function of treatment with HIV-1 and the neurotoxic agent tumor necrosis factor (TNF)-alpha. RaSH cDNAs were spotted (microarrayed) on nylon membranes and probed with temporally isolated reverse transcribed cDNAs from HIV-1-infected and TNF-alpha-treated PHFA. This strategy identified genes displaying parallel changes after TNF-alpha treatment as observed following HIV-1 infection. Confirmation of genuine differential expression was achieved by Northern blotting. These studies document that TNF-alpha can induce a set of corresponding changes in specific AEGs and ASGs as does HIV-1 infection in PHFA. Furthermore, this customized microarray approach with RaSH-derived clones represents an efficient and sensitive methodology for elucidating molecular changes in PHFA occurring as a consequence of treatment with pharmacological agents affecting astrocyte physiology. PMID:12657468

  17. 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, 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.)

  18. 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.

  19. 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.

    2012-12-01

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

  20. An Unusual Case of Large Posterior Fossa Neurenteric Cyst Involving Bilateral Cerebellopontine Angle Cisterns: Report of a Rare Case and Review of Literature

    International Nuclear Information System (INIS)

    Intracranial neurenteric cysts are rare cystic masses of endodermal origin lined with mucin producing low columnar or cuboidal epithelium. Approximately 141 cases have been reported so far. Most of the posterior fossa neurenteric cysts are typically small, located anteriorly to the brainstem in the midline or in the cerebellopontine angle cistern area. We present a rare, histologically proven case of a large lobulated intracranial neurenteric cyst measuring 4.2 centimeters in the maximal transverse dimension and involving bilateral cerebellopontine angle cisterns. We also present a review of the literature on this uncommon finding. Imaging features of neurenteric cyst are non-specific and it should be considered in the differential diagnosis for any intracranial extraaxial cystic lesion

  1. Two case series reports: 8 cases of arachnoid Temporoparietal cysts (middle fossa & sylvian fissure) and 2 cases of chronic subdural hematoma

    Science.gov (United States)

    Meshkini, Ali; Meshkini, Mohammad

    2012-01-01

    Abstract: Background: Arachnoid cysts are common intracranial space-occupying lesions which are often found in middle fossa and temporal regions of the skull. Many of these lesions are asymptomatic but some might appear as space-occupying lesions. Almost arachnoid cyst rupture, either following a trauma or spontaneously can result in intracystic hemorrhage, subdural hematoma and hygroma. The present study presents two case series including 8 cases of arachnoid cysts in temporal region and 2 cases of subdural hemorrhage. Methods: Demographic data and clinical and neuroimaging features of 8 patients were evaluated. Results: A total of 8 patients with arachnoid cysts in temporal region were assessed: age range 3 to 27 years old, 5 male and 3 female. The most important complains of the patients during their visit were seizure (3 cases), headache (4 cases), increased head circumference (1 case), parietotemporal arachnoid cyst in right (4 cases) and left hemisphere (4 cases). The conservative treatment and follow-up were performed in 6 out of 8 patients. In the other 2 patients, for craniotomy surgery with hematoma evacuation was performed. Furthermore, in the surgery the fenestration of arachnoid cyst wall into the basal cisterns as well as low pressure cysto-peritoneal shunt was performed. Conclusions: The risk of annual hemorrhage for patients with arachnoid cyst is very low. However, when the hemorrhage occurs it is treated by hematoma evacuation in most cases, but sometimes there is a need for fenestration of the cyst into basal cisterns under endoscopy, microsurgical or cystoperitoneal shunt. Keywords: Arachnoid cyst, Middle fossa, Chronic subdural hematoma

  2. Biorremediação vegetal do esgoto domiciliar: o caso da fossa verde em comunidades rurais do Alto Sertão Alagoano

    Directory of Open Access Journals (Sweden)

    Antonio Oliveira Netto

    2015-12-01

    Full Text Available O imenso déficit de atendimento referente a cobertura de coleta e tratamento do esgoto requer desenvolvimento de sistemas que combinam destinação adequada dos efluentes e baixos custos de construção e operação. Nesse contexto surge a biorremediação vegetal, através da fossa verde, tecnologia social sustentável e de baixo custo, apresentando-se como alternativa viável principalmente para a zona rural de municípios. Essa tecnologia social objetiva contribuir para o enfrentamento da problemática do esgoto domiciliar e das suas consequências para a saúde coletiva da comunidade e o meio ambiente; sendo alternativa de destinação do esgoto doméstico, além de possibilitar o cultivo de algumas espécies frutíferas. Mediante parceria estabelecida com o projeto Renas-Ser que atua na linha de gestão de corpos hídricos superficiais e subterrâneos, três unidades de fossa verde encontram-se construídas em comunidades rurais de municípios do alto sertão alagoano, contemplando o condicionamento adequado dos efluentes domésticos. Os primeiros resultados da observação pontual de redução de matéria orgânica são bastante animadores, tendo em vista a remoção de aproximadamente 38% da DQO já na primeira camada suporte. A etapa seguinte consiste na definição dos demais parâmetros a serem monitorados e verificar a aprovação dos usuários da tecnologia.

  3. %179200 RADIAL HEADS, POSTERIOR DISLOCATION OF [OMIM

    Lifescience Database Archive (English)

    Full Text Available FIELD NO 179200 FIELD TI %179200 RADIAL HEADS, POSTERIOR DISLOCATION OF FIELD TX CLINICAL FEATUR ... y in the father's antecubital fossae, raising skin web s. Reichenbach et al. (1995) reported on 4 cases of ... t. 55: 101-104, 1995. 5. Shun-Shin, M.: Congenital web ... formation. J. Bone Joint Surg. Br. 36: 268-271, 19 ...

  4. 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

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    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.

  5. 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.

  6. 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.

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

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    Alessandro Bonforte

    2013-05-01

    Full Text Available Results of recent monitoring activities on potentially unstable areas of the NW volcano flank of La Fossa cone (Vulcano Island, Italy are shown here. They are obtained by integration of data by aerial photogrammetry, terrestrial laser scanning (TLS and GPS taken in the 1996–2011 time span. A comparison between multi-temporal models built from remote sensing data (photogrammetry and TLS highlights areas characterized by ~7–10 cm/y positive differences (i.e., elevation increase in the upper crown of the slope. The GPS measurements confirm these results. Areas characterized by negative differences, related to both mass collapses or small surface lowering, also exist. The higher differences, positive and negative, are always observed in zones affected by higher fumarolic activity. In the 2010–2012 time span, ground motions in the northern part of the crater rim, immediately above the upper part of observed area, are also observed. The results show different trends for both vertical and horizontal displacements of points distributed along the rim, with a magnitude of some centimeters, thus revealing a complex kinematics. A slope stability analysis shows that the safety factors estimated from these data do not indicate evidence of possible imminent failures. Nevertheless, new time series are needed to detect possible changes with the time of the stability conditions, and the monitoring has to go on.

  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. Radiation therapy quality in CCG/POG intergroup 9961: implications for craniospinal irradiation and the posterior fossa boost in future medulloblastoma trials

    Science.gov (United States)

    Donahue, Bernadine; Marymont, Mary A. H.; Kessel, Sandra; Iandoli, Matthew K.; FitzGerald, Thomas; Holmes, Emiko; Kocak, Mehmet; Boyett, James M.; Gajjar, Amar; Packer, Roger J.

    2012-01-01

    Purpose: Associations of radiation therapy (RT) deviations and outcomes in medulloblastoma have not been defined well, particularly in the era of reduced-dose craniospinal irradiation and chemotherapy. The aim of this study is to evaluate the quality of RT on Children’s Cancer Group/Pediatric Oncology Group 9961 and analyze associations of RT deviations with outcome. Materials and Methods: Major volume deviations were assessed based on the distance from specified anatomical region to field edge. We investigated associations of RT deviations with progression-free survival (PFS), overall survival (OS), and explored associations with demographics and clinical variables. Results: Of the 308 patients who were evaluable for volume deviations, 101 patients (33%) did not have any. Of the remaining 207 patients, 50% had only minor deviations, 29% had only major deviations, and 21% had both minor and major deviations. Of the patients with major deviations, 73% had a single major deviation. The most common major deviation was in the cribriform plate region, followed by the posterior fossa (PF); PF deviations resulted from treating less than whole PF. There were no significant differences in PFS or OS between patients with deviations and those without. There was no evidence of associations of deviations with patient age. Conclusions: Approximately one-third of patients had major volume deviations. There was no evidence of a significant association between these and outcome. This lack of correlation likely reflects the current high quality of RT delivered in Children’s Oncology Group institutions, our strict definition of volume deviations, and the relatively few instances of multiple major deviations in individual patients. In is noteworthy that the types of PF volume deviations observed in this study were not adversely associated with outcome. As we move forward, quality assurance will continue to play an important role to ensure that deviations on study do not influence study outcome. PMID:23316474

  10. 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

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    C.F.S. Rodrigues

    1997-01-01

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

  11. 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

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

    Directory of Open Access Journals (Sweden)

    Mariano del Sol

    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.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 patterns. Type I where the CVF originates the MCV, t

  13. 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.

  14. Time sparing and effective procedure for dural closure in the posterior fossa using a vicryl mesh (Ethisorb®): un procedimiento simple y efectivo / Cierre de duramadre en cirugía de fosa posterior con una malla de vicryl (Ethisorb®)

    Scientific Electronic Library Online (English)

    I., Reyes-Moreno; R., Verheggen.

    2006-12-01

    Full Text Available Introducción. Los defectos en el cierre de duramadre y por consiguiente fístulas de líquido cefalorraquídeo son comunes en cirugía de fosa posterior. El tratamiento incluye manejo conservador o no quirúrgico como drenaje lumbar externo de líquido cefalorraquídeo, cuando éstas medidas fallan se requi [...] ere de una nueva cirugía. Objetivos. Con el propósito de evitar fístulas de líquido cefalorraquídeo en cirugía de fosa posterior desarrollamos un método simple, pero efectivo, que permite ahorrar tiempo quirúrgico utilizando una malla de viyril-poly-p-dioxanone (Ethisorb®) para cubrir por completo el defecto de la craniectomía. No se requiere del uso adicional de adhesivo de fibrina. Nuestra experiencia clínica, quirúrgica y hallazgos histopatológicos con ésta técnica de cierre dural se discuten en el presente artículo así como las complicaciones, en particular infección y presencia de fístulas de líquido cefalorraquídeo. Pacientes. En 85 pacientes sometidos a cirugía de fosa posterior debida a diferentes patologías, se utilizó una malla de vicryl (Ethisorb®) como sustituto de duramadre. Se presenta un caso que ilustra nuestra técnica. Resultados. En ninguno de los casos se presentó infección postoperatoria. Cuatro casos presentaron fístula de líquido cefalorraquídeo y fueron tratados con drenaje lumbar externo; tres pacientes mejoraron por completo sin requerir otras medidas. Sólo en un caso se requirió de exploración quirúrgica. Conclusiones. De acuerdo con los resultados y complicaciones, consideramos que la malla de vicryl (Ethisorb®) es un sustituto de duramadre ideal, en particular para cirugías de fosa posterior. Abstract in english Introduction. Dural defects and cerebrospinal fluid (CSF) leaks are a common problem following posterior fossa surgery. The management includes either nonoperative management (e.g. external lumbar drainage) or surgical re-exploration. Objectives. We present our surgical, clinical and histopathologic [...] al experience of dural closure in the posterior fossa. In order to avoid CSF leaks we developed a simple but effective and time-sparing method using a well-cut sheet of a vicryl-poly-pdioxanone mesh (Ethisorb®) covering the whole defect of the craniectomy. Additional fibrin glue or sealant is not necessary. Special attention was focused upon the frequency of postoperative complications, in particular infection rate and CSF leaks. Patients. 85 patients were treated with vicryl mesh as dural substitute after posterior fossa surgery due to distinct pathologies. An illustrative case is presented. Results. In none of the patients a postoperative infection was observed. Four patients presented postoperative CSF leakage and were treated by percutaneous lumbar drainage. Three of the patients improved completely, requiring no additional treatment. Only in one case defect covered by a vicryl mesh, a surgical reexploration became necessary. Conclusion. We consider the vicryl mesh (Ethisorb®) as an ideal dural substitute especially for the dural closure of the posterior fossa.

  15. Fractionated high-dose-rate and pulsed-dose-rate brachytherapy: first clinical experience in squamous cell carcinoma of the tonsillar fossa and soft palate

    International Nuclear Information System (INIS)

    Purpose: Fractionated high-dose-rate (fr.HDR) and pulsed-dose-rate (PDR) brachytherapy (BT) regimens, which simulate classical continuous low-dose-rate (LDR) interstitial radiation therapy (IRT) schedules, have been developed for clinical use. This article reports the initial results using these novel schedules in squamous cell carcinoma (SCC) of the tonsillar fossa (TF) and/or soft palate (SP). Methods and Materials: Between 1990 and 1994, 38 patients with TF and SP tumors (5 T1, 22 T2, 10 T3, and 1 T4) were treated by fr.HDR or PDR brachytherapy, either alone or in combination with external irradiation (ERT). Half of the patients were treated with fr.HDR, which entailed twice-daily fractions of ?3 Gy. The other 19 patients were administered PDR, which consisted of pulses of ?2 Gy delivered 4-8 times/day. The median cumulative dose of IRT ± ERT series was 66 Gy (range 55-73). The results in these patients treated by brachytherapy were compared to 72 patients with similar tumors treated in our institute with curative intent, using ERT alone. The median cumulative dose of ERT-only series was 70 Gy (range 40-77). Results: Excellent locoregional control was achieved with the use of IRT ± ERT, with only 13% (5 of 38) developing local failure, and salvage surgery being possible in three of the latter (60%). Neither BT scheme (fr.HDR vs. PDR) nor tumor site (TF vs. SP) significantly influenced local control rates. The type and severity of the side effects observed are comparable to those reported in the literature for LDR-IRT. These results contrast sharply with our ERT-only series, in which 39% of patients (28 of 72) developed local failure, with surgical salvage being possible only in three patients (11%). Taking the data set of 110 patients, in a univariate analysis IRT, T stage, N stage, overall treatment time (OTT), and BEDcor10 (biological effective dose with a correction for the OTT) were significant prognostic factors for local relapse-free survival (LRFS) and overall survival (OS) at 3 years. Using Cox proportional hazard analysis, only T stage and BEDcor10 remained significant for LRFS (p 10 (p = 0.03). Conclusion: The 3-year LRFS of approximately 90% for TF and SP tumors reported here is comparable with the best results in the literature, particularly given the fact that 30% of the patients (11 of 38) presented with T3/4 tumors. When compared with our historical (ERT-only) controls, the patients treated with IRT had superior local control. A dose-response relationship was established for the BEDcor10

  16. 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.

  17. Hot Tub Rash (Pseudomonas Dermatitis/Folliculitis)

    Science.gov (United States)

    ... based Exercise Swimmer Protection Steps of Healthy Swimming Triple A’s of Healthy Swimming Pool User Information Hot ... Birds & Pools Inflatable & Plastic Pools (Kiddie Pools) Water Play Areas & Interactive Fountains Design & Operation Designing Public Swimming ...

  18. A case of dyspnea and periorbital rash

    OpenAIRE

    Eldho, George C.; Gailin, B. Sebastian; Mithun, C. Mohan; Anoop, Thattungal M.; Sudha, R

    2012-01-01

    A 75-year-old woman presented with dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, and edema. Macroglossia, generalized petechiae, raccoon eyes sign, and peripheral neuropathy were present, and an echocardiogram showed cardiac dilatation and left ventricular systolic dysfunction. Rectal biopsy and immune fixation electrophoresis confirmed the diagnosis of AL amyloidosis.

  19. Skin Rashes Due to Bed-Wetting

    Science.gov (United States)

    ... fashion that the child might interpret as a punishment. NKF Cares Help Line Get help navigating the ... Point The National Kidney Foundation is the leading organization in the U.S. dedicated to the awareness, prevention ...

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

    Science.gov (United States)

    ... that might scratch the ear canal and cause infection. > Do not swim in locations that have been closed because of pollution. Pseudomonas can multiply quickly when water disinfectant levels drop, ...

  1. 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 ...

  2. Heat Rash (Miliaria or Prickly Heat)

    Science.gov (United States)

    ... help you stay cool and dry. Avoid using baby powders and creams. They can block your pores and actually make your skin warmer. ... Is there a treatment that will help? What can I do at home to make myself more comfortable? Should I let my baby go without a diaper to help clear up ...

  3. Chronic Itchy Skin Rashes in Children

    Science.gov (United States)

    ... limited or extensive areas of the skin, while scabies and hives (urticaria) are often widespread, covering the ... by errors in how the immune system works. Scabies (Pediatric) Scabies is an itchy skin condition caused ...

  4. The sweet Christmas rash (case series)

    DEFF Research Database (Denmark)

    Gyldenløve, Mette; Nepper-Christensen, Steen; Thyssen, Jacob P; Faurschou, Annesofie

    2013-01-01

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

  5. Drug Rash (Unclassified Drug Eruption) in Adults

    Science.gov (United States)

    ... Apply calamine lotion. Take an antihistamine, such as diphenhydramine. When to Seek Medical Care Whenever you are ... be helpful include: Oral antihistamine pills, such as diphenhydramine, hydroxyzine, loratadine, cetirizine, fexofenadine, or desloratadine, for itching. ...

  6. Drug Rash (Unclassified Drug Eruption) in Children

    Science.gov (United States)

    ... Apply calamine lotion. Take an antihistamine such as diphenhydramine. When to Seek Medical Care Whenever your child ... include: Oral antihistamine pills or syrups such as diphenhydramine, hydroxyzine, loratadine, cetirizine, fexofenadine, or desloratadine for itching ...

  7. 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.

  8. 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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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

    Scientific Electronic Library Online (English)

    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.

  10. 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

    Directory of Open Access Journals (Sweden)

    Mariano del Sol

    2012-03-01

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

  11. 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

    Scientific Electronic Library Online (English)

    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.

  12. 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.

  13. 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.

  14. 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. Ultr...

  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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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

    Scientific Electronic Library Online (English)

    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

  17. 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

    Scientific Electronic Library Online (English)

    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.

  18. 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.

  19. 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

    Scientific Electronic Library Online (English)

    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

  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. Multi-Institution Prospective Trial of Reduced-Dose Craniospinal Irradiation (23.4 Gy) Followed by Conformal Posterior Fossa (36 Gy) and Primary Site Irradiation (55.8 Gy) and Dose-Intensive Chemotherapy for Average-Risk Medulloblastoma

    International Nuclear Information System (INIS)

    Purpose: Limiting the neurocognitive sequelae of radiotherapy (RT) has been an objective in the treatment of medulloblastoma. Conformal RT to less than the entire posterior fossa (PF) after craniospinal irradiation might reduce neurocognitive sequelae and requires evaluation. Methods and Materials: Between October 1996 and August 2003, 86 patients, 3-21 years of age, with newly diagnosed, average-risk medulloblastoma were treated in a prospective, institutional review board-approved, multi-institution trial of risk-adapted RT and dose-intensive chemotherapy. RT began within 28 days of definitive surgery and consisted of craniospinal irradiation (23.4 Gy), conformal PF RT (36.0 Gy), and primary site RT (55.8 Gy). The planning target volume for the primary site included the postoperative tumor bed surrounded by an anatomically confined margin of 2 cm that was then expanded with a geometric margin of 0.3-0.5 cm. Chemotherapy was initiated 6 weeks after RT and included four cycles of high-dose cyclophosphamide, cisplatin, and vincristine. Results: At a median follow-up of 61.2 months (range, 5.2-115.0 months), the estimated 5-year event-free survival and cumulative incidence of PF failure rate was 83.0% ± 5.3% and 4.9% ± 2.4% (± standard error), respectively. The targeting guidelines used in this study resulted in a mean reduction of 13% in the volume of the PF receiving doses >55 Gy compared with conventionally planned RT. The reductions in the dose to the temporal lobes, cochleae, and hypothalamus were statistically significant. Conclusion: This prospective trial has demonstrated that irradiation of less than the entire PF after 23.4 Gy craniospinal irradiation for average-risk medulloblastoma results in disease control comparable to that after treatment of the entire PF

  2. Lumbar meningeal enhancement after surgery in the posterior cranial fossa: a normal finding in children?; Lumbales meningeales Enhancement in der KM-MRT nach Operationen in der hinteren Schaedelgrube: Eine normale Erscheinung bei Kindern?

    Energy Technology Data Exchange (ETDEWEB)

    Krampla, W.; Urban, M.; Newrkla, S.; Hruby, W. [Inst. fuer Roentgendiagnostik, Donauspital Wien und LBI fuer digitale Radiographie und interventionelle Radiologie (Austria); Schatzer, R.; Knosp, E. [Neurochirurgische Abt., Donauspital Wien und LBI fuer minimal invasive Techniken in der Neurochirurgie (Austria)

    2002-12-01

    Purpose: Spinal meningeal Gd-DTPA enhancement after cranial surgery is a known observation of a not well understood underlying mechanism. This paper demonstrates that this MRI finding is a normal meningeal reaction to subarachnoid hemorrhage, which should not be mistaken for metastatic spread. Material and methods: Three pediatric patients were examined by MRI for metastatic spread of malignant infratentorial tumors along the spinal canal two to nine days after the removal of the primary cerebral lesion. The findings were compared with a control group that underwent cranial surgery (cyst resection or fenestration of the posterior cranial fossa) without major bleeding into the subarachnoid space. Unenhanced and enhanced sequences were obtained to prove that the high singal within the CSF is caused by an abnormal Gd-DTPA uptake and not by methemoglobin. Results: Meningeal enhancement was observed in all patients with intraoperative bleeding resembling subarachnoid masses on enhanced T{sub 1}-weighted images. This was not present in any patient of the control group. This finding lasts for approximately two weeks. Conclusion: The meningeal enhancement renders immediate postoperative studies inconclusive for the detection of metastatic spread. Consequently, the obligatory tumor staging along the spinal canal should ideally be done prior to the resection of a cerebral tumor. (orig.) [German] Spinales meningeals Enhancement in der MRT nach Gd-DTPA Applikation nach kranialen Operationen ist eine beschriebene Tatsache, deren Ursache nicht eindeutig bekannt ist. Zweck der Arbeit ist die Darstellung dieses Phaenomens als normale postoperative Reaktion. Material und Methode: Drei paediatrische Patienten wurden zwischen 2 und 9 Tagen nach der Resektion maligner Tumoren in der hinteren Schaedelgrube (HSG) zum Staging des Spinalkanals einer MRT unterzogen. Diese Gruppe wurde mit einer postoperativen Kontrollgruppe ohne wesentliche Einblutung in den Spinalkanal verglichen (Zystenresektionen bzw. Fenestrationen in der HSG). Es wurden Sequenzen vor und nach Kontrastmittelapplikation angefertigt, um zu beweisen, dass die beobachteten Signalalterationen einem postoperativen Enhancement entsprechen und nicht durch die Blutabbauprodukte selbst verursacht sind. Ergebnis: Meningeales Enhancement, welches an Tumorgewebe erinnert, wurde in allen Faellen nach Tumorresektion beobachtet. Derartige Veraenderungen lagen in der Kontrollgruppe nicht vor. In allen Faellen kam es ohne Therapie zu einer Restitution. In keinem Fall kam es zu einem spaeteren Zeitpunkt zu einer Tumorabsiedelung. Diskussion: Die Veraenderungen an den Meningen machen eine Beurteilung hinsichtlich Abtropfmetastasen in der unmittelbar postoperativen Phase weitgehend unmoeglich. Das obligate Tumorstaging im Spinalkanal sollte daher idealerweise vor der Resektion des Primaertumors erfolgen. (orig.)

  3. The effect of M-stage on patterns of failure in posterior fossa primitive neuroectodermal tumors treated on CCG-921: a phase III study in a high-risk patient population

    International Nuclear Information System (INIS)

    Purpose: To analyze patterns of failure in patients (pts) with high-risk posterior fossa primitive neuroectodermal tumors (PF-PNETs) treated with combined modality therapy on a large, randomized multiinstitutional study. Methods and Materials: One hundred eighty-eight prospectively staged pts with PF-PNET confirmed by central pathology review, with high-risk features, were treated on Children's Cancer Group Study 921 (CCG-921), comparing two chemoradiotherapy regimens. Patterns of initial sites of failure were analyzed, specifically evaluating the impact of Chang M-stage. Results: Progression-free survival (PFS) correlated with the presence or absence of metastatic disease (p < 0.001), with 5-year PFS of 68 ± 5.8% for M0 vs. 43 ± 6.8% for M+ pts. The cumulative incidence functions (CIF) of recurrence were different (p = 0.005) and at 5 years were 29 ± 4.7% for M0 pts and 48 ± 5.5% for M+ pts. Involvement of the PF at time of initial failure as measured by CIF correlated with M-stage (p = 0.047) and occurred in 18 ± 3.9% of M0 pts and 8 ± 2.9% of M+ pts overall; PF as the only site of relapse also correlated with M-stage (p = 0.019) and was seen in 6 ± 2.5 and 0% of M0 and M+ pts, respectively, at 5 years. Relapse in the spine and/or cerebrospinal fluid (CSF) at initial recurrence was correlated with M-stage (p < 0.002), with 5-year cumulative incidences of 14 ± 3.7%, 26 ± 8.2%, 40 ± 15%, and 40 ± 7.7% for M0, M1, M2, and M3 pts, respectively. Isolated spine/CSF recurrence correlated with M-stage (p 0.034) and occurred in 2 ± 1.5% of M0 and 9 ± 3.2% of M+ pts by 5 years. The median time to relapse for pts who failed was 1.2 years (range 0.2-5.3). Ninety percent of all relapses occurred by 3 years. Conclusions: Original sites of disease are at the highest risk for relapse, but the entire neuraxis remains at significant risk, despite combined-modality treatment. M-Stage was prognostic for spine/CSF relapse as well as PFS and may be an important tool in guiding therapy. A more aggressive approach to local control in the neuraxis is warranted, especially in M+ patients

  4. 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.

    2014-09-01

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

  5. 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.

  6. 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.

  7. Toxicodermias. Erupciones cutáneas por fármacos / Toxicoderms. Drug rashes

    Scientific Electronic Library Online (English)

    Jimena, Aguilar Escobar; Ruitter, Calvi Fernandez.

    2008-06-01

    Full Text Available Las reacciones adversas provocadas por medicamentos originan una variedad de síndromes, con afección localizada o multiorgánica. Las manifestaciones de piel y mucosas representan la forma más frecuente y la de mayor diversidad mor­fológica. Estas reacciones cutáneas se pueden producir mediante mecan [...] ismos inmunológicos y por fenómenos de otra naturaleza (idiosincrasia). La identificación de los diferentes patrones clínicos de este tipo de dermatosis, cuya severidad varía desde formas leves y autolimitadas hasta aquellas potencialmente letales, constituye la base para el diagnós­tico. Existen otros factores que le imprimen una complejidad al problema: una expresión clínica muy variable y que además carece de especificidad etiológica en relación con medicamentos; la evaluación diagnóstica de los casos suele basarse en datos clínicos, ya sea porque interviene un mecanismo de producción no inmunológico, o bien, por las limi­taciones tecnológicas para demostrar que un medicamento es la causa de la reacción adversa.Se presenta un caso de una mujer de 62 años con toxicodermias por fármacos. Abstract in english Side effects produced by medicines causes a variety of syndromes, with localized or multiorganic disease. Signs in skin and mucous appear as the more common way and with an important morphologic diversity. That cutaneous reactions can be produced due to immunological mechanisms and due to other orig [...] ins (idiosyncrasy). Identification of the diffe­rent clinical patrons in this kind of dermathosis, which severity changes from level and limited situations to lethal ones, constitutes the basis of diagnosis. There are other factors that introduce complexity into the problem: a variable clinical expression that bears no etiological relation to medicines; diagnosis evaluation is usually based in clinical data, because a non­immunological mechanism mediates, or due to the technological limitations in the demonstration that a medicine is the side effect origin. We present a clinical case of a 62 years old woman who has toxicoderms by drugs.

  8. An Immunocompetent Patient with a Vesicular Rash and Neurological Symptomatology

    OpenAIRE

    Cooper, Chad J; Sarmad Said; Mohamed Teleb; Paola Rosa; S. Claudia Didia

    2013-01-01

    Viral infection is the most common cause of aseptic meningitis with the most frequent virus associated with aseptic meningitis being enteroviruses (coxsackievirus and echovirus). In viral meningitis, cerebrospinal fluid (CSF) shows a mild pleocytosis with a lymphocytic predominance, elevated protein, and normal glucose level. Nucleic acid amplification methods have greatly improved the detection of viral pathogens. In our case, a 47-year-old Caucasian female patient presented with a persisten...

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

    OpenAIRE

    Zonunsanga

    2015-01-01

    Isotretinoin is a vitamin A analogue, which is readily isomerized to tretinoin. It causes normalization of abnormal keratinisation. It also reduces sebum secretion. It also has anti-inflammatory as well as antibacterial properties. It has some adverse effects like teratogenecity, hypertriglyceridemia, pancreatitis, dryness of skin, cheilitis, altered liver functions etc. A 25 years old unmarried lady presented with acne vulgaris, who did not showed improvements with conventional (antibiotics)...

  10. Red, Itchy Rash? Get the Skinny on Dermatitis

    Science.gov (United States)

    ... In this condition, the water-tight barrier between skin cells gets weak, which lets moisture out and other things in. That’s why people with atopic dermatitis have to moisturize their skin, and they’re more susceptible to skin infections. ...

  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. 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.

  13. 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.

  14. A case of Hymenolepis diminuta in a young male from Odisha.

    Science.gov (United States)

    Karuna, T; Khadanga, Sagar

    2013-07-01

    Hymenolepis diminuta also known as rat tapeworm rarely causes hymenolepiasis in humans. We report a case of H. diminuta infection in an 18-year-old male farmer who presented with intermittent pruritic maculopaular rashes and dull aching left iliac fossa pain for 6 months. Patient was cured with 2 doses of praziquantel 20 mg/kg on day 0 and 7. PMID:24471000

  15. A case of Hymenolepis diminuta in a young male from Odisha

    OpenAIRE

    Karuna, T; Khadanga, Sagar

    2013-01-01

    Hymenolepis diminuta also known as rat tapeworm rarely causes hymenolepiasis in humans. We report a case of H. diminuta infection in an 18-year-old male farmer who presented with intermittent pruritic maculopaular rashes and dull aching left iliac fossa pain for 6 months. Patient was cured with 2 doses of praziquantel 20 mg/kg on day 0 and 7.

  16. PH- Mapping Of Prepubertal Skin Of Indian Subjects

    Directory of Open Access Journals (Sweden)

    Gupta A B

    1995-01-01

    Full Text Available PH- mapping of skin was made by measuring the skin surface pH in 61 normal Indian subjects (35M, 26F in the prepubertal age group at 21 different sites from scalp to sole at an ambient temperature 25-32C and a relative humidity 60-65%. The pH values at axilla, umbilicus, palm, fingerfolds, foot, sole, and cheek were found to be consistently higher than those at scalp, forehead, retroauricular folds, antecubital and popliteal fossae, anterior arm, anterior the mean pH of male skin appeared to be lower than that of female. The highest pH recorded was in axilla (5.98 for male, 6.00 for female, irrespective of sex. The lowest value however was in anterior neck (4.59 for male and in antecubital fossa (4.83 for female. While the origin of the skin pH is yet to be definitely known, it was observed that a high density of both sweat gland and bacteria flora leads to a high pH, and high concentration of sebaceous gland and of bacterial flora to a lower pH.

  17. 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.

  18. 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

  19. Arthroscopy-assisted percutaneous fixation of glenoid fossa fracture

    Directory of Open Access Journals (Sweden)

    Yallapragada Rahikiran

    2007-01-01

    Full Text Available We are reporting an interesting case of glenoid fracture in a 46-year-old male which was fixed with the help of arthroscopy. At present, anterior or posterior glenoid rim fractures and some greater tuberosity fractures are widely treated arthroscopically. We report the arthroscopically assisted fixation of a transverse articular glenoid fracture. Arthroscopic reduction and percutaneous fixation of glenoid fractures not only allows anatomic reduction with minimal surgical trauma but provides a valid diagnostic and treatment alternative for associated capsular, ligamentous, labral or tendon injuries as well as joint irrigation. The principle portals are discussed. We suggest fixation with cannulated screws for better stability of fracture fragments and advise K-wires for fractures that are comminuted and not amenable to cannulated screw fixation. However, arthroscopic fixation of shoulder fractures is associated with a learning curve depending on surgeon?s experience in shoulder arthroscopy.

  20. Arthroscopy-assisted percutaneous fixation of glenoid fossa fracture

    OpenAIRE

    Yallapragada Rahikiran; Patel Kuntal; Davuluri Pardhasaradhi; Sloan Andy; Marynissen Hans

    2007-01-01

    We are reporting an interesting case of glenoid fracture in a 46-year-old male which was fixed with the help of arthroscopy. At present, anterior or posterior glenoid rim fractures and some greater tuberosity fractures are widely treated arthroscopically. We report the arthroscopically assisted fixation of a transverse articular glenoid fracture. Arthroscopic reduction and percutaneous fixation of glenoid fractures not only allows anatomic reduction with minimal surgical trauma but provides a...

  1. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, P. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Kendall, B.E. [Lysholm Radiological Dept., National Hospital for Neurology and Neurosurgery, London (United Kingdom); Wilms, G. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Halpin, S.F.S. [Lysholm Radiological Dept., National Hospital for Neurology and Neurosurgery, London (United Kingdom); Casaer, P. [Dept. of Paediatrics, University Hospitals, Leuven (Belgium); Baert, A.L. [Dept. of Radiology, University Hospitals, Leuven (Belgium)

    1995-01-01

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

  3. Infarto agudo do cerebelo simulando tumor da fossa posterior Acute cerebellar infarction presenting as a posterior fossa tumor

    OpenAIRE

    José Alberto Gonçalves da Silva; Erasmo Barros da Silva; Carlos Agripino Branco

    1992-01-01

    Um homem de 58 anos foi acometido subitamente de cefaléia, vômitos, vertigens e incoordenação das extremidades esquerdas. A tomografia computadorizada do crânio evidenciou área hipodensa no hemisfério cerebelar esquerdo, cujo exame anátomo-patológica mostrou tratar-se de infarto cerebelar.We report a case of space-occupying infarction of the left cerebellar hemisphere with occlusive hydrocephalus and left to right shift of the fourth ventricle. The patient, a 58 years old man, underwent shunt...

  4. 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

  5. Catheter fracture- A rare complication of Peripherally Inserted Central Catheter (PICC .

    Directory of Open Access Journals (Sweden)

    Yasir Bashir

    2014-09-01

    flexible catheter made of biocompatible material, either silicone or polyurethane, inserted percutaneously into the basilic or cephalic vein in the forearm or the antecubital fossa, often with the help of ultrasound or fluoroscopy guidance. The catheter is then advanced into the central circulation with tip of the catheter most often placed in the superior vena cava or at the caval-atrial junction. Although peripherally inserted central catheters (PICCs offer advantages over traditional central venous approaches, PICC lines are associated with a number of insertion and maintenance problems .We present a case of Acute lymphoblastic leukemia(ALL on modified Berlin Frankfurt and ndash; Munster (BFM protocol with a rare complication of catheter fracture. [Natl J Med Res 2014; 4(3.000: 262-263

  6. Noninvasive measurement of central venous pressure

    Science.gov (United States)

    Webster, J. G.; Mastenbrook, S. M., Jr.

    1972-01-01

    A technique for the noninvasive measurement of CVP in man was developed. The method involves monitoring venous velocity at a point in the periphery with a transcutaneous Doppler ultrasonic velocity meter while the patient performs a forced expiratory maneuver. The idea is the CVP is related to the value of pressure measured at the mouth which just stops the flow in the vein. Two improvements were made over the original procedure. First, the site of venous velocity measurement was shifted from a vein at the antecubital fossa (elbow) to the right external jugular vein in the neck. This allows for sensing more readily events occurring in the central veins. Secondly, and perhaps most significantly, a procedure for obtaining a curve of relative mean venous velocity vs mouth pressure was developed.

  7. Ingested cylindrical batteries in an incarcerated male: a caustic tale!

    Science.gov (United States)

    Dunphy, Louise; Maatouk, Mohamed; Raja, Mazhar; O'Hara, Richard

    2015-01-01

    A 37-year-old incarcerated man presented to the accident and emergency department following the deliberate ingestion of eight cylindrical batteries. He also admitted to inserting a razor blade wrapped in cling-film into his rectum; in addition, he sustained a self-inflicted laceration to his left antecubital fossa, using the metal casing from a battery. His medical history included a borderline and emotionally unstable personality disorder. He had ingested several batteries 12?months previously and required an emergency laparotomy to retrieve them. On the present admission, as there was no clinical evidence of small bowel obstruction, he was treated conservatively with serial radiographs. Following conservative management, the batteries failed to progress through the gastrointestinal tract, hence a laparotomy was performed and all the batteries were extricated. This paper discusses the management and associated sequelae of patients presenting following the intentional ingestion of a battery. PMID:26420691

  8. Subcutaneous Venous Port Implantation in Patients with Bilateral Breast Surgery

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the long-term follow-up results of subcutaneous venous ports implanted in patients with bilateral mastectomies. We retrospectively reviewed the hospital charts and the electronic database of 17 patients with bilateral mastectomies whom had venous port implantation in our interventional radiology suit. A total of 17 ports were implanted to the paramedian (n = 3) and anterolateral (standard; n = 12) chest wall, on the trapezius muscle (n = 1), and to the antecubital fossa (n = 1). The mean age was 48.29 years (range: 35-60 years). The mean time interval from time of surgery to port implantation was 34 months (range: 1-84 months). The mean follow-up time was 15 months (range: 7-39 months). Follow-up parameters and classification of the complications was defined according to the SIR guidelines. No procedure-related complication occurred. A single case of mild late infection was noted and the infection rate was 0.19/1000 catheter days. Infusion chemotherapy administration was still going on in eight patients. Two patients died during the follow-up and four patients were lost after 6 months. Port removal was performed in three patients at follow-up because of the end of treatment. One trapezius port and one paramedian port weres among the removed ports without any problem. Although we have a limited number of patients, port placement to the anterior chest wall, either paramedian or anterolateral, on the trapezius muscle or to the antecubital fossa depending on the extent of the bilateral breast surgeries that can be performed with low complication rates by a careful patient and anatomical location selection by involving the patients in the decision-making process. We believe that patient education and knowledge of possible complications have high importance in follow-up

  9. 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.

  10. Mucocutaneous Leishmaniasis/HIV Coinfection Presented as a Diffuse Desquamative Rash

    OpenAIRE

    da Silva, Guilherme Almeida Rosa; Sugui, Daniel; Nunes, Rafael Fernandes; de Azevedo, Karime; de Azevedo, Marcelo; Marques, Alexandre; Martins, Carlos; Ferry, Fernando Raphael de Almeida

    2014-01-01

    Leishmaniasis is an infectious disease that is endemic in tropical areas and in the Mediterranean. This condition spreads to 98 countries in four continents, surpassing 12 million infected individuals, with 350 million people at risk of infection. This disease is characterized by a wide spectrum of clinical syndromes, caused by protozoa of the genus Leishmania, with various animal reservoirs, such as rodents, dogs, wolves, foxes, and even humans. Transmission occurs through a vector, a sandfl...

  11. 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 ...

  12. Skin rash, headache and abnormal behaviour: unusual presentation of intracranial haemorrhage in dengue fever

    OpenAIRE

    Wani, Abdul Majid; Mejally, Mousa Ali Al; Hussain, Waleed Mohd; Maimani, Wail Al; Hanif, Sadia; Khoujah, Amer Mohd; Siddiqi, Ahmad; Akhtar, Mubeena; Bafaraj, Mazen G; Fareed, Khurram

    2010-01-01

    Dengue viral infections are one of the most important mosquito borne diseases in the world. The dengue virus is a single stranded RNA virus belonging to the Flaviviridae family. There are four serotypes (DEN 1–4) classified according to biological and immunological criteria. Patients may be asymptomatic or their condition may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF), or dengue shock syndrome. Annually, 100 million cases of dengue fever and half a mill...

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

    OpenAIRE

    Raschke RA

    2014-01-01

    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 histo...

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

    OpenAIRE

    Svenson Svante; Knight Stefan; Cederberg Jonas; Melhus HÃ¥kan

    2004-01-01

    Abstract Background The skin contains a system for producing serotonin as well as serotonin receptors. Serotonin can also cause pruritus when injected into the skin. SSRI-drugs increase serotonin concentrations and are known to have pruritus and other dermal side effects. Case presentation A 46-year-old man consulted his doctor due to symptoms of depression. He did not suffer from any allergy but drinking red wine caused vasomotor rhinitis. Antidepressive treatment with fluoxetine 20 mg daily...

  15. Anti-fungal resistance in candida isolated from oral and diaper rash candidiasis in neonates

    Science.gov (United States)

    Mohamadi, Jasem; Motaghi, Mahsa; panahi, Jafar; Havasian, Mohamad Reza; Delpisheh, Ali; Azizian, Mitra; Pakzad, Iraj

    2014-01-01

    The purpose of the present study is to evaluate the sensitivity of Candida species isolated from oral candidiasis and diaper dermatitis infections in children. The children referring to private and public clinics in Ilam, Iran were exmined for oral candidiasis and diaper dermatitis. In this study, 248 oral candidiasis and diaper dermatitis samples were collected and cultured.Candida species were identified by using standard methods. Resistance and sensitivity to amphotericin B, nystatin, ketoconazole, fluconazole, itraconazole, clotrimazole, and posaconazole were determined using the CLSI M44-A standard disk diffusion method. From the 248 studied samples, 149 were positive for Candida, among which the Candida albicans was the most prevalent (64.4%). The resistance of different Candida species to nystatin, itraconazole, fluconazole, ketoconazole, clotrimazole, voriconazole, and posaconazole were 4, 43, 34.2, 34.9, 21.5, 6, and 6.7%, respectively. No resistance to amphotericin B was observed. Considering rather low resistance to nystatin, this drug is the best choice for oral candidiasis and diaper dermatitis. PMID:25512681

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

    OpenAIRE

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

    2015-01-01

    Background. Bilateral reduction mammoplasty is a common plastic surgery procedure that can be complicated by unfavorable scar formation along incision sites. Surgical adhesives can be utilized as an alternative or as an adjunct to conventional suture closures to help achieve good wound tension and provide an adequate barrier with excellent cosmesis. The recently introduced DERMABOND PRINEO Skin Closure System Skin Closure System combines the skin adhesive 2-octyl cyanoacrylate with a self-adh...

  17. Nucleotide sequence of the two rat cellular rasH genes.

    OpenAIRE

    Ruta, M. (Marcello); Wolford, R; Dhar, R.; Defeo-Jones, D; Ellis, R. W.; Scolnick, E.M.

    1986-01-01

    We present the nucleotide sequence of the coding region of the rat c-rasH-1 gene and a partial sequence analysis of the rat c-rasH-2 gene. By comparing these sequences with the Harvey murine sarcoma virus ras gene, we predict that the p21 protein encoded by the Harvey virus differs from the cellular c-rasH-1-encoded p21 at only two amino acids; those at positions 12 and 59. Alterations at each of these positions may play a role in activating the viral p21 protein. The c-rasH-2 gene is likely ...

  18. Pseudoxanthoma Elasticum: A Pediatric Case

    Directory of Open Access Journals (Sweden)

    Melis Çoban

    2015-12-01

    Full Text Available Pseudoxanthoma elasticum (PXE is a multisystemic, metabolic and autosomal recessive inherited disorder affecting especially elastic fibers of skin, retina and blood vessels. The prevalence varies from 1:25,000 to 1:100,000. The average age of onset is 13.5 years. Yellowish papules 1-3 mm in diameter and plaques merging as linear or reticular pattern are mostly on antecubital fossae, popliteal fossae, inguinal region, lower clavicle, neck, axilla, flexural regions as umbilicus and trauma sites. Of the patients, 85% have eye involvement. The first symptom of eye involvement is spot retinal pigmentation. Cardiovascular complications occur usually in adults. The most common and early cardiovascular complication is intermittent claudication. There is no specific treatment for skin signs. Lifestyle changes may have important effects on prognosis. A male patient with 3-year history of yellowish papules on his neck and 1-year history of yellowish papules on his groins, was presented in this case report. This 7-year-old patient received a diagnosis of PXE based on medical story, clinical examination and histopathological findings. This case was presented as PXE is a rare disease and should be diagnosed by the clinician at early ages.

  19. Orientação neuro-radiológica nos processos expansivos da fossa posterior / Neuro-radiologic orientation in the space-occupying processes of Posterior fossa

    Scientific Electronic Library Online (English)

    Sergio, Raupp; Eliseu, Paglioli.

    1964-12-01

    Full Text Available Os autores revêem sua experiência e procuram traçar esquemàticamente sua orientação neuro-radiológica na pesquisa e diagnóstico dos processos expansivos da região cerebelosa. A pneumo e iodoventrículografia, a encefalografía gasosa e a angiografia vértebro-basilar são os exames de escolha, sendo apr [...] esentados casos ilustrativos. A mais exata conclusão anatômica é o que importa; os métodos são secundários. O manejo de tôdas as técnicas é fundamental. Abstract in english The authors review their experience and establish a neuro-radiologic orientation in the investigation and diagnosis of the space-occupying processes of cerebelar region. The methods of choice are the pneumo and iodo-ventriculography, the gaseous encephalography and vertebral-basilar angiography. Ill [...] ustrative cases are presented. The important aspect is the exact anatomical localization, while the methods are secondary. The carrying-out of all the techniques is fundamental.

  20. Angioplasty of communicating veins to the brachial vein in haemodialysis patients with obliterated superficial veins of the upper arm

    International Nuclear Information System (INIS)

    Aim: To evaluate the outcomes of angioplasty of the communicating veins when superficial veins of the upper arm were almost totally obliterated in haemodialysis patients. Materials and methods: Twenty-one angioplasties of the communicating veins that were performed for failing haemodialysis fistulas in patients with almost totally obliterated superficial veins of the upper arm from December 2006 to March 2011 were retrospectively reviewed. Fistulas were of the following types: native radiocephalic fistulas (n = 20) and radio-antecubital fistulas (n = 1). All angioplasties were performed using 5–8 mm conventional balloons. Cutting balloon angioplasty was additionally performed in five patients. The primary, secondary, and target lesion patency rate was calculated using Kaplan–Meier analysis. Results: The communicating vein was located in the antecubital fossa. Technical and clinical success rates were 100% and 95.2%, respectively. Follow-up duration was 1–52 months (mean 20 months). The primary patency rates were 76%, 43%, and 29% at 3, 6, and 12 months, respectively, and target lesion patency rates were 81%, 62%, and 43% at 3, 6, and 12 months, respectively. The secondary patency rates were 81%, 76%, and 57% at 3, 6, and 12 months, respectively. There were no major or minor complications. Conclusion: Angioplasty of the communicating vein is effective in restoring function in failing haemodialysis fistula in patients with obliterated superficial veins of the upper arm. - Highlights: • Lack of patent superficial veins of upper arm is challenging condition for endovascular recanalization in haemodialysis patients. • This paper is to introduce angioplasty technique of communicating veins as an alternative pathway in the setting of totally obliterated superficial veins of upper arms. • The technical and clinical success rate of this technique were 100% and 95.2% and there was no major or minor complication

  1. Successful Treatment of Ulcerative Colitis With Vedolizumab in a Patient With an Infliximab-Associated Psoriasiform Rash.

    Science.gov (United States)

    Hirsch, Ayal; Colman, Ruben J; Lang, Gabriel D; Rubin, David T

    2015-07-01

    Psoriatic skin lesions associated with anti-tumor necrosis factor (TNF) agents are well-described in the medical literature. However, the etiology and optimal management of this condition remain unclear. Vedolizumab is a novel, gut-specific, anti-integrin agent used for the treatment of inflammatory bowel disease (IBD). We report a case of infliximab-associated psoriasiform lesions in an ulcerative colitis patient. Transition to vedolizumab resulted in resolution of the cutaneous lesions without recurrence and remission of his ulcerative colitis. PMID:26203450

  2. VZV multifocal vasculopathy with ischemic optic neuropathy, acute retinal necrosis and temporal artery infection in the absence of zoster rash.

    Science.gov (United States)

    Mathias, Marc; Nagel, Maria A; Khmeleva, Nelly; Boyer, Philip J; Choe, Alexander; Durairaj, Vikram D; Bennett, Jeffrey L; Mandava, Naresh; Gilden, Don

    2013-02-15

    We describe a 54-year-old diabetic woman who developed ischemic optic neuropathy followed by acute retinal necrosis and multiple areas of focal venous beading. Vitreous fluid contained amplifiable VZV DNA but not HSV-1, CMV or toxoplasma DNA. The clinical presentation was remarkable for jaw claudication and intermittent scalp pain, prompting a temporal artery biopsy that was pathologically negative for giant cell arteritis, but notable for VZV antigen. The current case adds to the clinical spectrum of multifocal VZV vasculopathy. The development of acute VZV retinal necrosis after ischemic optic neuropathy supports the notion that vasculitis is an important additional mechanism in the development of VZV retinal injury. PMID:23312850

  3. Unintentional side error for continuous sciatic nerve block at the popliteal fossa.

    Science.gov (United States)

    Al-Nasser, B

    2011-01-01

    Among all fields of healthcare about 45% of medical errors occur in the operating theatre. Wrong site procedures remain one of the most preventable medical errors. Unintentional wrong-sided peripheral nerve block is relatively a rare event in anesthesia care. However, the incidence is unknown but each time wrong-sided block occurs it represents a mistake and a potential for harm. The surgical safety checklist was established in 2008 by the world Health organization (WHO) as a part of the "Safe surgery save Lives" initiative. We report in this article a case of wrong sided continuous popliteal sciatic nerve block and discuss the role of the WHO's checklist in preventing wrong side peripheral nerve block and surgery. PMID:22379761

  4. Radiotherapy of posterior cerebral fossa medulloblastomas: comparison of conformational approaches by photons and protons

    International Nuclear Information System (INIS)

    It exists an indisputable advantage in favour of protons according to the homogeneity, conformity and tissues protection that should manifest by a significant decrease of neurological, cognitive, and endocrinal delayed aftereffects. (N.C.)

  5. Gabapentin for Postoperative Vomiting in Children Requiring Posterior Fossa Tumor Resection.

    Science.gov (United States)

    Tsai, Ko-Chun; Yang, Yung-Li; Fan, Pi-Chuan

    2015-10-01

    Gabapentin is well known for its pain control and antiepileptic effect, but its antiemetic effect is poorly investigated. Here we report on effective gabapentin use for refractory vomiting after craniotomy in two children with medulloblastoma in the fourth ventricle. The two pediatric patients (an 11-year-old girl and a 4-year-old boy) underwent near-total excision of the tumor via craniotomy. Both patients suffered from refractory postoperative nausea and vomiting, treated with multiple traditional antiemetic drugs but without relief. After gabapentin intake, their nausea and vomiting improved from one to two episodes per day to complete resolution of symptoms. This report suggests that gabapentin may be a novel antiemetic therapeutic intervention for patients with refractory nausea and vomiting after craniotomy. PMID:23764481

  6. 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.

  7. The trephine colostomy: a permanent left iliac fossa end colostomy without recourse to laparotomy.

    OpenAIRE

    Senapati, A.; Phillips, R. K.

    1991-01-01

    An operative technique for performing a permanent end sigmoid colostomy without recourse to laparotomy is presented. The results from 16 patients have shown a very low morbidity. The technique was unsuccessful in three patients, each needing a formal laparotomy.

  8. Primary leptomeningeal malignant melanoma in posterior fossa and upper cervical canal: a case report

    International Nuclear Information System (INIS)

    The term 'primary melanocytic neoplasm' covers a wide disease spectrum, from well differentiated meningeal melanocytoma to malignant melanoma, its most aggressive malignant counterpart. Previous reports have shown that due to the paramagnetic effect of melanin, melanocytic neoplasms show high signal intensity on T1-weighted images and very low signal intensity on T2-weighted images, with relatively homogeneous contrast enhancement. The differentiation of leptomeningeal malignant melanoma from benign melanocytoma is important because of their different prognosis but on the basis of imaging findings alone is difficult. Ultrastructural immunohistochemical analysis is a possible alternative. We report the imaging findings of rare primary malignant melanoma, revealed by noncontrast-enhanced CT as a high-density mass, and demonstrating high signal intensity on T1-weighted images, and very low signal intensity on T2WI, with relatively good contrast enhancement

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

    OpenAIRE

    Kamal Kataria; Sushma Sagar; Manish Singhal; Rajni Yadav

    2012-01-01

    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 l...

  10. Cisternal abnormalities produced by clinical tumours in the posterior cranial fossa. II

    International Nuclear Information System (INIS)

    A detailed analysis of the distortion of the subarachnoid cisterns produced by intraventricular tumours of the fourth ventricle was carried out on a clinical material of 30 patients examined with pneumography. The cisternal distortions in cases with a tumour originating from the roof of the ventricle have been compared with those in tumours originating from the floor, and the typical appearances for each group of tumours are recorded. The results should be applicable when analysing cisterns examined not only with pneumography but also with other radiologic methods, such as computer tomography and cisternography with positive contrast media. (Auth.)

  11. 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.

  12. 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.

  13. Pentobarbital Toxicity after Self-Administration of Euthasol Veterinary Euthanasia Medication.

    Science.gov (United States)

    Crellin, Steven Jason; Katz, Kenneth D

    2016-01-01

    Suicide attempt via sodium pentobarbital is uncommon. A 48-year-old woman with a history of depression and prior suicide attempt was found unresponsive by her veterinarian spouse near a syringe containing pink solution. Upon EMS' arrival, the patient was experiencing apnea, hypoxemia, and miotic pupils; her blood glucose level measured 73?mg/dL. She was bradycardic and administered atropine with transient improvement in heart rate and transported to an emergency department; 2?mg of intravenous naloxone was administered without effect. She was endotracheally intubated via rapid sequence intubation. Rapid urine drug screening detected both benzodiazepines and barbiturates. The patient was transferred to an intensive care unit where she demonstrated a nearly absent radial pulse. Emergent fasciotomy to the left forearm and carpal tunnel was performed for acute compartment syndrome; "Euthasol" had been self-administered into the antecubital fossa. Expanded toxicological analysis via liquid chromatography/mass spectroscopy detected caffeine, atropine, 7-aminoclonazepam, phenytoin, citalopram, and naproxen. The patient's coma resolved over 48 hours and she was successfully extubated without complication. Emergency physicians must closely monitor patients exposed to veterinary euthanasia agents who develop central nervous system and respiratory depression, hypothermia, bradycardia, hypotension, or skin injury. Consultation with a regional poison center and medical toxicologist is recommended. PMID:26881149

  14. Clinicopathological Study Of Actinomycotic Mycetomas

    Directory of Open Access Journals (Sweden)

    Sentamilselvi G

    1999-01-01

    Full Text Available Seventeen cases of actinomycotic mycetoma caused by actinomadura madurae, nocardia spp. And A. pelletierii has been described. Actinomadura madurae was the commonest organism (ten detected followed by norcardia spp. (four and A. pelletierii (three. Males were commonly involved. Large soft white grains of A. madurae and small firm red grains of A. pelletierii were consistently seen. Histopathological examination was diagnostic in all the cases showing grains with scalloped margin with pale center and deeply stained periphery with prominent eosinophilic club in A. madurae, deep stained grain with smooth margin and horizontal cracks in A. pelletierii and the pale stained small grain of other norcardia spp. Bone involvement varied from osteolytic to osteosclerotic changes. Actinomadura madurae commonly involved the feet which was by far the commonest site of mycetoma. Combined drug regimens like streptomycin along with cotrimoxazole and amikacin with cotrimaxazole were found to be effective in cases of mycetoma due to A. Pelletierii. Norcardia spp. Responded well to the oral cotrimoxazole given as a monotherapy. The need to start the patient on multi-drug therapy in cases of A. pelletierii and A. madurae especially with bone involvement is stressed. Rare sites like antecubital, popliteal fossae, posterior aspect of trunk, shin and scalp were also involved by actinomycotic species.

  15. Sampling Site Matters When Counting Lymphocyte Subpopulations

    OpenAIRE

    Ogunjimi, Benson; Peeters, Dieter; Hens, Niel; Malfait, Ronald; Van Tendeloo, Viggo; Van Damme, Pierre; Beutels, Philippe; Smits, Evelien

    2012-01-01

    Clinical and scientific work routinely relies on antecubital venipunctures for hematological, immunological or other analyses on blood. This study tested the hypothesis that antecubital veins can be considered to be a good proxy for other sampling sites. Using a hematocytometer and a flow cytometer, we analyzed the cell counts from samples coming from the radial artery, the dorsal hand veins and the antecubital veins from 18 volunteers. Most surprisingly, we identified the greatest difference...

  16. Symptomatic posterior fossa and supratentorial subdural hygromas as a rare complication following foramen magnum decompression for Chiari malformation Type I.

    Science.gov (United States)

    Bahuleyan, Biji; Menon, Girish; Hariharan, Easwer; Sharma, Mridul; Nair, Suresh

    2011-02-01

    Symptomatic subdural hygroma due to foramen magnum decompression for Chiari malformation Type I is extremely rare. The authors present their experience with 2 patients harboring such lesions and discuss treatment issues. They conclude that the possibility of subdural hygromas should be considered in all patients presenting with increased intracranial tension following foramen magnum decompression for Chiari malformation Type I. Immediate neuroimaging and appropriate surgical intervention provides a good outcome. PMID:20849216

  17. Avaliação clínica de vinte e quatro meses do Fluroshield e do Vitremer utilizados como selante de fossas e fissuras

    Directory of Open Access Journals (Sweden)

    VILLELA Lauro Cardoso

    1998-01-01

    Full Text Available Avaliou-se o desempenho de dois materiais utilizados como selante oclusal (Fluroshield e Vitremer. Foram selados 46 pré-molares, superiores e/ou inferiores, sem sinais clínicos de lesões de cárie, sendo que 23 dentes foram selados com Vitremer e 23 com Fluroshield. Após seis, doze e vinte e quatro meses de acompanhamento, observou-se que o Vitremer apresentou uma retenção total de 91,30%, 91,30% e 82,60%, enquanto o Fluroshield apresentou 100% de retenção total nos três intervalos de tempo. Ambos os materiais impediram o desenvolvimento de lesões de cárie, independente de sua retenção e períodos avaliados.

  18. Suggestion for the prostatic fossa clinical target volume in adjuvant or salvage radiotherapy after a radical prostatectomy

    International Nuclear Information System (INIS)

    Background and purpose: To assess the location of recurrent tumors and suggest the optimal target volume in adjuvant or salvage radiotherapy (RT) after a radical prostatectomy (RP). Material and methods: From January 2000 to December 2012, 113 patients had been diagnosed with suspected recurrent prostate cancer by MRI scan and received salvage RT in the Samsung Medical Center. This study assessed the location of the suspected tumor recurrences and used the inferior border of the pubic symphysis as a point of reference. Results: There were 118 suspect tumor recurrences. The most common site of recurrence was the anastomotic site (78.8%), followed by the bladder neck (15.3%) and retrovesical area (5.9%). In the cranial direction, 106 (87.3%) lesions were located within 30 mm of the reference point. In the caudal direction, 12 lesions (10.2%) were located below the reference point. In the transverse plane, 112 lesions (94.9%) were located within 10 mm of the midline. Conclusions: A MRI scan acquired before salvage RT is useful for the localization of recurrent tumors and the delineation of the target volume. We suggest the optimal target volume in adjuvant or salvage RT after RP, which includes 97% of suspected tumor recurrences

  19. Avaliação clínica de vinte e quatro meses do Fluroshield e do Vitremer utilizados como selante de fossas e fissuras

    OpenAIRE

    VILLELA Lauro Cardoso; Fava, Marcelo; VIEIRA Moema Cavalcanti; HAYASHI Paula Massumi; Silvio Issáo MYAKI

    1998-01-01

    Avaliou-se o desempenho de dois materiais utilizados como selante oclusal (Fluroshield e Vitremer). Foram selados 46 pré-molares, superiores e/ou inferiores, sem sinais clínicos de lesões de cárie, sendo que 23 dentes foram selados com Vitremer e 23 com Fluroshield. Após seis, doze e vinte e quatro meses de acompanhamento, observou-se que o Vitremer apresentou uma retenção total de 91,30%, 91,30% e 82,60%, enquanto o Fluroshield apresentou 100% de retenção total nos três intervalos de tempo. ...

  20. Parotid carcinoma and posterior fossa schwannoma following irradiation. Report of a patient treated in infancy for benign ear disease

    International Nuclear Information System (INIS)

    A 23-year-old man had received irradiation for a benign ear problem at the age of 1 year. Twenty years later, a malignant left parotid carcinoma and a right jugular foramen schwannoma developed. Earlier reports in the literature suggest that radiation can induce tumors in the head and neck. The localization of both tumors and the histological features of the parotid tumor suggest that they were radiation-induced

  1. Rupture of a small middle cerebral artery aneurysm into middle fossa arachnoid cyst presenting as a chronic subdural haematoma.

    Science.gov (United States)

    Kocaeli, H; Korfali, E

    2008-04-01

    The rupture of an aneurysm into an arachnoid cyst and subdural space is unusual. A 25-year-old man was admitted 2 weeks after having undergone a burr hole drainage for a chronic subdural haematoma elsewhere. An angiogram revealed a small aneurysm at the bifurcation of the middle cerebral artery. The aneurysm was clipped and the cyst communicated with the basal cisterns. To the best of our knowledge, this is the first report of an association of an aneurysm of the middle cerebral artery with an arachnoid cyst presenting as a chronic subdural haematoma. PMID:18311525

  2. Endovascular treatment of arteriovenous fistula with pseudoaneurysm at popliteal fossa using a PTFE stent-graft: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jeong Yeol; Kim, Dong Hyun; Oh, Hyung Woo; Jang, Jeong Hwan; Oh, Jae Hee; Kim, Young Suk; Byun, Joo Nam; Kim, Young Cheol [Chosun University Hospital, Gwangju (Korea, Republic of)

    2005-07-15

    We report the successful treatment of a postoperative pseudoaneurysm of a popliteal artery, which was associated with an arteriovenous fistula to the popliteal vein using an endovascular placement of a PTFE-covered stent graft. After a one-month follow-up, there was an in-stent stenosis, which was managed by balloon angioplasty. The patient was well with mild leg discomfort after a 3-month follow-up.

  3. Endovascular treatment of arteriovenous fistula with pseudoaneurysm at popliteal fossa using a PTFE stent-graft: a case report

    International Nuclear Information System (INIS)

    We report the successful treatment of a postoperative pseudoaneurysm of a popliteal artery, which was associated with an arteriovenous fistula to the popliteal vein using an endovascular placement of a PTFE-covered stent graft. After a one-month follow-up, there was an in-stent stenosis, which was managed by balloon angioplasty. The patient was well with mild leg discomfort after a 3-month follow-up

  4. 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

  5. Detection of Borrelia lonestari, Putative Agent of Southern Tick-Associated Rash Illness, in White-Tailed Deer (Odocoileus virginianus) from the Southeastern United States

    OpenAIRE

    Moore IV, Victor A.; Varela, Andrea S.; Yabsley, Michael J; Davidson, William R; Little, Susan E.

    2003-01-01

    To determine if white-tailed deer may serve as a reservoir host for Borrelia lonestari, we used a nested PCR for the Borrelia flagellin gene to evaluate blood samples collected from deer from eight southeastern states. Seven of 80 deer (8.7%) from 5 of 17 sites (29.4%) had sequence-confirmed evidence of a B. lonestari flagellin gene by PCR, indicating that deer are infected with B. lonestari or another closely related Borrelia species. Our findings expand the known geographic range of B. lone...

  6. 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.

  7. 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.

  8. 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.

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

    OpenAIRE

    Nakahara T; Moroi Y; Takayama K; Itoh E; Kido-Nakahara M; Nakanishi Y; Furue M

    2015-01-01

    Takeshi Nakahara,1,2 Yoichi Moroi,2 Koichi Takayama,3 Eriko Itoh,1,2 Makiko Kido-Nakahara,2 Yoichi Nakanishi,3 Masutaka Furue2 1Division of Skin Surface Sensing, 2Department of Dermatology, 3Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan Background: It has recently been shown that patients treated with epidermal growth factor receptor (EGFR) inhibitors often develop various cutaneous adverse events. While the pa...

  10. 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.

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

    OpenAIRE

    Keasberry Justin; Frazier Jeremy; Isbel Nicole M; van Eps Carolyn L; Oliver Kimberley; Mudge David W

    2013-01-01

    Abstract Introduction Anti-neutrophil cytoplasmic antibody-associated vasculitis has been associated with many drugs and it is a relatively rare side effect of the antihypertensive drug hydralazine. The diagnosis and management of patients who have anti-neutrophil cytoplasmic antibody-associated vasculitis may be challenging because of its relative infrequency, variability of clinical expression and changing nomenclature. The spectrum of anti-neutrophil cytoplasmic antibody-associated vasculi...

  12. A hospital in Ilkh?nid Iran: toward a socio-economic reconstruction of the Rab‘-i Rash?d?.

    Science.gov (United States)

    Khafipour, Hani

    2012-01-01

    In the first decade of the fourteenth century, Rashid al-D?n Fazl Allah penned a remarkable endowment deed in which he meticulously detailed his plans for the creation of a utopian community. He named it the Rab'-i Rashid. In this document, he provides socio-economic data concerning the day-to-day operations of this settlement unparalleled in comparable texts. This article focuses on the hospital ward of the Rab'-i Rashid, and provides a broader historical context for this medieval hospital and its personnel by examining the financial and monetary information in the endowment deed in order to piece together the inner workings of this community. In so doing, we are granted a rare opportunity to explore the daily lives of ordinary people whose endeavors, however significant, often went unnoticed. PMID:22334946

  13. 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...

  14. 191000 TROCHLEA OF THE HUMERUS, APLASIA OF [OMIM

    Lifescience Database Archive (English)

    Full Text Available FIELD NO 191000 FIELD TI 191000 TROCHLEA OF THE HUMERUS, APLASIA OF FIELD TX Mead and Martin (19 ... orearms in pronation. The humerus was shortened. A web ... of soft tissue stretched across the antecubital sp ... ; Flexed elbows; Pronated forearms; Short humerus; Web bed antecubital space; Hypoplastic/absent biceps br ...

  15. 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

  16. Effects of disturbed blood flow during exercise on endothelial function: a time course analysis.

    Science.gov (United States)

    Paiva, F M; Vianna, L C; Fernandes, I A; Nóbrega, A C; Lima, R M

    2016-01-01

    This study aimed to examine the time course of endothelial function after a single handgrip exercise session combined with blood flow restriction in healthy young men. Nine participants (28±5.8 years) completed a single session of bilateral dynamic handgrip exercise (20 min with 60% of the maximum voluntary contraction). To induce blood flow restriction, a cuff was placed 2 cm below the antecubital fossa in the experimental arm. This cuff was inflated to 80 mmHg before initiation of exercise and maintained through the duration of the protocol. The experimental arm and control arm were randomly selected for all subjects. Brachial artery flow-mediated dilation (FMD) and blood flow velocity profiles were assessed using Doppler ultrasonography before initiation of the exercise, and at 15 and 60 min after its cessation. Blood flow velocity profiles were also assessed during exercise. There was a significant increase in FMD 15 min after exercise in the control arm compared with before exercise (64.09%±16.59%, P=0.001), but there was no change in the experimental arm (-12.48%±12.64%, P=0.252). FMD values at 15 min post-exercise were significantly higher for the control arm in comparison to the experimental arm (P=0.004). FMD returned to near baseline values at 60 min after exercise, with no significant difference between arms (P=0.424). A single handgrip exercise bout provoked an acute increase in FMD 15 min after exercise, returning to near baseline values at 60 min. This response was blunted by the addition of an inflated pneumatic cuff to the exercising arm. PMID:26909789

  17. Effects of disturbed blood flow during exercise on endothelial function: a time course analysis

    Directory of Open Access Journals (Sweden)

    F.M. Paiva

    2016-01-01

    Full Text Available This study aimed to examine the time course of endothelial function after a single handgrip exercise session combined with blood flow restriction in healthy young men. Nine participants (28±5.8 years completed a single session of bilateral dynamic handgrip exercise (20 min with 60% of the maximum voluntary contraction. To induce blood flow restriction, a cuff was placed 2 cm below the antecubital fossa in the experimental arm. This cuff was inflated to 80 mmHg before initiation of exercise and maintained through the duration of the protocol. The experimental arm and control arm were randomly selected for all subjects. Brachial artery flow-mediated dilation (FMD and blood flow velocity profiles were assessed using Doppler ultrasonography before initiation of the exercise, and at 15 and 60 min after its cessation. Blood flow velocity profiles were also assessed during exercise. There was a significant increase in FMD 15 min after exercise in the control arm compared with before exercise (64.09%±16.59%, P=0.001, but there was no change in the experimental arm (-12.48%±12.64%, P=0.252. FMD values at 15 min post-exercise were significantly higher for the control arm in comparison to the experimental arm (P=0.004. FMD returned to near baseline values at 60 min after exercise, with no significant difference between arms (P=0.424. A single handgrip exercise bout provoked an acute increase in FMD 15 min after exercise, returning to near baseline values at 60 min. This response was blunted by the addition of an inflated pneumatic cuff to the exercising arm.

  18. Abnormal Branch of External Iliac Artery in the Iliac Fossa Rama Anormal de la Arteria Ilíaca Externa en la Fosa Ilíaca

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    Satheesha Nayak B

    2008-06-01

    Full Text Available An abnormal artery arising from external iliac artery was found during routine dissection class for medical undergraduates. The artery took its origin from the external iliac artery midway between its origin from common iliac and termination as femoral artery. The abnormal artery divided into two branches; an ascending and a descending. The ascending branch supplied iliacus and iliac crest. The descending branch entered the femoral triangle by passing behind the femoral sheath. It supplied the muscles of femoral triangle and anastomosed with medial circumflex femoral artery. The knowledge of this variation may be of use for surgeons doing surgery of femoral hernia.Una variación arterial proveniente de la arteria ilíaca externa fue encontrada durante una disección de rutina en Medicina de pregrado. La arteria se originaba de la arteria ilíaca externa a mitad de camino entre su origen desde la arteria ilíaca común y su terminación, la arteria femoral. La arteria se dividía en dos ramas: ascendente y descendente. La rama ascendente suministraba la irrigación al músculo ilíaco y a la cresta ilíaca. La rama descendente entraba en el trígono femoral pasando por detrás de la vaina femoral y daba la irrigación a los músculos del trígono femoral, anastomosándose con la arteria circunfleja femoral medial. El conocimiento de esta variación puede ser de utilidad para los cirujanos que realizan cirugía de hernia femoral.

  19. Abnormal Branch of External Iliac Artery in the Iliac Fossa / Rama Anormal de la Arteria Ilíaca Externa en la Fosa Ilíaca

    Scientific Electronic Library Online (English)

    Satheesha, Nayak B.

    2008-06-01

    Full Text Available Una variación arterial proveniente de la arteria ilíaca externa fue encontrada durante una disección de rutina en Medicina de pregrado. La arteria se originaba de la arteria ilíaca externa a mitad de camino entre su origen desde la arteria ilíaca común y su terminación, la arteria femoral. La arteri [...] a se dividía en dos ramas: ascendente y descendente. La rama ascendente suministraba la irrigación al músculo ilíaco y a la cresta ilíaca. La rama descendente entraba en el trígono femoral pasando por detrás de la vaina femoral y daba la irrigación a los músculos del trígono femoral, anastomosándose con la arteria circunfleja femoral medial. El conocimiento de esta variación puede ser de utilidad para los cirujanos que realizan cirugía de hernia femoral. Abstract in english An abnormal artery arising from external iliac artery was found during routine dissection class for medical undergraduates. The artery took its origin from the external iliac artery midway between its origin from common iliac and termination as femoral artery. The abnormal artery divided into two br [...] anches; an ascending and a descending. The ascending branch supplied iliacus and iliac crest. The descending branch entered the femoral triangle by passing behind the femoral sheath. It supplied the muscles of femoral triangle and anastomosed with medial circumflex femoral artery. The knowledge of this variation may be of use for surgeons doing surgery of femoral hernia.

  20. Partial MEF2C deletion in a Cypriot patient with severe intellectual disability and a jugular fossa malformation: review of the literature.

    Science.gov (United States)

    Tanteles, George A; Alexandrou, Angelos; Evangelidou, Paola; Gavatha, Marina; Anastasiadou, Violetta; Sismani, Carolina

    2015-03-01

    Deletions or intragenic mutations involving the MEF2C gene on chromosome 5q14.3 have generally been associated with a relatively uniform phenotype characterized by severe developmental delay, absent speech, stereotypies, absent or limited gait abilities, lack of a typical facial gestalt and scarcity of major malformations. We report on a patient of Cypriot descent with a de novo, approximately 147?kb in size, partial MEF2C deletion removing exons 1 to 3. He had a history of severe intellectual disability with absent speech, poor eye contact, hand stereotypies and a wide-based gait. A broad-based, shallow jugular pit with an overlying vascular malformation was also present. Partial MEF2C deletions have only been reported in a very small number of patients and have on occasion been associated with relatively milder phenotypes. We present a patient of Cypriot descent with such a deletion and review previously published literature on partial MEF2C gene deletions postulating a key role of the first few exons in the pathogenesis of the disease. PMID:25691421

  1. Treatment of a complex posterior fossa aneurysm in a child using side-to-side posterior inferior cerebellar artery-posterior inferior cerebellar artery bypass.

    Science.gov (United States)

    Chandela, Sid; Alzate, Juan; Sen, Chandranath; Song, Joon; Nimi, Yasunari; Berenstein, Alejandro; Langer, David

    2008-01-01

    Endovascular and cerebral bypass therapies are rarely used in children. The authors describe the treatment of a partially coiled giant distal vertebral artery (VA)-posterior inferior cerebellar artery (PICA) aneurysm in a child. They performed a side-to-side PICA-PICA anastomosis followed by endovascular VA aneurysm deconstruction with PICA preservation. A healthy 11-year-old boy developed progressive holocephalic headaches over the course of 2 months. Magnetic resonance imaging and magnetic resonance angiography revealed a large right PICA aneurysm causing brainstem compression. In November 2005, 2 Neuroform stents and Guglielmi detachable coils and Matrix were placed in the aneurysm at an outside institution. In 2006, angiography demonstrated aneurysm enlargement from which the PICA originated, coil compaction, and increased mass effect. The patient underwent a PICA-PICA bypass with intraoperative flow measurements followed by endovascular embolization of the aneurysm and parent VA. An angiogram obtained after the procedure demonstrated filling of the right PICA medullary branch through the bypass and obliteration of the aneurysm. The patient remained neurologically intact. Giant aneurysms of the posterior circulation are rare but do occur in children. With the aid of combined surgical and endovascular strategies the authors were able to safely eliminate the aneurysm from circulation with good outcome. Cerebral bypass and endovascular deconstructive therapies can be used safely in children but should be reserved for cases in which direct treatment carries significant risk. Careful surgical and endovascular planning with intraoperative flow assessment is essential for good outcome. PMID:18352808

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

    OpenAIRE

    Mariano del Sol; Miguel Lagos Mardones; Edison Torres Bustos

    2007-01-01

    Las venas superficiales de la fosa cubital constituyen uno de los sitios más importantes para punción venosa. La disposición de esas venas presenta numerosas variaciones y, la disposición de ellas no ha sido estudiada en el grupo étnico mapuche. Debido a esto, y considerando a este grupo como el mayor conglomerado étnico de América del Sur, efectuamos este estudio. Fueron analizadas las venas superficiales de la fosa cubital, en 300 miembros superiores (150 derechos y 150 izquierdos) de indiv...

  3. Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of E3024, a Novel and Selective Dipeptidyl Peptidase-IV Inhibitor, in Healthy Japanese Male Subjects: Rash Development in Men and Its Possible Mechanism

    OpenAIRE

    Yutaka Takeuchi; Masayuki Namiki; Yasumi Kitahara; Setsuo Hasegawa; Akihiro Ohnishi; Nobuyuki Yasuda; Takashi Inoue; Richard Clark; Kazuto Yamazaki

    2013-01-01

    E3024 (3-but-2-ynyl-5-methyl-2-piperazin-1-yl-3,5-dihydro-4H-imidazo[4,5-d]pyridazin-4-one tosylate) is a dipeptidyl peptidase-IV (DPP-IV) inhibitor that was expected to be an antidiabetic agent. Its safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) were investigated in a randomized, double-blind, placebo-controlled, ascending single-dose study in 48 healthy Japanese male subjects. Fasted subjects were orally administered E3024 (5, 10, 20, 40, or 80...

  4. 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.

  5. 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.

  6. 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.

  7. FDG dose extravasations in PET/CT: frequency and impact on SUV measurements

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    MedhatMOsman

    2011-11-01

    Full Text Available Objectives: PET/CT with 18F-FDG has proven to be effective in detecting and assessing various types of cancers. However, due to cancer and/or its therapy, intravenous (IV FDG injection may be problematic resulting in dose extravasations. In the most frequently used field of view (FOV, arms-up and base of skull to upper-thigh (limited Whole Body (LWB, the injection site may not be routinely imaged. The purpose of this study was to evaluate the frequency of dose extravasations in FDG PET and the potential impact on SUV measurements. Methods: True Whole Body (TWB FDG-PET/CT scans (including all extremities of 400 patients were retrospectively reviewed. A log recorded cases of IV dose extravasations. When possible, SUVs were measured in two frequently used reference locations: mediastinum and liver. The SUVs were obtained in the same patients who had studies with and without FDG extravasations within an average of 3 months without interval therapy. Results: Of the 400 scans, 42 (10.5% had extravasations on the maximum intensity projections (MIP images. In scans with or without dose infiltration, FDG injection site was at or distal to the antecubital fossa in 97% of studies. Of those 42 cases, dose infiltration was within the LWB FOV in 29/42 (69% and outside in the remaining 13/42 (31%. Of those 42 patients, 5 had repeat PET studies with no interval therapy. For those 5 patients, liver maximum SUV was 11.7% less in patients with infiltration than those without (2.22 ± 0.54 vs. 2.48 ± 0.6. Mediastinum SUVmax was 9.3% less in patients with infiltration than those without (1.72 ± 0.54 vs. 1.88 ± 0.49. Conclusion: We conclude dose extravasations were commonly encountered (10.5% in PET/CT. However, it is underreported by at least 31% due to omitting injection site from the FOV. When present, extravasations may lead to underestimation of SUVmax. Therefore, it should not only be avoided but also reported in order to avoid false interpretations of the exam.

  8. Drug-Induced Generalized Skin Eruption in a Diabetes Mellitus Patient Receiving a Dipeptidyl Peptidase-4 Inhibitor Plus Metformin

    OpenAIRE

    Nakatani, Kaori; Kurose, Takeshi; Hyo, Takanori; Watanabe, Koin; Yabe, Daisuke; Kawamoto, Terue; Seino, Yutaka

    2012-01-01

    A generalized skin eruption with strong itching was induced by sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, in a patient almost 6 months after initiation of the drug. Physical examination revealed a spread of skin rash from chest to back, and abdomen and thigh. Discontinuation of the drug eliminated the skin rash immediately. The emergence of new rash ended, and the rash itself withered after 1 week. The spread of the rash gradually shrank and the skin lesions subsided, leaving pi...

  9. 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.

  10. 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, de la IX...

  11. Macrometric and Micrometric Study of Sexual Dimorphism in Foramina of Middle Crania Fossa of Adult Nigerians / Estudio Macrométrico y Micrométrico del Dimorfismo Sexual en Foramina de la Fosa Craneal Media en Nigerianos Adultos

    Scientific Electronic Library Online (English)

    C. N, Orish; B. C, Didia.

    2010-06-01

    Full Text Available Hemos medido el diámetro longitudinal y transversal del canal óptico, agujero redondo, el agujero oval, agujero espinoso, para que sirva como una guía útil para los cirujanos, para mejorar la exactitud de la determinación del sexo del cráneo para estudios antropométricos y médico-legales y para real [...] izar análisis comparativos de valores de la población de Nigeria con los de la raza blanca. Fueron utilizados 100 cráneos adultos secos 81 cráneos masculinos, 19 femeninos de los departamentos de Anatomía de algunas Universidades de Nigeri. Se utilizó un calibrador vernier automático con una precisión de 0,1 mm. Los datos fueron analizados con el gráfico Pad Prism 3.0. Se realizó una comparación de los medios de la dimensión utilizando T de Student y el análisis de la varianza. Los tamaños de los agujeros no fueron significativamente diferentes de la de los caucásicos. Nuestros resultados muestran dimorfismo sexual significativo en los siguientes parámetros, el diámetro transversal del derecho de FR en los hombres resultó ser significativamente diferentes de las hembras con una p Abstract in english We have measured the longitudinal, transverse diameters of optic canal, foramen rotundum, foramen ovale, foramen spinosum, to serve as a handy guideline to surgeons, to enhance the accuracy of sexing the cranium for anthropometric/medico-legal studies and for comparative analyses of values of the Ni [...] gerian population with those of the Caucasians. A total of 100 adult dry skulls 81 male, 19 female from departments of Anatomy of some Nigerian Universities were used. Automatic vernier caliper with a precision of 0.1mm was used. Data analysis was performed with Graph Pad Prism 3.0. A comparison was made of the means of the dimension using Student's T-test and analysis of variance. Sizes of foramina were not significantly different from that of Caucasians Our results show significant sexual dimorphism in the following parameters, the right transverse diameter of the FR in males was found to be significantly different from the females at p

  12. Macrometric and Micrometric Study of Sexual Dimorphism in Foramina of Middle Crania Fossa of Adult Nigerians Estudio Macrométrico y Micrométrico del Dimorfismo Sexual en Foramina de la Fosa Craneal Media en Nigerianos Adultos

    Directory of Open Access Journals (Sweden)

    C. N Orish

    2010-06-01

    Full Text Available We have measured the longitudinal, transverse diameters of optic canal, foramen rotundum, foramen ovale, foramen spinosum, to serve as a handy guideline to surgeons, to enhance the accuracy of sexing the cranium for anthropometric/medico-legal studies and for comparative analyses of values of the Nigerian population with those of the Caucasians. A total of 100 adult dry skulls 81 male, 19 female from departments of Anatomy of some Nigerian Universities were used. Automatic vernier caliper with a precision of 0.1mm was used. Data analysis was performed with Graph Pad Prism 3.0. A comparison was made of the means of the dimension using Student's T-test and analysis of variance. Sizes of foramina were not significantly different from that of Caucasians Our results show significant sexual dimorphism in the following parameters, the right transverse diameter of the FR in males was found to be significantly different from the females at pHemos medido el diámetro longitudinal y transversal del canal óptico, agujero redondo, el agujero oval, agujero espinoso, para que sirva como una guía útil para los cirujanos, para mejorar la exactitud de la determinación del sexo del cráneo para estudios antropométricos y médico-legales y para realizar análisis comparativos de valores de la población de Nigeria con los de la raza blanca. Fueron utilizados 100 cráneos adultos secos 81 cráneos masculinos, 19 femeninos de los departamentos de Anatomía de algunas Universidades de Nigeri. Se utilizó un calibrador vernier automático con una precisión de 0,1 mm. Los datos fueron analizados con el gráfico Pad Prism 3.0. Se realizó una comparación de los medios de la dimensión utilizando T de Student y el análisis de la varianza. Los tamaños de los agujeros no fueron significativamente diferentes de la de los caucásicos. Nuestros resultados muestran dimorfismo sexual significativo en los siguientes parámetros, el diámetro transversal del derecho de FR en los hombres resultó ser significativamente diferentes de las hembras con una p <0,05, hubo una diferencia significativa entre las medias de los lados izquierdo y derecho del foramen oval. La distancia entre la derecha y oval espinoso en hombres y mujeres resultó ser significativamente diferente en ambos sexos. El efecto de lado en el diámetro longitudinal del foramen oval DE de los hombres mostraron una diferencia significativa entre las medias de los lados izquierdo y derecho del foramen oval. Una comparación de la distancia entre el canal izquierdo y agujero redondo óptica mostró una diferencia significativa entre los valores obtenidos para los machos y las hembras de p <0,05.

  13. Radiotherapy of posterior cerebral fossa medulloblastomas: comparison of conformational approaches by photons and protons; Radiotherapie de la fosse cerebrale posterieure des medulloblastomes: comparaison d'approches conformationnelles par photons et par protons

    Energy Technology Data Exchange (ETDEWEB)

    Chaurin, P.; Abdulkarim, B.; Beaudre, A.; Le Pechoux, C.; Biron, B.; Ibrahim, M.; Habrand, J.L. [Institut Gustave Roussy, Dept. de Radiotherapie, 94 - Villejuif (France); Chaurin, P. [Hopital d' Instruction des Armees du Val-de-Grace, Clinique de Radiotherapie et Oncologie, 75 - Paris (France); Hartman, O. [Institut Gustave Roussy, Dept. de Pediatrie, 94 - Villejuif (France); Ferrand, R.; Habrand, J.L. [Paris-11 Univ., Centre de Protontherapie d' Orsay, CPO, 91 - Orsay (France)

    2000-12-01

    It exists an indisputable advantage in favour of protons according to the homogeneity, conformity and tissues protection that should manifest by a significant decrease of neurological, cognitive, and endocrinal delayed aftereffects. (N.C.)

  14. 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.

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