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Sample records for antecubital fossae rash

  1. Antecubital Fossa Solitary Osteochondroma with Associated Bicipitoradial Bursitis

    Colin Ng; Luigi Bibiano; Stephan Grech; Branko Magazinovic

    2015-01-01

    Antecubital fossa lesions are uncommon conditions that present to the orthopaedic clinic. Furthermore, the radius bone is an uncommonly reported location for an osteochondroma, especially when presenting with a concurrent reactive bicipitoradial bursitis. Osteochondromas are a type of developmental lesion rather than a true neoplasm. They constitute up to 15% of all bone tumours and up to 50% of benign bone tumours. They may occur as solitary or multiple lesions. Multiple lesions are usually ...

  2. Antecubital Fossa Solitary Osteochondroma with Associated Bicipitoradial Bursitis

    Colin Ng

    2015-01-01

    Full Text Available Antecubital fossa lesions are uncommon conditions that present to the orthopaedic clinic. Furthermore, the radius bone is an uncommonly reported location for an osteochondroma, especially when presenting with a concurrent reactive bicipitoradial bursitis. Osteochondromas are a type of developmental lesion rather than a true neoplasm. They constitute up to 15% of all bone tumours and up to 50% of benign bone tumours. They may occur as solitary or multiple lesions. Multiple lesions are usually associated with a syndrome known as hereditary multiple exostoses (HME. Malignant transformation is known to occur but is rare. Bicipitoradial bursitis is a condition which can occur as primary or secondary (reactive pathology. In our case, the radius bone osteochondroma caused reactive bicipitoradial bursitis. The differential diagnosis of such antecubital fossa masses is vast but may be narrowed down through a targeted history, stepwise radiological investigations, and histological confirmation. Our aim is to ensure that orthopaedic clinicians keep a wide differential in mind when dealing with antecubital fossa mass lesions.

  3. Right Cardiac Catheterization Using the Antecubital Fossa Vein in Korean Patients

    Lee, Sang Hyun; Chun, Kook Jin; Lee, Dae Sung; Lee, Soo Yong; Hwang, Jongmin; Chon, Min Ku; Hwang, Ki Won; Kim, Jeong Su; Park, Yong Huyn; Kim, June Hong

    2016-01-01

    Background and Objectives Right heart catheterization is traditionally performed using a femoral vein approach that involves admission, bed rest, and risks of bleeding and hematoma. Recent studies have confirmed safety of the use of forearm vein for right cardiac catheterization. In the present study, we evaluated the feasibility of right cardiac catheterization via the antecubital fossa vein in Korean patients. Subjects and Methods The medical records of all patients who underwent right hear...

  4. Diaper Rash

    ... Use a diaper ointment or paste that contains zinc oxide with each diaper change. Seek Medical Care If: the diaper rash doesn't improve after several days pimples, blisters, or open sores appear in the diaper area your baby has diarrhea with fever or appears dehydrated Think Prevention! The ...

  5. First Aid: Rashes

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Rashes KidsHealth > For Parents > First Aid: Rashes Print A A A Text Size Rashes ... For Kids For Parents MORE ON THIS TOPIC First Aid: Skin Infections Poison Ivy Erythema Multiforme Hives (Urticaria) ...

  6. Tantalus Fossae

    2002-01-01

    (Released 25 June 2002) The Science Tantalus Fossae is a set of long valleys on the eastern side of Alba Patera. These valleys are referred to as grabens and are formed by extension of the crust and faulting. When large amounts of pressure or tension are applied to rocks on timescales that are fast enough that the rock cannot respond by deforming, the rock breaks along faults. In the case of a graben, two parallel faults are formed by extension of the crust and the rock in between the faults drops downward into the space created by the extension. Numerous sets of grabens are visible in this THEMIS image, trending from north-northeast to south-southwest. Because the faults defining the graben are formed parallel to the direction of the applied stress, we know that extensional forces were pulling the crust apart in the west-northwest/east-southeast direction. The large number of grabens around Alba Patera is generally believed to be the result of extensional forces associated with the uplift of Alba Patera. Also visible in this image are a series of linearly aligned pits, called a pit chain. The pits are not the result of impact cratering, but are similar to sinkholes on Earth. Sinkholes are typically formed by the removal of rock (commonly limestone) underground by groundwater -- when enough rock is removed, the overlying rock becomes too heavy to be supported, and it collapses, forming a pit. Unlike sinkholes, however, the pit chains near Alba Patera were likely formed when empty underground lava tubes collapsed, accounting for the presence and alignment of many pits. Numerous channel features are also observed in the image, and follow the local topographic slope, which is downhill to the east-southeast. One of these, a long channel in the center of the image, nicely demonstrates the complex relations possible between geologic features. The geologist's rule of superposition says that a feature on top of (superposing) another feature, or cutting across another

  7. Hot Tub Rash (Pseudomonas Folliculitis)

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

  8. Heat Rash or Prickly Heat (Miliaria Rubra)

    ... rash and rashes clinical tools newsletter | contact Share | Heat Rash or Prickly Heat (Miliaria Rubra) Information for adults A A A ... bumps can suddenly occur, as seen here. Overview Heat rash (miliaria rubra), also known as prickly heat, ...

  9. Drug Rash (Unclassified Drug Eruption) in Children

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

  10. Poison ivy - oak - sumac rash

    ... this page: //medlineplus.gov/ency/article/000027.htm Poison ivy - oak - sumac rash To use the sharing features on this page, please enable JavaScript. Poison ivy, oak, and sumac are plants that commonly ...

  11. Rash caused by Oryctes nasicornis.

    Veraldi, Stefano; Fanoni, Daniele; Nazzaro, Gianluca

    2016-02-01

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

  12. Pediatric Patient with a Rash

    Jared Sutton

    2014-07-01

    Full Text Available 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.

  13. Pediatric patient with a rash.

    Sutton, Jared; Walsh, Ryan; Franklin, Jillian

    2014-07-01

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

  14. Pediatric Patient with a Rash

    Sutton, Jared; Walsh, Ryan; Franklin, Jillian

    2014-01-01

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

  15. Butterfly rash with periodontitis: A diagnostic dilemma

    Manvi Aggarwal

    2012-01-01

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

  16. Ron Rash: One Foot in Eden

    Bjerre, Thomas Ærvold

    2010-01-01

    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...

  17. Stereolithography for Posterior Fossa Cranioplasty

    Agner, Celso; Dujovny, Manuel; Evenhouse, Raymond; Fady T. Charbel; Sadler, Lewis

    1998-01-01

    Posterior fossa cranioplasty has been suggested for improvement of neurological symptoms following craniectomy. However, there is no particular recommendation in the literature about techniques for prosthesis manufacture and implantation. We report our experience using rapid prototyping technology and stereolithography for pre-surgical implant design and production of cranioplasties.

  18. Skin rash during treatment with generic itraconazole

    Antonio De Vuono

    2014-01-01

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

  19. Heat Rash or Prickly Heat (Miliaria Rubra)

    ... heat rash consist of controlling heat and humidity. Acetaminophen or ibuprofen can help to reduce fever. Remove ... without any sweat. Your child may complain of dizziness, nausea, weakness, headache, confusion, or difficulty breathing. This ...

  20. Hot Tub Rash (Pseudomonas Dermatitis/Folliculitis)

    ... Español [PDF - 1 page] "Hot Tub Rash" ( Pseudomonas Dermatitis / Folliculitis) If contaminated water comes in contact ... is often caused by infection with the germ Pseudomonas aeruginosa . This germ is common in the environment ( ...

  1. Oxcarbazepine Induced Maculopapular Rash - A Case Report

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

    2015-01-01

    Unlike carbamazepine, newer anti epileptic drug like oxcarbazepine, reports fewer side effects. In this report we describe a case of oxcarbazepine induced maculopapular rash probably happened because of a drug interaction with isoniazid, and a brief review of the existing literature is presented herewith. A 40-year-old male patient received oxcarbazepine 300mg twice daily along with other anti-tubercular drugs including isoniazid (300mg) once daily since two days. Extensive cutaneous rash wit...

  2. Cadaveric study of fossa ovalis

    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.

  3. Posterior Fossa Tumor in Children

    Seyed Mahmoud TABATABAEI

    2012-06-01

    Full Text Available How to Cite this Article: Tabatabaei SM, Seddighi A, Seddighi AS. Posterior Fossa Tumor in Children. Iran. J. Child. Neurol 2012;6(2: 19-24. Objective Primary brain tumors are the most common solid neoplasms of childhood, representing 20% of all pediatric tumors. The best current estimates place the incidence between 2.76 and 4.28/100,000 children per year. Compared with brain tumors in adults, a much higher percentage of pediatric brain tumors arise in the posterior fossa. Infratentorial tumors comprise as many as two thirds of all pediatric brain tumors in some large series. Tumor types that most often occur in the posterior fossa include medulloblastoma, ependymoma, cerebellar astrocytoma and brainstem glioma. Materials & Methods All pediatric cases of posterior fossa tumor that were considered for surgery from 1981 to 2011 were selected and the demographic data including age, gender and tumor characteristics along with the location and pathological diagnosis were recorded. The surgical outcomes were assessed according to pathological diagnosis. Results Our series consisted of 84 patients (52 males, 32 females. Cerebellar symptoms were the most common cause of presentation (80.9% followed by headache (73.8% and vomiting (38.1%. The most common histology was medulloblastoma (42.8% followed by cerebellar astrocytoma (28.6%, ependymoma (14.3%, brainstem glioma (7.2% and miscellaneous pathologies (e.g., dermoid,  andtuberculoma (7.2%. Conclusion The diagnosis of brain tumors in the general pediatric population remains challenging. Most symptomatic children require several visits to a physician before the correct diagnosis is made. These patients are often misdiagnosed for gastrointestinal disorders. Greater understanding of the clinical presentation of these tumors and judicious use of modern neuroimaging techniques should lead to more efficacious therapies.References 1. Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ. Latency between

  4. Side Effects of HIV Medicines: HIV and Rash

    Side Effects of HIV Medicines HIV and Rash (Last updated 1/7/2016; last reviewed 1/7/2016) Key Points A rash is an irritated area of ... requires immediate medical attention. Why do people with HIV develop rash? A rash is an irritated area ...

  5. A progressive pruritic rash with blisters.

    Overcash, Michael D; Ewald, Matt

    2016-05-01

    This article describes a patient with a progressive pruritic rash and fluid-filled blisters. A punch biopsy later confirmed the diagnosis of bullous pemphigoid, an inflammatory condition that most commonly occurs in older adults and is treated with corticosteroids. PMID:27124233

  6. Clonazepam induced maculopapular rash: a case report

    S. Mabu Shareef

    2013-10-01

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

  7. Clonazepam induced maculopapular rash: a case report

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

    2013-01-01

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

  8. Posterior Fossa Tumors and Intellectual Impairment

    J Gordon Millichap

    2005-01-01

    Full Text Available The effect of cerebellar damage on intellectual function in 76 children treated surgically for malignant posterior fossa tumor was investigated at the Gustave Roussy Institute, Villejuif, and the Department of Pediatric Neurosurgery, Necker Hospital, Paris, France.

  9. Computer tomography of posterior cranial fossa

    Sobota, J.; Dutka, J. (Ustredni Vojenska Nemocnice, Prague (Czechoslovakia))

    1982-11-01

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

  10. Computer tomography of posterior cranial fossa

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

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

    Crushell, Ellen

    2012-09-01

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

  12. Leflunomide Induced Drug Rash And Hepatotoxicity

    Uppal Monica

    2004-01-01

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

  13. Arachnoid cyst of the middle cranial fossa

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

  14. Management of a widely disseminated skin rash.

    Gallagher, E

    2001-01-01

    T.J.'s case was interesting from the standpoint of both diagnosis and management. The recommended treatment for this drug reaction was prednisone: however, the use of a steroid in a patient who is neutropenic and has a fever is risky because the because the steroid can mask the symptoms of infection (e.g., fever). Administration of prednisone did help, and the patient experienced a rapid resolution of the skin rash. T.J. will need to avoid the use of these antibiotic agents in the future. Because it is unknown which antibiotic, vancomycin or ceftazidime, caused the allergic reaction, both medicines should be avoided. The decision to rechallenge a patient with a specific drug must be made on an individual basis. Rechallenging of a drug in patients who have had urticarial, bullous, or erythema multiforme-like eruptions can be very dangerous (Padial et al., 2000). Pinpointing the cause of a skin rash can be puzzling. Always ask the patient "Do you take any medicine for any condition (including aspirin, laxatives, vitamins, etc.)? Have you received any shots any shots in the last month?" Keep in mind that any chemical that is ingested can cause a cutaneous drug eruption. PMID:11899630

  15. Radiographic imaging of the canine intercondylar fossa

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

  16. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Glenoid fossa prosthesis. 872.3950 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the...

  17. New concepts on posterior fossa malformations

    Jaspan, Tim [Imaging Centre, University Hospital, Nottingham (United Kingdom)

    2008-06-15

    A full description of the embryology of the posterior fossa (PF) is beyond the scope of this review; several recent publications are recommended. Specific aspects of the processes involved are, however, reviewed as a background to malformations that involve defects or errors occurring at critical stages during the embryogenesis of the PF structures. (orig.)

  18. MORPHOMETRIC ANALYSIS OF GLENOID FOSSA OF SCAPULA

    Sangeeta

    2015-06-01

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

  19. Incidence and risk factors for nevirapine-associated rash.

    Maat, M.M. de; Heine, R. ter; Mulder, J.W.; Meenhorst, P.L.; Mairuhu, A.T.; Gorp, E. van; Huitema, A.D.; Beijnen, J.H.

    2003-01-01

    OBJECTIVE. To determine the incidence of rash in HIV-1 infected individuals starting a nevirapine-containing regimen in an unselected outpatient clinic population. Possible risk factors including plasma concentrations of nevirapine were evaluated for their relationship with the occurrence of a rash.

  20. Adult with morbilliform rash and tattoo bullae.

    Borok, Jenna; Hau, Jennifer; Worswick, Scott

    2016-01-01

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

  1. Not all that rashes is measles:

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

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

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

    2014-01-01

    Background: Diaper rash is one of the most common skin disorders of infancy and childhood. Some studies have shown that Shampoo-clay was effective to treat chronic dermatitis. Then, it is supposed that it may be effective in diaper rash; however, no published studies were found in this regard. Objectives: This study aimed to compare the effects of Shampoo-clay (S.C) and Calendula officinalis (C.O) to improve infantile diaper rash. Patients and Methods: A randomized, double blind, parallel con...

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

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

    2001-01-01

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

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

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

    2015-08-01

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

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

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

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

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

    2004-12-15

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

  7. Posterior fossa involvement in a recurrent gliosarcoma

    Srikant Balasubramaniam

    2012-01-01

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

  8. Acute Spontaneous Posterior Fossa Subdural Hematoma

    Osama Shukir Muhammed Amin

    2014-02-01

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

  9. A STUDY OF POSTERIOR FOSSA MALFORMATIONS: MR IMAGING

    Ravi

    2015-02-01

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

  10. Management of posterior fossa gliomas in children

    K Sridhar

    2011-01-01

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

  11. A systematic approach to posterior fossa malformations

    Full text: Embryology of the cerebellum and classification of posterior fossa malformations: At the 28th-37th gestational day, the thin roof of the hindbrain (future fourth ventricle) is formed by an ependymal membrane coated by pia mater. The plica choroidea, a precursor of the future choroid plexus, divides the roof of the fourth ventricle into the anterior membranous area (AMA) lying cephalad, and the posterior membranous area (PMA) lying caudad. The cerebellum arises from dorsal rhombomere 1 of the anterior hindbrain, in a position along the anterior/posterior axis of the neural tube that is determined by genes expressing in the isthmic organizer at the mid-hindbrain junction, and is also influenced by genetic cues from the roof plate of the adjacent fourth ventricle. Studies in mice have shown that during early embryogenesis, the dorsal rhombomere 1 rotates to establish the mediolaterally-oriented bilateral cerebellar primordial, which are interposed by the AMA. As neurogenesis progresses, the bilateral primordia fuse on the dorsal midline over the fourth ventricle to establish the medial vermis and lateral cerebellar hemispheres, while the intervening AMA progressively involutes until its remnants are incorporated in the choroid plexus. Meanwhile, the PMA shows a transient posterior finger-like expansion, the Blake’s pouch, which extends below the vermis and eventually disappears as the foramen of Magendie opens. Cerebellar neurons are generated from two anatomically and molecularly distinct progenitor zones within the cerebellar primordium: the cerebellar ventricular zone (vZ), and the dorsally located rhombic lip (Rl). Newly differentiating neurons from the vZ, including cerebellar Purkinje cells, are postmitotic, and leave the vZ to migrate radially within the developing cerebellum; instead, cells exiting the Rl migrate over the primordium forming the external granule layer (eGl), where they proliferate and then migrate inward to form the internal

  12. The Measurement of Dispositions to Rash Action in Children

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

    2010-01-01

    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…

  13. Congenital candidiasis presenting as septic shock without rash

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

    2009-01-01

    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. Gallbladder Fossa Abscess Masquerading as Cholecystitis After Cholecystectomy.

    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

  15. Malignant Fibrous Histiocytoma in the Infratemporal Fossa

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

  16. Malignant Fibrous Histiocytoma in the Infratemporal Fossa

    Lee, Kyung Hee; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1999-08-15

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

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

    Chuh AAT

    2015-10-01

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

  18. [Gastroenteritis with fever, headache and rash after travelling in India].

    Hecht, A; Seilmaier, M; Guggemos, W; Löscher, T

    2011-05-01

    A 63-year-old patient presented to our emergency unit two days after returning from India suffering from watery diarrhea, nausea, fever and headache. On admission we found a maculopapular rash on his trunk and forehead. Laboratory findings revealed a leuko-thrombopenia and elevated levels of CRP and procalcitonin. We started treatment with ciprofloxacin. After 48 hours of treatment the diarrhea subsided, whereas the rush on his trunk increased. Under the suspicion of rickettsial fever we started doxycycline 200 mg/d. Because of an incipient pneumonia we added ceftriaxon. The patient improved rapidly and the laboratory abnormalities resolved. Serological investigations revealed a significant increase of specific antibodies against Rickettsia typhi. In conclusion, headache with fever and maculopapular rash after traveling to endemic countries should rise suspicion for murine typhus. PMID:20945058

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

    Freundlich, E; Statter, M; Yatziv, S

    1981-01-01

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

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

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

    2013-01-01

    Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is an adverse reaction commonly occurring with antiepileptic agents. It was earlier referred to by various names such as dilantin hypersensitivity syndrome and anticonvulsant hypersensitivity syndrome. It is characterized by the triad of fever, skin eruption, and systemic involvement. DRESS syndrome has also been reported with a number of other drugs including allopurinol, minocycline, terbinafine, sulfonamides, azathioprine, ...

  1. MRI of the fetal posterior fossa

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

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

    Mupparapu, Mel

    2016-01-01

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

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

    Freundlich, E; Statter, M; Yatziv, S

    1981-02-01

    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 support the possibility of a block in tryptophan degradation. The family history suggests a genetically-determined disorder. PMID:6451201

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

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

    2013-01-01

    Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is an adverse reaction commonly occurring with antiepileptic agents. It was earlier referred to by various names such as dilantin hypersensitivity syndrome and anticonvulsant hypersensitivity syndrome. It is characterized by the triad of fever, skin eruption, and systemic involvement. DRESS syndrome has also been reported with a number of other drugs including allopurinol, minocycline, terbinafine, sulfonamides, azathioprine, dapsone, and antiretroviral agents such as abacavir and nevirapine. We describe a rare case of nevirapine-induced hypersensitivity syndrome that was successfully treated with oral steroids. PMID:24014920

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

    Shaman Gill

    2013-01-01

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

  6. BILATERAL ANOMALOUS MUSCLE IN THE POPLITEAL FOSSA & ITS CLINICAL SIGNIFICANCE

    Sowmya S

    2014-10-01

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

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

    Shahcheraghi, Seyed Hossein; Ayatollahi, Jamshid

    2015-01-01

    Brucellosis is the most widespread zoonotic infection in the world. The disease is endemic in countries bordering the Mediterranean Sea. It is an important re-emerging infectious disease. This disease is closely associated with the evolution of mankind as an agrarian society linked to the practice of shepherding and popularization of animal husbandry. The patients with this disease are typically present with chills, fever, asthenia and sweating. This paper describes a patient with brucellosis and skin rashes on the leg. A 41-year-old man presented with fever, ataxia, and dysarthria. He was a shepherd. The patient reported the loss of appetite, arthralgia and weight loss during previous five months. Finally, he was diagnosed with brucellosis by positive blood culture and high titer for Brucella agglutination test. The clinical manifestation of brucellosis is very broad, ranging from asymptomatic infection to serious debilitating disease. Current patient had skin rashes on his leg. Brucellosis must be considered in the differential diagnosis of acute infections, especially if there is a history of fresh milk product ingestion and living in an endemic region. PMID:26069179

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

    Seyed Hossein Shahcheraghi

    2015-06-01

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

  9. Piriformis Fossa – An Anatomical and Orthopedics Consideration

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

    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.

  10. Emotion-based Dispositions to Rash Action: Positive and Negative Urgency

    Cyders, Melissa A; Smith, Gregory T.

    2008-01-01

    Under heightened emotional states, individuals are more inclined to engage in ill-considered or rash actions than at other times. The authors present evidence for the existence of two related traits called positive and negative urgency. The traits refer to individual differences in the disposition to engage in rash action when experiencing extreme positive and negative affect, respectively. The authors provide evidence that these traits are distinct from other dispositions toward rash action,...

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

    Ghada Al-Janobi; Hisham Alkhalidi; Mohammed A Omair

    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 hel...

  12. STUDY OF POSTERIOR FOSSA TUMORS BY HIGH RESOLUTION MRI

    Sree Hari

    2016-01-01

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

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

    Gerber Peter

    2012-02-01

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

  14. Emotion-Based Dispositions to Rash Action: Positive and Negative Urgency

    Cyders, Melissa A.; Smith, Gregory T.

    2008-01-01

    Under heightened emotional states, individuals are more inclined to engage in ill-considered or rash actions than at other times. The authors present evidence for the existence of 2 related traits called positive and negative urgency. The traits refer to individual differences in the disposition to engage in rash action when experiencing extreme…

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

    Dundon Belinda

    2009-07-01

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

  16. Endovascular treatment of anterior cranial fossa dural arteriovenous fistula

    Lv, Xianli; Li, Youxiang; Wu, Zhongxue [Beijing Neurosurgical Institute, Beijing (China); Capital Medical University, Beijing Tiantan Hospital, Beijing (China)

    2008-05-15

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

  17. Endovascular treatment of anterior cranial fossa dural arteriovenous fistula

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

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

    Tian, Xiaoyan; Luo, Gui; Zhu, Xinhua

    2014-07-01

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

  19. Recurrent ameloblastoma in temporal fossa: A diagnostic dilemma

    Sagar S Vaishampayan; Deepa Nair; Asawari Patil; Pankaj Chaturvedi

    2013-01-01

    Ameloblastoma is a unique, histologically benign but aggressive neoplasm of the jaws, arising from odontogenic epithelium with potency to cause extensive destruction of jaw bones and infiltration into the surrounding tissues. Recurrences are common after incomplete treatment. Recurrences can occur at difficult sites such as temporal and infratemporal fossa, orbit, anterior cranial base, paranasal sinuses etc. Fine needle aspiration cytology or core biopsy of these recurrent lesions may be mis...

  20. Occipital artery occlusion to facilitate transmastoid posterior fossa tumor embolization

    Subhash Kumar; Rohitash Sharma; Sumit Goyal; Shakir Husain

    2011-01-01

    The transmastoid branch of the occipital artery is an important supply to posterior fossa vascular malformations and tumors and is often difficult to catheterize due to tortuosity and a transforaminal course. In very difficult situations, we can try to induce spasm of the occipital artery just beyond the origin of the mastoid branch by repeated passages of the microcatheter/wire. This induces a temporary ‘ligation’ like effect so that the microcatheter can then be manipulated into the mastoid...

  1. Petergopalatine Fossa A Key Area In Rhinocerebral Mucormycosis Extension

    Sadr-Hoseini S M

    2003-11-01

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

  2. Diffusion tensor imaging of midline posterior fossa malformations

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

  3. Rash: the only one clinical manifestation of dengue

    Sarah María Regueira Betancourt

    2015-12-01

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

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

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

  5. Tratamento cirúrgico da cisticircose da fossa craniana posterior

    Pedro Garcia Lopes

    1971-03-01

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

  6. Posterior Fossa Decompression with Duraplasty in Chiari-1 Malformations

    Objective: To evaluate the symptomatic outcome after PFD (Posterior Fossa Decompression) with duraplasty in Chiari-1 malformations. Study Design: Case series. Place and Duration of Study: Department of Neurosurgery, JPMC, Karachi, from July 2008 to September 2012. Methodology: This included 21 patients of Chiari 1 malformations admitted in department through OPD with clinical features of headache, neck pain, numbness, neurological deficit, and syringomyelia. Diagnosis was confirmed by MRI. PFD followed by C1 laminectomy with duraplasty was done in all cases and symptomatic outcome was assessed in follow-up clinic. Results: Among 21 patients, 13 were females and 8 were males. Age ranged from 18 to 40 years. All the patients had neck pain and numbness in hands. Only 3 patients had weakness of all four limbs and 12 with weakness of hands. Symptoms evolved over a mean of 12 months. Syringomyelia was present in all cases. All patients underwent posterior fossa decompression with duraplasty with an additional C1 laminectomy and in 2 cases C2 laminectomy was done. Syringo-subarachnoid shunt was placed in one patient and ventriculo-peritoneal shunt was placed in 2 patients. Pain was relieved in all cases. Weakness was improved in all cases and numbness was improved in 19 cases. Syringomyelia was improved in all cases. Postoperative complications included CSF leak in 2 patients and wound infection in one patient. However, there was no mortality. Conclusion: Posterior fossa decompression with duraplasty is the best treatment option for Chiari-1 malformations because of symptomatic improvement and less chances of complications. (author)

  7. Nuclear magnetic resonance imaging of the posterior fossa disorders

    Ikeda, Toshiaki; Fukaya, Takashi; Nomura, Yasuya; Yoshikawa, Kouki

    1985-03-01

    Nuclear magnetic resonance scans (NMR-CT) were performed on patients with posterior fossa disorders such as acoustic neurinoma, cerebellar tumour (gangliocytoma), epidermoid tumour and spinocerebellar degeneration, and compared with X-ray computed tomography (CT) scans. The advantages of NMR-CT include lack of bone artifact, variety of image planes, transverse, sagital and coronal imaging, and high ability to differentiate tissues. The disadvantages include prolonged data accumulation time, lack of bone detail and calcification, limited spatial resolution and suitability of patients. (author).

  8. Practical approach to prenatal posterior fossa abnormalities using MRI

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

  9. Recurrent ameloblastoma in temporal fossa: A diagnostic dilemma

    Sagar S Vaishampayan

    2013-01-01

    Full Text Available Ameloblastoma is a unique, histologically benign but aggressive neoplasm of the jaws, arising from odontogenic epithelium with potency to cause extensive destruction of jaw bones and infiltration into the surrounding tissues. Recurrences are common after incomplete treatment. Recurrences can occur at difficult sites such as temporal and infratemporal fossa, orbit, anterior cranial base, paranasal sinuses etc. Fine needle aspiration cytology or core biopsy of these recurrent lesions may be misleading. Clinical course and radiological features help immensely in these situations. Good communication between surgeon, radiologist, and pathologist is of paramount importance.

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

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

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

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

    2001-05-01

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

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

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

    1995-02-01

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

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

    Eduardo Cambruzzi

    2011-02-01

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

  14. ECG artefacts mimicking atrial flutter in posterior fossa surgery.

    Rudigwa, Priya; Elakkumanan, Lenin Babu; Rajan, Sakthi P; Prakash, M V Satya

    2015-01-01

    ECG artefacts are defined as abnormalities in the monitored ECG, which result from measurement of cardiac potentials on the body surface and are not related to the electrical activity of the heart. In the operation theatre, the use of various types of electrical equipment may interfere with ECG interpretation. We describe our experience with artefacts resembling atrial fibrillation when a nerve integrity monitoring device was used on a patient undergoing posterior fossa surgery for epidermoid tumour. These artefacts resemble serious arrhythmias and may result in unwanted interventions. To enable better identification of such artefacts, a 12-lead ECG should be considered as it will display rhythm in all the leads; while artefacts will present in only a few leads, true arrhythmia will be present in all the 12 leads. Our case report aims to increase awareness regarding ECG artefacts and to explain how to distinguish them from actual arrhythmias. PMID:26021382

  15. Hematoma extradural da fossa posterior: relato de sete casos

    Mauro A. Oliveira

    1993-06-01

    Full Text Available Hematomas da fossa posterior são complicação incomum de traumatismo cra-nioencefálico. Quase invariavelmente eles ocorrem após traumatismo da região occipital e estão associados com fraturas de crânio. O diagnóstico e tratamento dessa patologia tem sido grandemente favorecido pela tomografia computadorizada. Na presente série, a maioria dos pacientes teve evolução aguda, indicando o risco potencial de um tratamento conservador. Nossos resultados (29% de mortalidade são similares àqueles previamente relatados para outras séries dessas lesões.

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

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

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

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

    2010-06-15

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

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

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

    2014-01-01

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

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

    Wadin, K.; Wilbrand, H.

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

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

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

    2014-01-01

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

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

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

    2014-10-15

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

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

    Prashanth M. Thalanayar

    2015-01-01

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

  3. Nili Fossae in Natural Color and Across the Spectrum

    2007-01-01

    The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) took this image of the Nili Fossae region at 0643 UTC (2:43 a.m. EDT) on June 21, 2007, near 21.15 degrees north latitude, 74.24 degrees east longitude. CRISM's image was taken in 544 colors covering 0.36-3.92 micrometers, and shows features as small as 20 meters (66 feet) across. The region covered is just over 10 kilometers (6.2 miles) wide at its narrowest point, and is one of several dozen that CRISM has taken to map the minerals at candidate landing sites for the Mars Science Laboratory (MSL) mission, which will launch in 2010. The Nili Fossae region is critical to understanding the history of water on Mars and whether water ever formed environments suitable for life, because the region is underlain by a layer of phyllosilicate (clay) minerals. This type of mineralogy formed where water was in contact with Mars' crustal rocks for very long periods, altering the silicates in volcanic rocks. In addition, phyllosilicates can encapsulate and preserve organic chemicals associated with life (if life was present). Its rocky record of an ancient wet environment makes Nili Fossae a top contender among the 30-plus landing sites being considered for MSL, whose objectives include measuring the chemistry preserved in an ancient wet environment. This series of four different versions of the same 544-color image illustrates the mineral-mapping capability that comes from moving beyond the wavelength range of the human eye, and into infrared wavelengths where minerals leave distinct 'fingerprints' in reflected sunlight. At upper left, more than three dozen of the distinct wavelengths measured by CRISM were combined to mimic how the human eye would see the image. The subtle shading comes from the Sun's position high in Mars' sky when the image was taken, creating few shadows. The bland, butterscotch color comes from the dust coating nearly all of the Martian surface to some degree. At upper right, three infrared

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

    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

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

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

    2012-03-01

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

  6. 3DCRT for posterior fossa: Sparing of surrounding organs at risk

    Azza Helal

    2014-12-01

    Conclusion: 3DCRT using parallel opposed fields is recommended for posterior fossa irradiation boost as it minimizes the exit dose to all structures other than the cochlea, however its mean dose was within the tolerance.

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

    Gulsen, Salih; Sonmez, Erkin; Yilmaz, Cem; Altinors, Nur

    2009-01-01

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

  8. Improved Depiction of Pterygopalatine Fossa Anatomy Using Ultrahigh-Resolution Magnetic Resonance Imaging at 7 Tesla

    Oomen, K. P. Q.; Pameijer, F. A.; Zwanenburg, J. J. M.; Hordijk, G J; De Ru, J. A.; Bleys, R L A W

    2012-01-01

    Purpose. To study the anatomy of the pterygopalatine fossa (PPF) using ultrahigh-resolution magnetic resonance imaging. Methods. A human cadaveric tissue block containing the pterygopalatine fossa was examined on a clinical 7-Tesla magnetic resonance imaging system. Subsequently, cryosections of the tissue block were created in a coronal plane. The cryosections were photographed and collected on adhesive tape. The on-tape sections were stained for Mallory-Cason, in order to detail the anatomi...

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

    Devi B

    2000-10-01

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

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

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

    2014-05-01

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

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

    Masahiko Kimura

    2015-12-01

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

  12. Late-onset Rash in Patients with Group A Beta-hemolytic Streptococcal Pharyngitis Treated with Amoxicillin.

    Kimura, Masahiko

    2015-12-01

    We observed late-onset rashes in patients with group A beta-hemolytic streptococcal (GAS) pharyngitis. Of 1028 patients with GAS pharyngitis, which was principally treated with amoxicillin, we evaluated those who developed a late-onset rash and excluded those with scarlet fever alone. Twenty-one patients developed a rash (2.0%, 95% confidence interval, 1.3-3.1%), 7 to 20 days (median, 8 days) after GAS pharyngitis onset. The rashes were characterized by maculopapules, which increased in size with coalescence and some developing into plaques, with a symmetrical distribution with a propensity for the extremities, including the palms and soles. The clinical courses of the patients were good, and the rashes subsided within 14 days. A non-immediate reaction to β-lactams, which usually manifests as a maculopapular rash, is a possible cause in our patients, however, repeated courses of amoxicillin in 3 patients did not induce the rash. The underlying mechanism of the late-onset rash after GAS pharyngitis with amoxicillin treatment remains unclear. PMID:26734124

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

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

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

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

    2008-02-01

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

  15. 3-D simulation of posterior fossa reduction in Chiari I

    Yvens Barbosa Fernandes

    2016-05-01

    Full Text Available ABSTRACT We proposed a 3D model to evaluate the role of platybasia and clivus length in the development of Chiari I (CI. Using a computer aided design software, two DICOM files of a normal CT scan and MR were used to simulate different clivus lengths (CL and also different basal angles (BA. The final posterior fossa volume (PFV was obtained for each variation and the percentage of the volumetric change was acquired with the same method. The initial normal values of CL and BA were 35.65 mm and 112.66º respectively, with a total PFV of 209 ml. Ranging the CL from 34.65 to 29.65 – 24.65 – 19.65, there was a PFV decrease of 0.47% – 1.12% – 1.69%, respectively. Ranging the BA from 122.66º to 127.66º – 142.66º, the PFV decreased 0.69% – 3.23%, respectively. Our model highlights the importance of the basal angle and clivus length to the development of CI.

  16. 3-D simulation of posterior fossa reduction in Chiari I.

    Fernandes, Yvens Barbosa; Perestrelo, Pedro Fábio Mendonça; Noritomi, Pedro Yoshito; Mathias, Roger Neves; Silva, Jorge Vicente Lopes da; Joaquim, Andrei Fernandes

    2016-05-01

    We proposed a 3D model to evaluate the role of platybasia and clivus length in the development of Chiari I (CI). Using a computer aided design software, two DICOM files of a normal CT scan and MR were used to simulate different clivus lengths (CL) and also different basal angles (BA). The final posterior fossa volume (PFV) was obtained for each variation and the percentage of the volumetric change was acquired with the same method. The initial normal values of CL and BA were 35.65 mm and 112.66º respectively, with a total PFV of 209 ml. Ranging the CL from 34.65 to 29.65 - 24.65 - 19.65, there was a PFV decrease of 0.47% - 1.12% - 1.69%, respectively. Ranging the BA from 122.66º to 127.66º - 142.66º, the PFV decreased 0.69% - 3.23%, respectively. Our model highlights the importance of the basal angle and clivus length to the development of CI. PMID:27191237

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

    McCartan, D P

    2012-01-31

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

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

    Mansour Nassir

    2009-09-01

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

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

    Oliveira Maria I

    2002-01-01

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

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

    Maria I Oliveira

    2002-04-01

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

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

    Gómez-González JL

    2012-07-01

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

  2. Association between Rash and a Positive Drug Response Associated with Vinorelbine in a Patient with Primary Peritoneal Carcinoma

    Mustafa M. Mohammad

    2013-01-01

    Full Text Available Vinorelbine (Navelbine, VRL is commonly used for platinum-resistant ovarian cancer and has been shown to be effective in patients with recurrent primary peritoneal carcinoma. Of VRL’s major side effects, skin rash is uncommon, and, if it does occur, it is usually localized to site of injection. In this case report, a 71-year-old Hispanic female with primary peritoneal carcinoma received single agent VRL as fourth-line regimen, which she tolerated very well except for a skin rash related to VRL. The rash continued to progress throughout 6 cycles of VRL, and follow-up CT/PET scan demonstrated complete metabolic and radiological responses. We, therefore, believe that this rash was linked to VRL administration and correlated with response to therapy. Rash has been recognized as a useful surrogate marker with targeted agents such as cetuximab and erlotinib; to the best of our knowledge, this case report describes the first patient with a possible drug rash and its association with a positive outcome. This case report incites interest in further investigation of similar cases to support this observation, since there is a lack of reports of skin rash with VRL therapy.

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

    Ponnusamy Santhamoorthy

    2012-01-01

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

  4. Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery

    Verena Heymanns

    2016-07-01

    Full Text Available Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of the dura in posterior fossa surgery, which reduces significantly the number of CSF leaks (3.8% in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated. The dura closure method was as following: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, TachoSil® (Takeda Pharma A/S, Roskilde, Denmark, Gelfoam® (Pfizer Inc., New York, NY, USA and polymethylmethacrylate (osteoclastic craniotomy. The incidence of postsurgical complications associated with the dural closure like CSF leakage, infections, bleeding is evaluated. Only 3.8% of patients developed CSF leakage and only 0.5% needed a second surgery for CSF leakage closure. Two percent had a cerebellar bleeding with no need for re-operation and 3% had a wound infection treated with antibiotics. The sandwich wound closure we are applying for posterior fossa surgery in our patients correlates with a significant reduction of CSF leaks compared to the literature.

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

    Abdel-Aziz Mosaad

    2012-06-01

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

  6. Is Mandibular Fossa Morphology and Articular Eminence Inclination Associated with Temporomandibular Dysfunction?

    Paknahad, Maryam; Shahidi, Shoaleh; Akhlaghian, Marzieh; Abolvardi, Masoud

    2016-01-01

    Statement of the Problem Finding a significant relationship between temporomandibular joint (TMJ) morphology and the incidence of temporomandibular dysfunction (TMD) may help early prediction and prevention of these problems. Purpose The purpose of the present study was to determine the morphology of mandibular fossa and the articular eminence inclination in patients with TMD and in control group using cone beam computed tomography (CBCT). Materials and Method The CBCT data of bilateral TMJs of 40 patients with TMD and 23 symptom-free cases were evaluated. The articular eminence inclination, as well as the glenoid fossa depth and width of the mandibular fossa were measured. The paired t-test was used to compare these values between two groups. Results The articular eminence inclination and glenoid fossa width and depth were significantly higher in patients with TMD than in the control group (p TMD than in the control group. Glenoid fossa width and depth were higher in patients with TMD than that in the control group. This information may shed light on the relationship between TMJ morphology and the incidence of TMD. PMID:27284559

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

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

    2016-01-01

    Transcatheter arterial chemoembolization (TACE) is a well-recognized procedure for management of hepatocellular carcinoma. We present a 54-year-old man who presented with a periumbilical maculopapular skin rash that developed after an otherwise uneventful TACE procedure. A retrospective review of imaging was consistent with non-target embolization of the hepatic falciform artery (HFA). He was treated with oral non-steroidal antiinflammatory medication for 3 weeks with improvement, but had sli...

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

    Antonio Carlos M. Pereira

    2001-02-01

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

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

    Purpose: To assess the efficacy of a concomitant boost fractionation schedule of radiotherapy for treating patients with squamous carcinoma of the tonsillar fossa. Patients and Methods: Between December 1983 and November 1992, 83 patients with squamous carcinoma of the tonsil were treated with concomitant boost fractionation. The distribution of American Joint Committee on Cancer T stages was TX-4, T1-5, T2-29, T3-41, T4-4; N stages were NX-1, N0-26, N1-13, N2-31, N3-12. Patients were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment consisted of a second daily 1.5 Gy fraction for 10-12 fractions, usually delivered during the final phase of treatment. The tumor dose was 69-72 Gy, given over 6 weeks. Twenty-one patients, who all had N2 or N3 regional disease, underwent neck dissections, either before (13 patients) or 6 weeks after radiotherapy (8 patients); the other patients were treated with radiotherapy alone. Results: The 5-year actuarial disease-specific survival and overall survival rates were 71 and 60%, respectively. Patients with T2 and T3 primary tumors had 5-year actuarial local control rates of 96 and 78%, respectively. Patients with T3 disease who received the final-phase boost had a 5-year actuarial local control rate of 82%. Actuarial 5-year regional disease control rates were N0, 92%; N1, 76%; N2, 89%; and N3, 89%. The 21 patients who had neck dissections all had their disease regionally controlled. Patients presenting with nodal disease or after a node excision who were treated with radiation alone had a 5-year actuarial regional disease control rate of 79%. All but five patients had confluent Grade 4 mucositis during treatment. Severe late complications attributable to radiation included mandibular necrosis, in-field osteosarcoma, and chronic dysphagia for solid foods. Conclusions: High rates of local and regional disease control were achieved with the concomitant boost fractionation schedule, with few cases of severe late

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

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

    2014-01-01

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

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

    Prabhu, Sanjay P.; Zinkus, Timothy [Children' s Hospital Boston and Harvard Medical School, Division of Neuroradiology, Department of Pediatric Radiology, Boston, MA (United States); Cheng, Alan G. [Children' s Hospital Boston and Harvard Medical School, Department of Otolaryngology and Communication Enhancement, Boston, MA (United States); Stanford University School of Medicine, Department of Otolaryngology, Head and Neck Surgery, Stanford, CA (United States); Rahbar, Reza [Children' s Hospital Boston and Harvard Medical School, Department of Otolaryngology and Communication Enhancement, Boston, MA (United States)

    2009-09-15

    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.)

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

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

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

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

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

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

    2007-08-15

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

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

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

    2015-01-01

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

  16. Intraoperative precautionary insertion of external ventricular drainage catheters in posterior fossa tumors presenting with hydrocephalus

    Hosam A.M. Habib

    2014-12-01

    Conclusion: Intra-operative insertion of EVD catheter during surgery of posterior fossa tumors, as it allows better control of the ICT during surgery if needed, provides a life saving emergency CSF drainage outlet if tumor resection fails to resolve HC or for the occurrence of de novo HC, and finally it provides adequate control of CSF leak in cases with supratentorial ventriculomegaly, where the use of lumbar drains may be hazardous. Intraoperative drainage prevents possible complications met with early CSF diversion. But the application of this technique should better be restricted to midline posterior fossa tumors related to the ventricular system.

  17. Assessment of posterior fossa tumors in infants and children by means of computed tomography

    The attenuation profiles before and after contrast enhancement were examined in 18 infants and children with posterior fossa tumors: eight cerebellar astrocytomas, six medulloblastomas, and four brainstem tumors. The astrocytomas, with one exception, had characteristic pattersn, and all could be distinguished from the medulloblastomas, which have a distinct pattern of their own. The brainstem tumors had varying appearances, and were entirely low-attenuating, high-attenuating or had a ring shadow after enhancement. The nature of a postrior fossa tumor in a pediatric can usually be predicted fairly satisfactorily from a computed tomogram. (orig.)

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

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

    2004-08-01

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

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

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

    2012-01-01

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

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

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

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

    Vaidhyanath, R; Thomas, A; MESSIOS, N

    2010-01-01

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

  2. PAEDIATRIC POSTERIOR FOSSA TUMORS: A CLIN ICO - PATHOLOGICAL STUDY I N A TERTIARY CARE HOSPITAL

    Raja Sekhar Kennedy

    2015-09-01

    Full Text Available INTRODUCTION: Tumors of the Central Nervous S ystem , are the second commonest childhood tumors and are the most common solid paediatric tumors comprising 40% - 50% of all tumors . 1 2 Posterior fossa brain tumors are one of the most devastating forms of human illnesses wh ich are more common in children. AIMS AND OBJECTIVES : To study the incidence, clinicopathological features and management of paediatric posterior fossa tumors. MATERIALS AND METHOD S : This is a prospective study done in the Department of Neurosurgery, Ranga raya Medical College, Government General Hospital, Kakinada from 2012 to 2015. It is a Tertiary Care Hospital. A total of 25 paediatric patients ranging from infants to 15 years were included in the study. DISCUSSION AND CONCL USION: Posterior fossa tumors are the commonest solid brain tumors of children with a rate of 2.4 per lakh of children at risk per year. The predominant symptoms are headache and vomiting followed by cerebellar symptoms (gait disturbances. Posterior fossa tumors are predominantly seen in children with peak incidence in first decade. Commonest presenting symptoms are due to raised intracranial pressure with headache and vomiting followed by cerebellar symptoms. Meticulous microsurgical techniques are to be followed in removing these tum ors. The incidence of recurrence is very less after gross total excision. Prognosis is good in patients with total excision

  3. MOLA Topography of Small Volcanoes in Tempe Terra and Ceraunius Fossae, Mars: Implications for Eruptive Styles

    Wong, M. P.; Sakimoto, S. E. H.; Garvin, J. B.

    2001-01-01

    We use Mars Orbiter Laser Altimeter (MOLA) data to measure small volcanoes in the Tempe Terra and Ceraunius Fossae regions of Mars. We find that previous geometry estimates based on imagery alone are inaccurate, but MOLA data support image-based interpretations of eruptive style. Additional information is contained in the original extended abstract.

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

    Alok Umredkar

    2011-01-01

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

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

    Hong-yu XING

    2013-11-01

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

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

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

    2016-06-01

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

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

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

    2016-01-15

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

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

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

  9. Cutaneous Rosai-Dorfman disease presenting as a granulomatous rosacea-like rashs

    SHI Xiu-yan; MA Dong-lai; FANG Kai

    2011-01-01

    A case of cutaneous Rosai-Dorfman disease (CRDD) presenting as a granulomatous rosacea-like rashs was reported. A 45-year-old Chinese woman presented with a 1-month history of a widespread nonpruiginous papulonodular eruption.The rash had begun on her face and rapidly progressed to involve the neck and extremities. She was otherwise healthy,with no history of fever, malaise, or weight loss. Physical examination revealed multiple symmetrically distributed discrete and coalescing red plaques, papules and nodules scattered over the face, neck and extremities. No appreciable lymphadenopathy or hepatosplenomegaly was noted. There was no mucosal involvement. The biopsy specimen obtained from the face demonstrated the epidermis was normal, while the superficial dermis contained sheets of histiocytes with abundant, focally foamy cytoplasm. The histiocytes were surrounded by a patchy lymphocytic and plasma cell infiltrate. There was no significant histiocytic atypia. Some of these histiocytes engulfed, without destroying,lymphocytes and neutrophils (emperipolesis). Immunohistochemical staining revealed that the histiocytes were strongly positive for S100 protein, weakly positive for CD68, and negative for CD1a. A diagnosis of CRDD was made. Oral prednisone therapy was initiated at a dosage of 30 mg/d for 3 weeks and then tapered over the ensuing 2 weeks. After 5weeks of treatment, the lesions had markedly improved.

  10. the temperature dropped to normal When Rash Had appeared For 12 Hours:an atypical Case of Measles in adult

    Chun-ling Liu; Chun-wei Wang; Ying Liu; Ping Zhou; Xiao-juan Li; Hui-yuan Si; Hong-wei Zhang

    2014-01-01

    A twenty-eight-year-old male patient with five-day’s fever (the highest body tempreture reached 39.4℃) and 10-hour’s rash (first on face) presented to the department of emergency for “drug rash”, at that time his temperature was 38.6℃. Two hours later, his temperature fell to normal. Then this patient’s entire body rash increased signiifcantly and lasted for 13 hours. Serum measles antibody IgM(+) conifrmed the measles diagnosis. He had received measles vaccine as a baby. Clinicians should be aware of this atypical clinical manifestation of adult measles. If this kind of patients were misdiagnosed as drug rash and given corticosteroid, measles disease may be aggravated. Speciifc serum measles antibody testing may be the only reliable method for differential diagnosis, but the earliest time point for examining the antibodies of measles still needs precise research.

  11. The extended pterional approach allows excellent results for removal of anterior cranial fossa meningiomas

    Jose Carlos Lynch

    2016-05-01

    Full Text Available ABSTRACT Objective To describe a unique operative strategy, instead the classical pterional approach, and to analyses it safety and effectiveness for removal of anterior cranial fossa meningiomas. Method We identify 38 patients with tuberculum sellae and olphactory groove meningiomas operated between 1986 and 2013. Medical charts, operative reports, imaging studies and clinical follow-up evaluations were reviewed and analyzed retrospectively. The pterional craniotomy is extended toward the frontal bone providing access through the subfrontal route, besides the usual anterolateral view provided by the classical pterional approach. Results Surgical mortality occurred in one patient (2.6%. Gross total resection was achieved in 27 patients (86.8%. Median time of follow-up was 69.4 months. Conclusion The extended pterional approach allows excellent results. Total removal of meningiomas of the anterior cranial fossa was obtained in 86.8 % of patients, with low morbidity and mortality.

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

    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

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

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

    2016-01-01

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

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

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

    2016-02-01

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

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

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

    2011-01-01

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

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

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

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

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

    2014-06-01

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

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

    Budhiraja V; Rastogi R

    2010-01-01

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

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

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

  20. A Modification to the Fascia-Bone-Fascia Technique for Repair of the Middle Fossa Floor

    Copeland, William R.; Driscoll, Colin L. W.; Link, Michael J.

    2012-01-01

    A commonly used method for resurfacing of the middle fossa floor is the fascia-bone-fascia technique. One disadvantage of this technique however is the occasional migration of the bone graft. To prevent this, we have modified the technique to include securing of the graft using simple craniotomy fixation materials. We have now used this method in five patients, all of whom have had satisfactory clinical outcomes. Follow-up imaging has demonstrated the grafts to have remained in their original...

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

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

    2009-01-01

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

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

    Bynke, O

    1985-01-01

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

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

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

    2011-11-15

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

  4. Geologic Mapping of the Medusae Fossae Formation, Mars, and the Northern Lowland Plains, Venus

    Zimbelman, J. R.

    2010-01-01

    This report summarizes the status of mapping projects supported by NASA grant NNX07AP42G, through the Planetary Geology and Geophysics (PGG) program. The PGG grant is focused on 1:2M-scale mapping of portions of the Medusae Fossae Formation (MFF) on Mars. Also described below is the current status of two Venus geologic maps, generated under an earlier PGG mapping grant.

  5. Geologic Mapping of the Medusae Fossae Formation on Mars and the Northern Lowland Plains of Venus

    Zimbelman, J. R.

    2009-01-01

    This report summarizes the status of mapping projects supported by NASA grant NNX07AP42G, through the Planetary Geology and Geophysics (PGG) program. The PGG grant is focused on 1:2M-scale mapping of portions of the Medusae Fossae Formation (MFF) on Mars. Also described below is the current status of two Venus geo-logic maps, generated under an earlier PGG mapping grant.

  6. Case Report: Canine Fossa Abscess; A Rare Etiological Factor: The Lower Canine Tooth

    Agacayak, K. Serkan; Atılgan, S. Serhat; GORGUN, Belgin; Yaman, Ferhan; Ucan, M. Can; Atalay, Yusuf

    2013-01-01

    Odontogenic infection may be dangerous; especially when life-threatening complications occur. Infection spreads through the bone and periosteum toward nearby or more distant structures and spaces. Canine fossa abscess is an odontogenic infection that can lead to life-threatening complications. Successful treatment requires early recognition, determination of etiological factors, and proper medical and surgical management. The aim of this paper is to emphasize different and rare etiological fa...

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

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

    2004-03-01

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

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

    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...

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

    Hai Tao; Zhi-zhong Ma; Hai-Yang Wu; Peng Wang; Cui Han

    2014-01-01

    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 ...

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

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

    2003-06-01

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

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

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

    2009-09-15

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

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

    Buijsrogge, Michiel

    2014-11-01

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

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

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

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

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

    2015-05-01

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

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

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

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

    S Rea

    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.

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

    Kamal Kataria

    2012-05-01

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

  18. Miocene-Pliocene mantle depletion event in the northern Fossa Magna, western NE Japan

    Okamura, Satoshi; Inaba, Mitsuru; Adachi, Yoshiko; Shinjo, Ryuichi

    2016-07-01

    New isotopic and trace element data presented here imply a temporal change in magma sources and thermal conditions beneath the northern Fossa Magna of NE Japan from the Miocene to the Pliocene. Less radiogenic 176Hf/177Hf and 143Nd/144Nd, high Zr/Hf, and little or no Hf anomaly characterize the Early Miocene volcanism in the northern Fossa Magna region. The mantle wedge consisted of chemically heterogeneous mantle source. Based on out isotope proxies, we propose that during the onset of subduction, influx of hot asthenospheric mantle provided sufficient heat to partially melt newly subducting sediment. Geochemical modeling demonstrates that slab-derived melt mixed with mantle wedge produces the observed isotopic and trace elemental characteristics. In the Middle Miocene, the injection of hot and depleted asthenospheric material replaced the mantle beneath the northern Fossa Magna region of NE Japan. This caused the isotopic signature of the rocks to change from enriched to depleted. Then, the mantle wedge was gradually cooled during the Middle Miocene to the Pliocene with back-arc opening ending in the Late Miocene. Slab surface temperatures were still high enough for sediments to melt but not too high (<∼780 °C) to lose zircon as a residual phase. The Late Miocene and Pliocene volcanism at the post stage of the back-arc opening is best explained by a partial melting of subducted metasediment saturated with trace quantities of zircon and rutile.

  19. Miocene-Pliocene mantle depletion event in the northern Fossa Magna, western NE Japan

    Okamura, Satoshi; Inaba, Mitsuru; Adachi, Yoshiko; Shinjo, Ryuichi

    2016-07-01

    New isotopic and trace element data presented here imply a temporal change in magma sources and thermal conditions beneath the northern Fossa Magna of NE Japan from the Miocene to the Pliocene. Less radiogenic 176Hf/177Hf and 143Nd/144Nd, high Zr/Hf, and little or no Hf anomaly characterize the Early Miocene volcanism in the northern Fossa Magna region. The mantle wedge consisted of chemically heterogeneous mantle source. Based on out isotope proxies, we propose that during the onset of subduction, influx of hot asthenospheric mantle provided sufficient heat to partially melt newly subducting sediment. Geochemical modeling demonstrates that slab-derived melt mixed with mantle wedge produces the observed isotopic and trace elemental characteristics. In the Middle Miocene, the injection of hot and depleted asthenospheric material replaced the mantle beneath the northern Fossa Magna region of NE Japan. This caused the isotopic signature of the rocks to change from enriched to depleted. Then, the mantle wedge was gradually cooled during the Middle Miocene to the Pliocene with back-arc opening ending in the Late Miocene. Slab surface temperatures were still high enough for sediments to melt but not too high (explained by a partial melting of subducted metasediment saturated with trace quantities of zircon and rutile.

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

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

    2014-11-07

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

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

    Mohinder Kumar Malhotra

    2012-01-01

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

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

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

    2014-01-01

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

  3. Skin rashes in 87 patients with dengue fever%登革热皮疹87例分析

    杨晴; 夏瑾瑜; 李春娜; 洪仲思; 陈惠丽; 丁立; 游风云

    2009-01-01

    Objective To investigate the apearance and characteristics of skin rashes in patients suffering from dengue fever.Methods Clinical data were retrospectively analyzed for 126 hospitalized patients with dengue fever collected from August to October,2007.Results Out of 126 patients with dengue fever,69.0% (87/126)had skin rashes,which usually developed from day 1 and 11 after fever.About 59.7%(52/87)of these patients developed skin rashes from day 3 to 7 after fever.No eruption order was evidenced in 59(67.8%)patients.Skin rashes were located in both the trunk and limbs in 38(43.7%)patients,and only in the limbs in 30 (34.5%)patients.The incidence rates of maculae,maculopapules,papules.hemorrhagic rash and mixed eruptions were 14.9%(13/87),14.9%(13/87),18.4%(16/87),26.4%(23/87)and 21.8%(19/87),respectively.Conclusions Most patients with dengue fever developed skin rashes from day 3 to 7 after fever.Limbs and trunk are predilection sites of skin rashes in dengue fever.Skin rashes in dengue fever is complex,including maculae,papules,hemorrhagic rashes,vesicles and mixed rashes.%目的 分析登革热皮疹的临床表现及特点.方法 对2007年8-10月本院收治的126例登革热住院患者中伴发皮疹的87例临床资料进行分析.结果 登革热患者69.0%(87/126)出现皮疹,出疹时间在发热后1~11大,59.7%(52/87)于发热后3~7天出疹,67.8%(59/87)出疹无明显顺序.43.7%(38/87)为躯干合并四肢出疹,34.5%(30/87)为四肢出疹.皮疹为斑疹者占14.9%(13/87),斑丘疹占14.9%(13/87),丘疹占18.4%(16/87),各种出血疹占26.4%(23/87),混合皮疹占21.8%(19/87).结论 登革热患者在发热后3~7天出疹;出疹部位以四肢躯干为多;皮疹形态有斑疹、斑丘疹、丘疹、出血疹、疱疹等.

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

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

    1996-11-01

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

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

    Stewien Klaus Eberhard

    2000-01-01

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

  6. An Unrecognized Rash Progressing to Lyme Carditis: Important Features and Recommendations Regarding Lyme Disease.

    Lee, Shawn; Singla, Montish

    2016-01-01

    We present a case report of 46-year-old man with no medical history, who complained of extreme fatigue, near-syncope, and palpitations. He initially presented in complete heart block. A transvenous pacemaker was placed in the emergency department, and he was started empirically on Ceftriaxone for Lyme disease. He was admitted and over the course of the next few days, his rhythm regressed to Mobitz type I first-degree atrioventricular block and then to normal sinus rhythm. This case report highlights some important features regarding Lyme carditis, a rare presentation of early disseminated Lyme disease (seen in a few weeks to months after the initial tick bite). In 25%-30% of patients, the characteristic targetoid rash may not be seen, a likely culprit of the disease not being detected early and progressing to disseminated disease. The most common cardiac complaint of Lyme disease is palpitations, occurring in 6.6% of patients, which may not accurately reflect progression into disseminated Lyme disease because it is a nonspecific finding. Conduction abnormality, occurring in 1.8% of patients, is a more specific finding of Borrelia invading cardiac tissue. Finally, this case report highlights a recommendation that patients with confirmed Lyme disease or those presenting with cardiac abnormalities or symptoms who have an atypical profile for a cardiac event should be screened with a 12-lead electrocardiogram, Lyme serology, and be considered for antibiotic therapy with the possibility of temporary pacing. PMID:25730155

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

    Stig A Walsh

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

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

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

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

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

  10. ModFossa: A library for modeling ion channels using Python.

    Ferneyhough, Gareth B; Thibealut, Corey M; Dascalu, Sergiu M; Harris, Frederick C

    2016-06-01

    The creation and simulation of ion channel models using continuous-time Markov processes is a powerful and well-used tool in the field of electrophysiology and ion channel research. While several software packages exist for the purpose of ion channel modeling, most are GUI based, and none are available as a Python library. In an attempt to provide an easy-to-use, yet powerful Markov model-based ion channel simulator, we have developed ModFossa, a Python library supporting easy model creation and stimulus definition, complete with a fast numerical solver, and attractive vector graphics plotting. PMID:26932271

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

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

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

    Kevin Reinard

    2014-01-01

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

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

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

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

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

    2015-05-01

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

  15. The histologic changes of the olecranon fossa membrane in primary osteoarthritis of the elbow.

    Suvarna, S Kim; Stanley, David

    2004-01-01

    Eight randomly selected patients undergoing the Outerbridge-Kashiwagi (ulnohumeral arthroplasty) debridement procedure for primary osteoarthritis of the elbow had fenestration of the olecranon fossa by use of a bone trephine. The cores of bone removed were compared histologically with age- and sex-matched controls derived from necropsy samples with no history of osteoarthritis. All components of the olecranon fossa membrane (anterior cortical bone, medullary cavity, posterior cortical bone, and anterior and posterior fibrous tissue) were noted to be of increased thickness in those patients with osteoarthritis of the elbow when compared with the control group. With the exception of the anterior surface fibrous tissue, these differences were of statistical significance by use of the Wilcoxon signed rank test (anterior cortical bone, P =.01; medullary cavity, P =.01; posterior cortical bone, P =.02; and posterior surface fibrous tissue, P =.01). Bone volume was also measured in the two groups and was statistically greater in the patients with osteoarthritis compared with the control group (P =.01). PMID:15383814

  16. Right iliac fossa abscess as first manifestation of perforated adenocarcinoma of sigmoid: a rare case report

    Mohammad Hossein Hajisadeghizadeh; Hamid Reza Soltani. G; Seyed Mohammad Reza Mortazavizadeh; Fatemeh Akhiri A

    2012-01-01

    Colorectal cancer usually present with known symptoms while there are less common manifestation including abscess formation which can be intra or extra peritoneal. A 60-year-old Caucasian male with a history of RLQ abdominal pain, nausea, vomiting and anorexia from 15 days ago referred to surgery ward. Ultrasound showed a hypoachoic lesion with diameters 50 mm × 70 mm in RLQ of abdomen and a round echogenic area in right lobe of liver with diameter 15 mm. The findings were revealed an abscess located in right iliac fossa then local drainage of abscess was performed. Four days later the patient was re-admitted because of severe abdominal distention and lack of bowel movement. Laparoscopy was performed before proceeding with further examinations, due to the poor general condition of the patient. The sigmoid was adherent into the abdominal wall and mild intestinal loop distention and apple-core view was observed during operation. Can-cer of sigmoid complicated by a right iliac fossa abscess was diagnosed and Hartman colestomy was undertaken. At the last follow-up examination 3 months after operation, the patient was in good health with no clinical evidence of recurrence.

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

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

    2015-10-01

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

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

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

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

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

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

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

    2015-09-15

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

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

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

  2. Extranodal Rosai-Dorfman Disease involving paranasal sinuses, orbits and anterior cranial fossa

    Sudhansu Sekhar Mishra

    2014-01-01

    Full Text Available Rosai-Dorfman disease (RDD is a rare, benign pseudolymphatous condition, predominantly involving lymph nodes. Although several cases of extra-nodal involvement have been reported previously, central nervous system involvement, particularly in the absence of nodal disease is extremely rare. Extranodal large RDD presenting as a single lesion involving sino-orbital and anterior cranial fossa has rarely been described previously. We report a case of incisional biopsy proved RDD in a young lady who presented with nasal obstruction and subsequent proptosis with visual diminution. Radiography of head and paranasal sinus demonstrated a strongly enhanced, diffuse polypoid lesion filling the bilateral sinonasal cavity and orbit with extension to the anterior cranial fossa by way of splaying the bony foramina. Pre-operative low dose steroid therapy had resulted in decreased size of the mass which facilitate gross-total surgical resection. RDD was confirmed by histopathology (emperipolesis and immuno-histochemistry (S-100 positivity. The follow-up computed tomography 3 months later showed minimal tumor residue in left parasellar region with complete sinonasal decompression.

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

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

  4. Etiology of maculopapular rash in measles and rubella suspected patients from Belarus.

    Marina A Yermalovich

    Full Text Available As a result of successful implementation of the measles/rubella elimination program, the etiology of more and more double negative cases remains elusive. The present study determined the role of different viruses as causative agents in measles or rubella suspected cases in Belarus. A total of 856 sera sent to the WHO National Laboratory between 2009 and 2011 were tested for specific IgM antibodies to measles virus (MV, rubella virus (RV and human parvovirus B19 (B19V. The negatives were further investigated for antibodies to enterovirus (EV and adenovirus (AdV. Children of up to 3 years were tested for IgM antibodies to human herpesvirus 6 (HHV6. A viral etiology was identified in 451 (52.7% cases, with 6.1% of the samples being positive for MV; 2.6% for RV; 26.2% for B19V; 9.7% for EV; 4.6% for AdV; and 3.6% for HHV6. Almost all measles and rubella cases occurred during limited outbreaks in 2011 and nearly all patients were at least 15 years old. B19V, EV and AdV infections were prevalent both in children and adults and were found throughout the 3 years. B19V occurred mainly in 3-10 years old children and 20-29 years old adults. EV infection was most common in children up to 6 years of age and AdV was confirmed mainly in 3-6 years old children. HHV6 infection was mostly detected in 6-11 months old infants. Laboratory investigation of measles/rubella suspected cases also for B19V, EV, AdV and HHV6 allows diagnosing more than half of all cases, thus strengthening rash/fever disease surveillance in Belarus.

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

    Svenson Svante

    2004-11-01

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

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

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

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

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

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

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

  9. Soft tissue injury related to choice of entry point in antegrade femoral nailing : piriform fossa or greater trochanter tip

    Moein, CMA; Verhofstad, MHJ; Bleys, RLAW; van der Werken, C

    2005-01-01

    Intramedullary nailing through the piriform fossa results in some cases in toss of abduction strength and persistent pain. Nail insertion at the tip of the greater trochanter may be favourable. The aim of this study was to assess (possible) iatrogenic injury to the abductor and external rotator musc

  10. Osteonecrosis of hyoid bone and thyroid cartilage. [Following /sup 60/Co therapy of carcinoma of the pyriform fossa

    Bhatia, P.L.; Dutta, N.K.; Sanasam, J.C.

    1979-09-01

    A 55-year-old man with carcinoma of the right pyriform fossa was treated with cobalt therapy. Subsequently, osteonecrosis of the right greater horn and the right superior horn of the thyroid cartilage developed, followed by pathologic fractures of the processes and spontaneous expulsion of the sequestrae.

  11. Technical review of target volume delineation on the posterior fossa tumor: an optimal head and neck position

    Yoon, Sang Min; Lee, Sang Wook; Ahn, Seung Do; Kim, Jong Hoon; Yi, Byong Yong; Ra, Young Shin; Ghim, Thad; Choi, Eun Kyung [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    2003-03-01

    To explore a 3D conformal radiotherapy technique for a posterior fossa boost, and the potential advantages of a prone position for such radiotherapy, A CT simulator and 3D conformal radiotherapy planning system was used for the posterior fossa boost treatment of a 13-year-old medulloblastoma patient. He was placed in the prone position and immobilized with an aquaplast mask and immobilization mold. CT scans were obtained of the brain from the top of the skull to the lower neck, with IV contrast enhancement. The target volume and normal structures were delineated on each slice, with treatment planning performed using non-coplanar conformal beams. The CT scans, and treatment in the prone position, were performed successfully. In the prone position, the definition of the target volume was made easier due to the well enhanced tentorium. In addition, the posterior fossa was located anteriorly, and with the greater choice of beam arrangements, more accurate treatment planning was possible as the primary beams were not obstructed by the treatment table. A posterior fossa boost, in the prone position, is feasible in cooperating patients, but further evaluation is needed to define the optimal and most comfortable treatment positions.

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

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

    2011-01-01

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

  13. Mapping of Sand Types and Dune Morphologies in the Aeolis Dorsa Region, Western Medusae Fossae Formation, Mars

    Boyd, A. S.; Burr, D. M.

    2016-06-01

    Preliminary mapping of low- and high-albedo sand deposits in the Aeolis Dorsa region, Medusae Fossae Formation (MFF), suggests sand transport from the north, consistent with sand source(s) in Elysium Mons, the Cerberus plains, or the MFF itself.

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

    Vijay P Joshi

    2013-01-01

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

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

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

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

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

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

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

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

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

    2013-12-15

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

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

    Duo Chen; Xiangtai Wei; Qiang Yin; Junhong Guan; Weiran Pan; Chenglin Wang; Yunhui Liu

    2009-01-01

    OBIECTIVE To analyze and discuss about the clinical characteristics,pathological types,surgical modalities and techniques,and postoperative complications in children with tumor of posterior cranial fossa.METHODS Retrospective study was conducted on 102 cases of pediatric tumor of posterior cranial fossa,admitted and treated in our hospital during the period of January 1996 to January 2007.All patients underwent microscopic surgical treatment.Fiftyeight were male and 44 cases were female.The age ranged from 9months to 14 years old,with an average of 6.1±0.5 of age.Cranial CT or MRI examination was conducted before and after the surgery on all patients.RESULTS The primary manifestations for this group of patients were increased intracranial pressure and/or ataxia.Postoperative pathological diagnoses showed:46 cases of medulloblastoma,43cases of astrocytoma,11 cases of ependymoma(including 1 case of degenerative ependymoma),1 case of dermoid cvst,and 1 case of teratoma.In this group of the patients,radical surgery was used in 68 cases and subtotal surgical removal used in 31 cases,while surgical removal of large Section was performed on 3 cases.There were no deaths from surgery reported.Ninety-one cases showed significant symptomatic improvement when compared with preoperative conditions,while 11 cases showed either no improvement or more severely affected afterward.For 6 cases,postoperative ventriculoperitoneal shunt was performed within 7 days to 2 months after the surgery.Sixty-three patients gained follow-up for 3 to 60 months in duration.Thirty-nine patients regained normal life and were able to learn well,while there were 7 patients who could not live normally on their own.During the follow-up period,there were 17 cases of recurrence and 7 cases of death.In 23 cases of medulloblastoma in children with age of 3 Years old or above,2 cases who underwent surgical removal of intracranial ependymoma received small dosage of postoperative X-ray radiotherapy on the the

  20. Comparative Study on Two Surgical Procedures for Middle Cranial Fossa Arachnoid Cysts

    Liang ZENG; Li FENG; Jun WANG; Jun LI; Yuping WANG; Jincao CHEN; Jian CHEN; Ting LEI; Ling LI

    2008-01-01

    In this study, we explored the operation options for middle cranial fossa arachnoid cysts(MCFAC). One hundred and forty-nine patients who were operated for a symptomatic MCFAC between 1993 and 2006 in our hosptial were analyzed. Follow-up time ranged from 1 y to 14 y(mean=5.4 y). All these patients were divided into three subgroups according to Galassi classification.Long-term outcome and complications were studied respectively. Fenestration (F) resulted in a more favorable long-term outcome and less complication for cysts of types Ⅰ and Ⅱ, whereas a favorable outcome was noted in type Ⅲ patients who underwent cysto-peritoneal shunting (S). We are led to conclude that Fenestration is suitable for cysts of types Ⅰ and Ⅱ (Galassi classification),cysto-peritoneal shunting is better for cysts of type Ⅲ.

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

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

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

    Hai Tao

    2014-01-01

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

  3. A 14-year paraneoplastic rash: urticarial vasculitis and dermal binding bullous pemphigoid secondary to chronic lymphocytic leukaemia.

    Kassim, J M; Igali, L; Levell, N J

    2015-06-01

    A 72-year-old woman with a 14-year history of urticarial vasculitis (UV) and a 13-year history of bullous pemphigoid (BP) presented with associated progressive chronic lymphocytic leukaemia (CLL). Both skin conditions responded poorly to treatment, until chemotherapy for CLL was commenced. The skin features showed a clear paraneoplastic course, resolving with chemotherapy and recurring when the CLL relapsed and the lymphocyte count rose above 5 × 10(9)/L. No case of UV secondary to CLL, and very few cases of BP related to CLL have been reported, and no paraneoplastic rash of any type lasting 14 years has been reported previously. PMID:25524180

  4. Neisseria lactamica Causing a Lung Cavity and Skin Rash in a Renal Transplant Patient: First Report from India

    Khalid Hamid Changal

    2016-01-01

    Full Text Available Neisseria lactamica, a commensal, has been very rarely reported to cause diseases in immunocompromised hosts. In medical literature, there is only one report of a cavitatory lung lesion caused by it. The patient was a kidney transplant recipient. Neisseria lactamica was found to be the cause of his pulmonary cavity and a desquamating rash on feet. With the rapidly spreading medical advance, more and more patients are getting organ transplants, so the population of immunocompromised people is on the rise. We expect more sinister and less expected organisms to cause diseases in patients who have organ transplants.

  5. Anatomical character of pterygopalatine fossa and advancement of related technique%翼腭窝的解剖学特点及其相关技术进展

    李鹏

    2012-01-01

    翼腭窝是位于眶尖后下方、颞下窝内侧的一个狭小骨性间隙,窝内有丰富的血管、重要的神经等结构通过,众多起源于口鼻腔、眶内、颅中窝、颞下窝和鼻旁窦的病变均可累及此窝.本文总结了近年来翼腭窝的解剖学及其相关临床诊疗技术的研究进展.%Pterygopalatine fossa is a narrow rift, posteroinferior to orbital apex and interior to infratemporal fossa. There are many important blood vessels and nerve tissues passed through the pterygopalatine fossa. Many diseases from oral and nasal cavity, orbital cavity, middle cranial fossa, infratemporal fossa and paranasal sinuses can involve pterygopalatine fossa. This article summaried the anatomical characters of pterygopalatine fossa and research advancements of related technique for diagnosis and treatment.

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

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

    2010-01-01

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

  7. Generalized skin rash due to zoledronic acid%唑来膦酸致全身皮疹

    刘剑锋; 冯巧飞

    2012-01-01

    1例57岁女性患者因重度骨质疏松症给予碳酸钙和骨化三醇口服,1周后,给予唑来膦酸5 mg溶于0 9%氯化钠注射液100 ml静脉滴注.第2天,患者出现发热、全身皮疹,头晕、乏力、关节疼痛及双下肢肌肉酸痛.立即给予地塞米松、氯雷他定.第7天,患者头晕、乏力、关节疼痛及双下肢肌肉酸痛等症状消失,体温降至正常.第10天皮疹完全消退.%A 57-year- old woman received oral calcium carbonate and calcitriol for severe osteoporosis. One week later, an IV infusion of zoledronic acid 5 mg dissolved in 0. 9% sodium chloride solution 100 ml was given. On day 2, she developed fever, generalized skin rash, dizziness, asthenia, as well as joint pain and muscle aches in her lower limbs. She was given dexamethasone and loratadine immediately. On day 7, her clinical symptoms such as dizziness, asthenia, as well as joint pain and muscle aches in her lower limbs disappeared, and her body temperature returned to normal. On day 10, her skin rash completely disappeared.

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

    Nakahara T

    2015-01-01

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

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

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

    1992-01-01

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

  10. Two alternative dural sealing techniques in posterior fossa surgery: (Polylactide-co-glycolide) self-adhesive resorbable membrane versus polyethylene glycol hydrogel

    Marco Schiariti; Francesco Acerbi; Morgan Broggi; Giovanni Tringali; Alberto Raggi; Giovanni Broggi; Paolo Ferroli

    2014-01-01

    Background: Post-operative cerebrospinal fluid (CSF) leak in posterior fossa surgery remains a significant source of morbidity. TissuePatchDural (TPD), a novel impermeable adhesive membrane, was used to reinforce dural closure. A comparison with one of the most commonly used dural sealing devices, DuraSeal, has been made. Methods: A retrospective, single-center study was conducted on 161 patients who underwent elective posterior fossa surgery. On surgeon′s opinion, when a primary watertig...

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

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

    2014-01-01

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

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

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

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

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

  14. Cytological diagnosis of bancroftian filariasis presented as a subcutaneous swelling in the cubital fossa: an unusual presentation

    Pandey, Pinki; Dixit, Alok; Chandra, Subrat; Tanwar, Aparna

    2015-01-01

    Filariasis is a disabling parasitic disease and the prevalence of lymphatic filariasis caused by Wuchereria bancrofti is quite high in India. However, W. bancrofti presenting as a subcutaneous swelling and a demonstration of microfilariae in cytological smears from upper extremity lesions is extremely rare. We report a case of 20-year-old male who presented with a small subcutaneous swelling near medial aspect of the left cubital fossa. The wet mount preparation showed many motile microfilari...

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

    Zarina Abdul Assis

    2015-01-01

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

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

    André Luis Selmi

    2012-01-01

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

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

    Elnaz Faraji rad

    2015-01-01

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

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

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

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

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

  20. Indirect computerized tomography sign of chronic subdural hematoma demonstrated in the posterior fossa

    Machi, Takao; Fukui, Masashi; Maeyama, Ryutaro; Takaki, Tosuke; Yoshiura, Shogo; Kamoi, Itsuma

    1985-03-01

    In cases of chronic subdural hematoma (CSH), brain computerized tomography (CT) scans frequently disclose a low density band in the posterior fossa (LDBP) between the lateral margin of the cerebellum and the adjacent petrous bone/tentorium cerebelli. Out of 121 cases of CSH, 56 (46%) showed the LDBP. The LDBP was mostly ipsilateral to the side of the CSH or bilateral. The frequency of the LDBP had no correlation with the severity of the cerebral midline shift or the thickness of the hematoma. As normal controls, CT scans of 257 cases in which no organic lesions were detected were used. Also 30 cases with dementing diseases, 2 cases with spinocerebellar degeneration and 428 cases of other neurological diseases such as head trauma other than CSH, brain tumor, cerebrovascular disease etc. were studied as disease controls. The incidence of the LDBP in both controls was significantly lower than in CSH. Therefore, the LDBP in cases of CSH was considered to be a significant associated finding of CT scans. The mechanism of the LDBP is discussed.

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

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

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

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

    1997-08-01

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

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

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

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

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

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

    Yavetz, Dalia, E-mail: dalia.yavetz@gmail.com [Institute of Radiotherapy, Tel Aviv (Israel); Corn, Benjamin W.; Matceyevsky, Diana; Ben-Josef, Rahamim; Soyfer, Viacheslav [Institute of Radiotherapy, Tel Aviv (Israel); Bershtein, Igal [Diagnostic Imaging, Tel Aviv Medical Center, Tel Aviv (Israel); Inbar, Moshe; Ron, Ilan [Department of Medical Oncology, Tel Aviv (Israel); Jiveliouk, Irena [Institute of Radiotherapy, Tel Aviv (Israel); Department of Medical Oncology, Tel Aviv (Israel); Diagnostic Imaging, Tel Aviv Medical Center, Tel Aviv (Israel); Schifter, Dan [Institute of Radiotherapy, Tel Aviv (Israel)

    2011-01-01

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

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

    MR Etemadifar

    2005-05-01

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

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

    Lirng, J.F.; Fuh, J.L.; Chen, Y.Y.; Wang, S.J. [Taipei Veterans General Hospital, Taiwan (China). Dept. of Radiology and Neurological Inst.

    2005-11-01

    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.

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

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

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

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

    2016-01-01

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

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

    Jahanguiri B

    1994-04-01

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

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

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

    2015-04-01

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

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

    Yu-Tzu Tseng

    2014-12-01

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

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

    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.)

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

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

    2009-07-15

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

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

    Yoshida, Y.; Weon, Y.C.; Sachet, M.; Mahadevan, J.; Alvarez, H.; Rodesch, G.; Lasjaunias, P. [Service de Neuroradiologie Diagnostique et Therapeutique, CHU de Bicetre, 78 rue du General Leclerc, 94275, Le Kremlin Bicetre (France)

    2004-06-01

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

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

    Madhushankar

    2013-11-01

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

  17. [Rash and fever illness caused by herpes simplex virus type 1 needs to be distinguished from hand, foot and mouth disease].

    Zhu, Shuang-Li; Liu, Jian-Feng; Sun, Qiang; Li, Jing; Li, Xiao-Lei; Zhang, Yong; Chen, Ying; Wen, Xiao-Yun; Yan, Dong-Mei; Huang, Guo-Hong; Zhang, Bao-Min; Zhang, Bo; An, Hong-Qiu; Li, Hui; Xu, Wen-Bo

    2013-06-01

    An epidemic of rash and fever illnesses suspected of hand, foot and mouth disease (HFMD) occurred in Gansu Province of China in 2008, laboratory tests were performed in order to identify the pathogen that caused this epidemic. Eight clinical specimens collected from the 4 patients (each patient has throat swab and herpes fluid specimens) with rash and febrile illness, were inoculated onto RD and HEp-2 cells for virus isolation, and the viral nucleic acid was then extracted with the positive virus isolates, the dual-channel real-time reverse transcript-polymerase chain reaction (RT-PCR) was performed to detect the nucleic acid of human enterovirus (HEV) in the viral isolates at the same time. For the viral isolates with the negative results of HEV, a sequence independent single primer amplification technique (SISPA) was used for "unknown pathogen" identification. Totally, 6 viral isolates were identified as herpes simplex virus type 1 (HSV-1). Comprehensive analyses results of the clinical manifestations of the patients, epidemiological findings and laboratory test indicated that this epidemic of rash and febrile illness was caused by HSV-1. The differences among the gG region of 6 HSV-1 isolates at nucleotide level and amino acid level were all small, and the identities were up to 98. 8% and 97.9%, respectively, showing that this outbreak was caused by only one viral transmission chain of HSV-1. HSV-1 and other viruses that cause rash and febrile illnesses need differential diagnosis with HFMD. The etiology of rash and febrile illness is sometimes difficult to distinguish from the clinical symptoms and epidemiological data, the laboratory diagnosis is therefore critical. PMID:23895007

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

    Manoel Antonio de Paiva-Neto

    2010-06-01

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

  19. Comparative Morphology and Histology of the Nasal Fossa in Four Mammals: Gray Squirrel, Bobcat, Coyote, and White-Tailed Deer.

    Yee, Karen K; Craven, Brent A; Wysocki, Charles J; Van Valkenburgh, Blaire

    2016-07-01

    Although the anatomy of the nasal fossa is broadly similar among terrestrial mammals, differences are evident in the intricacies of nasal turbinal architecture, which varies from simple scroll-like to complex branching forms, and in the extent of nonsensory and olfactory epithelium covering the turbinals. In this study, detailed morphological and immunohistochemical examinations and quantitative measurements of the turbinals and epithelial lining of the nasal fossa were conducted in an array of species that include the gray squirrel, bobcat, coyote, and white-tailed deer. Results show that much more of the nose is lined with olfactory epithelium in the smallest species (gray squirrel) than in the larger species. In two species with similar body masses, bobcat and coyote, the foreshortened felid snout influences turbinal size and results in a decrease of olfactory epithelium on the ethmoturbinals relative to the longer canine snout. Ethmoturbinal surface area exceeds that of the maxilloturbinals in all four sampled animals, except the white-tailed deer, in which the two are similar in size. Combining our results with published data from a broader array of mammalian noses, it is apparent that olfactory epithelial surface area is influenced by body mass, but is also affected by aspects of life history, such as diet and habitat, as well as skull morphology, itself a product of multiple compromises between various functions, such as feeding, vision, and cognition. The results of this study warrant further examination of other mammalian noses to broaden our evolutionary understanding of nasal fossa anatomy. Anat Rec, 299:840-852, 2016. © 2016 Wiley Periodicals, Inc. PMID:27090617

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

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

    2015-01-15

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

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

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

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

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

    1994-12-01

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

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

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

  4. [Seroprevalence of human parvovirus B19 in children with fever and rash in the North of Tunisia].

    Bouafsoun, A; Hannachi, N; Smaoui, H; Boubaker, S H; Kazdaghli, K; Laabidi, D; Boukadida, J; Kechrid, A

    2016-08-01

    The aim of the study is to evaluate the prevalence of specific antibodies anti-human parvovirus B19 (PVB19) immunoglobulin M (IgM) and IgG in children with fever and rash. This study involved 257 children aged from 7 months to 15 years with febrile rash unrelated to measles and rubella (seronegative for IgM). The sera were examined by immunoenzymatic assay. Detection of antibodies of PVB19 was done by enzyme-linked immunosorbent assay (Elisa). In our study, prevalence of immunoglobulin G (IgG) and IgM were 44 and 11.3%, respectively. Clinically, children with positive IgM serology had submitted an erythema infectiosum (13/29 cases), myocarditis (1 case), encephalitis (1 case), severe sickle cell anemia (7 cases), and immunocompromised (7 cases). The incidence rate of viral infection was 11.3%; most of the cases of PVB19 infection occurred between the months of May and August. Incidence was higher in the 10-15 years age group (21%). The prevalence of IgG antibody varied and increased with age, it rises from 38.2% in preschool children (19 months-4 years) to 53.5% in those aged between 4.5 and 15 years, reaching 58% in the 10-15 years age group. The four risk factors of PVB19 infection are: (1) those aged between 4.5 and 9 years, which is the most affected age group (P = 0.0018); (2) female gender in children aged between 19 months and 4 years (P = 0.037); (3) transfusion and (4) immune deficiency (P = 0.022 and P = 0.001, respectively). The study of the prevalence of PVB19 infection shows that viral infection is acquired early in childhood, increases with age; viral transmission is favored by the community life. Because of the widespread vaccination program against measles and rubella, the systematic search of PVB19 in front of eruptive fevers becomes important. PMID:27385036

  5. Preoperative diffuse leptomeningeal spread in a medulloblastoma: Paraplegia following surgery for posterior fossa and call for newer management protocols

    Pravin Salunke

    2011-01-01

    Full Text Available Management of patients with medulloblastoma presenting with multiple metastasis in subarachnoid space preoperatively is unclear. An 11-year-old boy presented with vermian medulloblastoma with an unusually long segment cervico-dorsal lesion and suprasellar lesion. The child underwent a posterior fossa craniotomy (prone position and excision of vermian mass. He developed paraplegia in the immediate postoperative period, the possible causes for which are being discussed. Besides, treatment options for patients presenting with disseminated disease preoperatively have been highlighted. Preoperative chemotherapy to downstage such lesions may be tried and such complications could be avoided.

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

    Sweeney, Kieron J

    2013-02-01

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

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

    Leodante B. Costa Jr

    2004-03-01

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

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

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

    2010-12-01

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

  9. Differential Effects of Reward Drive and Rash Impulsivity on the Consumption of a Range of Hedonic Stimuli.

    Goodwin, Belinda C; Browne, Matthew; Rockloff, Matthew; Loxton, Natalie

    2016-06-01

    Background and aims Impulsivity has consistently been associated with over-consumption and addiction. Recent research has reconceptualized impulsivity as a two-dimensional construct ( Dawe, Gullo, & Loxton, 2004 ). This study explores the relationship of the two components of impulsivity, reward drive (RD) and rash impulsivity (RI), on a broad group of 23 hedonic consumption behaviors (e.g., gambling, substance use, eating, and media use). We tentatively grouped the behaviors into three descriptive classes: entertainment, foodstuffs, and illicit activities and substances. Results RD and RI positively predicted elevated levels of consumption in a community sample (N=5,391; 51% female), for the vast majority of the behaviors considered. However, the effect sizes for RD and RI varied significantly depending on the behavior; a pattern that appeared to be at least partially attributable to the class of consumption. Results support the view that RD is related more strongly to the consumption of products that provide social engagement or a sense of increased status; whereas RI better reflects an approach toward illicit or restricted products that are intensely rewarding with clear negative consequences. Discussion and conclusion Results support the utility of the two-factor model of impulsivity in explaining individual differences in patterns of hedonic consumption in the general population. We discuss findings in terms of strengthening current conceptualizations of RI and RD as having distinct implications with respect to health-related behaviors. PMID:27363460

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

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

    2015-12-01

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

  11. The intra-oceanic Cretaceous (~ 108 Ma) Kata-Rash arc fragment in the Kurdistan segment of Iraqi Zagros suture zone: Implications for Neotethys evolution and closure

    Ali, Sarmad A.; Ismail, Sabah A.; Nutman, Allen P.; Bennett, Vickie C.; Jones, Brian G.; Buckman, Solomon

    2016-09-01

    The Kata-Rash arc fragment is an allochthonous thrust-bound body situated near Penjween, 100 km northeast of Sulymannia city, Kurdistan Region, within the Iraqi portion of the Zagros suture zone. It forms part of the suprasubduction zone 'Upper Allochthon' terranes (designated as the Gimo-Qandil Group), which is dominated by calc-alkaline andesite and basaltic-andesite, rhyodacite to rhyolite, crosscut by granitic, granodioritic, and dioritic dykes. Previously, rocks of the Kata-Rash arc fragment were interpreted as a part of the Eocene Walash volcanic group. However, SHRIMP zircon U-Pb dates on them of 108.1 ± 2.9 Ma (Harbar volcanic rocks) and 107.7 ± 1.9 Ma (Aulan intrusion) indicate an Albian-Cenomanian age, which is interpreted as the time of igneous crystallisation. The Aulan intrusion zircons have initial εHf values of + 8.6 ± 0.2. On a Nb/Yb-Th/Yb diagram, all Kata-Rash samples fall within the compositional field of arc-related rocks, i.e. above the mid-ocean-ridge basalt (MORB)-ocean island basalt (OIB) mantle array. Primitive-mantle-normalised trace-element patterns for the Kata-Rash samples show enrichment in the large ion lithophile elements and depletion in the high-field-strength elements supporting their subduction-related character. Low Ba/La coupled with low La/Yb and Hf/Hf* temperature melt from subducted slab sediment, in an oceanic setting. This mechanism can explain the sub-DM initial εHf value, without the need to invoke melting of significantly older (continental) crust in an Andean setting. We interpret the Kata-Rash igneous rocks as a fragment of the Late Cretaceous suprasubduction zone system (named here the Kata-Rash arc) that most likely developed within the Neotethys Ocean rather than at a continental margin. Subsequently during the latest Cretaceous to Paleocene, the arc was accreted to the northern margin of the Arabian plate. The results indicate a > 3000 km continuity of Cretaceous arc activity (Oman to Cyprus), that consumed

  12. A new method to explore the spectral impact of the piriform fossae on the singing voice: benchmarking using MRI-based 3D-printed vocal tracts.

    Delvaux, Bertrand; Howard, David

    2014-01-01

    The piriform fossae are the 2 pear-shaped cavities lateral to the laryngeal vestibule at the lower end of the vocal tract. They act acoustically as side-branches to the main tract, resulting in a spectral zero in the output of the human voice. This study investigates their spectral role by comparing numerical and experimental results of MRI-based 3D printed Vocal Tracts, for which a new experimental method (based on room acoustics) is introduced. The findings support results in the literature: the piriform fossae create a spectral trough in the region 4-5 kHz and act as formants repellents. Moreover, this study extends those results by demonstrating numerically and perceptually the impact of having large piriform fossae on the sung output. PMID:25048199

  13. A new method to explore the spectral impact of the piriform fossae on the singing voice: benchmarking using MRI-based 3D-printed vocal tracts.

    Bertrand Delvaux

    Full Text Available The piriform fossae are the 2 pear-shaped cavities lateral to the laryngeal vestibule at the lower end of the vocal tract. They act acoustically as side-branches to the main tract, resulting in a spectral zero in the output of the human voice. This study investigates their spectral role by comparing numerical and experimental results of MRI-based 3D printed Vocal Tracts, for which a new experimental method (based on room acoustics is introduced. The findings support results in the literature: the piriform fossae create a spectral trough in the region 4-5 kHz and act as formants repellents. Moreover, this study extends those results by demonstrating numerically and perceptually the impact of having large piriform fossae on the sung output.

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

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

    2004-08-01

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

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

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

    2016-04-01

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

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

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

  17. Prophylactic Tetracycline Does Not Diminish the Severity of Epidermal Growth Factor Receptor (EGFR) Inhibitor Induced Rash: Results from the North Central Cancer Treatment Group (Supplementary N03CB)1

    Jatoi, Aminah; Dakhil, Shaker R.; Sloan, Jeff A.; Kugler, John W.; Rowland, Kendrith M.; Schaefer, Paul L.; Novotny, Paul J.; Wender, Donald B.; Gross, Howard M.; Loprinzi, Charles L.

    2014-01-01

    PURPOSE Previous studies suggest tetracycline and other antibiotics lessen the severity of epidermal growth factor receptor (EGFR) inhibitor-induced rash. This study sought to confirm such findings. METHODS Patients starting an EGFR inhibitor were eligible for this randomized, double-blinded, placebo-controlled study and had to be rash-free. They were then randomly assigned to tetracycline 500 milligrams orally twice a day for 28 days versus a placebo. Rash development and severity (monthly physician assessment and weekly patient-reported questionnaires), quality of life (SKINDEX-16), and adverse events were monitored during the 4-week intervention and then for an additional 4 weeks. The primary objective was to compare the incidence of grade 2 or worse rash between study arms; 32 patients per group provided a 90% probability of detecting a 40% difference in incidence with a type I error rate of 0.05 (2-sided). RESULTS 65 patients were enrolled, and groups were balanced on baseline characteristics. During the first 4 weeks, healthcare provider-reported data found that 27 tetracycline-treated patients (82%) and 24 placebo-exposed patients (75%) developed a rash. This rash was a grade 2+ in 17 (52%) and 14 (44%), respectively (p=0.62). Comparable grade 2+ rash rates were observed during weeks 5 through 8 as well as with patient-reported rash data throughout the study period. Quality of life was comparable across study arms, and tetracycline was well tolerated. CONCLUSION Although previous studies suggest otherwise, this randomized, double-blinded, placebo-controlled did not find that tetracycline lessened rash incidence or severity in patients who were taking EGFR inhibitors. PMID:20820817

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

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

  19. The intra-oceanic Cretaceous (~ 108 Ma) Kata-Rash arc fragment in the Kurdistan segment of Iraqi Zagros suture zone: Implications for Neotethys evolution and closure

    Ali, Sarmad A.; Ismail, Sabah A.; Nutman, Allen P.; Bennett, Vickie C.; Jones, Brian G.; Buckman, Solomon

    2016-09-01

    The Kata-Rash arc fragment is an allochthonous thrust-bound body situated near Penjween, 100 km northeast of Sulymannia city, Kurdistan Region, within the Iraqi portion of the Zagros suture zone. It forms part of the suprasubduction zone 'Upper Allochthon' terranes (designated as the Gimo-Qandil Group), which is dominated by calc-alkaline andesite and basaltic-andesite, rhyodacite to rhyolite, crosscut by granitic, granodioritic, and dioritic dykes. Previously, rocks of the Kata-Rash arc fragment were interpreted as a part of the Eocene Walash volcanic group. However, SHRIMP zircon U-Pb dates on them of 108.1 ± 2.9 Ma (Harbar volcanic rocks) and 107.7 ± 1.9 Ma (Aulan intrusion) indicate an Albian-Cenomanian age, which is interpreted as the time of igneous crystallisation. The Aulan intrusion zircons have initial εHf values of + 8.6 ± 0.2. On a Nb/Yb-Th/Yb diagram, all Kata-Rash samples fall within the compositional field of arc-related rocks, i.e. above the mid-ocean-ridge basalt (MORB)-ocean island basalt (OIB) mantle array. Primitive-mantle-normalised trace-element patterns for the Kata-Rash samples show enrichment in the large ion lithophile elements and depletion in the high-field-strength elements supporting their subduction-related character. Low Ba/La coupled with low La/Yb and Hf/Hf* 3000 km continuity of Cretaceous arc activity (Oman to Cyprus), that consumed Neotethyian oceanic crust between Eurasia and the Gondwanan fragment Arabia.

  20. Diaper rash (image)

    ... may be caused by chemical irritants rather than bacterial or candidal infection. Common irritants include ammonia from the breakdown of urine, acids in the stool, and soaps used in laundering cloth diapers.

  1. Simple technique for in field samples collection in the cases of skin rash illness and subsequent PCR detection of orthopoxviruses and varicella zoster virus.

    Catherine Dumont

    Full Text Available BACKGROUND: In case of outbreak of rash illness in remote areas, clinically discriminating monkeypox (MPX from severe form of chickenpox and from smallpox remains a concern for first responders. OBJECTIVE: The goal of the study was therefore to use MPX and chickenpox outbreaks in Democratic Republic of Congo (DRC as a test case for establishing a rapid and specific diagnosis in affected remote areas. METHODS: In 2008 and 2009, successive outbreaks of presumed MPX skin rash were reported in Bena Tshiadi, Yangala and Ndesha healthcare districts of the West Kasai province (DRC. Specimens consisting of liquid vesicle dried on filter papers or crusted scabs from healing patients were sampled by first responders. A field analytical facility was deployed nearby in order to carry out a real-time PCR (qPCR assay using genus consensus primers, consensus orthopoxvirus (OPV and smallpox-specific probes spanning over the 14 kD fusion protein encoding gene. A PCR-restriction fragment length polymorphism was used on-site as backup method to confirm the presence of monkeypox virus (MPXV in samples. To complete the differential diagnosis of skin rash, chickenpox was tested in parallel using a commercial qPCR assay. In a post-deployment step, a MPXV-specific pyrosequencing was carried out on all biotinylated amplicons generated on-site in order to confirm the on-site results. RESULTS: Whereas MPXV proved to be the agent causing the rash illness outbreak in the Bena Tshiadi, VZV was the causative agent of the disease in Yangala and Ndesha districts. In addition, each on-site result was later confirmed by MPXV-specific pyrosequencing analysis without any discrepancy. CONCLUSION: This experience of rapid on-site dual use DNA-based differential diagnosis of rash illnesses demonstrates the potential of combining tests specifically identifying bioterrorism agents and agents causing natural outbreaks. This opens the way to rapid on-site DNA-based identification of a

  2. 88例登革热患者皮疹特点分析%Analysis of skin rashes in 88 patients with dengue fever

    2015-01-01

    目的:观察登革热患者的皮疹特点,探讨登革热皮疹发生的相关因素。方法对住院的登革热患者进行皮疹观察,搜集临床和实验室数据,进行统计分析。结果共纳入127例登革热患者,出现皮疹88例(69.29%),皮疹大多在发热后5~7 d出现,平均为(5.06±2.50)d;其中有37例(42.05%)在发热时即出现,有51例(57.95%)在体温消退后出现。有瘙痒感48例(54.55%),无瘙痒感39例(44.32%),1例自觉全身针刺感。皮疹类型多样,其中出现双手掌充血性红斑、斑疹的患者26例(29.55%),可能为该病的特征性皮疹;皮疹初发部位多在双下肢,具体消退顺序不详。皮疹的发生与血小板、丙氨酸转氨酶、天冬氨酸转氨酶3个指标的差异具有统计学意义。皮疹的类型及有无瘙痒与白细胞、中性粒细胞、血小板、ALT、AST之间的差异无统计学意义。结论登革热皮疹的表现多样,双手掌充血性红斑、斑疹可能为登革热较特异的皮疹。%Objective To investigate skin rash characteristics in patients with dengue fever, and to explore factors associated with the occurrence of skin rashes in dengue fever. Methods Skin rashes were observed in 127 hospitalized patients with dengue fever. Clinical and laboratory data were collected from these patients. Statistical analysis was carried out by using a two-sample t-test and chi-square test with the SPSS16.0 software. Results Out of the 127 inpatients, 88 (69.29%)had skin rashes, which usually developed within 5-7 (average, 5.06 ± 2.50)days after fever onset. Among the 88 patients, 37(42.05%)developed skin rashes during fever, while 51(57.95%)after the drop of body temperature. Moreover, 48 (54.55%) patients complained of itching, while 39 (44.32%) never felt itch, and 1 complained of a tingling sensation all over the body. The type of skin rashes was various. Congestive erythema

  3. Tetracycline to Prevent Epidermal Growth Factor Receptor Inhibitor-Induced Skin Rashes: Results of a Placebo-Controlled Trial from the North Central Cancer Treatment Group (N03CB)1

    Jatoi, Aminah; Rowland, Kendrith; Sloan, Jeff A.; Gross, Howard M.; Fishkin, Paul A.; Kahanic, Stephen P.; Novotny, Paul J.; Schaefer, Paul L.; Johnson, David B.; Tschetter, Loren K.; Loprinzi, Charles L.

    2014-01-01

    PURPOSE Epidermal growth factor receptor inhibitors are effective cancer therapies, but they cause a rash in greater than 50% of patients. This study tested tetracycline for rash prevention. METHODS This placebo-controlled, double-blinded trial enrolled patients who were starting cancer treatment with an epidermal growth factor receptor inhibitor. Patients could not have had a rash at enrollment. All were randomly assigned to either tetracycline 500 milligrams orally twice a day for 28 days versus a placebo. Patients were monitored for rash (monthly physician assessment and weekly patient-reported questionnaires), quality of life (SKINDEX-16), and adverse events. Monitoring occurred during the 4-week intervention and then for an additional 4 weeks. The primary objective was to compare the incidence of rash between study arms, and 30 patients per arm provided a 90% probability of detecting a 40% difference in incidence with a p-value of 0.05 (2-sided). RESULTS Sixty-one evaluable patients were enrolled, and arms were well balanced on baseline characteristics, rates of drop out, and rates of discontinuation of the epidermal growth factor receptor inhibitor. Rash incidence was comparable across arms. Physicians reported that 16 tetracycline-treated patients (70%) and 22 placebo-exposed patients (76%) developed a rash (p=0.61). Tetracycline appears to have lessened rash severity, although high drop out rates invite caution in interpreting findings. By week 4, physician-reported grade 2 rash occurred in 17% of tetracycline-treated patients (n=4) and in 55% of placebo-exposed patients (n=16); (p=0.04). Tetracycline-treated patients reported better scores, as per the SKINDEX-16, on certain quality of life parameters, such as skin burning or stinging, skin irritation, and being bothered by a persistence/recurrence of a skin condition. Adverse events were comparable across arms. CONCLUSION Tetracycline did not prevent epidermal growth factor receptor inhibitor

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

    Meena Sanjay

    2013-06-01

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

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

    Sanjay Meena; Hira Lal Nag; Senthil Kumar; Nilesh Barwar; Samarth Mittal; Amit Singla

    2013-01-01

    Breakage of K-wires and stainless steel wires which are used for fracture fixation is not uncommon,but migration is rare.We report a case of migration of broken K-wire used for patella tension band wiring to the popliteal fossa.The broken hardware was removed surgically.We would like to suggest that K-wire and wire fixation used for treatment ofpatellar fractures can migrate into the posterior compartment of the knee and cause clinical symptoms.Close clinical and radiological follow-up after internal fixation to identify the presence of hardware breakage or movement and removal of wires once fracture has united can avert such complications.

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

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

    2015-10-01

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

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

    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.

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

    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.

  9. Cytological diagnosis of bancroftian filariasis presented as a subcutaneous swelling in the cubital fossa: an unusual presentation.

    Pandey, Pinki; Dixit, Alok; Chandra, Subrat; Tanwar, Aparna

    2015-04-01

    Filariasis is a disabling parasitic disease and the prevalence of lymphatic filariasis caused by Wuchereria bancrofti is quite high in India. However, W. bancrofti presenting as a subcutaneous swelling and a demonstration of microfilariae in cytological smears from upper extremity lesions is extremely rare. We report a case of 20-year-old male who presented with a small subcutaneous swelling near medial aspect of the left cubital fossa. The wet mount preparation showed many motile microfilariae. Cytology smears revealed a large number of sheathed microfilariae with the tail tip free of nucleus, identified as W. bancrofti without significant inflammatory cell infiltrate. Indirect ELISA was highly positive for specific recombinant W. bancrofti filarial antigen (WL-L2). The role of cytology cannot be underestimated in clinically unanticipated cases of bancroftian filariasis, especially with the amicrofilaremic state. Filariasis should always be considered in the differential diagnosis during cytological evaluation of any swelling, especially in endemic areas. PMID:26634138

  10. An audit of indications and techniques for supraclavicular fossa irradiation in early breast cancer in the United Kingdom.

    Landau, D B; Laing, R W

    2000-01-01

    This article describes an audit of the indications and techniques used by clinical oncologists in the United Kingdom (UK) in the delivery of adjuvant radiotherapy to the supraclavicular fossa (SCF) in patients with early breast cancer. A postal questionnaire was sent to one consultant clinical oncologist in each UK radiotherapy centre in November 1999. These were the same individuals listed in the Maher Committee Report as providing breast cancer services. Forty-one out of 51 completed forms were returned. The results show significant variation in the indications for SCF irradiation and for the definition of the radiotherapy target volume. We discuss the possible basis for the variations found in the audit. There was broad agreement on technique, in particular on the need for matching the tangential and SCF fields and maintaining patient position between fields, factors that are likely to minimize serious morbidity, including brachial plexus injury. PMID:10942334

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

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

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

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

  13. Internal Occipital Crest Misalignment with Internal Occipital Protuberance: A Case Report of Posterior Cranial Fossa Anatomic Variations

    Jae Ha Kim

    2016-01-01

    Full Text Available During gross anatomy head and neck laboratory session, one dissection group observed an abnormal anatomic variation in the posterior cranial fossa of a 94-year-old male cadaver. The internal occipital crest was not aligned with internal occipital protuberance and groove for superior sagittal sinus. It seemed that the internal occipital protuberance was shifted significantly to the right side. As a result the skull was overly stretched in order to connect with the internal occipital ridge. These internal skull variations of occipital bone landmarks can influence the location of adjacent dural venous sinuses and possibly influence cerebrospinal fluid flow. Similar anatomical anomalies have been attributed to presence of hydrocephalus and abnormalities in cisterna magna.

  14. Shallow hydrothermal alteration and permeability changes in pyroclastic deposits: a case study at La Fossa cone (Vulcano island, Italy):

    Cangemi, Marianna; Madonia, Paolo; Speziale, Sergio; Oliveri, Ygor

    2016-04-01

    La Fossa cone at Vulcano, the southernmost island of the Aeolian volcanic archipelago (Italy), has been characterized by an intense fumarolic activity since its last eruption dated 1888-90. Mineralogical alteration induced by shallow hydrothermal circulation has significantly reduced the permeability of the volcanic products, causing important feedbacks on the circulation of fluids in the shallowest portion of the volcanic edifice. The summit area of the cone is sealed by a quite continuous coating surface, fostering the condensation of hydrothermal fluids inside the volcanic edifice. The combination of fractures and volcano-stratigraphic discontinuities, conveying hydrothermal fluids, makes significant rock volumes prone to slide seaward, as occurred in 1988 during the main unrest experienced by Vulcano island since its last eruption. Similar instability conditions are found over the Forgia Vecchia crater rim area, formed by phreatic activity on the NE flank of the cone, where tensile fracturing and hydrothermal circulation interacts with mutual negative feedbacks. In the behalf of the DPC-INGV V3 Project 2012-15 we investigated the mineralogical composition and the hydraulic conductivity (under saturated conditions) of volcanic deposits potentially prone to hydrothermal fluid circulation, for evaluating their ability in retaining water, creating favourable conditions for gravitational instability. We also measured rainfall rate and volumetric soil moisture content in two automated stations located in different areas, with and without active hydrothermal circulation. We found that hydrothermal alteration transforms volcanic products into clay minerals, significantly reducing permeability of volcanic deposits. Argillified volcanic materials show background water contents, modulated by impulsive increments following rainfalls, higher than unaltered pyroclastic deposits, due to the combination of lower permeability and direct condensation of hydrothermal vapour. The

  15. 后颅窝囊实性病变MRI诊断价值%The significance of MRI in diagnosis of cystic and solid lesions in posterior cranial fossa

    唐广山

    2011-01-01

    目的 探讨后颅窝囊实性病变的磁共振成像(MRI)影像学特征及MRI对后颅窝囊实性病变的诊断价值.方法 回顾分析30例经病理或临床确诊后颅窝囊实性病变的MRI资料,根据病灶部位和解剖结构进行分组研究.结果 MRI对后颅窝囊实性病变能基本明确诊断,液体衰减反转恢复(T2FLAIR)、弥散加权成像(DWI)也应作为常规扫描序列.结论 MRI对后颅窝囊实性病变有很高的确诊率.%Objective To explore the characteristic features of MRI for cystic and solid lesions in posterior cranial fossa and diagnostic significance of MRI in diagnosis of cystic and solid lesions in posterior cranial fossa. Methods The data of MRI in 30 cases of cystic and solid lesions in posterior cranial fossa confirmed by pathological examination were retrospectively reviewed and analyzed, and they were allocated into different groups according to their sites of lesions and anatomical structures. Results The cystic and solid lesions in posterior cranial fossa can clearly be diagnosed by MRI, and T2FLAIR and DWI should also be used as conventional scanning sequence. Conclusion The diagnosis of cystic and solid lesions in posterior cranial fossa with MRI is effective and highly accurate.

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

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

    2006-01-15

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

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

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

    2015-04-01

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

  18. Trans aqueductal, third ventricle – Cervical subarachnoid stenting: An adjuvant cerebro spinal fluid diversion procedure in midline posterior fossa tumors with hydrocephalus: The technical note and case series

    Teegala, Ramesh

    2016-01-01

    Background: Persistent or progressive hydrocephalus is one of the complex problems of posterior fossa tumors associated with hydrocephalus. The author evaluated the effectiveness of single-stage tumor decompression associated with a stent technique (trans aqueductal third ventricle – Cervical subarachnoid stenting) as an adjuvant cerebro spinal fluid (CSF) diversion procedure in controlling the midline posterior fossa tumors with hydrocephalus. Materials and Methods: Prospective clinical case series of 15 patients was evaluated from July 2006 to April 2012. Fifteen clinicoradiological diagnosed cases of midline posterior fossa tumors with hydrocephalus were included in this study. All the tumors were approached through the cerebello medullary (telo velo tonsilar) fissure technique. Following the excision of the posterior fossa tumor, a sizable stent was placed across the aqueduct from the third ventricle to the cervical subarachnoid space. Results: There were nine male and six female patients with an average age of 23 years. Complete tumor excision could be achieved in 12 patients and subtotal excision with clearance of aqueduct in remaining three patients. Hydrocephalus was controlled effectively in all the patients. There were no stent-related complications. Conclusions: This study showed the reliability of single-stage tumor excision followed by placement of aqueductal stent. The success rate of this technique is comparable to those of conventional CSF diversion procedures. This is a simple, safe, and effective procedure for the management of persistent and or progressive hydrocephalus. This technique may be very useful in situations where the patient's follow-up is compromised and the patients who are from a poor economic background. Long-term results need further evaluation to assess the overall functioning of this stent technique. PMID:27366254

  19. 骨瓣成形术在后颅窝手术中的应用%Application of cranioplasty in posterior fossa surgery

    惠小波; 卜向飞; 李正明; 金孝东; 丁涟沭; 卞爱苗; 蒋健; 刘骥; 孙晓阳

    2011-01-01

    目的 探讨骨瓣成形术在后颅窝手术中的临床应用.方法 对13例后颅窝开颅的患者行骨瓣成形术.其中后颅窝硬膜外血肿6例,髓母细胞瘤2例,小脑血管母细胞瘤3例,小脑星形胶质细胞瘤2例.结果 所有行后颅窝骨瓣成形术的患者术后无长期发热、脑脊液漏,皮下积液等并发症.结论 后颅窝骨瓣成形术保持了颅骨的完整性,有效地减少了传统手术的并发症.避免了术后颅骨缺损对患者的小良心理影响.%Objective To investigate the effects of cranioplasty in posterior fossa surgery.Methods Of 13 patients with cranioplasty in posterior fossa surgery,6 suffered from posterior fossa epidural hematomas, 2 medulloblastomas, 3 hemangioblastomas of cerebellum and 2 cerebellar astrocytomas. Results All patients had no postoperative complications including chronic fever,cerebrospinal fluid leakage, subcutaneous effusion or incision pain. Conclusion Cranioplasty in posterior fossa can keep the integrity of the skull and reduce the complications of conventional operation and aviod postoperative bad psychological impacts.

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

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

    1999-01-01

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

  1. Two alternative dural sealing techniques in posterior fossa surgery: (Polylactide-co-glycolide self-adhesive resorbable membrane versus polyethylene glycol hydrogel

    Marco Schiariti

    2014-01-01

    Conclusions: TPD seems to be a safe tool for use as an adjunct to standard dural closure in posterior fossa surgery, particularly in patients without pre- or post-oper ative risk factors, in those who did not develop hydrocephalus, and who underwent craniectomy. The CSF leak rate in TPD group was found to be lower or within the range of the more advanced alternative dural closure strategies, including polyethylene glycol (PEG-based sealant.

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

    Bernadine eDonahue

    2012-12-01

    Full Text Available Purpose: Associations of RT deviations and outcomes in medulloblastoma have not been defined well, particularly in the era of reduced-dose CSI and chemotherapy. The aim of this study is to evaluate the quality of RT on CCG/POG 9961 and analyze associations of RT deviations with outcome.Methods and Materials: 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; posterior fossa deviations resulted from treating less than whole posterior fossa. There were no significant differences in PFS or OS between patients with deviations and those without. There was no evidence of associations of deviations with patient age. Conclusions: Approximately one-third of patients had major volume deviations. There was no evidence of a significant association between these and outcome. This lack of correlation likely reflects the current high quality of radiation therapy delivered in COG institutions, our strict definition of volume deviations, and the relatively few instances of multiple major deviations in individual patients. In is noteworthy that the types of posterior fossa volume deviations observed in this study were not adversely associated with outcome. As we move forward, quality assurance will continue to play an important role to ensure that deviations on study do not influence study outcome.

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

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

    2011-05-15

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

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

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

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

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

    2010-11-15

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

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

    Ana Carolina Figueiredo Lacerda

    2007-10-01

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

  7. Bilateral lipoma arborescens of the bicipitoradial bursa

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

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

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

    2007-01-01

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

  9. A new method to explore the spectral impact of the piriform fossae on the singing voice:Benchmarking using MRI-based 3D-printed vocal tracts

    Bertrand Delvaux; David Howard

    2014-01-01

    The piriform fossae are the 2 pear-shaped cavities lateral to the laryngeal vestibule at the lower end of the vocal tract. They act acoustically as side-branches to the main tract, resulting in a spectral zero in the output of the human voice. This study investigates their spectral role by comparing numerical and experimental results of MRI-based 3D printed Vocal Tracts, for which a new experimental method (based on room acoustics) is introduced. The findings support results in the literature...

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

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

    2010-06-15

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

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

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

    1992-01-01

    Right paramedian abomasopexy and right paralumbar fossa omentopexy appear to be the most widely used means of correcting left displacement of the abomasum in dairy cattle. We compared these two procedures in a prospective study of 101 cows with uncomplicated left displaced abomasum. The surgical treatment (right paramedian abomasopexy, n = 48; or right paralumbar fossa omentopexy, n = 53) was assigned randomly. Follow-up information was obtained, at regular intervals, from one week through six months following discharge from the hospital. Milk production, reproductive performance, surgical complications, and length of time retained in the herd after surgery were obtained for each animal. There was a trend in favor of the abomasopexy group in the one-month milk yield. There were no differences between procedures either in incisional complications, other problems noted at follow-up, or in the proportion dead/culled. Based on the milk yield at one month after surgery, we concluded that there may be a slight advantage to right paramedian abomasopexy in cows with uncomplicated left displaced abomasum. PMID:17424000

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

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

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

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

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

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

    2015-12-01

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

  15. Reactivation of Human Herpes Virus-6 in the Renal Tissue of a Patient with Drug-induced Hypersensitivity Syndrome/Drug Rash with Eosinophilia and Systemic Symptoms (DIHS/DRESS).

    Hagiya, Hideharu; Iwamuro, Masaya; Tanaka, Takehiro; Hasegawa, Kou; Hanayama, Yoshihisa; Kimura, Maya; Otsuka, Fumio

    2016-01-01

    A 74-year-old man who had been administered trimethoprim-sulfamethoxazole for three weeks suffered from drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms (DIHS/DRESS). In the early stage of the clinical course, he developed renal dysfunction. A renal biopsy showed granulomatous tubulointerstitial nephritis accompanying the proliferation of human herpes virus (HHV)-6 in tubular epithelial cells. With corticosteroid therapy, the systemic rash and renal function gradually improved. The present patient is the second case of DIHS/DRESS demonstrating a possible reactivation of HHV-6 in the renal tissue. The clinical role of viral reactivation in DIHS/DRESS must be further elucidated. PMID:27374681

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

    Aline Gomes Bittencourt

    2013-04-01

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

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

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

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

    Antonio Oliveira Netto

    2015-12-01

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

  19. Diaper Rash: How to Treat

    ... resources Meet our partners Español Donate Diseases and treatments Acne and rosacea Bumps and growths Color problems Contagious skin diseases ... to treat public SPOT Skin Cancer™ Diseases and treatments Acne and rosacea Bumps and growths Color problems Contagious skin diseases ...

  20. Rash - child under 2 years

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

  1. Poison ivy - oak - sumac rash

    Poison ivy, oak, and sumac are plants that commonly cause an allergic skin reaction. The result is most often ... oils most often enter the skin rapidly. POISON IVY This is one of the most frequent causes ...

  2. Skin Rashes and Other Changes

    ... painful red bumps? Yes This could be a BOIL. A cluster of boils is called a CARBUNCLE. These occur due to infection under the skin. Gently compress the boil with a warm cloth. Use antibiotic ointments if ...

  3. 海南省发热出疹性疾病发病本底调查%Investigation on Incidence of Rash and Fever Illnesses in Hainan Province

    尹锡玲; 梁晓峰; 曾雪霞; 罗会明; 莫少雄; 郝利新; 马静; 何剑; 马超; 孙莲英

    2011-01-01

    目的 开展发热出疹性疾病(Rash and Fever Illnesses,RFIs)发病本底调查,结合排除麻疹病例报告发病率进行分析,为中国接近消除麻疹地区能否达到麻疹监测系统(Measles Surveillance System,MSS)敏感性指标提供数据支持.方法 采用分层随机整群抽样方法,抽取海南省X市L区、W县、D县进行回顾性调查.基于世界卫生组织国际疾病分类法第10版(International Classification of Diseases 10th Edition,ICD-10)编码及疾病名称,搜索被调查县(区,下同)全部医疗机构2010年6月~2011年5月诊治的RFIs病例,结合同期相应县的疑似麻疹(风疹)病例报告数据进行分析.结果 RFIs小年龄儿童发病率高,<1岁婴儿发病率达457.19/10万,随年龄增长,发病率下降.45%的RFIs为幼儿急疹,31%为疑似麻疹(风疹).RFIs常年均有发生,3~5月的病例数占全年RFIs数的39.17%; RFIs年平均发病率为23.30/10万,校正年发病率为23.91/10万.三个县RFIs粗发病率均>8/10万.RFIs疾病谱差异有统计学意义(P<0.001).2010年6月~2011年5月,L、W、D县实验室诊断麻疹(风疹)阳性比例分别为26.32%、6.58%、5.26%,实验室排除麻疹(含风疹)病例报告发病率分别为4.12/10万、11.75/10万、3.60/10万.同期全省实验室排除麻疹病例报告发病率为3.75/10万.结论 据现有数据,2010年6月~2011年5月,海南省RFIs发病率本底值,对于年度排除麻疹病例报告发病率≥2/10万的MSS敏感性指标是有可能达到的.海南省致力于消除麻疹时期,宜以实验室排除麻疹病例(含风疹)报告发病率作为MSS敏感性指标;并严格按照监测病例定义将可能的RFIs纳入至MSS中.%Objective The incidence of rash and fever illnesses (RFIs) in Hainan province was investigated, and combined with analysis of the reported of discarded measles cases, to provide evidence for whether the reported rate of discarded measles cases meet the sensitivity standard of

  4. 后颅窝巨大血管母细胞瘤的显微外科治疗%Microsurgical management of large hemangioblastoma of posterior fossa

    崔华; 王勇; 万杰清; 周正文; 樊翊凌; 周彩芳

    2012-01-01

    目的 探讨采用显微手术治疗后颅窝巨大血管母细胞瘤的方法和疗效.方法 对16例后颅窝巨大血管母细胞瘤进行回顾性分析.其中,男11例,女5例,年龄为14 ~62岁,平均36.4岁,有8例合并VHL病.术前通过头颅影像学来诊断,有7例术前行肿瘤供血动脉栓塞.本组患者根据肿瘤分型分别采用枕下患侧入路、改良远外侧入路、枕下正中入路或枕下小脑上入路,术中辅以微血管多普勒分辨肿瘤供血动脉和引流静脉.结果 16例患者中,肿瘤均全切除,12例患者术后神经功能障碍得到改善,无手术死亡病例.随访3-12个月,有6例因伴有VHL病出现颅内其他部位复发,有2例手术后因肾细胞癌转移死亡.结论 显微技术的提高和对肿瘤血供特性的熟悉明显提高了全切除率,降低了死亡率,显微手术切除是后颅窝巨大血管母细胞瘤最有效的治疗方法.%Objective To studythe method and therapeutic effectiveness of microsurgical treatmentfor large hemangioblastomas of the posterior fossa.Methods During the 10-year period from January 2000to June2010,a retrospective study of 48 patients with intracranial hemangioblastomas revealed 16 patients presented with large solid lesions of the posterior fossa.There were 11males (73.3%) and 5females (26.7% ) with a mean age 36.4 year (range,14 ~62yr).There were concomitant findings associated with VHL disease in eightcases.Diagnostic imaging including CT,MRI and DSA showed large vascular lesions.Preoperative embolization was observedin 7cases.All 16 patients underwent surgery through a suboccipital ipsilateral,modified far-lateral,suboccipital midlineor suboccipital superior cerebellar approach.Microvascular Doppler probe was used to guide dissection of the tumor.Results Complete removal of the tumor was performed in all patients.An overall neurological improvement was observed in 12of the 16patients,corresponding to 75%.No patients died of surgery

  5. 翼腭窝神经阻滞相关解剖及其临床意义%Anatomy and Clinical Research of the Pterygolatine Fossa Nerve Block

    孙光孝; 朱亚文; 陶高见

    2011-01-01

    Objective: To explore the anatomy and the clinical use of the pterygolatine fossa nerve block. Methods :Anatomical parameters and communications of the pterygolatine fossa were obtained from 33 dried - specimen skulls , the data were analyzed by SPSS17. 0 and compared. Results : Major clinical approaches and their results are : Infrazygomatic approach - Flank front approach: left( 54. 87 ±3. 44 )mm , right( 54. 79 ±2. 81 )mm; Infrazygomatic approach - Flank front approach: left( 52. 90 ± 3. 39 )mm, right( 52. 98 ± 2. 76 )mm; Suprazygomatic approach: left( 47. 59 ±2. 93 )mm, right( 47. 34 ± 3. 05 )mm; the 3 major clinical approaches'angles ( between middle sagittal plane of skull and puncture needle ) is : left( 75. 5 ±6. 4 )° , right ( 73. 4 ±4. 7 )° ; left ( 83. 0 ±7. 1 )° , right( 82. 7 ±5. 2 )° ; left( 101. 4 ±7. 4 )° , right( 101. 9 ±6. 6 )°. Conclusions: Suprazygomatic approach and infrazygomatic approach are the two major ways of the pterygolatine fossa nerve block. Suprazygomatic approach is recommended.%目的:探讨翼腭窝神经阻滞相关解剖及其临床意义.方法:在33个干性颅骨标本上对翼腭窝相关孔道和穿刺路径进行解剖观测.应用SPSS17.0分析并比较相关解剖数据.结果:不同穿刺测量法测量翼腭窝的长度,分别为:颧弓下法之侧入法,左侧为(54.87±3.44)mm、右侧为(54.79±2.81)mm;颧弓下法之侧前入法,左侧为(52.90±3.39)mm、右侧为(52.98±2.76)mm;颧骨上法,左侧为(47.59±2.93)mm、右侧为(47.34±3.05)mm.穿刺针与颅骨正中矢状面的角度上述3种方法依次为:左侧(75.5±6.4)°、右侧为(73.4±4.7)°,左侧(83.0±7.1)°、右侧(82.7±5.2)°,左侧(101.4±7.4)°、右侧(101.9±6.6 )°.结论:翼腭窝神经阻滞术以颧骨上法、颧骨下法应用较多.以颧骨上法风险较小,效果较好.

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

    Omar López Arbolay.

    2005-11-01

    Full Text Available Introduction: Preoperative hydrocephalus is reported in about 80 % of posterior fossa tumor patients and in 15-40% of cases postoperative treatment for persistent or progressive hydrocephalus is required. There is no consensus on the way hydrocephalus should be managed before, during, and after PF surgery. Objective: To determine the presence of hidrocephalia in the tumors of the PF and the therapeutic focus in our means. Methods: We report a descriptive, retrospective study of 10 adult patients with posterior fossa mass lesions and obstructive hydrocephalus who were managed medically for compensate intracranial hypertension plus observation and were operated through posterior fossa craniectomy and tumor excision as unique method of surgical treatment. Results: In all 10 cases clinical improvement was obtained immediately after medical treatment. Circulation of cerebrospinal fluid (CSF was totally restored only by tumor excision in 9 patients. The other case had progression of hydrocephalus after surgery and a ventriculoperitoneal shunt was inserted. Radiological normal sized ventricles was obtained between one and two months of surgery Conclusions: Surgical elimination of CFS circulation obstacle helped by medical treatment for lower intracranial pressure should be considered as a safe option in adult patients, reserving endoscopic ventriculostomy and shunt insertion for cases with persistent or progressive hydrocephalus after treatment. Prospective multicenters randomized trials are needed to obtain stronger evidences. Fundamento: La hidrocefalia preoperatoria se reporta en el 80 % de los pacientes con tumores de fosa posterior y en 15-40 % de los casos se necesita tratamiento postoperatorio para hidrocefalia persistente o progresiva. No existe consenso en cuanto a la forma en que la hidrocefalia debe ser tratada antes, durante, o después de

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

    Alessandro Bonforte

    2013-05-01

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

  8. Mapping fumarolic fields in volcanic areas: A methodological approach based on the case study of La Fossa cone, Vulcano island (Italy)

    Madonia, Paolo; Cangemi, Marianna; Costa, Michela; Madonia, Ivan

    2016-09-01

    Changes in the activity state of a volcano can be inferred by monitoring the steam flux from fumarolic fields, in terms of 4D (x, y, z, time) variations in temperature and extension of the zone. During the last decades, several studies in this field have been conducted worldwide, and at Vulcano island (Italy) in particular. Both direct and remotely sensed measurements have been used for identifying thermally anomalous areas, but the possible role of the hydrothermal alteration of volcanic products, producing a sealing effect that obscures the surface thermal evidence of fumarolic activity, have never been explored. The novelty of the present study, carried out at La Fossa cone (Vulcano Island), was the integration of direct and remotely sensed temperature measurements with the evaluation of soil permeability, for the precise mapping of areas where shallow hydrothermal circulation could occur even in the absence of surface evidence. The main results of this study concern the role of a coating found on rock surfaces and regolith in introducing mapping errors, especially during diachronic temperature surveys based on remotely sensed measurements.

  9. Robotic radiosurgery vs. brachytherapy as a boost to intensity modulated radiotherapy for tonsillar fossa and soft palate tumors: the clinical and economic impact of an emerging technology.

    Nijdam, W; Levendag, P; Fuller, D; Schulz, R; Prevost, J-B; Noever, I; Uyl-de Groot, C

    2007-12-01

    As a basis for making decisions regarding optimal treatment for patients with tonsillar fossa and soft palate tumors, we conducted a preliminary investigation of costs and quality of life (QoL) for two modalities [brachytherapy (BT) and robotic radiosurgery] used to boost radiation to the primary tumors following external beam radiotherapy. BT was well established in our center; a boost by robotic radiosurgery was begun more recently in patients for whom BT was not technically feasible. Robotic radiosurgery boost treatment has the advantage of being non-invasive and is able to reach tumors in cases where there is deep parapharyngeal tumor extension. A neck dissection was performed for patients with nodal-positive disease. Quality of life (pain and difficulty swallowing) was established in long-term follow-up for patients undergoing BT and over a one-year follow-up in robotic radiosurgery patients. Total hospital costs for both groups were computed. Our results show that efficacy and quality of life at one year are comparable for BT and robotic radiosurgery. Total cost for robotic radiosurgery was found to be less than BT primarily due to the elimination of hospital admission and operating room expenses. Confirmation of robotic radiosurgery treatment efficacy and reduced morbidity in the long term requires further study. Quality of life and cost analyses are critical to Health Technology Assessments (HTA). The present study shows how a preliminary HTA of a new medical technology such as robotic radiosurgery with its typical hypofractionation characteristics might be based on short-term clinical outcomes and assumptions of equivalence. PMID:17994791

  10. 幼儿急疹引起粒细胞减少症的中西医结合治疗临床研究%Clinical study of children acute rash caused neutropenia in integrative medicine

    彭丽琨

    2015-01-01

    Objective:To discuss the clinical study of children acute rash caused neutropenia in integrative medicine.Methods:120 patients with acute rash were selected.They were divided into the experimental group and the control group.Two groups were given Siji antiviral mixture,and the experimental group added oral leucogen on the basis of oral Siji antiviral mixture.Then we analyzed peripheral blood test for the children in the administration of third,7 and 14 days.Results:The control group and the experimental group were released after 7~14 days,and there was no significant difference.The average recovery time of the experimental group was earlier than that of the control group.Conclusion:The effect of the integrated traditional Chinese and western medicine therapy in the treatment of children acute rash caused by neutropenia was better,and recovered faster.%目的:探讨中西医结合治疗幼儿急疹引起粒细胞减少症的临床研究。方法:收治急疹患儿120例,分成对照组和试验组,两组均口服四季抗病毒合剂,试验组在口服四季抗病毒合剂的基础上,加口服利血生。在给药后3 d、7 d 和14 d 对患儿进行外周血象检测分析。结果:对照组和试验组的患儿均在发病后第7~14天恢复,无明显差异。试验组平均恢复时间较对照组短。结论:中西医结合治疗幼儿急疹引起粒细胞减少症恢复较快,效果较好。

  11. Radiation dose to the lens of the eye during computerised tomography examinations of the orbit, the pituitary fossa and the brain on a general electric 9800 Quick C.T. scanner

    A phantom simulating the lens of the eye has been used to estimate the radiation dose to the lens of the eye during C.T. scanning of the orbit, pituitary fossa and brain. Routine scanning will deliver a dose to the lens which is many times less than the threshold for cataracts. However the potential exists to use techniques which will increase the dose substantially. Repeat examinations of this sort could theoretically exceed the threshold dose required to induce cataracts in the lens. A dramatic elevation of radiation dose was reported with overlapping slices and increased scan duration.. 12 refs., 8 tabs., 5 figs

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

    Maria I Oliveira

    2002-04-01

    Full Text Available OBJECTIVE: The clinical differential diagnosis of rash due to viral infections is often difficult, and misdiagnosis is not rare, especially after the introduction of measles and rubella vaccination. A study to determine the etiological diagnosis of exanthema was carried out in a group of children after measles vaccination. METHODS: Sera collected from children with rash who received measles vaccine were reported in 1999. They were analyzed for IgM antibodies against measles virus, rubella virus, human parvovirus B19 (HPV B19 using ELISA commercial techniques, and human herpes virus 6 (HHV 6 using immunofluorescence commercial technique. Viremia for each of those viruses was tested using a polimerase chain reaction (PCR. RESULTS: A total of 17 cases of children with exanthema after measles immunization were reported in 1999. The children, aged 9 to 12 months (median 10 months, had a blood sample taken for laboratory analysis. The time between vaccination and the first rash signs varied from 1 to 60 days. The serological results of those 17 children suspected of measles or rubella infection showed the following etiological diagnosis: 17.6% (3 in 17 HPV B19 infection; 76.5% (13 in 17 HHV 6 infection; 5.9% (1 in 17 rash due to measles vaccine. CONCLUSIONS: The study data indicate that infection due to HPV B19 or HHV 6 can be misdiagnosed as exanthema due to measles vaccination. Therefore, it is important to better characterize the etiology of rash in order to avoid attributing it incorrectly to measles vaccine.OBJETIVO: O diagnóstico diferencial de doenças exantemáticas causadas por vírus é geralmente difícil, e equívocos não são raros, especialmente depois da introdução da vacina contra o sarampo e a rubéola. Um estudo laboratorial foi conduzido com o objetivo de estabelecer o diagnóstico etiológico de casos de exantema em crianças que receberam a vacina contra o sarampo. MÉTODOS: Soros de casos de exantema em crianças que

  13. Associação singular de síndrome de Kallmann e cisto aracnóide da fossa média: relato de caso Singular association of Kallmann's syndrome and arachnoid cyst of middle fossa: case report

    Yvens B. Fernandes

    1995-09-01

    Full Text Available O hipogonadismo hipogonadotrófico pode resultar de diferentes anomalias do sistema nervoso central, apresentando sinais clínicos que dependem da idade de aparecimento, bem como do grau de deficiência gonadotrófica e de sua associação com outras deficiências hipofisárias. Relatamos o caso de um rapaz de 18 anos com atraso puberal, retardo de crescimento estatural a partir de 10 anos e história de dificuldade de aprendizado escolar. Ao exame apresentava discreto aspecto eunucóide, 162 cm de altura (z score = -2,17, estadiamento puberal GII, PII, testículos de 4 cm³. A avaliação complementar demonstrou níveis pré-puberais de testosterona, megateste com resposta normal, exceto ao teste de estímulo com GnRH agudo e prolongado. CT de crânio mostrou cisto aracnóide da fossa média esquerda com extensão supra-selar. Foi feito o diagnóstico de hipogonadismo hipogonadotrófico provavelmente secundário à compressão pelo cisto aracnóide e por isso, optou-se por derivação cisto-peritoneal. Após a cirurgia não houve retomada do desenvolvimento puberal, sendo então verificada anosmia bilateral e, portanto, diagnosticada Síndrome de Kallmann, que foi confirmada pelos achados da RNM, embora os resultados hormonais não sejam totalmente compatíveis com a referida síndrome. Não encontramos na literatura descrição da associação entre Síndrome de Kallmnann e cisto aracnóide e acreditamos que neste caso os resultados da avaliação hormonal possam ser devidos a tal associação que provocou adicionalmente uma disfunção hipofisária.Hypogonadotrophic hypogonadism can result from different abnormalities in the central nervous system. The clinical picture depends upon the time of onset the deficiency, the magnitude of the gonadotropins deficiency and whether there are other pituitary hormone deficiencies as well. We report on a 18-year-old boy, who was investigated because of pubertal and growth delay. He also had learning

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

    Maria de los Angeles Perez Lizama

    2008-02-01

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

  15. Avaliação da disposição de lodos de fossa e tanque sépticos em lagoas de estabilização que tratam lixiviados de aterro sanitário

    Samara Monayna Alves Vasconcelos Carrilho; Eraldo Henriques Carvalho

    2016-01-01

    Resumo A destinação dos Lodos de Fossa e Tanque Séptico (LFTS) tem resultado em problemas ambientais e de saúde pública, devido principalmente à falta de alternativas adequadas para a destinação, e de fiscalização mais rigorosa. O problema se agrava em municípios desprovidos de estações de tratamento de esgoto, já que a disposição nesses sistemas tem sido a prática mais utilizada no país. Desta forma, a presente pesquisa teve por finalidade avaliar os efeitos da disposição desses lodos no des...

  16. Delayed presentation of a traumatic brachial artery pseudoaneurysm.

    Forde, James C

    2009-09-01

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

  17. An approach to acanthosis nigricans

    Meghana Madhukar Phiske

    2014-01-01

    Acanthosis nigricans (AN) is characterized by dark, coarse and thickened skin with a velvety texture, being symmetrically distributed on the neck, the axillae, antecubital and popliteal fossae, and groin folds, histopathologically characterized by papillomatosis and hyperkeratosis of the skin. A high prevalence of AN has been observed recently. Different varieties of AN include benign, obesity associated, syndromic, malignant, acral, unilateral, medication-induced and mixed AN. Diagnosis is l...

  18. 小儿常见发热出疹性疾病智能诊断模型研究%Development of an intelligent model for diagnosis of common rash and fever illness in children

    王庆华; 唐甜; 王清青; 刘雅琼; 林辉; 黄国荣; 熊鸿燕

    2011-01-01

    Objective To explore an intelligent model for diagnosis of common rash and fever illness (RFIs) in children for medical staff in rural area and family members. Methods Clinical data of 248 RFIs cases (including 133 males and 115 females with an average age of 4.56) were collected from inpatients in the Southwest Hospital of The Third Military Medical University from Jan 2005 to Nov 2010. Diseases comprised of measles, exanthem subitum, chicken pox, hand-foot-and-mouth disease, scarlet fever, rubella and exanthema. Features of fever, rash, main concomitant symptoms, blood routine and epidemiological data were organized and described, and principal component analysis ( PC A) was carried out. PCA combined with back-propagation neural network ( BPNN) was used to set up an intelligent diagnosis model for children with common RFIs. The accuracy of the model was further confirmed based on prospective and retrospective analysis. Results Thirty-one clinical and epidemiological variables were integrated into 13 principle factors through PCA. These factors were then input to set up a BPNN with a 13-9-7 structure. When the model was used for children with RFIs, the average accuracy rate of retrospective diagnosis reached 99.53% , and the average accuracy rate of predictive diagnosis was 92. 86%. Conclusion BPNN diagnosis model on the basis of clinical samples can be applied for an accurate diagnosis of common RFIs in children, and has an significant application prospect.%目的 探索实用于社区医生和家庭成员使用的小儿常见发热出疹性疾病智能诊断方法.方法 收集2005年1月至2010年11月第三军医大学西南医院儿科及感染科248例小儿发热出疹性疾病住院患者的临床资料,其中男性133例,女性115例,平均年龄4.56岁.病种包括麻疹、幼儿急疹、水痘、手足口病、猩红热、风疹和药疹等.整理并描述发热、皮疹、主要伴随症状、血常规及流行病学相关数据特征,进行主成分

  19. Malnutrition and a rash: think zinc.

    Roberts, C M L; Martin-Clavijo, A; Winston, A P; Dharmagunawardena, B; Gach, J E

    2007-11-01

    Endemic zinc deficiency is recognised to be a common and serious problem in developing countries. However, it may be seen in routine practice in the UK, and can be easily overlooked. Malnutrition from any cause in conjunction with an undiagnosed cutaneous problem should alert the clinician to the diagnosis. Investigations may be unreliable, and if in doubt, a therapeutic trial of zinc supplementation is indicated. We present three cases of malnourished patients, in whom zinc deficiency was diagnosed after the development of cutaneous features. The malnutrition resulted from alcoholism in two cases and anorexia nervosa in the third. The heterogeneity of underlying causes of zinc deficiency is discussed, along with its effects, treatment and zinc homeostasis. PMID:17953634

  20. Photos of Slapped-Cheek Rash

    ... Search The CDC Cancel Submit Search The CDC Parvovirus B19 and Fifth Disease Note: Javascript is disabled or ... this page: About CDC.gov . Parvovirus Home About Parvovirus B19 Fifth Disease Pregnancy and Fifth Disease Photos of ...

  1. The sweet Christmas rash (case series)

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

    2013-01-01

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

  2. Skin Rashes Due to Bed-Wetting

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

  3. Hot Tub Rash (Pseudomonas Dermatitis/Folliculitis)

    ... Skin, Ear, & Eye Illness Respiratory Illness Neurologic Illness Wound Infections Other Illnesses Swimming Pool Operation & Disinfection Microbial Testing & Disinfection Swimming Pool Chemicals Injuries & Outdoor ...

  4. 导航技术在颅底-颞下区肿瘤手术中的应用%Application of computer-aided design and navigation technology in skull base and infratemporal fossa tumor surgery

    郭玉兴; 彭歆; 刘筱菁; 张雷; 俞光岩; 郭传殡

    2013-01-01

    Objective To evaluate the application of computer-aided design and navigation technology in skull base and infratemporal fossa tumor surgery and to analyze its advantages and disadvantages.Methods Twenty-nine cases with tumor of skull base and infratemporal fossa were treated with computer-aided design and navigation surgery.The Parameters of age,gender,primary or recurrent tumor,tumor nature and surgical approach were recorded.Results En bloc resection was performed in 20 cases and subtotal resection in 9 cases.The margin status was negative margin in 8 cases,near-tumor margin in 17 cases and positive resection margin in 4 cases.Postoperative complication rate was 14% (4/29).During the follow-up period,2 benign cases recurred.In the malignant group,there were 7 cases of recurrence,2 cases of metastasis and 3 deaths.The 5-year overall survival and progression-free survival rate were 69% and 40% respectively.Conclusions Navigation technology can enhance the confidence of the surgeons and operation safety in handling malignant tumors in skull base and infratemporal fossa.%目的 评价计算机辅助设计导航技术在颅底-颞下区肿瘤手术中的应用价值.方法 对29例颅底-颞下区肿瘤患者行计算机辅助手术方案设计及术中导航.记录患者的年龄、性别、肿瘤原发或复发、肿瘤性质及手术入路.应用SPSS 13.0软件计算生存率.结果 肿瘤完全切除20例、近全切除7例、次全切除2例;切除方式:整块切除20例、分块切除9例;切缘状态:阴性切缘8例、近肿瘤切除17例、阳性切缘4例.术后并发症发生率为14%(4/29).随访期内良性肿瘤复发2例.恶性肿瘤复发7例、转移2例、死亡3例,恶性肿瘤5年总生存率和无进展生存率分别为69%和40%.结论 计算机辅助设计导航技术可提高颅底-颞下区外科操作的手术安全性.

  5. 温州市瓯海区2008—2013年预防接种后过敏性皮疹监测分析%Surveillance analysis on anaphylactic rash after immunization in Ouhai District of Wenzhou City, 2008-2013

    陈红丹; 林献丹; 刘丽琳; 李万仓

    2015-01-01

    [目的] 分析温州市瓯海区2008—2013年预防接种后过敏性皮疹的发生特征. [方法] 收集温州市瓯海区2008—2013年疑似预防接种异常反应( AEFI)信息管理系统中诊断为过敏性皮疹的个案数据,采用描述性流行病学方法进行分析. [结果] 瓯海区2008—2013 年共报告过敏性皮疹111 例,过敏性皮疹报告发生率为3.58/10万剂. 男女性别比为1.27:1;<1岁儿童占65.77%;不伴发热的占75.68%;第三季度报告数占41.44%;主要发生在接种疫苗后24 h内(81.08%). 报告病例数居前三位的是麻-风疫苗(35.14%)、无细胞百白破疫苗(18.92%)、甲型H1N1流感疫苗(5.41%);报告发生率居前三位的是7价肺炎疫苗(115.85/10 万剂)、麻-风疫苗(29.33/10万剂)和甲型H1N1流感疫苗(13.07/10万剂). [结论] 需加强过敏性皮疹的鉴别诊断,虽然大部分疫苗过敏性皮疹报告发生率均在预期范围内,但仍需加强监测分析,尤其要关注发生率相对较高的疫苗.%[ Objective ] To analyze the characteristics of anaphylactic rash after vaccination in Ouhai District of Wenzhou City during 2008-2013. [ Methods ] Data on anaphylactic rash cases reported during 2008-2013 were collected through the national AEFI information management system.And descriptive epidemiologic methodology was used in this study. [ Results] A total of 111 anaphylactic rash cases were reported in Ouhai District during 2008-2013,the reported incidence rate of anaphylactic rash were 3.58 per million doses.The ratio of male-female was 1.27:1.Cases of ≤1 year old accounted for 65.77%.Those without fever accounted for 75.68%.The number of the reports for the third quarter of the year accounted for 41.44%of the total.The cases of anaphylactic rash mostly occurred within 24 h after immunization(81.08%) .The top three vaccines reported in occurrence of rash were measles and rubella at-tenuated live vaccine(35.14%), diphtheria, tetanus and acellular pertussis combined

  6. Medulloblastoma of Posterior Cranial Fossa in Children:a Report of 42 Cases%儿童后颅窝髓母细胞瘤42例临床分析

    毛伯镛; 雷町

    1997-01-01

    目的:为提高对儿童后颅窝髓母细胞瘤的诊治水平.临床资料:42例中男女之比为2:1,平均年龄7.3岁,病变位于小脑蚓部者36例,位于小脑半球6例,均有明显颅内压增高,39例伴重度梗阻性脑积水,31例出现小脑功能障碍.治疗结果:全部病例均行手术治疗,除3例死于术后呼吸循环衰竭外,其余39例恢复良好,术后即行颅脊柱放疗及化疗,随访至今,尚无一例死亡.结论:对儿童后颅窝髓母细胞瘤应采取以手术为主,辅以术后颅脊柱低剂量放疗及化疗的综合性治疗措施.%Objective:To improve the diagnosis and therapy of medulloblastoma of posterior cranial fossa in children.Clinical data:Forty-two cases(male 28,female 14)aging from 1.5 to 12 years(mean 7.3 yrs)were admitted.The lesions were in vermis(36),and cerebellar hemisphere (6).All cases presented symptoms and signs with increased intracranial pressure,and 31 had signs of cerebellar functional deficiency.CT scan showed marked obstructive hydrocephalus in 39 cases.Three died of postoperative respiratory and circulatory failure.Thirty-nine survivors received craniospinal radiotherapy plus chemotherapy have recoverd well.Conclusions:Surgical resection with postoperative low-dose craniospinsl radiotherapy and chemotherapy is a better procedure for medulloblastoma of posterior cranial fossa in children.

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

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

    2004-01-01

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

  8. Research Progress of Diagnosis and Treatment of Solid Hemangioblastoma in Posterior Fossa%后颅窝实质性血管母细胞瘤的诊治研究进展

    凌国源; 陈文斗

    2016-01-01

    Hemangioblastoma is a rare intracranial benign neoplasm and consisted with capillary-rich. Tumor locates mainly in the cerebellar hemisphere, secondly in the cerebellar vermis, a few in the medulla oblongata and spinal cord, but cerebellar screen rare.This article reviews the clinical manifestations, imaging findings, diagnosis and treatment of the patients with vascular neuroblastoma,especially the posterior cranial fossa.%血管母细胞瘤是一种罕见的颅内良性肿瘤,富含毛细血管,肿瘤主要位于小脑半球,其次在小脑蚓部,少数位于延髓、脊髓,但幕上少见。本文对血管母细胞瘤特别是后颅窝血管母细胞瘤的临床表现、影像学表现、诊断及治疗进行综述,深化对后颅窝实质性血管母细胞瘤的认识。

  9. Ultrasound measurement of fetal posterior fossa at 11 to 13 + 6 gestational weeks for screening open spina bifida%11~13+6周胎儿颅后窝结构的产前超声检测

    秦凤真; 李胜利; 华轩; 欧阳玉容; 郑琼; 毕静茹

    2014-01-01

    Objective To establish the normal reference ranges of transabdominal ultrasound measurements of the posterior fossa structure in fetuses at 11 to 13+6 gestational weeks and explore their clinical value in screening open spina bifida (OSB). Methods Between January, 2013 and September, 541 randomly selected normal fetuses underwent nuchal translucency at the gestational age 11 to 13+6 weeks. The parameters of the posterior fossa were measured in mid-sagittal view of the fetal face and the axial view of the transverse cerebellum insonated through the anterior fontanel by transabdominal ultrasound to establish the normal reference ranges. The measurements were obtained from 3 fetuses with OSB for comparison with the reference ranges. Results In normal fetuses, the parameters of the posterior fossa measured in the two views showed no significant differences (P>0.05). Two high echogenic lines were observed in normal fetuses, as compared with one in fetuses with OSB representing the posterior border of the brain stem and the anterior border of the fourth ventricle. The line between the posterior border of the fourth ventricle and the anterior border of the cisterna magna was not displayed in fetuses with OSB. The anteroposterior diameters of the brain stem, the fourth ventricle, and cisterna magna all increased in positive correlation with the crown-lump length in normal fetuses. In the 3 OSB fetuses, the anteroposterior diameter of the brain stem exceeded the 95th percentile and the anteroposterior diameter of fourth ventrical-cisterner magena was below the 5th percentile of the reference range for CRL;the brain stem to fourth ventrical-cisterner magena anteroposterior diameter ratio was increased to above 1. Conclusion The established normal reference ranges of the parameters of fetal posterior fossa may provide assistance in early OSB detection. The absence of the posterior border of the fourth ventricle and the anterior border of the cisterna magna and a brainstem to

  10. 中药治疗表皮生长因子受体酪氨酸激酶抑制剂相关皮疹的Meta分析%Meta-analysis of traditional Chinese medicine in the treatment of skin rash caused by epidermal growth factor receptor tyrosine kinase inhibitor

    陈创; 王秀改; 刘振昌; 张羽

    2015-01-01

    Objective To evaluate the efficacy and safety of traditional Chinese medicine in the treatment of skin rash caused by epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI).Methods The clinical randomized controlled trials of traditional Chinese medicine in the treatment of EGFR-TKI-induced skin rash which published in domestic journals were selected.The quality assessment of included literature was made by Jadad score,RevMan 5.2 software was used to make Meta-analysis.Results A total of 6 studies met the inclusion criteria,the 6 studies included 248 patients,133 cases in the treatment group,115 cases in the control group.All patients were 30 to 75 years old.Compared with the control group,the combined OR value of the clinical efficacy of traditional Chinese medicine in the treatment of EGFR-TKIinduced rash was 7.51,with 95 % confidence interval 4.46-12.65.Conclusions Meta-analysis shows that the clinical efficacy of traditional Chinese medicine in the treatment of EGFR-TKI-induced skin rash is better than Western medicine,and no adverse reactions.It can be widely used in clinical practice.%目的 评价中药治疗表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)相关皮疹的疗效和安全性.方法 检索国内期刊公开发表的关于中药治疗EGFR-TKI相关皮疹的临床随机对照试验文献,对纳入的文献应用Jadad评分法进行质量评价,采用RevMan 5.2软件进行Meta分析.结果 共有6条文献符合纳入标准,共纳入248例患者,其中治疗组133例,对照组115例;患者年龄30 ~ 75岁.与对照组比较,中药治疗EGFR-TKI相关皮疹临床疗效的合并OR值为7.51,95%可信区间为4.46 ~12.65.结论 Meta分析结果显示中药治疗EGFR-TKI相关皮疹的疗效较西药好,且不良反应鲜见,安全性好,可在临床推广应用.

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

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

    2008-01-01

    O presente trabalho teve como objetivo o estudo de copépodes parasitos de fossas nasais de peixes da planície de inundação do alto Rio Paraná. As coletas foram realizadas em diversos pontos da planície nos meses de março, junho e setembro de 2004. Foram coletados 73 exemplares de peixes da ordem Characiformes, de quatro famílias distintas, pertencentes a cinco espécies: Acestrorhynchus lacustris, Prochilodus lineatus, Schizodon borellii, Serrasalmus maculatus e Serrasalmus marginatus. Dentre ...

  12. The Value of Differentiation between Posterior Fossa Medulloblastomas and Ependymomas with ADC Value%ADC值在后颅窝髓母细胞瘤与室管膜瘤鉴别诊断中的价值研究

    刘建雄; 曹代荣; 邢振; 庄碧梅; 刘颖; 丁雅玲

    2011-01-01

    目的 探讨ADC值对后颅窝髓母细胞瘤与室管膜瘤鉴别诊断的价值.资料与方法回顾性分析手术病理证实的9例髓母细胞瘤和5例室管膜瘤的 ADC图像,全部病例均行常规MR平扫+增强扫描、DWI成像,ADC值测定感兴趣区(ROI)置于病灶强化最明显且在ADC图上呈相对低信号部位,取病灶最小ADC值,对同一病例以相同大小ROI置于正常大脑白质区测量三个ADC值,取其平均值.相对ADC值(rADC)取病灶最小ADC值与正常大脑白质区平均 ADC值的比值,对两组病例的ADC值和rADC值分别行Wilcoxon秩和检验.结果 髓母细胞瘤测得的最小ADC值范围为0.49-0.74×10-3 mm2/s,rADC值范围为0.61-1.09;室管膜瘤测得的最小 ADC值范围为0.80-0.92×10-3mm2 /s,rADC值范围为0.91-1.14.髓母细胞瘤与室管膜瘤最小ADC值范围没有重叠.髓母细胞瘤与室管膜瘤间的最小ADC值及rADC值差异均有统计学意义(P<0.05).结论 ADC值的测量可以准确鉴别后颅窝髓母细胞瘤与室管膜瘤.%Objective To evaluate value for differentiating posterior fossa medulloblastomas from ependymomas with apparent diffusion coefficient(ADC).Methods Fourteen patients with historically proved posterior fossa tumor were reviewed restrospectively.There were 9 medulloblastomas, 5 ependymomas.All patients were examined with conventional MRLenchanced MRI and diffusion weighted imaging(DWI).Region of interest (ROI) were draw on low signal regions of apparent diffusion coefficient ADC) maps in enchancing tumor.The lowest ADC values and rADCwere recorded.The ADC values and rADC values in medulloblastomas were compared with those in ependymomas as by using Wilcoxon rank sum test.Results The range of minADC values on medulloblastomas and ependymomas were 0.49-0.74* 10-3mm2/s and 0.80-0.92*10-3mm2/s, the range of rADC values were 0.61-1.09 and 0.91-1.14.There were no overlap in individual tumor minADC values between medulloblastomas and ependymomas.ADC and r

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

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

  14. Avaliação da disposição de lodos de fossa e tanque sépticos em lagoas de estabilização que tratam lixiviados de aterro sanitário

    Samara Monayna Alves Vasconcelos Carrilho

    2016-03-01

    Full Text Available Resumo A destinação dos Lodos de Fossa e Tanque Séptico (LFTS tem resultado em problemas ambientais e de saúde pública, devido principalmente à falta de alternativas adequadas para a destinação, e de fiscalização mais rigorosa. O problema se agrava em municípios desprovidos de estações de tratamento de esgoto, já que a disposição nesses sistemas tem sido a prática mais utilizada no país. Desta forma, a presente pesquisa teve por finalidade avaliar os efeitos da disposição desses lodos no desempenho, operação e manutenção de lagoas de estabilização que tratam lixiviados. O sistema estudado é composto por dois módulos idênticos de lagoa anaeróbia seguida de facultativa, de modo que o módulo receptor de LFTS foi submetido, durante seis meses, a diferentes taxas de aplicação volumétrica de lodo por lixiviado (13 a 204%. Utilizou-se o teste t de Student, para a análise estatística. Os resultados indicaram que, para a taxa máxima, o efluente do módulo receptor apresentou concentrações 1,8; 2,0; e 9,0 vezes superiores ao testemunho, para fósforo, nitrogênio amoniacal e E. coli, respectivamente. Além disso, houve aumento de lodo sedimentado na lagoa anaeróbia receptora (3,5 vezes em relação à testemunho e formação de escuma (0,4 m3 por mês. Entretanto, as interferências na operação e manutenção são de simples solução, pois esses resíduos podem ser destinados no próprio aterro e os padrões de lançamento em corpos hídricos não foram contrariados. Desta forma, as lagoas de estabilização que tratam lixividados apresentam-se como uma alternativa competitiva para a destinação dos LFTS, resguardadas as condições operacionais estudadas.

  15. Temporal fossa intra-extracranial dumbbell schwannoma.

    Wong, Limy

    2011-02-01

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

  16. Temporal fossa intra-extracranial dumbbell schwannoma.

    Wong, Limy

    2012-02-01

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

  17. The influence of gallbladder fossa fluid accumulation on gallbladder wall thickness in liver cirrhosis on sonographic imaging correlation with multi-slice CT scanning%利用CT三维重建分析肝硬化伴胆囊窝积液对胆囊壁超声成像的影响

    谭洁莹; 韦程纲; 谢琦

    2012-01-01

    目的:探讨肝硬化伴胆囊窝积液病者胆囊壁超声与CT三维重建在影像成像以及胆囊壁厚度测量的方面上对比差异.方法:对比39例患者于空腹状态同时行超声以及多层螺旋CT检查的影像图像,B超和CT测量胆囊厚度情况,绘制散点图,并进行Pearson相关性分析,应用配对样本t检验比较胆囊壁厚度情况.结果:①与CT三维重建图像对比,发现其中31例出现胆囊窝积液超声漏诊情况,并且发现胆囊壁厚度的超声测量值,存在高估情况的16例,低估情况2例.②B超与CT胆囊壁厚度的测量值相关系数为0.648 (P<0.000).③B超测量胆囊壁厚度((6.2±2.6)mm)较CT测量胆囊壁厚度((4.5±2.0)mm)平均值更大,测量差异具有统计学意义(t=4.465,P<0.000),变异系数分别为0.42、0.44.结论:局限性胆囊窝积液在CT检查中检出率较超声高,对肝硬化患者胆囊壁增厚与局限性胆囊窝积液能够更准确地进行鉴别诊断.%Objective: To discuss the difference of gallbladder wall thickness in liver cirrhosis with gallbladder fossa fluid accumulation on ultrasound scanning and CT multi-plane reconstruction images. Materials and Methods: Ultrasound scanning and multi-slice CT were performed in 39 patients who had gallbladder fossa fluid accumulation with liver cirrhosis, all cases were under fasting condition. Gallbladder wall thickness was measured both on ultrasonographic and multi —slice CT 3D reconstruction images. The scatter diagram was drawn and Pearson correlation analysis and paired sample t test comparison of gallbladder wall thickness were also carried out. Result: Compared with multi-plane CT reconstruction, (1) Ultrasound missed the diagnosis of gallbladder fossa fluid accumulation in 31 cases, over estimation of gallbladder wall thickness in 16 cases, and under estimation of the thickness in 2 cases. (2)The correlation coefficient of ultrasound detection of gallbladder wall thickness with CT detection was

  18. 快速诊断发热出疹婴幼儿疱疹病毒6型活动感染的研究%Study on fast diagnostics of activated infection of human herpes virus type 6 in infants with fever and rash

    孙荷; 吉川哲史

    2010-01-01

    目的 探讨分别用共聚焦显微镜和荧光显微镜观测疱疹病毒6型(hman herpes virus type 6,HHV-6)早期抗原(IEA)的检测结果,快速诊断发热出疹婴幼儿HHV-6活动感染.方法 采集临床2岁以下发热出疹婴幼儿末梢静脉血55例,在采血当日,用间接免疫荧光法,以HHV-6 IEA/ex3兔单克降抗体,检测患儿单核细胞中的HHV-6 IEA,使用共聚焦显微镜观测结果.同时进行患儿单核细胞HHV-6病毒分离.其中44例患儿单核细胞与脐血细胞混合培养48 h再进行HHV-6 IEA检测,用普通荧光显微镜观测结果.结果 共聚焦显微镜观测采血当日HHV-6 IEA结果与病毒分离结果的符合率达92.73%,敏感度90.32%,特异度95.83%.细胞培养48 h普通荧光显微镜观测结果与病毒分离结果符合率为87.50%,敏感度77.27%,特异度100%.结论 用共聚焦显微镜在采血当日观测HHV-6 IEA,及患儿单核细胞与脐血细胞混合培养48 h用荧光显微镜观测HHV-6 IEA,可以协助临床快速诊断发热出疹婴幼儿HHV-6活动性感染.%Objective To explore the fast diagnostics of activated infection of human herpes virus type 6 (HHV-6) with IEA/ex3( an antibody specific for an immediate early protein encoded by variant B HHV-6 U90 gene)in infants with fever and rash . Methods To collect the 55 samples of peripheral blood mononuclear cells (PBMCs) from clinical infants whose having a fever and rash, age are below 2 years old.The immediate early antigen (IEA) of HHV-6 were analyzed with IEA/ex3 in PBMCs by indirect immunofluorescence then using confocal microscope to observe, and using fluoromicroscope to observe after the PBMCs of 44 samples were incubated with cord blood cell at 37℃ in a humidified 5% CO2 atmosphere for 48 hours. The virus was isolated from the PBMCs. Results The conformation rate of the HHV-6 IEA using confocal microscope to observe and virus isolation was 92.73%, sensitivity was 90.32%, specificity was 95.83% and it was respectively 87

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

    Rita di Cássia de Oliveira Angelo

    2004-09-01

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

  20. Hyper-Immunoglobulin E Syndrome

    Gnanraj Pushpa

    2004-01-01

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

  1. 牛角型经皮气管切开术在颅后窝及颅颈交界区术后患者的应用%Application of horns percutaneous tracheostomy in the patients after posterior fossa and craniocervical junction surgery

    刘恒军; 闫传真; 关靖宇

    2014-01-01

    Objective:To investigate the application of horns percutaneous tracheostomy in the patients after posterior fossa and craniocervical junction surgery.Methods:253 cases of tracheotomy patients were selected from the Department of Severe Neurosurgery between January 2013 and November 2013, and a retrospective analysis was performed on 26 cases of postoperative posterior fossa and craniocervical junction patients with horns percutaneous tracheostomy to analyze the operation time, safety and complications.Results:26 postoperative posterior fossa and craniocervical junction patients were treated with percutaneous tracheostomy, and the mean operation time of 25 patients was 7.3±3.4 minutes, except one patient with the operation time of 15 minutes due to the local anatomic abnormality. The mean intraoperative blood loss was 2.4±1.9 mL. The postoperative short-term complications: one cases of postoperative bleeding, no postoperative infection, no casing off, no formation of sputum that blocking casing, no postoperative hypoxemia; one case of postoperative subcutaneous emphysema, and no postoperative subcutaneous hematoma. Postoperative long-term complications: infection in 0 case; casing off in 0 case; sputum formation that blocking casing in 0 case and postoperative hypoxemia in 0 case.Conclusions:Horns percutaneous tracheostomy has the advantages of less bleeding, short time and high security, which is suitable for the patients with posterior fossa and craniocervical junction surgery, as it can help the patient that can not head distorted or excessive lfexion and extension, and can solve the contradiction in the patients that need axis turn but required tracheotomy.%目的:探讨牛角型经皮气管切开术在颅后窝及颅颈交界区术后患者的应用。方法:回顾性分析2013年1月到2013年11月重症神经外科26例颅后窝及颅颈交界区术后应用牛角型经皮气管切开术患者资料,对手术时间、安全性、并发症等

  2. Spot diagnosis: An ominous rash in a newborn

    Wong William

    2009-04-01

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

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

    Heraldo Guedis Lobo Filho

    2011-03-01

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

  4. Detection of tumoral lesions in the posterior fossa, in brain computerized tomography scans for various conditions of acquiring a preliminary approach; Deteccion de lesiones tumorales en fosa posterior en imagenes de Tomografia Computarizada cerebral para diversas condiciones de adquisicion: un enfoque preliminar

    Perez, M.; Carvalho-Filho, A. E.; Khoury, H. J.; Casas, M. C.; Andrade, M. E.; Paz, J. E.

    2010-07-01

    The present work performs a study over 13 tomographic images, using an anthropomorphic head phantom. It contains small lesions in the posterior fossa. Tube current (I [mA]), slice thickness (E [mm]), were the parameters changed among studies, looking for the best acquisition conditions, which permit good lesion detectability, and applying the lowest dose. Air Kerma in air [mGy] was calculated. Image quality was analyzed by both expert criterion and some merit figures. Two of them were global: contrasts to noise ratio (RCR [dB]) and signal to noise ratio (RSR). The rest of the measures used were relatives to the maximum dose condition: The gain in signal to noise ratio (SNR [dB]) and the maximum signal to noise ratio (PSNR [dB]), the normalized mean squared error (NMSE) and the structural similarity index (SSIM). Objective and subjective results were correlated. It is shown that it is possible to reduce the dose using lower values of mAs without affecting lesion detectability and keeping good image quality for the scanner used. An optimized protocol is also proposed for the technology used. (Author) 27 refs.

  5. 呼和浩特地区2009~2011年发热伴出疹性疾病病原谱监测结果分析%The analysis of surveillance of rash and fever illness in Hohhot during 2009-2011

    卢爱桃; 郭卫东; 海岩; 王文瑞

    2013-01-01

    目的 探讨呼和浩特市地区发热伴出疹症性疾病(RFIs)的病原谱构成.方法 2009~2011年,采用酶联免疫吸附试验(ELISA)对RFIs患者急性期血清标本进行麻疹、风疹、水痘、肠道病毒、小DNA病毒B19、登革热IgM抗体检测,采用Real-time PCR方法对咽拭子标本检测病毒核酸.结果 对31份血清进行IgM抗体检测,其中3份为阳性结果,检出率为9.68%.对294份咽拭子样本进行核酸检测,其中117份为阳性,阳性率为39.80%.共104份为肠道病毒阳性,占所有阳性样本的86.67%,18份为水痘带状疱疹病毒,3份麻疹病毒,1份小DNA病毒B19,其中6份为混合感染.麻疹阳性病例均无免疫史,水痘阳性病例94.44%无免疫史.结论 2009~2011年,呼和浩特地区RFIs病原以肠道病毒为主,其次是水痘病毒.加速肠道病毒疫苗的研制,积极推行水痘、麻疹等疫苗接种是控制RFIs发病的主要措施.%OBJECTIVE To study the pathogen spectrum of rash and fever illness (RFIs) in Hohhot.METHODS From 2009 to 2011,ELISA was used to detect IgM antibody of measles,rubella,varicella-zoster virus,enterovirus,human parvovirus B19,dengue fever in the serum of RFIs samples and real-time PCR was used to detect viral nucleic acid in throat swab of RFIs samples.RESULTS Among 31 serum samples,3 samples were positive,the positive rate was 9.68%.117 samples were positive of 294 throat swab samples,the positive rate was 39.80%.104 samples were positive for enterovirus which accounted for 86.67% of all positive samples,18 samples were positive for varicella-zoster virus,3 samples were positive for measles,1 sample was human parvovirus B19 and 6 samples were mixed infection.All Measles positive cases had no immunization history,94.44% varicella-zoster virus positive cases had no immunization history.CONCLUSION From 2009 to 2011,the main pathogen is enterovirus leading to the RFIs in Hohhot,the next pathogen is varicella-zoster virus

  6. Surveillance and Analysis of Rash and Fever Illness in Binhai New Area (Tanggu District) of Tianjin during 2009-2010%2009-2010年天津滨海新区(塘沽)发热伴出疹性疾病监测分析

    王伟; 张丽平

    2011-01-01

    目的 探讨天津市塘沽地区发热伴出疹症性疾病(RFIs)病原谱构成.方法 采用酶联免疫吸附试验(ELISA)对2009年9月-2010年5月塘沽传染病医院就诊的发热伴出疹性疾病患者急性期血清标本进行麻疹、风疹和水痘IgM抗体检测,咽拭标本采用RT-PCR方法分离病毒.结果 243份血清标本中麻疹IgM抗体阳性检出率为51.44%,风疹IgM抗体阳性检出率为5.76%,水痘IgM阳性检出率为4.12%,三者全部阴性者占38.27%.236份咽试标本中麻疹病毒核糖核酸(RNA)阳性62份,风疹病毒RNA阳性27份.塘沽地区RFIs病例主要为20岁以上成人发病,占总病例的87.65%.麻疹IgM抗体阳性病例中,无免疫史和不详者占92.80%,风疹和水痘IgM抗体阳性病例均无免疫史.结论 目前,塘沽地区发热出疹性疾病以麻疹为主,发病以大年龄组人群为主,同时具有一定的风疹和水痘病例,积极推行疫苗接种是控制麻疹、风疹和水痘发病的主要策略.%[ Objective ] To study the pathogen spectrum of rash and fever illness (RFIs) in Tanggu area of Tianjin. [ Methods ] The method of ELISA was adopted to detect the IgM antibodies of measles, rubella and chickenpox in the serum of RFIs cases during acute stage in Tanggu infectious diseases hospital from September 2009 to May 2010. The viruses were isolated from oropharyngeal swabs by RT-PCR. [ Results] Among 243 serum samples, the positive rates of IgM antibody in measles, rubella and chickenpox were 51.44%, 5.76% and 4. 12% respectively, and 38.27% were negative all for measles, rubella and chickenpox. Among 236 oropharyngeal swabs, 62 samples were positive for measles virus RNA, and 27 samples were positive for rubella virus RNA. 87.65% of the total cases in Tanggu area were adults over 20 years old. Among measles cases with positive IgM antibody, 92.80% had no history or an uncertain history of vaccination. All of rubella and chickenpox cases with positive IgM antibody had

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

    Miréia Aparecida Bezerra Pereira

    2012-04-01

    Full Text Available

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

    Avaliou-se a produção e os aspectos sanitários de alface adubada com efluente humano de fossa séptica biodigestora no Assentamento Rural Vale Verde, Gurupi-TO. Foram realizadas avaliações morfofisiológicas e análises microbiológicas de amostras de água do solo, alface e do efluente de fossa séptica biodigestora. Para número de

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

    Flávia Helena Ciccone

    2010-06-01

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

  9. Infarto agudo do cerebelo simulando tumor da fossa posterior

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

    1992-01-01

    Um homem de 58 anos foi acometido subitamente de cefaléia, vômitos, vertigens e incoordenação das extremidades esquerdas. A tomografia computadorizada do crânio evidenciou área hipodensa no hemisfério cerebelar esquerdo, cujo exame anátomo-patológica mostrou tratar-se de infarto cerebelar.

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

    Roebuck, D.J. [Department of Radiology, Children' s Hospital Los Angeles, Los Angeles (United States); Department of Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH (United Kingdom); Villablanca, J.G. [Department of Pediatrics, Children' s Hospital Los Angeles, Los Angeles (United States); Maher, K.; Nelson, M.D. Jr. [Department of Radiology, Children' s Hospital Los Angeles, Los Angeles (United States)

    2000-07-01

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

  11. Lesão de nervo cutâneo antebraquial lateral relacionada à venipuntura: o que saber?

    Juan A. Ramos

    2014-04-01

    Full Text Available Justificativa e objetivos: a venipuntura é um dos procedimentos mais comuns na prática anestésica cotidiana. Embora geralmente inócuas, lesões de nervos periféricos com sequelas graves foram descritas após venipuntura. Apresentamos um caso de lesão de nervo cutâneo antebraquial lateral relacionada à venipuntura, juntamente com as informações de diagnóstico e prognóstico essenciais para a prática cotidiana. Relato de caso: paciente do sexo masculino, 27 anos, submetido à venipuntura de fossa antecubital direita, com uma agulha de calibre 20, para avaliação metabólica de rotina. O paciente sofreu uma dor aguda, tipo choque elétrico, que percorreu a face lateral do antebraço desde a fossa antecubital proximal até o pulso lateral direito e a base do polegar direito. Após 24 horas, o paciente ainda sentia a dor semelhante a choque elétrico que foi classificada como 8/10 no braço distal lateral direito, no pulso lateral direito e na base do polegar, acompanhada de parestesia. Fizemos uma revisão da literatura e o paciente recebeu orientação sobre os resultados publicados a respeito desse tipo de lesão. Durante o acompanhamento, o paciente relatou que a disestesia diminuiu cerca de 3-4 semanas após a lesão inicial e que não restou déficit neurológico. Conclusões: lesões de nervos periféricos foram descritas pós-venipuntura, mas a literatura é limitada. Os nervos da fossa antecubital estão classicamente localizados em um plano logo abaixo - e muito próximos - das veias, o que os torna susceptíveis a lesões durante a flebotomia; além disso, sabe-se que existe uma extensa variação anatômica, o que sugere que mesmo uma venipuntura satisfatória não traumática pode danificar diretamente esses nervos. O anestesiologista deve estar ciente dessa possível complicação e também do diagnóstico e prognóstico para orientar os pacientes de forma adequada, caso essa complicação ocorra.

  12. Assessment and comparison of anemia of chronic disease in healthy subjects and chronic periodontitis patients: A clinical and hematological study

    Rajashri A Kolte

    2014-01-01

    Full Text Available Background: Bacteremia is associated with periodontal diseases whose extent is related to the severity of inflammation in periodontal tissues. The purpose of this study was to assess and compare the various blood parameters in healthy subjects and severe chronic periodontitis patients. Materials and Methods: 100 patients with severe chronic periodontitis (test group and 100 periodontally healthy subjects (control group in the age group 35-60 years participated in the study. Blood parameters were recorded with blood samples drawn from the antecubital fossa by venous puncture. Results: Periodontitis group showed lower erythrocyte count and mean corpuscular hemoglobin concentration (MCHC, and increased total leukocyte count (TLC and neutrophil, lymphocyte, and eosinophil count, compared to the healthy control group. Conclusions: To conclude, periodontitis may tend toward anemia and there is marked leukocytosis due to increased number of circulating neutrophils and lymphocytes.

  13. An approach to acanthosis nigricans

    Meghana Madhukar Phiske

    2014-01-01

    Full Text Available Acanthosis nigricans (AN is characterized by dark, coarse and thickened skin with a velvety texture, being symmetrically distributed on the neck, the axillae, antecubital and popliteal fossae, and groin folds, histopathologically characterized by papillomatosis and hyperkeratosis of the skin. A high prevalence of AN has been observed recently. Different varieties of AN include benign, obesity associated, syndromic, malignant, acral, unilateral, medication-induced and mixed AN. Diagnosis is largely clinical with histopathology needed only for confirmation. Other investigations needed are fasting lipoprotein profile, fasting glucose, fasting insulin, hemoglobin and alanine aminotransferase for obesity associated AN and radiological investigations (plain radiography, ultrasonography, magnetic resonance imaging/computerized tomography for malignancy associated AN. The most common treatment modalities include retinoids and metformin.

  14. An approach to acanthosis nigricans.

    Phiske, Meghana Madhukar

    2014-07-01

    Acanthosis nigricans (AN) is characterized by dark, coarse and thickened skin with a velvety texture, being symmetrically distributed on the neck, the axillae, antecubital and popliteal fossae, and groin folds, histopathologically characterized by papillomatosis and hyperkeratosis of the skin. A high prevalence of AN has been observed recently. Different varieties of AN include benign, obesity associated, syndromic, malignant, acral, unilateral, medication-induced and mixed AN. Diagnosis is largely clinical with histopathology needed only for confirmation. Other investigations needed are fasting lipoprotein profile, fasting glucose, fasting insulin, hemoglobin and alanine aminotransferase for obesity associated AN and radiological investigations (plain radiography, ultrasonography, magnetic resonance imaging/computerized tomography) for malignancy associated AN. The most common treatment modalities include retinoids and metformin. PMID:25165638

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

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

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

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

    2010-01-01

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

  17. A New-Onset Rash in the Setting of Rifaximin Treatment for Hepatic Encephalopathy

    Fritz, Cassandra D.L.; Adebajo, Corlan; Aronsohn, Andrew; Jensen, Donald M.

    2014-01-01

    We present one of the first cases in the literature to describe an association between Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and rifaximin treatment in a patient with a recent diagnosis of alcoholic hepatitis, stage 2 hepatic encephalopathy, and no known existing allergies. Although SJS/TEN may be a rare reaction with rifaximin, it should be an important clinical consideration.

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

    Raschke RA

    2014-10-01

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

  19. 药物与小儿药疹%Drug and pedo-drug-rash

    徐景华; 孙海蓉

    2006-01-01

    药疹是指药物引起的皮肤粘膜炎症性反应。导致药疹发生的药物达数千种,有报道每20个治疗疗程就有1例药疹发生。药疹轻者仅有一过性皮疹,重症可伴有内脏损害直至危及生命。临床上以抗生素、解热镇痛类、磺胺类及巴比妥类药物最易引发皮肤损害。现就引起小儿药疹的药物、药疹的临床表现及治疗作一综述。

  20. Robot Assisted Laparoscopic Repair of Sciatic Hernia (RASH): A Case Report.

    Singh, Iqbal; Hudson, Jon E; Richards, Kyle A; Hemal, Ashok K

    2011-12-01

    Sciatic hernia is a surgical rarity. One such hernia was incidentally diagnosed in a 79-year-old woman who underwent Robot assisted laparoscopic radical cystectomy for locally invasive bladder cancer. Intra-operatively, a patent hernia sac was noted in the sciatic notch. The hernia was successfully repaired during the same operation by using robot assisted laparoscopic technique. This appears to be the first robot assisted sciatic hernia repair in the world literature although it was done incidentally during another procedure. The technical descriptions of the operation are also applicable when isolated sciatic hernia repair is intended. A robot assisted laparoscopic repair is safe, feasible and well suited to the repair of sciatic hernias in women. The surgeon needs to be aware of this uncommon surgical pathology that may occur in women presenting with persistent chronic pelvic discomfort. PMID:23204714

  1. A Woman with Unilateral Rash and Fever: Cellulitis in the Setting of Lymphedema

    Melissa Joseph

    2015-01-01

    Full Text Available Cellulitis in the setting of lymphedema is an uncommon but clinically important presentation to the emergency department. Stagnant lymph is an ideal medium for bacterial growth and progression can be rapid due to decreased ability to fight infection in the affected area. Infections are commonly caused by gram-positive cocci, though blood cultures are often negative. Treatment should be aimed at rapid initiation of antibiotics targeting these species. There may be a role for antibiotic prophylaxis in recurrent cases.

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

    Guilherme Almeida Rosa da Silva

    2014-01-01

    Full Text Available 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 sandfly of the genus Lutzomyia. There are three main clinical forms of leishmaniasis: visceral leishmaniasis, cutaneous leishmaniasis, and mucocutaneous leishmaniasis. The wide spectrum of nonvisceral forms includes: localized cutaneous leishmaniasis, a papular lesion that progresses to ulceration with granular base and a large framed board; diffuse cutaneous leishmaniasis; mucocutaneous leishmaniasis, which can cause disfiguring and mutilating injuries of the nasal cavity, pharynx, and larynx. Leishmaniasis/HIV coinfection is considered an emerging problem in several countries, including Brazil, where, despite the growing number of cases, a problem of late diagnosis occurs. Clinically, the cases of leishmaniasis associated with HIV infection may demonstrate unusual aspects, such as extensive and destructive lesions. This study aims to report a case of mucocutaneous leishmaniasis/HIV coinfection with atypical presentation of diffuse desquamative eruption and nasopharyngeal involvement.

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

    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...

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

    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...

  5. Simian varicella virus infection of Chinese rhesus macaques produces ganglionic infection in the absence of rash

    Ouwendijk, Werner J. D.; Mahalingam, Ravi; Traina-Dorge, Vicki; Amerongen, Geert van; Wellish, Mary; Osterhaus, Albert D. M. E.; Gilden, Don; Verjans, Georges M.G.M.

    2012-01-01

    Varicella-zoster virus (VZV) causes varicella (chickenpox), becomes latent in ganglia along the entire neuraxis, and may reactivate to cause herpes zoster (shingles). VZV may infect ganglia via retrograde axonal transport from infected skin or through hematogenous spread. Simian varicella virus (SVV) infection of rhesus macaques provides a useful model system to study the pathogenesis of human VZV infection. To dissect the virus and host immune factors during acute SVV infection, we analyzed ...

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

    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, keto...

  7. May 2015 pulmonary case of the month: pneumonia with a rash

    Robbins RA

    2015-05-01

    Full Text Available No abstract available. Article truncated at 150 words. History of Present Illness: A 77-year-old man underwent a thoracic CT scan for follow up of a known thoracic aneurysm. However, he had been feeling tired for about a week with a cough, night sweats and fever. He had no shortness of breath, wheezing or known history of lung disease. Past Medical History, Social History and Family History: He has a history of hypertension and a known thoracic aortic aneurysm. There was a surgical repair of his right clavicle after a motor vehicle accident. He is single and has lived in Arizona for over 50 years. He just returned from a trip to California where he visited Disneyland. He does not smoke. Family history is noncontributory. Current Medications: dutasteride, levothyroxine, atorvastatin. Physical Examination: His physical examination was reported as unremarkable. SpO2 was 95% on room air. Which of the following is appropriate at this time? 1. Begin empiric antibiotics; 2. ...

  8. May 2015 pulmonary case of the month: pneumonia with a rash

    Robbins RA

    2015-01-01

    No abstract available. Article truncated at 150 words. History of Present Illness: A 77-year-old man underwent a thoracic CT scan for follow up of a known thoracic aneurysm. However, he had been feeling tired for about a week with a cough, night sweats and fever. He had no shortness of breath, wheezing or known history of lung disease. Past Medical History, Social History and Family History: He has a history of hypertension and a known thoracic aortic aneurysm. There was a surgical repair ...

  9. A rare cause of petechial rash in the 21st century.

    Wong, Celestine; Lyons, Georgina; Nicolopoulos, Jenny; Varigos, George

    2014-12-01

    Scurvy was first described by Hippocrates (460-370 BC) as a condition characterised by poor dental health, bruising, bleeding and fragile skin. Despite the widespread availability of foods rich in vitamin C in Australia, scurvy continues to afflict certain high-risk subgroups of the population. Cutaneous signs may be the only manifestation of the disease, as in the case presented below, and therefore scurvy continues to be relevant to dermatologists. PMID:25705734

  10. Preliminary characterization of human skin microbiome in healthy Egyptian individuals.

    Ramadan, M; Solyman, S; Taha, M; Hanora, A

    2016-01-01

    Human skin is a large, complex ecosystem that harbors diverse microbial communities. The rapid advances in molecular techniques facilitate the exploration of skin associated bacterial populations. The objective of this study was to perform a preliminary characterization of skin associated bacterial populations in Egyptian individuals. Samples were collected from five healthy subjects from two skin sites; Antecubital Fossa (AF) and Popliteal Fossa (PF). Genomic DNA was extracted and used to amplify bacterial 16S rRNA genes which were sequenced on Illumina MiSeq platform. The two sites showed distinct diversity where PF was more diverse than AF. Taxonomic analysis of sequences revealed four main phyla Proteobacteria, Firmicutes, Actinobacteria and Deinococcus-Thermus, with Proteobacteria presenting the highest diversity. Klebsiella, Bacillus, Pseudomonas and Escherichia were the most predominant genera. Our data suggest that environmental factors can shape the composition of the skin microbiome in certain geographical regions. This study presents a new insight for subsequent analyses of human microbiome in Egypt. PMID:27545210

  11. Allergy to Prolene Sutures in a Dural Graft for Chiari Decompression

    Iahn Cajigas

    2015-01-01

    Full Text Available Allergy to Prolene suture is exceedingly rare with only 5 cases reported in the literature. There have been no such cases associated with neurosurgical procedures. Diagnosis is nearly always delayed in spite of persistent symptomatology. A 27-year-old girl with suspected Ehlers-Danlos, connective tissue disorder, underwent posterior fossa decompression for Chiari Type 1 malformation. One year later, the patient presented with urticarial rash from the neck to chest. Cerebrospinal fluid and blood testing, magnetic resonance imaging, and intraoperative exploration did not suggest allergic reaction. Eventually skin testing proved specific Prolene allergy. After suture material was removed, the patient no longer complained of pruritus or rash. This single case highlights the important entity of allergic reaction to suture material, namely, Prolene, which can present in a delayed basis. Symptomatology can be vague but has typical allergic characteristics. Multidisciplinary approach is helpful with confirmatory skin testing as a vital part of the workup.

  12. The morphology of synovial grooves (Fossae synoviales) in joints of cattle of different age groups

    Wegener, K. M.; Heje, N. I.; Aarestrup, Frank Møller;

    1993-01-01

    The joint cartilage of the head of the radius, the metacarpal bone, the tibial cochlea, the proximal trochlea of the talus and the metatarsal bone of 26 cattle in the age groups fetuses, 0 days, 2-5 weeks, 2-5 months, 7-13 months, 2-3.5 years, and 5-7 years were examined macroscopically and histo...... animals aged from 3 weeks to 13 months dyschondroplastic (osteochondrotic) lesions were observed in the joint cartilage both inside and outside the groove areas on one or more joint surfaces.......The joint cartilage of the head of the radius, the metacarpal bone, the tibial cochlea, the proximal trochlea of the talus and the metatarsal bone of 26 cattle in the age groups fetuses, 0 days, 2-5 weeks, 2-5 months, 7-13 months, 2-3.5 years, and 5-7 years were examined macroscopically...... and histologically. Synovial grooves developed on all joint surfaces examined, but at different times. At some locations the development of the grooves began prenatally. During the groove development the same features were in principle observed on all joint surfaces: Degeneration and progressive thinning...

  13. Acoustic Schwannoma Presenting as Acute Posterior Fossa Hematoma: Case Report and Review of the Literature

    Ghobashy, Ashraf; van Loveren, Harry

    1993-01-01

    Acoustic schwannomas usually present with gradually progressive unilateral sensorineural hearing loss. As the tumor enlarges, symptoms and signs develop when the adjacent cranial nerves, cerebelhim, and/or brainstem become compressed. Rarely, acoustic tumors present with acute subarachnoid or intratumoral hemorrhage. Of the 12 cases of acoustic schwannoma with tumoral hemorrhage presented in the literature of which we are aware, this is the third such case of a patient presenting with spontan...

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

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

    2013-01-01

    Extinct animal behavior has often been inferred from qualitative assessments of relative brain region size in fossil endocranial casts. For instance, flight capability in pterosaurs and early birds has been inferred from the relative size of the cerebellar flocculus, which in life protrudes from the lateral surface of the cerebellum. A primary role of the flocculus is to integrate sensory information about head rotation and translation to stabilize visual gaze via the vestibulo-occular reflex...

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

    Cho, Kyu Ran; Kim, Jung Hyuk; Shin, Bong Kyung; Lee, Nam Joon [Korea Univ. Hospital, Seoul (Korea, Republic of)

    2001-11-01

    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.

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

    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

  17. Vestibular schwannoma and tuberculoma occurring In collision in the posterior fossa: A case report

    Muzumdar, Dattatraya; Mahore, Amit; Ramdasi, Raghvendra; Bhatjiwale, Mrudul

    2015-01-01

    Highlights • We report a case of a 46 years female found to have vestibular schwannoma and tuberculoma in collision. • Such association of vestibular schwannoma and tuberculomas never been reported. • It must be kept in mind if two different tumors are detected radiologically in patients residing in endemic regions of tuberculosis.

  18. The Middle Fossa Approach for the Removal of a Trochlear Schwannoma

    Andrew B. Boucher

    2014-01-01

    Full Text Available Objectives. Schwannomas originating from the trochlear nerve are extremely rare; only 30 cases have been reported in the literature. Many operative approaches have been utilized for lesion resection, but the advantages of the anterior transpetrosal approach are numerous and include excellent exposure, minimal extradural retraction of the temporal lobe, and minimal cerebrospinal fluid leaks. We report the second case of a trochlear schwannoma resected via the anterior transpetrosal approach. Setting. A 64-year-old male presented with 3-month history of diplopia and headaches. On physical examination, he was found to have a right fourth nerve palsy. Brain magnetic resonance imaging revealed a mass within the right ambient cistern compressing the adjacent midbrain. A right-sided anterior transpetrosal approach was used—which confirmed that the trochlear nerve entered the mass—to achieve gross total resection. Pathological examination confirmed diagnosis of schwannoma. The patient was discharged on postoperative day 3. He experienced a persistent fourth nerve palsy postoperatively with an otherwise normal neurological examination. Follow-up imaging confirmed complete removal of the tumor. Conclusion. The anterior transpetrosal approach is an excellent approach for removal of trochlear schwannomas involving the cisternal course of the trochlear nerve. It affords complete visualization of this anatomical region while introducing minimal morbidity.

  19. Convective heat flux from hydrothermal system: First monitoring results at La Fossa of Vulcano

    Diliberto, I. S.; Istituto Nazionale di Geofisica e Vulcanologia, Sezione Palermo, Palermo, Italia; Finizola, A.; Istituto Nazionale di Geofisica e Vulcanologia, Sezione Palermo, Palermo, Italia; Madonia, P.; Istituto Nazionale di Geofisica e Vulcanologia, Sezione Palermo, Palermo, Italia; Aubert, M.; Université Blaise Pascal et CNRS-LMV

    2005-01-01

    Fluids circulating inside hydrothermal systems drive thermal and kinetic energy to balance the acting forces. Convective heat flux variations can be affected either by change in regional tectonic factor and by magma migration, both processes accountable for volcanic risk. The thermal release on quiescent volcano is not negligible if compared to that associated to eruptions, according to balances on hydrothermal activity and eruptive activity (Nuccio & Valenza, 1986, Chiodini et al., 2001). Mo...

  20. The extended retrosigmoid approach for neoplastic lesions in the posterior fossa: technique modification

    Raza, Shaan M.; Quinones-Hinojosa, Alfredo

    2010-01-01

    Approaches to the cerebellar-pontine angle and petroclival region can be challenging due to intervening eloquent neurovascular structures and cerebellar retraction required to view this anatomic compartment with the standard retrosigmoid technique. As previously described [11], the extended retrosigmoid provides additional access to space ventral to the brainstem through mobilization of the sigmoid sinus. We report our further experience and modifications of this approach for neoplastic patho...

  1. Estimates of seismic activity in the Cerberus Fossae region of Mars

    Taylor, J.; Teanby, N. A.; Wookey, J

    2013-01-01

    The 2016 NASA InSight lander is the first planetary mission designed to study the deep interior of Mars. InSight's Seismic Experiment for Interior Structure (SEIS) package will quantify global and regional seismic activity and determine parameters like core properties, mantle composition, and Martian lithospheric thickness. An improved understanding of the location, magnitude, and frequency of potential seismic sources is essential for optimization of instrument design, sampling strategy, and...

  2. Large lateral meniscal ganglion cyst extending into the intercondylar fossa of the knee.

    Jäger, Alwin; Eberhardt, Christian; Hailer, Nils P

    2004-07-01

    We report the case of a 31-year-old, otherwise healthy man with a large intra-articular meniscal ganglion cyst (27.7 x 13.5 mm) originating from the dorsal horn of the lateral meniscus. Clinically, the patient presented with knee pain in a squatting position. Magnetic resonance imaging revealed a large intra-articular cyst in the posterior compartment. At arthroscopic surgery, the ganglion cyst was found in the intercondylar space posteriorly to the posterior cruciate ligament. After removal of the ganglion cyst, a horizontal tear in the dorsal horn of the lateral meniscus was revealed and treated by partial meniscectomy. To our knowledge, a meniscal ganglion cyst originating from the lateral meniscus and extending into the joint is an extremely rare event, with only two previous reported cases. We review the current literature on the pathogenesis, distribution, and treatment of meniscal ganglion cysts. PMID:15243414

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

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

    1995-01-01

    stereomicroscopic changes was selected for histologic examination (x16). The histologic enamel and dentine changes were classified independently using 9 and 7 scores, respectively. The correlation between SM and the histologic enamel changes (HE scores) in terms of progressive demineralization and destruction were...... highly correlated (rs = 0.90). Dentinal changes were also highly correlated with enamel changes (rs = 0.85). The histologic classifications in conjunction with the macroscopical observations made it possible to demonstrate a clear relationship between the external degree of caries progression and the...... internal enamel and dentine reactions. The data did not support routine usage of radiographic examination for occlusal caries diagnosis....

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

    Jung-Ying Chiang

    2015-01-01

    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.

  5. Towards a Proactive Risk Mitigation Strategy at La Fossa Volcano, Vulcano Island

    Biass, S.; Gregg, C. E.; Frischknecht, C.; Falcone, J. L.; Lestuzzi, P.; di Traglia, F.; Rosi, M.; Bonadonna, C.

    2014-12-01

    A comprehensive risk assessment framework was built to develop proactive risk reduction measures for Vulcano Island, Italy. This framework includes identification of eruption scenarios; probabilistic hazard assessment, quantification of hazard impacts on the built environment, accessibility assessment on the island and risk perception study. Vulcano, a 21 km2 island with two primary communities host to 900 permanent residents and up to 10,000 visitors during summer, shows a strong dependency on the mainland for basic needs (water, energy) and relies on a ~2 month tourism season for its economy. The recent stratigraphy reveals a dominance of vulcanian and subplinian eruptions, producing a range of hazards acting at different time scales. We developed new methods to probabilistically quantify the hazard related to ballistics, lahars and tephra for all eruption styles. We also elaborated field- and GIS- based methods to assess the physical vulnerability of the built environment and created dynamic models of accessibility. Results outline the difference of hazard between short and long-lasting eruptions. A subplinian eruption has a 50% probability of impacting ~30% of the buildings within days after the eruption, but the year-long damage resulting from a long-lasting vulcanian eruption is similar if tephra is not removed from rooftops. Similarly, a subplinian eruption results in a volume of 7x105 m3 of material potentially remobilized into lahars soon after the eruption. Similar volumes are expected for a vulcanian activity over years, increasing the hazard of small lahars. Preferential lahar paths affect critical infrastructures lacking redundancy, such as the road network, communications systems, the island's only gas station, and access to the island's two evacuation ports. Such results from hazard, physical and systemic vulnerability help establish proactive volcanic risk mitigation strategies and may be applicable in other island settings.

  6. Skin rash caused by montelukast sodium tablets%孟鲁司特钠片致皮疹

    侯会玲

    2008-01-01

    1例51岁女性患者,有过敏史,因支气管哮喘,在吸入布地奈德的同时,口服孟鲁司特钠10 mg/d.服药第3天,四肢出现皮疹,伴瘙痒,立即停服孟鲁司特钠,继续使用布地奈德,给予氯雷他定10 mg/d口服.3 d后,皮疹减轻,1周后皮疹消退.

  7. If you can't stand the rash, get out of the kitchen: an unusual adverse reaction to ciprofloxacin.

    Jaffé, A; Bush, A

    1999-12-01

    Ciprofloxacin, a quinolone antibiotic, is used to treat a wide variety of infections including Pseudomonas aeruginosa in patients with cystic fibrosis (CF). Photosensitivity is a well-known complication of treatment with this group of antibiotics, and it is more common in patients with CF. We report on a case of photosensitivity induced by indoor fluorescent strip-lighting (spectral range, 295-760 nm) in a 12-year-old girl with CF treated with ciprofloxacin. This type of lighting emits UVA rays (320-400 nm) which cause skin damage in the presence of sensitizing agents. Patients taking ciprofloxacin are usually advised to protect their skin from direct sunlight. We suggest that more attention should be paid to indoor sources of UV light. PMID:10587421

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

    Steven Jason Crellin

    2016-01-01

    Full Text Available 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.

  9. Clinical report: the joint obstetric and psychiatric management of phobic anxiety disorders in pregnancy.

    Patel, Roshni R; Hollins, Kathryn

    2015-01-01

    Women who struggle with distressing pregnancy-related phobic anxiety disorders are regularly encountered in maternity services, and their management poses particular challenges. Early identification is crucial in order to offer an opportunity to treat and manage their fears and enable a positive birth experience. In this article, women with different phobias (tokophobia, emetophobia and ante-cubital fossa phobia) describe their first pregnancy experience, and the ways in which the Chelsea and Westminster Hospital offered them joint maternity and psychiatric care. A multidisciplinary hospital-based approach can be effective in managing mental health problems in pregnancy. Despite maternal preconceptions and professional misgivings, this approach can work for women with phobias and enable a good birth experience and successful mother and infant bonding. The lead obstetrician for mental health and perinatal psychiatrist describe their roles in enabling successful outcomes for both the current and subsequent pregnancies. The case is made for training of maternity staff in both the identification of severe pregnancy phobias and the prompt referral for shared psychiatric and maternity care. Even if previous treatments have failed, adequate coping strategies for childbirth may be achieved in a short time frame. Long-term improvements in the phobia itself may also be found. PMID:25547323

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

    Crellin, Steven Jason; Katz, Kenneth D

    2016-01-01

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

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

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

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

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

    2005-07-15

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

  13. Remote multiple intracranial hemorrhage in multiple metastatic lung adenocarcinoma following decompression of posterior fossa lesion: Unknown cause

    Subhas Konar

    2015-01-01

    Full Text Available Cerebral metastasis can present with hemorrhage. However, multiple hemorrhages in metastatic lesions following surgical decompression of a single lesion are never reported. We report a case of cerebral metastasis from lung cancer that developed multiple hemorrhages in supratentorial metastatic lesions following surgical resection of an infratentorial lesion.

  14. The enigma of post-radiation oedema and residual or recurrent carcinoma of the larynx and pyriform fossa

    Persistence of significant laryngeal oedema following radiotherapy presents the surgeon with a diagnostic dilemma. Though the oedema may represent a prolonged response to irradiation, the possibility of residual carcinoma must be considered. Several authors have commented upon it and have suggested frequent biopsies to prove the presence of residual or recurrent neoplasm (Ward et al., 1975; Lederman, 1970; Calcaterra et al., 1972). Some reluctance to laryngeal biopsy has been exercised to avoid inciting a fulminant perichondritis. However, the difficulty of obtaining a positive biopsy in a post-irradiated case is well known, and repeated negative biopsies do not exclude the presence of a residual tumour. The present paper studies 52 histopathologically proven cases of carcinoma of the larynx and laryngopharynx which had received radiotherapy earlier. These cases underwent salvage radical surgery on clinical suspicion of residual/recurrent tumour, manifested by persistence of significant laryngeal oedema and/or fixation of the larynx. No positive biopsies have been obtained following radiotherapy. (author)

  15. Posterior fossa craniectomy and C1/C2 laminectomy for Arnold-Chiari II decompression of syrinx

    Zammit, Daniela; Iles, Kelly

    2013-01-01

    This patient was diagnosed shortly after birth with right-sided facial palsy as a result of lower motor neuron facial nerve involvement, together with spinal abnormalities and hearing impairment (patient currently uses hearing aids). He also has 13 ribs on his left side and 11 ribs on the right, hemi-vertebra at T2/T3 and T8/T9 and fused vertebral bodies at C2/C3 and C6/C7. As a result, clinically he has a short neck with restriction of all neck movements, particularly rotation. Patient is al...

  16. Utility of abdominal ultrasonography in acute painful tables of right iliac Fossa with appendicitis acute suspicion. Maciel Hospital Experience

    Acute appendicitis is one of the most frequent causes of consultation and of indication of emergency laparotomy in most western countries. Despite its diagnostic being based mainly on clinical examination, there is a certain percentage of patients whose clinical presentation is atypical. In these cases image methods such as the abdominal ultrasound are particularly useful as diagnostic auxiliaries.The objective of this work is to compare the echographic with the Anatomopathological diagnosis in 80 patients who consulted the Hospital Maciel emergency service with episodes of acute appendicitis

  17. Significance of the site of injection in unexpected right-to-left shunting

    Lung perfusion scintigraphy, with Tc-99m MAA injected into a left antecubital vein, revealed extensive uptake in the myocardium, kidneys, spleen, thyroid, and brain. After a right antecubital injection, a normal pulmonary perfusion pattern was found. This finding is specific for right-to-left shunting due to anomalous systemic venous drainage into the left atrium

  18. Impact of donor arm cleaning with different aseptic solutions for prevention of contamination in blood bags.

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

    2013-03-01

    Transfusion associated sepsis cases are encountered occasionally and bacterial transmission remains the major cause. The goal of our study was to compare the efficacy of disinfectants in phlebotomy site preparation. After selection of donor the antecubital fossa area of the arm was disinfected with different types of disinfectants namely sprit (70% isopropyl alcohol), povidone iodine (0.5% w/v available iodine in distilled water), savlon (1.5% v/v chlorhexidine gluconate solution and 3.0% cetrimide solution) and combination of sprit and povidone iodine. Swabs were collected from 20 donors using a sterile forceps, after cleaning with different antiseptic solutions. Swab was streaked on blood agar plate aseptically and the plate was incubated at 37°C for 24 h. Colonies were counted and a single colony was re-cultured by growing on nutrient and Mac-Conkey agar. The biochemical characteristics were determined by performing Gram staining, Motility, Catalase and Oxidase tests. The mean values of colonies were significantly higher with savlon compared to other three solutions. The difference was statistically significant by "t" test (t values 1.7-3.0; P sp., Streptococcus sp., Micrococcus sp., Bacillus megaterium and Bacillus cereus were the organisms identified. After completion of bleeding, samples from the bag were aseptically inoculated in aerobic and anaerobic culture bottles to be tested on BacT/Alert system. The bag containing donor's blood did not show any contamination when three cleanings were carried out using sprit, povidone iodine and spirit respectively. PMID:24426327

  19. Dermatitis irritativa del pañal: Tratamiento local con productos barrera y calidad de vida Diaper rash: Local treatment with barrier products and quality of life

    Justo Rueda López

    2012-03-01

    Full Text Available Los trastornos cutáneos son derivados, en la mayoría de las ocasiones, de agresiones continuas por elementos externos que tiene como respuesta reacciones como la pérdida de lípidos epidérmicos por efecto de la humedad, cambios en el pH cutáneo (alcalinización y aumento del coeficiente de fricción (denudación junto al desequilibrio de la flora saprofita de la piel, que se traducen en procesos irritativos y en un aumento de la infecciones fúngicas y bacterianas en la zona expuesta a humedad. Dada la importancia de evaluar la calidad de vida de los pacientes con dermatitis que son tratados con productos barrera no irritantes (PBNI se ha desarrollado un estudio multicéntrico, con el objetivo de evaluar los aspectos relacionados con la mejora en la calidad de cuidados a pacientes tratados con Cavilon® que presentaban dermatitis por incontinencia mediante la escala ESCLI. Los pacientes incluidos en el estudio fueron 25. Los resultados muestran una mejora importante de los aspectos evaluados mediante la escala ESCLI sobre la evolución de la dermatitis. Esta escala valora aspectos como el área afectada por el enrojecimiento y la severidad, presentan una reversión del 47% de los casos. La denudación de la piel en la zona del pañal desaparece en el 56% de los casos y la severidad de la denudación que presenta una mejoría del 47%. La valoración del dolor en la zona de incontinencia se reduce en un 76% en la zona de incontinencia y en un 73% al realizar la limpieza de la zona. Las conclusiones del presente estudio ponen de manifiesto que la aplicación de productos formadores de una película barrera no irritante (PBNI en los pacientes que presentan dermatitis por incontinencia representa una alternativa a los tratamientos convencionales como son las cremas o ungüentos de óxido de cinc o pastas al agua. La reversión y reducción de la dermatitis es un aspecto que presenta una mejoría importante. Los resultados obtenidos que podemos relacionar con la calidad de vida o más concretamente con la mejora del dolor son destacables.The skin disorders are derived in most cases continuous injuries by external factors that have how responses the loss of epidermal lipids by the effect of moisture, derived of changes in skin pH (alkalinization, an increased coefficient of friction (denudation and the imbalance of the saprophytic flora of the skin, give how a result an increase to the irritative processes and the fungal and bacterian infections in the area exposed to moisture. Given the importance of assessing the quality of life of patients with dermatitis who are treated with No Sting Barrier Film (NSBF CavilonTM has developed a multicenter study, in order to evaluate the related to improving the quality of care that patients Incontinence Dermatitis with ESCLI scale. Patients included in the study were 25. The results show a significant improvement aspects ESCLI assessed by the scale of the evolution of the dermatitis. This scale assesses aspects such as the area affected by the redness and severity. Show a reversal 47% of cases. The denudation of the skin in the diaper area disappears in 56% of cases and the severity of the denudation which has a 47% improvement. The assessment of pain in the area of incontinence, is reduced by 76% in the area of incontinence and a 73% when cleaning the area. The findings of this study prove indicates that the application of forming products of a No Sting Barrier Film (NSBF in patients with incontinence dermatitis is an alternative to conventional treatments such as creams or ointments or zinc oxide paste water. The reversal and reduction of dermatitis is an aspect that has improved important. The results that we can relate to quality of life or longer specifically with the improvement of pain are significant.

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

    Heeger, Steffen; Hofheinz, Ralf-Dieter; McCloud, Philip; Ocvirk, Janja

    2013-01-01

    Background. 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 r...

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

    2013-01-01

    Background 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 re...

  2. Assessment of injuries in pyramidal tracts and cerebellar peduncles using three-dimensional anisotropy contrast MRI in patients with brain tumors in posterior fossa

    The purpose of this study is to evaluate neuronal tracts in patients with infratentorial brain tumors using three-dimensional anisotropy contrast (3DAC) imaging technique. Twenty-one patients with infratentorial tumors underwent echo-planar diffusion-weighted imaging (DWI). Gray-scale DWIs in each of the three orthogonal diffusion gradients were transformed and color-coded with three primary colors to compose a 3DAC image. Morphological changes of neuronal tracts were assessed. Fine anatomical structures of neuronal tracts were visible on 3DAC images, including pyramidal tracts, medial leminsci, and superior and middle cerebellar peduncles. Pathological findings of these tracts were categorized as compression or displacement, alteration of fiber directionality, involvement in tumor invasion or perifocal edema, and loss of anisotropy characterized by fading of color. Among these, only loss of anisotropy correlated with tract-related clinical deficits. Three-DAC imaging is useful in evaluating infratentorial neuronal tracts, and in providing useful information to determine surgical strategy in patients with infratentorial brain tumors. (author)

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

    BernadineDonahue; MaryAnneH.Marymont; SandraKessel; EmikoHolmes; MehmetKocak; RogerJ.Packer

    2012-01-01

    Purpose: Associations of radiation therapy (RT) deviations and outcomes in medulloblastoma have not been defined well, particularly in the era of reduced-dose craniospinal irradiation and chemotherapy. The aim of this study is to evaluate the quality of RT on Children’s Cancer Group/Pediatric Oncology Group 9961 and analyze associations of RT deviations with outcome. Materials and Methods: Major volume deviations were assessed based on the distance from specified anatomical region to field ed...

  4. Impaired hyperemic response is predictive of early access failure.

    Wall, L Philipp; Gasparis, Antonios; Callahan, Susan; van Bemmelen, Paul; Criado, Enrique; Ricotta, John

    2004-03-01

    The aim of this study was to demonstrate that hyperemic response is a predictor of access failure. We conducted a review of a prospective database of dialysis access patients with preoperative hyperemia studies from June 1998 to August 2002. These consisted of bilateral brachial artery pressures followed by flow velocity measurements of the brachial artery and radial artery at rest and after 3 min of arm ischemia. Measurements were taken by using a cuff placed above the antecubital fossa and inflated to 20 mmHg above systolic pressure. There were no differences recorded in brachial artery pressures for the bilateral studies. Hyperemic response was entered into a stepwise Cox regression to determine its effect on access failure. Access failure was defined as failure to mature or thrombosis. Accesses were placed according to Dialysis Outcome Quality Intiatives (DOQI) guidelines. Kaplan-Meier survival analysis was performed. Log-rank testing was used to compare patency results. Censored end points were death, renal transplant, and access survival to the end of the study period. Fistulas that failed to mature were considered failures at 3 months. Arteries with a <5 cm/sec increase in peak systolic velocity were defined as nonresponders. The 59 arteries used for dialysis access were divided into two groups on the basis of their hyperemic response in cm/sec. The nonresponders were compared with the remainder of accesses performed. Accesses based on arteries with absent or minimal hyperemic response had significantly lower (p < 0.0005) secondary patencies by Kaplan-Meier analysis. Upon further stratification into radial and brachial arteries, the significant difference in secondary patency remained for radial artery--based accesses (p = 0.024) and approached statistical significance for brachial artery--based accesses (p = 0.057). A significant difference was not seen in primary patencies, indicating that accesses based on arteries with an acceptable hyperemic response

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

    MedhatMOsman

    2011-11-01

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

  6. Mild episodes of tourniquet-induced forearm ischaemia-reperfusion injury results in leukocyte activation and changes in inflammatory and coagulation markers

    Bastawrous Salah S

    2007-05-01

    Full Text Available Abstract Background Monocytes and neutrophils are examples of phagocytic leukocytes, with neutrophils being considered as the 'chief' phagocytic leukocyte. Both monocytes and neutrophils have been implicated to play a key role in the development of ischaemia-reperfusion injury, where they are intrinsically involved in leukocyte-endothelial cell interactions. In this pilot study we hypothesised that mild episodes of tourniquet induced forearm ischaemia-reperfusion injury results in leukocyte activation and changes in inflammatory and coagulation markers. Methods Ten healthy human volunteers were recruited after informed consent. None had any history of cardiovascular disease with each subject volunteer participating in the study for a 24 hour period. Six venous blood samples were collected from each subject volunteer at baseline, 10 minutes ischaemia, 5, 15, 30, 60 minutes and 24 hours reperfusion, by means of a cannula from the ante-cubital fossa. Monocyte and neutrophil leukocyte sub-populations were isolated by density gradient centrifugation techniques. Leukocyte trapping was investigated by measuring the concentration of leukocytes in venous blood leaving the arm. The cell surface expression of CD62L (L-selectin, CD11b and the intracellular production of hydrogen peroxide (H2O2 were measured via flow cytometry. C-reactive protein (CRP was measured using a clinical chemistry analyser. Plasma concentrations of D-dimer and von Willebrand factor (vWF were measured using enzyme-linked fluorescent assays (ELFA. Results During ischaemia-reperfusion injury, there was a decrease in CD62L and an increase in CD11b cell surface expression for both monocytes and neutrophils, with changes in the measured parameters reaching statistical significance (p =2O2 production by leukocyte sub-populations, which was measured as a marker of leukocyte activation. Intracellular production of H2O2 in monocytes during ischaemia-reperfusion injury reached statistical

  7. What Is Shingles?

    Full Text Available ... three stages -- severe pain or tingling, possibly itchy rash and blisters that look like chicken pox but ... Adriana Marques M.D.: The location of the rash is a clue if the rash is shingles ...

  8. Lichen Planus

    ... scalp problems Itchy skin Painful skin / joints Rashes Diaper rash: How to treat Lichen planus Lupus and your skin Nickel allergy Pityriasis rosea Rash 101 in adults: When to seek treatment Scaly skin Skin cancer ...

  9. Eritema infeccioso: un exantema infantil a considerar en la práctica diaria Fifth disease or infectious erythema: a childhood rash to consider in the daily medical practice

    AD Pérez-Elizondo

    Full Text Available Se presenta el caso de un escolar con febrícula y leve ataque del estado general, quien desarrolla una erupción maculosa en mejillas, pocos días después un exantema en "encaje" o reticulado en tronco posterior y parte proximal de extremidades inferiores, compatible con la quinta enfermedad y confirmado por la morfología lesional característica y la inmuno-serología (IgM.We present a five years old child with a mild fever and malaise, a maculoedematous eruption on cheeks and a "lace" exanthema located on posterior aspect of the trunk and lower limbs, developed after a few days. A fifth disease was diagnosticated based on characteristic morphological presentation and immunoserological studies.

  10. Adubação do milho: IX - Ensaio com lôdo de fossas sépticas "OMS" Fertilizer experiments with corn: IX - Trial with dried sewage sludge

    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.

  11. The Value of Apparent Diffusion Coefficient in Differentiation of Pediatric Posterior Fossa Tumors%表观扩散系数值鉴别儿童后颅窝肿瘤的价值

    季学满; 张宗军; 卢光明; 毕俊; 袁彩云; 王俊鹏; 贾传海

    2011-01-01

    Objective To assess the utility of apparent diffusion coefficient ADC) for differential diagnosis of common pediatric posterior possa tumors. Materials and Methods In 43 pediatric patients with surgically and pathologically confirmed posterior possa tumors, there were 24 medulloblastomas,10 pilocytic astrocytomas,and 9 ependymomas. All pediatric patients recevied conventional MRI,DWI and contrast enhanced MRI examination, the signal intensity of tumor parenchyma was compared with that of normal cerebellar parenchymas. ADC values of tumor parenchyma were measured quantitatively. ADC values of medullohlastomas, pilocytic a8trocytomas,and ependymomas were compared by Wilcoxon rank sum test. Results On ADC map,In 24 patients with medulloblastomas, the tumors showed hypointense in 9 patients, slightly hypointense in 12 patients, and isointense in 3 patients; the average ADC value of tumor parenchymas was (0.70 ±0. II) x 10-3 mm2/s. All tumors showed hyperintense in 10 patients with pilocytic astrocytoma, the average ADC value of tumor parenchymas was (1.80 ±0.30) ×10-3 mm2/s. In 9 patients with ependymomas, the tumors showed slightly hyperintense in 5 patients, hyperintense in 4 patients; the average ADC value of tumor parenchymas was ( 1. 16 ±0.18) ×10-3 mm2/s. The ADC value of medulloblastoma was lower than that of pilocytic astrocytoma, which was statistically significant ( Z = -4. 54, P < 0.01). The ADC value of medulloblastoma was lower than that of ependymoma, which was statistically significant (Z= -4.29,P < 0.01), The ADC value of pilocytic astrocytoma was higher than that of ependymoma,which was statistically significant (Z= -3. 27,P < 0. 05). Conclusion Measurement of ADC value of cerebral tumor parenchyma is a simple and available method, which is useful for preoperative differentiation of pediatric posterior possa tumors, especially in differential diagnosis of medulloblastoma and pilocytic astrocytoma.%目的 评价MRI表观扩散系数(ADC)值在儿童小脑常见后颅窝肿瘤的鉴别诊断价值.资料与方法 43例经临床治疗及手术病理证实的儿童后颅窝肿瘤患者中,髓母细胞瘤24例,毛细胞型星形细胞瘤10例,室管膜瘤9例.所有患者行常规MRI、扩散加权成像(DWI)及增强MBI检查,在重组的ADC图像上比较肿瘤实质与正常小脑实质的信号强度,定量测定肿瘤实质区的ADC值.三组肿瘤实质的ADC值比较采用Wilcoxon秩和检验.结果 ADC图像上24例髓母细胞瘤中,9例肿瘤呈低信号、12例呈略低信号、3例呈等信号;肿瘤实质的平均ADC值为(0.70±0.11) ×l0-3mm2/s.所有10例毛细胞型星形细胞瘤均呈高信号,肿瘤实质的平均ADC值为(1.80±0.30)× 10-3 mm2/s.9例室管膜瘤中,5例肿瘤呈略高信号、4例呈高信号;肿瘤实质的平均ADC值为(1.16±0.18) ×l0-3 mm2/s.髓母细胞瘤较毛细胞型星形细胞瘤的ADC值减低,差异有统计学意义(Z=-4.54,P值<0.01).髓母细胞瘤较室管膜瘤的ADC值减低,差异有统计学意义(Z=-4.29,P值<0.01).毛细胞型星形细胞瘤较室管膜瘤的ADC值增高,差异有统计学意义(Z=-3.27,'P值<0.05).结论 脑肿瘤实质ADC值的测量简便易行,可用于术前鉴别儿童后颅窝肿瘤,尤其有助于鉴别髓母细胞瘤和毛细胞型星形细胞瘤.

  12. Osteogenesis imperfecta with joint contractures: Bruck syndrome

    Blacksin, M.F. [Department of Radiology, University of Medicine and Dentistry of New Jersey, 150 Bergen St., Rm. C320, Newark, NJ 07103-2426 (United States); Pletcher, B.A. [Center for Human and Molecular Genetics, Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Newark, New Jersey (United States); David, M. [Department of Radiology, Newark-Beth Israel Medical Center, Newark, New Jersey (United States)

    1998-02-01

    We describe an Egyptian boy with osteogenesis imperfecta who was born with thumb contractures and bilateral antecubital pterygia. He was seen at 16 months of age with femur and tibial fractures, thoracic vertebral compression fractures, scoliosis and Wormian bones. The findings are consistent with a diagnosis of Bruck syndrome. (orig.) With 1 fig., 5 refs.

  13. Osteogenesis imperfecta with joint contractures: Bruck syndrome

    We describe an Egyptian boy with osteogenesis imperfecta who was born with thumb contractures and bilateral antecubital pterygia. He was seen at 16 months of age with femur and tibial fractures, thoracic vertebral compression fractures, scoliosis and Wormian bones. The findings are consistent with a diagnosis of Bruck syndrome. (orig.)

  14. POSSIBLE ENTRAPMENT OF THE ULNAR ARTERY BY THE THIRD HEAD OF PRONATOR TERES MUSCLE. EL POSIBLE ATRAPAMIENTO DE LA ARTERIA ULNAR POR EL TERCER FASCÍCULO DEL MÚSCULO PRONADOR TERES

    Satheesha Nayak B; Ashwini Aithal; Srinivasa Rao Sirasanagandla; Naveen Kumar

    2012-01-01

    Knowledge of variations at and in the surroundings of cubital fossa is useful for the orthopedic surgeons, plastic surgeons and medical practitioners in general. During routine dissection, we observed arterial and muscular variations in and around the cubital fossa. The brachial artery terminated 2 inches above the base of the cubital fossa. The radial and ulnar arteries entered the cubital fossa by passing in front of the tendons of brachialis and biceps brachii respectively. The ulnar arter...

  15. Use of a Bone Graft Drill Harvester to Create the Fenestration During Arthroscopic Ulnohumeral Arthroplasty

    Wijeratna, Malin D.; Ek, Eugene T.; Hoy, Gregory A.; Chehata, Ash

    2015-01-01

    The Outerbridge-Kashiwagi procedure, or ulnohumeral arthroplasty, was described in 1978 as a method of treating elbow arthritis by creating a fenestration in the olecranon fossa. This fenestration diminishes the likelihood of recurrent spurs in the olecranon fossa and coronoid fossa, without loss of structural bony strength. Arthroscopic techniques have now been developed to perform this procedure. We describe an efficient method of creating the fenestration between the olecranon fossa and co...

  16. Use of a Bone Graft Drill Harvester to Create the Fenestration During Arthroscopic Ulnohumeral Arthroplasty.

    Wijeratna, Malin D; Ek, Eugene T; Hoy, Gregory A; Chehata, Ash

    2015-10-01

    The Outerbridge-Kashiwagi procedure, or ulnohumeral arthroplasty, was described in 1978 as a method of treating elbow arthritis by creating a fenestration in the olecranon fossa. This fenestration diminishes the likelihood of recurrent spurs in the olecranon fossa and coronoid fossa, without loss of structural bony strength. Arthroscopic techniques have now been developed to perform this procedure. We describe an efficient method of creating the fenestration between the olecranon fossa and coronoid fossa during an arthroscopic ulnohumeral arthroplasty, or Outerbridge-Kashiwagi procedure, that also reduces the amount of residual bone debris produced during the resection. PMID:26697312

  17. Contact Lens Solution Toxicity

    ... rash and rashes clinical tools newsletter | contact Share | Contact Lens Solution Toxicity Information for adults A A A This image shows a reaction to contact lens solution. The prominent blood vessels and redness ...

  18. Sweaty Sock Syndrome (Juvenile Plantar Dermatosis)

    ... rash and rashes clinical tools newsletter | contact Share | Sweaty Sock Syndrome (Juvenile Plantar Dermatosis) A parent's guide ... the feet typical to juvenile plantar dermatosis. Overview Sweaty sock syndrome (juvenile plantar dermatosis) is a condition ...

  19. Roman chamomile

    ... eczema, frostbite, diaper rash, bedsores (decubitus ulcers), and hemorrhoids. Roman chamomile is sometimes mixed with other herbs ... gums. Liver and gallbladder problems. Frostbite. Diaper rash. Hemorrhoids. Other conditions. More evidence is needed to rate ...

  20. Eczema (Atopic Dermatitis) in Children

    ... rash and rashes clinical tools newsletter | contact Share | Eczema (Atopic Dermatitis) A parent's guide to condition and treatment information ... and inflamed areas of skin typical of atopic dermatitis (eczema) on a person with darker skin. Overview ...

  1. Eczema (Atopic Dermatitis) in Infants

    ... rash and rashes clinical tools newsletter | contact Share | Eczema (Atopic Dermatitis) A parent's guide for infants and babies A ... scaling, red, slightly elevated lesions typical of atopic dermatitis (eczema). Overview Eczema, formally known as atopic dermatitis, ...

  2. Eczema (Atopic Dermatitis) in Adults

    ... rash and rashes clinical tools newsletter | contact Share | Eczema (Atopic Dermatitis) Information for adults A A A This image displays extensive atopic dermatitis (eczema); note the skin is dry and scaly, ...

  3. Diaper Dermatitis (Candidiasis)

    ... and rashes clinical tools newsletter | contact Share | Diaper Dermatitis (Candidiasis) A parent's guide for infants and babies ... is dirty (has fecal contamination), an inflammatory skin rash (dermatitis) may develop on the baby's skin. Diarrhea ...

  4. Laser Acne Treatment

    ... rash and rashes clinical tools newsletter | contact Share | Acne Treatment, Laser A A A BEFORE: This patient ... laster skin renewal to improve the appearance of acne scars on his cheeks. Procedure Overview A variety ...

  5. Plantar Wart

    ... rash and rashes clinical tools newsletter | contact Share | Plantar Wart Information for adults A A A This image displays the thick scale associated with plantar warts (warts on the feet). Overview Warts are ...

  6. Diabetic Dermopathy

    ... rash and rashes clinical tools newsletter | contact Share | Diabetic Dermopathy Information for adults A A A Brown, ... on the legs are typical in long-standing diabetics. Overview Diabetic dermopathy, also known as shin spots ...

  7. Head Lice (Pediculosis Capitis)

    ... rash and rashes clinical tools newsletter | contact Share | Head Lice (Pediculosis Capitis) A parent's guide to condition and treatment ... hair shaft are seen in this person with head lice. Overview Head lice (pediculosis capitis) is a common, ...

  8. Cryopyrin-Associated Autoinflammatory Syndromes (CAPS) - Juvenile

    ... symptoms. In Muckle-Wells syndrome, patients develop episodic fever, chills, rash, red eyes, joint pain and severe headaches ... a hive-like rash. Patients also can develop fever, chills, nausea, severe thirst, red eyes, headaches and joint ...

  9. Rocky Mountain Spotted Fever (For Parents)

    ... addition to the rash, the infection can cause fever, chills, muscle aches, vomiting, and nausea. Typically, RMSF is ... notice any symptoms of RMSF, such as: high fever headache chills muscle aches red eyes rash Without antibiotic treatment, ...

  10. Bug bites and stings: When to see a dermatologist

    Full Text Available ... a few minutes Dizziness Vomiting A headache A red, donut-shaped rash that develops after a tick ... be treated with antibiotics. A fever with a red or black, spotty rash that spreads: This could ...

  11. Cold Sores (Orofacial Herpes)

    ... rash and rashes clinical tools newsletter | contact Share | Cold Sores (Orofacial Herpes) Information for adults A A ... face, known as orofacial herpes simplex, herpes labialis, cold sores, or fever blisters, is a common, recurrent ...

  12. Post-Inflammatory Hyperpigmentation

    ... rash and rashes clinical tools newsletter | contact Share | Post-Inflammatory Hyperpigmentation Information for adults A A A ... 2006-2013 Logical Images, Inc. All rights reserved. Advertising Notice This Site and third parties who place ...

  13. Post-Inflammatory Hypopigmentation

    ... rash and rashes clinical tools newsletter | contact Share | Post-Inflammatory Hypopigmentation Information for adults A A A ... 2006-2013 Logical Images, Inc. All rights reserved. Advertising Notice This Site and third parties who place ...

  14. Strawberry Hemangioma

    ... rash and rashes clinical tools newsletter | contact Share | Strawberry Hemangioma (Infantile Hemangioma) A parent's guide for infants and babies A A A Strawberry red hemangiomas grow rapidly, and particularly those near ...

  15. Telangiectasias

    ... rash and rashes clinical tools newsletter | contact Share | Telangiectasia Information for adults A A A This image displays the dilated blood vessels typical of telangiectasia. Overview Telangiectasias are widely open (dilated) blood vessels ...

  16. Disease: H00285 [KEGG MEDICUS

    Full Text Available ch is presented with triad of juvenile-onset granulomatous arthritis, uveitis, and skin rashes. Inflammation...u EB Familial granulomatous arthritis, iritis, and rash. J Pediatr 107:689-93 (19

  17. Yeast Infection (Candidiasis)

    ... rash and rashes clinical tools newsletter | contact Share | Yeast Infection (Candidiasis) Information for adults A A A This is a candida (yeast) infection of the skin folds of the abdomen. Overview ...

  18. Hair Loss (Alopecia Areata)

    ... rash and rashes clinical tools newsletter | contact Share | Hair Loss (Alopecia Areata) Information for adults A A A This ... scalp with a round area of non-scarring hair loss typical of alopecia areata. Overview Alopecia areata is ...

  19. Sunburn

    ... Severe reactions (sometimes called sun poisoning), including fever, chills, nausea, or rash Skin peeling on sunburned areas ... eyes Pale, clammy, or cool skin Nausea , fever , chills, or rash Your eyes hurt and are sensitive ...

  20. Genetics Home Reference: Hartnup disease

    ... which can include skin rashes; difficulty coordinating movements ( cerebellar ataxia ); and psychiatric symptoms, such as depression or psychosis. ... signs and symptoms of this condition including rashes, cerebellar ataxia , and psychiatric symptoms. Researchers believe that many of ...

  1. Acne Keloidalis Nuchae

    ... rash and rashes clinical tools newsletter | contact Share | Acne Keloidalis Nuchae Information for adults A A A ... neck at the hairline that is affected by acne keloidalis nuchae. Overview Acne keloidalis nuchae, also known ...

  2. Acne Excoriée

    ... rash and rashes clinical tools newsletter | contact Share | Acne Excoriée Teen information A A A Scars displayed as dark spots (hyperpigmentation) with virtually no active acne on chest are a sign that the patient ...

  3. Acne (Acne Vulgaris)

    ... rash and rashes clinical tools newsletter | contact Share | Acne (Acne Vulgaris) Information for adults A A A Whiteheads (closed comedones) are the earliest lesions of acne. Overview Acne, also known as acne vulgaris, is ...

  4. Sun Damage

    ... rash and rashes clinical tools newsletter | contact Share | Sun Damage A A A The sun has a profound effect over years of exposure ... changes. Exposure to ultraviolet (UV) light from the sun accounts for most premature skin aging. Many skin ...

  5. Jellyfish Stings, First Aid

    ... rashes clinical tools newsletter | contact Share | Jellyfish Stings, First Aid A A A The rash caused by a ... to Portuguese man-of-war stings as well. First Aid Guide The rescuer should take care to avoid ...

  6. Reinterpreting Islamic Historiography: Hārūn al-Rashīd and the Narrative of the ‘Abbāsid Caliphate, Cambridge Studies in Islamic Civilisation, Cambridge, Cambridge University Press, 1999, x-236 p., table généalogique, index.

    Szuppe, Maria

    2010-01-01

    Le regain d’intérêt pour l’historiographie de l’époque islamique peut-être situé dans le cadre des nouvelles approches pour l’étude de l’histoire des sociétés musulmanes, approches pluridisciplinaires mettant à profit des données nouvelles (archéologiques, numismati­ques ...), et les nouvelles interprétations des sources connues. L’ouvrage de T. el-Hibri se situe dans ce même courant auquel appartiennent aussi le livre de J. Scott Meisami, Persian Historiography to the End of the Twelth Centu...

  7. Intravenous digital subtraction angiography (IVDSA) in children

    Forty-one intravenous digital subtraction angiographic (IVDSA) studies were performed in 39 patients aged 4 weeks to 19 years (mean: 9.4 years) in order to evaluate the heart, great vessels and palliative shunts. Contrast agents were injected via antecubital vein cannulation in 14 examinations. In the remaining 27, injections were made through centrally-placed catheters inserted via right antecubital or femoral veins. All but one of the centrally-injected procedures resulted in technically satisfactory images. Four of the peripherally-injected IVDSA studies were unsatisfactory or of limited value due to motion artefacts, insufficient contrast, equipment failure or perivenous extravasations. Systemic-pulmonary shunt lesions were difficult to image, but IVDSA of the aorta and pulmonary arteries provided consistently useful information. (orig.)

  8. Pseudo-Anterior Interosseous Nerve Syndrome by Multiple Intramuscular Injection

    Kim, Min Young; Kim, Dong Hwee; Park, Byung Kyu; Kim, Baik Hyun

    2013-01-01

    Blind intramuscular injection might cause severe neurovascular injury if it would be performed with insufficient knowledge of anatomy around the injection area. We report a case of pseudo-anterior interosseous syndrome caused by multiple intramuscular steroid injections around the antecubital area. The patient had weakness of the 1st to 3rd digits flexion with typical OK sign. Muscle atrophy was noted on the proximal medial forearm, and sensation was intact. The electrophysiologic studies sho...

  9. WHITE BLOOD CELLS IN POLISH ATHLETES OF VARIOUS SPORTS DISCIPLINES

    Joanna Orysiak; Konrad Witek; Piotr Zmijewski; Jan Gajewski

    2012-01-01

    The purpose of this study was to examine the diversity of white blood cell (WBC) counts and their subsets (neutrophils, lymphocytes and monocytes) among competitive athletes of different sports disciplines. The blood samples were collected from 608 healthy, medically examined athletes (181 females and 427 males) aged 20.1 ± 5.1 years, who represented five sport disciplines: canoeing, judo, rowing, swimming and volleyball. All blood samples were taken from the antecubital vein in the morning, ...

  10. Red blood cell deformability and aggregation in chronic venous disease patients with varicose veins

    Karolina Słoczyńska; Mariusz Kózka; Henryk Marona

    2013-01-01

    Introduction: Red blood cells’ (RBC) rheological properties are disturbed in chronic venous disease (CVD). The aim of the study was to compare deformability and aggregation of erythrocytes taken from the varicose vein and the antecubital vein of patients with chronic venous disease.Materials and Methods: Blood samples were taken from twelve CVD patients presenting clinical, aetiological, anatomical and pathological elements (CEAP) stages II and III. Blood was sampled from varicose veins and a...

  11. Klippel–Feil syndrome associated with a craniocervico-thoracic dermoid cyst

    McLaughlin, Nancy; Weil, Alexander G.; Demers, Jacques; Shedid, Daniel

    2013-01-01

    Background: Uncommonly, Klippel–Feil syndrome (KFS) has been associated with intracranial or spinal tumors, most frequently dermoid or epidermoid cysts. Although the associated dermoid cyst (DC) is usually located in the posterior fossa, isolated upper cervical DC has been reported. Extension from the posterior fossa to the upper cervical spine (C2) has been reported once. We report a rare case of KFS in association with a posterior fossa DC that extended down to the upper thoracic spine and ...

  12. PHENYTION, CARBAMAZEPINE, SODIUM VALPROATE AND LAMOTRIGINE INDUCED CUTANEOUS REACTIONS

    M. Ghaffarpour; S. S. Hejazie; M. H. Harirchian; H. Pourmahmoodian

    2005-01-01

    Adverse effects of antiepileptic drugs including cutaneous reactions may not only affect the result of treatment and quality of life, but can also be fatal if severe. Skin rash is more likely to occur during the first few months of treatment. The objective of this study was description of skin rashes in users of four antiepileptic drugs. We identified skin rashes of phenytoin, carbamazepine, sodium valproate and lamotrigine in a prospective descriptive cross sectional study in 1086 cases. Pat...

  13. Systemic candidiasis: diagnosis from cutaneous manifestations.

    Slater, D N; Wylde, P; Harrington, C I; Worth, R

    1982-01-01

    Three patients are described who developed systemic candidiasis. Each had either leukaemia or lymphoma, and developed a similar erythematous maculopapular rash which, in places, was purpuric. In the first patient the nature of the rash was not appreciated during life, but postmortem histology revealed candida within the lesions. In the other two patients, a diagnosis of systemic candidiasis was successfully established by skin biopsy. This paper emphasizes that a maculopapular rash can be rel...

  14. Dural AVM supplied by the ophthalmic artery.

    Flynn, T H

    2012-02-03

    Dural arteriovenous malformations in the anterior cranial fossa are rare and are especially prone to haemorrhage. These lesions are usually treated by surgical excision. We report the embolization of an anterior cranial fossa DAVM using an endovascular approach via the ophthalmic artery.

  15. Typhoid fever

    ... nih.gov/pubmed/25458731 . Read More Abdominal pain Acute kidney failure Delirium Diarrhea - overview Fatigue Fever Gastrointestinal bleeding Hepatic Malaise Peritonitis Rashes Systemic Weakness Update Date 5/ ...

  16. A Case Report of Hairy Cell Leukemia Presenting Concomitantly with Sweet Syndrome

    Mohammad Alkayem; Waina Cheng

    2014-01-01

    Hairy cell leukemia and Sweet syndrome are both uncommon hematological diagnoses. We present a patient who was admitted with fevers, pancytopenia, pneumonia, and rash. Diagnostic bone marrow biopsy demonstrates Hairy cell Leukemia and skin biopsy demonstrates neutrophils infiltration consistent with Sweet syndrome. The patient was treated with purine analogs with resolution of the cytopenias, infection, and rash.

  17. A Case Report of Hairy Cell Leukemia Presenting Concomitantly with Sweet Syndrome

    Mohammad Alkayem

    2014-01-01

    Full Text Available Hairy cell leukemia and Sweet syndrome are both uncommon hematological diagnoses. We present a patient who was admitted with fevers, pancytopenia, pneumonia, and rash. Diagnostic bone marrow biopsy demonstrates Hairy cell Leukemia and skin biopsy demonstrates neutrophils infiltration consistent with Sweet syndrome. The patient was treated with purine analogs with resolution of the cytopenias, infection, and rash.

  18. Hepatit A geçiren hastada akut ürtiker ve Guillain-Barre like sendromun birlikteliği

    GERENLİ, Nelgin Esenrodoplu; GÜVEN, Feray; UYGUR, Nihan; AKYÜZ, Ümit; Say, Aysu

    2004-01-01

    Hepatitis A infection (HAV) may present with extrahepatic manifestations rather than causing typical hepatitis. These are: urticarial rash, vasculitis, arthritis, transient arthralgia, hemolytic anemia, thrombocytopenia, cryoglobulinemia, . Guillain-Barre Syndrome and polymyositis. We report a case of 4.5 years old boy with a rare association of acute HAV infection and urticarial rash accompanied by Guillain-Barre like Syndrome.

  19. PEDIATRIC SCRUB TYPHUS WITH MENINGOENCEPHALITIS

    Swati M; Deepika,

    2014-01-01

    BACKGROUND: Pediatric Scrub typhus is under-diagnosed but life threatening febrile illness which requires early treatment. CASE CHARACTERISTICS: A 2-year-old boy presenting with fever, maculopapular rash, hepatosplenomegaly, altered sensorium and hemiparesis. OUTCOME: He was diagnosed as Scrub Typhus with Meningoencephalitis. MESSAGE: Pediatricians should consider scrub typhus in children with hemorrhagic rash, fever and hepatosplenomegaly, even in the absence of eschar.

  20. Acetaminophen in children: An old drug with new warnings

    Goldman, Ran D.

    2013-01-01

    Question I frequently suggest to parents to use acetaminophen to treat their children’s fever and pain. Recently, I had a child in my office who presented with a target-lesion skin rash a day after receiving acetaminophen. The rash resolved after 3 days and after stopping administration of acetaminophen. Does acetaminophen carry a risk of adverse events such as this?

  1. Lidocaine alleviates propofol related pain much better than metoprolol and nitroglycerin

    Asutay Goktug

    2015-10-01

    Full Text Available ABSTRACTBACKGROUND AND OBJECTIVES: Injection pain after propofol administration is common and maydisturb patients' comfort. The aim of this study was to compare effectiveness of intravenous(iv nitroglycerin, lidocaine and metoprolol applied through the veins on the dorsum of hand orantecubital vein on eliminating propofol injection pain.METHOD: There were 147 patients and they were grouped according to the analgesic adminis-tered. Metoprolol (n = 31, Group M, lidocaine (n = 32, Group L and nitroglycerin (n = 29, GroupN were applied through iv catheter at dorsum hand vein or antecubital vein. Pain was evalu-ated by 4 point scale (0 - no pain, 1 --- light pain, 2 --- mild pain, 3 --- severe pain in 5, 10, 15and 20th seconds. ASA, BMI, patient demographics, education level and the effect of pathwaysfor injection and location of operations were analyzed for their effect on total pain score.RESULTS: There were no differences between the groups in terms of total pain score (p = 0.981.There were no differences in terms of total pain score depending on ASA, education level,location of operation. However, lidocaine was more effective when compared with metoprolol(p = 0.015 and nitroglycerin (p = 0.001 among groups. Although neither lidocaine nor metopro-lol had any difference on pain management when applied from antecubital or dorsal hand vein(p > 0.05, nitroglycerin injection from antecubital vein had demonstrated statistically lowerpain scores (p = 0.001.CONCLUSION: We found lidocaine to be the most effective analgesic in decreasing propofolrelated pain. We therefore suggest iv lidocaine for alleviating propofol related pain at operations.

  2. Digital subtraction angiography in children

    Preliminary results with digital subtraction angiography in infants and children have shown this to be an excellent screening procedure and often diagnostic. The examination can be performed satisfactorily on outpatients. Sixty patients have undergone this examination for evaluation of suspected abnormalities of the aortic arch and its branches, intracranial arteries, pulmonary arteries, abdominal aorta and its branches, and peripheral vessels. Adequate sedation is mandatory to prevent motion artifacts. While the literature reports increasing use of central venous catheters for delivery of contrast material, the use of short catheters placed in an antecubital vein is satisfactory for the pediatric patient. Techniques of the procedures are described along with seven appropriate case examples

  3. Intervillous blood flow in normal and complicated late pregnancy measured by means of an intravenous 133Xe method

    Intervillous blood flow (IVBF) was measured intravenously with a new quantitative 133-Xe method in 50 normal and 74 complicated late pregnancies between the 35th and 42nd weeks. A dose of 2.5 mCi of 133-Xe saline was injected rapidly into the left antecubital vain and flushed immediately with 10 ml of physiological saline. For recording quantitative data from the placenta, a data storage and read-out system with fast television techniques was connected to the scintillation camera. This method may open a new diagnostic area in the management of high risk pregnancies. (author)

  4. Use of Na{sup 24} in a circulation study on a patient believed to have impaired circulation in the left leg

    Leifer, E.; Hogness, J.R.

    1949-04-19

    This report describes a diagnostic study utilizing sodium 24 on a patient with a vascular disorder in a left lower extremity. Five cc. of normal saline containing 50 microcuries of radioactive sodium were injected into the left antecubital vein. Radioactivity was determined at the soles of both feet for 30 seconds until the counts had levelled off and the exchange of sodium had apparently reached equilibrium. Circulation time from arm to foot was measured and was found to be 30 seconds in both extremities.

  5. Continuous monitoring of blood volume changes in humans

    Hinghofer-Szalkay, H.; Greenleaf, J. E.

    1987-01-01

    Use of on-line high-precision mass densitometry for the continuous monitoring of blood volume changes in humans was demonstrated by recording short-term blood volume alterations produced by changes in body position. The mass density of antecubital venous blood was measured continuously for 80 min per session with 0.1 g/l precision at a flow rate of 1.5 ml/min. Additional discrete plasma density and hematocrit measurements gave linear relations between all possible combinations of blood density, plasma density, and hematocrit. Transient filtration phenomena were revealed that are not amenable to discontinuous measurements.

  6. Colgajo de perforantes de la arteria colateral cubital inferior para defectos por quemadura eléctrica en fosa cubital

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

    2014-01-01

    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 colgajos 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 d...

  7. Assessment of mandibular posterior regional landmarks using cone-beam computed tomography in dental implant surgery.

    de Souza, Lílian Azevedo; Souza Picorelli Assis, Neuza Maria; Ribeiro, Rosangela Almeida; Pires Carvalho, Antônio Carlos; Devito, Karina Lopes

    2016-05-01

    The aim of this study has been to evaluate and correlate the anatomical features of the posterior mandibular region (submandibular fossa depth, bone height and thickness, and mandibular canal corticalization) to improve accident prevention and allow safe planning in implantology. Four parasagittal sections of cone-beam computed tomography (CBCT) from 100 patients were bilaterally analyzed. Linear measurements of the submandibular fossa depth, bone height and thickness were performed. The submandibular fossa was also classified into non-influential undercuts and influential undercuts for implant placement. Mandibular canal corticalization was also evaluated and classified according to the visualization. Data on patient age and gender were also collected. Forty-one scans (41%) were from male patients, and 59 (59%) were from female patients. Patient age ranged between 18 and 84 years, with an average age of 51.37 years. The submandibular fossa depth and implant bone thickness had a significant effect on the variability of the sample (46.1% and 22.3%, respectively). The submandibular fossa depth was quite variable, and the highest values were observed in the posterior regions. In 18.27% of the cases, the presence of the fossa directly influenced implant placement, considering a bone height of 10mm (standard implant). A significant correlation was observed between fossa depth and bone thickness. Thus, greater attention should be paid to thick ridges; although thick ridges are favorable, they may be associated with deeper submandibular fossae. The mandibular canal was the most influential anatomical structure in the premolar region due to the reduced bone height in this region and the greater difficulty in viewing the canal, and the submandibular fossa was the most influential structure in the molar region due to lower bone height leading up to the fossa and the greater fossa depth in this region. Therefore, CBCT is an important tool for assessing the mandibular region

  8. Mandibular condyle position in cone beam computed tomography

    Hwang, Hyoung Joo; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [Kyung Hee Univ. School of Dentistry, Seoul (Korea, Republic of)

    2006-06-15

    To evaluate position of the mandibular condyle within articular fossa in an asymptomatic population radiographically by a cone beam computed tomography. Cone beam computed tomography of 60 temporomandibular joints was performed on 15 males and 15 females with no history of any temporomandibular disorders, or any other orthodontic or photoconductors treatments. Position of mandibular condyle within articular fossa at centric occlusion was evaluated. A statistical evaluation was done using a SPSS. In the sagittal views, mandibular condyle within articular fossa was laterally located at central section. Mandibular condyles in the right and left sides were showed asymmetric positional relationship at medial, central, and lateral sections. Mandibular condyle within articular fossa in an asymptomatic population was observed non-concentric position in the sagittal and coronal views.

  9. Surgical technique for repair of complex anterior skull base defects

    Kevin Reinard

    2015-01-01

    Conclusion: The layered reconstruction of large anterior cranial fossa defects resulted in postoperative CSF leak in only 5% of the patients and represents a simple and effective closure option for skull base surgeons.

  10. CASE REPORT: DANDY WALKER MALFORMATION WITH ASSOCIATED OCCIPITAL MENINGOCELE

    Shrishail S; Apoorva

    2014-01-01

    A neonate presented with Dandy walker syndrome associated with occipital meningocele manifesting as soft tissue mass on the skull. Computed tomography demonstrated a large posterior fossa cyst communicating between fourth ventricle and occipital meningocele and dilated ventricular system (hydrocephalus).

  11. Common Acupoints in Chest and Abdomen

    Journal of Acupuncture and Tuina Science Editor; CUI Xue-jun

    2003-01-01

    @@ Tiantu (CV 21) Location: In the center of the suprasternal fossa(Fig. l ). Indications: Cough, dyspnea, chest pain, pharyngolaryngeal swelling and pains, sudden hoarseness of the voice, goiter, globus hystericus, and dysphagia.

  12. Tumour type and size are high risk factors for the syndrome of "cerebellar" mutism and subsequent dysarthria

    C.E. Catsman-Berrevoets (Coriene); H.R. van Dongen (Hugo); D. Paz y Geuze; P.F. Paquier; M.H. Lequin (Maarten); P.G.H. Mulder (Paul)

    1999-01-01

    textabstractOBJECTIVE: "Cerebellar mutis" and subsequent dysarthria (MSD) is a documented complication of posterior fossa surgery in children. In this prospective study the following risk factors for MSD were assessed: type, size and site of the tumour; hydrocephalus at

  13. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Full Text Available ... opposite shoulder lines up carefully to avoid nerve injury with no pressure on the popliteal fossa. We ... here, which we feel is affected by radiation injury but not by cancer. Now we switch back ...

  14. Robot-Assisted Prostatectomy

    Full Text Available ... prostatic fossa. Okay. This is where the prostate sat. If you look at the bottom of the ... as assistant, and I am waiting for the new instruments to be inserted so we can perform ...

  15. Cerebellar mutism: review of the literature

    Gudrunardottir, Thora; Sehested, Astrid; Juhler, Marianne;

    2011-01-01

    Cerebellar mutism is a common complication of posterior fossa surgery in children. This article reviews current status with respect to incidence, anatomical substrate, pathophysiology, risk factors, surgical considerations, treatment options, prognosis and prevention....

  16. Colgajo de perforantes de la arteria colateral cubital inferior para defectos por quemadura eléctrica en fosa cubital

    I. González-Alaña

    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 colgajos 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.

  17. Immediate function of temporomandibular joint after total resection and reconstruction

    Richter, M.; Dulguerov, Pavel; Pittet Cuenod, Brigitte Maud; Becker, Minerva

    1997-01-01

    Two patients with recurrent parotid gland carcinoma required subtotal petrosectomy and infratemporal fossa type C approach. To achieve en bloc resection, the ascending mandibular ramus and the entire temporomandibular joint, including the adjacent temporal bone, were removed. An original technique for immediate reconstruction of the infratemporal region, including the glenoid fossa and the ramus of the mandible, is described. Rigid fixation, as well as good functional and aesthetic results, w...

  18. How does occipitalization influence the dimensions of the cranium?

    Caspersen, L M; Kjaer, I; Sonnesen, L

    2010-01-01

    To describe occipitalization on human dry skulls and to compare craniofacial morphology including the posterior cranial fossa in skulls with occipitalization and in skulls without occipitalization and with normal craniofacial morphology (controls).......To describe occipitalization on human dry skulls and to compare craniofacial morphology including the posterior cranial fossa in skulls with occipitalization and in skulls without occipitalization and with normal craniofacial morphology (controls)....

  19. CT and MR Studies of Giant Dermoid Cyst Associated to Fat Dissemination at the Cortical and Cisternal Cerebral Spaces

    Alessandro D'Amore

    2013-01-01

    Full Text Available This study focuses on CT and MR studies of adult patient with giant lesion of the posterior cranial fossa associated with micro- and macroaccumulations with density and signal like “fat” at the level of the cortical and cisternal cerebral spaces. This condition is compatible with previous asymptomatic ruptured dermoid cyst. Histological findings confirm the hypothesis formulated using the imaging. We also integrate elements of differential diagnosis by another giant lesion of the posterior cranial fossa.

  20. Anomalous posterior clinoid process and its clinical importance

    Shipra Paul; Srijit Das

    2007-01-01

    The anterior, middle and the posterior clinoid processes are located in the middle cranial fossa of the skull. The posterior boundary of the pituitary fossa is formed by the dorsum sellae, the supero-lateral angles of which are raised to form the posterior clinoid process. Unlike the anterior clinoid process, the posterior clinoid process has received less attention in past research studies. The anatomy textbooks do not mention about the anomalies pertaining to the posterior clinoid process a...