Sample records for anatomical considerations aetiology

  1. Oriental eyelids. Anatomic difference and surgical consideration. (United States)

    Liu, D; Hsu, W M


    Fashions change with time and beauty standards differ in different cultures. In recent years, there has been an increase in the number of immigrants to the United States from the Orient. The creation of an upper eyelid crease has been for the past several decades the most popular cosmetic procedure in many Asian countries. In order to perform this procedure to the satisfaction of an Oriental patient, the surgeon must know what the patient perceives as beautiful and the anatomic differences between the Oriental and the Occidental eyelids. In this paper with data collected from over 3,600 patients, we are presenting important statistics that enables the surgeon to understand better the Oriental mind and facilitate communications. The anatomic difference in the upper eyelid is also discussed.

  2. Imaging of hand injuries. Anatomic and radiodiagnostic considerations

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    Schmitt, Rainer


    Imaging recommendations for assessing injuries of the forearm, wrist, metacarpus and the digits are given with respect to anatomic considerations. Furthermore, dedicated algorithms of advanced imaging are introduced with radiography as the primary diagnostic tool. High-resolution CT is used for detecting and staging the complex fractures of the radius and the wrist, whereas contrast-enhanced MRI serves for depicting the injured soft tissues. At the wrist, tears of the intrinsic ligaments and the TFCC are assessed with high accuracy when applying MR arthrography or CT arthrography. Dedicated radiologic tools as well as comprehensive reports are suggested in the management of the various hand injuries. (orig.)

  3. Sciatica in the female patient: anatomical considerations, aetiology and review of the literature (United States)

    Bovay, Philippe; Gobelet, Charles


    The principal author was confronted few years ago with the case of a 38-year-old woman with a 5-month history of ill-defined L5 sciatic pain that was referred to an orthopaedic department for investigation and eventual surgical treatment for what was suspected to be herniated disc-related sciatica. Removal of her enlarged uterus found unexpectedly close to the sacroiliac joint upon lumbar MRI abolished her symptoms. Review of the literature showed that the lumbosacral trunk is vulnerable to pressure from any abdominal mass originating from the uterus and the ovaries. Physiological processes in the female patient and gynaecological diseases may be the source of sciatica, often not readily searched for, leading to fruitless investigations and surgical treatments. The aim of the paper is to highlight gynaecological and obstetrical causes of sciatica and sciatica-like symptoms. To prevent unproductive expenses and morbidity, a thorough gynaecological examination should be done even though neurological examination may be suggestive of a herniated intervertebral disc, and the cyclic pattern of pain related to menses should be routinely asked for. PMID:16622708

  4. Anatomical Considerations on Surgical Anatomy of the Carotid Bifurcation

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    Adamantios Michalinos


    Full Text Available Surgical anatomy of carotid bifurcation is of unique importance for numerous medical specialties. Despite extensive research, many aspects such as precise height of carotid bifurcation, micrometric values of carotid arteries and their branches as their diameter, length, and degree of tortuosity, and variations of proximal external carotid artery branches are undetermined. Furthermore carotid bifurcation is involved in many pathologic processes, atheromatous disease being the commonest. Carotid atheromatous disease is a major predisposing factor for disabling and possibly fatal strokes with geometry of carotid bifurcation playing an important role in its natural history. Consequently detailed knowledge of various anatomic parameters is of paramount importance not only for understanding of the disease but also for design of surgical treatment, especially selection between carotid endarterectomy and carotid stenting. Carotid bifurcation paragangliomas constitute unique tumors with diagnostic accuracy, treatment design, and success of operative intervention dependent on precise knowledge of anatomy. Considering those, it becomes clear that selection and application of proper surgical therapy should consider anatomical details. Further research might ameliorate available treatment options or even lead to innovative ones.

  5. Transphenoidal surgery in acromegalic patients: anatomical considerations and potential pitfalls. (United States)

    Carrabba, Giorgio; Locatelli, Marco; Mattei, Luca; Guastella, Claudio; Mantovani, Giovanna; Rampini, Paolo; Gaini, Sergio Maria


    Transphenoidal surgery is an effective treatment for acromegalic patients with growth hormone (GH) producing pituitary adenomas. Since acromegaly is a systemic disease which causes multiple bony alterations, we hypothesized that it could affect the sphenoid sinus anatomy. The aim of the study was to determine whether acromegalic patients have sphenoid sinus alterations with potential surgical impact. Fourty-six consecutive patients (23 acromegalics-GH group, 23 non-acromegalics-nGH group) undergoing transphenoidal surgery were included in this study. Pre-operative volumetric CT scan of the head was used to assess the following anatomic characteristics: type of sphenoid sinus (sellar, pre-sellar, conchal); number of intrasphenoid septa; number of carotid-directed septa; intercarotid distance; depth of the sphenoid sinus; depth and size of the sella. The sphenoid sinus was of the pre-sellar/conchal type in 26 % of the patients with acromegaly (n = 23) versus 9 % of the patients of the nGH group (n = 23). The number of intrasphenoid septations was significantly higher in the GH group than in the nGH group (P = .03). Interestingly, the intercarotid distance was smaller in GH patients than in nGH displaying a trend toward significance (P = .05). The sphenoid bone was deeper in the GH group as compared to the nGH group (P = .01) but the distance sphenoid sinus-sella was reduced (P < .01). Finally, the sella was not deeper, nor larger in acromegalic patients. The sphenoid sinus of acromegalic patients resulted in being deeper, characterized by more septa and by a reduced intercarotid distance. These alterations deserve special pre- and intraoperative care, being potentially responsible for surgical difficulties.

  6. Terminal bifurcation of the biceps brachii muscle and tendon: anatomic considerations and clinical implications. (United States)

    Dirim, Berna; Brouha, Sharon Sudarshan; Pretterklieber, Michael L; Wolff, Klaus S; Frank, Andreas; Pathria, Mini N; Chung, Christine B


    The objective of our study was to describe the anatomic variation of a bifurcated distal biceps tendon with MRI, histology, and dissection in cadavers and to report the MR appearance of superimposed lesions in a patient population with this anatomic variant. Visual and histologic examinations of the distal biceps brachii tendon in eight sectioned fresh-frozen elbow specimens were performed. Dissection of 17 elbow specimens was performed to describe the distal biceps brachii tendon. In addition, all elbow MRI reports over a 3-year period (n = 411) were retrospectively reviewed to determine the presence of bifurcation of the distal biceps brachii tendon. The distal biceps brachii tendon appeared bifurcated in 25% of the sectioned specimens, and these findings were confirmed histologically. The distal biceps brachii tendon was completely separable into two components-that is, a short head and long head- throughout their proximal to distal extent in 41.2% of the dissected specimens. The distal biceps brachii tendon appeared bifurcated in 11.8% of 68 clinical cases that showed distal biceps brachii tendon abnormalities or injuries. The following patterns of injury were noted: complete rupture of both tendons (n = 1), complete rupture of the short head and normal insertion of the long head (n = 2), complete rupture of the short head and partial tear of the long head (n = 2), partial tear of both tendons (n = 2), and complete rupture of the short head and tendinosis in the long head (n = 1). A bifurcated distal biceps brachii tendon is an anatomic variant that arises from persistent division between the short head and long head of the distal biceps brachii tendon and can be characterized with MRI. Knowledge of a bifurcated distal biceps brachii tendon is important to characterize injury to the components and to avoid pitfalls in imaging diagnosis.

  7. Ultrasound monitoring in cannulation of the internal jugular vein: anatomic and technical considerations. (United States)

    Docktor, B; So, C B; Saliken, J C; Gray, R R


    To examine the effect of variations in anatomic features and operator experience on the success and complication rates of sonographically monitored cannulation of the internal jugular vein. The authors prospectively collected data for ultrasound-monitored cannulation of the internal jugular vein in 150 patients. In all cases the radiologist recorded the side of puncture, the number of passes needed, the number of vein punctures (one or two), whether the walls were opposed during puncture and any complications. For the last 80 patients the following information was also recorded: the distance from the skin to the internal jugular vein, the diameter of the vein with the Valsalva manoeuvre and the location of the vein relative to the carotid artery. All but three of the cannulations were performed by one of three radiologists, all of whom had at least 5 years of experience. Cannulation was successful in all of the patients, and the first pass was successful in 133 (88.7%). These results are better than those of blind placement techniques reported in the literature. The only complications were hematoma and carotid puncture, which both occurred in the same two patients (1.3%). There was no significant difference among the radiologists in the number of passes needed (one-way analysis of variance, p > 0.05). The number of passes was independent of anatomic factors, including depth from skin, vein diameter or relative location. However, significantly more passes were needed for left-side punctures than for right-side punctures (Student t-test, p < 0.05). Real-time ultrasound monitoring is superior to blind techniques in cannulation of the internal jugular vein because of its ease, accuracy and safety. Sonographic real-time monitoring minimizes the impact of anatomic factors on success and complication rates. It is a safe and efficacious approach that should be preferred in the placement of central lines.

  8. Anatomical Variations in the Sinoatrial Nodal Artery: A Meta-Analysis and Clinical Considerations.

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    Jens Vikse

    Full Text Available The sinoatrial nodal artery (SANa is a highly variable vessel which supplies blood to the sinoatrial node (SAN. Due to its variability and susceptibility to iatrogenic injury, our study aimed to assess the anatomy of the SANa and determine the prevalence of its anatomical variations.An extensive search of major electronic databases was performed to identify all articles reporting anatomical data on the SANa. No lower date limit or language restrictions were applied. Anatomical data regarding the artery were extracted and pooled into a meta-analysis.Sixty-six studies (n = 21455 hearts were included in the meta-analysis. The SANa usually arose as a single vessel with a pooled prevalence of 95.5% (95%CI:93.6-96.9. Duplication and triplication of the artery were also observed with pooled prevalence of 4.3% (95%CI:2.8-6.0 and 0.3% (95%CI:0-0.7, respectively. The most common origin of the SANa was from the right coronary artery (RCA, found in 68.0% (95%CI:55.6-68.9 of cases, followed by origin from the left circumflex artery, and origin from the left coronary artery with pooled prevalence of 22.1% (95%CI:15.0-26.2 and 2.7 (95%CI:0.7-5.2, respectively. A retrocaval course of the SANa was the most common course of the artery with a pooled prevalence of 47.1% (95%CI:36.0-55.5. The pooled prevalence of an S-shaped SANa was 7.6% (95%CI:2.9-14.1.The SANa is most commonly reported as a single vessel, originating from the RCA, and taking a retrocaval course to reach the SAN. Knowledge of high risk anatomical variants of the SANa, such as an S-shaped artery, must be taken into account by surgeons to prevent iatrogenic injuries. Specifically, interventional or cardiosurgical procedures, such as the Cox maze procedure for atrial fibrillation, open heart surgeries through the right atrium or intraoperative cross-clamping or dissection procedures during mitral valve surgery using the septal approach can all potentiate the risk for injury in the setting of high

  9. Post-septal orbital complications of acute bacterial rhinosinusitis: Endoscopic anatomical considerations

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    Ahmed A. Ibrahim


    The study was carried out on 240 patients suffering from acute rhino-sinusitis with 90 patients suffering from orbital post-septal complicating acute rhino-sinusitis. Eighty-five cases underwent orbital decompression, except 5 cases with orbital cellulitis; they were improved on medical treatment. Visual monitoring by the ophthalmological team on regular basis was performed, until clinical and radiological improvement of the condition. This study proves that there may be a relationship between anatomic variation and orbital infections complicating acute sinusitis or acute on top of chronic sinusitis.

  10. Anatomic considerations when performing the modified Henry approach for exposure of distal radius fractures. (United States)

    Conti Mica, Megan A; Bindra, Randy; Moran, Steven L


    Identify the proximity of anatomic structures during the modified Henry approach (MHA). Distances between median nerve (MN), palmar cutaneous branch (PCB), radial artery (RA) and the flexor carpi radialis (FCR) were measured at the wrist crease (WC), 5 and 10 cm proximal in 16 fresh frozen cadavers. The FPL origin and innervation was measured. Most at risk was the MN proximally and the PCB distally while the RA was safe. Innervation occurred at the proximal third of the FPL's origin along the ulnar aspect. The MHA is safe when understanding the proximity of structures.

  11. Prognostic classification of Hodgkin disease in pathologic stage III, based on anatomic considerations

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    Desser, R.K.; Golomb, H.M.; Ultmann, J.E.; Ferguson, D.J.; Moran, E.M.; Griem, M.L.; Vardiman, J.; Miller, B.; Oetzel, N.; Sweet, D.


    Fifty-two patients with pathologic stage III Hodgkin's disease were studied in an effort to determine whether location of involved abdominal nodes influenced survival. Treatment consisted of total nodal radiotherapy with or without subsequent combination chemotherapy. The initial radiation field was the ''extended mantle,'' which included supradiaphragmatic nodes, the splenic hilar area, and paraaortic nodes to the level of L2-L4. Subsequently, lower paraaortic and iliac regions were treated (''lower inverted Y''). Patients with disease limited to the spleen and/or splenic, celiac, or portal nodes (''anatomic substage'' III/sub 1/) had a more favorable 5-yr survival than did patients with involvement of paraaortic, iliac, or mesenteric nodes (''anatomic substage'' III/sub 2/) : 93% versus 57%, respectively (p < 0.05). The addition of combination chemotherapy to total nodal irradiation was associated with improved survival of patients in stage III/sub 2/, but not of those in stage III/sub 1/.

  12. Biologic considerations in anatomic imaging with radionuclides. Final progress report, July 1974--June 1975

    International Nuclear Information System (INIS)

    Potchen, E.J.


    An important task relating to anatomic imaging with radionuclides is the determination of factors which effect the use of imaging procedures. This is important to reduce radiation exposure in the population, to improve the efficacy of diagnostic imaging procedures and finally to provide a basis for evaluating the potential effects of proposed regulation of use rates. In this report we describe a methodology for obtaining clinical data relating to the use of the brain scan in an inner city teaching hospital. The development of a questionnaire suitable for use in a clinical setting and providing both prospective and retrospective data is presented. The results of the use of the questionnaire at the Johns Hopkins Hospital during a three month period in 1974 are shown and discussed. Some preliminary results from these data are given and a method for further analysis is indicated

  13. A study of biceps brachii muscle: Anatomical considerations and clinical implications

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    Vaishaly Kishore Bharambe


    Full Text Available Context: Biceps brachii muscle (BBm is a very variable muscle, the variations being associated with a variety of clinical conditions. This study delves on anatomical variations in this muscle, possible phylogenic causes for their frequency and their clinical importance. Aims: The aim was to study anatomy of bicep brachii muscle, its variations and their clinical importance. Subjects and Methods: A total of 60 upper limbs preserved in 10% formalin were dissected meticulously to study anatomical details of the BBm. Results: The incidence of variation in anatomy of BBm was 15%, with incidence being 11.6% and 3.3% among male and female cadavers studied, respectively. Variation was unilateral in 10% and bilateral in 3.3%. The incidence of third head was 13.3% out of which 3.3% took origin from the capsule of the shoulder joint, 8.3% from humerus, and 1.6% from brachialis muscle. Incidence of extra bellies of insertion was found to be 1.6%. A 3.3% incidence was observed in the nerve supply. Conclusions: Variations in BBm are a reflection of its late development in human phylum. The extra bellies can cause neurovascular compression, change the kinematics at the elbow joint and be misinterpreted as tears of muscle on magnetic resonance imaging. They should be watched for in the shoulder as well as elbow joint surgeries. The authors suggest that the extra bellies of BBm instead of being labeled as third, fourth or fifth heads, can be classified as those of origin and insertion and bellies of origin be referred to clearly as capsular, humeral or brachial heads.

  14. Dentate control pathways of cortical motor activity. Anatomical and physiological studies in rat: comparative considerations. (United States)

    Angaut, P; Cicirata, F


    The dentato-thalamocortical projections have been studied in albino rats using anatomical and physiological approaches. The anatomical analysis reveals that the dentatothalamic input to the ventral thalamus and the thalamocortical projection from this region onto the motor cortical area have a complex topographical arrangement. The corticothalamic reverberating pathways, both direct and through a relay in the nucleus reticularis thalami, are also roughly arranged in register with the same topographical pattern. This arrangement has been reconciled with that of the motor cortex, as determined by the motor effects of intracortical microstimulations. From this is inferred a somatotopical arrangement of the cerebellar nucleus lateralis, or dentate. These observations are confirmed by the results of our physiological analysis. The movements obtained with direct microstimulations of the nucleus lateralis affect either one joint (simple movements) or, more seldom, several joints (complex movements) of the same limb. A rough rostrocaudal arrangement is found in the nucleus lateralis: the caudocentral regions of the nucleus contain the representation of the musculature of forelimb and head, whereas the hindlimb is represented in the rostralmost part of the nucleus. A more complex organization is found to be related to the three cytoarchitectonic subdivisions of the nucleus lateralis. The main, large-celled part of the nucleus is engaged in the control of the large skeletal musculature. The dorsolateral hump is involved in mouth and peri-oral activities. The ventral, parvocellular, subnucleus is involved in fine exploratory movements of vibrissae, eyes, and forelimb wrist and fingers. The implication of the dentato-thalamocortical pathways in the cortical motor activities in the rat is discussed with attention to the dentate control of the "voluntary" motricity in primates.

  15. Oval Window Size and Shape: a Micro-CT Anatomical Study With Considerations for Stapes Surgery. (United States)

    Zdilla, Matthew J; Skrzat, Janusz; Kozerska, Magdalena; Leszczyński, Bartosz; Tarasiuk, Jacek; Wroński, Sebastian


    The oval window is an important structure with regard to stapes surgeries, including stapedotomy for the treatment of otosclerosis. Recent study of perioperative imaging of the oval window has revealed that oval window niche height can indicate both operative difficulty and subjective discomfort during otosclerosis surgery. With regard to shape, structures incorporated into the oval window niche, such as cartilage grafts, must be compatible with the shape of the oval window. Despite the clinical importance of the oval window, there is little information regarding its size and shape. This study assessed oval window size and shape via micro-computed tomography paired with modern morphometric methodology in the fetal, infant, child, and adult populations. Additionally, the study compared oval window size and shape between sexes and between left- and right-sided ears. No significant differences were found among traditional morphometric parameters among age groups, sides, or sexes. However, geometric morphometric methods revealed shape differences between age groups. Further, geometric morphometric methods provided the average oval window shape and most-likely shape variance. Beyond demonstrating oval window size and shape variation, the results of this report will aid in identifying patients among whom anatomical variation may contribute to surgical difficulty and surgeon discomfort, or otherwise warrant preoperative adaptations for the incorporation of materials into and around the oval window.

  16. Radiological review of intercostal artery: anatomical considerations when performing procedures via intercostal space

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    Choi, S.; Trieu, J; Ridley, L


    The aim of this study was to closely examine the course of the intercostal arteries within the intercostal spaces particularly with regard to where the arteries were located in relation to their adjacent ribs. The degree of tortuosity of the arteries was also examined, along with anatomical differences in different age groups. A total of 81 patients between the age of 30 and 90 years who had underwent a CT examination of the chest for any indication were included in the study. All studies were performed on a dual source 64 slice CT (Siemens Definition Erlangen Germany). Analysis of the intercostal arteries was performed on a CT workstation using volume rendered 3D reconstructions F, or each patient the 10'n intercostals pacesb ilaterally were examined for the course and tortuosity of the intercostal arteries. The ICA is located relatively inferiorly in the intercostal space at costovertebral junction and it gradually becomes more superiorly positioned within the intercostal space it as courses laterally. This finding was consistent in all age groups. In addition, analysis of the data demonstrated increasing intercostal artery tortuosity with advancing age. In this study we have examined the course of the posterior intercostal arteries using MDCT. This study confirms the classical description of the course of ICA. We have shown that in the medial chest, posteriorly, the artery is located in the inferior half of the intercostal space. As it moves away from the costovertebral junction it travels closer to the inferior border of the rib above and reaches the intercostal groove. We have also shown that the artery tends to be more tortuous in elderly patients, decreasing the area of 'safe' space for interventions. Both of these findings are relevant to radiologists and non-radiologists performing interventional procedures via the intercostal space.

  17. Metabolic response to optic centers to visual stimuli in the albino rat: anatomical and physiological considerations

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    Toga, A.W.; Collins, R.C.


    The functional organization of the visual system was studied in the albino rat. Metabolic differences were measured using the 14 C-2-deoxyglucose (DG) autoradiographic technique during visual stimulation of one entire retina in unrestrained animals. All optic centers responded to changes in light intensity but to different degrees. The greatest change occurred in the superior colliculus, less in the lateral geniculate, and considerably less in second-order sites such as layer IV of visual cortex. These optic centers responded in particular to on/off stimuli, but showed no incremental change during pattern reversal or movement of orientation stimuli. Both the superior colliculus and lateral geniculate increased their metabolic rate as the frequency of stimulation increased, but the magnitude was twice as great in the colliculus. The histological pattern of metabolic change in the visual system was not homogenous. In the superior colliculus glucose utilization increased only in stratum griseum superficiale and was greatest in visuotopic regions representing the peripheral portions of the visual field. Similarly, in the lateral geniculate, only the dorsal nucleus showed an increased response to greater stimulus frequencies. Second-order regions of the visual system showed changes in metabolism in response to visual stimulation, but no incremental response specific for type or frequency of stimuli. To label proteins of axoplasmic transport to study the terminal fields of retinal projections 14 C-amino acids were used. This was done to study how the differences in the magnitude of the metabolic response among optic centers were related to the relative quantity of retinofugal projections to these centers

  18. Aneurysms of the vein of Galen: Embryonic considerations and anatomical features relating to the pathogenesis of the malformation

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    Raybaud, C.A.; Strother, C.M.; Hald, J.K.


    Vein of Galen aneurysms may be defined as direct arteriovenous fistulas between choroidal and/or quadrigeminal arteries and an overlying single median venous sac. Anatomic analysis of 23 cases of vein of Galen aneurysm and correlation with known embryologic data indicate that the venous sac most probably represents persistence of the embryonic median prosencephalic vein of Markowski, not the vein of Galen, per se. The frequent concurrent venous abnormalities are easily understood as (a) retention of fetal anatomical features and (b) frequent occlusions of the dural sinuses of the posterior fossa, especially the sigmoid sinuses. (orig.)

  19. Change in anatomic distribution and incidence of colorectal carcinoma over a period of 15 years - Clinical considerations

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    Mensink, PBF; Kolkman, JJ; van Baarlen, J; Kleibeuker, JH


    PURPOSE: Colorectal cancer is the second most common cancer in the Netherlands. Its incidence rates are among the highest in Europe. In the past decades, a right-sided shift of the subsite location of colorectal cancer has been reported. These changes in anatomic distribution might have clinical

  20. Aetiology of acute meningoencephalitis in Cambodian children, 2010-2013

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    Horwood, Paul F.; Duong, Veasna; Laurent, Denis; Mey, Channa; Sothy, Heng; Santy, Ky; Richner, Beat; Heng, Seiha; Hem, Sopheak; Cheval, Justine; Gorman, Christopher; Dussart, Philippe; de Jong, Menno D.; Kerleguer, Alexandra; Guillard, Bertrand; Murgue, Bernadette; Lecuit, Marc; de Lamballerie, Xavier; Farrar, Jeremy J.; Tarantola, Arnaud; Eloit, Marc; Buchy, Philippe


    Acute meningoencephalitis (AME) is associated with considerable morbidity and mortality in children in developing countries. Clinical specimens were collected from children presenting with AME at two Cambodian paediatric hospitals to determine the major aetiologies associated with AME in the

  1. Relevant Anatomic and Morphological Measurements of the Rat Spine: Considerations for Rodent Models of Human Spine Trauma. (United States)

    Jaumard, Nicolas V; Leung, Jennifer; Gokhale, Akhilesh J; Guarino, Benjamin B; Welch, William C; Winkelstein, Beth A


    Basic science study measuring anatomical features of the cervical and lumbar spine in rat with normalized comparison with the human. The goal of this study is to comprehensively compare the rat and human cervical and lumbar spines to investigate whether the rat is an appropriate model for spine biomechanics investigations. Animal models have been used for a long time to investigate the effects of trauma, degenerative changes, and mechanical loading on the structure and function of the spine. Comparative studies have reported some mechanical properties and/or anatomical dimensions of the spine to be similar between various species. However, those studies are largely limited to the lumbar spine, and a comprehensive comparison of the rat and human spines is lacking. Spines were harvested from male Holtzman rats (n = 5) and were scanned using micro- computed tomography and digitally rendered in 3 dimensions to quantify the spinal bony anatomy, including the lateral width and anteroposterior depth of the vertebra, vertebral body, and spinal canal, as well as the vertebral body and intervertebral disc heights. Normalized measurements of the vertebra, vertebral body, and spinal canal of the rat were computed and compared with corresponding measurements from the literature for the human in the cervical and lumbar spinal regions. The vertebral dimensions of the rat spine vary more between spinal levels than in humans. Rat vertebrae are more slender than human vertebrae, but the width-to-depth axial aspect ratios are very similar in both species in both the cervical and lumbar regions, especially for the spinal canal. The similar spinal morphology in the axial plane between rats and humans supports using the rat spine as an appropriate surrogate for modeling axial and shear loading of the human spine.

  2. Below-the-ankle Angioplasty and Stenting for Limb Salvage: Anatomical Considerations and Long-term Outcomes

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    Katsanos, Konstantinos, E-mail:; Diamantopoulos, Athanasios; Spiliopoulos, Stavros; Karnabatidis, Dimitris; Siablis, Dimitris [School of Medicine, Patras University Hospital, Department of Interventional Radiology (Greece)


    PurposeTo report the long-term angiographic and clinical results in a series of below-the-ankle (BTA) angioplasty procedures and to present some biomechanical issues related to the unique anatomical geometry of the ankle.MethodsWe performed a retrospective analysis of BTA angioplasty procedures. Clinical end points included technical success, patient mortality, salvage of the treated foot, and repeat target lesion revascularization. Imaging end points included primary patency, binary restenosis of the target lesion at the 50 % threshold, and stent integrity (stent fracture, deformation, or collapse). Univariate subgroup analysis was performed.ResultsIn total, 40 limbs in 37 patients (age 73.5 {+-} 8.2 years) with critical limb ischemia were included and 42 inframalleolar lesions (4.2 {+-} 1.4 cm) were analyzed. Technical success was achieved in 95.2 % (40 of 42). Provisional stent placement was performed in 45.2 % (19 of 42). Two patients died, and two major amputations occurred up to 3 years. At 1 year, overall primary vessel patency was 50.4 {+-} 9.1 %, lesion binary restenosis rate was 64.1 {+-} 8.3 %, and repeat intervention-free survival was 93.6 {+-} 4.3 % according to life table analysis of all treated lesions. Pairwise subgroup analysis showed that BTA self-expanding stents were associated with significantly higher restenosis and poorer primary patency compared to plain balloon angioplasty or sirolimus-eluting balloon-expandable stents. Significant deformation and/or fracture of balloon-expandable stents placed BTA were identified in five of 11. Dynamic imaging showed that the dorsalis pedis artery is kinked during foot dorsiflexion, whereas the distal posterior tibial artery is kinked during plantar flexion of the foot.ConclusionBTA angioplasty for critical limb ischemia treatment is safe and feasible with satisfactory long-term results. BTA stent placement must be reserved for bailout indications.

  3. Anatomical analysis of human ligamentum flavum in the cervical spine: Special consideration to the attachments, coverage, and lateral extent. (United States)

    Rahmani, Mohammad Suhrab; Terai, Hidetomi; Akhgar, Javid; Suzuki, Akinobu; Toyoda, Hiromitsu; Hoshino, Masatoshi; Tamai, Koji; Ahmadi, Sayed Abdullah; Hayashi, Kazunori; Takahashi, Shinji; Nakamura, Hiroaki


    Posterior decompression surgeries of cervical spine such as laminoplasty and laminoforaminotomy are well established and increasing in aging population. The anatomical knowledge of cervical ligamentum flavum (LF) is critical to perform posterior spinal surgeries, however, few studies have evaluated it, especially the relation of LF and neural foramen. The whole spine was removed en bloc from 15 formalin-embalmed human cadavers and then divided into two segments along the pedicle bases. A total of 90 LFs from C2-C3 to C7-T1 were measured manually from the ventral side before being painted with iron powder containing contrast agent and scanned by computed tomography. We recorded dimensions, coverage of adjacent laminae, and the relationships between LF and neural foramen or facet joints. Three-dimensional CT data was used to evaluate manually limited areas and make reconstructed images. LF height gradually increased from C2-C3 to C7-T1, and gradually decreased from medial to lateral within each level. LF width and thickness were relatively constant from cranial to caudal. The laminar surface covered by LF gradually increased from 33% in para midline and 30% laterally at C2, and increased to 70% in para midline and 47% laterally at C6, this trend was not completed at C7. The empty zone of the laminar surface (without LF coverage) was located at the upper half of each lamina; this zone gradually decreased from cranial to caudal. The craniomedial side of the cervical facet joint was covered by a mean 4.6 ± 0.7 mm of LF, however, LF did not enter the cervical neural foramen. LF did not enter the neural foramen in cervical spine unlike lumbar spine. This information might be critical to avoid neurological deterioration after cervical laminoplasty or laminoforaminotomy. Surgeons would imagine the attachments and coverage of LF and its relation to posterior bony structures to perform safe posterior cervical surgeries. Copyright © 2017 The Japanese Orthopaedic

  4. [Aetiology of childhood alopecia]. (United States)

    Cortés G, Andrea; Mardones V, Felipe; Zemelman D, Viviana


    Childhood alopecia is a relative rare event in general paediatric dermatology practice. Hair loss in children may have multiple causes, and there are different types of alopecia according to age groups. The aim of the study was to describe the clinical and epidemiological profile of alopecia in children from two Chilean paediatric hospitals. Descriptive analysis of clinical records of patients from the Dermatology Department of Roberto del Rio and Luis Calvo Mackenna Hospitals between January 2007 and June 2010. Patients with clinical diagnosis of alopecia were included. A total of 345 clinical records were analysed, with 179 males (51.9%). The median age was 72 months. Overall, the most common diagnoses were: alopecia areata (AA), (36.8%), tinea capitis (TC), (21%), nevus sebaceous (13.2%), and tellogen effluvium (8.7%). According to age groups, in newborns, the most common causes were aplasia cutis and nevus sebaceous. In toddlers, pre-school and school children, the principal causes were nevus sebaceous, AA and TC. Trichotillomania was also significant in school children. In adolescents, nevus sebaceous, AA and tellogen effluvium were the most frequent diagnoses. AA was statistically associated with autoimmune disease, thyroid disease, nail disorder, psychiatric disease, and Down's syndrome. The most common aetiological agent in TC was M. canis (86.6%). Trichotillomania was also statistically associated to psychiatric disorders. In this study, the main causes of alopecia in children were acquired and non-scarring alopecia. In our results, the type of alopecia varies according to age group. Some types of childhood alopecia showed a close correlation to psychiatric disorders. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. [Capgras delusion: a review of aetiological theories]. (United States)

    Madoz-Gúrpide, Agustín; Hillers-Rodríguez, Rosalía


    Features of the Capgras delusion, the most common among the delusional misidentification syndromes, are reviewed. We describe its phenomenology in psychiatric and organic diseases, its prevalence and comorbidity with other reduplicative disorders and review aetiological models in order to elucidate the origins of the delusion from both the cognitive psychology and psychodynamics precepts, as the neuropsychiatry and anatomical basis. According to cognitive models, Capgras syndrome cannot be exclusively conceived as a dysfunction in facial recognition but in recognizing a person globally considered. Feeling of familiarity is absent due to the inability to integrate successive memories about a person along episodic experiences, thus generating delusional doubles in accordance to the patient's needs or drives. From the neuropsychiatry point of view Capgras delusion arises from the failure in reconciling information about identification of the person and its associated emotions by the disconnection between frontal lobes and right temporo-limbic regions (hippocampus), in addition to bilateral frontal damage. Delusions are more commonly associated with right hemisphere lesions because of the impairment of several functions such as self monitoring, reality monitoring, memory and feelings of familiarity as well as the necessary preservation of the left hemisphere. Aetiology of Capgras delusion should include the conjoint involvement of clinical, neuropsychiatric and neuropsychological data with different theoretical models.

  6. EAMJ Aetiology Sep 09.indd

    African Journals Online (AJOL)


    Sep 9, 2009 ... have shown that in many cases the aetiologic agent cannot be identified (3, 4). ... and sanitary practices. All HIV-positive participants ... day. Diarrhoea was treated with oral rehydration solution and, if indicated, antimicrobial and anti- motility agents. Only one stool sample was collected for each episode of ...

  7. Transepidermal water loss in erythrodermic patients of various aetiologies. (United States)

    Mohd Noor, Noorlaily; Hussein, Suraiya H


    Despite its severity not much work has been done to explore the barrier function in patients with erythroderma. This study compares TEWL between skin of healthy subjects and erythrodermic patients of various aetiologies and at different sites. We also assess TEWL between patients with acute and chronic erythroderma. Twenty-five erythrodermic patients and 26 age, race and sex-matched healthy controls were recruited. TEWL measurements were performed at five sites; right cheek, left volar forearm, abdomen, upper back and right calf using Tewameter TM 210. TEWL in erythrodermic patients were significantly higher than healthy individuals at all the sites (P < 0.001). There were significant differences in TEWL between different anatomical sites in controls (P < 0.001) but not in patients. The highest TEWL for the patient and control groups were that of the abdomen and the right cheek respectively. Acute erythrodermic patients (n = 9) seemed to have a higher TEWL than chronic erythrodermic patients (n = 16) although the differences were not statistically significant. There was no significant difference in TEWL among erythrodermic patients of various aetiologies. Erythrodermic skin regardless of aetiology has much higher TEWL compared to normal skin. Differences in TEWL among various anatomical sites observed in normal skin were not seen in erythroderma. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Short article: Presence, extent and location of pancreatic necrosis are independent of aetiology in acute pancreatitis. (United States)

    Verdonk, Robert C; Sternby, Hanna; Dimova, Alexandra; Ignatavicius, Povilas; Koiva, Peter; Penttila, Anne K; Ilzarbe, Lucas; Regner, Sara; Rosendahl, Jonas; Bollen, Thomas L


    The most common aetiologies of acute pancreatitis (AP) are gallstones, alcohol and idiopathic. The impact of the aetiology of AP on the extent and morphology of pancreatic and extrapancreatic necrosis (EXPN) has not been clearly established. The aim of the present study was to assess the influence of aetiology on the presence and location of pancreatic necrosis in patients with AP. We carried out a post-hoc analysis of a previously established multicentre cohort of patients with AP in whom a computed tomography was available for review. Clinical data were obtained from the medical records. All computed tomographies were revised by the same expert radiologist. The impact of aetiology on pancreatic and EXPN was calculated. In total, 159 patients with necrotizing pancreatitis were identified from a cohort of 285 patients. The most frequent aetiologies were biliary (105 patients, 37%), followed by alcohol (102 patients, 36%) and other aetiologies including idiopathic (78 patients, 27%). No relationship was found between the aetiology and the presence of pancreatic necrosis, EXPN, location of pancreatic necrosis or presence of collections. We found no association between the aetiology of AP and the presence, extent and anatomical location of pancreatic necrosis.

  9. Enterovesical Fistulae: Aetiology, Imaging, and Management

    Directory of Open Access Journals (Sweden)

    Tomasz Golabek


    Full Text Available Background and Study Objectives. Enterovesical fistula (EVF is a devastating complication of a variety of inflammatory and neoplastic diseases. Radiological imaging plays a vital role in the diagnosis of EVF and is indispensable to gastroenterologists and surgeons for choosing the correct therapeutic option. This paper provides an overview of the diagnosis of enterovesical fistulae. The treatment of fistulae is also briefly discussed. Material and Methods. We performed a literature review by searching the Medline database for articles published from its inception until September 2013 based on clinical relevance. Electronic searches were limited to the keywords: “enterovesical fistula,” “colovesical fistula” (CVF, “pelvic fistula”, and “urinary fistula”. Results. EVF is a rare pathology. Diverticulitis is the commonest aetiology. Over two-thirds of affected patients describe pathognomonic features of pneumaturia, fecaluria, and recurrent urinary tract infections. Computed tomography is the modality of choice for the diagnosis of enterovesical fistulae as not only does it detect a fistula, but it also provides information about the surrounding anatomical structures. Conclusions. In the vast majority of cases, this condition is diagnosed because of unremitting urinary symptoms after gastroenterologist follow-up procedures for a diverticulitis or bowel inflammatory disease. Computed tomography is the most sensitive test for enterovesical fistula.

  10. Post-traumatic Collet-Sicard syndrome: personal observation and review of the pertinent literature with clinical, radiologic and anatomic considerations. (United States)

    Domenicucci, Maurizio; Mancarella, Cristina; Dugoni, Eugenio Demo; Ciappetta, Pasqualino; Paolo, Missori


    The lesion of the lower four cranial nerves, commonly called Collet-Sicard syndrome, can be caused by a blunt head and neck trauma. It may be associated to an isolated fracture of the occipital condyle or of the atlas. The aim of this report is to assess the modality of the trauma, the type of fracture, the anatomic characteristics, the treatment and clinical results of this syndrome. We discuss 14 cases of fracture of occipital condyle and of atlas and 1 personal case. We analyzed 14 cases collected from the literature between 1925 and 2013, reported a further personal case and performed an anatomical study of the paracondylar, atlas and styloid process region. The anatomical dissection was performed to assess the anatomic relationships in the site of transit in which the nerves IX, X, XI and XII are injured. A total of 14 cases of p-CSS were collected: 9 caused by a condyle fracture and 5 by an atlas fracture. The patients were 13 males and only 1 female, 10 of them had a blunt trauma due to the result of axial loading (force directed through the top of the head and through the spine) falling on the head. The nine cases with a condyle fracture were associated to the dislocation of part of it, while those with atlas fractures showed the fracture and/or disjunction of the articular mass. The anatomical evaluations reveal that the lower four cranial nerves, at their emergency, pass through a close osteo-ligamentous space in relationship to the condyle. Below they run through a little wider channel between the articular mass of C1 and the styloid process. Two cases underwent surgical procedure. All the other cases were treated conservatively with immobilization of the cervical spine. During follow-up three cases with condylar fractures were found to be clinically unchanged and six showed modest improvements while one case with atlas fracture had a complete recovery and four improved significantly. The p-CSS is caused by force directed through the top of the head. We

  11. A median sacral artery anterior to the iliocaval junction: a case report-anatomical considerations and clinical relevance for spine surgery. (United States)

    Chenin, Louis; Tandabany, Sharmila; Foulon, Pascal; Havet, Eric; Peltier, Johann


    The median sacral artery (MSA) is a relatively small vessel that always arises from the posterior, terminal part of the infrarenal aorta. In most cases, the MSA runs behind the iliocaval junction. Here, we describe a very rare case of an MSA running in front of this junction. During a human cadaveric dissection of the retroperitoneal area, we unexpectedly observed that the MSA passed in front of the left common iliac vein. The anatomy of the MSA has been extensively described and variations are quite rare. On the basis of this specific case, knowledge of the anatomic interactions between the MSA and other lumbar retroperitoneal vessels may help to avoid potential complications during surgery.

  12. Schizophrenia : Current concepts in aetiology

    Directory of Open Access Journals (Sweden)

    P S Bhat


    Full Text Available Schizophrenia is perhaps the most devastating neuropsychiatric illness. Worldwide, its prevalence rate is about 1%. Schizophrenia is considered a neurodevelopmental disorder involving the interplay of susceptibility genes and environmental factors. There is a wide range of pathologic findings, but there is no specific or diagnostic laboratory abnormality. Till date, the aetiology, neuropathology, and pathophysiology of schizophrenia remain elusive. Over the last forty years, the dopaminergic model has been the leading neurochemical hypothesis of schizophrenia. Yet it remains unlikely that dopaminergic dysfunction, on its own. Glutamatergic models provide an alternate approach for conceptualizing the brain abnormalities associated with schizophrenia. New pharmacological and behavioral approaches aimed at potentiating glutamatergic neurotransmission, offer new hopeforfuture clinical development

  13. Ovine wet carcass syndrome of unknown aetiology

    African Journals Online (AJOL)

    A condition of unknown aetiology, known as 'the wet sheep carcass syndrome' has led to the loss of about ... aetiology. Introduction. Wet sheep carcasses were seen with increasing frequency at abattoirs from January 1981. ... the holding pens, and transport stress. In the high incidence area (see Figure 1), feeding systems.

  14. Aetiological considerations in 96 consecutive cases of ascites ...

    African Journals Online (AJOL)

    Background: Ascites is always a feature of an underlying disease, whose cause is unknown at presentation most of the time. Its initial treatment therefore will be empirical and dependent on the most frequent and common causes in the environment. Aim: To evaluate a cohort of patients with ascites to determine the common ...

  15. Oculocerebrocutaneous syndrome : report of three additional cases and aetiological considerations

    NARCIS (Netherlands)

    Moog, U; deDieSmulders, C; Systermans, JMJ; Cobben, JM


    The oculocerebrocutaneous (OCC) syndrome is characterized by the presence of orbital cysts and microphthalmia/anophthalmia, focal hypo- and aplastic skin defects, skin appendages and cerebral malformations. Most of the patients suffer from psychomotor retardation and seizures. To date, 23 patients

  16. Atypical odontalgia. Its aetiology and prognosis. (United States)

    Brooke, R I; Schnurr, R F


    Atypical odontalgia is a chronic pain disorder in which persistent pain develops in clinically normal teeth. Its possible aetiology and long-term prognosis are discussed. Suggested management regimes are reviewed.

  17. Aetiology of auditory dysfunction in amusia: a systematic review. (United States)

    Casey, Daniel Aj


    Amusia, a music-specific agnosia, is a disorder of pitch interval analysis and pitch direction change recognition which results in a deficit in musical ability. The full range of aetiological factors which cause this condition is unknown, as is each cause's frequency. The objective of this study was to identify all causes of amusia, and to measure each of their frequencies. systematic review was conducted by search of multiple databases for articles related to the aetiology of amusic auditory dysfunction. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting of systematic reviews were followed, utilizing the PRISMA checklist and PRISMA flowchart methodology. Retrospective medical database review. evidence yielded from the systematic review process. The initial search protocol identified 5723 articles. Application of a classification review filter and exclusion of irrelevant or duplicates led to the initial identification of 56 relevant studies which detailed 301 patients. However, these studies were of poor quality. Because of this, synthesis and statistical analysis were not appropriate. Although initially a large number of relevant studies were identified, and might point in future to potential diagnostic categories, it was not appropriate to synthesise and analyse them due to poor quality, considerable heterogeneity and small numbers. This suggests that large, high quality studies focussed directly on understanding the aetiology of amusia are required.

  18. Aetiology of supernumerary teeth: a literature review. (United States)

    Anthonappa, R P; King, N M; Rabie, A B M


    Supernumerary teeth are teeth, or tooth-like structures that have either erupted or remain unerupted in addition to the 20 primary and 32 permanent teeth. This paper attempts to (a) provide an overview of the proposed hypotheses and the current understanding of the aetiology of supernumerary teeth, and (b) review the published cases of supernumerary teeth occurring in families. No studies have been able to distinguish between different aetiologies for the different locations of supernumerary teeth, while, from a developmental or molecular perspective, the proposed hypotheses may be plausible and explains the origin of different types of supernumerary teeth. The only clearly evident feature, based on the existing published reports, is that it is logical to state that supernumerary teeth have a genetic component in their aetiology.

  19. Anorexia nervosa--diagnosis, aetiology, and treatment. (United States)

    Hartman, D


    The aetiology, assessment and treatment of anorexia nervosa are reviewed in the light of the classical accounts of Morton, Lasègue and Gull. The core symptoms are deliberate weight loss, disturbed body image and amenorrhoea, and complications may include cardiac failure, electrolyte disturbances, hypothermia and osteoporosis. Common clinical findings are described. Disturbed brain serotonin activity is implicated in the aetiology of anorexia nervosa, but there is little support for the use of pharmacological treatments. Psychological theories of aetiology are discussed with reference to Bruch, Crisp, Palazzoli and Minuchin: the common theme is the reaction of the patient and her family to the physical and social changes of puberty. Individual and/or family psychotherapy is seen as central to the treatment of anorexia nervosa, and the relevant clinical research is reviewed. The roles of general practitioners, general psychiatrists and eating disorder specialists are discussed in the light of recent consensus treatment guidelines.

  20. Animal trypanosomiasis in Africa: Aetiology and Epidemiology ...

    African Journals Online (AJOL)

    The aetiology and epidemiology of African trypanosomiasis in bovine species are comprehensively presented. In addition, a critical review o the history and transmission of the disease is exhaustively discussed. The mystery of other epizootiological factors associated with bovine trypanosomiasis is highlighted. Four major ...

  1. Acute Pancreatitis: Demographics, aetiological factors and ...

    African Journals Online (AJOL)

    Introduction. The spectrum of aetiologies and outcomes of acute pancreatitis in South African settings is under-reported. We report our experience at a regional hospital and compare it with international norms. Patients and methods. Data were prospectively collected on all admissions of patients with acute pancreatitis to a ...

  2. Hepatocellular carcinoma in South Sudan: possible aetiologies ...

    African Journals Online (AJOL)

    Hepatocellular carcinoma is one of the common malignancies in both the developed and developing worlds. This is most likely due to its wide variety of causes. The aetiologies vary from one part of the world to another determined by many factors ranging from geography, life style, availability of advanced medical care etc ...

  3. Dynamic bowel obstruction: aetiology, clinical presentation ...

    African Journals Online (AJOL)

    This study was conducted to describe in our region, the aetiology, clinical presentation, management and outcome of dynamic bowel obstruction. Data were analyzed using SPSS software system. A total of 342 patients were studied. Males outnumbered females by a ratio of 2.1: 1. The median age of patients at presentation ...

  4. Dynamic bowel obstruction: aetiology, clinical presentation ...

    African Journals Online (AJOL)

    2005). This makes it essential that studies are made periodically in every region to define the local causes with the idea to do work on their prevention (Adhikari et al., 2010). This study was conducted to describe in our region, the aetiology, clinical presentation, management and outcome of dynamic bowel obstruction.

  5. Incidence, symptomatology and aetiological factors for Asherman's ...

    African Journals Online (AJOL)

    Background: Asherman's syndrome is a significant cause of secondary amenorrhoea and infertility in Nigeria. It is largely preventable and safe practices will make it rare. Aim: To determine the incidence, symptomatology and aetiological factors for Asherman's syndrome in Orlu, South East Nigeria. Methods: A prospective ...

  6. Aetiological blood biomarkers of ischaemic stroke. (United States)

    Sonderer, Julian; Katan Kahles, Mira


    Each year, over 5 million people die worldwide from stroke, and at least every sixth patient who survives will experience another stroke within five years [1]. We are therefore eager to advance early and rapid diagnosis, prognosis and optimal risk stratification, as well as secondary prevention. In this context, blood biomarkers may improve patient care, as they have already done in other fields in the past, for example, troponin T/I in patients with heart attacks, natriuretic peptides in patients with heart failure or PCT (procalcitonin) [2] in patients with pneumonia. In the setting of acute stroke, a blood biomarker can be any quantifiable entity that reflects the manifestation of a stroke-related process. The most fruitful implementation of stroke biomarkers is in areas where information from traditional clinical sources is limited. There may be markers, for example, to guide risk stratification, reveal stroke aetiology, identify patients who may benefit most from interventions, monitor treatment efficacy, and recognise the risk of short-term complications or unfavourable long-term outcomes. For this review we focus on blood biomarkers that could help distinguish the underlying aetiology of an ischaemic stroke. Stroke tends to be a much more heterogeneous condition than ischaemic heart disease, which is caused by atherosclerosis in the vast majority of cases. Causes of stroke include small and large vessel disease, cardioembolism, dissections, and rare vasculo- and coagulopathies, among others. Because of this heterogeneity among stroke patients, it is clear that a monolithic approach to stroke prevention or secondary prevention is not warranted. Aetiological classification is important specifically because prognosis, risk of recurrence and management options differ greatly between aetiological subtypes. Considering that today up to 30% of stroke patients still cannot be classified into a specific subtype [3], the ability to improve aetiological classification

  7. Car drivers with dementia : different complications due to different aetiologies?

    NARCIS (Netherlands)

    Piersma, D. Waard, D. de Davidse, R. Tucha, O. & Brouwer,W.


    Older drivers with dementia are an at-risk group for unsafe driving. However, dementia refers to various aetiologies and the question is whether dementias of different aetiology have similar effects on driving ability. The literature on the effects of dementia of various aetiologies on driving

  8. New aetiology of patellofemoral pain syndrome. (United States)

    Chas, Julie; Mariot, Philippe; Tassart, Marc; Pialoux, Gilles


    We report the case of a 30-year-old man with more than 100 different male sexual partners per year. He reported using cocaine, ecstasy, γ-hydroxybutyric acid and crystal mephedrone and presented with bilateral gonalgia resistant to standard analgesia. He had no noteworthy medical history, and physical examination and laboratory tests were uninformative. MRI showed marked intra-articular effusion but no meniscus or ligament damage. The aetiological diagnosis in this case was made by excluding other potential causes. Patellofemoral pain syndrome (PFPS) is one of the most common and challenging injuries. In this first case reported, the aetiology was found to be mechanical, due to the position adopted during fellatio with multiple male partners. 2014 BMJ Publishing Group Ltd.

  9. Xerostomia: aetiology and management in cancer patients. (United States)

    Holmes, S


    Although oral complications are common sequelae of cancer/cancer treatment, only sporadic research is published in the literature. It is clear that 'routine' oral hygiene measures are inadequate; a little time and effort may, however, reduce oral discomfort. This is particularly true in the case of xerostomia, which is often thought to be a relatively minor symptom with few deleterious effects. Many patients, however, find xerostomia a significant cause of distress, and for this reason alone, health care professionals require knowledge and appreciation of the pathology and aetiology of the condition and approaches to its management. This paper reviews the physiology of salivation and the aetiology of xerostomia and considers the ways in which the condition can be managed.

  10. Abnormal fetal head shape: aetiology and management

    DEFF Research Database (Denmark)

    Petersen, Olav Bjørn; David, Anna; Thomasson, Louise


    and define management pathways for fetuses with an abnormal skull shape. Methods: Our FMU databases were searched to ascertain all fetuses with an abnormal skull shape. Sonographic findings, diagnosis and outcome were reviewed. Results: Of the 370 cases identified, 31.6% were associated with spinabifida......Background: Abnormal head shape is an uncommon finding on prenatal ultrasound, often associated with breech presentation, spinabifida, aneuploidy or secondary to oligohydramnios or fetal position. Other aetiologies are rarer and may be more difficult to define. Objective: To determine the aetiology...... incidence of genetic syndromes, in the absence of a clear diagnosis, referral to a tertiary centre and genetic input is advised as detection of subtle sonographic features may aid diagnosis, allowing for targeted molecular analysis. An algorithm for management will be proposed....

  11. Aetiology of Oral Cancer in the Sudan

    Directory of Open Access Journals (Sweden)

    Hussain Gadelkarim Ahmed


    Full Text Available Objectives: To review the studied risk factors that linked to aetiology of oral cancer in the Sudan. There have been numerous reports in the increase in the incidence of oral cancer from various parts of the world. A recent trend for a rising incidence of oral cancer, with the absence of the well established risk factors, has raised concern. Although, there are inconsistent data on incidence and demographical factors, studies suggest that the physiologic response to risk factors by men and women vary in different populations.Material and Methods: This review principally examines 33 publications devoted to aetiology of oral cancer in the Sudan, in addition to some risk factors that are commonly practiced in the Sudan.Results: Several studies examining risk factors for oral cancer include tobacco use (Smoked and Smokeless, alcohol consumption, occupational risk, familial risk, immune deficits, virus infection and genetic factors.Conclusions: Toombak use and infection with high risk Human Papilloma Virus (HPV were extensively investigated and linked to the aetiology of oral cancer in Sudan.

  12. MDCT evaluation of congenital mitral-aortic intervalvular fibrosa aneurysm: implications for the aetiology and differential diagnosis

    International Nuclear Information System (INIS)

    Tsai, I. Chen; Fu, Yun-Ching; Lin, Ming-Chih; Jan, Sheng-Ling; Lin, Pao-Chun


    Mitral-aortic intervalvular fibrosa aneurysm is a rare disease whose aetiology remains a matter of debate. Here we present the youngest reported patient with the disease, a 6-month-old boy, without a history of infection, which supports a congenital origin as initially proposed. Multidetector-row CT (MDCT) surpassed echocardiography in delineating the intracardiac anatomical details with high spatial resolution, confirming the important problem-solving role of MDCT in the diagnosis of congenital heart disease. (orig.)

  13. Anterior open bite: aetiology and management. (United States)

    Sandler, Paul Jonathan; Madahar, Arun K; Murray, Alison


    Anterior open bite has a multi-factorial aetiology comprising: genetically inherited skeletal pattern, soft tissue effect and digit-sucking habits. To formulate an appropriate treatment plan, accurate diagnosis is essential. Simple open bites may sometimes resolve completely during the transition from mixed to permanent dentition, if the digit-sucking habit is broken. More significant open bites, however, sometimes extending right back to the terminal molars, rarely resolve spontaneously and will often require complex orthodontic treatment, involving active molar intrusion or even major orthognathic surgery. Unfortunately, surgery has associated risks attached, including pain, swelling, bruising, altered nerve sensation and, occasionally, permanent anaesthesia, as well as involving significant costs, as with any major surgical procedure under general anaesthesia. The introduction of Temporary Anchorage Devices (TADs) has expanded the possibilities of orthodontic treatment, beyond traditional limitations of tooth movement. Molar intrusion can be successfully carried out without the need for major surgical intervention, thus avoiding all the attendant risks and disadvantages. This paper provides an overview of anterior open bite and uses an illustrative case where open bite was successfully treated with a combination of fixed appliance therapy and TADs. Anterior open bite is commonly seen in general practice. A knowledge of the possible aetiological factors and their potential management should be understood by general dental practitioners. The increased popularity of TADS allows a new and less invasive approach to management of these cases.

  14. Aetiology of allergic rhinitis in Hong Kong

    Directory of Open Access Journals (Sweden)

    Christopher W.K. Lam


    Full Text Available In a 1993 survey, allergic rhinitis was identified as the most common allergic disease in Hong Kong, affecting 29.1% of schoolchildren. Recently (1995, the International Study of Asthma and Allergies in Childhood (ISAAC also reported 44.5% current rhinitis among Hong Kong teenagers. Our objective was to study the aetiology of allergic rhinitis in Hong Kong using serological tests of allergen sensitization. In 57 allergic rhinitis patients and in the same number of age- and sex-matched controls the following were measured: serum total IgE, mixed aeroallergen IgE (Phadiatop™ and specific IgE versus house dust mite (HDM, cockroach, cat and dog dander, mould mixture (Penicillium, Cladosporium, Aspergillus and Alternaria species and four local pollens (Bermuda grass, Timothy, ragweed and mugwort. Compared with controls, allergic rhinitis patients (26 males, 31 females; mean (± SD age 25 ±11 years had a significantly elevated serum total IgE concentration (mean ± SEM: 496 ± 88 vs 179 ± 38 kU/L and an increased proportion of positive Phadiatop (95 vs 33% and specific IgE tests versus HDM (90 vs 44% and cockroach (42 vs 9%; Mann-Whitney U-test and χ2 tests all P < 0.005. There was no significant difference in sensitization to other allergens tested. House dust mite and cockroach are ubiquitous in Hong Kong with a warm, humid climate and crowded living conditions. Their identification as aetiological agents of allergic rhinitis should help in the development of environmental strategies for reducing the inhalant allergen load to prevent and control this prevalent and costly health problem in our community.

  15. Tobacco usage in relation to the anatomical site of oral leukoplakia

    NARCIS (Netherlands)

    Schepman, K. P.; Bezemer, P. D.; van der Meij, E. H.; Smeele, L. E.; van der Waal, I.


    Tobacco usage is the most important known aetiological factor in the development of oral leukoplakia. The purpose of this study was to investigate the possible relation of tobacco usage to the anatomical site of the leukoplakia. Clinical data regarding tobacco usage and localisation of leukoplakia

  16. Aetiology of Abdominal Injuries in Children:- at Olabisi Onabanjo ...

    African Journals Online (AJOL)

    The occurrence of abdominal injuries in children appear to be on the increase in our environment and; several aetiological factors have been implicated. To outline the aetiological factors responsible for abdominal injuries in children managed at our health institution. A two-year prospective study carried out between ...

  17. Aetiology of Depression: Insights from epidemiological and genetic research

    NARCIS (Netherlands)

    O. Story-Jovanova (Olivera)


    markdownabstractThis thesis includes several population-based studies that explore the aetiology of depression, with a specific interest on biological factors, genetics and epigenetics, and physical health factors for depression. Unravelling the aetiology of depression could potentially answer some

  18. Aetiology and outcome of severe community-acquired pneumonia in ...

    African Journals Online (AJOL)

    Objective. To determine the aetiological agents and outcome of severe community-acquired pneumonia (SCAP) in children admitted to the paediatric intensive care unit (PICU) at Kalafong Hospital, Pretoria. Patients and methods. An audit was done after a protocol was implemented to identify the aetiological agents in ...

  19. The aetiology of otosclerosis: a review of the literature

    NARCIS (Netherlands)

    Menger, D. J.; Tange, R. A.


    During the last century, hundreds of studies have been performed to identify factors that are involved in the aetiology of otosclerosis. These studies include a variety of aetiological factors and, although many theories have been postulated, the process of the development of the disease remains

  20. Transcatheter aortic valve implantation using anatomically oriented, marrow stromal cell-based, stented, tissue-engineered heart valves: technical considerations and implications for translational cell-based heart valve concepts. (United States)

    Emmert, Maximilian Y; Weber, Benedikt; Behr, Luc; Sammut, Sebastien; Frauenfelder, Thomas; Wolint, Petra; Scherman, Jacques; Bettex, Dominique; Grünenfelder, Jürg; Falk, Volkmar; Hoerstrup, Simon P


    While transcatheter aortic valve implantation (TAVI) has rapidly evolved for the treatment of aortic valve disease, the currently used bioprostheses are prone to continuous calcific degeneration. Thus, autologous, cell-based, living, tissue-engineered heart valves (TEHVs) with regeneration potential have been suggested to overcome these limitations. We investigate the technical feasibility of combining the concept of TEHV with transapical implantation technology using a state-of-the-art transcatheter delivery system facilitating the exact anatomical position in the systemic circulation. Trileaflet TEHVs fabricated from biodegradable synthetic scaffolds were sewn onto self-expanding Nitinol stents seeded with autologous marrow stromal cells, crimped and transapically delivered into the orthotopic aortic valve position of adult sheep (n = 4) using the JenaValve transapical TAVI System (JenaValve, Munich, Germany). Delivery, positioning and functionality were assessed by angiography and echocardiography before the TEHV underwent post-mortem gross examination. For three-dimensional reconstruction of the stent position of the anatomically oriented system, a computed tomography analysis was performed post-mortem. Anatomically oriented, transapical delivery of marrow stromal cell-based TEHV into the orthotopic aortic valve position was successful in all animals (n = 4), with a duration from cell harvest to TEHV implantation of 101 ± 6 min. Fluoroscopy and echocardiography displayed sufficient positioning, thereby entirely excluding the native leaflets. There were no signs of coronary obstruction. All TEHV tolerated the loading pressure of the systemic circulation and no acute ruptures occurred. Animals displayed intact and mobile leaflets with an adequate functionality. The mean transvalvular gradient was 7.8 ± 0.9 mmHg, and the mean effective orifice area was 1.73 ± 0.02 cm(2). Paravalvular leakage was present in two animals, and central aortic regurgitation due to a

  1. Cracked tooth syndrome. Part 1: aetiology and diagnosis. (United States)

    Banerji, S; Mehta, S B; Millar, B J


    Symptomatic, incompletely fractured posterior teeth can be a great source of anxiety for both the dental patient and dental operator. For the latter, challenges associated with deriving an accurate diagnosis together with the efficient and time effective management of cases of cracked tooth syndrome are largely accountable for the aforementioned problem. The aim of this series of two articles is to provide the reader with an in-depth insight into this condition, through the undertaking of a comprehensive literature review of contemporarily available data. The first article will provide details relating to the background of cracked tooth syndrome including the epidemiology, patho-physiology, aetiology and diagnosis of the syndrome, together with a consideration of factors which may influence the prognostic outcome of teeth affected by incomplete, symptomatic fractures. The second article will focus on the immediate and intermediate management of cracked teeth, and also provide a detailed account of the application of both direct and indirect restorations and restorative techniques used respectively in the management of teeth affected by this complex syndrome.

  2. [Cellular subcutaneous tissue. Anatomic observations]. (United States)

    Marquart-Elbaz, C; Varnaison, E; Sick, H; Grosshans, E; Cribier, B


    We showed in a companion paper that the definition of the French "subcutaneous cellular tissue" considerably varied from the 18th to the end of the 20th centuries and has not yet reached a consensus. To address the anatomic reality of this "subcutaneous cellular tissue", we investigated the anatomic structures underlying the fat tissue in normal human skin. Sixty specimens were excised from the surface to the deep structures (bone, muscle, cartilage) on different body sites of 3 cadavers from the Institut d'Anatomie Normale de Strasbourg. Samples were paraffin-embedded, stained and analysed with a binocular microscope taking x 1 photographs. Specimens were also excised and fixed after subcutaneous injection of Indian ink, after mechanic tissue splitting and after performing artificial skin folds. The aspects of the deep parts of the skin greatly varied according to their anatomic localisation. Below the adipose tissue, we often found a lamellar fibrous layer which extended from the interlobular septa and contained horizontally distributed fat cells. No specific tissue below the hypodermis was observed. Artificial skin folds concerned either exclusively the dermis, when they were superficial or included the hypodermis, but no specific structure was apparent in the center of the fold. India ink diffused to the adipose tissue, mainly along the septa, but did not localise in a specific subcutaneous compartment. This study shows that the histologic aspects of the deep part of the skin depend mainly on the anatomic localisation. Skin is composed of epidermis, dermis and hypodermis and thus the hypodermis can not be considered as being "subcutaneous". A difficult to individualise, fibrous lamellar structure in continuity with the interlobular septa is often found under the fat lobules. This structure is a cleavage line, as is always the case with loose connective tissues, but belongs to the hypodermis (i.e. fat tissue). No specific tissue nor any virtual space was

  3. Chronic fatigue syndrome: aetiology, diagnosis and treatment

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    Palacín Delgado Cecilia


    Full Text Available Abstract Chronic fatigue syndrome is characterised by intense fatigue, with duration of over six months and associated to other related symptoms. The latter include asthenia and easily induced tiredness that is not recovered after a night's sleep. The fatigue becomes so severe that it forces a 50% reduction in daily activities. Given its unknown aetiology, different hypotheses have been considered to explain the origin of the condition (from immunological disorders to the presence of post-traumatic oxidative stress, although there are no conclusive diagnostic tests. Diagnosis is established through the exclusion of other diseases causing fatigue. This syndrome is rare in childhood and adolescence, although the fatigue symptom per se is quite common in paediatric patients. Currently, no curative treatment exists for patients with chronic fatigue syndrome. The therapeutic approach to this syndrome requires a combination of different therapeutic modalities. The specific characteristics of the symptomatology of patients with chronic fatigue require a rapid adaptation of the educational, healthcare and social systems to prevent the problems derived from current systems. Such patients require multidisciplinary management due to the multiple and different issues affecting them. This document was realized by one of the Interdisciplinary Work Groups from the Institute for Rare Diseases, and its aim is to point out the main social and care needs for people affected with Chronic Fatigue Syndrome. For this, it includes not only the view of representatives for different scientific societies, but also the patient associations view, because they know the true history of their social and sanitary needs. In an interdisciplinary approach, this work also reviews the principal scientific, medical, socio-sanitary and psychological aspects of Chronic Fatigue Syndrome.

  4. Aetiology of shigellosis in northern Pakistan. (United States)

    Ahmed, Khalil; Shakoori, Farah R; Shakoori, A R


    People of northern Pakistan face health hazards because of poor sanitation practices. Bacterial gastrointestinal infections are very common, and sometimes outbreaks occur. The present study was aimed at evaluating and analyzing infestation of Shigella spp. in patients with suspected gastroenteritis and ascertaining the status of antibiotic therapy. Five hundred and eighty-five faecal samples of patients with suspected gastroenteritis, referred to the District Headquarter Hospital Gilgit, were investigated for common enteropathogenic bacteria from July 1997 to September 1999. Seventy-seven (13.2%) of the faecal specimens were infected with different strains of Shigella spp., 61% of which were Shigella dysenteriae, 15.6% were S. flexneri, and 23.4% were Shigella sp. All Shigella strains were sensitive to ceftriaxone, cefotaxime, ciprofloxacin, and enoxacin. Sixty-one percent of the strains were resistant to both ampicillin and chloramphenicol, and 3.9% to ampicillin and nalidixic acid, while 10.4% were resistant to ampicillin alone and 14.3% to chloramphenicol only. Only 10.4% of the strains were sensitive to all the antibiotics tested. Sixty strains of Shigella spp. were processed for isolation of plasmids, and 58 (97%) of these antibiotic-resistant bacteria harboured at least one plasmid. The number of plasmids varied from 1 to 9. Escherichia coli C600 were transformed with the isolated plasmids. Transformants, containing 23-kb plasmid, resisted growth in media containing antibiotics, thereby indicating that antibiotic resistance is plasmid-borne. Based on the findings of the study, it is concluded that the infestation of Shigella spp. is high in northern Pakistan, the aetiological agents are highly resistant to chloramphenicol and ampicillin, and the antibiotic resistance is mediated by the 23-kb plasmid.

  5. Review of the Aetiology and Complications of Primary Postpartum ...

    African Journals Online (AJOL)

    Review of the Aetiology and Complications of Primary Postpartum Haemorrhage following vaginal delivery at University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria: A 5-year Review. CI Emechebe, CO Njoku, AN Njoku, JT Ukaga, EM Eyong ...

  6. Extrahepatic portal vein thrombosis : aetiology and determinants of survival

    NARCIS (Netherlands)

    Janssen, HLA; Haagsma, EB; van Uum, SHM; van Nieuwkerk, CMJ; Adang, RP; Chamuleau, RAFM; van Hattum, J; Vleggaar, FP; Hansen, BE; Rosendaal, FR; van Hoek, B


    Background-Malignancy, hypercoagulability, and conditions leading to decreased portal flow have been reported to contribute to the aetiology of extrahepatic portal vein thrombosis (EPVT). Mortality of patients with, EPVT may be associated with these concurrent medical conditions or with

  7. Extrahepatic portal vein thrombosis: aetiology and determinants of survival

    NARCIS (Netherlands)

    H.L.A. Janssen (Harry); B.E. Hansen (Bettina); B. van Hoek (Bart); F.R. Rosendaal (Frits); E.B. Haagsma (Els); S.H. van Uum; C.M. van Nieuwkerk; R.P.R. Adang (Rob); R.A. Chamuleau; J. van Hattum (Jan); F.P. Vleggaar (Frank); A.D. Wijnhoud (Annemarie)


    textabstractBACKGROUND: Malignancy, hypercoagulability, and conditions leading to decreased portal flow have been reported to contribute to the aetiology of extrahepatic portal vein thrombosis (EPVT). Mortality of patients with EPVT may be associated with these concurrent medical


    African Journals Online (AJOL)

    Consideration of the distribution showed that Escherichia coli was more prevalent in children aged between 3 to 5 years (57%) and was the most encountered of the organisms isolated (present in 77.8% of all samples) while Shigella spp was found in 16.3% of samples, Vibrio cholerae 0.7% and other coliforms 5.2%.

  9. Aetiology of thrombosed external haemorrhoids: a questionnaire study

    Directory of Open Access Journals (Sweden)

    Rohde Henning


    Full Text Available Abstract Background It is important to better understand the aetiology of thrombosed external haemorrhoids (TEH because recurrence rates are high, prophylaxis is unknown, and optimal therapy is highly debated. Findings We conducted a questionnaire study of individuals with and without TEH. Aetiology was studied by comparison of answers to a questionnaire given to individuals with and without TEH concerning demography, history, and published aetiologic hypotheses. Participants were evaluated consecutively at our institution from March 2004 through August 2005. One hundred forty-eight individuals were enrolled, including 72 patients with TEH and 76 individuals without TEH but with alternative diagnoses, such as a screening colonoscopy or colonic polyps. Out of 38 possible aetiologic factors evaluated, 20 showed no significant bivariate correlation to TEH and were no longer traced, and 16 factors showed a significant bivariate relationship to TEH. By multivariate analysis, six independent variables were found to predict TEH correctly in 79.1% of cases: age of 46 years or younger, use of excessive physical effort, and use of dry toilet paper combined with wet cleaning methods after defaecation were associated with a significantly higher risk of developing TEH; use of bathtub, use of the shower, and genital cleaning before sleep at least once a week were associated with a significantly lower risk of developing TEH. Conclusion Six hypotheses on the causes of TEH have a high probability of being correct and should be considered in future studies on aetiology, prophylaxis, and therapy of TEH.

  10. The incidence and aetiology of acute pancreatitis across Europe. (United States)

    Roberts, Stephen E; Morrison-Rees, Sian; John, Ann; Williams, John G; Brown, Tim H; Samuel, David G

    Acute pancreatitis is increasingly one of the most important acute gastrointestinal conditions throughout much of the world, although incidence and aetiology varies across countries and regions. This study investigated regional and national patterns in the incidence and aetiology of acute pancreatitis, demographic patterns in incidence and trends over time in incidence across Europe. A structured review of acute pancreatitis incidence and aetiology from studies of hospitalised patient case series, cohort studies or other population based studies from 1989 to 2015 and a review of trends in incidence from 1970 to 2015 across all 51 European states. The incidence of acute pancreatitis was reported from 17 countries across Europe and ranged from 4.6 to 100 per 100 000 population. Incidence was usually highest in eastern or northern Europe, although reported rates often varied according to case ascertainment criteria. Of 20 studies that reported on trends in incidence, all but three show percentage increases over time (overall median increase = 3.4% per annum; range = -0.4%-73%). The highest ratios of gallstone to alcohol aetiologies were identified in southern Europe (Greece, Turkey, Italy and Croatia) with lowest ratios mainly in eastern Europe (Latvia, Finland, Romania, Hungary, Russia and Lithuania). The incidence of acute pancreatitis varies across Europe. Gallstone is the dominant aetiology in southern Europe and alcohol in eastern Europe with intermediate ratios in northern and western Europe. Acute pancreatitis continues to increase throughout most of Europe. Copyright © 2017. Published by Elsevier B.V.

  11. Anatomical terminology in Ophthalmology


    Abib, Fernando César; Oréfice, Fernando


    O objetivo deste artigo é informar à classe oftalmológica a existência da edição em língua portuguesa da Terminologia Anatômica Internacional, editada pela Federation Committee on Anatomical Terminology (FCAT). No Brasil a Terminologia Anatômica Internacional é traduzida pela Comissão de Terminologia Anatômica (CTA) da Sociedade Brasileira de Anatomia (SBA).The purpose of this article is inform ophthalmologists of the International Anatomical Terminology in the Portuguese language edited by t...

  12. Aetiological Patterns and Management Outcome of Paediatric Head ...

    African Journals Online (AJOL)

    Trauma is themost common cause of paediatric deaths. In75% of paediatric trauma deaths, head injury is responsible, and most are from falls. Recent reports from Nigeria, however, appear to indicate a predominance of road traffic accidents, instead of falls. To evaluate the aetiology of paediatric head trauma, management ...

  13. The aetiology of idiopathic scoliosis : biomechanical and neuromuscular factors

    NARCIS (Netherlands)

    Veldhuizen, AG; Webb, PJ

    The aetiology of adolescent idiopathic scoliosis (AIS) remains an enigma. In the literature there are two opinions: one believes a deviating growth pattern is responsible for the condition - patients with AIS lend to be growing faster/be taller - while the other opinion assumes that the growth

  14. Ignored Aetiologic Factors of Growth Faltering/Stunting In Sierra ...

    African Journals Online (AJOL)

    Until recently, the role of aflatoxins as a causative agent of stunting was never explored. Recent studies carried out in Benin, Togo and The Gambia have implicated aflatoxin in the aetiology of stunting/growth faltering in children. Studies carried out in the Southern province (Bo and Njala) have demonstrated that children not ...

  15. Aetiology, pattern and management of oral and maxillofacial injuries ...

    African Journals Online (AJOL)

    Objective: To establish the aetiology, pattern and methods of management of oral and Maxillofacial injuries (OMFIs) seen at the Oral and Jaw injuries unit of Mulago National Referral Hospital (MNRH) Kampala, Uganda, over a ten year period. Design: A descriptive retrospective study. Setting: Oral and jaw injury unit of ...


    African Journals Online (AJOL)

    Engr E. Egbochukwu

    Abstract. The study investigated the aetiology of Igbo cultural rites with the aim of highlighting the implications for church and community relations as a means of promoting peaceful co-existence. The investigation isolated the following rites namely: “igu afa” (naming ceremony); “igba nnunnu”(shooting of birds); “uche.

  17. “Spoiling the womb”: Definitions, Aetiologies and responses to ...

    African Journals Online (AJOL)

    Spoiling the womb”: Definitions, Aetiologies and responses to infertility in North West Province, Cameroon. ... Now, family planning is promoted nationwide to reduce population growth, and infertility is not addressed by public health policy or services. In contrast to the biomedical definition used by planners, at the local level ...

  18. A study of the aetiology of anaemia in hospitalized newborns ...

    African Journals Online (AJOL)

    Background: Anaemia contributes significantly to neonatal morbidity and mortality. This study describes the aetiology of anemia in ill babies in order to highlight the underlying conditions, proffer preventive measures and sensitize Physicians to improve on the management of anemia in babies. Methods: This was a ...

  19. Extrahepatic portal vein thrombosis: aetiology and determinants of survival

    NARCIS (Netherlands)

    Janssen, H. L.; Wijnhoud, A.; Haagsma, E. B.; van Uum, S. H.; van Nieuwkerk, C. M.; Adang, R. P.; Chamuleau, R. A.; van Hattum, J.; Vleggaar, F. P.; Hansen, B. E.; Rosendaal, F. R.; van Hoek, B.


    Malignancy, hypercoagulability, and conditions leading to decreased portal flow have been reported to contribute to the aetiology of extrahepatic portal vein thrombosis (EPVT). Mortality of patients with EPVT may be associated with these concurrent medical conditions or with manifestations of portal

  20. The aetiology and possible prevention of myocardial infarction ...

    African Journals Online (AJOL)

    The subjects of this study were 250 cases of myocardial infarction treated personally. Despite lack of proof that the relationship is causal there is a clear association with obesity, excessive cigarette smoking, hypertension, emotional stress, hyperuricaemia and in qualified groups hyperlipidaemia. Until the aetiology of ...

  1. Changing pattern of incidence, aetiology and mortality from acute ...

    African Journals Online (AJOL)

    Background: Literature reports from Western countries suggest an increasing incidence of acute pancreatitis (AP) and changing pattern over the past two decades. The aim of this study was to document the incidence, aetiology and mortality from AP over two decades and to examine any emerging trends. Methods: A ...

  2. Aetiology of molar-incisor hypomineralization: a critical review. (United States)

    Crombie, Felicity; Manton, David; Kilpatrick, Nicola


    The objective of this study was to assess the strength of evidence for the aetiology of molar-incisor hypomineralization (MIH), often as approximated by demarcated defects. A systematic search of online medical databases was conducted with assessment of titles, abstracts, and finally full articles for selection purposes. The level and quality of evidence were then assessed for each article according to Australian national guidelines. Of 1123 articles identified by the database search, 53 were selected for review. These covered a variety of potential aetiological factors, some of which were grouped together for convenience. The level of evidence provided by the majority of papers was low and most did not specifically investigate MIH. There was moderate evidence that polychlorinated biphenyl/dioxin exposure is involved in the aetiology of MIH; weak evidence for the role of nutrition, birth and neonatal factors, and acute or chronic childhood illness/treatment; and very weak evidence to implicate fluoride or breastfeeding. There is currently insufficient evidence in the literature to establish aetiological factor/s relevant for MIH. Improvements in study design, as well as standardization of diagnostic and examination protocols, would improve the level and strength of evidence.

  3. aetiology, pattern and management of oral and maxillofacial injuries ...

    African Journals Online (AJOL)


    Nov 1, 2012 ... injuries and public health measures targeting prevention should focus on these areas. INTRODUCTION. In sub-Saharan Africa, ... casualty transport systems and ill-equipped health facilities. The aetiology of Oral and ... chronic traffic jams on major roads in Uganda and for its ability to pass through difficult ...

  4. Occurrence, aetiology and challenges in the management of ...

    African Journals Online (AJOL)

    Introduction: The aim of the study was to investigate the occurrence, the aetiology and the management of congestive heart failure in the cardiac centre of the St. Elizabeth catholic general hospital Shisong in Cameroon. Methods: Between November 2002 and November 2008, a population of 8121 patients was consulted in ...

  5. Aetiology of Proximal Weakness among Adult Sudanese patients ...

    African Journals Online (AJOL)

    Objective: To determine the aetiology of proximal myopathy among adult. Sudanese patients seen in Elshaab Teaching Hospital. Methods: This is a descriptive cross sectional hospital based study conducted in Elshaab Teaching Hospital, during the period from January 2004 September 2005. 100 adult Sudanese patients ...

  6. Early fetal anatomical sonography.

    LENUS (Irish Health Repository)

    Donnelly, Jennifer C


    Over the past decade, prenatal screening and diagnosis has moved from the second into the first trimester, with aneuploidy screening becoming both feasible and effective. With vast improvements in ultrasound technology, sonologists can now image the fetus in greater detail at all gestational ages. In the hands of experienced sonographers, anatomic surveys between 11 and 14 weeks can be carried out with good visualisation rates of many structures. It is important to be familiar with the normal development of the embryo and fetus, and to be aware of the major anatomical landmarks whose absence or presence may be deemed normal or abnormal depending on the gestational age. Some structural abnormalities will nearly always be detected, some will never be and some are potentially detectable depending on a number of factors.

  7. Reference Man anatomical model

    Energy Technology Data Exchange (ETDEWEB)

    Cristy, M.


    The 70-kg Standard Man or Reference Man has been used in physiological models since at least the 1920s to represent adult males. It came into use in radiation protection in the late 1940s and was developed extensively during the 1950s and used by the International Commission on Radiological Protection (ICRP) in its Publication 2 in 1959. The current Reference Man for Purposes of Radiation Protection is a monumental book published in 1975 by the ICRP as ICRP Publication 23. It has a wealth of information useful for radiation dosimetry, including anatomical and physiological data, gross and elemental composition of the body and organs and tissues of the body. The anatomical data includes specified reference values for an adult male and an adult female. Other reference values are primarily for the adult male. The anatomical data include much data on fetuses and children, although reference values are not established. There is an ICRP task group currently working on revising selected parts of the Reference Man document.

  8. Anatomical imaging for radiotherapy

    International Nuclear Information System (INIS)

    Evans, Philip M


    The goal of radiation therapy is to achieve maximal therapeutic benefit expressed in terms of a high probability of local control of disease with minimal side effects. Physically this often equates to the delivery of a high dose of radiation to the tumour or target region whilst maintaining an acceptably low dose to other tissues, particularly those adjacent to the target. Techniques such as intensity modulated radiotherapy (IMRT), stereotactic radiosurgery and computer planned brachytherapy provide the means to calculate the radiation dose delivery to achieve the desired dose distribution. Imaging is an essential tool in all state of the art planning and delivery techniques: (i) to enable planning of the desired treatment, (ii) to verify the treatment is delivered as planned and (iii) to follow-up treatment outcome to monitor that the treatment has had the desired effect. Clinical imaging techniques can be loosely classified into anatomic methods which measure the basic physical characteristics of tissue such as their density and biological imaging techniques which measure functional characteristics such as metabolism. In this review we consider anatomical imaging techniques. Biological imaging is considered in another article. Anatomical imaging is generally used for goals (i) and (ii) above. Computed tomography (CT) has been the mainstay of anatomical treatment planning for many years, enabling some delineation of soft tissue as well as radiation attenuation estimation for dose prediction. Magnetic resonance imaging is fast becoming widespread alongside CT, enabling superior soft-tissue visualization. Traditionally scanning for treatment planning has relied on the use of a single snapshot scan. Recent years have seen the development of techniques such as 4D CT and adaptive radiotherapy (ART). In 4D CT raw data are encoded with phase information and reconstructed to yield a set of scans detailing motion through the breathing, or cardiac, cycle. In ART a set of

  9. Anatomic anterior cruciate ligament reconstruction using an individualized approach

    Directory of Open Access Journals (Sweden)

    Carola F. van Eck


    Full Text Available Anterior cruciate ligament (ACL reconstruction is one of the most commonly performed orthopaedic procedures. Recently, there has been a shift in interest towards reconstruction techniques that more closely restore the native anatomy of the ACL. This review paper discusses our approach to individualized anatomic ACL reconstruction, including the anatomy of the ACL, the physical exam, imaging modalities, the surgical technique for anatomic reconstruction including pre- and intraoperative considerations and our postoperative rehabilitation protocol.

  10. Corona mortis: an anatomical variation with clinical relevance. Case report.

    Directory of Open Access Journals (Sweden)

    Guillermo Adrián Rivera-Cardona


    Full Text Available The obturator artery is one of the parietal branches arising from the internal iliac artery, the anatomical variation from which this artery originates is called “The corona mortis”, generally from the external iliac artery or the inferior epigastric artery. This finding was observed bilaterally in a male cadaver during a pelvis dissection. Clinical consideration of the anatomical variation in the obturator artery, during surgical procedures, is of great importance due to the risk of pelvic hemorrhage.

  11. Central Pattern Generator for Locomotion: Anatomical, Physiological and Pathophysiological Considerations

    Directory of Open Access Journals (Sweden)

    Pierre A. Guertin


    Full Text Available This article provides a perspective on major innovations over the past century in research on the spinal cord and, specifically, on specialized spinal circuits involved in the control of rhythmic locomotor pattern generation and modulation. Pioneers such as Charles Sherrington and Thomas Graham Brown have conducted experiments in the early twentieth century that changed our views of the neural control of locomotion. Their seminal work supported subsequently by several decades of evidence has led to the conclusion that walking, flying and swimming are largely controlled by a network of spinal neurons generally referred to as the central pattern generator (CPG for locomotion. It has been subsequently demonstrated across all vertebrate species examined, from lampreys to humans, that this CPG is capable, under some conditions, to self-produce, even in absence of descending or peripheral inputs, basic rhythmic and coordinated locomotor movements. Recent evidence suggests, in turn, that plasticity changes of some CPG elements may contribute to the development of specific pathophysiological conditions associated with impaired locomotion or spontaneous locomotor-like movements. This article constitutes a comprehensive review summarizing key findings on the CPG as well as on its potential role in Restless Leg Syndrome (RLS, Periodic Leg Movement (PLM, and Alternating Leg Muscle Activation (ALMA. Special attention will be paid to the role of the CPG in a recently identified, and uniquely different neurological disorder, called the Uner Tan Syndrome.

  12. Anatomic Considerations for Radical Retropubic Prostatectomy in an Achondroplastic Dwarf

    Directory of Open Access Journals (Sweden)

    Dennis Gyomber


    Full Text Available This is the first report of a radical retropubic prostatectomy (RRP in an achondroplastic dwarf. We highlight the pelvic anatomy, precluding laparoscopic or robotic prostatectomy, and making open surgery extremely difficult. We review relevant literature regarding general, urological, and orthopedic abnormalities of achondroplasia (ACH and present a clinical case. No reports of RRP in achondroplastic dwarfs exist, with only one case of an abandoned RRP due to similar pelvic anatomy in a patient with osteogenesis imperfecta. Significant lumbar lordosis found in ACH results in a short anteroposterior dimension, severely limiting access to the prostate. We present a case of a 62-year-old achondroplastic dwarf who had Gleason 3+4 disease on transrectal ultrasound-guided biopsy in four from 12 cores. Surgery was difficult due to narrow anteroposterior pelvic dimension, but achievable. Histological analysis revealed multifocal prostate cancer, with negative surgical margins and no extraprostatic extension. RRP in ACH patients, although possible, should be approached with caution due to the abnormal pelvic dimensions, and discussions regarding potential abandonment of surgery should be included during informed consent. This case highlights the preoperative use of computed tomography to assist in the surgical planning for patients with difficult pelvic anatomy.

  13. Anatomic Considerations on the Middle Ear in Dog

    Directory of Open Access Journals (Sweden)

    Carmen Berghes


    Full Text Available Purpose of this study is to explain some aspects of middle ear anatomy in dog. The study was conducted on five dog skulls (different ages from common, large size dogs. The skulls were processed by maceration and submitted to a treatment of mechanical cleaning with perhydrol. The temporal bone was collected first; the external wall was opened carefully to study the tympanic cavity. The ossicles were collected separately and subsequently described. From research carried promontory appears as an elongated projection that separates the oval window and round window. Vestibular window is oval or slightly ovoid shape of a hole, located dorso-medially to the promontory, which communicates with the middle ear vestibule. Cochlearia window appears as a round or circular hole located caudo-lateral to the promontory . it is blocked by a membrane called the tympanum secondary, cavity separating the ramp of the snail. In the ventro-oral cavity openings ductus faringo tympanicum. The osicules sound represented by hammer, anvil and stirrup are articulated with each other and form a chain as a link between the eardrum and vestibular window. Bones are driven by two muscles: the tensor muscle and muscle stirrup eardrum is very thin. osicules ear are relatively large and resemble those of humans. Lenticular bone is the lenticular process of the long arm of anvile.

  14. Percutaneous Biopsy of Retrobulbar Masses: Anatomical Considerations and MRI Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Edalat, Faramarz, E-mail:; Cazzato, Roberto Luigi; Garnon, Julien; Tsoumakidou, Georgia [Nouvel Hôpital Civil (Hôpitaux Universitaires de Strasbourg, HUS), Department of Interventional Radiology (France); Avérous, Gerlinde [CHU Strasbourg Hautepierre, Department of Pathology (France); Caudrelier, Jean; Koch, Guillaume; Gangi, Afshin [Nouvel Hôpital Civil (Hôpitaux Universitaires de Strasbourg, HUS), Department of Interventional Radiology (France)


    PurposeObtaining adequate tissue from retrobulbar masses remains a challenge. To this end, a new method of retrobulbar mass biopsy using MRI guidance is presented.Materials and MethodsTwo patients (7- and 71-year-old male) with indeterminate retrobulbar masses underwent bioptic and cytological samplings using MR-compatible 18G and 20–22G needles, and multi-planar MR fluoroscopy. An inferior approach was taken to avoid injury to the optic nerve and ophthalmic arteries.ResultsThe two biopsies were completed without complication. The core biopsy resulted in a final diagnosis, whereas the cytological sampling was non-diagnostic.ConclusionPercutaneous MR-guided retrobulbar mass biopsy proved to be feasible and safe in the two cases described in this report.

  15. Placement of Plantar Plates for Lapidus Arthrodesis: Anatomical Considerations. (United States)

    Plaass, Christian; Claassen, Leif; Daniilidis, Kiriakos; Fumy, Mariesol; Stukenborg-Colsman, Christina; Schmiedl, Andreas; Ettinger, Sarah


    The modified Lapidus procedure is an accepted treatment option for patients with moderate to severe hallux valgus. Placing a plate plantar on the tension side of the arthrodesis has been shown to be biomechanically superior and has provided good clinical results. There is some concern about interference of the plantar placed plates on the tendon insertions. The purpose of this study was to determine a "safe zone" for plantar plate placement without irritation of the tendons. Twenty-nine embalmed right feet were used for this study. The anatomy of the insertion of the peroneus longus (PL) tendon and tibialis anterior (TA) tendon on the medial cuneiform and first metatarsal were analyzed. Six different plate designs for plantar plating of the first tarsometatarsal fusion were included. The fit to the bone and contact to tendon insertion were analyzed. The PL showed a main insertion to the first metatarsal and a lesser insertion to the medial cuneiform. The TA inserted onto the medial cuneiform and first metatarsal in all cases in our series. There was a "safe zone" between the TA and PL insertion areas for plate placement. Straight, Y- and U-shaped plates could be placed without compromising the tendon insertion. Depending on the design, even preshaped plates may have to be bent to allow a good fit to the plantar side of the first tarsometatarsal joint. Plantar plating for modified Lapidus arthrodesis can be safely performed, without damaging the plantar tendon insertion area of the PL and TA. The exact knowledge of the anatomy of the plantar region of the tarsometatarsal joint can help to improve plate placement. © The Author(s) 2015.

  16. Understanding anatomical terms. (United States)

    Mehta, L A; Natrajan, M; Kothari, M L


    Words are our masters and words are our slaves, all depending on how we use them. The whole of medical science owes its origin to Greco-Roman culture and is replete with terms whose high sound is not necessarily accompanied by sound meaning. This is even more the case in the initial, pre-clinical years. Anatomical terminology seems bewildering to the initiate; and maybe that is a reason why love of anatomy as a subject does not always spill over through later years. Employing certain classifications of the origin of the anatomical terms, we have prepared an anthology that we hope will ease the student's task and also heighten the student's appreciation of the new terms. This centers on revealing the Kiplingian "how, why, when, where, what, and who" of a given term. This presentation should empower students to independently formulate a wide network of correlations once they understand a particular term. The article thus hopes to stimulate students' analytic and synthetic faculties as well. A small effort can reap large rewards in terms of enjoyment of the study of anatomy and the related subjects of histology, embryology, and genetics. It is helpful to teachers and students alike. This exercise in semantics and etymology does not demand of the student or his teacher any background in linguistics, grammar, Greek, Latin, Sanskrit, anatomy, or medicine.

  17. The post-discectomy syndrome. Aetiology, diagnosis, treatment, prevention. (United States)

    Ivanic, G M; Pink, T P; Homann, N C; Scheitza, W; Goyal, S


    The post-discectomy syndrome (PDS) is a common diagnosis in patients with problems following a disc operation. The different causes of PDS make the establishment of the correct diagnosis and its corresponding efficient treatment difficult. A general overview published in the bibliographical data covering the entity of PDS is rare. The following paper aims to specify PDS according to its aetiology, diagnosis, treatment and prevention. The diagnosis should be made efficiently, so that the patient can receive prompt adequate therapy.

  18. Diverse genetic aetiologies and clinical outcomes of paediatric hypoparathyroidism. (United States)

    Kim, Ja Hye; Shin, Young-Lim; Yang, Seung; Cheon, Chong Kun; Cho, Ja Hyang; Lee, Beom Hee; Kim, Gu-Hwan; Lee, Jin Ok; Seo, Eul Joo; Choi, Jin-Ho; Yoo, Han-Wook


    Hypoparathyroidism is characterized by hypocalcaemia, hyperphosphataemia, and low or inappropriately normal parathyroid hormone (PTH) levels. Idiopathic or genetic drivers are the predominant causes of hypoparathyroidism in paediatric-age patients. This study investigated the aetiology and clinical course of primary hypoparathyroidism in infancy and childhood. This study included 37 patients (23 males, 14 females) with primary hypoparathyroidism diagnosed prior to 18 years of age. We analysed aetiologies, initial presentation, age at diagnosis, endocrine and radiological findings, and outcomes. The median age at presentation was 1·7 months (range 1 day-17 years), and the mean follow-up duration was 7·0 ± 5·3 years (range 0·5-16·8 years). Our cohort included 22 cases (59·5%) of 22q11·2 microdeletion syndrome. Other aetiologies included hypoparathyroidism-deafness-renal dysplasia syndrome (5/37, 13·5%) and one patient each with autoimmune polyglandular syndrome type 1, Kearns-Sayre syndrome and Kenny-Caffey syndrome. The remaining 7 (18·9%) patients were classified as idiopathic hypoparathyroidism cases. Among the 15 patients who underwent brain imaging, 5 (33·3%) had basal ganglia calcification. Among the 26 patients examined by renal imaging, 5 (19·2%) had either nephrocalcinosis or a renal stone. After 11 months of calcium or calcitriol supplementation, 16 patients (43·2%) discontinued medication. The final PTH levels were significantly higher in patients with transient hypoparathyroidism than those with permanent hypoparathyroidism. Identification of the genetic aetiologies of hypoparathyroidism makes it possible to predict patient outcomes and provide appropriate genetic counselling. Long-term treatment with calcium and calcitriol necessitates monitoring for renal complications. © 2015 John Wiley & Sons Ltd.


    Directory of Open Access Journals (Sweden)

    Mallikarjun R. Patil


    Full Text Available BACKGROUND Acute non-traumatic coma is one of the most common paediatric emergencies, which arouses much anxiety and apprehension in both parents and physicians. Due to heterogeneity of causes in these patients, prediction of outcome is difficult and unfortunately no single clinical, laboratory or electrophysiological parameters singly predict their outcome. Aetiology of nontraumatic coma varies depending on different geographical area. We have attempted to find the incidence, aetiology and outcome and delineate neurological signs to predict the prognosis in this study. The aim of this study is to study the incidence, aetiology and outcome of non-traumatic coma in children. MATERIALS AND METHODS 100 consecutive cases of non-traumatic coma between 5months and 15 years of age were selected for the study. Clinical signs and findings were recorded at admission (‘0’ Hr and after ‘48’ Hrs. of hospital stay. Aetiology of coma is determined on the basis of clinical history, examination and relevant laboratory investigations by the treating physician. These children were followed up till the death in the hospital or discharged from the hospital. Discharged patients were asked for followup after 4 weeks. During this period, all of them were evaluated by formal neurological examination and for special sensory involvement. The neurological outcomes were categorised into 6 groups (I-VI based on the severity of neurological involvement. Chisquare test was applied to determine the predictors of outcome. RESULTS 1. The incidence of non-traumatic coma in our hospital based study was 8.02% of all paediatric admissions and 21.64% of all PICU admissions. 2. CNS infections contributed the majority (58% of cases. (Dengue encephalitis-28%, viral encephalitis-12%, TB meningitis-8%, pyogenic meningitis- 6%, Shigella encephalopathy-3% and cerebral malaria-1%. 3. Other non-infectious aetiologies were toxic and metabolic group- 21%, post status epilepticus- 9

  20. Mandibular Ramus Fracture: An Overview of Rare Anatomical Subsite

    Directory of Open Access Journals (Sweden)

    Anendd Jadhav


    Full Text Available Aim. The present study aims at exemplifying the incidence, and aetiology and analyses the outcomes of open reduction internal fixation (ORIF over closed treatment of mandibular ramus fractures. Patients and Method. In the present retrospective analysis of mandibular fracture patients, variables analysed were age, sex, cause of injury, pretreatment occlusion, treatment given, period of maxillo-mandibular fixation (MMF, and posttreatment occlusion. Results. Out of 388 mandibular fractures treated, ramus fractures were 12 (3.09%. In the present study, predominant cause of mandibular ramus fracture was road traffic accident (RTA n = 07 (58.33% followed by fall n = 04 (33.33% and assault n = 1 (8.33%. The average age was 35.9 years with a male predilection. Of these, 9 patients were treated with ORIF while remaining 3 with closed treatment. The average MMF after closed treatment was 21 days and 3 to 5 days after ORIF. There was improvement in occlusion in all 12 patients posttreatment with no major complication except for reduced mouth opening in cases treated with ORIF which recovered with physiotherapy and muscle relaxants. Conclusion. Mandibular ramus fractures accounted for 3.09% with RTA as a common aetiology. ORIF of ramus fractures facilitated adequate functional and anatomic reduction with early return of function.

  1. Clinical presentation, aetiology and complications of pancreatitis in children

    International Nuclear Information System (INIS)

    Fayyaz, Z.; Cheema, H.A.; Suleman, H.; Hashmi, M.A.; Parkash, A.; Waheed, N.


    Background: Childhood Pancreatitis is an uncommon but serious condition with incidence on the rise. It manifests as acute or chronic form with epigastric pain, vomiting and elevated serum -amylase and lipase. This study was conducted with the aim to determine the clinical presentation, aetiology, and complications of pancreatitis in children. Method: This descriptive case series was conducted in the Department of Paediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital and the Institute of Child Health, Lahore from 1st January to 31st December 2014. Seventy-two patients up to the age of 15 years having abdominal pain, Amylase >200 IU/L and/or lipase >165 IU/L, with features of acute or chronic pancreatitis on abdominal imaging; were included in study. Data analysis was done using SPSS-20. Results: Of the total 72 patients, 43 (60 percentage) had acute pancreatitis, males were 25 (58 percentage) and females 18 (42 percentage) and chronic pancreatitis was diagnosed in 29 (40 percentage), males 10 (34 percentage) and females 19 (66 percentage). Common clinical features were abdominal pain (100 percentage), nausea and vomiting (79 percentage). Common aetiologies were idiopathic (40 percentage) while choledochal cyst 8 percentage, hyperlipidaemia 7 percentage, biliary tract stones/sludge 7 percentage and abdominal trauma 6percentage. Complications were more frequently associated with acute pancreatitis (60 percentage) than with chronic pancreatitis (34 percentage). Common complications were pseudo-pancreatic cyst (36 percentage), ascites (17 percentage) and pleural effusion (4 percentage). Conclusion: Abdominal pain, nausea and vomiting were common presenting features of childhood pancreatitis. Common aetiologies were idiopathic hyperlipidemia, biliary tract stones/sludge, choledochal cyst and abdominal trauma. Common complications were Pseudo-pancreatic cyst, ascites and pleural effusion. (author)

  2. Myelitis: Differences between multiple sclerosis and other aetiologies. (United States)

    Presas-Rodríguez, S; Grau-López, L; Hervás-García, J V; Massuet-Vilamajó, A; Ramo-Tello, C


    Myelitis can appear as an initial symptom in the context of demyelinating diseases, systemic inflammatory diseases, and infectious diseases. We aim to analyse the differences between myelitis associated with multiple sclerosis (MS) and myelitis resulting from other aetiologies. Single-centre, retrospective analysis of patients with initial myelitis (2000-2013). Demographic, aetiological, clinical, radiological and prognostic variables were analysed and compared between patients with myelitis from MS and those with myelitis due to other aetiologies. We included 91 patients; mean follow-up was 7 years. Diagnoses were as follows: MS 57 (63%), idiopathic transverse myelitis 22 (24%), associated systemic diseases 6 (7%), and other diagnoses (6%). Myelitis due to MS was associated with younger age of onset (35 ± 11 vs. 41 ± 13; P = .02), more pronounced sphincter involvement (40.4 vs. 27.3%; P=.05), greater multifocal involvement in spinal MRI (77.2 vs. 26.5%; P=.001), shorter lesion extension (2.4 vs. 1.4 vertebral segments; P=.001), cervical location (82.5 vs. 64.7%; P=.05) and posterior location (89.5 vs. 41.2%; P=.001). Myelitis due to other aetiologies more frequently showed anterior location (47.1 vs. 24.6%; P=.02), and central cord involvement (47.1 vs. 14.1%; P=.001), with better recovery at one year of follow up (EDSS 2.0 vs. 1.5; P=.01). Multivariate analysis showed that multifocal spinal cord involvement (OR 9.38, 95% CI: 2.04-43.1) and posterior cord involvement (OR 2.16, 95% CI: 2.04-2.67) were independently associated with the diagnosis of MS. A high percentage of patients with an initial myelitis event will be diagnosed with MS. The presence of multifocal and posterior spinal cord lesions was significantly associated with the diagnosis of MS. Copyright © 2015 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  3. Epidemiology, aetiology, diagnosis and screening of lung cancer

    International Nuclear Information System (INIS)

    Berzinec, P.


    Lung cancer is the leading cause of cancer death globally. Smoking causes about 90 % of all lung cancer cases. Passive, i.e. involuntary smoking has been confirmed to enhance the risk of lung cancer in exposed people. Individual susceptibility is one of important factors in lung cancer formation. New knowledge in epidemiology and aetiology of lung cancer gives new possibilities in diagnostic and screening of this disease. Results of large randomised trials aimed at new technologies in lung cancer screening will be available in a few years. (author)

  4. Importance of pituitary hormones in aetiology of diabetic ketoacidosis

    International Nuclear Information System (INIS)

    Barnes, A.J.; Kohner, E.M.; Bloom, S.R.; Johnston, D.G.; Alberti, K.G.M.M.; Smythe, P.


    The role of pituitary hormones in the aetiology of diabetic ketoacidosis was examined by withdrawing insulin from five pituitary-ablated diabetics for a 12-hour period. The rise in blood glucose and ketone-body concentrations was markedly retarded in these patients when compared with five matched juvenile-type diabetic controls with normal pituitary function. When cortisol replacement in the pituitary-ablated patients was increased to reproduce the high plasma concentrations found in severe ketoacidosis, blood ketones and glucose were increased but were still significantly lower than in the control diabetics. It is concluded that pituitary hormones may be important in the development of diabetic ketoacidosis. (author)

  5. Left atrio-esophageal fistula of a possibly iatrogenic aetiology. (United States)

    Arkuszewski, Piotr; Barzdo, Maciej; Ostrowski, Stanisław; Szram, Stefan; Berent, Jarosław


    The study presents an exceptionally rare case of an esophago-left atrial fistula, which was diagnosed during a forensic post-mortem examination. Due to complex nature of the disease and many attempts to cure the patient, the authors did not manage to identify the aetiology of the fistula. It was only implied that the fistula might have been a distant complication of intraoperative endocardial ablation or it might have appeared as a consequence of perforation of the esophageal wall or left atrial wall of the enlarged heart with the end of an intubation tube or nasogastric tube. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Painful bladder syndrome/interstitial cystitis: Aetiology, evaluation and management

    Directory of Open Access Journals (Sweden)

    William Rourke


    Full Text Available Interstitial cystitis or bladder pain syndrome (BPS is often a chronic debilitating condition characterised by predominantly storage symptoms and associated frequently with pelvic pain that varies with bladder filling. The aetiology is uncertain as the condition occurs in the absence of a urinary tract infection or other obvious pathology. Resulting discomfort may vary and ranges from abdominal tenderness to intense bladder spasms. Diagnosis and management of this syndrome may be difficult and is often made by its typical cystoscopic features. This review discusses the diagnosis and management of interstitial cystitis according to the current available best evidence and advises a multimodal approach in its management.

  7. Imaging in mediastinitis: a systematic review based on aetiology

    Energy Technology Data Exchange (ETDEWEB)

    Akman, C. E-mail:; Kantarci, F.; Cetinkaya, S


    Mediastinitis refers to inflammation of the tissues located in the middle chest cavity. It can be secondary to infectious or non-infectious causes and depending on the aetiology may be acute or chronic. The majority of cases of acute mediastinitis are secondary to oesophageal perforation and open chest surgery. Less common causes include tracheal, bronchial perforation or direct extension of infection from adjacent tissues. Chronic or slowly developing mediastinitis mostly arise from tuberculosis, histoplasmosis, other fungal infections, cancer, or sarcoidosis. In a minority of cases the aetiology is lymphatic obstruction or an autoimmune disease. Radiological imaging plays an essential role in the diagnosis and therapeutic approach to mediastinitis. Generally, the initial radiological work-up includes radiographic studies either with or without contrast material. However, conventional chest radiography may be misleading in the diagnosis of mediastinitis. Cross-sectional imaging techniques are generally required for diagnosis and evaluation of the site and extent of mediastinal involvement. Computed tomography and magnetic resonance imaging may also guide the choice of the optimal therapeutic approach.

  8. Anatomical adaptations of aquatic mammals. (United States)

    Reidenberg, Joy S


    This special issue of the Anatomical Record explores many of the anatomical adaptations exhibited by aquatic mammals that enable life in the water. Anatomical observations on a range of fossil and living marine and freshwater mammals are presented, including sirenians (manatees and dugongs), cetaceans (both baleen whales and toothed whales, including dolphins and porpoises), pinnipeds (seals, sea lions, and walruses), the sea otter, and the pygmy hippopotamus. A range of anatomical systems are covered in this issue, including the external form (integument, tail shape), nervous system (eye, ear, brain), musculoskeletal systems (cranium, mandible, hyoid, vertebral column, flipper/forelimb), digestive tract (teeth/tusks/baleen, tongue, stomach), and respiratory tract (larynx). Emphasis is placed on exploring anatomical function in the context of aquatic life. The following topics are addressed: evolution, sound production, sound reception, feeding, locomotion, buoyancy control, thermoregulation, cognition, and behavior. A variety of approaches and techniques are used to examine and characterize these adaptations, ranging from dissection, to histology, to electron microscopy, to two-dimensional (2D) and 3D computerized tomography, to experimental field tests of function. The articles in this issue are a blend of literature review and new, hypothesis-driven anatomical research, which highlight the special nature of anatomical form and function in aquatic mammals that enables their exquisite adaptation for life in such a challenging environment. 2007 Wiley-Liss, Inc.

  9. On the new anatomical nomenclature. (United States)

    Marecková, E; Simon, F; Cervený, L


    The present paper is concerned with the linguistic aspect of the new anatomical nomenclature (Terminologia Anatomica 1998). Orthographic, morphological, syntactic, lexical, and terminological comments are presented. In the authors' opinion, shortcomings might have been effectively avoided by cooperation with linguists.

  10. Anatomic Preformed Post: Case Report


    Lamas Lara, César; Cirujano Dentista, Docente del Área de Operatoria Dental y Endodoncia de la Facultad de OdontoIogía de la UNMSM.; Alvarado Menacho, Sergio; Cirujano Dentista, Especialista en Rehabilitación Oral, Profesor Asociado del Área de Prótesis y Oclusión de la Facultad de Odontología de la UNMSM.; Pari Espinoza, Rosa; Alumna del 5to año de Odontología de la UNMSM.


    Nowadays, preformed posts are being used frequently, but they do not follow root canal anatomy. Obtaining a more anatomical form of the root canal and reducing the space of the cement, it would help to reduce the possibility of its eviction. This article details the process of making of an anatomical preformed post and the advantages that would represent its clinical use. En la actualidad los postes preformados se utilizan con mucha frecuencia, pero tienenla dificultad de no seguir la anat...

  11. Villitis of unknown aetiology: correlation of recurrence with clinical outcome.

    LENUS (Irish Health Repository)

    Feeley, L


    Villitis of unknown aetiology (VUA) is associated with adverse pregnancy outcome. Consequently, an ability to predict recurrence could be clinically relevant. We examined placentas where villitis was diagnosed in a previous pregnancy to establish the risk of recurrence and outcome. A total of 304 cases of VUA were diagnosed in our laboratory over a 4-year period. Subsequently, 19 of this cohort had a second placenta examined histologically. Recurrence and clinical outcome were recorded. Villitis recurred in 7 of 19 cases (37%). There was a high level of adverse pregnancy outcome in this cohort overall, characterised by small for gestational age infants and stillbirth, particularly in cases with high-grade villitis. We identified recurrent villitis more frequently than previously reported. Our findings confirm an association between high-grade villitis and poor outcome. Adequately powered prospective studies are required to determine if enhanced surveillance of subsequent pregnancies is indicated following a diagnosis of villitis.

  12. Dermatoglyphics in childhood leukaemia: a guide to prognosis and aetiology? (United States)

    Till, M.; Larrauri, S.; Smith, P. G.


    The results of analysis of the dermatoglyphics of 152 children with acute lymphoblastic leukaemia (ALL) (and the first-degree relatives of 54 of them) contrast with those of 31 children with acute myeloblastic leukaemia (AML) (and the first-degree relatives of 25 of them). In ALL our findings suggest that neither genetic susceptibility nor an environmental factor, effective during the early antenatal period, is of aetiological importance; but the response to treatment, assessed as length of first remission, was found to be related to the amount of fingertip pattern. This may have clinical application. In AML there is evidence of a genetically determined factor carrying a high risk of the development of the disease, in that a member of each of 5 different families of the 25 studied bore a rare hypothenar pattern, compared with none in 75 control families. No dermatoglyphic features were of prognostic significance in AML. PMID:277206

  13. Molar incisor hypomineralization (MIH): clinical presentation, aetiology and management. (United States)

    Weerheijm, K L


    In this paper, the current knowledge about Molar Incisor Hypomineralization (MIH) is presented. MIH is defined as hypomineralization of systemic origin of one to four permanent first molars frequently associated with affected incisors and these molars are related to major clinical problems in severe cases. At the moment, only limited data are available to describe the magnitude of the phenomenon. The prevalence of MIH in the different studies ranges from 3.6-25% and seems to differ in certain regions and birth cohorts. Several aetiological factors (for example, frequent childhood diseases) are mentioned as the cause of the defect. Children at risk should be monitored very carefully during the period of eruption of their first permanent molars. Treatment planning should consider the long-term prognosis of these teeth.

  14. Bovine pododermatitis aseptica diffusa (laminitis) aetiology, pathogenesis, treatment and control. (United States)

    Mgasa, M N


    Pododermatitis aseptica diffusa (laminitis) is a major cause of lameness and discomfort to cattle with resultant economic losses. The disease is a result of multifactorial aetiology most of which is not clearly understood. Feeding readily fermentable carbohydrates to unaccustomed cattle predisposes to the disease. Histamine, lactic acid and endotoxins are believed to be involved. Systemic acidosis, histaminosis and endotoxaemia are thought to produce the pathophysiological characteristics of laminitis. The diagnosis is primarily based on the observation of symmetrical and bilateral lesions in hooves and characteristic lameness affecting all feet. Gross lesions include concavity of the dorsal wall, discolorations in the sole and rotation of the pedal bone. Degenerative changes and arteriosclerosis are constant histological findings in the corium, with chronic thrombi and chronic granulation tissue. The disease may be treated conservatively and by application of cyclo-oxygenase inhibiting non-steroidal anti-inflammatory drugs and prevented or controlled by proper feeding and management practices.

  15. The aetiology of cardiovascular disease: a role for mitochondrial DNA? (United States)

    Venter, Marianne; van der Westhuizen, Francois H; Elson, Joanna L


    Cardiovascular disease (CVD) is a world-wide cause of mortality in humans and its incidence is on the rise in Africa. In this review, we discuss the putative role of mitochondrial dysfunction in the aetiology of CVD and consequently identify mitochondrial DNA (mtDNA) variation as a viable genetic risk factor to be considered. We then describe the contribution and pitfalls of several current approaches used when investigating mtDNA in relation to complex disease. We also propose an alternative approach, the adjusted mutational load hypothesis, which would have greater statistical power with cohorts of moderate size, and is less likely to be affected by population stratification. We therefore address some of the shortcomings of the current haplogroup association approach. Finally, we discuss the unique challenges faced by studies done on African populations, and recommend the most viable methods to use when investigating mtDNA variation in CVD and other common complex disease.

  16. [Dyskinesia in Parkinson's disease--major clinical features, aetiology, therapy]. (United States)

    Ellrichmann, G; Russ, H; Müller, T


    Parkinson's disease (PD), a slowly, progressive degenerative disorder of the central nervous system, which affects about ten million people world-wide, is currently treated symptomatically. Current treatment aim i. e. to balance the decreased dopamine turnover in striatal neurons. Chronic exposure to dopaminergic agents, however, supports onset of motor complications and dyskinesia in the long term. Dyskinesia appear mainly as chorea, athetosis, dystonia, stereotypia, ballism or a combination. Sometimes excessive abnormal facial, body and limb movements depend on the overall dosage of dopaminergic substitution. This is why the main therapy is based on reducing the total dosage of dopaminergic substances. Either alternative or additional well-tried substances like apomorphine, amantadine or clozapine are used. New possibilities in treatment emerge from substances like sarizotan, istradefylline, fipampezol or talampanel. Even so disability and reduced quality of life in PD patients and their caregivers may exist. This survey describes the major clinical features, aetiology and demographics of treatment-associated dyskinesia in PD.

  17. Levels of uric acid in erectile dysfunction of different aetiology. (United States)

    Barassi, Alessandra; Corsi Romanelli, Massimiliano Marco; Pezzilli, Raffaele; Dozio, Elena; Damele, Clara Anna Linda; Vaccalluzzo, Liborio; Di Dario, Marco; Goi, Giancarlo; Papini, Nadia; Massaccesi, Luca; Colpi, Giovanni Maria; Melzi d'Eril, Gian Vico


    Erectile dysfunction is a common disease characterized by endothelial dysfunction. The aetiology of ED is often multifactorial but evidence is being accumulated in favor of the proper function of the vascular endothelium that is essential to achieving and maintaining penile erection. Uric acid itself causes endothelial dysfunction via decreased nitric oxide production. This study aims to evaluate the serum uric acid (SUA) levels in 180 ED patients, diagnosed with the International Index of Erectile Function-5 (IIEF-5) and 30 non-ED control. Serum uric acid was analyzed with a commercially available kit using ModularEVO (Roche, Monza, Italy). Within-assay and between-assay variations were 3.0% and 6.0%, respectively. Out of the ED patients, 85 were classified as arteriogenic (A-ED) and 95 as non-arteriogenic (NA-ED) with penile-echo-color-Doppler. Uric acid levels (median and range in mg/dL) in A-ED patients (5.8, 4.3-7.5) were significantly higher (p uric acid levels in patients with mild A-ED (IIEF-5 16-20) and severe/complete A-ED (IIEF-5 ≤ 10) that were 5.4 (range 4.3-6.5) mg/dL and 6.8 (range 6.4-7.2) mg/dL, respectively. There was no difference between the levels of uric acid in patients with different degree of NA-ED. Our findings reveal that SUA is a marker of ED but only of ED of arteriogenic aetiology.

  18. Anatomical pathology is dead? Long live anatomical pathology. (United States)

    Nicholls, John M; Francis, Glenn D


    The standard diagnostic instrument used for over 150 years by anatomical pathologists has been the optical microscope and glass slide. The advent of immunohistochemistry in the routine laboratory in the 1980s, followed by in situ hybridisation in the 1990s, has increased the armamentaria available to the diagnostic pathologist, and this technology has led to changed patient management in a limited number of neoplastic diseases. The first decade of the 21 century has seen an increasing number of publications using proteomic technologies that promise to change disease diagnosis and management, the traditional role of an anatomical pathologist. Despite the plethora of publications on proteomics and pathology, to date there are actually limited data where proteomic technologies do appear to be of greater diagnostic value than the standard histological slide. Though proteomic techniques will become more prevalent in the future, it will need the expertise of an anatomical pathologist to dissect out and validate this added information.

  19. The aetiology of community associated pneumonia in children in Nanjing, China and aetiological patterns associated with age and season. (United States)

    Chen, Keping; Jia, Runqing; Li, Li; Yang, Chuankun; Shi, Yan


    Viral and atypical bacterial pathogens play an important role in respiratory tract infection. Using the Pneumoslide IgM test, the presented study explored the aetiology of community-acquired pneumonia and investigated further whether there was an association between age or season and aetiological organisms. Serum samples, taken between August 2011 and August 2013, from patients with CAP were tested with the Pneumoslide IgM kit. The Pneumoslide IgM technology can simultaneously diagnose 9 viral and atypical bacterial pathogens: Legionella pneumophila serogroup 1 (LP1), Mycoplasma pneumoniae (MP), Coxiella burnetii (COX), Chlamydophila pneumonia (CP), Adenovirus (ADV), Respiratory syncytial virus (RSV), Influenza A (INFA), Influenza B (INFB), Parainfluenza 1, 2 and 3 (PIVs). The data was analyzed by using Statistical Package for the Social Sciences for Windows (SPSS, version 11.0). Of a total of 1204 serum samples tested, 624 samples were positive. M. pneumoniae was the dominant pathogen, with INFB, PIVs, and RSV ranking second to fourth, respectively. The positive percentages of MP, INFB, PIVs and RSV were found to be associated with age, especially MP, INFB and PIVs. The positive percentages of MP, PIVs and RSV were also found to be associated with season. The positive percentage of MP in autumn was the highest. The positive percentages of LP1 in August and September, ADV in June and INFB in March were relatively higher than that in other months. The results show there were 4 main viral and atypical bacterial pathogens causing CAP in our study. Some pathogens were found to be associated with age and season. M. pneumoniae was the most predominant pathogen among these 9 pathogens. It is necessary to take preventative measures in order to prevent the spread of these pathogens in susceptible age groups during peak season.

  20. Vaginal discharge: aetiological agents and evaluation of syndromic management in Lagos. (United States)

    Onyekonwu, C L; Olumide, Y M; Oresanya, F A; Onyekonwu, G C


    The WHO introduced the syndromic management to help in the control of STIs in resource-poor settings. This needs to be adapted to local settings taking into consideration the prevalence of the various organisms causing STIs. This has given rise to a need to validate the algorithm. The study aimed to correlate the syndromic management treatment algorithm for vaginal discharge with the aetiological diagnosis based on laboratory investigations. Specifically, the sensitivity, specificity and positive predictive values of the syndromic management against a gold standard laboratory diagnosis were evaluated. A total of 195 consecutive patients presenting to the study sites with vaginal discharge were enrolled in the study. Information on sociodemographic data was obtained with the aid of questionnaires. Samples were taken and examined for candida, trichomonas, bacterial vaginosis (BV), chlamydia and gonorrheal infections, after speculum and vaginal examinations. The sensitivity and positive predictive values (PPV) of the syndromic management in detecting vaginal infections performed better than corresponding values for cervicitis. The algorithm for cervicitis improved on addition of speculum examination (36% and 32.1% for sensitivity and PPV respectively). The study shows that the syndromic diagnosis for vaginal discharge fares better for vaginitis, especially with addition of speculum examination. The application of syndromic diagnosis for cervicitis resulted in omission of patients who had evidence of cervical infections by bacteriologic examination.

  1. Aetiology of obstructive azoospermia in Chinese infertility patients. (United States)

    Han, H; Liu, S; Zhou, X-G; Tian, L; Zhang, X-D


    To explore the aetiology of obstructive azoospermia (OA) in Chinese infertility patients, 133 OA patients was included in this study diagnosed and evaluated by one major specialist trained urological infertility. We retrospected the medical records to collect relative information. All of the patients had been underwent physical examination, ultrasound scan to the urogenital system, serum hormone tests, genetic tests and two separate semen analyses. The mean age of all 133 patients was 32.7 ± 6.8 years. A total of 266 reproductive tract units (two/patient) were classified into four categories: no causes (Idiopathic) for 74 units (27.8%), single cause for 173 units (65.0%), double causes for 17 units (6.4%) and triple causes for two units (0.8%). As to single cause of OA, there were four types: trauma for 0 unit (0%), infection for 125 units (47.0%), dysplasia for 11 units (4.1%) and surgeries for 37 units (13.9%). As to total cause of OA, there were five types: infection for 144 units (54.1%), orchitis for 51 units (19.2%), epididymitis for 54 units (20.3%), gonorrhoea for 28 units (10.5%) and inguinal hernia repair surgery for 18 units (6.8%). The most frequent cause of obstructive azoospermia was infection revealed in these Chinese infertility populations, followed by idiopathic reason. © 2015 Blackwell Verlag GmbH.

  2. Seasonal trends in the prevalence of hypospadias: Aetiological implications. (United States)

    Mamoulakis, C; Avgenakis, G; Gkatzoudi, C; Duyker, G; Zisis, I E; Heretis, I; Antypas, S; Sofikitis, N; Spandidos, D A; Tsatsakis, A M; Tzonou, A


    The aim of the present study was to examine the seasonality of hypospadias in Greece in an attempt to elucidate the aetiology. All boys born between 1991-1998, who underwent hypospadias repair at 'Aghia Sophia' Children's Hospital, Athens (n=542) were analysed. All Greek live-born males during the same period (population at risk; m=421,175) served as the controls. Seasonality by month of birth was evaluated with specific statistical tools. Meteorological parameters were also analysed. All tests yielded significant results, suggesting a simple harmonic prevalence pattern (highest/lowest: autumn, peak in October/spring, trough in April). Therefore, the first trimester of hypospadiac gestations coincides more frequently with winter. Meteorological parameters varied seasonally (maximal sunlight; air temperature in summer/minimal in winter, maximal rainfall in winter/minimal in summer) and were strongly associated pairwise. Hypospadiac birth prevalence follows a simple harmonic seasonal pattern and is associated with that of cryptorchidism in Greece. The coincidence of the first or third trimester of a potentially genetically influenced gestation with winter could lead to the phenotypic expression of hypospadias or cryptorchidism, respectively. The potential role of a cyclic-varied androgen-production stimulator, such as human chorionic gonadotrophin may be speculated. The seasonality of a common environmental factor acting directly/indirectly may contribute to these patterns, and possibly to the common pathogenesis of these congenital malformations.

  3. Thromboembolic Conditions, Aetiology Diagnosis and Treatment in Dogs and Cats

    Directory of Open Access Journals (Sweden)

    Filip Konečný


    Full Text Available In veterinary medicine, thrombo-embolism (TE is an under-appreciated medical condition that requires immediate recognition. Since TE is multifactorial and its mode of presentation may vary, veterinarians face great difficulties in making a definitive diagnosis in a timely manner. In addition, most of the underlying conditions that give rise to TE are life-threatening and an aggressive diagnostic and therapeutic approach is required. Not only does the diagnosis and treatment of this condition require the collaboration of many specialties, the costs of therapy can be excessive with a high risk of recurrence. As such, owners have to be thoroughly informed before the therapy commences. While TE has been well-characterized in humans and is associated with significant morbidity and mortality, little information of similar quality is available in veterinary medicine. In addition, TE in animals is distinct from its human counterpart and we cannot simply adapt what is known from human clinical trials. With the promise of improvements in imaging modalities that improve our diagnostic capabilities, the window of opportunity to treat TE increases. This article focuses on aetiology, clinical presentation, diagnosis, and treatment of dogs and cats affected by TE.

  4. Comparison of radiological findings and microbial aetiology of childhood pneumonia

    International Nuclear Information System (INIS)

    Korppi, M.; Kiekara, O.; Kosma, T.H.; Soimakallio, S.


    61 children were treated in hospital from 1981 to 1982 because of both radiologically and microbiologically verified viral or bacterial pneumonia. The chest radiographs were interpreted by two radiologists, not familiar with the clinical data, on two occasions three years apart, and only those patients with a definite alveolar or interstitial pneumonia at both evaluations were included in the present analysis. In addition, all patients had viral, mixed viral-bacterial or bacterial infections diagnosed by viral or bacterial antibody or antigen assays. Viral infection alone was seen in 7, mixed viral-bacterial infection in 8 and bacterial infection alone in 12 of the 27 patients with alveolar pneumonia. The respective figures were 13, 13 and 8 for the 34 patients with interstitial pneumonia. C-reactive protein concentration was greater than 40 mg/l in 15 of the patients with alveolar and in 11 of the patients with interstitial pneumonia. Thus 74% of the patients with alveolar and 62% with interstitial pneumonia had bacterial infection, either alone or as a mixed viral-bacterial infection. The results suggest that the presence of an alveolar infiltrate in a chest radiograph is a specific but insensitive indicator of bacterial pneumonia. It is concluded that patients with alveolar pneumonia should be treated with antibiotics. In patients with interstitial pneumonia, however, both viral and bacterial aetiology are possible. In those, the decision concerning antibiotic treatment should be based on clinical and laboratory findings. 21 refs., 4 tabs

  5. Schizophrenia: metabolic aspects of aetiology, diagnosis and future treatment strategies. (United States)

    Harris, Laura W; Guest, Paul C; Wayland, Matthew T; Umrania, Yagnesh; Krishnamurthy, Divya; Rahmoune, Hassan; Bahn, Sabine


    Despite decades of research, the pathophysiology and aetiology of schizophrenia remains incompletely understood. The disorder is frequently accompanied by metabolic symptoms including dyslipidaemia, hyperinsulinaemia, type 2 diabetes and obesity. These symptoms are a common side effect of currently available antipsychotic medications. However, reports of metabolic dysfunction in schizophrenia predate the antipsychotic era and have also been observed in first onset patients prior to antipsychotic treatment. Here, we review the evidence for abnormalities in metabolism in schizophrenia patients, both in the central nervous system and periphery. Molecular analysis of post mortem brain tissue has pointed towards alterations in glucose metabolism and insulin signalling pathways, and blood-based molecular profiling analyses have demonstrated hyperinsulinaemia and abnormalities in secretion of insulin and co-released factors at first presentation of symptoms. Nonetheless, such features are not observed for all subjects with the disorder and not all individuals with such abnormalities suffer the symptoms of schizophrenia. One interpretation of these data is the presence of an underlying metabolic vulnerability in a subset of individuals which interacts with environmental or genetic factors to produce the overt symptoms of the disorder. Further investigation of metabolic aspects of schizophrenia may prove critical for diagnosis, improvement of existing treatment based on patient stratification/personalised medicine strategies and development of novel antipsychotic agents. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Inflammatory aetiology of human myometrial activation tested using directed graphs.

    Directory of Open Access Journals (Sweden)


    Full Text Available THERE ARE THREE MAIN HYPOTHESES FOR THE ACTIVATION OF THE HUMAN UTERUS AT LABOUR: functional progesterone withdrawal, inflammatory stimulation, and oxytocin receptor activation. To test these alternatives we have taken information and data from the literature to develop causal pathway models for the activation of human myometrium. The data provided quantitative RT-PCR results on key genes from samples taken before and during labour. Principal component analysis showed that pre-labour samples form a homogenous group compared to those during labour. We therefore modelled the alternative causal pathways in non-labouring samples using directed graphs and statistically compared the likelihood of the different models using structural equations and D-separation approaches. Using the computer program LISREL, inflammatory activation as a primary event was highly consistent with the data (p = 0.925, progesterone withdrawal, as a primary event, is plausible (p = 0.499, yet comparatively unlikely, oxytocin receptor mediated initiation is less compatible with the data (p = 0.091. DGraph, a software program that creates directed graphs, produced similar results (p= 0.684, p= 0.280, and p = 0.04, respectively. This outcome supports an inflammatory aetiology for human labour. Our results demonstrate the value of directed graphs in determining the likelihood of causal relationships in biology in situations where experiments are not possible.

  7. Orbital cellulitis in Scotland: current incidence, aetiology, management and outcomes. (United States)

    Murphy, C; Livingstone, I; Foot, B; Murgatroyd, H; MacEwen, C J


    Orbital cellulitis is a potentially blinding and life-threatening condition. There are little published data on the incidence of orbital cellulitis and little is known about the differences between children and adults affected. The purpose of this study was to identify the incidence, aetiology, management and outcome of orbital cellulitis in children and adults in Scotland. This study was a 1-year prospective observational study using the Scottish Ophthalmic Surveillance Unit reporting system among Scottish ophthalmologists. The response rate from ophthalmologists was 66.4%. There were 15 children and 5 adults reported giving an incidence of 1.6 per 100 000 and 0.1 per 100 000 in children and adults, respectively. 47% of children had a preceding upper respiratory tract infection with 87% having radiological evidence of sinus disease. Within the adult group, there was preceding immunosuppression and trauma. Streptococcus (66%) and Haemophilus (46%) species were the most commonly isolated pathogens in children. Respiratory pathogens were less predictable in adults. All patients were treated with intravenous antibiotics. All children with orbital and subperiosteal abscesses had surgery; one adult with orbital abscess did not have surgery. There were two cases of series morbidity: one intracranial spread of infection and one evisceration. The incidence of orbital cellulitis is higher in children than in adults. In children, it commonly follows upper respiratory infection and sinus disease; however, in adults, preceding illness and trauma are more common. Respiratory pathogens are common in affected children. Intravenous antibiotics and surgical treatment of abscesses remain the preferred management. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  8. Binocular diplopia in a tertiary hospital: Aetiology, diagnosis and treatment. (United States)

    Merino, P; Fuentes, D; Gómez de Liaño, P; Ordóñez, M A


    To study the causes, diagnosis and treatment in a case series of binocular diplopia. A retrospective chart review was performed on patients seen in the Diplopia Unit of a tertiary centre during a one-year period. Diplopia was classified as: acute≤1 month since onset; subacute (1-6 months); and chronic (>6 months). Resolution of diplopia was classified as: spontaneous if it disappeared without treatment, partial if the course was intermittent, and non-spontaneous if treatment was required. It was considered a good outcome when diplopia disappeared completely (with or without treatment), or when diplopia was intermittent without significantly affecting the quality of life. A total of 60 cases were included. The mean age was 58.65 years (60% female). An acute or subacute presentation was observed in 60% of the patients. The mean onset of diplopia was 82.97 weeks. The most frequent aetiology was ischaemic (45%). The most frequent diagnosis was sixth nerve palsy (38.3%), followed by decompensated strabismus (30%). Neuroimaging showed structural lesions in 17.7% of the patients. There was a spontaneous resolution in 28.3% of the cases, and there was a good outcome with disappearance of the diplopia in 53.3% at the end of the study. The most frequent causes of binocular diplopia were cranial nerve palsies, especially the sixth cranial nerve, followed by decompensated strabismus. Structural lesions in imaging tests were more than expected. Only one third of patients had a spontaneous resolution, and half of them did not have a good outcome despite of treatment. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Anaesthetic considerations for paediatric laparoscopy | Lasersohn ...

    African Journals Online (AJOL)

    Children, infants and neonates represent an anaesthetic challenge because of age-specific anatomical and physiological issues. Apart from paediatric-specific anaesthetic considerations, the paediatric anaesthetist must understand the implications of laparoscopic surgery, and prevent and react appropriately to changes ...

  10. Acute colonic pseudo-obstruction: A systematic review of aetiology and mechanisms (United States)

    Wells, Cameron I; O’Grady, Gregory; Bissett, Ian P


    AIM To critically review the literature addressing the definition, epidemiology, aetiology and pathophysiology of acute colonic pseudo-obstruction (ACPO). METHODS A systematic search was performed to identify articles investigating the aetiology and pathophysiology of ACPO. A narrative synthesis of the evidence was undertaken. RESULTS No consistent approach to the definition or reporting of ACPO has been developed, which has led to overlapping investigation with other conditions. A vast array of risk factors has been identified, supporting a multifactorial aetiology. The pathophysiological mechanisms remain unclear, but are likely related to altered autonomic regulation of colonic motility, in the setting of other predisposing factors. CONCLUSION Future research should aim to establish a clear and consistent definition of ACPO, and elucidate the pathophysiological mechanisms leading to altered colonic function. An improved understanding of the aetiology of ACPO may facilitate the development of targeted strategies for its prevention and treatment. PMID:28852322

  11. Anatomical structure of Polystichum Roth ferns rachises

    Directory of Open Access Journals (Sweden)

    Oksana V. Tyshchenko


    Full Text Available The morpho-anatomical characteristics of rachis cross sections of five Polystichum species is presented. The main and auxiliary anatomical features which help to distinguish investigated species are revealed.

  12. Unification of Sinonasal Anatomical Terminology

    Directory of Open Access Journals (Sweden)

    Voegels, Richard Louis


    Full Text Available The advent of endoscopy and computed tomography at the beginning of the 1980s brought to rhinology a revival of anatomy and physiology study. In 1994, the International Conference of Sinus Disease was conceived because the official “Terminologia Anatomica”[1] had little information on the detailed sinonasal anatomy. In addition, there was a lack of uniformity of terminology and definitions. After 20 years, a new conference has been held. The need to use the same terminology led to the publication by the European Society of Rhinology of the “European Position Paper on the Anatomical Terminology of the Internal Nose and Paranasal Sinuses,” that can be accessed freely at Professor Valerie Lund et al[2] wrote this document reviewing the anatomical terms, comparing to the “Terminology Anatomica” official order to define the structures without eponyms, while respecting the embryological development and especially universalizing and simplifying the terms. A must-read! The text's purpose lies beyond the review of anatomical terminology to universalize the language used to refer to structures of the nasal and paranasal cavities. Information about the anatomy, based on extensive review of the current literature, is arranged in just over 50 pages, which are direct and to the point. The publication may be pleasant reading for learners and teachers of rhinology. This text can be a starting point and enables searching the universal terminology used in Brazil, seeking to converge with this new European proposal for a nomenclature to help us communicate with our peers in Brazil and the rest of the world. The original text of the European Society of Rhinology provides English terms that avoided the use of Latin, and thus fall beyond several national personal translations. It would be admirable if we created our own cross-cultural adaptation of this new suggested anatomical terminology.

  13. Bruxism threshold: an explanation for successful treatment of the multifactorial aetiology of bruxism. (United States)

    Nel, J C; Bester, S P; Snyman, W D


    Many authors claim successful treatment of bruxism by various treatment modalities. This paper presents a review of the nature of bruxism, the multifactorial aetiology of bruxism and a discussion of successful treatment of bruxism by various treatment modalities. The aim of this paper is to provide an explanation for successful treatment of bruxism on the basis of decreasing or eliminating any one or more of the aetiological stimuli to a combined level below the bruxism threshold.

  14. The aetiology of acute and chronic pancreatitis over time in a hospital in Copenhagen

    DEFF Research Database (Denmark)

    Nøjgaard, Camilla; Bendtsen, Flemming; Matzen, Peter


    The change in aetiology over time of acute and chronic pancreatitis has been sparsely described, as has also the validity of the diagnostic codes. The aim of the study was 1) to clarify whether the aetiology of acute and chronic pancreatitis changed during the period 1983-2005, and 2) to validate...... the diagnostic codes over time for acute and chronic pancreatitis registered in the Danish National Patient Registry (NPR) in the same period....



    M. Amarendra; Garuda Rama; C. Rohit Kiran; DVRB Raju


    BACKGROUND Respiratory distress is a common problem encountered within the first 48-72 hours of life. It is one of the commonest cause of admission to NICU. So, it is very important to know the aetiology and risk factors associated with development of respiratory distress to provide better management. The aim of the study is to study the aetiology of respiratory distress and the risk factors associated with development of respiratory distress in term newborns. MATERIALS ...

  16. Anatomic-physiological schema of the gastrointestinal tract, to be taken in account in determining the levels of radioactive contamination; Schema anatomo-physiologique du tractus gastro-intestinal a prendre en consideration pour le calcul des niveaux de contamination Radioactive

    Energy Technology Data Exchange (ETDEWEB)

    Fabry, C. [Commissariat a l' Energie Atomique, Cadarache, Association EURATOM-CEA, Niveaux de Contamination (France). Centre d' Etudes Nucleaires


    Anatomical and physiological data of the gastrointestinal tract of adults and children were summarized in a standard schema, to be used in calculating the levels of radioactive contamination, in the food chain. (author) [French] Cette note a pour objet de rassembler les donnees anatomiques et physiologiques du tractus gastrointestinal, chez l'adulte et chez l'enfant, et d'en deduire un schema standard qui puisse servir de base au calcul des niveaux de contamination de la chaine alimentaire par les substances radioactives. (auteur)


    Directory of Open Access Journals (Sweden)

    Prem Prakash


    Full Text Available BACKGROUND Urinary tract infection (UTI is a common infection in pregnant women. It is responsible for range of complications causing perinatal and maternal morbidity and mortality. AIM To assess the associated risk factors, aetiology and their antibiogram of UTI among pregnant women. METHODOLOGY This is a cross-sectional study carried out in Department of Microbiology & Department of Obstetrics from March 2015 to February 2016. The patient details and risk factors were recorded. Midstream & catheter urine specimens from pregnant women with symptoms of UTI were collected and sent for routine microscopy, culture and sensitivity. RESULTS In 550 pregnant women, 122(22.18% had significant bacteriuria and 72(17.72% had low colony count UTI. The most affected number age group was 25-35 years (58.85% followed by 15-25 years. Of the associated risk factors, multiparity 45.31%, low socioeconomic status 42.18%, anaemia 39.06% etc. were important. Escherichia coli was most frequently isolated with a percentage of 29.14%, followed by Klebsiella species (17.49%, S. aureus (14.34% etc. Other isolated micro-organisms included Enterococci, Proteus mirabilis, Citrobacter, Pseudomonas, Acinetobacter species. The antibiotics with more than 50% sensitivity against Gram-negative isolates were Imipenem (74.7%, Levofloxacin (73.17%, Ciprofloxacin (69.10%, Amikacin (57.72%, Amoxiclav (55.28%, and Cefoperazone/Sulbactam (50.40%. The antibiotics for Gram-positive isolates were Linezolid (88.46%, Cefoxitin (78.84%, Teicoplanin (69.23% and Vancomycin (65.22%. CONCLUSION We found associated risk factors such as multiparity, low socioeconomic status, etc. E. coli was the most common bacteria isolated in our setting. Therefore, pregnant women should be assessed for associated risk factors and evaluated for the pathogenic organism during their regular follow-up. The drug sensitivity should be taken into consideration with their side effects related to pregnancy.

  18. Variations in the Anatomical Structures of the Guyon Canal. (United States)

    Fadel, Zahir T; Samargandi, Osama A; Tang, David T


    Compression neuropathy of the ulnar nerve at the Guyon canal is commonly seen by hand surgeons. Different anatomical variations of structures related to the Guyon canal have been reported in the literature. A thorough knowledge of the normal contents and possible variations is essential during surgery and exploration. To review the recognized anatomical variations within and around the Guyon canal. This study is a narrative review in which relevant papers, clinical studies, and anatomical studies were selected by searching electronic databases (PubMed and EMBASE). Extensive manual review of references of the included studies was performed. We also describe a case report of an aberrant muscle crossing the Guyon canal. This study identified several variations in the anatomical structures of the Guyon canal reported in the literature. Variations of the ulnar nerve involved its course, branching pattern, deep motor branch, superficial sensory branch, dorsal cutaneous branch, and the communication with the median nerve. Ulnar artery variations involved its course, branching pattern, the superficial ulnar artery, and the dorsal perforating artery. Aberrant muscles crossing the Guyon canal were found to originate from the antebrachial fascia, pisiform bone, flexor retinaculum, the tendon of palmaris longus, flexor carpi ulnaris, or flexor carpi radialis; these muscles usually fuse with the hypothenar group. The diverse variations of the contents of the Guyon canal were adequately described in the literature. Taking these variations into consideration is important in preventing clinical misinterpretation and avoiding potential surgical complications.

  19. Utilization management in anatomic pathology. (United States)

    Lewandrowski, Kent; Black-Schaffer, Steven


    There is relatively little published literature concerning utilization management in anatomic pathology. Nonetheless there are many utilization management opportunities that currently exist and are well recognized. Some of these impact only the cost structure within the pathology department itself whereas others reduce charges for third party payers. Utilization management may result in medical legal liabilities for breaching the standard of care. For this reason it will be important for pathology professional societies to develop national utilization guidelines to assist individual practices in implementing a medically sound approach to utilization management. © 2013.

  20. WLH Duckworth (1870-1956) and his translation of Galen's Anatomical Procedures. (United States)

    Rocca, Julius


    Wynfrid Laurence Henry Duckworth was one of the leading comparative anatomists of the first half of the 20th century, and he made important contributions to biological anthropology and anatomical education. In his eighth decade Duckworth turned his considerable gifts to the history of medicine. This paper examines the circumstances of his English translation of the second half of Anatomical Procedures, one of Galen's most important works.

  1. The Science and Politics of Naming: Reforming Anatomical Nomenclature, ca. 1886-1955. (United States)

    Buklijas, Tatjana


    Anatomical nomenclature is medicine's official language. Early in their medical studies, students are expected to memorize not only the bodily geography but also the names for all the structures that, by consensus, constitute the anatomical body. The making and uses of visual maps of the body have received considerable historiographical attention, yet the history of production, communication, and reception of anatomical names-a history as long as the history of anatomy itself-has been studied far less. My essay examines the reforms of anatomical naming between the first modern nomenclature, the 1895 Basel Nomina Anatomica (BNA), and the 1955 Nomina Anatomica Parisiensia (NAP, also known as PNA), which is the basis for current anatomical terminology. I focus on the controversial and ultimately failed attempt to reform anatomical nomenclature, known as Jena Nomina Anatomica (INA), of 1935. Discussions around nomenclature reveal not only how anatomical names are made and communicated, but also the relationship of anatomy with the clinic; disciplinary controversies within anatomy; national traditions in science; and the interplay between international and scientific disciplinary politics. I show how the current anatomical nomenclature, a successor to the NAP, is an outcome of both political and disciplinary tensions that reached their peak before 1945. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email:

  2. Shifting white pox aetiologies affecting Acropora palmata in the Florida Keys, 1994–2014 (United States)

    Berry, Brett; Park, Andrew; Kemp, Dustin W.; Kemp, Keri M.; Lipp, Erin K.; Porter, James W.


    We propose ‘the moving target hypothesis’ to describe the aetiology of a contemporary coral disease that differs from that of its historical disease state. Hitting the target with coral disease aetiology is a complex pursuit that requires understanding of host and environment, and may lack a single pathogen solution. White pox disease (WPX) affects the Caribbean coral Acropora palmata. Acroporid serratiosis is a form of WPX for which the bacterial pathogen (Serratia marcescens) has been established. We used long-term (1994–2014) photographic monitoring to evaluate historical and contemporary epizootiology and aetiology of WPX affecting A. palmata at eight reefs in the Florida Keys. Ranges of WPX prevalence over time (0–71.4%) were comparable for the duration of the 20-year study. Whole colony mortality and disease severity were high in historical (1994–2004), and low in contemporary (2008–2014), outbreaks of WPX. Acroporid serratiosis was diagnosed for some historical (1999, 2003) and contemporary (2012, 2013) outbreaks, but this form of WPX was not confirmed for all WPX cases. Our results serve as a context for considering aetiology as a moving target for WPX and other coral diseases for which pathogens are established and/or candidate pathogens are identified. Coral aetiology investigations completed to date suggest that changes in pathogen, host and/or environment alter the disease state and complicate diagnosis. PMID:26880837

  3. Shifting white pox aetiologies affecting Acropora palmata in the Florida Keys, 1994-2014. (United States)

    Sutherland, Kathryn P; Berry, Brett; Park, Andrew; Kemp, Dustin W; Kemp, Keri M; Lipp, Erin K; Porter, James W


    We propose 'the moving target hypothesis' to describe the aetiology of a contemporary coral disease that differs from that of its historical disease state. Hitting the target with coral disease aetiology is a complex pursuit that requires understanding of host and environment, and may lack a single pathogen solution. White pox disease (WPX) affects the Caribbean coral Acropora palmata. Acroporid serratiosis is a form of WPX for which the bacterial pathogen (Serratia marcescens) has been established. We used long-term (1994-2014) photographic monitoring to evaluate historical and contemporary epizootiology and aetiology of WPX affecting A. palmata at eight reefs in the Florida Keys. Ranges of WPX prevalence over time (0-71.4%) were comparable for the duration of the 20-year study. Whole colony mortality and disease severity were high in historical (1994-2004), and low in contemporary (2008-2014), outbreaks of WPX. Acroporid serratiosis was diagnosed for some historical (1999, 2003) and contemporary (2012, 2013) outbreaks, but this form of WPX was not confirmed for all WPX cases. Our results serve as a context for considering aetiology as a moving target for WPX and other coral diseases for which pathogens are established and/or candidate pathogens are identified. Coral aetiology investigations completed to date suggest that changes in pathogen, host and/or environment alter the disease state and complicate diagnosis. © 2016 The Author(s).



    V. N. Bubenchikova; E. A. Nikitin


    The article present results of the study for a anatomic structure of Campanula rotundifolia grass from Campanulaceae family. Despite its dispersion and application in folk medicine, there are no data about its anatomic structure, therefore to estimate the indices of authenticity and quality of raw materials it is necessary to develop microdiagnostical features in the first place, which could help introducing of thisplant in a medical practice. The purpose of this work is to study anatomical s...

  5. Sonography of gallstones and biliary dilatation without a visible aetiology: The infrequency of obstructing choledocholithiasis

    Energy Technology Data Exchange (ETDEWEB)

    Cabrera, O.; Van Sonnenberg, E.; Wittich, G.R.; Leopold, G.R.; Gosink, U.B.; Bowen, J.S.


    This paper describes 50 consecutive patients who sonographically had gallbladder stones and dilated bile ducts, but no visible aetiology for the dilatation. We reviewed these cases to determine the frequency of choledocholithiasis in this setting. Common duct stones caused obstruction in only 36% of these patients. Other aetiologies included strictures due to chronic pancreatitis or prior stone passage in 24% of the patients, and malignant obstruction in 16%. In 24% of the patients, no cause was found for biliary dilatation: common duct stones or obstructing tumours were excluded in the group. Since aetiologies other than stones are likely in a majority of cases, further preoperative workup (CT, percutaneous transhepatic cholangiography, ERCP) or intraoperative cholangiography (if the patient requires urgent cholecystectomy) is indicated. The additional studies should provide a diagnosis, help determine whether or not the common duct should be explored, or avoid unnecessary operation in case of incurable malignancy.

  6. Sonography of gallstones and biliary dilatation without a visible aetiology: The infrequency of obstructing choledocholithiasis

    International Nuclear Information System (INIS)

    Cabrera, O.; Van Sonnenberg, E.; Wittich, G.R.; Leopold, G.R.; Gosink, U.B.; Bowen, J.S.; California Univ., San Diego, La Jolla


    This paper describes 50 consecutive patients who sonographically had gallbladder stones and dilated bile ducts, but no visible aetiology for the dilatation. We reviewed these cases to determine the frequency of choledocholithiasis in this setting. Common duct stones caused obstruction in only 36% of these patients. Other aetiologies included strictures due to chronic pancreatitis or prior stone passage in 24% of the patients, and malignant obstruction in 16%. In 24% of the patients, no cause was found for biliary dilatation: common duct stones or obstructing tumours were excluded in the group. Since aetiologies other than stones are likely in a majority of cases, further preoperative workup (CT, percutaneous transhepatic cholangiography, ERCP) or intraoperative cholangiography (if the patient requires urgent cholecystectomy) is indicated. The additional studies should provide a diagnosis, help determine whether or not the common duct should be explored, or avoid unnecessary operation in case of incurable malignancy. (orig.)

  7. MR urography: Anatomical and quantitative information on ...

    African Journals Online (AJOL)

    MR urography: Anatomical and quantitative information on congenital malformations in children. Maria Karaveli, Dimitrios Katsanidis, Ioannis Kalaitzoglou, Afroditi Haritanti, Anastasios Sioundas, Athanasios Dimitriadis, Kyriakos Psarrakos ...

  8. Our experience with the aetiological diagnosis of global developmental delay and intellectual disability: 2006-2010. (United States)

    López-Pisón, J; García-Jiménez, M C; Monge-Galindo, L; Lafuente-Hidalgo, M; Pérez-Delgado, R; García-Oguiza, A; Peña-Segura, J L


    Global developmental delay (GDD) and intellectual disability (ID) are common reasons for consultation in paediatric neurology. Results from aetiological evaluations of children with GDD/ID vary greatly, and consequently, there is no universal consensus regarding which studies should be performed. We review our experience with determining aetiological diagnoses for children with GDD/ID who were monitored by the paediatric neurology unit over the 5-year period between 2006 and 2010. During the study period, 995 children with GDD/ID were monitored. An aetiological diagnosis was established for 309 patients (31%), but not in 686 (69%), despite completing numerous tests. A genetic cause was identified in 142 cases (46% of the total aetiologies established), broken down as 118 cases of genetic encephalopathy and 24 of metabolic hereditary diseases. Our data seem to indicate that diagnosis is easier when GDD/ID is associated with cerebral palsy, epilepsy, infantile spasms/West syndrome, or visual deficit, but more difficult in cases of autism spectrum disorders. Genetic studies provide an increasing number of aetiological diagnoses, and they are also becoming the first step in diagnostic studies. Array CGH (microarray-based comparative genomic hybridisation) is the genetic test with the highest diagnostic yield in children with unexplained GDD/ID. The cost-effectiveness of complementary studies seems to be low if there are no clinically suspected entities. However, even in the absence of treatment, aetiological diagnosis is always important in order to provide genetic counselling and possible prenatal diagnosis, resolve family (and doctors') queries, and halt further diagnostic studies. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  9. Epidemiology, aetiology and management of visual impairment in children. (United States)

    Solebo, Ameenat Lola; Rahi, Jugnoo


    An estimated 19 million of the world's children are visually impaired, while 1.4 million are blind. Using the UK as a model for high income countries, from a population-based incidence study, the annual cumulative incidence of severe visual impairment/blindness (SVL/BL) is estimated to be 6/10 000 by age 15 years, with the incidence being highest in the first year of life. The population of visually impaired children within high, middle and lower income countries differ considerably between and within countries. The numerous and mainly uncommon disorders which can cause impaired vision result in heterogeneous population which includes a substantial proportion (for SVI/BL, the majority) of children with additional systemic disorders or impairments whose needs differ substantially from those with isolated vision impairment. Paediatricians and other paediatric professionals have a key role in early detection and multidisciplinary management to minimise the impact of visual impairment (VI) in childhood.

  10. Anatomical and palynological characteristics of Salvia willeana ...

    African Journals Online (AJOL)

    In this study, anatomical and palynological features of the roots, stems, petiole and leaves of Salvia willeana (Holmboe) Hedge and Salvia veneris Hedge, Salvia species endemic to Cyprus, were investigated. In the anatomical characteristics of stem structures, it was found that the chlorenchyma composed of 6 or 7 rows of ...

  11. Morphological and anatomical response of Acacia ehrenbergiana ...

    African Journals Online (AJOL)

    ajl user 3


    Feb 20, 2012 ... The response of Acacia ehrenbergiana Hayne and Acacia tortilis (Forssk) Haynes subspp. raddiana seedlings to 100, 50 and 25% field capacity (FC) watering regimes was studied to determine their morphological and anatomical behaviour. Both species responded morphologically as well as anatomically ...

  12. The aetiology of community-acquired pneumonia and implications for patient management.

    NARCIS (Netherlands)

    Gageldonk-Lafeber, A.B. van; Wever, P.C.; Lubben, I.M. van der; Jager, C.P. de; Meijer, A.; Vries, M.C. de; Elberse, K.; Sande, M.A.B. van der; Hoek, W. van der


    PURPOSE: Understanding which pathogens are associated with clinical manifestation of community-acquired pneumonia (CAP) is important to optimise treatment. We performed a study on the aetiology of CAP and assessed possible implications for patient management in the Netherlands. METHODS: Patients

  13. Aetiology and resistance patterns of community-acquired pneumonia in León, Nicaragua

    NARCIS (Netherlands)

    Matute, A J; Brouwer, W P; Hak, E; Delgado, E; Alonso, E; Hoepelman, I M


    We conducted a prevalence study to gain greater insight into the aetiology, bacterial resistance and risk factors for community-acquired pneumonia (CAP) in the region of León, Nicaragua. During the period from July 2002 to January 2005, all consecutive patients with signs and symptoms suggestive of

  14. Domestic donkey (Equus africanus asinus bites: An unusual aetiology of severe scalp injuries in Morocco

    Directory of Open Access Journals (Sweden)

    Hatim Droussi


    Discussion: The bite of a donkey is rare aetiology of scalp injuries. Special features of these injuries, including a literature review, are discussed focusing on the care of these patients in the emergency centre, describing the surgical procedures required and antibiotic choice. Recommendations for the management of donkey bite scalp injuries are provided.

  15. Modern views on aetiology and pathogenesis of tumor growths and benign ovarian tumors

    Directory of Open Access Journals (Sweden)

    Serebrennikova K.G.


    Full Text Available The article represents modern data of aetiology and pathogenesis of tumor growths and benign ovarian tumors as systemic diseases of organism. These diseases appear on the cellular level and involve the presence of polymorphous metabolic, endocrine and immune disorders. Exogenous and endogenous risk factors of ovarian carcinomas are considered

  16. Cytoarchitecture of epithelial inflammatory infiltration indicates the aetiology of infectious keratitis. (United States)

    Smedowski, Adrian; Tarnawska, Dorota; Orski, Michal; Wroblewska-Czajka, Ewa; Kaarniranta, Kai; Aragona, Pasquale; Wylegala, Edward


    To analyse cytological features of corneal epithelium in infectious keratitis. One hundred and eighteen patients (53 males and 65 females) diagnosed with acute stage of infectious keratitis (45 viral, 40 bacterial, 23 fungal, 10 Acanthamoeba keratitis) were included in study. We performed retrospective analysis of bright and blue-light slit-lamp photographs and in vivo corneal confocal microscopy scans of the corneal epithelium from five corneal regions (superior, inferior, temporal, nasal and central). Density, morphology of inflammatory cells and their relation to epithelial structures, as well as density of nerve fibres, were evaluated in relation to the keratitis aetiology. We characterized five morphological types of inflammatory cells forming infiltration. Cell and nerve fibre densities showed significant differences between groups, and the most intense inflammatory infiltration was associated with fungal then bacterial, viral and Acanthamoeba keratitis. Additionally, differences in aetiology-specific ratio of round/non-round inflammatory cells were observed. Confocal microscopy analysis in infectious keratitis of various aetiologies revealed quantitative and qualitative differences in inflammatory cell infiltration expressed in different ratio of round/non-round inflammatory cells. In vivo microscopic analysis of both the corneal epithelial layer cytopathology and the cytology of inflammatory infiltration provides a fast and specific differentiation of keratitis aetiology that may increase the accuracy in the selection of the initial treatment. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  17. The role of personality pathology in the aetiology and treatment of substance use disorders

    NARCIS (Netherlands)

    Verheul, R; van den Brink, W


    The concept of personality in addiction research has traditionally been subject to controversies about its measurement and role in aetiology and treatment. Early studies (1950-1980) typically sought but failed to identify a single pre-addictive personality, suggesting either clinical heterogeneity

  18. Aetiology of male urethritis in patients recruited from a population with a high HIV prevalence.

    NARCIS (Netherlands)

    Sturm, P.D.J.; Moodley, P.; Khan, N.; Ebrahim, S.; Govender, K.; Connolly, C.E.; Sturm, A.W.


    The aetiology of urethritis, the significance of potential pathogens and the relation of urethritis to HIV infection were determined in 335 men (cases) with and 100 men (controls) without urethral symptoms. Urethral swab specimens were tested for different organisms by PCR or by culture for

  19. The incidence and aetiology of acute kidney injury in children in Norway between 1999 and 2008 (United States)

    Jenssen, Gaute Reier; Hovland, Eirik; Bangstad, Hans-Jacob; Nygård, Karin; Vold, Line; Bjerre, Anna


    Aim Primary acute kidney injury (AKI) is a direct cause of hospitalisation in children, but can also result from other conditions. There is limited information on the epidemiology of this condition. Our aim was to describe the national incidence rate and aetiology of acute kidney injury in children under the age of 16 in Norway from 1999 to 2008. Methods We carried out a retrospective study of medical records provided by all 18 of the paediatric hospital departments that specialise in treating paediatric patients with AKI. Results We identified 315 cases of AKI (53% male), with an estimated average annual incidence rate of 3.3 cases per 100 000 children and a median annual occurrence of 33 cases. Most cases (43%) were in children under five. We identified 53 aetiologies and classified these into 30 aetiological groups: 24% of the cases were prerenal (n = 75), 74% were intrinsic/renal (n = 234) and 2% were postrenal (n = 5). Nephritic syndromes was the major cause (44%) of AKI, followed by haemolytic-uraemic syndrome (HUS) (15%). Conclusion Nephritic syndromes and HUS are the most common aetiologies of AKI in Norway. Although our results could indicate a low incidence of paediatric AKI in Norway, the lack of other national studies makes comparisons difficult. PMID:25039408

  20. Aetiological profile of nasal trauma in Ilorin North-Central Nigeria ...

    African Journals Online (AJOL)

    Background: The nose being the most prominent part of the face is easily traumatized in facial injuries and these has been found to be common among the Caucasians compared to the Africans and Asians. The aim is to ighlight the Aetiological profile of nasal trauma in Ilorin orth-central Nigeria. Method: A prospective study ...

  1. Perspectives on the Aetiology of ODD and CD: A Grounded Theory Approach (United States)

    McFarland, Patrick; Sanders, James; Hagen, Bradley


    Antisocial disorders, such as oppositional defiant disorder (ODD) and conduct disorder (CD), are common reasons for youth to be seen for clinical intervention. The intent of this constructivist grounded theory study was to evaluate clinicians' perspectives on the aetiology of antisocial disorders. Six professionals from various professional…

  2. Prevalence of potential underlying aetiology of macrocytic anaemia in Dutch general practice

    NARCIS (Netherlands)

    K. Stouten (Karlijn); J.A. Riedl (Jurgen); J. Droogendijk (Jolanda); Castel, R. (Rob); J.M. van Rosmalen (Joost); R.J. Van Houten; P.B. Berendes (Paul); P. Sonneveld (Pieter); M.-D. Levin (Mark-David)


    textabstractBackground: Macrocytic anaemia (MCV ≥ 100 fL) is a relatively common finding in general practice. However, literature on the prevalence of the different causes in this population is limited. The prevalence of macrocytic anaemia and its underlying aetiology were analysed in a general

  3. Neonatal seizures : Aetiology by means of a standardized work-up

    NARCIS (Netherlands)

    Loman, Annemiek M. W.; ter Horst, Henk J.; Lambrechtsen, Florise A. C. P.; Lunsing, Roelineke J.

    Neonatal seizures are an alarming symptom and are frequent in neonates. It is important to find the cause of neonatal seizures to start a specific treatment and to give a meaningful prognosis. The aim of this study is to investigate the incidence of different aetiologies of neonatal seizures in our

  4. Systematic review of survival after acute mesenteric ischaemia according to disease aetiology

    NARCIS (Netherlands)

    Schoots, I. G.; Koffeman, G. I.; Legemate, D. A.; Levi, M. [=Marcel M.; van Gulik, T. M.


    BACKGROUND: Differentiation of acute mesenteric ischaemia on the basis of aetiology is of great importance because of variation in disease progression, response to treatment and outcome. The aim of this study was to analyse the published data on survival following acute mesenteric ischaemia over the

  5. Age-related risk factors for bacterial aetiology in community-acquired pneumonia. (United States)

    Sahuquillo-Arce, José M; Menéndez, Rosario; Méndez, Raúl; Amara-Elori, Isabel; Zalacain, Rafael; Capelastegui, Alberto; Aspa, Javier; Borderías, Luis; Martín-Villasclaras, Juan J; Bello, Salvador; Alfageme, Inmaculada; de Castro, Felipe Rodriguez; Rello, Jordi; Molinos, Luis; Ruiz-Manzano, Juan; Torres, Antoni


    The objective of this study was to evaluate the effect of age and comorbidities, smoking and alcohol use on microorganisms in patients with community-acquired pneumonia (CAP). A prospective multicentre study was performed with 4304 patients. We compared microbiological results, bacterial aetiology, smoking, alcohol abuse and comorbidities in three age groups: young adults (65 years). Bacterial aetiology was identified in 1522 (35.4%) patients. In seniors, liver disease was independently associated with Gram-negative bacteria (Haemophilus influenzae and Enterobacteriaceae), COPD with Pseudomonas aeruginosa (OR = 2.69 (1.46-4.97)) and Staphylococcus aureus (OR = 2.8 (1.24-6.3)) and neurological diseases with S. aureus. In adults, diabetes mellitus (DM) was a risk factor for Streptococcus pneumoniae and S. aureus, and COPD for H. influenzae (OR = 3.39 (1.06-10.83)). In young adults, DM was associated with S. aureus. Smoking was a risk factor for Legionella pneumophila regardless of age. Alcohol intake was associated with mixed aetiology and Coxiella burnetii in seniors, and with S. pneumoniae in young adults. It should be considered that the bacterial aetiology may differ according to the patient's age, comorbidities, smoking and alcohol abuse. More extensive microbiological testing is warranted in those with risk factors for infrequent microorganisms. © 2016 Asian Pacific Society of Respirology.

  6. Prospective evaluation of the aetiological profile of acute pancreatitis in young adult patients. (United States)

    Culetto, Adrian; Bournet, Barbara; Haennig, Audrey; Alric, Laurent; Peron, Jean-Marie; Buscail, Louis


    The aetiologies of acute pancreatitis in young adult patients are poorly known. To prospectively evaluate the causes of acute pancreatitis in patients aged less than 35 years. Overall, 309 consecutive patients admitted to our centre for acute pancreatitis received first-line investigations, including medical history, standard laboratory tests, abdominal ultrasound and computed tomography. If no aetiology was found, second-line investigations were performed, including endoscopic ultrasound, magnetic-resonance cholangiopancreatography and genetic testing in cases of idiopathic pancreatitis. Overall, 66 patients aged between 16 and 35 years were included. After first-line investigations, 49% of cases of acute pancreatitis remained idiopathic. Second-line investigations reduced this rate to 21%. The frequency of aetiologies for acute pancreatitis significantly differed in adults aged ≤ 35 compared to those aged >35 years: biliary aetiology was less frequent (23% versus 43%, p=0.003) as well as alcohol-related (8% versus 24%, p=0.01); drug-induced was more common (16% versus 4%, p=0.0007), as well as cannabis-related (13% versus 1%, pacute pancreatitis significantly differed in adults aged less than 35 years when compared to older patients. Thus, use of medications, exposure to cannabis, and genetic mutations should be actively sought in these patients. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. Prevalence, Phenomenology, Aetiology and Predictors of Challenging Behaviour in Smith-Magenis Syndrome (United States)

    Sloneem, J.; Oliver, C.; Udwin, O.; Woodcock, K. A.


    Background: The prevalence, phenomenology aetiology and correlates of four forms of challenging behaviour in 32 children and adults with Smith-Magenis syndrome (SMS) were investigated. Methods: Cognitive assessments, questionnaires and semi-structured interviews were used to gather data on intellectual disability, verbal and physical aggression,…

  8. Epilepsy in sub-Saharan Africa: its socio-demography, aetiology ...

    African Journals Online (AJOL)

    Objective: To assess epileptics with regard to socio-demographic characteristics, aetiology, EEG results and classification. Design: A descriptive cohort study from 1997 to 2001. Setting: Parirenyatwa Group of Hospitals in Harare, Zimbabwe. Subjects: A total of 229 consecutive epileptic subjects. Results: The mean (s.d.) ...

  9. A review of the current literature on aetiology and measurement methods of halitosis.

    NARCIS (Netherlands)

    Broek, A.M. van den; Feenstra, L.; Baat, C. de


    OBJECTIVES: This work reviews the current knowledge of aetiology and measurement methods of halitosis. DATA: Halitosis is an unpleasant or offensive odour emanating from the breath. The condition is multifactorial and may involve both oral and non-oral conditions. SOURCES: A private, monthly with

  10. Does the sun play a role in the aetiology of malignant melanoma ...

    African Journals Online (AJOL)

    The role of the sun in the aetiology of malignant melanoma is controversial. In 1992 Schuster1 wrote provocatively, 'Despite the lack of evidence of a causal link between sun exposure and melanoma, fear has been used shamelessly to frighten people out of the sun and into pigmented lesion clinics.' He claimed that the ...

  11. Symptoms and aetiology of delirium: a comparison of elderly and adult patients. (United States)

    Grover, S; Agarwal, M; Sharma, A; Mattoo, S K; Avasthi, A; Chakrabarti, S; Malhotra, S; Kulhara, P; Bas, D


    OBJECTIVE. To compare the symptoms of delirium as assessed by the Delirium Rating Scale-Revised-98 (DRS-R-98) and associated aetiologies in adult and elderly patients seen in a consultation-liaison service. METHODS. A total of 321 consecutive patients with a DSM-IV-TR diagnosis of delirium were assessed on the DRS-R-98 and a study-specific aetiology checklist. RESULTS. Of the 321 patients, 245 (76%) aged 18 to 64 years formed the adult group, while 76 (24%) formed the elderly group (≥ 65 years). The prevalence and severity of various symptoms of delirium as assessed using the DRS-R-98 were similar across the 2 groups, except for the adult group having statistically higher prevalence and severity scores for thought process abnormalities and lability of affect. For both groups and the whole sample, factor analysis yielded a 3-factor model for the phenomenology. In the 2 groups, the DRS-R-98 item loadings showed subtle differences across various factors. The 2 groups were similar for the mean number of aetiologies associated with delirium, the mean number being 3. However, the 2 groups differed with respect to hepatic derangement, substance intoxication, withdrawal, and postpartum causes being more common in the adult group, in contrast lung disease and cardiac abnormalities were more common in the elderly group. CONCLUSION. Adult and elderly patients with delirium are similar with respect to the distribution of various symptoms, motor subtypes, and associated aetiologies.

  12. Bell's palsy: aetiology, clinical features and multidisciplinary care. (United States)

    Eviston, Timothy J; Croxson, Glen R; Kennedy, Peter G E; Hadlock, Tessa; Krishnan, Arun V


    Bell's palsy is a common cranial neuropathy causing acute unilateral lower motor neuron facial paralysis. Immune, infective and ischaemic mechanisms are all potential contributors to the development of Bell's palsy, but the precise cause remains unclear. Advancements in the understanding of intra-axonal signal molecules and the molecular mechanisms underpinning Wallerian degeneration may further delineate its pathogenesis along with in vitro studies of virus-axon interactions. Recently published guidelines for the acute treatment of Bell's palsy advocate for steroid monotherapy, although controversy exists over whether combined corticosteroids and antivirals may possibly have a beneficial role in select cases of severe Bell's palsy. For those with longstanding sequaelae from incomplete recovery, aesthetic, functional (nasal patency, eye closure, speech and swallowing) and psychological considerations need to be addressed by the treating team. Increasingly, multidisciplinary collaboration between interested clinicians from a wide variety of subspecialties has proven effective. A patient centred approach utilising physiotherapy, targeted botulinum toxin injection and selective surgical intervention has reduced the burden of long-term disability in facial palsy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  13. The brain atlas concordance problem: quantitative comparison of anatomical parcellations.

    Directory of Open Access Journals (Sweden)

    Jason W Bohland


    Full Text Available Many neuroscientific reports reference discrete macro-anatomical regions of the brain which were delineated according to a brain atlas or parcellation protocol. Currently, however, no widely accepted standards exist for partitioning the cortex and subcortical structures, or for assigning labels to the resulting regions, and many procedures are being actively used. Previous attempts to reconcile neuroanatomical nomenclatures have been largely qualitative, focusing on the development of thesauri or simple semantic mappings between terms. Here we take a fundamentally different approach, discounting the names of regions and instead comparing their definitions as spatial entities in an effort to provide more precise quantitative mappings between anatomical entities as defined by different atlases. We develop an analytical framework for studying this brain atlas concordance problem, and apply these methods in a comparison of eight diverse labeling methods used by the neuroimaging community. These analyses result in conditional probabilities that enable mapping between regions across atlases, which also form the input to graph-based methods for extracting higher-order relationships between sets of regions and to procedures for assessing the global similarity between different parcellations of the same brain. At a global scale, the overall results demonstrate a considerable lack of concordance between available parcellation schemes, falling within chance levels for some atlas pairs. At a finer level, this study reveals spatial relationships between sets of defined regions that are not obviously apparent; these are of high potential interest to researchers faced with the challenge of comparing results that were based on these different anatomical models, particularly when coordinate-based data are not available. The complexity of the spatial overlap patterns revealed points to problems for attempts to reconcile anatomical parcellations and nomenclatures

  14. Middle cerebral artery revascularization: anatomical studies and considerations on the anastomosis site Revascularização da artéria cerebral média: estudo anatômico e considerações sobre o local de sutura

    Directory of Open Access Journals (Sweden)

    Murilo S. Meneses


    Full Text Available In the surgical management of skull base lesions and vascular diseases such as giant aneurysms, involvement of the internal carotid artery may require the resection or the occlusion of the vessel. The anastomosis of the external carotid artery and the middle cerebral artery with venous graft may be indicated to re-establish the blood flow. To determine the best suture site in the middle cerebral artery, an anatomical study was carried out. Fourteen cerebral hemispheres were analysed after the injection of red latex into the internal carotid artery. The superior and inferior trunk of the main division of the middle cerebral artery have more than 2 mm of diameter. They are superficial allowing an anastomosis using a venous graft. The superior trunk has a disadvantage, it gives rise to branches for the precentral and post-central giri. The anastomosis with the inferior trunk presents lower risk of neurological deficit even though the angular artery originates from it.No tratamento cirúrgico das lesões da base do crânio e patologias vasculares como aneurismas gigantes, a ressecção ou oclusão da artéria carótida interna pode ser necessária. A anastomose das artérias carótida externa e cerebral média com interposição de enxerto venoso pode ser utilizada para restabelecer o fluxo sangüíneo. Para determinar o melhor local de sutura na artéria cerebral média, realizou-se um estudo anatômico. Quatorze hemisférios cerebrais foram analisados depois da injeção de látex vermelho na artéria carótida interna. Os ramos superior e inferior da divisão principal da artéria cerebral média têm mais de 2 mm de diâmetro. Eles são superficiais e permitem uma anastomose utilizando um enxerto venoso. O tronco superior tem a desvantagem de dar origem aos ramos para os giros pré e pós-centrais. A anastomose com o tronca inferior apresenta menor risco de déficit neurológico, apesar da artéria angular ter origem desse vaso.

  15. Bottlenecks in domestic animal populations can facilitate the emergence of Trypanosoma cruzi, the aetiological agent of Chagas disease. (United States)

    Levy, Michael Z; Tustin, Aaron; Castillo-Neyra, Ricardo; Mabud, Tarub S; Levy, Katelyn; Barbu, Corentin M; Quispe-Machaca, Victor R; Ancca-Juarez, Jenny; Borrini-Mayori, Katty; Naquira-Velarde, Cesar; Ostfeld, Richard S


    Faeces-mediated transmission of Trypanosoma cruzi (the aetiological agent of Chagas disease) by triatomine insects is extremely inefficient. Still, the parasite emerges frequently, and has infected millions of people and domestic animals. We synthesize here the results of field and laboratory studies of T. cruzi transmission conducted in and around Arequipa, Peru. We document the repeated occurrence of large colonies of triatomine bugs (more than 1000) with very high infection prevalence (more than 85%). By inoculating guinea pigs, an important reservoir of T. cruzi in Peru, and feeding triatomine bugs on them weekly, we demonstrate that, while most animals quickly control parasitaemia, a subset of animals remains highly infectious to vectors for many months. However, we argue that the presence of these persistently infectious hosts is insufficient to explain the observed prevalence of T. cruzi in vector colonies. We posit that seasonal rains, leading to a fluctuation in the price of guinea pig food (alfalfa), leading to annual guinea pig roasts, leading to a concentration of vectors on a small subpopulation of animals maintained for reproduction, can propel T. cruzi through vector colonies and create a considerable force of infection for a pathogen whose transmission might otherwise fizzle out. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  16. Benign anatomical mistakes: the correct anatomical term for the recurrent laryngeal nerve. (United States)

    Mirilas, Petros; Skandalakis, John E


    The term recurrent laryngeal nerve has been adopted by Nomina Anatomica (1989) and Terminologia Anatomica (1998) to describe this vagus branch from its origin, its turn dorsally around the subclavian artery and the aortic arch, and its cranial pathway until it reaches its terminal organs in the neck. However, there is still much confusion, and either the terms inferior and recurrent laryngeal nerve are used interchangeably or inferior laryngeal nerve is considered the terminal branch of the recurrent laryngeal nerve. We hereby feel that it is necessary to reassess the term and we propose the term inferior laryngeal nerve for the entire nerve under consideration, from its origin from the vagus nerve to its destinations, including tracheal, esophageal, and pharyngeal branches. If the term superior laryngeal nerve is a given, standard and accepted term in the anatomical terminology, then logically the term inferior laryngeal nerve should also be accepted, as opposed to it. Of course the upward travel of the inferior laryngeal nerve is "recurrent". When nonrecurrence is encountered together with an arteria lusoria, a retroesophageal right subclavian artery or a right aortic arch, we consider that the term nonrecurrent inferior laryngeal nerve should be used to describe the deviation from the normal.

  17. A quantitative comparison of the electrical and anatomical definition of the pulmonary vein ostium. (United States)

    Spies, Florian; Kühne, Michael; Reichlin, Tobias; Osswald, Stefan; Sticherling, Christian; Knecht, Sven


    Anatomically guided pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. However, the position where to confirm electrical isolation is ill-defined. The aim of the current study was to quantify the relationship between the anatomical and electrical definition of the pulmonary vein ostium. We analyzed 20 patients with paroxysmal AF undergoing PVI using radiofrequency energy and an electroanatomical mapping system. The anatomical ostium was defined based on the geometry obtained from preprocedural magnetic resonance imaging and computed tomography. The electrical ostium was defined at the position with a far-field atrial signal preceding a sharp pulmonary vein (PV) signal without any isoelectric interval in between. The electrically defined ostia were 8.4 ± 4.7 mm more distal in the PV compared to the anatomically defined ostia. The distances varied considerably between the four PVs and were 10.5 ± 6.5 mm, 7.4 ± 4.3 mm, 5.3 ± 4.0 mm, and 8.3 ± 3.4 mm for the left superior, left inferior, right superior, and right inferior PVs, respectively (P  =  0.009). The position of the electrical and anatomical ostium differs markedly. The site of the electrical ostium is variable within the PV but always more distal in the PV compared to the site of the anatomical ostium. © 2017 Wiley Periodicals, Inc.

  18. Incidence and aetiology of talipes equino-varus with recent population changes. (United States)

    Paton, Robin W; Fox, Anna E; Foster, Anne; Fehily, Max


    This study looks at the changing incidence and aetiology of congenital talipes equinovarus due to the recent population changes within the area. Between 1st June 1992 and the 31st May 2006, 83 consecutive children (121 feet) born with fixed talipes equinovarus (TEV) were assessed and treated (an incidence of 1.6 per 1000 live births) in an observational longitudinal cohort study assessing associated factors. There were 17 syndromal cases in the fixed group (20.8%), 6 cases of non-syndromal distal arthrogryposis (7.2%), and a strong family history in 12 cases (14.5%). This study would suggest that genetic and primary causes of fixed TEV are more common than previously considered. Many of the primary aetiologies were diagnosed months or years after birth.

  19. The aetiology of borderline personality disorder (BPD): contemporary theories and putative mechanisms. (United States)

    Winsper, Catherine


    This article presents an overview of current knowledge regarding the aetiology of Borderline Personality Disorder (BPD). It begins with a brief synopsis of early research and theory, and discusses how changing conceptualisations of BPD have impacted on our aetiological knowledge. Contemporary theories are described and presented within a developmental psychopathology framework. Deficient co-regulation and social communication in infancy are purported to underpin emotional dysregulation and social cognition deficits across development. These mechanisms are further potentiated by maladaptive social experiences in a series of positive feedback loops. Prospective research provides preliminary evidence for the reciprocal (or mediating) effects of maladaptive experiences and childhood dysregulation. Moving forward, cohort studies may incorporate neurobiological assessments to examine the biological systems underpinning phenotypic (e.g., impulsivity, disturbed relatedness) covariation. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  20. Aetiology and pathology of otitis media with effusion in adult life. (United States)

    Mills, R; Hathorn, I


    To gather and analyse information concerning the aetiology and pathology of otitis media with effusion in adults. A review of the English language literature from 1970 to the present was conducted. The available evidence suggests that otitis media with effusion in adult life is best viewed as a syndrome with a number of causes, including: infiltration of the eustachian tube by nasopharyngeal carcinoma and other local malignancies; changes in the middle ear and eustachian tube induced by radiotherapy; and systemic disease. There is now a body of evidence specifically related to the aetiology and pathology of otitis media with effusion in adult life. However, further research is required to fill in the gaps in our knowledge and understanding of this condition.

  1. The aetiology of acute and chronic pancreatitis over time in a hospital in Copenhagen

    DEFF Research Database (Denmark)

    Nøjgaard, Camilla; Bendtsen, Flemming; Matzen, Peter


    INTRODUCTION: The change in aetiology over time of acute and chronic pancreatitis has been sparsely described, as has also the validity of the diagnostic codes. The aim of the study was 1) to clarify whether the aetiology of acute and chronic pancreatitis changed during the period 1983-2005, and 2......) to validate the diagnostic codes over time for acute and chronic pancreatitis registered in the Danish National Patient Registry (NPR) in the same period. MATERIAL AND METHODS: All admissions at Hvidovre Hospital coded in the NPR in 1983, 1994 and 2005 with a diagnosis of either acute or chronic pancreatitis......: Gallstone disease significantly (p = 0.04) increased as the cause of acute pancreatitis over the 22-year period, while alcohol remained the major cause of chronic pancreatitis. The validity of the diagnoses for patients with acute pancreatitis varied between 51% and 73%, and for chronic pancreatitis between...

  2. Chronic kidney disease of unknown aetiology and ground-water ionicity: study based on Sri Lanka. (United States)

    Dharma-Wardana, M W C; Amarasiri, Sarath L; Dharmawardene, Nande; Panabokke, C R


    High incidence of chronic kidney disease of unknown aetiology (CKDU) in Sri Lanka is shown to correlate with the presence of irrigation works and rivers that bring-in 'nonpoint source' fertilizer runoff from intensely agricultural regions. We review previous attempts to link CKDU with As, Cd and other standard toxins. Those studies (e.g. the WHO-sponsored study), while providing a wealth of data, are inconclusive in regard to aetiology. Here, we present new proposals based on increased ionicity of drinking water due to fertilizer runoff into the river system, redox processes in the soil and features of 'tank'-cascades and aquifers. The consequent chronic exposure to high ionicity in drinking water is proposed to debilitate the kidney via a Hofmeister-type (i.e. protein-denaturing) mechanism.

  3. Behavioural phenotypes and special educational needs: is aetiology important in the classroom? (United States)

    Reilly, C


    A number of genetic conditions with associated intellectual disability and/or special educational needs have increasingly well-defined behavioural phenotypes. Thus, the concept of 'behavioural phenotype' and aetiology of intellectual disability may be important with regard to school-based interventions. The evidence for distinctive cognitive and behavioural aspects of five of the most common genetic syndromes (Down syndrome, fragile X syndrome, Williams syndrome, Prader-Willi syndrome and velo-cardio-facial syndrome) associated with special educational needs is reviewed with respect to key studies and findings. The possible utility of aetiology-related interventions in education is discussed with reference to arguments for and against such approaches with respect to published guidelines and published research. Behavioural phenotypes are probabilistic and many children with a specific genetic syndrome will share commonalities with other children with other genetic syndromes and within syndrome variability is not uncommon. There is evidence that teachers and parents have limited knowledge of aspects of the proposed cognitive and behaviour profiles associated with the reviewed syndromes. While there are published guidelines in the area of learning and behaviour for each of the five reviewed syndromes there is a limited amount of evidence of the efficacy of such approaches in school settings. It is likely that knowing the aetiology of a child's special educational needs will be helpful for staff who work in school settings in relation to cognitive and behavioural implications. However, how such knowledge might inform teaching practice or behavioural interventions has not been studied. A model is proposed that might help inform educators about the possible role of aetiology in the classroom. © 2012 The Author. Journal of Intellectual Disability Research © 2012 Blackwell Publishing Ltd.

  4. Clinical Presentation, Aetiology, and Outcomes of Meningitis in a Setting of High HIV and TB Prevalence


    Thinyane, Keneuoe Hycianth; Motsemme, Keanole Mofona; Cooper, Varsay Jim Lahai


    Meningitis causes significant morbidity and mortality globally. The aim of this study was to study the clinical presentation, aetiology, and outcomes of meningitis among adult patients admitted to Queen Mamohato Memorial Hospital in Maseru, Lesotho, with a diagnosis of meningitis. A cross-sectional study was conducted between February and April 2014; data collected included presenting signs and symptoms, laboratory results, and clinical outcomes. Descriptive statistics were used to summarise ...

  5. Understanding the aetiology and resolution of chronic otitis media from animal and human studies


    Bhutta, Mahmood F; Thornton, Ruth B; Kirkham, Lea-Ann S; Kerschner, Joseph E; Cheeseman, Michael T


    ABSTRACT Inflammation of the middle ear, known clinically as chronic otitis media, presents in different forms, such as chronic otitis media with effusion (COME; glue ear) and chronic suppurative otitis media (CSOM). These are highly prevalent diseases, especially in childhood, and lead to significant morbidity worldwide. However, much remains unclear about this disease, including its aetiology, initiation and perpetuation, and the relative roles of mucosal and leukocyte biology, pathogens, a...

  6. [Nature meets nurture: the importance of epigenetics for the aetiology of psychiatric diseases]. (United States)

    Buchholz, V; Kotsiari, A; Bleich, S; Frieling, H


    A successful therapy requires an understanding and investigation of the aetiology of a disease. Psychiatric diseases represent a special challenge, because environmental factors may play a crucial role in their development as well as possible physiological and genetic causes. Therefore, epigenetics has established itself to be a branch of research that studies the effect of environmental factors on the development of psychiatric diseases, leading to promising new approaches for diagnosis and therapy. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiology

    Directory of Open Access Journals (Sweden)

    Sharon L. Brennan-Olsen


    Conclusions: The observed paucity of data and suggestion of continent-specific differences indicate an urgent need for further research regarding indigenous status and fracture epidemiology and aetiology. Our findings also have implications for communities, governments and healthcare professionals to enhance the prevention of trauma-related fractures in indigenous persons, and an increased focus on modifiable lifestyle behaviours to prevent osteoporotic fractures in all populations.

  8. Posterior Laryngitis- Aetiology,Treatment and Health-Related Quality of Life


    Pendleton, Hillevi


    Posterior laryngitis (PL) is defined as an inflammation involving the posterior part of the glottal region in conjunction with symptoms. The cause is multifactorial. The aims of the work presented in this thesis were to examine symptoms, physical signs, different aetiologies and health-related quality of life (HRQOL) in patients with PL and/or oesophageal dysmotility. In paper I, a group of patients diagnosed as having PL were examined, treated and followed, to determine whether follo...


    Directory of Open Access Journals (Sweden)

    Chandrakala Guruprasad Yelwanti


    Full Text Available BACKGROUND The heart failure is a worldwide health problem with ever increasing proportion and is a major health problem in elderly persons. It has many aetiological factors. It is one of the most frequently encountered illnesses in day-to-day practice and most common cause of death in patients with cardiac disease. This study was done to determine the age and sex distribution and to evaluate clinical features and aetiological factors in patients admitted with heart failure at Khaja Banda Nawaz Teaching and General Hospital, Gulbarga, on the basis of clinical assessment, electrocardiography and echocardiography. MATERIALS AND METHODS A prospective study was done in Department of General Medicine at Khaja Banda Nawaz Teaching and General Hospital, Gulbarga, from January 2015 to June 2016 on patients with heart failure to determine the clinical and aetiological profile. A total of 100 cases above the age of 20 years were included in the study. The patients below the age of 20 years and known cases of congenital heart disease were excluded. RESULTS Out of 100 patients, the heart failure was seen more commonly in men than in women between the age groups of 46-65 years of age. Breathlessness was the most common presentation followed by pedal oedema, orthopnoea, etc. In our study, the primary aetiology for heart failure was found to be coronary artery disease (47% followed by dilated cardiomyopathy (20%, hypertension (14%, rheumatic heart disease (7%, anaemia (6%, cor pulmonale (4% and others (2%. Dyslipidaemia was the common risk factor followed by obesity and smoking. CONCLUSION The heart failure commonly occurs in elderly people and the incidence was higher in men than in women. The commonest presentation was breathlessness followed by pedal oedema. The commonest cause of heart failure was coronary artery disease followed by dilated cardiomyopathy and then hypertension combined with ischaemic heart disease.

  10. New data on aetiology of nodular gill disease in rainbow trout, Oncorhynchus mykiss

    Czech Academy of Sciences Publication Activity Database

    Dyková, Iva; Kostka, Martin; Wortberg, F.; Nardy, E.; Pecková, Hana


    Roč. 57, č. 3 (2010), s. 157-163 ISSN 0015-5683 R&D Projects: GA ČR GA524/09/0137; GA MŠk LC522 Institutional research plan: CEZ:AV0Z60220518 Keywords : nodular gill disease * aetiological study * amoebae * Naegleria sp. * fish diseases * aquaculture * Oncorhynchus mykiss Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 1.533, year: 2010

  11. Theories of urinary incontinence causation: aetiological descriptions by sub-Saharan African women. (United States)

    Morhason-Bello, Imran O; Ojengbede, Oladosu A; Adedokun, Babatunde O; Okonkwo, Ngozi S; Kolade, Charles


    To describe the perceived causes of urinary incontinence (UI) and factors associated with awareness of causes of UI among women in the community. Secondary analysis of data extracted from the Ibadan Urinary Incontinence Household Survey (IUIHS), a multi-stage community survey conducted among 5001 women in Nigeria. The mean age was 34.8 years (SD=14.2). The majority had at least secondary education and were currently married. Within this population, 13% had ever leaked urine. On their perception of possible aetiological factors of UI, 20.5% mentioned pelvic floor or bladder-related causes such as stress incontinence triggers and bladder problems; 14.6% mentioned uncontrollable factors such as medical comorbidity, age and prior surgery; 8.8% attributed the cause to being female; and 6.8% mentioned sex-related factors. Multiple logistic regression analysis revealed significantly lower odds of awareness of the aetiology of urinary incontinence among women aged less than 30 years, those with lower level of education, rural women, those with five or more children and women without history of urine leakage. The study shows a low level of awareness of possible cause of UI amongst women surveyed. We recommend health education and mobilization of women on the right aetiological factors of UI. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  12. Aetiology of maxillofacial fractures: a review of published studies during the last 30 years. (United States)

    Boffano, Paolo; Kommers, Sofie C; Karagozoglu, K Hakki; Forouzanfar, Tymour


    The epidemiology of facial trauma may vary widely across countries (and even within the same country), and is dependent on several cultural and socioeconomic factors. We know of few reviews of published reports that have considered the sex distribution and aetiology of maxillofacial trauma throughout the world. The aim of this review was to discuss these aspects as they have been presented in papers published during the last 30 years. We made a systematic review of papers about the epidemiology of maxillofacial trauma that were published between January 1980 and December 2013 and identified 69 studies from Africa (n=9), North America and Brazil (n=6), Asia (n=36), Europe (n=16), and Oceania (n=2). In all the studies men outnumbered women, the ratio usually being more than 2:1. In American, African, and Asian studies road traffic crashes were the predominant cause. In European studies the aetiology varied, with assaults and road traffic crashes being the most important factors. In Oceania assaults were the most important. A comparison of the incidence of maxillofacial trauma of different countries together with a knowledge of different laws (seat belts for drivers, helmets for motocyclists, speed limits, and protection worn during sports and at work) is crucial to allow for improvement in several countries. To our knowledge this paper is the first attempt to study and compare the aetiologies of maxillofacial trauma. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. An investigation into febrile illnesses of unknown aetiology in Wipim, Papua New Guinea. (United States)

    Bande, Grace; Hetzel, Manuel W; Iga, Jonah; Barnadas, Celine; Mueller, Ivo; Siba, Peter M; Horwood, Paul F


    In Papua New Guinea the aetiology of febrile illnesses remains poorly characterized, mostly due to poor diagnostic facilities and the inaccessibility of much of the rural areas of the country. We investigated the aetiological agents of febrile illnesses for 136 people presenting to Wipim Health Centre in Western Province, Papua New Guinea. Arboviral and rickettsial real-time polymerase chain reaction (PCR) assays, malaria blood smears and a malaria PCR test were used to identify pathogens associated with a history of fever. In 13% (n = 18) of cases an aetiological agent was identified. Dengue virus type 1 was detected in 11% (n = 15) of the samples tested and malaria in 2% (n = 3). None of the other arboviral or rickettsial pathogens tested for were detected in any of the samples. Although dengue viruses have been identified in Papua New Guinea using serological methods, this study represents the first direct detection of dengue in the country. The detection of malaria, on the other hand, was surprisingly low considering the previous notion that this was a hyperendemic region of Papua New Guinea.

  14. Non-traumatic cortical subarachnoid haemorrhage: diagnostic work-up and aetiological background

    Energy Technology Data Exchange (ETDEWEB)

    Spitzer, C.; Kosinski, C.M. [University Hospital of RWTH Aachen, Department of Neurology, Aachen (Germany); Mull, M. [University Hospital of RWTH Aachen, Department of Neuroradiology, Aachen (Germany); Rohde, V. [University Hospital of RWTH Aachen, Department of Neurosurgery, Aachen (Germany)


    Only 15% of all subarachnoid haemorrhages (SAHs) are not of aneurysmal origin. Among those, circumscribed SAHs along the cortical convexity are rare and have only been described in singular case reports so far. Here, we present a collection of 12 cases of SAH along the convexity, of non-traumatic origin. Over a period of 10 years, 12 cases of circumscribed SAH along the convexity were identified at our clinic. The clinical presentations, neuroradiological SAH characteristics, further diagnostic work-up to identify the underlying aetiologies, the therapy and clinical outcome were analysed. The patients' chief complaints were unspecific cephalgia, focal or generalised seizures and focal neurological deficits. Typical signs of basal SAH, such as nuchal rigidity, thunderclap-headache or alteration of consciousness, were rare. Magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) revealed different aetiologies, namely postpartal posterior encephalopathy (three), cerebral vasculitis (two), dural sinus thrombosis (two), cortical venous thrombosis (one), intracerebral abscesses (one) and cerebral cavernoma (one). Two cases remained unresolved. Treatment of the underlying disease and symptomatic medication led to good clinical outcome in almost all cases. On the basis of these findings, we demonstrate that the clinical presentation, localisation and aetiology of cortical SAH differ clearly from other SAHs. A diagnostic work-up with MRI and eventually DSA is essential. Mostly, the causative disease can be identified, and specific treatment allows a favourable outcome. (orig.)

  15. Mental disorders of known aetiology and precision medicine in psychiatry: a promising but neglected alliance. (United States)

    Fraguas, D; Díaz-Caneja, C M; State, M W; O'Donovan, M C; Gur, R E; Arango, C


    Personalized or precision medicine is predicated on the assumption that the average response to treatment is not necessarily representative of the response of each individual. A commitment to personalized medicine demands an effort to bring evidence-based medicine and personalized medicine closer together. The use of relatively homogeneous groups, defined using a priori criteria, may constitute a promising initial step for developing more accurate risk-prediction models with which to advance the development of personalized evidence-based medicine approaches to heterogeneous syndromes such as schizophrenia. However, this can lead to a paradoxical situation in the field of psychiatry. Since there has been a tendency to loosely define psychiatric disorders as ones without a known aetiology, the discovery of an aetiology for psychiatric syndromes (e.g. 22q11.2 deletion syndrome in some cases of schizophrenia), while offering a path toward more precise treatments, may also lead to their reclassification away from psychiatry. We contend that psychiatric disorders with a known aetiology should not be removed from the field of psychiatry. This knowledge should be used instead to guide treatment, inasmuch as psychotherapies, pharmacotherapies and other treatments can all be valid approaches to mental disorders. The translation of the personalized clinical approach inherent to psychiatry into evidence-based precision medicine can lead to the development of novel treatment options for mental disorders and improve outcomes.

  16. Molar incisor hypomineralization: a study of aetiological factors in a group of UK children. (United States)

    Whatling, Rosemary; Fearne, Janice M


    The objectives were to investigate the aetiology of molar incisor hypomineralization (MIH), and to discuss previously published studies. One hundred and nine children attending the Department of Paediatric Dentistry at the Royal London Hospital were included in the study: 57 children with MIH and 52 controls. Their mothers completed a medical history interview. No significant associations were found with MIH and delivery and birth complications, breastfeeding, immunization history, other illnesses and allergies, general anaesthetics, fluoride history, and trauma or abscesses affecting the primary predecessors. A family history of enamel defects was more commonly reported for MIH children, but the association was not statistically significant. However, MIH was significantly more common among those whose mothers had experienced problems during pregnancy (P = 0.025), those who had chickenpox between the ages of 3 and 3.99 (P = 0.047), and those for whom amoxycillin was the only antibiotic they had received (P = 0.028). The aetiology of MIH remains unclear, and this study questions whether it is because of a lone aetiological insult. This study recommends further research looking at the links with chickenpox occurring around the third year of life and amoxycillin.

  17. Aetiology and types of neonatal seizures presenting at ayub teaching hospital abbottabad

    International Nuclear Information System (INIS)

    Najeeb, S.; Qureshi, A.M.; Rehman, A.U.; Ahmed, F.; Shah, S.


    Background: Neonatal seizures (NS) affect approximately 1% of neonates. Clonic, tonic, myoclonic and subtle seizures are the common types. Birth asphyxia, sepsis, metabolic derangements, intracranial bleed, kernicterus, tetanus and 5th day fits are the common aetiologies. This study was planned to evaluate the types and causes of neonatal seizures. Methods: It was a descriptive case series conducted at Ayub Teaching Hospital, Abbottabad from 12th December 2006 to 25th September 2007 on neonates having seizures. Serum chemistry, blood counts, cerebrospinal fluid examination and cranial ultrasound were done in all patients. Blood culture, renal and liver function tests, computerised tomography scan, metabolic and septic screening was done in selected patients. Descriptive statistics were applied for analysis. Results: Tonic clonic seizure was the commonest type (28%) followed by multi-focal clonic, and focal tonic seizures (25% each). Birth asphyxia was found to be the main aetiology (46%). Conclusion: Tonic clonic seizure was the commonest type and birth asphyxia the main aetiology identified in the majority of neonatal seizures. (author)

  18. High non-anatomic tunnel position rates in ACL reconstruction failure using both transtibial and anteromedial tunnel drilling techniques. (United States)

    Jaecker, Vera; Zapf, Tabea; Naendrup, Jan-Hendrik; Pfeiffer, Thomas; Kanakamedala, Ajay C; Wafaisade, Arasch; Shafizadeh, Sven


    Although it is well known from cadaveric and biomechanical studies that transtibial femoral tunnel (TT) positioning techniques are associated with non-anatomic tunnel positions, controversial data exist as so far no clinical differences could have been found, comparing transtibial with anteromedial techniques (AM). The purpose of the study was to analyze if graft failure following TT ACL reconstruction was more commonly associated with non-anatomic tunnel position in comparison with the AM technique. We hypothesized that, compared to AM techniques, non-anatomic tunnel positions correlate with TT tunnel positioning techniques. A total of 147 cases of ACL revision surgery were analyzed retrospectively. Primary ACL reconstructions were analyzed regarding the femoral tunnel drilling technique. Femoral and tibial tunnel positions were determined on CT scans using validated radiographic measurement methods. Correlation analysis was performed to determine differences between TT and AM techniques. A total of 101 cases were included, of whom 64 (63.4%) underwent the TT technique and 37 (36.6%) the AM technique for primary ACL reconstruction. Non-anatomic femoral tunnel positions were found in 77.2% and non-anatomical tibial tunnel positions in 40.1%. No correlations were found comparing tunnel positions in TT and AM techniques, revealing non-anatomic femoral tunnel positions in 79.7 and 73% and non-anatomic tibial tunnel positions in 43.7 and 35.1%, respectively (p > 0.05). Considerable rates of non-anatomic femoral and tibial tunnel positions were found in ACL revisions with both transtibial and anteromedial femoral drilling techniques. Despite the potential of placing tunnels more anatomically using an additional AM portal, this technique does not ensure anatomic tunnel positioning. Consequently, the data highlight the importance of anatomic tunnel positioning in primary ACL reconstruction, regardless of the applied drilling technique.

  19. Role of medical history and medication use in the aetiology of upper aerodigestive tract cancers in Europe: the ARCAGE study.

    LENUS (Irish Health Repository)

    Macfarlane, T V


    The study aimed to investigate the role of medical history (skin warts, Candida albicans, herpetic lesions, heartburn, regurgitation) and medication use (for heartburn; for regurgitation; aspirin) in the aetiology of upper aerodigestive tract (UADT) cancer.

  20. Determining customer satisfaction in anatomic pathology. (United States)

    Zarbo, Richard J


    Measurement of physicians' and patients' satisfaction with laboratory services has become a standard practice in the United States, prompted by national accreditation requirements. Unlike other surveys of hospital-, outpatient care-, or physician-related activities, no ongoing, comprehensive customer satisfaction survey of anatomic pathology services is available for subscription that would allow continual benchmarking against peer laboratories. Pathologists, therefore, must often design their own local assessment tools to determine physician satisfaction in anatomic pathology. To describe satisfaction survey design that would elicit specific information from physician customers about key elements of anatomic pathology services. The author shares his experience in biannually assessing customer satisfaction in anatomic pathology with survey tools designed at the Henry Ford Hospital, Detroit, Mich. Benchmarks for physician satisfaction, opportunities for improvement, and characteristics that correlated with a high level of physician satisfaction were identified nationally from a standardized survey tool used by 94 laboratories in the 2001 College of American Pathologists Q-Probes quality improvement program. In general, physicians are most satisfied with professional diagnostic services and least satisfied with pathology services related to poor communication. A well-designed and conducted customer satisfaction survey is an opportunity for pathologists to periodically educate physician customers about services offered, manage unrealistic expectations, and understand the evolving needs of the physician customer. Armed with current information from physician customers, the pathologist is better able to strategically plan for resources that facilitate performance improvements in anatomic pathology laboratory services that align with evolving clinical needs in health care delivery.

  1. Anatomic breast coordinate system for mammogram analysis

    DEFF Research Database (Denmark)

    Karemore, Gopal; Brandt, S.; Karssemeijer, N.


    inside the breast. Most of the risk assessment and CAD modules use a breast region in a image centered Cartesian x,y coordinate system. Nevertheless, anatomical structure follows curve-linear trajectories. We examined an anatomical breast coordinate system that preserves the anatomical correspondence...... between the mammograms and allows extracting not only the aligned position but also the orientation aligned with the anatomy of the breast tissue structure. Materials and Methods The coordinate system used the nipple location as the point A and the border of the pectoral muscle as a line BC. The skin air...... interface was identified as a curve passing through A and intersecting the pectoral muscle line. The nipple was defined as the origin of the coordinate system. A family of second order curves were defined through the nipple and intersecting the pectoral line (AD). Every pixel location in mammogram...

  2. Anatomic Eponyms in Neuroradiology: Head and Neck. (United States)

    Bunch, Paul M


    In medicine, an eponym is a word-typically referring to an anatomic structure, disease, or syndrome-that is derived from a person's name. Medical eponyms are ubiquitous and numerous. They are also at times controversial. Eponyms reflect medicine's rich and colorful history and can be useful for concisely conveying complex concepts. Familiarity with eponyms facilitates correct usage and accurate communication. In this article, 22 eponyms used to describe anatomic structures of the head and neck are discussed. For each structure, the author first provides a biographical account of the individual for whom the structure is named. An anatomic description and brief discussion of the structure's clinical relevance follow. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  3. Lacrimal Gland Pathologies from an Anatomical Perspective

    Directory of Open Access Journals (Sweden)

    Mahmut Sinan Abit


    Full Text Available Most of the patients in our daily practice have one or more ocular surface disorders including conjucntivitis, keratitis, dry eye disease, meibomian gland dysfunction, contact lens related symptoms, refractive errors,computer vision syndrome. Lacrimal gland has an important role in all above mentioned pathologies due to its major secretory product. An anatomical and physiological knowledge about lacrimal gland is a must in understanding basic and common ophthalmological cases. İn this paper it is aimed to explain the lacrimal gland diseases from an anatomical perspective.

  4. [Remote results of using prostaglandins E1 and immunotherapy in combined modality treatment of various-aetiology trophic ulcers]. (United States)

    Alekhin, D I; Mikhaĭlova, O A; Sumnaia, D B; Dodonov, N P; Baltrushevich, O A


    The purpose of this study was to assess short- and long-term efficacy of combined-modality therapy (comprising PGE1-group preparations and immunocorrection) used to treat indolent trophic ulcers in patients presenting with chronic venous insufficiency (CVI) and cutaneous angiitis. Examined herein were both immediate and remote therapeutic outcomes obtained in patients suffering from indolent trophic ulcers secondary to CVI (post-thrombophlebic disease [PTPD] and varicose disease [VD]), as well as ulcers resulting from vasculitis or vasculopathy. The conventional therapy was supplemented with infusion of PGE1-group preparations and immunocorrection. Also investigated were the indices of microcirculation and the immune status, the percentage of the trophic ulcers having healed, the trophic-ulcer recurrence rate in the remote period, feasibility offurther performing a radical surgical intervention, the patients' quality of life after the treatment, and the need for repeat therapeutic courses according to the regimen proposed. The use of PGE1-group preparations in a combination with immunocorrection confirmed high efficacy of the treatment for various-aetiology trophic ulcers (with the preserved arterial blood flow). The trophic ulcers were observed to epithelialize rapidly following the initiation of treatment, thus making it possible to appropriately prepare the patient suffering from varicose disease for further surgical management. The remote-period evidence clearly showed that the use of the proposed therapeutic regimen had eventually led to a considerable improvement in the patients' quality of life, dramatically decreasing the recurrence rate of trophic ulcers in patients with PTPD and vasculopathies, and thus may safely be recommended both for prevention of ulcer relapses and as part of maintaining therapeutic courses. The detected deviations in the immune status of the patients afflicted with vasculitis and those suffering from CVI confirmed the need for

  5. Lack of evidence for a role of islet autoimmunity in the aetiology of canine diabetes mellitus. (United States)

    Ahlgren, Kerstin M; Fall, Tove; Landegren, Nils; Grimelius, Lars; von Euler, Henrik; Sundberg, Katarina; Lindblad-Toh, Kerstin; Lobell, Anna; Hedhammar, Åke; Andersson, Göran; Hansson-Hamlin, Helene; Lernmark, Åke; Kämpe, Olle


    Diabetes mellitus is one of the most common endocrine disorders in dogs and is commonly proposed to be of autoimmune origin. Although the clinical presentation of human type 1 diabetes (T1D) and canine diabetes are similar, the aetiologies may differ. The aim of this study was to investigate if autoimmune aetiology resembling human T1D is as prevalent in dogs as previously reported. Sera from 121 diabetic dogs representing 40 different breeds were tested for islet cell antibodies (ICA) and GAD65 autoantibodies (GADA) and compared with sera from 133 healthy dogs. ICA was detected by indirect immunofluorescence using both canine and human frozen sections. GADA was detected by in vitro transcription and translation (ITT) of human and canine GAD65, followed by immune precipitation. Sections of pancreata from five diabetic dogs and two control dogs were examined histopathologically including immunostaining for insulin, glucagon, somatostatin and pancreas polypeptide. None of the canine sera analysed tested positive for ICA on sections of frozen canine or human ICA pancreas. However, serum from one diabetic dog was weakly positive in the canine GADA assay and serum from one healthy dog was weakly positive in the human GADA assay. Histopathology showed marked degenerative changes in endocrine islets, including vacuolisation and variable loss of immune-staining for insulin. No sign of inflammation was noted. Contrary to previous observations, based on results from tests for humoral autoreactivity towards islet proteins using four different assays, and histopathological examinations, we do not find any support for an islet autoimmune aetiology in canine diabetes mellitus.

  6. Lack of evidence for a role of islet autoimmunity in the aetiology of canine diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Kerstin M Ahlgren

    Full Text Available AIMS/HYPOTHESIS: Diabetes mellitus is one of the most common endocrine disorders in dogs and is commonly proposed to be of autoimmune origin. Although the clinical presentation of human type 1 diabetes (T1D and canine diabetes are similar, the aetiologies may differ. The aim of this study was to investigate if autoimmune aetiology resembling human T1D is as prevalent in dogs as previously reported. METHODS: Sera from 121 diabetic dogs representing 40 different breeds were tested for islet cell antibodies (ICA and GAD65 autoantibodies (GADA and compared with sera from 133 healthy dogs. ICA was detected by indirect immunofluorescence using both canine and human frozen sections. GADA was detected by in vitro transcription and translation (ITT of human and canine GAD65, followed by immune precipitation. Sections of pancreata from five diabetic dogs and two control dogs were examined histopathologically including immunostaining for insulin, glucagon, somatostatin and pancreas polypeptide. RESULTS: None of the canine sera analysed tested positive for ICA on sections of frozen canine or human ICA pancreas. However, serum from one diabetic dog was weakly positive in the canine GADA assay and serum from one healthy dog was weakly positive in the human GADA assay. Histopathology showed marked degenerative changes in endocrine islets, including vacuolisation and variable loss of immune-staining for insulin. No sign of inflammation was noted. CONCLUSIONS/INTERPRETATIONS: Contrary to previous observations, based on results from tests for humoral autoreactivity towards islet proteins using four different assays, and histopathological examinations, we do not find any support for an islet autoimmune aetiology in canine diabetes mellitus.


    Directory of Open Access Journals (Sweden)

    Radhakrishnan Natarajan


    Full Text Available BACKGROUND Portal Vein Thrombosis (PVT has become an increasingly recognisable disorder during evaluation of cases of abdominal pain with usage of widespread imaging techniques. VT can result due to various clinical conditions like chronic liver disease, infections, malignancies and hypercoagulable states. The aim of the study is to observe the clinical presentation and to do the aetiological workup of cases of PVT in a tertiary care centre. MATERIALS AND METHODS The study is a cross-sectional observational study done on patients having PVT who presented to Institute of Medical Gastroenterology, MMC and RGGGH, during the period of January 2016-July 2017 were taken up for the study. The clinical presentation of the above patients was observed and their aetiological workup were done. RESULTS Totally, 45 cases were taken into study. 27 were males and 18 were females. Clinical presentation- The main symptoms were abdominal distension (18 patients, 51%, abdominal pain (10 patients, 27%, pain associated with diarrhoea and vomiting (5 patients, 14%, pain with nausea and anorexia (3 patients, 8%. Aetiological workup showed chronic liver disease (24 patients, 54%, prothrombotic states (9 patients, 20%, local factors, prothrombotic risks and idiopathic causes (12 patients, 26%. Detection of PVT were done mostly by portal vein Doppler (32 patients, 72% and computed tomography (13 patients, 27%. CONCLUSION Higher incidence of PVT were seen among patients with chronic liver disease. Prothrombotic states like myeloproliferative disorders and coagulation defects were the next common causes detected. PVT presenting as plain abdominal pain, pain associated with nausea, vomiting and diarrhoea were seen in patients as well thereby suggesting that PVT is an important differential diagnosis in patients presenting as abdominal pain with a negative workup for common causes. With the help of widespread and improved imaging techniques, earlier diagnosis of PVT can be


    Directory of Open Access Journals (Sweden)

    M. Amarendra


    Full Text Available BACKGROUND Respiratory distress is a common problem encountered within the first 48-72 hours of life. It is one of the commonest cause of admission to NICU. So, it is very important to know the aetiology and risk factors associated with development of respiratory distress to provide better management. The aim of the study is to study the aetiology of respiratory distress and the risk factors associated with development of respiratory distress in term newborns. MATERIALS AND METHODS Prospective study of 100 term newborns admitted in our NICU with respiratory distress. General information, history and clinical examination findings of mother and newborn were documented. Time of onset of respiratory distress and the severity of the distress were documented. Severity was assessed using Downe’s clinical scoring. X-ray was done at 6 hours in all newborns. Various aetiologies and risk factors associated with respiratory distress were assessed. RESULTS In our study, the most common cause of respiratory distress was transient tachypnoea of newborn seen in 59% cases followed by early onset sepsis 20% cases and meconium aspiration syndrome 17% cases. Majority of newborn had severe distress (42% followed by moderate distress (35% and mild distress (23%. The risk factors associated with development of respiratory distress were low socioeconomic status, more than four per vaginal examinations, meconium-stained liquor, caesarean section, low birth weight and male sex of the baby. CONCLUSION Transient tachypnoea of newborn is the most common cause of respiratory distress in term newborns and the risk factors for development of respiratory distress are low socioeconomic status, more than four per vaginal examinations, meconiumstained liquor, caesarean section, low birth weight and male sex of the baby. Early diagnosis and management of respiratory distress in newborn is needed to decrease the severity of the disease and to reduce the mortality.

  9. Anatomical and palynological characteristics of Salvia willeana ...

    African Journals Online (AJOL)



    Apr 5, 2010 ... investigated in this study and the findings obtained were compared with other studies conducted on Salvia genus. Metcalfe and Chalk (1950) found the data on the anatomical characteristics of S. species. These researchers revealed that the species belonging to Labiatae family usually have rectangle or ...

  10. Descriptions of anatomical differences between skulls and ...

    African Journals Online (AJOL)

    The external anatomical differences between the skulls and mandibles of 10 mountain zebras Equus zebra and 10 plains zebras E. burchelli of both sexes were studied. The nomenclature used conforms to Nomina Anatomica Veterinaria (1983). Eleven structural differences are described for the first time and illustrated, viz., ...

  11. HPV Vaccine Effective at Multiple Anatomic Sites (United States)

    A new study from NCI researchers finds that the HPV vaccine protects young women from infection with high-risk HPV types at the three primary anatomic sites where persistent HPV infections can cause cancer. The multi-site protection also was observed at l

  12. Report of a rare anatomic variant

    DEFF Research Database (Denmark)

    De Brucker, Y; Ilsen, B; Muylaert, C


    We report the CT findings in a case of partial anomalous pulmonary venous return (PAPVR) from the left upper lobe in an adult. PAPVR is an anatomic variant in which one to three pulmonary veins drain into the right atrium or its tributaries, rather than into the left atrium. This results in a lef...

  13. Morphological and anatomical response of Acacia ehrenbergiana ...

    African Journals Online (AJOL)

    Both species responded morphologically as well as anatomically to water stress. Water stress caused significant (P=0.05) decrease in relative water content, leaf number and area and leaf water potential, chlorophyll content, and stem height and diameter. Seedlings of both species responded to water stress by the ...

  14. Anatomical characteristics of southern pine stemwood (United States)

    Elaine T. Howard; Floyd G. Manwiller


    To obtain a definitive description of the wood and anatomy of all 10 species of southern pine, juvenile, intermediate, and mature wood was sampled at three heights in one tree of each species and examined under a light microscope. Photographs and three-dimensional drawings were made to illustrate the morphology. No significant anatomical differences were found...


    Directory of Open Access Journals (Sweden)

    M. V. Demesсhenko


    Full Text Available Purpose: to identify anatomical landmarks on tibial articular surface to serve as reference in preparing tibial canal with respect to the center of ACL footprint during single bundle arthroscopic repair.Materials and methods. Twelve frozen knee joint specimens and 68 unpaired macerated human tibia were studied using anatomical, morphometric, statistical methods as well as graphic simulation.Results. Center of the tibial ACL footprint was located 13,1±1,7 mm anteriorly from posterior border of intercondylar eminence, at 1/3 of the distance along the line connecting apexes of internal and external tubercles and 6,1±0,5 mm anteriorly along the perpendicular raised to this point.Conclusion. Internal and external tubercles, as well as posterior border of intercondylar eminence can be considered as anatomical references to determine the center of the tibial ACL footprint and to prepare bone canals for anatomic ligament repair.

  16. Handbook of anatomical models for radiation dosimetry

    CERN Document Server

    Eckerman, Keith F


    Covering the history of human model development, this title presents the major anatomical and physical models that have been developed for human body radiation protection, diagnostic imaging, and nuclear medicine therapy. It explores how these models have evolved and the role that modern technologies have played in this development.

  17. Influences on anatomical knowledge: The complete arguments

    NARCIS (Netherlands)

    Bergman, E.M.; Verheijen, I.W.; Scherpbier, A.J.J.A.; Vleuten, C.P.M. van der; Bruin, A.B. De


    Eight factors are claimed to have a negative influence on anatomical knowledge of medical students: (1) teaching by nonmedically qualified teachers, (2) the absence of a core anatomy curriculum, (3) decreased use of dissection as a teaching tool, (4) lack of teaching anatomy in context, (5)

  18. Anatomical entity mention recognition at literature scale. (United States)

    Pyysalo, Sampo; Ananiadou, Sophia


    Anatomical entities ranging from subcellular structures to organ systems are central to biomedical science, and mentions of these entities are essential to understanding the scientific literature. Despite extensive efforts to automatically analyze various aspects of biomedical text, there have been only few studies focusing on anatomical entities, and no dedicated methods for learning to automatically recognize anatomical entity mentions in free-form text have been introduced. We present AnatomyTagger, a machine learning-based system for anatomical entity mention recognition. The system incorporates a broad array of approaches proposed to benefit tagging, including the use of Unified Medical Language System (UMLS)- and Open Biomedical Ontologies (OBO)-based lexical resources, word representations induced from unlabeled text, statistical truecasing and non-local features. We train and evaluate the system on a newly introduced corpus that substantially extends on previously available resources, and apply the resulting tagger to automatically annotate the entire open access scientific domain literature. The resulting analyses have been applied to extend services provided by the Europe PubMed Central literature database. All tools and resources introduced in this work are available from Supplementary data are available at Bioinformatics online.

  19. Anatomically Plausible Surface Alignment and Reconstruction

    DEFF Research Database (Denmark)

    Paulsen, Rasmus R.; Larsen, Rasmus


    With the increasing clinical use of 3D surface scanners, there is a need for accurate and reliable algorithms that can produce anatomically plausible surfaces. In this paper, a combined method for surface alignment and reconstruction is proposed. It is based on an implicit surface representation ...

  20. Mycotoxic nephropathy in Bulgarian pigs and chickens: complex aetiology and similarity to Balkan endemic nephropathy

    CSIR Research Space (South Africa)

    Stoev, SD


    Full Text Available , 1–17, iFirst Mycotoxic nephropathy in Bulgarian pigs and chickens: complex aetiology and similarity to Balkan Endemic Nephropathy S.D. Stoeva*, M.F. Duttonb, P.B. Njobehb, J.S. Mosonikb and P.A. Steenkampc aDepartment of General and Clinical... of fungi was done using the keys of Klich and Pitt (1988) and Klich (2002) for Aspergillus spp. and Pitt and Hocking (1997) for Penicillium and Nelson et al. (1983) for Fusarium spp. This was done by observing both macroscopic characteristics...

  1. Driveline infections in patients supported with a HeartMate II: Incidence, aetiology and outcome

    DEFF Research Database (Denmark)

    Bomholt, Tobias Peter Zwergius; Moser, Claus; Sander, Kaare


    Abstract Objectives. To investigate the incidence and outcome of driveline infections in patients supported with a continuous flow left ventricular assist device (HeartMate II (HMII)) and to study the microbiological aetiology. Design. Retrospective analysis of 31 patients who received...... an implantation of a HMII. Follow-up was from implantation to either device explantation, death or closure of the study. Clinical signs of infections were divided into superficial, deep or systemic and compared to culture and gram stain, the clinical course and infectious parameters. Results. The incidence...

  2. [Japanese anatomical terminology (nomina anatomica japonica) from the educational view point (1)--sune and nezumi]. (United States)

    Hojo, T


    A few considerations on two Japanese anatomical terms, sune (the anterior part of the leg or the shin in medical terminology) and nezumi (the rat) from the anatomical point of view are made. Japanese words generally have two readings. For example, sune which means the anterior part of the leg, may be read as sune and kei. But kei has two other meanings, the neck and the road. Sune is used more for the anterior part of the leg than kei, especially in classes for beginners of the anatomical course. Nezumi means rat, but is also read as so. Because kei means road, and kan means canal, sokeikan means the rat's tubular passageway, namely, the descent of testis (Descensus testis). In Japanese anatomical terminology the passage of the testis through the inguinal canal is considered similar to a rat going through a passageway. The work sokeikan is better than the English anatomical term inguinal canal which means only the canal in the root of the groin. In Japanese, two words, fukurahagi and komura are used for the posterior part of the leg.


    Directory of Open Access Journals (Sweden)

    V. N. Bubenchikova


    Full Text Available The article present results of the study for a anatomic structure of Campanula rotundifolia grass from Campanulaceae family. Despite its dispersion and application in folk medicine, there are no data about its anatomic structure, therefore to estimate the indices of authenticity and quality of raw materials it is necessary to develop microdiagnostical features in the first place, which could help introducing of thisplant in a medical practice. The purpose of this work is to study anatomical structureof Campanula rotundifolia grass to determine its diagnostic features. Methods. Thestudy for anatomic structure was carried out in accordance with the requirements of State Pharmacopoeia, edition XIII. Micromed laboratory microscope with digital adjutage was used to create microphotoes, Photoshop CC was used for their processing. Result. We have established that stalk epidermis is prosenchymal, slightly winding with straight of splayed end cells. After study for the epidermis cells we established that upper epidermis cells had straight walls and are slightly winding. The cells of lower epidermishave more winding walls with prolong wrinkled cuticule. Presence of simple one-cell, thin wall, rough papillose hair on leaf and stalk epidermis. Cells of epidermis in fauces of corolla are prosenchymal, with winding walls, straight or winding walls in a cup. Papillary excrescences can be found along the cup edges. Stomatal apparatus is anomocytic. Conclusion. As the result of the study we have carried out the research for Campanula rotundifolia grass anatomic structure, and determined microdiagnostic features for determination of raw materials authenticity, which included presence of simple, one-cell, thin-walled, rough papillose hair on both epidermises of a leaf, along the veins, leaf edge, and stalk epidermis, as well as the presence of epidermis cells with papillary excrescences along the edges of leaves and cups. Intercellular canals are situatedalong the

  4. Life course models: improving interpretation by consideration of total effects. (United States)

    Green, Michael J; Popham, Frank


    Life course epidemiology has used models of accumulation and critical or sensitive periods to examine the importance of exposure timing in disease aetiology. These models are usually used to describe the direct effects of exposures over the life course. In comparison with consideration of direct effects only, we show how consideration of total effects improves interpretation of these models, giving clearer notions of when it will be most effective to intervene. We show how life course variation in the total effects depends on the magnitude of the direct effects and the stability of the exposure. We discuss interpretation in terms of total, direct and indirect effects and highlight the causal assumptions required for conclusions as to the most effective timing of interventions. © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association.

  5. A Review of Salivary Gland Malignancies: Common Histologic Types, Anatomic Considerations, and Imaging Strategies. (United States)

    Lobo, Remy; Hawk, Jeffrey; Srinivasan, Ashok


    Major and minor salivary gland malignancies come in various shapes and sizes. They can present as palpable masses or can be detected incidentally when imaging patients for other indications. A complete evaluation of salivary gland malignancies requires knowledge of the anatomy and various routes of spread of neoplasias. Computed tomography (CT) and MR imaging are complementary tools in this respect and offer useful information to the proceduralist. Advanced imaging (diffusion-weighted imaging and PET-CT) and other modalities (eg, ultrasound) help with characterization, although biopsy or excision is often needed for definitive tissue diagnosis. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. The Integration of Voice and Dance Techniques in Musical Theatre: Anatomical Considerations. (United States)

    Morton, Jennie


    Musical theatre performers are required to be proficient in the three artistic disciplines of dancing, singing, and acting, although in today's modern productions, there is often a requirement to incorporate other skills such as acrobatics and the playing of an instrument. This article focuses on the issues faced by performers when dancing and voicing simultaneously, as it is between these two disciplines where we see the greatest pedagogical divide in terms of breath management and muscle recruitment patterns. The traditional teaching methods of dance and voice techniques are examined, areas of conflict highlighted, and solutions proposed through an exploration of the relevant anatomy.

  7. The imaging anatomical consideration of the resonance of the cranial cavity

    International Nuclear Information System (INIS)

    Lee, Dong Myoung


    Because vocal technique is the basis of singing a song beautifully, so this study was undertaken to use the scientific and correct technique in order to get much better musical expressions. Shimadzu X-ray remote control TV system was used for checking the supporting state of diaphragmatic respiration after 5, 10, 15, 20, 25 and 30 sec during phonation in the state of full inhalation between professional singer and non-professional singer. Shimadzu Magnet nex-α(SMT-50CX/H) was used for examining the scattering state from the resonance of nasal caity to that of cranial cavity on the basis of diaphragmatic respiration. The results obtained were summerized as follows: 1. The resonance of cranial cavity must be scattered by the energy of diaphragmatic respiration after gathering the foci of the fundamental 5 vowels. 2. While raising the epiglottis, the resonance of nasal cavity must be clearly in order to maintain the resonance of cranial cavity beautifully. 3. We can get musical expressions by maintaining the elasticity of diaphragmatic respiration.=20

  8. Dysphagia after arteria lusoria dextra surgery: Anatomical considerations before redo-surgery. (United States)

    Mayer, Judith; van der Werf-Grohmann, Natascha; Kroll, Johannes; Spiekerkoetter, Ute; Stiller, Brigitte; Grohmann, Jochen


    Aberrant right subclavian artery (arteria lusoria) is the most common congenital root anomaly, remaining asymptomatic in most cases. Nevertheless, some of the 20%-40% of those affected present tracheo-esophageal symptoms. We report on a 6-year-old previously healthy girl presenting with progressive dysphagia over 4 wk. Diagnostics including barium swallow, echocardiography and magnetic resonance angiography (MRA) revealed a retro-esophageal compression by an aberrant right subclavian artery. Despite the successful, uneventful transposition of this arteria lusoria to the right common carotid via right-sided thoracotomy, the girl was suffering from persisting dysphagia. Another barium swallow showed the persistent compression of the esophagus on the level where the arteria lusoria had originated. As MRA showed no evidence of a significant re-obstruction by the transected vascular stump, we suspected a persisting ligamentum arteriosum. After a second surgical intervention via left-sided thoracotomy consisting of transecting the obviously persisting ligamentum and shortening the remaining arterial stump of the aberrant right subclavian artery, the patient recovered fully. In this case report we discuss the potential relevance of a persisting ligamentum arteriosum for patients with left aortic arch suffering from dysphagia lusoria and rational means of diagnosing, as well as the surgical options to prevent re-do surgery.

  9. Upper First Premolar Positioning Evaluation for the Stability of the Dental Occlusion: Anatomical Considerations. (United States)

    Sambataro, Sergio; Cervino, Gabriele; Fiorillo, Luca; Cicciù, Marco


    The present study aimed to find the proper distorotation of the upper first premolar to achieve the therapeutic ideal advocated for the stability of the human occlusion. Normal teeth were analyzed and occlusal photocopies of upper arch were made to perform the 2 measurements. The first parameter was the angle formed by the perpendicular to the wire through the buccal cusp and a line connecting the buccal and the lingual cusps of the upper first premolar. The second one was the angle from the buccal line and the sagittal plane of the model. The amount of distorotation was calculated and a method to bond the bracket was suggested.

  10. Port Placement via the Anterior Jugular Venous System: Case Report, Anatomic Considerations, and Literature Review

    Directory of Open Access Journals (Sweden)

    Gernot Rott


    Full Text Available We report on a patient who was referred for port implantation with a two-chamber pacemaker aggregate on the right and total occlusion of the central veins on the left side. Venous access for port implantation was performed via left side puncture of the horizontal segment of the anterior jugular vein system (AJVS and insertion of the port catheter using a crossover technique from the left to the right venous system via the jugular venous arch (JVA. The clinical significance of the AJVS and the JVA for central venous access and port implantation is emphasised and the corresponding literature is reviewed.

  11. Impact of lateral mass anatomic variation on ideal polyaxial screw head mobility: technical considerations. (United States)

    Ray, Wilson Z; Murphy, Rory K J; Dorward, Ian G; Lusis, Eriks A; Blackburn, Spiros L; Stewart, Todd


    To assess optimal angulation characteristics of lateral mass screws for subaxial (C3 to C6) fixation of the cervical spine in the neutral position. In the typical Magerl or Anderson placement technique, the screw trajectory is ideally parallel to the facet joint. For the rod and screw to align properly, the screw head must rotate enough to become perpendicular to the rod. If the optimal angle for the screw head is limited by the screw design, abnormal torsional forces will be generated at the rod/screw interface inducing kyphosis. In this paper, we examined the spinal anatomy in patients with normal CTs to determine the necessary range of motion between tulip head and screw to prevent forced persuasion and abnormal cervical spine alignment. We examined subaxial radiographs of 292 vertebrae from C3 to C6 in 73 normal subjects. Computed tomography (CT) scans of the cervical spine with multiplanar reconstructions were evaluated in the axial and sagittal planes. A planned screw entry angle of 30° based upon the midpoint of the lateral mass was used in the axial plane, and parallel to the facet joint in the sagittal plane. The screw head angle (SHA) was then calculated from this 3D measured angle. The measured SHA ranged from 27 to 60°. The average SHA was 43.8°. The average SHA was not significantly different between the levels measured with consistent range and standard deviation. Seventy-six percent (223/292) of levels measured required a SHA >40°, and 12% (36/292) required a SHA >50°. The authors recommend using cervical instrumentation systems that allow for at least 55° of freedom of the polyaxial head to prevent abnormal segmental forces. In systems with lesser angulation, technique modifications must be applied to prevent translational forces.

  12. Magnetic resonance imaging of the visual pathway - anatomical and technical considerations

    International Nuclear Information System (INIS)

    Sosnowski, P.; Paprzycki, W.


    Magnetic resonance tomography creates possibility of imaging the whole visual pathway and is superior to CT. Plenitude of MR techniques can sometimes be the reason of unnecessary prolongation of the examination. This study tries to evaluate usefulness of different MR techniques and planes for optimal imaging of consecutive sections of visual pathway. (author)

  13. Secondary Progressive and Relapsing Remitting Multiple Sclerosis Leads to Motor-Related Decreased Anatomical Connectivity

    DEFF Research Database (Denmark)

    Lyksborg, Mark; Siebner, Hartwig R.; Sørensen, Per S.


    Multiple sclerosis (MS) damages central white matter pathways which has considerable impact on disease-related disability. To identify disease-related alterations in anatomical connectivity, 34 patients (19 with relapsing remitting MS (RR-MS), 15 with secondary progressive MS (SP-MS) and 20 healthy...... subjects underwent diffusion magnetic resonance imaging (dMRI) of the brain. Based on the dMRI, anatomical connectivity mapping (ACM) yielded a voxel-based metric reflecting the connectivity shared between each individual voxel and all other brain voxels. To avoid biases caused by inter-individual brain......-shape differences, they were estimated in a spatially normalized space. Voxel-based statistical analyses using ACM were compared with analyses based on the localized microstructural indices of fractional anisotropy (FA). In both RR-MS and SP-MS patients, considerable portions of the motor-related white matter...

  14. Pituitary transcription factors in the aetiology of combined pituitary hormone deficiency. (United States)

    Pfäffle, R; Klammt, J


    The somatotropic axis is the central postnatal regulator of longitudinal growth. One of its major components--growth hormone--is produced by the anterior lobe of the pituitary, which also expresses and secretes five additional hormones (prolactin, thyroid stimulating hormone, follicle stimulating hormone, luteinizing hormone, adrenocorticotropic hormone). Proper development of the pituitary assures the regulation of critical processes such as metabolic control, puberty and reproduction, stress response and lactation. Ontogeny of the adenohypophysis is orchestrated by inputs from neighbouring tissues, cellular signalling molecules and transcription factors. Perturbation of expression or function of these factors has been implicated in the aetiology of combined pituitary hormone deficiency (CPHD). Mutations within the genes encoding for the transcription factors LHX3, LHX4, PROP1, and POU1F1 (PIT1) that act at different stages of pituitary development result in unique patterns of hormonal deficiencies reflecting their differential expression during organogenesis. In the case of LHX3 and LHX4 the phenotype may include extra-pituitary manifestations due to the function of these genes/proteins outside the pituitary gland. The remarkable variability in the clinical presentation of affected patients indicates the influence of the genetic background, environmental factors and possibly stochastic events. However, in the majority of CPHD cases the aetiology of this heterogeneous disease remains unexplained, which further suggests the involvement of additional genes. Identification of these factors might also help to close the gaps in our understanding of pituitary development, maintenance and function. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Role of Gut Microbiota in the Aetiology of Obesity: Proposed Mechanisms and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Muhammad Jaffar Khan


    Full Text Available The aetiology of obesity has been attributed to several factors (environmental, dietary, lifestyle, host, and genetic factors; however none of these fully explain the increase in the prevalence of obesity worldwide. Gut microbiota located at the interface of host and environment in the gut are a new area of research being explored to explain the excess accumulation of energy in obese individuals and may be a potential target for therapeutic manipulation to reduce host energy storage. Several mechanisms have been suggested to explain the role of gut microbiota in the aetiology of obesity such as short chain fatty acid production, stimulation of hormones, chronic low-grade inflammation, lipoprotein and bile acid metabolism, and increased endocannabinoid receptor system tone. However, evidence from animal and human studies clearly indicates controversies in determining the cause or effect relationship between the gut microbiota and obesity. Metagenomics based studies indicate that functionality rather than the composition of gut microbiota may be important. Further mechanistic studies controlling for environmental and epigenetic factors are therefore required to help unravel obesity pathogenesis.

  16. Chicken astrovirus as an aetiological agent of runting-stunting syndrome in broiler chickens. (United States)

    Kang, Kyung-Il; Linnemann, Erich; Icard, Alan H; Durairaj, Vijay; Mundt, Egbert; Sellers, Holly S


    Despite descriptions of runting-stunting syndrome (RSS) in broiler chickens dating back over 40 years, the aetiology has not yet been described. A novel chicken astrovirus (CkAstV) was isolated in an LMH liver cell line from the intestines of chickens affected with RSS. Clinical RSS is characterized by retarded growth and cystic crypt lesions in the small intestine. In 1-day-old broiler chickens infected with the CkAstV isolate, virus was only detected in the intestinal epithelial cells during the first few days after infection. Notably, the preferred host cells are the crypt epithelial cells following initial replication in the villous epithelial cells, thus implying viral preference for immature intestinal cells. Nevertheless, the CkAstV isolate did not induce remarkable pathological changes, despite the presence of the virus in situ. Serial chicken-to-chicken passages of the virus induced increased virulence, as displayed by decreased weight gain and the presence of cystic lesions in the small intestine reproducing clinical RSS in chickens. The analysis of the full-length genome sequences from the isolated CkAstV and the CkAstV from the bird-to-bird passages showed >99 % similarity. The data obtained in this study suggest that the CkAstV isolate is capable of inducing RSS following serial bird-to-bird passages in broilers and is as an aetiological agent of the disease.

  17. ENDOCRINOLOGY OF PREGNANCY: Gestational diabetes mellitus: definition, aetiological and clinical aspects. (United States)

    Baz, Baz; Riveline, Jean-Pierre; Gautier, Jean-François


    Gestational diabetes (GDM) is defined as a glucose intolerance resulting in hyperglycaemia of variable severity with onset during pregnancy. This review aims to revisit the pathogenesis and aetiology of GDM in order to better understand its clinical presentation and outcomes. During normal pregnancy, insulin sensitivity declines with advancing gestation. These modifications are due to placental factors, progesterone and estrogen. In a physiological situation, a compensatory increase in insulin secretion maintains a normal glucose homeostasis. GDM occurs if pancreatic β-cells are unable to face the increased insulin demand during pregnancy. GDM is most commonly a forerunner of type 2 diabetes (T2D) - the most prevalent form of diabetes. These women share similar characteristics with predisposed subjects to T2D: insulin resistance before and after pregnancy, and carry more T2D risk alleles. Auto-immune and monogenic diabetes are more rare aetiologies of GDM. Adverse pregnancy outcomes of GDM are mainly related to macrosomia caused by fetal hyperinsulinism in response to high glucose levels coming from maternal hyperglycaemia. Screening recommendations and diagnosis criteria of GDM have been recently updated. High risk patients should be screened as early as possible using fasting plasma glucose, and if normal, at 24-28 weeks of gestation using 75 g oral glucose tolerance test. The treatment of GDM is based on education with trained nurses and dieticians, and if necessary insulin therapy. © 2016 European Society of Endocrinology.

  18. Incidence, aetiology and prevention of musculoskeletal injuries in volleyball: A systematic review of the literature. (United States)

    Kilic, O; Maas, M; Verhagen, E; Zwerver, J; Gouttebarge, V


    Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies.

  19. A Latter-day Saint Approach to Addiction: Aetiology, Consequences and Treatment in a Theological Context

    Directory of Open Access Journals (Sweden)

    James D. Holt


    Full Text Available This article explores the theological underpinning of the nature, aetiology and treatment of addictions within The Church of Jesus Christ of Latter-day Saints. The first section outlines the “plan of salvation” and how this provides the theological framework for the source and solution to addictions. The final section explores addiction against this background in terms of its aetiology, types, consequences and treatment in a Latter-day Saint context. In so doing it builds on the recognition by the Church in recent years that addiction is a problem in the lives of some of its members and that treatment programs coherent with its teachings and beliefs are necessary. The article concludes by suggesting that while addiction may be more openly discussed within a Latter-day Saint context there is a need to keep this dialogue moving forward. This article does not examine Latter-day Saint teaching within the wider context of psychotherapy and other definitions of addiction; rather it explores the place of addiction as understood within the theological and ecclesiological context of Mormonism.

  20. Genetic evidence implicates the immune system and cholesterol metabolism in the aetiology of Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Lesley Jones


    Full Text Available Late Onset Alzheimer's disease (LOAD is the leading cause of dementia. Recent large genome-wide association studies (GWAS identified the first strongly supported LOAD susceptibility genes since the discovery of the involvement of APOE in the early 1990s. We have now exploited these GWAS datasets to uncover key LOAD pathophysiological processes.We applied a recently developed tool for mining GWAS data for biologically meaningful information to a LOAD GWAS dataset. The principal findings were then tested in an independent GWAS dataset.We found a significant overrepresentation of association signals in pathways related to cholesterol metabolism and the immune response in both of the two largest genome-wide association studies for LOAD.Processes related to cholesterol metabolism and the innate immune response have previously been implicated by pathological and epidemiological studies of Alzheimer's disease, but it has been unclear whether those findings reflected primary aetiological events or consequences of the disease process. Our independent evidence from two large studies now demonstrates that these processes are aetiologically relevant, and suggests that they may be suitable targets for novel and existing therapeutic approaches.

  1. The prevalence, aetiology and management of wounds in a community care area in Ireland.

    LENUS (Irish Health Repository)

    Skerritt, Louise


    This study aimed to establish the prevalence and aetiology of wounds, allowing an insight into the management of wound care, the use of dressings and the nursing time allocated to the provision of wound care in a community setting in Ireland. A cross-sectional survey was used, with data collected on all clients in the community who received treatment from public health nurses or community registered general nurses for wound care over a 1-week period in April 2013. A 98.9% response rate was realised, and 188 people were identified as having wounds, equating to a crude prevalence of 5% of the active community nursing caseload. A total of 60% (n=112) had leg ulcers, 22% (n=42) had pressure ulcers, 16% (n=30) had an acute wound (surgical or traumatic wounds), 1% (n=2) had a diabetic foot wound and a further 1% (n=2) had wounds of other aetiologies. The mean duration of wounds was 5.41 months. A total of 18% of wounds were identified as infected; however, 60% (n=112) of wounds had antimicrobial products in use as either a primary or secondary dressing. The study established that there is a significant prevalence of wounds in this community care area. There was absence of a clinical diagnosis in many cases, and evidence of inappropriate dressing use, risking an increase in costs and a decrease in good clinical outcomes. It also highlighted the importance of ongoing education and auditing in the provision of wound care.

  2. Viral pneumonia in adults in sub-Saharan Africa – epidemiology, aetiology, diagnosis and management

    Directory of Open Access Journals (Sweden)

    Antonia Ho


    Full Text Available Community-acquired pneumonia causes substantial morbidity and mortality in sub-Saharan Africa with an estimated 131 million new cases each year. Viruses – such as influenza virus, respiratory syncytial virus and parainfluenza virus – are now recognised as important causes of respiratory disease in older children and adults in the developed world following the emergence of sensitive molecular diagnostic tests, recent severe viral epidemics, and the discovery of novel viruses. Few studies have comprehensively evaluated the viral aetiology of adult pneumonia in Africa, but it is likely to differ from Western settings due to varying seasonality and the high proportion of patients with immunosuppression and co-morbidities. Emerging data suggest a high prevalence of viral pathogens, as well as multiple viral and viral/bacterial infections in African adults with pneumonia. However, the interpretation of positive results from highly sensitive polymerase chain reaction tests can be challenging. Therapeutic and preventative options against viral respiratory infections are currently limited in the African setting. This review summarises the current state of the epidemiology, aetiology, diagnosis and management of viral pneumonia in sub-Saharan Africa.

  3. South African Muslim Faith Healers perceptions of mental illness: understanding, aetiology and treatment. (United States)

    Ally, Yaseen; Laher, Sumaya


    The important role that religious beliefs may have on perceptions of mental illness cannot be ignored. Many religions including Islam advocate witchcraft and spirit possession--all of which are thought to influence the behaviour of a person so as to resemble that of a mentally ill individual. Thus this research explored Muslim Faith Healers perceptions of mental and spiritual illness in terms of their understanding of the distinctions between the two, the aetiologies and the treatments thereof. Six Muslim Healers in the Johannesburg community were interviewed and thematic content analysis was used to analyse the data. From the results it is clear that the faith healers were aware of the distinction between mental and spiritual illnesses. It was also apparent that Islam has a clear taxonomy that distinguishes illness and the causes thereof. Treatments are then advised accordingly. Thus this paper argues that the predominant Western view of the aetiology and understanding of mental illness needs to acknowledge the various culturally inclined taxonomies of mental illness so as to better understand and aid clients.

  4. Permanent Childhood Hearing Impairment: Aetiological Evaluation of Infants identified through the Irish Newborn Hearing Screening Programme

    LENUS (Irish Health Repository)

    Smith, A


    The Newborn Hearing Screening Programme (NHSP) was established in Cork University Maternity Hospital (CUMH) in April 2011. Between April 2011 and July 2014, 42 infants were identified with a Permanent Childhood Hearing Impairment (PCHI). Following this diagnosis, infants underwent a paediatric assessment according to recognised guidelines with the intention of identifying the underlying aetiology of the PCHI. The aim of this study was to assess the findings of this aetiological workup via retrospective chart review. PCHI data was obtained from the eSP database. This is a web based information system (eSP) used to track each baby through the screening and referral process A retrospective chart review of these patients was performed. Sixteen (38%) infants were diagnosed with a bilateral sensorineural hearing loss. Two infants had congenital CMV infection. A Connexin 26 gene mutation was detected in one infant. Two infants were diagnosed with Waardenburg syndrome, One with Pendred syndrome and one with Pfeiffer syndrome. Five babies underwent cochlear implantation. Through adherence to the recommended protocol a possible cause of PCHI may be determined. This study has identified areas of future improvement for this service in Ireland.

  5. Role of Gut Microbiota in the Aetiology of Obesity: Proposed Mechanisms and Review of the Literature (United States)

    Gerasimidis, Konstantinos; Edwards, Christine Ann; Shaikh, M. Guftar


    The aetiology of obesity has been attributed to several factors (environmental, dietary, lifestyle, host, and genetic factors); however none of these fully explain the increase in the prevalence of obesity worldwide. Gut microbiota located at the interface of host and environment in the gut are a new area of research being explored to explain the excess accumulation of energy in obese individuals and may be a potential target for therapeutic manipulation to reduce host energy storage. Several mechanisms have been suggested to explain the role of gut microbiota in the aetiology of obesity such as short chain fatty acid production, stimulation of hormones, chronic low-grade inflammation, lipoprotein and bile acid metabolism, and increased endocannabinoid receptor system tone. However, evidence from animal and human studies clearly indicates controversies in determining the cause or effect relationship between the gut microbiota and obesity. Metagenomics based studies indicate that functionality rather than the composition of gut microbiota may be important. Further mechanistic studies controlling for environmental and epigenetic factors are therefore required to help unravel obesity pathogenesis. PMID:27703805

  6. Epidemiology, aetiology and outcomes of acute pancreatitis: A retrospective cohort study. (United States)

    Nesvaderani, Maryam; Eslick, Guy D; Vagg, Daniel; Faraj, Shadi; Cox, Michael R


    Acute pancreatitis is a common acute surgical presentation in Western Society. The causes and pattern of pancreatitis has not been previously documented for Western Sydney. As Western Sydney contains many areas of low socio-economic status with an expected high level of alcohol abuse, it was hypothesised that alcoholic pancreatitis would be more prevalent in this population. The aims of this study were to determine the epidemiology, aetiology and outcomes of acute pancreatitis. A retrospective analysis of patients presenting with acute pancreatitis to four tertiary hospitals over a four-year period was undertaken. 932 patients presented with acute pancreatitis with a median age of 50 years (range 16-95); 470 (50.4%) were female. Almost half had gallstones (40%), 25.6% idiopathic, 22% alcohol induced and 3.9% post ERCP. 69 (7.4%) of patients were admitted to ICU/HDU, with a median length of stay in ICU was 6 days (range 1-106). 85 (11.1%) patients had severe pancreatitis (score ≥ 3). Mortality in this study was 1% (9). The majority of patients with acute pancreatitis in Western Sydney present with mild disease and have a low risk of morbidity or mortality. The ratio of gallstone to alcohol aetiology was 2:1. Idiopathic pancreatitis is responsible for more cases than expected. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  7. Viral aetiology influenza like illnesses in Santa Cruz, Bolivia (2010-2012). (United States)

    Delangue, Julie; Roca Sanchez, Yelin; Piorkowski, Géraldine; Bessaud, Maël; Baronti, Cécile; Thirion-Perrier, Laurence; Mafayle, Roxana Loayza; Ardaya, Cinthia Avila; Aguilera, Gabriela Añez; Guzman, Jimmy Revollo; Riera, Javier Lora; de Lamballerie, Xavier


    Acute respiratory infections represent a serious public health issue worldwide but virological aetiologies of Influenza Like Illnesses (ILIs) remain largely unknown in developing countries. This study represents the first attempt to characterise viral aetiologies of ILIs in Bolivia. It was performed in Santa Cruz city from January 2010 to September 2012, based on 564 naso-pharyngeal swabs collected in a National Reference Laboratory and real-time PCR techniques, viral cultures and phylogenetic analyses. 50.2% of samples were positive for at least one virus with influenza viruses (Flu A: ~15%; Flu B: ~9%), rhinoviruses (~8%), coronaviruses (~5%) and hRSV (~4%) being the most frequently identified. The pattern of viral infections varied according to age groups. The elucidation rate was the highest (>60%) amongst patients under 10 yo and the lowest (Bolivia in the study period, originating from Central and North America, Europe, Asia and Australia. Our results emphasise the requirement for a reinforced epidemiological and genetic follow-up of influenza and other ILIs in Bolivia to further inform the preparation of vaccines used in the region, guide vaccination campaigns and improve the medical management of patients.

  8. Risk factors, aetiology and outcome of ischaemic stroke in young adults: the Swiss Young Stroke Study (SYSS). (United States)

    Goeggel Simonetti, Barbara; Mono, Marie-Luise; Huynh-Do, Uyen; Michel, Patrik; Odier, Celine; Sztajzel, Roman; Lyrer, Philippe; Engelter, Stefan T; Bonati, Leo; Gensicke, Henrik; Traenka, Christopher; Tettenborn, Barbara; Weder, Bruno; Fischer, Urs; Galimanis, Aekaterini; Jung, Simon; Luedi, Rudolf; De Marchis, Gian Marco; Weck, Anja; Cereda, Carlo W; Baumgartner, Ralf; Bassetti, Claudio L; Mattle, Heinrich P; Nedeltchev, Krassen; Arnold, Marcel


    Ischaemic stroke (IS) in young adults has been increasingly recognized as a serious health condition. Stroke aetiology is different in young adults than in the older population. This study aimed to investigate aetiology and risk factors, and to search for predictors of outcome and recurrence in young IS patients. We conducted a prospective multicentre study of consecutive IS patients aged 16-55 years. Baseline demographic data, risk factors, stroke aetiology including systematic genetic screening for Fabry disease and severity were assessed and related to functional neurological outcome (modified Rankin Scale, mRS), case fatality, employment status, place of residence, and recurrent cerebrovascular events at 3 months. In 624 IS patients (60% men), median age was 46 (IQR 39-51) years and median NIHSS on admission 3 (IQR 1-8). Modifiable vascular risk factors were found in 73%. Stroke aetiology was mostly cardioembolism (32%) and of other defined origin (24%), including cervicocerebral artery dissection (17%). Fabry disease was diagnosed in 2 patients (0.3%). Aetiology remained unknown in 20%. Outcome at 3 months was favourable (mRS 0-1) in 61% and fatal in 2.9%. Stroke severity (p young adults with IS had modifiable vascular risk factors, emphasizing the importance of prevention strategies. Outcome was unfavourable in more than a third of patients and was associated with initial stroke severity and diabetes mellitus. Previous cerebrovascular events predicted recurrent ones.

  9. Historical evolution of anatomical terminology from ancient to modern. (United States)

    Sakai, Tatsuo


    The historical development of anatomical terminology from the ancient to the modern can be divided into five stages. The initial stage is represented by the oldest extant anatomical treatises by Galen of Pergamon in the Roman Empire. The anatomical descriptions by Galen utilized only a limited number of anatomical terms, which were essentially colloquial words in the Greek of this period. In the second stage, Vesalius in the early 16th century described the anatomical structures in his Fabrica with the help of detailed magnificent illustrations. He coined substantially no anatomical terms, but devised a system that distinguished anatomical structures with ordinal numbers. The third stage of development in the late 16th century was marked by innovation of a large number of specific anatomical terms especially for the muscles, vessels and nerves. The main figures at this stage were Sylvius in Paris and Bauhin in Basel. In the fourth stage between Bauhin and the international anatomical terminology, many anatomical textbooks were written mainly in Latin in the 17th century, and in modern languages in the 18th and 19th centuries. Anatomical terms for the same structure were differently expressed by different authors. The last stage began at the end of the 19th century, when the first international anatomical terminology in Latin was published as Nomina anatomica. The anatomical terminology was revised repeatedly until the current Terminologia anatomica both in Latin and English.

  10. Experimental Analyses for The Mechanical Behavior of Pressed All-Ceramic Molar Crowns with Anatomical Design


    Porojan Liliana; Porojan Sorin; Rusu Lucian; Boloş Adrian; Savencu Cristina


    Ceramic restorations show considerable variation in strength and structural reliability regarding to the type of material, and design characteristics. The fracture of ceramics occurs with little or no plastic deformation, with cracks propagated in an unstable manner under applied tensile stresses. The aim of the study was to assess experimental analyses of pressed monolithic ceramic crowns with anatomical design used in the posterior areas in order to understand their mechanical behavior befo...

  11. Accessory mental foramen: a rare anatomical finding (United States)

    Thakur, Gagan; Thomas, Shaji; Thayil, Sumeeth Cyriac; Nair, Preeti P


    Accessory mental foramen (AMF) is a rare anatomical variation with a prevalence ranging from 1.4 to 10%. Even so, in order to avoid neurovascular complications, particular attention should be paid to the possible occurrence of one or more AMF during surgical procedures involving the mandible. Careful surgical dissection should be performed in the region so that the presence of AMF can be detected and the occurrence of a neurosensory disturbance or haemorrhage can be avoided. Although this anatomical variation is rare, it should be kept in mind that an AMF may exist. Trigeminal neuralgia was diagnosed. On the basis of diagnostic test results, peripheral neurectomy of mental nerve was planned. Failure to do neurectomy of mental nerve branch in the reported case, coming out from AMF, would have resulted in recurrence of pain and eventually failure of the procedure. PMID:22707601

  12. Hamstring tendons insertion - an anatomical study


    Cristiano Antonio Grassi; Vagner Messias Fruheling; Joao Caetano Abdo; Marcio Fernando Aparecido de Moura; Mario Namba; Joao Luiz Vieira da Silva; Luiz Antonio Munhoz da Cunha; Ana Paula Gebert de Oliveira Franco; Isabel Ziesemer Costa; Edmar Stieven Filho


    OBJECTIVE: To study the anatomy of the hamstring tendons insertion and anatomical rela-tionships. METHODS: Ten cadaver knees with medial and anterior intact structures were selected. The dissection was performed from anteromedial access to exposure of the insertion of the flexor tendons (FT), tibial plateau (TP) and tibial tuberosity (TT). A needle of 40 × 12 and a caliper were used to measure the distance of the tibial plateau of the knee flexor tendons insertion at 15 mm from the ...

  13. Anatomically corrected transposition of great vessels

    International Nuclear Information System (INIS)

    Ivanitskij, A.V.; Sarkisova, T.N.


    The paper is concerned with the description of rare congenital heart disease: anatomically corrected malposition of major vessels in a 9-mos 24 day old girl. The diagnosis of this disease was shown on the results of angiocardiography, concomitant congenital heart diseases were descibed. This abnormality is characterized by common atrioventricular and ventriculovascular joints and inversion position of the major vessels, it is always attended by congenital heart diseases. Surgical intervention is aimed at the elimination of concomitant heart dieseases

  14. Exploring brain function from anatomical connectivity

    Directory of Open Access Journals (Sweden)

    Gorka eZamora-López


    Full Text Available The intrinsic relationship between the architecture of the brain and the range of sensory and behavioral phenomena it produces is a relevant question in neuroscience. Here, we review recent knowledge gained on the architecture of the anatomical connectivity by means of complex network analysis. It has been found that corticocortical networks display a few prominent characteristics: (i modular organization, (ii abundant alternative processing paths and (iii the presence of highly connected hubs. Additionally, we present a novel classification of cortical areas of the cat according to the role they play in multisensory connectivity. All these properties represent an ideal anatomical substrate supporting rich dynamical behaviors, as-well-as facilitating the capacity of the brain to process sensory information of different modalities segregated and to integrate them towards a comprehensive perception of the real world. The result here exposed are mainly based in anatomical data of cats’ brain, but we show how further observations suggest that, from worms to humans, the nervous system of all animals might share fundamental principles of organization.


    Directory of Open Access Journals (Sweden)

    Dipak Bhuyan


    Full Text Available BACKGROUND Corneal transplantation or grafting is an operation in which abnormal corneal host tissue is replaced by healthy donor cornea. According to the World Health Organization (WHO, corneal diseases are among the major causes of vision loss and blindness in the world today after cataract and glaucoma. The aim of the study is to- 1. Evaluate the different aetiology of corneal opacity including active infective aetiology as indicated for penetrating keratoplasty. 2. Determine the clinical outcome of penetrating keratoplasty in relation to graft survival, graft rejection and peri-operative complications in different aetiology groups. 3. Determine the final visual outcome. MATERIALS AND METHODS Candidates for keratoplasty were selected from- 1. Eye Bank of Regional Institute of Ophthalmology (R.I.O. 2. R.I.O OPD. The study period was from September 2014 to August 2015. 30 cases were taken in the study. Descriptive statistics were applied to analyse the data wherever necessary. RESULTS 34.6±19.73 yrs. (mean±SD was the mean age at which transplants were done in the study. Out of total 30 cases, 13 (43.33% and 17 (56.66% were male and female, respectively. The different indications for penetrating keratoplasty are- Post ulcer corneal opacity in 14 cases (46.66%, posttraumatic corneal opacity 9 cases (30%, pseudophakic bullous keratopathy 4 cases (13.33%, corneal dystrophy in 2 cases (6.66% and non-healing corneal ulcer in 1 case (3.33%. 16 cases (53.33% showed clear graft till the last follow up while 11 (33.33% cases showed partially clear graft resulting in improved visual outcome while 3 cases (10.00% of the grafts were opaque due to graft failure. CONCLUSION The major indications for penetrating keratoplasty in this part of the world are post ulcer and posttraumatic corneal opacity and majority of them are illiterate agricultural workers who failed to get adequate treatment on time. Graft survival rate is high, which can be attributed to the

  16. The Application of an Anatomical Database for Fetal Congenital Heart Disease. (United States)

    Yang, Li; Pei, Qiu-Yan; Li, Yun-Tao; Yang, Zhen-Juan


    Fetal congenital heart anomalies are the most common congenital anomalies in live births. Fetal echocardiography (FECG) is the only prenatal diagnostic approach used to detect fetal congenital heart disease (CHD). FECG is not widely used, and the antenatal diagnosis rate of CHD varies considerably. Thus, mastering the anatomical characteristics of different kinds of CHD is critical for ultrasound physicians to improve FECG technology. The aim of this study is to investigate the applications of a fetal CHD anatomic database in FECG teaching and training program. We evaluated 60 transverse section databases including 27 types of fetal CHD built in the Prenatal Diagnosis Center in Peking University People's Hospital. Each original database contained 400-700 cross-sectional digital images with a resolution of 3744 pixels × 5616 pixels. We imported the database into Amira 5.3.1 (Australia Visage Imaging Company, Australia) three-dimensional (3D) software. The database functions use a series of 3D software visual operations. The features of the fetal CHD anatomical database were analyzed to determine its applications in FECG continuing education and training. The database was rebuilt using the 3D software. The original and rebuilt databases can be displayed dynamically, continuously, and synchronically and can be rotated at arbitrary angles. The sections from the dynamic displays and rotating angles are consistent with the sections in FECG. The database successfully reproduced the anatomic structures and spatial relationship features of different fetal CHDs. We established a fetal CHD anatomy training database and a standardized training database for FECG. Ultrasound physicians and students can learn the anatomical features of fetal CHD and FECG through either centralized training or distance education. The database of fetal CHD successfully reproduced the anatomic structures and spatial relationship of different kinds of fetal CHD. This database can be widely used in

  17. Remarkable anatomic variations in paranasal sinus region and their clinical importance

    Energy Technology Data Exchange (ETDEWEB)

    Kantarci, Mecit E-mail:; Karasen, R. Murat; Alper, Fatih; Onbas, Omer; Okur, Adnan; Karaman, Adem


    With the advent of functional endoscopic sinus surgery (FESS) and coronal computed tomography (CT) imaging, considerable attention has been directed toward paranasal region anatomy. Detailed knowledge of anatomic variations in paranasal sinus region is critical for surgeons performing endoscopic sinus surgery as well as for the radiologist involved in the preoperative work-up. To be in the known anatomical variants with some accompanying pathologies, directly influence the success of diagnostic and therapeutic management of paranasal sinus diseases. A review of 512 (1024 sides) paranasal sinus tomographic scans was carried out to expose remarkable anatomic variations of this region. We used only coronal sections, but for some cases to clear exact diagnosis, additional axial CT scan, magnetic resonance imaging (MRI) and nasal endoscopy were also performed. In this pictorial essay, rates of remarkable anatomic variations in paranasal region were displayed. The images of some interesting cases were illustrated, such as the Onodi cell in which isolated mucocele caused loss of visual acuity, agger nasi cell, Haller's cell, uncinate bulla, giant superior concha bullosa, inferior concha bullosa, bilateral carotid artery protrusion into sphenoid sinus, maxillary sinus agenesis, bilateral secondary middle turbinate (SMT) and sphenomaxillary plate. The clinical importance of all these variations were discussed under the light of the literature. It was suggested that remarkable anatomic variations of paranasal region and their possible pathologic consequences should be well defined in order to improve success of management strategies, and to avoid potential complications of endoscopic sinus surgery. The radiologist must pay close attention to anatomical variations in the preoperative evaluation.

  18. The earliest evidence for anatomically modern humans in northwestern Europe. (United States)

    Higham, Tom; Compton, Tim; Stringer, Chris; Jacobi, Roger; Shapiro, Beth; Trinkaus, Erik; Chandler, Barry; Gröning, Flora; Collins, Chris; Hillson, Simon; O'Higgins, Paul; FitzGerald, Charles; Fagan, Michael


    The earliest anatomically modern humans in Europe are thought to have appeared around 43,000-42,000 calendar years before present (43-42 kyr cal BP), by association with Aurignacian sites and lithic assemblages assumed to have been made by modern humans rather than by Neanderthals. However, the actual physical evidence for modern humans is extremely rare, and direct dates reach no farther back than about 41-39 kyr cal BP, leaving a gap. Here we show, using stratigraphic, chronological and archaeological data, that a fragment of human maxilla from the Kent's Cavern site, UK, dates to the earlier period. The maxilla (KC4), which was excavated in 1927, was initially diagnosed as Upper Palaeolithic modern human. In 1989, it was directly radiocarbon dated by accelerator mass spectrometry to 36.4-34.7 kyr cal BP. Using a Bayesian analysis of new ultrafiltered bone collagen dates in an ordered stratigraphic sequence at the site, we show that this date is a considerable underestimate. Instead, KC4 dates to 44.2-41.5 kyr cal BP. This makes it older than any other equivalently dated modern human specimen and directly contemporary with the latest European Neanderthals, thus making its taxonomic attribution crucial. We also show that in 13 dental traits KC4 possesses modern human rather than Neanderthal characteristics; three other traits show Neanderthal affinities and a further seven are ambiguous. KC4 therefore represents the oldest known anatomically modern human fossil in northwestern Europe, fills a key gap between the earliest dated Aurignacian remains and the earliest human skeletal remains, and demonstrates the wide and rapid dispersal of early modern humans across Europe more than 40 kyr ago. ©2011 Macmillan Publishers Limited. All rights reserved

  19. Design and use of numerical anatomical atlases for radiotherapy

    International Nuclear Information System (INIS)

    Commowick, O.


    The main objective of this thesis is to provide radio-oncology specialists with automatic tools for delineating organs at risk of a patient undergoing a radiotherapy treatment of cerebral or head and neck tumors. To achieve this goal, we use an anatomical atlas, i.e. a representative anatomy associated to a clinical image representing it. The registration of this atlas allows us to segment automatically the patient structures and to accelerate this process. Contributions in this method are presented on three axes. First, we want to obtain a registration method which is as independent as possible from the setting of its parameters. This setting, done by the clinician, indeed needs to be minimal while guaranteeing a robust result. We therefore propose registration methods allowing a better control of the obtained transformation, using rejection techniques of inadequate matching or locally affine transformations. The second axis is dedicated to the consideration of structures associated with the presence of the tumor. These structures, not present in the atlas, indeed lead to local errors in the atlas-based segmentation. We therefore propose methods to delineate these structures and take them into account in the registration. Finally, we present the construction of an anatomical atlas of the head and neck region and its evaluation on a database of patients. We show in this part the feasibility of the use of an atlas for this region, as well as a simple method to evaluate the registration methods used to build an atlas. All this research work has been implemented in a commercial software (Imago from DOSIsoft), allowing us to validate our results in clinical conditions. (author)

  20. Aetiological spectrum of benign gastric outlet obstruction in India: new trends. (United States)

    Maharshi, Sudhir; Puri, Amarender Singh; Sachdeva, Sanjeev; Kumar, Ajay; Dalal, Ashok; Gupta, Manish


    There is a paucity of data on the spectrum of benign gastric outlet obstruction in India. Our aim was to evaluate its spectrum and to identify the subgroup which would be most amenable to endoscopic therapy. We studied 64 patients whose aetiology revealed in approximately equal proportions: corrosive injury; gastroduodenal tuberculosis (TB); and peptic ulcer disease. The median number of endoscopic dilations required was two for TB, four for peptic ulcer disease and five for corrosive injury. Gastroduodenal TB and corrosive injury appear now to be more, or at least as, common as peptic ulcer disease as causes of benign gastric outlet obstruction in India. Gastroduodenal TB responds best to endoscopic therapy. © The Author(s) 2016.

  1. Aetiological overlap between obsessive-compulsive related and anxiety disorder symptoms: multivariate twin study. (United States)

    López-Solà, Clara; Fontenelle, Leonardo F; Bui, Minh; Hopper, John L; Pantelis, Christos; Yücel, Murat; Menchón, José M; Alonso, Pino; Harrison, Ben J


    The aetiological boundary between obsessive-compulsive related disorders (OCRDs) including obsessive-compulsive disorder (OCD) and anxiety disorders is unclear and continues to generate debate. To determine the genetic overlap and the pattern of causal relationships among OCRDs and anxiety disorders. Multivariate twin modelling methods and a new regression analysis to infer causation were used, involving 2495 male and female twins. The amount of common genetic liability observed for OCD symptoms was higher when considering anxiety disorders and OCRDs in the model v. modelling OCRD symptoms alone. OCD symptoms emerged as risk factors for the presence of generalised anxiety, panic and hoarding symptoms, whereas social phobia appeared as a risk factor for OCD symptoms. OCD represents a complex phenotype that includes important shared features with anxiety disorders and OCRDs. The novel patterns of risk identified between OCD and anxiety disorder may help to explain their frequent co-occurrence. © The Royal College of Psychiatrists 2016.

  2. Shared genetic aetiology of puberty timing between sexes and with health-related outcomes. (United States)

    Day, Felix R; Bulik-Sullivan, Brendan; Hinds, David A; Finucane, Hilary K; Murabito, Joanne M; Tung, Joyce Y; Ong, Ken K; Perry, John R B


    Understanding of the genetic regulation of puberty timing has come largely from studies of rare disorders and population-based studies in women. Here, we report the largest genomic analysis for puberty timing in 55,871 men, based on recalled age at voice breaking. Analysis across all genomic variants reveals strong genetic correlation (0.74, P=2.7 × 10(-70)) between male and female puberty timing. However, some loci show sex-divergent effects, including directionally opposite effects between sexes at the SIM1/MCHR2 locus (Pheterogeneity=1.6 × 10(-12)). We find five novel loci for puberty timing (Ppuberty, LEPR and KAL1. Finally, we identify genetic correlations that indicate shared aetiologies in both sexes between puberty timing and body mass index, fasting insulin levels, lipid levels, type 2 diabetes and cardiovascular disease.

  3. Spontaneous chylothorax complicating small cell lung cancer – Review of aetiology and diagnosis

    Directory of Open Access Journals (Sweden)

    S. Hanina


    Full Text Available We report the first case of spontaneous chylothorax complicating small cell lung cancer. A 52 year old female presented with exertional dyspnoea, left-sided chest and neck pain, and dysphagia. The chest X-ray on admission revealed a large left-sided pleural effusion. A subsequent CT chest showed a large anterior mediastinal mass with a left brachiocephalic and jugular vein thrombosis. The patient underwent medical thoracoscopy with chest drain insertion, which drained pleural fluid high in triglycerides, consistent with a chylothorax. Due to its uncommon nature, the management of chylothorax is not well defined. Alongside the case report, we provide a review of aetiology, mechanism and diagnosis with a brief summary of treatment options.

  4. Infection of PTFE mesh 15 years following pedicled TRAM flap breast reconstruction: mechanism and aetiology. (United States)

    Elfaki, A; Gkorila, A; Khatib, M; Malata, C M


    The pedicled transverse rectus abdominis myocutaneous (TRAM) flap procedure is still widely used for breast reconstruction. The repair of the flap harvest site in the transverse rectus abdominis muscle and sheath is often assisted by the use of prosthetic meshes. This decreases the risk of abdominal wall weakness and herniation but, being a foreign body, it also carries the risk of infection. In this report, we describe the case of a 63-year-old patient who, whilst receiving chemotherapy for metastatic breast cancer, presented with an infected polytetrafluoroethylene mesh 15 years after pedicled TRAM flap immediate breast reconstruction. This necessitated mesh removal to treat the infection. Following a thorough review of the English literature, this is the longest recorded presentation of an abdominal prosthetic mesh infection. The mechanism and aetiology of such a late complication are discussed.

  5. Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care

    DEFF Research Database (Denmark)

    Holm, Anette; Nexoe, Joergen; Bistrup, Lene A


    BACKGROUND: Knowledge of predominant pathogens and their association with outcome are of importance for the management of lower respiratory tract infection (LRTI). As antibiotic therapy is indicated in pneumonia and not in acute bronchitis, a predictor of pneumonia is needed. AIM: To describe...... the aetiology and outcome of LRTI in adults with pneumonic and adults with non-pneumonic LRTI treated in general practice and to identify predictors of radiographic pneumonia. DESIGN OF STUDY: Prospective, observational study. SETTING: Forty-two general practices and an outpatient clinic at the Department....... Primary outcome measure was hospitalisation within 4 weeks. RESULTS: Pneumonia was radiographically verified in 48 of 364 patients (13%). Bacterial infection was seen more often in patients with pneumonia (33% versus 17%, P

  6. Trends in the aetiology of facial fractures in the south of Ireland (1975-1993).

    LENUS (Irish Health Repository)

    Carroll, S M


    An aetiological review of 332 patients with facial fractures seen in a 1 year period (1993) was carried out and compared to a similar study of 266 patients, performed in this unit in 1975. Males predominated in both years. Two thirds of fractures occurred in the second and third decades. Road traffic accident (RTA) related facial fractures decreased from 27% of the total in 1975 to 17% in 1993. Assault related facial fractures increased from 18% of the total in 1975 to 27% in 1993. In both study periods nasal fractures were the most common facial fracture seen and sport was the most common cause of facial fracture. The number of patients undergoing surgery increased from 67% of the total to 79% over the same period.

  7. Patterns of infections, aetiological agents, and antimicrobial resistance at a tertiary care hospital in northern Tanzania

    DEFF Research Database (Denmark)

    Kumburu, Happiness Houka; Sonda, Tolbert; Mmbaga, Blandina Theophil


    Objective To determine the causative agents of infections and their antimicrobial susceptibility at a tertiary care hospital in Moshi, Tanzania, to guide optimal treatment. Methods A total of 590 specimens (stool (56), sputum (122), blood (126) and wound swabs (286)) were collected from 575...... patients admitted in the medical and surgical departments. The bacterial species were determined by conventional methods and disk diffusion was used to determine the antimicrobial susceptibility pattern of the bacteria isolates. Results A total of 249 (42.2%) specimens were culture-positive yielding...... to the commonly used antimicrobial agents. Furthermore, the bacterial spectrum differs from those often observed in high-income countries. This highlights the imperative of regular generation of data on aetiological agents and their antimicrobial susceptibility patterns especially in infectious disease endemic...

  8. A comparison of phenylketonuria with attention deficit hyperactivity disorder: do markedly different aetiologies deliver common phenotypes? (United States)

    Stevenson, M; McNaughton, N


    Phenylketonuria (PKU) is a well-defined metabolic disorder arising from a mutation that disrupts phenylalanine metabolism and so produces a variety of neural changes indirectly. Severe cognitive impairment can be prevented by dietary treatment; however, residual symptoms may be reported. These residual symptoms appear to overlap a more prevalent childhood disorder: Attention Deficit/Hyperactivity Disorder (ADHD). However, the aetiology of ADHD is a vast contrast to PKU: it seems to arise from a complex combination of genes; and it has a substantial environmental component. We ask whether these two disorders result from two vastly different genotypes that converge on a specific core phenotype that includes similar dysfunctions of Gray's (Gray, 1982) Behavioural Inhibition System (BIS), coupled with other disorder-specific dysfunctions. If so, we believe comparison of the commonalities will allow greater understanding of the neuropsychology of both disorders. We review in detail the aetiology, treatment, neural pathology, cognitive deficits and electrophysiological abnormalities of PKU; and compare this with selected directly matching aspects of ADHD. The biochemical and neural pathologies of PKU and ADHD are quite distinct in their causes and detail; but they result in the disorder in the brain of large amino acid levels, dopamine and white matter that are very similar and could explain the overlap of symptoms within and between the PKU and ADHD spectra. The common deficits affect visual function, motor function, attention, working memory, planning, and inhibition. For each of PKU and ADHD separately, a subset of deficits has been attributed to a primary dysfunction of behavioural inhibition. In the case of ADHD (excluding the inattentive subtype) this has been proposed to involve a specific failure of the BIS; and we suggest that this is also true of PKU. This accounts for a substantial proportion of the parallels in the superficial symptoms of both disorders and

  9. Fungal Nail Infections: Spectrum of Aetiologic Agents and Pattern of Lesions

    Directory of Open Access Journals (Sweden)

    Anyimson James


    Full Text Available Objective: Worldwide, fungal nail infections have been on the increase, with social, cultural and economic factors contributing to it. Information on the spectrum of fungal nail infection is sparse in Nigeria. This study was carried out to establish the infection rates, aetiology and clinical types of onychomycosis in Calabar. Methods: Subjects were drawn from manicure and pedicure salons, farming settlements, mechanic workshops and dermatology clinic. A structured questionnaire was administered to participants for demographic data. Nail scrapings and clippings were obtained from subjects under standard aseptic procedure. Samples were pulverized and subjected to microscopy and culture. Standard mycological techniques were used to identify and characterize isolates. Results: Out of the 32.7% infection rates in the study, males 33.8%% were more infected than females 32.3% and subjects aged 41-50 years had the highest rate of infections. Candida species were more prevalent 63.6% than dermatophytic moulds 36.4%. Trichophyton rubrum was the most prevalent 18.2% dermatophyte. The distribution of pathogenic isolates on fingernails 45.5% and toenails 42.4% was statistically significant (χ2 =7.2, p= 0.03. Disto-lateral subungual onychomycosis (DLSO 51(50.5% was the most common type of nail lesion but most of the isolates 14(42.4% were recovered from TDO. Conclusion: Onychomycosis affected more adults than adolescents of both sexes in our locality. Candida species are becoming prevalent aetiologic agents of these infections, and their importance should not be overlooked in the management of patients. J Microbiol Infect Dis 2016;6(1: 23-27

  10. Polygenic interactions with environmental adversity in the aetiology of major depressive disorder. (United States)

    Mullins, N; Power, R A; Fisher, H L; Hanscombe, K B; Euesden, J; Iniesta, R; Levinson, D F; Weissman, M M; Potash, J B; Shi, J; Uher, R; Cohen-Woods, S; Rivera, M; Jones, L; Jones, I; Craddock, N; Owen, M J; Korszun, A; Craig, I W; Farmer, A E; McGuffin, P; Breen, G; Lewis, C M


    Major depressive disorder (MDD) is a common and disabling condition with well-established heritability and environmental risk factors. Gene-environment interaction studies in MDD have typically investigated candidate genes, though the disorder is known to be highly polygenic. This study aims to test for interaction between polygenic risk and stressful life events (SLEs) or childhood trauma (CT) in the aetiology of MDD. The RADIANT UK sample consists of 1605 MDD cases and 1064 controls with SLE data, and a subset of 240 cases and 272 controls with CT data. Polygenic risk scores (PRS) were constructed using results from a mega-analysis on MDD by the Psychiatric Genomics Consortium. PRS and environmental factors were tested for association with case/control status and for interaction between them. PRS significantly predicted depression, explaining 1.1% of variance in phenotype (p = 1.9 × 10(-6)). SLEs and CT were also associated with MDD status (p = 2.19 × 10(-4) and p = 5.12 × 10(-20), respectively). No interactions were found between PRS and SLEs. Significant PRSxCT interactions were found (p = 0.002), but showed an inverse association with MDD status, as cases who experienced more severe CT tended to have a lower PRS than other cases or controls. This relationship between PRS and CT was not observed in independent replication samples. CT is a strong risk factor for MDD but may have greater effect in individuals with lower genetic liability for the disorder. Including environmental risk along with genetics is important in studying the aetiology of MDD and PRS provide a useful approach to investigating gene-environment interactions in complex traits.

  11. Aetiology and severity of gingival recession in an adult population sample in Greece

    Directory of Open Access Journals (Sweden)

    Nikolaos Andreas Chrysanthakopoulos


    Full Text Available Background: Gingival recession is the most common and undesirable condition of the gingiva. The aim of study was to investigate the aetiology and severity of gingival recession in a Greek adult population sample. Methods : The study was performed on 165 males and 179 females, 18-68 years old who sought dental treatment in a private dental practice and showed gingival recession. All subjects were clinically examined and answered questions regarding their oral hygiene habits such as the type of toothbrush, frequency of brushing and method of brushing. The association between gingival recession and the following parameters was assessed: plaque score, gingival score and tooth position. Statistical analysis of the results was accomplished using chi-square test (α = 0.05. Results: The majority (79.4% of the patients showed grade I gingival recession and 15.3% showed grade II gingival recession. The maxillary 1 st and 2 nd molars (35.3% and the mandibular 1 st and 2 nd molars (28.7% were the teeth most frequently affected by root surface exposure. Patients with sub-gingival calculus, bacterial plaque and gingival inflammation (P < 0.05, malpositioned teeth (P < 0.001, horizontal brushing method, medium type of toothbrush (P < 0.001 and brushing once daily (P < 0.001 appeared to be the most common precipitating aetiological factor for gingival recession. Conclusion: According to the results of the present study, gingival recession was the result of more than one factor acting together. Horizontal brushing method, usage of medium type toothbrush and tooth brushing once daily were found to be more associated with gingival recession.

  12. A systematic review of personality disorder, race and ethnicity: prevalence, aetiology and treatment

    Directory of Open Access Journals (Sweden)

    Lee Tennyson


    Full Text Available Abstract Background Although psychoses and ethnicity are well researched, the importance of culture, race and ethnicity has been overlooked in Personality Disorders (PD research. This study aimed to review the published literature on ethnic variations of prevalence, aetiology and treatment of PD. Method A systematic review of studies of PD and race, culture and ethnicity including a narrative synthesis of observational data and meta-analyses of prevalence data with tests for heterogeneity. Results There were few studies with original data on personality disorder and ethnicity. Studies varied in their classification of ethnic group, and few studies defined a specific type of personality disorder. Overall, meta-analyses revealed significant differences in prevalence between black and white groups (OR 0.476, CIs 0.248 - 0.915, p = 0.026 but no differences between Asian or Hispanic groups compared with white groups. Meta-regression analyses found that heterogeneity was explained by some study characteristics: a lower prevalence of PD was reported among black compared with white patients in UK studies, studies using case-note diagnoses rather than structured diagnostic interviews, studies of borderline PD compared with the other PD, studies in secure and inpatient compared with community settings, and among subjects with co-morbid disorders compared to the rest. The evidence base on aetiology and treatment was small. Conclusion There is some evidence of ethnic variations in prevalence of personality disorder but methodological characteristics are likely to account for some of the variation. The findings may indicate neglect of PD diagnosis among ethnic groups, or a true lower prevalence amongst black patients. Further studies are required using more precise cultural and ethnic groups.

  13. Cochlear implantation in children with single-sided deafness: does aetiology and duration of deafness matter? (United States)

    Arndt, Susan; Prosse, Susanne; Laszig, Roland; Wesarg, Thomas; Aschendorff, Antje; Hassepass, Frederike


    For adult patients with single-sided deafness (SSD), treatment with a cochlear implant (CI) is well established as an acceptable and beneficial hearing rehabilitation method administered routinely in clinical practice. In contrast, for children with SSD, CI has been applied less often to date, with the rationale to decide either on a case-by-case basis or under the realm of clinical research. The aim of our clinical study was to evaluate the longitudinal benefits of CI for a group of children diagnosed with SSD and to compare their outcomes with respect to patient characteristics. Evaluating a pool of paediatric SSD patients presenting for possible CI surgery revealed that the primary aetiology of deafness was congenital cochlear nerve deficiency. A subgroup of children meeting the CI candidacy criteria for the affected ear (the majority with acquired hearing loss) were enrolled in the study. Preliminary group results suggest substantial improvements in speech comprehension in noise and in the ability to localise sound, which was demonstrated through objective and subjective assessments after CI treatment for the group, with results varying from patient to patient. Our study shows a trend towards superior outcomes for children with acquired hearing loss and a shorter duration of hearing loss compared to congenitally deafened children who had a longer duration of SSD. This indicates an interactive influence of the age at onset, aetiology and duration of deafness upon the restoration of binaural integration and the overall benefits of sound stimulation to two ears after CI treatment. Continued longitudinal investigation of these children and further studies in larger groups may provide more guidance on the optimal timing of treatment for paediatric patients with acquired and congenital SSD. © 2015 S. Karger AG, Basel.

  14. Investigating risk factors and possible infectious aetiologies of mummified fetuses on a large piggery in Australia. (United States)

    Dron, N; Hernández-Jover, M; Doyle, R E; Holyoake, P K


    To investigate risk factors and potential infectious aetiologies of an increased mummification rate (>2%) identified over time on a 1200-sow farrow-to-finish farm in Australia. Association of potential non-infectious risk factors and the mummification rate was investigated using 15 years of breeding herd data (40,940 litters) and logistic regression analysis. Samples from a limited number of mummified fetuses were taken to identify potential infectious aetiologies (porcine parvovirus, Leptospira pomona, porcine circovirus type 2, Bungowannah virus and enterovirus). Logistic regression analysis suggested that the mummification rate was significantly associated with sow breed and parity, year and total born and stillborn piglets per litter. The mummification rate was lower (P < 0.001) in Landrace (3.4%) and Large White (2.6%) sows than in Duroc sows (4.9%). Gilts (2.9%) had a lower (P < 0.001) mummification rate than older sows. The mummification rate increased with total born litter size and decreased with the number of stillborn piglets (P < 0.001). A clustering effect within individual sows was identified, indicating that some sows with mummified fetuses in a litter were more likely to have repeated mummifications in subsequent litters. No infectious agents were identified in the samples taken. Results from this study suggest that the increased mummification rate identified over time on this farm is likely to be a non-infectious multifactorial problem predisposing the occurrence of mummification. Further research is required to better understand the pathophysiology of mummification and the role that different non-infectious factors play in the occurrence of mummified fetuses. © 2014 Australian Veterinary Association.

  15. Causal inference regarding infectious aetiology of chronic conditions: a systematic review.

    Directory of Open Access Journals (Sweden)

    Sofia Orrskog

    Full Text Available BACKGROUND: The global burden of disease has shifted from communicable diseases in children to chronic diseases in adults. This epidemiologic shift varies greatly by region, but in Europe, chronic conditions account for 86% of all deaths, 77% of the disease burden, and up to 80% of health care expenditures. A number of risk factors have been implicated in chronic diseases, such as exposure to infectious agents. A number of associations have been well established while others remain uncertain. METHODS AND FINDINGS: We assessed the body of evidence regarding the infectious aetiology of chronic diseases in the peer-reviewed literature over the last decade. Causality was assessed with three different criteria: First, the total number of associations documented in the literature between each infectious agent and chronic condition; second, the epidemiologic study design (quality of the study; third, evidence for the number of Hill's criteria and Koch's postulates that linked the pathogen with the chronic condition. We identified 3136 publications, of which 148 were included in the analysis. There were a total of 75 different infectious agents and 122 chronic conditions. The evidence was strong for five pathogens, based on study type, strength and number of associations; they accounted for 60% of the associations documented in the literature. They were human immunodeficiency virus, hepatitis C virus, Helicobacter pylori, hepatitis B virus, and Chlamydia pneumoniae and were collectively implicated in the aetiology of 37 different chronic conditions. Other pathogens examined were only associated with very few chronic conditions (≤ 3 and when applying the three different criteria of evidence the strength of the causality was weak. CONCLUSIONS: Prevention and treatment of these five pathogens lend themselves as effective public health intervention entry points. By concentrating research efforts on these promising areas, the human, economic, and societal

  16. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. (United States)

    Ayers, S; Bond, R; Bertullies, S; Wijma, K


    There is evidence that 3.17% of women report post-traumatic stress disorder (PTSD) after childbirth. This meta-analysis synthesizes research on vulnerability and risk factors for birth-related PTSD and refines a diathesis-stress model of its aetiology. Systematic searches were carried out on PsycINFO, PubMed, Scopus and Web of Science using PTSD terms crossed with childbirth terms. Studies were included if they reported primary research that examined factors associated with birth-related PTSD measured at least 1 month after birth. In all, 50 studies (n = 21 429) from 15 countries fulfilled inclusion criteria. Pre-birth vulnerability factors most strongly associated with PTSD were depression in pregnancy (r = 0.51), fear of childbirth (r = 0.41), poor health or complications in pregnancy (r = 0.38), and a history of PTSD (r = 0.39) and counselling for pregnancy or birth (r = 0.32). Risk factors in birth most strongly associated with PTSD were negative subjective birth experiences (r = 0.59), having an operative birth (assisted vaginal or caesarean, r = 0.48), lack of support (r = -0.38) and dissociation (r = 0.32). After birth, PTSD was associated with poor coping and stress (r = 0.30), and was highly co-morbid with depression (r = 0.60). Moderator analyses showed that the effect of poor health or complications in pregnancy was more apparent in high-risk samples. The results of this meta-analysis are used to update a diathesis-stress model of the aetiology of postpartum PTSD and can be used to inform screening, prevention and intervention in maternity care.

  17. Epilepsia partialis continua: aetiology, semiology and prognosis in a Spanish adult cohort. (United States)

    Bejr-Kasem, Helena; Sala-Padró, Jacint; Toledo, Manuel; Santamarina, Estevo; Sarria, Silvana; Gonzalez-Cuevas, Montserrat; Sueiras-Gil, María; Quintana, Manolo; Salas-Puig, Xavier


    To describe the semiological features in patients suffering with Epilepsia Partialis Continua (EPC), also referred as Kozhevnikov syndrome and their relationship with aetiology, duration, and prognosis, as well as recurrence during follow-up. We analysed consecutive EPC patients diagnosed and followed in our centre over a seven-and-a half year period. We collected demographic and clinical data, along with neuroimaging and EEG recordings. All patients were followed for more than six months. Patients were categorised with single body area or multiple body area involvement according to the body parts affected. Recurrence was defined as a second EPC episode after one week. We collected data from 27 adult patients; 70.4% were men, the mean age was 65.2 years old (range: 17-89 years), and 40.7% had previous epilepsy. EPC causes were structural in 85.1% (stroke being the most frequent; 44.4%), metabolic in 11.1%, and of unknown origin in 7.4%. A cortical lesion on neuroimaging was shown in 70.4%. Involvement of multiple body areas was reported in 55.6% of patients. The optimal cut-off period to predict death was nine days (with a sensitivity of 62.5% and specificity of 75%; p=0.039), and this group of patients exhibited more multiple body area involvement (88.9% vs 38.9%; p=0.04). During follow-up, patients with cortical lesions had more EPC relapses (p=0.037). The most frequent aetiology of EPC in our patients was stroke. Multiple body area involvement and duration were associated with mortality. Patients with cortical lesions had more EPC relapses during follow-up.

  18. Review article: sarcopenia in cirrhosis--aetiology, implications and potential therapeutic interventions. (United States)

    Sinclair, M; Gow, P J; Grossmann, M; Angus, P W


    Sarcopenia (loss of muscle mass) is common in cirrhosis and is associated with poor outcomes. Current teaching recommends the use of protein supplementation and exercise, however, this fails to address many other factors which contribute to muscle loss in this setting. To summarise existing knowledge regarding the aetiology of sarcopenia in cirrhosis, diagnostic modalities and the clinical significance of this condition. In addition to discuss recent research findings that may allow the development of more effective treatments. We conducted a Medline and PubMed search using the search terms 'sarcopenia', 'muscle', 'body composition', 'cirrhosis', 'liver' and 'malnutrition' from inception to October 2015. Cirrhotic patients with sarcopenia have reduced survival, experience increased rates of infection and have worse outcomes following liver transplantation. The aetiology of this condition is more complex than simple protein and calorie malnutrition. Cirrhosis also results in depleted glycogen stores and metabolic alterations that cause excessive protein catabolism, increased activation of the ubiquitin-proteasome pathway and inappropriate muscle autophagy. Satellite cell differentiation and proliferation is also reduced due to a combination of elevated myostatin levels, reduced IGF-1 and hypogonadism. Although there is some evidence supporting the use of late evening snacks, branched chain amino acid supplementation and high protein/high calorie diets, well designed clinical trials addressing the effects of treatment on body composition in cirrhosis are lacking. Sarcopenia in cirrhosis has a complex pathogenesis and simple dietary interventions are insufficient. Improved understanding of the multiple mechanisms involved should allow the development of more effective therapies, which target the specific underlying metabolic derangements. © 2016 John Wiley & Sons Ltd.

  19. Review article: the aetiology of primary Budd-Chiari syndrome - differences between the West and China. (United States)

    Qi, X; Han, G; Guo, X; De Stefano, V; Xu, K; Lu, Z; Xu, H; Mancuso, A; Zhang, W; Han, X; Valla, D C; Fan, D


    China may have the largest number of Budd-Chiari syndrome (BCS) cases in the world (at least 1914 original papers were published, and at least 20 191 BCS patients were reported). Considering the discrepancy in the clinical profiles and preferred treatment selection of primary BCS between the West and China, understanding its aetiology in these two different regions is very important. To review the data from large cohort studies and meta-analyses to illustrate the epidemiology of risk factors for BCS in the West and China. Relevant papers were identified by major English- and Chinese-language databases, conference abstracts, and by manual search. Risk factors reviewed include myeloproliferative neoplasms (MPNs) and their related gene mutations, anti-phospholipid syndrome, paroxysmal nocturnal haemoglobinuria (PNH), hyperhomocysteinaemia and 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T mutation, factor V Leiden (FVL) and prothrombin G20210A mutations, inherited anti-thrombin, protein C and protein S deficiencies, pregnancy and puerperium, poverty, and family history. We examined the differences in the aetiological distribution of BCS between the West and China. Several recommendations should be considered in Chinese BCS patients: (i) screening for hyperhomocysteinaemia and MTHFR mutation should be regularly performed; (ii) screening for MPNs, PNH, and anti-phospholipid syndrome should be selectively performed; (iii) inherited anti-thrombin, protein C, and protein S deficiencies should be actively explored; (iv) screening for FVL and prothrombin G20210A mutations may be unnecessary; and (v) the clinical significance of pregnancy and puerperium, poverty with bacterial infections and unsanitary environments, and family history as possible risk factors should never be neglected. © 2016 John Wiley & Sons Ltd.

  20. Probabilistic anatomical labeling of brain structures using statistical probabilistic anatomical maps

    International Nuclear Information System (INIS)

    Kim, Jin Su; Lee, Dong Soo; Lee, Byung Il; Lee, Jae Sung; Shin, Hee Won; Chung, June Key; Lee, Myung Chul


    The use of statistical parametric mapping (SPM) program has increased for the analysis of brain PET and SPECT images. Montreal neurological institute (MNI) coordinate is used in SPM program as a standard anatomical framework. While the most researchers look up Talairach atlas to report the localization of the activations detected in SPM program, there is significant disparity between MNI templates and Talairach atlas. That disparity between Talairach and MNI coordinates makes the interpretation of SPM result time consuming, subjective and inaccurate. The purpose of this study was to develop a program to provide objective anatomical information of each x-y-z position in ICBM coordinate. Program was designed to provide the anatomical information for the given x-y-z position in MNI coordinate based on the statistical probabilistic anatomical map (SPAM) images of ICBM. When x-y-z position was given to the program, names of the anatomical structures with non-zero probability and the probabilities that the given position belongs to the structures were tabulated. The program was coded using IDL and JAVA language for the easy transplantation to any operating system or platform. Utility of this program was shown by comparing the results of this program to those of SPM program. Preliminary validation study was performed by applying this program to the analysis of PET brain activation study of human memory in which the anatomical information on the activated areas are previously known. Real time retrieval of probabilistic information with 1 mm spatial resolution was archived using the programs. Validation study showed the relevance of this program: probability that the activated area for memory belonged to hippocampal formation was more than 80%. These programs will be useful for the result interpretation of the image analysis performed on MNI coordinate, as done in SPM program

  1. TOPICAL REVIEW: Anatomical imaging for radiotherapy (United States)

    Evans, Philip M.


    The goal of radiation therapy is to achieve maximal therapeutic benefit expressed in terms of a high probability of local control of disease with minimal side effects. Physically this often equates to the delivery of a high dose of radiation to the tumour or target region whilst maintaining an acceptably low dose to other tissues, particularly those adjacent to the target. Techniques such as intensity modulated radiotherapy (IMRT), stereotactic radiosurgery and computer planned brachytherapy provide the means to calculate the radiation dose delivery to achieve the desired dose distribution. Imaging is an essential tool in all state of the art planning and delivery techniques: (i) to enable planning of the desired treatment, (ii) to verify the treatment is delivered as planned and (iii) to follow-up treatment outcome to monitor that the treatment has had the desired effect. Clinical imaging techniques can be loosely classified into anatomic methods which measure the basic physical characteristics of tissue such as their density and biological imaging techniques which measure functional characteristics such as metabolism. In this review we consider anatomical imaging techniques. Biological imaging is considered in another article. Anatomical imaging is generally used for goals (i) and (ii) above. Computed tomography (CT) has been the mainstay of anatomical treatment planning for many years, enabling some delineation of soft tissue as well as radiation attenuation estimation for dose prediction. Magnetic resonance imaging is fast becoming widespread alongside CT, enabling superior soft-tissue visualization. Traditionally scanning for treatment planning has relied on the use of a single snapshot scan. Recent years have seen the development of techniques such as 4D CT and adaptive radiotherapy (ART). In 4D CT raw data are encoded with phase information and reconstructed to yield a set of scans detailing motion through the breathing, or cardiac, cycle. In ART a set of

  2. Chronic ankle instability: Arthroscopic anatomical repair. (United States)

    Arroyo-Hernández, M; Mellado-Romero, M; Páramo-Díaz, P; García-Lamas, L; Vilà-Rico, J

    Ankle sprains are one of the most common injuries. Despite appropriate conservative treatment, approximately 20-40% of patients continue to have chronic ankle instability and pain. In 75-80% of cases there is an isolated rupture of the anterior talofibular ligament. A retrospective observational study was conducted on 21 patients surgically treated for chronic ankle instability by means of an arthroscopic anatomical repair, between May 2012 and January 2013. There were 15 men and 6 women, with a mean age of 30.43 years (range 18-48). The mean follow-up was 29 months (range 25-33). All patients were treated by arthroscopic anatomical repair of anterior talofibular ligament. Four (19%) patients were found to have varus hindfoot deformity. Associated injuries were present in 13 (62%) patients. There were 6 cases of osteochondral lesions, 3 cases of posterior ankle impingement syndrome, and 6 cases of peroneal pathology. All these injuries were surgically treated in the same surgical time. A clinical-functional study was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. The mean score before surgery was 66.12 (range 60-71), and after surgery it increased up to a mean of 96.95 (range 90-100). All patients were able to return to their previous sport activity within a mean of 21.5 weeks (range 17-28). Complications were found in 3 (14%) patients. Arthroscopic anatomical ligament repair technique has excellent clinical-functional results with a low percentage of complications, and enables patients to return to their previous sport activity within a short period of time. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Anatomical Variations of Brachial Artery - Its Morphology, Embryogenesis and Clinical Implications (United States)

    KS, Siddaraju; Venumadhav, Nelluri; Sharma, Ashish; Kumar, Neeraj


    Background: Accurate knowledge of variation pattern of the major arteries of upper limb is of considerable practical importance in the conduct of reparative surgery in the arm, forearm and hand however brachial artery and its terminal branches variations are less common. Aim: Accordingly the present study was designed to evaluate the anatomical variations of the brachial artery and its morphology, embryogenesis and clinical implications. Materials and Methods: In an anatomical study 140 upper limb specimens of 70 cadavers (35 males and 35 females) were used and anatomical variations of the brachial artery have been documented. Results: Accessory brachial artery was noted in eight female cadavers (11.43%). Out of eight cadavers in three cadavers (4.29%) an unusual bilateral accessory brachial artery arising from the axillary artery and it is continuing in the forearm as superficial accessory ulnar artery was noted. Rare unusual variant unilateral accessory brachial artery and its reunion with the main brachial artery in the cubital fossa and its variable course in relation to the musculocutaneous nerve and median nerve were also noted in five cadavers (7.14%). Conclusion: As per our knowledge such anatomical variations of brachial artery and its terminal branches with their relation to the surrounding structures are not reported in the modern medical literature. An awareness of such a presence is valuable for the surgeons and radiologists in evaluation of angiographic images, vascular and re-constructive surgery or appropriate treatment for compressive neuropathies. PMID:25653931

  4. [Anatomical studying of the tear trough area]. (United States)

    Yang, Ningze; Qiu, Wei; Wang, Zhijun; Su, Xiaowei; Jia, Huafeng; Shi, Heng


    To explore the mechanism of the aging deformity of tear trough through the anatomic study of the tear trough region. 13 adult cadaveric heads (26 sides), including 9 male heads (18 sides) and 4 female heads (8 sides), aged 22-78 years old, were used. Anatomic study was performed around the orbital, especially tear trough region, with microsurgery instrument under microscope( x 10 times). The lower orbicularis retaining ligament was dissected and exposed. The anatomic location was recorded and photographed. (1) The anatomic layers of the tear trough region contains skin, subcutaneous tissue, orbicularis oculi muscle, periosteal membrane. There is no subcutaneous fat above the tear trough, while it exists below the tear trough, called malar fat pad. (2) There is a natural boundary between the septal and the orbital portions of the orbicularis oculi muscle of lower eyelid at surface of the orbital bone. The natural boundary, projected on the body surface corresponds to tear trough. The width of boundary is (2.06 +/- 0.15) mm on the vertical line through inner canthus and (3.25 +/- 0.12) mm on the vertical line through the lateral margin of the ala. The septal portion and the orbital portion of the orbicularis oculi muscle began to merge in (16.56 +/- 0.51) mm to inner canthus. (3) There is ligament attachment in the medial, upper and lower orbital and no ligament attachment in the lateral orbital. Orbicularis retaining ligament of lower eyelid is divided into two layers. (4) The medial of the upper layer of the orbicularis retaining ligament in lower eyelid originates from orbital margin and from preorbital walls laterally in (16.10 +/- 0.43) mm to the medial of lateral orbital margin, through orbicularis oculi muscle and ends at the skin. The lower layer of the orbicularis retaining ligament of lower eyelid originates from preorbital walls through orbicularis oculi muscle and its superficial fat, then ends at the skin. The length of tear trough is (16.56 +/- 0.51) mm

  5. The upper respiratory tract microbiome of hospitalised patients with community-acquired pneumonia of unknown aetiology: a pilot study

    Directory of Open Access Journals (Sweden)

    Timothy L Wiemken


    Full Text Available   The composition of the upper respiratory tract microbiome may play an important role in the development of lower respiratory tract infections. Here, we characterised the microbiome of the nasopharynx and oropharynx of hospitalised patients with community-acquired pneumonia (CAP with unknown aetiology in an attempt to obtain insight into the aetiology of CAP. A random sample of 10 patients hospitalised with CAP previously enrolled in a separate clinical trial ( registry, Study ID: NCT01248715 in which a complete microbiological workup was not able to define an aetiology were analysed in this pilot study. This larger trial (n = 1,221 enrolled patients from 9 adult hospitals in Louisville, Kentucky, USA. Nasopharyngeal and oropharyngeal swabs were obtained for metagenomic analysis. Polymerase chain reaction (PCR for Streptococcus pneumoniae was performed in all patients. One patient had a distinct nasophararyngeal microbiome consisting largely of Haemophilus influenzae. This was the only patient with a negative PCR for S. pneumoniae in both nasophararyngeal and oropharyngeal specimens. Overall, substantial differences were found between nasophararyngeal and oropharyngeal microbiomes. The upper respiratory tract microbiome of only one patient suggested H. influenzae as a probable aetiology of CAP. Although this was a pilot study of only 10 patients, the presence of S. pneumoniae in the upper respiratory tract of the other 9 patients warrants further investigation.

  6. Aetiology-Specific Estimates of the Global and Regional Incidence and Mortality of Diarrhoeal Diseases Commonly Transmitted through Food

    DEFF Research Database (Denmark)

    Pires, Sara Monteiro; Fischer-Walker, Christa L; Lanata, Claudio F


    Diarrhoeal diseases are major contributors to the global burden of disease, particularly in children. However, comprehensive estimates of the incidence and mortality due to specific aetiologies of diarrhoeal diseases are not available. The objective of this study is to provide estimates of the gl...

  7. Aetiologies of Central Nervous System Infection in Viet Nam: A Prospective Provincial Hospital-Based Descriptive Surveillance Study

    NARCIS (Netherlands)

    Ho Dang Trung, Nghia; Le Thi Phuong, Tu; Wolbers, Marcel; Nguyen van Minh, Hoang; Nguyen Thanh, Vinh; van, Minh Pham; Thieu, Nga Tran Vu; van, Tan Le; Song, Diep To; Thi, Phuong Le; Thi Phuong, Thao Nguyen; van, Cong Bui; Tang, Vu; Ngoc Anh, Tuan Hoang; Nguyen, Dong; Trung, Tien Phan; Thi Nam, Lien Nguyen; Kiem, Hao Tran; Thi Thanh, Tam Nguyen; Campbell, James; Caws, Maxine; Day, Jeremy; de Jong, Menno D.; van Vinh, Chau Nguyen; van Doorn, H. Rogier; Tinh, Hien Tran; Farrar, Jeremy; Schultsz, Constance; Loi, Tran Quoc; Son, Nguyen Truong; Bay, Phan Van Be; Tham, Nguyen Thi Hong; Phuong, Le Thi; Tri, Le Trung; Binh, Nguyen Thi Nguyet; Du, Doan Cong; Thao, Nguyen Thi Phuong; Tien, Truong Thi My; La, Tran Thi Phi; Cong, Bui Van; Diep, Pham Ngoc; Dong, Duong Phuoc; Lanh, Tran Thi Mong; Dom, Pham Van; Dung, Tran Quang; Tri, Phan Nhut; Ho, Tang Thi; Tai, Nguyen Anh; Luc, Quach Van; Phuoc, Dinh Xuan


    Background: Infectious diseases of the central nervous system (CNS) remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date

  8. Shared Genetic Aetiology between Cognitive Ability and Cardiovascular Disease Risk Factors: Generation Scotland's Scottish Family Health Study (United States)

    Luciano, Michelle; Batty, G. David; McGilchrist, Mark; Linksted, Pamela; Fitzpatrick, Bridie; Jackson, Cathy; Pattie, Alison; Dominiczak, Anna F.; Morris, Andrew D.; Smith, Blair H.; Porteous, David; Deary, Ian J.


    People with higher general cognitive ability in early life have more favourable levels of cardiovascular disease (CVD) risk factors in adulthood and CVD itself. The mechanism of these associations is not known. Here we examine whether general cognitive ability and CVD risk factors share genetic and/or environmental aetiology. In this large,…

  9. Assessment of the aetiological factors of non-specific (non gonococcal urethritis, taking burning micturition as criteria

    Directory of Open Access Journals (Sweden)

    Kuravi Anandam


    Full Text Available Out of 90 cases of non-specific urethritis investigated, aetiological factors could be found in 58 cases. However, in 45 cases i.e. 50%, the causative factors turned out to be common factors like pyogenic, fungal, and trichomonal infections only.

  10. Classification of hand eczema: clinical and aetiological types. Based on the guideline of the Danish Contact Dermatitis Group

    DEFF Research Database (Denmark)

    Johansen, Jeanne Duus; Hald, Marianne; Andersen, Bo Lasthein


    aetiological diagnosis. Results. Irritant contact dermatitis was most frequent in chronic, dry fissured hand eczema (44.3%), pulpitis (41.7%), and nummular hand eczema (40.9%), whereas allergic contact dermatitis dominated in vesicular types of hand eczema, with recurrent (35%) and few (24.2%) eruptions...

  11. System viability of organizations and the aetiology of organizational crisis : A Quantitative Assessment of Stafford Beer's Viable System Model

    NARCIS (Netherlands)

    Pfiffner, M.D.


    Subject of this dissertation is the aetiology of crisis processes which place organizations under existential threats and which often cause organizational demise and bankruptcy. To date, research on organizational crises (OC) has not succeeded in identifying the generic grounds for these detrimental

  12. A ten-year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam: Incidence and aetiology

    NARCIS (Netherlands)

    Salentijn, E.G.; Peerdeman, S.M.; Boffano, P.; van den Bergh, B.; Forouzanfar, T.


    In the literature it is questioned if the presence of maxillofacial trauma is associated with the presence of brain injury. The aim of this study is to present a 10-year retrospective study of the incidence and aetiology of maxillofacial trauma associated with brain injury that required both oral

  13. A ten-year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam: incidence and aetiology

    NARCIS (Netherlands)

    Salentijn, E.G.; Peerdeman, S.M.; Boffano, P.; van den Bergh, B.; Forouzanfar, T.


    In the literature it is questioned if the presence of maxillofacial trauma is associated with the presence of brain injury. The aim of this study is to present a 10-year retrospective study of the incidence and aetiology of maxillofacial trauma associated with brain injury that required both oral

  14. Aetiologies of non-malaria febrile episodes in children under 5 years in sub-Saharan Africa

    NARCIS (Netherlands)

    Kiemde, Francois; Spijker, René; Mens, Petra F.; Tinto, Halidou; Boele, Michael; Schallig, Henk D. F. H.


    ObjectivesTo provide an overview of the most frequent aetiologies found in febrile episodes of children under 5 years from sub-Saharan Africa. MethodsMEDLINE and EMBASE were searched for publications in English and French on non-malaria fever episodes in African children under 5 years of age, which

  15. Perceptions of disease aetiology and the effect of own behaviour on health among poly-pharmacy patients with non-Western backgrounds in Denmark

    DEFF Research Database (Denmark)

    Molin, Katrine Rutkaer; Mygind, Anna; Nørgaard, Lotte Stig


    To examine the perceptions of disease aetiology and the effect of own behaviour on health among poly-pharmacy patients with non-Western backgrounds in Denmark.......To examine the perceptions of disease aetiology and the effect of own behaviour on health among poly-pharmacy patients with non-Western backgrounds in Denmark....

  16. DOE handbook: Design considerations

    Energy Technology Data Exchange (ETDEWEB)



    The Design Considerations Handbook includes information and suggestions for the design of systems typical to nuclear facilities, information specific to various types of special facilities, and information useful to various design disciplines. The handbook is presented in two parts. Part 1, which addresses design considerations, includes two sections. The first addresses the design of systems typically used in nuclear facilities to control radiation or radioactive materials. Specifically, this part addresses the design of confinement systems and radiation protection and effluent monitoring systems. The second section of Part 1 addresses the design of special facilities (i.e., specific types of nonreactor nuclear facilities). The specific design considerations provided in this section were developed from review of DOE 6430.1A and are supplemented with specific suggestions and considerations from designers with experience designing and operating such facilities. Part 2 of the Design Considerations Handbook describes good practices and design principles that should be considered in specific design disciplines, such as mechanical systems and electrical systems. These good practices are based on specific experiences in the design of nuclear facilities by design engineers with related experience. This part of the Design Considerations Handbook contains five sections, each of which applies to a particular engineering discipline.

  17. DOE handbook: Design considerations

    International Nuclear Information System (INIS)


    The Design Considerations Handbook includes information and suggestions for the design of systems typical to nuclear facilities, information specific to various types of special facilities, and information useful to various design disciplines. The handbook is presented in two parts. Part 1, which addresses design considerations, includes two sections. The first addresses the design of systems typically used in nuclear facilities to control radiation or radioactive materials. Specifically, this part addresses the design of confinement systems and radiation protection and effluent monitoring systems. The second section of Part 1 addresses the design of special facilities (i.e., specific types of nonreactor nuclear facilities). The specific design considerations provided in this section were developed from review of DOE 6430.1A and are supplemented with specific suggestions and considerations from designers with experience designing and operating such facilities. Part 2 of the Design Considerations Handbook describes good practices and design principles that should be considered in specific design disciplines, such as mechanical systems and electrical systems. These good practices are based on specific experiences in the design of nuclear facilities by design engineers with related experience. This part of the Design Considerations Handbook contains five sections, each of which applies to a particular engineering discipline

  18. Fast correspondences search in anatomical trees (United States)

    dos Santos, Thiago R.; Gergel, Ingmar; Meinzer, Hans-Peter; Maier-Hein, Lena


    Registration of multiple medical images commonly comprises the steps feature extraction, correspondences search and transformation computation. In this paper, we present a new method for a fast and pose independent search of correspondences using as features anatomical trees such as the bronchial system in the lungs or the vessel system in the liver. Our approach scores the similarities between the trees' nodes (bifurcations) taking into account both, topological properties extracted from their graph representations and anatomical properties extracted from the trees themselves. The node assignment maximizes the global similarity (sum of the scores of each pair of assigned nodes), assuring that the matches are distributed throughout the trees. Furthermore, the proposed method is able to deal with distortions in the data, such as noise, motion, artifacts, and problems associated with the extraction method, such as missing or false branches. According to an evaluation on swine lung data sets, the method requires less than one second on average to compute the matching and yields a high rate of correct matches compared to state of the art work.

  19. Anatomical modeling of the bronchial tree (United States)

    Hentschel, Gerrit; Klinder, Tobias; Blaffert, Thomas; Bülow, Thomas; Wiemker, Rafael; Lorenz, Cristian


    The bronchial tree is of direct clinical importance in the context of respective diseases, such as chronic obstructive pulmonary disease (COPD). It furthermore constitutes a reference structure for object localization in the lungs and it finally provides access to lung tissue in, e.g., bronchoscope based procedures for diagnosis and therapy. This paper presents a comprehensive anatomical model for the bronchial tree, including statistics of position, relative and absolute orientation, length, and radius of 34 bronchial segments, going beyond previously published results. The model has been built from 16 manually annotated CT scans, covering several branching variants. The model is represented as a centerline/tree structure but can also be converted in a surface representation. Possible model applications are either to anatomically label extracted bronchial trees or to improve the tree extraction itself by identifying missing segments or sub-trees, e.g., if located beyond a bronchial stenosis. Bronchial tree labeling is achieved using a naïve Bayesian classifier based on the segment properties contained in the model in combination with tree matching. The tree matching step makes use of branching variations covered by the model. An evaluation of the model has been performed in a leaveone- out manner. In total, 87% of the branches resulting from preceding airway tree segmentation could be correctly labeled. The individualized model enables the detection of missing branches, allowing a targeted search, e.g., a local rerun of the tree-segmentation segmentation.

  20. Sleep Disturbance and Anatomic Shoulder Arthroplasty. (United States)

    Morris, Brent J; Sciascia, Aaron D; Jacobs, Cale A; Edwards, T Bradley


    Sleep disturbance is commonly encountered in patients with glenohumeral joint arthritis and can be a factor that drives patients to consider surgery. The prevalence of sleep disturbance before or after anatomic total shoulder arthroplasty has not been reported. The authors identified 232 eligible patients in a prospective shoulder arthroplasty registry following total shoulder arthroplasty for primary glenohumeral joint arthritis with 2- to 5-year follow-up. Sleep disturbance secondary to the affected shoulder was characterized preoperatively and postoperatively as no sleep disturbance, frequent sleep disturbance, or nightly sleep disturbance. A total of 211 patients (91%) reported sleep disturbance prior to surgery. Patients with nightly sleep disturbance had significantly worse (Psleep disturbance, with 186 patients (80%) reporting no sleep disturbance (Psleep disturbance group had significantly greater patient-reported outcome scores and range of motion following surgery compared with the other sleep disturbance groups for nearly all outcome measures (P≤.01). Patients have significant improvements in sleep after anatomic shoulder arthroplasty. There was a high prevalence of sleep disturbance preoperatively (211 patients, 91%) compared with postoperatively (46 patients, 20%). [Orthopedics. 2017; 40(3):e450-e454.]. Copyright 2017, SLACK Incorporated.

  1. Anatomical and roentgenographic features of atlantooccipital instability. (United States)

    Harris, M B; Duval, M J; Davis, J A; Bernini, P M


    An anatomical study using six fresh, human cadaveric cervical spine specimens was performed. After the dissection of all soft tissue, flexion-extension radiographs were obtained to verify initial stability. A sagittal plane bone cut was then made, centered on the odontoid and sparing the alar ligaments, the tectorial membrane, and the atlantooccipital (AO) ligaments. Repeat flexion-extension radiographs and photographs were taken to document maintenance of stability of these hemisections. The occipital-atlantoaxial ligaments were then individually and sequentially incised, maintaining all other structures each time. After the sectioning of each ligament, flexion-extension radiographs and photographs were obtained to identify subsequent motion patterns. Both gross anatomical and roentgenographic examinations demonstrated the important stabilizing role of the tectorial membrane in flexion. Additionally, contact between the posterior arch of C1 and the occiput limited hyperextension as a secondary restraint once the tectorial membrane was sectioned. Furthermore, the AO ligaments proved to play an insignificant role in the preservation of AO stability through a flexion-extension arc of motion. Under normal circumstances, the AO articulation is not excessively stressed. However, acute AO injury, as well as the insidious failure of these ligaments, has been documented in several cases involving various pathologies. This study demonstrates a mechanism of instability and highlights the essential role of the tectorial membrane in maintaining upper cervical spine stability.

  2. Anatomical features for an adequate choice of experimental animal model in biomedicine: II. Small laboratory rodents, rabbit, and pig. (United States)

    Lossi, Laura; D'Angelo, Livia; De Girolamo, Paolo; Merighi, Adalberto


    The anatomical features distinctive to each of the very large array of species used in today's biomedical research must be born in mind when considering the correct choice of animal model(s), particularly when translational research is concerned. In this paper we take into consideration and discuss the most important anatomical and histological features of the commonest species of laboratory rodents (rat, mouse, guinea pig, hamster, and gerbil), rabbit, and pig related to their importance for applied research. Copyright © 2015 Elsevier GmbH. All rights reserved.

  3. Computed tomography of the retroperitoneum: an anatomical and pathological atlas with emphasis on the fascial planes

    International Nuclear Information System (INIS)

    Feldberg, M.A.M.


    The aim of this thesis is to provide a descriptive clinical pathological CT atlas of a range of conditions involving retroperitoneum and neighbouring organs and structures (excluding the pelvic part of the retroperitoneum). Chapter 1 describes the patient material studied, some aspects of CT techniques and patient handling. Chapter 2 describes the anatomy of the renal fascia based upon reports derived from the literature and is followed by our CT observations in more than 5000 abdominal CT examinations. In short it is an anatomical CT atlas. Chapters 3, 4 and 5 deal with reactions of the fascial structures in different pathological conditions caused by major disease entities. The patients were scanned for these diseases, of which anatomical topographical appearances and spread are described in the general considerations, followed by CT findings and illustrative cases, combined with abstracted experience from other workers. (Auth.)

  4. The aetiology of rickets-like lower limb deformities in Malawian children. (United States)

    Braithwaite, V S; Freeman, R; Greenwood, C L; Summers, D M; Nigdikar, S; Lavy, C B D; Offiah, A C; Bishop, N J; Cashman, J; Prentice, A


    Debilitating rickets-like lower limb deformities are common in children throughout the world, particularly in Malawi, Africa where the causes are unknown. We have identified that Blount disease and calcium deficiency rickets are the likely causes of these deformities and propose calcium supplementation as a potential treatment of Malawian rickets. Surgical correction of rickets-like lower limb deformities is the most common paediatric operation performed at Beit Cure Orthopaedic Hospital, Malawi. The aim of this study was to investigate the aetiology of these deformities. Children with a tibio-femoral angle of deformity >20° were enrolled (n = 42, 3.0-15.0 years). Anthropometric and early life and well-being data were collected. Early morning serum and urine samples were collected on the morning of the operation for markers of calcium and phosphate homeostasis. Knee radiographs were obtained, and the children were diagnosed with either Blount (BD, n = 22) or evidence of rickets disease (RD, n = 20). As BD is a mechanical rather than metabolic disease, BD were assumed to be biochemically representative of the local population and thus used as a local reference for RD. There were no differences in anthropometry or early life experiences between BD and RD. Parathyroid hormone (PTH), 1,25-dihydroxyvitamin D, total alkaline phosphatase and urinary phosphate were significantly higher and serum phosphate, 25-hydroxyvitamin D (25OHD) and tubular maximal reabsorption of phosphate significantly lower in RD than BD. There was no difference in serum calcium, fibroblast growth factor 23 or markers of iron status between groups. All children had 25OHD > 25 nmol/L. Vitamin D deficiency is not implicated in the aetiology of RD or BD in Malawian children. The cause of RD in Malawi is likely to be dietary calcium deficiency leading to elevated PTH resulting in increased losses of phosphate from the bone and glomerular filtrate. The causes of BD remain unclear

  5. The Influence of Circadian Variation on Aetiological Markers of Ankle Injury. (United States)

    Brogden, Chris; Marrin, Kelly; Page, Richard; Greig, Matt


    Clinical and functional assessments are performed regularly in sporting environments to screen for performance deficits and injury risk. Circadian rhythms have been demonstrated to affect human performance, however the influence of time of day on a battery of multiple ankle injury risk factors has yet to be established within athletic populations. To investigate the influence of circadian variation on a battery of tests, used to screen for ankle aetiological risk factors. Randomised crossover design. University laboratory. Thirty-three semi-professional soccer players (age 24.9 ± 4.4 years; height 1.77 ± 0.17 m; body mass 75.47 ± 7.98 kg) completed three randomized experimental trials (07:00 h, 12:00 h, 19:00 h) Main Outcome Measures: Trials involved the completion of a standardized test battery comprising Biodex Stability System (BSS), Star Excursion Balance Test (SEBT), isokinetic inversion: eversion ratio, joint position sense, and a drop landing inversion cutting manoeuvre. Repeated measures analysis of variance revealed significantly (P < 0.05) lower values for all BSS indicia; Overall Stability Index (1.10 ± 0.31 a.u), Anterior-Posterior (0.76 ± 0.21 a.u) and Medio-Lateral (0.68 ± 0.23) at 12:00 h when compared to 07:00 h. (1.30 ± 0.45 a.u; 0.96 ± 0.26 a.u; 0.82 ± 0.40 a.u) respectively. However, no significant (P ≥ 0.05) main effects for time of day were reported for any other test. Circadian influence on ankle aetiological risk factors was task dependent, with measures of proprioception, strength and SEBT displaying no circadian variation, indicating no association between time of day and markers of injury risk. However, the BSS displayed improved performance at midday, indicating postural stability tasks requiring unanticipated movements to display a time of day effect and potential increased injury risk. Consequently, time of testing for this task should be standardized to ensure correct interpretations of assessments and/or interventions.

  6. Anatomical study of middle cluneal nerve entrapment

    Directory of Open Access Journals (Sweden)

    Konno T


    Full Text Available Tomoyuki Konno,1 Yoichi Aota,2 Tomoyuki Saito,1 Ning Qu,3 Shogo Hayashi,3 Shinichi Kawata,3 Masahiro Itoh3 1Department of Orthopaedic Surgery, Yokohama City University, 2Department of Spine and Spinal Cord, Yokohama Brain and Spine Center, Yokohama City, 3Department of Anatomy, Tokyo Medical University, Tokyo, Japan Object: Entrapment of the middle cluneal nerve (MCN under the long posterior sacroiliac ligament (LPSL is a possible, and underdiagnosed, cause of low-back and/or leg symptoms. To date, detailed anatomical studies of MCN entrapment are few. The purpose of this study was to ascertain, using cadavers, the relationship between the MCN and LPSL and to investigate MCN entrapment. Methods: A total of 30 hemipelves from 20 cadaveric donors (15 female, 5 male designated for education or research, were studied by gross anatomical dissection. The age range of the donors at death was 71–101 years with a mean of 88 years. Branches of the MCN were identified under or over the gluteus maximus fascia caudal to the posterior superior iliac spine (PSIS and traced laterally as far as their finest ramification. Special attention was paid to the relationship between the MCN and LPSL. The distance from the branch of the MCN to the PSIS and to the midline and the diameter of the MCN were measured. Results: A total of 64 MCN branches were identified in the 30 hemipelves. Of 64 branches, 10 (16% penetrated the LPSL. The average cephalocaudal distance from the PSIS to where the MCN penetrated the LPSL was 28.5±11.2 mm (9.1–53.7 mm. The distance from the midline was 36.0±6.4 mm (23.5–45.2 mm. The diameter of the MCN branch traversing the LPSL averaged 1.6±0.5 mm (0.5–3.1 mm. Four of the 10 branches penetrating the LPSL had obvious constriction under the ligament. Conclusion: This is the first anatomical study illustrating MCN entrapment. It is likely that MCN entrapment is not a rare clinical entity. Keywords: middle cluneal nerve, sacroiliac joint

  7. Mistakes in the usage of anatomical terminology in clinical practice. (United States)

    Kachlik, David; Bozdechova, Ivana; Cech, Pavel; Musil, Vladimir; Baca, Vaclav


    Anatomical terminology serves as a basic communication tool in all the medical fields. Therefore Latin anatomical nomenclature has been repetitively issued and revised from 1895 (Basiliensia Nomina Anatomica) until 1998, when the last version was approved and published as the Terminologia Anatomica (International Anatomical Terminology) by the Federative Committee on Anatomical Terminology. A brief history of the terminology and nomenclature development is mentioned, along with the concept and contributions of the Terminologia Anatomica including the employed abbreviations. Examples of obsolete anatomical terms and their current synonyms are listed. Clinicians entered the process of the nomenclature revision and this aspect is demonstrated with several examples of terms used in clinical fields only, some already incorporated in the Terminologia Anatomica and a few obsolete terms still alive in non-theoretical communication. Frequent mistakes in grammar and orthography are stated as well. Authors of the article strongly recommend the use of the recent revision of the Latin anatomical nomenclature both in theoretical and clinical medicine.

  8. Contribution to the anatomical nomenclature concerning lower limb anatomy. (United States)

    Kachlik, David; Musil, Vladimir; Baca, Vaclav


    The aim of this article is to extend and revise the sections of Terminologia Anatomica (TA) dealing with the lower limb structures and to justify the use of newly proposed anatomical terms in clinical medicine, education, and research. Anatomical terms were gathered during our educational experience from anatomical textbooks and journals and compared with the four previous editions of the official Latin anatomical nomenclature. The authors summarise 270 terms with their definitions and explanations for both constant and variable morphological structures (bones, joints, muscles, vessels, nerves and superficial structures) of the hip, thigh, knee, leg, ankle, and foot completed with several grammatical remarks and some general anatomical terms. The proposed terms should be discussed in wider anatomical community and potentially added to next edition of the TA.

  9. Early Results of Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction


    Demet Pepele


    Aim: The goal in anterior cruciate ligament reconstruction (ACLR) is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our ...

  10. Internuclear ophthalmoplegia: MR imaging and anatomic correlation

    International Nuclear Information System (INIS)

    Atlas, S.W.; Grossman, R.I.; Savino, P.J.


    Internuclear ophthalmoplegia is a gaze disorder characterized by impaired adduction of the side of a lesion in the medial longitudinal fasciculus (MLF) with dissociated nystagmus of the abducting eye. Eleven patients with internuclear ophthalmoplegia (nine with multiple sclerosis, two with infarction) were examined with spin-echo MR imaging performed at 1.5 T. Nine of the 11 patients also underwent CT. MR imaging was highly sensitive (10 of 11 cases) and CT was of no value (0 of 9 cases) in detecting clinically suspected MLF lesions. These lesions must be distinguished from ''pseudo-MLF hyperintensity,'' which appears as a thin, strictly midline, linear hyperintensity just interior to the fourth ventricle and aqueduct in healthy subjects. True MLF lesions are nodular, more prominent, and slightly off the midline, corresponding to the paramedian anatomic site of the MLF

  11. Anatomic Twist to a Straightforward Ablation

    Directory of Open Access Journals (Sweden)

    Mandeep Singh Randhawa, MD


    Full Text Available Atrioventricular (AV junction ablation for treatment of refractory atrial fibrillation is a well defined, standardized procedure and the simplest of commonly performed radiofrequency ablations in the field of cardiac electrophysiology. We report successful AV junction ablation using an inferior approach in a case of inferior vena cava interruption. Inability during the procedure to initially pass the ablation catheter into the right ventricle, combined with low amplitude electrograms, led to suspicion of an anatomic abnormality. This was determined to be a heterotaxy syndrome with inferior vena cava interruption and azygos continuation, draining in turn into the superior vena cava. Advancing Schwartz right 0 (SRO sheath through the venous abnormality into the right atrium allowed adequate catheter stability to successfully induce complete AV block with radiofrequency energy.

  12. [Antique anatomical collections for contemporary museums]. (United States)

    Nesi, Gabriella; Santi, Raffaella


    Anatomy and Pathology Museum collections display a great biological value and offer unique samples for research purposes. Pathological specimens may be investigated by means of modern radiological and molecular biology techniques in order to provide the etiological background of disease, with relevance to present-day knowledge. Meanwhile, historical resources provide epidemiologic data regarding the socio-economic conditions of the resident populations, the more frequently encountered illnesses and dietary habits. These multidisciplinary approaches lead to more accurate diagnoses also allowing new strategies in cataloguing and musealization of anatomical specimens. Further, once these data are gathered, they may constitute the basis of riedited Museum catalogues feasible to be digitalized and displayed via the Web.

  13. Considerations for Visualizing Comparison. (United States)

    Gleicher, Michael


    Supporting comparison is a common and diverse challenge in visualization. Such support is difficult to design because solutions must address both the specifics of their scenario as well as the general issues of comparison. This paper aids designers by providing a strategy for considering those general issues. It presents four considerations that abstract comparison. These considerations identify issues and categorize solutions in a domain independent manner. The first considers how the common elements of comparison-a target set of items that are related and an action the user wants to perform on that relationship-are present in an analysis problem. The second considers why these elements lead to challenges because of their scale, in number of items, complexity of items, or complexity of relationship. The third considers what strategies address the identified scaling challenges, grouping solutions into three broad categories. The fourth considers which visual designs map to these strategies to provide solutions for a comparison analysis problem. In sequence, these considerations provide a process for developers to consider support for comparison in the design of visualization tools. Case studies show how these considerations can help in the design and evaluation of visualization solutions for comparison problems.

  14. Tuberous sclerosis Anaesthetic considerations

    African Journals Online (AJOL)


    SYNDROMIC VIGNETTES IN ANAESTHESIA. Southern African Journal of Anaesthesia & Analgesia - May 2003. 4. Tuberous sclerosis. Anaesthetic considerations. Tuberous sclerosis. Tuberous sclerosis(TS) was first described by Bourneville in. 1880.1 TS is said to be one of the commonest autosomal domi- nant diseases.

  15. Review article: the aetiology, diagnosis, mechanisms and clinical evidence for food intolerance. (United States)

    Lomer, M C E


    Food intolerance is non-immunological and is often associated with gastrointestinal symptoms. To focus on food intolerance associated with gastrointestinal symptoms and critically appraise the literature in relation to aetiology, diagnosis, mechanisms and clinical evidence. A search using the terms and variants of food intolerance, lactose, FODMAP, gluten, food chemicals within Pubmed, Embase and Scopus was carried out and restricted to human studies published in English. Additionally, references from relevant papers were hand searched for other appropriate studies. Food intolerance affects 15-20% of the population and may be due to pharmacological effects of food components, noncoeliac gluten sensitivity or enzyme and transport defects. There have been significant advances in understanding the scientific basis of gastrointestinal food intolerance due to short-chain fermentable carbohydrates (FODMAPs). The most helpful diagnostic test for food intolerance is food exclusion to achieve symptom improvement followed by gradual food reintroduction. A low FODMAP diet is effective, however, it affects the gastrointestinal microbiota and FODMAP reintroduction to tolerance is part of the management strategy. There is increasing evidence for using a low FODMAP diet in the management of functional gastrointestinal symptoms where food intolerance is suspected. Exclusion diets should be used for as short a time as possible to induce symptom improvement, and should be followed by gradual food reintroduction to establish individual tolerance. This will increase dietary variety, ensure nutritional adequacy and minimise impact on the gastrointestinal microbiota. © 2014 John Wiley & Sons Ltd.

  16. Clinical Presentation, Aetiology, and Outcomes of Meningitis in a Setting of High HIV and TB Prevalence

    Directory of Open Access Journals (Sweden)

    Keneuoe Hycianth Thinyane


    Full Text Available Meningitis causes significant morbidity and mortality globally. The aim of this study was to study the clinical presentation, aetiology, and outcomes of meningitis among adult patients admitted to Queen Mamohato Memorial Hospital in Maseru, Lesotho, with a diagnosis of meningitis. A cross-sectional study was conducted between February and April 2014; data collected included presenting signs and symptoms, laboratory results, and clinical outcomes. Descriptive statistics were used to summarise data; association between variables was analysed using Fisher’s exact test. 56 patients were enrolled; the HIV coinfection rate was 79%. The most common presenting symptoms were altered mental status, neck stiffness, headache, and fever. TB meningitis was the most frequent diagnosis (39%, followed by bacterial (27%, viral (18%, and cryptococcal meningitis (16%. In-hospital mortality was 43% with case fatalities of 23%, 40%, 44%, and 90% for TB, bacterial, cryptococcal, and viral meningitis, respectively. Severe renal impairment was significantly associated with mortality. In conclusion, the causes of meningitis in this study reflect the high prevalence of HIV and TB in our setting. Strategies to reduce morbidity and mortality due to meningitis should include improving diagnostic services to facilitate early detection and treatment of meningitis and timely initiation of antiretroviral therapy in HIV-infected patients.

  17. Periodontitis with hypercementosis: report of a case and discussion of possible aetiologic factors. (United States)

    Zhou, J; Zhao, Yf; Xia, Cy; Jiang, L


    Hypercementosis may be idiopathic or secondary to either local factors or systemic disorders. However, periodontitis as an aetiologic factor in the formation of hypercementosis has never been documented in the literature. We report a case of periodontitis with hypercementosis, affecting the right mandibular second premolar and first molar teeth. Our patient's maxillary was edentulous and the mandibular teeth #47, #43, #42, #41, #31, #32, #33, #36, #37 were missing. The right mandibular second premolar and first molar had first-degree mobility and second-degree mobility respectively. Periodontal pocket depth in the right mandibular second premolar and first molar were 5 mm and 8 mm at buccal pockets, 6 mm and 9 mm at distal pockets, respectively. The radiograph revealed that the roots of both teeth were grossly thickened and blunted. The right mandibular first molar was extracted and sent for histopathological examination. The definitive diagnoses were periodontitis and hypercementosis. The concomitant occurrence of periodontitis and hypercementosis in our patient suggests that periodontitis is a predisposing factor for hypercementosis development. This condition may be associated with various local stimuli and possible compensative phenomenon. © 2012 Australian Dental Association.

  18. Chronic kidney disease of unknown aetiology in Sri Lanka: is cadmium a likely cause?

    Directory of Open Access Journals (Sweden)

    Peiris-John Roshini J


    Full Text Available Abstract Background The rising prevalence of chronic kidney disease (CKD and subsequent end stage renal failure necessitating renal replacement therapy has profound consequences for affected individuals and health care resources. This community based study was conducted to identify potential predictors of microalbuminuria in a randomly selected sample of adults from the North Central Province (NCP of Sri Lanka, where the burden of CKD is pronounced and the underlying cause still unknown. Methods Exposures to possible risk factors were determined in randomly recruited subjects (425 females and 461 males from selected areas of the NCP of Sri Lanka using an interviewer administered questionnaire. Sulphosalicylic acid and the Light Dependent Resister microalbumin gel filtration method was used for initial screening for microalbuminuria and reconfirmed by the Micral strip test. Results Microalbumnuria was detected in 6.1% of the females and 8.5% of the males. Smoking (p Conclusions Hypertension, diabetes mellitus, UTI, and smoking are known risk factors for microalbuminuria. The association between microalbuminuria and consumption of well water suggests an environmental aetiology to CKD in NCP. The causative agent is yet to be identified. Investigations for cadmium as a potential causative agent needs to be initiated.

  19. Clinical Presentation, Aetiology, and Outcomes of Meningitis in a Setting of High HIV and TB Prevalence (United States)

    Thinyane, Keneuoe Hycianth; Motsemme, Keanole Mofona; Cooper, Varsay Jim Lahai


    Meningitis causes significant morbidity and mortality globally. The aim of this study was to study the clinical presentation, aetiology, and outcomes of meningitis among adult patients admitted to Queen Mamohato Memorial Hospital in Maseru, Lesotho, with a diagnosis of meningitis. A cross-sectional study was conducted between February and April 2014; data collected included presenting signs and symptoms, laboratory results, and clinical outcomes. Descriptive statistics were used to summarise data; association between variables was analysed using Fisher's exact test. 56 patients were enrolled; the HIV coinfection rate was 79%. The most common presenting symptoms were altered mental status, neck stiffness, headache, and fever. TB meningitis was the most frequent diagnosis (39%), followed by bacterial (27%), viral (18%), and cryptococcal meningitis (16%). In-hospital mortality was 43% with case fatalities of 23%, 40%, 44%, and 90% for TB, bacterial, cryptococcal, and viral meningitis, respectively. Severe renal impairment was significantly associated with mortality. In conclusion, the causes of meningitis in this study reflect the high prevalence of HIV and TB in our setting. Strategies to reduce morbidity and mortality due to meningitis should include improving diagnostic services to facilitate early detection and treatment of meningitis and timely initiation of antiretroviral therapy in HIV-infected patients. PMID:26491454

  20. Factor structure and aetiological architecture of the BRIEF: A twin study. (United States)

    Little, Callie W; Taylor, Jeanette; Moltisanti, Allison; Ennis, Chelsea; Hart, Sara A; Schatschneider, Chris


    Executive function is a broad construct that encompasses various processes involved in goal-directed behaviour in non-routine situations (Banich, 2009). The present study uses a sample of 560 5- to 16-year-old twin pairs (M = 11.14, SD = 2.53): 219 monozygotic twin pairs (114 female; 105 male) and 341 dizygotic twin pairs (136 female, 107 male; 98 opposite sex) to extend prior literature by providing information about the factor structure and the genetic and environmental architecture of the Behavior Rating Inventory of Executive Function (BRIEF; Gioia et al., 2000, Child Neuropsychol., 6, 235; Gioia et al., 2000, Behavior rating inventory of executive function, Lutz, FL: Psychological Assessment Resources), a multifaceted rating scale of everyday executive functions. Phenotypic results revealed a 9-scale, 3-factor model best represents the BRIEF structure within the current sample. Results of the genetically sensitive analyses indicated the presence of rater bias/contrast effects for the Initiate, Working Memory, and Task-Monitor scales. Additive genetic and non-shared environmental influences were present for the Initiate, Plan/Organize, Organization of Materials, Shift, and Monitor and Self-Monitor scales. Influences on Emotional Control were solely environmental. Interestingly, the aetiological architecture observed was similar to that of performance-based measures of executive function. This observed similarity provided additional evidence for the usefulness of the BRIEF as a measure of 'everyday' executive function. © 2015 The British Psychological Society.

  1. Understanding the aetiology and resolution of chronic otitis media from animal and human studies

    Directory of Open Access Journals (Sweden)

    Mahmood F. Bhutta


    Full Text Available Inflammation of the middle ear, known clinically as chronic otitis media, presents in different forms, such as chronic otitis media with effusion (COME; glue ear and chronic suppurative otitis media (CSOM. These are highly prevalent diseases, especially in childhood, and lead to significant morbidity worldwide. However, much remains unclear about this disease, including its aetiology, initiation and perpetuation, and the relative roles of mucosal and leukocyte biology, pathogens, and Eustachian tube function. Chronic otitis media is commonly modelled in mice but most existing models only partially mimic human disease and many are syndromic. Nevertheless, these models have provided insights into potential disease mechanisms, and have implicated altered immune signalling, mucociliary function and Eustachian tube function as potential predisposing mechanisms. Clinical studies of chronic otitis media have yet to implicate a particular molecular pathway or mechanism, and current human genetic studies are underpowered. We also do not fully understand how existing interventions, such as tympanic membrane repair, work, nor how chronic otitis media spontaneously resolves. This Clinical Puzzle article describes our current knowledge of chronic otitis media and the existing research models for this condition. It also identifies unanswered questions about its pathogenesis and treatment, with the goal of advancing our understanding of this disease to aid the development of novel therapeutic interventions.

  2. Understanding the aetiology and resolution of chronic otitis media from animal and human studies. (United States)

    Bhutta, Mahmood F; Thornton, Ruth B; Kirkham, Lea-Ann S; Kerschner, Joseph E; Cheeseman, Michael T


    Inflammation of the middle ear, known clinically as chronic otitis media, presents in different forms, such as chronic otitis media with effusion (COME; glue ear) and chronic suppurative otitis media (CSOM). These are highly prevalent diseases, especially in childhood, and lead to significant morbidity worldwide. However, much remains unclear about this disease, including its aetiology, initiation and perpetuation, and the relative roles of mucosal and leukocyte biology, pathogens, and Eustachian tube function. Chronic otitis media is commonly modelled in mice but most existing models only partially mimic human disease and many are syndromic. Nevertheless, these models have provided insights into potential disease mechanisms, and have implicated altered immune signalling, mucociliary function and Eustachian tube function as potential predisposing mechanisms. Clinical studies of chronic otitis media have yet to implicate a particular molecular pathway or mechanism, and current human genetic studies are underpowered. We also do not fully understand how existing interventions, such as tympanic membrane repair, work, nor how chronic otitis media spontaneously resolves. This Clinical Puzzle article describes our current knowledge of chronic otitis media and the existing research models for this condition. It also identifies unanswered questions about its pathogenesis and treatment, with the goal of advancing our understanding of this disease to aid the development of novel therapeutic interventions. © 2017. Published by The Company of Biologists Ltd.

  3. Proteomics of a conundrum: Thoughts on addressing the aetiology versus progression of multiple sclerosis. (United States)

    Partridge, Melissa A; Myers, Simon J; Gopinath, Sumana; Coorssen, Jens R


    Currently in the field of multiple sclerosis (MS) research there is an ongoing debate concerning the cause of the disease. MS is widely considered to begin with an autoimmune dysregulation. The disease does have a prominent autoimmune component however this may be representative of a secondary effect. There is growing evidence that the disease may be initiated by an underlying degeneration of oligodendrocytes. In our viewpoint, we discuss the potential differences between the aetiology and progression of MS. For the most part, proteomic analysis has focused on the autoimmune component of the disease. We suggest that proteomic analysis should be applied to investigating oligodendrocyte degeneration. We discuss the potential of the cuprizone animal model of demyelination and its usefulness in understanding oligodendrocyte degeneration. Immune suppressive therapies are effective at reducing clinical symptoms and improving quality of life. However, a cure is still lacking and as such the disease does still progress. We suggest that if the initiating cause is poorly understood, then curing MS is unlikely. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. A cross-sectional study on aetiology of diarrhoeal disease, India

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    S Purwar


    Full Text Available Background: Global, regional and national estimates clearly place diarrhoeal diseases as a major, albeit to an extant neglected public health problem. Deaths of children aged <5 years owing to diarrhoea was estimated to be 1.87 million at the global level (uncertainty range from 1.56 to 2.19 million, which is approximately 19% of total child deaths. Objectives: The present report is a cross-sectional study undertaken to estimate the role of various aetiological agents causing diarrhoea in North Karnataka and adjoining areas of Maharashtra and Goa. Methods: Three hundred stool samples were collected from patients seeking health care at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum; and processed for detection of various bacterial, viral and parasitic agents. Results: Bacterial pathogens attributed to 65.7% of diarrhoea cases, followed by viral infection (22%, parasitic infection (16.3% and infection by Candida spp. (5.6%. The study identified Escherichia coli in general and Enteropathogenic E. coli in particular, and Group A Rotavirus to be the most frequently isolated pathogens among diarrhoea patients. Conclusion: The data generated from the current study will help the health officials for better interventional and treatment strategies for diarrhoeal diseases.

  5. Supernatural beliefs, aetiological models and help seeking behaviour in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Natasha Kate


    Full Text Available Background: Few studies have evaluated the supernatural beliefs of patients with schizophrenia. This study aimed to study the personal beliefs, aetiological models and help seeking behaviour of patients with schizophrenia using a self-rated questionnaire. Materials and Methods: Seventy three patients returned the completed supernatural Attitude questionnaire. Results: 62% of patients admitted that people in their community believed in sorcery and other magico-religious phenomena. One fourth to half of patients believed in ghosts/evil spirit (26%, spirit intrusion (28.8% and sorcery (46.6%. Two-third patients believed that mental illness can occur either due to sorcery, ghosts/evil spirit, spirit intrusion, divine wrath, planetary/astrological influences, dissatisfied or evil spirits and bad deeds of the past. 40% of the subjects attributed mental disorders to more than one of these beliefs. About half of the patients (46.6% believed that only performance of prayers was sufficient to improve their mental status. Few patients (9.6% believed that magico-religious rituals were sufficient to improve their mental illness but about one-fourth (24.7% admitted that during recent episode either they or their caregivers performed magico-religious rituals. Conclusion: Supernatural beliefs are common in patients with schizophrenia and many of them attribute the symptoms of mental disorders to these beliefs.

  6. Aetiological overlap between anxiety and attention deficit hyperactivity symptom dimensions in adolescence. (United States)

    Michelini, Giorgia; Eley, Thalia C; Gregory, Alice M; McAdams, Tom A


    Anxiety and attention-deficit/hyperactivity (ADH) problems are common in adolescence, often co-occur, and are characterised by high heterogeneity in their phenotypic expressions. Although it is known that anxiety and ADH problems correlate, the relationships between subtypes of anxiety and ADH problems have been scarcely investigated. Using a large population sample of adolescent twins and siblings we explored the phenotypic and aetiological association between anxiety subtypes (panic/agoraphobia, separation anxiety, social anxiety, physical injury fears, obsessive-compulsive symptoms and generalised anxiety) and the two ADH dimensions (attention problems and hyperactivity/impulsivity). Both phenotypes were assessed using self-report questionnaires. The association between ADH problems and anxiety could be entirely attributed to attention problems, not hyperactivity/impulsivity. Most of the correlations between anxiety subtypes and attention problems showed an approximately equal role of genetic and nonshared environmental factors. The high heterogeneity within anxiety and ADH problems should be taken into account in order to better understand comorbidity between them. © 2014 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

  7. Eisenmenger syndrome and idiopathic pulmonary arterial hypertension: do parenchymal lung changes reflect aetiology?

    International Nuclear Information System (INIS)

    Griffin, N.; Allen, D.; Wort, J.; Rubens, M.; Padley, S.


    Aim: To document the pulmonary vascular changes on thin-section computed tomography (CT) in patients with Eisenmenger syndrome and idiopathic pulmonary arterial hypertension, and to determine whether there is any correlation with pulmonary arterial pressures or the aetiology of pulmonary hypertension. Material and methods: From the National Pulmonary Hypertension Database, we identified eight patients with idiopathic pulmonary arterial hypertension and 20 patients with Eisenmenger syndrome (secondary to a ventriculoseptal defect) who had also undergone contrast-enhanced thin-section CT. CT studies were reviewed for the presence of centrilobular nodules, mosaicism, neovascularity, and bronchial artery hypertrophy. Haemodynamic data were also reviewed. Results: Centrilobular nodules, mosaicism, and neovascularity were seen in both patient groups (p > 0.05). A significantly higher number of enlarged bronchial arteries were seen in patients with Eisenmenger syndrome. There was no correlation with pulmonary arterial pressures. Conclusion: Patients with idiopathic pulmonary arterial hypertension and Eisenmenger syndrome demonstrated similar pulmonary vascular changes on CT. These changes did not predict the underlying cause of pulmonary hypertension or its severity

  8. Eisenmenger syndrome and idiopathic pulmonary arterial hypertension: do parenchymal lung changes reflect aetiology?

    Energy Technology Data Exchange (ETDEWEB)

    Griffin, N. [Royal Brompton and Harefield NHS Trust, London (United Kingdom)]. E-mail:; Allen, D. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Wort, J. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Rubens, M. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Padley, S. [Royal Brompton and Harefield NHS Trust, London (United Kingdom)


    Aim: To document the pulmonary vascular changes on thin-section computed tomography (CT) in patients with Eisenmenger syndrome and idiopathic pulmonary arterial hypertension, and to determine whether there is any correlation with pulmonary arterial pressures or the aetiology of pulmonary hypertension. Material and methods: From the National Pulmonary Hypertension Database, we identified eight patients with idiopathic pulmonary arterial hypertension and 20 patients with Eisenmenger syndrome (secondary to a ventriculoseptal defect) who had also undergone contrast-enhanced thin-section CT. CT studies were reviewed for the presence of centrilobular nodules, mosaicism, neovascularity, and bronchial artery hypertrophy. Haemodynamic data were also reviewed. Results: Centrilobular nodules, mosaicism, and neovascularity were seen in both patient groups (p > 0.05). A significantly higher number of enlarged bronchial arteries were seen in patients with Eisenmenger syndrome. There was no correlation with pulmonary arterial pressures. Conclusion: Patients with idiopathic pulmonary arterial hypertension and Eisenmenger syndrome demonstrated similar pulmonary vascular changes on CT. These changes did not predict the underlying cause of pulmonary hypertension or its severity.


    Directory of Open Access Journals (Sweden)

    Salvatore Perrone


    Full Text Available Marginal zone lymphomas have been associated with several infectious agents covering both viral and bacterial pathogens and in some cases a clear aetiological role has been established. Pathogenetic mechanisms are currently not completely understood, however the role of chronic stimulation of the host immune response with persistent lymphocyte activation represents the most convincing explanation for lymphoproliferation. Gastric MALT lymphoma is strictly associated with Helicobacter pylori infection and various eradicating protocols, developed due to increasing antibiotic resistance, represent the first line therapy. The response rate to eradication is good with 80% of response at 1 year; this finding is also noteworthy because recapitulates a cancer cured only by antibacterial approach and it satisfies the Koch postulates of causation, establishing a causative relationship between Hp and gastric MALT lymphoma. Patients with chronic HCV infection have 5 times higher risk to develop MZL, in particular an association with splenic and nodal MZL has been shown in several studies. Moreover, there is evidence of lymphoma regression after antiviral therapy with interferon+ribavirin, thus rising hope that new available drugs, extremely effective against HCV replication, could improve outcome also in HCV-driven lymphomas. The rare cases of MZL localized to orbital fat and eye conjunctivas have been associated with Chlamydia psittaci infection carried by birds. Efficacy of antibacterial therapy against C. psittaci are conflicting and generally poorer thain gastric MALT. Finally some case-reports will cover the relationship between primary cutaneous B-cell Lymphomas and Borrelia Burgdorferi.

  10. Understanding the aetiology and resolution of chronic otitis media from animal and human studies (United States)

    Thornton, Ruth B.; Kirkham, Lea-Ann S.; Kerschner, Joseph E.; Cheeseman, Michael T.


    ABSTRACT Inflammation of the middle ear, known clinically as chronic otitis media, presents in different forms, such as chronic otitis media with effusion (COME; glue ear) and chronic suppurative otitis media (CSOM). These are highly prevalent diseases, especially in childhood, and lead to significant morbidity worldwide. However, much remains unclear about this disease, including its aetiology, initiation and perpetuation, and the relative roles of mucosal and leukocyte biology, pathogens, and Eustachian tube function. Chronic otitis media is commonly modelled in mice but most existing models only partially mimic human disease and many are syndromic. Nevertheless, these models have provided insights into potential disease mechanisms, and have implicated altered immune signalling, mucociliary function and Eustachian tube function as potential predisposing mechanisms. Clinical studies of chronic otitis media have yet to implicate a particular molecular pathway or mechanism, and current human genetic studies are underpowered. We also do not fully understand how existing interventions, such as tympanic membrane repair, work, nor how chronic otitis media spontaneously resolves. This Clinical Puzzle article describes our current knowledge of chronic otitis media and the existing research models for this condition. It also identifies unanswered questions about its pathogenesis and treatment, with the goal of advancing our understanding of this disease to aid the development of novel therapeutic interventions. PMID:29125825

  11. Aetiological factors contributing to road traffic accidents in Riyadh City, Saudi Arabia. (United States)

    Nofal, F H; Saeed, A A; Anokute, C C


    The study analysed 13,390 police records of road traffic accidents (RTAs) covering a three and a half year period according to different suspected aetiological factors. The majority of the accidents were recorded for vehicles in good condition on well-paved straight roads with well-operating traffic light systems. Adverse weather conditions such as precipitation, fog and dust were of minimal importance, with most of the accidents being reported during sunny days during the rush period of 12 noon to 3 pm. Driver's error was identified as the main contributing factor in about two thirds of all RTAs mainly as reckless driving and excess speeding. About 27% of the drivers were professional drivers and 41% were in the age group 25-35 years in good health with no alcohol or drug intake. Hence, human errors may be attributed to carelessness, experience, lack of knowledge or attention, over-exhaustion or fatigue. The effects of physical stressors on performance of drivers need to be further explored and clarified but this need not underestimate the importance of vehicle and environment since most accidents are multifactoral and a slight change in them may effectively enhance perception and minimise personal error. Recommendations for remedial measures adopting an interdisciplinary approach are presented.

  12. Adult nonconvulsive status epilepticus in a clinical setting: Semiology, aetiology, treatment and outcome. (United States)

    Power, Kjersti Nesheim; Gramstad, Arne; Gilhus, Nils Erik; Engelsen, Bernt A


    Our objective was to study the semiology, aetiology, treatment and outcome of nonconvulsive status epilepticus (NCSE) in adults. All NCSE episodes in an unselected hospital cohort in the period 2004-2009 were identified, and the files reviewed. STESS (Status Epilepticus Severity Scale) was conducted retrospectively and correlated to outcome. Follow-up was undertaken after >2 years. 48 NCSEs in 39 patients, 22 men and 17 women, were found. Mean age was 63 years. 23/39 (59%) patients had established epilepsy. The underlying cause of NCSE was cerebrovascular disease in 17/39 (44%). 37/48 (77%) NCSEs were complex focal status epilepticus. 3/48 NCSEs (6.3%) lead to death, whereas 8.5% lead to severe sequelae. Cognitive sequelae were found after 14.9% of NCSEs. The outcome was worst in the group with no prior epilepsy (p=0.013). STESS had a negative predictive value of 96% (cut-off value of 3) for severe sequelae and death combined (p<0.002). NCSE has a potential for severe sequelae and represents an emergency in need of intensive treatment. The major determinant of outcome is the underlying cause. The outcome was worse in patients without epilepsy than in patients with epilepsy. STESS is of value in predicting outcome. Cognitive sequelae following NCSE can occur, but need further investigation with prospective, systematic studies. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  13. Consonant and syllable complexity of toddlers with Down syndrome and mixed-aetiology developmental delays. (United States)

    Sokol, Shari B; Fey, Marc E


    This study examines whether speech sound production of toddlers with Down syndrome (DS) is on par with or more severely impaired than that of mental age (MA) peers with developmental delay due to aetiologies other than Down syndrome at two points within an 18-month period near the onset of spoken word production. The utterances of 26 children with DS, aged 24-33 months, with a mean MA of 14.3 months, originally studied by Fey et al. and Warren et al. were compared to those of a group of 22 children with similar intellectual and communication delay but no DS (NDS). Phonological measures included the size of the consonant inventory, syllable shape complexity, and number of communication acts with canonical vocalizations. At Time 1, the DS group performed as well as or better than the NDS group on these measures of speech production. At Time 2, 18 months later, the DS group was behind the NDS group on the same measures. Results extended the pattern of more severe impairment in children with DS than NDS peers commonly noted in expressive language to measures of phonological development.

  14. Supernatural beliefs, aetiological models and help seeking behaviour in patients with schizophrenia. (United States)

    Kate, Natasha; Grover, Sandeep; Kulhara, Parmanand; Nehra, Ritu


    Few studies have evaluated the supernatural beliefs of patients with schizophrenia. This study aimed to study the personal beliefs, aetiological models and help seeking behaviour of patients with schizophrenia using a self-rated questionnaire. Seventy three patients returned the completed supernatural Attitude questionnaire. 62% of patients admitted that people in their community believed in sorcery and other magico-religious phenomena. One fourth to half of patients believed in ghosts/evil spirit (26%), spirit intrusion (28.8%) and sorcery (46.6%). Two-third patients believed that mental illness can occur either due to sorcery, ghosts/evil spirit, spirit intrusion, divine wrath, planetary/astrological influences, dissatisfied or evil spirits and bad deeds of the past. 40% of the subjects attributed mental disorders to more than one of these beliefs. About half of the patients (46.6%) believed that only performance of prayers was sufficient to improve their mental status. Few patients (9.6%) believed that magico-religious rituals were sufficient to improve their mental illness but about one-fourth (24.7%) admitted that during recent episode either they or their caregivers performed magico-religious rituals. Supernatural beliefs are common in patients with schizophrenia and many of them attribute the symptoms of mental disorders to these beliefs.

  15. The aetiologies of central nervous system infections in hospitalised Cambodian children. (United States)

    Turner, Paul; Suy, Kuong; Tan, Le Van; Sar, Pora; Miliya, Thyl; Hong, Nguyen Thi Thu; Hang, Vu Thi Ty; Ny, Nguyen Thi Han; Soeng, Sona; Day, Nicholas P J; van Doorn, H Rogier; Turner, Claudia


    Central nervous system (CNS) infections are an important cause of childhood morbidity and mortality. The aetiologies of these potentially vaccine-preventable infections have not been well established in Cambodia. We did a one year prospective study of children hospitalised with suspected CNS infection at Angkor Hospital for Children, Siem Reap. Cerebrospinal fluid specimens (CSF) samples underwent culture, multiplex PCR and serological analysis to identify a range of bacterial and viral pathogens. Viral metagenomics was performed on a subset of pathogen negative specimens. Between 1st October 2014 and 30th September 2015, 284 analysable patients were enrolled. The median patient age was 2.6 years; 62.0% were aged <5 years. CSF white blood cell count was ≥10 cells/μL in 116/272 (42.6%) cases. CNS infection was microbiologically confirmed in 55 children (19.3%). Enteroviruses (21/55), Japanese encephalitis virus (17/55), and Streptococcus pneumoniae (7/55) accounted for 45 (81.8%) of all pathogens identified. Of the pathogens detected, 74.5% (41/55) were viruses and 23.6% (13/55) were bacteria. The majority of patients were treated with ceftriaxone empirically. The case fatality rate was 2.5%. Enteroviruses, JEV and S. pneumoniae are the most frequently detected causes of CNS infection in hospitalised Cambodian children.

  16. Parametric Anatomical Modeling: A method for modeling the anatomical layout of neurons and their projections

    Directory of Open Access Journals (Sweden)

    Martin ePyka


    Full Text Available Computational models of neural networks can be based on a variety of different parameters. These parameters include, for example, the 3d shape of neuron layers, the neurons' spatial projection patterns, spiking dynamics and neurotransmitter systems. While many well-developed approaches are available to model, for example, the spiking dynamics, there is a lack of approaches for modeling the anatomical layout of neurons and their projections. We present a new method, called Parametric Anatomical Modeling (PAM, to fill this gap. PAM can be used to derive network connectivities and conduction delays from anatomical data, such as the position and shape of the neuronal layers and the dendritic and axonal projection patterns. Within the PAM framework, several mapping techniques between layers can account for a large variety of connection properties between pre- and post-synaptic neuron layers. PAM is implemented as a Python tool and integrated in the 3d modeling software Blender. We demonstrate on a 3d model of the hippocampal formation how PAM can help reveal complex properties of the synaptic connectivity and conduction delays, properties that might be relevant to uncover the function of the hippocampus. Based on these analyses, two experimentally testable predictions arose: i the number of neurons and the spread of connections is heterogeneously distributed across the main anatomical axes, ii the distribution of connection lengths in CA3-CA1 differ qualitatively from those between DG-CA3 and CA3-CA3. Models created by PAM can also serve as an educational tool to visualize the 3d connectivity of brain regions. The low-dimensional, but yet biologically plausible, parameter space renders PAM suitable to analyse allometric and evolutionary factors in networks and to model the complexity of real networks with comparatively little effort.

  17. Parametric Anatomical Modeling: a method for modeling the anatomical layout of neurons and their projections. (United States)

    Pyka, Martin; Klatt, Sebastian; Cheng, Sen


    Computational models of neural networks can be based on a variety of different parameters. These parameters include, for example, the 3d shape of neuron layers, the neurons' spatial projection patterns, spiking dynamics and neurotransmitter systems. While many well-developed approaches are available to model, for example, the spiking dynamics, there is a lack of approaches for modeling the anatomical layout of neurons and their projections. We present a new method, called Parametric Anatomical Modeling (PAM), to fill this gap. PAM can be used to derive network connectivities and conduction delays from anatomical data, such as the position and shape of the neuronal layers and the dendritic and axonal projection patterns. Within the PAM framework, several mapping techniques between layers can account for a large variety of connection properties between pre- and post-synaptic neuron layers. PAM is implemented as a Python tool and integrated in the 3d modeling software Blender. We demonstrate on a 3d model of the hippocampal formation how PAM can help reveal complex properties of the synaptic connectivity and conduction delays, properties that might be relevant to uncover the function of the hippocampus. Based on these analyses, two experimentally testable predictions arose: (i) the number of neurons and the spread of connections is heterogeneously distributed across the main anatomical axes, (ii) the distribution of connection lengths in CA3-CA1 differ qualitatively from those between DG-CA3 and CA3-CA3. Models created by PAM can also serve as an educational tool to visualize the 3d connectivity of brain regions. The low-dimensional, but yet biologically plausible, parameter space renders PAM suitable to analyse allometric and evolutionary factors in networks and to model the complexity of real networks with comparatively little effort.

  18. [Historical development of modern anatomical education in Japan]. (United States)

    Sakai, Tatsuo


    The medical schools in the beginning of Meiji era were diverse both in the founders and in the way of education, frequently employing foreign teachers of various nationalities. In 1871, German teachers were appointed to organized medical education at the medical school of the university of Tokyo. The anatomical education in the school was conducted by German teachers, i.e. Miller (1871-1873), Dönitz (1873-1877), Gierke (1877-1880) and Disse (1880-1885), followed by Koganei who returned from the study in Germany. In 1882 (Meiji 15th), the general rule for medical school was enforced so that the medical schools were practically obliged to employ numbers of graduates of the university of Tokyo. In 1887 (Meiji 20th), the educational system was reformed so that many of the medical schools were closed, and the medical schools were integrated into one university, five national senior high schools and three prefectural ones in addition to four private ones. After that most of anatomical teachers were either graduates of the university of Tokyo or those who studied in the anatomical department of the university. Before 1877 (Meiji 10th), the anatomical books were mainly translated from English books, and foreign teachers of various nationality were employed in many medical schools in Japan. After 1877 (Meiji 10th), the anatomical books based on the lectures by German teachers at the university of Tokyo were published. The anatomical books after 1887 (Meiji 20th) were written based on German books, and the German anatomical terms were utilized. After 1905 (Meiji 38th), the original Japanese anatomical books appeared, employing international anatomical terms. At the first meeting of Japanese Association of Anatomists in 1893 (Meiji 26th), the Japanese anatomical teachers met together and most of them were graduates of the university of Tokyo or fellows of its anatomical department.

  19. Recent advances in standards for collaborative Digital Anatomic Pathology (United States)


    Context Collaborative Digital Anatomic Pathology refers to the use of information technology that supports the creation and sharing or exchange of information, including data and images, during the complex workflow performed in an Anatomic Pathology department from specimen reception to report transmission and exploitation. Collaborative Digital Anatomic Pathology can only be fully achieved using medical informatics standards. The goal of the international integrating the Healthcare Enterprise (IHE) initiative is precisely specifying how medical informatics standards should be implemented to meet specific health care needs and making systems integration more efficient and less expensive. Objective To define the best use of medical informatics standards in order to share and exchange machine-readable structured reports and their evidences (including whole slide images) within hospitals and across healthcare facilities. Methods Specific working groups dedicated to Anatomy Pathology within multiple standards organizations defined standard-based data structures for Anatomic Pathology reports and images as well as informatic transactions in order to integrate Anatomic Pathology information into the electronic healthcare enterprise. Results The DICOM supplements 122 and 145 provide flexible object information definitions dedicated respectively to specimen description and Whole Slide Image acquisition, storage and display. The content profile “Anatomic Pathology Structured Report” (APSR) provides standard templates for structured reports in which textual observations may be bound to digital images or regions of interest. Anatomic Pathology observations are encoded using an international controlled vocabulary defined by the IHE Anatomic Pathology domain that is currently being mapped to SNOMED CT concepts. Conclusion Recent advances in standards for Collaborative Digital Anatomic Pathology are a unique opportunity to share or exchange Anatomic Pathology structured

  20. The anatomical diaspora: evidence of early American anatomical traditions in North Dakota. (United States)

    Stubblefield, Phoebe R


    The current focus in forensic anthropology on increasing scientific certainty in ancestry determination reinforces the need to examine the ancestry of skeletal remains used for osteology instruction. Human skeletal remains were discovered on the University of North Dakota campus in 2007. After recovery, the osteological examination resulted in a profile for a 33- to 46-year-old woman of African descent with stature ranging from 56.3 to 61.0 in. The pattern of postmortem damage indicated that the remains had been prepared for use as an anatomical teaching specimen. Review of the American history of anatomical teaching revealed a preference for Black subjects, which apparently extended to states like North Dakota despite extremely low resident populations of people of African descent. This study emphasizes the need to examine the ancestry of older teaching specimens that lack provenience, rather than assuming they are derived from typical (i.e., Indian) sources of anatomical material. © 2011 American Academy of Forensic Sciences.

  1. A rare occurrence of hepatic portal venous gas in a patient with chemotherapy-induced enterocolitis: the rise of benign aetiologies. (United States)

    Tan, Elizabeth W; Smith, Mark D


    Hepatic portal venous gas (HPVG) is often viewed as an ominous imaging finding with a poor prognosis and a high mortality rate. We recently encountered a case of HPVG in a patient with advanced metastatic prostate cancer previously treated with chemotherapy and radiotherapy. A laparotomy was performed, which was negative. Although HPVG secondary to chemotherapy is extremely rare, we as clinicians need to consider this aetiology and other benign aetiologies. With the increased rate of benign aetiologies and their successful conservative management, the role of emergency laparotomies needs to be re-considered. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2015.

  2. Retracted: Aetiology and clinical profile of children with 46, XY differences of sex development at an Indian referral centre. (United States)

    Chauhan, V; Dada, R; Jain, V


    Retraction: 'Aetiology and clinical profile of children with 46, XY differences of sex development at an Indian referral centre' by Vasundhera Chauhan, Rima Dada, Vandana Jain The above article, published online on 8 August 2016 in Wiley Online Library (, has been retracted by agreement between the authors, the Journal Editors-in-Chief, Wolf-Bernhard Schill and Ralf Henkel, and Blackwell Verlag GmbH. The retraction has been agreed as the result of an unresolved dispute between the first author and a colleague research fellow due to the inclusion of data from patients who were simultaneously enrolled in two studies being conducted separately by the two parties. Reference Chauhan, V., Dada, R. and Jain, V. (2016), Aetiology and clinical profile of children with 46, XY differences of sex development at an Indian referral centre. Andrologia. doi:10.1111/and.12663. © 2016 Blackwell Verlag GmbH.

  3. Fusion facility siting considerations

    International Nuclear Information System (INIS)

    Bussell, G.T.


    Inherent in the fusion program's transition from hydrogen devices to commercial power machines is a general increase in the size and scope of succeeding projects. This growth will lead to increased emphasis on safety, environmental impact, and the external effects of fusion in general, and of each new device in particular. A critically important consideration in this regard is site selection. The purpose of this paper is to examine major siting issues that may affect the economics, safety, and environmental impact of fusion

  4. Storage array reflection considerations

    International Nuclear Information System (INIS)

    Haire, M.J.; Jordan, W.C.; Taylor, R.G.


    The assumptions used for reflection conditions of single containers are fairly well established and consistently applied throughout the industry in nuclear criticality safety evaluations. Containers are usually considered to be either fully water reflected (i.e., surrounded by 6 to 12 in. of water) for safety calculations or reflected by 1 in. of water for nominal (structural material and air) conditions. Tables and figures are usually available for performing comparative evaluations of containers under various loading conditions. Reflection considerations used for evaluating the safety of storage arrays of fissile material are not as well established. When evaluating arrays, it has become more common for analysts to use calculations to demonstrate the safety of the array configuration. In performing these calculations, the analyst has considerable freedom concerning the assumptions made for modeling the reflection of the array. Considerations are given for the physical layout of the array with little or no discussion (or demonstration) of what conditions are bounded by the assumed reflection conditions. For example, an array may be generically evaluated by placing it in a corner of a room in which the opposing walls are far away. Typically, it is believed that complete flooding of the room is incredible, so the array is evaluated for various levels of water mist interspersed among array containers. This paper discusses some assumptions that are made regarding storage array reflection

  5. The curious case of the disappearing IVC: A case report and review of the aetiology of Inferior Vena Cava Agenesis (United States)

    Paddock, Michael; Robson, Nicola


    We report the case of a previously well 18-year-old male who presented to the Emergency Department with lower limb pain. An ultrasound demonstrated extensive left sided deep vein thrombosis and computed tomography demonstrated inferior vena cava agenesis, leading to the diagnosis of inferior vena cava agenesis associated deep vein thrombosis. The aetiology of inferior vena cava agenesis is explored in depth. PMID:24967034

  6. Natural history of severe eosinophilia with uncertain aetiology and proposals on a practical approach to its management. (United States)

    Ang, A L; Wong, R X; Zhuang, Q Y; Linn, Y C


    Eosinophilia is commonly encountered during clinical practice. Some can be attributed to well-defined causes while others cannot. Optimal management of hypereosinophilia with unknown aetiology is uncertain as the natural history is not well described. We retrospectively studied patients with hypereosinophilia (>5 × 10(9)/L) and described the characteristics, natural history and treatment of those with eosinophilia of uncertain aetiology. There were 141 patients with hypereosinophilia: 87 with well-defined causes, 54 with uncertain aetiology. The latter was managed as hypereosinophilic syndrome (HES) (n = 5), idiopathic hypereosinophilia (IH) (n = 11), presumptive helminthic infection (n = 11) and reactive eosinophilia (n = 5), while 22 were insufficiently investigated and did not have definite working diagnoses. Their median age and peak eosinophil count were 64 (22 to 94) years and 10.0 (5.2-33.9) × 10(9)/L respectively. Forty-six per cent had symptoms attributable to eosinophilia, with the HES and insufficiently investigated groups having the highest (100%) and lowest (27%) percentages respectively. HES and IH patients were most extensively investigated. All 14 HES or IH patients who received steroids responded. All presumptive helminthic infection patients received mebendazole: nine responded, and two had unassessable responses. For the remaining patients, seven received steroids and all responded; one received mebendazole but defaulted; 19 were not treated: 11 resolved spontaneously. No non-HES patients developed eosinophilia-related organ dysfunction. No mortality was caused by hypereosinophilia. Patients with hypereosinophilia of uncertain aetiology can be empirically managed according to working diagnoses derived from history taking, examination and selective investigations. Most patients have benign short-term outcomes, but longer monitoring is required to assess long-term outcomes from untreated hypereosinophilia. © 2011 The Authors. Internal Medicine

  7. Incidence, severity, aetiology and type of neck injury in men's amateur rugby union: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Pollard Henry P


    Full Text Available Abstract Background There is a paucity of epidemiological data on neck injury in amateur rugby union populations. The objective of this study was to determine the incidence, severity, aetiology and type of neck injury in Australian men's amateur rugby union. Methods Data was collected from a cohort of 262 participants from two Australian amateur men's rugby union clubs via a prospective cohort study design. A modified version of the Rugby Union Injury Report Form for Games and Training was used by the clubs physiotherapist or chiropractor in data collection. Results The participants sustained 90 (eight recurrent neck injuries. Exposure time was calculated at 31143.8 hours of play (12863.8 hours of match time and 18280 hours of training. Incidence of neck injury was 2.9 injuries/1000 player-hours (95%CI: 2.3, 3.6. As a consequence 69.3% neck injuries were minor, 17% mild, 6.8% moderate and 6.8% severe. Neck compression was the most frequent aetiology and was weakly associated with severity. Cervical facet injury was the most frequent neck injury type. Conclusions This is the first prospective cohort study in an amateur men's rugby union population since the inception of professionalism that presents injury rate, severity, aetiology and injury type data for neck injury. Current epidemiological data should be sought when evaluating the risks associated with rugby union football.

  8. Predicting the characteristics of the aetiological agent for Kawasaki disease from other paediatric infectious diseases in Japan. (United States)

    Nagao, Y; Urabe, C; Nakamura, H; Hatano, N


    Although Kawasaki disease (KD), which was first reported in the 1960s, is assumed to be infectious, its aetiological agent(s) remains unknown. We compared the geographical distribution of the force of infection and the super-annual periodicity of KD and seven other paediatric infectious diseases in Japan. The geographical distribution of the force of infection, which was estimated as the inverse of the mean patient age, was similar in KD and other paediatric viral infections. This similarity was due to the fact that the force of infection was determined largely by the total fertility rate. This finding suggests that KD shares a transmission route, i.e. sibling-to-sibling infection, with other paediatric infections. The super-annual periodicity, which is positively associated with the sum of an infectious disease's incubation period and infectious period, was much longer for KD and exanthema subitum than other paediatric infectious diseases. The virus for exanthema subitum is known to persist across the host's lifespan, which suggests that the aetiological agent for KD may also be capable of persistent infection. Taken together, these findings suggest that the aetiological agent for KD is transmitted through close contact and persists asymptomatically in most hosts.

  9. Anatomical features of renal artery in a black Kenyan population ...

    African Journals Online (AJOL)

    Knowledge of anatomical features of the renal artery is important in prediction, management and control of atherosclerotic renal artery stenosis. These features show population variations but data from black African populations are scarce. The aim of this study was therefore to describe the anatomical features of the renal ...

  10. A theoretical ovary position in link with the global anatomical ...

    African Journals Online (AJOL)

    Generally the position of different organs is determined by simple description following the anatomical elements surrounded them and such description could be developed and applied in surgical anatomy. Here, I present for the first time a theoretical three-dimensional ovary position in link with the global anatomical ...

  11. Role of anatomic variations of paranasal sinuses on the prevalence ...

    African Journals Online (AJOL)

    Objective: The aim of this study was to determine the frequency of anatomic variations of the paranasal sinuses and their roles in the development of sinusitis. Materials and Methods: Computed tomography of paranasal sinuses of 350 patients was assessed in terms of anatomic variations and inflammatory sinus pathology.

  12. Evaluation of anatomical and physical properties of Khaya nthotheca

    African Journals Online (AJOL)

    The anatomical and physical properties of Khaya anthotheca (Welw.) C. DC wood from the transition forest of middle altitude (zone 1) and the humid dense forest of low altitude (zone 2) in the East of the Democratic Republic of Congo were evaluated to ascertain the effect of growth area on the anatomical and physical ...

  13. Anatomical variability of the trunk wood and root tissues of ...

    African Journals Online (AJOL)

    The aim of this study was to investigate the anatomical structure of the trunk wood and the roots of A. nitida and R. racemosa, two mangrove trees from Gabon. The anatomical differences between the trunks and the roots were used to understand their bio-remediating differences through heavy metals. It was found that the ...

  14. Anatomic anterior cruciate ligament reconstruction: reducing anterior tibial subluxation

    NARCIS (Netherlands)

    Muller, Bart; Duerr, Eric R. H.; van Dijk, C. Niek; Fu, Freddie H.


    To measure and compare the amount of anterior tibial subluxation (ATS) after anatomic ACL reconstruction for both acute and chronic ACL-deficient patients. Fifty-two patients were clinically and radiographically evaluated after primary, unilateral, anatomic ACL reconstruction. Post-operative true

  15. Role of Anatomic Variations of Paranasal Sinuses on the ...

    African Journals Online (AJOL)


    May 9, 2017 ... pathology. The coexistence of anatomic variations with sinusitis was statistically investigated.Results: At least one anatomical variation of paranasal sinuses was detected in 325 patients ... area, hardly evaluated regions of sinonasal pathologies ..... formation. Optic nerve and extraorbital muscle damage.

  16. Form follows function: molecular and anatomical information in conventional nuclear medicine

    International Nuclear Information System (INIS)

    Kirsch, C.M.; Hellwig, D.; Schaefer, A.


    The merger of anatomical information with functional results of nuclear medical studies represents an important step in evaluation and generating a report. The design of a gamma-camera system furnished with a tomographic X-ray unit allows for the almost simultaneous acquisition of tomographic data of the nuclear examination as well as the structure of surrounding tissue and attenuating material within one study without changing the patient's position. The results of this kind of fusion present considerable progress compared to side by side interpretation or software based fusion procedures of different methods like CT and MRI with nuclear studies. (orig.) [de

  17. Chronic mitral regurgitation detected on cardiac MDCT: differentiation between functional and valvular aetiologies.

    LENUS (Irish Health Repository)

    Killeen, Ronan P


    OBJECTIVE: To determine whether cardiac computed tomography (MDCT) can differentiate between functional and valvular aetiologies of chronic mitral regurgitation (MR) compared with echocardiography (TTE). METHODS: Twenty-seven patients with functional or valvular MR diagnosed by TTE and 19 controls prospectively underwent cardiac MDCT. The morphological appearance of the mitral valve (MV) leaflets, MV geometry, MV leaflet angle, left ventricular (LV) sphericity and global\\/regional wall motion were analysed. The coronary arteries were evaluated for obstructive atherosclerosis. RESULTS: All control and MR cases were correctly identified by MDCT. Significant differences were detected between valvular and control groups for anterior leaflet length (30 +\\/- 7 mm vs. 22 +\\/- 4 mm, P < 0.02) and thickness (3.0 +\\/- 1 mm vs. 2.2 +\\/- 1 mm, P < 0.01). High-grade coronary stenosis was detected in all patients with functional MR compared with no controls (P < 0.001). Significant differences in those with\\/without MV prolapse were detected in MV tent area (-1.0 +\\/- 0.6 mm vs. 1.3 +\\/- 0.9 mm, P < 0.0001) and MV tent height (-0.7 +\\/- 0.3 mm vs. 0.8 +\\/- 0.8 mm, P < 0.0001). Posterior leaflet angle was significantly greater for functional MR (37.9 +\\/- 19.1 degrees vs. 22.9 +\\/- 14 degrees , P < 0.018) and less for valvular MR (0.6 +\\/- 35.5 degrees vs. 22.9 +\\/- 14 degrees, P < 0.017). Sensitivity, specificity, and positive and negative predictive values of MDCT were 100%, 95%, 96% and 100%. CONCLUSION: Cardiac MDCT allows the differentiation between functional and valvular causes of MR.

  18. Impact of immunosuppression on incidence, aetiology and outcome of ventilator-associated lower respiratory tract infections. (United States)

    Moreau, Anne-Sophie; Martin-Loeches, Ignacio; Povoa, Pedro; Salluh, Jorge; Rodriguez, Alejandro; Thille, Arnaud W; Diaz Santos, Emilio; Vedes, Elisa; Lobo, Suzana Margareth; Mégarbane, Bruno; Molero Silvero, Esperanza; Coelho, Luis; Argaud, Laurent; Sanchez Iniesta, Rafael; Labreuche, Julien; Rouzé, Anahita; Nseir, Saad


    The aim of this planned analysis of the prospective multinational TAVeM database was to determine the incidence, aetiology and impact on outcome of ventilator-associated lower respiratory tract infections (VA-LRTI) in immunocompromised patients.All patients receiving mechanical ventilation for >48 h were included. Immunocompromised patients (n=663) were compared with non-immunocompromised patients (n=2297).The incidence of VA-LRTI was significantly lower among immunocompromised than among non-immunocompromised patients (16.6% versus 24.2%; sub-hazard ratio 0.65, 95% CI 0.53-0.80; p<0.0001). Similar results were found regarding ventilator-associated tracheobronchitis (7.3% versus 11.6%; sub-hazard ratio 0.61, 95% CI 0.45-0.84; p=0.002) and ventilator-associated pneumonia (9.3% versus 12.7%; sub-hazard ratio 0.72, 95% CI 0.54-0.95; p=0.019). Among patients with VA-LRTI, the rates of multidrug-resistant bacteria (72% versus 59%; p=0.011) and intensive care unit mortality were significantly higher among immunocompromised than among non-immunocompromised patients (54% versus 30%; OR 2.68, 95% CI 1.78-4.02; p<0.0001). In patients with ventilator-associated pneumonia, mortality rates were higher among immunocompromised than among non-immunocompromised patients (64% versus 34%; p<0.001).Incidence of VA-LRTI was significantly lower among immunocompromised patients, but it was associated with a significantly higher mortality rate. Multidrug-resistant pathogens were more frequently found in immunocompromised patients with VA-LRTI. Copyright ©ERS 2018.

  19. Local Aetiology and Pathways to Care in Malaria among the Ibibio of South-coastal Nigeria

    Directory of Open Access Journals (Sweden)

    A. S. Ajala


    Full Text Available There is a parallel between local and bio-medical perceptions of malaria among the Ibibio people of South-coastal Nigeria, as in many other societies of sub-Saharan Africa where malaria is endemic. Despite the fact that this accounts for resilience of the disease, earlier studies on malaria in Africa focused on causes, prevalence and socio-environmental factors. Local meanings of malaria and their influence on therapeutic choices have been largely ignored. This study examines local perceptions of malaria among the Ibibio and explains how attitudes are generated from indigenous meanings. It also examines how such attitudes inform a local aetiology of malaria. Similarly, our study examines how local meanings of, and attitudes towards malaria, set the pathway of care in malaria management among the Ibibio. Through qualitative and descriptive ethnography, Key Informant Interview (KII, Focus Group Discussion (FGD and the textual analysis of documents, our study seeks to establish that malaria is caused by parasites–protozoa. 83% of the respondents held that malaria is due to witchcraft, exposure to sunlight and eating of yellowish food items such as yellow maize, paw-paw, orange and red oil. These local perceptions are drawn from local conceptions which in turn encourage malaria patients to seek assistance outside modern health care facilities. This also discourages local communities from attending health education workshops that link malaria with germ theory and care. Treatment of malaria is thus mostly home-based where a wide variety of traditional remedies is practiced. Our study concludes that the lack of convergence between local knowledge-contents and bio-medical explanations account for a high prevalence rate and the lack of effective management. For proper management of malaria, there is a need to understand local knowledge and indigenous concepts in order to establish a convergence between bio-medical explanations and indigenous

  20. Edible oil adulterants, argemone oil and butter yellow, as aetiological factors for gall bladder cancer. (United States)

    Mishra, Vivek; Mishra, Manjari; Ansari, Kausar M; Chaudhari, Bhushan P; Khanna, Raj; Das, Mukul


    Carcinogenic potential of argemone oil (AO) and butter yellow (BY), the adulterants encountered in edible oil, in gall bladder of Swiss albino mice was undertaken to investigate the potential aetiological factors of gall bladder carcinoma (GBC) in the Indo-Gangetic basin. Twice weekly intraperitoneal (ip) administration of AO (5 ml/kg body wt) and BY (25 mg/kg body wt) to Swiss albino male and female mice for 30 and 60 days indicated that females were more vulnerable to these adulterants in terms of responses to inflammatory markers. Subsequent experiments with dietary exposure of AO (1%) and BY (0.06%) for 6 months in female mice showed symptoms related to cachexia, jaundice and anaemia. High levels of total cholesterol, low density lipoprotein (LDL), TG, bilirubin and low level of high density lipoprotein (HDL) as well as gallstone formation was shown by AO exposure only, leading to the development of adenocarcinoma. BY exposure resulted in adenoma and hyperplasia without stone formation. The cyclooxygenase (COX-2) overexpression was found to be related to prostaglandin E2 (PGE2) production in AO treated mice but not in BY exposed animals, thereby indicating a differential pathway specific carcinogenicity. PGE2 stimulates the secretion of secreted mucins (MUC5AC), which is involved in stone formation following AO exposure. Enhanced secretion of membrane bound mucins (MUC4) in BY and AO exposed mice resulted in the activation of ErbB2 and downstream signalling such as p-AKT, p-ERK and p-JNK, which ultimately affects the target proteins, p53 and p21 leading to adenoma and adenocarcinoma, respectively. The study suggests that AO and BY are responsible for producing GBC in mice along with stone formation in the AO exposed animals. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. [Aetiology and outcomes of potentially serious infections in febrile infants less than 3 months old]. (United States)

    de la Torre, Mercedes; de Lucas, Nieves; Velasco, Roberto; Gómez, Borja; Mintegi, Santiago


    Recent studies have shown changes in the aetiology of serious bacterial infections in febrile infants ≤ 90 days of age. The aim of this study was to describe the current microbiology and outcomes of these infections in Spain. Sub-analysis of a prospective multicentre study focusing on febrile infants of less than 91 days of life, admitted between October 2011 and September 2013 to Emergency Departments of 19 Spanish hospitals, members of the Spanish Paediatric Emergency Research Group of the Spanish Society of Paediatric Emergencies (RISeuP/SPERG). The analysis included 3,401 febrile infants ≤90 days of age with fever without source. There were 896 positive cultures: 766 urine (85.5%), 100 blood (11.2%), 18 cerebrospinal fluid (2%), 10 stool, and 2 umbilical cultures. Among the 3,401 infants included, 784 (23%) were diagnosed with a serious bacterial infection, and 107 of them (3.1%) with an invasive infection. E. coli was the most common pathogen isolated from urine (628; 82%), blood (46; 46%), and cerebrospinal fluid cultures (7; 38.9%), followed by S. agalactiae that was isolated from 24 (24%) blood cultures and 3 (16.7%) cerebrospinal fluid cultures. There were only 2 L. monocytogenes infections. Four children died, and seven had severe complications. Among infants ≤ 90 days of age with fever without source, E. coli was the most common pathogen isolated from urine, blood, and cerebrospinal fluid cultures. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Aetiology of stillbirths and neonatal deaths in rural Ghana: implications for health programming in developing countries. (United States)

    Edmond, Karen M; Quigley, Maria A; Zandoh, Charles; Danso, Samuel; Hurt, Chris; Owusu Agyei, Seth; Kirkwood, Betty R


    In developing countries many stillbirths and neonatal deaths occur at home and cause of death is not recorded by national health information systems. A community-level verbal autopsy tool was used to obtain data on the aetiology of stillbirths and neonatal deaths in rural Ghana. Objectives were to describe the timing and distribution of causes of stillbirths and neonatal deaths according to site of death (health facility or home). Data were collected from 1 January 2003 to 30 June 2004; 20,317 deliveries, 696 stillbirths and 623 neonatal deaths occurred over that time. Most deaths occurred in the antepartum period (28 weeks gestation to the onset of labour) (33.0%). However, the highest risk periods were during labour and delivery (intrapartum period) and the first day of life. Infections were a major cause of death in the antepartum (10.1%) and neonatal (40.3%) periods. The most important cause of intrapartum death was obstetric complications (59.3%). There were significantly fewer neonatal deaths resulting from birth asphyxia in the home than in the health facilities and more deaths from infection. Only 59 (20.7%) mothers of neonates who died at home reported that they sought care from an appropriate health care provider (doctor, nurse or health facility) during their baby's illness. The results from this study highlight the importance of studying community-level data in developing countries and the high risk of intrapartum stillbirths and infectious diseases in the rural African mother and neonate. Community-level interventions are urgently needed, especially interventions that reduce intrapartum deaths and infection rates in the mother and infant.

  3. Acute mechanical intestinal obstruction in children at zinder national hospital, Niger: Aetiologies and prognosis

    Directory of Open Access Journals (Sweden)

    Harissou Adamou


    Full Text Available Background: To describe the aetiological and prognostic aspects of acute mechanical intestinal obstruction (AMIO in children at Zinder National Hospital (Niger. Materials and Methods: This was a cross-sectional study on a period to January 2013–June 2015. The database included all children under 15 years of age with a surgical diagnosis of mechanical intestinal obstruction. P < 0.05 was considered statistically significant for analysis. Results: AMIOs represent 21.78% (n = 78 of child digestive surgical emergencies (n = 358. Median age was 12 months (range: 1 day–15 years. Fifteen (19.23% were neonates and sixty children (76.92% had ≤60 months. The sex ratio (male/female was 2.8. The mean time from onset to presentation was 39.96 ± 36.22 h. Intussusception and strangulated hernias were the main causes of AMIO with, respectively, 43.59% (n = 34 and 29.48% (n = 23. Anorectal malformations represent 17.95% (n = 14 of cases of AMIO. Intestinal resection was made in 22.08% and colostomy in 19.23% of patients. The average length of hospital stay was 6.44 ± 4.30 days. The post-operative complications were recorded in 26 patients (33.33%, mostly surgical site infections. Overall mortality of AMIO was 15.38% (n = 12. It was higher in the neonates (33.33% (P = 0.032. Deaths were associated with delay of admission (P = 0.0005 and waiting time for surgery (P = 0.019. Conclusion: Intussusception and strangulated hernia are the most common cause of AMIO in children. Diagnostic and therapeutic delays, lack of paediatric intensive care and post-operative complications are prognostic factors.

  4. Epidemiology and aetiology of traumatic cardiac arrest in England and Wales - A retrospective database analysis. (United States)

    Barnard, Ed; Yates, David; Edwards, Antoinette; Fragoso-Iñiguez, Marisol; Jenks, Tom; Smith, Jason E


    Historically, reported survival from traumatic cardiac arrest (TCA) was extremely low. More recent publications have recorded survival to discharge of up to 8%. This improvement is likely to be multi-factorial; however, there are currently no published data describing the epidemiology or aetiology of TCA in England and Wales to guide future practice improvement. Population-based analysis of 2009-2015 Trauma Audit and Research Network (TARN) data. The primary aim was to describe the 30-day survival following TCA. Patients of all ages with traumatic cardiac arrest pre-hospital or in the emergency department (ED) were included. Data are described as number (%), and median [interquartile range]. Two-group analysis with Chi-squared test was performed. During the study period 227,944 patients were included in the TARN database. Seven hundred and five (0.3%) suffered TCA: 74.3% were male, aged 44.3 [25.2-83.2] years, ISS 29 [21-75], and 601 (85.2%) had blunt injuries. 612 (86.8%) had a severe traumatic brain injury and or severe haemorrhage. Overall 30-day survival was 7.5% (95%CI 5.6-9.5) - 'pre-hospital only' TCA 11.5%, 'ED only' TCA 3.9%, p<0.02. No patients who were in TCA both pre-hospital and in the ED survived. This study has shown that short-term survival from TCA in this large civilian registry is 7.5%. Early and aggressive management of patients with TCA, using protocols that target the reversible causes of TCA, should be initiated. Further work to establish novel ways to manage patients with reversible causes of TCA is indicated. Resuscitation in this patient group is not futile. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Aetiological patterns and management outcome of paediatric head trauma: one-year prospective study. (United States)

    Emejulu, J K C; Shokunbi, M T


    Trauma is the most common cause ofpaediatric deaths. In 75% ofpaediatric trauma deaths, head injury is responsible, and most are from falls. Recent reports from Nigeria, however, appear to indicate a predominance of road traffic accidents, instead of falls. To evaluate the aetiology of paediatric head trauma, management protocols and outcome from our Centre, in order to acquire a baseline data base and recommend measures to reduce childhood trauma. A prospective study of all paediatric head trauma cases presenting to Nnamdi Azikiwe University Teaching Hospital, Nnewi, for 12months from April 21, 2006 to April 20, 2007, was done and collated data subsequently analyzed. The paediatric age group was taken as = 15 years, and grading of head injury was with the Glasgow Coma Scale (3-15) and the modified scale for non-verbal children; while outcome was measured with the Glasgow Outcome Scale (1-5). Out of 334 patients treated within the period of study, 210 were head trauma cases. Of these, 52 were paediatric head trauma, representing 24.8% of all head trauma cases; and 19.2% (10 of 52) of them were aged 0-2 years. About 62% (32 of 52) were males. Falls and RTA were each responsible in 25 (48.1%) cases. Mild head injury occurred in 31 (59.6%), and 49 (94.2%) patients were evaluated by plain radiography. Treatment was conservative in 39 (75%) cases; with satisfactory outcome in 36 (69.2%), and a mortality rate of 15.4%. Road traffic injury, mostly from motorcycles, has become the major cause of morbidity and mortality amongst the paediatric age group, especially the male gender, and outcome from management is mostly satisfactory.

  6. Clinical Spectrum Of Acute Disseminated Encephalo Myelitis In Relation To Aetiology And Neuroimaging Study

    Directory of Open Access Journals (Sweden)

    Das K


    Full Text Available Background: Acute disseminated Encephalo Myelitis (ADEM is an important neurological cause of mortality and morbidity and many aspects of the aetiopathogenesis and clinical presentation are still not clear. More studies are needed to be continued particularly from developing countries on ADEM. Aims & Objects: To study the clinical spectrum of ADEM in relation to aetiology and neuroimaging study and to compare the findings observed in the other parts of India and abroad. Materials and Methods: Clinical examinations, neuroimaging study and electrophysiological tests and follow up in 62 patients of ADEM in the Bangur Institute of Neurology, Kolkata, India from January 1996 to March 2004. Results: Thirty Four patients (54.83% were below 20 years. Among the preceding events, presumptive viral infections accounted for 32.25% of the total cases, specific viral infections in 43.54% cases, and sample antirabies vaccinations in 24.19% cases. Myeloradiculitis were the common neuroparalytic complications following semple anti rabies vaccination found in 10 patients and in another 5 post vaccinated patients had multiple sites of involvement. Acute cerebellar ataxia was the common clinical presentation following varicella infection found in 8 cases and another 6 cases had multiple sites involvement. Multimodal evoked potential studies corresponds to the clinical localization of lesions. MRI studies disclosed that white matter lesions were maximum in subcortical white matter and periventricular regions. No signal alterations were observed in 4 cases of acute cerebellar ataxia following varicellar infection and 4 cases of Myeloradiculitis following semple anti rabies vaccinations. Out of 62 patients, 50 patients survived (80.64%, among them 22 patients (44% had significant motor disability and rest 28 (56% recovered well in the functional status. Mortality found in the study was in 12 patients (19.36%. Conclusion: Specific viral infections is the common

  7. Aetiology and pathogenesis of cranial cruciate ligament rupture in cats by histological examination. (United States)

    Wessely, Marlis; Reese, Sven; Schnabl-Feichter, Eva


    of cats revealed no other signs of degeneration in the cranial cruciate ligaments. Thus, degeneration is likely not an aetiological factor for cranial cruciate ligament rupture in cats.

  8. Is the cervical fascia an anatomical proteus? (United States)

    Natale, Gianfranco; Condino, Sara; Stecco, Antonio; Soldani, Paola; Belmonte, Monica Mattioli; Gesi, Marco


    The cervical fasciae have always represented a matter of debate. Indeed, in the literature, it is quite impossible to find two authors reporting the same description of the neck fascia. In the present review, a historical background was outlined, confirming that the Malgaigne's definition of the cervical fascia as an anatomical Proteus is widely justified. In an attempt to provide an essential and a more comprehensive classification, a fixed pattern of description of cervical fasciae is proposed. Based on the morphogenetic criteria, two fascial groups have been recognized: (1) fasciae which derive from primitive fibro-muscular laminae (muscular fasciae or myofasciae); (2) fasciae which derive from connective thickening (visceral fasciae). Topographic and comparative approaches allowed to distinguish three different types of fasciae in the neck: the superficial, the deep and the visceral fasciae. The first is most connected to the skin, the second to the muscles and the third to the viscera. The muscular fascia could be further divided into three layers according to the relationship with the different muscles.

  9. Metacarpophalangeal portal safety. An anatomical study. (United States)

    Limousin, B; Corella, F; Del Campo, B; Fernández, E; Corella, M Á; Ocampos, M; Vázquez, T; Larrainzar-Garijo, R


    To quantify the risk of dorsal innervation injury when performing direct metacarpophalangeal joint portals of the second to fifth fingers. An anatomical study of 11 upper limbs of fresh corpses was carried out. After placing them in a traction tower, the metacarpophalangeal portals were developed on both sides of the extensor tendon. The dorsal sensory branches were dissected and the distances between the portal and the nearest nerve were measured by a digital caliper. The portals of all the fingers were compared globally to assess the safest finger and two to two radial and ulnar portals were compared in each of the fingers to assess the safest portal within each finger. The overall comparison of all portals and fingers showed that the third finger is the safest in any of its portals, while the ulnar side of the second and radial of the fourth are the portals with the highest risk of nerve injury (P=8.96·10 -5 ). Comparing two to two of the radial and ulnar portals in each of the fingers showed that the ulnar portal is safer than the radial on the fourth finger (P=.042), while the radial is safer than the ulnar on the fifth finger (P=.003). The third finger was the safest to perform metacarpophalangeal portals, while the ulnar side of the second finger and radial side of the fourth had the highest risk of nerve injury. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Hamstring tendons insertion - an anatomical study

    Directory of Open Access Journals (Sweden)

    Cristiano Antonio Grassi


    Full Text Available OBJECTIVE: To study the anatomy of the hamstring tendons insertion and anatomical rela-tionships. METHODS: Ten cadaver knees with medial and anterior intact structures were selected. The dissection was performed from anteromedial access to exposure of the insertion of the flexor tendons (FT, tibial plateau (TP and tibial tuberosity (TT. A needle of 40 × 12 and a caliper were used to measure the distance of the tibial plateau of the knee flexor tendons insertion at 15 mm from the medial border of the patellar tendon and tibial tuberosity to the insertion of the flexor tendons of the knee. The angle between tibial plateau and the insertion of the flexor tendons of the knee (A-TP-FT was calculated using Image Pro Plus software. RESULTS: The mean distance TP-FT was 41 ± 4.6 mm. The distance between the TT-FT was 6.88 ± 1 mm. The (A-TP-FT was 20.3 ± 4.9°. CONCLUSION: In the anterior tibial flexor tendons are about 40 mm from the plateau with an average of 20°.

  11. Employing anatomical knowledge in vertebral column labeling (United States)

    Yao, Jianhua; Summers, Ronald M.


    The spinal column constitutes the central axis of human torso and is often used by radiologists to reference the location of organs in the chest and abdomen. However, visually identifying and labeling vertebrae is not trivial and can be timeconsuming. This paper presents an approach to automatically label vertebrae based on two pieces of anatomical knowledge: one vertebra has at most two attached ribs, and ribs are attached only to thoracic vertebrae. The spinal column is first extracted by a hybrid method using the watershed algorithm, directed acyclic graph search and a four-part vertebra model. Then curved reformations in sagittal and coronal directions are computed and aggregated intensity profiles along the spinal cord are analyzed to partition the spinal column into vertebrae. After that, candidates for rib bones are detected using features such as location, orientation, shape, size and density. Then a correspondence matrix is established to match ribs and vertebrae. The last vertebra (from thoracic to lumbar) with attached ribs is identified and labeled as T12. The rest of vertebrae are labeled accordingly. The method was tested on 50 CT scans and successfully labeled 48 of them. The two failed cases were mainly due to rudimentary ribs.

  12. Do retractile testes have anatomical anomalies?

    Directory of Open Access Journals (Sweden)

    Kleber M. Anderson

    Full Text Available ABSTRACT Objectives: To assess the incidence of anatomical anomalies in patients with retractile testis. Materials and Methods: We studied prospectively 20 patients (28 testes with truly retractile testis and compared them with 25 human fetuses (50 testes with testis in scrotal position. We analyzed the relations among the testis, epididymis and patency of the processus vaginalis (PV. To analyze the relations between the testis and epididymis, we used a previous classification according to epididymis attachment to the testis and the presence of epididymis atresia. To analyze the structure of the PV, we considered two situations: obliteration of the PV and patency of the PV. We used the Chi-square test for contingency analysis of the populations under study (p <0.05. Results: The fetuses ranged in age from 26 to 35 weeks post-conception (WPC and the 20 patients with retractile testis ranged in ages from 1 to 12 years (average of 5.8. Of the 50 fetal testes, we observed complete patency of the PV in 2 cases (4% and epididymal anomalies (EAs in 1 testis (2%. Of the 28 retractile testes, we observed patency of the PV in 6 cases (21.4% and EA in 4 (14.28%. When we compared the incidence of EAs and PV patency we observed a significantly higher prevalence of these anomalies in retractile testes (p=0.0116. Conclusions: Retractile testis is not a normal variant with a significant risk of patent processus vaginalis and epididymal anomalies.

  13. Basilar expansion of the human sphenoidal sinus: an integrated anatomical and computerized tomography study

    International Nuclear Information System (INIS)

    Haetinger, Rainer G.; Navarro, Joao A.C.; Liberti, Edson A.


    Basilar expansion of the sphenoidal sinus (BESS) was studied in order to demonstrate its critical relevance in endoscopic or microscopic endonasal surgical interventions, including access to the sphenoidal sinus itself or in transsphenoidal pituitary approaches. Direct evaluation of anatomical specimens (25 dry skulls and 25 formalin-fixed hemi heads) and the use of computerized tomography (CT) (50 dry skulls and 750 patients) showed a high BESS frequency (69%). The authors considered BESS to be critical when the posterior wall of the clivus was 2-mm thick and found a high incidence of this important anatomical variation (44%). This study also evaluated the relationship between the sinonasal septa, the clivus, and the internal carotid arteries, and a considerable regularity in the location of these structures was seen. The septa were anatomically related to the internal carotid arteries in 55% and to the clivus in 33% of the cases. In conclusion, the high frequency of critical BESS here described is relevant to endoscopic or microscopic endonasal surgical interventions, including access to the sphenoidal sinus itself or in transsphenoidal pituitary approaches. (orig.)

  14. Room considerations with TAVR. (United States)

    Kleiman, Neal


    While transcatheter aortic valve replacement is considered a viable alternative to traditional surgery for patients with critical aortic stenosis, it is still a cardiac surgical procedure with a steep learning curve. Space consideration is a key aspect of the procedure's success. A TAVR program requires the commitment from and investment of institutional resources, the outfitting of an appropriate procedure room, and meticulous training of a multidisciplinary TAVR team. Careful integration of the various imaging modalities, medical specialties, and equipment is necessary to ensure the safety and efficacy of the procedure and to treat complications that may arise.

  15. Part 8. Deployment considerations

    International Nuclear Information System (INIS)

    Dance, K.D.; Chang, Y.I.; Daly, T.A.


    This report addresses considerations of fast breeder reactor development and deployment from a national perspective. Nations vary greatly in their expertise and interest relative to nuclear power, and hence a single set of steps to be taken by a nation in decision-making on breeder development and deployment cannot be presented. The approach taken in this report is to present discussions on key factors influencing the breeder development and deployment decisions, especially in non-breeder nations, by drawing upon historical perspectives of the Light Water Reactor for comparison

  16. Cutaneous melanoma: hints from occupational risks by anatomic site in Swedish men (United States)

    Perez-Gomez, B; Pollan, M; Gustavsson, P; Plato, N; Aragones, N; Lopez-Abente, G


    Aims: To improve knowledge of the epidemiology of melanoma by comparing occupational risks of cutaneous melanoma (CM) by anatomic site in Swedish workers. Methods: Male workers employed in 1970 and living in the country in 1960 were followed up from 1971 to 1989 using the Swedish Registers of Death and Cancer. A more specifically exposed subcohort included men reporting the same occupation in 1960 and 1970. For each location, occupational risk ratios (RRs) were extracted from Poisson regression models adjusted by age, period, town size, and geographical area. To diminish the influence of socioeconomic factors, intrasector analyses, comparing only jobs belonging to the same occupational sector, were performed. Risk patterns for different locations were compared. Results: High RRs for different sites were found among workers exposed to UV sources (dentists, physiotherapists, and lithographers), and sun exposed workers (harbour masters, and lighthouse/related work). Risk excesses were seen in fur tailors, tanners/fur dressers, patternmakers/cutters, electrical fitters/wiremen, telephone/telegraph installers/repairmen, and some glass/pottery/tile workers. Results for lower and upper limbs were significantly correlated but somewhat independent of those found in thorax, the most frequent location. Correlation between head/neck and thorax was moderate. Specific risk excesses were found for rolling mill workers in head/neck, for chimney sweeps in upper limbs, and for aircraft pilots/navigators/flight engineers in lower limbs. Conclusions: High RRs in the trunk among occupations with UV exposure from artificial sources suggest an effect not restricted to exposed sites. An unusual distribution of cases and RRs in chimney sweeps, rolling-mill, or glass/pottery/tile workers suggests local effects of exposures. The not previously reported risk excess in this job and in fur related processes, and the RR in electrical fitters and telephone/telegraph installers deserve further

  17. In vivo posterior cruciate ligament elongation in running activity after anatomic and non-anatomic anterior cruciate ligament reconstruction. (United States)

    Tang, Jing; Thorhauer, Eric; Bowman, Karl; Fu, Freddie H; Tashman, Scott


    The goals of this study were to (1) investigate the in vivo elongation behaviour of the posterior cruciate ligament (PCL) during running in the uninjured knee and (2) evaluate changes in PCL elongation during running after anatomic or non-anatomic anterior cruciate ligament (ACL) reconstruction. Seventeen unilateral ACL-injured subjects were recruited after undergoing anatomic (n = 9) or non-anatomic (n = 8) ACL reconstruction. Bilateral high-resolution CT scans were obtained to produce 3D models. Anterolateral (AL) and posteromedial (PM) bundles insertion sites of the PCL were identified on the 3D CT scan reconstructions. Dynamic knee function was assessed during running using a dynamic stereo X-ray (DSX) system. The lengths of the AL and PM bundles were estimated from late swing through mid-stance. The contralateral knees served as normal controls. Control knees demonstrated a slight decrease in AL bundle and a significant decrease in PM bundle length following foot strike. Length and elongation patterns of the both bundles of the PCL in the anatomic ACL reconstruction group were similar to the controls. However, the change in dynamic PCL length was significantly greater in the non-anatomic group than in the anatomic reconstruction group after foot strike (p < 0.05). The AL bundle length decreased slightly, and the PM bundle length significantly decreased after foot strike during running in uninjured knees. Anatomic ACL reconstruction maintained normal PCL elongation patterns more effectively than non-anatomic ACL reconstruction during high-demand, functional loading. These results support the use of anatomic ACL reconstruction to achieve normal knee function in high-demand activities. Case-control study, Level III.

  18. Morphological approach of the sternal foramen: an anatomic study and a short review of the literature. (United States)

    Gkantsinikoudis, N; Chaniotakis, C; Gkasdaris, G; Georgiou, N; Kapetanakis, S


    The sternal foramen (SF) constitutes a specific anatomic defect in sternum, indicating an impaired fusion of ossificated segments, which occurs either in an anatomical part of the sternum or in sternal joints. The aim of this article is to provide baseline statistical data about the variations of the SF, to present a short review of the relevant literature and to compare results with other studies and populations. We review relevant literature, and we present data obtai-ned from skeletal samples of known population and sex. A total of 35 well-preserved dried sterna from the prefecture of Eastern Macedonia and Thrace, Greece, were selected: 20 men and 15 women with a mean age of 55 ± 6 years old. Measurements were made with a sliding calliper and photographic documentation. The incidence of the SF in the 35 dried specimens was 14.2%, 4 men (20% of male sample) and 1 woman (6.6% of female sample) and 80% of sternal foramina were observed in male individuals. The SF was found in the sternum body (2 cases, 40% of foramina), in xiphoid process (2 cases, 40% of foramina) and in sternoxiphoidal junction (1 case, 20% of foramina). All of the sterna presented 1 single visible SF. Two anatomically unique cases were identified throughout these 5 sterna, both belonging in male subjects. The SF constitutes a relatively common variation with great radiological, clinical, and forensic significance. Presence of a SF with irregular bony margins complicates considerably radiological differential diagnosis. Awareness of this important anatomic variation is fundamental for clinicians and autopsy pathologists, in order to avoid severe fatal complications and elucidate the exact cause of death, respectively.

  19. Anatomical basis for the fastigial pressor response. (United States)

    Giuditta, Marianna; Ruggiero, David A; Del Bo, Alberto


    Electrical stimulation of rostromedial portion of cerebellar fastigial nucleus elicits integrated cardiovascular effects, which are neurally and humorally mediated. In this study, we sought to demonstrate the anatomical substrates of the fastigial pressor response (FPR) in the rat. The response was electrophysiologically localized in anesthetized, paralyzed-ventilated rats. Anterograde transport techniques were used to study the efferent projections of the fastigial pressor area; the distribution of efferent projection cells were then mapped by injecting retrograde tracers into anterogradely labeled sites. Electrolytic lesions were then placed bilaterally in selected brainstem areas in the attempt to block the pressor response. Sites of cerebellar stimulation and of brainstem lesions were subsequently histologically identified. The following lesions abolished the FPR: in nine animals lesions involved portions of the nucleus gigantocellularis dorsalis (NGCd), paramedian reticular formation (PMN) and the nucleus tractus solitarii (NTS) (in two animals fairly selectively the caudal NTS); in two other animals lesions destroyed the rostral ventrolateral medulla (C1 area) and in one animal the area encompassing the dorsal convexity of the superior cerebellar peduncle bordering the locus coeruleus-lateral parabrachial complex; partially effective were unilateral lesions of NGCd and NTS (three), bilateral lesions confined to NGCd and PMN (two), to vestibular complex and uncinate fasciculus (UF) (three), to UF and locus coeruleus (three) and to nucleus reticularis ventralis (two). Ineffective lesions involved A1 area, the nucleus gigantocellularis ventralis (NGCv), the spinal trigeminal nucleus and nucleus reticularis parvocellularis, the A5 area of the ventrolateral pons, the central gray and lateral mesencephalic tegmentum. It seems therefore that the pressor response elicited by stimulation of the cerebellar fastigial nucleus utilizes central specific pathways, as

  20. Radiological considerations for decommissioning

    International Nuclear Information System (INIS)

    Adler, J.J.


    It has been said, by those uninitiated to decommissioning work, that radiological considerations required for decommissioning are the same as those for an operating facility. In reality, nothing could be further from the truth. The act of decommissioning can be likened to cutting off a tree limb while sitting on it. This paper discusses some of the unique radiological aspects that are associated with implementing a decommissioning health physics program. There are physical constraints that may cause major differences between a normal operational and a decommissioning health physics program. Throughout the decommissioning process, the installed equipment and services that were needed to support an operational program are constantly being removed or may already be disabled due to the age of the facility. Those affecting radiological protection programs typically would include radiation shielding, ventilation systems, breathing air supply for respiratory protection, and radiological monitoring systems

  1. Nomina anatomica. Anatomic terminology and the old French terminology. (United States)

    Chiapas-Gasca, Karla; Passos, Luiz Fernando De Souza; Euzébio Ribeiro, Sandra Lúcia; Villaseñor-Ovies, Pablo

    A surprising finding in our seminars in Latin America and Spain was that approximately half of the participants continued to use the old French anatomical nomenclature. The substance of this paper is a table in which we compare the anatomical names for the items reviewed in our seminar, in a Spanish version of the old French nomenclature and in the Spanish, Portuguese, and English versions of the currently employed anatomical terms. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  2. Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiology. (United States)

    Brennan-Olsen, Sharon L; Vogrin, Sara; Leslie, William D; Kinsella, Rita; Toombs, Maree; Duque, Gustavo; Hosking, Sarah M; Holloway, Kara L; Doolan, Brianna J; Williams, Lana J; Page, Richard S; Pasco, Julie A; Quirk, Shae E


    . The observed paucity of data and suggestion of continent-specific differences indicate an urgent need for further research regarding indigenous status and fracture epidemiology and aetiology. Our findings also have implications for communities, governments and healthcare professionals to enhance the prevention of trauma-related fractures in indigenous persons, and an increased focus on modifiable lifestyle behaviours to prevent osteoporotic fractures in all populations.

  3. Cervicitis aetiology and case definition: a study in Australian women attending sexually transmitted infection clinics. (United States)

    Lusk, M Josephine; Garden, Frances L; Rawlinson, William D; Naing, Zin W; Cumming, Robert G; Konecny, Pam


    Studies examining cervicitis aetiology and prevalence lack comparability due to varying criteria for cervicitis. We aimed to outline cervicitis associations and suggest a best case definition. A cross-sectional study of 558 women at three sexually transmitted infection clinics in Sydney, Australia, 2006-2010, examined pathogen and behavioural associations of cervicitis using three cervicitis definitions: 'microscopy' (>30 pmnl/hpf (polymorphonuclear leucocytes per high-powered field on cervical Gram stain)), 'cervical discharge' (yellow and/or mucopurulent cervical discharge) or 'micro+cervical discharge' (combined 'microscopy' and 'cervical discharge'). Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Trichomonas vaginalis (TV) and Neisseria gonorrhoeae (NG) had the strongest associations with cervicitis definitions 'micro+cervical discharge': CT adjusted prevalence ratio (APR)=2.13 (95% CI 1.38 to 3.30) p=0.0006, MG APR=2.21 (1.33 to 3.69) p=0.002, TV APR=2.37 (1.44 to 3.90) p=0.0007 NG PR=4.42 (3.79 to 5.15) pcervical discharge': CT APR=1.90 (1.25 to 2.89) p=0.003, MG APR=1.93 (1.17 to 3.19) p=0.011, TV APR=2.02 (1.24 to 3.31) p=0.005 NG PR=3.88 (3.36 to 4.48) pcervicitis risk: ('micro+cervical discharge') APR=0.69 (0.51 to 0.93) p=0.016. Combined population attributable risk % (PAR%) of these four pathogens was only 18.0% with a protective PAR% of condoms of 25.7%. Exposures not associated with cervicitis included bacterial vaginosis, Mycoplasma hominis, Ureaplasma urealyticum, herpes simplex virus 1&2, cytomegalovirus, Candida, age, smoking and hormonal contraception. Cervicitis was associated with CT, MG, TV and NG with combined PAR% of these pathogens only 18% in this setting, suggesting other factors are involved. Condoms significantly reduced cervicitis risk. Cervicitis definitions with best clinical utility and pathogen prediction were 'cervical discharge' and 'micro+cervical discharge'. Published by the BMJ Publishing Group Limited. For

  4. Patterns of infections, aetiological agents and antimicrobial resistance at a tertiary care hospital in northern Tanzania. (United States)

    Kumburu, Happiness Houka; Sonda, Tolbert; Mmbaga, Blandina Theophil; Alifrangis, Michael; Lund, Ole; Kibiki, Gibson; Aarestrup, Frank M


    To determine the causative agents of infections and their antimicrobial susceptibility at a tertiary care hospital in Moshi, Tanzania, to guide optimal treatment. A total of 590 specimens (stool (56), sputum (122), blood (126) and wound swabs (286)) were collected from 575 patients admitted in the medical and surgical departments. The bacterial species were determined by conventional methods, and disc diffusion was used to determine the antimicrobial susceptibility pattern of the bacterial isolates. A total of 249 (42.2%) specimens were culture-positive yielding a total of 377 isolates. A wide range of bacteria was isolated, the most predominant being Gram-negative bacteria: Proteus spp. (n = 48, 12.7%), Escherichia coli (n = 44, 11.7%), Pseudomonas spp. (n = 40, 10.6%) and Klebsiella spp (n = 38, 10.1%). Wound infections were characterised by multiple isolates (n = 293, 77.7%), with the most frequent being Proteus spp. (n = 44, 15%), Pseudomonas (n = 37, 12.6%), Staphylococcus (n = 29, 9.9%) and Klebsiella spp. (n = 28, 9.6%). All Staphylococcus aureus tested were resistant to penicillin (n = 22, 100%) and susceptible to vancomycin. Significant resistance to cephalosporins such as cefazolin (n = 62, 72.9%), ceftriaxone (n = 44, 51.8%) and ceftazidime (n = 40, 37.4%) was observed in Gram-negative bacteria, as well as resistance to cefoxitin (n = 6, 27.3%) in S. aureus. The study has revealed a wide range of causative agents, with an alarming rate of resistance to the commonly used antimicrobial agents. Furthermore, the bacterial spectrum differs from those often observed in high-income countries. This highlights the imperative of regular generation of data on aetiological agents and their antimicrobial susceptibility patterns especially in infectious disease endemic settings. The key steps would be to ensure the diagnostic capacity at a sufficient number of sites and implement structures to routinely exchange, compare, analyse and report data. Sentinel sites

  5. The Aetiologies and Impact of Fever in Pregnant Inpatients in Vientiane, Laos. (United States)

    Chansamouth, Vilada; Thammasack, Syvilay; Phetsouvanh, Rattanaphone; Keoluangkot, Valy; Moore, Catrin E; Blacksell, Stuart D; Castonguay-Vanier, Josee; Dubot-Pérès, Audrey; Tangkhabuanbutra, Jarasporn; Tongyoo, Narongchai; Souphaphonh, Phooksavanh; Sengvilaipaseuth, Onanong; Vongsouvath, Manivanh; Phommasone, Koukeo; Sengdethka, Davanh; Seurbsanith, Amphayvanh; Craig, Scott B; Hermann, Laura; Strobel, Michel; Newton, Paul N


    Laos has the highest maternal mortality ratio in mainland Southeast Asia and a high incidence of infectious diseases. Globally, malaria has been the pathogen most intensively investigated in relation to impact on pregnancy, but there has been relatively little research on the aetiology and impact of other diseases. We therefore aimed to determine the causes and impact of fever in pregnant women admitted to two central hospitals in Vientiane City, Lao PDR (Laos). This hospital-based prospective study was conducted in Mahosot Hospital and the Mother and Child Hospital, Vientiane, between 2006 and 2010, with the aim to recruit 250 consenting pregnant women admitted with tympanic temperature ≥37.5°C. Primary outcome was the cause of fever and secondary outcomes were pregnancy outcomes. Specific investigations (culture, antigen, molecular and serological tests) were performed to investigate causes of fever. After discharge, all pregnant women were asked to return for review and convalescence serum on day 10-14 and were monitored until delivery. 250 pregnant women were recruited to this study between February 2006 and November 2010. Fifty percent were pregnant for the first time. Their median (range) gestational age on admission was 24 (4-43) weeks. The median (range) tympanic admission temperature was 38.5°C (37.5-40.5°C). Fifteen percent of patients stated that they had taken antibiotics before admission. Headache, myalgia, back pain and arthralgia were described by >60% of patients and 149 (60%) were given a laboratory diagnosis. Of those with confirmed diagnoses, 132 (53%) had a single disease and 17 (7%) had apparent mixed diseases. Among those who had a single disease, dengue fever was the most common diagnosis, followed by pyelonephritis, scrub typhus, murine typhus and typhoid. Patients were also diagnosed with tuberculosis, appendicitis, Staphylococcus aureus septicemia, leptospirosis, Japanese encephalitis virus infection and Plasmodium falciparum malaria

  6. Aetiology, maternal and foetal outcome in 60 cases of obstetrical acute renal failure

    International Nuclear Information System (INIS)

    Khalil, M.A.M.; Azhar, A.; Anwar, N.


    Acute renal failure is a serious complication in pregnancy. Not only does it result in significant maternal morbidity and mortality but also results in significant number of foetal loss. Although incidence of obstetrical acute renal failure has decreased in developed countries but still it is one of the major health problem of developing nations. The objective of this study was to study aetiology, maternal and foetal outcome in obstetrical acute renal failure. This study was conducted at Department of Nephrology, Khyber Teaching Hospital, Peshawar from August 2006 to December 2007. It was a descriptive, case series study. Female patients with pregnancy and acute renal failure, irrespective of age, were included in the study. Patients were thoroughly examined and baseline urea, creatinine, serum electrolytes, peripheral smear, prothrombin time, partial thromboplastin time, fibrinogen degradation products, renal and obstetrical ultrasound were performed on each patient and 24-hr urinary protein and bacterial culture sensitivity on blood, urine or vaginal swabs were done in selected patients. Foetal and maternal outcome were recorded. Data were analysed using SPSS. A total of 60 patients were included in the study. Mean age of the patients was 29 +- 5.4 years and duration of gestation was 33 +- 4.9 weeks. Mean gravidity was 4 +- 2.2. Sixteen patients (26.66%) were treated conservatively while 44 (73.33%) required dialysis. Postpartum haemorrhage was present in 14 (23.33%), postpartum haemorrhage and disseminated intravascular coagulation (DIC) in 11 (18.33%), eclampsia-preeclampsia in 8 (13.33%), antepartum haemorrhage in 8 (13.33%), antepartum haemorrhage with DIC in 6 (10%), DIC alone in 4 (6.66%), obstructed labour in 3 (5%), septic abortion in 3 (3.33%), HELLP (haemolysis elevated liver enzyme and low platelet) in 2 (3.33%), urinary tract infection with sepsis in 1 (1.66%) and puerperal sepsis in 1 (1.66%). Foetal loss was 40 (66.66%). Maternal mortality was 9 (15

  7. The Aetiologies and Impact of Fever in Pregnant Inpatients in Vientiane, Laos.

    Directory of Open Access Journals (Sweden)

    Vilada Chansamouth


    Full Text Available Laos has the highest maternal mortality ratio in mainland Southeast Asia and a high incidence of infectious diseases. Globally, malaria has been the pathogen most intensively investigated in relation to impact on pregnancy, but there has been relatively little research on the aetiology and impact of other diseases. We therefore aimed to determine the causes and impact of fever in pregnant women admitted to two central hospitals in Vientiane City, Lao PDR (Laos.This hospital-based prospective study was conducted in Mahosot Hospital and the Mother and Child Hospital, Vientiane, between 2006 and 2010, with the aim to recruit 250 consenting pregnant women admitted with tympanic temperature ≥37.5°C. Primary outcome was the cause of fever and secondary outcomes were pregnancy outcomes. Specific investigations (culture, antigen, molecular and serological tests were performed to investigate causes of fever. After discharge, all pregnant women were asked to return for review and convalescence serum on day 10-14 and were monitored until delivery.250 pregnant women were recruited to this study between February 2006 and November 2010. Fifty percent were pregnant for the first time. Their median (range gestational age on admission was 24 (4-43 weeks. The median (range tympanic admission temperature was 38.5°C (37.5-40.5°C. Fifteen percent of patients stated that they had taken antibiotics before admission. Headache, myalgia, back pain and arthralgia were described by >60% of patients and 149 (60% were given a laboratory diagnosis. Of those with confirmed diagnoses, 132 (53% had a single disease and 17 (7% had apparent mixed diseases. Among those who had a single disease, dengue fever was the most common diagnosis, followed by pyelonephritis, scrub typhus, murine typhus and typhoid. Patients were also diagnosed with tuberculosis, appendicitis, Staphylococcus aureus septicemia, leptospirosis, Japanese encephalitis virus infection and Plasmodium falciparum

  8. Neonatal seizures in a rural Kenyan District Hospital: aetiology, Incidence and outcome of hospitalization

    Directory of Open Access Journals (Sweden)

    Newton Charles RJC


    Full Text Available Abstract Background Acute seizures are common among children admitted to hospitals in resource poor countries. However, there is little data on the burden, causes and outcome of neonatal seizures in sub-Saharan Africa. We determined the minimum incidence, aetiology and immediate outcome of seizures among neonates admitted to a rural district hospital in Kenya. Methods From 1st January 2003 to 31st December 2007, we assessed for seizures all neonates (age 0-28 days admitted to the Kilifi District Hospital, who were resident in a defined, regularly enumerated study area. The population denominator, the number of live births in the community on 1 July 2005 (the study midpoint was modelled from the census data. Results Seizures were reported in 142/1572 (9.0% of neonatal admissions. The incidence was 39.5 [95% confidence interval (CI 26.4-56.7] per 1000 live-births and incidence increased with birth weight. The main diagnoses in neonates with seizures were sepsis in 85 (60%, neonatal encephalopathy in 30 (21% and meningitis in 21 (15%, but only neonatal encephalopathy and bacterial meningitis were independently associated with seizures. Neonates with seizures had a longer hospitalization [median period 7 days - interquartile range (IQR 4 to10] -compared to 5 days [IQR 3 to 8] for those without seizures, P = 0.02. Overall, there was no difference in inpatient case fatality between neonates with and without seizures but, when this outcome was stratified by birth weight, it was significantly higher in neonates ≥ 2.5 kg compared to low birth weight neonates [odds ratio 1.59 (95%CI 1.02 to 2.46, P = 0.037]. Up to 13% of the surviving newborn with seizures had neurological abnormalities at discharge. Conclusion There is a high incidence of neonatal seizures in this area of Kenya and the most important causes are neonatal encephalopathy and meningitis. The high incidence of neonatal seizures may be a reflection of the quality of the perinatal and

  9. [Aetiology and pathogenesis of damages to blood vessels in drug addicts]. (United States)

    Sultanaliev, T A; Tursynbaev, S E; Ivakin, V M


    The article deals with the problems concerning aetiology and pathogenesis of damages to blood vessels in patients practicing parenteral administration of surrogates of narcotic substances. In order to clinically and experimentally study the pattern of morphological alterations in the area of narcotic substances administration and to work out an appropriate classification of the forms and stages of development of the pathological process, the authors analysed the clinical course of vascular lesions and complications thereof in a total of 244 drug abusers having parenterally administered surrogates of narcotic substances and undergoing treatment at the Department of Vascular Surgery of the Municipal Clinical Hospital of the city of Almaty. Additionally, experimental studies were carried out on 16 rabbits with the induced model of parenteral administration of surrogates of narcotic substances, thus making it possible to study the degree of their effect and to confirm the theory of a chemical impact of the homemade drugs on the vascular wall. The findings of the carried out studies enabled us to single out the following clinical stages of vascular lesions: stage I - the initial stage of cicatricial-and-ulcerous lesions formation, stage II - formation of cutaneous-and-vascular fistulas, stage III - the stage of complications characterized by development of health-hazardous vascular lesions, i. e., arterial and venous thromboses of the major vessels, as well as arrosive bleedings. It was noted that more than 50% of patients were admitted to the clinic presenting with the third stage of vascular lesions. The experimental part of the study included 64 experiments on 16 rabbits (one experiment per each paw of the animal). The laboratory animals were subdivided into three groups. The first experimental group consisted of the rabbits with a mechanically inflicted injury to the vessels. The second and third experimental groups were composed of the rabbits having received

  10. Anatomic considerations for C2 pedicle screw placement: the use of computerized tomography measurements Consideraciones anatómicas de la cocalización de los tornillos pediculares en C2: uitlización de las medidas de la tomografia computadorizada Considerações anatômicas sobre a localização dos parafusos pediculares em C2: utilização das medidas da tomografia computadorizada

    Directory of Open Access Journals (Sweden)

    Adebukoa Onibokun


    Full Text Available OBJECTIVE: more detailed anatomical knowledge of the C2 pedicle is required to optimize and minimize the risk of screw placement. The aim of this study was to evaluate the linear and angular dimensions of the true C2 pedicle using axial CT. METHODS: ninety three patients (47 males, 46 females mean age 48 years who had cervical spinal CT imaging performed were evaluated for this study. Axial images of the C2 pedicle were selected and the following pedicle parameters were determined: pedicle width (PW, the mediolateral diameter of the pedicle isthmus, perpendicular to the pedicle axis and pedicle transverse angle (PTA, that is, the angle between the pedicle axis and the midline of the vertebral body. RESULTS: the overall mean pedicle width was 5.8 1.2mm. The mean pedicle width in males (6.01.3mm was greater than that in the female subjects (5.6 1.1mm. This difference was not found to be statistically significant (p=.6790. The overall mean pedicle transverse angle was 43.93.9 degrees. The mean PTA in males was 43.23.8 degrees, while that in females was 44.73.7 degrees. CONCLUSION: preoperative planning is absolutely mandatory, particularly in determining not only screw trajectory, but in analyzing individual patient anatomy and reception to a C2 pedicle screw.OBJETIVO: el conocimiento detallado de las características anatómicas del pedículo de C2 es necesario para minimizar los riesgos relacionados con la colocación de los tornillos. El objetivo del estudio fue evaluar las medidas lineares y angulares del eje axial verdadero del pedículo de C2 utilizando la tomografía computadorizada. MÉTODOS: fueron utilizadas tomografías computadorizadas axiales de 93 pacientes (47 del sexo masculino y 46 del sexo femenino con promedio de edad de 48 años. Las imágenes axiales del pedículo de C2 fueron seleccionadas para el estudio y los parámetros estudiados fueron: Ancho del pedículo (diámetro mediolateral del istmo del pedículo perpendicular al

  11. The production of anatomical teaching resources using three-dimensional (3D) printing technology. (United States)

    McMenamin, Paul G; Quayle, Michelle R; McHenry, Colin R; Adams, Justin W


    The teaching of anatomy has consistently been the subject of societal controversy, especially in the context of employing cadaveric materials in professional medical and allied health professional training. The reduction in dissection-based teaching in medical and allied health professional training programs has been in part due to the financial considerations involved in maintaining bequest programs, accessing human cadavers and concerns with health and safety considerations for students and staff exposed to formalin-containing embalming fluids. This report details how additive manufacturing or three-dimensional (3D) printing allows the creation of reproductions of prosected human cadaver and other anatomical specimens that obviates many of the above issues. These 3D prints are high resolution, accurate color reproductions of prosections based on data acquired by surface scanning or CT imaging. The application of 3D printing to produce models of negative spaces, contrast CT radiographic data using segmentation software is illustrated. The accuracy of printed specimens is compared with original specimens. This alternative approach to producing anatomically accurate reproductions offers many advantages over plastination as it allows rapid production of multiple copies of any dissected specimen, at any size scale and should be suitable for any teaching facility in any country, thereby avoiding some of the cultural and ethical issues associated with cadaver specimens either in an embalmed or plastinated form. © 2014 American Association of Anatomists.

  12. Anatomical influences on internally coupled ears in reptiles. (United States)

    Young, Bruce A


    Many reptiles, and other vertebrates, have internally coupled ears in which a patent anatomical connection allows pressure waves generated by the displacement of one tympanic membrane to propagate (internally) through the head and, ultimately, influence the displacement of the contralateral tympanic membrane. The pattern of tympanic displacement caused by this internal coupling can give rise to novel sensory cues. The auditory mechanics of reptiles exhibit more anatomical variation than in any other vertebrate group. This variation includes structural features such as diverticula and septa, as well as coverings of the tympanic membrane. Many of these anatomical features would likely influence the functional significance of the internal coupling between the tympanic membranes. Several of the anatomical components of the reptilian internally coupled ear are under active motor control, suggesting that in some reptiles the auditory system may be more dynamic than previously recognized.

  13. Contribution to the anatomical nomenclature concerning upper limb anatomy. (United States)

    Kachlik, David; Musil, Vladimir; Baca, Vaclav


    The aim of this article is to revise and extend the existing sections of Terminologia Anatomica dealing with the upper limb structures, which nomenclature belongs to its most neglected and not developing parts, and to justify the use of the proposed anatomical terms in the clinical practice, research, and education. A sample collected from own educational and research experience was matched in the main anatomical textbooks as well as old and recent anatomical journals and compared with four versions of the official Latin anatomical nomenclatures. The authors summarize here 145 terms, completed with their definitions or explanations, concerning both constant and variable (inconstant) morphological structures (bones, joints, muscles, vessels, and nerves) of the pectoral girdle, arm, cubital region, forearm, wrist, and hand, completed with some grammar remarks and several general terms. After a broad discussion on this topic, the Terminologia Anatomica should be revised and extend with the listed terms (or their equivalents).

  14. Anatomical terminology and nomenclature: past, present and highlights. (United States)

    Kachlik, David; Baca, Vaclav; Bozdechova, Ivana; Cech, Pavel; Musil, Vladimir


    The anatomical terminology is a base for medical communication. It is elaborated into a nomenclature in Latin. Its history goes back to 1895, when the first Latin anatomical nomenclature was published as Basiliensia Nomina Anatomica. It was followed by seven revisions (Jenaiensia Nomina Anatomica 1935, Parisiensia Nomina Anatomica 1955, Nomina Anatomica 2nd to 6th edition 1960-1989). The last revision, Terminologia Anatomica, (TA) created by the Federative Committee on Anatomical Terminology and approved by the International Federation of Associations of Anatomists, was published in 1998. Apart from the official Latin anatomical terminology, it includes a list of recommended English equivalents. In this article, major changes and pitfalls of the nomenclature are discussed, as well as the clinical anatomy terms. The last revision (TA) is highly recommended to the attention of not only teachers, students and researchers, but also to clinicians, doctors, translators, editors and publishers to be followed in their activities.


    Directory of Open Access Journals (Sweden)

    Thulaseedharan Sreedharan


    Full Text Available BACKGROUND Oral cancer is the sixth most common cancer in the world. Oral cancer represents 14% of all cancer cases in Kerala. The aim of this study is to find out the aetiological factors, symptomatology, morphologic types and the distribution in the sub-sites of oral cavity. MATERIALS AND METHODS A cross-sectional study was conducted in the Department of ENT, Government Medical College, Thrissur, Kerala from May 2009 to October 2013; 136 patients (88 males and 48 females with histopathologically confirmed oral cancers were studied. Variables such as age, sex, residing area, occupation, educational level, socio-economic status, substance abuse, oral hygiene, family history and premalignant conditions were assessed. The presenting complaints, the site, morphology and histopathology of the lesions were noted. RESULTS Mean age in this study was 57.83 with male-to-female ratio of 1.83:1. Majority of cases were from socially and economically weaker section, 62% patients were smokers, 45% patients were alcoholic, 41% patients were pan chewers and 90% had more than one bad habit; 72.05% patients had poor orodental hygiene. Most common symptom in our patients was growth in the mouth. Tongue and buccal mucosa were the most affected sites. Majority presented with ulcerative type and most of the cases were squamous cell carcinoma. CONCLUSION Oral cancers are mainly seen in males of 55 – 64 years’ age group. Important aetiological factors identified in this study are substance abuse, poor oral hygiene and poor socio-economic status. Tobacco consumption is the most dominant risk factor. Most common symptom in our patients is growth in the mouth. Tongue and buccal mucosa are the most affected sites. Most of the cases were squamous cell carcinoma. The study of aetiology and common clinical presentations may help in prevention, early detection and management.

  16. Incidence, aetiology and injury characteristics of traumatic spinal cord injury in Stockholm, Sweden: A prospective, population-based update. (United States)

    Joseph, Conran; Andersson, Nina; Bjelak, Sapko; Giesecke, Kajsa; Hultling, Claes; Nilsson Wikmar, Lena; Phillips, Julie; Seiger, Åke; Stenimahitis, Vasilios; Trok, Katarzyna; Åkesson, Elisabet; Wahman, Kerstin


    To update the incidence rate, aetiology and injury characteristics of acutely-injured adults with traumatic spinal cord injury in Stockholm, Sweden, using international standards of reporting. Prospective, (regional) population-based observation. Forty-nine consecutively enrolled individuals. A surveillance system of newly-injured adults with traumatic spinal cord injury was implemented for an 18-month period. The International Spinal Cord Injury Core Data Set was used to collect data on those who survived the first 7 days post-injury. After an 18-month period, 49 incident cases were registered, of whom 45 were included in this study. The crude incidence rate was 19.0 per million, consisting mainly of men (60%), and the mean age of the cohort was 55 years (median 58). Causes of injury were almost exclusively limited to falls and transport-related events, accounting for 58% and 40% of cases, respectively. The incidence has remained stable when compared with the previous study; however, significant differences exist for injury aetiology (p = 0.004) and impairment level (p = 0.01) in that more fall- and transport-related spinal cord injury occurred, and a larger proportion of persons was left with resultant tetraplegia, in the current study, compared with more sport-related injuries and those left with paraplegia in the previous study. The incidence rate appeared to remain stable in Stockholm, Sweden. However, significant changes in injury aetiology and impairment-level post injury were found, compared with the previous study. There remains a need for developing fall-related prevention strategies in rehabilitation settings as well as in population-based programmes.

  17. Automatic anatomical segmentation of the liver by separation planes


    Boltcheva , Dobrina; Passat , Nicolas; Agnus , Vincent; Jacob-Da Col , Marie-Andrée; Ronse , Christian; Soler , Luc


    International audience; Surgical planning in oncological liver surgery is based on the location of the 8 anatomical segments according to Couinaud’s definition and tumors inside these structures. The detection of the boundaries between the segments is then the first step of the preoperative planning. The proposed method, devoted to binary images of livers segmented from CT-scans, has been designed to delineate these segments. It automatically detects a set of landmarks using a priori anatomic...

  18. Ultrasound of the rotator cuff with MRI and anatomic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Rutten, Matthieu J.C.M. [Department of Radiology, Jeroen Bosch Hospital, Nieuwstraat 34, 5211 NL ' s-Hertogenbosch (Netherlands)]. E-mail:; Maresch, Bas J. [Department of Radiology, Hospital Gelderse Vallei, Willy Brandtlaan 10, 6710 HN Ede (Netherlands)]. E-mail:; Jager, Gerrit J. [Department of Radiology, Jeroen Bosch Hospital, Nieuwstraat 34, 5211 NL ' s-Hertogenbosch (Netherlands)]. E-mail:; Blickman, Johan G. [Department of Radiology, University Medical Center Nijmegen, Geert Grooteplein Zuid 18, 6500 HB Nijmegen (Netherlands)]. E-mail:; Holsbeeck, Marnix T. van [Department of Radiology, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI 48202 (United States)]. E-mail:


    Magnetic resonance imaging and high-resolution ultrasound (US) are frequently used for the detection of rotator cuff tears. The diagnostic yield of US is influenced by several factors as technique, knowledge of the imaging characteristics of anatomic and pathologic findings and of pitfalls. The purpose of this article is to illustrates that the standardized high-resolution US examination of the shoulder covers the entire rotator cuff and correlates with MR imaging and anatomic sections.

  19. Anatomical knee postero-lateral corner reconstruction: The "Versailles" technique. (United States)

    Murgier, J; Boisrenoult, P; Steltzlen, C; Beaufils, P; Pujol, N


    Postero-lateral knee instability raises surgical challenges. Of the many available reconstruction techniques, few ensure anatomical reconstruction of the postero-lateral corner (PLC). The "Versailles" technique ensures the anatomical reconstruction of the three main PLC stabilisers (lateral collateral ligament, popliteus tendon, and popliteo-fibular ligament) by using either a hamstring autograft or a tendon allograft. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. Epigenetic considerations in aquaculture

    Directory of Open Access Journals (Sweden)

    Mackenzie R. Gavery


    Full Text Available Epigenetics has attracted considerable attention with respect to its potential value in many areas of agricultural production, particularly under conditions where the environment can be manipulated or natural variation exists. Here we introduce key concepts and definitions of epigenetic mechanisms, including DNA methylation, histone modifications and non-coding RNA, review the current understanding of epigenetics in both fish and shellfish, and propose key areas of aquaculture where epigenetics could be applied. The first key area is environmental manipulation, where the intention is to induce an ‘epigenetic memory’ either within or between generations to produce a desired phenotype. The second key area is epigenetic selection, which, alone or combined with genetic selection, may increase the reliability of producing animals with desired phenotypes. Based on aspects of life history and husbandry practices in aquaculture species, the application of epigenetic knowledge could significantly affect the productivity and sustainability of aquaculture practices. Conversely, clarifying the role of epigenetic mechanisms in aquaculture species may upend traditional assumptions about selection practices. Ultimately, there are still many unanswered questions regarding how epigenetic mechanisms might be leveraged in aquaculture.

  1. Viral and bacterial aetiologies of male urethritis: findings of a high prevalence of Epstein-Barr virus. (United States)

    Berntsson, M; Löwhagen, G-B; Bergström, T; Dubicanac, L; Welinder-Olsson, C; Alvengren, G; Tunbäck, P


    Male urethritis is one of the most common sexually transmitted infections (STIs). However, the aetiology is still unclear in many cases. In this study the prevalences of Epstein-Barr virus (EBV), herpes simplex virus type 1 (HSV-1), HSV-2, cytomegalovirus (CMV), adenovirus, Chlamydia trachomatis, Mycoplasma genitalium and Ureaplasma urealyticum (including subtyping) were investigated. Samples from 112 male STI attendants with microscopically verified urethritis and from a control group of 103 men without clinical or microscopic signs of urethritis were analysed. Prevalences in the urethritis group compared with the controls were as follows: EBV 21%, 6% (P urethritis and may play a role in its pathogenesis.

  2. Do environmental factors play a role in the aetiology of carcinoma in situ testis and the testicular dysgenesis syndrome?

    DEFF Research Database (Denmark)

    Sonne, S B; Hoei-Hansen, C E; Fisher, J S


    development, and may be provoked by external factors such as endocrine disruptors in addition to genetic predisposition. Testicular germ cell tumours (TGCTs), considered the most severe symptom of TDS, have increased in incidence during the last 60 years, to become the most common malignancy in young...... (DBP) suggesting that ubiquitously present environmental endocrine disruptors may play a role in the aetiology of human TDS. So far, no animal model has been able to mimick all the symptoms of TDS including TGCTs although CIS-like cells have been found in a spontaneous testicular neoplasm in a rabbit....

  3. Growth hormone abuse and bodybuilding as aetiological factors in the development of bilateral internal laryngocoeles. A case report. (United States)

    Moor, James W; Khan, M Iqbal J


    A 36-year-old man presented with hoarseness and stridor. He was an elite professional bodybuilder and admitted to having abusing anabolic steroids and growth hormone in the recent past. A CT scan showed bilateral laryngocoeles. The patient was initially managed with intravenous corticosteroids and broad-spectrum antibiotics, and the stridor resolved sufficiently to permit discharge from the hospital. He proceeded to undergo endoscopic marsupialisation of his laryngocoeles and to date has made a full recovery. This is the first reported case where anabolic steroid and growth hormone abuse combined with an elite bodybuilder's exercise regime has been implicated in the aetiology of bilateral laryngocoeles.

  4. The linguistic roots of Modern English anatomical terminology. (United States)

    Turmezei, Tom D


    Previous research focusing on Classical Latin and Greek roots has shown that understanding the etymology of English anatomical terms may be beneficial for students of human anatomy. However, not all anatomical terms are derived from Classical origins. This study aims to explore the linguistic roots of the Modern English terminology used in human gross anatomy. By reference to the Oxford English Dictionary, etymologies were determined for a lexicon of 798 Modern English gross anatomical terms from the 40(th) edition of Gray's Anatomy. Earliest traceable language of origin was determined for all 798 terms; language of acquisition was determined for 747 terms. Earliest traceable languages of origin were: Classical Latin (62%), Classical Greek (24%), Old English (7%), Post-Classical Latin (3%), and other (4%). Languages of acquisition were: Classical Latin (42%), Post-Classical Latin (29%), Old English (8%), Modern French (6%), Classical Greek (5%), Middle English (3%), and other (7%). While the roots of Modern English anatomical terminology mostly lie in Classical languages (accounting for the origin of 86% of terms), the anatomical lexicon of Modern English is actually much more diverse. Interesting and perhaps less familiar examples from these languages and the methods by which such terms have been created and absorbed are discussed. The author suggests that awareness of anatomical etymologies may enhance the enjoyment and understanding of human anatomy for students and teachers alike. Copyright © 2012 Wiley Periodicals, Inc.

  5. Reappraising the functional implications of the primate visual anatomical hierarchy. (United States)

    Hegdé, Jay; Felleman, Daniel J


    The primate visual system has been shown to be organized into an anatomical hierarchy by the application of a few principled criteria. It has been widely assumed that cortical visual processing is also hierarchical, with the anatomical hierarchy providing a defined substrate for clear levels of hierarchical function. A large body of empirical evidence seemed to support this assumption, including the general observations that functional properties of visual neurons grow progressively more complex at progressively higher levels of the anatomical hierarchy. However, a growing body of evidence, including recent direct experimental comparisons of functional properties at two or more levels of the anatomical hierarchy, indicates that visual processing neither is hierarchical nor parallels the anatomical hierarchy. Recent results also indicate that some of the pathways of visual information flow are not hierarchical, so that the anatomical hierarchy cannot be taken as a strict flowchart of visual information either. Thus, while the sustaining strength of the notion of hierarchical processing may be that it is rather simple, its fatal flaw is that it is overly simplistic.

  6. Toledo School of Translators and their influence on anatomical terminology. (United States)

    Arráez-Aybar, Luis-Alfonso; Bueno-López, José-L; Raio, Nicolas


    Translation facilitates transmission of knowledge between cultures. The fundamental transfer of anatomic terminology from the Ancient Greek and Islamic Golden Age cultures, to medieval Latin Christendom took place in the so-called Toledo School of Translators in the 12th-13th centuries. Translations made in Toledo circulated widely across Europe. They were the foundation of scientific thinking that was born in the boards of first universities. In Toledo, Gerard of Cremona translated Avicenna's Canon of Medicine, the key work of Islamic Golden Age of medicine. Albertus Magnus, Mondino de Luzzi and Guy de Chauliac, the leading authors of anatomical Latin words in the Middle Ages, founded their books on Gerard's translations. The anatomical terms of the Canon retain auctoritas up to the Renaissance. Thus, terms coined by Gerard such as diaphragm, orbit, pupil or sagittal remain relevant in the current official anatomical terminology. The aim of the present paper is to bring new attention to the highly significant influence that the Toledo School of Translators had in anatomical terminology. For this, we shall review here the onomastic origins of a number of anatomical terms (additamentum; coracoid process; coxal; false ribs; femur; panniculus; spondylus; squamous sutures; thorax; xiphoid process, etc.) which are still used today. Copyright © 2015 Elsevier GmbH. All rights reserved.

  7. [Ten years after the latest revision International Anatomical Terminology]. (United States)

    Kachlík, D; Bozdechová, I; Cech, P; Musil, V; Báca, V


    Ten years ago, the latest revision of the Latin anatomical nomenclature was approved and published as Terminologia Anatomica (International Anatomical Terminology), and is acknowledged by the organization uniting national anatomical societies--International Federation of Associations of Anatomists. The authors concentrate on new terms included in the nomenclature and on the linguistic changes of terminology. The most frequent errors done by medical specialists in the usage of the Latin anatomical terminology are emphasized and the situation of eponyms in contemporary anatomy is discussed in detail as well. The last version of the nomenclature makes its way very slowly in the professional community and it is necessary to refer to positive changes and advantages it has brought. The usage of this Latin anatomical nomenclature version is suggested by the International Federation to follow in theoretical and clinical fields of medicine. The authors of the article strongly recommend using the recent revision of the Latin anatomical nomenclature both in the oral and written forms, when educating and publishing.

  8. Specific Considerations for LGBT Eldercare


    Claassen, Ashley


    The LGBT community has changed considerably in numbers, awareness, and acceptance in the past few decades. Due to the growing number of LGBT elderly, special considera-tions must be taken into account in planning their care. This study aimed at showcasing considerations that should be taken into account when planning elderly care and future elderly living arrangements. The research questions used were (a) are there special considerations for LGBT seniors? and (b), if so, what are the cons...

  9. [Aetiology of candidiasis in paediatric patients: Comparative analysis with adult patients]. (United States)

    Gil-Tomás, Jesús J; Colomina-Rodríguez, Javier


    Candida spp. represents a group of commensal yeasts that can act as pathogens and cause candidiasis in different anatomical locations. The aim of this study was to perform an epidemiological and comparative analysis between the isolates of Candida spp. in clinical specimens during a three year-period (2010-2012) from children (0-14 years) and adults (15-99 years) in the Valencian Community (RedMIVA). The microbiological surveillance network of Valencian Community was used as the information source. Candida was isolated in 52,436 patients (1,604 [3.1%] children and 50,832 [96.9%] adults). Candida albicans was significantly (p<0.05) the predominant species in both age groups, and in almost every type of clinical specimen. The distribution of other species varied depending on the sample type and age group. In blood specimens, Candida parapsilosis followed by C. albicans, Candida famata and Candida lusitaniae were the main species found in children, whereas C. albicans followed by C. parapsilosis, Candida glabrata and Candida tropicalis were the predominant species in adults. In sterile fluids, urine and lower respiratory tract samples, C. parapsilosis was the second most prevalent species in the children group, while C. glabrata and C. tropicalis were the main second species in adults. Copyright © 2015 Asociación Española de Micología. Published by Elsevier Espana. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Mane Makarand, Mane Priyanka, Mohite Rajsinh , Bhattad Prashant, Bangar Kushal, Mahajani Anup


    Full Text Available The Artery of Percheron, a rare anatomical variant of brain vascularisation, arises from the posterior cerebral artery. Occlusion of this artery leads to bilateral paramedian thalamic infarct leads to dysfunction of central nervous system. Incidence of bilateral thalamic infarct secondary to occlusion of artery of Percheron is unknown because of its rarity. Here we report a case of 35 year old female presented with altered state of consciousness and the underlying cause was occlusion of Artery of Percheron which leads to bilateral thalamic infarct detected on MRI scanning. It showed hyperintensities on T2W1 and FLAIR, and hypointensity on T1W1, restricted to bilateral ventromedial thalami showing corresponding area of high signal intensity on diffusion weighted images and hypointensity on apparent diffusion coefficient images indicating diffusion restriction, suggestive of infarct. On further investigation magnetic resonance arteriogram (MRA of the brain demonstrated a single common artery arising from the left P1 segment which divided into two branches distally supplying bilateral thalami. Patient became alright after 2 weeks of medical line of treatment.

  11. Contribution to the anatomical nomenclature concerning general anatomy and anatomical variations. (United States)

    Kachlik, David; Musil, Vladimir; Baca, Vaclav


    Nomenclature of the general and variant anatomy belongs to the most neglected parts of the Latin anatomical nomenclature in Terminologia Anatomica. Although many important small structures are included in Terminologia Anatomica, when describing and teaching particular anatomy of any part of the human body, the general terms are necessary, such as planes, lines and flexion grooves. Moreover, Terminologia Anatomica contains only 149 terms of variant structures, enlisted in the parentheses to differentiate them from constant ones. They are only a rather representative selection and some more should be added, both from the educational and clinical point of view. The authors present some terms, completed with their definitions or explanations concerning the general and variant anatomy to evoke broader discussion on this topic which should issue in incorporation of proposed terms (or their equivalents) into the Terminologia Anatomica.

  12. Regulatory considerations for biosimilars

    Directory of Open Access Journals (Sweden)

    Ranjani Nellore


    Full Text Available Currently there is considerable interest in the legislative debate around generic biological drugs or "biosimilars" in the EU and US due to the large, lucrative market that it offers to the industry. While some countries have issued a few regulatory guidelines as well as product specific requirements, there is no general consensus as to a single, simple mechanism similar to the bioequivalence determination that leads to approval of generic small molecules all over the world. The inherent complex nature of the molecules, along with complicated manufacturing and analytical techniques to characterize them make it difficult to rely on a single human pharmacokinetic study for assurance of safety and efficacy. In general, the concept of comparability has been used for evaluation of the currently approved "similar" biological where a step by step assessment on the quality, preclinical and clinical aspects is made. In India, the focus is primarily on the availability and affordability of life-saving drugs. In this context every product needs to be evaluated on its own merit irrespective of the innovator brand. The formation of the National Biotechnology Regulatory Authority may provide a step in the right direction for regulation of these complex molecules. However, in order to have an efficient machinery for initial approval and ongoing oversight with a country-specific focus, cooperation with international authorities for granting approvals and continuous risk-benefit review is essential. Several steps are still needed for India to be perceived as a country that leads the world in providing quality biological products.

  13. [The remarkable debate during the beginning of the nineteenth century concerning the aetiology of scabies]. (United States)

    Thyresson, N


    The scabies mite (acarus or sarcoptes scabiei) was known already to Aristoteles, to the Arabic medicine during the early and to European physicians as well as laymen during the later Middle Ages, depicted in 1687 by Bonomo in Italy and by Schwiebe in Germany during the beginning of the eighteenth century. Later in the middle of the century three pupils to Linnaeus in their doctor's theses stated that the scabies mite (Acarus humanus subcutaneus) was the cause of scabies. The best pictures of the scabies-mite as well as of the flour- and cheese-mite was given by the Swedish entomologist Charles de Geer in 1778. In spite of all these facts the real aetiology of scabies seemed to be unknown in France and in most parts of Europe. This was probably due to the fact that no one had learned the rather simple method to extract the mite from the skin with a needle and thereby verify its existence. In the beginning of the twentieth century scabies was a real problem for the health authorities. In Paris l'Académie de Médecine even offered a reward to the person who could solve the enigma of the itch. Jean Chrysanthe Galés was the pharmacist at l'Hôpital St. Louis, the famous skin hospital in Paris, where at this time about 65 percent of the beds were occupied by patients suffering from scabies. Galés also studied medicine and wanted to write a doctor's thesis. As the theme of a dissertation he was given the cause of the itch. In 1812 he published his thesis ("Essai sur la Gale") including a plate with sketches of mites that he claimed to have extracted from vesicules on the skin of his scabies patients. His findings could not be verified by other investigators. Galés however refused to take part in any control experiments and left the hospital. The debate concerning the supposed cause of the itch continued for two decades both inside and outside the hospital. F.C. Raspail, a famous natural scientist, was interested. After having studied the literature and especially the

  14. Oxytocin receptor (OXTR) does not play a major role in the aetiology of autism: genetic and molecular studies. (United States)

    Tansey, Katherine E; Brookes, Keeley J; Hill, Matthew J; Cochrane, Lynne E; Gill, Michael; Skuse, David; Correia, Catarina; Vicente, Astrid; Kent, Lindsey; Gallagher, Louise; Anney, Richard J L


    Oxytocin (OXT) has been hypothesized to play a role in aetiology of autism based on a demonstrated involvement in the regulation of social behaviours. It is postulated that OXT reduces activation of the amygdala, inhibiting social anxiety, indicating a neural mechanism for the effects of OXT in social cognition. Genetic variation at the oxytocin receptor gene (OXTR) has been reported to be associated with autism. We examined 18 SNPs at the OXTR gene for association in three independent autism samples from Ireland, Portugal and the United Kingdom. We investigated cis-acting genetic effects on OXTR expression in lymphocytes and amygdala region of the brain using an allelic expression imbalance (AEI) assay and by investigating the correlation between RNA levels and genotype in the amygdala region. No marker survived multiple correction for association with autism in any sample or in a combined sample (n=436). Results from the AEI assay performed in the lymphoblast cell lines highlighted two SNPs associated with relative allelic abundance in OXTR (rs237897 and rs237895). Two SNPs were found to be effecting cis-acting variation through AEI in the amygdala. One was weakly correlated with total gene expression (rs13316193) and the other was highlighted in the lymphoblast cell lines (rs237895). Data presented here does not support the role of common genetic variation in OXTR in the aetiology of autism spectrum disorders in Caucasian samples. 2010 Elsevier Ireland Ltd. All rights reserved.

  15. Causal narratives in public health: the difference between mechanisms of aetiology and mechanisms of prevention in non-communicable diseases. (United States)

    Kelly, Michael P; Russo, Federica


    Research in the health sciences has been highly successful in revealing the aetiologies of many morbidities, particularly those involving the microbiology of communicable disease. This success has helped form a narrative to be found in numerous public health documents, about interventions to reduce the burden of non-communicable diseases (e.g., obesity or alcohol related pathologies). These focus on tackling the purported pathogenic factors causing the diseases as a means of prevention. In this paper, we argue that this approach has been sub-optimal. The mechanisms of aetiology and of prevention are sometimes significantly different and failure to make this distinction has hindered efforts at preventing non-communicable diseases linked to diet, exercise and alcohol consumption. We propose a sociological approach as an alternative based on social practice theory. (A virtual abstract for this paper can be found at: © 2017 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

  16. Aetiology of Bacteraemia as a Risk Factor for Septic Shock at the Onset of Febrile Neutropaenia in Adult Cancer Patients

    Directory of Open Access Journals (Sweden)

    Regis Goulart Rosa


    Full Text Available Septic shock (SS at the onset of febrile neutropaenia (FN is an emergency situation that is associated with high morbidity and mortality. The impact of the specific aetiology of bloodstream infections (BSIs in the development of SS at the time of FN is not well established. The aim of this study was to evaluate the association between the aetiology of BSIs and SS at the time of FN in hospitalised adult cancer patients. This prospective cohort study was performed at a single tertiary hospital from October 2009 to August 2011. All adult cancer patients admitted consecutively to the haematology ward with FN were evaluated. A stepwise logistic regression was conducted to verify the association between the microbiological characteristics of BSIs and SS at the onset of FN. In total, 307 cases of FN in adult cancer patients were evaluated. There were 115 cases with documented BSI. A multivariate analysis showed that polymicrobial bacteraemia (P=0.01 was associated with SS. The specific blood isolates independently associated with SS were viridans streptococci (P=0.02 and Escherichia coli (P=0.01. Neutropaenic cancer patients with polymicrobial bacteraemia or BSI by viridans streptococci or Escherichia coli are at increased risk for SS at the time of FN.

  17. Genetic testing of aetiology of intellectual disability in a dedicated physical healthcare outpatient clinic for adults with intellectual disability. (United States)

    Wallace, R A


    No guidelines exist for assessment of aetiology of intellectual disability in adults with intellectual disability by adult physicians, although robust guidelines exist for paediatric populations. It was speculated that the paediatric guidelines would also be suitable for adults. In rural/regional setting with limited clinical genetics, to perform a quality assurance evaluation on genetics assessment of aetiology of developmental disability in adults attending a dedicated healthcare clinic for adults with intellectual disability, compared results with paediatric standards, speculates if these seem appropriate for adults and speculates on a role for clinical genetics services. Retrospective chart audit of eligible patients looking at genetic clinical assessment, tests selected (molecular karyotype, G banding, metabolics), and yields of positive results. The results were compared with the recommended paediatric guidelines. Of 117 eligible adult patients, ideal genetic history was incomplete for 40% of patients without Down syndrome because of physician cause and lack of information. The number of abnormal genetic results increased from 46% to 66%, mainly from the molecular karyotype, though not all may have been clinically relevant. The improved yield from this test was similar to that in paediatric studies. Use of G banding and metabolic testing could be refined. Improvement can be made in clinical genetic assessment, but results generally support use of molecular karyotyping as first tier testing of cause of unknown intellectual disability in adults, as in the case for paediatric populations. The study highlights a necessary complementary role for clinical geneticists to interpret abnormal results. © 2016 Royal Australasian College of Physicians.

  18. The epileptic encephalopathy jungle - from Dr West to the concepts of aetiology-related and developmental encephalopathies. (United States)

    Kalser, Judith; Cross, J Helen


    We aim to further disentangle the jungle of terminology of epileptic encephalopathy and provide some insights into the current understanding about the aetiology and pathophysiology of this process. We cover also the key features of epilepsy syndromes of infancy and childhood which are considered at high risk of developing an epileptic encephalopathy. The concept of 'epileptic encephalopathy' has progressively been elaborated by the International League Against Epilepsy according to growing clinical and laboratory evidence. It defines a process of neurological impairment caused by the epileptic activity itself and, therefore, potentially reversible with successful treatment, although to a variable extent. Epileptic activity interfering with neurogenesis, synaptogenesis, and normal network organization as well as triggering neuroinflammation are among the possible pathophysiological mechanisms leading to the neurological compromise. This differs from the newly introduced concept of 'developmental encephalopathy' which applies to where the epilepsy and developmental delay are both because of the underlying aetiology and aggressive antiepileptic treatment may not be helpful. The understanding and use of correct terminology is crucial in clinical practice enabling appropriate expectations of antiepileptic treatment. Further research is needed to elucidate underlying pathophysiological mechanisms, define clear outcome predictors, and find new treatment targets.

  19. Primary rhegmatogenous retinal detachment - surgical methods and anatomical outcome. (United States)

    Haugstad, Marta; Moosmayer, Stefan; Bragadόttir, Ragnheiður


    The aim of the study was to evaluate the anatomical success of surgical management of primary rhegmatogenous retinal detachment (RRD) and to compare the anatomical outcomes from different surgical techniques. During 2012, 517 consecutive eyes (514 patients) were operated by 11 surgeons at the Department of Ophthalmology, Oslo University Hospital. Patient records were retrospectively analysed with no exclusions. Main outcome measures were primary and final anatomical success. Primary anatomical success was defined as retinal reattachment 6 months after primary surgery with reoperations excluded. Final anatomical success was defined as retinal reattachment 6 months after primary surgery with reoperations included. Incidence of RRD was 18.6 eyes per 100 000 person-years. The macula was detached in 50.5% of the eyes at baseline. Of 517 operated eyes, 317 (61.3%) underwent pars plana vitrectomy (PPV), 23 (4.5%) pars plana vitrectomy together with a scleral buckle (PPV-SB), 175 (33.9%) scleral buckle (SB) surgery and two (0.4%) pneumatic retinopexy (PR). Primary anatomical success was 89.0% in the PPV group, 87.0% in the PPV-SB group and 85.7% in the SB group. Final anatomical success was 98.1% in the PPV group, 100% in the PPV-SB group and 99.4% in the SB group. Factors which were correlated to the redetachment were detachment of more than 6 clock hours (p = 0.003) and visual acuity (VA) on Snellen chart retina were large detachment and low VA. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  20. Bovine paramphistomosis in Galicia (Spain): prevalence, intensity, aetiology and geospatial distribution of the infection. (United States)

    González-Warleta, Marta; Lladosa, Silvia; Castro-Hermida, José Antonio; Martínez-Ibeas, Ana María; Conesa, David; Muñoz, Facundo; López-Quílez, Antonio; Manga-González, Yolanda; Mezo, Mercedes


    The present study explored various basic aspects of the epidemiology of paramphistomosis in Galicia, the main cattle producing region in Spain. In total, 589 cows from different farms located across the region were selected at random in the slaughterhouse for examination of the rumens and reticula for the presence of Paramphistomidae flukes. Paramphistomes were found in 111 of 589 necropsied cows (18.8%; 95% CI: 15.7-21.9%), with higher prevalences of infection in beef cows than in dairy cows (29.2% vs 13.9%). Although the number of flukes per animal was generally low (median=266 flukes), some cows harboured large parasite burdens (up to 11,895 flukes), which may have harmful effects on their health or productivity. Cows with higher parasite burdens also excreted greater numbers of fluke eggs in their faeces, which suggests that heavily parasitized mature cows play an important role in the transmission of paramphistomosis. This role may be particularly important in Galicia, where the roe deer, which is the only wild ruminant in the study area, was found not to be a reservoir for the infection. The use of morpho-anatomical and molecular techniques applied to a large number of fluke specimens provided reliable confirmation that Calicophoron daubneyi is the only species of the family Paramphistomidae that parasitizes cattle in Galicia. The environmental data from the farms of origin of the necropsied cows were used in Bayesian geostatistical models to predict the probability of infection by C. daubneyi throughout the region. The results revealed the role of environmental risk factors in explaining the geographical heterogeneity in the probability of infection in beef and dairy cattle. These explanatory factors were used to construct predictive maps showing the areas with the highest predicted risk of infection as well as the uncertainty associated with the predictions. Copyright © 2012 Elsevier B.V. All rights reserved.

  1. Euthanasia of Cattle: Practical Considerations and Application

    Directory of Open Access Journals (Sweden)

    Jan Keith Shearer


    Full Text Available Acceptable methods for the euthanasia of cattle include overdose of an anesthetic, gunshot and captive bolt. The use of anesthetics for euthanasia is costly and complicates carcass disposal. These issues can be avoided by use of a physical method such as gunshot or captive bolt; however, each requires that certain conditions be met to assure an immediate loss of consciousness and death. For example, the caliber of firearm and type of bullet are important considerations when gunshot is used. When captive bolt is used, a penetrating captive bolt loaded with the appropriate powder charge and accompanied by a follow up (adjunctive step to assure death are required. The success of physical methods also requires careful selection of the anatomic site for entry of a “free bullet” or “bolt” in the case of penetrating captive bolt. Disease eradication plans for animal health emergencies necessitate methods of euthanasia that will facilitate rapid and efficient depopulation of animals while preserving their welfare to the greatest extent possible. A portable pneumatic captive bolt device has been developed and validated as effective for use in mass depopulation scenarios. Finally, while most tend to focus on the technical aspects of euthanasia, it is extremely important that no one forget the human cost for those who may be required to perform the task of euthanasia on a regular basis. Symptoms including depression, grief, sleeplessness and destructive behaviors including alcoholism and drug abuse are not uncommon for those who participate in the euthanasia of animals.


    Monza, Francesca; Licata, Marta


    The international debate on the issue of human remains in museums and on the ethical issues related to their exhibition stimulates reflection on the Italian anatomical collections and on their preparations. A definition of human remains or of anatomical preparation does not exist in the Italian legislation. The anatomical specimens in museums are protected by the laws of Cultural Heritage as part of public collections, but their status is not well defined. By their nature of human material they would in fact be considered as a special category of Cultural Heritage. Because they are part of a cadaver they can be regarded as res nullius, but since treated with special techniques they could also change their meaning and being considered a species nova. Finally, it reflects on the possibility of creating a museum in Italy composed by new anatomical preparations. The article outline the contours of a museological issue that deserves to be investigated in order to better identify the anatomical preparations and their management in museums.

  3. CT following US for possible appendicitis: anatomic coverage

    Energy Technology Data Exchange (ETDEWEB)

    O' Malley, Martin E. [University of Toronto, Princess Margaret Hospital, 3-920, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Alharbi, Fawaz [University of Toronto, Toronto General Hospital, NCSB 1C572, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Qassim University, Department of Medical Imaging, Buraydah, Qassim (Saudi Arabia); Chawla, Tanya P. [University of Toronto, Mount Sinai Hospital, Room 567, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Moshonov, Hadas [University of Toronto, Joint Department of Medical Imaging, Toronto, Ontario (Canada)


    To determine superior-inferior anatomic borders for CT following inconclusive/nondiagnostic US for possible appendicitis. Ninety-nine patients with possible appendicitis and inconclusive/nondiagnostic US followed by CT were included in this retrospective study. Two radiologists reviewed CT images and determined superior-inferior anatomic borders required to diagnose or exclude appendicitis and diagnose alternative causes. This ''targeted'' coverage was used to estimate potential reduction in anatomic coverage compared to standard abdominal/pelvic CT. The study group included 83 women and 16 men; mean age 32 (median, 29; range 18-73) years. Final diagnoses were: nonspecific abdominal pain 50/99 (51 %), appendicitis 26/99 (26 %), gynaecological 12/99 (12 %), gastrointestinal 9/99 (10 %), and musculoskeletal 2/99 (2 %). Median dose-length product for standard CT was 890.0 (range, 306.3 - 2493.9) To confidently diagnose/exclude appendicitis or identify alternative diagnoses, maximum superior-inferior anatomic CT coverage was the superior border of L2-superior border of pubic symphysis, for both reviewers. Targeted CT would reduce anatomic coverage by 30-55 % (mean 39 %, median 40 %) compared to standard CT. When CT is performed for appendicitis following inconclusive/nondiagnostic US, targeted CT from the superior border of L2-superior border of pubic symphysis can be used resulting in significant reduction in exposure to ionizing radiation compared to standard CT. (orig.)

  4. Anatomical success in patients after retinectomy for complex retinal detachment

    International Nuclear Information System (INIS)

    Mukhtar, A.; Ishaq, M.; Islam, Q.U.


    To evaluate the efficacy of primary and redo retinectomy in eyes with complex retinal detachment. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology Rawalpindi from Jan 2012 to June 2013. Patients and Methods: Fifty eight eyes (patients) underwent relaxing retinectomies for complex retinal detachment with proliferative vitreoretinopathy or intrinsic retinal shortening. Operative technique included pars plana vitrectomy, proliferative vitreoretinopathy management, use of intraoperative perfluorocarbon liquid, retinectomy, endolaser and intraocular temponade. The main outcome was anatomic success, defined as complete retinal reattachment at four months follow up. Eighteen eyes out of the same primary group underwent second retinectomy because of anatomical failure. Results: Mean age of study population was 53.78 ± 15.11 years, 56.9% of patients were male(s). Anatomic success rate after 1st retinectomy was achieved in 68.96% (40 eyes out of 58). In eighteen eyes that underwent 2nd retinectomy, anatomic success rate was 72.22% (13 eyes out of 18). Overall success rate was 91.3% (53 eyes out of 58) in our study. Conclusions: Relaxing retinectomies for retinal shortening can improve the anatomical success rate in patients with complex RD. (author)

  5. [Parameters of cardiac muscle repolarization on the electrocardiogram when changing anatomical and electric position of the heart]. (United States)

    Chaĭkovskiĭ, I A; Baum, O V; Popov, L A; Voloshin, V I; Budnik, N N; Frolov, Iu A; Kovalenko, A S


    While discussing the diagnostic value of the single channel electrocardiogram a set of theoretical considerations emerges inevitably, one of the most important among them is the question about dependence of the electrocardiogram parameters from the direction of electrical axis of heart. In other words, changes in what of electrocardiogram parameters are in fact liable to reflect pathological processes in myocardium, and what ones are determined by extracardiac factors, primarily by anatomic characteristics of patients. It is arguable that while analyzing electrocardiogram it is necessary to orient to such physiologically based informative indexes as ST segment displacement. Also, symmetry of the T wave shape is an important parameter which is independent of patients anatomic features. The results obtained are of interest for theoretical and applied aspects of the biophysics of the cardiac electric field.

  6. Morpho-anatomical investigations on Momordica charantia L. (Cucurbitaceae

    Directory of Open Access Journals (Sweden)

    İlham Eröz Poyraz


    Full Text Available Momordica charantia L. (Cucurbitaceae used for some medicinal purposes like antidiabetic, anticancer, antiviral and treat to gastritis was investigated. Morphological studies were supported by morphometric measurements and drawings of male and female flowers, fruit and seeds of the species. In anatomical studies, cross sections of stem and leaf, upper and lower surface sections of leaves were evaluated. It was detected that the stem with typical anatomical properties of a climbing dicotyl plant. The leaves were amphistotamic and with lots of cyctoliths on the lower surface of leaves. Stomata are anomocytic and situated much more at the lower surface of leaves. Morpho-anatomical investigations on Momordica charantia L. (Cucurbitaceae*

  7. Lost and found anatomical terms: Crista choanalis vomeris. (United States)

    Marusić, Ana; Vinter, Ivan; Krmpotić-Nemanić, Jelena


    Pars cuneiformis vomeris and Crista choanalis are morphological structures on the vomer listed in the current official anatomical nomenclature, Terminologia anatomica, but are either not mentioned or incorrectly described in different anatomical books. The term Crista choanalis vomeris was originally proposed by Drago Perović in 1958 to describe the vertical crest beginning at the angle of the alae vomeris, running downwards to the posterior free margin of the vomer. Perović also described the part of the vomer behind this crest was shaped as a cone, and termed it Pars cuneiformis vomeris. Because of their important contributions to the function of the respiratory pathway, Crista choanalis vomeris and Pars cuneiformis vomeris deserve proper definitions in the anatomical terminology.

  8. Orbitofrontal sulcal and gyrus pattern in human: an anatomical study

    Directory of Open Access Journals (Sweden)

    Thiago Pereira Rodrigues


    Full Text Available The anatomical characterization of the orbitofrontal cortex in human is limited in literature instead of many functional and clinical studies involving it. Objective Anatomically define the orbitofrontal region aiming to possible neurosurgical treatments and unify the scientific nomenclature as well. Method We analyze eighty four human hemispheres using a surgical microscope. Then we chose four hemispheres and dissect them according to Klinger’ technique. Results We found five main sulcus: olfatory sulcus, orbital medial sulcus, orbital lateral sulcus, orbital transverse sulcus and orbital intermediate sulcus. These sulcus, excluding the intermediate sulcus, delimit five gyrus: rectus gurys, orbital medial gyrus, orbital anterior gyrus, orbital lateral gyrus and orbital posterior gyrus. The main sulcal configuration can be divided on four more frequently patterns. Conclusion Orbitofrontal cortex is associated with many psychiatric disorders. Better anatomical and functional characterization of the orbitofrontal cortex and its connections will improve our knowledge about these diseases.

  9. Dissimilarity-based classification of anatomical tree structures

    DEFF Research Database (Denmark)

    Sørensen, Lauge; Lo, Pechin Chien Pau; Dirksen, Asger


    A novel method for classification of abnormality in anatomical tree structures is presented. A tree is classified based on direct comparisons with other trees in a dissimilarity-based classification scheme. The pair-wise dissimilarity measure between two trees is based on a linear assignment...... between the branch feature vectors representing those trees. Hereby, localized information in the branches is collectively used in classification and variations in feature values across the tree are taken into account. An approximate anatomical correspondence between matched branches can be achieved...... by including anatomical features in the branch feature vectors. The proposed approach is applied to classify airway trees in computed tomography images of subjects with and without chronic obstructive pulmonary disease (COPD). Using the wall area percentage (WA%), a common measure of airway abnormality in COPD...

  10. Pathophysiology and aetiology of impaired fasting glycaemia and impaired glucose tolerance: does it matter for prevention and treatment of type 2 diabetes?

    DEFF Research Database (Denmark)

    Faerch, K; Borch-Johnsen, K; Holst, Jens Juul


    the transition from the prediabetic states to overt type 2 diabetes is characterised by a non-reversible vicious cycle that includes severe deleterious effects on glucose metabolism, there are good reasons to use the well-established aetiological and pathophysiological differences in i-IFG, i-IGT and IFG...... sensitivity as well as a progressive loss of beta cell function. The aetiologies of i-IFG and i-IGT also seem to differ, with i-IFG being predominantly related to genetic factors, smoking and male sex, while i-IGT is predominantly related to physical inactivity, unhealthy diet and short stature. Since...

  11. The stylomastoid artery as an anatomical landmark to the facial nerve during parotid surgery: a clinico-anatomic study

    Directory of Open Access Journals (Sweden)

    Nouraei Seyed


    Full Text Available Abstract Background The identification of the facial nerve can be difficult in a bloody operative field or by an incision that limits exposure; hence anatomical landmarks and adequate operative exposure can aid such identification and preservation. In this clinico-anatomic study, we examined the stylomastoid artery (SMA and its relation to the facial nerve trunk; the origin of the artery was identified on cadavers and its nature was confirmed histologically. Methods The clinical component of the study included prospective reviewing of 100 consecutive routine parotidectomies; while, the anatomical component of the study involved dissecting 50 cadaveric hemifaces. Results We could consistently identify a supplying vessel, stylomastoid artery, which tends to vary less in position than the facial nerve. Following this vessel, a few millimetres inferiorly and medially, we have gone on to identify the facial nerve trunk, which it supplies, with relative ease. The origin of the stylomastoid artery, in our study, was either from the occipital artery or the posterior auricular artery. Conclusion This anatomical aid, the stylomastoid artery, when supplemented by the other more commonly known anatomical landmarks and intra-operative facial nerve monitoring further reduces the risk of iatrogenic facial nerve damage and operative time.

  12. Anatomic mapping of molecular subtypes in diffuse glioma. (United States)

    Tang, Qisheng; Lian, Yuxi; Yu, Jinhua; Wang, Yuanyuan; Shi, Zhifeng; Chen, Liang


    Tumor location served as an important prognostic factor in glioma patients was considered to postulate molecular features according to cell origin theory. However, anatomic distribution of unique molecular subtypes was not widely investigated. The relationship between molecular phenotype and histological subgroup were also vague based on tumor location. Our group focuses on the study of glioma anatomic location of distinctive molecular subgroups and histology subtypes, and explores the possibility of their consistency based on clinical background. We retrospectively reviewed 143 cases with both molecular information (IDH1/TERT/1p19q) and MRI images diagnosed as cerebral diffuse gliomas. The anatomic distribution was analyzed between distinctive molecular subgroups and its relationship with histological subtypes. The influence of tumor location, molecular stratification and histology diagnosis on survival outcome was investigated as well. Anatomic locations of cerebral diffuse glioma indicate varied clinical outcome. Based on that, it can be stratified into five principal molecular subgroups according to IDH1/TERT/1p19q status. Triple-positive (IDH1 and TERT mutation with 1p19q codeletion) glioma tended to be oligodendroglioma present with much better clinical outcome compared to TERT mutation only group who is glioblastoma inclined (median overall survival 39 months VS 18 months). Five molecular subgroups were demonstrated with distinctive locational distribution. This kind of anatomic feature is consistent with its corresponding histological subtypes. Each molecular subgroup in glioma has unique anatomic location which indicates distinctive clinical outcome. Molecular diagnosis can be served as perfect complementary tool for the precise diagnosis. Integration of histomolecular diagnosis will be much more helpful in routine clinical practice in the future.

  13. [Strabismus determined by anatomical changes in the extrinsic ocular muscles]. (United States)

    Voinea, L; Samson, M; Glejaru, M; Popa, R


    The anatomical primitive strabismus is prenatal and its characteristic is the loose in the elasticity of the muscles of the surrounding tissues. The cause is the deficit of embryogenesis, originating in the first two months of pregnancy. They are presented the clinical cases of anatomical strabismus, investigated and treated in the Ophthalmological Clinic during 10 years, the surgical techniques used and the postoperative functional and obstetrical results the ocular disturbances are intense and the debut is early. The surgery involves both eyes and the results depend on the clinical form, the restant ocular motility and the degree of fibrosis of the affected muscle.

  14. Sonographic and Anatomic Description of the Subtalar Joint

    DEFF Research Database (Denmark)

    Mandl, Peter; Bong, David; Balint, Peter V


    Our study provides a detailed anatomic and sonographic description of the subtalar joint, a single joint that, anatomically, is divided into the anterior subtalar joint (ASTJ) and the posterior subtalar joint (PSTJ). Cadaver specimens of the ankle and foot were examined in detail by ultrasound (US......), and the subtalar joints of all the specimens were injected with colored latex of a contrasting color under US guidance. Compatible with other studies, examination of the sections revealed lack of communication between the ASTJ and the PSTJ and communication between the PSTJ and the posterior recess...

  15. Double auricles of the right atrium: a unique anatomic deformity

    Directory of Open Access Journals (Sweden)

    Lampoura Stefania S


    Full Text Available Abstract Background Anatomic deviations, especially those detected during the course of an operation, are medically intriguing, as they raise concerns about their clinical significance and putative complications. Case presentation We present, to our knowledge, for the first time a case of an anatomic deviation in the form of a second right atrial auricle in a 70 year-old, coronary bypass-operated male Caucasian patient of Greek origin. No complications were noted intra-or postoperatively. Conclusions A second right atrial auricle was found intraoperatively, without causing any clinical complications, or obstructing the normal course of a surgical procedure.

  16. Anatomic Eponyms in Neuroradiology: Brain, Cerebral Vasculature, and Calvarium. (United States)

    Bunch, Paul M; Zamani, Amir A


    Medical eponyms are ubiquitous, numerous, and at times controversial. They are often useful for succinctly conveying complex concepts, and familiarity with eponyms is important for proper usage and appropriate communication. In this historical review, we identify 18 anatomic eponyms used to describe structures of the brain, cerebral vasculature, and calvarium. For each structure, we first offer a biographical sketch of the individual for whom the structure is named. This is followed by a description of the anatomic structure and a brief discussion of its clinical relevance. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  17. Wood Anatomical Structure of Morus alba L. and Morus nigra L., Native to Iran

    Directory of Open Access Journals (Sweden)

    Elham KARAMI


    Full Text Available Iran is a wast country with many different tree species. Among those there are two species of Morus genus including alba and nigra. Since long time ago, white mulberry�s wood (Morus alba has been used for making musical instruments especially bowl shaped instruments in Iran.. In contrast, black mulberry�s wood (Morus nigra has never been used for these types of applications. In order to investigate the possible replacement choices, this study has been carried out to investigate the anatomical differences and similarities between these two species. Wood samples of the two species have been collected from same site and microsections for light microscopic studies and maceration samples have been prepared. The anatomical characteristics were studied according to the IAWA List of Hardwoods. The most important similarities between them are: vessel solitary in short radial multiples or irregular clusters, fiber nonseptate, rays uniseriate and multiseriate type, paratracheal parenchyma, varying from vasicentric to aliform confluent, apotracheal as marginal bands, Rhombic crystals present in rays and sometimes in parenchyma. The main differences are: semi-ring porous distribution of vessels in M. alba, fewer number of vessels and presence of aliform parenchyma in M. nigra. Taking these results into consideration, the most important features of both species are similar and it could be recommended to use the nigra species as well as the alba for making musical instruments.

  18. Morpho-anatomical and physiological responses to waterlogging of sesame (Sesamum indicum L.). (United States)

    Wei, Wenliang; Li, Donghua; Wang, Linhai; Ding, Xia; Zhang, Yanxin; Gao, Yuan; Zhang, Xiurong


    Waterlogging threatens severely to the sesame production in China, India and Burma, which are the top three sesame producers of the world. It was of great importance to explore the dynamics and mechanisms of action of anaerobic proteins and antioxidant enzymes together with the morph-anatomic adaptions in waterlogged sesame. The sesame accessions ZZM2541 and Ezhi-2 respond to waterlogging in considerably different performance. The stress induced wilting and leaf chlorosis in both accessions, but symptom occurred earlier in the susceptive Ezhi-2. In the more tolerant ZZM2541, adventitious roots formed above the flooding level, and plentiful of aerenchyma developed in the root and stem. However, it was discovered no apparent intercellular spaces existing in the spongy mesophyll in leaves of both accessions. The activities of ADH, PDC and LDH increased in roots of both accessions after suffering of the stress. The increase of ADH and PDC activity was more pronounced in ZZM2541, while a significantly higher LDH activity appeared in Ezhi-2. All the activities of SOD, APX and CAT were higher in the leaves of ZZM2541 than in Ezhi-2, and the leaves of Ezhi-2 showed a higher content of MDA throughout the duration of waterlogging. It was suggested that the tolerance to waterlogging of ZZM2541 appears to depend on a combination of metabolic and morpho-anatomical adaptions. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Modeling the pharyngeal anatomical effects on breathing resistance and aerodynamically generated sound. (United States)

    Xi, Jinxiang; Si, Xiuhua; Kim, JongWon; Su, Guoguang; Dong, Haibo


    The objective of this study was to systematically assess the effects of pharyngeal anatomical details on breathing resistance and acoustic characteristics by means of computational modeling. A physiologically realistic nose-throat airway was reconstructed from medical images. Individual airway anatomy such as the uvula, pharynx, and larynx was then isolated for examination by gradually simplifying this image-based model geometry. Large eddy simulations with the FW-H acoustics model were used to simulate airflows and acoustic sound generation with constant flow inhalations in rigid-walled airway geometries. Results showed that pharyngeal anatomical details exerted a significant impact on breathing resistance and energy distribution of acoustic sound. The uvula constriction induced considerably increased levels of pressure drop and acoustic power in the pharynx, which could start and worsen snoring symptoms. Each source anatomy was observed to generate a unique spectrum with signature peak frequencies and energy distribution. Moreover, severe pharyngeal airway narrowing led to an upward shift of sound energy in the high-frequency range. Results indicated that computational aeroacoustic modeling appeared to be a practical tool to study breathing-related disorders. Specifically, high-frequency acoustic signals might disclose additional clues to the mechanism of apneic snoring and should be included in future acoustic studies.

  20. Root and Root Canal Morphology of Maxillary First Premolars: A Literature Review and Clinical Considerations. (United States)

    Ahmad, Ibrahim Ali; Alenezi, Mohammad Ahmad


    Sound knowledge of the external and internal morphology of the different teeth groups is essential to ensure a successful outcome of root canal treatment. The aims of this study were to review the available literature with respect to the root and root canal morphology of maxillary first premolars and discuss the clinical considerations of this morphology on the various dental procedures. The MEDLINE/PubMed and Scopus databases were searched for relevant literature. The identified publications were classified into anatomic studies and clinical case reports. The data extracted from anatomic studies were tabulated, and weighted averages for certain internal and external morphologic features were calculated. The anatomic and developmental variations in the clinical case reports were summarized. A total of 92 studies (45 anatomic studies and 47 case reports) including a total of 11,299 teeth were identified. The majority of maxillary first premolars had 1 root (41.7%) or 2 roots (56.6%). Regardless of the number of roots, the vast majority (86.6%) had 2 root canals, with type IV (2-2) being the most common canal configuration (64.8%). The majority of the apical foramina (66.6%) did not coincide with the apical root tip. About 38% of the teeth had lateral canals, 12.3% had apical deltas, and 16.0% had isthmi. The clinical case reports showed that the 3-rooted variant was the most common anatomic variation, and developmental anomalies were rarely reported. The maxillary first premolars are predominantly 2-rooted teeth with 2 root canals. However, the clinician should be aware about the possible anatomic variations of these teeth and their relationship with the adjacent anatomic structures while planning and performing endodontic, restorative, periodontal, and surgical procedures. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  1. Advanced LBB methodology and considerations

    Energy Technology Data Exchange (ETDEWEB)

    Olson, R.; Rahman, S.; Scott, P. [Battelle, Columbus, OH (United States)] [and others


    LBB applications have existed in many industries and more recently have been applied in the nuclear industry under limited circumstances. Research over the past 10 years has evolved the technology so that more advanced consideration of LBB can now be given. Some of the advanced considerations for nuclear plants subjected to seismic loading evaluations are summarized in this paper.

  2. Ethical Considerations in Technology Transfer. (United States)

    Froehlich, Thomas J.


    Examines ethical considerations involved in the transfer of appropriate information technology to less developed countries. Approaches to technology are considered; two philosophical frameworks for studying ethical considerations are discussed, i.e., the Kantian approach and the utilitarian perspective by John Stuart Mill; and integration of the…

  3. Advanced LBB methodology and considerations

    International Nuclear Information System (INIS)

    Olson, R.; Rahman, S.; Scott, P.


    LBB applications have existed in many industries and more recently have been applied in the nuclear industry under limited circumstances. Research over the past 10 years has evolved the technology so that more advanced consideration of LBB can now be given. Some of the advanced considerations for nuclear plants subjected to seismic loading evaluations are summarized in this paper

  4. Revealed preference with limited consideration

    NARCIS (Netherlands)

    Demuynck, T.; Seel, C.


    We derive revealed preference tests for models where individuals use consideration sets to simplify their consumption problem. Our basic test provides necessary and sufficient conditions for consistency of observed choices with the existence of consideration set restrictions. The same conditions can

  5. A study on the aetiology of reserpine ulceration and the antiulcer action of solcoseryl in rat stomach. (United States)

    Cho, C H; Ogle, C W; Dai, S


    The aetiology of reserpine-induced gastric ulcer formation and the antiulcer effects of solcoseryl were studied in rats. Intraperitoneal injection of reserpine produced severe ulceration, as well as mast cell and histamine depletion, in the gastric glandular mucosa. Mepyramine and cimetidine markedly antagonized the gastric lesions, but did not influence the reduced mast cell count; atropine pretreatment significantly inhibited both parameters. Intramuscular injection of solcoseryl lessened ulcer severity and prevented the decreased mast cell counts and histamine levels in reserpine-treated rats. However, the same dose of solcoseryl injected intraperitoneally was ineffective. Solcoseryl, irrespective of the route of administration, did not influence the gastric secretory activities of reserpine. It is concluded that reserpine ulceration is both cholinergic- and histamine-mediated, and that the antiulcer effects of solcoseryl appear to be due to prevention of histamine depletion in the gastric mucosa.

  6. [Analysis and classification of Latin anatomical names of skeletal fossa in Terminologia Anatomica, and comparison with corresponding Japanese anatomical names]. (United States)

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


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

  7. [Analysis and classification of Latin anatomical names of skeletal canals in Terminologia anatomica, and comparison with corresponding Japanese anatomical names]. (United States)

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


    For a better understanding of the structures comprising the human body and in view of the possible need for future revision of anatomical nomenclature, Latin anatomical names of skeletal canals (including canaliculi) in Terminologia Anatomica were analyzed and classified, and compared with the corresponding Japanese anatomical names. The words following Canalis or Canales indicated: (1) the structure to which the canal belongs, (2) the structure to which the opening of the canal belongs, (3) the position of the canal, (4) the structure to which the canal leads, (5) the structure that exists near the opening of the canal, (6) the structure that transmits the canal, (7) the structure that is a component of the canal, or (8) the function of the canal. The analysis of Latin names and comparison with Japanese names clarified some characteristics of both names and revealed some problems in them.

  8. The Slothful Claw: Osteology and Taphonomy of Nothronychus mckinleyi and N. graffami (Dinosauria: Theropoda) and Anatomical Considerations for Derived Therizinosaurids. (United States)

    Hedrick, Brandon P; Zanno, Lindsay E; Wolfe, Douglas G; Dodson, Peter


    Nothronychus was the first definitive therizinosaurian discovered in North America and currently represents the most specialized North American therizinosaurian genus. It is known from two species, No. mckinleyi from the Moreno Hill Formation (middle Turonian) in west-central New Mexico, and No. graffami from the Tropic Shale (early Turonian) in south-central Utah. Both species are represented by partial to nearly complete skeletons that have helped elucidate evolutionary trends in Therizinosauria. In spite of the biogeographical and evolutionary importance of these two taxa, neither has received a detailed description. Here, we present comprehensive descriptions of No. mckinleyi and No. graffami, the latter of which represents the most complete therizinosaurid skeleton known to date. We amend previous preliminary descriptions of No. mckinleyi and No. graffami based on these new data and modify previous character states based on an in-depth morphological analysis. Additionally, we review the depositional history of both specimens of Nothronychus and compare their taphonomic modes. We demonstrate that the species were not only separated geographically, but also temporally. Based on ammonoid biozones, the species appear to have been separated by at least 1.5 million years and up to 3 million years. We then discuss the impacts of diagenetic deformation on morphology and reevaluate potentially diagnostic characters in light of these new data. For example, the ulna of No. mckinleyi is curved whereas the ulna of No. graffami was considered straight, a character originally separating the two species. However, here we present the difference as much more likely related to diagenetic compression in No. graffami rather than as a true biologic difference. Finally, we include copies of three-dimensional surface scans of all major bones for both taxa for reference.

  9. Portal Vein Embolization as an Oncosurgical Strategy Prior to Major Hepatic Resection: Anatomic, Surgical and Technical Considerations for Successful Outcomes

    Directory of Open Access Journals (Sweden)

    Sonia Tewani Orcutt


    Full Text Available Preoperative portal vein embolization (PVE is used to extend the indications for major hepatic resection, and it has become the standard of care for selected patients with hepatic malignancies treated at major hepatobiliary centers. To date, various techniques with different embolic materials have been used with similar results in the degree of liver hypertrophy. Regardless of the specific strategy used, both surgeons and interventional radiologists must be familiar with each other’s techniques to be able to create the optimal plan for each individual patient. Knowledge of the segmental anatomy of the liver is paramount to fully understand the liver segments that need to be embolized and resected. Understanding the portal vein anatomy and the branching variations, along with the techniques used to transect the portal vein during hepatic resection, is important because these variables can affect the PVE procedure and the eventual surgical resection. Comprehension of the advantages and disadvantages of approaches to the portal venous system and the various embolic materials used for PVE is essential to best tailor the procedures for each patient and to avoid complications. Before PVE, meticulous assessment of the portal vein branching anatomy is performed with cross-sectional imaging, and embolization strategies are developed based on the patient’s anatomy. The PVE procedure consists of several technical steps, and knowledge of these technical tips, potential complications and how to avoid the complications in each step is of great importance for safe and successful PVE, and ultimately successful hepatectomy. Because PVE is used as an adjunct to planned hepatic resection, priority must always be placed on safety, without compromising the integrity of the future liver remnant, and close collaboration between interventional radiologists and hepatobiliary surgeons is essential to achieve successful outcomes.

  10. Possible Common Aetiology behind Maternal Preeclampsia and Congenital Heart Defects in the Child: a Cardiovascular Diseases in Norway Project Study. (United States)

    Brodwall, Kristoffer; Leirgul, Elisabeth; Greve, Gottfried; Vollset, Stein Emil; Holmstrøm, Henrik; Tell, Grethe S; Øyen, Nina


    The aetiology of congenital heart defects (CHD) is mostly unknown, but maternal factors may modify the infant risk of CHD. We investigated the association between maternal preeclampsia and offspring risk of severe CHD in a nation-wide cohort study. Information on all births registered in the Medical Birth Registry of Norway, 1994-2009, was completed with information on CHD diagnoses from national health registries and the Cardiovascular Diseases in Norway Project (CVDNOR). Among 914 703 singleton births without chromosomal abnormalities, 32 864 (3.6%) were born after a pregnancy with preeclampsia. The preeclampsia was diagnosed before the 34th week of pregnancy (early-onset preeclampsia) in 2618 (8.0% of preeclamptic pregnancies). CHDs were diagnosed in 10 691 infants; of these, 2473 had severe CHD. The risk of severe CHD was compared between births with and without maternal preeclampsia and estimated with binomial log-linear regression. When adjusting for year of birth, maternal age, parity, and pregestational diabetes, the risk ratio (RR) for severe CHD in offspring of mothers with any preeclampsia was 1.3 [95% confidence interval (CI) 1.1, 1.5], and in pregnancies with early-onset preeclampsia, the RR was 2.8 (95% CI 1.8, 4.4). The association between early-onset preeclampsia and specific types of severe CHD was stronger for atrioventricular septal defects (AVSD), with adjusted RR 13.5 (95% CI 6.8, 26.8). Early-onset preeclampsia was strongly associated with infant risk of severe CHD, specifically; the risk of AVSD was 15-fold higher if the mother was diagnosed with early-onset preeclampsia, suggesting common aetiological factors for early-onset preeclampsia and erroneous fetal heart development. © 2015 John Wiley & Sons Ltd.

  11. When the human viral infectome and diseasome networks collide: towards a systems biology platform for the aetiology of human diseases. (United States)

    Navratil, Vincent; de Chassey, Benoit; Combe, Chantal Rabourdin; Lotteau, Vincent


    Comprehensive understanding of molecular mechanisms underlying viral infection is a major challenge towards the discovery of new antiviral drugs and susceptibility factors of human diseases. New advances in the field are expected from systems-level modelling and integration of the incessant torrent of high-throughput "-omics" data. Here, we describe the Human Infectome protein interaction Network, a novel systems virology model of a virtual virus-infected human cell concerning 110 viruses. This in silico model was applied to comprehensively explore the molecular relationships between viruses and their associated diseases. This was done by merging virus-host and host-host physical protein-protein interactomes with the set of genes essential for viral replication and involved in human genetic diseases. This systems-level approach provides strong evidence that viral proteomes target a wide range of functional and inter-connected modules of proteins as well as highly central and bridging proteins within the human interactome. The high centrality of targeted proteins was correlated to their essentiality for viruses' lifecycle, using functional genomic RNAi data. A stealth-attack of viruses on proteins bridging cellular functions was demonstrated by simulation of cellular network perturbations, a property that could be essential in the molecular aetiology of some human diseases. Networking the Human Infectome and Diseasome unravels the connectivity of viruses to a wide range of diseases and profiled molecular basis of Hepatitis C Virus-induced diseases as well as 38 new candidate genetic predisposition factors involved in type 1 diabetes mellitus. The Human Infectome and Diseasome Networks described here provide a unique gateway towards the comprehensive modelling and analysis of the systems level properties associated to viral infection as well as candidate genes potentially involved in the molecular aetiology of human diseases.

  12. The opposite end of the attention deficit hyperactivity disorder continuum: genetic and environmental aetiologies of extremely low ADHD traits. (United States)

    Greven, Corina U; Merwood, Andrew; van der Meer, Jolanda M J; Haworth, Claire M A; Rommelse, Nanda; Buitelaar, Jan K


    Although attention deficit hyperactivity disorder (ADHD) is thought to reflect a continuously distributed quantitative trait, it is assessed through binary diagnosis or skewed measures biased towards its high, symptomatic extreme. A growing trend is to study the positive tail of normally distributed traits, a promising avenue, for example, to study high intelligence to increase power for gene-hunting for intelligence. However, the emergence of such a 'positive genetics' model has been tempered for ADHD due to poor phenotypic resolution at the low extreme. Overcoming this methodological limitation, we conduct the first study to assess the aetiologies of low extreme ADHD traits. In a population-representative sample of 2,143 twins, the Strength and Weaknesses of ADHD Symptoms and Normal behaviour (SWAN) questionnaire was used to assess ADHD traits on a continuum from low to high. Aetiological influences on extreme ADHD traits were estimated using DeFries-Fulker extremes analysis. ADHD traits were related to behavioural, cognitive and home environmental outcomes using regression. Low extreme ADHD traits were significantly influenced by shared environmental factors (23-35%) but were not significantly heritable. In contrast, high-extreme ADHD traits showed significant heritability (39-51%) but no shared environmental influences. Compared to individuals with high extreme or with average levels of ADHD traits, individuals with low extreme ADHD traits showed fewer internalizing and externalizing behaviour problems, better cognitive performance and more positive behaviours and positive home environmental outcomes. Shared environmental influences on low extreme ADHD traits may reflect passive gene-environment correlation, which arises because parents provide environments as well as passing on genes. Studying the low extreme opens new avenues to study mechanisms underlying previously neglected positive behaviours. This is different from the current deficit-based model of

  13. One-stage revision anatomic anterior cruciate ligament reconstruction with rectangular tunnel technique

    Directory of Open Access Journals (Sweden)

    Konsei Shino


    Full Text Available We developed the anatomic rectangular tunnel anterior cruciate ligament reconstruction (ART ACLR with a bone–patellar tendon–bone graft to mimic fibre arrangement inside the native ACL via tunnels with smaller apertures. With a 10-mm-wide graft, the cross-sectional area of the tunnels of 50 mm2 in ART ACLR is less than that of 79 mm2 in a 10-mm round tunnel one. Because tunnel encroachment would be less of a problem, the ART ACLR technique could be most frequently applied to patients after a failed primary ACLR. In this instructional lecture, the indication and technical considerations for ART ACLR as one-stage revision ACLR are described.

  14. Did pterosaurs feed by skimming? Physical modelling and anatomical evaluation of an unusual feeding method.

    Directory of Open Access Journals (Sweden)

    Stuart Humphries


    Full Text Available Similarities between the anatomies of living organisms are often used to draw conclusions regarding the ecology and behaviour of extinct animals. Several pterosaur taxa are postulated to have been skim-feeders based largely on supposed convergences of their jaw anatomy with that of the modern skimming bird, Rynchops spp. Using physical and mathematical models of Rynchops bills and pterosaur jaws, we show that skimming is considerably more energetically costly than previously thought for Rynchops and that pterosaurs weighing more than one kilogram would not have been able to skim at all. Furthermore, anatomical comparisons between the highly specialised skull of Rynchops and those of postulated skimming pterosaurs suggest that even smaller forms were poorly adapted for skim-feeding. Our results refute the hypothesis that some pterosaurs commonly used skimming as a foraging method and illustrate the pitfalls involved in extrapolating from limited morphological convergence.

  15. Wood anatomical and chemical properties related to the pulpability ...

    African Journals Online (AJOL)

    Eucalyptus globulus is one of the most important hardwood species used by the pulp and paper industry due to its high pulp yield, high wood density, excellent fibre quality and good handsheet properties. However, the wood is a highly variable and complex material that has different chemical, physical and anatomical ...

  16. The effects of selected anatomical characteristics on physical ...

    African Journals Online (AJOL)

    The effects of selected anatomical characteristics on physical properties of Ethiopian Highland Bamboo Arundinaria Alpina K. Schum. (Poaceae) ... In early maturing bamboo, fibers are relatively small in wall thickness. The results of statistical analyses revealed that bamboo portion has significant effects on all variables.

  17. Optimizing conditions for computer-assisted anatomical learning.

    NARCIS (Netherlands)

    Luursema, J.M.; Verwey, Willem B.; Kommers, Petrus A.M.; Geelkerken, Robert H.; Vos, Hendrik J.


    An experiment evaluated the impact of two typical features of virtual learning environments on anatomical learning for users of differing visuo-spatial ability. The two features studied are computer-implemented stereopsis (the spatial information that is based on differences in visual patterns

  18. Prevalence and anatomical pattern of the median artery among ...

    African Journals Online (AJOL)

    Knowledge of the anatomy of median arteries is important in the diagnosis and management of carpal tunnel and pronator teres syndromes, reconstructive surgery in the forearm, minimizing inadvertent vascular injury as well as in limiting operative complications due to unexpected bleeding. The anatomical pattern displays ...

  19. An anatomical and functional topography of human auditory cortical areas

    Directory of Open Access Journals (Sweden)

    Michelle eMoerel


    Full Text Available While advances in magnetic resonance imaging (MRI throughout the last decades have enabled the detailed anatomical and functional inspection of the human brain non-invasively, to date there is no consensus regarding the precise subdivision and topography of the areas forming the human auditory cortex. Here, we propose a topography of the human auditory areas based on insights on the anatomical and functional properties of human auditory areas as revealed by studies of cyto- and myelo-architecture and fMRI investigations at ultra-high magnetic field (7 Tesla. Importantly, we illustrate that - whereas a group-based approach to analyze functional (tonotopic maps is appropriate to highlight the main tonotopic axis - the examination of tonotopic maps at single subject level is required to detail the topography of primary and non-primary areas that may be more variable across subjects. Furthermore, we show that considering multiple maps indicative of anatomical (i.e. myelination as well as of functional properties (e.g. broadness of frequency tuning is helpful in identifying auditory cortical areas in individual human brains. We propose and discuss a topography of areas that is consistent with old and recent anatomical post mortem characterizations of the human auditory cortex and that may serve as a working model for neuroscience studies of auditory functions.

  20. Anatomical Variation in the Wall Thickness of Wood Fibres of ...

    African Journals Online (AJOL)

    The wall thickness of wood fibres of rubber (Hevea brasiliensis) grown and tapped for latex in south eastern Nigeria were investigated to determine anatomical variation. The rubber trees which were overmature for tapping and keeping were sampled in hierarchical order of plantations, bud classes, trees, discs, cardinal ...

  1. Correlation of clinical data, anatomical site and disease stage in ...

    African Journals Online (AJOL)

    Objective: To evaluate the colorectal cancer clinical data with respect to the anatomical location and stage of disease. Design: Retrospective observational study. Setting: Kenyatta National Hospital (KNH), Nairobi, Kenya. Subjects: Two hundred and fifty three tumours were categorised as right colonic (RCC), left colonic ...

  2. A comparison of some anatomical characteristics of male and ...

    African Journals Online (AJOL)

    A comparison of some anatomical characteristics of male and female reproductive organs of the white Fulani and west African short horn cattle in Ghana: a ... be due to the confounding effects of the physiological state (follicular or luteal) of the ovaries depending on the oestrus cycle of the cow at the time measurements ...

  3. Anatomical studies of the gastrointestinal tract of the striped sand ...

    African Journals Online (AJOL)

    A study was carried out on the gross anatomical, morphometric features and histology of the gastrointestinal tract of the Striped Sand Snake (Psammophis sibilans). Ten snakes (five males and five females) were euthanized and dissected for the study. The gastrointestinal tract appeared as a straight tubular organ from oral ...

  4. A hierarchical scheme for geodesic anatomical labeling of airway trees

    DEFF Research Database (Denmark)

    Feragen, Aasa; Petersen, Jens; Owen, Megan


    . In tree-space, the airway tree topology and geometry change continuously, giving a natural way to automatically handle anatomical differences and noise. The algorithm is made efficient using a hierarchical approach, in which labels are assigned from the top down. We only use features of the airway...

  5. Agreement between anatomic and ultrasound measurements of femoral trochlear depth

    DEFF Research Database (Denmark)

    Miles, James Edward; Westrup, Ulrik; Eriksen, Thomas

    and ultrasonographic measurements of trochlear depth using the red fox hind limb as a canine surrogate, dividing the trochlea into five regions from the origin of the caudal cruciate ligament to the proximal aspect of the trochlea. We found reasonable agreement between anatomic and ultrasonographic measurements...

  6. Dissimilarity-based classification of anatomical tree structures

    DEFF Research Database (Denmark)

    Sørensen, Lauge Emil Borch Laurs; Lo, Pechin Chien Pau; Dirksen, Asger


    between the branch feature vectors representing those trees. Hereby, localized information in the branches is collectively used in classification and variations in feature values across the tree are taken into account. An approximate anatomical correspondence between matched branches can be achieved...

  7. Anatomical practices of preserving, handling and management of ...

    African Journals Online (AJOL)

    The result of this review is that an act will be required to address the management of human remains as well the regulation of the anatomical practices of preserving, handling and management of human remains. Human remains as used in this context includes established lifeless or dead whole human body otherwise ...

  8. Anatomical approach for surgery of the male posterior urethra. (United States)

    Dalpiaz, Orietta; Mitterberger, Michael; Kerschbaumer, Andrea; Pinggera, Germar M; Bartsch, Georg; Strasser, Hannes


    To investigate, in a morphological study, the anatomy of the male rhabdosphincter and the relation between the membranous urethra, the rhabdosphincter and the neurovascular bundles (NVBs) to provide the anatomical basis for surgical approach of the posterior urethra as successful outcomes in urethral reconstructive surgery still remain a challenging issue. In all, 11 complete pelves and four tissue blocks of prostate, rectum, membranous urethra and the rhabdosphincter were studied. Besides anatomical preparations, the posterior urethra and their relationship were studied by means of serial histological sections. In the histological cross-sections, the rhabdosphincter forms an omega-shaped loop around the anterior and lateral aspects of the membranous urethra. Ventrally and laterally, it is separated from the membranous urethra by a delicate sheath of connective tissue. Through a midline approach displacing the nerves and vessels laterally, injuries to the NVBs can be avoided. With meticulous dissection of the delicate ventral connective tissue sheath between the ventral wall of the membranous urethra and the rhabdosphincter, the two structures can be separated without damage to either of them. This anatomical approach can be used for dissection of the anterior urethral wall in urethral surgery. Based on precise anatomical knowledge, the ventral wall of the posterior urethra can be dissected and exposed without injuring the rhabdosphincter and the NVBs. This approach provides the basis for sparing of the rhabdosphincter and for successful outcomes in urethral surgery for the treatment of bulbo-membranous urethral strictures.

  9. Gross anatomical syringeal structures of goose (Anser anser domesticus

    Directory of Open Access Journals (Sweden)

    Reda Mohamed


    Conclusion: There were some similarities and some differences of the anatomical structures of the syrinx of goose and that of other bird species. No differences between male and female syrinx were observed. [J Adv Vet Anim Res 2017; 4(4.000: 343-347

  10. Anatomical variations of the brachial plexus terminal branches in ...

    African Journals Online (AJOL)

    Anatomical variations are clinically significant, but many are inadequately described or quantified. Variations in anatomy of the brachial plexus are important to surgeons and anesthesiologists performing surgical procedures in the neck, axilla and upper limb regions. It is also important for radiologists who interpret plain and ...

  11. Plastination technology for anatomical studies in Nigeria: Opinion of ...

    African Journals Online (AJOL)


    Apr 9, 2013 ... Plastination technology for anatomical studies in. Nigeria: Opinion of ... Today, modern techniques used to preserve the human body for didactic purposes are built on methods that began in ... of new techniques and computer science, alternative methods of teaching anatomy have come. Dr. Gunther von ...

  12. Anatomical variability of the trunk wood and root tissues of ...

    African Journals Online (AJOL)

    performed with an optic microscope “Motic. 2.0” to a magnification of forty x. The observation was facilitated by a Ken-A-Vision camera connected to a computer. The software. Vision 4 allowed to take pictures and to measure the constituent of the woody plan. The following anatomical characters were measured: the number ...

  13. More about...Anatomical Pathology | Eyal | Continuing Medical ...

    African Journals Online (AJOL)

    Continuing Medical Education. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 30, No 2 (2012) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. More about...Anatomical Pathology. P Eyal. Abstract.

  14. Gross and morphometric anatomical changes of the thyroid gland in ...

    African Journals Online (AJOL)

    Gross and morphometric anatomical changes of the thyroid gland in the West African Dwarf Goat ( Capra hircus ) during the foetal and post-natal periods of development. ... The right lobe was more cranially located on the larynx and trachea than the left lobe in all age groups. Thyroid isthmus was absent in few foetal thyroid ...

  15. Assessment of Anatomical Knowledge and Core Trauma Competency Vascular Skills. (United States)

    Granite, Guinevere; Pugh, Kristy; Chen, Hegang; Longinaker, Nyaradzo; Garofalo, Evan; Shackelford, Stacy; Shalin, Valerie; Puche, Adam; Pasley, Jason; Sarani, Babak; Henry, Sharon; Bowyer, Mark; Mackenzie, Colin


    Surgical residents express confidence in performing specific vascular exposures before training, but such self-reported confidence did not correlate with co-located evaluator ratings. This study reports residents' self-confidence evaluated before and after Advanced Surgical Skills for Exposure in Trauma (ASSET) cadaver-based training, and 12-18 mo later. We hypothesize that residents will better judge their own skill after ASSET than before when compared with evaluator ratings. Forty PGY2-7 surgical residents performed four procedures: axillary artery (AA), brachial artery (BA), femoral artery exposure and control (FA), and lower extremity fasciotomy (FAS) at the three evaluations. Using 5-point Likert scales, surgeons self-assessed their confidence in anatomical understanding and procedure performance after each procedure and evaluators rated each surgeon accordingly. For all the three evaluations, residents consistently rated their anatomical understanding (p < 0.04) and surgical performance (p < 0.03) higher than evaluators for both FA and FAS. Residents rated their anatomical understanding and surgical performance higher (p < 0.005) than evaluators for BA after training and up to 18 mo later. Only for third AA evaluation were there no rating differences. Residents overrate their anatomical understanding and performance abilities for BA, FA, and FAS even after performing the procedures and being debriefed three times in 18 mo.

  16. Anatomical factors predicting lower calyceal stone clearance after ...

    African Journals Online (AJOL)

    M. Khan


    Feb 17, 2016 ... Curr Opin Urol 2008;18:214–9. [9] Lingeman JE, Siegal YI, Steele B, Nyhus AW, Woods JR. Manage- ment of lower pole nephrolithiasis: a critical analysis. J Urol 1994;151: 663–7. [10] Sampaio FJB, Aragao AHM. Limitations of extracorporeal shock wave lithotripsy for lower caliceal stone: anatomic insight.

  17. Ethmomaxillary sinus: a particular anatomic variation of the paranasal sinuses

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    Sirikci, Akif; Bayram, Metin [Department of Radiology, Faculty of Medicine, Gaziantep University, Kolejtepe, 27310, Gaziantep (Turkey); Bayazit, Y.A.; Kanlikama, Muzaffer [Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Gaziantep University, Kolejtepe, 27310, Gaziantep (Turkey)


    We assessed the morphological and radiological characteristics of ethmomaxillary sinus (EMS), which is an enlarged posterior ethmoidal air cell occupying the superior portion of the maxillary sinus while draining into superior meatus. This study is based on 1450 patients submitted to CT examination of the paranasal sinuses between 1998 and 2002. Sequential CT scans were obtained in the coronal plane in all the patients with 2.5- to 5-mm section thickness and were evaluated for EMS. The diagnosis of EMS was made when there was a posterior ethmoidal cell occupying the superior part of the maxillary sinus while draining to the superior meatus. When EMS was diagnosed, the morphology of the septum between the and maxillary sinus, and width of the superior meatus, were noted. The EMS was found in 10 of 1450 (0.7%) patients. The coexisting anatomic variations were concha bullosa (50%), upper concha pneumatization (20%), maxillary sinus hypoplasia (20%), uncinate bulla (10%), hypertrophied inferior concha (10%), paradoxic middle concha (10%), and septate maxillary sinus (10%). There was no relation between EMS and sinus disease. The EMS is a rare anatomic variation and does not appear to be associated with sinusitis. The EMS is not a well-studied anatomic variation, and the literature is lacking adequate information about this anatomic variation. This study performed in a large series of patients will possibly contribute to better understanding of this particular anomaly. (orig.)

  18. An Investigation of How Clinicians use Anatomical Knowledge in ...

    African Journals Online (AJOL)

    An Investigation of How Clinicians use Anatomical Knowledge in Diagnostic Reasoning: A Grounded Theory Study of Clinicians in Zambia. ... observations, self-administered questionnaires from 168 respondents (140 doctors and 28 medical students at UTH), and unstructured interviews with doctors working in hospitals.

  19. Anatomical site predilections of non-Hodgkin's lymphoma in Human ...

    African Journals Online (AJOL)

    Anatomical site predilections of non-Hodgkin's lymphoma in Human Immunodeficiency Virus infection: A report on 54 cases. OW Mwanda, C Whalen, CR Scot, M Lederman, J Orem, C Banura. Abstract. No Abstract Available East African Medical Journal August (Supplement) 2004: S90-S96.

  20. Motor perception and anatomical realism in Classical Greek art. (United States)

    Skoyles, J R


    The rise of anatomical realism in sculpture with the Classical Greeks puzzles art historians. Recently, it has been discovered that the motor cortex perceives motor actions. I argue that Classical artists discovered a new aesthetic based on using art to stimulate not just, as previously, the visual cortex, but also the motor one.

  1. CAVEman: Standardized Anatomical Context for Biomedical Data Mapping (United States)

    Turinsky, Andrei L.; Fanea, Elena; Trinh, Quang; Wat, Stephen; Hallgrimsson, Benedikt; Dong, Xiaoli; Shu, Xueling; Stromer, Julie N.; Hill, Jonathan W.; Edwards, Carol; Grosenick, Brenda; Yajima, Masumi; Sensen, Christoph W.


    The authors have created a software system called the CAVEman, for the visual integration and exploration of heterogeneous anatomical and biomedical data. The CAVEman can be applied for both education and research tasks. The main component of the system is a three-dimensional digital atlas of the adult male human anatomy, structured according to…

  2. Anatomical features of the sternum in a Kenyan population | El ...

    African Journals Online (AJOL)

    Anatomical features of the sternum in a Kenyan population. ... Eighty one dry adult sterna were studied at the Department of Human Anatomy, University of Nairobi, Kenya. Sternal asymmetry was taken as displacement of the ... Further research is needed to correlate these findings. However, careful evaluation of chest ...

  3. Gross Anatomical Variations and Congenital Anomalies of Surgical ...

    African Journals Online (AJOL)

    Results: A wide range of Anatomical variations of surgical importance were noted among the Ugandan cadavers. In 5% of the cases, the common hepatic artery originated from the superior Mesenteric artery. The course of the cystic artery in 61.9% of the cases was anterior to the right hepatic duct, in 31% it passed anterior ...

  4. Adaptation of Museum Specimens for Use in Anatomical Teaching Aids (United States)

    Harris, P. F.; And Others


    Color transparencies are prepared of a re-colored anatomical specimen after placing labels temporarily in position to indicate specific structures. The specimen is also radiographed to show skeletal and soft tissue structures. Cross-reference among the specimen, photographs, and radiographs is supplemented by examination and self-assessment…

  5. Beyond Anatomical Dolls: Professionals' Use of Other Play Therapy Techniques. (United States)

    Kendall-Tackett, Kathleen A.


    Telephone interviews were conducted with 201 Boston-area professionals who work with child victims of sexual abuse. Questions concerned use of anatomical dolls and other techniques and behavioral indicators of sexual abuse. Results indicated that mental health professionals used significantly more techniques than did law enforcement professionals.…

  6. Anatomical and magnetic resonance imaging study of the medial ...

    African Journals Online (AJOL)

    Sally Mahmood Mohamed Hussin Omar


    Jul 10, 2015 ... Anatomical and magnetic resonance imaging study of the medial collateral ligament of the ankle joint. Sally Mahmood Mohamed Hussin Omar a. , Fardos Ahmed El-Kalaa a. ,. El Sebai Farag Ali b. , Ali Ali Abd El-Karim c. , Nancy Mohamed El Sekily d,. * a Department of Anatomy and Embryology, Faculty of ...

  7. ORIGINAL ARTICLE Uterine and tubal anatomical abnormalities in ...

    African Journals Online (AJOL)

    120 SA JOURNAL OF RADIOLOGY • December 2011. ORIGINAL ARTICLE. Uterine and tubal anatomical abnormalities in infertile women: diagnosis with routine hystero- salpingography prior to selective laparoscopy. M Heis, MD, FRCR, FFRRCSI, CST. Z Amarin, MD, FRCOG, FFPH. A Y Ibrahim, MD. N Obeidat, MD.

  8. Additive Manufacturing of Anatomical Models from Computed Tomography Scan Data. (United States)

    Gür, Y


    The purpose of the study presented here was to investigate the manufacturability of human anatomical models from Computed Tomography (CT) scan data via a 3D desktop printer which uses fused deposition modelling (FDM) technology. First, Digital Imaging and Communications in Medicine (DICOM) CT scan data were converted to 3D Standard Triangle Language (STL) format by using In Vaselius digital imaging program. Once this STL file is obtained, a 3D physical version of the anatomical model can be fabricated by a desktop 3D FDM printer. As a case study, a patient's skull CT scan data was considered, and a tangible version of the skull was manufactured by a 3D FDM desktop printer. During the 3D printing process, the skull was built using acrylonitrile-butadiene-styrene (ABS) co-polymer plastic. The printed model showed that the 3D FDM printing technology is able to fabricate anatomical models with high accuracy. As a result, the skull model can be used for preoperative surgical planning, medical training activities, implant design and simulation to show the potential of the FDM technology in medical field. It will also improve communication between medical stuff and patients. Current result indicates that a 3D desktop printer which uses FDM technology can be used to obtain accurate anatomical models.

  9. Environmental impact on morphological and anatomical structure of ...

    African Journals Online (AJOL)

    Morphological and anatomical structure of Tansy (Tanacetum vulgare L.) from two specific locations in one town, depending on environmental conditions, were carried out: anthropogenic Ada Huja (polluted zone) and non anthropogenic Topcider park (unpolluted). Study included the diferences in the structure of leaves, ...

  10. The concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction

    NARCIS (Netherlands)

    Hofbauer, M.; Muller, B. [=Bart; Murawski, C. D.; van Eck, C. F.; Fu, F. H.


    To describe the concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction. The PubMed/Medline database was searched using keywords pertaining to ACL reconstruction. Relevant articles were reviewed in order to summarize important concepts of individualized surgery in ACL

  11. An anatomically oriented breast coordinate system for mammogram analysis

    DEFF Research Database (Denmark)

    Brandt, Sami; Karemore, Gopal; Karssemeijer, Nico


    the breast cancer became visible to a radiologist. The coordinate system provides both the relative position and orientation information on the breast region from which the features are derived. In addition, the coordinate system can be used in temporal studies to pin-point anatomically equivalent locations...

  12. A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment

    DEFF Research Database (Denmark)

    Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm


    This paper discusses methods for assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology...... to properly reveal the clinical value. The paper exemplifies the methodology using recent studies of Synthetic Aperture Sequential Beamforming tissue harmonic imaging....

  13. Comparison of ultrasound-guided versus anatomical landmark ...

    African Journals Online (AJOL)

    Background Femoral vein cannulation may be required during major surgery in infants and children and may prove to be life saving under certain conditions. This study compared ultrasound (US)-guided cannulation of the femoral vein in infants with the traditional anatomical landmark-guided technique. Methods Eighty ...

  14. Tinkering and the Origins of Heritable Anatomical Variation in Vertebrates

    Directory of Open Access Journals (Sweden)

    Jonathan B. L. Bard


    Full Text Available Evolutionary change comes from natural and other forms of selection acting on existing anatomical and physiological variants. While much is known about selection, little is known about the details of how genetic mutation leads to the range of heritable anatomical variants that are present within any population. This paper takes a systems-based view to explore how genomic mutation in vertebrate genomes works its way upwards, though changes to proteins, protein networks, and cell phenotypes to produce variants in anatomical detail. The evidence used in this approach mainly derives from analysing anatomical change in adult vertebrates and the protein networks that drive tissue formation in embryos. The former indicate which processes drive variation—these are mainly patterning, timing, and growth—and the latter their molecular basis. The paper then examines the effects of mutation and genetic drift on these processes, the nature of the resulting heritable phenotypic variation within a population, and the experimental evidence on the speed with which new variants can appear under selection. The discussion considers whether this speed is adequate to explain the observed rate of evolutionary change or whether other non-canonical, adaptive mechanisms of heritable mutation are needed. The evidence to hand suggests that they are not, for vertebrate evolution at least.

  15. Morphology and anatomical structure of the larval salt gland of ...

    African Journals Online (AJOL)

    polymerase chain reaction (RT-PCR), was also determined. The morphology and anatomical structure of the salt gland varied according to the salinity degree. At low salinities, salt gland was small, thin and flat having many shallow canals, while ...

  16. 3 Variation in Leaf Anatomical Characters.cdr

    African Journals Online (AJOL)


    Dry and wet season studies of the leaf anatomy of ten plant species in the family Euphorbiaceae from three sites with different pollution levels in Southwestern Nigeria were carried out. This is with a view to establish the response of plant anatomical structures to air pollution. The species investigated were Alchornea laxiflora.

  17. Conventional trans‑tibial versus anatomic medial portal technique ...

    African Journals Online (AJOL)

    In this study, we aimed to determine if there is any difference between the clinical outcomes of two most commonly used drilling techniques; which are conventional trans‑tibial (TT) drilling of femoral tunnel and anatomic preparation of femoral tunnel through medial portal (MP), in patients who underwent ACL reconstruction.

  18. Plastination technology for anatomical studies in Nigeria: Opinion of ...

    African Journals Online (AJOL)

    Dr. Gunther von Hagens developed plastination as a technique of tissue preservation in 1977. He used a delicate method of forced impregnation with curable polymers like silicone, epoxy or polyester resins for preservation of anatomical specimens. With plastination, every part of a biological tissue is treated, preserving it ...

  19. Anatomic anterior cruciate ligament reconstruction: reducing anterior tibial subluxation. (United States)

    Muller, Bart; Duerr, Eric R H; van Dijk, C Niek; Fu, Freddie H


    To measure and compare the amount of anterior tibial subluxation (ATS) after anatomic ACL reconstruction for both acute and chronic ACL-deficient patients. Fifty-two patients were clinically and radiographically evaluated after primary, unilateral, anatomic ACL reconstruction. Post-operative true lateral radiographs were obtained of both knees with the patient in supine position and knees in full passive extension with heels on a standardized bolster. ATS was measured on the radiographs by two independent and blinded observers. ATS was calculated as the side-to-side difference in tibial position relative to the femur. An independent t test was used to compare ATS between those undergoing anatomic reconstruction for an acute versus chronic ACL injury. Chronic ACL deficiency was defined as more than 12 weeks from injury to surgery. Patients averaged 26.4 ± 11.5 years (mean ± SD) of age, 43.6 % were female, and 48.1 % suffered an injury of the left knee. There were 30 and 22 patients in the acute and chronic groups, respectively. The median duration from injury to reconstruction for the acute group was 5 versus 31 weeks for the chronic group. After anatomic ACL reconstruction, the mean ATS was 1.0 ± 2.1 mm. There was no statistical difference in ATS between the acute and chronic groups (1.2 ± 2.0 vs. 0.6 ± 2.3 mm, n.s.). Assessment of inter-tester reliability for radiographic evaluation of ATS revealed an excellent intraclass correlation coefficient of 0.894. Anatomic ACL reconstruction reduces ATS with a mean difference of 1.0 mm from the healthy contralateral limb. This study did not find a statistical difference in ATS between patients after anatomic ACL reconstruction in the acute or chronic phase. These observations suggest that anatomic ACL reconstruction, performed in either the acute or the chronic phase, approaches the normal AP relationship of the tibiofemoral joint. IV.

  20. Bovine papillomavirus type 2 in enzootic haematuria aetiology/ Papilomavírus bovino tipo 2 na etiologia da hematúria enzoótica bovina

    Directory of Open Access Journals (Sweden)

    Amauri Alcindo Alfieri


    Full Text Available Bovine enzootic haematuria (EH occurs worldwide and is endemic in regions with bracken fern (Pteridium aquilinum infested grassland. EH is chronic disease that is characterized by clinical signs of intermitent haematuria, anemia and progressive emaciation and haemorragic, hyperplasic and neoplasic lesions of urinary bladder. Although bracken fern intoxication has been related to EH, most recent bovine papillomavirus type 2 (BPV-2 infection has been also assessed. Some researches has shown that the presence of BPV-2 in association with bracken fern carcinogenic compound leads to the malignant progression of urinary bladder lesions that cause the clinical signs of EH. In this review the major evidence of BPV-2 involviment in the aetiology of EH is presented along with diagnostic methods and prophylaxis of this disease that causes considerable economic losses in brazilian cattle breeding.A hematúria enzoótica (HE bovina é de ocorrência mundial e apresenta caráter endêmico em regiões com pastagens infestadas com samambaia (Pteridium aquilinum. A HE é uma doença crônica caracterizada por sinais clínicos de hematúria intermitente, anemia e emagrecimento progressivo e por lesões hemorrágicas, hiperplásicas e neoplásicas da mucosa da bexiga. Apesar da intoxicação pela samambaia estar relacionada à etiologia da HE, mais recentemente a infecção pelo papilomavírus bovino tipo 2 (BPV-2 também tem sido avaliada. Estudos demonstram que a presença do BPV-2, associada à ação dos compostos carcinogênicos da samambaia, leva à progressão maligna das lesões na mucosa vesical responsáveis pelos quadros clínicos observados na HE. Nesta revisão são apresentadas as principais evidências do envolvimento do BPV-2 na etiologia da HE, bem como métodos de diagnóstico e profilaxia desta doença que ocasiona prejuízos econômicos consideráveis à pecuária bovina brasileira.