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Sample records for anterior intraparietal area

  1. Effects of Microstimulation in the Anterior Intraparietal Area during Three-Dimensional Shape Categorization.

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    Bram-Ernst Verhoef

    Full Text Available The anterior intraparietal area (AIP of rhesus monkeys is part of the dorsal visual stream and contains neurons whose visual response properties are commensurate with a role in three-dimensional (3D shape perception. Neuronal responses in AIP signal the depth structure of disparity-defined 3D shapes, reflect the choices of monkeys while they categorize 3D shapes, and mirror the behavioral variability across different stimulus conditions during 3D-shape categorization. However, direct evidence for a role of AIP in 3D-shape perception has been lacking. We trained rhesus monkeys to categorize disparity-defined 3D shapes and examined AIP's contribution to 3D-shape categorization by microstimulating in clusters of 3D-shape selective AIP neurons during task performance. We find that microstimulation effects on choices (monkey M1 and reaction times (monkey M1 and M2 depend on the 3D-shape preference of the stimulated site. Moreover, electrical stimulation of the same cells, during either the 3D-shape-categorization task or a saccade task, could affect behavior differently. Interestingly, in one monkey we observed a strong correlation between the strength of choice-related AIP activity (choice probabilities and the influence of microstimulation on 3D-shape-categorization behavior (choices and reaction time. These findings propose AIP as part of the network responsible for 3D-shape perception. The results also show that the anterior intraparietal cortex contains cells with different tuning properties, i.e. 3D-shape- or saccade-related, that can be dynamically read out depending on the requirements of the task at hand.

  2. Enhancing multiple object tracking performance with noninvasive brain stimulation: A causal role for the anterior intraparietal sulcus

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    Eric Joshua Blumberg

    2015-02-01

    Full Text Available Multiple object tracking (MOT is a complex task recruiting a distributed network of brain regions. There are also marked individual differences in MOT performance. A positive causal relationship between the anterior intraparietal sulcus (AIPS, an integral region in the MOT attention network and inter-individual variation in MOT performance has not been previously established. The present study used transcranial direction current stimulation (tDCS, a form of non-invasive brain stimulation, in order to examine such a causal link. Active anodal stimulation was applied to the right AIPS and the left dorsolateral prefrontal cortex (and sham stimulation, an area associated with working memory (but not MOT while participants completed a MOT task. Stimulation to the right AIPS significantly improved MOT accuracy more than the other two conditions. The results confirm a causal role of the AIPS in the MOT task and illustrate that transcranial direct current stimulation has the ability to improve MOT performance.

  3. Spatial Representations in Local Field Potential Activity of Primate Anterior Intraparietal Cortex (AIP.

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    Sebastian J Lehmann

    Full Text Available The execution of reach-to-grasp movements in order to interact with our environment is an important subset of the human movement repertoire. To coordinate such goal-directed movements, information about the relative spatial position of target and effector (in this case the hand has to be continuously integrated and processed. Recently, we reported the existence of spatial representations in spiking-activity of the cortical fronto-parietal grasp network (Lehmann & Scherberger 2013, and in particular in the anterior intraparietal cortex (AIP. To further investigate the nature of these spatial representations, we explored in two rhesus monkeys (Macaca mulatta how different frequency bands of the local field potential (LFP in AIP are modulated by grip type, target position, and gaze position, during the planning and execution of reach-to-grasp movements. We systematically varied grasp type, spatial target, and gaze position and found that both spatial and grasp information were encoded in a variety of frequency bands (1-13Hz, 13-30Hz, 30-60Hz, and 60-100Hz, respectively. Whereas the representation of grasp type strongly increased towards and during movement execution, spatial information was represented throughout the task. Both spatial and grasp type representations could be readily decoded from all frequency bands. The fact that grasp type and spatial (reach information was found not only in spiking activity, but also in various LFP frequency bands of AIP, might significantly contribute to the development of LFP-based neural interfaces for the control of upper limb prostheses.

  4. Morphological patterns of the intraparietal sulcus and the anterior intermediate parietal sulcus of Jensen in the human brain.

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    Zlatkina, Veronika; Petrides, Michael

    2014-12-22

    Distinct parts of the intraparietal sulcal cortex contribute to sensorimotor integration and visual spatial attentional processing. A detailed examination of the morphological relations of the different segments of the complex intraparietal sulcal region in the human brain in standard stereotaxic space, which is a prerequisite for detailed structure-to-function studies, is not available. This study examined the intraparietal sulcus (IPS) and the related sulcus of Jensen in magnetic resonance imaging brain volumes registered in the Montreal Neurological Institute stereotaxic space. It was demonstrated that the IPS is divided into two branches: the anterior ramus and the posterior ramus of the IPS, often separated by a submerged gyral passage. The sulcus of Jensen emerges between the anterior and posterior rami of the IPS, and its ventral end is positioned between the first and second caudal branches of the superior temporal sulcus. In a small number of brains, the sulcus of Jensen may merge superficially with the first caudal branch of the superior temporal sulcus. The above morphological findings are discussed in relation to previously reported functional neuroimaging findings and provide the basis for future exploration of structure-to-function relations in the posterior parietal region of individual subjects.

  5. Spatial Representation and Cognitive Modulation of Response Variability in the Lateral Intraparietal Area Priority Map

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    Falkner, Annegret L.; Goldberg, Michael E.; Krishna, B. Suresh

    2013-01-01

    The lateral intraparietal area (LIP) in the macaque contains a priority-based representation of the visual scene. We previously showed that the mean spike rate of LIP neurons is strongly influenced by spatially wide-ranging surround suppression in a manner that effectively sharpens the priority map. Reducing response variability can also improve the precision of LIP's priority map. We show that when a monkey plans a visually guided delayed saccade with an intervening distractor, variability (...

  6. Morphological patterns of the intraparietal sulcus and the anterior intermediate parietal sulcus of Jensen in the human brain

    OpenAIRE

    Zlatkina, Veronika; Petrides, Michael

    2014-01-01

    Distinct parts of the intraparietal sulcal cortex contribute to sensorimotor integration and visual spatial attentional processing. A detailed examination of the morphological relations of the different segments of the complex intraparietal sulcal region in the human brain in standard stereotaxic space, which is a prerequisite for detailed structure-to-function studies, is not available. This study examined the intraparietal sulcus (IPS) and the related sulcus of Jensen in magnetic resonance ...

  7. Variation in functional connectivity along anterior-to-posterior intraparietal sulcus, and relationship with age across late childhood and adolescence

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    Sarah A. Vinette

    2015-06-01

    Full Text Available The intraparietal sulcus (IPS, a region in the dorsal attention network (DAN, has been implicated in multi-sensory attention and working memory. Working memory and attention develop across childhood; changes in functional connectivity within the DAN may relate to this maturation. Previous findings regarding fronto-parietal intrinsic functional connectivity age-effects were mixed. Our study aimed to circumvent limitations of previous work using a large cross-sectional sample, 183 typically developing participants 6.5–20 years, from the Autism Brain Imaging Data Exchange, and seed regions along the anterior-to-posterior axis of the IPS. These seeds, IPS0-4, were entered into functional connectivity models. Group-level models investigated differential connectivity along the IPS and relationships with age. Anterior IPS3/4 exhibited greater connectivity with sensorimotor/pre-motor regions. Posterior IPS0/1 demonstrated greater connectivity with dorsal and ventral visual regions. Positive age-effects were found between IPS3-4 and visual regions. Negative age-effects were found between IPS and superior parietal and medial orbitofrontal cortices. Follow-up region of interest analyses were used to estimate age-effects for DAN and anticorrelated default mode network regions. Results suggest age-effects on IPS functional connectivity are relatively modest, and may differ pre- and across-adolescence. Studying typical age-related connectivity variability within this network may help to understand neurodevelopmental disorders marked by impaired attention.

  8. Decoding Target Distance and Saccade Amplitude from Population Activity in the Macaque Lateral Intraparietal Area (LIP)

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    Bremmer, Frank; Kaminiarz, Andre; Klingenhoefer, Steffen; Churan, Jan

    2016-01-01

    Primates perform saccadic eye movements in order to bring the image of an interesting target onto the fovea. Compared to stationary targets, saccades toward moving targets are computationally more demanding since the oculomotor system must use speed and direction information about the target as well as knowledge about its own processing latency to program an adequate, predictive saccade vector. In monkeys, different brain regions have been implicated in the control of voluntary saccades, among them the lateral intraparietal area (LIP). Here we asked, if activity in area LIP reflects the distance between fovea and saccade target, or the amplitude of an upcoming saccade, or both. We recorded single unit activity in area LIP of two macaque monkeys. First, we determined for each neuron its preferred saccade direction. Then, monkeys performed visually guided saccades along the preferred direction toward either stationary or moving targets in pseudo-randomized order. LIP population activity allowed to decode both, the distance between fovea and saccade target as well as the size of an upcoming saccade. Previous work has shown comparable results for saccade direction (Graf and Andersen, 2014a,b). Hence, LIP population activity allows to predict any two-dimensional saccade vector. Functional equivalents of macaque area LIP have been identified in humans. Accordingly, our results provide further support for the concept of activity from area LIP as neural basis for the control of an oculomotor brain-machine interface. PMID:27630547

  9. Grasping with the Press of a Button: Grasp-selective Responses in the Human Anterior Intraparietal Sulcus Depend on Nonarbitrary Causal Relationships between Hand Movements and End-effector Actions.

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    Frey, Scott H; Hansen, Marc; Marchal, Noah

    2015-06-01

    Evidence implicates ventral parieto-premotor cortices in representing the goal of grasping independent of the movements or effectors involved [Umilta, M. A., Escola, L., Intskirveli, I., Grammont, F., Rochat, M., Caruana, F., et al. When pliers become fingers in the monkey motor system. Proceedings of the National Academy of Sciences, U.S.A., 105, 2209-2213, 2008; Tunik, E., Frey, S. H., & Grafton, S. T. Virtual lesions of the anterior intraparietal area disrupt goal-dependent on-line adjustments of grasp. Nature Neuroscience, 8, 505-511, 2005]. Modern technologies that enable arbitrary causal relationships between hand movements and tool actions provide a strong test of this hypothesis. We capitalized on this unique opportunity by recording activity with fMRI during tasks in which healthy adults performed goal-directed reach and grasp actions manually or by depressing buttons to initiate these same behaviors in a remotely located robotic arm (arbitrary causal relationship). As shown previously [Binkofski, F., Dohle, C., Posse, S., Stephan, K. M., Hefter, H., Seitz, R. J., et al. Human anterior intraparietal area subserves prehension: A combined lesion and functional MRI activation study. Neurology, 50, 1253-1259, 1998], we detected greater activity in the vicinity of the anterior intraparietal sulcus (aIPS) during manual grasp versus reach. In contrast to prior studies involving tools controlled by nonarbitrarily related hand movements [Gallivan, J. P., McLean, D. A., Valyear, K. F., & Culham, J. C. Decoding the neural mechanisms of human tool use. Elife, 2, e00425, 2013; Jacobs, S., Danielmeier, C., & Frey, S. H. Human anterior intraparietal and ventral premotor cortices support representations of grasping with the hand or a novel tool. Journal of Cognitive Neuroscience, 22, 2594-2608, 2010], however, responses within the aIPS and premotor cortex exhibited no evidence of selectivity for grasp when participants employed the robot. Instead, these regions showed

  10. Spatial representation and cognitive modulation of response variability in the lateral intraparietal area priority map.

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    Falkner, Annegret L; Goldberg, Michael E; Krishna, B Suresh

    2013-10-01

    The lateral intraparietal area (LIP) in the macaque contains a priority-based representation of the visual scene. We previously showed that the mean spike rate of LIP neurons is strongly influenced by spatially wide-ranging surround suppression in a manner that effectively sharpens the priority map. Reducing response variability can also improve the precision of LIP's priority map. We show that when a monkey plans a visually guided delayed saccade with an intervening distractor, variability (measured by the Fano factor) decreases both for neurons representing the saccade goal and for neurons representing the broad spatial surround. The reduction in Fano factor is maximal for neurons representing the saccade goal and steadily decreases for neurons representing more distant locations. LIP Fano factor changes are behaviorally significant: increasing expected reward leads to lower variability for the LIP representation of both the target and distractor locations, and trials with shorter latency saccades are associated with lower Fano factors in neurons representing the surround. Thus, the LIP Fano factor reflects both stimulus and behavioral engagement. Quantitative modeling shows that the interaction between mean spike count and target-receptive field (RF) distance in the surround during the predistractor epoch is multiplicative: the Fano factor increases more steeply with mean spike count further away from the RF. A negative-binomial model for LIP spike counts captures these findings quantitatively, suggests underlying mechanisms based on trial-by-trial variations in mean spike rate or burst-firing patterns, and potentially provides a principled framework to account simultaneously for the previously observed unsystematic relationships between spike rate and variability in different brain areas. PMID:24107945

  11. Recurrent unicystic ameloblastoma in mandibular anterior teeth area

    International Nuclear Information System (INIS)

    The unicystic ameloblastoma (UA) is a variant of the solid or multicystic ameloblastoma, a less encountered variant of the ameloblastoma. It appears more frequently in the second or third decade with no sexual or racial predilection. It is almost exclusively encountered asymptomatically in the posterior mandible. We report a case of a 43-year old patient with UA, who had previously undergone a surgical treatment on the same site about 1 year ago, this lesion recurred and presented as an exophytic gingival lesion in the anterior mandibular region.

  12. Lesion evidence for the critical role of the intraparietal sulcus in spatial attention.

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    Gillebert, Céline R; Mantini, Dante; Thijs, Vincent; Sunaert, Stefan; Dupont, Patrick; Vandenberghe, Rik

    2011-06-01

    Based on lesion mapping studies, the inferior parietal lobule and temporoparietal junction are considered the critical parietal regions for spatial-attentional deficits. Lesion evidence for a key role of the intraparietal sulcus, a region featuring prominently in non-human primate studies and human functional imaging studies of the intact brain, is still lacking, probably due to the exceptional nature of isolated intraparietal sulcus lesions. We combined behavioural testing and functional imaging in two patients with a focal intraparietal sulcus lesion sparing the inferior parietal lobule and temporoparietal junction to examine the critical contribution of the intraparietal sulcus to spatial attention. Case H.H. had a focal ischaemic lesion (1.8 cm3) that was confined to the posterior segment of the left intraparietal sulcus, whereas Case N.V. had a partially reversible lesion of the middle segment of the right intraparietal sulcus extending into the superior parietal lobule (13.8 cm3). The performance of these cases was contrasted with five cases with a classical inferior parietal lesion, as well as with a group of 31 age-matched controls. In the behavioural study, the patients performed an orientation discrimination task on a peripheral target (eccentricity 7.6°) that was preceded by a central spatial cue. We manipulated both the cue validity (17% trials with an invalid spatial cue) and the presence of a competing distracter in the visual field contralateral to the target (17% double stimulation trials). The ability of the patients with an intraparietal sulcus lesion to reorient their spatial focus of attention and to select between competing stimuli was impaired for contralesional targets compared with controls, similarly to what we saw in the inferior parietal group. Furthermore, we could observe that the deficit in Case N.V. resolved with regression of the lesion. To further evaluate the correspondence between spatial-attentional deficits and the

  13. Cortical connectivity suggests a role in limb coordination for macaque area PE of the superior parietal cortex.

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    Bakola, Sophia; Passarelli, Lauretta; Gamberini, Michela; Fattori, Patrizia; Galletti, Claudio

    2013-04-10

    In macaques, superior parietal lobule area 5 has been described as occupying an extensive region, which includes the caudal half of the postcentral convexity as well as the medial bank of the intraparietal sulcus. Modern neuroanatomical methods have allowed the identification of various areas within this region. In the present study, we investigated the corticocortical afferent projections of one of these subdivisions, area PE. Our results demonstrate that PE, defined as a single architectonic area that contains a topographic map of the body, forms specific connections with somatic and motor fields. Thus, PE receives major afferents from parietal areas, mainly area 2, PEc, several areas in the medial bank of the intraparietal sulcus, opercular areas PGop/PFop, and the retroinsular area, frontal afferents from the primary motor cortex, the supplementary motor area, and the caudal subdivision of dorsal premotor cortex, as well as afferents from cingulate areas PEci, 23, and 24. The presence and relative strength of these connections depend on the location of injection sites, so that lateral PE receives preferential input from anterior sectors of the medial bank of intraparietal sulcus and from the ventral premotor cortex, whereas medial PE forms denser connections with area PEc and motor fields. In contrast with other posterior parietal areas, there are no projections to PE from occipital or prefrontal cortices. Overall, the sensory and motor afferents to PE are consistent with functions in goal-directed movement but also hint at a wider variety of motor coordination roles. PMID:23575861

  14. Connections between the thalamus and the somatosensory areas of the anterior ectosylvian gyrus in the cat.

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    Burton, H; Kopf, E M

    1984-04-01

    labeled other parts of the posterior complex but failed to label any part of VB except when the injection mass also diffused into SII. Injections into the somatic sensory cortex located lateral to SII, within the lips and depth of the upper bank of the anterior ectosylvian sulcus (AES), heavily labeled the central and posterior portions of Pom. Substantial labeling was noted in the lateral (Pol) and intermediate (Poi) divisions of Po only when the injections involved some part of the auditory areas located immediately posterior to SII. This region included the anterior auditory area that occupies the most posterior part of the AEG and both banks of the immediately adjoining AES. The magnocellular nucleus of the medial geniculate (MGmc) was labeled only when some part of the auditory cortex was injected. The suprageniculate nucleus (SG) was labeled from the insula and lower bank of the AES. These results indicated that the medial (rostral and caudal Pom) and lateral components (Poi, Pol, MGmc) of the posterior complex have separate cortical projection zones to somatic sensory and auditory cortical regions, respectively. SIV and the lateral extent of area 5a located in the medial bank of the anterior suprasylvian sulcus sent projections to the deep layers of the superior colliculus and the ventrolateral periaqueductal gray. No cortico-tectal projections were seen from SII.

  15. A novel method for measuring anterior segment area of the eye on ultrasound biomicroscopic images using photoshop.

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    Zhonghao Wang

    Full Text Available To describe a novel method for quantitative measurement of area parameters in ocular anterior segment ultrasound biomicroscopy (UBM images using Photoshop software and to assess its intraobserver and interobserver reproducibility.Twenty healthy volunteers with wide angles and twenty patients with narrow or closed angles were consecutively recruited. UBM images were obtained and analyzed using Photoshop software by two physicians with different-level training on two occasions. Borders of anterior segment structures including cornea, iris, lens, and zonules in the UBM image were semi-automatically defined by the Magnetic Lasso Tool in the Photoshop software according to the pixel contrast and modified by the observers. Anterior chamber area (ACA, posterior chamber area (PCA, iris cross-section area (ICA and angle recess area (ARA were drawn and measured. The intraobserver and interobserver reproducibilities of the anterior segment area parameters and scleral spur location were assessed by limits of agreement, coefficient of variation (CV, and intraclass correlation coefficient (ICC.All of the parameters were successfully measured by Photoshop. The intraobserver and interobserver reproducibilities of ACA, PCA, and ICA were good, with no more than 5% CV and more than 0.95 ICC, while the CVs of ARA were within 20%. The intraobserver and interobserver reproducibilities for defining the spur location were more than 0.97 ICCs. Although the operating times for both observers were less than 3 minutes per image, there was significant difference in the measuring time between two observers with different levels of training (p<0.001.Measurements of ocular anterior segment areas on UBM images by Photoshop showed good intraobserver and interobserver reproducibilties. The methodology was easy to adopt and effective in measuring.

  16. More Than Meets the Eye: The Merging of Perceptual and Conceptual Knowledge in the Anterior Temporal Face Area

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    Collins, Jessica A.; Koski, Jessica E.; Olson, Ingrid R.

    2016-01-01

    An emerging body of research has supported the existence of a small face sensitive region in the ventral anterior temporal lobe (ATL), referred to here as the “anterior temporal face area”. The contribution of this region in the greater face-processing network remains poorly understood. The goal of the present study was to test the relative sensitivity of this region to perceptual as well as conceptual information about people and objects. We contrasted the sensitivity of this region to that of two highly-studied face-sensitive regions, the fusiform face area (FFA) and the occipital face area (OFA), as well as a control region in early visual cortex (EVC). Our findings revealed that multivoxel activity patterns in the anterior temporal face area contain information about facial identity, as well as conceptual attributes such as one’s occupation. The sensitivity of this region to the conceptual attributes of people was greater than that of posterior face processing regions. In addition, the anterior temporal face area overlaps with voxels that contain information about the conceptual attributes of concrete objects, supporting a generalized role of the ventral ATLs in the identification and conceptual processing of multiple stimulus classes. PMID:27199711

  17. Stress and Sucrose Intake Modulate Neuronal Activity in the Anterior Hypothalamic Area in Rats

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    Mitra, Arojit; Guèvremont, Geneviève; Timofeeva, Elena

    2016-01-01

    The anterior hypothalamic area (AHA) is an important integrative relay structure for a variety of autonomic, endocrine, and behavioral responses including feeding behavior and response to stress. However, changes in the activity of the AHA neurons during stress and feeding in freely moving rats are not clear. The present study investigated the firing rate and burst activity of neurons in the central nucleus of the AHA (cAHA) during sucrose intake in non-stressful conditions and after acute stress in freely behaving rats. Rats were implanted with micro-electrodes into the cAHA, and extracellular multi-unit activity was recorded during 1-h access to 10% sucrose in non-stressful conditions or after acute foot shock stress. Acute stress significantly reduced sucrose intake, total sucrose lick number, and lick frequency in licking clusters, and increased inter-lick intervals. At the cluster start (CS) of sucrose licking, the cAHA neurons increased (CS-excited, 20% of the recorded neurons), decreased (CS-inhibited, 42% of the neurons) or did not change (CS-nonresponsive, 38% of the neurons) their firing rate. Stress resulted in a significant increase in the firing rate of the CS-inhibited neurons by decreasing inter-spike intervals within the burst firing of these neurons. This increase in the stress-induced firing rate of the CS-inhibited neurons was accompanied by a disruption of the correlation between the firing rate of CS-inhibited and CS-nonresponsive neurons that was observed in non-stressful conditions. Stress did not affect the firing rate of the CS-excited and CS-nonresponsive neurons. However, stress changed the pattern of burst firing of the CS-excited and CS-nonresponsive neurons by decreasing and increasing the burst number in the CS-excited and CS-nonresponsive neurons, respectively. These results suggest that the cAHA neurons integrate the signals related to stress and intake of palatable food and play a role in the stress- and eating-related circuitry

  18. Esthetic Rehabilitation of a Severely Compromised Anterior Area: Combined Periodontal and Restorative Approach

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    Rachele Censi

    2014-01-01

    Full Text Available The complete oral rehabilitation of patients demanding a beautiful and attractive smile involves a multidisciplinary approach that includes the change of both the morphological aspect of the teeth and the architecture of gum tissues. This clinical report describes a successful interdisciplinary approach for the treatment of an esthetically compromised dentition. In a first phase, the periodontal plastic surgery was performed for root coverage and, in particular, it was decided for the execution of a coronally advanced flap for the treatment of multiple recession defects. Once complete healing of soft tissues was obtained, six lithium disilicate veneers were placed over the anterior maxillary teeth. Lithium disilicate is a glass-based ceramic which presents excellent aesthetics and allows the passage of light without creating unnatural reflections. This feature has made it possible to recreate a natural aspect of teeth that in combination with the harmonic architecture of soft tissue has permitted obtaining a beautiful and pleasant smile.

  19. Non-symbolic and symbolic notations in simple arithmetic differentially involve intraparietal sulcus and angular gyrus activity.

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    van der Ven, Frauke; Takashima, Atsuko; Segers, Eliane; Fernández, Guillén; Verhoeven, Ludo

    2016-07-15

    Addition problems can be solved by mentally manipulating quantities for which the bilateral intraparietal sulcus (IPS) is likely recruited, or by retrieving the answer directly from fact memory in which the left angular gyrus (AG) and perisylvian areas may play a role. Mental addition is usually studied with problems presented in the Arabic notation (4+2), and less so with number words (four+two) or dots (:: +·.). In the present study, we investigated how the notation of numbers influences processing during simple mental arithmetic. Twenty-five highly educated participants performed simple arithmetic while their brain activity was recorded with functional magnetic resonance imaging. To reveal the effect of number notation, arithmetic problems were presented in a non-symbolic (Dots) or symbolic (Arabic; Words) notation. Furthermore, we asked whether IPS processing during mental arithmetic is magnitude specific or of a more general, visuospatial nature. To this end, we included perception and manipulation of non-magnitude formats (Colors; unfamiliar Japanese Characters). Increased IPS activity was observed, suggesting magnitude calculations during addition of non-symbolic numbers. In contrast, there was greater activity in the AG and perisylvian areas for symbolic compared to non-symbolic addition, suggesting increased verbal fact retrieval. Furthermore, IPS activity was not specific to processing of numerical magnitude but also present for non-magnitude stimuli that required mental visuospatial processing (Color-mixing; Character-memory measured by a delayed match-to-sample task). Together, our data suggest that simple non-symbolic sums are calculated using visual imagery, whereas answers for simple symbolic sums are retrieved from verbal memory. PMID:27117869

  20. Social phobia modulates risk sensitivity through activity in the anterior insula

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    Grace Shi Min Tang

    2012-01-01

    Full Text Available Decision neuroscience offers the potential for decomposing differences in behavior across individuals into components of valuation intimately tied to brain function. One application of this approach lies in novel conceptualizations of behavioral attributes that are aberrant in psychiatric disorders. We investigated the relationship between social phobia and behavior in a novel socially-determined risk task. Behaviorally, higher scores on a social phobia inventory (SPIN among healthy participants were associated with an increase in risky responses. Furthermore, activity in a region of the dorsal anterior insula (dAI scaled in proportion to SPIN score in risky versus non-risky choices. This region of the insula was functionally connected to areas in the intraparietal sulcus (IPS and anterior cingulate cortex (ACC that were related to decision-making across all participants. Overall, social phobia was associated with decreased risk aversion in our task, consistent with previous results investigating risk taking in many everyday behaviors. Moreover, this difference was linked to the anterior insula, a region commonly implicated in risk attitudes and socio-emotional processes.

  1. Cortical afferents of visual area MT in the Cebus monkey: possible homologies between New and Old World monkeys.

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    Rosa, M G; Soares, J G; Fiorani, M; Gattass, R

    1993-01-01

    Cortical projections to the middle temporal (MT) visual area were studied by injecting the retrogradely transported fluorescent tracer Fast Blue into MT in adult New World monkeys (Cebus apella). Injection sites were selected based on electrophysiological recordings, and covered eccentricities from 2-70 deg, in both the upper and lower visual fields. The position and laminar distribution of labeled cell bodies were correlated with myeloarchitectonic boundaries and displayed in flat reconstructions of the neocortex. Topographically organized projections were found to arise mainly from the primary, second, third, and fourth visual areas (V1, V2, V3, and V4). Coarsely topographic patterns were observed in transitional V4 (V4t), in the parieto-occipital and parieto-occipital medial areas (PO and POm), and in the temporal ventral posterior area (TVP). In addition, widespread or nontopographic label was found in visual areas of the superior temporal sulcus (medial superior temporal, MST, and fundus of superior temporal, FST), annectent gyrus (dorsointermediate area, DI; and dorsomedial area, DM), intraparietal sulcus (lateral intraparietal, LIP; posterior intraparietal, PIP; and ventral intraparietal, VIP), and in the frontal eye field (FEF). Label in PO, POm, and PIP was found only after injections in the representation of the peripheral visual field (> 10 deg), and label in V4 and FST was more extensive after injections in the central representation. The projections from V1 and V2 originated predominantly from neurons in supragranular layers, whereas those from V3, V4t, DM, DI, POm, and FEF consisted of intermixed patches with either supragranular or infragranular predominance. All of the other projections were predominantly infragranular. Invasion of area MST by the injection site led to the labeling of further pathways, including substantial projections from the dorsal prelunate area (DP) and from an ensemble of areas located along the medial wall of the hemisphere

  2. Activation of left intraparietal sulcus using a fMRI conceptual praxis paradigm Ativação do sulco intraparietal esquerdo utilizando RMf e um paradigma de praxis conceitual

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    JORGE MOLL; RICARDO DE OLIVEIRA-SOUZA; FABIANA DE SOUZA-LIMA; PEDRO ANGELO ANDREIUOLO

    1998-01-01

    The present paper reports the results of a fMRI subtraction study of the pattern of cortical activation induced by an ideational praxis paradigm in six normal right-handed subjects. The control task consisted of a sequence of complex meaningless hand movements. A complete study was done for each hand in each subject. The left intraparietal sulcus was the only structure activated in all subjects regardless of the hand used in the task. These findings, albeit preliminary, suggest that the organ...

  3. Cervicoplastia anterior Anterior cervicoplasty

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    Lucas Gomes Patrocínio

    2004-10-01

    Full Text Available Muitos pacientes buscam correção estética da frouxidão da pele do pescoço, depósito de gordura na região submentoneana ou bandas de platisma. Em grande parte dos casos a ação medial, via cervicoplastia anterior é necessária. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de cervicoplastia anterior no Serviço de Otorrinolaringologia da Universidade Federal de Uberlândia. FORMA DE ESTUDO: Relato de série. PACIENTES E MÉTODOS: Quarenta e dois pacientes, entre 39 e 65 anos de idade, sendo 40 (95,2% do sexo feminino e 2 (4,8% do masculino, foram submetidos a cervicoplastia anterior. Retrospectivamente foram avaliados resultados e complicações. RESULTADOS: Destes, 34 apresentaram resultados satisfatórios, 4 apresentaram déficit estético notado somente pelo cirurgião, 3 apresentaram déficit estético notado somente pelo paciente e 1 apresentou déficit estético necessitando cirurgia revisional. Ao estudo fotográfico, todos os pacientes apresentaram melhora do perfil cervical, redução das bandas de platisma e da frouxidão da pele, estabilização da musculatura cervical e acentuação do ângulo cervicomental, em graus variados. Houve complicação em 2 casos (discreto serohematoma e cicatriz um pouco alargada. CONCLUSÃO: A cervicoplastia, associada ou não à tração lateral pela ritidoplastia, é uma técnica que produz resultados satisfatórios na grande maioria dos casos.Many patients look for aesthetic correction of the laxity of neck skin, submandibular fat deposit or platisma bands. In a large part of the cases, medial action, through anterior cervicoplasty is necessary. AIM: To demonstrate the casuistic and to evaluate the results and complications with anterior cervicoplasty technique in the Otorhinolaryngology Service of the Federal University of Uberlândia. STUDY DESIGN: Serie report. PATIENTS AND METHODS: Forty-two patients, between 39 and 65 years of age, being 40 (95

  4. C-fos protein expression in the anterior amygdaloid area and nc. accumbens in the hypoxic rat brain

    Directory of Open Access Journals (Sweden)

    Babović Siniša S.

    2014-01-01

    Full Text Available Introduction. By examining the production of c-Fos protein, we analyzed the response to the ischemic attack in different brain tissue, two of which are regions of the limbic system: the anterior amygdaloid area and nc. accumbens. Material and Methods. We used the model of rat brain ischemia - four-vessel occlusion, and Pulsinelli’s method. The rats were treated in two ways, according to which they were divided into two groups: a total ischemia (ligation of four blood vessels, i.e. electrocauterization of the vertebral artery with bilateral ligation of the carotid artery - the so-called R-group rats, and transient ischemic attack (ligation of four blood vessels, i.e. electrocauterization of the vertebral artery, with mutual re-ligation of the carotid arteries in the form of transient ischemia - the so-called T-group rats, which can also be called “pre-conditioned group”. Both groups had their own control group. Conclusion. We have concluded that parts of the brain with an important role for the survival have a strong expression of c-fos gene.

  5. Beyond the core face-processing network: Intracerebral stimulation of a face-selective area in the right anterior fusiform gyrus elicits transient prosopagnosia.

    Science.gov (United States)

    Jonas, Jacques; Rossion, Bruno; Brissart, Hélène; Frismand, Solène; Jacques, Corentin; Hossu, Gabriela; Colnat-Coulbois, Sophie; Vespignani, Hervé; Vignal, Jean-Pierre; Maillard, Louis

    2015-11-01

    According to neuropsychological evidence, a distributed network of regions of the ventral visual pathway - from the lateral occipital cortex to the temporal pole - supports face recognition. However, functional magnetic resonance imaging (fMRI) studies have generally confined ventral face-selective areas to the posterior section of the occipito-temporal cortex, i.e., the inferior occipital gyrus occipital face area (OFA) and the posterior and middle fusiform gyrus fusiform face area (FFA). There is recent evidence that intracranial electrical stimulation of these areas in the right hemisphere elicits face matching and recognition impairments (i.e., prosopagnosia) as well as perceptual face distortions. Here we report a case of transient inability to recognize faces following electrical stimulation of the right anterior fusiform gyrus, in a region located anteriorly to the FFA. There was no perceptual face distortion reported during stimulation. Although no fMRI face-selective responses were found in this region due to a severe signal drop-out as in previous studies, intracerebral face-selective event-related potentials and gamma range electrophysiological responses were found at the critical site of stimulation. These results point to a causal role in face recognition of the right anterior fusiform gyrus and more generally of face-selective areas located beyond the "core" face-processing network in the right ventral temporal cortex. It also illustrates the diagnostic value of intracerebral electrophysiological recordings and stimulation in understanding the neural basis of face recognition and visual recognition in general.

  6. The Anterior Temporal Face Area Contains Invariant Representations of Face Identity That Can Persist Despite the Loss of Right FFA and OFA.

    Science.gov (United States)

    Yang, Hua; Susilo, Tirta; Duchaine, Bradley

    2016-03-01

    Macaque neurophysiology found image-invariant representations of face identity in a face-selective patch in anterior temporal cortex. A face-selective area in human anterior temporal lobe (fATL) has been reported, but has not been reliably identified, and its function and relationship with posterior face areas is poorly understood. Here, we used fMRI adaptation and neuropsychology to ask whether fATL contains image-invariant representations of face identity, and if so, whether these representations require normal functioning of fusiform face area (FFA) and occipital face area (OFA). We first used a dynamic localizer to demonstrate that 14 of 16 normal subjects exhibit a highly selective right fATL. Next, we found evidence that this area subserves image-invariant representation of identity: Right fATL showed repetition suppression to the same identity across different images, while other areas did not. Finally, to examine fATL's relationship with posterior areas, we used the same procedures with Galen, an acquired prosopagnosic who lost right FFA and OFA. Despite the absence of posterior face areas, Galen's right fATL preserved its face selectivity and showed repetition suppression comparable to that in controls. Our findings suggest that right fATL contains image-invariant face representations that can persist despite the absence of right FFA and OFA, but these representations are not sufficient for normal face recognition.

  7. Five-year survival of 3-unit fiber-reinforced composite fixed partial dentures in the anterior area.

    NARCIS (Netherlands)

    Heumen, C.C.M. van; Dijken, J.W.V. van; Tanner, J.; Pikaar, R.; Lassila, L.V.; Creugers, N.H.J.; Vallittu, P.K.; Kreulen, C.M.

    2009-01-01

    OBJECTIVES: The purpose of this clinical study was to evaluate the long-term outcome of 3-unit anterior fixed partial dentures (FPDs) made of fiber-reinforced resin composite (FRC), and to identify design factors influencing the survival rate. METHODS: 52 patients (26 females, 26 males) received 60

  8. Increased number of TH-immunoreactive cells in the ventral tegmental area after deep brain stimulation of the anterior nucleus of the thalamus.

    Science.gov (United States)

    Dela Cruz, J A D; Hescham, S; Adriaanse, B; Campos, F L; Steinbusch, H W M; Rutten, B P F; Temel, Y; Jahanshahi, A

    2015-09-01

    Dopamine (DA) has been long implicated with the processes of memory. In long-term memory, the hippocampus and ventral tegmental area (VTA) use DA to enhance long-term potentiation, while prefrontal DA D1 receptors are involved in working memory. Deep brain stimulation (DBS) of specific brain areas have been shown to affect memory impairments in animal models. Here, we tested the hypothesis that DBS could reverse memory impairments by increasing the number of dopaminergic cells in the VTA. Rats received DBS at the level of the mammillothalamic tract, the anterior nucleus of the thalamus, and entorhinal cortex before euthanasia. These regions are part of the so-called memory circuit. Brain sections were processed for c-Fos and tyrosine hydroxylase (TH) immunocytochemistry in the VTA and the substantia nigra pars compacta (SNc). c-Fos, TH and c-Fos/TH immunoreactive cells were analyzed by means of stereology and confocal microscopy. Our results showed that DBS of the anterior nucleus of the thalamus induced substantial higher numbers of TH-immunoreactive cells in the VTA, while there were no significant differences between the experimental groups in the number of TH immunoreactive cells in the SNc, c-Fos immunoreactive cells and c-Fos/TH double-labeled cells in both the SNc and VTA. Our findings suggest a phenotypic switch, or neurotransmitter respecification, of DAergic cells specifically in the VTA which may be induced by DBS in the anterior nucleus of the thalamus.

  9. Anterior cingulate cortex surface area relates to behavioral inhibition in adolescents with and without heavy prenatal alcohol exposure

    OpenAIRE

    Migliorini, R; Moore, EM; Glass, L.; Infante, MA; Tapert, SF; Jones, KL; Mattson, SN; Riley, EP

    2015-01-01

    © 2015 Elsevier B.V. Prenatal alcohol exposure is associated with behavioral disinhibition, yet the brain structure correlates of this deficit have not been determined with sufficient detail. We examined the hypothesis that the structure of the anterior cingulate cortex (ACC) relates to inhibition performance in youth with histories of heavy prenatal alcohol exposure (AE, n=. 32) and non-exposed controls (CON, n=. 21). Adolescents (12-17 years) underwent structural magnetic resonance imaging ...

  10. Amplified somatosensory and visual cortical projections to a core auditory area, the anterior auditory field, following early- and late-onset deafness.

    Science.gov (United States)

    Wong, Carmen; Chabot, Nicole; Kok, Melanie A; Lomber, Stephen G

    2015-09-01

    Cross-modal reorganization following the loss of input from a sensory modality can recruit sensory-deprived cortical areas to process information from the remaining senses. Specifically, in early-deaf cats, the anterior auditory field (AAF) is unresponsive to auditory stimuli but can be activated by somatosensory and visual stimuli. Similarly, AAF neurons respond to tactile input in adult-deafened animals. To examine anatomical changes that may underlie this functional adaptation following early or late deafness, afferent projections to AAF were examined in hearing cats, and cats with early- or adult-onset deafness. Unilateral deposits of biotinylated dextran amine were made in AAF to retrogradely label cortical and thalamic afferents to AAF. In early-deaf cats, ipsilateral neuronal labeling in visual and somatosensory cortices increased by 329% and 101%, respectively. The largest increases arose from the anterior ectosylvian visual area and the anterolateral lateral suprasylvian visual area, as well as somatosensory areas S2 and S4. Consequently, labeling in auditory areas was reduced by 36%. The age of deafness onset appeared to influence afferent connectivity, with less marked differences observed in late-deaf cats. Profound changes to visual and somatosensory afferent connectivity following deafness may reflect corticocortical rewiring affording acoustically deprived AAF with cross-modal functionality.

  11. Impact of aesthetic restorative treatment on anterior teeth with fluorosis among residents of an endemic area in Brazil: intervention study

    Science.gov (United States)

    2014-01-01

    Background Endemic dental fluorosis has already been described in some regions of the world. The aim of this study was to evaluate the functional and psychosocial impact of direct aesthetic restorative treatments in endemic fluorosis patients in the northern state of Minas Gerais, Brazil. Was a quasi-experimental intervention study. Methods The reference population consisted of individuals between 9 and 27 years of age that were served by a project intended to recover the smiles of patients with severe fluorosis. The questionnaires were administered on two occasions, 24 months apart (before and after dental treatment). Initially, descriptive analyses were conducted. Prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders were estimated based on the Oral Health Impact Profile instrument (OHIP-14). Comparisons between baseline and follow-up and between treatment techniques were carried out using the McNemar, Wilcoxon, and Mann–Whitney tests. Results The study involved 53 individuals, with a mean age of 15.9 years, treated with microabrasion, dental composite, or a combination of both techniques. The treatments performed proved to be competent for reducing the functional and psychosocial impact of oral disorders as measured by the OHIP-14, pointing to the possibility of establishing protocols to be used in programs aimed at restoring the aesthetics and functionality of the anterior teeth in large populations. Conclusions After performing the direct aesthetic restorative treatments in patients with endemic fluorosis, a significant improvement was observed in the prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders. PMID:24886223

  12. Cross-sectional area measurements versus volumetric assessment of the quadriceps femoris muscle in patients with anterior cruciate ligament reconstructions

    Energy Technology Data Exchange (ETDEWEB)

    Marcon, Magda [University Hospital Zurich, Department of Radiology, Zurich (Switzerland); University Hospital Udine, Department of Radiology, Udine (Italy); Ciritsis, Bernhard; Laux, Christoph [University Hospital Zurich, Department of Traumatology, Zurich (Switzerland); Nanz, Daniel; Nguyen-Kim, Thi Dan Linh; Fischer, Michael A.; Andreisek, Gustav; Ulbrich, Erika J. [University Hospital Zurich, Department of Radiology, Zurich (Switzerland)

    2014-10-31

    Our aim was to validate the use of cross-sectional area (CSA) measurements at multiple quadriceps muscle levels for estimating the total muscle volume (TMV), and to define the best correlating measurement level. Prospective institutional review board (IRB)-approved study with written informed patient consent. Thighs of thirty-four consecutive patients with ACL-reconstructions (men, 22; women, 12) were imaged at 1.5-T using three-dimensional (3D) spoiled dual gradient-echo sequences. CSA was measured at three levels: 15, 20, and 25 cm above the knee joint line. TMV was determined using dedicated volumetry software with semiautomatic segmentation. Pearson's correlation and regression analysis (including standard error of the estimate, SEE) was used to compare CSA and TMV. The mean ± standard deviation (SD) for the CSA was 60.6 ± 12.8 cm{sup 2} (range, 35.6-93.4 cm{sup 2}), 71.1 ± 15.1 cm{sup 2} (range, 42.5-108.9 cm{sup 2}) and 74.2 ± 17.1 cm{sup 2} (range, 40.9-115.9 cm{sup 2}) for CSA-15, CSA-20 and CSA-25, respectively. The mean ± SD quadriceps' TMV was 1949 ± 533.7 cm{sup 3} (range, 964.0-3283.0 cm{sup 3}). Pearson correlation coefficient was r = 0.835 (p < 0.01), r = 0.906 (p < 0.01), and r = 0.956 (p < 0.01) for CSA-15, CSA-20 and CSA-25, respectively. Corresponding SEE, expressed as percentage of the TMV, were 15.2 %, 11.6 % and 8.1 %, respectively. The best correlation coefficient between quadriceps CSA and TMV was found for CSA-25, but its clinical application to estimate the TMV is limited by a relatively large SEE. (orig.)

  13. Anterior ventral tegmental area dopaminergic neurons are not involved in the motivational effects of bromocriptine, pramipexole and cocaine in drug-free rats.

    Science.gov (United States)

    Ouachikh, Omar; Dieb, Wisam; Durif, Franck; Hafidi, Aziz

    2014-04-01

    Dopamine dysregulation syndrome in Parkinson's disease has been attributed to dopamine replacement therapies and/or a lesion of the dopaminergic system. Dopaminergic neuronal loss targets the substantia nigra and the ventral tegmental area (VTA). We hypothesize that dopamine replacement therapy is responsible for the potential reinforcement effect in Parkinson's disease, by acting on the neuronal reward circuitry. We previously demonstrated that the posterior (p) VTA, which projects to the nucleus accumbens (NAc), is implicated in the motivational effect of dopamine receptor agonists in 6-OHDA bilateral pVTA-lesioned drug-free animals. In the present study we investigated the implication of the anterior (a) VTA in the potential reinforcement effect of dopamine receptor agonists. Using the conditioned place preference (CPP) behavioral paradigm, we investigated the motivational effects of dopamine receptor agonists (bromocriptine and pramipexole), and cocaine in rats with a 6-OHDA bilateral lesion of the aVTA. Bromocriptine and pramipexole did not induce a significant CPP at 1mg/kg in both sham and bilateral 6-OHDA-lesioned rats. However bromocriptine induced CPP only at a dose of 3mg/kg in both animal groups. Moreover cocaine, which is known to increase dopamine release, induced reinforcing effects in both 6-OHDA-lesioned and sham rats. Our data show a lack of involvement of aVTA dopamine neurons in the motivational effects of bromocriptine, pramipexole and cocaine.

  14. The anterior cingulate cortex

    Directory of Open Access Journals (Sweden)

    Pavlović D.M.

    2009-01-01

    Full Text Available The anterior cingulate cortex (ACC has a role in attention, analysis of sensory information, error recognition, problem solving, detection of novelty, behavior, emotions, social relations, cognitive control, and regulation of visceral functions. This area is active whenever the individual feels some emotions, solves a problem, or analyzes the pros and cons of an action (if it is a right decision. Analogous areas are also found in higher mammals, especially whales, and they contain spindle neurons that enable complex social interactions. Disturbance of ACC activity is found in dementias, schizophrenia, depression, the obsessive-compulsive syndrome, and other neuropsychiatric diseases.

  15. Neurofeedback of the difference in activation of the anterior cingulate cortex and posterior insular cortex: two functionally connected areas in the processing of pain

    Directory of Open Access Journals (Sweden)

    Mariela eRance

    2014-10-01

    Full Text Available The aim of this study was the analysis of the effect of a learned increase in the dissociation between the rostral anterior cingulate cortex (rACC and the left posterior insula (pInsL on pain intensity and unpleasantness and the contribution of each region to the effect, exploring the possibility to influence the perception of pain with neurofeedback methods. We trained ten healthy subjects to increase the difference in the blood oxygenation level-dependent response between the rACC and pInsL to painful electric stimuli. Subjects learned to increase the dissociation with either the rACC (state 1 or the pInsL (state 2 being higher. For feedback we subtracted the signal of one region from the other and provided feedback in four conditions with six trials each yielding two different states: (rACC – pInsL increase (state 1, rACC – pInsL decrease (state 2, pInsL – rACC increase (state 2, pInsL – rACC decrease (state 1. Significant changes in the dissociation from trial one to six were seen in all conditions. There were significant changes from trial one to six in the pInsL in three of the four conditions, the rACC showed no significant change. Pain intensity or unpleasantness ratings were unrelated to the dissociation between the regions and the activation in each region. Learning success in the conditions did not significantly correlate and there was no significant correlation between the two respective conditions of one state, i.e. learning to achieve a specific state is not a stable ability. The pInsL seems to be the driving force behind changes in the learned dissociation between the regions. Despite successful differential modulation of activation in areas responsive to the painful stimulus, no corresponding changes in the perception of pain intensity or unpleasantness emerged. Learning to induce different states of dissociation between the areas is not a stable ability since success did not correlate overall or between two conditions of

  16. Herniation of the anterior lens capsule

    Directory of Open Access Journals (Sweden)

    Pereira Nolette

    2007-01-01

    Full Text Available Herniation of the anterior lens capsule is a rare abnormality in which the capsule bulges forward in the pupillary area. This herniation can be mistaken for an anterior lenticonus where both the capsule and the cortex bulge forward. The exact pathology behind this finding is still unclear. We report the clinical, ultrasound biomicroscopy (UBM and histopathological findings of a case of herniation of the anterior lens capsule. UBM helped to differentiate this entity from anterior lenticonus. Light microscopy revealed capsular splitting suggestive of capsular delamination and collection of fluid (aqueous in the area of herniation giving it a characteristic appearance.

  17. 牙周生物型对前牙美学区口腔治疗影响的研究进展%Advances of the effects of periodontal biotype on oral therapy in anterior dental aesthetic area

    Institute of Scientific and Technical Information of China (English)

    陈晨; 孙颖

    2016-01-01

    Periodontal biotype is very important for oral therapy, especially in anterior dental aesthetic area. It is related with period-ontology, implantology, prosthodontics, orthodontics and so on, and has attracted attentions from more and more researchers and clini-cians. This paper reviewed the classifications, characteristics, measurement methods and effects of periodontal biotype on oral therapy in anterior dental aesthetic area.%牙周生物型对口腔治疗,尤其是前牙美学区治疗具有重要意义,涉及牙周、种植、修复、正畸等多个临床领域,近年来已受到越来越多学者的关注.该文拟就牙周生物型的分型、特点、常用测量方法 及对前牙美学区治疗的影响作一综述.

  18. Rotated alphanumeric characters do not automatically activate frontoparietal areas subserving mental rotation

    DEFF Research Database (Denmark)

    Weiss, Michael M; Wolbers, Thomas; Peller, Martin;

    2008-01-01

    Functional neuroimaging studies have identified a set of areas in the intraparietal sulcus and dorsal precentral cortex which show a linear increase in activity with the angle of rotation across a variety of mental rotation tasks. This linear increase in activity with angular disparity suggests...... task was associated with a linear increase in neuronal activity with angular disparity in a bilateral set of frontoparietal areas, comprising the rostral dorsal premotor cortex, frontal eye field, ventral and medial intraparietal sulcus. Neuronal activity in these regions was neither increased nor...

  19. Representation of continuous hand and arm movements in macaque areas M1, F5, and AIP: a comparative decoding study

    Science.gov (United States)

    Menz, Veera Katharina; Schaffelhofer, Stefan; Scherberger, Hansjörg

    2015-10-01

    Objective. In the last decade, multiple brain areas have been investigated with respect to their decoding capability of continuous arm or hand movements. So far, these studies have mainly focused on motor or premotor areas like M1 and F5. However, there is accumulating evidence that anterior intraparietal area (AIP) in the parietal cortex also contains information about continuous movement. Approach. In this study, we decoded 27 degrees of freedom representing complete hand and arm kinematics during a delayed grasping task from simultaneously recorded activity in areas M1, F5, and AIP of two macaque monkeys (Macaca mulatta). Main results. We found that all three areas provided decoding performances that lay significantly above chance. In particular, M1 yielded highest decoding accuracy followed by F5 and AIP. Furthermore, we provide support for the notion that AIP does not only code categorical visual features of objects to be grasped, but also contains a substantial amount of temporal kinematic information. Significance. This fact could be utilized in future developments of neural interfaces restoring hand and arm movements.

  20. CONGENITAL ANTERIOR TIBIOFEMURAL SUBLUXATION

    Directory of Open Access Journals (Sweden)

    A. Shahla

    2008-06-01

    Full Text Available Congenital anterior tibiofemoral subluxation is an extremely rare disorder. All reported cases accompanied by other abnormalities and syndromes. A 16-year-old high school girl referred to us with bilateral anterior tibiofemoral subluxation as the knees were extended and reduced at more than 30 degrees flexion. Deformities were due to tightness of the iliotibial band and biceps femuris muscles and corrected by surgical release. Associated disorders included bilateral anterior shoulders dislocation, short metacarpals and metatarsals, and right calcaneuvalgus deformity.

  1. Bilateral anterior shoulder dislocation

    OpenAIRE

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  2. Anterior cruciate ligament (ACL) injury

    Science.gov (United States)

    Cruciate ligament injury - anterior; ACL injury; Knee injury - anterior cruciate ligament (ACL) ... knee. It prevents the knee from bending out. Anterior cruciate ligament (ACL) is in the middle of the knee. ...

  3. Congenital anterior urethral diverticulum.

    Science.gov (United States)

    Singh, Sanjeet Kumar; Ansari, Ms

    2014-09-01

    Congenital anterior urethral diverticulum (CAUD) may be found all along the anterior urethra and may present itself at any age, from infant to adult. Most children with this condition present with difficulty in initiating micturition, dribbling of urine, poor urinary stream, or urinary tract infection. A careful history will reveal that these children never had a good urinary stream since birth, and the telltale sign is a cystic swelling of the penile urethra. In this paper, we present two cases of CAUD that were managed by excision of the diverticulum with primary repair. PMID:26328174

  4. Anterior commissure versus corpus callosum: A quantitative comparison across mammals.

    Science.gov (United States)

    Ashwell, Ken W S

    2016-04-01

    Mammals rely on two major pathways to transfer information between the two hemispheres of the brain: the anterior commissure and the corpus callosum. Metatheria and monotremes rely exclusively on the anterior commissure for interhemispheric transfer between the isocortices and olfactory allocortices of each side, whereas Eutheria use a combination of the anterior commissure and an additional pathway exclusive to Eutheria, the corpus callosum. Midline cross-sectional area of the anterior commissure and corpus callosum were measured in a range of mammals from all three infraclasses and plotted against brain volume to determine how midline anterior commissure area and its size relative to the corpus callosum vary with brain size and taxon. In Metatheria, the square root of anterior commissure area rises in almost direct proportion with the cube root of brain volume (i.e. the ratio of the two is relatively constant), whereas among Eutheria the ratio of the square root of anterior commissure area to the cube root of brain volume declines slightly with increasing brain size. The total of isocortical and olfactory allocortical commissure area rises more rapidly with increasing brain volume among Eutheria than among Metatheria. This means that the midline isocortical and olfactory allocortical commissural area of metatherians with large brains (about 70 ml) is only about 50% of that among eutherians with similarly sized brains. On the other hand, isocortical and olfactory allocortical commissural area is similar in Metatheria and Eutheria at brain volumes around 1 ml. Among the Eutheria, some groups make less use of the anterior commissure pathway than do others: soricomorphs, rodents and cetaceans have smaller anterior commissures for their brain size than do afrosoricids, erinaceomorphs and proboscideans. The findings suggest that use of the anterior commissural route for isocortical commissural connections may have placed limitations on interhemispheric transfer of

  5. Anterior commissure versus corpus callosum: A quantitative comparison across mammals.

    Science.gov (United States)

    Ashwell, Ken W S

    2016-04-01

    Mammals rely on two major pathways to transfer information between the two hemispheres of the brain: the anterior commissure and the corpus callosum. Metatheria and monotremes rely exclusively on the anterior commissure for interhemispheric transfer between the isocortices and olfactory allocortices of each side, whereas Eutheria use a combination of the anterior commissure and an additional pathway exclusive to Eutheria, the corpus callosum. Midline cross-sectional area of the anterior commissure and corpus callosum were measured in a range of mammals from all three infraclasses and plotted against brain volume to determine how midline anterior commissure area and its size relative to the corpus callosum vary with brain size and taxon. In Metatheria, the square root of anterior commissure area rises in almost direct proportion with the cube root of brain volume (i.e. the ratio of the two is relatively constant), whereas among Eutheria the ratio of the square root of anterior commissure area to the cube root of brain volume declines slightly with increasing brain size. The total of isocortical and olfactory allocortical commissure area rises more rapidly with increasing brain volume among Eutheria than among Metatheria. This means that the midline isocortical and olfactory allocortical commissural area of metatherians with large brains (about 70ml) is only about 50% of that among eutherians with similarly sized brains. On the other hand, isocortical and olfactory allocortical commissural area is similar in Metatheria and Eutheria at brain volumes around 1ml. Among the Eutheria, some groups make less use of the anterior commissure pathway than do others: soricomorphs, rodents and cetaceans have smaller anterior commissures for their brain size than do afrosoricids, erinaceomorphs and proboscideans. The findings suggest that use of the anterior commissural route for isocortical commissural connections may have placed limitations on interhemispheric transfer of

  6. 儿童前牙区牙槽骨和基骨骨密度的锥形束CT测量%Density of the anterior area of alveolar and basal bones on the children measured by cone beam computed tomography

    Institute of Scientific and Technical Information of China (English)

    王军; 任卫萍; 龙飞; 栗震亚

    2012-01-01

    Objective The purpose of this investigation was to evaluate density value on anterior of the alveolar and basal bones on children. Methods 138 cases cone beam computed tomography images were selected. The densities of these bones were measured in Hounsfield units(Hu) for the incisor, canine of the anterior area of alveolar and basal bones on the children. Results There is no significant difference on the same position of the maxillary bilateral(right and left) incisors of the density value(P>0.05). To compare with the incisors of the density value on the same position of the mandibule on left and right, there is significant difference on the base bone on cortical bone density of lingual, P=0.012. There is no significant difference on the same position of the maxillary bilateral(right and left) canine of the density value. To compare with the canine of the density value on the same position of the mandibule on left and right, there is significant difference on the alveolar bone and basal bone cancellous density, P=0.046 and 0.002, respectively. Conclusion These might provide determinate data for anterior teeth zone when selecting sites and placement methods for microscrew implants in the dental arch.%目的 评估儿童前牙区上下颌牙槽骨和基骨的骨密度.方法 选择138例患者的锥形束CT扫描图像,以亨斯菲尔德单位(X线衰减单位Hu)来测定其上下颌切牙区、尖牙区牙槽嵴和基骨骨密质及骨松质的骨密度.结果 上颌切牙区左右两侧相同部位间的骨密度值相比较,差异没有统计学意义(P>0.05);下颌切牙区左右两侧相同部位的骨密度值相比较,基骨区舌侧骨密质的骨密度值差异有统计学意义(P=0.012);上颌尖牙区左右两侧相同部位的骨密度值相比较,差异没有统计学意义(P>0.05):下颌尖牙区左右两侧相同部位的骨密度值相比较,牙槽骨和基骨区骨松质的骨密度值差异有统计学意义,P值分别为0.046和0.002.结

  7. THYMOLIPOMA: A RARE, LARGE ANTERIOR MEDIASTINAL MASS

    Directory of Open Access Journals (Sweden)

    Premananth

    2015-07-01

    Full Text Available Thymolipoma is a rare benign tumor of anterior mediastinum, described by Lange in 1916. 1 Less than 200 cases have been reported worldwide. 2 It accounts for 2% to 9% of thymic tumours. 3 We report a case of thymolipoma in a 37 year s old male patient, who pre sented with cough, dys p nea, chest pain for 2 months. CT THORAX revealed a large anterior mediastinal mass extending in to right hemithorax arising from thymus gland, with multiple areas of fat density, no significant mediastinal adenopathy, complete collap se of right middle and lower lobe suggestive of thymolipoma. CT guided biopsy suggestive of thymic neoplasm. The tumour was removed enbloc through surgery. Histopathological examination of large mass lesion confirmed thymolipoma. We report this case to emp hasize the importance of considering thymolipoma as a differential diagnosis of anterior mediastinal mass, although rare.

  8. [Surgical anatomy of the anterior mediastinum].

    Science.gov (United States)

    Biondi, Alberto; Rausei, Stefano; Cananzi, Ferdinando C M; Zoccali, Marco; D'Ugo, Stefano; Persiani, Roberto

    2007-01-01

    The mediastinum is located from the thoracic inlet to the diaphragm between the left and right pleural cavities and contains vital structures of the circulatory, respiratory, digestive, and nervous system. Over the years, since there are no fascial or anatomic planes, anatomists and radiologists have suggested various schemes for subdividing the mediastinum and several anatomical and radiological classifications of the mediastinum are reported in the literature. The most popular of these scheme divides medistinum, for purposes of description, into two parts: an upper portion, above the upper level of the pericardium, which is named the superior mediastinum; and a lower portion, below the upper level of the pericardium. For clinical purposes, the mediastinum may be subdivided into three major areas, i.e. anterior, middle, and posterior compartments. The anterior mediastinum is defined as the region posterior to the sternum and anterior to the heart and brachiocephalic vessels. It extends from the thoracic inlet to the diaphragm and contains the thymus gland, fat, and lymph nodes. This article will review surgical anatomy of the anterior mediastinum and will focus on the surgical approch to anterior mediastinum and thymic diseases.

  9. 不翻瓣即刻牙种植对患者口腔软硬组织的影响分析%Effect of immediate dental implant on the oral and soft tissue of patients with anterior teeth area

    Institute of Scientific and Technical Information of China (English)

    方杨

    2016-01-01

    Objective: To study the effect of immediate dental implantation on the oral and soft tissue of the patients with anterior teeth area. Methods: From January 2013 to June 2015 in our hospital for imme-diate dental implant patients (n=30). The digital random were randomly divided into observation group and control group, 15 cases. The patients in the control group were flap in immediate implant in, the observa tion group of flapless immediate dental implantation. The effects of two groups were compared. Results: The survival rate of the observation group was 93.33%(14/15), significantly higher than that in the control group of 86.67%(13/15). The incidence of postoperative symptoms was significantly lower than that of the control group. Observation group, operation time and alveolar bone status were signifi-cantly lower than those of the control group, two groups of vas before treatment, PES score compared to no difference, respectively after the treatment, the observation group VAS score was significantly lower than that of the control group, and PES score was significantly higher than that of control group. After 1 years of operation, the crest crest absorption of the observation group was (0.71 ±0.15)mm, was signifi-cantly lower than that of the control group(1.13±0.32)mm. The difference was statistically significant (all P<0.05). Conclusion: The immediate dental implantation in the anterior teeth area of the maxillary an-terior teeth is significant, which can reduce postoperative pain, reduce the incidence of edema, and can relieve the pain and safety of the patients, which is worthy of clinical application.%目的:研究不翻瓣即刻牙种植对患者口腔软硬组织的影响并进行分析。方法:选取从2013年1月至2015年6月,于我院进行即刻牙种植患者30例。以数字法随机随机分为观察组及对照组各15例。其中对照组患者进行翻瓣即刻牙种植术,观察组则进行不翻瓣即刻牙种植术,对比两组

  10. Anterior hypothalamic area: a neural site involved in the effects of meIatonin on blood pressure%下丘脑前核:参与褪黑素对血压影响的中枢部位

    Institute of Scientific and Technical Information of China (English)

    丁超南; 曹银祥; 周莉; 沈仲元; 费民毅; 余平; 朱大年

    2002-01-01

    The cardiovascular effects of melatonin in the anterior hypothalamic area (AHA) have been examined by using microinjection technique and the projections of the AHA which may by involved in the sympathetic output for the cardiovascular activity have been examined by using the horseradish peroxidase (HRP) tract-tracing method in the rat.The results indicated that microinjection of melatonin produced a dose-dependent fall in mean arterial pressure (MAP),and the AHA supplied substantial inputs to the periventricular nucleus ( Pe), median eminence ( ME), ventromedial hypothalamic nucleus (VMH), arcuate nucleus(ARC) and periaqueductal gray (PAG). Moreover, a small amount of projections from the AHA to the ventrolateral medulla (VLM) and the nucleus raphe obscurus (NRO) were also found .Thus, melatonin may act as a hypotensive factor, and the AHA may be one of the important central areas where melatonin can exert modulatory effects on cardiovascular activities. Thus, the AHA is in a position to control the sympathetic outflow through such potential routes as the VMH, ARC, PAG, VLM and NRO.%在大鼠用微量注射技术研究褪黑素在下丘脑前核对心血管活动的作用,以及用辣根过氧化物酶神经传导通路追踪技术研究下丘脑前核参与心血管活动交感传出的纤维投射.结果表明,下丘脑前核微量注射褪黑素可使血压呈剂量依赖性降低,下丘脑前核有大量纤维投射到室旁核、正中隆起、下丘脑腹内侧核、弓状核、中脑导水管周围灰质,有少量纤维投射到延髓腹外侧区、中缝隐核.因此,褪黑素可能为一种降压因子,下丘脑前核是褪黑素调节心血管活动的重要中枢部位之一,而且下丘脑前核可能通过下丘脑腹内侧核、弓状核、中脑导水管周围灰质、延髓腹外侧区和中缝隐核来影响心血管交感传出活动.

  11. Variant attachments of the anterior horn of the medial meniscus.

    Science.gov (United States)

    Jakubowicz, Marian; Ratajczak, Wojciech; Pytel, Andrzej

    2003-01-01

    The purpose of this study was to analyse the occurrence of variants of anomalous insertions of the anterior horn of the medial meniscus in human knee joints. The study was carried out on 78 human lower limbs of both sexes (42 males and 36 females). Out of 78 knee joints, 10 knee joints (12.82%) presented atypical attachments of the anterior horn of the medial meniscus. In 9 cases we found that the anterior horn of the medial meniscus was attached to the transverse ligament of the knee and in 1 case it was attached to the coronary ligament. In the remaining cases the anterior horn of the medial meniscus was attached to the anterior intercondylar area of the tibia.

  12. Anterior hip pain.

    Science.gov (United States)

    O'Kane, J W

    1999-10-15

    Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. Osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. Patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "Sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity. PMID:10537384

  13. Anterior ischemic optic neuropathy: a comparison of the optic disc area of patients with the arteritic and non-arteritic forms of the disease and that of normal controls Neuropatia óptica isquêmica anterior: estudo comparativo da área do disco óptico de pacientes com as formas arterítica e não-arterítica da doença e de controles normais

    Directory of Open Access Journals (Sweden)

    Mário Luiz Ribeiro Monteiro

    2006-12-01

    Full Text Available PURPOSE: To evaluate the optic disc area of patients with non-arteritic anterior ischemic optic neuropathy (NA-AION and arteritic anterior ischemic optic neuropathy (A-AION and compare the results between each other and with those from controls in order to verify the existence and the magnitude of anatomical factors predisposing to the development of anterior ischemic optic neuropathy. METHODS: This is a case-controlled study of the optic disc area of 24 consecutive patients affected with NA-AION, 13 patients with A-AION and 24 consecutive healthy normals, sex- and age-matched with the patients with the NA-AION group. Measurements of optic disc area were performed for each studied group using disc photographs projected, measured and corrected for the refractive error and the keratometric readings, according to Littmann's method in each studied group. The results were compared using variance analysis. RESULTS: The mean areas and standard deviations of the optic discs from patients with NA-AION, A-AION and normals were respectively 1.99 ± 0.35 mm², 2.29 ± 0.39 mm² and 2.49 ± 0.53 mm². The statistical analysis revealed that the mean areas of the optic disc of patients with NA-AION were significantly different from those of normal controls. No statistical difference was found between A-AION and normal controls. CONCLUSION: NA-AION occurs predominantly in small discs while the arteritic form of the disease shows no such preference. Factors related to optic disc structure play a role in the pathophysiology of NA-AION. The occurrence of AION in large optic optic discs should raise the suspicion of temporal arteritis. On the other hand, small optic disc areas do not rule out that vasculitis.OBJETIVO: Calcular a área do disco óptico de pacientes com neuropatia óptica isquêmica anterior não arterítica (NOIA-NA e com neuropatia óptica isquêmica anterior por arterite temporal (NOIA-A comparando os resultados entre si e com o grupos controle

  14. Analysis on self-healing effect of anterior teeth area gingival soft tissue in canine model%前牙区软组织自我修复效果的实验测量观察

    Institute of Scientific and Technical Information of China (English)

    黄伟; 张志宏; 刘红红; 鲍军燕; 张敏; 韩倩; 何华

    2014-01-01

    Residual roots model was conducted in the maxillary anterior teeth area of the canine ( right maxillary lateral incisor and left maxillary central incisor) by grinding dental crown to approximate alveolar ridge top level in subgingival margin and avoiding wearing gingival tissue. The growth of gums was observed in the 1, 3, 4, 5 weeks after surgery through measuring the distance between gingival papilla and adjacent regions spire, the vertical dis-tance between gingival papilla and the level of the adjacent regions spire, the distance between the modpoint of gin-gival margin and adjacent tooth spire and the vertical distance between the modpoint of gingival margin and the level of the adjacent regions spire. All the statistical analyses for experimental data were performed by SPSS statistical software. The results showed hyperplasia of the gum tissue in the fourth week after surgery was nearly full of residu-al root fracture, and no color and texture difference was found between the gum tissue in the fifth week after surgery and normal gum. According to data the growth of gum tissue was toward the direction of hyperplasia during the ob-servation period. This study shows that gums have some certain ability of self-healing in the case of no damage, and the residual root tissue can complete self-healing in 4 weeks.%在犬的上颌前牙区(右上颌侧切牙、左上颌中切牙)制造残根模型,将牙冠磨至龈缘下约平齐牙槽嵴顶水平,避免磨损牙龈软组织,术后第1、3、4、5周观察其牙龈生长情况,测量龈乳头至邻牙牙尖顶的距离、龈乳头至邻牙牙尖顶的水平面的垂直距离、龈缘中点至邻牙牙尖顶的距离、龈缘中点至邻牙牙尖顶的水平面的垂直距离。利用SPSS软件对测量的实验数据进行线图分析。结果显示术后第4周增生的软组织基本长满残根断面,术后第5周新生的软组织与正常牙龈在颜色、质地上基本一致,测量数据显示在观察周期

  15. Anterior dental microwear texture analysis of the Krapina Neandertals

    Science.gov (United States)

    Krueger, Kristin; Ungar, Peter

    2012-12-01

    Some Neandertal anterior teeth show unusual and excessive gross wear, commonly explained by non-dietary anterior tooth use, or using the anterior dentition as a tool, clamp, or third hand. This alternate use is inferred from aboriginal arctic populations, who used their front teeth in this manner. Here we examine anterior dental microwear textures of the Krapina Neandertals to test this hypothesis and further analyze tooth use in these hominins. Microwear textures from 17 Krapina Dental People were collected by white-light confocal profilometry using a 100x objective lens. Four adjacent scans were generated, totaling an area of 204x276 μm, and were analyzed using Toothfrax and SFrax SSFA software packages. The Neandertals were compared to six bioarchaeological/ethnographic samples with reported variation in diet, abrasive load, and non-dietary anterior tooth use. Results indicate that Krapina anterior teeth lack extreme microwear textures expected of hominins exposed to heavy abrasives or those that regularly generated high stresses associated with intense use of the front teeth as tools. Krapina hominins have microwear attributes in common with Coast Tsimshian, Aleut, and Puye Pueblo samples. Collectively, this suggests that the Krapina Neandertals faced moderate abrasive loads and only periodically used their anterior teeth as tools for non-diet related behaviors.

  16. Multidisciplinary management of anterior diastemata

    DEFF Research Database (Denmark)

    Furuse, Adilson Yoshio; Herkrath, Fernando José; Franco, Eduardo Jacomino;

    2007-01-01

    the aesthetic results when orthodontic therapy itself is not feasible. This article presents integrated orthodonticrestorative solutions of anterior diastemata, associated with the conditioning of the gingival tissue with composite resin, and discusses the most relevant aspects related to their etiology...

  17. Anterior approach for knee arthrography

    International Nuclear Information System (INIS)

    Objective. To develop a new method of magnetic resonance arthrography (MRA) of the knee using an anterior approach analogous to the portals used for knee arthroscopy.Design. An anterior approach to the knee joint was devised mimicking anterior portals used for knee arthroscopy. Seven patients scheduled for routine knee MRA were placed in a decubitus position and under fluoroscopic guidance a needle was advanced from a position adjacent to the patellar tendon into the knee joint. After confirmation of the needle tip location, a dilute gadolinium solution was injected.Results and conclusion. All the arthrograms were technically successful. The anterior approach to knee MRA has greater technical ease than the traditional approach with little patient discomfort. (orig.)

  18. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement through the anterior supine ... renewed interest at this time due to several advantages that it brings. The approach that is performed ...

  19. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... it to have any real negative or deleterious effect by removing the anterior capsule. Now I would ... is what happens with one of the competitive designs. Like I told you, I just take a ...

  20. Update on anterior ankle impingement

    OpenAIRE

    Vaseenon, Tanawat; Amendola, Annunziato

    2012-01-01

    Anterior ankle impingement results from an impingement of the ankle joint by a soft tissue or osteophyte formation at the anterior aspect of the distal tibia and talar neck. It often occurs secondary to direct trauma (impaction force) or repetitive ankle dorsiflexion (repetitive impaction and traction force). Chronic ankle pain, swelling, and limitation of ankle dorsiflexion are common complaints. Imaging is valuable for diagnosis of the bony impingement but not for the soft tissue impingemen...

  1. Minimally invasive surgery of the anterior skull base: transorbital approaches

    Science.gov (United States)

    Gassner, Holger G.; Schwan, Franziska; Schebesch, Karl-Michael

    2016-01-01

    Minimally invasive approaches are becoming increasingly popular to access the anterior skull base. With interdisciplinary cooperation, in particular endonasal endoscopic approaches have seen an impressive expansion of indications over the past decades. The more recently described transorbital approaches represent minimally invasive alternatives with a differing spectrum of access corridors. The purpose of the present paper is to discuss transorbital approaches to the anterior skull base in the light of the current literature. The transorbital approaches allow excellent exposure of areas that are difficult to reach like the anterior and posterior wall of the frontal sinus; working angles may be more favorable and the paranasal sinus system can be preserved while exposing the skull base. Because of their minimal morbidity and the cosmetically excellent results, the transorbital approaches represent an important addition to established endonasal endoscopic and open approaches to the anterior skull base. Their execution requires an interdisciplinary team approach. PMID:27453759

  2. Case study: limitations of panoramic radiography in the anterior mandible.

    LENUS (Irish Health Repository)

    Walker, Cameron

    2009-12-01

    Dental Panoramic Tomography (DPT) is a widely used and valuable examination in dentistry. One area prone to artefacts and therefore misinterpretation is the anterior region of the mandible. This case study discusses a periapical radiolucency related to lower anterior teeth that is discovered to be a radiographic artefact. Possible causes of the artefact include a pronounced depression in the mental region of the mandible or superimposition of intervertebral spaces. Additional limitations of the DPT image include superimposition of radio-opaque structures, reduced image detail compared to intra-oral views and uneven magnification. These problems often make the DPT inappropriate for imaging the anterior mandible. Clinical Relevance: Panoramic radiography is often unsuitable for radiographic examination of the anterior mandible.

  3. Anterior chamber depth during hemodialysis

    Directory of Open Access Journals (Sweden)

    Gracitelli CPB

    2013-08-01

    Full Text Available Carolina Pelegrini Barbosa Gracitelli,1 Francisco Rosa Stefanini,1 Fernando Penha,1 Miguel Ângelo Góes,2 Sérgio Antonio Draibe,2 Maria Eugênia Canziani,2 Augusto Paranhos Junior1 1Ophthalmology Department, 2Division of Nephrology, Federal University of São Paulo – UNIFESP, São Paulo, Brazil Background: Exacerbation of chronic glaucoma or acute glaucoma is occasionally observed in patients undergoing hemodialysis (HD because of anterior chamber depth changes during this therapy. Purpose: To evaluate anterior chamber depth and axial length in patients during HD sessions. Methods: A total of 67 eyes of 35 patients were prospectively enrolled. Axial length and anterior chamber depth were measured using ultrasonic biometry, and these measures were evaluated at three different times during HD sessions. Body weight and blood pressure pre- and post-HD were also measured. Results: There was no difference in the axial length between the three measurements (P = 0.241. We observed a significantly decreased anterior chamber depth (P = 0.002 during HD sessions. Conclusion: Our results support the idea that there is a change in anterior chamber depth in HD sessions. Keywords: anterior chamber, hemodialysis, axial length, acute angle-closure glaucoma

  4. 微型种植体在前牙牙列缺损种植修复中的应用%Application of microimplants in the restoration of dentition defect in anterior teeth area

    Institute of Scientific and Technical Information of China (English)

    徐莉亚; 胡劲松; 李春林

    2015-01-01

    Objective To evaluate clinical effects of restorations in anterior teeth area with the microimplants and compare the effects between microimplant supported fixed dentures, removable partial dentures and porcelain-fused-to-metal(PFM) fixed bridges. Methods From January 2012 to December 2014, 26 cases of patients were selected as the experimental group in Guiyang Stomatological Hospital. Experiment group:The sample consisted of 26 consecutively treated partially edentulous patients who had a total of 30 microimplants, which were 2.3mm or 2.8mm in diameter and placed in 3.5-5mm edentulous space.The final restorations were fabricated with zirconia all ceramic crow 3 months later.All implants were examined clinically and radiologically in 3 months, 6 months,12 months and 24 months respectively.Another 48 cases of patients were selected as control group in the same period in the rehabilitation department of the hospital.Control group:A sample consisted of 48 patients who had a single missing tooth in the anterio teeth area.24 patients were treated with removable partial dentures(RPDs). 24 patients were treated with PFM fixed bridges. After the denture completion, the satisfaction survey to the patients was made about the aesthetic results, mastication, retention and comfort. Results Two loosing implants were removed, the remaining implants were successfully fabricated with crows.Bone level surrounding the implant is highly stable. Appearance of restorations had a good effect.The patients were satisfied with the microimplant supported fixed dentures.The satisfaction of patients with implant fixed dentures and PFM fixed bridges were higher than the patients with RPDs in aesthetic results, mastication, retention and comfort(P<0.05). The satisfaction of patients with implant fixed dentures was higher than the patients treated with PFM bridges in the comfort. No obvious differences were observed about aesthetic results, mastication, retention satisfaction among implant fixed

  5. Relevance of anterior mandibular body ostectomy in mandibular prognathism

    Science.gov (United States)

    Bansal, Pankaj; Singh, Virender; Anand, S. C.; Bansal, Sumidha

    2013-01-01

    Purpose: We tried to find out the relevance of anterior mandibular body ostectomy in deformities of the mandible specially prognathism, which is primarily limited to anterior part only. Patients and Methods: Ten patients with skeletal deformity along with malocclusion, which was limited to anterior body of mandible were selected. Selected patients had proper molar interdigitation (even if class 3) and in general had anterior crossbite (except one). All patients had crossed their growth spurts and had no hormonal influence on facial deformity. Specific protocol, including cephelometric analysis cephalometry for orthognathic surgery, prediction tracing and model surgeries were devised. Pre and post-surgical orthodontics and body ostectomy were performed in all patients along with 18-month post-op follow-up. Results: There was significant reduction in prognathism and horizontal dysplasia in all ten patients. Anterior crossbite as well as axis of incisiors over mandibular plane was corrected in all patients due to decrease in length of mandibular body. All patients showed decreased facial height and better lip competence with intact posterior occlusion and no (negligible or transient) sensory loss. Conclusions: Our study could confirm that people whose deformity is limited to the anterior part of mandible with reasonable occlusion posteriorly can get satisfactory cosmetic and functional results through body ostectomy alone rather than going for surgical procedure in the ramal area, which is liable to cause sensory and occlusal disturbances. PMID:24163554

  6. Anterior dislocation of an empty capsular bag in a pseudophakic eye: A rare case report

    Directory of Open Access Journals (Sweden)

    Hyung Bin Hwang

    2015-01-01

    Full Text Available Spontaneous intraocular lens (IOL dislocation is uncommon in the absence of any ocular areas with zonular weakness or trauma. There have been no reports of spontaneous capsular bag dislocation into the anterior chamber without an IOL. We report a rare, interesting case of spontaneous capsular bag anterior dislocation, without an IOL, into the anterior chamber with no history of genetic disease, ocular trauma, or pseudoexfoliation that might predispose to a zonular abnormality.

  7. Features extraction in anterior and posterior cruciate ligaments analysis.

    Science.gov (United States)

    Zarychta, P

    2015-12-01

    The main aim of this research is finding the feature vectors of the anterior and posterior cruciate ligaments (ACL and PCL). These feature vectors have to clearly define the ligaments structure and make it easier to diagnose them. Extraction of feature vectors is obtained by analysis of both anterior and posterior cruciate ligaments. This procedure is performed after the extraction process of both ligaments. In the first stage in order to reduce the area of analysis a region of interest including cruciate ligaments (CL) is outlined in order to reduce the area of analysis. In this case, the fuzzy C-means algorithm with median modification helping to reduce blurred edges has been implemented. After finding the region of interest (ROI), the fuzzy connectedness procedure is performed. This procedure permits to extract the anterior and posterior cruciate ligament structures. In the last stage, on the basis of the extracted anterior and posterior cruciate ligament structures, 3-dimensional models of the anterior and posterior cruciate ligament are built and the feature vectors created. This methodology has been implemented in MATLAB and tested on clinical T1-weighted magnetic resonance imaging (MRI) slices of the knee joint. The 3D display is based on the Visualization Toolkit (VTK).

  8. Anterior cruciate ligament - updating article.

    Science.gov (United States)

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques.

  9. Anterior cruciate ligament - updating article.

    Science.gov (United States)

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques. PMID:27517015

  10. Válvula de uretra anterior Anterior urethral valves

    Directory of Open Access Journals (Sweden)

    Silvio Tucci Jr.

    2003-02-01

    Full Text Available Objetivo: apresentar os aspectos clínicos, diagnósticos e terapêuticos de pacientes portadores de válvula da uretra anterior. Descrição: em dois neonatos, o diagnóstico presuntivo de patologia obstrutiva do trato urinário foi sugerido pela ultra-sonografia realizada no período pré-natal, confirmando-se o diagnóstico de válvula de uretra anterior pela avaliação pós-natal. Os pacientes foram submetidos a tratamento cirúrgico paliativo, com vesicostomia temporária e, posteriormente, definitivo, pela fulguração endoscópica das válvulas. Ambos evoluíram com função renal normal. Comentários: a válvula da uretra anterior é anomalia rara que deve ser considerada em meninos com quadro radiológico pré-natal sugestivo de obstrução infravesical, secundariamente à hipótese mais comum de válvula da uretra posterior. Ressaltamos a utilização da vesicostomia como derivação urinária temporária nestes casos, prevenindo potenciais complicações pela manipulação da uretra do recém-nascido.Objective: to discuss clinical signs, diagnostic tools and therapeutics of anterior urethral valves, an obstructive anomaly of the urinary system in males. Description: signs of urinary tract obstruction were identified on pre-natal ultrasound in two male fetuses and the diagnosis of anterior urethral valves was made through post-natal evaluation. As an initial treatment, vesicostomy was performed in both patients. Later, the valves were fulgurated using an endoscopic procedure. During the follow-up period both patients presented normal renal function. Comments: anterior urethral valves are a rare form of urethral anomaly that must be ruled out in boys with pre-natal ultrasound indicating infravesical obstruction. Vesicostomy used as an initial treatment rather than transurethral fulguration may prevent potential complications that can occur due to the small size of the neonatal urethra.

  11. 成人骨性Ⅱ类错牙合不同垂直骨面型前牙区牙槽骨形态的 CBCT 研究%A cone-beam CT study on alveolar bone morphology in anterior teeth area of adult skeletal Class Ⅱ mal-occlusion subjects with different vertical skeletal types

    Institute of Scientific and Technical Information of China (English)

    季海宁; 梁源; 隋珂; 高麒; 丁寅

    2016-01-01

    目的:应用锥形束 CT(CBCT)研究成人骨性Ⅱ类错(牙合)患者前牙区牙槽骨形态特征及垂直骨面型对其的影响。方法:纳入64名成人骨性Ⅱ类错(牙合)患者,对照组选择正常(牙合)15名,进行锥形束 CT 的拍摄,对前牙区牙槽骨各项数据进行对比分析;并将骨性Ⅱ类错(牙合)患者根据垂直骨面型的不同进行分组整理分析。结果:骨性Ⅱ类错(牙合)患者前牙区唇舌侧牙槽骨高度及厚度均低于对照组(P <0.05)。骨性Ⅱ类错(牙合)高角组患者前牙区唇舌侧牙槽骨高度、牙槽骨厚度均低于低角组(P <0.05)。结论:骨性Ⅱ类错(牙合)患者前牙区牙槽骨厚度尤其是切牙区牙槽骨厚度较低,高角组低于低角组。%Objective:To study the alveolar bone morphology in the anterior teeth area of the skeletal Class Ⅱ malocclusion subjects with different vertical skeletal types.Methods:64 patients with skeletal Class Ⅱ malocclusion and 15 subjects with normal occlusion were included.The alveolar bone structure of the anterior teeth were observed using CBCT.Results:The labial and lingual alveolar bone height and the alveolar bone thickness of the incisors of the patients were much lower than those of the normal controls.The height of labial and lingual alveolar bone and the alveolar bone thickness of anterior teeth in high-angle subgroup were lower than those in low-angle subgroup.Conclusion:The thickness of the anterior teeth alveolar bone of skeletal Class Ⅱ malocclusion is low,espe-cially in the high-angle group.

  12. [Large distal anterior cerebral artery aneurysm associated with azygos anterior cerebral artery: case report].

    Science.gov (United States)

    Suzuki, Y; Kawamata, T; Matsumoto, H; Kunii, N; Matsumoto, K

    1998-10-01

    A 51-year-old woman presented with a distal anterior cerebral artery aneurysm (DACAA) manifesting as severe headache and monoparesis of the left lower limb. Computed tomography revealed subarachnoid hemorrhage in the interhemispheric fissure, bilateral sylvian fissures, and basal cistern, and a hematoma in the supracallosal region. Angiography showed a large aneurysm (23 x 18 mm) located on the distal end of the azygos anterior cerebral artery (azygos ACA) at the supracallosal portion. T2-weighted magnetic resonance imaging demonstrated the hematoma as a mixed intensity mass, compressing the corpus callosum downward, and the aneurysm as a flow void anterior to the hematoma. Unilateral frontoparietal parasagittal craniotomy was performed with a horse-shoe shaped incision. The aneurysm was clipped via the interhemispheric approach, and the hematoma was aspirated. Postoperative angiography showed disappearance of the aneurysm and intact azygos ACA. The patient was discharged with mild monoparesis, paresthesia of the left lower limb and diagnostic dyspraxia. DACAA almost always arises at or near the genu of the corpus callosum and is often associated with vascular anomaly. In the literature, 22 of 26 cases of large and giant DACAA were located at or near the genu, but only 3 cases, including ours, in the supracallosal area. 11 cases were associated with azygos ACA. Therefore, hemodynamic stress caused by vascular anomaly may be involved in the formation of large or giant DACAA in contrast with cases of normal DACAA. PMID:9789300

  13. 38 CFR 3.379 - Anterior poliomyelitis.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Anterior poliomyelitis. 3... Specific Diseases § 3.379 Anterior poliomyelitis. If the first manifestations of acute anterior poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it...

  14. ATP economy of force maintenance in human tibialis anterior muscle

    DEFF Research Database (Denmark)

    Nakagawa, Yoshinao; Ratkevicius, Aivaras; Mizuno, Masao;

    2005-01-01

    -MRS). The total volume of ankle dorsiflexor muscles was assessed by H magnetic resonance imaging (MRI) (H-MRI), and the fiber type composition of the tibialis anterior muscle was evaluated using histochemical analysis of muscle biopsies. RESULTS: The tibialis anterior muscle occupied 59.7 +/- 0.6% (mean +/- SEM......) of the total ankle dorsiflexor muscle volume, which was 267 +/- 10 cm. Relative cross-sectional areas occupied by Type I, IIA, and IIB fibers in the tibialis anterior were 69.3 +/- 2.2, 27.4 +/- 2.76, and 3.2 +/- 1.0%, respectively. ATP economy of force maintenance did not change significantly during the 60-s...

  15. Epidermoid cyst in Anterior, Middle

    Directory of Open Access Journals (Sweden)

    Kankane Vivek Kumar

    2016-09-01

    Full Text Available Epidermoid cysts are benign slow growing more often extra-axial tumors that insinuate between brain structures, we present the clinical, imaging, and pathological findings in 35 years old female patients with atypical epidermoid cysts which was situated anterior, middle & posterior cranial fossa. NCCT head revealed hypodense lesion over right temporal and perisylvian region with extension in prepontine cistern with mass effect & midline shift and MRI findings revealed a non-enhancing heterogeneous signal intensity cystic lesion in right frontal & temporal region extending into prepontine cistern with restricted diffusion. Patient was detoriated in night of same day of admission, emergency Fronto-temporal craniotomy with anterior peterousectomy and subtotal resection was done. The histological examination confirms the epidermoid cyst. The timing of ectodermal tissue sequestration during fetal development may account for the occurrence of atypical epidermoid cysts.

  16. Spindle neurons of the human anterior cingulate cortex

    Science.gov (United States)

    Nimchinsky, E. A.; Vogt, B. A.; Morrison, J. H.; Hof, P. R.; Bloom, F. E. (Principal Investigator)

    1995-01-01

    The human anterior cingulate cortex is distinguished by the presence of an unusual cell type, a large spindle neuron in layer Vb. This cell has been noted numerous times in the historical literature but has not been studied with modern neuroanatomic techniques. For instance, details regarding the neuronal class to which these cells belong and regarding their precise distribution along both ventrodorsal and anteroposterior axes of the cingulate gyrus are still lacking. In the present study, morphological features and the anatomic distribution of this cell type were studied using computer-assisted mapping and immunocytochemical techniques. Spindle neurons are restricted to the subfields of the anterior cingulate cortex (Brodmann's area 24), exhibiting a greater density in anterior portions of this area than in posterior portions, and tapering off in the transition zone between anterior and posterior cingulate cortex. Furthermore, a majority of the spindle cells at any level is located in subarea 24b on the gyral surface. Immunocytochemical analysis revealed that the neurofilament protein triple was present in a large percentage of these neurons and that they did not contain calcium-binding proteins. Injections of the carbocyanine dye DiI into the cingulum bundle revealed that these cells are projection neurons. Finally, spindle cells were consistently affected in Alzheimer's disease cases, with an overall loss of about 60%. Taken together, these observations indicate that the spindle cells of the human cingulate cortex represent a morphological subpopulation of pyramidal neurons whose restricted distribution may be associated with functionally distinct areas.

  17. Anterior impingement syndrome in dancers

    OpenAIRE

    O’Kane, John William; Kadel, Nancy

    2007-01-01

    Anterior impingement is a common problem in dancers occurring primarily secondary to the repetitive forced ankle dorsiflexion inherent in ballet. Symptoms generally occur progressively and may respond to conservative treatment including addressing biomechanical faults that contribute to the problem. As impingement progresses, movements essential to ballet may become impossible and arthroscopic ankle surgery is often effective for both diagnosis and treatment, allowing athletes to return to da...

  18. 数字化快速成型种植导板在上前牙区种植的临床应用研究%Application of digital rapid process implant template in implant surgery of maxillary anterior teeth area

    Institute of Scientific and Technical Information of China (English)

    时光辉; 任春富; 杨中锐; 朱永翠; 翟蕾

    2013-01-01

    目的:评价数字化快速成型种植导板在上前牙区种植的临床应用效果。方法对2010年4月至2012年6月在河南大学第一附属医院口腔科就诊的6例上前牙缺失患者,拍摄螺旋CT及常规取超硬石膏模型,经过三维重建、模拟种植及数字化快速成型技术制作导板后,将该导板应用于手术中。术后再次拍摄螺旋CT并与术前的情况进行对比。结果6例患者均应用该导板完成手术,手术效果满意。患者术后反应轻微,植入后3~6个月均顺利完成冠部修复,美观效果良好。经过术前、术后CT结果对比,种植体颈部的偏移为(0.71±0.17)mm,根部的偏移为(0.85±0.19)mm。结论数字化快速成型种植导板应用于上前牙种植,具有明显的技术优势与广阔的应用前景。%Objective To evaluate the effect of the application of digital rapid process implant template in implant sur-gery of maxillary anterior teeth area. Methods Totally six patients with maxillary anterior teeth missing who need im-plant surgery were collected and the implant template was made by digital rapid process technology and was used in im-plant surgery. Then the deviations of the implant body were measured. Results The surgery process was satisfactory. Slight postoperative reaction was observed,and 3-6 months after implant crown repair was successfully completed. In CT image the deviation of the neck and apical of the implant body was(0.71±0.17)mm and(0.85±0.19)mm,respectively. Conclusion The digital rapid process implant template is a very effective method in implant surgery of maxillary anteri-or teeth area.

  19. MR imaging of anterior cruciate ligament tears

    Energy Technology Data Exchange (ETDEWEB)

    Takaki, Kazuhiro; Tomari, Kazuhide; Asao, Tsunenori [Shinbeppu Hospital, Oita (Japan)

    1995-09-01

    To investigate magnetic resonance (MR) imaging of anterior cruciate ligament (ACL) tears, the authors retrospectively reviewed 39 MR imaging examinations in 39 patients. We classified the MR imaging patterns of the torn ACL into four types. Torn ACL appears as a homogeneous iso-intensity mass on Type I images; as a continuous thin and waving low-intensity band with or without high-signal-intensity spots on the Type II images; as a disrupted band with a high-signal-intensity area on Type III images and as an absence of the ACL on Type IV images. We also report secondary lesions on MR imaging findings associated with tears of the ACL, posterior cruciate ligament index and bone bruising, in our patients. (author).

  20. MR imaging of anterior cruciate ligament tears

    International Nuclear Information System (INIS)

    To investigate magnetic resonance (MR) imaging of anterior cruciate ligament (ACL) tears, the authors retrospectively reviewed 39 MR imaging examinations in 39 patients. We classified the MR imaging patterns of the torn ACL into four types. Torn ACL appears as a homogeneous iso-intensity mass on Type I images; as a continuous thin and waving low-intensity band with or without high-signal-intensity spots on the Type II images; as a disrupted band with a high-signal-intensity area on Type III images and as an absence of the ACL on Type IV images. We also report secondary lesions on MR imaging findings associated with tears of the ACL, posterior cruciate ligament index and bone bruising, in our patients. (author)

  1. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

    Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.

  2. Positioning of anterior teeth in removable dentures

    Directory of Open Access Journals (Sweden)

    Strajnić Ljiljana

    2002-01-01

    Full Text Available Introduction The aim of this paper was to present methods of placement of artificial anterior teeth in edentulous individuals. The following review takes account of the majority of papers published during the last 100 years. The review has been divided into sections regarding the method used to determine the position of artificial anterior teeth. Geometric aspect Gysi (1895-1920 produced the first scientific theory about the position of artificial anterior teeth. Physiognomic theory The aim of this theory is to find the most natural position for artificial anterior teeth for each individual. Camper's "face angle" as a physiognomic criterion, has been introduced in papers of Wehrli (1961, Marxhors (1966, Tanzer (1968, Lombardi (1973. Esthetic aspect Important names in the field of dental esthetics are: Schön and Singer (1961, Arnheim (1965, Krajiček (1969, Tanzer (1968, Lombardi (1973, Goldstein (1976. They have introduced principles of visual aspects for selection of contours, dimension and position of artificial anterior teeth. Constitution aspect Flagg (1880, Williams (1913 and Hrauf (1957, 1958, have considered body constitution and individual characteristics regarding position of artificial anterior teeth. Physiological theory In 1971, Marxhors pointed to the fact that the position of artificial teeth corresponds with the function of the surrounding soft tissue and from the aspect of physiognomy as well. Phonetic aspect According to Silverman (1962 artificial anterior teeth are nearest when we pronounce the sound "S". Cephalometrical research Rayson (1970, Watson (1989, Strajnić Lj. (1999, Bassi F. (2001 have presented cephalometric radiographic analyses of natural anterior teeth compared with cephalometric radiographic analyses of artificial anterior teeth. A review of dental literature shows several factors suggesting modalities which should determine the position of artificial anterior teeth. Numerous methods have been designed for

  3. Pharyngocutaneous fistula after anterior cervical spine surgery

    OpenAIRE

    Sansur, Charles A.; Early, Stephen; Reibel, James; Arlet, Vincent

    2009-01-01

    Pharyngocutaneous fistulae are rare complications of anterior spine surgery occurring in less than 0.1% of all anterior surgery cases. We report a case of a 19 year old female who sustained a C6 burst fracture with complete quadriplegia. She was treated urgently with a C6 corpectomy with anterior cage and plating followed by posterior cervical stabilization at another institution. Post operatively she developed a pharyngocutaneous fistula that failed to heal despite several attempts of closu...

  4. Incidental Anterior Cruciate Ligament Calcification: Case Report.

    Science.gov (United States)

    Hayashi, Hisami; Fischer, Hans

    2016-03-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding.

  5. Perawatan Gigitan Terbalik Anterior Dengan Menggunakan Inclined Plane

    OpenAIRE

    Siregar, Wilda A.

    2008-01-01

    Gigitan terbalik anterior adalah suatu anomali posisi gigi anterior atas yang lebih ke lingual dibandingkan gigi anterior bawah. Anomali gigitan terbalik anterior dapat ditemui pada periode gigi sulung, gigi bercampur, dan gigi permanen. Faktor etiologi gigitan terbalik anterior dibedakan atas dental, fungsional atau skeletal. Untuk menentukan etiologi dari anomali gigitan terbalik anterior perlu dilakukan diagnosa yang tepat. Perawatan gigitan terbalik anterior ini dapat dilakukan de...

  6. Toxic Anterior Segment Syndrome (TASS

    Directory of Open Access Journals (Sweden)

    Özlem Öner

    2011-12-01

    Full Text Available Toxic anterior segment syndrome (TASS is a sterile intraocular inflammation caused by noninfectious substances, resulting in extensive toxic damage to the intraocular tissues. Possible etiologic factors of TASS include surgical trauma, bacterial endotoxin, intraocular solutions with inappropriate pH and osmolality, preservatives, denatured ophthalmic viscosurgical devices (OVD, inadequate sterilization, cleaning and rinsing of surgical devices, intraocular lenses, polishing and sterilizing compounds which are related to intraocular lenses. The characteristic signs and symptoms such as blurred vision, corneal edema, hypopyon and nonreactive pupil usually occur 24 hours after the cataract surgery. The differential diagnosis of TASS from infectious endophthalmitis is important. The main treatment for TASS formation is prevention. TASS is a cataract surgery complication that is more commonly seen nowadays. In this article, the possible underlying causes as well as treatment and prevention methods of TASS are summarized. (Turk J Oph thal mol 2011; 41: 407-13

  7. Mild toxic anterior segment syndrome mimicking delayed onset toxic anterior segment syndrome after cataract surgery

    Directory of Open Access Journals (Sweden)

    Su-Na Lee

    2014-01-01

    Full Text Available Toxic anterior segment syndrome (TASS is an acute sterile postoperative anterior segment inflammation that may occur after anterior segment surgery. I report herein a case that developed mild TASS in one eye after bilateral uneventful cataract surgery, which was masked during early postoperative period under steroid eye drop and mimicking delayed onset TASS after switching to weaker steroid eye drop.

  8. Anterior segment complications of retinal photocoagulation.

    Science.gov (United States)

    Kanski, J J

    1975-03-01

    Seven patients had anterior segment complications following xenon arc retinal photocoagulation. Irreversible keratopathy was induced in two cases; all patients showed evidence of iris injury. The absorption of radiation by the iris was considered the main factor in producing overheating of the anterior segment.

  9. Dentulous Appliance for Upper Anterior Edentulous Span

    OpenAIRE

    Chalakkal, Paul; Devi, Ramisetty Sabitha; Srinivas, G Vijay; Venkataramana, Pammi

    2013-01-01

    This article discusses about a fixed dentulous appliance that was constructed to replace the primary upper anterior edentulous span in a four year old girl. It constituted a design, whereby the maxillary primary second molars were used to support the appliance through bands and a wire that contained an acrylic flange bearing trimmed acrylic teeth, anteriorly. The appliance was functionally and aesthetically compliant.

  10. Totally thrombosed giant anterior communicating artery aneurysm

    Directory of Open Access Journals (Sweden)

    V R Roopesh Kumar

    2015-01-01

    Full Text Available Giant anterior communicating artery aneurysmsarerare. Apatient presented with visual dysfunction, gait ataxia and urinary incontinence. MRI showed a giant suprasellar mass.At surgery, the lesion was identified as being an aneurysm arising from the anterior communicating artery.The difficulty in preoperative diagnosis and relevant literature are reviewed.

  11. Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

    Science.gov (United States)

    Durban, Claire Marie C.; Kim, Je Kyun; Kim, Sae Hoon

    2016-01-01

    Background The aims of this study were to investigate the clinical characteristics of patients with combined anterior instability and superior labrum from anterior to posterior (SLAP) lesions, and to analyze the effect of concomitant SLAP repair on surgical outcomes. Methods We retrospectively reviewed patients who underwent arthroscopic stabilization for anterior shoulder instability between January 2004 and March 2013. A total of 120 patients were available for at least 1-year follow-up. Forty-four patients with reparable concomitant detached SLAP lesions (group I) underwent combined SLAP and anterior stabilization, and 76 patients without SLAP lesions (group II) underwent anterior stabilization alone. Patient characteristics, preoperative and postoperative pain scores, Rowe scores, and shoulder ranges of motion were compared between the 2 groups. Results Patients in group I had higher incidences of high-energy trauma (p = 0.03), worse preoperative pain visual analogue scale (VAS) (p = 0.02), and Rowe scores (p = 0.04). The postoperative pain VAS and Rowe scores improved equally in both groups without significant differences. Limitation in postoperative range of motion was similar between the groups (all p-value > 0.05). Conclusions Anterior instability with SLAP lesion may not be related to frequent episodes of dislocation but rather to a high-energy trauma. SLAP fixation with anterior stabilization procedures did not lead to poor functional outcomes if appropriate surgical techniques were followed. PMID:27247742

  12. Anterior spinal artery syndrome of the cervical hemicord.

    Science.gov (United States)

    Baumgartner, R W; Waespe, W

    1992-01-01

    Three patients developed signs of a unilateral cervical cord lesion 6 to 36 h after the acute onset of severe cervico-brachial pain. The neurological deficit progressed over 6 to 18 h. On the painful side a central Horner's syndrome, a hemiparesis with plegia of the hand, and a slight pallhypaesthesia were found. On the opposite side thermhypaesthesia and hypalgesia were noted with a level at the dermatome C5 or C6. T2-weighted MR images revealed in one patient a small area of increased signal intensity restricted to one half of the cervical cord, and electromyography in another patient showed after 6 months evidence of segmental chronic denervation. Both abnormalities were found at the clinically expected level. The findings are consistent with a small infarction of the cervical cord in the perfusion territory of a central (sulco-commissural) artery, a duplicated anterior spinal artery or an anterior spinal branch of the vertebral artery. PMID:1315578

  13. Anterior retropharyngeal approach to the cervical spine.

    OpenAIRE

    Behari S; Banerji D; Trivedi P; Jain V; Chhabra D

    2001-01-01

    The anterior retropharyngeal approach (ARPA) accesses anteriorly situated lesions from the clivus to C3, in patients with a short neck, Klippel Feil anomaly or those in whom the C2-3 and C3-4 disc spaces are situated higher in relation to the hyoid bone and the angle of mandible where it is difficult to approach this region using the conventional anterior approach, due to the superomedial obliquity of the trajectory. The ARPA avoids the potentially contaminated oropharyngeal cavity providing ...

  14. A direct anterior cingulate pathway to the primate primary olfactory cortex may control attention to olfaction

    Science.gov (United States)

    García-Cabezas, Miguel Á.; Barbas, Helen

    2016-01-01

    Behavioral and functional studies in humans suggest that attention plays a key role in activating the primary olfactory cortex through an unknown circuit mechanism. We report that a novel pathway from the anterior cingulate cortex, an area which has a key role in attention, projects directly to the primary olfactory cortex in rhesus monkeys, innervating mostly the anterior olfactory nucleus. Axons from the anterior cingulate cortex formed synapses mostly with spines of putative excitatory pyramidal neurons and with a small proportion of a neurochemical class of inhibitory neurons that are thought to have disinhibitory effect on excitatory neurons. This novel pathway from the anterior cingulate is poised to exert a powerful excitatory effect on the anterior olfactory nucleus, which is a critical hub for odorant processing via extensive bilateral connections with primary olfactory cortices and the olfactory bulb. Acting on the anterior olfactory nucleus, the anterior cingulate may activate the entire primary olfactory cortex to mediate the process of rapid attention to olfactory stimuli. PMID:23797208

  15. Quadriceps muscle contraction protects the anterior cruciate ligament during anterior tibial translation.

    Science.gov (United States)

    Aune, A K; Cawley, P W; Ekeland, A

    1997-01-01

    The proposed skiing injury mechanism that suggests a quadriceps muscle contraction can contribute to anterior cruciate ligament rupture was biomechanically investigated. The effect of quadriceps muscle force on a knee specimen loaded to anterior cruciate ligament failure during anterior tibial translation was studied in a human cadaveric model. In both knees from six donors, average age 41 years (range, 31 to 65), the joint capsule and ligaments, except the anterior cruciate ligament, were cut. The quadriceps tendon, patella, patellar tendon, and menisci were left intact. One knee from each pair was randomly selected to undergo destructive testing of the anterior cruciate ligament by anterior tibial translation at a displacement rate of 30 mm/sec with a simultaneously applied 889 N quadriceps muscle force. The knee flexion during testing was 30 degrees. As a control, the contralateral knee was loaded correspondingly, but only 5 N of quadriceps muscle force was applied. The ultimate load for the knee to anterior cruciate ligament failure when tested with 889 N quadriceps muscle force was 22% +/- 18% higher than that of knees tested with 5 N of force. The linear stiffness increased by 43% +/- 30%. These results did not support the speculation that a quadriceps muscle contraction contributes to anterior cruciate ligament failure. In this model, the quadriceps muscle force protected the anterior cruciate ligament from injury during anterior tibial translation.

  16. Care of children with anterior uveitis.

    Science.gov (United States)

    Kanski, J J

    1981-09-01

    The clinical features of 290 children with anterior uveitis are presented. The vast majority suffered from chronic uveitis. Specific uveitis entities in children include the syndrome of 'chronic iridocyclitis' in girls, heterochromic cyclitis, and pars planitis. Systemic associations include sarcoidosis, the Vogt-Harada-Koyanagi syndrome, and the seronegative arthritides (juvenile chronic arthritis, juvenile ankylosing spondylitis, psoriatic arthritis, and rarely Reiter's and Beçet's syndromes). Children with a pauciarticular onset of juvenile chronic arthritis, especially when combined with positive findings for antinuclear antibody, are at particular risk of developing chronic anterior uveitis. Most cases of chronic anterior uveitis can be controlled with topical corticosteroids. Those that are resistant to both topical and systemic corticosteroids may have to be treated with chlorambucil. The operation of lensectomy is a great advance in the management of complicated cataract. Secondary glaucoma is the most devastating complication of chronic anterior uveitis in children and responds poorly to therapy.

  17. Guideline on anterior cruciate ligament injury

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan); M.T. Poldervaart (Michelle T.); R.L. Diercks (Ron L.); A.W.F.M. Fievez (Alex W.F.M.); T.W. Patt (Thomas W.); C.P. van der Hart (Cor P.); E.R. Hammacher (Eric); F. van der Meer (Fred); E.A. Goedhart (Edwin A.); A.F. Lenssen (Anton F); S.B. Muller-Ploeger (Sabrina B); M.A. Pols (Margreet); D.B.F. Saris (Daniel)

    2012-01-01

    textabstractThe Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulate

  18. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available Anterior Cervical Discectomy and Fusion with Plating Broward Health Medical Center Fort Lauderdale, FL November 17, 2011 I'm Dr. Matthew Moore, head of the Spine Care Center here at North Broward Medical Center. And ...

  19. Erlotinib-related bilateral anterior uveitis

    Science.gov (United States)

    Ali, Kashif; Kumar, Indu; Usman-Saeed, Muniba; Usman Saeed, Muhammad

    2011-01-01

    The authors report the case of a 68-year-old woman with secondary adenocarcinoma of the lungs from an unknown primary. Erlotinib was started which produced symptoms suggestive of uveitis. Erlotinib was stopped and restarted a month later at a lower dose, which resulted in severe bilateral anterior uveitis. The uveitis settled after stopping erlotinib and treatment with topical steroids and cycloplegics. To the best of the authors’ knowledge, this is the first case of erlotinib-related anterior uveitis. PMID:22694887

  20. Can hyaluronan injections augment deficient papillae at implant-supported crowns in the anterior maxilla?

    DEFF Research Database (Denmark)

    Bertl, Kristina; Gotfredsen, Klaus; Jensen, Simon S;

    2016-01-01

    OBJECTIVES: The present randomized controlled trial aimed to assess the effect of hyaluronan (HY) injections to augment deficient interproximal papillae at implant-supported crowns in the anterior maxilla. METHODS: Twenty-two patients with a deficient papilla in the anterior maxilla next to an im......OBJECTIVES: The present randomized controlled trial aimed to assess the effect of hyaluronan (HY) injections to augment deficient interproximal papillae at implant-supported crowns in the anterior maxilla. METHODS: Twenty-two patients with a deficient papilla in the anterior maxilla next...... index score (MPIS), and standard clinical periodontal parameters. Pain level after injection was recorded on a visual analogue scale (VAS). The deficient area was evaluated on clinical photographs, and the esthetic appearance was recorded on a VAS. Differences in mucosal volume were assessed after 3...

  1. Anterior Eye Imaging with Optical Coherence Tomography

    Science.gov (United States)

    Huang, David; Li, Yan; Tang, Maolong

    The development of corneal and anterior segment optical coherence tomography (OCT) technology has advanced rapidly in recently years. The scan geometry and imaging wavelength are both important choices to make in designing anterior segment OCT systems. Rectangular scan geometry offers the least image distortion and is now used in most anterior OCT systems. The wavelength of OCT light source affects resolution and penetration. An optimal choice of the OCT imaging wavelength (840, 1,050, or 1,310 nm) depends on the application of interest. Newer generation Fourier-domain OCT technology can provide scan speed 100-1000 times faster than the time-domain technology. Various commercial anterior OCT systems are available on the market. A wide spectrum of diagnostic and surgical applications using anterior segment OCT had been investigated, including mapping of corneal and epithelial thicknesses, keratoconus screening, measuring corneal refractive power, corneal surgery planning and evaluation in LASIK, intracorneal ring implantation, assessment of angle closure glaucoma, anterior chamber biometry and intraocular lens implants, intraocular lens power calculation, and eye bank donor cornea screening.

  2. 下丘脑前核微量注射褪黑素及其受体拮抗剂对大鼠血压和心率的影响%Effects of microinjection of melatonin and its receptor antagonists into anterior hypothalamic area on blood pressure and heart rate in rats

    Institute of Scientific and Technical Information of China (English)

    丁超南; 曹银祥; 周莉; 朱大年; 沈仲元; 费民毅; 余平

    2001-01-01

    目的:研究下丘脑前核微量注射褪黑素及其受体拮 抗剂对正常血压和应激性高血压大鼠心血管活动的 影响.方法:微量注射褪黑素及其受体拮抗剂至下 丘脑前区前核,记录血压、平均动脉压和心率. 结果:微量注射褪黑素可降低平均动脉压,其竞争 性ML1受体拮抗剂luzindole可完全阻断褪黑素的降 压反应,而其ML2受体拮抗剂prazosin不能阻断褪 黑素的降压反应.结论:褪黑素为一种降压因子, 其降压反应主要通过激活ML1受体,而不是ML2受 体来介导的,下丘脑前核是褪黑素影响心血管活动 的重要中枢部位.%AIM: To examine the effects of microinjection of melatonin and its receptor antagonists into the anterior hypothalamic area (AHA) on blood pressure (BP) and heart rate (HR) in normotensive and stress-induced hypertensive rats. METHODS: Melatonin and its receptor antagonists were microinjected into the AHA, then BP, mean arterial pressure (MAP), and HR were synchronously recorded. RESULTS: Microinjection of melatonin produced a fall in MAP. Prazosin, an antagonist of melatonin ML2 receptor, could not antagonize the depressive response induced by melatonin. While luzindole, a competitive antagonist of melatonin ML1 receptor, was able to almost completely prevented the depressive response induced by injection of melatonin. CONCLUSION: Melatonin acts as a hypotensive factor and the effects are mainly due to activation of ML1 receptors in rat brain, and the AHA may be one of the important central areas where melatonin can exert modulatory effects on BP and HR.

  3. Palpation for muscular tenderness in the anterior chest wall

    DEFF Research Database (Denmark)

    Christensen, Henrik Wulff; Vach, Werner; Manniche, Claus;

    2003-01-01

    OBJECTIVE: To asses the interobserver and intraobserver reliability (in terms of day-to-day and hour-to-hour reliability) of palpation for muscular tenderness in the anterior chest wall. DESIGN: A repeated measures designs was used. SETTING: Department of Nuclear Medicine, Odense University...... Hospital, Denmark. PARTICIPANTS: Two experienced chiropractors examined 29 patients and 27 subjects in the interobserver part, and 1 of the 2 chiropractors examined 14 patients and 15 subjects in the intraobserver studies. INTERVENTION: Palpation for muscular tenderness was done in 14 predetermined areas...

  4. Beyond the peak of the anterior glenoid rim: A cadaveric study

    Directory of Open Access Journals (Sweden)

    Guillaume D Dumont

    2013-01-01

    Full Text Available Purpose: The purpose of this study was to quantify the width of bone beyond the peak of the anterior glenoid rim and to determine if this anatomic region of the glenoid significantly affects measurement of the anteroposterior glenoid diameter. Materials and Methods: 19 cadaveric scapulae were examined and the width of bone beyond the peak of the anterior glenoid rim was measured. The percent width of this region relative to the anteroposterior diameter of the glenoid was evaluated. Male and female specimens were compared. Measurements of the anteroposterior diameter of the glenoid, both including and excluding this region, were compared. Results: The mean width of bone beyond the peak of the anterior glenoid rim was 3.2 ± 0.7 mm, corresponding to 10.5% of the anteroposterior glenoid diameter. This anatomic region is of similar relative size in males and females (11% vs 10% of the glenoid diameter. Measurement of the anteroposterior diameter of the glenoid is significantly different depending on whether this region is included or not ( P = 0.0064. Conclusions: There exists a portion of the anterior glenoid that is beyond the peak of the anterior rim, and is not part of the concave articular surface. The width of this anatomic area comprises a significant percent of the anteroposterior glenoid diameter, and should be understood when quantifying and describing anterior glenoid bone loss in cases of glenohumeral instability. Clinical Relevance: Understanding of anterior glenoid anatomy is important in the evaluation of glenohumeral instability. The portion of glenoid bone beyond the anterior rim peak is likely important for its soft tissue attachments, but its contribution to bony stability may be misunderstood.

  5. Esthetic crown lengthening for maxillary anterior teeth.

    Science.gov (United States)

    Sonick, M

    1997-08-01

    In the maxillary anterior region, the gingival labial margin position is an important parameter in the achievement of an ideal smile. The relationship between the periodontium and the restoration is critical if gingival health and esthetics are to be achieved. Periodontal therapy is a necessary and useful adjunct when any anterior restoration is undertaken. Anterior surgical crown lengthening may be undertaken to avoid restorative margin impingement on the biologic width. Crown lengthening is also used to alter the gingival labial profiles. This article discusses the esthetic parameters of ideal gingival labial positions and presents a classification of crown-lengthening procedures and the procedure for a two-stage crown-lengthening technique. The two-stage crown-lengthening technique is surgically precise because healing is predictable.

  6. Nonnecrotizing anterior scleritis mimicking orbital inflammatory disease

    Directory of Open Access Journals (Sweden)

    Lynch MC

    2013-08-01

    Full Text Available Michelle Chen Lynch,1 Andrew B Mick21Optometry Clinic, Ocala West Veterans Affairs Specialty Clinic, Ocala, FL, USA; 2Eye Clinic, San Francisco VA Medical Center, San Francisco, CA, USABackground: Anterior scleritis is an uncommon form of ocular inflammation, often associated with coexisting autoimmune disease. With early recognition and aggressive systemic therapy, prognosis for resolution is good. The diagnosis of underlying autoimmune disease involves a multidisciplinary approach.Case report: A 42-year-old African American female presented to the Eye Clinic at the San Francisco Veteran Affairs Medical Center, with a tremendously painful left eye, worse on eye movement, with marked injection of conjunctiva. There was mild swelling of the upper eyelid. Visual acuity was unaffected, but there was a mild red cap desaturation. The posterior segment was unremarkable. The initial differential diagnoses included anterior scleritis and orbital inflammatory disease. Oral steroid treatment was initiated with rapid resolution over a few days. Orbital imaging was unremarkable, and extensive laboratory work-up was positive only for antinuclear antibodies. The patient was diagnosed with idiopathic diffuse, nonnecrotizing anterior scleritis and has been followed for over 5 years without recurrence. The rheumatology clinic monitors the patient closely, as suspicion remains for potential arthralgias including human leukocyte antigen-B27-associated arthritis, lupus-associated arthritis, seronegative rheumatoid arthritis, recurrent juvenile idiopathic arthritis, and scleroderma, based on her constitutional symptoms and clinical presentation, along with a positive anti-nuclear antibody lab result.Conclusion: Untreated anterior scleritis can progress to formation of cataracts, glaucoma, uveitis, corneal melting, and posterior segment disease with significant risk of vision loss. Patients with anterior scleritis must be aggressively treated with systemic anti

  7. Dual (type IV left anterior descending artery

    Directory of Open Access Journals (Sweden)

    Ozdil Baskan

    2013-11-01

    Full Text Available Congenital coronary artery anomalies are uncommon. Dual left anterior descending coronary artery (LAD is defined as the presence of two LADs within the anterior interventricular sulcus (AIVS, and is classified into four types. Type IV is a rarely reported subtype and differs from the others, with a long LAD originating from the right coronary artery (RCA. Dual LAD is a benign coronary artery anomaly, but should be recognised especially before interventional procedures. With the increasing use of multidedector computed tomography (MDCT, it is essential for radiologists to be aware of this entity and the cross-sectional findings.

  8. ANTERIOR OSTEOPHYTE IDENTIFICATION IN CERVICAL VERTEBRAE

    Directory of Open Access Journals (Sweden)

    A. T. Chougale

    2011-06-01

    Full Text Available Radiologist always examines X-ray to determine abnormal changes in cervical, lumbar & thoracic vertebrae. Osteophyte (bony growth may appear at the corners of vertebrae so that vertebral shape becomes abnormal. This paper presents the idea from Image processing techniques such as customised Hough transform which will be used for segmentation which should be independent of rotation, scale, noise & shape. This segmented image will be then used for computing size invariant, convex hull based features to differentiate normal cervical vertebrae from cervical vertebrae containing anterior osteophyte. This approach effectively finds anterior osteophytes in cervical vertebrae.

  9. Anatomia microcirúgica da substâcia perfurada anterior basal humana Microsurgical anatomy of the human basal anterior perforated substance

    Directory of Open Access Journals (Sweden)

    Arlindo Alfredo Silveira D’Ávila

    2006-06-01

    Full Text Available A substância perfurada anterior constitui referencial na base do encéfalo. Localizada acima da bifurcação subaracnóidea da artéria carótida interna em sua porção basal e junto à artéria comunicante anterior na face inter-hemisférica, é transfixada por ramos perfurantes dirigidos aos núcleos telencefálicos corticais, cápsula interna e parte do tálamo. Por injeção intravascular de gelatina carminada, resina de Batson e látex, analisamos 50 hemisférios cerebrais humanos adultos de ambos os sexos, sob o microscópio cirúrgico. Objetivamos contribuir para a determinação da origem, número e topografia dos ramos destinados a essa região, seu curso, anastomoses e territórios de penetração. Propusemo-nos também a analisar a contribuição da artéria comunicante anterior à substância perfurada anterior. Foram encontradas variações anatômicas, incluindo anastomoses, envolvendo principalmente a artéria cerebral média e a artéria coróidea anterior. Estes conhecimentos são de interesse clínico-cirúrgico em razão da freqüência de patologias vasculares e tumorais a ela relacionadas.The anterior perforated substance (APS is a landmark in the basal forebrain. It has a basal face located above the carotid bifurcation in the subarachnoid space, and an interhemispheric one. It is the site of passage of the arteries to the caudate nucleus, putamen, internal capsule, adjacent areas of the globus pallidus and thalamus. Fifty hemispheres from twenty-five adult cadavers were obtained. The arteries were perfused with colored latex, Batson’s resin and gelatin colored with carmine. Using a surgical microscope we have determined the origin, local and number of origin from the parent vessel. The sites of penetration in the mediolateral and anteroposterior direction were also recorded. The anterior communicating artery contribution to the basal APS was reviewed. Significant vascular variations and anastomoses were encountered

  10. Perawatan Ortodontik Gigi Anterior Berjejal dengan Tulang Alveolar yang Tipis

    Directory of Open Access Journals (Sweden)

    Miesje K. Purwanegara

    2015-09-01

    Full Text Available Anterior teeth movement in orthodontic treatment is limited to labiolingual direction by very thin alveolar bone. An uncontrolled anterior tooth movement to labiolingual direction can cause alveolar bone perforation at its root segment. This case report is to remind us that alveolar bone thickness limits orthodontc tooth movement. A case of crowded anterior teeth with thin alveolar bone in malocclusion I is reported. This case is treated using adgewise orthodontic appliance. Protraction of anterior teeth is anticipated due to thin alveolar bone on the anterior surface. The conclusion is although the alveolar bone surrounding the crowded anterior teeth is thin, by controlling the movement the teeth reposition is allowed.

  11. ANTERIOR COLUMN FRACTURES OF THE ACETABULUM

    NARCIS (Netherlands)

    HEEG, M; OTTER, N; KLASEN, HJ

    1992-01-01

    We retrospectively reviewed 20 patients at three to 19 years after displaced anterior fracture-dislocations of the hip. Eighteen of them were treated by traction, after ensuring that the femoral head was adequately reduced beneath the undisrupted part of the weight-bearing dome. Two required operati

  12. Anterior retropharyngeal approach to the cervical spine.

    Directory of Open Access Journals (Sweden)

    Behari S

    2001-10-01

    Full Text Available The anterior retropharyngeal approach (ARPA accesses anteriorly situated lesions from the clivus to C3, in patients with a short neck, Klippel Feil anomaly or those in whom the C2-3 and C3-4 disc spaces are situated higher in relation to the hyoid bone and the angle of mandible where it is difficult to approach this region using the conventional anterior approach, due to the superomedial obliquity of the trajectory. The ARPA avoids the potentially contaminated oropharyngeal cavity providing for a simultaneous arthrodesis and instrumentation during the primary surgical procedure. Experience of five patients with high cervical extradural compression, who underwent surgery using this approach between 1994 and 1999, is presented. The surgical procedures included excision of ossified posterior longitudinal ligament (n=2; excision of prolapsed disc and osteophytes (n=2; and excision of a vertebral body neoplasm (n=1. Following the procedure, vertebral arthrodesis was achieved using an iliac graft in all the patients. Only one patient with vertebral body neoplasm required an additional anterior cervical plating procedure for stabilisation the construct. The complications included transient respiratory insufficiency and neurological deterioration in two patients; and, pharyngeal fistula and donor site infection in one patient.

  13. Anterior process fractures of the calcaneus

    Energy Technology Data Exchange (ETDEWEB)

    Renfrew, D.L.; El-Khoury, G.Y.

    1985-07-01

    Fractures of the anterior process of the calcaneus are often missed. This error follows from the tendency to focus exclusively on the mortise and malleoli when a history of ankle trauma is supplied. Seven patients with this fracture are presented. The anatomy, mechanism of injury, clinical presentation, and the radiographic features of this injury are discussed.

  14. Anorgasmia in anterior spinal cord syndrome.

    OpenAIRE

    Berić, A; Light, J K

    1993-01-01

    Three male and two female patients with anorgasmia and dissociated sensory loss due to an anterior spinal cord syndrome are described. Clinical, neurophysiological and quantitative sensory evaluation revealed preservation of the large fibre dorsal column functions from the lumbosacral segments with concomitant severe dysfunction or absence of the small fibre neospinothalamic mediated functions. These findings indicate a role for the spinothalamic system in orgasm.

  15. Causes of anterior cruciate ligament injuries

    Directory of Open Access Journals (Sweden)

    Ristić Vladimir

    2010-01-01

    Full Text Available In order to prevent anterior cruciate ligament injuries it is necessary to define risk factors and to analyze the most frequent causes of injuries - that being the aim of this study. The study sample consisted of 451 surgically treated patients, including 400 sportsmen (65% of them being active and 35% recreational sportsmen, 29% female and 71% male; of whom 90% were younger than 35. Sports injuries, as the most frequent cause of anterior cruciate ligament injuries, were recorded in 88% of patients (non-contact ones in 78% and contact ones in 22%, injuries occurring in everyday activities in 11% and in traffic in 1%. Among sportsmen, reconstruction of the anterior cruciate ligament was most frequently performed in football players (48%, then in handball players (22%, basketball players (13%, volleyball players (8%, martial arts fighters (4%. However, the injury incidence was the highest among the active basketball players (1 injured among 91 active players. Type of footwear, warming up before the activity, genetic predisposition and everyday therapy did not have a significant influence on getting injured. Anterior cruciate ligament injuries happened three times more often during matches, in the middle and at the end of a match and training session (79%, at landing after the jump or when changing direction of movement (75% without a contact with other competitors, on dry surfaces (79%, among not so well prepared sportsmen.

  16. Anterior Chamber Live Loa loa: Case Report.

    Science.gov (United States)

    Kagmeni, G; Cheuteu, R; Bilong, Y; Wiedemann, P

    2016-01-01

    We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis. PMID:27441005

  17. Anterior Chamber Live Loa loa: Case Report

    Science.gov (United States)

    Kagmeni, G.; Cheuteu, R.; Bilong, Y.; Wiedemann, P.

    2016-01-01

    We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis. PMID:27441005

  18. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

    Frobell, Richard B; Roos, Harald P; Roos, Ewa M;

    2013-01-01

    To compare, in young active adults with an acute anterior cruciate ligament (ACL) tear, the mid-term (five year) patient reported and radiographic outcomes between those treated with rehabilitation plus early ACL reconstruction and those treated with rehabilitation and optional delayed ACL...

  19. Tunnel widening in anterior cruciate ligament reconstruction

    DEFF Research Database (Denmark)

    Clatworthy, M G; Annear, P; Bulow, J U;

    1999-01-01

    We report a prospective series evaluating the incidence and degree of tunnel widening in a well-matched series of patients receiving a hamstring or patella tendon graft for anterior cruciate ligament (ACL) deficiency. We correlated tunnel widening with clinical factors, knee scores, KT-1000...

  20. Guideline on anterior cruciate ligament injury

    NARCIS (Netherlands)

    Meuffels, Duncan E; Poldervaart, Michelle T; Diercks, Ronald; Fievez, Alex W F M; Patt, Thomas W; Hart, Cor P van der; Hammacher, Eric R; Meer, Fred van der; Goedhart, Edwin A; Lenssen, Anton F; Muller-Ploeger, Sabrina B; Pols, Margreet A; Saris, Daniel B F

    2012-01-01

    The Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steer

  1. Novel Insights into Anterior Cruciate Ligament Injury

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan)

    2011-01-01

    textabstractAnterior cruciate ligament (ACL) injury is one of the most common sports injuries of the knee. ACL reconstruction has become, standard orthopaedic practice worldwide with an estimated 175,000 reconstructions per year in the United States.6 The ACL remains the most frequently studied liga

  2. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

    Frobell, Richard B; Roos, Harald P; Roos, Ewa M;

    2015-01-01

    STUDY QUESTION: In young active adults with an acute anterior cruciate ligament (ACL) rupture, do patient reported or radiographic outcomes after five years differ between those treated with rehabilitation plus early ACL reconstruction and those treated with rehabilitation and optional delayed ACL...

  3. 牙龈软组织自我修复与拔牙创软组织愈合在前牙美学区软组织愈合中的比较%The comparison between the self-repair of gingival tissue and tooth extraction wound of soft tissue healing in the zone of soft tissue anterior aesthetic area healing

    Institute of Scientific and Technical Information of China (English)

    黄伟; 张志宏; 刘红红; 鲍军燕; 翁海燕; 韩倩

    2015-01-01

    Objective To observe the difference between the self-repair of gingival tissue in retained dental root and the soft tissue healing after tooth extraction in the area of the anterior teeth of the canines. Methods Residual roots models were made in the three dogs' maxillary anterior teeth areas ( right maxillary lateral incisor and left max-illary central incisor) . Moreover, the three dogs' left mandibular lateral incisors were extracted. Then, the degrees of growth under the two different gingiva healing conditions were observed in the 1st, 3rd, 4th and 5th week after surgery. Besides, the gingival hyperplasia tissue in the left maxillary central incisor and soft tissue hyperplasia in the left mandibular lateral incisor tooth were obtained at 3rd, 4th and 5th week after surgery respectively for histo-logical observation. Results We found that the new soft tissue around residual root was overgrown on cross-section in the 4th week after surgery by the unaided eye, and the texture and color of the new soft tissue in the 5th week af-ter surgery was similar to that of the normal gingiva. Meanwhile, soft tissue which was harder in texture and lighter in color compared with the normal gingiva was fully covered on wound 3 weeks after tooth extractions. Histological observation found that the new born soft tissue hyperplasia around the residual roots mainly was squamous cell hy-perplasia, and the inflammatory cells infiltration was not obvious. On the contrary, histological observation on the soft tissue around the tooth extraction wound demonstrated obvious inflammatory cells infiltration and mild squamous cell hyperplasia. Conclusion The hyperplasia and healing of gingival tissue in reserving residual roots are slower than those in soft tissue after extracting a tooth, but it is more similar to the normal gingiva.%目的:观察残根保留情况下牙龈软组织的自我修复与拔牙后软组织愈合在犬前牙区软组织愈合中的不同。方法在A、B、C3

  4. 上颌前牙区不翻瓣即刻牙种植术对患者口腔内软硬组织的影响分析%Analysis of Maxillary Anterior Teeth Area Flapless Dental Implants Immediately to Soft and Sclerous Tissue in the Mouth

    Institute of Scientific and Technical Information of China (English)

    刘伟林

    2015-01-01

    Objective:To study maxillary anterior teeth area flapless dental implants immediately to soft and sclerous tissue in the mouth .Method:From Mar.2010 to Mar.2013 in our hospital with surgery treat-ment of front teeth or premoLar repair patients 100 cases as the research object .In digital method of 50 cases was randomly divided into observation group and control group of 50 cases.The control group was treated with flap of immediate implant surgery , while the observation group was treated with flapless dental implants im-mediately surgery , statistics and compared two groups of postoperative overall situation , sclerous and soft tis-sue following surgery , and PES grading and VAS score before and after the treatment .Result:The postoper-ative pain and swelling of 1 day ratio in observation group were significantly lower than the control group , and 12 months after gingival papilla index proportion was significantly higher than the control group , differences were statistically significant (all P 0.05) .Observation group of 12 months after the operation of the crest of absorption value was significantly less than the control group;the difference was statistically significant ( P 0.05) .PES rating of the two groups after treatment , and VAS scores were raising before the treatment , but the rising degree of observation group was significantly higher than the control group, the difference was statistically significant (P <0.05).Conclusion: Maxillary anterior teeth area flapless dental implants immediately , curative effect is better , which has more aesthetic feeling , is worth promoting .%目的:研究分析上颌前牙区不翻瓣即刻牙种植术对患者口腔内软硬组织的影响。方法:选择2010年3月至2013年3月在我院接受手术治疗的前牙或者前磨牙修复患者100例作为研究对象。以数字法随机分成观察组50例以及对照组50例。对照组实施翻瓣的即刻牙种植手术,观察组则实施不翻瓣的即刻牙

  5. Anterior labral tear: diagnostic value of MR arthrography of the shoulder

    International Nuclear Information System (INIS)

    To assess the accuracy of magnetic resonance(MR) arthrography in the diagnosis of anterior labral tear of the shoulder Between september 1996 and February 2000, MR arthrography of the shoulder was performed in 281 patients with a history of shoulder pain or instability. Among this total, only 157 shoulders in 154 patients who underwent arthroscopy or open surgery 0 to 230 (average, 20.9) days after MR arthrography were included in this study; the subjects comprised of 150 males and 4 females with an average age of 23.3 years. MR arthrographs of these 154 patients were analyzed for the presence of anterior labral tears, and the findings were correlated with the arthroscopic and surgical findings. Anterior labral tear was classified as A to D according to its location, as determined by arthroscopy and surgery. (A=4 to 6 o'clock direction, anteroinferior; B=2 to 4 o'clock direction, central; C=12 to 2 o'clock direction, anterosuperior; D= SLAP lesion). The retrospective analysis of MR arthrographs showing false-positive and negative findings was also underthken.. In the diagnosis of anterior labral tear, MR arthrography showed a sensitivity of 94%, a specificity of 90% and an accuracy of 91%. Anterior labral tears were confirmed by arthroscopy or surgery in 62 of the 157 shoulders (39%). Among 62 lesion, two (3%) were observed in area A, 32(52%) in area A+B, nine (15%) in area A+B+C, one(2%) in area A+B+D,13(21%) in area A+B+C+D, two (3%) in area B+C, one(2%) in area B+D, and two(3%) in area C. Among ten false-positive cases, seven were focal lessions (two, three and two lesions in area A, B and C, respectively), and in the remaining three cases, lacated in area A+B, MR arthrography revealed thickening and deformation. All four false negatives were focal lesions (two in area A and two in area C). Other than in focal lesions, in which accuracy was relatively low, MR arthrography showed high sensitivity, specificity and accuracy in the diagnosis of anterior labral tear

  6. Is cone-beam computed tomography diagnostic for anterior Stafne bone cyst: Report of a rare case

    Directory of Open Access Journals (Sweden)

    Abbas Shokri

    2015-01-01

    Full Text Available Introduction: The incidence of anterior Stafne bone cyst (lingual mandibular bone defect, static bone cyst, latent bone cyst, developmental submandibular gland defect of the mandible has been estimated to between 0.009% and 0.3%. It is characterized by a round or ovoid, well-defined border, unilocular radiolucency. Most of anterior Stafne bone defects were located between the cuspid and the first molar, but a few cases have been reported in the incisor area. Case Report: We present a 48-year-old man with anterior Stafne bone defect in the incisor area diagnosed by using cone-beam computed tomography (CBCT. Discussion: CBCT can be a confirmatory imaging technique to detect anterior mandibular bony configurations such as Stafne bone cavity with the lingual cortical plate being spared.

  7. Transient superficial peroneal nerve palsy after anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Majed Alrowaili

    2016-06-01

    Full Text Available A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status.

  8. Transient Superficial Peroneal Nerve Palsy After Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Alrowaili, Majed

    2016-04-26

    A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status.

  9. Transient Superficial Peroneal Nerve Palsy After Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    2016-01-01

    A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status. PMID:27478579

  10. Inferior Frontal Gyrus Activity Triggers Anterior Insula Response to Emotional Facial Expressions

    NARCIS (Netherlands)

    Jabbi, Mbemba; Keysers, Christian

    2008-01-01

    The observation of movies of facial expressions of others has been shown to recruit similar areas involved in experiencing one's own emotions: the inferior frontal gyrus (IFG). the anterior insula and adjacent frontal operculum (IFO). The Causal link bet between activity in these 2 regions, associat

  11. Automated detection of inflammatory cells in whole anterior chamber of a uveitis mouse from swept-source optical coherence tomography images

    Science.gov (United States)

    Choi, Woo June; Pepple, Kathryn L.; Wang, Ruikang K.

    2016-03-01

    Cell grading in a rodent anterior chamber is essential for anterior inflammation evaluation in preclinical vision research. This paper describes a computerized method for detection and counting of the anterior chamber cells from swept-source optical coherence tomography (SS-OCT) images of a experimental rodent model of uveitis. The volumetric anterior segment OCT data is obtained from 100 kHz SS-OCT imaging of mouse eye in vivo. For the OCT cross-sections, each OCT structural image is de-speckled and binarized. After removal of cornea, iris, and crystalline lens structures connected to the binary image border, an area thresholding is then employed for each labeled region to isolate only celllike objects in the anterior chamber, followed by roundness estimation of the objects to identify potential cell candidates in the data. Eventually, the cell candidates are counted and graded as total number of cells in the anterior chamber.

  12. Anterior ethmoidal artery emerging anterior to bulla ethmoidalis: An abnormal anatomical variation in Waardenburg's syndrome

    OpenAIRE

    Wong, Danny K. C.; Shao, Angus; Campbell, Raewyn; Douglas, Richard

    2014-01-01

    In endoscopic sinus surgery, the anterior ethmoidal artery (AEA) is usually identified as it traverses obliquely across the fovea ethmoidalis, posterior to the bulla ethmoidalis and anterior to or within the ground lamella's attachment to the skull base. Injury to the AEA may result in hemorrhage, retraction of the AEA into the orbit, and a retrobulbar hematoma. The resulting increase in intraorbital pressure may threaten vision. Waardenburg's syndrome (WS) is a rare congenital, autosomal dom...

  13. Differing Connectivity of Exner's Area for Numbers and Letters.

    Science.gov (United States)

    Klein, Elise; Willmes, Klaus; Jung, Stefanie; Huber, Stefan; Braga, Lucia W; Moeller, Korbinian

    2016-01-01

    There is a growing body of evidence indicating a crucial role of Exner's area in (hand-) writing symbolic codes such as letters and words. However, a recent study reported a patient with a lesion affecting Broca's and Exner's area, who suffered from severe peripheral agraphia for letters but not for Arabic digits. The authors suggested a speculative account postulating differential connectivity of Exner's area for numbers and letters in order to explain this dissociation. In the present study, we evaluated this account, employing atlas-based tractography for the patient's anatomy, deterministic fiber-tracking as well as an automated toolkit to investigate the connectivity of Exner's area in healthy adults. In particular, fiber pathways connecting Exner's area with areas associated with language processing (e.g., the arcuate fascicle, ventral pathways encompassing the external/extreme capsule system) reached the inferior part of Exner's area, while fronto-parietal fibers (e.g., the superior longitudinal fascicle) connected the upper part of Exner's area with the intraparietal sulcus typically involved in number processing. Our results substantiated the differential connectivity account for Exner's area by identifying the neural connections between fiber tracts and cortex areas of interest. Our data strongly suggest that white matter connectivity should be taken into account when investigating the neural underpinnings of impaired and intact human cognition. PMID:27378882

  14. Chordal geometry determines the shape and extent of systolic anterior mitral motion: in vitro studies.

    Science.gov (United States)

    Cape, E G; Simons, D; Jimoh, A; Weyman, A E; Yoganathan, A P; Levine, R A

    1989-05-01

    In patients with hypertrophic cardiomyopathy, the mitral valve moves anteriorly and assumes a unique shape, with mitral-septal contact centrally and preserved valve orifice area laterally. This shape is not clearly predicted by the Venturi mechanism, which stresses flow above the valve as opposed to changes intrinsic to the valve. On the other hand, it has been suggested that displacement of the papillary muscles anteriorly and toward one another, as observed in this disease, can promote anterior mitral valve motion and produce this unusual shape. The purpose of this in vitro study was to test the hypotheses that anterior motion of a membrane in a flow field can be generated by altering the distribution or effectiveness of chordal tension tethering the membrane, and that the shape achieved by this membrane depends on the geometry of chordal tension. Accordingly, a horizontal leaflet mounted in a flow chamber was attached by chords at its distal end to a series of upstream screws. Chordal tension could be varied by turning the screws or redirected by shifting the screws anteriorly. Anterior leaflet motion having the same unusual configuration seen in patients was reproduced by decreasing central chordal restraint while tension on the leaflet edges was maintained. Directing chordal tension anteriorly caused greater degrees of anterior motion at earlier stages in the release of chordal restraint; increased flow rate had a similar but less marked effect. These studies suggest that primary geometric alterations in the papillary-mitral apparatus can play an important role in determining the presence and geometry of systolic anterior mitral motion. The nature of these alterations suggests a role for anterior and inward papillary muscle displacement in promoting such motion. The geometric factors embodied in this model can explain many observed features of this motion not adequately explained by the Venturi effect, such as early systolic onset and the importance of a

  15. Provisional anterior tooth replacement using nonimpregnated fiber and fiber-reinforced composite resin materials: a clinical report.

    Science.gov (United States)

    Chan, Daniel C N; Giannini, Marcelo; De Goes, Mario Fernando

    2006-05-01

    The loss of anterior teeth is often a serious esthetic concern. While conventional fixed partial dentures and implant-supported restorations may be the treatments of choice, nonimpregnated fibers (NFs) and fiber-reinforced composite (FRC) resins offer a conservative alternative for improving esthetics. This article describes 2 clinical situations in which NF glass ribbon and FRC were successfully used to provisionally restore anterior edentulous areas in an esthetic, functional, and timely manner.

  16. Resin-Bonded Fiber-Reinforced Composite for Direct Replacement of Missing Anterior Teeth: A Clinical Report

    Directory of Open Access Journals (Sweden)

    Sufyan Garoushi

    2011-01-01

    Full Text Available Missing anterior teeth is of serious concern in the social life of a patient in most of societies. While conventional fixed partial dentures and implant-supported restorations may often be the treatment of choice, fiber-reinforced composite (FRC resins offer a conservative, fast, and cost-effective alternative for single and multiple teeth replacement. This paper presents two cases where FRC technology was successfully used to restore anterior edentulous areas in terms of esthetic values and functionality.

  17. Transverse cervical skin incision and vertical platysma splitting approach for anterior cervical vertebral column exposure

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2014-03-01

    Full Text Available Anterior surgical approaches provide direct access to symptomatic areas of the cervical spine, allow management of the vast spectrum of cervical spine pathologies and there are many articles in the literature that discussed these techniques in detail. Cosmesis is an important issue for patients who undergone surgeryon neck structures as an improperly placed incision attracting significant morbidity and few publications discuss this issue in details. The purpose of the present article is to describe our experience with transverse cervical skin incision and vertical platysma splitting approach for anterior cervical vertebral column exposure.

  18. Anterior capsule tear after laser iridotomy complicating phacoemulsification

    OpenAIRE

    Vivien Cherng Hui, Yip; Sanjay, Srinivasan; Benjamin Chong-Ming, Chang

    2011-01-01

    A 70-year-old Indian lady had a history of bilateral laser peripheral iridotomy (LPI) for primary angle closure. Subsequently she developed cataract in both the eyes. Right eye cataract surgery was complicated by an anterior capsule rupture, which was discovered intra-operatively at the site of the LPI. Trypan blue was used to stain the anterior capsule to delineate the anterior capsule defect. An attempt at continuous curvilinear capsulorhexis was unsuccessful, and the anterior capsulotomy w...

  19. Surgical treatment of anterior cruciate ligament injury in adults.

    Science.gov (United States)

    Alazzawi, Sulaiman; Sukeik, Mohamed; Ibrahim, Mazin; Haddad, Fares S

    2016-04-01

    Anterior cruciate ligament injury is among the most common soft tissue injuries of the knee joint and reconstruction of the anterior cruciate ligament is the gold standard treatment for young active symptomatic patients. This review summarizes the surgical treatment of anterior cruciate ligament injury.

  20. Uveítes anteriores associadas a doenças sistêmicas Anterior uveitis associated to systemic diseases

    Directory of Open Access Journals (Sweden)

    Maria Angélica Pavão Dimantas

    2003-01-01

    Full Text Available As uveítes anteriores são caracterizadas pela inflamação preponderante do segmento anterior do olho. Hiperemia conjuntival, reação de câmara anterior com células e "flare", precipitados ceráticos e sinéquias posteriores são sinais que compõem o quadro inflamatório. Aspectos clínicos de algumas doenças sistêmicas envolvidas na etiologia das uveítes anteriores serão abordados neste artigo.Anterior uveitis describes a disease predominantly limited to the anterior segment of the eye. Conjunctival hyperemia, anterior chamber cell and flare, keratic precipitates, and iris abnormalities including posterior synechiae characterize the inflammation. This article discusses clinical aspects of the systemic diseases that cause anterior uveitis with review of the literature.

  1. Mini-implantes ortodônticos como auxiliares da fase de retração anterior Orthodontic mini-implants assisting the anterior retraction phase

    Directory of Open Access Journals (Sweden)

    Carlo Marassi

    2008-10-01

    Full Text Available INTRODUÇÃO: os mini-implantes ortodônticos se estabeleceram como um importante método de ancoragem e vêm auxiliando os ortodontistas nas várias etapas do tratamento ortodôntico, eliminando, em grande parte, a necessidade de colaboração dos pacientes e tornando os resultados mais previsíveis. OBJETIVO: este artigo descreve os principais aspectos do uso dos mini-implantes como auxiliares da fase de retração anterior, trazendo considerações sobre suas indicações, quantidade de movimentação dos dentes anteriores, os vetores de força de retração, o controle vertical, o posicionamento dos mini-implantes, os tipos de apoio na região anterior e a força a ser utilizada. São citados os sítios de instalação mais usados para a retração anterior e abordados fatores que deverão ser controlados durante o fechamento de espaço. Por fim, são citadas algumas considerações clínicas sobre o uso dos mini-implantes nessa importante fase do tratamento ortodôntico.INTRODUCTION: The use of orthodontic mini-implants has settled as an important anchorage method and is aiding the orthodontists in the several stages of the treatment, largely eliminating the need of patients' compliance, and turning the results more predictable. AIM: This article describes the main aspects of the use of mini-implants as auxiliaries on the retraction phase of the anterior teeth, bringing considerations about their indications, amount of movement of the anterior teeth, the vectors of retraction force, the vertical control and evaluation of the incisors vestibulolingual tipping, the positioning of the mini-implants, the support types in the anterior area and the force to be applied. The placement sites best used for the anterior retraction are mentioned, and the factors that should be controlled during the space closure are approached. Lastly, some clinical considerations on the use of mini-implants in such important phase of the orthodontic treatment are

  2. Head Position in the MEG Helmet Affects the Sensitivity to Anterior Sources

    Science.gov (United States)

    Marinkovic, K; Cox, B; Reid, K; Halgren, E

    2013-01-01

    Current MEG instruments derive the whole-head coverage by utilizing a helmet-shaped opening at the bottom of the dewar. These helmets, however, are quite a bit larger than most people’s heads so subjects commonly lean against the back wall of the helmet in order to maintain a steady position. In such cases the anterior brain sources may be too distant to be picked up by the sensors reliably. Potential “invisibility” of the frontal and anterior temporal sources may be particularly troublesome for the studies of cognition and language, as they are subserved significantly by these areas. We examined the sensitivity of the distributed anatomically-constrained MEG (aMEG) approach to the head position (“front” vs. “back”) secured within a helmet with custom-tailored bite-bars during a lexical decision task. The anterior head position indeed resulted in much greater sensitivity to language-related activity in frontal and anterior temporal locations. These results emphasize the need to adjust the head position in the helmet in order to maximize the “visibility” of the sources in the anterior brain regions in cognitive and language tasks. PMID:16012659

  3. Displaced fracture through the anterior atlantal synchondrosis

    Energy Technology Data Exchange (ETDEWEB)

    Thakar, Chrishan; Allibone, James [Royal National Orthopaedic Hospital NHS Trust, Department of Spinal Deformity, Stanmore, Middlesex (United Kingdom); Harish, Srinivasan [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Saifuddin, Asif [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); University College, The Institute of Orthopaedics and Musculoskeletal Sciences, London (United Kingdom)

    2005-09-01

    In the acute setting, accurate radiological interpretation of paediatric cervical spine trauma can be difficult due to a combination of normal variants and presence of multiple synchondroses. We present a rare case of a fracture through the anterior atlantal synchondrosis in a paediatric spine. A five-year-old boy, who fell backwards onto the top of his head while swinging across on a monkey bar frame, presented with neck pain, cervical muscle spasm and decreased right lateral rotation and extension of his neck. Computed tomography showed a displaced diastatic fracture through right anterior atlantal synchondrosis. There are only 12 cases of paediatric C1 fractures reported in the world literature. The importance of considering this diagnosis in the appropriate clinical setting, and the normal variants in the paediatric atlas that can cause diagnostic dilemma to the interpreting radiologist, are discussed in this case report. (orig.)

  4. Anterior uveitis in juvenile rheumatoid arthritis.

    Science.gov (United States)

    Kanski, J J

    1977-10-01

    The ocular and systemic characteristics of 160 patients with anterior uveitis and seronegative juvenile rheumatoid arthritis are reviewed. Chronic uveitis occurred in 131 patients, 76% of whom were girls. Both eyes were involved in 70% of the cases. Band keratopathy occurred in 41% of the eyes, cataract in 42%, and secondary glaucoma in 19%. Only 11 patients had uveitis before the onset of arthritis. Notable correlations included a pauciarticular onset of arthritis in 95% of the patients, and positive tests for antinuclear antibody in 82%. Of 29 patients with acute anterior uveitis, 27 were boys. The inflammation responded well to therapy, and serious complications did not occur. At follow-up 21 patients had typical ankylosing spondylitis, and five had sacroiliitis. The incidence of positive results of tests for HLA-B27 antigen was 94%.

  5. Erlotinib-related bilateral anterior uveitis

    OpenAIRE

    Ali, Kashif; Kumar, Indu; Usman-Saeed, Muniba; Usman Saeed, Muhammad

    2011-01-01

    The authors report the case of a 68-year-old woman with secondary adenocarcinoma of the lungs from an unknown primary. Erlotinib was started which produced symptoms suggestive of uveitis. Erlotinib was stopped and restarted a month later at a lower dose, which resulted in severe bilateral anterior uveitis. The uveitis settled after stopping erlotinib and treatment with topical steroids and cycloplegics. To the best of the authors’ knowledge, this is the first case of erlotinib-related anterio...

  6. Multimodal emotion perception after anterior temporal lobectomy

    OpenAIRE

    Valérie Milesi; Chiara Cristinzio; Margitta Seeck

    2014-01-01

    In the context of emotion information processing, several studies have demonstrated the involvement of the amygdala in emotion perception, for unimodal and multimodal stimuli. However, it seems that not only the amygdala, but several regions around it, may also play a major role in multimodal emotional integration. In order to investigate the contribution of these regions to multimodal emotion perception, five patients who had undergone unilateral anterior temporal lobe resection were exposed...

  7. Anterior Tibial Artery Pseudoaneurysm: Case Report

    Directory of Open Access Journals (Sweden)

    Funda Tor

    2012-06-01

    Full Text Available The aneurysmsatic changes of the infrapopliteal arteries are rarely seen. They are pseudoaneurysms rather than true aneursyms. The most important cause of them is trauma. There is not a standart treatment for infrapopliteal aneursyms. In this study, we have evaluated a case operated for anterior tibial artery pseudoaneurysm developed after penetrant trauma and diagnosed two weeks later. [Cukurova Med J 2012; 37(3.000: 172-175

  8. Psychological Aspects of Anterior Cruciate Ligament Injuries

    OpenAIRE

    Ardern, Clare; Kvist, Joanna; Webster, Kate E.

    2016-01-01

    Impairment-based evaluation has, until recently, been the mainstay of orthopaedic research in anterior cruciate ligament (ACL) reconstruction. However, participation-based outcomes, in particular returning to sport, have lately garnered increased research attention. This is important because returning to sport is typically a main concern of injured athletes. Recent metaanalyses have demonstrated that the return to sport rate after ACL reconstruction is disappointingly low, and that a range of...

  9. Bilateral anterior uveitis secondary to erlotinib

    OpenAIRE

    Lim, Lik Thai; Blum, Robert Alexander; Cheng, Chee Peng; Hanifudin, Abdul

    2010-01-01

    Bilateral anterior uveitis secondary to erlotinib phone: +44-784-3617788 (Lim, Lik Thai) (Lim, Lik Thai) Ophthalmology Department, Gartnavel General Hospital - Great Western Road - G12 0YN - Glasgow - UNITED KINGDOM (Lim, Lik Thai) Ophthalmology Department, Gartnavel General Hospital - Great Western Road - G12 0YN - Glasgow - UNITED KINGDOM (Blum, Robert Alexander) Ophthalmology Department, Gartnavel General Hospital - Great Western Road - G12 0YN - G...

  10. Anterior segment dysgenesis in mosaic Turner syndrome

    OpenAIRE

    Lloyd, I; Haigh, P; Clayton-Smith, J.; Clayton, P.; Price, D.; Ridgway, A; Donnai, D

    1997-01-01

    AIMS/BACKGROUND—Females with Turner syndrome commonly exhibit ophthalmological abnormalities, although there is little information in the literature documenting findings specific to Turner syndrome mosaics. Ophthalmic findings are described in four patients with mosaic Turner syndrome. All had anterior chamber abnormalities and all four had karyotypic abnormalities with a 45, X cell line. The possible relation between the karyotypic and the phenotypic findings in these patients is discussed.
...

  11. Foreign Body Embedded in Anterior Chamber Angle

    OpenAIRE

    Shmuel Graffi; Beatrice Tiosano; Ran Ben Cnaan; Jonathan Bahir; Modi Naftali

    2012-01-01

    Introduction. We present a case of a metallic foreign body embedded in the anterior chamber angle. After standing in close proximity to a construction worker breaking a tile, a 26-year-old woman using soft contact lens for the correction of mild myopia presented to emergency department for evaluation of a foreign body sensation of her right eye. Methods and Results. Diagnosis was confirmed by gonioscopic examination and a noncontrast CT scan of head and orbits. The foreign body was removed by...

  12. Anatomic distribution of nerves and microvascular density in the human anterior vaginal wall: prospective study.

    Directory of Open Access Journals (Sweden)

    Ting Li

    Full Text Available BACKGROUND: The presence of the G-spot (an assumed erotic sensitive area in the anterior wall of the vagina remains controversial. We explored the histomorphological basis of the G-spot. METHODS: Biopsies were drawn from a 12 o'clock direction in the distal- and proximal-third areas of the anterior vagina of 32 Chinese subjects. The total number of protein gene product 9.5-immunoreactive nerves and smooth muscle actin-immunoreactive blood vessels in each specimen was quantified using the avidin-biotin-peroxidase assay. RESULTS: Vaginal innervation was observed in the lamina propria and muscle layer of the anterior vaginal wall. The distal-third of the anterior vaginal wall had significantly richer small-nerve-fiber innervation in the lamina propria than the proximal-third (p = 0.000 and in the vaginal muscle layer (p = 0.006. There were abundant microvessels in the lamina propria and muscle layer, but no small vessels in the lamina propria and few in the muscle layer. Significant differences were noted in the number of microvessels when comparing the distal- with proximal-third parts in the lamina propria (p = 0.046 and muscle layer (p = 0.002. CONCLUSIONS: Significantly increased density of nerves and microvessels in the distal-third of the anterior vaginal wall could be the histomorphological basis of the G-spot. Distal anterior vaginal repair could disrupt the normal anatomy, neurovascular supply and function of the G-spot, and cause sexual dysfunction.

  13. The Response of Tibialis Anterior Muscle Fibers in Mice to Increased Muscle Activity

    OpenAIRE

    HIROFUJI, Chiyoko; Ishihara, Akihiko; Nakatani, Toshiaki; ITOH, Kazuoa; ITOH, Minoru; Katsuta, Shigeru

    2001-01-01

    Cross-sectional areas and oxidative enzyme (succinate dehydrogenase) activities of fibers in the deep, middle, and superficial regions of the mouse tibialis anterior muscle were examined and compared after 30 days of increased muscle activity with voluntary running exercise. Eight 19-week-old male mice were assigned randomly to either a sedentary control (control, n=4) or voluntary running exercise (exercise, n=4) group. There were no differences in the cross-sectional area of fibers between ...

  14. A Novel Technique for Anterior Vaginal Wall Prolapse Repair: Anterior Vaginal Wall Darn

    Directory of Open Access Journals (Sweden)

    Osman Köse

    2013-01-01

    Full Text Available Aim. The aim of this study is to introduce a new technique, anterior vaginal wall darn (AVWD, which has not been used before to repair the anterior vaginal wall prolapse, a common problem among women. Materials and Methods. Forty-five women suffering from anterior vaginal wall prolapse were operated on with a new technique. The anterior vaginal wall was detached by sharp and blunt dissection via an incision beginning from the 1 cm proximal aspect of the external meatus extending to the vaginal apex, and the space between the tissues that attach the lateral walls of the vagina to the arcus tendineus fascia pelvis (ATFP was then darned. Preoperation and early postoperation evaluations of the patients were conducted and summarized. Results. Data were collected six months after operation. Cough stress test (CST, Pelvic Organ Prolapse Quantification (POP-Q evaluation, Incontinence Impact Questionnaire (IIQ-7, and Urogenital Distress Inventory (UDI-6 scores indicated recovery. According to the early postoperation results, all patients were satisfied with the operation. No vaginal mucosal erosion or any other complications were detected. Conclusion. In this initial series, our short-term results suggested that patients with grade II-III anterior vaginal wall prolapsus might be treated successfully with the AVWD method.

  15. The anterior loop of the inferior alveolar nerve. A radiographic study of panoramic radiographs and review of the literature.

    Directory of Open Access Journals (Sweden)

    Konstantinos VLASTOS

    2014-04-01

    Full Text Available The inferior alveolar nerve sometimes extends anteriorly beyond the mental foramen and runs outward, upward and backward before it reaches the mental foramen, creating what is known as the anterior loop. Placement of dental implants in this area, has a high risk of injury to the inferior alveolar nerve. Aim: This study seeks to investigate the visualization of the anterior loop on panoramic radiographs. Material and methods: 100 panoramic radiographs were analysed in terms of loop visualization. Results: Anterior loop was observed in 34% of the radiographs. Its prevalence was higher in males (70.5% and in patients between 40-60 years old (47%. In most cases the loop was located bilaterally (64.7%, while the interforaminal area was mostly edentulous (64.7%. The loop length ranged between 0.5-8 mm, with an average length of 4.37mm. Conclusions: An analysis of the findings shows that implants should be placed at least 5-8mm anteriorly to the mental foramen. According to a review of the literature, computed tomography is more accurate than panoramic radiography in identifying the anterior loop.

  16. Low Anterior Resection Syndrome: Current Management and Future Directions.

    Science.gov (United States)

    Ridolfi, Timothy J; Berger, Nicholas; Ludwig, Kirk A

    2016-09-01

    Outcomes for rectal cancer surgery have improved significantly over the past 20 years with increasing rates of survival and recurrence, specifically local recurrence. These gains have been realized during a period of time in which there has been an increasing emphasis on sphincter preservation. As we have become increasingly aggressive in avoiding resection of the anus, we have begun accepting bowel dysfunction as a normal outcome. Low anterior resection syndrome, defined as a constellation of symptoms including incontinence, frequency, urgency, or feelings of incomplete emptying, has a significant impact on quality of life and results in many patients opting for a permanent colostomy to avoid these symptoms. In this article, we will highlight the most recent clinical and basic science research on this topic and discuss areas of future investigation. PMID:27582649

  17. Anterior prefrontal involvement in implicit contextual change detection

    Directory of Open Access Journals (Sweden)

    Stefan Pollmann

    2009-10-01

    Full Text Available Anterior prefrontal cortex is usually associated with high level executive functions. Here, we show that the frontal pole, specifically left lateral frontopolar cortex, is involved in signaling change in implicitly learned spatial contexts, in the absence of conscious change detection. In a variant of the contextual cueing paradigm, participants first learned implicitly contingencies between distractor contexts and target locations. After learning, repeated distractor contexts were paired with new target locations. Left lateral frontopolar (BA10 and superior frontal (BA9 cortices showed selective signal increase for this target location change in repeated displays in an event-related fMRI experiment, which was most pronounced in participants with high contextual facilitation before the change. The data support the view that left lateral frontopolar cortex is involved in signaling contextual change to posterior brain areas as a precondition for adaptive changes of attentional resource allocation. This signaling occurs in the absence of awareness of learned contingencies or contextual change.

  18. MRI appearances of the anterior fibulocalcaneus muscle: a rare anterior compartment muscle

    Energy Technology Data Exchange (ETDEWEB)

    Upadhyay, Bhavin [Basildon and Thurrock University Hospitals NHS Foundation Trust, Imaging Department, Essex (United Kingdom); Amiras, Dimitri [Imperial College Health Care NHS Trust, Imaging Department, London (United Kingdom)

    2015-05-01

    MRI of a 62-year-old female presenting with ankle pain demonstrated an accessory muscle within the anterior compartment of the lower leg. The muscle originated from the fibula and anterior crural septum. The tendon passed anterior to the lateral malleolus and inserted at the critical angle of Gissane on the calcaneus. This muscle was initially described in the anatomic literature by Lambert and Atsas in 2010. To our knowledge, this is the first time the MRI appearances of this muscle has been described in the radiological literature. Awareness of the fibulocalcaneal muscle is important as it may represent a cause of ankle pain. In addition, the tendon could potentially be harvested for use in reconstructive procedures. (orig.)

  19. Anterior Decompression and Anterior Instrumentation of Tuberculosis of Cervicothoracic Spine by Cervicomanubrial Approach

    Directory of Open Access Journals (Sweden)

    Anant Kumar Garg

    2012-04-01

    Full Text Available Background: Evaluation of result of anterior cervical approach with manubriotomy and anterior instrumentation in tuberculosis of cervicothoracic spine in terms of the neurological recovery, reconstruction of spine and prevention of deformity along with relief of pain. Materials and Methods: All five patients with cervicothoracic caries spine had surgery through anterior cervical approach with manubriotomy in our hospital and underwent excision of the involved vertebrae and intervertebral discs followed by anterior spinal reconstruction with titanium spacer cage filled with cancellous iliac crest bone graft and Orion plate with locking screw. Antitubercular drugs were administered for 12 months. The follow-up period ranged from 12 to 36 months. Results: Analysis of result was done on the basis of clinical and radiological criteria. Clinical assessment based on Frankel grade and modified JOA score showed significant improvement from preoperative findings. Radiological assessment showed osteointegration, no spinal instability and no progression of the deformity. The pain control, based on visual analog scale changed from a pre-operative average of 7.5 to 2 at the last follow-up thereby indicating significant improvement and all patients returned to preoperative functional status. One patient had transient hoarseness of voice. No other complication had been encountered in the immediate post operative and during the follow-up period. Conclusions: Our study showed that anterior cervical approach with manubriotomy and anterior insertion of titanium cage, filled with autogenous bone graft, secured with locking plate instrumentation has a successful role in the eradication of infection, neurological recovery, segmental spinal reconstruction and it also reduces surgical time, blood loss, and surgical complications and approach related comorbidity in follow up period. Level of Evidence- Level 4, Case series

  20. Auditory Spatial Coding Flexibly Recruits Anterior, but Not Posterior, Visuotopic Parietal Cortex

    OpenAIRE

    Michalka, Samantha W.; Rosen, Maya L.; Kong, Lingqiang; Shinn-Cunningham, Barbara G.; Somers, David C.

    2015-01-01

    Audition and vision both convey spatial information about the environment, but much less is known about mechanisms of auditory spatial cognition than visual spatial cognition. Human cortex contains >20 visuospatial map representations but no reported auditory spatial maps. The intraparietal sulcus (IPS) contains several of these visuospatial maps, which support visuospatial attention and short-term memory (STM). Neuroimaging studies also demonstrate that parietal cortex is activated during au...

  1. Anomia for people's names after left anterior temporal lobe resection--case report.

    Science.gov (United States)

    Kurimoto, Masanori; Takaiwa, Akiko; Nagai, Shoichi; Hayashi, Nakamasa; Endo, Shunro

    2010-01-01

    A 47-year-old man was admitted to our hospital with an intrinsic brain tumor in the left anterior temporal lobe. Preoperative sodium thiopental test demonstrated left hemispheric dominance. Awake craniotomy was performed for dominant-hemispheric tumor resection using language mapping to identify the stimulation-induced positive language area. The tasks of object naming and repetition were used, along with specific tests for famous people's names. The language area was detected on the superior temporal gyrus and preserved. Following surgery, this patient was unable to retrieve the names of famous individuals (i.e. anomia for people's name) despite preservation of semantic knowledge for those individuals. This anomia for people's names showed no improvement at all for a period of 15 months. This case report and other sporadic cases with this type of deficit reveal the left anterior temporal lobe is an important brain area for retrieving people's names.

  2. Arterial supply of the olfactory trigone and the anterior perforated substance in macrosmatic and microsmatic animals.

    Science.gov (United States)

    Nachman, Ewa; Topol, Mirosław

    2002-01-01

    An investigation was conducted into the differences between macrosmatic and microsmatic animals of arterial supply in the area of the olfactory trigone and the anterior perforated substance. A brain of domestic cat was taken as an example of a macrosmatic animal and a brain of baboon as an example of a microsmatic animal. The cerebral blood vessels of the cadavers of 30 cats and 11 baboons were filled with latex and, after fixation in acid alcohol by means of microscopic operation, the cortical and deep branches of the anterior and middle cerebral arteries were dissected. We discovered that there were differences between these two groups of animals in the places of arising of deep branches and in their course. In the cat the deep branches running through the area of the olfactory trigone arose from the beginning part of the middle cerebral artery in numbers 5-10 and entered the brain in the olfactory tubercle. In the baboon the deep branches arose from two sources: the middle cerebral artery and the anterior cerebral artery. The branches of the middle cerebral artery went through the anterior perforated substance, forming two groups of branches: lateral and medial. PMID:12725495

  3. Tireoide ectópica no mediastino anterior Ectopic thyroid in the anterior mediastinum

    OpenAIRE

    Maria José Araújo da Cunha Guimarães; Carla Manuela Silva Valente; Lèlita Santos; Manuel Fontes Baganha

    2009-01-01

    A ectopia de tireoide é rara, e a sua localização no mediastino anterior é excepcional, estando descritos apenas 5 casos nos últimos 30 anos. Os autores apresentam 2 casos clínicos, além de uma revisão da literatura abordando a etiologia, a embriologia e manifestações clínicas de ectopia de tireoide.Ectopic thyroid is a rare condition, and its location in the anterior mediastinum is even rarer, there having been only 5 reported cases in the past 30 years. Here, we describe 2 clinical cases an...

  4. Toxic anterior-segment syndrome (TASS

    Directory of Open Access Journals (Sweden)

    Cetinkaya S

    2014-10-01

    Full Text Available Servet Cetinkaya,1 Zeynep Dadaci,2 Hüsamettin Aksoy,3 Nursen Oncel Acir,2 Halil Ibrahim Yener,4 Ekrem Kadioglu5 1Ophthalmology Clinics, Turkish Red Crescent Hospital, Konya, 2Department of Ophthalmology, Faculty of Medicine, Mevlana University, Konya, 3Ophthalmology Clinics, Karaman State Hospital, Karaman, 4Konya Eye Center Hospital, Konya, 5Ophthalmology Clinics, Beyhekim State Hospital, Konya, Turkey Purpose: To evaluate the clinical findings and courses of five patients who developed toxic anterior-segment syndrome (TASS after cataract surgery and investigate the cause.Materials and methods: In May 2010, on the same day, ten patients were operated on by the same surgeon. Five of these patients developed TASS postoperatively.Results: Patients had blurred-vision complaints on the first day after the operation, but no pain. They had different degrees of diffuse corneal edema, anterior-chamber reaction, fibrin, hypopyon, iris atrophies, and dilated pupils. Their vision decreased significantly, and their intraocular pressures increased. Both anti-inflammatory and antiglaucomatous therapies were commenced. Corneal edema and inflammation resolved in three cases; however, penetrating keratoplasty was needed for two cases and additional trabeculectomy was needed for one case. Although full investigations were undertaken at all steps, we could not find the causative agent.Conclusion: TASS is a preventable complication of anterior-segment surgery. Recognition of TASS, differentiating it from endophthalmitis, and starting treatment immediately is important. Controlling all steps in surgery, cleaning and sterilization of the instruments, and training nurses and other operation teams will help us in the prevention of TASS. Keywords: cataract, phacoemulsification, TASS, corneal edema, inflammation

  5. Infections after reconstructions of anterior cruciate ligament

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    Ristić Vladimir

    2014-01-01

    Full Text Available Introduction. Infections after anterior cruciate ligament reconstructions are rare, but, on the other hand, they are difficult to be treated. The aim of this study was to analyze causes of infections, risk factors, diagnostics, and possibilities of their prevention. Material and Methods. Seventeen deep infections (1.2% were found in 1425 patients who had undergone anterior cruciate ligament reconstructions. Fifteen patients were males and two were females. Out of 475 professional athletes nine (1.9% had this postoperative complication. Eleven patients with septic arthritis were allergic to penicillin. Three of them had immunosuppressive diseases. Results. Staphylococcus aureus was isolated in eleven cases (65%, other Staphylococcus and Streptococcus groups were found in four and three patients, respectively; while one patient had infection although the punctate was negative. Out of 965 patients with the patellar tendon grafts, ten (1.03% had this complication, while the incidence was 1.52% (7/460 in those with the hamstring grafts. Fifteen infections were acute with obvious symptoms within 14 days after surgery. Severe pain, limited range of motion, swelling of the knee joint and fever were the most common symptoms, while rubor and pus developed rarely. The infection was three times more frequent in the patients who had undergone surgery lasting more than 1.5 hour. Discussion and Conclusion. The following population groups are at risk of developing septic arthritis after anterior cruciate ligament reconstructions: professional athletes, those who are allergic to penicillin, and those with immunosuppressive diseases. Staphyllococus aureus is the most common cause of infection. The patients with the hamstring autografts have a higher risk than those with the patellar tendon grafts. Preventive measures that should be performed include aseptic conditions in operative rooms, irrigation of the graft before its placement into the bone tunnels

  6. The morphology of the cephalic lobes and anterior pectoral fins in six species of batoids.

    Science.gov (United States)

    Mulvany, Samantha; Motta, Philip J

    2013-09-01

    Many benthic batoids utilize their pectoral fins for both undulatory locomotion and feeding. Certain derived, pelagic species of batoids possess cephalic lobes, which evolved from the anterior pectoral fins. These species utilize the pectoral fins for oscillatory locomotion while the cephalic lobes are used for feeding. The goal of this article was to compare the morphology of the cephalic lobes and anterior pectoral fins in species that possess and lack cephalic lobes. The skeletal elements (radials) of the cephalic lobes more closely resembled the radials in the pectoral fin of undulatory species. Second moment of area (I), calculated from cephalic lobe radial cross sections, and the number of joints revealed greater flexibility and resistance to bending in multiple directions as compared to pectoral fin radials of oscillatory species. The cephalic lobe musculature was more complex than the anterior pectoral fin musculature, with an additional muscle on the dorsal side, with fiber angles running obliquely to the radials. In Rhinoptera bonasus, a muscle presumably used to help elevate the cephalic lobes is described. Electrosensory pores were found on the cephalic lobes (except Mobula japonica) and anterior pectoral fins of undulatory swimmers, but absent from the anterior pectoral fins of oscillatory swimmers. Pore distributions were fairly uniform except in R. bonasus, which had higher pore numbers at the edges of the cephalic lobes. Overall, the cephalic lobes are unique in their anatomy but are more similar to the anterior pectoral fins of undulatory swimmers, having more flexibility and maneuverability compared to pectoral fins of oscillatory swimmers. The maneuverable cephalic lobes taking on the role of feeding may have allowed the switch to oscillatory locomotion and hence, a more pelagic lifestyle. PMID:23801572

  7. The Anterior Cingulate Cortex and Pain Processing

    Directory of Open Access Journals (Sweden)

    Perry Neil Fuchs

    2014-05-01

    Full Text Available The neural network that contributes to the suffering which accompanies persistent pain states involves a number of brain regions. Of primary interest is the contribution of the cingulate cortex in processing the affective component of pain. The purpose of this review is to summarize recent data obtained using novel behavioral paradigms in animals based on measuring escape and/or avoidance of a noxious stimulus. These paradigms have successfully been used to study the nature of the neuroanatomical and neurochemical contributions of the anterior cingulate cortex to higher order pain processing in rodents.

  8. Biological fixation in anterior cruciate ligament surgery

    Directory of Open Access Journals (Sweden)

    Chih-Hwa Chen

    2014-04-01

    Full Text Available Successful anterior cruciate ligament (ACL reconstruction with tendon graft requires extensive tendon-to-bone healing in the bone tunnels and progressive graft ligamentization for biological, structural, and functional recovery of the ACL. Improvement in graft-to-bone healing is crucial for facilitating early, aggressive rehabilitation after surgery to ensure an early return to pre-injury activity levels. The use of various biomaterials for enhancing the healing of tendon grafts in bone tunnels has been developed. With the biological enhancement of tendon-to-bone healing, biological fixation of the tendon graft in the tunnel can be achieved in ACL reconstruction.

  9. [LAPAROSCOPIC ANTERIOR UTERINE LIGAMENTOPEXY--OUR EXPERIENCE].

    Science.gov (United States)

    Blagovest, Bechev; Magunska, Nadya; Kovachev, Emil; Ivanov, Stefan

    2015-01-01

    A great number operative techniques for correction of retroverted uterus are reported in the last years. The aim of these different methods is correction of the retroversion of the uterus, which is connected with pelvic congestion and symptomatic relief. We present a clinical case of 26 years old patient with one Caesarean section. The lady complains of chronic pelvic pain, dispareunia and dismenorrhea. The US exam shows an uterus in strong retroversion position. We restored the anatomic position of the uterus using laparoscopic anterior ligementopexy.

  10. Anterior segment spectral domain optical coherence tomography imaging of patients with anterior scleritis.

    Science.gov (United States)

    Levison, Ashleigh L; Lowder, Careen Y; Baynes, Kimberly M; Kaiser, Peter K; Srivastava, Sunil K

    2016-08-01

    The purpose of the study was to describe the findings seen on anterior segment spectral domain optical coherence tomography (SD-OCT) in patients with anterior scleritis and determine the feasibility of using SD-OCT to image and grade the degree of scleral inflammation and monitor response to treatment. All patients underwent slit lamp examination by a uveitis specialist, and the degree of scleral inflammation was recorded. Spectral domain OCT imaging was then performed of the conjunctiva and scleral tissue using a standardized acquisition protocol. The scans were graded and compared to clinical findings. Twenty-eight patients with anterior scleritis and ten patients without ocular disease were included in the study. Seventeen of the scleritis patients were followed longitudinally. Common findings on SD-OCT in patients with active scleritis included changes in hyporeflectivity within the sclera, nodules, and visible vessels within the sclera. There was significant variation in findings on SD-OCT within each clinical grade of active scleritis. These changes on SD-OCT improved with treatment and clinical improvement. SD-OCT imaging provided various objective measures that could be used in the future to grade inflammatory activity in patients with anterior scleritis. Longitudinal imaging of patients with active scleritis demonstrated that SD-OCT may have great utility in monitoring response to treatment.

  11. Accuracy of Lachman and Anterior Drawer Tests for Anterior Cruciate Ligament Injuries

    Directory of Open Access Journals (Sweden)

    Hadi Makhmalbaf

    2013-12-01

    Full Text Available   Background: The knee joint is prone to injury because of its complexity and weight-bearing function. Anterior cruciate ligament (ACL ruptures happen in young and physically active population and can result in instability, meniscal tears, and articular cartilage damage. The aim of this study is to evaluate the accuracy of Lachman and anterior drawer test in ACL injury in compare with arthroscopy.   Methods: In a descriptive, analytical study from 2009 to 2013, 653 patients who were suspected to ACL rapture were entered the study. Statistical analysis was performed by the usage of SPSS 19.0. Multiple comparison procedure was performed for comparing data between clinical examination and arthroscopic findings and their relation with age and sex. Results: Mean age of patients was 28.3±7.58 years (range from 16 to 68 years. From 428 patients, 41.2% (175 patients were between 26 and 35, 38.8% (165 ones between 15 and 25 and 20% (85 patients over 36 years. 414 patients were male (97.2% and 12 were female (2.8%. Sensitivity of anterior drawer test was 94.4% and sensitivity of Lachman test was 93.5%. Conclusion: The diagnosis and decision to reconstruct ACL injury can be reliably made regard to the anterior drawer and Lachman tests result. The tests did not have privilege to each other. These test accuracy increased considerably under anesthesia especially in women.

  12. The normal anterior cruciate ligament as a model for tensioning strategies in anterior cruciate ligament grafts

    NARCIS (Netherlands)

    Arnold, MP; Verdonschot, N; van Kampen, A

    2005-01-01

    Background: There is some confusion about the relationship between the tension placed on the graft and the joint position used in the fixation of anterior cruciate ligament grafts. This is because of deficiency in accurate basic science about this important interaction in the normal and reconstructe

  13. The normal anterior cruciate ligament as a model for tensioning strategies in anterior cruciate ligament grafts.

    NARCIS (Netherlands)

    Arnold, M.P.; Verdonschot, N.J.J.; Kampen, A. van

    2005-01-01

    BACKGROUND: There is some confusion about the relationship between the tension placed on the graft and the joint position used in the fixation of anterior cruciate ligament grafts. This is because of deficiency in accurate basic science about this important interaction in the normal and reconstructe

  14. Penghentian Karies Gigi Sulung Anterior (Laporan Penelitian

    Directory of Open Access Journals (Sweden)

    Titi Pratiwi Indra Yoga

    2015-10-01

    Full Text Available Salah satu cara menanggulangi karies pada gigi sulung anterior adalah dengan mengasah gigi menjadi bentuk self cleansing atau tapered dan kemudian mengolesnya dengan larutan SnF2 10%. Cara ini relatif mudah mengerjakannya serta murah biayanya. Keburukannya hanya pada masalah estetis, yaitu bentuk gigi menjadi lebih kecil, serta adanya staining kecoklatan karena pengendapan Sn. Penelitian ini dilakukan untuk mengetahui apakah cara ini dapat menghentikan karies pada gigi sulung anterior, serta sampai berapa lama pengaruh SnF2 10% dapat menghentikan karies. Sampel diambil dari murid TK yang berusia 2,5 sampai 5 tahun, gigi sulung anteriornya terkena karies email pada bagian proksimal satu atau dua sisi. Mengingat usia sampel yang masih muda, maka sampai akhir penelitian hanya didapat 20 orang anak yang memenuhi kriteria, dan hasil penelitian dihitung secara statistik dengan X2 – test. Hasil penelitian ternyata prosedur perawatan ini berhasil secara bermakna setelah 3-6 bulan (X2 = 0.056, df = 1, dan p < 0.05.

  15. Adjacent Segment Pathology after Anterior Cervical Fusion.

    Science.gov (United States)

    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon; Kim, Sung Kyu

    2016-06-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion.

  16. MRI of anterior cruciate ligament autografts

    Energy Technology Data Exchange (ETDEWEB)

    Ogi, Shigeyuki; Ariizumi, Mitsuko; Yamagishi, Tsuneo [The Aoyama Tokyo Metropolitan office' s Hospital (Japan); Agata, Toshihiko; Tada, Shinpei; Fukuda, Kunihiko

    2000-09-01

    The purpose of this study was to assess the usefulness of MRI in the evaluation of autografts after anterior cruciate ligament reconstruction. The subjects were 110 patients with anterior cruciate ligament reconstruction using patellar tendon autografts who underwent clinical examination, MRI, and arthroscopy of the knee. T1- and T2-weighted MR images were obtained in sagittal plane. Clinical findings were categorized into three groups: normal, borderline, and abnormal. The MRI appearances of the autografts were categorized into three types: straight continuous band (type I), interrupted band (type II) and generalized increased intensity band (type III). The clinical findings and MRI findings were compared with arthroscopic findings. Ninety-six percent of the type I showed no autograft tear on arthroscopy. In comparison with the clinical findings, MRI was found to be well correlated with arthroscopic findings. In conclusion, if the clinical findings are normal, patients are to be followed-up without MRI and arthroscopy. However, if clinical findings are either borderline or abnormal, MRI should be performed prior to arthroscopy. (author)

  17. The Semantic Network at Work and Rest: Differential Connectivity of Anterior Temporal Lobe Subregions

    Science.gov (United States)

    Jackson, Rebecca L.; Hoffman, Paul; Pobric, Gorana

    2016-01-01

    The anterior temporal lobe (ATL) makes a critical contribution to semantic cognition. However, the functional connectivity of the ATL and the functional network underlying semantic cognition has not been elucidated. In addition, subregions of the ATL have distinct functional properties and thus the potential differential connectivity between these subregions requires investigation. We explored these aims using both resting-state and active semantic task data in humans in combination with a dual-echo gradient echo planar imaging (EPI) paradigm designed to ensure signal throughout the ATL. In the resting-state analysis, the ventral ATL (vATL) and anterior middle temporal gyrus (MTG) were shown to connect to areas responsible for multimodal semantic cognition, including bilateral ATL, inferior frontal gyrus, medial prefrontal cortex, angular gyrus, posterior MTG, and medial temporal lobes. In contrast, the anterior superior temporal gyrus (STG)/superior temporal sulcus was connected to a distinct set of auditory and language-related areas, including bilateral STG, precentral and postcentral gyri, supplementary motor area, supramarginal gyrus, posterior temporal cortex, and inferior and middle frontal gyri. Complementary analyses of functional connectivity during an active semantic task were performed using a psychophysiological interaction (PPI) analysis. The PPI analysis highlighted the same semantic regions suggesting a core semantic network active during rest and task states. This supports the necessity for semantic cognition in internal processes occurring during rest. The PPI analysis showed additional connectivity of the vATL to regions of occipital and frontal cortex. These areas strongly overlap with regions found to be sensitive to executively demanding, controlled semantic processing. SIGNIFICANCE STATEMENT Previous studies have shown that semantic cognition depends on subregions of the anterior temporal lobe (ATL). However, the network of regions

  18. Review of 31 cases of anterior thoracolumbar fixation with the anterior thoracolumbar locking plate system.

    Science.gov (United States)

    Wilson, J A; Bowen, S; Branch, C L; Meredith, J W

    1999-07-15

    Anterior fixation devices for the thoracolumbar spine have gained wide acceptance as viable alternatives to long-segment posterior fixation in cases of thoracolumbar spine trauma. This review was undertaken to evaluate the safety and efficacy of the Synthes anterior thoracolumbar locking plate (ATLP) system. Over a 3-year period, 31 patients with unstable traumatic fractures of the thoracolumbar spine underwent corpectomy, placement of a structural bone graft, and anterior fixation in which the Synthes ATLP system was used. Long-term follow-up data were obtained in 29 patients. Two patients were lost to follow up, one at 4 months and the other at 1 year. In the remaining patients, the average length of follow up was 20 months. In all patients radiographic evidence of solid bone fusion was demonstrated on follow-up plain x-ray films, and there were no signs or symptoms of pseudarthrosis. No patient suffered neurological deterioration as a result of surgery, and there was relatively little morbidity associated with this plating system. To date, none of the patients in this study has developed any delayed complications related to the fixation device. In one patient, who had sustained a severe flexion injury, loosening of the anterior fixation device occurred, and the patient developed progressive kyphosis, which required a posterior stabilization procedure. These results appear slightly better than those obtained in published studies in which other anterior plating systems were used, indicating that this system is safe and effective in the treatment of unstable fractures of the thoracolumbar spine. PMID:16918232

  19. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

    OpenAIRE

    Jung-Ju Huang; Lih-Huei Chen; Chi-Chien Niu; Tsai-Sheng Fu; Po-Liang Lai; Wen-Jer Chen

    2004-01-01

    Background: In multilevel spinal cord compression caused by cervical spondylosis, surgeonsface the choice of performing a posterior route as a laminectomy orlaminoplasty, or an anterior route as multiple adjacent interbody decompressionsor corpectomies. The anterior cervical operation is not considered bysome clinicians because of concerns about complications and the complexityof multilevel anterior cervical surgery.Methods: In this retrospective study, 14 patients with multilevel cervical sp...

  20. Complications of the anterior approach to the cervical spine

    OpenAIRE

    Marcelo Lemos Vieira da Cunha; Francisco Alves de Araújo Júnior; Cássio Czottis Grapiglia; Denildo César Amaral Veríssimo; Roberta Rehder; Samir Ale Bark; Luis Alencar Biurrum Borba

    2014-01-01

    OBJECTIVE: To evaluate the complications of anterior approach to the cervical spine in patients who underwent cervical arthrodesis with instrumentation. METHODS: Prospective and descriptive study was conducted from January 2009 to April 2010. All patients who underwent arthrodesis of the cervical spine by anterior approach were included, regardless the diagnosis. Access was made by the anterior approach on the right side. We evaluated the number of operated levels (1, 2 or 3 levels) and,...

  1. Current approach in diagnosis and management of anterior uveitis

    OpenAIRE

    Agrawal Rupesh; Murthy Somasheila; Sangwan Virender; Biswas Jyotirmay

    2010-01-01

    Uveitis is composed of a diverse group of disease entities, which in total has been estimated to cause approximately 10% of blindness. Uveitis is broadly classified into anterior, intermediate, posterior and panuveitis based on the anatomical involvement of the eye. Anterior uveitis is, however, the commonest form of uveitis with varying incidences reported in worldwide literature. Anterior uveitis can be very benign to present with but often can lead to severe morbidity if not treated...

  2. Double anterior chamber in a patient with glaucoma and microspherophakia

    Directory of Open Access Journals (Sweden)

    Hamid Khakshoor

    2011-01-01

    Full Text Available We report the case of a 16-year-old woman with microspherophakia and secondary open angle glaucoma. The patient presented with a membrane dividing the anterior chamber into two segments without edema or Descemet′s membrane detachment. Slit lamp biomicroscopy, Pentacam, and specular microscopy images were obtained. Double anterior chamber is primarily found in patients with anterior chamber anomalies when there is no history of surgery or trauma.

  3. Winging of scapula due to serratus anterior tear

    Institute of Scientific and Technical Information of China (English)

    Varun Kumar Singh; Gauresh Shantaram Vargaonkar

    2014-01-01

    Winging of scapula occurs most commonly due to injury to long thoracic nerve supplying serratus anterior muscle.Traumatic injury to serratus anterior muscle itself is very rare.We reported a case of traumatic winging of scapula due to tear of serratus anterior muscle in a 19-year-old male.Winging was present in neutral position and in extension of right shoulder joint but not on "push on wall" test.Patient was managed conservatively and achieved satisfactory result.

  4. Transanal stent in anterior resection does not prevent anastomotic leakage

    DEFF Research Database (Denmark)

    Bülow, Steffen; Bulut, O; Christensen, Ib Jarle;

    2006-01-01

    OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS AND METH....... On this basis it was decided to discontinue the study prematurely for ethical reasons. CONCLUSION: Decompression of the anastomosis with a transanal stent does not reduce the risk of anastomotic leakage after anterior resection....

  5. Rehablitation of mandibular fracture with anterior teeth loss

    OpenAIRE

    Singh, Meenakshi; Singh, Ajay; Rajpal, Jaisika; K. K. Gupta; Singh, Vibha

    2011-01-01

    We report here on rehabilitating a case with mandibular fracture and lower anterior teeth loss. Three double-staged implants were placed in the lower anterior region; in an attempt to rehabilitate the condition of five missing lower teeth, two natural teeth were prepared to act as natural abutments. Teeth implant-supported prosthesis was fabricated. Patient with a right mandibular fracture and loss of lower anterior missing teeth was successfully rehabilitated with teeth implant-supported pro...

  6. Audit on necessity of radiographs in anterior shoulder dislocations

    OpenAIRE

    K. Ahmadi, M.D; M. Mofidi, M.D.

    2008-01-01

    AbstractBackground and Purpose: Anterior shoulder dislocation is the most common major joint dislocation. In most cases, this dislocation is being relocated in emergency departments. Routinely, pre and post reduction radiographs are performed. This study was done to determine the necessity of radiographs in the emergency department for management of patients with suspected anterior shoulder dislocation.Materials and Methods: In this case series study, 116 patients suspected of anterior should...

  7. No volumetric differences in the anterior cingulate of psychopathic individuals

    OpenAIRE

    Glenn, Andrea L.; Yang, Yaling; Raine, Adrian; Colletti, Patrick

    2010-01-01

    Functional imaging studies of psychopathy have demonstrated reduced activity in the anterior cingulate, yet it is unclear whether this region is structurally impaired. In this study, we used structural MRI to examine whether volumetric differences exist in the anterior cingulate between psychopathic (n=24) and control (n=24) male participants. We found no group differences in the volume of the anterior cingulate or its dorsal and ventral subregions. Our findings call into question whether the...

  8. Evaluation of Changes in Anterior Segment Configuration by Ultrasound Biomicroscopy after Phacoemulsification and Foldable Intraocular Lens Implantation

    Directory of Open Access Journals (Sweden)

    ilhami Salcan

    2011-08-01

    Full Text Available Purpose: To quantify the configuration changes in anterior segment structures after cataract extraction using ultrasound biomicroscopy (UBM. Material and Method: 33 eyes of 33 patients (21 male, 12 female; mean age: 69.0±8.3 years with senile or presenile cataracts undergoing cataract surgery were prospectively studied. UBM was performed for each patient before and 1 month after surgery. At each UBM examination, axial images of the anterior chamber and radial sections of the angle in four quadrants were obtained. The measurements were performed by using the calipers included in the equipment software and UBM Pro2000® software. Results: After cataract surgery, we determined statistically significant increases in anterior chamber depth and angle parameters (p=0.001. We found that the postoperative increases in anterior chamber depth, angle recess area, angle opening distance 250 and angle opening distance 500 were 1.3, 1.4, 1.7 and 1.5 times, respectively, when compared with the preoperative levels. Decreases in acceleration and increases in y-intercept were determined in 4 quadrants postoperatively by of linear regression analysis of anterior chamber angle and these were also statistically significant (p=0.001. Discussion: UBM gives both qualitative and quantitative valuable information about anterior segment structures. We think that UBM may be a useful tool for evaluation of patients with cataract and occludable and/or narrow angles undergoing cataract surgery for therapeutic purpose. (Turk J Ophthalmol 2011; 41: 200-6

  9. Winging of scapula due to serratus anterior tear

    Directory of Open Access Journals (Sweden)

    Varun Singh Kumar

    2014-10-01

    Full Text Available 【Abstract】Winging of scapula occurs most commonly due to injury to long thoracic nerve supplying serratus anterior muscle. Traumatic injury to serratus anterior muscle itself is very rare. We reported a case of traumatic winging of scapula due to tear of serratus anterior muscle in a 19-year-old male. Winging was present in neutral position and in extension of right shoulder joint but not on "push on wall" test. Patient was managed conservatively and achieved satisfactory result. Key words: Serratus anterior tear; Scapula; Wounds and injuries

  10. Anterior Segment Eye Assessment of Refractive Surgery Candidates in the Southeast of Iran.

    Science.gov (United States)

    Nakhjavanpour, Neda; Payandeh, Abolfazl; Rajabi, Majid; Shoja, Vahid

    2016-01-01

    Anterior segment eye parameters are essential factors in diagnosis, screening and management of abnormal ocular conditions. Based on the previous studies, they might differ from one race or population to another. Sistan-and-Baluchestan province, the southeast of Iran, has special weather conditions and race, plus lack of research on these diagnostic factors. Hence, the objective of the present study was to assess anterior segment parameters using pentacam in this area. 800 eyes of subjects which had been referred to the Al-Zahra eye hospital of Zahedan, the capital city of the province, for corneal refractive surgery from October 2014 to March 2015 participated in this research. 95% confidence limits for mean of central corneal thickness, anterior chamber depth and volume were (536.02, 541.20), (3.13, 3.18) and (187.63, 192.58) respectively. Multiple linear regression models showed a lower mean central corneal thickness, and maximum/minimum of keratometry, for males than females, adjusting for age and spherical equivalent. Inversely, anterior chamber depth, and volume were more in males. In order to diagnosis and treating ocular diseases which have effect on retinal thickness, precisely specification of predictive factors is highly needed. PMID:27357884

  11. Exploring the role of the posterior middle temporal gyrus in semantic cognition: Integration of anterior temporal lobe with executive processes.

    Science.gov (United States)

    Davey, James; Thompson, Hannah E; Hallam, Glyn; Karapanagiotidis, Theodoros; Murphy, Charlotte; De Caso, Irene; Krieger-Redwood, Katya; Bernhardt, Boris C; Smallwood, Jonathan; Jefferies, Elizabeth

    2016-08-15

    Making sense of the world around us depends upon selectively retrieving information relevant to our current goal or context. However, it is unclear whether selective semantic retrieval relies exclusively on general control mechanisms recruited in demanding non-semantic tasks, or instead on systems specialised for the control of meaning. One hypothesis is that the left posterior middle temporal gyrus (pMTG) is important in the controlled retrieval of semantic (not non-semantic) information; however this view remains controversial since a parallel literature links this site to event and relational semantics. In a functional neuroimaging study, we demonstrated that an area of pMTG implicated in semantic control by a recent meta-analysis was activated in a conjunction of (i) semantic association over size judgements and (ii) action over colour feature matching. Under these circumstances the same region showed functional coupling with the inferior frontal gyrus - another crucial site for semantic control. Structural and functional connectivity analyses demonstrated that this site is at the nexus of networks recruited in automatic semantic processing (the default mode network) and executively demanding tasks (the multiple-demand network). Moreover, in both task and task-free contexts, pMTG exhibited functional properties that were more similar to ventral parts of inferior frontal cortex, implicated in controlled semantic retrieval, than more dorsal inferior frontal sulcus, implicated in domain-general control. Finally, the pMTG region was functionally correlated at rest with other regions implicated in control-demanding semantic tasks, including inferior frontal gyrus and intraparietal sulcus. We suggest that pMTG may play a crucial role within a large-scale network that allows the integration of automatic retrieval in the default mode network with executively-demanding goal-oriented cognition, and that this could support our ability to understand actions and non

  12. Síndrome tóxica do segmento anterior Toxic anterior segment syndrome

    Directory of Open Access Journals (Sweden)

    Luiz Filipe de Albuquerque Alves

    2013-02-01

    Full Text Available A síndrome tóxica do segmento anterior (STSA é uma severa reação inflamatória aguda causada por agente não infeccioso que entra no segmento anterior, resultando em lesão celular tóxica com necrose e apoptose mediado por resposta imunológica. Neste relato de caso de STSA são enfatizadas as causas mais comuns para o aparecimento da síndrome, apontam para os cuidados que devem ser tomados no processo de esterilização do material cirúrgico além de revisar a melhor conduta diante desses casos. Em conclusão notou-se que o foco principal deve ser a prevenção, pois o tratamento busca apenas suprimir a resposta inflamatória secundária. O tratamento nos casos de STSA consiste em intensa instilação de esteróides tópicos com seguimento rigoroso e controle de complicações tardias como o glaucoma.Toxic anterior segment syndrome is acute inflammatory reaction caused by a noninfectious substance that enters the anterior segment, resulting in extracellular damage with necrosis and apoptosis during an immune response. We have the report of a case of toxic anterior segment syndrome (TASS, in which the authors seek to emphasize the most common causes of the appearance of these syndrome. They point out the care that must be taken in the process of sterilization of surgical material, in addition to reviewing the best conduct when faced with these cases. In conclusion, it was noted that the main focus should be on prevention, as treatment only seeks to suppress the secondary inflammatory response. Treatment in cases of toxic anterior segment syndrome (TASS consists of intense instillation of topical steroids with strict follow-up and control of late complications such as glaucoma.

  13. Single Anterior Tooth Replacement by a Cast Lingual Loop Connector - A Conservative Approach

    OpenAIRE

    Dandekeri, Shilpa Sudesh; Dandekeri, Savita

    2014-01-01

    One of the most challenging and complex treatment modality is replacement of single anterior tooth. This can be overcome by different treatment options such as implant-supported restorations as well as conventional porcelain-fused-to-metal and resin-bonded fixed partial dentures. Drifting of teeth into the edentulous area may reduce the available pontic space; whereas a diastema existing before an extraction may result in excessive mesiodistal dimension to the pontic space. Loop connector fix...

  14. Bipartite Anterior Extraperitoneal Teratoma: Evidence for the Embryological Origins of Teratomas?

    OpenAIRE

    Keene, D. J. B.; Craigie, R. J.; Shabani, A.; Batra, G.; Hennayake, S.

    2011-01-01

    Teratomas are thought to arise from totipotent primordial germ cells (PGCs) Dehner (1983) which may miss their target destination Moore and Persaud (1984). Teratomas can occur anywhere from the brain to the coccygeal area but are usually in the midline close to the embryological position of the gonadal ridges Bale (1984), Nguyen and Laberge (2000). We report a case of a bipartite anterior extraperitoneal teratoma. This is an unusual position for a teratoma, but one which may support the “mis...

  15. Combined operative technique with anterior surgical approach and video-assisted thoracoscopic surgical lobectomy for anterior superior sulcus tumours.

    Science.gov (United States)

    Yokoyama, Yuhei; Chen, Fengshi; Aoyama, Akihiro; Sato, Toshihiko; Date, Hiroshi

    2014-11-01

    Video-assisted thoracoscopic surgery (VATS) has been widely used, but surgical resections of superior sulcus tumours remain challenging because of their anatomical location. For such cases, less-invasive procedures, such as the anterior transcervical-thoracic and transmanubrial approaches, have been widely performed because of their excellent visualization of the subclavian vessels. Recently, a combined operative technique with an anterior surgical approach and VATS for anterior superior sulcus tumours has been introduced. Herein, we report three cases of anterior superior sulcus tumours successfully resected by surgical approaches combined with a VATS-based lobectomy. In all cases, operability was confirmed by VATS, and upper lobectomies with hilar and mediastinal lymph node dissections were performed. Subsequently, dissections of the anterior inlet of the tumours were performed using the transmanubrial approach in two patients and the anterior trans-cervical-thoracic approach in one patient. Both approaches provided excellent access to the anterior inlet of the tumour and exposure of the subclavian vessels, resulting in radical resection of the tumour with concomitant resection of the surrounding anatomical structures, including the chest wall and vessels. In conclusion, VATS lobectomy combined with the anterior surgical approach might be an excellent procedure for the resection of anterior superior sulcus tumours.

  16. Neurologic complication after anterior sciatic nerve block.

    Science.gov (United States)

    Shah, Shruti; Hadzic, Admir; Vloka, Jerry D; Cafferty, Maureen S; Moucha, Calin S; Santos, Alan C

    2005-05-01

    The lack of reported complications related to lower extremity peripheral nerve blocks (PNBs) may be related to the relatively infrequent application of these techniques and to the fact that most such events go unpublished. Our current understanding of the factors that lead to neurologic complications after PNBs is limited. This is partly the result of our inability to conduct meaningful retrospective studies because of a lack of standard and objective monitoring and documentation procedures for PNBs. We report a case of permanent injury to the sciatic nerve after sciatic nerve block through the anterior approach and discuss mechanisms that may have led to the injury. Intraneural injection and nerve injury can occur in the absence of pain on injection and it may be heralded by high injection pressure (resistance).

  17. Tibial Tubercle Osteotomy for Anterior Knee Pain

    Science.gov (United States)

    Bonasia, Davide; Rosso, Federica; Cottino, Umberto; Governale, Giorgio; Cherubini, Valeria; Dettoni, Federico; Bruzzone, Matteo; Rossi, Roberto

    2016-01-01

    Objectives: The aim of this study was to evaluate the mid-term radiological and clinical outcomes of tibial tubercle osteotomy in patients affected by anterior knee pain. In addition, prognostic factors correlated with the outcomes were evaluated. Methods: The patients treated with tibial tubercle osteotomy (anteromedialization) for anterior knee pain between 2002 and 2014 were included. Exclusion criteria: 1) previous knee surgeries; 2) different procedures to treat anterior knee pain; 3) history of patellar dislocation, 4) Rheumatic conditions. Different variables were collected, as shown in. The patients were prospectively evaluated using the WOMAC short form and Kujala scores. An objective evaluation was performed looking for different potential risk factors and using part of the International Knee Documentation Committee (IKDC) score. Radiological evaluation was performed, including the congruence angle, the grade of osteoarthritis (Kellegren-Lawrence) and the patellar tilt angle. Three main outcomes were identified. The multiple logistic regression was used to analyze the correlation between the variables and a worse outcome. Results: 72 cases were included in the study (9 bilateral). 72.2% of the cases were female, and the average age was 42,2 years (SD15,9). The average BMI was 24.4 kg/m2 (SD5,2). In 70.8% of patients a lateral release was associated to the tibial tubercle osteotomy. 77.8% of patients were evaluated clinically, the remaining, who were unable to come for the visits, were interviewed and the subjective scores were administered by phone. The average follow-up was 68.4 months (SD35.5).In 62.5% of cases a valgus lower limb alignment was detected, with 25% and 39.3% of patients having respectively an increased femoral antiversion and foot pronation. Post-operatively there was a statistical significant improvement in all the scores. No differences in the pre-operative and post-operative congruence angle or patellar tilt were detected (p>0.05). All

  18. RETAINED STONE PIECE IN ANTERIOR CHAMBER

    Directory of Open Access Journals (Sweden)

    ZvornicaninJasmin, Nadarevic-VodencarevicAmra

    2015-04-01

    Full Text Available ABSTRACT We read with interest the article by Surekha et al. regarding the retained stone piece in anterior chamber. Similar to the results of previous studies, the authors found that delayed intraocular foreign body (IOFB management can result in good visual outcome without an apparent increased risk of endophthalmitis or other deleterious side effects. However, the authors failed to explain the exact reason for the diminution of vision in patients left eye. It is unclear what the uncorrected visual acuity was and what kind of correction was used, more precisely type and amount of cylinder, given the presence of the corneal opacity. Since the size of the IOFB is approximately 4x4x1mm, significant irido-corneal angle changes resulting in intraocular pressure raise and optic nerve head damage can be expected. Traumatic glaucoma following open globe injury can occur in 2.7 to 19% of cases, with several risk factors associated with glaucoma development (advanced age, poor visual acuity at presentation,perforating rather than penetrating ocular injury,lens injury, presence of vitreous hemorrhage and presence of an IOFB. Earlier reportsof latetraumaticoptic neuropathy onset, even after several years, indicate that this possibility cannot be completely ruled out too. Therefore, repeated intraocular pressure measurements, gonioscopy, pupillary reaction assessment, together with through posterior segment examination including visual field and optical coherence tomography examinations can be useful in determining the possible optic nerve damage as one of the possible reasons for visual acuity reduction. The authors did not suggest any operative treatment at this time. However, it should bear in mind that the inert anterior chamber IOFB could be a risk factor for non-infectious endophthalmitis development even after many years. Also, long term retained anterior chamber foreign body leads to permanent endothelial cell loss and can even result in a corneal

  19. Foreign Body Embedded in Anterior Chamber Angle

    Directory of Open Access Journals (Sweden)

    Shmuel Graffi

    2012-01-01

    Full Text Available Introduction. We present a case of a metallic foreign body embedded in the anterior chamber angle. After standing in close proximity to a construction worker breaking a tile, a 26-year-old woman using soft contact lens for the correction of mild myopia presented to emergency department for evaluation of a foreign body sensation of her right eye. Methods and Results. Diagnosis was confirmed by gonioscopic examination and a noncontrast CT scan of head and orbits. The foreign body was removed by an external approach without utilizing a magnet. The patient's final outcome was favorable. Discussion. The above is a rare clinical situation, which is impossible to detect on slit-lamp examination without a gonioscopic view. Proper imaging and a specific management are mandatory in order to achieve favorable outcome.

  20. MR imaging evaluation of anterior cruciate ligaments

    International Nuclear Information System (INIS)

    On 546 knees, the authors have obtained MR images (0.5 T or 1.5 T). The protocol included 5-mm-thick contiguous sagittal and oblique coronal images (in the plane of the anterior cruciate ligament [ACL]) and T1-, proton-density-, and T2-weighted sequences. In 174 patients, correlations with arthroscopic or surgical findings were available. In these cases, sagittal and oblique coronal images were retrospectively and separately read by two radiologists, who were blinded to other results. The mean accuracy of sagittal MR images alone was 88% for the depiction of partial and complete ACL tears, intraligamental bleeding, and scarring; the accuracy of oblique coronal images alone was 96%. Use of sagittal and oblique coronal images together achieved 98% accuracy

  1. Patellotibial contusions in anterior cruciate ligament tears.

    Science.gov (United States)

    Wissman, Robert D; England, Eric; Mehta, Kaushal; Nepute, Joshua; Von Fischer, Nathaniel; Apgar, Josh; Javadi, Ariyan

    2014-02-01

    Bone contusions are an important ancillary finding of many knee injuries. Not only are they a source of pain, they may suggest a mechanism of injury or a specific derangement of the knee joint. We have encountered a small number of patients being evaluated for anterior cruciate ligament (ACL) tears with unexplained patellar and tibial edema at magnetic resonance (MR) imaging. We present three individuals with contusions of the inferior patella with a corresponding contusion of the anteromedial tibial plateau. Internal derangements in these patients were similar to other individuals with acute ACL tears, however osseous contusions were more widespread. In conclusion, patellotibial contusions are rare and may indicate an injury with forces greater than usually encountered in most ACL tears. A careful search for uncommon associated injuries is prudent in these high-energy knee injuries. PMID:24037484

  2. Concrescent triplets involving primary anterior teeth

    Directory of Open Access Journals (Sweden)

    Urvashi Sharma

    2013-01-01

    Full Text Available Odontogenesis is a complex process wherein more than 200 genes are known to play a significant role in tooth development. An imbalance can lead to an abnormality in the number, size, shape or structure of the developing tooth/teeth. The presence of an extra dental lamina forms a supernumerary tooth. The supernumerary teeth are of two types: A rudimentary tooth where the supernumerary tooth does not resemble any tooth in the normal series or a supplemental tooth in which this anomalous tooth resembles one in the normal series. It is also very rare to encounter triple teeth in primary dentition. The union of these teeth may be through fusion, gemination, concrescence or a combination of fusion and gemination. Presented is a rare case of concrescence involving maxillary deciduous incisors and a supplemental tooth in a 7-year-old boy. The differential diagnosis, etiology, and complications of primary anterior triple teeth are discussed.

  3. Anterior cruciate ligament injuries: etiology and prevention.

    Science.gov (United States)

    Brophy, Robert H; Silvers, Holly J; Mandelbaum, Bert R

    2010-03-01

    The relatively high risk of noncontact anterior cruciate ligament (ACL) rupture among female athletes has been a major impetus for investigation into the etiology of this injury. A number of risk factors have been identified, both internal and external to the athlete, including neuromuscular, anatomical, hormonal, shoe-surface interaction, and environmental, such as weather. The anatomic and neuromuscular risk factors, often gender related, are the focus of most ACL injury prevention programs. Although studies have shown that biomechanic- centered prevention programs can reduce the risk of ACL injury, many questions remain unanswered. More research is needed to increase our understanding of the risk factors for ACL injury; how injury prevention programs work and can the clinical application of such programs be optimized. PMID:20160623

  4. Endoscopic anterior decompression in cervical disc disease

    Directory of Open Access Journals (Sweden)

    Yad Ram Yadav

    2014-01-01

    Full Text Available Background: Although microscopic anterior cervical discectomy with or without fusion are common surgical procedures for treatment of cervical herniated discs, loss of disc height, pseudarthrosis, and adjacent disc degeneration are some of the problems associated with it. This study is aimed to evaluate results of endoscopic microforaminotomy in cervical disc diseases. Materials and Methods: A prospective study of 50 patients of mono segmental soft or hard disc causing myeloradiculopathy was undertaken. A visual analogue scale (VAS for neck and arm pain and functional outcomes using the Nurick grading system were assessed. There were 28, 12, 8, and 2 patients at C5-6, C6-7, C4-5, and C3-4 levels disc diseases, respectively. Patients with two or more level disc, instabilities, disc extending more than half vertebral body height, and previous operation at the same segment were excluded. Results: Age ranged from 21 to 67 years. Average postoperative reduction in disc height, operating time, and blood loss was 1.1 mm, 110 minutes, and 30 ml, respectively. Average pre-operative VAS score for arm pain and Nurick grading was 7.6 and 2.7, which improved to 1.9 and 0.82, respectively. All patients improved; 1, 2, 3 grade improvement was seen in 10, 27, and 10 patients, respectively. There was no significant complication or any mortality. Conclusion: Although longer follow up of large number of patients is required, endoscopic microforaminotomy is a safe and an effective alternative to microscopic anterior discectomy with or without fusion.

  5. Etiological aspects of anterior open bite

    Directory of Open Access Journals (Sweden)

    Stojanović Ljiljana

    2007-01-01

    Full Text Available Introduction. Open bite is a multifactorial phenomenon and no single factor can account for open-bite. Etiology plays an important role in diagnosis. Heredity, unfavorable growth patterns, incorrect jaw postoure, are the characteristics of skeletal open bite. Digit sucking. Depending on where the thumb is placed, a number of different types of dental problems can develop. Malocclusions of the late mixed or permanent dentitions, caused by thumb sucking are not self corrected and orthodontic treatment is necessary for their correction. Lymphatic tissue. In order to produce oral respiration, the mandible is postured inferiorly with the tongue protruded and resting against the oral floor. This postural alteration induces dental and skeletal modifications similar to those caused by thumb sucking. This may cause excessive eruption of the posterior teeth, leading to an increase in the vertical dimension of the face and result in development of anterior open bite. Tongue thrust. Tongue habits cause an anterior open bite or they develop secondarily to thumb sucking. In skeletal open bite the tongue habit acts as a secondary factor which helps to maintain or exacerbate the condition. Many orthodontists have had a discouraging experience of completing dental treatment, with what appeared to be good results, only to discover that the case had relapsed because the patient had a tongue thrust swallowing pattern. Conclusion. Dentoalveolar or habitual open bite is caused by habits, which influence the growth and development of dentoalveolar processes and contribute to occlusal disharmonies. Prior to eruption of adult dentition, open bite related to oral habits is usually not a concern as when the habits stop, because the erupting dentition tends to improve spontaneously. Treatment is usually not necessary until permanent teeth erupt (~6 years old. .

  6. Clinical Outcomes Following Revision Anterior Shoulder Stabilization

    Science.gov (United States)

    Frank, Rachel M.; Mellano, Chris; Shin, Jason J.; Feldheim, Terrence F.; Mascarenhas, Randhir; Yanke, Adam Blair; Cole, Brian J.; Nicholson, Gregory P.; Romeo, Anthony A.; Verma, Nikhil N.

    2015-01-01

    Objectives: The purpose of this study was to determine the clinical outcomes following revision anterior shoulder stabilization performed either via all-arthroscopic soft tissue repair or via Latarjet coracoid transfer. Methods: A retrospective review of prospectively collected data on 91 shoulders undergoing revision anterior shoulder stabilization was performed. All patients underwent prior soft tissue stabilization; those with prior open bone grafting procedures were excluded. For patients with 25% glenoid bone loss, Latarjet was performed (n=28). Patients were queried regarding recurrent instability (subluxation or dislocation). Clinical outcomes were evaluated using validated patient reported outcome questionnaires including the American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), visual analog scale (VAS) for pain, and Western Ontario Shoulder Instability Index (WOSI). Results: A total of 63 shoulders in 62 patients (46 males, 16 females) with an average age of 23.2 ± 6.9 years were included in the revision arthroscopy group. At an average follow-up of 46.9 ± 16.8 months (range, 15 to 78), the mean WOSI score was 80.1 (range, 15.0 to 100), and there were significant improvements (pLatarjet group. Thirteen (46%) had more than one previous stabilization attempt. ), the average WOSI score was 71.9, and there were significant improvements (pLatarjet. Conclusion: Both arthroscopic revision stabilization and Latarjet coracoid transfer result in satisfactory outcomes in patients who have failed previous arthroscopic capsulolabral repair. Recurrent instability rates were higher in the all-arthroscopic group (19% versus 7%). Longer-term studies are required to determine whether similar results are maintained over time, and to provide guidance on focused clinical indications for this challenging patient population.

  7. Pleasant human touch is represented in pregenual anterior cingulate cortex.

    Science.gov (United States)

    Lindgren, Lenita; Westling, Göran; Brulin, Christine; Lehtipalo, Stefan; Andersson, Micael; Nyberg, Lars

    2012-02-15

    Touch massage (TM) is a form of pleasant touch stimulation used as treatment in clinical settings and found to improve well-being and decrease anxiety, stress, and pain. Emotional responses reported during and after TM have been studied, but the underlying mechanisms are still largely unexplored. In this study, we used functional magnetic resonance (fMRI) to test the hypothesis that the combination of human touch (i.e. skin-to-skin contact) with movement is eliciting a specific response in brain areas coding for pleasant sensations. The design included four different touch conditions; human touch with or without movement and rubber glove with or without movement. Force (2.5 N) and velocity (1.5 cm/s) were held constant across conditions. The pleasantness of the four different touch stimulations was rated on a visual analog scale (VAS-scale) and human touch was rated as most pleasant, particularly in combination with movement. The fMRI results revealed that TM stimulation most strongly activated the pregenual anterior cingulate cortex (pgACC). These results are consistent with findings showing pgACC activation during various rewarding pleasant stimulations. This area is also known to be activated by both opioid analgesia and placebo. Together with these prior results, our finding furthers the understanding of the basis for positive TM treatment effects.

  8. Tireoide ectópica no mediastino anterior Ectopic thyroid in the anterior mediastinum

    Directory of Open Access Journals (Sweden)

    Maria José Araújo da Cunha Guimarães

    2009-04-01

    Full Text Available A ectopia de tireoide é rara, e a sua localização no mediastino anterior é excepcional, estando descritos apenas 5 casos nos últimos 30 anos. Os autores apresentam 2 casos clínicos, além de uma revisão da literatura abordando a etiologia, a embriologia e manifestações clínicas de ectopia de tireoide.Ectopic thyroid is a rare condition, and its location in the anterior mediastinum is even rarer, there having been only 5 reported cases in the past 30 years. Here, we describe 2 clinical cases and present a review of the literature regarding the etiology, embryology and clinical manifestations of ectopic thyroid.

  9. Transphyseal anterior cruciate ligament reconstruction in a skeletally immature knee using anterior tibialis allograft.

    Science.gov (United States)

    Cho, Yool; Jang, Soo-Jin; Son, Jung-Hwan

    2011-05-18

    Anterior cruciate ligament (ACL) injury in the skeletally immature individual is being recognized with increasing frequency. Nonoperative treatment of ACL injuries in skeletally immature patients have not been favorable. Surgical treatment options for complete ACL tears include primary ligament repair, extraarticular tenodesis, transphyseal reconstruction, partial transphyseal reconstruction, and physeal-sparing reconstruction. The advantage of transphyseal reconstruction is placement of the graft tissue in an isometric position, which provides better results, according to the literature. The potential disadvantage is angular or limb-length discrepancy caused by physeal violation. Controversy exists in allograft selection about whether bone or soft tissue passes into physes. The use of standard tunnels provides reliable results, but carries the risk of iatrogenic growth disturbance from physeal injury.This article presents 4 cases of transphyseal ACL reconstruction using anterior tibialis allograft in skeletally immature patients that had satisfactory functional outcomes with no growth disturbances. This is the first report of transphyseal ACL reconstruction using anterior tibialis allograft in skeletally immature patients in the English-speaking literature. All patients underwent transphyseal ACL reconstruction using anterior tibialis tendon allograft. None of the patients had angular deformities. No early physeal arrest was measured between the preoperative and postoperative radiographs. At last follow-up, the results of the Lachman test were normal for 3 patients and nearly normal for 1 patient. All patients demonstrated full range of knee motion (comparing the reconstructed knee to the contralateral knee). The results of the pivot-shift test were normal for 3 patients and nearly normal for 1 patient. No patients reported giving way.

  10. [Key points in anterior esthetic restorations with all ceramic].

    Science.gov (United States)

    Luo, Xiaoping; Qian, Dongdong; Yuan, Yu; Meng, Xiangfeng

    2013-04-01

    This paper introduced the key points in fabricating anterior esthetic restorations with all ceramic materials, including pre-operative smile design, standard tooth preparation, provisional restoration fabrication, all ceramic materials selection, all ceramic restoration bonding, ceramic crack and fracture prevention. And then, the authors summarized and reviewed the clinical common problems in anterior esthetic restorations.

  11. Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

    DEFF Research Database (Denmark)

    Roemer, Frank W; Frobell, Richard; Lohmander, Stefan;

    2014-01-01

    OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN...

  12. Dysphagia due to anterior cervical osteophytosis: case report

    OpenAIRE

    Frederico Miguel Santos Silva Marquez Correia; João Paulo de Sousa Goucha Jorge; Ana Sofia Teixeira Neves; Gabriel Filipe Gonçalves Xavier; Marco Miguel Barroso de Oliveira; José Eduardo Paiva Ferreira

    2014-01-01

    The objective of this study is to highlight the possibility of dysphagia induced by anterior cervical osteophytes. When not diagnosed early this condition may be responsible for complications such as severe dysphagia and potential lung aspiration, especially in elderly patients. Analysis of a case report of a 72-year old woman who presented cervical pain and progressive dysphagia. Imaging studies have shown anterior ce...

  13. [Bilateral anterior uveiopapillitis, suspicious of Lyme disease--case report].

    Science.gov (United States)

    Nicula, Cristina; Nicula, D; Rusu, Ioana; Popescu, Raluca

    2013-01-01

    We present the case of a patient which associated bilateral anterior uveitis manifestations with those of bilateral anterior inflammatory optic neuropathy. We followed the evolution of the case under treatment and we discussed the differential diagnosis and the association of the two ocular pathologies.

  14. Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

    NARCIS (Netherlands)

    van Eijk, F.

    2009-01-01

    This thesis describes the long-term results of reconstruction of the anterior cruciate ligament with an allograft. Due to the poor results found, further studies were performed to investigate alternative strategies for reconstruction of the anterior cruciate ligament in the field of tissue engineeri

  15. Anterior chamber cholesterolosis in a patient with retinoblastoma.

    Science.gov (United States)

    Hong, Bryan K; Say, Emil Anthony T; Chévez-Barrios, Patricia; Lee, Thomas C; Kim, Jonathan W

    2016-01-01

    Anterior chamber cholesterolosis is a rare phenomenon typically associated with non-neoplastic conditions such as hyphema or Coats disease; it has never been reported to be associated with intraocular malignancy. We report a case of anterior chamber cholesterolosis presenting in the setting of retinoblastoma and discuss clinical features relevant for its differentiation from Coats disease. PMID:27330481

  16. Return to Play Following Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Morris, Ryan C; Hulstyn, Michael J; Fleming, Braden C; Owens, Brett D; Fadale, Paul D

    2016-10-01

    Anterior cruciate ligament reconstructions are commonly performed in an attempt to return an athlete to sports activities. Accelerated rehabilitation has made recovery for surgery more predictable and shortened the timeline for return to play. Despite success with and advancements in anterior cruciate ligament reconstructions, some athletes still fail to return to play. PMID:27543405

  17. Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

    OpenAIRE

    Eijk, F. van

    2009-01-01

    This thesis describes the long-term results of reconstruction of the anterior cruciate ligament with an allograft. Due to the poor results found, further studies were performed to investigate alternative strategies for reconstruction of the anterior cruciate ligament in the field of tissue engineering.

  18. Bilateral agenesis of the anterior cruciate ligament: MRI evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Bedoya, Maria A.; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Radiology Department, Philadelphia, PA (United States); McGraw, Michael H. [Hospitalof theUniversityof Pennsylvania, Divisionof Orthopaedics, Philadelphia, PA (United States); Wells, Lawrence [The Children' s Hospital of Philadelphia, Division of Orthopaedics, Philadelphia, PA (United States)

    2014-09-15

    Bilateral agenesis of the anterior cruciate ligament (ACL) is extremely rare. We describe a 13-year-old girl who presented with bilateral knee pain without history of trauma; she has two family members with knee instability. Magnetic resonance imaging showed bilateral absence of the ACL, and medial posterior horn meniscal tears. Bilateral arthroscopic partial meniscectomy and anterior cruciate ligament reconstruction was performed. (orig.)

  19. Temporal and spatial requirements for Nodal-induced anterior mesendoderm and mesoderm in anterior neurulation.

    Science.gov (United States)

    Gonsar, Ngawang; Coughlin, Alicia; Clay-Wright, Jessica A; Borg, Bethanie R; Kindt, Lexy M; Liang, Jennifer O

    2016-01-01

    Zebrafish with defective Nodal signaling have a phenotype analogous to the fatal human birth defect anencephaly, which is caused by an open anterior neural tube. Previous work in our laboratory found that anterior open neural tube phenotypes in Nodal signaling mutants were caused by lack of mesendodermal/mesodermal tissues. Defects in these mutants are already apparent at neural plate stage, before the neuroepithelium starts to fold into a tube. Consistent with this, we found that the requirement for Nodal signaling maps to mid-late blastula stages. This timing correlates with the timing of prechordal plate mesendoderm and anterior mesoderm induction, suggesting these tissues act to promote neurulation. To further identify tissues important for neurulation, we took advantage of the variable phenotypes in Nodal signaling-deficient sqt mutant and Lefty1-overexpressing embryos. Statistical analysis indicated a strong, positive correlation between a closed neural tube and presence of several mesendoderm/mesoderm-derived tissues (hatching glands, cephalic paraxial mesoderm, notochord, and head muscles). However, the neural tube was closed in a subset of embryos that lacked any one of these tissues. This suggests that several types of Nodal-induced mesendodermal/mesodermal precursors are competent to promote neurulation.

  20. Method for measuring anterior chamber volume by image analysis

    Science.gov (United States)

    Zhai, Gaoshou; Zhang, Junhong; Wang, Ruichang; Wang, Bingsong; Wang, Ningli

    2007-12-01

    Anterior chamber volume (ACV) is very important for an oculist to make rational pathological diagnosis as to patients who have some optic diseases such as glaucoma and etc., yet it is always difficult to be measured accurately. In this paper, a method is devised to measure anterior chamber volumes based on JPEG-formatted image files that have been transformed from medical images using the anterior-chamber optical coherence tomographer (AC-OCT) and corresponding image-processing software. The corresponding algorithms for image analysis and ACV calculation are implemented in VC++ and a series of anterior chamber images of typical patients are analyzed, while anterior chamber volumes are calculated and are verified that they are in accord with clinical observation. It shows that the measurement method is effective and feasible and it has potential to improve accuracy of ACV calculation. Meanwhile, some measures should be taken to simplify the handcraft preprocess working as to images.

  1. The relationship between the morphological features of A1 segment of anterior cerebral artery and anterior communicating artery aneurysms

    Institute of Scientific and Technical Information of China (English)

    冯文峰

    2013-01-01

    Objective To improve the predictability of surgical clipping and guide the steam shaping of microcatheters in endovascular embolization by analyzing the association of morphological features of A1 segment of anterior cerebral artery(ACA) with formation and classification of anterior

  2. Anterior tension band plating for anterior tibial stress fractures in high-performance female athletes - A report of 4 cases

    NARCIS (Netherlands)

    O. Borens; M.K. Sen; R.C. Huang; J. Richmond; P. Kloen; J.B. Jupiter; D.L. Helfet

    2006-01-01

    Stress fracture of the anterior tibial cortex is an extremely challenging fracture to treat, especially in the high-performance female athlete who requires rapid return to competition. Previous reports have not addressed treating these fractures in the world-class athlete with anterior plating. We h

  3. Catarata polar anterior piramidal deslocada para a câmara anterior causando edema de córnea: relato de caso Corneal edema caused by a pyramidal anterior polar cataract dislocated to the anterior chamber: case report

    Directory of Open Access Journals (Sweden)

    Ramon Coral Ghanem

    2004-08-01

    Full Text Available Cataratas polares anteriores piramidais são opacidades cônicas que se projetam para a câmara anterior a partir da cápsula anterior do cristalino. Na grande maioria dos pacientes a opacidade permanece aderida e estável durante toda a vida. O objetivo deste trabalho é documentar uma manifestação incomum desse tipo de catarata: a deiscência espontânea das pirâmides para a câmara anterior causando descompensação endotelial e edema corneal bilateral. Relatamos o caso de uma paciente feminina, de 66 anos, branca, que apresentava edema corneal localizado inferiormente no olho direito associado à lesão nodular branco-esclerótica compatível com a pirâmide anterior da catarata polar. O olho esquerdo apresentava edema corneal difuso intenso e presença de uma catarata polar anterior com a região piramidal deslocada para a câmara anterior. Sabe-se que a pirâmide anterior pode permanecer inabsorvida na câmara anterior por longo período, pois é composta de tecido colágeno denso. Isto causa perda endotelial progressiva e edema corneal e deve ser considerada indicação de remoção cirúrgica da catarata polar anterior e de seu fragmento. Ressalta-se, também, a importância do bom senso no julgamento das cataratas polares anteriores, considerando-se tamanho da opacidade, simetria das opacidades e componente cortical associado, na tentativa de se evitar ambliopia.Pyramidal anterior polar cataracts are conical opacities that project into the anterior chamber from the anterior capsule of the lens. In the vast majority of patients the opacity remains bound and stable throughout life. We report an unusual complication of this type of cataract: spontaneous dehiscence of the pyramids to the anterior chamber causing bilateral endothelial damage and corneal edema. 66-year-old white woman presented with inferior corneal edema in the right eye and diffuse corneal edema in the left eye. A white nodular lesion was observed in the inferior angle

  4. Restoring primary anterior teeth: updated for 2014.

    Science.gov (United States)

    Waggoner, William F

    2015-01-01

    The purpose of this paper was to review the current literature associated with the techniques and materials for the restoration of primary anterior teeth and make clinical recommendations based upon the available literature. A variety of esthetic restorative materials are available to utilize for restoring primary incisors. Awareness of the specific strengths, weakness, and properties of each material can enhance the clinician's ability to make the best choice of selection for each individual situation. Intracoronal restorations of primary teeth may utilize resin composites, glass ionomer cements, resin-modified ionomers, or polyacid-modified resins. Full coronal restoration of primary incisors may be indicated for a number of reasons. Crowns available for restoration of primary incisors include those that are directly bonded onto the tooth, which generally are a resin material, and crowns that are luted onto the tooth and are either some type of stainless steel or zirconia crown. There is insufficient controlled, clinical data to suggest that one type of restoration is superior to another. Operator preferences, esthetic demands by parents, the child's behavior, the amount of tooth structure remaining, and moisture and hemorrhage control are all variables that affect the decision and ultimate outcome of whatever restorative solution is chosen. PMID:25905657

  5. MRI of anterior cruciate ligament healing

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    Ihara, Hidetoshi; Miwa, Megumi; Deya, Keizo; Torisu, Kenji [Kyushu Rosai Hospital, Kitakyushu (Japan)

    1996-03-01

    The purpose of this study was to evaluate using MRI the natural healing of the anterior cruciate ligament (ACL) when treated conservatively by early protective motion. Consecutive acute complete intraligamentous ruptures of the ACL in 50 cases that were allowed to heal without surgery were evaluated before and after 3 month treatment by MRI, arthroscopy, and stress radiographs. Twenty-nine of the 50 patients were also reevaluated 11 months from the initial injury, of which 7 were reevaluated again 24 months from the initial injury by MRI. The MR appearance of the treated ACL was categorized into four grades depending on homogeneity, straight band, and size. MR assessment of the ACL after 3 month treatment demonstrated a well defined normal-sized straight band in 37 cases (74%). There was a significant relationship between the 3 and 11 month MR evaluations (r. = 0.801, p < 0.0001). There were also significant relationships between the MR and arthroscopic evaluations (r, = 0.455, p < 0.005) and between the MR and stress radiographic evaluations (r, = 0.348, p < 0.025) after the 3 month treatment. MRI can demonstrate ACL healing when treated conservatively with early protective mobilization. 40 refs., 3 figs., 2 tabs.

  6. Principles of postoperative anterior cruciate ligament rehabilitation.

    Science.gov (United States)

    Saka, Tolga

    2014-09-18

    It is known that anterior cruciate ligament (ACL) reconstruction needs to be combined with detailed postoperative rehabilitation in order for patients to return to their pre-injury activity levels, and that the rehabilitation process is as important as the reconstruction surgery. Literature studies focus on how early in the postoperative ACL rehabilitation period rehabilitation modalities can be initiated. Despite the sheer number of studies on this topic, postoperative ACL rehabilitation protocols have not been standardized yet. Could common, "ossified" knowledge or modalities really prove themselves in the literature? Could questions such as "is postoperative brace use really necessary?", "what are the benefits of early restoration of the range of motion (ROM)?", "to what extent is neuromuscular electrical stimulation (NMES) effective in the protection from muscular atrophy?", "how early can proprioception training and open chain exercises begin?", "should strengthening training start in the immediate postoperative period?" be answered for sure? My aim is to review postoperative brace use, early ROM restoration, NMES, proprioception, open/closed chain exercises and early strengthening, which are common modalities in the very comprehensive theme of postoperative ACL rehabilitation, on the basis of several studies (Level of Evidence 1 and 2) and to present the commonly accepted ways they are presently used. Moreover, I have presented the objectives of postoperative ACL rehabilitation in tables and recent miscellaneous studies in the last chapter of the paper. PMID:25232521

  7. Deep anterior lamellar keratoplasty in keratoconus

    Directory of Open Access Journals (Sweden)

    Nikolić Ljubiša

    2011-01-01

    Full Text Available Introduction. Deep anterior lamellar keratoplasty (DALK is intended for the surgical treatment of corneal pathology without the involvement of the endothelium. Sparing of the healthy host endothelium for lifetime is of utmost importance in young patients. Therefore, keratoconus is among the main indications for DALK. Outline of Cases. Two men, 22 and 28 years of age, underwent DALK for the treatment of progressive keratoconus, with low visual acuity, impossible to be corrected with gas-permeable contact lenses, due to the extreme conical protrusion of the cornea. Baring of Descemet’s membrane was achieved with lamellar dissection and peeling off the stroma. An 8.5 mm graft without the endothelium was sutured into an 8.0 mm bed. Both grafts remained clear and attached, without either ocular surface pathology or problems arising from sutures. The best corrected visual acuity was 20/25 and 20/40, with the astigmatism of 2.5 and 3.0 diopters, respectively. The follow-up was one year. Conclusion. This is the first presentation of DALK in our literature. The restoration of corneal transparency and stability, with sparing of the host endothelium, has put DALK among successful corneal tranplantation procedures. Together with Descemet stripping endothelial keratoplasty, which already accounts for almost a half of all our keratoplasties, it offers an alternative to penetrating keratoplasty.

  8. [Rehabilitation after arthroscopic anterior cruciate ligament reconstruction].

    Science.gov (United States)

    Smékal, D; Kalina, R; Urban, J

    2006-12-01

    Rehabilitation is an important part of therapy in patients who have had arthroscopic anterior cruciate ligament reconstruction. A well-designed rehabilitation program avoids potential graft damage and speeds up patients' return to their full function level. The course of rehabilitation depends on the type of surgery, mode of fixation and possible co-existing injury to the knee's soft tissues. The rehabilitation program presented here is based on the present-day knowledge of neurophysiological and biomechanical principles and is divided into five phases. In the pre-operative phase (I), the main objective is to prepare patients for surgery in terms of maximum muscle strength and range of motion. It also includes providing full information on the procedure. In the early post-operative phase (II) we are concerned with pain alleviation and reduction of knee edema. After suture removal we begin with soft techniques for the patella and post-operative physical therapy to reduce scarring. In the next post-operative phase (III) patients are able to walk with their full weight on the extremity operated on, and we continue doing exercises that improve flexor/extensor co-contraction. In this phase we also begin with exercises improving the patient's proprioceptive and sensorimotor functions. In the late post-operative phase (IV) we go on with exercises promoting proprioception of both lower extremities with the aim of increasing muscle control of the knee joints. In the convalescent phase (V) patients gradually return to their sports activities.

  9. [Experimental hypertony caused by obstruction of the anterior chamber angle ab interno (author's transl)].

    Science.gov (United States)

    Maguritsas, N; Vikas, C; Theodossiadis, G; Vergados, I; Velissaropoulos, P

    1976-07-01

    In 30 rabbits, separated into 3 groups (A, B and C), the entire area (A), three quarters (B) half of the anterior chamber angle (C) was experimentally obstructed by means of a homologous scleral graft. In groups A and B a statistically significant change of the intraocular pressure and of the cornea diameter was shown as compared with the control eye and group C. This change is due to the obstructed area of the angle. The increased intraocular pressure lasted for some months. The graft was well tolerated by the tissue of the angle and the obstruction of the angle was total, as was confirmed by means of the histological preparations.

  10. An indirect veneer technique for simple and esthetic treatment of anterior hypoplastic teeth

    Directory of Open Access Journals (Sweden)

    Amit Khatri

    2010-01-01

    Full Text Available This study describes a technique for treating anterior hypoplastic teeth using indirect nanocomposite veneer restoration. The prime advantage of an indirect veneer technique is that it provides an esthetic and conservative result. One of the most frequent reasons that patients seek dental care is discolored anterior teeth. Although treatment options such as removal of surface stains, bleaching, microabrasion or macroabrasion, veneering, and placement of porcelain crowns are available, conservative approach such as veneer preserves the natural tooth as much as possible. Full veneers are recommended for the restoration of localized defects or areas of intrinsic discoloration, which are caused by deeper internal stains or enamel defects. Indirectly fabricated veneers are much less sensitive compared to a operator′s technique and if multiple teeth are to be veneered, indirect veneers can be usually placed much more expeditiously. Indirect veneers last much longer than the direct veneers. Therefore, indirectly fabricated veneers are more advantageous than directly fabricated veneers in many cases.

  11. Congenital Mucous Retention Cyst of the Anterior Hard Palate! the First Case Report

    Science.gov (United States)

    Priyadarshini, Smita; Pati, Abhishek Ranjan; Bhuyan, Sanat Kumar; Panigrahi, Rajat G

    2014-01-01

    Children may be born with birth defects, the most common being oro-facial clefts and fissural cysts. A well circumscribed pedunculated soft tissue growth that occurs congenitally is known as congenital epulis of the newborn or ‘Neuman’s Tumour’ as described in the literature. It is a rare lesion and the diagnosis has to be confirmed histologically. We present a rare case of a 7-year-old child with a congenital growth in the pre-maxillary region of the anterior hard palate clinically diagnosed as congenital epulis however, histologically confirmed as a mucous retention cyst. An elaborate clinical differential diagnosis is discussed. The anterior hard palate is devoid of salivary glands and the presence of a mucous retention cyst in the area is suggestive of ectopic salivary gland tissue and in a child manifesting at birth is probably the first case to be reported in the English literature. PMID:25478467

  12. Anterior segment parameters and eyelids in systemic sclerosis.

    Science.gov (United States)

    Sahin Atik, Sevinc; Koc, Feray; Akin Sari, Sirin; Sefi Yurdakul, Nazife; Ozmen, Mustafa; Akar, Servet

    2016-08-01

    To evaluate main numerical parameters of anterior segment and the effects of eyelid skin changes on these parameters in patients with systemic sclerosis (SSc). Thirty-four patients with SSc and 34 healthy individuals were enrolled. Besides full eye examination, anterior segment measurements including anterior chamber depth (ACD), anterior chamber volume, anterior chamber angle width, central corneal thickness, pupil size, corneal volume and keratometry were obtained using a Sirius Scheimpflug/Placido photography-based topography system. Eyelid thickness was evaluated using the scala of the modified Rodnan skin score and the patients were subgrouped with respect to these scores to evaluate the effect of eyelid thickening on the anterior segment parameters. Age and sex distributions of the groups were similar (p > 0.05). SSc patients had steeper and thinner corneas, smaller corneal volumes, narrower, shallower and smaller anterior segments but only the mean ACD value of right eyes was found significantly less than those of the controls (p = 0.047). The mean ACD values of SSc subgroup patients with moderate to severe eyelid thickening (50 %) had lower ACD measurements compared to those of control group. (p = 0.043 for the right eyes, p = 0.070 for the left eyes). However, SSc subgroup patients with none to mild eyelid thickening (50 %) had similar anterior segment parameters with control subjects (p > 0.05). Anterior chamber parameters of the SSc patients could show significant differences. These differences occur parallel to the eyelid changes but not secondary to it. PMID:26694912

  13. Anterior cruciate ligament allograft transplantation for intraarticular ligamentous reconstruction.

    Science.gov (United States)

    Goertzen, M; Dellmann, A; Gruber, J; Clahsen, H; Bürrig, K F

    1992-01-01

    A multiplicity of surgical operations have been developed in an attempt to achieve satisfactory function after anterior cruciate ligament (ACL) repair. None of these procedures have been able to reproduce the fiber organization anatomy of attachment site, vascularity, or function of the ACL. Twenty-nine foxhounds received a deep-frozen bone-ACL-bone allograft and a ligament augmentation device (LAD). Biomechanical, microvascular, and histological changes were evaluated 3, 6, and 12 months following implantation. The maximum loads of the allograft/LADs were 34.3% (387.2 N) after 3 months, 49.3% (556.6 N) after 6 months, and 61.1% (698.8 N) after a year. The maximum load was 69.1% (780 N). In general, after 6 months the allografts showed normal collagen orientation. The allografts demonstrated no evidence of infection or immune reaction. No bone ingrowth into the LAD was observed. Polarized light microscopy and periodic acid-schiff staining showed that the new bone-ligament substance interface had intact fiber orientation at the area of the ligament insertion. Microvascular examination using the Spalteholtz technique revealed revascularization and the importance of an infrapatellar fat pad for the nourishment of ACL allografts.

  14. Anterior insula coordinates hierarchical processing of tactile mismatch responses.

    Science.gov (United States)

    Allen, Micah; Fardo, Francesca; Dietz, Martin J; Hillebrandt, Hauke; Friston, Karl J; Rees, Geraint; Roepstorff, Andreas

    2016-02-15

    The body underlies our sense of self, emotion, and agency. Signals arising from the skin convey warmth, social touch, and the physical characteristics of external stimuli. Surprising or unexpected tactile sensations can herald events of motivational salience, including imminent threats (e.g., an insect bite) and hedonic rewards (e.g., a caressing touch). Awareness of such events is thought to depend upon the hierarchical integration of body-related mismatch responses by the anterior insula. To investigate this possibility, we measured brain activity using functional magnetic resonance imaging, while healthy participants performed a roving tactile oddball task. Mass-univariate analysis demonstrated robust activations in limbic, somatosensory, and prefrontal cortical areas previously implicated in tactile deviancy, body awareness, and cognitive control. Dynamic Causal Modelling revealed that unexpected stimuli increased the strength of forward connections along a caudal to rostral hierarchy-projecting from thalamic and somatosensory regions towards insula, cingulate and prefrontal cortices. Within this ascending flow of sensory information, the AIC was the only region to show increased backwards connectivity to the somatosensory cortex, augmenting a reciprocal exchange of neuronal signals. Further, participants who rated stimulus changes as easier to detect showed stronger modulation of descending PFC to AIC connections by deviance. These results suggest that the AIC coordinates hierarchical processing of tactile prediction error. They are interpreted in support of an embodied predictive coding model where AIC mediated body awareness is involved in anchoring a global neuronal workspace. PMID:26584870

  15. Anterior insula coordinates hierarchical processing of tactile mismatch responses.

    Science.gov (United States)

    Allen, Micah; Fardo, Francesca; Dietz, Martin J; Hillebrandt, Hauke; Friston, Karl J; Rees, Geraint; Roepstorff, Andreas

    2016-02-15

    The body underlies our sense of self, emotion, and agency. Signals arising from the skin convey warmth, social touch, and the physical characteristics of external stimuli. Surprising or unexpected tactile sensations can herald events of motivational salience, including imminent threats (e.g., an insect bite) and hedonic rewards (e.g., a caressing touch). Awareness of such events is thought to depend upon the hierarchical integration of body-related mismatch responses by the anterior insula. To investigate this possibility, we measured brain activity using functional magnetic resonance imaging, while healthy participants performed a roving tactile oddball task. Mass-univariate analysis demonstrated robust activations in limbic, somatosensory, and prefrontal cortical areas previously implicated in tactile deviancy, body awareness, and cognitive control. Dynamic Causal Modelling revealed that unexpected stimuli increased the strength of forward connections along a caudal to rostral hierarchy-projecting from thalamic and somatosensory regions towards insula, cingulate and prefrontal cortices. Within this ascending flow of sensory information, the AIC was the only region to show increased backwards connectivity to the somatosensory cortex, augmenting a reciprocal exchange of neuronal signals. Further, participants who rated stimulus changes as easier to detect showed stronger modulation of descending PFC to AIC connections by deviance. These results suggest that the AIC coordinates hierarchical processing of tactile prediction error. They are interpreted in support of an embodied predictive coding model where AIC mediated body awareness is involved in anchoring a global neuronal workspace.

  16. Anterior insula coordinates hierarchical processing of tactile mismatch responses

    Science.gov (United States)

    Allen, Micah; Fardo, Francesca; Dietz, Martin J.; Hillebrandt, Hauke; Friston, Karl J.; Rees, Geraint; Roepstorff, Andreas

    2016-01-01

    The body underlies our sense of self, emotion, and agency. Signals arising from the skin convey warmth, social touch, and the physical characteristics of external stimuli. Surprising or unexpected tactile sensations can herald events of motivational salience, including imminent threats (e.g., an insect bite) and hedonic rewards (e.g., a caressing touch). Awareness of such events is thought to depend upon the hierarchical integration of body-related mismatch responses by the anterior insula. To investigate this possibility, we measured brain activity using functional magnetic resonance imaging, while healthy participants performed a roving tactile oddball task. Mass-univariate analysis demonstrated robust activations in limbic, somatosensory, and prefrontal cortical areas previously implicated in tactile deviancy, body awareness, and cognitive control. Dynamic Causal Modelling revealed that unexpected stimuli increased the strength of forward connections along a caudal to rostral hierarchy—projecting from thalamic and somatosensory regions towards insula, cingulate and prefrontal cortices. Within this ascending flow of sensory information, the AIC was the only region to show increased backwards connectivity to the somatosensory cortex, augmenting a reciprocal exchange of neuronal signals. Further, participants who rated stimulus changes as easier to detect showed stronger modulation of descending PFC to AIC connections by deviance. These results suggest that the AIC coordinates hierarchical processing of tactile prediction error. They are interpreted in support of an embodied predictive coding model where AIC mediated body awareness is involved in anchoring a global neuronal workspace. PMID:26584870

  17. Anterior cruciate ligament allograft transplantation for intraarticular ligamentous reconstruction.

    Science.gov (United States)

    Goertzen, M; Dellmann, A; Gruber, J; Clahsen, H; Bürrig, K F

    1992-01-01

    A multiplicity of surgical operations have been developed in an attempt to achieve satisfactory function after anterior cruciate ligament (ACL) repair. None of these procedures have been able to reproduce the fiber organization anatomy of attachment site, vascularity, or function of the ACL. Twenty-nine foxhounds received a deep-frozen bone-ACL-bone allograft and a ligament augmentation device (LAD). Biomechanical, microvascular, and histological changes were evaluated 3, 6, and 12 months following implantation. The maximum loads of the allograft/LADs were 34.3% (387.2 N) after 3 months, 49.3% (556.6 N) after 6 months, and 61.1% (698.8 N) after a year. The maximum load was 69.1% (780 N). In general, after 6 months the allografts showed normal collagen orientation. The allografts demonstrated no evidence of infection or immune reaction. No bone ingrowth into the LAD was observed. Polarized light microscopy and periodic acid-schiff staining showed that the new bone-ligament substance interface had intact fiber orientation at the area of the ligament insertion. Microvascular examination using the Spalteholtz technique revealed revascularization and the importance of an infrapatellar fat pad for the nourishment of ACL allografts. PMID:1389780

  18. Measurement of anterior chamber volume with rotating scheimpflug camera and anterior segment optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    FU Jing; LI Shu-ning; WANG Xiao-zhen; WU Ge-wei; MU Da-peng; WANG Jian; WANG Ning-li

    2010-01-01

    Background Measurement of anterior segment parameters plays an important role in diagnosis and treatment of glaucoma. The objective of this study was to evaluate the repeatability and reproducibility of anterior chamber volume (ACV) measurements with rotating scheimpflug camera (RSC) and to examine agreement with anterior segment optical coherence tomography (AS-OCT). Methods Thirty nine healthy normal subjects were recruited from the Eye Center of Tongren Hospital. ACV was measured using RSC and AS-OCT in a randomly selected eye for each subject. For RSC measurements, both automatic and manual ACV measurements and 2 independent operators' ACV measurements were obtained. All subjects were invited for 3 visits within a week to evaluate repeatability and reproducibility of ACV measurement by RSC. Agreement was evaluated between RSC and AS-OCT. Results Good repeatability and reproducibility were found for both automatic and manual ACV measurements obtained by RSC. For intrasession repeatability, coefficient of variation (CVw) and intraclass correlation coefficient (ICC) values for automatic were 3.52% and 0.98; the values for manual were 3.44% and 0.97, respectively. For intersession reproducibility, the respective CVw and ICC values were 3.96% and 0.96. Good agreement was also found in 2 operators for both automatic and manual ACV measurements; nevertheless, poor agreement was found between RSC and AS-OCT (95% confidence interval (CI) for agreement of automatic RSC measurement versus AS-OCT were -96.3 to 72.8 μl and 95% CI for agreement of manual RSC measurement versus AS-OCT were between -41.7 to 10.1 μl). Conclusions Both RSC automatic and manual ACV measurements showed good repeatability and reproducibility, and showed comparable agreement between 2 independent operators, but poor agreement was found between RSC and AS-OCT.

  19. Orbicularis oris musculomucosal flap for anterior palatal fistula

    Directory of Open Access Journals (Sweden)

    Tiwari V

    2006-01-01

    Full Text Available Anterior palatal fistulae or residual anterior clefts are a frequent problem following palatoplasty. Various techniques have been used to repair such fistulae, each having its own advantages and disadvantages. We have successfully used orbicularis oris musculomucosal flap to close anterior fistula and residual clefts in 25 patients. This study shows the superiority of this flap over other techniques because of its reliable blood supply, easy elevation and transfer to fistula site and finally because it is a single-stage procedure.

  20. Multi drug resistant tuberculosis presenting as anterior mediastinal mass

    Directory of Open Access Journals (Sweden)

    Parmarth Chandane

    2016-01-01

    Full Text Available Enlargement of the mediastinal lymphatic glands is a common presentation of intrathoracic tuberculosis (TB in children. However, usually, the mediastinal TB nodes enlarge to 2.8 ± 1.0 cm. In this report, we describe a case of anterior mediastinal lymphnode TB seen as huge mass (7 cm on computed tomography (CT thorax without respiratory or food pipe compromise despite anterior mediastinum being an enclosed space. CT guided biopsy of the mass cultured Mycobacterium TB complex which was resistant to isoniazide, rifampicin, streptomycin ofloxacin, moxifloxacin, and pyrazinamide. Hence, we report primary multi drug resistant TB presenting as anterior mediastinal mass as a rare case report.

  1. Fibrinous anterior uveitis following laser in situ keratomileusis

    Directory of Open Access Journals (Sweden)

    Parmar Pragya

    2009-01-01

    Full Text Available A 29-year-old woman who underwent laser in situ keratomileusis (LASIK for myopic astigmatism in both eyes presented with severe pain, photophobia and decreased visual acuity in the left eye eight days after surgery. Examination revealed severe anterior uveitis with fibrinous exudates in the anterior chamber, flap edema and epithelial bullae. Laboratory investigations for uveitis were negative and the patient required systemic and intensive topical steroids with cycloplegics to control the inflammation. This case demonstrates that severe anterior uveitis may develop after LASIK and needs prompt and vigorous management for resolution.

  2. Assessment of Anterior Segment Measurements with Swept Source Optical Coherence Tomography before and after Ab Interno Trabeculotomy (Trabectome) Surgery

    Science.gov (United States)

    Huang, Ping

    2016-01-01

    Purpose. To compare the changes of anterior segment parameters, assessed by swept source anterior segment optical coherence tomography (AS-OCT) after combined Trabectome-cataract surgery and Trabectome-only surgery in open angle glaucoma patients. Methods. Thirty-eight eyes of 24 patients with open angle glaucoma were scanned with swept source AS-OCT before and 4 weeks after combined Trabectome-cataract or Trabectome-only surgery. Intraocular pressure, number of medications, and AS-OCT parameters, such as angle opening distance at 500 and 750 μm from the scleral spur (AOD500 and AOD750), trabecular-iris space area at 500 and 750 mm2 (TISA500, TISA750), angle recess area at 500 and 750 mm2 (ARA500, ARA750), trabecular iris angle (TIA), anterior chamber depth (ACD), anterior chamber width (ACW), and anterior chamber volume (ACV), were obtained before the surgery. These parameters were compared to evaluate whether the outcome of the surgery differed among the patients after the surgery. The width of the trabecular cleft was also measured for both groups. Results. The reduction of IOP and number of medications was found to be statistically significant in both groups (p ACV, and angle parameters such as AOD 500/750, TISA 500/750, ARA 500/750, and TIA500 showed significantly greater changes from the preoperative values to postoperative 1st month values in combined Trabectome-cataract surgery group (p 0.05). There was no statistically significant difference between two groups for the width of the trabecular cleft (p = 0.7). Conclusion. Anterior chamber angle parameters measured with swept source AS-OCT may be useful for evaluating glaucoma patients before and after Trabectome surgery with or without cataract surgery. PMID:27795855

  3. Assessment of the anterior loop of the mandibular canal: A study using cone-beam computed tomography

    Science.gov (United States)

    do Nascimento, Eduarda Helena Leandro; dos Anjos Pontual, Maria Luiza; dos Anjos Pontual, Andréa; da Cruz Perez, Danyel Elias; Figueiroa, José Natal; Frazão, Marco Antônio Gomes

    2016-01-01

    Purpose Sufficient area in the interforaminal region is required for dental implant placement, and the anterior loop of the mandibular canal is located within the limits of this area. The aim of this study was to evaluate the prevalence and extent of the anterior loop in a Brazilian sample population using cone-beam computed tomography (CBCT). Materials and Methods CBCT images from 250 patients (500 hemimandibles) obtained for various clinical indications were randomly selected and evaluated to determine the presence and length of the anterior loop. The length of the anterior loop was then compared based on gender, age, and the side of the mandible. The data were analyzed using the Pearson chi-square test and linear regression analysis. Results An anterior loop was identified in 41.6% of the cases, and its length ranged from 0.25 mm to 4.00 mm (mean, 1.1±0.8 mm). The loop had a greater mean length and was significantly more prevalent in males (p=0.014). No significant differences were found between the right and left sides regarding length (p=0.696) or prevalence (p=0.650). Conclusion In this study, a high prevalence of the anterior loop of the mandibular canal was found, and although its length varied greatly, in most cases it was less than 1 mm long. Although this is a prevalent anatomical variation, safety limits for the placement of implants in this region cannot be established before an accurate evaluation using imaging techniques in order to identify and preserve the neurovascular bundles. PMID:27358813

  4. Multimodal emotion perception after anterior temporal lobectomy

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    Valérie eMilesi

    2014-05-01

    Full Text Available In the context of emotion information processing, several studies have demonstrated the involvement of the amygdala in emotion perception, for unimodal and multimodal stimuli. However, it seems that not only the amygdala, but several regions around it, may also play a major role in multimodal emotional integration. In order to investigate the contribution of these regions to multimodal emotion perception, five patients who had undergone unilateral anterior temporal lobe resection were exposed to both unimodal (vocal or visual and audiovisual emotional and neutral stimuli. In a classic paradigm, participants were asked to rate the emotional intensity of angry, fearful, joyful, and neutral stimuli on visual analog scales. Compared with matched controls, patients exhibited impaired categorization of joyful expressions, whether the stimuli were auditory, visual, or audiovisual. Patients confused joyful faces with neutral faces, and joyful prosody with surprise. In the case of fear, unlike matched controls, patients provided lower intensity ratings for visual stimuli than for vocal and audiovisual ones. Fearful faces were frequently confused with surprised ones. When we controlled for lesion size, we no longer observed any overall difference between patients and controls in their ratings of emotional intensity on the target scales. Lesion size had the greatest effect on intensity perceptions and accuracy in the visual modality, irrespective of the type of emotion. These new findings suggest that a damaged amygdala, or a disrupted bundle between the amygdala and the ventral part of the occipital lobe, has a greater impact on emotion perception in the visual modality than it does in either the vocal or audiovisual one. We can surmise that patients are able to use the auditory information contained in multimodal stimuli to compensate for difficulty processing visually conveyed emotion.

  5. Dirofilaria in the anterior chamber: A rare occurrence

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    Rupali Chopra

    2012-01-01

    Full Text Available Dirofilariasis is a parasitic infection of the carvivores that may present as a zoonotic infestation in humans. Systemic involvement in man is subcutaneous, pulmonary, or ocular. We report a rare occurrence of ocular dirofilariasis in a 25-year-old male patient who presented with pain and redness in the eye. A live, white, coiled, and highly motile worm was present in the anterior chamber. The worm, however, could not be detected in the anterior chamber, posterior segment, or the angle of the anterior chamber when the patient was taken to the operating room for surgical removal of the worm. The patient was made to lie prone till the worm reappeared in the anterior chamber and was removed by paracentesis. The worm was identified as Dirofilaria repens on the basis of microscopic and histopathological examination.

  6. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... a second wick down distally to prevent transitional cell carcinoma spillage. In this case it's probably not ... pulled the bladder off of the anterior abdominal wall and off of the pubic bone, the pubic ...

  7. Esthetic Challenges in Rehabilitating the Anterior Maxilla: A Case Report.

    Science.gov (United States)

    Miranda, M E; Olivieri, K A; Rigolin, F J F; de Vasconcellos, A A

    2016-01-01

    The rehabilitation of an unesthetic smile in the anterior maxilla is always a clinical challenge, especially when an improper shape and size, old restorations, and unesthetic shading are present. In addition, an irregular gingival zenith contour in the anterior maxilla can affect the smile's harmony. Thus, detailed treatment planning is needed to define a functional and esthetic prosthetic rehabilitation. This study describes a clinical case in which a 55-year-old woman was rehabilitated using Digital Smile Design planning and full ceramic crowns (metal free) in the anterior zone of the maxilla and mandible. To normalize the gingival zenith, a dynamic compression technique was performed using provisional restorations to condition the gingival tissues and harmonize the proportional length of the anterior upper teeth.

  8. Dysphagia due to anterior cervical osteophytosis: case report

    Directory of Open Access Journals (Sweden)

    Frederico Miguel Santos Silva Marquez Correia

    2014-12-01

    Full Text Available The objective of this study is to highlight the possibility of dysphagia induced by anterior cervical osteophytes. When not diagnosed early this condition may be responsible for complications such as severe dysphagia and potential lung aspiration, especially in elderly patients. Analysis of a case report of a 72-year old woman who presented cervical pain and progressive dysphagia. Imaging studies have shown anterior cervical osteophytosis and multilevel degenerative changes in the cervical spine. The patient underwent surgical excision of the cervical anterior osteophytes (C4, C5 and C6 and C5/C6 arthrodesis through anterior approach. The postoperative period was uneventful and symptoms resolved within 2 weeks. Early diagnosis and treatment led to complete resolution, avoiding late and serious complications associated with this pathology in the geriatric population, especially severe and progressive dysphagia and risk of pulmonary aspiration, and the consequent morbidity and mortality associated. A multidisciplinary approach is essential for the correct assessment of this condition

  9. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... Anterior Pelvic Exenteration January 22, 2009 From Pennsylvania Hospital Welcome to this "OR Live" Webcast presentation brought ... And I'm a gynecologic oncologist at Pennsylvania Hospital in Philadelphia. My colleague, Dr. Daniel Eun and ...

  10. Cytomegalovirus as a cause of anterior uveitis in immunocompetent patients

    NARCIS (Netherlands)

    van Boxtel, Lonneke A. A.; van der Lelij, Allegonda; van der Meer, Johannes; Los, Leonoor I.

    2007-01-01

    Purpose: To describe 7 cases of unilateral, chronic and/or recurrent anterior uveitis caused by cytomegalovirus (CMV) in immunocompetent patients; to identify specific ophthalmologic characteristics; and to evaluate the clinical effect of valganciclovir treatment. Design: Retrospective observational

  11. QUADROS CONCEITUAIS DO CETICISMO ANTERIOR A SEXTO EMPÍRICO

    Directory of Open Access Journals (Sweden)

    Rodrigo Pinto de Brito

    2013-08-01

    Full Text Available Artigo em que demonstramos, através de tabelas que servem como ferramentas depesquisa, os principais ganhos conceituais do ceticismo anterior a Sexto Empírico, em suasdiferentes fases.

  12. Elevator Muscle Anterior Resection: A New Technique for Blepharoptosis.

    Science.gov (United States)

    Zigiotti, Gian Luigi; Delia, Gabriele; Grenga, Pierluigi; Pichi, Francesco; Rechichi, Miguel; Jaroudi, Mahmoud O; d'Alcontres, Francesco Stagno; Lupo, Flavia; Meduri, Alessandro

    2016-01-01

    Blepharoptosis is a condition of inadequate upper eyelid position, with a downward displacement of the upper eyelid margin resulting in obstruction of the superior visual field. Levator resection is an effective technique that is routinely used to correct aponeurotic ptosis. The anterior levator resection is the procedure of choice in moderate blepharoptosis when there is moderate to good levator muscle function, furthermore, with an anterior approach, a greater resection can be achieved than by a conjunctival approach. The authors describe a modification in the Putterman technique with a resection done over a plicated elevator, plication that was suggested by Mustardè. The technique has been named as elevator muscle anterior resection. The elevator muscle anterior resection inspires from the Fasanella-Servat operation by the use of a clamp, making the operation simple and predictable. PMID:26703054

  13. Anomalous right coronary artery arising from left anterior descending artery

    Directory of Open Access Journals (Sweden)

    M.L. Sreenivas Kumar

    2012-07-01

    Full Text Available A 54-year-old male patient presented with acute myocardial infarction involving left anterior descending and right coronary artery territories. Coronary angiogram showed a single coronary artery with right coronary artery arising from left anterior descending artery (LAD, which coursed anterior to right ventricular outflow tract and thrombotic lesion in mid left anterior descending artery before origin of right coronary artery. The patient was treated with thrombolytic therapy and glycoprotein IIb/IIIa inhibitors. Anomalous origin of right coronary artery as a branch of LAD is a very rare type of congenital coronary artery anomalies. It is important to recognize this anomaly as it can be associated with extensive myocardial ischemia and sudden cardiac death in young persons even without atherosclerosis.

  14. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... this plane right in front of the pubic bone. That’s where it's avascular and you can do ... anterior abdominal wall and off of the pubic bone, the pubic symphysis. And now we have approached ...

  15. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... and uterine arteries and opened the recto-vaginal space posteriorly, taken down much of those pelvic side ... anterior extent, coming down in the pre-vesicle space and doing the cystectomy and connecting that cystectomy ...

  16. Examination of the sprained ankle: Anterior drawer test or arthrography?

    International Nuclear Information System (INIS)

    The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis. (orig.)

  17. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... no transfusion of blood or blood products. Therefore, we had to be absolutely meticulous and be able ... this case, since the rectum is not involved, we would surgically remove the bladder, the anterior part ...

  18. Surgical technique for repair of complex anterior skull base defects

    Directory of Open Access Journals (Sweden)

    Kevin Reinard

    2015-01-01

    Conclusion: The layered reconstruction of large anterior cranial fossa defects resulted in postoperative CSF leak in only 5% of the patients and represents a simple and effective closure option for skull base surgeons.

  19. Simple self-reduction method for anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Reiner Wirbel

    2014-01-01

    Conclusion: The presented Boss-Holzach-Matter method for reduction of anterior shoulder dislocation is a simple method without the need of anaesthesia, but cooperation from patients is crucial. The successful rate is comparable with other established methods.

  20. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... anterior pelvic exenteration performed with the robotic surgical system on a woman with recurrent cervical cancer developing ... proceed with a pelvic exenteration using the robotic system both to minimize the risk of complications due ...

  1. Examination of the sprained ankle: Anterior drawer test or arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Laehde, S.; Putkonen, M.; Puranen, J.; Raatikainen, T.

    1988-11-01

    The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis.

  2. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... to you by Intuitive Surgical. During the program, it’s easy for you to learn about the procedure. ... of the cervix and the anterior vagina and it invading into the posterior bladder. To make matters ...

  3. CARTILAGE-LIKE PHENOMENON IN THE ANTERIOR CRUCIATE LIGAMENT

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective. To detect histological characteristic of anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Methods. In each of 20 skeletally mature male mongrels and 4 men, the ACL and MCL were examined by standard hematoxylin-eosin procedure and toluidine blue staining for histologic observation. Results. The fibroblasts in medial collateral are elongated to spindle shape and aligned in a row between the bundles of collagenous fibers. Toluidine blue staining is negative. The anterior cruciate ligament demonstrated more heterogenous cell types and arrangement. It had three major cell forms:spindle, round and ovoid type, which were shorter but greater than the cells in medial collateral ligament. Toluidine blue staining was positive in anterior cruciate ligament. Most cells in anterior cruciate ligament were enclosed within lacunae. Conclusion. This study suggests that the ACL has different histological characteristics from MCL, and is more cartilage-like in nature.

  4. CARTILAGE-LIKE PHENOMENON IN THE ANTERIOR CRUCIATE LIGAMENT

    Institute of Scientific and Technical Information of China (English)

    蒋青; 林共周; 典绵域; 崔国庆; 滕华建

    2001-01-01

    Objective. To detect histological characteristic of anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Methods. In each of 20 skeletally mature male mongrels and 4 men, the ACL and MCL were examined by standard hematoxylin-eosin procedure and toluidine blue staining for histologic observation. Results. The fibroblasts in medial collateral are elongated to spindle shape and aligned in a row between the bundles of collagenous fibers. Toluidine blue staining is negative. The anterior cruciate ligament demonstrated more heterogenous cell types and arrangement. It had three major cell forms: spindle, round and ovoid type,which were shorter but greater than the cells in medial collateral ligament. Toluidine blue staining was positive in anterior cruciate ligament. Most cells in anterior cruciate ligament were enclosed within lacunae. Conclusion. This study suggests that the ACL has different histological characteristics from MCL, and is more cartilage-like in nature.

  5. Anticoagulation after anterior myocardial infarction and the risk of stroke.

    Directory of Open Access Journals (Sweden)

    Jacob A Udell

    Full Text Available BACKGROUND: Survivors of anterior MI are at increased risk for stroke with predilection to form ventricular thrombus. Commonly patients are discharged on dual antiplatelet therapy. Given the frequency of early coronary reperfusion and risk of bleeding, it remains uncertain whether anticoagulation offers additional utility. We examined the effectiveness of anticoagulation therapy for the prevention of stroke after anterior MI. METHODS AND FINDINGS: We performed a population-based cohort analysis of 10,383 patients who survived hospitalization for an acute MI in Ontario, Canada from April 1, 1999 to March 31, 2001. The primary outcome was four-year ischemic stroke rates compared between anterior and non-anterior MI patients. Risk factors for stroke were assessed by multivariate Cox proportional-hazards analysis. Warfarin use was determined at discharge and followed for 90 days among a subset of patients aged 66 and older (n = 1483. Among the 10,383 patients studied, 2,942 patients survived hospitalization for an anterior MI and 20% were discharged on anticoagulation therapy. Within 4 years, 169 patients (5.7% were admitted with an ischemic stroke, half of which occurred within 1-year post-MI. There was no significant difference in stroke rate between anterior and non-anterior MI patients. The use of warfarin up to 90 days was not associated with stroke protection after anterior MI (hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.37-1.26. The use of angiotensin-converting-enzyme inhibitors (HR, 0.65; 95% CI, 0.44-0.95 and beta-blockers (HR, 0.60; 95% CI, 0.41-0.87 were associated with a significant decrease in stroke risk. There was no significant difference in bleeding-related hospitalizations in patients who used warfarin for up to 90 days post-MI. CONCLUSION: Many practitioners still consider a large anterior-wall MI as high risk for potential LV thrombus formation and stroke. Among a cohort of elderly patients who survived an anterior

  6. Anterior chamber flare after trabeculectomy and after phacoemulsification

    OpenAIRE

    Siriwardena, D; Kotecha, A; Minassian, D; Dart, J.; KHAW, P.

    2000-01-01

    AIMS—To evaluate and compare prospectively the anterior chamber inflammatory response after phacoemulsification cataract surgery and after trabeculectomy with peripheral iridectomy.
METHODS—Anterior chamber inflammation was measured using the Kowa FM-500 laser flare meter in 131 patients undergoing trabeculectomy and 148 patients undergoing phacoemulsification cataract extraction with intraocular lens implantation. Flare was measured before surgery and on each postoperative visit up to 12 mon...

  7. An overlay partial denture to restore worn mandibular anterior teeth.

    Science.gov (United States)

    Samant, Asha; DeSciscio, Peter

    2014-01-01

    Restoring worn anterior mandibular teeth is a challenge, especially when teeth are small, esthetics are a concern, the long-term prognosis is questionable, and/or patient finances are an issue. This article describes an alternate treatment for a patient with a collapsed bite, missing posterior mandibular teeth, an ill-fitting complete maxillary denture with poor esthetics, and irregular, worn mandibular anterior teeth.

  8. Is dysphonia permanent or temporary after anterior cervical approach?

    OpenAIRE

    Kahraman, Serdar; Sirin, Sait; Erdogan, Ersin; Atabey, Cem; Daneyemez, Mehmet; Gonul, Engin

    2007-01-01

    The rate, causes and prognosis of dysphonia after anterior cervical approach (ACA) were investigated in our clinical series. During a 10-year interval, 235 consecutive patients with cervical disc disease underwent surgical treatment using anterior approach. Retrospective chart reviews showed recurrent laryngeal nerve (RLN) injury in 3 (1.27%) patients. All three patients were men and only one patient had multilevel surgery. These patients had RLN injury after virgin surgery. Laryngoscopic exa...

  9. Missing Screw as a Rare Complication of Anterior Cervical Instrumentation

    OpenAIRE

    Yusuf Kurtuluş Duransoy; Mesut Mete; Baha Zengel; Mehmet Selçukı

    2013-01-01

    Although anterior cervical arthrodesis is an effective procedure for the treatment of cervical disorders, the method has some complications. Here, we describe this rare complication of cervical instrumentation with a literature review. A 23-year-old male patient was operated for a C6-C7 dislocation. At postoperative month 10, he presented with hemoptysis and dysphagia. Cervical roentgenograms showed anterior migrations of one broken screw and a plate-locking screw at the C6 corpus. One screw ...

  10. Anterior uveitis secondary to type II essential cryoglobulinemia

    OpenAIRE

    Nicholson, Laura; Sobrin, Lucia

    2013-01-01

    Background: The purpose of this report is to describe the association of severe anterior uveitis with type II essential cryoglobulinemia. Findings: A 40-year-old male with a history of psoriatic arthritis presented with severe anterior uveitis associated with type II essential cryoglobulinemia. His uveitis, refractory to steroid treatments, was well controlled following treatments for cryoglobulinemia. The temporal association between his cryoglobulinemia and uveitis, combined with his improv...

  11. Increased CD40 ligand in patients with acute anterior uveitis

    DEFF Research Database (Denmark)

    Øgard, Carsten; Sørensen, Torben Lykke; Krogh, Erik

    2005-01-01

    The inflammatory response in acute anterior uveitis (AU) is believed to be primarily mediated by autoreactive T-cells. We wanted to evaluate whether the T-cell activation marker CD40 ligand is involved in the AU immunopathogenesis.......The inflammatory response in acute anterior uveitis (AU) is believed to be primarily mediated by autoreactive T-cells. We wanted to evaluate whether the T-cell activation marker CD40 ligand is involved in the AU immunopathogenesis....

  12. Intrusion of anterior teeth to improve smile esthetics

    OpenAIRE

    Chandrasekharan, Deepak; Balaji, S. M.

    2010-01-01

    A gummy smile is probably one of the most common causes of an unaesthetic smile. Causes include overeruption of maxillary anterior teeth and maxillary vertical excess. Intrusion of maxillary anterior teeth with Orthodontics and Le forte I superior repositioning may form a part of the solution. Of late the use of micro implants have improved the smile esthetics of borderline surgical cases by allowing the Orthodontist to intrude teeth more than what was possible with conventional Orthodontics.

  13. Bilateral Traumatic Anterior Dislocation of Shoulder – a rare entity

    OpenAIRE

    Yashavantha Kumar C; Nalini K B; Lalit Maini; Prashanth Nagaraj

    2013-01-01

    Introduction: Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislo...

  14. Neglected Traumatic Locked Anterior Shoulder Fracture-Dislocation

    OpenAIRE

    Er, Mehmet Serhan; Eroglu, Mehmet; Erten, Recep Abdullah; Metineren, Hasan; Altinel, Levent

    2015-01-01

    Anterior shoulder dislocations are the most common major joint dislocations encountered in the emergency departments and fractures of proximal humerus can accompany with dislocations. Although the treatment of acute isolated traumatic anterior shoulder dislocation is generally simple, the treatment of neglected fracture-dislocations becomes more complicated. In this report, a 22-year-old male patient who had posttraumatic locked, shoulder fracture-dislocation is presented. Open reduction and ...

  15. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    OpenAIRE

    Patil, Mallanagouda N

    2013-01-01

    Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand). He complained of...

  16. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    Energy Technology Data Exchange (ETDEWEB)

    Petrover, David [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Hopital Beaujon, Service de Radiologie, Paris (France); Schweitzer, Mark E. [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Laredo, J.D. [Hopital Lariboisiere, Service de Radiologie, Paris (France)

    2007-07-15

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  17. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    International Nuclear Information System (INIS)

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  18. [Chondroblastoma in the anterior cruciate ligament origo: a case report].

    Science.gov (United States)

    Aydin, Hafız; Turhan, Ahmet Uğur; Karataş, Metin; Onay, Atilgan; Yildiz, Kadriye

    2012-01-01

    Chondroblastoma is a rarely seen cartilage originated tumor. It is mostly localized in the epiphysis of long bones. In this article, we present an 18-year-old male case in whom the tumor was located in the right distal femoral lateral condyle and destroyed anterior cruciate ligament origo. The tumor was curetted and the cavity was filled with cement. Anterior cruciate ligament resection was mandatory for this treatment. The patient had no complaint in the postoperative period.

  19. [Chondroblastoma in the anterior cruciate ligament origo: a case report].

    Science.gov (United States)

    Aydin, Hafız; Turhan, Ahmet Uğur; Karataş, Metin; Onay, Atilgan; Yildiz, Kadriye

    2012-01-01

    Chondroblastoma is a rarely seen cartilage originated tumor. It is mostly localized in the epiphysis of long bones. In this article, we present an 18-year-old male case in whom the tumor was located in the right distal femoral lateral condyle and destroyed anterior cruciate ligament origo. The tumor was curetted and the cavity was filled with cement. Anterior cruciate ligament resection was mandatory for this treatment. The patient had no complaint in the postoperative period. PMID:22765492

  20. Altered anterior visual system development following early monocular enucleation

    Directory of Open Access Journals (Sweden)

    Krista R. Kelly

    2014-01-01

    Conclusions: The novel finding of an asymmetry in morphology of the anterior visual system following long-term survival from early monocular enucleation indicates altered postnatal visual development. Possible mechanisms behind this altered development include recruitment of deafferented cells by crossing nasal fibres and/or geniculate cell retention via feedback from primary visual cortex. These data highlight the importance of balanced binocular input during postnatal maturation for typical anterior visual system morphology.

  1. Heading Tuning in Macaque Area V6

    Science.gov (United States)

    Fan, Reuben H.; Liu, Sheng; DeAngelis, Gregory C.

    2015-01-01

    Cortical areas, such as the dorsal subdivision of the medial superior temporal area (MSTd) and the ventral intraparietal area (VIP), have been shown to integrate visual and vestibular self-motion signals. Area V6 is interconnected with areas MSTd and VIP, allowing for the possibility that V6 also integrates visual and vestibular self-motion cues. An alternative hypothesis in the literature is that V6 does not use these sensory signals to compute heading but instead discounts self-motion signals to represent object motion. However, the responses of V6 neurons to visual and vestibular self-motion cues have never been studied, thus leaving the functional roles of V6 unclear. We used a virtual reality system to examine the 3D heading tuning of macaque V6 neurons in response to optic flow and inertial motion stimuli. We found that the majority of V6 neurons are selective for heading defined by optic flow. However, unlike areas MSTd and VIP, V6 neurons are almost universally unresponsive to inertial motion in the absence of optic flow. We also explored the spatial reference frames of heading signals in V6 by measuring heading tuning for different eye positions, and we found that the visual heading tuning of most V6 cells was eye-centered. Similar to areas MSTd and VIP, the population of V6 neurons was best able to discriminate small variations in heading around forward and backward headings. Our findings support the idea that V6 is involved primarily in processing visual motion signals and does not appear to play a role in visual–vestibular integration for self-motion perception. SIGNIFICANCE STATEMENT To understand how we successfully navigate our world, it is important to understand which parts of the brain process cues used to perceive our direction of self-motion (i.e., heading). Cortical area V6 has been implicated in heading computations based on human neuroimaging data, but direct measurements of heading selectivity in individual V6 neurons have been lacking. We

  2. Four year experience with the AO Anterior Thoracolumbar Locking Plate.

    Science.gov (United States)

    Thalgott, J S; Kabins, M B; Timlin, M; Fritts, K; Giuffre, J M

    1997-05-01

    For decades spinal surgeons have attempted to design simple, single stage anterior internal fixation systems for the thoracic and lumbar spine. Early devices presented both biomechanical and technical problems. The AO Anterior Thoracolumbar Locking Plate (ATLP) was designed to solve some of the problems encountered with early anterior instrumentation. The ATLP system is constructed in Commercially Pure titanium. It is a low profile device indicated for use for unstable burst fractures in the anterior column; metastatic tumor management; and degenerative diseases of the thoracolumbar spine between levels T10 and L5. Implantation of the device involves direct anterior decompression with sagittal reduction and corpectomy. This is followed by grafting reconstruction, and plate fixation. This device has been implanted in 25 patients with an average follow-up of 38 months. There were five (5) broken screws in three (3) patients, and no broken plates. Implant related postoperative complications included two misplaced screws. Preliminary results indicate that the ATLP system seems to be a safe, low profile, MRI/CT compatible device that provides definitive single stage fixation of the anterior spinal column. PMID:9160452

  3. Heterotopic ossification following surgical treatment of avulsion fracture of the anterior inferior iliac spine

    Directory of Open Access Journals (Sweden)

    Gojković Zoran

    2011-01-01

    Full Text Available Avulsion fractures of the anterior inferior iliac spine are rare injuries of the pelvic ring and occur during sports activities. Hereby is presented a case of a 22-year-old professional football player who was diagnosed to have an avulsion fracture of the anterior inferior iliac spine on the right side four months after the initial injury and he was treated surgically with the excision of the avulsed fragment. The football player recovered completely and returned to his usual sports activities. Two years later, due to the pain in the hip an x-ray and MR image were made, which established the existence of crescent formation, a heterotopic bone, in the area of the anterior inferior iliac spine, which was surgically removed. Physical and medical therapy was conducted and after four months, the professional athlete was back playing football. Two years after the surgical excision of heterotopic ossification, the patient was completely asymptomatic with the same ROM without any thigh muscle hypotrophy, although isokinetic muscle testing did show some weakness of the thigh extensor muscles. An x-ray did not show any signs of heterotopic ossification.

  4. Restoring Anterior Aesthetics by a Rotational Path Cast Partial Denture: An Overlooked Technique.

    Science.gov (United States)

    Sharma, Deeksha; Bhat, Bala Saraswati; Arora, Himanshu

    2016-05-01

    Cast Partial Dentures (CPD) has long been known to restore missing teeth in patients with minimal invasion on hard and soft tissues. Although satisfactory otherwise, the main concern in CPD is the anterior display of metal. Also the technique sensitive lab procedures, together with the esthetic concern have built an iceberg around the frequent utilization of this treatment modality. With the advent of various techniques to get rid of the metallic display, it was predicted to have more CPD's done in the dental arena. But the conceptual technicalities of the procedure took away the limelight from this treatment modality and focused on the fixed prosthodontics. Although feasible in a large number of patients, fixed prosthesis still has areas of restriction. It is here, when we apply our knowledge and skill of esthetic CPD. Esthetic CPD eliminates the metal display by utilizing desirable undercuts. The engaging action of the framework into these undercuts paves way for a rotational motion to seat the remaining prosthesis. Hence dual path of insertion helps eliminating the anterior clasp. In this case report dual path of insertion is discussed for replacing anterior teeth in an old male patient who had mild esthetic concerns. Following the conservative approach of CPD (over FPD) esthetic and restorative treatment was planned with patient's consent. PMID:27437375

  5. Biomechanical analysis of the anterior displacement of Tibial tuberosity (Maquet operation: A computer model study

    Directory of Open Access Journals (Sweden)

    Farahmand F

    2000-08-01

    Full Text Available Computer model of the patellofemoral joint was developed and the effects on the anterior displacement of the tibial tuberosity were investigated. The input geometrical and verification data for the model were obtained form an experimental study on a cadaver knee, mounted in an instron machine. The computer program found the configuration of the patellofemoral joint which satified both the geometrical and force equilibrium conditions, simultaneously, using a trial graphical approach.verification of the model was achieved by determining the patellar sagittal plane motion and patellofemoral contact locations and comparing the results with the experimental results of the same specimen and published data. Simulation of the anterior displacement of the tibial tuberosity by the model showed that the location of contact area migrates distally on the femur and proximally on the patella following operation. The contact force of the patellofemoral joint decreased significantly by 70% at full extension, 30% at 30 degrees flexion and around 15% at higher flexion angles for a 1 cm anterior displacement of the tibial tuberosity and nearly doubled for a 2cm anterior displacement. The change of the effective moment are of the quadriceps was not considerable. The results suggest that the major effect of the Maquet operation on the contact force appears in extension and mid-flexion rather than deep flexion amgles. Further displacement of the tuberosity enhances the reduction of the contact force, however, the total reduction is less than what was predicted by Maquet. The change of the contact location relieves pain in short term but causes hyperpressure in the proximal retropatellar surface which might be detrimental in long term

  6. Anterior, posterior, left anterior oblique, and geometric mean views in gastric emptying studies using a glucose solution

    International Nuclear Information System (INIS)

    Previous research has shown that the single anterior view of the stomach overestimates the gastric half-emptying time of a solid meal compared to the geometric mean of the anterior and posterior views. Little research has been performed comparing the various views of gastric emptying of a glucose solution. After an overnight fast, 49 nondiabetic subjects were given a 450 ml solution containing 50 g of glucose and 200 μCi of technetium-99m sulfur colloid. Sequential 1-min anterior, posterior, and left anterior oblique views were obtained every 15 min. The mean percent solution remaining in the stomach for all three views differed from the geometric mean by 1.9% or less at all time points. Average gastric half-emptying times were: geometric mean, 62.7±3.3 min; anterior, 61.9±3.2 min; posterior, 63.5±3.5 min; and left anterior oblique, 61.6±3.3 min. These half-emptying times were not statistically different. For individual patients, differences between all three views and the geometric mean were not clinically important. Approximately 95% of all patients are expected to have gastric half-emptying times measured by any of the three single views within 17 min of the gastric half-emptying time obtained using the geometric mean. The imaging of gastric emptying using glucose solutions can be performed using a convenient single view which allows continuous dynamic imaging. (orig.)

  7. The findings of Tc-99m ECD brain perfusion SPECT in the patients with left anterior thalamic infarction

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Y. A.; Kim, S. H.; Sohn, H. S.; Jeong, S. G. [The Catholic University of Korea, Seoul (Korea, Republic of)

    2005-07-01

    The thalamus has multiple connections with areas of the cerebral cortex involved in arousal and cognition. Thalamic damage has been reported to be associated with variable neuropsychological dysfunctions and dementia. This study evaluates the changes of regional cerebral blood flow (rCBF) by using SPM analysis of brain perfusion SPECT and examining the neuropsychological abnormalities of 4 patients with anterior thalamic infarctions. Four patients with left anterior thalamic infarctions and eleven normal controls were evaluated. K-MMSE and the Seoul Neuropsychological Screening Battery were performed within 2 days after stroke. The normalized SPECT data of 4 patients were compared to those of 11 controls for the detection of areas with decreased rCBF by SPM analysis. All 4 patients showed anterograde amnesia in their verbal memory, which was not improved by recognition. Dysexecutive features were occasionally present, such as decreased word fluency and impaired Stroop test results. SPM analysis revealed decreased rCBF in the left supra marginal gyrus, the superior temporal gyrus, the middle and inferior frontal gyrus, the medial dorsal and anterior nucleus of the left thalamus. The changes of rCBF in patients with left anterior thalamic infarctions may be due to the remote suppression on metabolism by the interruption of the cortico-subcortical circuit, which connects the anterior thalamic nucleus and various cortical areas. The executive dysfunction and dysnomia may be caused by the left dorsolateral frontal dysfunction of the thalamo-cortical circuit. Anterograde amnesia with storage deficit may be caused by the disruption of mamillothalamic tract.

  8. Silicone Oil Tamponade Combined with Lensectomy Preserving Anterior Lens Capsule

    Institute of Scientific and Technical Information of China (English)

    LuL; YangJ

    1999-01-01

    Purpose:To investigate the therapeutic effect and indicatio n of silicone oil tamponade combined with lensectomy preserving anterior lens capsule.Methods:Silicone oil tamponade combined with lensectomy preserving anterior lens capsule was performed in 33 cases (33 eyes)of high myopia ,proliferative vitroretinopathy(PVR)D grade and giant retinal tear(GRT).10 cases were onlyeye and 11 cases had harder nucleus of lens.The surgical methods included:1.smashing lens nucleus and lensectomy preserving complete anterior capsule;2,vitrectomy and membrane peeling;3,usage of liquid perfluorocarbin or retinotomy or drainage;4.silicone oil tamponade;5.postoperative Nd;YAG laser for anterior capsulectomy. Results:Follow-up time was 6 months or more in 29 cases.Total retinal reattachment was achieved in 22 cases,macular retinal reattachment in 5 cases.The visual acuity was 20/800 to 20/200 in 13 cases,20/100 to 20/50 in 12 cases.Visual acuity was significantly improved in GRT group(P<0.05).Complications included unexpected anterior capsule break intraoperatively,anterior capsule opacity,silicone oil emulsification and liquid perfluorocarbin remainig postoperatively.Conclusions:Silicone oil tamponade combined with lensectomy preserving anterior capsule was safe and can reduce the operative complications.The indications included:1.GRT complicated with high myopia;2,advanced PVR cases complicated with high myopia in which silicone oil must be used;3.severe lens opacity cases in which silicone oil must be used;4.complex retinal detachment of only ye.

  9. MRI anatomy of anteriorly displaced anus: what obstructs defecation?

    Energy Technology Data Exchange (ETDEWEB)

    AbouZeid, Amr Abdelhamid [Ain-Shams University, Department of Pediatric Surgery, Cairo (Egypt); Mohammad, Shaimaa Abdelsattar; Khairy, Khaled Talaat [Ain-Shams University, Department of Radiodiagnosis, Cairo (Egypt)

    2014-07-15

    Anteriorly displaced anus is an anomaly that is debated with regard to its nomenclature, diagnosis and management. To describe MRI anatomy of the anal canal in children with anteriorly displaced anus and its impact on the process of defecation. We prospectively examined ten children (7 girls, 3 boys; age range 7 months to 8 years, mean 3 years) with anteriorly displaced anus between August 2009 and April 2012. Noncontrast MRI examinations were performed on a 1.5-T magnet. T1- and T2-weighted turbo spin-echo images were acquired in axial, sagittal and coronal planes of the pelvis. The anorectal angle and the relative hiatal distance were measured in mid-sagittal images, and compared with those of a control group using the Mann-Whitney test. In children with anteriorly displaced anus, no anatomical abnormality was depicted at the level of the proximal anal canal. However, the distal anal canal was displaced anteriorly, running out its external muscle cuff, which remained un-displaced at the usual site of the anus. This changes the orientation of the central axis of the anal canal by passing across instead of along the fibers of the longitudinal muscle coat. Children with anteriorly displaced anus had a more obtuse anorectal angle (mean 112.1 ), which was significantly greater than that of the control group (mean 86.2 ). MRI is a valuable tool in studying the anatomy of the anal canal in children with anteriorly displaced anus. The abnormal orientation of the longitudinal muscle across the anal canal can explain the obstructed defecation in these children. Based on this study, it might be of interest to use MRI in studying equivocal cases and children with unexplained constipation. (orig.)

  10. Attention for speaking: domain-general control from the anterior cingulate cortex in spoken word production

    Directory of Open Access Journals (Sweden)

    Vitoria ePiai

    2013-12-01

    Full Text Available Accumulating evidence suggests that some degree of attentional control is required to regulate and monitor processes underlying speaking. Although progress has been made in delineating the neural substrates of the core language processes involved in speaking, substrates associated with regulatory and monitoring processes have remained relatively underspecified. We report the results of an fMRI study examining the neural substrates related to performance in three attention-demanding tasks varying in the amount of linguistic processing: vocal picture naming while ignoring distractors (picture-word interference, PWI; vocal colour naming while ignoring distractors (Stroop; and manual object discrimination while ignoring spatial position (Simon task. All three tasks had congruent and incongruent stimuli, while PWI and Stroop also had neutral stimuli. Analyses focusing on common activation across tasks identified a portion of the dorsal anterior cingulate cortex that was active in incongruent trials for all three tasks, suggesting that this region subserves a domain-general attentional control function. In the language tasks, this area showed increased activity for incongruent relative to congruent stimuli, consistent with the involvement of domain-general mechanisms of attentional control in word production. The two language tasks also showed activity in anterior-superior temporal gyrus. Activity increased for neutral PWI stimuli (picture and word did not share the same semantic category relative to incongruent (categorically related and congruent stimuli. This finding is consistent with the involvement of language-specific areas in word production, possibly related to retrieval of lexical-semantic information from memory. The current results thus suggest that in addition to engaging language-specific areas for core linguistic processes, speaking also engages the anterior cingulate cortex, a region that is likely implementing domain

  11. Reproducibility and Agreement Between 2 Spectral Domain Optical Coherence Tomography Devices for Anterior Chamber Angle Measurements

    OpenAIRE

    Marion, Kenneth M.; Maram, Jyotsna; Pan, Xiaojing; Dastiridou, Anna; Zhang, ZhouYuan; Ho, Alex; Francis, Brian A; Sadda, Srinivas R.; Chopra, Vikas

    2015-01-01

    Purpose: To compare anterior chamber angle parameters based on the location of Schwalbe line (SL) from 2 spectral domain optical coherence tomography (SD-OCT) instruments and to measure their reproducibility. Methods: Forty-two eyes from 21 normal, healthy participants underwent imaging of the inferior irido-corneal angle with the Spectralis and Cirrus SD-OCT under tightly controlled low-light conditions. SL-angle opening distance (SL-AOD) and SL-trabecular iris space area (SL-TISA) were meas...

  12. Anterior Prostatic Cyst Causing Acute Urinary Retansion in a Young Patient

    Directory of Open Access Journals (Sweden)

    Huseyin Celik

    2014-12-01

    Full Text Available Prostatic cysts are rare entities. Mostly, they originate from the posterior area of the prostate and asymptomatic. Anterior location of the prostatic cyst is rarer than posterior. The prostatic cyst in a 41 year-old man presenting with acute urinary retansion. Transurethral resection (TUR of the cyst was performed, which revealed a benign cyst lined with columnar epithelium and proliferative urothelial lining on histopathological evaluation. Prostatic cysts particularly in young men with obstructive lower urinary tract symptoms are rarely seen. Management of the prostatic cyst with TUR seems to be a minimally invasive approach with successful outcomes.

  13. [The anterior sonographic-guided celiac plexus blockade. Review and personal observations].

    Science.gov (United States)

    Zenz, M; Kurz-Müller, K; Strumpf, M; May, B

    1993-04-01

    The coeliac plexus block is an approved method for the relief of upper abdominal pain due to cancer of the upper intra-abdominal viscera or to chronic pancreatitis. While there are many reports concerning the posterior approach to the coeliac plexus block, little attention has been given the anterior approach. There are two ways of implementing the anterior approach to the coeliac plexus: CT-guided and the ultrasound guided approach. METHODS. The ultrasonic-guided anterior approach to the coeliac plexus block is used with the patient in the supine position. The aorta and discharge of the truncus coeliacus or the a. lienalis respectively, are ultrasonographically presented at two levels. After setting local cutaneous and subcutaneous anaesthesia, a 15-cm-long 25 G-needle is introduced into the epigastrium. The point of the needle is--ultrasonographically guided--inserted into the pre-aortic area near the discharge of the truncus coeliacus. The position of the needle point is ultrasonographically controlled on two levels. For the enforcement of a diagnostic coeliac plexus block after careful aspiration on two levels, 10 ml of bupivacaine 0.5% is injected. The spread of the solution is evaluated by ultrasound. If the needle position is correct; a few minutes later the patient has a feeling of warmth in the upper abdominal region. For the enforcement of a neurolytic coeliac plexus block 10 ml ethanol 96% and 10 ml prilocaine 1% can be administered. The two solutions are applied as small volumes in permanent succession. Thus the burning pain, which is often observed after the injection of alcohol, is avoided. RESULTS. In the literature there are only a few reports, about the results and side-effects after use of the anterior approach in the coeliac plexus block. The results of these investigations and our own show total pain relief or at least good pain reduction by at best 85%. The reduction in pain achieved continues in as many as 60% of the treated patients. There is

  14. Pentacam could be a useful tool for evaluating and qualifying the anterior chamber morphology

    OpenAIRE

    Li, Xiaoyu; Wang, Zheng; Cao, Qun; Hu, Lei; Tian, Fang; Dai, Hong

    2014-01-01

    Objective: This study aims to investigate the changes of anterior chamber morphology after laser peripheral iridotomy (LPI) in primary angle-closure (PAC) patients using Pentacam. Methods: 35 normal persons and 35 patients of PAC before and 1 week after neodymium: yttrium: aluminum garnet (Nd: YAG) LPI were evaluated with Pentacam. We measured the anterior chamber angle (ACA), central anterior chamber depth (CACD), peripheral anterior chamber depth (PACD), anterior chamber volume (ACV) and pu...

  15. [Microsurgical anatomy importance of A1-anterior communicating artery complex].

    Science.gov (United States)

    Monroy-Sosa, Alejandro; Pérez-Cruz, Julio César; Reyes-Soto, Gervith; Delgado-Hernández, Carlos; Macías-Duvignau, Mario Alberto; Delgado-Reyes, Luis

    2013-01-01

    Antecedentes: la arteria cerebral anterior se origina de la bifurcación de la arteria carótida interna lateral al quiasma óptico, posteriormente se une con su homóloga contralateral mediante la arteria comunicante anterior. El complejo precomunicante(A1)-arteria comunicante anterior es el lugar más frecuente de variantes anatómicas y el sitio con mayor cantidad de aneurismas (30 a 37%). Objetivo: conocer la anatomía microquirúrgica, las variantes anatómicas y la importancia del complejo segmento precomunicante-arteria comunicante anterior en cirugía neurológica de la patología vascular, principalmente aneurismas, en población mexicana. Material y métodos: estudio prospectivo y descriptivo efectuado en el Departamento de Anatomía de la Facultad de Medicina (UNAM) en 30 encéfalos inyectados. Se estudió la anatomía microquirúrgica (longitud y calibre) del complejo segmento precomunicante-arteria comunicante anterior de la arteria cerebral anterior y sus variantes. Resultados: se encontraron 60 segmentos precomunicantes. La longitud promedio del lado izquierdo fue de 11.35 mm y del derecho de 11.84 mm. El calibre medio en el lado izquierdo fue de 1.67 mm y en el derecho de 1.64 mm. El número promedio de perforantes en el lado izquierdo fue de 7.9 y en el derecho de 7.5. La arteria comunicante anterior se encontró en 29 encéfalos sobre el quiasma óptico, su trayecto dependió de la longitud del segmento A1. La longitud media del segmento fue de 2.84 mm, el calibre fue de 1.41 mm y el número promedio de perforantes de 3.27. En 18 encéfalos (60%) se encontraron variantes del complejo A1-arteria comunicante anterior y dos aneurismas tipo blíster. Conclusión: es necesario entender la anatomía microquirúrgica del complejo segmento precomunicante-arteria comunicante anterior y conocer las variantes para tener una visión en tercera dimensión durante la cirugía de aneurismas.

  16. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens

    Science.gov (United States)

    Spierer, Oriel; O'Brien, Terrence P.

    2016-01-01

    A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful.

  17. Myringoplasty for anterior and subtotal perforations using KTP-532 laser.

    Science.gov (United States)

    Gerlinger, Imre; Ráth, Gábor; Szanyi, István; Pytel, József

    2006-09-01

    A retrospective study was performed on patients who underwent myringoplasty for either anterior or subtotal perforations over an 8-year period (from 1994 till 2004). We used the KTP-laser assisted anterior anchoring technique combining with anterior "pull-back" method. Patients' ages ranged from 6-62 years (median 36.5). The mean follow-up period was 2.8 years (minimum 6 months). The audiological results were analysed with the "Pytel software", which was developed in our department. As for the procedure, the drum remnant was freed from the malleus handle with the use of the laser and elevated out of it's sulcus anterior-superiorly. Large fascia graft was fashioned with a split of 4-5 mm in the middle of one edge. The graft was placed using the underlay technique medial to the handle of the malleus. A pull-back tunnel was created at the border of the anterior quadrants to further facilitate the survival of the graft. In this series the graft taking rate was 100%. Reperforation due to an undersized fascia was observed in one case. Post-operative audiological results indicated no bone conduction threshold elevation in any frequencies. Using the laser, cochlear trauma can be prevented, double fixation of the drum prevents lateralisation and blunting. Wide canalplasty makes both the approach and the follow-up very easy. Thorough soft tissue and bone work is advantageous from the fascia taking rate point of view.

  18. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens

    Directory of Open Access Journals (Sweden)

    Oriel Spierer

    2016-05-01

    Full Text Available A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful.

  19. Association of Cryptogenic Organizing Pneumonia in Bilateral Anterior Uveitis

    Directory of Open Access Journals (Sweden)

    Kaori Fujimoto

    2014-11-01

    Full Text Available Two female patients with histories of cancer who showed cryptogenic organizing pneumonia (COP complications and bilateral anterior uveitis with hypopyon were examined. Both patients had suffered from COP and received intermitted systemic corticosteroid administration (SCA. The first patient, a 65-year-old woman with a history of breast cancer, showed bilateral uveitis with hypopyon. The topical corticosteroid treatment was ineffective. After SCA for the treatment of COP was started, the hypopyon gradually dissipated. Upon termination of SCA, uveitis relapses were controlled by renewed SCA. The other patient, a 69-year-old woman with a history of ovarian cancer, showed bilateral anterior uveitis with hypopyon. Her intraocular outcome did not improve by the topical corticosteroid administration, but SCA that was applied to treat COP led to remission of uveitis. Imaging examinations, biochemical analysis, symptoms or HLA-B27 antigen screenings in either patient did not explain the development of uveitis. Bilateral anterior uveitis is commonly related to autoimmune disease or systemic syndrome. We report two cases with COP that developed bilateral anterior uveitis with hypopyon resistant to topical administration but responsive to systemic administration of corticosteroid. These findings suggest that COP can be associated with the etiology of anterior uveitis.

  20. HLA-B27 Anterior Uveitis: Immunology and Immunopathology.

    Science.gov (United States)

    Wakefield, Denis; Yates, William; Amjadi, Shahriar; McCluskey, Peter

    2016-08-01

    Acute anterior uveitis (AAU) is the commonest type of uveitis and HLA-B27 AAU is the most frequently recognized type of acute anterior uveitis and anterior uveitis overall. Recent evidence indicates that acute anterior uveitis is a heterogenous disease, is polygenic and is frequently associated with the spondyloarthropathies (SpA). Studies of patients with AAU and animal models of disease indicate a role for innate immunity, the IL-23 cytokine pathway and exogenous factors, in the pathogenesis of both SpA and acute anterior uveitis. Recently described genetic associations cluster around immunologic pathways, including the IL-17 and IL-23 pathways, antigen processing and presentation, and lymphocyte development and activation. Patients with ankylosing spondylitis (AS) and AAU share other genetic markers, such as ERAP-1, which show strong evidence of gene-gene interaction and point to new mechanisms of disease pathogenesis. These observations have major implications for understanding the pathogenesis of HLA-B27 diseases, such as AAU, and may lead to the development of more specific therapy for AAU. Received 6 January 2016; revised 6 February 2016; accepted 18 February 2016; published online 31 May 2016. PMID:27245590

  1. Ophthalmohelioses and peripheral light focusing by the anterior eye

    Science.gov (United States)

    Coroneo, Minas T.

    1994-07-01

    A coincidence of the locations of foci of scattered light in the anterior eye with the usual locations of common sun-related eye conditions has been observed. These phenomena may explain the pathogenesis of pterygium and the initial location of certain cortical lens opacities and eyelid malignancies. Human and bovine eyes were used to demonstrate that the anterior eye acts as a side-on lens system. Light incident at the temporal limbus can be concentrated at the nasal limbus or beyond or at the nasal crystalline lens equator. The main pathways of light are transcameral and this is demonstrated by the use of baffles. Although this phenomenon is obvious with visible light, focusing of light at 308nm can be demonstrated. Computer-assisted optical ray tracing in a standard human anterior segment model showed that the peak intensity at the distal limbus is approximately twenty times that of the incident light intensity. The degree of limbal focusing is determined by corneal shape and anterior chamber depth. Such light focusing may be particularly injurious to corneal and lenticular epithelial stem cells. These observations provide circumstantial evidence that peripheral refraction phenomena are involved in the pathogenesis of the anterior ophthalmohelioses. Adequate lateral protection of the eye from increasing ultraviolet insolation may be prudent.

  2. Psychological Aspects of Recovery Following Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Christino, Melissa A; Fantry, Amanda J; Vopat, Bryan G

    2015-08-01

    Recovery following anterior cruciate ligament reconstruction is an arduous process that requires a significant mental and physical commitment to rehabilitation. Orthopaedic research in recent years has focused on optimizing anterior cruciate ligament surgical techniques; however, despite stable anterior cruciate ligament reconstructions, many athletes still never achieve their preinjury ability or even return to sport. Psychological factors associated with patient perceptions and functional outcomes following anterior cruciate ligament reconstruction are important to acknowledge and understand. Issues related to emotional disturbance, motivation, self-esteem, locus of control, and self-efficacy can have profound effects on patients' compliance, athletic identity, and readiness to return to sport. The psychological aspects of recovery play a critical role in functional outcomes, and a better understanding of these concepts is essential to optimize the treatment of patients undergoing anterior cruciate ligament reconstruction, particularly those who plan to return to sport. Identifying at-risk patients, encouraging a multidisciplinary approach to patient care, and providing early referral to a sports psychologist may improve patient outcomes and increase return-to-play rates among athletes.

  3. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens

    Science.gov (United States)

    Spierer, Oriel; O'Brien, Terrence P.

    2016-01-01

    A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful. PMID:27462251

  4. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens.

    Science.gov (United States)

    Spierer, Oriel; O'Brien, Terrence P

    2016-01-01

    A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful.

  5. Evaluation of Anterior Segment's Structures in Tilted Disc Syndrome

    Science.gov (United States)

    Ozsoy, Ercan; Demirel, Ersin Ersan; Cumurcu, Tongabay

    2016-01-01

    Purpose. To evaluate anterior segment's structures by Pentacam in patients with tilted disc syndrome (TDS). Methods. Group 1 included forty-six eyes of forty-six patients who have the TDS. Group 2 including forty-six eyes of forty-six cases was the control group which was equal to the study group in age, gender, and refraction. A complete ophthalmic examination was performed in both groups. All cases were evaluated by Pentacam. The axial length (AL) of eyes was measured by ultrasound. Quantitative data obtained from these measurements were compared between two groups. Results. There was no statistically significant difference for age, gender, axial length, and spherical equivalent measurements between two groups (p = 0.625, p = 0.830, p = 0.234, and p = 0.850). There was a statistically significant difference for central corneal thickness (CCT), corneal volume (CV), anterior chamber angle (ACA), and pupil size measurements between two groups (p = 0.001, p = 0.0001, p = 0.003, and p = 0.001). Also, there was no statistically significant difference for anterior chamber depth (ACD), anterior chamber volume (ACV), and lens thickness (LT) measurements between two groups (p = 0.130, p = 0.910, and p = 0.057). Conclusion. We determined that CCT was thinner, CV was less, and ACA was narrower in patients with TDS. There are some changes in the anterior segment of the eyes with tilted disc. PMID:27648303

  6. In vitro evaluation of fracture resistance of Fiber-Reinforced Composite inlay bridges in upper anterior and lower posterior teeth

    Directory of Open Access Journals (Sweden)

    Jalalian E.

    2007-07-01

    Full Text Available Background and Aim: Considering flexural strength of fiber-reinforced composites (FRC and also the role of conservative cavities in protecting sound tissue of abutments, the aim of this study was to evaluate the fracture resistance of these bridges by handmade samples in vitro.Materials and Methods: In this experimental in vitro study, 44 sound newly extracted teeth were used to make 22 fixed inlay bridges including 11 three unit anterior upper inlay bridges substituting clinical model of upper central and 11 three unit posterior lower inlay bridges substituting clinical model of lower first molar. Specimens were prepared with FRC and mounted with artificial PDL in acryl. Cases were exposed to final load by using Universal Testing Machine (Instron 1195 with the speed of 1 mm/min. Statistical analysis was performed by Kolmogorov- Smirnov, independent sample T and Kaplan-Meier tests with p<0.05 as the level of significance.Results: Based on the statistical tests, the 95% confidence interval of mean was 450-562 N in anterior and  1473- 1761 N in posterior area. Fracture strength was high in the studied groups. Fractures in both groups occurred on composite facing, and the framework remained intact. The highest percentage of fracture in posterior teeth was in the middle of pontic towards the distal connector and in the anterior teeth in the lateral connector, between central pontic and lateral abutment. Using the independent sample T  test a significant statistical difference was observed between two groups (P<0.001. The fracture resistance of anterior samples was lower than the posterior ones.Conclusion: Based on the results of this study regarding the high fracture resistance in both areas FRC inlay bridges could be recommended for upper anterior and lower posterior teeth in clinical dentistry certainly more studies are needed to ascertain this treatment option.

  7. Tendinopatia do compartimento anterior do tornozelo Tendinopathy of the anterior compartment of the ankle

    Directory of Open Access Journals (Sweden)

    Antonio Egydio de Carvalho Junior

    2010-01-01

    Full Text Available OBJETIVO: Análise retrospectiva da etiopatogenia, diagnóstico e opções de tratamento nos casos de tendinopatias do compartimento anterior do tornozelo (TCAT. MÉTODO: No período de setembro de 1998 a fevereiro de 2009, 13 pacientes foram operados por tendinopatia do compartimento anterior do tornozelo. A casuística constou de 10 pacientes do sexo masculino e três do feminino. O lado direito foi acometido em 12 pés e um do esquerdo. A média de idade foi de 35 anos (15-67. A etiologia foi traumática em oito pacientes e em cinco, degenerativa (atraumática. O tempo médio do diagnóstico ao tratamento foi de 19 meses (1-60 e o seguimento foi de 34 meses (4-127. O diagnóstico foi feito através da história e exame clínico. A ressonância magnética foi realizada em nove pacientes para estadiamento e planejamento. O tratamento cirúrgico foi personalizado para cada caso (sinovectomia, ressecção de ventre muscular, solidarização com o tendão adjacente e enxerto livre de tendão semitendíneo. Para a avaliação dos resultados foram utilizadas as escalas: 1 graduação subjetiva de satisfação, 2 AOFAS e 3 Maryland. RESULTADO: Em relação à escala de graduação subjetiva de satisfação, 12 pacientes satisfeitos e um paciente insatisfeito. A média da escala AOFAS foi de 80 pontos, a média da escala Maryland foi de 86 pontos. CONCLUSÃO: O tratamento cirúrgico é eficaz para recuperação funcional. As técnicas cirúrgicas devem ser personalizadas. A opção do enxerto livre de tendão semitendíneo é eficiente nas falhas maiores que cinco centímetros.OBJECTIVE: To carry out a retrospective analysis of the etiopathogeny, diagnosis and therapeutic options in cases of tendinopathies of the anterior compartment of the ankle. METHOD: 13 patients underwent surgery between September 1998 and February 2009; ten men and three women. The right side was involved in twelve patients and the left in one. The averaging age was 35 years of

  8. Osgood Schlatter lesion: histologic features of slipped anterior tibial tubercle.

    Science.gov (United States)

    Falciglia, F; Giordano, M; Aulisa, A G; Poggiaroni, A; Guzzanti, V

    2011-01-01

    No study reports the histological features of the various zone of the anterior tubercle of the tibia in the different stages of the Osgood-Schlatter (O-S) lesion. For this reason we carried on an histological study. Specimens were taken from 13 patients with O-S lesion prior to surgery. In 4 cases in the apophyseal stage lesions were present in an altered fibrocartilage anterior to the ossification centre. In 9 cases in the epiphyseal stage varying degrees of reparative tissues were observed in the bed of the fragment of the secondary ossification centre. In 3 of them a zone of lesion was observed within the fibrocartilage anterior to the ossification centre. These results suggest that the slippage of the patellar tendon insertion may be progressive and caused by pathological fibrocartilage. PMID:21669134

  9. Perforation forces of the intact porcine anterior lens capsule.

    Science.gov (United States)

    Ullrich, Franziska; Lussi, Jonas; Felekis, Dimitrios; Michels, Stephan; Petruska, Andrew J; Nelson, Bradley J

    2016-09-01

    During the first step of cataract surgery, the lens capsule is perforated and a circular hole is created with a sharp instrument, a procedure called capsulorhexis. To develop automated systems that can assist ophthalmologists during capsulorhexis, the forces required must be quantified. This study investigates perforation forces of the central anterior lens capsule in porcine eyes, which are used as a conservative model for the human eye. A micro-mechanical characterisation method is presented that measures capsular bag perforation forces with a high precision positioning and high-resolution force sensing system. The force during perforation of the anterior lens capsule was measured with various sized needles and indentation speeds and is found to be 15-35mN. A bio-mechanical model is identified that describes an exponential correlation between indentation force and depth, indicating strain hardening behaviour of the porcine anterior lens capsule. PMID:27254279

  10. Misdiagnosis induced intraocular lens dislocation in anterior megalophthalmos

    Institute of Scientific and Technical Information of China (English)

    WANG Qi-wei; XU Wen; ZHU Ya-nan; LI Jin-yu; ZHANG Li; YAO Ke

    2012-01-01

    Anterior megalophthalmos (AM) is an uncommon developmental anomaly of the anterior segment of the eye with a constellation of findings that includes enlarged cornea,deep anterior chamber,posterior positioning of the iris and lens,iris stroma atrophy,hypoplasia of iris dilator,pupil displacement,large capsular bag,lens subluxation,prematurely cataract and the tendency to retinal detachment.AM,especially when symptoms are mild,is not an easy disease to diagnose.We present 3 AM cases that were misdiagnosed as congenital cataract with weak zonule and megalocornea.Intraocular lenses (IOLs) dislocated after standard cataract surgeries and subsequent surgery (replacing the dislocated IOLs with iris-claw intraocular lenses) achieved satisfactory outcome.Although rare,AM should be included in the differential diagnosis of enlarged cornea and we recommend implanting Artisan lens in AM patients.

  11. Compartment syndrome with mononeuropathies after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Kindle, Brett J; Murthy, Naveen; Stolp, Kathryn

    2015-05-01

    Compartment syndrome rarely follows anterior cruciate ligament reconstruction. However, when it does, it may result in mononeuropathies that are amenable to neurolysis. The authors of this study present an 18-yr-old woman who sustained a right anterior cruciate ligament tear and underwent uneventful anterior cruciate ligament reconstruction using femoral and popliteal nerve blocks. Postoperatively, she developed compartment syndrome requiring emergent fasciotomies. At 11 wks after fasciotomy, results of electrophysiologic tests showed evidence of severe fibular and tibial neuropathies. Magnetic resonance images showed extensive tricompartmental myonecrosis. Fibular and tibial neurolysis as well as decompression were performed, followed by intensive outpatient rehabilitation. At the 6-mo follow-up, she reported resolution of pain as well as significant improvement in sensation, strength, and function. Early recognition and intervention are crucial to prevent serious neurologic damage. Excessive tourniquet pressure and anesthetic nerve blocks may have been responsible.

  12. Perforation forces of the intact porcine anterior lens capsule.

    Science.gov (United States)

    Ullrich, Franziska; Lussi, Jonas; Felekis, Dimitrios; Michels, Stephan; Petruska, Andrew J; Nelson, Bradley J

    2016-09-01

    During the first step of cataract surgery, the lens capsule is perforated and a circular hole is created with a sharp instrument, a procedure called capsulorhexis. To develop automated systems that can assist ophthalmologists during capsulorhexis, the forces required must be quantified. This study investigates perforation forces of the central anterior lens capsule in porcine eyes, which are used as a conservative model for the human eye. A micro-mechanical characterisation method is presented that measures capsular bag perforation forces with a high precision positioning and high-resolution force sensing system. The force during perforation of the anterior lens capsule was measured with various sized needles and indentation speeds and is found to be 15-35mN. A bio-mechanical model is identified that describes an exponential correlation between indentation force and depth, indicating strain hardening behaviour of the porcine anterior lens capsule.

  13. Anterior mediastinal synovial sarcoma: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Wen-xiang YUE

    2015-01-01

    Full Text Available Objective To study the clinical manifestations, pathologic features, diagnosis, treatment and prognosis of primary synovial sarcoma in the anterior mediastinum. Methods A case of primary synovial sarcoma in the anterior mediastinum was reported. Clinical features, imaging manifestations, pathology features and therapeutic effect were analysed and the relevant literature was reviewed. Results A 48-year-male patient was admitted with complaint of right chest pain for 4 days. Chest computerized tomography revealed a large mass located at the right anterior mediastinum, and it was primarily diagnosed as invasive thymoma. Pathological examination by CT-guided percutaneous needle biopsy manifested that, under microscope, the tumor cells were short and spindle in shape forming a nest structure, suggested it was a thymoma. The patient then underwent resection of thymoma with removal of fat and connective tissue in the anterior mediastinum. During the operation the size of the tumor was 15cm×15cm×10cm, being located at the anterior mediastinum, and it tended to bleed. The diagnosis of primary monophasic synovial sarcoma in the mediastinum was confirmed by postoperative/pathology examination. Immunohistochemistry staining showed that the tumor cells were positive for the markers Bcl-2 and EMA, but negative for the markers CK (pan and S100. The patient suffered from local recurrence with metastases to lung 4 months after surgery. The patient received 2 chemotherapeutic courses with ifosfamide, epirubicin and cisplatin. He died 6 months after surgery. Conclusion Primary synovial sarcoma in the anterior mediastinum is an extremely rare and highly malignant tumor with poor prognosis. The diagnosis depends on the pathological features, immunohistochemistry and RT-PCR. Radical resection combined with comprehensive treatment may improve the survival rate. DOI: 10.11855/j.issn.0577-7402.2014.12.12

  14. Sandwich-like Reconstruction of Anterior Skull Base Defects

    Institute of Scientific and Technical Information of China (English)

    Wang Zheng-min; Wang De-hui

    2001-01-01

    Objective: To evaluate the safety and efficacy of new modality of anterior skull base repair,namely sandwich-like reconstruction of anterior skull base defects. Methods: A retrospective analysis of patients who underwent transcranial or transcranial-facial resections of malignant or benign aggressive tumors involving the anterior skull base was conducted in our department. We used the sandwich-like reconstruction, using pedicled pericranial flap, frontal muscle flap and free abdominal adipose tissue between them, to separate of cranial cavity and aerodigest tract and keep the frontal lobes in place following resections of anterior skull base tumors. Results: From October, 1984 to October, 1998, 116 patients underwent transcranial or transcranialfacial approach for the resection of malignant or aggressive benign tumor, and sandwich-like repairs were performed for the anterior skull base defect. 54 (46.6 % ) patients had previous operation, with a maximum of 5 surgeries. The average age of patients was 35.9 years old, ranging form 6 to 73 years old. Forty-eight (41.4%)patients had malignant neoplasmas, and sixty-eight (58.6%) patients had benign aggressive tumors. In our series, with the maximal follow-ups for as long as 14 years, NO one had early failure of the one-stage reconstruction. CSF fluid leakage was not encountered, nor was ascending bacterial meningitis observed. No immediate or delayed prolapse of dura or frontal lobes was observed. Conclusion: We conclude that the sandwich-like reconstruction, using pericranial flap, frontal muscle flap and free abdominal adipose between them, is an extremely safe and effective procedure for the repair of skull base defect, even when tumor extensively involves anterior skull base.

  15. Sandwich-like Reconstruction of Anterior Skull Base Defects

    Institute of Scientific and Technical Information of China (English)

    WangZheng-min,MD; WangDe-hui,MD

    2001-01-01

    Objective:To evaluate the safety and efficacy of new modality of anterior skull base repair,namely sandwich-like reconstruction of anterior skull base defects. Methods : A retrospective analysis of patients who underwent wanscranial or wanscranial-facial resections of malignant or benign aggressive tumors involving the anterior skull base was conducted in our department. We used the sandwich-like reconstruction, using pedicled pericranial flap, frontal muscle flap and free abdominal adipose tissue between them, to separate of cranial cavity and aerodigest tract and keep the frontal lobes in place following resections of anterior skull base tumors. Results: From October, 1984 to October, 1998, 116 patients underwent tmnscranial or tmnscranial-facial approach for the resection of malignant or aggressive benign tumor, and sandwich-like repairs were performed for the anterior skull base defect.54 (46.6%) patients had previous operation, with a maximum of 5 surgeries. The average age of patients was 35.9 years old, ranging form 6 to 73 years old. Forty-eight (41.4%) patients had malignant neoplasmas, and sixty-eight (58.6%) patients had benign aggressive tumors. In our series, with the maximal follow-ups for as long as 14 years, NO one had early failure of the one-stage reconstruction. CSF fluid leakage was not encountered, nor was ascending bacterial meningitis observed. No immediate or delayed prolapse of dura or frontal lobes was observed. Conclusion: We conclude that the sandwich-like reconstruction, using pericranial flap, frontal muscle flap and free abdominal adipose between them, is an extremely safe and effective procedure for the repair of skull base defect, even when tumor extensively involves anterior skull base.

  16. The significance of biometric parameters in determining anterior teeth width

    Directory of Open Access Journals (Sweden)

    Strajnić Ljiljana

    2013-01-01

    Full Text Available Background/Aim. An important element of prosthetic treatment of edentulous patients is selecting the size of anterior artificial teeth that will restore the natural harmony of one’s dentolabial structure as well as the whole face. The main objective of this study was to determine the correlation between the inner canthal distance (ICD and interalar width (IAW on one side and the width of both central incisors (CIW, the width of central and lateral incisors (CLIW, the width of anterior teeth (ATW, the width between the canine cusps (CCW, which may be useful in clinical practice. Methods. A total of 89 subjects comprising 23 male and 66 female were studied. Their age ranged from 19 to 34 years with the mean of 25 years. Only the subjects with the preserved natural dentition were included in the sample. All facial and intraoral tooth measurements were made with a Boley Gauge (Buffalo Dental Manufacturing Co., Brooklyn NY, USA having a resolution of 0.1mm. Results. A moderate correlation was established between the interalar width and combined width of anterior teeth and canine cusp width (r = 0.439, r = 0.374. A low correlation was established between the inner canthal distance and the width of anterior teeth and canine cusp width (r = 0.335, r = 0.303. The differences between the two genders were highly significant for all the parameters (p < 0.01. The measured facial distances and width of anterior teeth were higher in men than in women. Conclusion. The results of this study suggest that the examined interalar width and inner canthal distance cannot be considered reliable guidelines in the selection of artificial upper anterior teeth. However, they may be used as a useful additional factor combined with other methods for objective tooth selection. The final decision should be made while working on dentures fitting models with the patient’s consent.

  17. Role of Optical Coherence Tomography in Assessing Anterior Chamber Angles

    Science.gov (United States)

    Kochupurakal, Reema Thomas; Jha, Kirti Nath; Rajalakshmi, A.R.; Nagarajan, Swathi; Ezhumalai, G.

    2016-01-01

    Introduction Gonioscopy is the gold standard in assessing anterior chamber angles. However, interobserver variations are common and there is a need for reliable objective method of assessment. Aim To compare the anterior chamber angle by gonioscopy and Spectral Domain Optical Coherence Tomography (SD-OCT) in individuals with shallow anterior chamber. Materials and Methods This comparative observational study was conducted in a rural tertiary multi-speciality teaching hospital. A total of 101 eyes of 54 patients with shallow anterior chamber on slit lamp evaluation were included. Anterior chamber angle was graded by gonioscopy using the shaffer grading system. Angles were also assessed by SD-OCT with Trabecular Iris Angle (TIA) and Angle Opening Distance (AOD). Chi-square test, sensitivity, specificity, positive and negative predictive value to find correlation between OCT parameters and gonioscopy grading. Results Females represented 72.7%. The mean age was 53.93 ±8.24 years and mean anterior chamber depth was 2.47 ± 0.152 mm. Shaffer grade ≤ 2 were identified in 95(94%) superior, 42(41.5%) inferior, 65(64.3%) nasal and 57(56.4%) temporal quadrants. Cut-off values of TIA ≤ 22° and AOD ≤ 290 μm were taken as narrow angles on SD-OCT. TIA of ≤ 22° were found in 88(92.6%) nasal and 87(87%) temporal angles. AOD of ≤ 290 μm was found in 73(76.8%) nasal and 83(83%) temporal quadrants. Sensitivity in detecting narrow angles was 90.7% and 82.2% for TIA and AOD, while specificity was 11.7% and 23.4%, respectively. Conclusion Individuals were found to have narrow angles more with SD-OCT. Sensitivity was high and specificity was low in detecting narrow angles compared to gonioscopy, making it an unreliable tool for screening. PMID:27190851

  18. Refraction and eye anterior segment parameters in schizophrenic patients

    Directory of Open Access Journals (Sweden)

    Tongabay Cumurcu

    2015-06-01

    Full Text Available ABSTRACT Purpose: To evaluate the difference in terms of refractive errors and anterior segment parameters between schizophrenic patients and healthy volunteers. Methods: This study compared 70 patients (48 men who were diagnosed with schizophrenia with a control group of 60 (35 men who were similar in terms of age, gender, education, and socioeconomic level. Anterior segment examination was performed using a Scheimflug system. Axial length and lens thickness (LT were measured using optic biometry. The following tests were administered to the psychiatric patient group: Brief Psychiatric Rating Scale (BPRS, Scale for the Assessment of Negative Symptoms (SANS, and Scale for the Assessment of Positive Symptoms (SAPS. Results: Mild myopia was detected in both the schizophrenic and control groups, with no statistically significant difference (p>0.005. Corneal volume (CV, anterior chamber volume (ACV, anterior chamber depth (ACD, and central corneal thickness (CCT values were lower in the schizophrenic group, and there was a statistically significant between-group difference (p=0.026, p=0.014, p=0.048, and p=0.005, respectively. LT was greater in schizophrenics, and the difference was found to be statistically significant (p=0.006. A statistically significant negative correlation was found between SAPS and cylinder values (p=0.008. The axial eye length, cylinder value, pupil diameter, mean keratometric value, and anterior chamber angle revealed no statistically significant difference between the groups (p>0.05. Conclusion: No statistically significant difference was detected in terms of refraction disorders between schizophrenics and the healthy control group, while some differences in anterior chamber parameters were present. These results demonstrate that schizophrenics may exhibit clinical and structural differences in the eye.

  19. Autopsy case of a giant aneurysm of the anterior communicating artery. Correlation of CT findings and angiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Shinmura, Fujio; Takayasu, Kenji; Ohiwa, Yasuyuki; Sakata, Ryuichi; Ariwa, Rokuro

    1983-06-01

    A 64-year-old female was admitted to the hospital with a history of three previous subarachnoid hemorrhages. Neurological examinations revealed incontinentia urinae, gait disturbance, recent memory disturbance and motor weakness on the left side. Plain X-ray films showed a ring-like calcification in the right frontal region. A plain CT scan showed a ring-shaped iso- and high-density area in the intra hemispheric region, the intra bilateral anterior horn of the lateral ventricle, the intra septum pellucidum, and the intra anterior part of the third ventricle. Left carotid angiography showed a large aneurysmal shadow arising from the anterior communicating artery and another from the left middle cerebral artery. In the venous phase the venous angle was supero-posteriorly shifted, and the septal vein was elevated. She died unexpectedly with a status epilepticus of unknown origin. An autopsy specimen revealed that a giant aneurysm occupied the intra ventricular space, the anterior horn of the lateral ventricle, and the right thalamic region. Also, there was a large berry aneurysm arising from the middle cerebral artery. A coronary section through the giant aneurysm showed a markedly compressed left lateral ventricle, right thalamus, and hypothalamus, while the third ventricle had shifted toward the left side.

  20. A chondrosarcoma in the anterior mediastinum mimicking a thymoma

    DEFF Research Database (Denmark)

    Østergaard, Mia L.; Petersen, Rene H; Kalhauge, Anna

    2015-01-01

    A chondrosarcoma in the anterior mediastinum is a rare finding with a relatively good prognosis. We describe a case of a 75-year-old man with a 2-year history of neck discomfort and weight loss. Imaging showed a homogenous tumor with a minor compression on the anterior part of the heart. It had...... close relation to the ribs, no surrounding fat, and a thymoma was suspected. Biopsy prior to surgery was impossible due to the location of the tumor. Unfortunately, final pathology from the surgical specimen revealed a chondrosarcoma....

  1. Right upper lobe lung cancer: Resection through left anterior mediastinotomy.

    Science.gov (United States)

    Sirois, Marco; Abu Arab, Walid; Turcotte, Eric; Poulin, Yannick

    2016-01-01

    There is sparse information concerning approaches to metachronous lung cancer in patients who had a previous pneumonectomy for lung carcinoma. We describe the case of a 55-year-old woman who underwent a left pneumonectomy for lung carcinoma. Four years later, a radiological examination revealed a hypermetabolic nodule in the right upper lobe, which was located in the left hemithorax because of right lung hyperinflation and a mediastinal shift to the left. Wedge resection was carried out through a left anterior mediastinotomy. We believe that an anterior mediastinotomy represents a valuable option for the management of recurrent lung cancer after previous surgery. PMID:26124429

  2. Perikymata spacing and distribution on hominid anterior teeth.

    Science.gov (United States)

    Dean, M C; Reid, D J

    2001-11-01

    We documented the spacing and distribution of perikymata on the buccal enamel surface of fossil hominin anterior teeth with reference to a sample of modern human and modern great ape teeth. A sample of 27 anterior teeth attributed to Australopithecus (5 to A. afarensis, 22 to A. africanus) and of 33 attributed to Paranthropus (6 to P. boisei, and 27 to P. robustus) were replicated and sputter-coated with gold to enable reflected light microscopy of their surface topography. Anterior teeth were then divided into 10 equal divisions of buccal crown height. The total perikymata count in each division of crown height was recorded using a binocular microscope fitted with a vernier micrometer eyepiece. Then the mean number of perikymata per millimeter was calculated for each division. Similar comparative data for a modern sample of 115 unworn human anterior teeth and 30 African great ape anterior teeth were collected from ground sections. Perikymata counts in each taxon (together with either known or presumed periodicities of perikymata) were then used to estimate enamel formation times in each division of crown height, for all anterior tooth types combined. The distributions of these estimates of time taken to form each division of crown height follow the same trends as the actual perikymata counts and differ between taxa in the same basic way. The distinction between modern African great apes and fossil hominins is particularly clear. Finally, we calculated crown formation times for each anterior tooth type by summing cuspal and lateral enamel formation times. Estimates of average crown formation times in australopiths are shorter than those calculated for both modern human and African great ape anterior teeth. The data presented here provide a better basis for exploring differences in perikymata spacing and distribution among fossil hominins, and provide the first opportunity to describe four specimens attributed to Homo in this context. Preliminary data indicate that

  3. A chondrosarcoma in the anterior mediastinum mimicking a thymoma

    International Nuclear Information System (INIS)

    A chondrosarcoma in the anterior mediastinum is a rare finding with a relatively good prognosis. We describe a case of a 75-year-old man with a 2-year history of neck discomfort and weight loss. Imaging showed a homogenous tumor with a minor compression on the anterior part of the heart. It had close relation to the ribs, no surrounding fat, and a thymoma was suspected. Biopsy prior to surgery was impossible due to the location of the tumor. Unfortunately, final pathology from the surgical specimen revealed a chondrosarcoma

  4. Patella fracture following anterior cruciate ligament reconstruction: A case report

    OpenAIRE

    Milankov Miroslav; Kecojević Vaso; Ninković Srđan; Gajdobranski Đorđe R.

    2003-01-01

    Introduction The most frequent procedure in treatment of acute or chronic anterior cruciate ligament (ACL) rupture is the so called bone-tendon-bone reconstruction. A transverse dislocated patella fracture is a rare complication of this procedure with an incidence of 0.23%-2.3%. In a five year period, (1998-2002), 407 arthroscopic reconstructions of the anterior cruciate ligaments were done at our Clinic, and there was only one case of patella fracture. Case report An 18-year-old female patie...

  5. Endovascular treatment of axillary artery dissection following anterior shoulder dislocation.

    Science.gov (United States)

    Fass, G; Barchiche, M Reda; Lemaitre, J; De Quin, I; Goffin, C; Bricart, R; Bellens, B

    2008-01-01

    Injury to the axillary artery is a rare complication of anterior shoulder dislocation. Open surgical repair is technically demanding because of the anatomical position of the vessel and the propensity for concomitant injuries. Standard surgical exposure techniques involve extensive dissection, including a combination of supraclavicular or infraclavicular incision, median sternotomy, and thoracotomy causing significant morbidity and mortality rates. Endovascular techniques may offer an alternative to these surgically demanding procedures. We present a patient with a traumatic dissection of the axillary artery following anterior shoulder dislocation who was successfully managed with an endovascular stent. PMID:18411587

  6. Clearance from the anterior chamber of RBCs from human diabetics

    International Nuclear Information System (INIS)

    Erythrocytes from diabetic patients manifest decreased deformability and increased adherence. These abnormal membrane properties may diminish the ability of erythrocytes (RBCs) from diabetics to undergo deformation in passage through the trabecular meshwork. Using sodium chromate Cr 51-labeled RBCs from type I diabetic patients with proliferative retinopathy and normal control subjects, we studied RBC clearance from the rabbit anterior chamber. The mean time for 50% clearance (T50) of RBCs from diabetics (76 hours) was significantly longer than that for RBCs from normal subjects (19.5 hours). In this model, RBCs from diabetics have a slower clearance from the anterior chamber than do RBCs from normal subjects

  7. Rehabilitation after first-time anterior cruciate ligament injury and reconstruction in female football players: a study of resilience factors

    OpenAIRE

    Johnson, Urban; Ivarsson, Andreas; Karlsson, Jón; Hägglund, Martin; Waldén, Markus; Börjesson, Mats

    2016-01-01

    Background Most of the research in the area of psychosocial factors in rehabilitation after sports injuries has focused on risk behaviors, while relatively few studies have focused on behaviors that facilitate rehabilitation. The objective of our study was to understand the psychosocial features that characterize elite female football players who express a resilient behaviour during rehabilitation after a first-time anterior cruciate ligament (ACL) injury and reconstruction. Methods A qualita...

  8. Proprioception in anterior cruciate ligament deficient knees and its relevance in anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Mandeep S Dhillon

    2011-01-01

    Full Text Available Injury to the anterior cruciate ligament (ACL not only causes mechanical instability but also leads to a functional deficit in the form of diminished proprioception of the knee joint. "Functional" recovery is often incomplete even after "anatomic" arthroscopic ACL reconstruction, as some patients with a clinically satisfactory repair and good ligament tension continue to complain of a feeling of instability and giving way, although the knee does not sublux on clinical testing. Factors that may play a role could be proprioceptive elements, as the intact ACL has been shown to have significant receptors. Significant data have come to light demonstrating proprioceptive differences between normal and injured knees, and often between injured and reconstructed knees. ACL remnants have been shown to have proprioceptive fibers that could enhance functional recovery if they adhere to or grow into the reconstructed ligament. Conventionally the torn remnants are shaved off from the knee before graft insertion; modern surgical techniques, with remnant sparing methods have shown better outcomes and functional recovery, and this could be an avenue for future research and development. This article analyzes and reviews our understanding of the sensory element of ACL deficiency, with specific reference to proprioception as an important component of functional knee stability. The types of mechanoreceptors, their distribution and presence in ACL remnants is reviewed, and suggestions are made to minimize soft tissue shaving during ACL reconstruction to ensure a better functional outcome in the reconstructed knee.

  9. Clinical commissioning of an in vivo range verification system for prostate cancer treatment with anterior and anterior oblique proton beams.

    Science.gov (United States)

    Hoesl, M; Deepak, S; Moteabbed, M; Jassens, G; Orban, J; Park, Y K; Parodi, K; Bentefour, E H; Lu, H M

    2016-04-21

    The purpose of this work is the clinical commissioning of a recently developed in vivo range verification system (IRVS) for treatment of prostate cancer by anterior and anterior oblique proton beams. The IRVS is designed to perform a complete workflow for pre-treatment range verification and adjustment. It contains specifically designed dosimetry and electronic hardware and a specific software for workflow control with database connection to the treatment and imaging systems. An essential part of the IRVS system is an array of Si-diode detectors, designed to be mounted to the endorectal water balloon routinely used for prostate immobilization. The diodes can measure dose rate as function of time from which the water equivalent path length (WEPL) and the dose received are extracted. The former is used for pre-treatment beam range verification and correction, if necessary, while the latter is to monitor the dose delivered to patient rectum during the treatment and serves as an additional verification. The entire IRVS workflow was tested for anterior and 30 degree inclined proton beam in both solid water and anthropomorphic pelvic phantoms, with the measured WEPL and rectal doses compared to the treatment plan. Gafchromic films were also used for measurement of the rectal dose and compared to IRVS results. The WEPL measurement accuracy was in the order of 1 mm and after beam range correction, the dose received by the rectal wall were 1.6% and 0.4% from treatment planning, respectively, for the anterior and anterior oblique field. We believe the implementation of IRVS would make the treatment of prostate with anterior proton beams more accurate and reliable. PMID:27002470

  10. Connectivity and neurochemistry of the commissura anterior of the pigeon (Columba livia).

    Science.gov (United States)

    Letzner, Sara; Simon, Annika; Güntürkün, Onur

    2016-02-01

    The anterior commissure (AC) and the much smaller hippocampal commissure constitute the only interhemispheric pathways at the telencephalic level in birds. Since the degeneration study from Zeier and Karten (), no detailed description of the topographic organization of the AC has been performed. This information is not only necessary for a better understanding of interhemispheric transfer in birds, but also for a comparative analysis of the evolution of commissural systems in the vertebrate classes. We therefore examined the fiber connections of the AC by using choleratoxin subunit B (CTB) and biotinylated dextran amine (BDA). Injections into subareas of the arcopallium and posterior amygdala (PoA) demonstrated contralateral projection fields within the anterior arcopallium (AA), intermediate arcopallium (AI), PoA, lateral, caudolateral and central nidopallium, dorsal and ventral mesopallium, and medial striatum (MSt). Interestingly, only arcopallial and amygdaloid projections were reciprocally organized, and all AC projections originated within a rather small area of the arcopallium and the PoA. The commissural neurons were not GABA-positive, and thus possibly not of an inhibitory nature. In sum, our neuroanatomical study demonstrates that a small group of arcopallial and amygdaloid neurons constitute a wide range of contralateral projections to sensorimotor and limbic structures. Different from mammals, in birds the neurons that project via the AC constitute mostly heterotopically organized and unidirectional connections. In addition, the great majority of pallial areas do not participate by themselves in interhemispheric exchange in birds. Instead, commissural exchange rests on a rather small arcopallial and amygdaloid cluster of neurons. PMID:26179777

  11. Tibiofemoral cartilage contact biomechanics in patients after reconstruction of a ruptured anterior cruciate ligament.

    Science.gov (United States)

    Hosseini, Ali; Van de Velde, Samuel; Gill, Thomas J; Li, Guoan

    2012-11-01

    We investigated the in vivo cartilage contact biomechanics of the tibiofemoral joint in patients after reconstruction of a ruptured anterior cruciate ligament (ACL). A dual fluoroscopic and MR imaging technique was used to investigate the cartilage contact biomechanics of the tibiofemoral joint during in vivo weight-bearing flexion of the knee in eight patients 6 months following clinically successful reconstruction of an acute isolated ACL rupture. The location of tibiofemoral cartilage contact, size of the contact area, cartilage thickness at the contact area, and magnitude of the cartilage contact deformation of the ACL-reconstructed knees were compared with those previously measured in intact (contralateral) knees and ACL-deficient knees of the same subjects. Contact biomechanics of the tibiofemoral cartilage after ACL reconstruction were similar to those measured in intact knees. However, at lower flexion, the abnormal posterior and lateral shift of cartilage contact location to smaller regions of thinner tibial cartilage that has been described in ACL-deficient knees persisted in ACL-reconstructed knees, resulting in an increase of the magnitude of cartilage contact deformation at those flexion angles. Reconstruction of the ACL restored some of the in vivo cartilage contact biomechanics of the tibiofemoral joint to normal. Clinically, recovering anterior knee stability might be insufficient to prevent post-operative cartilage degeneration due to lack of restoration of in vivo cartilage contact biomechanics. PMID:22528687

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

    Science.gov (United States)

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

    2014-11-01

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

  13. Connectivity and neurochemistry of the commissura anterior of the pigeon (Columba livia).

    Science.gov (United States)

    Letzner, Sara; Simon, Annika; Güntürkün, Onur

    2016-02-01

    The anterior commissure (AC) and the much smaller hippocampal commissure constitute the only interhemispheric pathways at the telencephalic level in birds. Since the degeneration study from Zeier and Karten (), no detailed description of the topographic organization of the AC has been performed. This information is not only necessary for a better understanding of interhemispheric transfer in birds, but also for a comparative analysis of the evolution of commissural systems in the vertebrate classes. We therefore examined the fiber connections of the AC by using choleratoxin subunit B (CTB) and biotinylated dextran amine (BDA). Injections into subareas of the arcopallium and posterior amygdala (PoA) demonstrated contralateral projection fields within the anterior arcopallium (AA), intermediate arcopallium (AI), PoA, lateral, caudolateral and central nidopallium, dorsal and ventral mesopallium, and medial striatum (MSt). Interestingly, only arcopallial and amygdaloid projections were reciprocally organized, and all AC projections originated within a rather small area of the arcopallium and the PoA. The commissural neurons were not GABA-positive, and thus possibly not of an inhibitory nature. In sum, our neuroanatomical study demonstrates that a small group of arcopallial and amygdaloid neurons constitute a wide range of contralateral projections to sensorimotor and limbic structures. Different from mammals, in birds the neurons that project via the AC constitute mostly heterotopically organized and unidirectional connections. In addition, the great majority of pallial areas do not participate by themselves in interhemispheric exchange in birds. Instead, commissural exchange rests on a rather small arcopallial and amygdaloid cluster of neurons.

  14. Anterior Cingulate Cortex in Schema Assimilation and Expression

    Science.gov (United States)

    Wang, Szu-Han; Tse, Dorothy; Morris, Richard G. M.

    2012-01-01

    In humans and in animals, mental schemas can store information within an associative framework that enables rapid and efficient assimilation of new information. Using a hippocampal-dependent paired-associate task, we now report that the anterior cingulate cortex is part of a neocortical network of schema storage with NMDA receptor-mediated…

  15. Genetic studies in congenital anterior midline cervical cleft

    DEFF Research Database (Denmark)

    Jakobsen, L P; Pfeiffer, P; Andersen, M;

    2012-01-01

    Congenital anterior midline cervical cleft (CAMCC) is a rare anomaly, with less than 100 cases reported. The cause of CAMCC is unknown, but genetic factors must be considered as part of the etiology. Three cases of CAMCC are presented. This is the first genetic study of isolated CAMCC. Conventional...

  16. Complications of the anterior approach to the cervical spine

    Directory of Open Access Journals (Sweden)

    Marcelo Lemos Vieira da Cunha

    2014-09-01

    Full Text Available OBJECTIVE: To evaluate the complications of anterior approach to the cervical spine in patients who underwent cervical arthrodesis with instrumentation. METHODS: Prospective and descriptive study was conducted from January 2009 to April 2010. All patients who underwent arthrodesis of the cervical spine by anterior approach were included, regardless the diagnosis. Access was made by the anterior approach on the right side. We evaluated the number of operated levels (1, 2 or 3 levels and, the type of procedure performed: discectomy and placement of cage and plate (D+C+P, discectomy with placement of a cage (D+C or corpectomy with placement of cage and plate (C+C+P. All complications related to surgical approach were reported. RESULTS: We studied 34 patients, 70% male. The average age was 50 years and mean follow-up was 8 months. Eighteen percent of patients had complications, distributed as follows: dysphasia (33% and dysphonic (67%. Among patients who developed complications, most underwent to D+C+P (83% and no complications were found in patients where no cervical plate was used. Regarding levels, both complications were identified in patients operated to one or two levels. However, in patients operated on three levels, only dysphonia was identified. CONCLUSION: The most frequent complication was dysphonia. Patients who presented more complications were those undergoing discectomy and fusion with cage and anterior cervical plate. All cases of dysphonia were in this group. The number of accessible levels does not seem to have affected the incidence of complications.

  17. Holistic approach to understanding anterior knee pain. Clinical implications.

    Science.gov (United States)

    Sanchis-Alfonso, Vicente

    2014-10-01

    Anterior knee pain is one of the most frequent reasons for consultation within knee conditions. The aetiology is not well known, which explains the sometimes unpredictable results of its treatment. Normally, when we see a patient in the office with anterior knee pain, we only study and focus on the knee. If we do this, we are making a big mistake. We must not forget to evaluate the pelvis and proximal femur, as well as the psychological factors that modulate the course of the illness. Both the pelvifemoral dysfunction as well as the psychological factors (anxiety, depression, catastrophization and kinesiophobia) must be included in our therapeutic targets of the multidisciplinary treatment of anterior knee pain. We must not only focus on the knee, we must remember to "look up" to fully understand what is happening and be able to solve this difficult problem. The aetiology of anterior knee pain is multifactorial. Therefore, diagnosis and treatment of patellofemoral disorders must be individualized. Our findings stress the importance of tailoring physiotherapy, surgery and psycho-educational interventions to each patient.

  18. Nocardia Septic Arthritis Complicating an Anterior Cruciate Ligament Repair.

    Science.gov (United States)

    Yong, Elaine X L; Cheong, Elaine Y L; Boutlis, Craig S; Chen, Darren B; Liu, Eunice Y-T; McKew, Genevieve L

    2015-08-01

    Nocardia infection following anterior cruciate ligament (ACL) allograft reconstruction is a rare occurrence. We report a case of Nocardia infection of an allograft ACL reconstruction and septic arthritis of the knee joint due to an organism most similar to the novel Nocardia species Nocardia aobensis.

  19. Anastomotic leakage after anterior resection for rectal cancer: risk factors

    DEFF Research Database (Denmark)

    Bertelsen, C A; Andreasen, A H; Jørgensen, Torben;

    2010-01-01

    OBJECTIVE: The study aimed to identify risk factors for clinical anastomotic leakage (AL) after anterior resection for rectal cancer in a consecutive national cohort. METHOD: All patients with an initial first diagnosis of colorectal adenocarcinoma were prospectively registered in a national...

  20. The anterior temporal lobes support residual comprehension in Wernicke's aphasia.

    Science.gov (United States)

    Robson, Holly; Zahn, Roland; Keidel, James L; Binney, Richard J; Sage, Karen; Lambon Ralph, Matthew A

    2014-03-01

    Wernicke's aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory-verbal comprehension is significantly impaired in Wernicke's aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke's aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke's aphasia and 12 control participants performed semantic animate-inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke's aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke's aphasia group displayed an 'over-activation' in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke's aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions. PMID:24519979

  1. Computed tomography of the human developing anterior skull base

    NARCIS (Netherlands)

    J. van Loosen (J.); A.I.J. Klooswijk (A. I J); D. van Velzen (D.); C.D.A. Verwoerd (Carel)

    1990-01-01

    markdownabstractAbstract The ossification of the anterior skull base, especially the lamina cribrosa, has been studied by computed tomography and histopathology. Sixteen human fetuses, (referred to our laboratory for pathological examination after spontaneous abortion between 18 and 32 weeks of ge

  2. Anterior Myocardial Infarction And Developing Ventricular Aneurysm After Cannabis Use

    OpenAIRE

    Murat Yalcin

    2014-01-01

        Incidence of drug abuse and cannabis have increased in young adults, recently. Cannabis induced myocardial infarction has rarely been reported in these people. Herein, we reported 20 years old male who had acute anterior myocardial infarction and developing apical ventricular aneurysm after heavy cannabis use.

  3. Ankle Joint Fusion With an Anatomically Preshaped Anterior Locking Plate.

    Science.gov (United States)

    Wiewiorski, Martin; Barg, Alexej; Schlemmer, Thomas; Valderrabano, Victor

    2016-01-01

    We present a novel fixation plate for primary ankle joint fusion. A single anatomically preshaped angular stable plate was used with an anterior approach. An excellent result with good bone consolidation was present at the 1-year follow-up examination. PMID:25998475

  4. Anterior Colporrhaphy Technique and Approach Choices: Turkey Evaluation

    Directory of Open Access Journals (Sweden)

    Serdar Aydın

    2016-09-01

    Full Text Available Aim: To evaluate the diversity in techniques and approaches for anterior colporrhaphy among operators in Turkey. Methods: A survey evaluating the preoperative examination, technique of anterior colporrhaphy, operation choice and postoperative care was presented to surgeons. We contacted via directly, mail or telephone. We used 28 item questionnaire. Results: Majority (87.9% was composed of young gynecologists. Urologists composed of the 9.5% of the study population. The rate of paravaginal defect evaluation was 75.9% and mostly by inspection the presence of vaginal rugae. The use of transperineal 3D pelvic floor ultrasonography was low (5.7%. The evaluation of levator ani muscle defect was 46.6%. The usage of the transperineal 3D ultrasonography for levator ani muscle defect was 19 percent of operators. There were diversity in use of hydrodissection, fascial plication, excision of vaginal mucosa and suture choice. Usage of mesh for anterior colporrhaphy was limited (17.8% and mostly in recurrent cases (12.2%. Paravaginal defect repair rate was 31.9%. The urinary catheter was generally removed one or two day after operation. Vaginal pack usually removed 24 hours after. Conclusion: Several techniques and approaches for anterior vaginal wall repair among operators in Turkey. The variety of techniques suggested that there is no consensus on best surgical technique.

  5. Predictive factors for anterior chamber fibrin formation after vitreoretinal surgery

    Directory of Open Access Journals (Sweden)

    Leonardo Provetti Cunha

    2014-04-01

    Full Text Available Purpose: The aim of this study was to investigate possible predictive factors related to anterior chamber fibrin formation after vitreoretinal surgery in a large series of patients. Methods: The data of 185 eyes of 185 patients submitted to vitreoretinal surgery was reviewed. The following variables were evaluated: the postoperatively presence of fibrin, age, diabetes mellitus, the vitrectomy system gauge (20, 23 or 25 gauge, the type of vitreous substitute, the influence of prior surgical procedures and the combination with cataract extraction. To evaluate predictive factors for anterior chamber fibrin formation, univariate analysis was performed. A multivariate stepwise logistic regression model was adjusted to investigate factors associated with fibrin formation (p<0.05. Results: Fibrinoid anterior chamber reaction was found in 12 (6.4% patients. For multivariate logistic regression analysis, balanced salt solution (BSS, the chance of fibrin occurrence was 5 times greater (odds ratio 4.83, CI 95% 1.302 - 17.892; p=0.019, while combination with phacoemulsification increased the chance of fibrin formation by 20 times (odds ratio 20, CI 95% 2.480 - 161.347; p=0.005. No significant difference was found regarding other variables. Conclusion: Anterior chamber fibrin formation is an unwanted complication after vitreoretinal surgery. Factors such as combined performance of phacoemulsification and the use of balanced salt solution as a vitreous substitute may predispose the occurrence of this complication.

  6. Orthodontic and orthopaedic treatment for anterior open bite in children

    NARCIS (Netherlands)

    Lentini-Oliveira, D.; Carvalho, F. R.; Qingsong, Y.; Junjie, L.; Saconato, H.; Machado, M. A. C.; Prado, L. B. F.; Prado, G. F.

    2007-01-01

    Background Anterior open bite occurs when there is a lack of vertical overlap of the upper and lower incisors. The aetiology is multifactorial including: oral habits, unfavourable growth patterns, enlarged lymphatic tissue with mouth breathing. Several treatments have been proposed to correct this m

  7. The anterior process of the malleus in Cetartiodactyla.

    Science.gov (United States)

    Maier, Wolfgang; Ruf, Irina

    2016-02-01

    The anterior fixation of the anterior process of the malleus has been studied in a number of Cetartiodactyla. This anterior process, also known as processus gracilis, is provided by the prearticular (gonial), a dermal bone, whereas the cartilage of Meckel becomes resorbed in perinatal ontogenetic stages. Posteriorly, the prearticular fuses with the cartilaginous caput of the malleus; rostrally, the prearticular (= processus gracilis) is always fixed to the anterior crus of the ectotympanic by an extremely thin splint (thickness fused to the adjacent bones already in juveniles. However, in ruminants, the tegmen tympani tends to disappear and the processus internus praearticularis appears as relatively small bony knob at the floor of the medial cranial cavity, and it seems not to be fused to the surrounding bones; in later age stages, it may become secondarily overgrown by the petrosal. This dorsally exposed processus internus praearticularis seems to be a synapomorphy of the Ruminantia. The functional meaning of this internal process of the prearticular, which is also developed to a minor degree in Carnivora, remains unclear at the moment - but we present some speculations about this. PMID:26510377

  8. Editorial Commentary: Anterior Cruciate Ligament Reconstruction: Auto or Allo?

    Science.gov (United States)

    Verma, Nikhil N

    2016-01-01

    Considerable controversy exists regarding appropriate graft choice for patients undergoing anterior cruciate ligament reconstruction. Allografts pretreated with high-dose irradiation should be avoided. Otherwise, multiple factors should be considered to individualize patient decision making, including patient age and activity level, graft type, and fixation type.

  9. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... viewer, Samir Sharma writes in, “What was the estimated blood loss with the robotic procedure and what ... for an open case for anterior exenteration?” Our estimated blood loss for this procedure was 100 cc’s. ...

  10. Anterior ischemic optic neuropathy in patients undergoing hemodialysis

    NARCIS (Netherlands)

    DoorenbosBot, ACC; Geerlings, W; Houtman, IA

    1996-01-01

    Four patients are discussed who underwent hemodialysis and developed anterior ischemic optic neuropathy (AION). Three patients had been treated by hemodialysis for several years. One patient developed bilateral optic neuropathy after the first hemodialysis session, So far, only four hemodialysis pat

  11. Clinical outcomes of surgical management of anterior bilateral mandibular fractures

    NARCIS (Netherlands)

    P. Boffano; C. Gallesio; F. Roccia; B. van den Bergh; T. Forouzanfar

    2013-01-01

    Purpose: The aims of this study were to assess the clinical outcomes of patients with anterior bifocal mandibular fractures and to discuss the management of this peculiar type of trauma. Methods: From the systematic computer-assisted database that has continuously recorded patients hospitalized with

  12. Nocardia Septic Arthritis Complicating an Anterior Cruciate Ligament Repair

    OpenAIRE

    Yong, Elaine X. L.; Cheong, Elaine Y. L.; Boutlis, Craig S.; Chen, Darren B.; Liu, Eunice Y.-T.; McKew, Genevieve L.

    2015-01-01

    Nocardia infection following anterior cruciate ligament (ACL) allograft reconstruction is a rare occurrence. We report a case of Nocardia infection of an allograft ACL reconstruction and septic arthritis of the knee joint due to an organism most similar to the novel Nocardia species Nocardia aobensis.

  13. Nocardia Septic Arthritis Complicating an Anterior Cruciate Ligament Repair.

    Science.gov (United States)

    Yong, Elaine X L; Cheong, Elaine Y L; Boutlis, Craig S; Chen, Darren B; Liu, Eunice Y-T; McKew, Genevieve L

    2015-08-01

    Nocardia infection following anterior cruciate ligament (ACL) allograft reconstruction is a rare occurrence. We report a case of Nocardia infection of an allograft ACL reconstruction and septic arthritis of the knee joint due to an organism most similar to the novel Nocardia species Nocardia aobensis. PMID:26041900

  14. Editorial Commentary: Anterior Cruciate Ligament Reconstruction: Auto or Allo?

    Science.gov (United States)

    Verma, Nikhil N

    2016-01-01

    Considerable controversy exists regarding appropriate graft choice for patients undergoing anterior cruciate ligament reconstruction. Allografts pretreated with high-dose irradiation should be avoided. Otherwise, multiple factors should be considered to individualize patient decision making, including patient age and activity level, graft type, and fixation type. PMID:26743418

  15. The effect of anterior cruciate ligament injury on bone curvature

    DEFF Research Database (Denmark)

    Hunter, D J; Lohmander, Stefan; Makovey, J;

    2014-01-01

    OBJECTIVE: Investigate the 5-year longitudinal changes in bone curvature after acute anterior cruciate ligament (ACL) injury, and identify predictors of such changes. METHODS: In the KANON-trial (ISRCTN 84752559), 111/121 young active adults with an acute ACL tear to a previously un-injured knee...

  16. Removal of a giant intrathoracic cyst from the anterior mediastinum

    NARCIS (Netherlands)

    Bouma, Wobbe; Klinkenberg, Theo J.; Van De Wauwer, Caroline; Timens, Wim; Mariani, Massimo A.

    2014-01-01

    A 45-year-old caucasian man with progressive dyspnea appeared to have a giant intrathoracic cyst in the anterior mediastinum encasing the heart and compressing both lungs. He underwent succesful removal of the cyst through a median sternotomy. Recovery was uneventful. Gross examination revealed a th

  17. MR imaging of anterior cruciate ligament injury: associated findings

    International Nuclear Information System (INIS)

    Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament (ACL) injury in MR image. The knee MR images of 47 patients with ACL injury (complete;24, partial;23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament (PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. The means(± 2 standard errors) of anterior translocation were different significantly in statistical analysis (ρ < 0.001, student t-test) between injury group (7.51 ± 1.16 mm) and normal group (-0.56 ± 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically between injury group(0.23 ± 0.02) and normal group(0.17 ± 0.01)(ρ < 0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear (66%), thirteen lateral meniscus tear (28%), ten medial collateral ligament injury (28%), one PCL injury(2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients (43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients (19%) and avulsion fractures of anterior tibial spine in four patients(9%). The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and

  18. Posterior shoulder pain and anterior instability: a preliminary clinical study.

    Science.gov (United States)

    Castagna, Alessandro; Conti, Marco; Borroni, Mario; Massazza, Giuseppe; Vinci, Enzo; Franceschi, Giorgio; Garofalo, Raffaele

    2008-02-01

    Different clinical tests have been suggested in the literature as significant indicators of anterior shoulder instability. Sometimes patients with recurrent anterior shoulder instability may show some muscular guarding thus making the evaluation of specific clinical tests very difficult. These patients may also report a medical history with posterior shoulder pain that can be also elicited during some clinical manoeuvres. From September 2005 to September 2006 we prospectively studied patients who underwent an arthroscopic anterior capsuloplasty. Shoulder clinical examination was performed including anterior shoulder instability tests (drawer, apprehension and relocation tests). Furthermore the exam was focused on the presence of scapular dyskinesia and posterior shoulder pain. The patients were also evaluated with ASES, Rowe, SST (Simple Shoulder Test), Constant and UCLA (University of California at Los Angeles) scoring system preoperatively and at the latest follow-up time. In the period of this study we observed 16 patients treated for anterior gleno-humeral arthroscopic stabilisation, who preoperatively complained also of a posterior scapular pain. The pain was referred at the level of lower trapezium and upper rhomboids tendon insertion on the medial border of the scapula. It was also reproducible upon local palpation by the examiner. Four of these patients also referred pain in the region of the insertion of the infraspinatus and teres minor. After arthroscopic stabilisation the shoulder was immobilised in a sling with the arm in the neutral rotation for a period of 4 weeks. A single physician supervised shoulder rehabilitation. After a mean time of 6.8 months of follow-up, all the shoulder scores were significantly improved and, moreover, at the same time the patients referred the disappearance of the posterior pain. Posterior scapular shoulder pain seems to be another complaint and sign that can be found in patients affected by anterior shoulder instability

  19. M pathway and areas 44 and 45 are involved in stereoscopic recognition based on binocular disparity.

    Science.gov (United States)

    Negawa, Tsuneo; Mizuno, Shinji; Hahashi, Tomoya; Kuwata, Hiromi; Tomida, Mihoko; Hoshi, Hiroaki; Era, Seiichi; Kuwata, Kazuo

    2002-04-01

    We characterized the visual pathways involved in the stereoscopic recognition of the random dot stereogram based on the binocular disparity employing a functional magnetic resonance imaging (fMRI). The V2, V3, V4, V5, intraparietal sulcus (IPS) and the superior temporal sulcus (STS) were significantly activated during the binocular stereopsis, but the inferotemporal gyrus (ITG) was not activated. Thus a human M pathway may be part of a network involved in the stereoscopic processing based on the binocular disparity. It is intriguing that areas 44 (Broca's area) and 45 in the left hemisphere were also active during the binocular stereopsis. However, it was reported that these regions were inactive during the monocular stereopsis. To separate the specific responses directly caused by the stereoscopic recognition process from the nonspecific ones caused by the memory load or the intention, we designed a novel frequency labeled tasks (FLT) sequence. The functional MRI using the FLT indicated that the activation of areas 44 and 45 is correlated with the stereoscopic recognition based on the binocular disparity but not with the intention artifacts, suggesting that areas 44 and 45 play an essential role in the binocular disparity.

  20. Bilateral Traumatic Anterior Dislocation of Shoulder – a rare entity

    Directory of Open Access Journals (Sweden)

    Yashavantha Kumar C

    2013-01-01

    Full Text Available Introduction: Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislocation of shoulder without associated fracture in a 45 old women without any predisposing pathoanatomy.Case Report: A 45-year-old women presented to casualty with sudden onset of pain and restriction of movement in both shoulders fallowing trauma. Immediately post trauma she had severe pain and restriction of both shoulders. On examination arms were abducted and externally rotated. Bilateral shoulder movements were painful and restricted . There was loss of round contour of shoulder with increased vertical diameter of axilla anteriorly. Radiological examination revealed bilateral anterior dislocation of the shoulders without any associated fractures. Closed reduction done by Milch technique after intraraticular lignocaine injection. MRI of bilateral shoulder showed no pathological lesion. Both shoulders were immobilized with a shoulder immobilizer for three weeks.Conclusion: Most of the bilateral shoulder dislocations are posterior type seen in seizure disorders. Bilateral traumatic anterior shoulder dislocations are rare and are seen as a result of unique mechanism of injury. In our case patient had a fall on her elbows causing forced extension. If diagnosed and treated promptly completely normal function of the shoulders can be restored.

  1. FUNCTIONAL OUTCOME OF ARTHROSCOPIC RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT TEARS

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2016-02-01

    Full Text Available BACKGROUND Anterior Cruciate Ligament (ACL tear is the most common serious ligamentous injury to the knee joint. Anterior Cruciate Ligament (ACL injury is quite common among young active population, athletes and contact sports. The exact incidence of anterior cruciate ligament tears is not known as the cases are being under reported. The ACL is the primary stabilizer against anterior translation of the tibia on the femur and is important in counteracting rotation and valgus stress. MATERIALS AND METHODS Between November 2012 to October 2014, 34 consecutive patients who underwent arthroscopic assisted ACL reconstructions in the Department of Orthopedics and Traumatology, King George Hospital, Visakhapatnam were the material in our study. Age groups between 18 to 45 years considered. We utilised both BPTB and Quadrupled hamstring graft depending on the patient’s age, outcome testing in all cases was performed at the latest follow-up (at least 6 months. Post-operative physiotherapy rehabilitation protocol followed for 06 months. RESULTS Standard protocol of Lysholm and IKDC knee scoring system were used for evaluation of the results of the surgery during followup. Patients were evaluated periodically at preop, 3 months, 6 months, 12 months, 18 months and 24 months. CONCLUSION Patients with isolated ACL injury had better outcome compared to patients who underwent associated meniscectomy. Most common mechanism of injury was activity of sports in 20 patients. Postoperatively at 3 months, anterior drawer’s was 1+ in 6, 29 (85.2% patients had normal range of motion; 29 (85.29% patients had 5/5 quadriceps power (MRC grading 94% of them had 5/5 power at latest followup. No significant difference between outcomes of BPTB and Hamstrings graft. Functional outcome of our study were similar to the previously published studies.

  2. Simple self-reduction method for anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    Reiner Wirbel; Martin Ruppert; Elmar Schwarz; Bernhard Zapp

    2014-01-01

    Objective:To demonstrate and evaluate a modified simple method about self-reduction of anterior shoulder dislocation for significance in the emergency room. Methods:TheBoss-Holzach-Matter method for self-reduction of anterior shoulder disloaction is described.Patients with an anterior shoulder dislocation were retrospectively analysed concerning age, gender, type of anterior shoulder dislocation, occurrence of associated fractures, time between injury and reduction, reduction time, and method of reduction with its respective success rate. Results:Eighty-six patients(52 men,34 women, mean age49 years) were treated fromJanuary 2010 toJune2014.The reduction time ranged between20 seconds and6 min(mean1.5 min). Subcoracoid type of shoulder dislocation was seen in72 cases(84%), subglenoid type in14 cases(16%).Associated factures were seen in20 cases, proportionally more often in subgleboid dislocations,12 at the greater tuberosity,6 at the inferior rim of the glenoid fossa and2 at both localizations.TheBoss-Holzach-Matter method was used in35 cases with a success rate of 71.5%; dieKocher method and traction/countertraction method with premedication were used in 14 cases and17 cases with success rates of64% and70%, respectively.All other cases and the failed primary attempts required hyponotic medication.All patients older than70(n=16) were not able to perform the self reducing procedure. Conclusion:The presentedBoss-Holzach-Matter method for reduction of anterior shoulder dislocation is a simple method without the need of anaesthesia, but cooperation from patients is crucial.The successful rate is comparable with other established methods.

  3. Immunohistological analysis of extracted anterior cruciate ligament graft impinged against posterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Kato So

    2011-11-01

    Full Text Available Abstract A young female athlete suffered from the residual instability of the knee after anterior cruciate ligament (ACL reconstruction with hamstring autograft. The 3-dimensional (3-D CT scan showed the "high noon" positioning of the primary femoral bone tunnel. The revision surgery with anatomic double-bundle technique was performed two years after the primary surgery and the femoral tunnels were created with the assistance of the 3-D fluoroscopy-based navigation. An arthroscopic examination confirmed the ACL graft impingement against posterior cruciate ligament (PCL when the knee was deeply flexed. The histological analysis of the resected primary ACL graft showed local inflammatory infiltration, enhanced synovial coverage and vascularization at the impinged site. The enhanced expression of vascular endothelial growth factor (VEGF at the impinged area when compared with non-impinged area was observed on immunohistochemical analysis. Abnormal mechanical stress by the impingement against PCL might have induced chronic inflammation and VEGF overexpression.

  4. Miniplacas permitem tratamento eficiente e eficaz da mordida aberta anterior Miniplates allow efficient and effective treatment of anterior open bites

    Directory of Open Access Journals (Sweden)

    Jorge Faber

    2008-10-01

    Full Text Available INTRODUÇÃO: o tratamento das deformidades e más oclusões que incluem mordidas abertas anteriores foi uma das primeiras aplicações de miniplacas como forma de ancoragem ortodôntica. A implementação desse sistema de tratamento reduz o número de pacientes indicados para a cirurgia ortognática e simplifica muitos problemas. Nessa abordagem, os dentes posteriores são intruídos e a mandíbula sofre um giro no sentido anti-horário, diminuindo a altura facial inferior e projetando os pogônios de tecidos duro e mole. OBJETIVO: o presente artigo apresenta os fundamentos da mecânica ortodôntica para correção da mordida aberta anterior e os ilustra com uma série de casos clínicos.INTRODUCTION: The treatment of facial deformities and malocclusions, such as anterior open bite, was one of the first applications of miniplates for orthodontic anchorage. The use of this treatment system reduces the number of patients referred to orthognathic surgery and simplifies many problems. This approach applies intrusive forces to posterior teeth, and the mandible undergoes counterclockwise rotation, which decreases lower facial height and advances the projection of hard and soft tissue pogonions. OBJECTIVE: This study describes the principles of orthodontic mechanics in the correction of anterior open bite and illustrates these principles with a series of cases.

  5. Structural basis of empathy and the domain general region in the anterior insular cortex

    Directory of Open Access Journals (Sweden)

    Isabella eMutschler

    2013-05-01

    Full Text Available Empathy is key for healthy social functioning and individual differences in empathy have strong implications for manifold domains of social behavior. Empathy comprises emotional and cognitive components, such as feeling and knowing what another person is feeling, and may also be closely linked to sensorimotor processes, which go along with the motivation and behavior to respond compassionately to another person’s feelings and to reduce another person’s pain. There is growing evidence for local plastic change in the structure of the healthy adult human brain in response to environmental demands or intrinsic factors. Here we have investigated changes in brain structure resulting from or predisposing to empathy. Structural MRI data of 101 healthy adult females was analyzed. Empathy in fictitious as well as real-life situations was assessed by using a widely used and validated self-evaluation measure. Furthermore, empathy-related structural effects were also put into the context of a functional map of the anterior insular cortex determined by activation likelihood estimate (ALE meta-analysis of previous functional imaging studies. We found that gray matter density in the left dorsal anterior insular cortex correlates with empathy and that this area overlaps with the domain general region of the anterior insula that is situated in-between functional systems involved in emotion-cognition, pain and motor tasks as determined by our meta-analysis. Thus, we propose that this insular region where we find structural differences depending on individual empathy might play a crucial role in modulating the efficiency of neural integration underlying emotional, cognitive, and sensorimotor information which is essential for global empathy.

  6. Sex differences in volume and structural covariance of the anterior and posterior hippocampus.

    Science.gov (United States)

    Persson, Jonas; Spreng, R Nathan; Turner, Gary; Herlitz, Agneta; Morell, Arvid; Stening, Eva; Wahlund, Lars-Olof; Wikström, Johan; Söderlund, Hedvig

    2014-10-01

    Sex differences in episodic and spatial memory are frequently observed, suggesting that there may be sex-related structural differences in the hippocampus (HC). Earlier findings are inconsistent, possibly due to a known variability along the hippocampal longitudinal axis. Here, we assessed potential sex differences in hippocampal volume and structural covariance with the rest of the brain in young men and women (N=76), considering the anterior (aHC) and posterior (pHC) hippocampus separately. Women exhibited a larger pHC than men adjusted for brain size. Using partial least squares, we identified two significant patterns of structural covariance of the aHC and pHC. The first included brain areas that covaried positively and negatively in volume with both the aHC and pHC in men, but showed greater covariance with the aHC than pHC in women. The second pattern revealed distinct structural covariance of the aHC and pHC that showed a clear difference between men and women: in men the pHC showed reliable structural covariance with the medial and lateral parietal lobes and the prefrontal cortex, whereas in women the aHC showed reliable structural covariance with the anterior temporal lobe bilaterally. This pattern converges with resting state functional connectivity of the aHC and pHC and suggests that these hippocampal sections interact with different brain regions, consistent with a division of labor with regards to episodic and spatial memory. Our findings lend support to a division of the HC into an anterior and posterior part and identify sex as a potential moderating factor when investigating hippocampal structure and connectivity.

  7. Total endoscopic free flap harvest of a serratus anterior fascia flap for microsurgical lower leg reconstruction

    Directory of Open Access Journals (Sweden)

    Erdmann, Alfons

    2014-04-01

    Full Text Available [english] Background: A tremendous number of free flaps have been developed in the past. As the surgical result depends not only on a successful flap transfer but also on the harvest, this paper details the procedures for undertaking the first total endoscopic harvest of a serratus fascia flap for free flap transplantation to the lower leg. Patient and methods: In September 2012 we performed the first total endoscopic serratus anterior fascia free flap harvest. The incision of 2.5 cm length was made 10 cm in front of anterior muscle border of the latissimus dorsi at level with the midthorax. After insertion of a flexible laparoscopic single port system we started CO gas insufflation. We used this setting to meticulously prepare a neo cavity between atissimus dorsi and M. serratus anterior. The vessels were dissected and the thoraco-dorsal nerve was separated. With a second auxiliary incision we used a clamp to support the raising of the fascia flap from the underlying muscle. Finally we clipped the vessels to the latissimus dorsi muscle and the flap vessels at the Arteria and Vena axillaris. The flap was extracted via the 2.5 cm incision.Results: We were able to perform a total endoscopic harvest of a serratus fascia flap for free flap reconstruction of soft tissues. With this new operative technique we were able to avoid a long skin incision, which in our view lowers the morbidity at the harvest area.Conclusion: We describe a new method for the total endoscopic harvest of the serratus fascia flap for free flap transfer. The flap was harvested within reasonable time and following surgery leaves the patient with minimal donor site morbidity compared to the open technique.

  8. Effect of primary iris and ciliary body cyst on anterior chamber angle in patients with shallow anterior chamber

    Institute of Scientific and Technical Information of China (English)

    Bing-hong WANG; Yu-feng YAO

    2012-01-01

    Objective:To evaluate the prevalence of primary iris and/or ciliary body cysts in eyes with shallow anterior chamber and their effect on the narrowing of the anterior chamber angle.Methods:Among the general physical check-up population,subjects with shallow anterior chambers,as judged by van Herick technique,were recruited for further investigation.Ultrasound biomicroscope (UBM) was used to detect and measure the cysts located in the iris and/or ciliary body,the anterior chamber depth (ACD),the angle opening distance at 500 μm (AOD500),and the trabecular-iris angle (TIA).A-scan ultrasonography was used to measure the ocular biometry,including lens thickness,axial length,lens/axial length factor (LAF),and relative lens position (RLP).The effect of the cyst on narrowing the corresponding anterior chamber angle and the entire angle was evaluated by the UBM images,ocular biometry,and gonioscopic grading.The eye with unilateral cyst was compared with the eye without the cyst for further analysis.Results:Among the 727 subjects with shallow anterior chamber,primary iris and ciliary body cysts were detected in 250 (34.4%) patients; among them 96 (38.4%) patients showed unilateral single cyst,21 (8.4%) patients had unilateral double cysts,and 42 (16.8%) patients manifested unilateral multiple and multi-quadrants cysts.Plateau iris configuration was found in 140 of 361 (38.8%) eyes with cysts.The mean size of total cysts was (0.6547±0.2319) mm.In evaluation of the effect of the cyst size and location on narrowing the corresponding angle to their position,the proportion of the cysts causing corresponding angle narrowing or closure among the cysts larger than 0.8 mm (113/121,93.4%) was found to be significantly higher than that of the cysts smaller than 0.8 mm (373/801,46.6%),and a significant higher proportion was also found in the cysts located at iridociliary sulcus (354/437,81.0%) than in that at the pars plicata (131/484,27.1%).In evaluating the effect

  9. Calcitonin gene-related peptide in anterior and posterior horns of spinal cord after brachial plexus injury

    Institute of Scientific and Technical Information of China (English)

    Longju Chen; Peijun Wang; Feng Li; Wutian Wu

    2007-01-01

    vertebral plates were prayed open, and then the skin was sutured. The C7 segments of spinal cord were removed on the 1st, 3rd, 7th and 14th days postoperatively respectively, and the CGRP expressions in the anterior and posterior horns of spinal cord were determined and analyzed using immunohistochemical method and image analysis.MAIN OUTCOME MEASURES: ① Number of CGRP immuno-positive motor neurons in the anterior horn of spinal cord; ② Total area of CGRP immuno-positive fibers in the posterior horn of spinal cord.RESULTS: All the 65 rats were involved in the analysis of results. ① Number of CGRP immuno-positive motor neurons in the anterior horn of spinal cord: CGRP immuno-positive motor neurons could be observed in the anterior horns of C7 spinal cord in the control group and damage groups, the neurons had big cell body with stained cytoplasm, appeared as brown granules, and mainly distributed in the ventral lateral anterior horn of spinal cord. On the 1st day postoperatively, the number of CGRP positive neurons was obviously higher in the in the avulsion of anterior root group than in the control group (P < 0.01), whereas obviously lower in the disjunction of posterior root group than in the control group (P < 0.01), and there was no obvious difference between the transection of spinal cord group and the control group (P > 0.05). On the 7th day, the numbers of CGRP positive neurons in the damage groups were obviously higher than that in the control group (P < 0.01), also obviously different from those on the 1st day in the same group respectively (P < 0.01). On the 14th day, the number of CGRP positive neurons in the disjunction of posterior root group was decreased, but there was no obvious difference as compared with that in the control group, whereas those in the avulsion of anterior root group and transection of spinal cord group were still obviously higher than that in the control group (P < 0.01). The number of CGRP positive neurons was the most

  10. The advantages of submandibular gland resection in anterior retropharyngeal approach to the upper cervical spine

    OpenAIRE

    Skaf, Ghassan S.; Sabbagh, Amira S.; Hadi, Usamah

    2006-01-01

    Anterior surgery to the upper cervical spine, although rare, several successful approaches were described in the literature. To avoid the risks and limitations of transoral approach, the anterior retropharyngeal approach was developed. In this study, we describe our experience with anterior retropharyngeal approach to the upper cervical spine and discuss the significance of resecting the submandibular gland. From July 2001 to July 2004, we performed six anterior prevascular retropharyngeal ap...

  11. Anterior Cervical Corpectomy and Fusion Accelerates Degenerative Disease at Adjacent Vertebral Segments

    OpenAIRE

    Pickett, Gwynedd E.; Duggal, Neil; Theodore, Nicholas; Sonntag, Volker K.H.

    2008-01-01

    Background Anterior cervical corpectomy provides the most direct and thorough surgical approach for anterior decompression when spinal cord compression is found directly behind the vertebral body. However, anterior cervical fusion has been shown to be associated with the development of new degenerative changes at levels immediately adjacent to the fused segments. Th e incidence of adjacent segment disease (ASD) following anterior cervical corpectomy has not been widely reported. We set out to...

  12. The Anterior Ratio: The Missing Link between Orthodontics and Aesthetic Dentistry

    OpenAIRE

    Raman Aulakh

    2013-01-01

    There is an increase in the number of dentists using orthodontic treatment for anterior tooth alignment. This is either combined with additive bonding or interproximal reduction; knowing “when to” and “how much” requires an understanding of the anterior ratio. This case report explains how to use the anterior ratio to help provide optimal aesthetics and function for the ortho-restorative patient. The anterior ratio is an important diagnostic tool required for both disciplines of orthodontics ...

  13. Pupillary block glaucoma following implantation of a posterior chamber pseudophakos in the anterior chamber.

    Directory of Open Access Journals (Sweden)

    Mandal Anil

    2002-01-01

    Full Text Available Pupillary block glaucoma is a common complication of cataract surgery, especially following anterior chamber intraocular lens implantation. We report a case of pupillary block glaucoma with a posterior chamber IOL that was implanted in the anterior chamber following a complicated extracapsular cataract extraction. The case was successfully managed by explantation of the posterior chamber lens, anterior vitrectomy, peripheral iridectomy and secondary anterior chamber intraocular lens implantation. The intraocular pressure was controlled with a single topical antiglaucoma medication.

  14. The Relationship between Lower Extremity Alignment Characteristics and Anterior Knee Joint Laxity

    OpenAIRE

    Shultz, Sandra J.; Anh-Dung, Nguyen; Levine, Beverly J.

    2009-01-01

    Background: Lower extremity alignment may influence the load distribution at the knee, potentially predisposing the anterior cruciate ligament to greater stress. We examined whether lower extremity alignment predicted the magnitude of anterior knee laxity in men and women. Hypothesis: Greater anterior pelvic angle, hip anteversion, tibiofemoral angle, genu recurvatum, and navicular drop will predict greater anterior knee laxity. Study Design: Descriptive laboratory study. Methods: Women (n = ...

  15. Detached Anterior Horn of the Medial Meniscus Mimicking a Parameniscal Cyst

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    Shoji Fukuta

    2015-01-01

    Full Text Available We report a case of a detached anterior horn of the medial meniscus with anterior knee pain. Preoperative magnetic resonance images of the knee were initially interpreted as a parameniscal cyst. Arthroscopic examination revealed subluxation of the anterior horn of the medial meniscus due to detachment from its anterior tibial insertion. Arthroscopic fixation with a suture anchor was successful and the cystic lesion was no longer visible on postoperative images.

  16. Anterior approach v. posterior approach - ultrasound-guided shoulder arthrogram injection

    OpenAIRE

    Merle Neethling-du Toit; Richard de villiers

    2008-01-01

    Anterior approach ultrasound guided arthrogram injections are a quick reliable way of injecting contrast prior to MRI scan. We did a retrospective study on patients, previously injected and scanned at our clinic, to compare the more manifested posterior approach with the anterior approach. The success rate for successful intra-articular injections for the anterior approach far outweighs the posterior approach. Also the anterior approach is more tolerable for patients as the injections are muc...

  17. Patella fracture following anterior cruciate ligament reconstruction: A case report

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    Milankov Miroslav

    2003-01-01

    Full Text Available Introduction The most frequent procedure in treatment of acute or chronic anterior cruciate ligament (ACL rupture is the so called bone-tendon-bone reconstruction. A transverse dislocated patella fracture is a rare complication of this procedure with an incidence of 0.23%-2.3%. In a five year period, (1998-2002, 407 arthroscopic reconstructions of the anterior cruciate ligaments were done at our Clinic, and there was only one case of patella fracture. Case report An 18-year-old female patient, a handball player, suffered an acute rupture of anterior cruciate ligament of the left knee, so arthroscopic bone-tendon-bone reconstruction of the anterior cruciate ligament was performed. After adequate skin incision, a bone graft was taken from the patella and upper part of trapezoid tibia, which was 25 mm long, 10 mm wide and 5 mm thick, together with a part of patellar ligament. After the remains of the anterior cruciate ligament had been arthroscopically removed, tunnels were made in tibia and femur and a graft was inserted and fixed with two metal interference screws. Knee stability was tested, and drainage was put in the knee joint. The wound was closed by layers. The quadriceps exercises and passive knee movements started immediately. Full range of movements was accomplished six weeks later when the patient started to walk with full weight-bearing on her operated leg. Three weeks later, (nine weeks after the operation, the patient has accidentally lost her balance and fell. A transverse, dislocated fracture of the left patella was diagnosed and osteosynthesis of the fractured patella with two Kirschner wires and a metallic loop was performed. Postoperatively, full range of movement was allowed. Six months later, the patient felt no pain, there was no swelling, full range of knee movement was achieved, while the Lachman Test was identical in both knees and the pivot shift test was negative. Discussion Fracture of patella after ACL reconstruction is

  18. Germ cell tumor located in the midline of the anterior neck.

    Science.gov (United States)

    Pirdopska, Tatyana; Terziev, Ivan; Hristova, Sv; Mladenovsky, W; Petkov, R

    2011-01-01

    Primary germ cell tumors involving midline of the anterior neck are extremely rare. Here we report a 68-year-old male who was operated due to a mass lesion in the anterior neck with infiltration of the isthmus of the thyroid gland. Histopathological examination revealed a germ cell tumor with extragonadal localization in the anterior neck infiltrating the isthmus of the thyroid gland.

  19. Reshaping of the Anterior Nasal Spine: An Important Step in Rhinoplasty

    Science.gov (United States)

    Boccieri, Armando; Pascali, Michele

    2016-01-01

    Background: The importance of analysis of the nasal spine should not be underestimated in the correct planning of rhinoplasty. Deformations in position with respect to the midline and/or in size are often present, and their correction to ensure harmony between the spine and the other components of the nasal pyramid constitutes a key step in rhinoplasty that can lead to excellent results. Methods: The study includes 160 patients who underwent surgical treatment of the anterior nasal spine with or without other techniques of nasal reshaping. Eighty-seven of these patients presented with hyperplasia of the nasal spine, 43 with hypoplasia, and 30 with deviation. A combination of deviation and hyperplasia was present in 15 cases. Results: No patients developed postoperative complications. Five patients who underwent anterior nasal spine reduction reported postoperative numbness in the premaxillary area, but sensitivity was fully regained within 4 months after surgery in these patients. All the patients reported postoperative improvement of nasal airflow. A total of 142 patients considered their postoperative aesthetic result as excellent and 18 as good. Conclusion: The simplicity of the surgical procedures performed on the nasal spine and the marked aesthetic improvements thus achieved suggest that greater attention should be paid to this anatomical region.

  20. Recurrent anterior glenohumeral instability: the quantification of glenoid bone loss using magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Martins e Souza, Patricia [Fleury Medicina e Saude and Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ (Brazil); Brandao, Bruno Lobo; Motta, Geraldo; Monteiro, Martim [Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ (Brazil); Brown, Eduardo [Grupo Fleury Medicina Diagnostica, Rio de Janeiro, RJ (Brazil); Marchiori, Edson [Universidade Federal do Rio de Janeiro, Petropolis, RJ (Brazil)

    2014-08-15

    To investigate the accuracy of conventional magnetic resonance imaging (MRI) in determining the severity of glenoid bone loss in patients with anterior shoulder dislocation by comparing the results with arthroscopic measurements. Institutional review board approval and written consent from all patients were obtained. Thirty-six consecutive patients (29 men, seven women; mean age, 34.5 [range, 18-55] years) with recurrent anterior shoulder dislocation (≥3 dislocations; mean, 37.9; range, 3-200) and suspected glenoid bone loss underwent shoulder MRI before arthroscopy (mean interval, 28.5 [range, 9-73] days). Assessments of glenoid bone loss by MRI (using the best-fit circle area method) and arthroscopy were compared. Inter- and intrareader reproducibility of MRI-derived measurements was evaluated using arthroscopy as a comparative standard. Glenoid bone loss was evident on MRI and during arthroscopy in all patients. Inter- and intrareader correlations of MRI-derived measurements were excellent (intraclass correlation coefficient = 0.80-0.82; r = 0.81-0.86). The first and second observers' measurements showed strong (r = 0.76) and moderate (r = 0.69) interreader correlation, respectively, with arthroscopic measurements. Conventional MRI can be used to measure glenoid bone loss, particularly when employed by an experienced musculoskeletal radiologist. (orig.)

  1. Recurrent anterior glenohumeral instability: the quantification of glenoid bone loss using magnetic resonance imaging

    International Nuclear Information System (INIS)

    To investigate the accuracy of conventional magnetic resonance imaging (MRI) in determining the severity of glenoid bone loss in patients with anterior shoulder dislocation by comparing the results with arthroscopic measurements. Institutional review board approval and written consent from all patients were obtained. Thirty-six consecutive patients (29 men, seven women; mean age, 34.5 [range, 18-55] years) with recurrent anterior shoulder dislocation (≥3 dislocations; mean, 37.9; range, 3-200) and suspected glenoid bone loss underwent shoulder MRI before arthroscopy (mean interval, 28.5 [range, 9-73] days). Assessments of glenoid bone loss by MRI (using the best-fit circle area method) and arthroscopy were compared. Inter- and intrareader reproducibility of MRI-derived measurements was evaluated using arthroscopy as a comparative standard. Glenoid bone loss was evident on MRI and during arthroscopy in all patients. Inter- and intrareader correlations of MRI-derived measurements were excellent (intraclass correlation coefficient = 0.80-0.82; r = 0.81-0.86). The first and second observers' measurements showed strong (r = 0.76) and moderate (r = 0.69) interreader correlation, respectively, with arthroscopic measurements. Conventional MRI can be used to measure glenoid bone loss, particularly when employed by an experienced musculoskeletal radiologist. (orig.)

  2. Observation of posterior corneal vesicles with in vivo confocal microscopy and anterior segment OCT

    Directory of Open Access Journals (Sweden)

    Ryou Watanabe

    2010-10-01

    Full Text Available Ryou Watanabe, Toru Nakazawa, Nobuo FuseDepartment of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, JapanAbstract: The histopathology of posterior corneal vesicles (PCV has not yet been revealed. A 15-year-old girl, who was diagnosed by slit-lamp microscopy as PCV, was examined using specular microscopy, in vivo confocal microscopy, and anterior segment OCT (optical coherence tomography. Anterior segment OCT showed that the thickness of both corneas was within normal limits. At the same time, in vivo confocal microscopy revealed endothelial cells in the rounded dark areas, acellular hyporeflective layers on the Descemet’s membrane, and hyperreflective linear lesions. These findings were not reported previously by slit-lamp and specular microscopy. The abnormal findings only existed at the Descemet’s membrane and corneal endothelial layer. Previous reports dealing with posterior polymorphous dystrophy (PPMD examined using in vivo confocal microscopy reported almost the same findings, suggesting that PCV and PPMD may be the same at the microstructural level.Keywords: cornea, Descemet’s membrane, imaging

  3. In Vivo Confocal Microscopy and Anterior Segment Optic Coherence Tomography Findings in Ocular Ochronosis

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    Elif Demirkilinc Biler

    2015-01-01

    Full Text Available Purpose. To report clinical and in vivo confocal microscopy (IVCM findings of two patients with ocular ochronosis secondary due to alkaptonuria. Materials and Methods. Complete ophthalmologic examinations, including IVCM (HRT II/Rostock Cornea Module, Heidelberg, Germany, anterior segment optical coherence tomography (AS-OCT (Topcon 3D spectral-domain OCT 2000, Topcon Medical Systems, Paramus, NJ, USA, corneal topography (Pentacam, OCULUS Optikgeräte GmbH, Wetzlar, Germany, and anterior segment photography, were performed. Results. Biomicroscopic examination showed bilateral darkly pigmented lesions of the nasal and temporal conjunctiva and episclera in both patients. In vivo confocal microscopy of the lesions revealed prominent degenerative changes, including vacuoles and fragmentation of collagen fibers in the affected conjunctival lamina propria and episclera. Hyperreflective pigment granules in different shapes were demonstrated in the substantia propria beneath the basement membrane. AS-OCT of Case 1 demonstrated hyporeflective areas. Fundus examination was within normal limits in both patients, except tilted optic discs with peripapillary atrophy in one of the patients. Corneal topography, thickness, and macular OCT were normal bilaterally in both cases. Conclusion. The degenerative and anatomic changes due to ochronotic pigment deposition in alkaptonuria can be demonstrated in detail with IVCM and AS-OCT. Confocal microscopic analysis in ocular ochronosis may serve as a useful adjunct in diagnosis and monitoring of the disease progression.

  4. [Somatotopic Representation of the Anterior Horn within Cervical Enlargement: Reappraisal of Known Doctrine Based on Clinicopathological Findings Seen in Hirayama Disease].

    Science.gov (United States)

    Hirayama, Keizo

    2016-05-01

    Clinical features (weakness and amyotrophy of intrinsic hand muscles and obliquely distributed amyotrophy of forearm muscles, figure 1), needle electromyographic findings (distribution of neurogenic activities, figure 2), and pathological findings (ischemic necroses of the anterior horns between C6 and T1, figure 3) of Hirayama disease suggest that understanding of somatotopic representation of the anterior horn innervating arm muscles in the cervical enlargement of spinal cord differs from the known doctrine. Anterior horn cells of the intrinsic hand muscles are located between C7 and T1, those of forearm muscles and triceps brachii muscle as elbow extensor are, contrary to the known doctrine, located in C5 and C6, and those of elbow flexors such as biceps brachii and brachioradialis are located in C4 and above (figure 5). Development of dexterity in human hand may reflect development of cervical enlargement in accord with larger areas representing the hand and fingers on cerebral motor cortex.

  5. Edge-to-edge chordal transfer repair for anterior leaflet prolapse of mitral valve in 21 patients

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jian-qun; CHI Li-qun; KONG Qing-yu; ZHENG Si-hong; XIAO Wei

    2010-01-01

    Background Repair of anterior mitral leaflet (AML) prolapse is still a technical challenge for cardiac surgeons. It is an important issue to find a way to repair the AML prolapse with a reliable and reproducible technique.Methods Between January 2002 and June 2009, the operation of chordal transfer based on the "edge-to-edge"technique was performed in 21 patients with serious mitral valve regurgitation because of prolapse of the anterior leaflet.After the operation, echocardiography was performed in each patient before discharge and at the time of follow-up.Results All patients survived the operation. One patient required mitral valve replacement because of anterior leaflet perforation 3 days after the operation. The other patients were free from reoperation. At the time of follow-up, all these patients were in New York Heart Association (NYHA) functional class I. In all these patients, pre-discharge and follow-up echocardiography showed neither stenosis nor significant regurgitation of the mitral valve: the cross-sectional area of the mitral valve was 3.3-4.8 cm2 (mean (3.78:±0.52) cm2), the mean regurgitation area was (0.45:±0.22) cm2. At the same time, both dimension of left atrium and left ventricle reduced significantly (left atrium diameter: pre-operation (48.26±11.12) mm, post-operation (37.57±9.56) mm, P <0.05; the end-diastolic diameter of the left ventricle:pre-operation (61.43±8.24) mm, post-operation (42.35±10.79) mm, P<0.01).Conclusion "Edge-to-edge" chordal transfer technique is a simple, reliable, and reproducible technique that can provide good results for repair of anterior leaflet prolapse of mitral valve.

  6. Treatment of lumbosacral spinal tuberculosis by one-stage anterior debridement and fusion combined with dual screw-rod anterior instrumentation underneath the iliac vessel

    OpenAIRE

    Zhang, Ting; He, Xijing; Li, Haopeng; Xu, Siyue

    2016-01-01

    Background There has been no consensus regarding what is the optimal means of treating lumbosacral segment tuberculosis. The aim of this study was to evaluate the clinical outcomes of our newly developed one-stage anterior debridement and fusion combined with dual screw-rod construct anterior instrument underneath the iliac vessels for lumbosacral spinal tuberculosis. Methods We retrospectively reviewed 22 patients with lumbosacral spinal tuberculosis who underwent one-stage anterior debridem...

  7. Prokaryotic adenylate cyclase toxin stimulates anterior pituitary cells in culture

    Energy Technology Data Exchange (ETDEWEB)

    Cronin, M.J.; Evans, W.S.; Rogol, A.D.; Weiss, A.A.; Thorner, M.O.; Orth, D.N.; Nicholson, W.E.; Yasumoto, T.; Hewlett, E.L.

    1986-08-01

    Bordetella pertussis synthesis a variety of virulence factors including a calmodulin-dependent adenylate cyclase (AC) toxin. Treatment of anterior pituitary cells with this AC toxin resulted in an increase in cellular cAMP levels that was associated with accelerated exocytosis of growth hormone (GH), prolactin, adrenocorticotropic hormone (ACTH), and luteinizing hormone (LH). The kinetics of release of these hormones, however, were markedly different; GH and prolactin were rapidly released, while LH and ACTH secretion was more gradually elevated. Neither dopamine agonists nor somatostatin changes the ability of AC toxin to generate cAMP (up to 2 h). Low concentrations of AC toxin amplified the secretory response to hypophysiotrophic hormones. The authors conclude that bacterial AC toxin can rapidly elevate cAMP levels in anterior pituitary cells and that it is the response that explains the subsequent acceleration of hormone release.

  8. Unilateral ophthalmoplegia secondary to anterior clinoid process mucocele.

    Science.gov (United States)

    Forer, Boaz; Hui, Ng Yuk; Sethi, Dharmbir Singh

    2010-12-01

    A 50-year-old Chinese man presented with rapidly progressive unilateral ophthalmoplegia and then an ipsilateral afferent pupil defect. CT and MRI revealed a mass centered in the anterior clinoid process causing bone destruction and showing high T1 and T2 signal intensity indicative of mucosal protein secretion. These imaging features suggested a mucocele, which may have resulted from sequestration of a clinoidal extension of the sphenoid sinus. The sphenoid sinus was opened via an image-guided endoscopic approach, and the lesion incised. There were no complications. The ophthalmoplegia and afferent pupil defect had completely resolved within 1 week of surgery. This is the eighth reported case of anterior clinoidal mucocele, a rare cause of ophthalmoplegia or optic neuropathy. Advances in endoscopic instrumentation, navigation systems, and intraoperative imaging have reduced the operative risk and made the endoscopic approach a feasible and safer alternative to open surgery for this condition. PMID:20881616

  9. Missing Screw as a Rare Complication of Anterior Cervical Instrumentation

    Directory of Open Access Journals (Sweden)

    Yusuf Kurtuluş Duransoy

    2013-01-01

    Full Text Available Although anterior cervical arthrodesis is an effective procedure for the treatment of cervical disorders, the method has some complications. Here, we describe this rare complication of cervical instrumentation with a literature review. A 23-year-old male patient was operated for a C6-C7 dislocation. At postoperative month 10, he presented with hemoptysis and dysphagia. Cervical roentgenograms showed anterior migrations of one broken screw and a plate-locking screw at the C6 corpus. One screw was missing. We concluded that the missing screw had perforated the esophagus and had been eliminated spontaneously through the gastrointestinal tract. No screw should migrate. Even loose screws should be noted in follow-up X-ray studies. If such findings are detected, a second operation for revision should be considered as soon as possible to prevent potentially fatal complications.

  10. Hubungan Rasio Anterior dengan Overjet dan Overbite pada Perawatan Orthodontik

    Directory of Open Access Journals (Sweden)

    J. A. Budiman

    2015-10-01

    Full Text Available The important role of the tooth size information is in making diagnosis and treatment plan of the cases with malocclusion. A lot of studies have been done in this aspect such as about tooth size with its variation, and also the ratio of maxillary to mandibular tooth size. The most famous tooth size analysis is Bolton analysis with his anterior ratio and overall ratio. Because the accordance of those ratio is not found in all orthodontic cases, some studies (Korbitz, Neff, Moyers and Steadman tried to relate the anterior ratio with the amount of overjet and overbite in orthodontic treatment. Those relationship was found strong, but there are also other analysis that should be considered in treating orthodontic cases.

  11. Surgical Management of Significant Maxillary Anterior Vertical Ridge Defects.

    Science.gov (United States)

    Urban, Istvan A; Monje, Alberto; Nevins, Myron; Nevins, Marc L; Lozada, Jamie L; Wang, Hom-Lay

    2016-01-01

    Severe vertical ridge deficiency in the anterior maxilla represents one of the most challenging scenarios in bone regeneration. Under ideal circumstances, guided bone regeneration in combination with soft tissue management has shown predictable esthetic and functional outcomes. Success largely relies on primary wound closure during and after the surgical procedure. Surgical sites present different challenges that need to be considered when designing the flap. The goal of this article is to propose a classification of flap designs that considers vestibular depth and scar formation around the periosteum when performing vertical ridge augmentation in the atrophic anterior maxilla. The four clinical conditions proposed under this classification are (1) shallow vestibule with healthy periosteum, (2) deep vestibule with healthy periosteum, (3) shallow vestibule with scarred periosteum, and (4) deep vestibule with scarred periosteum. The classification will allow clinicians to achieve tension-free closure and more predictable vertical bone gain.

  12. Traumatic rupture of the tibialis anterior tendon: A case report

    Directory of Open Access Journals (Sweden)

    Maria Elisa Rodrigues

    2013-06-01

    Full Text Available OBJECTIVE: The autors report a case of a traumatic rupture of the tibialis anterior tendon (TTA that was early diagnosed and treated in the emergency service. This is a rare clinical entity with few cases reported in the literature. CASE REPORT: A 66-year old female presented at the emergency service complaining about pain at the anterior aspect of her ankle and inability to walk normally, after a fall. Physical examination revealed clinical signs for TTA rupture, which was later confirmed by ultrasound. Surgical treatment was performed immediately â€" the tendon was anchored into the medial cuneiform with a soft tissue-to-bone anchor. The follow-up revealed good functional result. CONCLUSION: Physical examination and a high index of suspicion are important when facing a patient who had sustained an ankle trauma. The TTA rupture is a diagnosis to consider because unrecognized ruptures led to important functional deficits and poor functional results.

  13. An anatomical evaluation of the serratus anterior plane block.

    Science.gov (United States)

    Mayes, J; Davison, E; Panahi, P; Patten, D; Eljelani, F; Womack, J; Varma, M

    2016-09-01

    The serratus anterior plane block has been described for analgesia of the hemithorax. This study was conducted to determine the spread of injectate and investigate the anatomical basis of the block. Ultrasound-guided serratus anterior plane block was performed on six soft-fix embalmed cadavers. All cadavers received bilateral injections, on one side performed with 20 ml latex and on the other with 20 ml methylene blue. Subsequent dissection explored the extent of spread and nerve involvement. Photographs were taken throughout dissection. The intercostal nerves were involved on three occasions with dye, but not with latex. The lateral cutaneous branches of the intercostal nerve contained dye and latex on all occasions. The serratus plane block appears to be mediated through blockade of the lateral cutaneous branches of the intercostal nerves. Anatomically, serratus plane block does not appear to be equivalent to paravertebral block for rib fracture analgesia. PMID:27440171

  14. Genetics in Ophthalmology II–Anterior Segment Diseases

    Directory of Open Access Journals (Sweden)

    Canan Aslı Utine

    2012-10-01

    Full Text Available Genetic diseases are congenital or acquired hereditary diseases that result from structural/functional disorders of the human genome. Today, the genetic factors that play a role in many diseases are being highlighted with the rapid progress in the field of genetics science. It becomes increasingly important that physicians from all disciplines have knowledge about the basic principles of genetics, patterns of inheritance, etc., so that they can follow the new developments. In genetic eye diseases, ophthalmologists should know the basic clinical and recently rapidly developing genetic characteristics of these diseases in order to properly approach the diagnosis and treatment and to provide genetic counseling. In this paper, anterior segment eye diseases of genetic origin are reviewed, and aniridia, anterior segment dysgenesis, glaucoma, corneal dystrophies, cataract, ectopia lentis, myopia, and other refractive errors are covered. (Turk J Ophthalmol 2012; 42: 378-85

  15. Transanal stent in anterior resection does not prevent anastomotic leakage

    DEFF Research Database (Denmark)

    Bülow, Steffen; Bulut, O; Christensen, Ib Jarle;

    2006-01-01

    OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS...... completion of the operation the patients were randomized in two groups with and without a transanal stent. RESULTS: A clinically significant leakage was diagnosed in 25 patients (13%). No significant difference was found 17 of 98 patients with a stent and 8 of 96 without (P = 0.09), or in 9 of 44 ileostomy...... patients with a stent and in 3 of 45 without (P = 0.07). Several leaks over a short time led to an interim analysis after inclusion of 194 of 448 planned patients. The analysis showed no significant protective effect of the stent, and more leakages in the stent group, although not statistically significant...

  16. Cerec anterior crowns: restorative options with monolithic ceramic materials.

    Science.gov (United States)

    Reich, Sven; Fiedlar, Kurt

    2013-01-01

    The aim of this article is to discuss the different types of monolithic ceramic crowns that can be placed on anterior teeth with existing shoulder preparations. Anterior crowns were indicated for the teeth 12 to 22 in the present case. The patient, a 65-year-old male, had received all-ceramic crowns 20 years earlier, which had started to develop cracks and palatal fractures over the last few years. The patient's teeth were prepared and four sets of crowns were fabricated using different monolithic ceramic materials: IPS e.max CAD, Cerec Blocs C In, VITABLOCS Real Life, and ENAMIC. Both shade characterization and crystallization firing were performed on the monolithic lithium disilicate glass ceramic crowns. The silicate ceramic crowns received glaze firing alone. The crowns made of hybrid ceramic (ENAMIC) were treated with a polymer sealant. PMID:24555406

  17. [Modern surgery of meningiomas affecting anterior visual pathways].

    Science.gov (United States)

    Grimm, F; Ebner, F H; Honegger, J

    2013-05-01

    Meningiomas are the most common form of primary intracranial tumors. If the anterior visual pathways are affected clinical visual compromise, visual field defects, oculomotor nerve disturbances or propotosis are predominant. Meningiomas of the anterior visual pathway remain therapeutically challenging due to the direct anatomical relationship to the circulus arteriosus cerebri, the cavernous sinus and cranial nerves. The therapy of choice is microsurgical resection. In many cases a curative approach can be achieved with modern surgical techniques and simultaneously maintaining patient quality of life. Problematic are cases in which resection would be associated with the risk of clinical impairment and in these cases radiotherapy is an important therapeutic option. In cases involving complex invasiveness an interdisciplinary treatment to control local clinical symptoms is favored. PMID:23604251

  18. Organic mood disorder following left anterior temporal lobectomy with amygdalohippocampectomy

    Directory of Open Access Journals (Sweden)

    Nishanth J Haridas

    2015-01-01

    Full Text Available One third of patients with antiepileptic-resistant temporal lobe epilepsy (TLE will have to undergo surgery for a better seizure control. Anterior temporal lobectomy (ATL is done for mesial temporal sclerosis that is the most common histopathological lesion associated with TLE. Psychiatric manifestations following ATL are not uncommon with depressive symptoms more common with left ATL and manic symptoms following right ATL. Mr. A is a 42-year-old left cerebral dominant (Confirmed by WADA test male with no past history of psychiatric illness who had undergone anterior temporal lobectomy with amygdalohippocampectomy. He started having manic episodes post operatively which subsided with antipsychotics. He had multiple such episodes over the next 13 years with minimal inter episodic symptoms. This is a rare instance of manic symptoms following left-sided ATL that emphasizes the need for better understanding of the cerebral laterality of affective symptoms.

  19. Esthetic Rehabilitation of Anterior Teeth with Laminates Composite Veneers

    Directory of Open Access Journals (Sweden)

    Dino Re

    2014-01-01

    Full Text Available No- or minimal-preparation veneers associated with enamel preservation offer predictable results in esthetic dentistry; indirect additive anterior composite restorations represent a quick, minimally invasive, inexpensive, and repairable option for a smile enhancement treatment plan. Current laboratory techniques associated with a strict clinical protocol satisfy patients’ restorative and esthetic needs. The case report presented describes minimal invasive treatment of four upper incisors with laminate nanohybrid resin composite veneers. A step-by-step protocol is proposed for diagnostic evaluation, mock-up fabrication and trial, teeth preparation and impression, and adhesive cementation. The resolution of initial esthetic issues, patient satisfaction, and nice integration of indirect restorations confirmed the success of this anterior dentition rehabilitation.

  20. Effect of bone loss in anterior shoulder instability

    Science.gov (United States)

    Garcia, Grant H; Liu, Joseph N; Dines, David M; Dines, Joshua S

    2015-01-01

    Anterior shoulder instability with bone loss can be a difficult problem to treat. It usually involves a component of either glenoid deficiency or a Hill-Sachs lesion. Recent data shows that soft tissue procedures alone are typically not adequate to provide stability to the shoulder. As such, numerous surgical procedures have been described to directly address these bony deficits. For glenoid defects, coracoid transfer and iliac crest bone block procedures are popular and effective. For humeral head defects, both remplissage and osteochondral allografts have decreased the rates of recurrent instability. Our review provides an overview of current literature addressing these treatment options and others for addressing bone loss complicating anterior glenohumeral instability. PMID:26085984

  1. MR for assessing anterior cruciate ligament reconstructions by tendon grafts

    International Nuclear Information System (INIS)

    150 patients were examined via magnetic resonance (MR) after anterior cruciate (ACL) ligament reconstruction (76 patellar tendon grafts, 53 semitendinosous tendon grafts and 21 sutures). The results of MR were compared with clinical tests (Lachman, pivot-shift and anterior drawer test), in 2 cases with the operative findings, and in one case with arthroscopy findings. In 91% of patients with a clinically stable knee we found a continuous low-intensity ligamental structure. 10 patients were examined twice or more between 8 days and 6 months after surgery. Ligamental structures of low signal intensity did not significantly change their MR characteristics. MR is a valuable noninvasive method for evaluating ligament reconstructions. (orig./GDG)

  2. Right Ventricular Involvement in either Anterior or Inferior Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Firoozeh Abtahi

    2016-06-01

    Full Text Available Background: Unlike left ventricular function, less attention has been paid to Right Ventricular (RV function after Myocardial Infarction (MI. Objectives: The current study aimed to compare RV function in patients with inferior and anterior MI. Patients and Methods: During the study period, 60 patients consecutively presented to the Emergency Department with chest pain were divided into two groups based on their electrocardiographic findings. Accordingly, 25 patients had inferior MI (IMI group and 35 ones had anterior MI (AMI group. Echocardiography was performed 48 hours after starting the standard therapy. Conventional echocardiographic parameters and Tissue Doppler Imaging (TDI measurements were acquired from the standard views. Student t-test and the chi-square test were respectively used for comparisons of the normally distributed continuous and categorical variables in the two groups. Besides, P < 0.05 was considered to be statistically significant.

  3. Síndrome tóxica do segmento anterior

    OpenAIRE

    Luiz Filipe de Albuquerque Alves; Marcelo Jarczun Kac; Tiago Bisol; Bruno Franco Fernandes; Demian Temponi Eskenazi

    2013-01-01

    A síndrome tóxica do segmento anterior (STSA) é uma severa reação inflamatória aguda causada por agente não infeccioso que entra no segmento anterior, resultando em lesão celular tóxica com necrose e apoptose mediado por resposta imunológica. Neste relato de caso de STSA são enfatizadas as causas mais comuns para o aparecimento da síndrome, apontam para os cuidados que devem ser tomados no processo de esterilização do material cirúrgico além de revisar a melhor conduta diante desses casos. Em...

  4. [Medullary venous malformation with azygos anterior cerebral artery aneurysm: a case report].

    Science.gov (United States)

    Harada, K; Kobayashi, S; Sigemori, M; Watanabe, M; Kuramoto, S

    1987-03-01

    A case of medullary venous malformation with azygos anterior cerebral artery aneurysm is reported, which was associated with the leptomenigeal angiomatosis on the cortex of the right frontal lobe. A 62-year-old female was admitted to the Kurume University Hospital on June 21, 1985, because of a convulsive seizure. On admission, neurological and general examinations, except for slightly liver function disorder, was no abnormality. Plain CT scan showed the cortical atrophy and two small high-density areas in the right frontal lobe. Enhanced CT scan showed a high-density area in the genu of the corpus callosum. MRI (magnetic resonance imaging), on T2 weighted image, showed a high signal intensity area in the right paraventricular deep white matter and the right frontal region. A right internal carotid angiogram in the venous phase showed numerous enlarged medullary veins in the deep frontal region, converging into a single large draining vein that empties into the basal vein of Rosenthal. An azygos anterior cerebral artery was visualized on the right and left carotid angiograms. The aneurysm was situated at the distal end of the azygos artery. Twenty eight days after admission, a right frontal cranioplastic craniotomy was performed. During operation, the surface of the right frontal lobe was covered by fine, vascular networks, which was reddish brown. A right frontal lobectomy, including venous malformation and vascular networks, was performed. The aneurysm was clipped via an interhemispheric approach. Histologically, the malformation vessels had spread into the subarachnoid space.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3600991

  5. Luxação glenoumeral anterior bilateral: caso clínico Bilateral anterior glenohumeral dislocation: clinical case

    Directory of Open Access Journals (Sweden)

    Luís Pires Silva

    2011-01-01

    Full Text Available A luxação glenoumeral anterior bilateral é uma ocorrência rara. Apresentamos um caso de luxação glenoumeral anterior bilateral com origem após uma queda da própria altura. O interesse desta publicação reside no fato de se tratar de uma raridade clínica com poucos casos descritos na literatura. Paciente do sexo feminino com 89 anos recorre ao serviço de urgência (SU após queda referindo dor intensa e incapacidade de mobilização de ambos os ombros. Ao exame objetivo apresentava sinais clínicos suspeitos de luxação glenoumeral anterior bilateral confirmados por radiografia. Ambas as luxações foram reduzidas no SU pela técnica de Milch modificada, com sucesso. Quando existe uma força simétrica e síncrona sobre os ombros e estes se apresentarem dolorosos e com limite funcional significativo, a suspeita de luxação glenoumeral bilateral, embora rara, é um diagnóstico diferencial a ter em conta.Bilateral anterior glenohumeral dislocation is a rare occurrence. We present a case of bilateral anterior glenohumeral dislocation caused by a fall. The interest in publishing this case is that this is a clinical rarity with few cases reported in the literature. An 89-year-old female patient was brought to the emergency department after a fall, complaining of intense pain in both shoulders and inability to move them. Objective examination showed clinical signs giving the suspicion of bilateral anterior glenohumeral dislocation, which was confirmed by x-ray imaging. Both dislocations were successfully reduced in the emergency department using the modified Milch technique. When a synchronous and symmetrical force has acted on both shoulders and these are painful with significant functional limitation, the suspicion of bilateral glenohumeral dislocation is a differential diagnosis to be considered, even though it is rare.

  6. Anterior chamber gas bubbles in open globe injury.

    Science.gov (United States)

    Barnard, E B G; Baxter, D; Blanch, R

    2013-01-01

    We present a case of a 40-year-old soldier who was in close proximity to the detonation of an improvised explosive device (IED). Bubbles of gas were visible within the anterior chamber of his left eye. The authors propose that intraocular gas, present acutely after trauma, is diagnostic of open globe injury and is of particular importance in remote military environments. PMID:24079202

  7. Anterior knee pain: an update of physical therapy.

    Science.gov (United States)

    Werner, Suzanne

    2014-10-01

    Anterior knee pain is one of the most common knee problems in physically active individuals. The reason for anterior knee pain has been suggested to be multifactorial with patella abnormalities or extensor mechanism disorder leading to patellar malalignment during flexion and extension of the knee joint. Some patients complain mostly of non-specific knee pain, while others report patellar instability problems. The patients present with a variety of symptoms and clinical findings, meaning that a thorough clinical examination is the key for optimal treatment. Weakness of the quadriceps muscle, especially during eccentric contractions, is usually present in the majority of anterior knee pain patients. However, irrespective of whether pain or instability is the major problem, hypotrophy and reduced activity of the vastus medialis are often found, which result in an imbalance between vastus medialis and vastus lateralis. This imbalance needs to be corrected before quadriceps exercises are started. The non-operative rehabilitation protocol should be divided into different phases based on the patient's progress. The goal of the first phase is to reduce pain and swelling, improve the balance between vastus medialis and vastus lateralis, restore normal gait, and decrease loading of the patello-femoral joint. The second phase should include improvement of postural control and coordination of the lower extremity, increase of quadriceps strength and when needed hip muscle strength, and restore good knee function. The patient should be encouraged to return to or to start with a suitable regular physical exercise. Therefore, the third phase should include functional exercises. Towards the end of the treatment, single-leg functional tests and functional knee scores should be used for evaluating clinical outcome. A non-operative treatment of patients with anterior knee pain should be tried for at least 3 months before considering other treatment options.

  8. Anterior-posterior asymmetry in iris mechanics measured by indentation.

    Science.gov (United States)

    Whitcomb, Julie E; Amini, Rouzbeh; Simha, Narendra K; Barocas, Victor H

    2011-10-01

    Indentation and histological analysis of the porcine iris were done to assess the relative stiffness of the anterior (stroma) and posterior (dilator and sphincter) layers. The dimensions of the constituent structures were documented histologically by staining with a monoclonal anti-human α-smooth muscle actin antibody to determine the location of the stroma, sphincter, and dilator. Intact porcine irides (4-8 h post-mortem) were bisected into two equal C-shaped halves to indent both surfaces. Indentation experiments were performed using a 1 mm cylindrical indenter tip. The load-displacement curve for each experiment was used to estimate effective instantaneous and equilibrium moduli for the anterior and posterior surfaces of the tissue. A total of 18 irides (9 pairs) with 3-5 indentations per iris surface was performed. The average thickness of the samples was 550 μm; the indentation depth was limited to 60-100 μm depending on the thickness of the sample at each point. Posterior surface indentation gave larger forces than anterior, with the resulting instantaneous modulus of 6.0 ± 0.6 kPa versus 4.0 ± 0.5 kPa (mean ± 95% CI, n = 45, p poroelasticity, we conclude that the posterior components of the iris - dilator, pigment epithelium, and sphincter - are on average stiffer than the stroma and anterior border layer. PMID:21787771

  9. Bone graft substitutes in anterior cervical discectomy and fusion

    OpenAIRE

    Chau, Anthony M.T.; Mobbs, Ralph J.

    2009-01-01

    Anterior cervical discectomy with fusion is a common surgical procedure for patients suffering pain and/or neurological deficits and unresponsive to conservative management. For decades, autologous bone grafted from the iliac crest has been used as a substrate for cervical arthrodesis. However patient dissatisfaction with donor site morbidity has led to the search for alternative techniques. We present a literature review examining the progress of available grafting options as assessed in hum...

  10. Complications and Management of Deep Anterior Lamellar Keratoplasty

    Directory of Open Access Journals (Sweden)

    Banu Torun Acar

    2014-10-01

    Full Text Available Objectives: To report the intraoperative and postoperative follow-up complications and management of these in deep anterior lamellar keratoplasty (DALK surgery. Materials and Methods: Two hundred eighty-four eyes of 252 patients followed up in our cornea clinic who underwent DALK using Anwar’s big-bubble technique with healthy Descemet’s membrane and endothelium were included in this study. Intraoperative and postoperative complications as well as the management and treatment of these complications were evaluated. Results: Big bubble was created in 220 (77.5% eyes of 284 eyes, and lamellar dissection was performed in 64 (22.5% eyes. Perforation occurred during trephination in 4 eyes, and the procedure was accomplished by penetrating keratoplasty (PK. Intraoperative microperforation occurred in 44 eyes. Perforation enlarged in 4 eyes and PK was performed. Operation was continued in 40 eyes with air injection into the anterior chamber. In postopertive follow-up period, double anterior chamber (DAC occurred in 32 of 40 eyes. DAC spontaneously regressed in 8 eyes, and air was given into the anterior chamber with a second surgical intervention in 24 eyes. DAC improved in 20 eyes. Four eyes underwent PK. Fungal keratitis evolved at the interface in one eye, because of no healing during the follow-up period, this eye underwent PK under antifungal therapy. Eyes with interface haze and Descemet’s membrane folds were followed. Conclusion: DALK is a difficult technique with a steep learning curve. In addition to the complications seen in PK, specific complications can occur in lamellar surgery. (Turk J Ophthalmol 2014; 44: 337-40

  11. Anterior Cruciate Ligament Reconstruction Using a Flexible Reamer System

    OpenAIRE

    Fitzgerald, Judd; Saluan, Paul; Richter, Dustin L.; Huff, Nathan; Schenck, Robert C.

    2015-01-01

    Anatomic reconstruction of the anterior cruciate ligament (ACL) has been shown to improve stability of the knee, particularly rotational stability, potentially leading to superior clinical outcomes and a shorter return to sport. Nonanatomic ACL reconstruction has been linked to graft failure and abnormal cartilage loading thought to contribute to progression of degenerative joint disease. Use of the far anteromedial portal (FAMP) to uncouple the tibial and femoral tunnels has led to improved ...

  12. Acute anterior uveitis following intravitreal bevacizumab but not subsequent ranibizumab

    OpenAIRE

    Antonopoulos C; Stem M; Comer GM

    2011-01-01

    Christina Antonopoulos1, Maxwell Stem2, Grant M Comer21Department of Ophthalmology, Boston University, Boston, MA, USA; 2WK Kellogg Eye Center, Department of Ophthalmology, University of Michigan, Ann Arbor, MI, USAPurpose: Previous reports have identified noninfectious uveitis as a potential sequela following both intravitreal bevacizumab and ranibizumab injections. We present two unique cases of acute anterior uveitis following intravitreal bevacizumab that did not occur with subsequent ran...

  13. Audit on necessity of radiographs in anterior shoulder dislocations

    Directory of Open Access Journals (Sweden)

    K. Ahmadi, M.D

    2008-01-01

    Full Text Available AbstractBackground and Purpose: Anterior shoulder dislocation is the most common major joint dislocation. In most cases, this dislocation is being relocated in emergency departments. Routinely, pre and post reduction radiographs are performed. This study was done to determine the necessity of radiographs in the emergency department for management of patients with suspected anterior shoulder dislocation.Materials and Methods: In this case series study, 116 patients suspected of anterior shoulder dislocation were referred to Hazrat Rasoul Akram and Haftome Tir Hospitals emergency departments in Tehran, and were investigated for a one year period. The emergency physicians evaluated and documented the possibility of dislocation or relocation, before obtaining radiographs. Outcome measures were the assessment of joint positions on the x-rays by an orthopedic surgeon.Results: 84 cases (72% were male and 32 cases (28% were female. Mean age of the patients was 31.5±8.5 yrs. Thirty (30 patients had recurrent dislocations without traumatic mechanism (group 1 and eighty six (86 patients had no prior dislocation or a blunt mechanism of injury (group 2. The accuracy of the emergency physician’s assessment in dislocations was 100% in group 1 and 98% in group 2. False assessments occurred only in patients with fractures. There is no significant difference between emergency physicians and orthopedic surgeons in the assessment of dislocations and relocations, when the emergency physicians did accuralty diagnose them.Conclusion: Our study showed that the physicians are highly accurate in clinical determination of anterior shoulder dislocation and relocation. Pre-reduction films should be obtained when the mechanism of injury is trauma. Post-reduction films should be obtained in fracture-dislocations or when the physicians are uncertain of correct relocation.

  14. Ultrasonographic test for complete anterior cruciate ligament injury

    Directory of Open Access Journals (Sweden)

    Piotr Grzelak

    2015-01-01

    Full Text Available Background: Although ultrasound (US has a wide range of applications in orthopedic diagnostics, sonographic evaluation of traumatic anterior cruciate ligament (ACL insufficiency is still inadequate. There is a growing need for diagnostic tests that allow for simple and reliable assessment of ACL instability. This investigation aims to evaluate feasibility of sonographic technique for diagnosing complete ACL insufficiency. Materials and Methods: Eighty three consecutive patients suspected of ACL injury were examined with sonographic, dynamic test of anterior instability. The translation of the intercondylar eminence against the patellar tendon was measured in the injured and opposite (injured knee. Subsequent magnetic resonance imaging was performed on all patients. Forty-seven of them underwent a further arthroscopy. Five patients have been examined for the 2 nd time to evaluate interclass and intraclass agreement and bias. Results: Complete ACL insufficiency has been confirmed in 37 patients. In those individuals, the total anterior knee translation and the difference between two joints (side-to-side difference were significantly increased (8.67 mm standard deviation [SD] 2.65 mm in the affected knee versus 2.88 mm SD 1.26 mm in uninjured joint; P < 0.001. Based on a threshold of 2.0 mm for the side-to-side difference and 5.0 mm for the absolute translation, the sonographic test was found to have a sensitivity and specificity of 91.9% and 95.6%, respectively. Conclusions: The present technique supports the clinician with additional fast and noninvasive diagnostic procedure that can facilitate the evaluation of anterior knee instability.

  15. Multimodal emotion perception after anterior temporal lobectomy (ATL)

    OpenAIRE

    Milesi, Valérie; Cekic, Sezen; Péron, Julie; Frühholz, Sascha; Cristinzio, Chiara; Seeck, Margitta; Grandjean, Didier

    2014-01-01

    In the context of emotion information processing, several studies have demonstrated the involvement of the amygdala in emotion perception, for unimodal and multimodal stimuli. However, it seems that not only the amygdala, but several regions around it, may also play a major role in multimodal emotional integration. In order to investigate the contribution of these regions to multimodal emotion perception, five patients who had undergone unilateral anterior temporal lobe resection were exposed...

  16. [Aneurysm of the anterior inferior cerebellar artery: case report].

    Science.gov (United States)

    Adorno, Juan Oscar Alarcón; de Andrade, Guilherme Cabral

    2002-12-01

    The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA) are considered rare, can cause cerebello pontine angle (CPA) syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.

  17. Access related complications during anterior exposure of the lumbar spine

    OpenAIRE

    Fantini, Gary A; Pawar, Abhijit Y.

    2013-01-01

    The new millennium has witnessed the emergence of minimally invasive, non-posterior based surgery of the lumbar spine, in particular via lateral based methodologies to discectomy and fusion. In contrast, and perhaps for a variety of reasons, anterior motion preservation (non-fusion) technologies are playing a comparatively lesser, though incompletely defined, role at present. Lateral based motion preservation technologies await definition of their eventual role in the armamentarium of minimal...

  18. Complications of Anterior and Posterior Cervical Spine Surgery

    OpenAIRE

    Cheung, Jason Pui Yin; Luk, Keith Dip-Kei

    2016-01-01

    Cervical spine surgery performed for the correct indications yields good results. However, surgeons need to be mindful of the many possible pitfalls. Complications may occur starting from the anaesthestic procedure and patient positioning to dura exposure and instrumentation. This review examines specific complications related to anterior and posterior cervical spine surgery, discusses their causes and considers methods to prevent or treat them. In general, avoiding complications is best achi...

  19. A case report on desmoplastic ameloblastoma of anterior mandible

    OpenAIRE

    Sharma Lamichhane, Narayan; Liu, Qilin; Sun, Hongchen; Zhang, Wei

    2016-01-01

    Background Desmoplastic ameloblastoma (DA) is a rare variant that accounts for approximately 4–13 % of ameloblastoma, displaying significant differences in anatomical site, imaging, and histologic appearance. It has been included in WHO classification of head and neck tumor (WHO-2005) as a variant of ameloblastoma. The tumor resembles benign fibro-osseous lesion for being frequently occurring in the anterior region of jaws as a mixed radiopaque-radiolucent lesion. Case presentation We present...

  20. 3D spectral imaging system for anterior chamber metrology

    Science.gov (United States)

    Anderson, Trevor; Segref, Armin; Frisken, Grant; Frisken, Steven

    2015-03-01

    Accurate metrology of the anterior chamber of the eye is useful for a number of diagnostic and clinical applications. In particular, accurate corneal topography and corneal thickness data is desirable for fitting contact lenses, screening for diseases and monitoring corneal changes. Anterior OCT systems can be used to measure anterior chamber surfaces, however accurate curvature measurements for single point scanning systems are known to be very sensitive to patient movement. To overcome this problem we have developed a parallel 3D spectral metrology system that captures simultaneous A-scans on a 2D lateral grid. This approach enables estimates of the elevation and curvature of anterior and posterior corneal surfaces that are robust to sample movement. Furthermore, multiple simultaneous surface measurements greatly improve the ability to register consecutive frames and enable aggregate measurements over a finer lateral grid. A key element of our approach has been to exploit standard low cost optical components including lenslet arrays and a 2D sensor to provide a path towards low cost implementation. We demonstrate first prototypes based on 6 Mpixel sensor using a 250 μm pitch lenslet array with 300 sample beams to achieve an RMS elevation accuracy of 1μm with 95 dB sensitivity and a 7.0 mm range. Initial tests on Porcine eyes, model eyes and calibration spheres demonstrate the validity of the concept. With the next iteration of designs we expect to be able to achieve over 1000 simultaneous A-scans in excess of 75 frames per second.

  1. Mini-Open Latarjet Procedure for Recurrent Anterior Shoulder Instability

    Directory of Open Access Journals (Sweden)

    Numa Mercier

    2011-01-01

    Full Text Available Anterior shoulder instability is a common problem. The Latarjet procedure has been advocated as an option for the treatment of anteroinferior shoulder instability. The purpose of this paper is to explain our surgical procedure titled “Mini-open Latarjet Procedure.” We detailed patient positioning, skin incision, subscapularis approach, and coracoid fixation. Then, we reviewed the literature to evaluate the clinical outcomes of this procedure.

  2. Septic arthritis of the knee following anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Matjaz Sajovic

    2009-04-01

    Full Text Available Septic arthritis of the knee is a rare complication after arthroscopic anterior cruciate ligament reconstruction, and the most appropriate treatment is unclear. All case series reported so far have been retrospective, and case numbers of septic arthritis have ranged from 4 to 11. From a consecutive case series of 1,283 patients who underwent arthroscopic anterior cruciate ligament reconstruction between January 1997 and May 2008, we report on 3 patients (0.23% with post-operative septic arthritis. All patients had acute infection (≤ 2 weeks, bacterial cultures showed Staphylococcus species in 2 patients, while the bacterial culture was negative in the third. All of them underwent immediate arthroscopic debridement and lavage with continuous irrigation, as well as antibiotic treatment. The results were evaluated with physical and radiographic examination, functional testing, KT-2000, Lysholm and Tegner scales. The infection was successfully eradicated without further surgical treatment and the ligament graft was retained in all patients. Follow-up, at an average of 33 months, revealed that the patients had full symmetric knee range of motion and no effusion. The average Lysholm score was 91 points. In the patient with a lower subjective score, radiographs demonstrated patellofemoral joint-space narrowing, which is most probably in correlation with his anterior knee pain problems and lower activity level. The 134 N KT-2000 arthrometer side-to-side differences averaged 13 mm. Their performance in the single-legged hop test gave excellent results. The goals of treatment for septic arthritis after anterior cruciate ligament reconstruction are, primarily, to protect the articular cartilage and, secondly, to protect the graft. Through early diagnosis and prompt treatment, the infection can be successfully eradicated, with stability of the knee and full range of motion achieved.

  3. Anatomic anterior cruciate ligament reconstruction using an individualized approach

    Directory of Open Access Journals (Sweden)

    Carola F. van Eck

    2014-01-01

    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.

  4. Class I malocclusion with anterior crossbite and severe crowding

    OpenAIRE

    Ritter, Daltro Enéas

    2014-01-01

    This article reports the orthodontic diagnosis and treatment planning carried out with a 14-year and 5-month-old female patient with esthetic and functional complaints. She presented an Angle Class I malocclusion, anterior crossbite and severe crowding in both maxillary and mandibular arches, in addition to a lightly concave straight facial profile. Orthodontic treatment did not require extraction. Crossbite was corrected by protrusion of upper teeth, which contributed to alignment and leveli...

  5. Fracture of the patella after the anterior cruciate ligament reconstruction

    OpenAIRE

    Milović Milan; Bojat Veselin; Kovačev Nemanja; Rašović Predrag; Milankov Miroslav

    2012-01-01

    Introduction. Fracture of the patella, after harvesting the central third of the patellar tendon for a bone-tendon-bone autograft, is a rare complication. Material and Methods. We made 1714 reconstructions of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and 7 patients had fracture of the patella (0.42%). The fracture was immediately recognized in the patients with vertical non-displaced patellar fracture and the broken screw osteosynthesis was ca...

  6. Graft selection in arthroscopic anterior cruciate ligament reconstruction

    OpenAIRE

    Romanini, Emilio; D’Angelo, Franca; De Masi, Salvatore; Adriani, Ezio; Magaletti, Massimiliano; Lacorte, Eleonora; Laricchiuta, Paola; Sagliocca, Luciano; Morciano, Cristina; Mele, Alfonso

    2010-01-01

    Background Anterior cruciate ligament (ACL) surgical reconstruction is performed with the use of an autogenic, allogenic or synthetic graft. The document issued by the Italian National Guidelines System (SNLG, Sistema Nazionale Linee Guida) at the National Institute of Health aims to guide orthopaedic surgeons in selecting the optimal graft for ACL reconstruction using an evidence-based approach. Materials and methods A monodisciplinary panel was formed to define a restricted number of clinic...

  7. Linguatula serrata in the anterior chamber of the eye

    Directory of Open Access Journals (Sweden)

    Muna Bhende

    2014-01-01

    Full Text Available We report a case of intraocular Linguatula in healthy young female who presented with a history of trivial trauma, dislocated lens, inflammation and secondary glaucoma. A mobile worm was seen in the anterior chamber. Pars plana lensectomy and vitrectomy was planned to remove both the cataractous lens and the parasite during which the worm disappeared from view but was later recovered from the cassette fluid. It was identified as the nymphal form of Linguatula serrata (tongue worm.

  8. Interesting clinical presentation of anterior knee pain causing diagnostic dilemma.

    Science.gov (United States)

    Morgan, Samer S; Balasubramanian, S; Teanby, D

    2009-09-01

    A diverse variety of lesions may occasionally occur in the patella. In this case report, we are presenting an interesting case of anterior knee pain in middle aged gentleman. Initial investigations including Magnetic Resonance Imaging not showed any abnormality. Due to prolonged continued pain he had bone scan and MRI, which confirmed the diagnosis of Brodie's abscess. We are presenting this case of Brodie's abscess of the patella causing diagnostic dilemma because of its rarity.

  9. Relationship between static anterior laxity using the KT-1000 and dynamic tibial rotation during motion in patients with anatomical anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Sato, Koji; Maeda, Akira; Takano, Yoshio; Matsuse, Hiroo; Ida, Hirofumi; Shiba, Naoto

    2013-01-01

    The anterior cruciate ligament (ACL) plays an important role in controlling knee joint stability, not only by limiting tibial anterior translation but also by controlling knee axial rotation. The aim of ACL reconstruction is to reduce excessive anterior joint laxity, hoping to restore normal tibiofemoral kinematics including knee axial rotation. The purpose of this study was to investigate the relationship between static anterior instability and tibial rotation during several activities in an anterior cruciate ligament reconstructed knee. Seven patients with unilateral ACL injury performed plain walking, running, landing and side step cutting tasks after ACL reconstruction with a mean follow-up of 14 months. The kinematic data for the 4 motions was measured using a motion analysis system and the point cluster technique. The evaluation period was defined to be from the first contact to removal of the tested leg from the ground. Maximum tibial internal rotation during tasks was calculated using the point cluster technique (PCT). Passive anterior tibial translation was measured using a KT-1000 arthrometer. Regression analysis was used to determine the correlation of the maximum internal rotation with the side-to-side difference of static anterior tibial translation measured using a KT-1000 arthrometer. During side step cutting maneuvers, maximum tibial internal rotation significantly showed negative correlation with static anterior tibial translation (pknee rotation kinematics. The normal anterior tibial translation obtained by ACL reconstruction is thought to be the key factor in successful restoration of normal knee kinematics. PMID:23925154

  10. Diagnosis and treatment of anterior uveitis: optometric management

    Directory of Open Access Journals (Sweden)

    Harthan JS

    2016-03-01

    Full Text Available Jennifer S Harthan,1 Dominick L Opitz,2 Stephanie R Fromstein,1 Christina E Morettin3 1Cornea Center for Clinical Experience, 2Ophthalmology Services and Practice Development, 3Urgent Eye Care Service, Illinois College of Optometry, Chicago, IL, USA Abstract: Anterior uveitis encompasses inflammation of the iris and/or ciliary body and is one of the most common types of ocular inflammation that primary eye care practitioners will encounter. Anterior uveitis may be caused by a variety of etiologies, including infectious, noninfectious, and masquerade diseases. The short-term and long-term treatment of uveitis should include the evaluation of location, duration, pathology, and laterality, in addition to presenting signs and symptoms of the disease. A complete review of systems, thorough examination, and laboratory testing, may assist the practitioner in narrowing the list of possible causes for the uveitis. This is imperative as once a list of diagnoses has been made, a targeted approach to treatment can be pursued. Keywords: anterior uveitis, iritis, inflammation

  11. Is biologic width of anterior and posterior teeth similar?

    Directory of Open Access Journals (Sweden)

    Amir Alireza Rasouli Ghahroudi

    2014-09-01

    Full Text Available The biologic width (BW includes attached epithelial cells and connective tissue attachment complex being very important in the periodontal health during prosthetic treatments as invading this zone can cause bone resorption and gingival recession. The present study investigated biologic width values in the normal periodontium in anterior and posterior teeth. 30 patients that referred from restorative department to periodontics department of Tehran University of medical sciences who need crown lengthening procedure on their teeth with no history of orthodontic, prosthodontic and periodontal treatment were randomly enrolled in this cross-sectional trial. Sulcus depths (SD as well as the distance between free gingival margin and the bone crest (FB of anterior and posterior teeth were measured by UNC-15 probe and compared. periodontium thickness was also assessed. The data were subjected to Student t test. Mean BW in the 43 anterior and 47 posterior teeth was measured and not significantly different (1.4651±0.39 mm vs. 1.6312±0.49 mm was observed; however, BW was significantly more in the teeth with thick periodontium compared to those with thin periodontium (1.703±0.5 vs. 1.408±0.35; P=0.002. BW not only is different in individuals but also could be dissimilar in different teeth and should be calculated independently prior to restorative treatments.

  12. Imaging of traumatic injury and impingement of anterior knee fat.

    Science.gov (United States)

    Lapègue, F; Sans, N; Brun, C; Bakouche, S; Brucher, N; Cambon, Z; Chiavassa, H; Larbi, A; Faruch, M

    2016-01-01

    Fat is not just used by the body as bulk tissue. In addition to its role in storing energy and regulating hormone action, fat is used in some parts of the body for its mechanical properties. The anatomy of anterior knee fat is more complex than it appears at first sight and is capable of withstanding considerable compressive and shear stress. Specific lesions occur when such mechanical stress exceeds the physiological limits and are yet little known. Superficial fat can be the site of either acute injury by closed degloving called the Morel-Lavallée lesion or chronic injury, when subject to repeat excessive shear forces, due to more complex and less well-defined disruptions that result in pseudo-bursitis. There are three main anterior, intracapsular and extrasynovial fat pads in the knee joint, which are the infrapatellar fat pad (IFP) or Hoffa's fat pad, the quadriceps fat pad and the prefemoral fat pad. The IFP plays an important role as a mechanical shock absorber and guides the patella tendon and even the patella itself during flexion-extension movements. In response to repeated excessive stress, an inflammatory reaction and swelling of the IFP is first observed, followed by a fibrotic reaction with metaplastic transformation into fibrous, cartilaginous or bone tissue. More rarely, the two other deep fat pads (quadriceps and prefemoral) can, if subject to repeated stress, undergo similar restructuring inflammatory reactions with metaplasia resulting in tissue hardening, anterior pain and partial loss of function. PMID:27118690

  13. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

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    Mallanagouda N Patil

    2013-04-01

    Full Text Available Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand. He complained of pain and difficulty in moving both the shoulders. On clinical examination, patient’s both upper limbs were abducted and externally rotated. Bilaterally shoulder contour was lost with flattening. Other classical signs of shoulder dislocation viz, Bryants test, Callway sign, Hamilton’s ruler test were positive. Diagnosis was confirmed on X rays. Both shoulders were reduced in emergency operation theater under general anaesthesia by Kocher’s method and were immobilised in sling. Conclusion: Though bilateral shoulder dislocations are commonly posterior, usually either secondary to convulsions or electric shock, anterior dislocation has to be kept in mind , especially in post traumatic injuries. This bilateral dislocation also presents with practical problems immobilization and day to day care of patients. Keywords: Simultaneous, bilateral, shoulder dislocation, traumatic.

  14. Automatic segmentation of anterior segment optical coherence tomography images

    Science.gov (United States)

    Williams, Dominic; Zheng, Yalin; Bao, Fangjun; Elsheikh, Ahmed

    2013-05-01

    Optical coherence tomography (OCT) images can provide quantitative measurements of the eye's entire anterior segment. A new technique founded on a newly proposed level set-based shape prior segmentation model has been developed for automatic segmentation of the cornea's anterior and posterior boundaries. This technique comprises three major steps: removal of regions containing irrelevant structures and artifacts, estimation of the cornea's location using a thresholding technique, and application of the new level set-based shape prior segmentation model to improve segmentation. The performance of our technique is compared to previously developed methods for analysis of the cornea in 33 OCT images of normal eyes, whereby manual annotations are used as a reference standard. The new technique achieves much improved concordance than previous methods, with a mean Dice's similarity coefficient of >0.92. This demonstrates the technique's potential to provide accurate and reliable measurements of the anterior segment geometry, which is important for many applications, including the construction of representative numerical simulations of the eye's mechanical behavior.

  15. Activation of anterior insula during self-reflection.

    Directory of Open Access Journals (Sweden)

    Gemma Modinos

    Full Text Available BACKGROUND: Functional neuroimaging studies have suggested activation of midline frontoparietal brain regions to be at the core of self-related processes. However, although some studies reported involvement of the insula, little attention has been paid to this region as forming part of the "self"-network. METHODOLOGY/PRINCIPAL FINDINGS: Using functional magnetic resonance imaging (fMRI, we aimed at replicating and extending previous studies by scanning subjects whilst reflecting upon their own personal qualities as compared to those of an acquaintance. A third condition with statements about general knowledge was used to control for attention, semantic processing and decision making processes. The results showed a significant effect of task in brain activity, consistent with previous findings, by which both person conditions recruited a common set of medial prefrontal and posterior regions, yet significant differences between self and other were found in the medial prefrontal cortex (MPFC and the anterior cingulate cortex (ACC. Notably, significant neural activation in the left anterior insula was observed as uniquely associated with self-reflection. CONCLUSIONS/SIGNIFICANCE: The results provide further evidence for the specific recruitment of anterior MPFC and ACC regions for self-related processing, and highlight a role for the insula in self-reflection. As the insula is closely connected with ascending internal body signals, this may indicate that the accumulation of changes in affective states that might be implied in self-processing may contribute to our sense of self.

  16. Anterior cervical decompression and fusion with caspar plate fixation

    International Nuclear Information System (INIS)

    Objective: To evaluate the role of anterior cervical decompression and fixation with Caspar plating in cervical spine injury on neurological outcome. Study Design: A case series. Place and Duration of Study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2008 to March 2011. Methodology: Thirty patients admitted with cervical spine injuries were inducted in the study. All cases were evaluated for their clinical features, level of injury and degree of neurological injury was assessed using Frankel grading. Pre and postoperative record with X-rays and MRI were maintained. Cervical traction was applied to patients with sub-luxation. All patients underwent anterior cervical decompression, fusion and Caspar plate fixation. The follow-up period was 6 months with clinical and radiological assessment. Results: Among 30 patients, 24 (80%) were males and 6 (20%) were females. Age ranged from 15 to 55 years. Causes of injury were road traffic accident (n = 20), fall (n = 8) and assault (n = 2). Commonest mode of injury was road traffic accident (66.6%). Postoperative follow-up showed that pain and neurological deficit were improved in 21 patients. There was no improvement in 7 patients, one patient deteriorated and one expired. All patients developed pain at donor site. Conclusion: Anterior decompression, fusion and fixation with Caspar plate is an effective method with good neurological and radiological outcome. However, it is associated with pain at donor site. (author)

  17. Anatomic variations of anterior cerebral artery cortical branches.

    Science.gov (United States)

    Stefani, M A; Schneider, F L; Marrone, A C; Severino, A G; Jackowski, A P; Wallace, M C

    2000-01-01

    The anterior cerebral artery (ACA) is a major vessel responsible for the blood supply to the interhemispheric region. The ACA segment after the anterior communicating artery (AComA) origin is called the distal ACA and has central and cortical branches. The cortical branches are distributed in the different regions of the orbital and medial part of the brain. The objects of this study are the anatomical variations found in the distal ACA. In 76 hemispheres the ACA distal branches were injected with latex and dissected under microscope magnification. Vessel diameters and distances between vessel origins and anterior communicating artery were recorded and analyzed. Microsurgical dissection was carried out to demonstrate anatomic variations of these vessels. Average diameter of ACA at origin was 2.61 +/- 0.34 mm and average diameter of cortical branches diameter ranged from 0.79 +/- 0.27 mm to 1.84 +/- 0.3 mm. Distances between vessel origin and AComA ranged from 7.68 +/- 3.91 mm (orbitofrontal) to 112.6 +/- 11.63 mm (inferior internal parietal). This study found anatomical variations: a single (azygos) ACA was present in one case and three in three cases. Crossing branches of the distal ACA to the contralateral hemisphere were present in 26% of the cases. In some cases a single ACA may supply the posterior hemispheric region through crossing branches. This calls attention to potential bilateral brain infarcts due to a single unilateral ACA occlusion. PMID:10873213

  18. Microbiological profile of anterior chamber aspirates following uncomplicated cataract surgery

    Directory of Open Access Journals (Sweden)

    Prajna N

    1998-01-01

    Full Text Available Anterior chamber aspirate cultures were done for 66 patients who underwent either an uncomplicated intracapsular cataract extraction, extracapsular cataract extraction with posterior-chamber intraocular lens implantation, or phacoemulsification with posterior-chamber intraocular lens implantation. The aspirate was obtained at the time of wound closure. The aspirates were immediately transferred to the microbiology laboratory where one drop of the aspirate was placed on a glass slide for gram stain, and the remainder was unequally divided and inoculated into blood agar, chocolate agar and thioglycolate broth. The cultures were incubated at 37° C with 5% CO2 and held for 5 days. Of 66 patients 4 (6%, had smear-positive anterior chamber aspirates. None of the aspirates showed any growth on any of the 3 culture media used. None of the eyes in the study developed endophthalmitis. This study concludes that there is no contamination of the anterior chamber by viable bacteria after cataract surgery, irrespective of the mode of intervention.

  19. Monetary reward suppresses anterior insula activity during social pain.

    Science.gov (United States)

    Cristofori, Irene; Harquel, Sylvain; Isnard, Jean; Mauguière, François; Sirigu, Angela

    2015-12-01

    Social pain after exclusion by others activates brain regions also involved in physical pain. Here we evaluated whether monetary reward could compensate for the negative feeling of social pain in the brain. To address this question we used the unique technique of intracranial electroencephalography in subjects with drug resistant epilepsy. Specifically, we recorded theta activity from intracranial electrodes implanted in the insular cortex while subjects experienced conditions of social inclusion and exclusion associated with monetary gain and loss. Our study confirmed that theta rhythm in the insular cortex is the neural signature of social exclusion. We found that while monetary gain suppresses the effect of social pain in the anterior insula, there is no such effect in the posterior insula. These results imply that the anterior insula can use secondary reward signals to compensate for the negative feeling of social pain. Hence, here we propose that the anterior insula plays a pivotal role in integrating contingencies to update social pain feelings. Finally, the possibility to modulate the theta rhythm through the reward system might open new avenues of research for treating pathologies related to social exclusion.

  20. Robot-assisted Anterior Odontoid Screw Fixation: A Case Report.

    Science.gov (United States)

    Tian, Wei; Wang, Han; Liu, Ya-Jun

    2016-08-01

    Anterior odontoid screw fixation has been proved to be effective but technically challenging because the difficult approach is associated with high risks of screw malposition and damage to surrounding vital structures. Navigation techniques are therefore increasingly being used to improve safety and accuracy. However, no robot-assisted odontoid screw fixation has yet been reported. We here report a 61-year-old woman with a type II dens fracture on whom anterior odontoid screw fixation was performed under the guidance of a newly developed robotic system (TiRobot, co-designed by Beijing Jishuitan Hospital and TINAVI Medical Technologies). One odontoid screw was safely and accurately placed, the calculated deviation between the planned and actual positions being 0.9 mm. No intraoperative complications were identified and the patient was discharged on Day 5. Follow-up studies after 2 weeks showed good clinical and radiological results. We believe this is the first reported case of robot-assisted anterior odontoid screw fixation. We consider that complicated procedures can become feasible, safe and accurate using TiRobot systems. PMID:27627725

  1. Inferior Flap Tympanoplasty: A Novel Technique for Anterior Perforation Closure

    Directory of Open Access Journals (Sweden)

    Haim Gavriel

    2013-01-01

    Full Text Available Objective. To report a novel tympanoplasty modification for anterior tympanic membrane perforation closure. Materials and Methods. A prospective study on 13 patients who underwent inferior tympanoplasty between December 2008 and May 2011 was carried out. In our technique, an inferior rather than a posterior flap is raised and the graft is laid from the inferior direction to obtain better access to the anterior part of the tympanic membrane perforation and provide better support. Results. A total of 13 patients underwent the novel inferior tympanoplasty technique with a mean age of 33 years. Six patients had undergone tympanoplasties and/or mastoidectomies in the past, 3 in the contralateral ear. A marginal perforation was observed in 3 cases, total perforation in 2 and subtotal in 1 case. The mean preoperative pure-tone average was 40.4 dB (10 to 90 dB, compared to 26.5 dB (10 to 55 dB postoperatively. All perforations were found to be closed but one (92.3% success rate. Conclusions. The inferior tympanoplasty technique provides a favorable outcome in terms of tympanic membrane closure and hearing improvement for anterior perforations, even in difficult and complex cases. It is based on a well-known technique and is easy to implement.

  2. Robot-assisted Anterior Odontoid Screw Fixation: A Case Report.

    Science.gov (United States)

    Tian, Wei; Wang, Han; Liu, Ya-Jun

    2016-08-01

    Anterior odontoid screw fixation has been proved to be effective but technically challenging because the difficult approach is associated with high risks of screw malposition and damage to surrounding vital structures. Navigation techniques are therefore increasingly being used to improve safety and accuracy. However, no robot-assisted odontoid screw fixation has yet been reported. We here report a 61-year-old woman with a type II dens fracture on whom anterior odontoid screw fixation was performed under the guidance of a newly developed robotic system (TiRobot, co-designed by Beijing Jishuitan Hospital and TINAVI Medical Technologies). One odontoid screw was safely and accurately placed, the calculated deviation between the planned and actual positions being 0.9 mm. No intraoperative complications were identified and the patient was discharged on Day 5. Follow-up studies after 2 weeks showed good clinical and radiological results. We believe this is the first reported case of robot-assisted anterior odontoid screw fixation. We consider that complicated procedures can become feasible, safe and accurate using TiRobot systems.

  3. Vascularised local and free flaps in anterior skull base reconstruction.

    Science.gov (United States)

    Hoffmann, Thomas K; El Hindy, Nicolai; Müller, Oliver M; Schuler, Patrick J; Bergmann, Christoph; Hierner, Robert; Lehnerdt, Götz; Mattheis, Stefan; Wagenmann, Martin; Schipper, Jörg; Sure, Ulrich; Lang, Stephan; Hänggi, Daniel; Sandalcioglu, I Erol

    2013-03-01

    Lesions of the anterior skull base often require sufficient closure in order to prevent cerebrospinal fluid (CSF) leak, ascending infection and/or brain tissue prolapse. The transfer of devitalized autologous, allogenic or xenogeneic material is not always sufficient particularly not in larger defects or in the recurrent situation. Here the transfer of vascularised tissue seems to be more appropriate. The anterior skull base with various complex defects of 41 patients was reconstructed in an interdisciplinary setting by vascularised, autologous tissue transfer. Minor defects (chondroblastoma, metastasis, nasal fistula), were reconstructed by a local, vascularized pedicled mucosal flap of the lower turbinate (n = 3) or septum (n = 23). Patients with major defects (>2.5 cm in max. diameter, n = 15), comprising those with malignoma, meningoencephalocele, aneurysmatic bone cyst and trauma, were repaired by a "sandwich technique" with a combination of calvarian split and galea periosteum flap in 10 patients, in one case with a temporalis muscle flap, while in 4 further patients free vascularised radial forearm flaps were used for revision after multiple unsuccessful operations elsewhere. After a mean follow-up time of 30.5 months 38 of the 41 cases were successfully repaired with respect to prevention and treatment of CSF leakage or brain tissue prolapse, only 3 cases needed surgical revision. The reconstruction of the anterior skull base bearing complex lesions is feasible using vascularised, autologous local and also distal tissue transfer in a close interdisciplinary cooperation. PMID:22878359

  4. Monetary reward suppresses anterior insula activity during social pain.

    Science.gov (United States)

    Cristofori, Irene; Harquel, Sylvain; Isnard, Jean; Mauguière, François; Sirigu, Angela

    2015-12-01

    Social pain after exclusion by others activates brain regions also involved in physical pain. Here we evaluated whether monetary reward could compensate for the negative feeling of social pain in the brain. To address this question we used the unique technique of intracranial electroencephalography in subjects with drug resistant epilepsy. Specifically, we recorded theta activity from intracranial electrodes implanted in the insular cortex while subjects experienced conditions of social inclusion and exclusion associated with monetary gain and loss. Our study confirmed that theta rhythm in the insular cortex is the neural signature of social exclusion. We found that while monetary gain suppresses the effect of social pain in the anterior insula, there is no such effect in the posterior insula. These results imply that the anterior insula can use secondary reward signals to compensate for the negative feeling of social pain. Hence, here we propose that the anterior insula plays a pivotal role in integrating contingencies to update social pain feelings. Finally, the possibility to modulate the theta rhythm through the reward system might open new avenues of research for treating pathologies related to social exclusion. PMID:25964499

  5. Motor recovery by anterior choroidal artery territory in a patient with middle cerebral artery infarct

    Institute of Scientific and Technical Information of China (English)

    Ji Heon Hong; Sung Ho Jang

    2010-01-01

    In this study,the uninjured periventricular area of a female patient who presented with complete paralysis of the left extremities following middle cerebral artery infarction was analyzed using diffusion tensor tractography,transcranial magnetic stimulation,and functional magnetic resonance imaging.Diffusion tensor tractography revealed interrupted corticospinal tract at the infarct lesion in the corona radiata at 2 weeks after onset,which descended through the spared periventricular area at 6 months after onset.Transcranial magnetic stimulation and functional magnetic resonance imaging revealed a motor pathway of the affected hand that was compatible with the lateral corticospinal tract.At 6 months after onset,motor function in the affected extremities recovered to normal levels,which suggested that motor function in the affected hand recovered by the corticospinal tract that passed through the spared periventricular area.The arterial territory of the spared periventricular area corresponded with the anterior choroidal artery.These results suggest that care should be taken in spared periventricular areas in patients with lesions at the corona radiata level.

  6. Levator hiatal area as a risk factor for cystocele recurrence after surgery: a prospective study

    NARCIS (Netherlands)

    Vergeldt, T.F.; Notten, K.; Weemhoff, M.; Kuijk, S. van; Mulder, F.; Beets-Tan, R.G.; Vliegen, R.; Gondrie, E.; Bergmans, M.; Roovers, J.; Kluivers, K.B.

    2015-01-01

    OBJECTIVE: To investigate whether increased levator hiatal area, measured preoperatively, was independently associated with anatom-ical cystocele recurrence 12 months after anterior colporrhaphy. DESIGN: Multicentre prospective cohort study. SETTING: Nine teaching hospitals in the Netherlands. POPUL

  7. Anterior approach v. posterior approach - ultrasound-guided shoulder arthrogram injection

    Directory of Open Access Journals (Sweden)

    Merle Neethling-du Toit

    2008-11-01

    Full Text Available Anterior approach ultrasound guided arthrogram injections are a quick reliable way of injecting contrast prior to MRI scan. We did a retrospective study on patients, previously injected and scanned at our clinic, to compare the more manifested posterior approach with the anterior approach. The success rate for successful intra-articular injections for the anterior approach far outweighs the posterior approach. Also the anterior approach is more tolerable for patients as the injections are much quicker and seemingly less painful. In our knowledge it is thus far better to perform anterior approach shoulder arthrogram injections than posterior approach injections

  8. Minimally invasive approaches for histological diagnosis of anterior mediastinal masses

    Institute of Scientific and Technical Information of China (English)

    FANG Wen-tao; XU Mei-ying; CHEN Gang; CHEN Yong; CHEN Wen-hu

    2007-01-01

    Background Anterior mediastinal masses include a wide variety of diseases from benign lesions to extremely malignant tumors. Management strategies are highly diverse and depend strongly on the histological diagnosis as well as the extent of the disease. We reported a prospective study comparing the usefulness of core needle biopsy and mini-mediastinotomy under local anesthesia for histological diagnosis in anterior mediastinal masses.Methods A total of 40 patients with masses of unknown histology and located either at or near the anterior mediastinum received biopsy prior to treatment. The diagnostic methods were core needle biopsy in 28 patients and biopsy through mini-mediastinotomy under local anesthesia in 15 patients (including 3 patients for whom core needle biopsy failed to yield a definite diagnosis).Results Histological diagnosis was achieved in 18 of the 28 patients receiving core needle biopsy. Of them, all 4 patients with pleural fibromas and 9 of the 12 patients (75%) with pulmonary mass were diagnosed definitively. In the remaining 12 patients with mediastinal mass, histological diagnosis was achieved in only 5 patients (41.7%). In contrast,biopsy through a mini-mediastinotomy failed in only 3 patients. In the remaining 12 patients with huge mediastinal masses, who underwent mini-mediastinotomy, a definitive histological diagnosis was reached by pathological and/or immunohistochemical study (diagnostic yield 85.7% in 12 of 14 cases of mediastinal mass, P=0.038 vs core needle biopsy). For the 9 patients with thymic epithelial tumors, the diagnostic yield was 40% (2 in 5 cases) for core needle biopsy and 83.3% (5 in 6 cases) for mini-mediastinotomy. There was no morbidity in patients receiving mini-mediastinotomy. In the 30 patients with biopsy-proven histological diagnosis, the results contributed to therapeutic decision making in 25 cases (83.3%).Conclusions Core needle biopsy is effective in the diagnosis of pulmonary and pleural diseases. Yet its

  9. Short-term meditation increases blood flow in anterior cingulate cortex and insula

    Directory of Open Access Journals (Sweden)

    Yi-Yuan eTang

    2015-02-01

    Full Text Available Asymmetry in frontal electrical activity has been reported to be associated with positive mood. One form of mindfulness meditation, integrative body-mind training (IBMT improves positive mood and neuroplasticity. The purpose of this study is to determine whether short-term IBMT improves mood and induces frontal asymmetry. This study showed that five-day (30-min per day IBMT significantly enhanced cerebral blood flow (CBF in subgenual/adjacent ventral anterior cingulate cortex (ACC, medial prefrontal cortex and insula. The results showed that both IBMT and relaxation training increased left laterality of CBF, but only IBMT improved CBF in left ACC and insula, critical brain areas in self-regulation.

  10. Via de acesso para exposição ampla da coluna toracolombar anterior (T10 -L5 Extensive anterior approach to the thoracolumbar spine (T10 -L5

    Directory of Open Access Journals (Sweden)

    Roberto Augusto Caffaro

    1998-08-01

    Full Text Available Os autores descrevem técnica de via de acesso para exposição ampla da coluna toracolombar anterior (T10 -L5 a que foi submetida uma série de cem pacientes com indicação cirúrgica para correção de diversas doenças da coluna. A partir das estruturas envolvidas, são analisados e comentados os tempos operatórios pertinentes bem como as complicações transoperatórias e pós-operatórias decorrentes da técnica. Sugere-se que a técnica de acesso proposta seja utilizada quando adequada à doença a cuja correção se destina, independente da área de comprometimento clinicamente objetivada.The authors describe a technique for extensive anterior approach to the thoracolumbar spine (T10 -L5, to which 100 patients with surgical indication for correcting orthopedic anomalies were submitted. The anatomical structures involved in surgical procedures are analyzed and discussed. Results have shown that this extensive anterior approach to the thoracolumbar spine a allows the aimed approach in 100% for the cases, making easier the arthopedic management necessary to the correction of the spine deformity to be treated; b makes possible to avoid transoperative complications from the knowledge of anatomical structures exposed in the surgical field, except for the sympathetic trunk, in which lesion can occur in 70% of cases; and c presents a low rate (2% of post operative complications. It is suggested that this technique for extensive anterior approach to the thoracolumbar spine should be used, independently of the extension of the clinically diagnosed affected area.

  11. Measurements of elastic modulus for human anterior lens capsule with atomic force microscopy: the effect of loading force.

    Science.gov (United States)

    Tsaousis, Konstantinos T; Karagiannidis, Panagiotis G; Kopsachilis, Nikolaos; Symeonidis, Chrysanthos; Tsinopoulos, Ioannis T; Karagkiozaki, Varvara; Lamprogiannis, Lampros P; Logothetidis, Stergios

    2014-06-01

    The purpose of the study was to appraise the effect of loading force magnitude on the determination of the elastic modulus of the anterior lens capsule through atomic force microscopy. Four human anterior lens capsules taken during phacoemulsification cataract surgery were studied, free of epithelial cells, with atomic force microscopy. For the experiment, five different indentation loading forces were applied to near areas of the specimen. Experimental data was exported and analyzed according to the Hertz model to obtain the Young's modulus with regards to the elastic behavior of the material. Force-distance curves were acquired by applying a load of 2, 5, 10, 20 and 30 nN. When examining the results it was evident that determination of Young's modulus of the anterior lens capsule is dependent on the loading force concerning the examined range. Loading forces of 10 and 20 nN led to results without significant difference (p > 0.05) and more reproducible (coefficients of variation 12.4 and 11.7 %, respectively). PMID:24037592

  12. Dopamine and serotonin imbalances in the left anterior cingulate and pyriform cortices following the repeated intermittent administration of cocaine.

    Science.gov (United States)

    Heidbreder, C A; Oertle, T; Feldon, J

    1999-03-01

    Studies on the neurobiology of cocaine abuse suggest that cocaine directly modifies the activity of dopamine neurons projecting from the dopamine-synthesizing cells of the ventral tegmental area to the nucleus accumbens. The repeated use of cocaine produces persistent adaptations within the mesocorticolimbic system and the resulting changes in monoamine neurotransmission may lead to behavioral sensitization. The present series of experiments sought to determine the effects of the repeated, intermittent challenge that took place two days after discontinuation of the pretreatment regimen; (ii) the ex vivo levels of biogenic monoamines, choline and acetylcholine in the nucleus accumbens, the dorsolateral caudate nucleus, as well as the anterior cingulate, frontal motor, frontal somatosensory and pyriform cortices; and (iii) the degree of neurochemical relationship between the left and right hemispheres. The repeated administration of cocaine produced sensitized behavioral responses to a subsequent challenge. Neurochemical correlates of repeated cocaine administration were observed at the cortical level and included a significant decrease in serotonin levels in the left anterior cingulate and pyriform cortices and an increase in dopamine metabolism in the left pyriform cortex. Furthermore, a shift in the interhemispheric coupling coefficient matrix for dopamine neurotransmission was observed in both the pyriform cortex and nucleus accumbens of cocaine-sensitized animals suggesting that, in these structures, the two hemispheres are operating independently. These results demonstrate that cocaine produces alterations in specific dopaminergic and serotonergic pathways that arise from the mesencephalon and project towards both the anterior cingulate and pyriform cortices. PMID:10199606

  13. Deep brain stimulation versus anterior capsulotomy for obsessive-compulsive disorder: a review of the literature.

    Science.gov (United States)

    Pepper, Joshua; Hariz, Marwan; Zrinzo, Ludvic

    2015-05-01

    Obsessive-compulsive disorder (OCD) is a chronic and debilitating psychiatric condition. Traditionally, anterior capsulotomy (AC) was an established procedure for treatment of patients with refractory OCD. Over recent decades, deep brain stimulation (DBS) has gained popularity. In this paper the authors review the published literature and compare the outcome of AC and DBS targeting of the area of the ventral capsule/ventral striatum (VC/VS) and nucleus accumbens (NAcc). Patients in published cases were grouped according to whether they received AC or DBS and according to their preoperative scores on the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and then separated according to outcome measures: remission (YBOCS score DBS of the VC/VS or the NAcc (mean age 38 years, follow-up 19 months, baseline YBOCS score of 33), and 108 patients underwent AC (mean age 36 years, follow-up 61 months, baseline YBOCS score of 30). In patients treated with DBS there was a 40% decrease in YBOCS score, compared with a 51% decrease for those who underwent AC (p = 0.004). Patients who underwent AC were 9% more likely to go into remission than patients treated with DBS (p = 0.02). No difference in complication rates was noted. Anterior capsulotomy is an efficient procedure for refractory OCD. Deep brain stimulation in the VC/VS and NAcc area is an emerging and promising therapy. The current popularity of DBS over ablative surgery for OCD is not due to nonefficacy of AC, but possibly because DBS is perceived as more acceptable by clinicians and patients. PMID:25635480

  14. Elastic Knee Sleeves Limit Anterior Tibial Translation in Healthy Females

    Directory of Open Access Journals (Sweden)

    Robert Csapo, Simona Hosp, Ramona Folie, Robert Eberle, Michael Hasler, Werner Nachbauer

    2016-03-01

    Full Text Available Knee sleeves or braces represent auxiliary tools that have repeatedly been used by athletes, in an attempt to increase knee stability and, thus, reduce the risk of (recurrent ligamentous injuries. Since ACL injuries typically occur in situations involving either torsion or hyperextension of the knee, it has been speculated that braces might protect the ACL by countering excessive anterior translation of the tibia with respect to the femur (Beynnon et al., 1997. However, the preponderance of in vivo studies to test this hypothesis was performed in cohorts of patients suffering from existent ligamentous (Branch et al., 1988; Colville et al., 1986 or other knee injury (Beynnon et al., 1997; Fleming et al., 2000. This complicates the extrapolation of results to healthy subjects. Further, the braces used in these studies were mostly rigid constructs that consisted of either uni- or bilateral hinged bars (Rishiraj et al., 2009. Such braces might hinder performance (Veldhuizen et al., 1991 and would be rejected by the vast majority of healthy athletes. For these reasons, we would like to use this letter to the editor to report the results of our experiments investigating whether a relatively light elastic knee sleeve would limit the degree of anterior tibial translation in computerized arthrometry tests as performed in a sample of non-injured subjects. We recruited ten female college students (age: 23.4 ± 3.2 yrs, height: 1.68 ± 0.05 m, mass: 59.9 ± 5.5 kg who were free of acute or previous injury or any form of orthopaedic disease of the knee joints. The anterior displacement of the tibia was measured using the GNRB® computerized arthrometer (GeNouRob, Laval, France. With subjects lying in the supine position, the lower leg was firmly fixed with plastic caps mounted over the ankle joint and patella. An electrical pressure pad then exerted increasing pressure of up to 250 N on the calf, while a motion sensor, which was positioned on the ventral

  15. Speaking without Broca's area after tumor resection.

    Science.gov (United States)

    Plaza, Monique; Gatignol, Peggy; Leroy, Marianne; Duffau, Hugues

    2009-08-01

    We present the case of a right-handed patient who received surgical treatment for a left frontal WHO grade II glioma invading the left inferior and middle frontal gyri, the head of the caudate nucleus, the anterior limb of the internal capsule and the anterior insula, in direct contact also with the anterior-superior part of the lentiform nucleus. The tumor resection was guided by direct electrical stimulation on brain areas, while the patient was awake. Adding a narrative production task to the neuropsychological assessment, we compared pre-, peri- and post-surgical language skills in order to analyze the effects of the tumor infiltration and the consequences of the left IFG resection, an area known to be involved in various language and cognitive processes. We showed that the tumor infiltration and its resection did not lead to the severe impairments predicted by the localization models assigning a significant role in language processing to the left frontal lobe, notably Broca's area. We showed that slow tumor evolution - the patient had been symptom-free for a long time - enabled compensatory mechanisms to process most language functions endangered by the tumor infiltration. However, a subtle fragility was observed in two language devices, i.e., reported speech and relative clauses, related to minor working memory deficits. This case study of a patient speaking without Broca's area illustrates the efficiency of brain plasticity, and shows the necessity to broaden pre-, peri-, post-surgery language and cognitive assessments. PMID:19274574

  16. A 3-year follow-up after anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse

    DEFF Research Database (Denmark)

    Rudnicki, Martin; Laurikainen, E; Pogosean, R;

    2016-01-01

    To compare the 1-year (previously published) and 3-year objective and subjective cure rates, and complications, related to the use of a collagen-coated transvaginal mesh for anterior vaginal wall prolapse against a conventional anterior repair. DESIGN: Randomised controlled study. SETTING: Six......-7) and the Pelvic Floor Distress Inventory (PFDI-20). MAIN OUTCOME MEASURES: Objective cure, defined as POP-Q stage

  17. Segond fracture: involvement of the iliotibial band, anterolateral ligament, and anterior arm of the biceps femoris in knee trauma

    Energy Technology Data Exchange (ETDEWEB)

    Maeseneer, Michel de; Boulet, Cedric; Willekens, Inneke; Mey, Johan de; Shahabpour, Maryam [Universitair Ziekenhuis Brussel, Department of Radiology, Brussels (Belgium); Lenchik, Leon [Wake Forest University, Department of Radiology, Winston Salem, NC (United States); Cattrysse, Erik [Vrije Universiteit Brussel, Department of Experimental Anatomy, Brussels (Belgium)

    2014-12-04

    To evaluate the involvement of the iliotibial band (ITB), the anterolateral ligament (ALL), and the anterior arm of the biceps femoris in MRI-diagnosed Segond fracture and to evaluate other associated findings of Segond fracture. We retrospectively reviewed the MRI of 13 cases of Segond fracture. The studies included proton density-weighted, T2-weighted, and proton density-weighted with fat saturation images in the three planes. We studied 2 cadaveric specimens with emphasis on the ALL. One cadaveric specimen was dissected while the other was sectioned in the sagittal plane. The mean age of the patients was 36 years (range, 17-52). There were 7 men and 6 women. The mean size of the Segond bone fragment was 8 x 10 x 2 mm. The distance from the tibia varied from 2 to 6 mm. Associated findings included anterior cruciate ligament (ACL) tear (n = 13), medial collateral ligament (MCL) tear (n = 8), meniscocapsular tear of the posterior horn of the medial meniscus (n = 5), and posterolateral corner involvement (n = 4). Bone marrow edema involved the mid-lateral femoral condyle and the posterior tibial plateau on both the medial and the lateral side. Edema at the Segond area was seen, but was limited. Fibular head edema was also seen. The ITB (11 out of 13) and ALL (10 out of 13) inserted on the Segond bone fragment. The anterior arm of the biceps tendon did not insert on the Segond fracture. Associated findings of Segond fracture include ACL tear, MCL tear, medial meniscus tear, and posterolateral corner injury. Both the ITB and the ALL may be involved in the Segond avulsion. The anterior arm of the biceps femoris tendon is not involved. (orig.)

  18. Clinical outcomes of pars plicata anterior vitrectomy: 2-year results

    Directory of Open Access Journals (Sweden)

    Priya Narang

    2015-01-01

    Full Text Available Purpose: To demonstrate the safety and outcome of a surgical approach that uses pars plicata site for anterior vitrectomy during phacoemulsification procedure complicated by posterior capsule rupture and residual cortical matter. Design: Single center, retrospective, interventional, noncomparative study. Materials and Methods: Medical records of a consecutive series of 35 eyes of 35 patients who underwent pars plicata anterior vitrectomy (PPAV were reviewed. The main outcome measures were corrected and uncorrected distance visual acuity (CDVA, UDVA, early and late postoperative complications and intraocular pressure (IOP. Ultrasound biomicroscopic (UBM evaluation of sclerotomy site and spectral domain optical coherence tomography analysis for central macular thickness (CMT was performed. The final visual outcome at 2 years was evaluated. Results: At 2 years follow-up, the mean postoperative UDVA (logarithm of the minimum angle of resolution [logMAR] and CDVA (logMAR was 0.49 ± 0.26 and 0.19 ± 0.14, respectively. There was no significant change in the IOP (P = 0.061 and the mean CMT at 2 years was 192.5 ± 5.54 mm. The postoperative UBM image of the sclerotomy site at 8 weeks demonstrated a clear wound without any vitreous adhesion or incarceration. Intraoperative hyphema was seen in 1 (2.8% case and postoperative uveitis was seen in 2 (5.7% cases, which resolved with medications. No case of an iatrogenic retinal break or retinal detachment was reported. Conclusions: PPAV enables a closed chamber approach, allows thorough cleanup of vitreous in the pupillary plane and anterior chamber and affords better access to the subincisional and retropupillary cortical remnant with a significant visual outcome and an acceptable complication rate.

  19. Microsurgical anatomy of the anterior cerebral artery in Indian cadavers

    Directory of Open Access Journals (Sweden)

    Shweta Kedia

    2013-01-01

    Full Text Available Background: The microanatomy features of cerebral arteries may be variable and may be different in different ethnic groups. Aim: To study the anterior cerebral artery (ACA anatomy in North-West Indian cadavers. Materials and Methods: Microanatomy features of the ACA were studied in 15 formalin fixed human cadaveric brains under microscope. The outer diameter, length, and number of perforating branches with respective anomalies were measured for each of the following vessels: ACA (proximal A1 segment to distal A2 segment, anterior communicating artery (ACoA, Recurrent artery of Heubner (RAH, and callosomarginal artery and photographed for documentation. Results: The mean length and external diameter of right and left A1 segment was 12.09 mm and 12.0 mm and 2.32 mm and 2.36 mm respectively. Narrowing, duplication, and median ACA were seen in 6.6%, 3.3% and 6.6% of the vessels respectively. Complex ACoA type was seen in 40% cadavers. RAH originated at an average point of 0.2 mm distal to ACoA, but in one cadaver it arose 5 mm proximal to ACoA. Double RAH was found in 26.6%. The course of RAH in relation to A1 was superiorly in 60%, in anteriorly 30% and posteriorly in 10% of cadavers. The orbitofrontal artery (OFA and frontopolar artery (FPA arose from A2 in 83.3% to 40% respectively. The mean distance of OFA and FPA from ACoA was 4.17 mm and 8.5 mm respectively. After giving rise to central, callosal and cortical branches, pericallosal artery terminated near the splenium of the corpus callosum or on the precuneus as the inferomedial parietal artery. Conclusion: Knowledge of the microvascular anatomy is indispensable and it is mandatory to be aware of the possible variations in the anomalies to minimize morbidity.

  20. Direction of the formation of anterior lumbar vertebral osteophytes

    Directory of Open Access Journals (Sweden)

    Akeda Koji

    2009-01-01

    Full Text Available Abstract Background X-ray images of lumbar degenerative diseases often show not only claw osteophytes, but also pairs of osteophytes that form in a direction away from the adjacent disc. We have investigated the direction of the formation of anterior lumbar vertebral osteophytes across the lumbar vertebrae using a sufficient number of lumbar radiographs, because osteophytes images can provide essential information that will contribute to the understanding of the pathology and progress of lumbar spine degeneration. Methods The direction of the formation of 14,250 pairs of anterior lumbar vertebral osteophytes across the adjacent intervertebral discs in 2,850 patients who were all over 60 years old was investigated. Anterior lumbar vertebral osteophytes were distributed into six groups based on the direction of extension of each pair of osteophytes across the intervertebral disc space. Results In L1–L2 and L2–L3, the number of patients classified into groups B (the pair of osteophytes extended in the direction of the adjacent disc and C (almost complete bone bridge formation by a pair of osteophytes across the intervertebral disc space was larger than that classified into group D (the pair of osteophytes extended in a direction away from the adjacent disc. In L3–L4, L4–L5 and L5-S1, the number of patients in group D was greater than that of patients belonging to groups B and C. Conclusion Our study showed that pairs of osteophytes frequently formed in the direction of the adjacent disc in the upper lumbar vertebrae (L1–L2 and L2–L3 and in the direction away from the adjacent disc in middle or lower lumbar vertebrae (L3–L4, L4–L5, and L5-S1.

  1. Novel mutations in PXDN cause microphthalmia and anterior segment dysgenesis.

    Science.gov (United States)

    Choi, Alex; Lao, Richard; Ling-Fung Tang, Paul; Wan, Eunice; Mayer, Wasima; Bardakjian, Tanya; Shaw, Gary M; Kwok, Pui-Yan; Schneider, Adele; Slavotinek, Anne

    2015-03-01

    We used exome sequencing to study a non-consanguineous family with two children who had anterior segment dysgenesis, sclerocornea, microphthalmia, hypotonia and developmental delays. Sanger sequencing verified two Peroxidasin (PXDN) mutations in both sibs--a maternally inherited, nonsense mutation, c.1021C>T predicting p.(Arg341*), and a paternally inherited, 23-basepair deletion causing a frameshift and premature protein truncation, c.2375_2397del23, predicting p.(Leu792Hisfs*67). We re-examined exome data from 20 other patients with structural eye defects and identified two additional PXDN mutations in a sporadic male with bilateral microphthalmia, cataracts and anterior segment dysgenesis--a maternally inherited, frameshift mutation, c.1192delT, predicting p.(Tyr398Thrfs*40) and a paternally inherited, missense substitution that was predicted to be deleterious, c.947 A>C, predicting p.(Gln316Pro). Mutations in PXDN were previously reported in three families with congenital cataracts, microcornea, sclerocornea and developmental glaucoma. The gene is expressed in corneal epithelium and is secreted into the extracellular matrix. Defective peroxidasin has been shown to impair sulfilimine bond formation in collagen IV, a constituent of the basement membrane, implying that the eye defects result because of loss of basement membrane integrity in the developing eye. Our finding of a broader phenotype than previously appreciated for PXDN mutations is typical for exome-sequencing studies, which have proven to be highly effective for mutation detection in patients with atypical presentations. We conclude that PXDN sequencing should be considered in microphthalmia with anterior segment dysgenesis.

  2. Acute Anterior Uveitis and Spondyloarthritis: More Than Meets the Eye.

    Science.gov (United States)

    Khan, Muhammad A; Haroon, Muhammad; Rosenbaum, James T

    2015-09-01

    Ankylosing spondylitis (AS) and related forms of spondyloarthritis (SpA) are associated with some extra-articular features, and the most common symptomatic association is with acute anterior uveitis (AAU). Thus, approximately 40 % of patients with AS will experience a sudden onset of a unilateral anterior uveitis sometime during the course of their disease. Patients with AAU, especially those who are HLA-B27 positive, should be questioned about inflammatory low back pain and also evaluated for other clinical features of SpA. Since a prolonged delay in diagnosis is common among SpA patients and occurrence of AAU may be the reason for their first interaction with medical care, occurrence of AAU presents a unique opportunity for identifying such undiagnosed SpA patients. Therefore, a novel evidence-based algorithm called Dublin Uveitis Evaluation Tool (DUET) has been proposed to guide ophthalmologists and primary care physicians to refer appropriate AAU patients to rheumatologists. In a large two-phase study, approximately 40 % of patients presenting with idiopathic AAU were noted to have undiagnosed SpA, and DUET algorithm was noted to have excellent sensitivity (96 %) and specificity (97 %). It has a positive likelihood ratio (LR) 41.5 and negative LR 0.03. In most instances, the eye inflammation responds well to corticosteroid and mydriatic eye drops and without the need for additional therapy. Use of oral corticosteroids is reserved for patients, especially with associated chronic inflammatory bowel disease or psoriatic arthritis presenting with bilateral, chronic, anterior, and/or intermediate uveitis, and this treatment is rarely needed for more than a couple of weeks. A very small percentage may be more refractory to such treatment and require potential novel therapies, including the use of tumor necrosis factor blockers. PMID:26233598

  3. Novel spatula and dissector for safer deep anterior lamellar keratoplasty

    Directory of Open Access Journals (Sweden)

    Gustavo ,2,3 Bonfadini

    2014-10-01

    Full Text Available Objective: We describe a novel spatula and dissector to facilitate the big-bubble technique in deep anterior lamellar keratoplasty (DALK. Methods: A 29-year-old man who was diagnosed with bilateral keratoconus underwent deep anterior lamellar keratoplasty (DALK. After 350μm partial thickness incision of the recipient cornea, the Bonfadini dissector was inserted at the deepest point in the peripheral incision and could be advanced to the center of the cornea safely because of its "semi-sharp" tip. After achieving the big-bubble (BB separation of Descemet membrane (DM from the overlying stroma, the anterior stromal disc was removed. Viscoelastic material was placed on the stromal bed to prevent uncontrolled collapse and perforation of DM during the paracentesis blade incision into the BB. We could detect the safe opening of the BB using the Bonfadini dissector by the leakage of air bubbles into the viscoelastic material. After injecting viscoelastic material into the BB space, we inserted the Bonfadini spatula into the bigbubble safely because of its curved profile and blunt edges. The groove along the length of the Bonfadini spatula enables safe and efficient incision or the residual stromal tissue using the pointed end of a sharp blade while protecting the underlying DM. After removal of posterior stroma, the donor button was sutured with 16 interrupted 10-0 nylon sutures. Results: This technique and the use of the Bonfadini spatula and dissector facilitate exposure of Descemet membrane. Conclusion: The smooth Bonfadini DALK spatula and dissector facilitate safe and efficient completion of DALK surgery.

  4. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    Science.gov (United States)

    Nejaim, Yuri; de Freitas, Deborah Queiroz; de Oliveira Santos, Christiano

    2016-01-01

    Purpose The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Materials and Methods Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. Results In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. Conclusion CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region. PMID:27672611

  5. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    Science.gov (United States)

    Nejaim, Yuri; de Freitas, Deborah Queiroz; de Oliveira Santos, Christiano

    2016-01-01

    Purpose The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Materials and Methods Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. Results In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. Conclusion CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.

  6. Progressive bilateral anterior sacral meningoceles in Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Scheck, R.J. [Dept. of Radiology, Univ. Muenchen (Germany); Schramm, T. [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany); Gloning, K.P. [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany); Vogl, T. [Dept. of Radiology, Univ. Muenchen (Germany); Ostermayer, E. [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany)

    1995-08-01

    Anterior sacral meningoceles (ASM) in Marfan syndrome are rare. They may cause constipation, urinary frequency, dysmenorrhoea, and low back pain or numbness. This report describes bilateral ASM at the level of S1, S2 and S3 in a woman with Marfan syndrome who was admitted to the gynaecology department for evaluation of left lower abdominal pain. The magnetic resonance appearance of the meningoceles is discussed and compared with findings from transvaginal ultrasound and CT. As MRI offers excellent delineation of spinal and pelvic structures, it is the most useful technique available in establishing the diagnosis and planning the treatment of ASM. (orig.)

  7. Progressive bilateral anterior sacral meningoceles in Marfan syndrome

    International Nuclear Information System (INIS)

    Anterior sacral meningoceles (ASM) in Marfan syndrome are rare. They may cause constipation, urinary frequency, dysmenorrhoea, and low back pain or numbness. This report describes bilateral ASM at the level of S1, S2 and S3 in a woman with Marfan syndrome who was admitted to the gynaecology department for evaluation of left lower abdominal pain. The magnetic resonance appearance of the meningoceles is discussed and compared with findings from transvaginal ultrasound and CT. As MRI offers excellent delineation of spinal and pelvic structures, it is the most useful technique available in establishing the diagnosis and planning the treatment of ASM. (orig.)

  8. Anterior dislocation of shoulder in eclampsia:a case report

    Institute of Scientific and Technical Information of China (English)

    Seema Rawat; Sanjay Meena; Shreesh Kumar Gangari; Lalit Kumar Lohia

    2012-01-01

    This case report presents a 25-year-old female patient with anterior dislocation of right shoulder secondary to seizures as a complication of eclampsia.This is an unusual mechanism of injury,but similar to other uncontrolled muscular contractions caused by electroconvulsive therapy,etc.To the best of our knowledge only one such case has been reported in the English literature.Closed reduction under general anaesthesia was successfully achieved.High suspicion in patients complaining of pain over shoulder joint is necessary for early diagnosis of this condition.

  9. Hubungan Rasio Anterior dengan Overjet dan Overbite pada Perawatan Orthodontik

    OpenAIRE

    J. A. Budiman; E. D. D. Yashadana; S. D. Sadoso; P. I. Masbirin

    2015-01-01

    The important role of the tooth size information is in making diagnosis and treatment plan of the cases with malocclusion. A lot of studies have been done in this aspect such as about tooth size with its variation, and also the ratio of maxillary to mandibular tooth size. The most famous tooth size analysis is Bolton analysis with his anterior ratio and overall ratio. Because the accordance of those ratio is not found in all orthodontic cases, some studies (Korbitz, Neff, Moyers and Steadman)...

  10. A Rare Complication of Tuberculous Meningitis Pediatric Anterior Glenohumeral Instability

    Directory of Open Access Journals (Sweden)

    Kerem Bilsel

    2012-01-01

    Full Text Available Dislocation and instability of the shoulder joint are rare occurrences in childhood. Traumatic, infectious, congenital, and neuromuscular causes of pediatric recurrent shoulder dislocations are reported before. Central nervous system infection in infancy may be a reason for shoulder instability during childhood. This situation, which causes a disability for children, can be treated successfully with arthroscopic stabilization of the shoulder and postoperative effective rehabilitation protocols. Tuberculous meningitis may be a reason for neuromuscular shoulder instability. We describe a 12-year-old child with a recurrent anterior instability of the shoulder, which developed after tuberculous meningitis at 18 months of age. We applied arthroscopic treatment and stabilized the joint.

  11. Anterior cruciate ligament injury in indoor ball games.

    Science.gov (United States)

    Ebstrup, J F; Bojsen-Møller, F

    2000-04-01

    Three videorecorded incidents of knee injuries inflicted during indoor ball games are reported. Injuries and especially anterior cruciate ligament ruptures seemed to be triggered in varus loaded knees by femural external rotation, or in valgus loaded knees by femural internal rotation with the pivot shifted to the lateral femurotibial compartment. The observations suggest that it may be to the players' advantage to be trained in not letting their knees sag medially or laterally during side-stepping or sudden changes in speed. PMID:10755283

  12. Esthetic management of anterior dental anomalies: A clinical case.

    Science.gov (United States)

    Chafaie, Amir

    2016-09-01

    Many types of dental abnormality can be observed in the anterior sectors, where they can cause genuine esthetic problems for our patients. While conventional prosthetic treatments offer the best solutions in terms of esthetic result and durability, they involve the sacrifice of significant quantities of mineralized dental material and cannot be undertaken before the periodontal tissues are mature. Other less invasive alternatives should be envisaged as transitional, or sometimes even permanent, solutions for the management of these anomalies in children and adolescents. This article discusses these options and presents a clinical case where composite resin veneers and microabrasion of the enamel were used to treat dental agenesis and enamel dysplasia. PMID:27498052

  13. Coracoid syndrome: a neglected cause of anterior shoulder pain

    Science.gov (United States)

    GIGANTE, ANTONIO; BOTTEGONI, CARLO; BARBADORO, PAMELA

    2016-01-01

    Purpose the present prospective open-label study was designed to gain further insights into a condition thought to constitute a neglected but not uncommon syndrome characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process, not related to rotator cuff or pectoralis minor tendinopathy, long head of the biceps tendon disorders, or instability. The aim was to clarify its prevalence, clinical characteristics, differential diagnosis and response to corticosteroid injections. Methods patients with primary anterior shoulder pain precisely reproduced by deep pressure on the apex of the coracoid process were recruited. Patients with clinical or instrumental signs of other shoulder disorders were excluded. Patients were given an injection of triamcinolone acetonide 40 mg/ml 1 ml at the coracoid trigger point. They were evaluated after 15, 30 and 60 days and at 2 years using Equal Visual Analog Scale (EQ-VAS) and the Italian version of the Simple Shoulder Test (SST). Results between January 1 and December 31 2010, we treated 15 patients aged 26–66 years. The majority were women (86.67%). At 15 days, 6 (40%) patients reported complete resolution of their symptoms, while 9 (60%) complained of residual symptoms and received another injection. At 30 days, 14 (93.33%) patients were pain-free and very satisfied. At 2 years, the 14 patients who had been asymptomatic at 30 days reported that they had experienced no further pain or impaired shoulder function. The analysis of variance for repeated measures showed a significant effect of time on EQ-VAS and SST scores. Conclusions the present study documents the existence, and characteristics, of a “coracoid syndrome” characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process and showed that the pain is usually amenable to steroid treatment. This syndrome should be clearly distinguished from anterior shoulder pain due to other causes, in

  14. Melioidosis:a rare cause of anterior chest wall abscess

    Institute of Scientific and Technical Information of China (English)

    Rashidi Ahmad; Azhar Amir Hamzah; Ahmad Kasfi Abdul Rahman; Phee Kheng Cheah

    2010-01-01

    Melioidosis is an unusual tropical infectious disease caused by the gram-negative bacterium Burkholderia pseudomallei, which was formerly known asPseudomonas pseudomallei. Melioidosis is characterized by abscess formation and it may manifest in any part of the human body, however, musculoskeletel melioidosis is uncommon and chest wall melioidosis is very rare. To determine the exact organism based solely on clinical presentation poses a great challenge to the physician. Yet, delay administration of antibiotic may be harmful. We describe a diabetic patient who had anterior chest wall melioidosis that mimicsStaphylococcus aureus infection. A description of his presentation and management, along with a review of literature is presented.

  15. Anterior Cruciate Ligament Injuries in Children and Adolescents.

    Science.gov (United States)

    Fabricant, Peter D; Kocher, Mininder S

    2016-10-01

    Dramatic increases in youth competitive athletic activity, early sport specialization, and year-round training and competition, along with increased awareness of anterior cruciate ligament (ACL) injuries in children, have led to a commensurate increase in the frequency of ACL tears in the skeletally immature. Recent understanding of the risks of nonoperative treatment and surgical delay have supported a trend toward early operative treatment. This article discusses treatment strategies for ACL injuries in children and adolescents, and offers our preferred treatment strategy for skeletally immature youth athletes with ACL tears. PMID:27637664

  16. Does the Microbiome Cause B27-related Acute Anterior Uveitis?

    Science.gov (United States)

    Rosenbaum, James T; Lin, Phoebe; Asquith, Mark

    2016-08-01

    The microbiome is strongly implicated in a broad spectrum of immune-mediated diseases. Data support the concept that HLA molecules shape the microbiome. We provide hypotheses to reconcile how HLA-B27 might affect the microbiome and in turn predispose to acute anterior uveitis. These theories include bacterial translocation, antigenic mimicry, and dysbiosis leading to alterations in regulatory and effector T-cell subsets. Received 31 October 2015; revised 7 January 2016; accepted 8 January 2016; published online 22 March 2016. PMID:27002532

  17. Acute anterior uveitis as the initial presentation of alkaptonuria

    Directory of Open Access Journals (Sweden)

    Padhan P

    2009-01-01

    Full Text Available Alkaptonuria is a rare autosomal recessive metabolic disorder that may present with multi-system involvement such as ochronotic arthropathy, renal, urethral and prostatic calculi, cardiac valvular lesions and pigmentation of the skin, sclera, cartilage and other connective tissues. An association of the disease with uveitis has never been reported. We report the first case of alkaptonuria with ochronotic arthropathy presenting with recurrent acute anterior uveitis as the initial manifestation. The possible common link with the HLA-B27 gene is discussed.

  18. Anterior Cruciate Ligament Reconstruction in Ehlers-Danlos Syndrome

    Directory of Open Access Journals (Sweden)

    John Williams

    2015-01-01

    Full Text Available This report details the reconstruction of the anterior cruciate ligament in an 18-year-old man with Ehlers-Danlos syndrome (EDS. The reduced mechanical properties of the tissue in EDS can pose a challenge to the orthopaedic surgeon. In this case, we describe the use of a hamstring autograft combined with a Ligament Advanced Reinforcement System (LARS. There was a good radiographical, clinical, and functional outcome after two years. This technique gave a successful outcome in the reconstruction of the ACL in a patient with EDS and therefore may help surgeons faced with the same clinical scenario.

  19. Sensitivitas Gigi Anterior Perempuan Suku Sasak yang Melaksanakan Tradisi Ngasaq

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    Edeh Roletta Haroen

    2015-09-01

    Full Text Available “Nqasaq” or tooth grinding traditional is the one of the culture of the Sasak’s ethnic group in Lombok. The sensation of tingling or acute tooth pain as the result of tooth erosion have been the symptom that became the prominent complaint of the “pengasaq”. The aim of the research were obtained the illustration and the difference in sensitivity interelements of the anterior tooth of the adolescent and young adult Sasak’s ethnic group women that carried out “ngasaq”. The method of the research was quasi experimental through the approach of the electrical stimulus from the dentotest tester to induce the physiological tooth pain, that were measured the NARN, pain reaction threshold. The subjects of the research were the anterior tooth of the 30 healthy adolescent and young adult Sasak’s ethnic group women that carried out “ngasaq” and as the control of the research were the tooth of the 30 subjects without “ngasaq”. The results of the research showed that the mean of the pain reaction threshold (NARN of the maxillary and mandibulary anterior tooth that were the central incisors, and the canines after “ngasaq” in the adolescent were: 4.15; 4.38; 5.48 and 3.08; 3.75; 4.85; in the young adult were: 2.26; 2.78; 4.03; and 2.52; 2.77; 3.70. Without “ngasaq”, in the adolescent were: 4.52; 5.37; 6.25 and 3.40; 3.77; 5.25; in the young adult: 3.00; 3.23; 34.33 and 3.17; 3.40; 4.12. The statistical test t Student (p = 0.05 in the adolescent showed that t were: 1.52; 1.43; 1.10 and 0.99; 0.56; 0.77; in young adult were: 0.808; 1.38; 0.793 and 0.588; 0.517; 0.992. The conclusion of the research showed that the mean of the “pengasaq” tooth sensitivity was relatively more lower than tooth sensitivity without “ngasaq”, so that was no significant tooth sensitivity difference in the interelements of the anterior tooth, in the adolescent and young adult of the Sasak’s ethnic group women.

  20. A checklist for endonasal transsphenoidal anterior skull base surgery.

    Science.gov (United States)

    Laws, Edward R; Wong, Judith M; Smith, Timothy R; de Los Reyes, Kenneth; Aglio, Linda S; Thorne, Alison J; Cote, David J; Esposito, Felice; Cappabianca, Paolo; Gawande, Atul

    2016-06-01

    OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and decrease complication rates. Although the authors' institution has instituted a general preoperative "time-out" designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for transnasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery uses a completely different conceptual approach, set-up, instrumentation, and operative procedure. Therefore, it can be associated with different types of complications as compared with open cranial surgery. The authors hypothesized that a detailed, procedure-specific, preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and maximize both teambuilding and operational efficiency. Thus, the object of this study was to develop such a checklist for endonasal transsphenoidal anterior skull base surgery. METHODS An expert panel was convened that consisted of all members of the typical surgical team for transsphenoidal endoscopic cases: neurosurgeons, anesthesiologists, circulating nurses, scrub technicians, surgical operations managers, and technical assistants. Beginning with a general checklist, procedure-specific items were added and categorized into 4 pauses: Anesthesia Pause, Surgical Pause, Equipment Pause, and Closure Pause. RESULTS The final endonasal transsphenoidal anterior skull base surgery checklist is composed of the following 4 pauses. The Anesthesia Pause consists of patient identification, diagnosis, pertinent laboratory studies, medications, surgical preparation, patient positioning, intravenous/arterial access, fluid management

  1. Class I malocclusion with anterior crossbite and severe crowding

    Directory of Open Access Journals (Sweden)

    Daltro Enéas Ritter

    2014-04-01

    Full Text Available This article reports the orthodontic diagnosis and treatment planning carried out with a 14-year and 5-month-old female patient with esthetic and functional complaints. She presented an Angle Class I malocclusion, anterior crossbite and severe crowding in both maxillary and mandibular arches, in addition to a lightly concave straight facial profile. Orthodontic treatment did not require extraction. Crossbite was corrected by protrusion of upper teeth, which contributed to alignment and leveling of teeth, in addition to improving the patient's facial profile. The case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO as a requirement for the BBO certification.

  2. Graves' disease presenting as unilateral anterior ischaemic optic neuropathy.

    Science.gov (United States)

    Monigari, Naresh; Deshpande, Anirudda; Nalabothu, Murali; Rao, Shilpa

    2014-03-19

    We report a case of a 28-year-old man who presented with 1-day history of sudden diminution of vision in the right eye. Examination showed unilateral exophthalmos with restricted eyeball movement on upward gaze in the right eye. MRI of the orbit showed no evidence of compression of the optic nerve on the right side. Visual-evoked potential showed prolonged P100 in the right eye. Fundus examination revealed swollen optic disc and para papillary nerve fibre layer splinter haemorrhages with corresponding altitudinal field defect on perimetry suggestive of anterior ischaemic optic neuropathy.

  3. Superior labrum anterior to posterior tears in throwing athletes.

    Science.gov (United States)

    Lintner, David M

    2013-01-01

    Superior labrum anterior to posterior (SLAP) tears and partial undersurface tears of the rotator cuff are common in experienced throwers, may be adaptive, and are only occasionally symptomatic. Pain in the shoulder of a throwing athlete with an MRI-documented SLAP tear or partial undersurface tear of the rotator cuff can be managed nonsurgically, with attention to posterior capsular contracture, scapular dyskinesia, and rotator cuff strength. The results of the surgical repair of SLAP lesions in the throwing athlete, with or without rotator cuff repair, are inferior to those of nonsurgical treatment. The cause of pain in the throwing athlete must be accurately diagnosed without reliance on MRI findings. PMID:23395053

  4. Anterior Segment Tomography with the Cirrus Optical Coherence Tomography

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    Eduardo B. Rodrigues

    2012-01-01

    Full Text Available Optical coherence tomography (OCT is an optical acquisition method to examine biological tissues. In recent years, OCT has become an important imaging technology used in diagnosing and following macular pathologies. Further development enabled application of optical coherence tomography in evaluation of the integrity of the nerve fiber layer, optic nerve cupping, anterior chamber angle, or corneal topography. In this manuscript we overview the use of OCT in the clinical practice to enable corneal, iris, ciliary body, and angle evaluation and diagnostics.

  5. Anterior Cruciate Ligament: Structure, Injuries and Regenerative Treatments.

    Science.gov (United States)

    Negahi Shirazi, Ali; Chrzanowski, Wojciech; Khademhosseini, Ali; Dehghani, Fariba

    2015-01-01

    Anterior cruciate ligament (ACL) is one of the most vulnerable ligaments of the knee. ACL impairment results in episodic instability, chondral and meniscal injury and early osteoarthritis. The poor self-healing capacity of ACL makes surgical treatment inevitable. Current ACL reconstructions include a substitution of torn ACL via biological grafts such as autograft, allograft. This review provides an insight of ACL structure, orientation and properties followed by comparing the performance of various constructs that have been used for ACL replacement. New approaches, undertaken to induce ACL regeneration and fabricate biomimetic scaffolds, are also discussed. PMID:26545750

  6. Anatomical reconstruction of the anterior cruciate ligament: a logical approach

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    Julio Cesar Gali

    2015-08-01

    Full Text Available ABSTRACT We describe the surgical approach that we have used over the last years for anterior cruciate ligament (ACL reconstruction, highlighting the importance of arthroscopic viewing through the anteromedial portal (AMP and femoral tunnel drilling through an accessory anteromedial portal (AMP. The AMP allows direct view of the ACL femoral insertion site on the medial aspect of the lateral femoral condyle, does not require guides for anatomic femoral tunnel reaming, prevents an additional lateral incision in the distal third of the thigh (as would be unavoidable when the outside-intechnique is used and also can be used for double-bundle ACL reconstruction.

  7. Absence of sensory function in the reconstructed anterior cruciate ligament

    DEFF Research Database (Denmark)

    Krogsgaard, Michael R; Fischer-Rasmussen, Torsten; Dyhre-Poulsen, Poul

    2011-01-01

    Cruciate ligaments provide sensory information that cause excitatory as well as inhibitory effects to the activity of the muscles around the knee. The aim of the study was to determine whether these muscular reflexes are reestablished after anterior cruciate ligament (ACL) re-construction. Wire...... electrodes were inserted during arthroscopy into the normal posterior cruciate ligament (PCL) and the reconstructed ACL in 11 patients who had a successful ACL re-construction 8 months to 12 years earlier. After the anesthesia had subsided, the PCL was stimulated electrically through the electrodes...

  8. Anterior Cruciate Ligament: Structure, Injuries and Regenerative Treatments.

    Science.gov (United States)

    Negahi Shirazi, Ali; Chrzanowski, Wojciech; Khademhosseini, Ali; Dehghani, Fariba

    2015-01-01

    Anterior cruciate ligament (ACL) is one of the most vulnerable ligaments of the knee. ACL impairment results in episodic instability, chondral and meniscal injury and early osteoarthritis. The poor self-healing capacity of ACL makes surgical treatment inevitable. Current ACL reconstructions include a substitution of torn ACL via biological grafts such as autograft, allograft. This review provides an insight of ACL structure, orientation and properties followed by comparing the performance of various constructs that have been used for ACL replacement. New approaches, undertaken to induce ACL regeneration and fabricate biomimetic scaffolds, are also discussed.

  9. Avaliação da artéria etmoidal anterior pela tomografia computadorizada no plano coronal Anterior ethmoidal artery evaluation on coronal CT scans

    Directory of Open Access Journals (Sweden)

    Soraia Ale Souza

    2009-02-01

    Full Text Available O conhecimento da localização da artéria etmoidal anterior (AEA constitui etapa importante na cirurgia do recesso do seio frontal e do etmóide anterior. A tomografia computadorizada (TC, em especial no plano coronal pode fornecer reparos anatômicos que identificam o trajeto da AEA. OBJETIVO: Identificar os reparos anatômicos que caracterizam o trajeto da AEA na parede medial da órbita e na parede lateral da fossa olfatória. Verificar a correlação entre a presença de pneumatização supra-orbitária e a visualização do etmoidal anterior (canal da AEA. CASUÍSTICA E MÉTODOS: Estudo retrospectivo de 198 tomografias computadorizadas dos seios paranasais no plano coronal do período de agosto a dezembro de 2006. RESULTADOS: Pneumatização supra-orbitária foi identificada em 35% (70 exames. O canal da AEA foi caracterizado em 41% (81 exames. O sulco etmoidal anterior foi visualizado em 98% (194 dos exames e o forame etmoidal anterior foi identificado em todos os exames (100%. CONCLUSÃO: O forame etmoidal anterior e o sulco etmoidal anterior foram referências anatômicas presentes em quase 100% dos exames avaliados. Houve correlação entre a presença de pneumatização supra-orbitária e a caracterização do canal da AEA.The anterior ethmoidal artery (AEA is an important point for frontal and ethmoid sinuses surgery. CT scans can identify landmarks to help the surgeon find the AEA. AIM: To identify the landmarks of the AEA on the orbital medial wall and on the lateral wall of the olfactory fossa. and to correlate the presence of supraorbital ethmoidal cells with spotting the anterior ethmoidal artery canal. MATERIALS AND METHODS: Retrospective review of 198 direct coronal paranasal sinuses computed tomography (CT scans from August to December, 2006. RESULTS: Supraorbital pneumatization was seen in 35% (70 scans. The AEA canal was seen in 41% (81 scans. The anterior ethmoidal sulcus was seen in 98% (194 scans and the anterior

  10. Activation of cannabinoid system in anterior cingulate cortex and orbitofrontal cortex modulates cost-benefit decision making

    OpenAIRE

    Khani, Abbas; Kermani, Mojtaba; Hesam, 6Soghra; Haghparast, Abbas; Enrike G Argandoña; Rainer, Gregor

    2015-01-01

    Despite the evidence for altered decision making in cannabis abusers, the role of the cannabinoid system in decision-making circuits has not been studied. Here, we examined the effects of cannabinoid modulation during cost-benefit decision making in the anterior cingulate cortex (ACC) and orbitofrontal cortex (OFC), key brain areas involved in decision making. We trained different groups of rats in a delay-based and an effort-based form of cost-benefit T-maze decision-making task. During test...

  11. Frontopolar and anterior temporal cortex activation in a moral judgment task. Preliminary functional MRI results in normal subjects

    International Nuclear Information System (INIS)

    The objective was to study the brain areas which are activated when normal subjects make moral judgments. Ten normal adults underwent BOLD functional magnetic resonance imaging (fMRI) during the auditory presentation of sentences that they were instructed to silently judge as either 'right' or 'wrong'. Half of the sentences had an explicit moral content ('We break the law when necessary'), the other half comprised factual statements devoid of moral connotation ('Stones are made of water'). After scanning, each subject rated the moral content, emotional valence, and judgment difficulty of each sentence on Likert-like scales. To exclude the effect of emotion on the activation results, individual responses were hemo dynamically modeled for event-related f MRI analysis. The general linear model was used to evaluate the brain areas activated by moral judgment. Regions activated during moral judgment included the frontopolar cortex (FPC), medial frontal gyrus, right anterior temporal cortex, lenticular nucleus, and cerebellum. Activation of FPC and medial frontal gyrus (B A 10/46 and 9) were largely independent of emotional experience and represented the largest areas of activation. These results concur with clinical observations assigning a critical role for the frontal poles and right anterior temporal cortex in the mediation of complex judgment processes according to moral constraints. The FPC may work in concert with the orbitofrontal and dorsolateral cortex in the regulation of human social conduct. (author)

  12. Frontopolar and anterior temporal cortex activation in a moral judgment task. Preliminary functional MRI results in normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Moll, Jorge [LABS and Rede D' Or Hospitais, Rio de Janeiro RJ (Brazil). Grupo de Neuroimagem e Neurologia do Comportamento; Eslinger, Paul J. [Pensylvania State Univ. (United States). College of Medicine. Div. of Neurology and Behavioral Science; The Milton S. Hershey Medical Center, Hershey, PN (United States); Oliveira-Souza, Ricardo de [Universidade do Rio de Janeiro (UNI-Rio), RJ (Brazil). Hospital Universitario Gaffree e Guinle]. E-mail: neuropsychiatry@hotmail.com

    2001-09-01

    The objective was to study the brain areas which are activated when normal subjects make moral judgments. Ten normal adults underwent BOLD functional magnetic resonance imaging (fMRI) during the auditory presentation of sentences that they were instructed to silently judge as either 'right' or 'wrong'. Half of the sentences had an explicit moral content ('We break the law when necessary'), the other half comprised factual statements devoid of moral connotation ('Stones are made of water'). After scanning, each subject rated the moral content, emotional valence, and judgment difficulty of each sentence on Likert-like scales. To exclude the effect of emotion on the activation results, individual responses were hemo dynamically modeled for event-related f MRI analysis. The general linear model was used to evaluate the brain areas activated by moral judgment. Regions activated during moral judgment included the frontopolar cortex (FPC), medial frontal gyrus, right anterior temporal cortex, lenticular nucleus, and cerebellum. Activation of FPC and medial frontal gyrus (B A 10/46 and 9) were largely independent of emotional experience and represented the largest areas of activation. These results concur with clinical observations assigning a critical role for the frontal poles and right anterior temporal cortex in the mediation of complex judgment processes according to moral constraints. The FPC may work in concert with the orbitofrontal and dorsolateral cortex in the regulation of human social conduct. (author)

  13. Optimizing Anterior En Masse Retraction with Miniscrew Anchorage

    Directory of Open Access Journals (Sweden)

    Pavankumar Janardan Vibhute

    2011-01-01

    Full Text Available In severely protrusive patients, skeletal anchorage from miniscrew is often used to avoid anchorage loss with preferred miniscrew location near centre of resistance (Cres of posterior teeth. Biomechanical requirement for directing retraction force towards Cres of posterior teeth demands the insertion of miniscrew in loose mucosa, where risk of infection and failure increases. In addition, undesirable biomechanical side effects on anterior and posterior segments may be possible in all three planes, when continuous arch sliding mechanics are installed with miniscrew anchorage. This paper describes technique of molar-stabilizing power arm (MSPA for simultaneous intrusion and retraction of anteriors with miniscrew placement at attached gingiva between 1st molar and 2nd premolar. Advantages of this technique include (i the need of miniscrews placement in loose mucosa apically near the Cres of the posterior teeth is eliminated, (ii the risk of infection and miniscrew failure is lowered since the miniscrew is placed in attached gingiva rather than the loose mucosa, and (iii by adjusting vertical length or replacing MSPA, alteration of the retraction force vector is possible in all three planes; thus, need of removal and repositioning of the miniscrew (e.g., in correction of occlusal cant can be eliminated.

  14. Secondary signs of anterior cruciate ligament tear at MR imaging

    International Nuclear Information System (INIS)

    The value of secondary signs of anterior cruciate ligament (ACL) tear was evaluated. MR images of 47 knees, 15 with normal, 6 with acutely torn and 26 with chronically torn ACLs confirmed at arthroscopy, were reviewed. Lateral and medial anterior tibial translocations (ATT), posterior cruciate ligament (PCL) bowing ratio and depth of lateral femoral notch (LFN) were measured. The degrees of lateral and medial ATTs and the PCL bowing ratio of the chronically torn ACLs were significantly higher than those of normal ACLs. With cutoff values of 5-mm lateral ATT, 2.5-mm medial ATT and 0.35-PCL bowing ratio, torn ligaments were distinguished from intact ligaments with accuracies of over 80%. Depth of LFN was less sensitive and less accuracies. All knees with lateral ATT of 6.4 mm medial ATT of 3.5 mm, PCL bowing ratio of 0.43 and LFN depth of 1.5 mm or more had torn ACLs. Higher correlations were revealed between lateral ATT and medial ATT, and also between lateral ATT and PCL bowing ratio. Combined criteria of lateral ATT and PCL bowing ratio indicated the highest diagnostic value as a reliable secondary sign of torn ACLs. (author)

  15. Síndrome tóxica do segmento anterior

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    Luiz Filipe de Albuquerque Alves

    2013-02-01

    Full Text Available A síndrome tóxica do segmento anterior (STSA é uma severa reação inflamatória aguda causada por agente não infeccioso que entra no segmento anterior, resultando em lesão celular tóxica com necrose e apoptose mediado por resposta imunológica. Neste relato de caso de STSA são enfatizadas as causas mais comuns para o aparecimento da síndrome, apontam para os cuidados que devem ser tomados no processo de esterilização do material cirúrgico além de revisar a melhor conduta diante desses casos. Em conclusão notou-se que o foco principal deve ser a prevenção, pois o tratamento busca apenas suprimir a resposta inflamatória secundária. O tratamento nos casos de STSA consiste em intensa instilação de esteróides tópicos com seguimento rigoroso e controle de complicações tardias como o glaucoma.

  16. Anterior knee pain following primary total knee arthroplasty.

    Science.gov (United States)

    Shervin, David; Pratt, Katelyn; Healey, Travis; Nguyen, Samantha; Mihalko, William M; El-Othmani, Mouhanad M; Saleh, Khaled J

    2015-11-18

    Despite improvements in technique and technology for total knee arthroplasty (TKA), anterior knee pain impacts patient outcomes and satisfaction. Addressing the prosthetic and surgical technique related causes of pain after TKA, specifically as it relates to anterior knee pain, can aid surgeons in addressing these issues with their patients. Design features of the femoral and patellar components which have been reported as pain generators include: Improper femoral as well as patellar component sizing or designs that result in patellofemoral stuffing; a shortened trochlear groove distance from the flange to the intercondylar box; and then surgical technique related issues resulting in: Lateral patellar facet syndrome; overstuffed patella/flange combination; asymmetric patellar resurfacing, improper transverse plane component rotation resulting in patellar subluxation/tilt. Any design consideration that allows impingement of extensor mechanism anatomical elements has the possibility of impacting outcome by becoming a pain generator. As the number of TKA procedures continues to increase, it is increasingly critical to develop improved, evidence based prostheses that maximize function and patient satisfaction while minimizing pain and other complications. PMID:26601061

  17. Anterior cruciate ligament reconstruction in patients older than 35 years.

    Science.gov (United States)

    El-Sallakh, Sameh; Pastides, Philip; Thomas, Panos

    2014-12-01

    Anterior cruciate ligament (ACL) reconstruction is an increasingly established method even in patients older than 35 years. Our hypothesis is that functional outcome after ACL reconstruction is comparable in patients younger and older than 35 years. A total of 28 patients (5 women and 23 men) with average age of 41.5 years (36-68) were retrospectively evaluated. The average follow-up period was 33 months. All of them were treated operatively with arthroscopic single-bundle four-strand hamstring tendon autograft. The functional outcome was determined by clinical scores (Tegner activity scale and Lysholm knee score). The median values for the Lysholm knee score were preoperatively 77 and postoperatively 96 points (range, 90-100) with significant improvement (p pre- and postoperatively with an overall return to baseline for all patients. No significant correlation between functional outcome and patients' age was present and no reported significant complications. The good results and a high level of patient satisfaction show that ACL reconstruction is justified even in patients (older than 35 years) with symptomatic anterior knee instability. We commonly propose surgical treatment in symptomatic patients who express the need to restore their preinjury activity levels, regardless of their age.

  18. Displaced anterior cruciate ligament avulsion fractures: Arthroscopic staple fixation

    Directory of Open Access Journals (Sweden)

    S R Sundararajan

    2011-01-01

    Full Text Available Background: Anterior cruciate ligament (ACL avulsion fracture is commonly associated with knee injuries and its management is controversial ranging from conservative treatment to arthroscopic fixation. The aim of our study was to assess the clinical and radiological results of arthroscopic staple fixation in the management of ACL avulsion fractures. Materials and Methods: Twenty-two patients (17 males and 5 females who underwent arthroscopic staple fixation for displaced ACL avulsion fractures were analysed. The mean age was 32.2 years (15-55 years with a mean followup of 21 months (6-36 months. All patients were assessed clinically by calculating their Lysholm and International Knee Documentation Committee (IKDC scores and the radiological union was assessed in the followup radiographs. Results: The mean Lysholm score was 95.4(83-100 and the mean IKDC score was 91.1(77-100 at the final followup. In 20 patients anterior drawer′s test was negative at the end of final followup while two patients had grade I laxity. Associated knee injuries were found in seven cases. The final outcome was not greatly influenced by the presence of associated injuries when treated simultaneously. At final followup all the patients were able to return to their pre-injury occupation Conclusion: Arthroscopic staple fixation is a safe and reliable method for producing clinical and radiological outcome in displaced ACL avulsion fractures.

  19. STUDY OF ANTERIOR CRUCIATE LIGAMENT INJURY AND ITS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Tummala Venkata

    2016-03-01

    Full Text Available BACKGROUND The anterior cruciate ligament is the weaker of the two cruciate ligaments stabilizing the knee joint, and therefore gets torn easier than the posterior cruciate ligament. OBJECTIVE To determine pattern of anterior cruciate ligament injury and its management in a tertiary care center. MATERIALS AND METHODS A prospective study was carried out for two years, 28 patients with ACL injury were included. A detailed history regarding the pattern of injury was noted and ACL reconstruction was done using BT Bautograft with mini-arthrotomy and arthroscopic assisted ACL reconstruction. RESULTS The mean age of the study subjects was 30.6±7.3 years & majority were males. Majority of the ACL injury was sports related & was on the right knee. 64% underwent arthroscopic assisted ACL reconstruction & majority of them had normal range of motion of the knee. CONCLUSION Our present study concludes that most common age group involved was 20-30 years & ACL injury was more common among males. Patients with an early ACL reconstruction were more satisfied with the end result. Also, ACL reconstruction techniques using BTB auto graft leads to good ligamentous stability and function of the knee.

  20. Optimizing anterior en masse retraction with miniscrew anchorage.

    Science.gov (United States)

    Vibhute, Pavankumar Janardan

    2011-01-01

    In severely protrusive patients, skeletal anchorage from miniscrew is often used to avoid anchorage loss with preferred miniscrew location near centre of resistance (Cres) of posterior teeth. Biomechanical requirement for directing retraction force towards Cres of posterior teeth demands the insertion of miniscrew in loose mucosa, where risk of infection and failure increases. In addition, undesirable biomechanical side effects on anterior and posterior segments may be possible in all three planes, when continuous arch sliding mechanics are installed with miniscrew anchorage. This paper describes technique of molar-stabilizing power arm (MSPA) for simultaneous intrusion and retraction of anteriors with miniscrew placement at attached gingiva between 1st molar and 2nd premolar. Advantages of this technique include (i) the need of miniscrews placement in loose mucosa apically near the Cres of the posterior teeth is eliminated, (ii) the risk of infection and miniscrew failure is lowered since the miniscrew is placed in attached gingiva rather than the loose mucosa, and (iii) by adjusting vertical length or replacing MSPA, alteration of the retraction force vector is possible in all three planes; thus, need of removal and repositioning of the miniscrew (e.g., in correction of occlusal cant) can be eliminated. PMID:22567438