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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. 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.

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

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    Lehmann, Sebastian J; Scherberger, Hansjörg

    2015-01-01

    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. Mirror observation of finger action enhances activity in anterior intraparietal sulcus: a functional magnetic resonance imaging study.

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    Numata, Kenji; Murayama, Takashi; Takasugi, Jun; Monma, Masahiko; Oga, Masaru

    2013-01-01

    Mirror therapy can be used to promote recovery from paralysis in patients with post-stroke hemiplegia, There are a lot of reports that mirror-image observation of the unilateral moving hand enhanced the excitability of the primary motor area (M1) ipsilateral to the moving hand in healthy subjects. but the neural mechanisms underlying its therapeutic effects are currently unclear. To investigate this issue, we used functional magnetic resonance imaging to measure activity in brain regions related to visual information processing during mirror image movement observation. Thirteen healthy subjects performed a finger-thumb opposition task with the left and right hands separately, with or without access to mirror observation. In the mirror condition, one hand was reflected in a mirror placed above the abdomen in the MRI scanner. In the masked mirror condition, subjects performed the same task but with the mirror obscured. In both conditions, the other hand was held at rest behind the mirror. A between-task comparison (mirror versus masked mirror) revealed significant activation in the ipsilateral hemisphere in the anterior intraparietal sulcus (aIP) while performing all tasks, regardless of which hand was used. The right aIP was significantly activated while moving the right hand. In contrast, in the left aIP, a small number of voxels showed a tendency toward activation during both left and right hand movement. The enhancement of ipsilateral aIP activity by the mirror image observation of finger action suggests that bimodal aIP neurons can be activated by visual information. We propose that activation in the M1 ipsilateral to the moving hand can be induced by information passing through the ventral premotor area from the aIP.

  6. Surround suppression sharpens the priority map in the lateral intraparietal area.

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

    2010-09-22

    In the visual world, stimuli compete with each other for allocation of the brain's limited processing resources. Computational models routinely invoke wide-ranging mutually suppressive interactions in spatial priority maps to implement active competition for attentional and saccadic allocation, but such suppressive interactions have not been physiologically described, and their existence is controversial. Much evidence implicates the lateral intraparietal area as a candidate priority map in the macaque (Macaca mulatta). Here, we demonstrate that the responses of neurons in the lateral intraparietal area (LIP) to a task-irrelevant distractor are strongly suppressed when the monkey plans saccades to locations outside their receptive fields. Suppression can be evoked both by flashed visual stimuli and by a memorized saccade plan. The suppressive surrounds of LIP neurons are spatially tuned and wide ranging. Increasing the monkey's motivation enhances target-distractor discriminability by enhancing both distractor suppression and the saccade goal representation; these changes are accompanied by correlated improvements in behavioral performance.

  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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    Frank Bremmer

    2016-08-01

    Full Text Available Primates perform saccadic eye movements in order to bring the image of an interesting target onto the fovea. Compared to stationary targets, saccades towards 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 towards 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.

  9. Eye-centered visual receptive fields in the ventral intraparietal area.

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    Chen, Xiaodong; DeAngelis, Gregory C; Angelaki, Dora E

    2014-07-15

    The ventral intraparietal area (VIP) processes multisensory visual, vestibular, tactile, and auditory signals in diverse reference frames. We recently reported that visual heading signals in VIP are represented in an approximately eye-centered reference frame when measured using large-field optic flow stimuli. No VIP neuron was found to have head-centered visual heading tuning, and only a small proportion of cells had reference frames that were intermediate between eye- and head-centered. In contrast, previous studies using moving bar stimuli have reported that visual receptive fields (RFs) in VIP are head-centered for a substantial proportion of neurons. To examine whether these differences in previous findings might be due to the neuronal property examined (heading tuning vs. RF measurements) or the type of visual stimulus used (full-field optic flow vs. a single moving bar), we have quantitatively mapped visual RFs of VIP neurons using a large-field, multipatch, random-dot motion stimulus. By varying eye position relative to the head, we tested whether visual RFs in VIP are represented in head- or eye-centered reference frames. We found that the vast majority of VIP neurons have eye-centered RFs with only a single neuron classified as head-centered and a small minority classified as intermediate between eye- and head-centered. Our findings suggest that the spatial reference frames of visual responses in VIP may depend on the visual stimulation conditions used to measure RFs and might also be influenced by how attention is allocated during stimulus presentation.

  10. Face-infringement space: the frame of reference of the ventral intraparietal area.

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    McCollum, Gin; Klam, François; Graf, Werner

    2012-07-01

    Experimental studies have shown that responses of ventral intraparietal area (VIP) neurons specialize in head movements and the environment near the head. VIP neurons respond to visual, auditory, and tactile stimuli, smooth pursuit eye movements, and passive and active movements of the head. This study demonstrates mathematical structure on a higher organizational level created within VIP by the integration of a complete set of variables covering face-infringement. Rather than positing dynamics in an a priori defined coordinate system such as those of physical space, we assemble neuronal receptive fields to find out what space of variables VIP neurons together cover. Section 1 presents a view of neurons as multidimensional mathematical objects. Each VIP neuron occupies or is responsive to a region in a sensorimotor phase space, thus unifying variables relevant to the disparate sensory modalities and movements. Convergence on one neuron joins variables functionally, as space and time are joined in relativistic physics to form a unified spacetime. The space of position and motion together forms a neuronal phase space, bridging neurophysiology and the physics of face-infringement. After a brief review of the experimental literature, the neuronal phase space natural to VIP is sequentially characterized, based on experimental data. Responses of neurons indicate variables that may serve as axes of neural reference frames, and neuronal responses have been so used in this study. The space of sensory and movement variables covered by VIP receptive fields joins visual and auditory space to body-bound sensory modalities: somatosensation and the inertial senses. This joining of allocentric and egocentric modalities is in keeping with the known relationship of the parietal lobe to the sense of self in space and to hemineglect, in both humans and monkeys. Following this inductive step, variables are formalized in terms of the mathematics of graph theory to deduce which

  11. Overlapping activity periods in early visual cortex and posterior intraparietal area in conscious visual shape perception: a TMS study.

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    Koivisto, Mika; Lähteenmäki, Mikko; Kaasinen, Valtteri; Parkkola, Riitta; Railo, Henry

    2014-01-01

    Parietal cortex is often activated in brain imaging studies on conscious visual processing, but its causal role and timing in conscious and nonconscious perception are poorly understood. We studied the role of posterior intraparietal sulcus (IPS) and early visual areas (V1/V2) in conscious and nonconscious vision by interfering with their functioning with MRI-guided transcranial magnetic stimulation (TMS). The observers made binary forced-choice decisions concerning the shape or color of the metacontrast masked targets and rated the quality of their conscious perception. TMS was applied 30, 60, 90, or 120ms after stimulus-onset. In the shape discrimination task, TMS of V1/V2 impaired conscious perception at 60, 90, and 120ms and nonconscious perception at 90ms. TMS of IPS impaired only conscious shape perception, also around 90ms. Conscious color perception was facilitated or suppressed depending on the strength of the TMS-induced electric field in V1/V2 at 90ms. The results suggest that simultaneous activity in V1/V2 and IPS around 90ms is necessary for visual awareness of shape but not for nonconscious perception. The overlapping activity periods of IPS and V1/V2 may reflect recurrent interaction between parietal cortex and V1 in conscious shape perception.

  12. Mirror Observation of Finger Action Enhances Activity in Anterior Intraparietal Sulcus: A Functional Magnetic Resonance Imaging Study

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    Numata, Kenji; Murayama, Takashi; Takasugi, Jun; Monma, Masahiko; Oga, Masaru

    2013-01-01

    Mirror therapy can be used to promote recovery from paralysis in patients with post-stroke hemiplegia, There are a lot of reports that mirror-image observation of the unilateral moving hand enhanced the excitability of the primary motor area (M1) ipsilateral to the moving hand in healthy subjects. but the neural mechanisms underlying its therapeutic effects are currently unclear. To investigate this issue, we used functional magnetic resonance imaging to measure activity in brain regions rela...

  13. Multimodal convergence within the intraparietal sulcus of the macaque monkey.

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    Guipponi, Olivier; Wardak, Claire; Ibarrola, Danielle; Comte, Jean-Christophe; Sappey-Marinier, Dominique; Pinède, Serge; Ben Hamed, Suliann

    2013-02-27

    The parietal cortex is highly multimodal and plays a key role in the processing of objects and actions in space, both in human and nonhuman primates. Despite the accumulated knowledge in both species, we lack the following: (1) a general description of the multisensory convergence in this cortical region to situate sparser lesion and electrophysiological recording studies; and (2) a way to compare and extrapolate monkey data to human results. Here, we use functional magnetic resonance imaging (fMRI) in the monkey to provide a bridge between human and monkey studies. We focus on the intraparietal sulcus (IPS) and specifically probe its involvement in the processing of visual, tactile, and auditory moving stimuli around and toward the face. We describe three major findings: (1) the visual and tactile modalities are strongly represented and activate mostly nonoverlapping sectors within the IPS. The visual domain occupies its posterior two-thirds and the tactile modality its anterior one-third. The auditory modality is much less represented, mostly on the medial IPS bank. (2) Processing of the movement component of sensory stimuli is specific to the fundus of the IPS and coincides with the anatomical definition of monkey ventral intraparietal area (VIP). (3) A cortical sector within VIP processes movement around and toward the face independently of the sensory modality. This amodal representation of movement may be a key component in the construction of peripersonal space. Overall, our observations highlight strong homologies between macaque and human VIP organization.

  14. Functional organization of human intraparietal and frontal cortex for attending, looking, and pointing

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    Astafiev, Serguei V.; Shulman, Gordon L.; Stanley, Christine M.; Snyder, Abraham Z.; Van Essen, David C.; Corbetta, Maurizio

    2003-01-01

    We studied the functional organization of human posterior parietal and frontal cortex using functional magnetic resonance imaging (fMRI) to map preparatory signals for attending, looking, and pointing to a peripheral visual location. The human frontal eye field and two separate regions in the intraparietal sulcus were similarly recruited in all conditions, suggesting an attentional role that generalizes across response effectors. However, the preparation of a pointing movement selectively activated a different group of regions, suggesting a stronger role in motor planning. These regions were lateralized to the left hemisphere, activated by preparation of movements of either hand, and included the inferior and superior parietal lobule, precuneus, and posterior superior temporal sulcus, plus the dorsal premotor and anterior cingulate cortex anteriorly. Surface-based registration of macaque cortical areas onto the map of fMRI responses suggests a relatively good spatial correspondence between human and macaque parietal areas. In contrast, large interspecies differences were noted in the topography of frontal areas.

  15. Specialization of the Right Intraparietal Sulcus for Processing Mathematics During Development.

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    Schel, Margot A; Klingberg, Torkel

    2016-08-27

    Mathematical ability, especially perception of numbers and performance of arithmetics, is known to rely on the activation of intraparietal sulcus (IPS). However, reasoning ability and working memory, 2 highly associated abilities also activate partly overlapping regions. Most studies aimed at localizing mathematical function have used group averages, where individual variability is averaged out, thus confounding the anatomical specificity when localizing cognitive functions. Here, we analyze the functional anatomy of the intraparietal cortex by using individual analysis of subregions of IPS based on how they are structurally connected to frontal, parietal, and occipital cortex. Analysis of cortical thickness showed that the right anterior IPS, defined by its connections to the frontal lobe, was associated with both visuospatial working memory, and mathematics in 6-year-old children. This region specialized during development to be specifically related to mathematics, but not visuospatial working memory in adolescents and adults. This could be an example of interactive specialization, where interacting with the environment in combination with interactions between cortical regions leads from a more general role of right anterior IPS in spatial processing, to a specialization of this region for mathematics.

  16. Role of fusiform and anterior temporal cortical areas in facial recognition.

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    Nasr, Shahin; Tootell, Roger B H

    2012-11-15

    Recent fMRI studies suggest that cortical face processing extends well beyond the fusiform face area (FFA), including unspecified portions of the anterior temporal lobe. However, the exact location of such anterior temporal region(s), and their role during active face recognition, remain unclear. Here we demonstrate that (in addition to FFA) a small bilateral site in the anterior tip of the collateral sulcus ('AT'; the anterior temporal face patch) is selectively activated during recognition of faces but not houses (a non-face object). In contrast to the psychophysical prediction that inverted and contrast reversed faces are processed like other non-face objects, both FFA and AT (but not other visual areas) were also activated during recognition of inverted and contrast reversed faces. However, response accuracy was better correlated to recognition-driven activity in AT, compared to FFA. These data support a segregated, hierarchical model of face recognition processing, extending to the anterior temporal cortex.

  17. Development of a superior frontal-intraparietal network for visuo-spatial working memory.

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    Klingberg, Torkel

    2006-01-01

    Working memory capacity increases throughout childhood and adolescence, which is important for the development of a wide range of cognitive abilities, including complex reasoning. The spatial-span task, in which subjects retain information about the order and position of a number of objects, is a sensitive task to measure development of spatial working memory. This review considers results from previous neuroimaging studies investigating the neural correlates of this development. Older children and adolescents, with higher capacity, have been found to have higher brain activity in the intraparietal cortex and in the posterior part of the superior frontal sulcus, during the performance of working memory tasks. The structural maturation of white matter has been investigated by diffusion tensor magnetic resonance imaging (DTI). This has revealed several regions in the frontal lobes in which white matter maturation is correlated with the development of working memory. Among these is a superior fronto-parietal white matter region, located close to the grey matter regions that are implicated in the development of working memory. Furthermore, the degree of white matter maturation is positively correlated with the degree of cortical activation in the frontal and parietal regions. This suggests that during childhood and adolescence, there is development of networks related to specific cognitive functions, such as visuo-spatial working memory. These networks not only consist of cortical areas but also the white matter tracts connecting them. For visuo-spatial working memory, this network could consist of the superior frontal and intraparietal cortex.

  18. Interhemispheric Connections between the Primary Visual Cortical Areas via the Anterior Commissure in Human Callosal Agenesis.

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    van Meer, Nathalie; Houtman, Anne C; Van Schuerbeek, Peter; Vanderhasselt, Tim; Milleret, Chantal; Ten Tusscher, Marcel P

    2016-01-01

    Aim: In humans, images in the median plane of the head either fall on both nasal hemi-retinas or on both temporal hemi-retinas. Interhemispheric connections allow cortical cells to have receptive fields on opposite sides. The major interhemispheric connection, the corpus callosum, is implicated in central stereopsis and disparity detection in front of the fixation plane. Yet individuals with agenesis of the corpus callosum may show normal stereopsis and disparity vergence. We set out to study a possible interhemispheric connection between primary visual cortical areas via the anterior commissure to explain this inconsistency because of the major role of these cortical areas in elaborating 3D visual perception. Methods: MRI, DTI and tractography of the brain of a 53-year old man with complete callosal agenesis and normal binocular single vision was undertaken. Tractography seed points were placed in both the right and the left V1 and V2. Nine individuals with both an intact corpus callosum and normal binocularity served as controls. Results: Interhemispheric tracts through the anterior commissure linking both V1 and V2 visual cortical areas bilaterally were indeed shown in the subject with callosal agenesis. All other individuals showed interhemispheric visual connections through the corpus callosum only. Conclusion: Callosal agenesis may result in anomalous interhemispheric connections of the primary visual areas via the anterior commissure. It is proposed here that these connections form as alternative to the normal callosal pathway and may participate in binocularity.

  19. 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.

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

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    Jessica A. Collins

    2016-05-01

    Full Text Available 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 and the occipital face area, as well as a control region in early visual cortex. 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.1IntroductionOver a decade of neuroimaging work has characterized the neural basis of face perception and identified several nodes that preferentially respond to faces relative to other objects (Haxby, Hoffman, & Gobbini, 2000; Nancy Kanwisher & Yovel, 2006. Most of this work has focused on the fusiform face area (FFA and the occipital face area (OFA (Kanwisher, McDermott, & Chun, 1997; Kanwisher & Yovel, 2006; Pitcher, Walsh, Yovel, & Duchaine, 2007, however an emerging literature has implicated an anterior temporal face area, on the ventral surface of the right anterior temporal lobes (vATLs in or near perirhinal cortex, in facial processing (Avidan et al., 2013; Pinsk et al., 2009; Rajimehr, Young, & Tootell, 2009; Tsao

  1. 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.

  2. 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

  3. 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

  4. Differential influences of unilateral tDCS over the intraparietal cortex on numerical cognition

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    Christina eArtemenko

    2015-03-01

    Full Text Available Recent neuro-imaging research identified the bilateral intraparietal sulcus (IPS to be a key area associated with number processing. However, causal structure-function relationships are hard to evaluate from neuro-imaging techniques such as fMRI. Nevertheless, brain stimulation methods like transcranial direct current stimulation (tDCS allow for investigating the functional relevance of the IPS for number processing. Following up on a study using bilateral bi-cephalic tDCS over the IPS, the current study aimed at evaluating the differential lateralized functional contributions of the left and right IPS to number processing using unilateral bi-cephalic tDCS over either the left or right IPS. Results indicated a right lateralization for the processing of the place-value structure of the Arabic number system. Importantly, the processing of number magnitude information was not affected by unilateral IPS corroborating the assumption that number magnitude is processed in the bilateral IPS. Taken together, these data suggest that even though number magnitude is represented bilaterally, the left and right IPS seem to contribute differentially to numerical cognition with respect to the processing of specific other aspects of numerical information.

  5. Dorsal anterior cingulate cortex modulates supplementary motor area in coordinated unimanual motor behavior

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    Avisa eAsemi

    2015-06-01

    Full Text Available Motor control is integral to all types of human behavior, and the dorsal Anterior Cingulate Cortex (dACC is thought to play an important role in the brain network underlying motor control. Yet the role of the dACC in motor control is under-characterized. Here we aimed to characterize the dACC’s role in adolescent brain network interactions during a simple motor control task involving visually coordinated unimanual finger movements. Network interactions were assessed using both undirected and directed functional connectivity analysis of fMRI BOLD signals, comparing the task with a rest condition. The relation between the dACC and Supplementary Motor Area (SMA was compared to that between the dACC and Primary Motor Cortex (M1. The directed signal from dACC to SMA was significantly elevated during motor control in the task. By contrast, the directed signal from SMA to dACC, both directed signals between dACC and M1, and the undirected functional connections of dACC with SMA and M1, all did not differ between task and rest. Undirected coupling of dACC with both SMA and dACC, and only the dACC-to-SMA directed signal, were significantly greater for a proactive than a reactive task condition, suggesting that dACC plays a role in motor control by maintaining stimulus timing expectancy. Overall, these results suggest that the dACC selectively modulates the SMA during visually coordinated unimanual behavior in adolescence. The role of the dACC as an important brain area for the mediation of task-related motor control may be in place in adolescence, continuing into adulthood. The task and analytic approach described here should be extended to the study of healthy adults to examine network profiles of the dACC during basic motor behavior.

  6. The anterior insular cortex represents breaches of taste identity expectation.

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    Veldhuizen, Maria G; Douglas, Danielle; Aschenbrenner, Katja; Gitelman, Darren R; Small, Dana M

    2011-10-12

    Despite the importance of breaches of taste identity expectation for survival, its neural correlate is unknown. We used fMRI in 16 women to examine brain response to expected and unexpected receipt of sweet taste and tasteless/odorless solutions. During expected trials (70%), subjects heard "sweet" or "tasteless" and received the liquid indicated by the cue. During unexpected trials (30%), subjects heard sweet but received tasteless or they heard tasteless but received sweet. After delivery, subjects indicated stimulus identity by pressing a button. Reaction time was faster and more accurate after valid cuing, indicating that the cues altered expectancy as intended. Tasting unexpected versus expected stimuli resulted in greater deactivation in fusiform gyri, possibly reflecting greater suppression of visual object regions when orienting to, and identifying, an unexpected taste. Significantly greater activation to unexpected versus expected stimuli occurred in areas related to taste (thalamus, anterior insula), reward [ventral striatum (VS), orbitofrontal cortex], and attention [anterior cingulate cortex, inferior frontal gyrus, intraparietal sulcus (IPS)]. We also observed an interaction between stimulus and expectation in the anterior insula (primary taste cortex). Here response was greater for unexpected versus expected sweet compared with unexpected versus expected tasteless, indicating that this region is preferentially sensitive to breaches of taste expectation. Connectivity analyses confirmed that expectation enhanced network interactions, with IPS and VS influencing insular responses. We conclude that unexpected oral stimulation results in suppression of visual cortex and upregulation of sensory, attention, and reward regions to support orientation, identification, and learning about salient stimuli.

  7. Cortical activation by tactile stimulation to face and anterior neck areas: an fMRI study with three analytic methods.

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    Lin, Chou-Ching K; Sun, Yung-Nien; Huang, Chung-I; Yu, Chin-Yin; Ju, Ming-Shaung

    2010-12-01

    The main purpose of this study was to investigate the sensory cortical activation of the anterior neck region and the relationship between the neck and face representation areas. Functional MRI by blood oxygenation level dependent measurements was performed while tactile stimulation was applied to the face or neck area. Nonpainful tactile stimuli were manually delivered by an experimenter at a frequency of ∼1 Hz. Block (epoch) design was adopted with a block duration of 30 s and a whole run duration of 6 min. For each location, two runs were performed. After the image data were preprocessed, both parameteric and nonparametric methods were performed to test the group results. The results showed that (1) unilateral face or neck stimulation could elicit bilateral cortical activation, (2) mainly the face representation and face-hand junction areas, but not the conventional neck representation area, were activated by face or neck stimulation, and (3) the activation areas were larger when right face or neck was stimulated. In conclusion, the sensory cortical representation area of the anterior neck region was mainly at the junction of hand and face representation area and the activated area was larger when the right face or neck was stimulated.

  8. 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

  9. Developmental dyscalculia: compensatory mechanisms in left intraparietal regions in response to nonsymbolic magnitudes

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    Starke Marc

    2009-08-01

    Full Text Available Abstract Background Functional magnetic resonance imaging (fMRI studies investigating the neural mechanisms underlying developmental dyscalculia are scarce and results are thus far inconclusive. Main aim of the present study is to investigate the neural correlates of nonsymbolic number magnitude processing in children with and without dyscalculia. Methods 18 children (9 with dyscalculia were asked to solve a non-symbolic number magnitude comparison task (finger patterns during brain scanning. For the spatial control task identical stimuli were employed, instructions varying only (judgment of palm rotation. This design enabled us to present identical stimuli with identical visual processing requirements in the experimental and the control task. Moreover, because numerical and spatial processing relies on parietal brain regions, task-specific contrasts are expected to reveal true number-specific activations. Results Behavioral results during scanning reveal that despite comparable (almost at ceiling performance levels, task-specific activations were stronger in dyscalculic children in inferior parietal cortices bilaterally (intraparietal sulcus, supramarginal gyrus, extending to left angular gyrus. Interestingly, fMRI signal strengths reflected a group × task interaction: relative to baseline, controls produced significant deactivations in (intraparietal regions bilaterally in response to number but not spatial processing, while the opposite pattern emerged in dyscalculics. Moreover, beta weights in response to number processing differed significantly between groups in left – but not right – (intraparietal regions (becoming even positive in dyscalculic children. Conclusion Overall, findings are suggestive of (a less consistent neural activity in right (intraparietal regions upon processing nonsymbolic number magnitudes; and (b compensatory neural activity in left (intraparietal regions in developmental dyscalculia.

  10. 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.

  11. Esthetic rehabilitation of a severely compromised anterior area: combined periodontal and restorative approach.

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    Censi, Rachele; Vavassori, Virna; Borgonovo, Andrea Enrico; Re, Dino

    2014-01-01

    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.

  12. 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

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

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    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.

  14. 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

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

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    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.

  16. Separate evaluation of target facilitation and distractor suppression in the activity of macaque lateral intraparietal neurons during visual search.

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    Nishida, Satoshi; Tanaka, Tomohiro; Ogawa, Tadashi

    2013-12-01

    During visual search, neurons in the lateral intraparietal area (LIP) discriminate the target from distractors by exhibiting stronger activation when the target appears within the receptive field than when it appears outside the receptive field. It is generally thought that such target-discriminative activity is produced by the combination of target-related facilitation and distractor-related suppression. However, little is known about how the target-discriminative activity is constituted by these two types of neural modulation. To address this issue, we recorded activity from LIP of monkeys performing a visual search task that consisted of target-present and target-absent trials. Monkeys had to make a saccade to a target in the target-present trials, whereas they had to maintain fixation in the target-absent trials, in which only distractors were presented. By introducing the activity from the latter trials as neutral activity, we were able to separate the target-discriminative activity into target-related elevation and distractor-related reduction components. We found that the target-discriminative activity of most LIP neurons consisted of the combination of target-related elevation and distractor-related reduction or only target-related elevation. In contrast, target-discriminative activity composed of only distractor-related reduction was observed for very few neurons. We also found that, on average, target-related elevation was stronger and occurred earlier compared with distractor-related reduction. Finally, we consider possible underlying mechanisms, including lateral inhibitory interactions, responsible for target-discriminative activity in visual search. The present findings provide insight into how neuronal modulations shape target-discriminative activity during visual search.

  17. Distinct roles of the intraparietal sulcus and temporoparietal junction in attentional capture from distractor features: An individual differences approach.

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    Painter, David R; Dux, Paul E; Mattingley, Jason B

    2015-07-01

    Setting attention for an elementary visual feature, such as color or motion, results in greater spatial attentional "capture" from items with target compared with distractor features. Thus, capture is contingent on feature-based control settings. Neuroimaging studies suggest that this contingent attentional capture involves interactions between dorsal and ventral frontoparietal networks. To examine the distinct causal influences of these networks on contingent capture, we applied continuous theta-burst stimulation (cTBS) to alter neural excitability within the dorsal intraparietal sulcus (IPS), the ventral temporoparietal junction (TPJ) and a control site, visual area MT. Participants undertook an attentional capture task before and after stimulation, in which they made speeded responses to color-defined targets that were preceded by spatial cues in the target or distractor color. Cues appeared either at the target location (valid) or at a non-target location (invalid). Reaction times were slower for targets preceded by invalid compared with valid cues, demonstrating spatial attentional capture. Cues with the target color captured attention to a greater extent than those with the distractor color, consistent with contingent capture. Effects of cTBS were not evident at the group level, but emerged instead from analyses of individual differences. Target capture magnitude was positively correlated pre- and post-stimulation for all three cortical sites, suggesting that cTBS did not influence target capture. Conversely, distractor capture was positively correlated pre- and post-stimulation of MT, but uncorrelated for IPS and TPJ, suggesting that stimulation of IPS and TPJ selectively disrupted distractor capture. Additionally, the effects of IPS stimulation were predicted by pre-stimulation attentional capture, whereas the effects of TPJ stimulation were predicted by pre-stimulation distractor suppression. The results are consistent with the existence of distinct neural

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

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    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.

  19. 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

    1998-12-01

    Full Text Available 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 organization of actions involving the mediation of tools and utensils are strongly lateralized to the left hemisphere and that damage to the dominant intraparietal sulcus may be critical for the development of the clinical syndrome of conceptual apraxia.No presente artigo, reportamos os resultados de RMf da ativação cortical induzida por um paradigma de praxis de uso de ferramentas em seis pessoas dextras normais. A tarefa-controle consistiu de uma sequência de movimentos unimanuais complexos, mas desprovidos de significado. Um estudo completo de pantomima e controle foi feito para cada mão. O sulco intraparietal esquerdo foi a única estrutura ativada em todos os indivíduos, independentemente da mão utilizada. Esses achados, embora preliminares, indicam que a organização de ações mediadas por ferramentas e utensílios são fortemente lateralizadas para o hemisfério esquerdo nas pessoas normais, e sugerem que lesões na região do sulco intraparietal do hemisfério dominante são críticas para o aparecimento de apraxia conceitual.

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

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    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.

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

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    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.

  2. Connections between intraparietal sulcus and a sensorimotor network underpin sustained tactile attention.

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    Goltz, Dominique; Gundlach, Christopher; Nierhaus, Till; Villringer, Arno; Müller, Matthias; Pleger, Burkhard

    2015-05-20

    Previous studies on sustained tactile attention draw conclusions about underlying cortical networks by averaging over experimental conditions without considering attentional variance in single trials. This may have formed an imprecise picture of brain processes underpinning sustained tactile attention. In the present study, we simultaneously recorded EEG-fMRI and used modulations of steady-state somatosensory evoked potentials (SSSEPs) as a measure of attentional trial-by-trial variability. Therefore, frequency-tagged streams of vibrotactile stimulations were simultaneously presented to both index fingers. Human participants were cued to sustain attention to either the left or right finger stimulation and to press a button whenever they perceived a target pulse embedded in the to-be-attended stream. In-line with previous studies, a classical general linear model (GLM) analysis based on cued attention conditions revealed increased activity mainly in somatosensory and cerebellar regions. Yet, parametric modeling of the BOLD response using simultaneously recorded SSSEPs as a marker of attentional trial-by-trial variability quarried the intraparietal sulcus (IPS). The IPS in turn showed enhanced functional connectivity to a modality-unspecific attention network. However, this was only revealed on the basis of cued attention conditions in the classical GLM. By considering attentional variability as captured by SSSEPs, the IPS showed increased connectivity to a sensorimotor network, underpinning attentional selection processes between competing tactile stimuli and action choices (press a button or not). Thus, the current findings highlight the potential value by considering attentional variations in single trials and extend previous knowledge on the role of the IPS in tactile attention.

  3. 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

  4. 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.)

  5. 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.

  6. Opposing roles of the nucleus accumbens and anterior lateral hypothalamic area in the control of sexual behaviour in the male rat.

    Science.gov (United States)

    Kippin, Tod E; Sotiropoulos, Veneta; Badih, Julia; Pfaus, James G

    2004-02-01

    Opposing roles have been implicated for the nucleus accumbens (NAc) and anterior portion of the lateral hypothalamic area (aLHA) in the regulation of sexual behaviour in male rats based on in vivo neurochemical correlates. The present study provides functional evidence supporting this hypothesis by examining the effects of lesions to these structures on copulation, noncontact erection and receptive female preference. Sexually naïve male Long-Evans rats received either bilateral 1.0- micro L injections of NMDA (10 micro g/ micro L/side) or vehicle (shams) into either the aLHA or the NAc. During repeated tests of copulation most of the sham-lesioned males, but few of the aLHA-lesioned and NAc-lesioned males, copulated to ejaculation. Most of the NAc-lesioned males also failed to intromit, whereas the majority of the aLHA-lesioned males intromitted repeatedly. During exposure to an inaccessible receptive female behind a wire-mesh screen, aLHA-lesioned males displayed facilitation of noncontact erections, whereas NAc-lesioned males displayed impaired noncontact erections. Conversely, during simultaneous exposure to inaccessible receptive and nonreceptive females in different compartments, all males spent more time in the proximity of the receptive female. These findings indicate that the aLHA plays an inhibitory role in the regulation of sexual arousal and an excitatory role in the regulation of ejaculation. Conversely, the NAc plays an excitatory role in the regulation in sexual arousal.

  7. 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.

  8. Identification of atrophy of the subgenual anterior cingulate cortex, in particular the subcallosal area, as an effective auxiliary means of diagnosis for major depressive disorder

    Directory of Open Access Journals (Sweden)

    Niida A

    2012-08-01

    cingulate cortex (sACC on the z-score map obtained.Results: No significant difference in atrophy was noted between the left and right sACCs. The VSRAD advance used in the present study was more effective than the VSRAD plus for diagnosis of MDD, with a sensitivity of 90.7%, specificity of 86.7%, accuracy of 89.5%, a positive predictive value of 94.4%, and a negative predictive value of 78.8%. In particular, atrophy was observed in the subcallosal area of the sACC.Conclusion: The identification of atrophy in the sACC, in particular of the subcallosal area, with the use of updated voxel-based morphometric software proved to be effective as an auxiliary diagnostic method for MDD.Keywords: major depressive disorder, magnetic resonance imaging, subgenual anterior cingulate cortex, voxel-based morphometry, VSRAD

  9. Architectonic mapping of somatosensory areas involved in skilled forelimb movements and tool use.

    Science.gov (United States)

    Mayer, Andrei; Nascimento-Silva, Márcio L; Keher, Natalia B; Bittencourt-Navarrete, Ruben Ernesto; Gattass, Ricardo; Franca, João G

    2016-05-01

    Cebus monkeys stand out from other New World monkeys by their ability to perform fine hand movements, and by their spontaneous use of tools in the wild. Those behaviors rely on the integration of somatosensory information, which occurs in different areas of the parietal cortex. Although a few studies have examined and parceled the somatosensory areas of the cebus monkey, mainly using electrophysiological criteria, very little is known about its anatomical organization. In this study we used SMI-32 immunohistochemistry, myelin, and Nissl stains to characterize the architecture of the parietal cortical areas of cebus monkeys. Seven cortical areas were identified between the precentral gyrus and the anterior bank of the intraparietal sulcus. Except for areas 3a and 3b, distinction between different somatosensory areas was more evident in myelin-stained sections and SMI-32 immunohistochemistry than in Nissl stain, especially for area 2 and subdivisions of area 5. Our results show that cebus monkeys have a relatively complex somatosensory cortex, similar to that of macaques and humans. This suggests that, during primate evolution, the emergence of new somatosensory areas underpinned complex manual behaviors in most Old World simians and in the New World cebus monkey. J. Comp. Neurol. 524:1399-1423, 2016. © 2015 Wiley Periodicals, Inc.

  10. 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.

  11. Diffuse anterior retinoblastoma: current concepts

    Directory of Open Access Journals (Sweden)

    Yang J

    2015-07-01

    Full Text Available Jing Yang,1–3 Yalong Dang,1–3 Yu Zhu,1 Chun Zhang2,3 1Department of Ophthalmology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou City, Henan Province, 2Department of Ophthalmology, Peking University Third Hospital, 3Clinical Stem Cell Research Center, Peking University Third Hospital, Beijing, People’s Republic of China Abstract: Diffuse anterior retinoblastoma is a rare variant of retinoblastoma seeding in the area of the vitreous base and anterior chamber. Patients with diffuse anterior retinoblastoma are older than those with the classical types, with the mean age being 6.1 years. The original cells of diffuse anterior retinoblastoma are supposed to be cone precursor. Patients most commonly present with pseudouveitis, pseudohypopyon, and increased intraocular pressure. The retina under fundus examination is likely to be normal, and the clinical features mimic the inflammation progress, which can often lead to misdiagnosis. The published diffuse anterior retinoblastoma cases were diagnosed after fine-needle aspiration biopsy running the potential risk of inducing metastasis. The most common treatment for diffuse anterior retinoblastoma is enucleation followed by systematic chemotherapy according to the patient’s presentation and clinical course. This review summarizes the recent advances in etiology (including tumorigenesis and cell origin, pathology, diagnosis, differential diagnosis, and new treatment. The challenges of early diagnosis and prospects are also discussed. Keywords: pathology, microenvironment, treatment, diagnosis 

  12. 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.

  13. Mini-open anterior lumbar interbody fusion.

    Science.gov (United States)

    Gandhoke, Gurpreet S; Ricks, Christian; Tempel, Zachary; Zuckerbraun, Brian; Hamilton, D Kojo; Okonkwo, David O; Kanter, Adam S

    2016-07-01

    In deformity surgery, anterior lumbar interbody fusion provides excellent biomechanical support, creates a broad surface area for arthrodesis, and induces lordosis in the lower lumbar spine. Preoperative MRI, plain radiographs, and, when available, CT scan should be carefully assessed for sacral slope as it relates to pubic symphysis, position of the great vessels (especially at L4/5), disc space height, or contraindication to an anterior approach. This video demonstrates the steps in an anterior surgical procedure with minimal open exposure. The video can be found here: https://youtu.be/r3bC4_vu1hQ .

  14. Anterior Cruciate Ligament (ACL) Injuries

    Science.gov (United States)

    ... Week of Healthy Breakfasts Shyness Anterior Cruciate Ligament (ACL) Injuries KidsHealth > For Teens > Anterior Cruciate Ligament (ACL) ... and Recovery Coping With an ACL Injury About ACL Injuries A torn anterior cruciate ligament (ACL) is ...

  15. Anterior cervical plating

    Directory of Open Access Journals (Sweden)

    Gonugunta V

    2005-01-01

    Full Text Available Although anterior cervical instrumentation was initially used in cervical trauma, because of obvious benefits, indications for its use have been expanded over time to degenerative cases as well as tumor and infection of the cervical spine. Along with a threefold increase in incidence of cervical fusion surgery, implant designs have evolved over the last three decades. Observation of graft subsidence and phenomenon of stress shielding led to the development of the new generation dynamic anterior cervical plating systems. Anterior cervical plating does not conclusively improve clinical outcome of the patients, but certainly enhances the efficacy of autograft and allograft fusion and lessens the rate of pseudoarthrosis and kyphosis after multilevel discectomy and fusions. A review of biomechanics, surgical technique, indications, complications and results of various anterior cervical plating systems is presented here to enable clinicians to select the appropriate construct design.

  16. Bone mass change and aesthetic outcomes in the upper anterior tooth area after immediate-delayed implantation%上前牙区延期即刻种植后的骨量变化及美学影响

    Institute of Scientific and Technical Information of China (English)

    张宁; 姚希; 杜文华; 李红梅; 李昀生

    2015-01-01

    背景:拔牙后牙槽骨伴有冠根向和颊舌向大量的骨吸收,导致失牙区牙槽骨骨量明显不足;对种植初期的稳定性及修复后美学效果均有一定影响,严重影响种植义齿的远期成功率。因此,即刻种植技术可以缩短种植修复时间。目的:评价上颌前牙区行延期即刻种植及引导骨再生技术后种植修复效果。方法:选择19例(28颗缺牙)上颌前牙缺失伴唇侧单壁骨缺损患者,分别于拔牙后4周植入奥齿泰种植体28枚,唇侧骨缺损区种植同期采用引导骨再生技术,6个月后行二期修复。结果与结论:28枚种植体在24个月后,存留率100%。6个月后平均种植体周边缘骨高度丧失为0.1 mm,1年平均骨高度丧失为0.6 mm,2年平均骨高度丧失为0.11 mm。红色美学分值评分满意。在上颌前牙缺失伴轻度骨缺损延期即刻种植中采用引导骨再生技术可较好的恢复种植体周围骨高度和宽度,垂直向骨吸收稳定,牙龈美学效果满意。%BACKGROUND:A large amount of apicocoronal and buccolingual bone resorption occur in alveolar bone after tooth extraction, leading to the distinct shortage of bone mass of alveolar bone in tooth-missing area, which has a certain effect on the stability of early implantation and postoperative aesthetic outcomes and greatly affects the long-term success rate of denture implantation. Therefore, immediate-delayed implantation can shorten the time of repair. OBJECTIVE:To evaluate the effect of implant repair after immediate-delayed implantation and application of guided bone regeneration technique in anterior maxila area. METHODS:Nineteen patients (28 teeth lost) with maxilary anterior tooth loss and labial one-waled bone defects were selected. Twenty-eight OSSTEM implants were implanted at 4 weeks after tooth extraction. Guided bone regeneration technique was applied concurrently in labial bone defect area. The secondary repair was

  17. Efeito da área de secção do enxerto na cirurgia de reconstrução do ligamento cruzado anterior - estudo histológico em cães Effect of the grafting section area on the anterior cruciate ligament reconstruction surgery - histological study on dogs

    Directory of Open Access Journals (Sweden)

    Ricardo Violante Pereira

    2012-01-01

    Full Text Available OBJETIVO: Relacionar a área de secção inicial do enxerto com o resultado da cirurgia de reconstrução do LCA. Foram operados oito cães, divididos em dois grupos, de acordo com o tamanho do enxerto: grupo A - 25% e grupo B - 40% da largura do ligamento patelar (LP. MÉTODOS: Após oito meses, os cães foram sacrificados para análise macroscópica e histológica dos ligamentos reconstruídos, utilizando-se o joelho contralateral do cão como controle. RESULTADOS: Em ambos os grupos, todos os ligamentos reconstruídos apresentaram-se viáveis e hipertrofiados; o enxerto de LP teve sua morfologia alterada, verificada através da medida do crimp e da celularidade, assemelhando-se com a do LCA. CONCLUSÃO: A área de secção do enxerto não influenciou o resultado histológico da cirurgia de reconstrução do LCA em cães.OBJECTIVE: To correlate the initial grafting section area with the outcomes from anterior cruciate ligament (ACL reconstruction surgery. Eight dogs underwent operations, divided into two groups according to graft size: Group A, 25% and Group B, 40% of the patellar ligament (PL width. METHODS: After eight months, the dogs were sacrificed for macroscopic and histological analysis on the reconstructed ligaments. Each dog's contralateral knee was used as a control. RESULTS: In both groups, all the reconstructed ligaments were seen to be viable and hypertrophied. The morphology of the PL grafting had changed, which was observed by measuring the crimp and cellularity, and it resembled that of the ACL. CONCLUSION: The grafting section area did not influence the histological outcomes from ACL reconstruction surgery in dogs.

  18. 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

  19. 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

  20. Balanitis xerotica obliterans involving anterior urethra.

    Science.gov (United States)

    Herschorn, S; Colapinto, V

    1979-12-01

    Balanitis xerotica obliterans (BXO) is known to affect the urethral meatus, glans, and prepuce. We describe a case of biopsy-proved BXO that involves not only the usual areas but the anterior urethra as well. Of added interest is the subsequent development of squamous cell carcinoma in the fossa navicularis. The literature is reviewed.

  1. Anterior crucate ligament (ACL) injury

    Science.gov (United States)

    ... An anterior cruciate ligament injury is the over-stretching or tearing of the anterior cruciate ligament (ACL) ... may be injured. This is a medical emergency. Prevention Use proper techniques when playing sports or exercising. ...

  2. 前牙区牙龈组织的自我修复效果研究%Study on self-healing effect of anterior teeth area gingival soft tissue in clinical patients

    Institute of Scientific and Technical Information of China (English)

    程旭; 黄伟; 张志宏; 刘红红; 倪婧; 查大慧; 龚乃胜; 张燕

    2015-01-01

    Objective:The purpose of this study is to observe the self-healing effect of gingival soft tissue under the condition of keeping the residual roots in anterior teeth area. Method:16 patients,involving the residual roots or crowns in maxillary anterior teeth area (right maxillary central incisor) were included in the study. Grinding the residual roots or crowns to approximate alveolar ridge top level in subgingival margin and avoiding wearing gingival tissue were conducted for these 24 patients. The growth of gums were observed in the 10 th,20 th,30 th days after surgery,and then,the distance be-tween gingival papilla and adjacent regions spire and the distance between the modpoint of gingival margin and adjacent tooth spire were measured. All the statistical analyses for the experimental data measured were performed by SPSS 13.0 sta-tistical software. Result:Hyperplasia of the gum tissue in the 30 th day after surgery was nearly full of residual root fracture, and no color and texture difference was found between the gingival tissue and normal gingival. With the increasing of obser-vation time,the distance between gingival papilla and adjacent regions spire and the distance between the modpoint of gin-gival margin and adjacent tooth spire were much shorter,and the difference was statistically significant(F=11.502,P<0.001;F=26.088,P <0.001). Conclusion:Keeping the residual roots in clinic can make gingival have an ability of self-healing in the case of no damage.%目的:观察前牙区残根保留情况下牙龈组织的自我修复能力. 方法:上颌前牙区残根或残冠患者16例,将残根或残冠磨至龈缘下平齐牙槽嵴顶水平,避免磨损牙龈组织,术后第10、20、30 d观察牙龈生长情况,测量龈乳头至邻牙牙尖水平面的垂直距离、龈缘中点至邻牙牙尖水平面的垂直距离. 利用SPSS 13.0软件对测量的实验数据进行统计学分析. 结果:术后第30 d增生的软组织基本覆盖残根断面,且新生的

  3. Facetas em dentes anteriores

    OpenAIRE

    Veloso, Helena Rafaela Lourenço Martins

    2015-01-01

    Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária A presente revisão bibliográfica aborda as facetas estéticas em dentes anteriores, pela crescente valorização de um sorriso esteticamente agradável, facto que faz com que as pessoas procurem cada vez mais alternativas de tratamento para melhorar a aparência do seu sorriso. Os dentes anteriores são decisivos na aparência estética e, c...

  4. 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.

  5. [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.

  6. Intradural anterior transpetrosal approach.

    Science.gov (United States)

    Ichimura, Shinya; Hori, Satoshi; Hecht, Nils; Czabanka, Marcus; Vajkoczy, Peter

    2016-10-01

    The standard anterior transpetrosal approach (ATPA) for petroclival lesions is fundamentally an epidural approach and has been practiced for many decades quite successfully. However, this approach has some disadvantages, such as epidural venous bleeding around foramen ovale. We describe here our experience with a modified technique for anterior petrosectomy via an intradural approach that overcomes these disadvantages. Five patients with petroclival lesions underwent surgery via the intradural ATPA. The intraoperative hallmarks are detailed, and surgical results are reported. Total removal of the lesions was achieved in two patients with petroclival meningioma and two patients with pontine cavernoma, whereas subtotal removal was achieved in one patient with petroclival meningioma without significant morbidity. No patient experienced cerebrospinal fluid leakage. The intradural approach is allowed to tailor the extent of anterior petrosectomy to the individually required exposure, and the surgical procedure appeared to be more straightforward than via the epidural route. Caveats encountered with the approach were the temporal basal veins that could be spared as well as identification of the petrous apex due to the lack of familial epidural landmarks. The risk of injury to the temporal bridging veins is higher in this approach than in the epidural approach. Intradural approach is recommended in patients with a large epidural venous route, such as sphenobasal and sphenopetrosal vein. Navigation via bone-window computed tomography is useful to identify the petrous apex.

  7. 上海市青年人上前牙邻接触区和龈外展隙的形态研究%Proximal contact areas and gingival embrasures of the maxillary anterior dentition in Shanghai adolescents: a morphology study

    Institute of Scientific and Technical Information of China (English)

    厉超元; 丛磊

    2012-01-01

    Objective To investigate the morphology of proximal contact areas (PCA) and gingival embrasures of the maxillary anterior dentition in Shanghai adolescents, hoping to provide evidence for clinical treatment of maxillary anterior tooth esthetic restoration. Methods Totally 62 dental models of Shanghai adolescents with normal occlusion were collected with silicon rubber, and each case was scanned by Sirona inlab inEos Blue and measured by CAD/CAM bundled software. The collected data were analyzed by SPSS18.0 software. Results The mean proximal contact area proportion (PCAP) between central incisors (CI-Cl), central and lateral incisors (CI-LI), and lateral incisors and canines (U-CA) were (47. 7±5. 1)%, (34.6±5.0)%, and(24.2± 4.2)% in central incisor of square shape, (43.1±3.7)%, (31. 3±4.1)% and (22. 3±3.7)% in ovoid shape, and (38. 8±5. 3)%, (33.1±5.7)% and (23.2±3. 7)% in the tapered shape. Linear relation was found between PCA and clinic crown length of ipsilateral central incisor in the position of CI-CI and LI-CA in square and ovoid shapes. There were significant differences in the clinic crown length of central incisors (P<0. 01), midline papilla height (PH) (P<0. 01) and gingival embrasure angle (GEA) (P<0. 01) between different shapes of central incisor of square, ovoid, and tapering. Conclusion The shapes of central incisors are closely related to the PCAP, PH and GEA, which provides reference for clinical anterior and soft tissue restoratioa%目的 对上海市青年人不同牙形的上颌前牙邻接触区(PCA)和龈外展隙形态进行研究,为前牙美学修复的临床治疗提供依据.方法 选取上海市青年人62例作为研究对象,采用硅橡胶印模材法获取牙列模型,用Sirona inlab inEos Blue蓝光扫描仪扫描模型并测量,测量结果用SPSS 18.0软件进行统计分析.结果 三种牙体形态的上前牙邻接触区百分散(PCAP)比例:方圆形上前牙的中切牙与中切牙(CI-CI)、中切牙与侧切牙(CI

  8. Anterior knee pain

    Energy Technology Data Exchange (ETDEWEB)

    LLopis, Eva [Hospital de la Ribera, Alzira, Valencia (Spain) and Carretera de Corbera km 1, 46600 Alzira Valencia (Spain)]. E-mail: ellopis@hospital-ribera.com; Padron, Mario [Clinica Cemtro, Ventisquero de la Condesa no. 42, 28035 Madrid (Spain)]. E-mail: mario.padron@clinicacemtro.com

    2007-04-15

    Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries.

  9. 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 t...... modulated by angular disparity during the stimulus categorization task. These results suggest that at least for alphanumerical characters, areas implicated in mental rotation will only be called into action if the task requires a rotational transformation....

  10. Representation of accumulating evidence for a decision in two parietal areas.

    Science.gov (United States)

    de Lafuente, Victor; Jazayeri, Mehrdad; Shadlen, Michael N

    2015-03-11

    Decisions are often made by accumulating evidence for and against the alternatives. The momentary evidence represented by sensory neurons is accumulated by downstream structures to form a decision variable, linking the evolving decision to the formation of a motor plan. When decisions are communicated by eye movements, neurons in the lateral intraparietal area (LIP) represent the accumulation of evidence bearing on the potential targets for saccades. We now show that reach-related neurons from the medial intraparietal area (MIP) exhibit a gradual modulation of their firing rates consistent with the representation of an evolving decision variable. When decisions were communicated by saccades instead of reaches, decision-related activity was attenuated in MIP, whereas LIP neurons were active while monkeys communicated decisions by saccades or reaches. Thus, for decisions communicated by a hand movement, a parallel flow of sensory information is directed to parietal areas MIP and LIP during decision formation.

  11. Multidisciplinary management of anterior diastemata

    DEFF Research Database (Denmark)

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

    2007-01-01

    Anterior diastemata may compromise the harmony of a patient's smile. Consideration of etiologic factors, previous gingival conditioning, and individual treatment planning are essential in the proper management of anterior diastemata. An integrated orthodontic-restorative approach may enhance...... 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...

  12. 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.

  13. [Anterior cervical hypertrichosis: case report].

    Science.gov (United States)

    Orozco-Gutiérrez, Mario H; Sánchez-Corona, José; García-Ortiz, José E; Castañeda-Cisneros, Gema; Dávalos-Rodríguez, Nory O; Corona-Rivera, Jorge R; García-Cruz, Diana

    2016-10-01

    The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years.

  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. Inestabilidad Anterior de Hombro

    Directory of Open Access Journals (Sweden)

    Pablo David Flint Kuran

    2013-11-01

    Full Text Available In­tro­duc­ción La luxación recidivante de hombro es una patología frecuente en pacientes jóvenes, laboralmente activos. Existen numerosas técnicas quirúrgicas para la inestabilidad glenohumeral. La técnica de Bristow, discutida por no ser anatómica y por sus complicaciones, continúa vigente debido al bajo índice de reluxaciones. Los objetivos fueron determinar el índice de recidiva, alteraciones funcionales e índice de consolidación del injerto. Materiales­ y­ Métodos Se evaluaron 24 pacientes del sexo masculino, de entre 19 y 40 años, operados por luxación anterior recidivante de hombro según la técnica de Bristow, entre enero de 2003 y agosto de 2011. Se evaluó la tasa de reluxación, la función articular según el puntaje de Constant y el posicionamiento del injerto con respecto a la superficie articular con tomografía y radiografías para evaluar la consolidación del injerto. Se registraron las complicaciones quirúrgicas. Resultados ­Todos los pacientes eran hombres, con rango de edad de 19 a 40 años. La causa fue traumática en 24 pacientes. Dieciséis pacientes presentaron más de 3 episodios de luxación prequirúrgicos. Según la escala de Constant, 21 obtuvieron entre 96 y 100 puntos, y los restantes, entre 90 y 95 puntos. No hubo nuevos episodios de luxaciones. La tomografía mostró la consolidación en todos los casos. Un paciente tuvo una imagen osteolítica alrededor del tornillo, sin compromiso funcional del hombro. Conclusión La técnica de Bristow para tratar la luxación anterior recidivante de hombro provocó un bajo índice de complicaciones, con resultados funcionales entre excelentes y buenos. No hubo episodios de reluxación y se logró la consolidación del injerto óseo en todos los casos.

  16. 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

  17. Involuntary masturbation and hemiballismus after bilateral anterior cerebral artery infarction.

    Science.gov (United States)

    Bejot, Yannick; Caillier, Marie; Osseby, Guy-Victor; Didi, Roy; Ben Salem, Douraied; Moreau, Thibault; Giroud, Maurice

    2008-02-01

    Ischemia of the areas supplied by the anterior cerebral artery is relatively uncommon. In addition, combined hemiballismus and masturbation have rarely been reported in patients with cerebrovascular disease. We describe herein a 62-year-old right-handed man simultaneously exhibiting right side hemiballismus and involuntary masturbation with the left hand after bilateral infarction of the anterior cerebral artery territory. Right side hemiballismus was related to the disruption of afferent fibers from the left frontal lobe to the left subthalamic nucleus. Involuntary masturbation using the left hand was exclusively linked to a callosal type of alien hand syndrome secondary to infarction of the right side of the anterior corpus callosum. After 2 weeks, these abnormal behaviours were completely extinguished. This report stresses the wide diversity of clinical manifestations observed after infarction of the anterior cerebral artery territory.

  18. 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.

  19. 内镜经鼻腔入路治疗前颅底中线区和鞍上病变的解剖学观察%An anatomical observation of endoscopic endonasal approach for the lesions of midline anterior skull base area and suprasellar

    Institute of Scientific and Technical Information of China (English)

    陶超; 殷敏; 顾培元; 魏栋; 陈功; 许洪升; 程雷; 胡卫星

    2011-01-01

    目的 观察内镜经鼻腔人路手术治疗前颅底中线区和鞍上病变的解剖学特点.方法 在10例成人尸头标本上模拟内镜下经鼻腔至前颅底中线区和鞍上的手术入路.采用经双鼻孔-鼻中隔黏膜间入路,前、后组筛窦和双侧上、中鼻甲根据需要决定是否切除.研究该人路下的手术可及范围、路径、各区域的解剖特点,确立术中具有指导意义的解剖标志等.结果 以两侧颈内动脉-视神经隐窝(OCR)的连线定位,在鞍结节、蝶骨平台处磨开骨质,可暴露前达额窦、两侧达眶内侧壁的整个前颅底中线区域,向鞍上可以显露鞍上池、视交叉池、终板池及其内的重要组织结构,并可经终板进入第三脑室.测定了鼻小柱至蝶窦口、鞍底、鞍结节、OCR内缘、筛后动脉、筛前动脉的距离,两侧OCR内缘间的距离.结论 内镜下经鼻腔入路视角明显扩大,手术可及范围得到极大扩展,且具有可以直接到达病变区域、避免对脑组织、血管的牵拉等优点.%Objective To study the anatomical features of endoscopic endonasal approach for the lesions of midline anterior skull base area and suprasellar. Methods Ten human cadaver heads were dissected to perform the endoscopic endonasal approach for the lesions of midline anterior skull base area and suprasellar. A route through two nostrils and nasal septum mucosa was taken. The anterior and posterior ethmoid sinus, superior and middle turbinate suposed to be selectively removed as needed. The anatomical landmarks useful in guiding surgery through this approach were recorded.Results After making a line between two sides of the optocarotid recess (OCR), the skull base bone was opened in the tuberculum sellae and sphenoid platform. And then the midline anterior skull base area was exposed including both sides of the medial orbital wall and the frontal sinus. In the suprasellar area, the suprasellar cistern, cistern of the lamina

  20. 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

  1. 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.

  2. 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.

  3. 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).

  4. 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.

  5. Anterior cruciate ligament - updating article

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius Malheiros Luzo

    2016-08-01

    Full Text Available ABSTRACT 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.

  6. 前路钛板加方形区螺钉治疗髋臼双柱骨折的坐位生物力学分析%Biomechanical analysis of sitting position in both-column acetabular fractures fixed by anterior plate-screws in quadrilateral area

    Institute of Scientific and Technical Information of China (English)

    吴咏德; 蔡贤华; 刘曦明; 张红喜

    2013-01-01

    目的 探讨前路钛板加方形区螺钉治疗髋臼双柱骨折早期取坐位的可能性.方法 取成年防腐保湿处理的全骨盆标本6具,保留韧带及髋关节囊,制作单侧髋臼高位双柱骨折模型,随机先后采用前路钛板加方形区螺钉(B组)或常规钛板加1/3管型钛板(C组)内固定,固定标本于ZWICKZ100电子万能材料试验机上,模拟坐立位以400~700N加载,采用循环多次测量的方法,每组含标本6具,先后测定完整骨盆(A组)、B组及C组后柱内壁横向位移、骨盆轴向位移,计算骨盆轴向刚度.结果 随着载荷增加,位移:A组0.05),骨盆轴向位移及刚度有统计学差异(P0.05) ,while the difference of the axial displacement and the stiffness in pelvis were markedly significant (P <0.01).Conclusion The both-eolumn acetabular fractures fixed by anterior titanium plate-screws in quadrilateral area or the conventional 1/3 tube type titanium plate has the ideal internal result which allows patients to take the seat early ,but "anterior titanium plate-screws in quadrilateral area" is better than the conventional 1/3 tube type titanium plate on the stability of the hip joint ,which is close to the stability of normal pelvis.Sitting early is more secure and reliable in anterior titanium plate -screws in quadrilateral area.

  7. 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.

  8. Primary treatment of the anterior vocal commissure squamous carcinoma

    NARCIS (Netherlands)

    Bradley, Patrick J.; Rinaldo, Alessandra; Suarez, Carlos; Shaha, Ashok R.; Leemans, C. Rene; Langendijk, Johannes A.; Patel, Snehal G.; Ferlito, Alfio

    2006-01-01

    Squamous cell carcinoma may involve the anterior commissure (AC) area of the laryngeal glottis, and can be grouped morphologically into four groups; (1) tumor confined to the AC, (2) tumor involving one cord and the AC, (3) tumor involving the AC and a portion of both vocal cords, and (4) tumor invo

  9. Usurering af osteosyntesemateriale gennem øsofagus efter anterior cervikalkirurgi

    DEFF Research Database (Denmark)

    Wiis, Julie Therese; Nittby, Henrietta Carolina; Lauritsen, Anne Oberg

    2014-01-01

    The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal perforation, occurs after surgical trauma or due to erosion by migrating hardware. Symptoms are hoarseness, dysphagia, neck/throat pain, subcutaneous emphysema and fever. Imaging and endoscopic diagnosis...... can give false negative results. We present a case of a 74-year-old male, who was readmitted with sepsis and abscess in the operation area three weeks after anterior cervical surgery. Veillonella parvula was found in the abscess material and computed tomography confirmed the diagnosis of oesophageal...

  10. Fenestration of the anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Ito, J.; Washiyama, K.; Hong, K.C.; Ibuchi, Y.

    1981-08-01

    Three cases of angiographically demonstrated fenestration of the anterior cerebral artery are reported. Fenestration occurred at the medial half of the horizontal segment of the anterior cerebral artery in all cases. Its embryology and clinical significance are briefly discussed, and the anatomical and radiological literature on fenestration of the anterior cerebral artery is reviewed.

  11. 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...

  12. 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.

  13. Relationship between gingival thickness and the underlying bone thickness in maxillary anterior tooth area%牙龈厚度与上前牙唇侧骨板厚度的相关性研究

    Institute of Scientific and Technical Information of China (English)

    林璐; 何平华; 苏莎; 宗娟娟

    2016-01-01

    Objective:To study the relationship between gingival thickness(GT)and the underlying alveolar bone thickness(BT)in maxillary anterior region and the distance from cemento-enamel junction(CEJ)to alveolar crest.Methods:30 young volunteers with healthy gingiva were included.GT was measured at 2mm below the CEJ,buccal BT were measured at 3 locations:2,4 and 6 mm below the alveolar crest respectively,the distance from CEJ to alveolar crest were measured by CBCT and clinical direct measure respectively. Results:The correlation coefficient (r)values between GT and BT at 2,4 and 6 mm below alveolar crest were 0.493,0.383 and 0.342 (P <0.001 )respectively,the r value between GT and the distance from CEJ to alveolar crest was -0.21 3(P <0.01 ).No statistically significant difference was observed between CBCT and clinical measurements(t =-0.521 ,P =0.603).Conclusion:There is positive correlation between GT and BT at 2,4 and 6 mm below alveolar crest and negative relation between GT and the distance from CEJ to alveolar crest.%目的:测量分析上前牙牙龈厚度与唇侧骨板厚度及牙槽嵴顶到釉牙骨质界距离的相关性。方法:对30位青年受试者用间接显影法进行 CBCT 扫描,测量并记录以下数据并进行统计分析:龈缘下2 mm 牙龈厚度,牙槽嵴顶下2、4、6 mm 骨板厚度,牙槽嵴顶到釉牙骨质界的距离。CBCT 测量的准确性用直接测量法进行检测。结果:牙龈厚度与牙槽嵴顶下2、4、6 mm 处骨板厚度相关系数(r)分别为0.493、0.383、0.342(P <0.001),牙龈厚度与牙槽嵴顶至釉牙骨质界距离相关系数(r)为-0.213(P <0.01)。CBCT 扫描法测量与直接测量法之间差异无统计学意义(t =-0.521,P =0.603)结论:上前牙唇侧中央牙龈厚度与对应牙槽骨骨板厚度正相关,与牙槽嵴顶到釉牙骨质界的距离呈负相关。

  14. 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.

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. Anterior urethral diverticulum: A rare presentation

    Directory of Open Access Journals (Sweden)

    Annavarupu Gopalkrishna

    2016-01-01

    Full Text Available Congenital anomalies of the urogenital tract are the most common anomalies found in the foetus, neonates and infants, but anterior urethral valves and diverticula are rare. Here, we present a case with congenital anterior urethral diverticulum associated with patent ductus arteriosus and polydactyly.

  20. 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.

  1. 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.

  2. Anterior cervical hypertrichosis: a sporadic case.

    Science.gov (United States)

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-03-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature.

  3. Differential Effects of Two Rehabilitation Programs Following Anterior Cruciate Ligament Reconstruction

    DEFF Research Database (Denmark)

    Setuain, Igor; Izquierdo, Mikel; Idoate, Fernando

    2017-01-01

    Context- The muscular function restoration related to the type of physical rehabilitation followed after anterior cruciate ligament reconstruction (ACLR) using autologous hamstring tendon graft in terms of strength and cross sectional area (CSA) remain controversial. Objective- To analyze the CSA...... to persist in both rehabilitation groups. However, OCBR after ACLR lead to substantial gains on maximal knee flexor strength and ensured more symmetrical anterior-posterior laxity levels at the knee joint....

  4. Anterior hippocampus and goal-directed spatial decision making.

    Science.gov (United States)

    Viard, Armelle; Doeller, Christian F; Hartley, Tom; Bird, Chris M; Burgess, Neil

    2011-03-23

    Planning spatial paths through our environment is an important part of everyday life and is supported by a neural system including the hippocampus and prefrontal cortex. Here we investigated the precise functional roles of the components of this system in humans by using fMRI as participants performed a simple goal-directed route-planning task. Participants had to choose the shorter of two routes to a goal in a visual scene that might contain a barrier blocking the most direct route, requiring a detour, or might be obscured by a curtain, requiring memory for the scene. The participant's start position was varied to parametrically manipulate their proximity to the goal and the difference in length of the two routes. Activity in medial prefrontal cortex, precuneus, and left posterior parietal cortex was associated with detour planning, regardless of difficulty, whereas activity in parahippocampal gyrus was associated with remembering the spatial layout of the visual scene. Activity in bilateral anterior hippocampal formation showed a strong increase the closer the start position was to the goal, together with medial prefrontal, medial and posterior parietal cortices. Our results are consistent with computational models in which goal proximity is used to guide subsequent navigation and with the association of anterior hippocampal areas with nonspatial functions such as arousal and reward expectancy. They illustrate how spatial and nonspatial functions combine within the anterior hippocampus, and how these functions interact with parahippocampal, parietal, and prefrontal areas in decision making and mnemonic function.

  5. 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...... palpating for intercostal tenderness or tenderness in the minor and major pectoral muscles in a population of patients with and without chest pain. This may hamper the ability of clinicians to diagnose and classify the musculoskeletal component of chest pain if based exclusively on palpation of the anterior...

  6. How I do it: Anterior pull-through tympanoplasty for anterior eardrum perforations.

    Science.gov (United States)

    Harris, Jeffrey P; Wong, Yu-Tung; Yang, Tzong-Hann; Miller, Mia

    2016-01-01

    Conclusions This technique is offered as a convenient and reliable method for cases with anterior TM perforation and inadequate anterior remnant. Objectives Chronic otitis media surgery is one of the most common procedures in otology. Anterior tympanic membrane (TM) perforation with inadequate anterior remnant is associated with higher rates of graft failure. It was the goal of this series to evaluate the anatomical and functional outcomes of a modified underlay myringoplasty technique-the anterior pull-through method. Materials and methods In a retrospective clinical study, 13 patients with anterior TM perforations with inadequate anterior remnants underwent tympanoplasty with anterior pull-through technique. The anterior tip of the temporalis fascia was pulled through and secured in a short incision lateral to the anterior part of the annulus. Data on graft take rate, pre-operative, and post-operative hearing status were analyzed. Results A graft success rate of 84.6% (11 out of 13) was achieved, without lateralization, blunting, atelectasia, or epithelial pearls. The air-bone gap was 21.5 ± 6.8 dB before intervention and 11.75 ± 5.7 dB after surgery (p = 0.003).

  7. 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.

  8. 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

  9. 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.

  10. Head positioning for anterior circulation aneurysms microsurgery

    Directory of Open Access Journals (Sweden)

    Feres Chaddad-Neto

    2014-11-01

    Full Text Available Objective To study the ideal patient's head positioning for the anterior circulation aneurysms microsurgery. Method We divided the study in two parts. Firstly, 10 fresh cadaveric heads were positioned and dissected in order to ideally expose the anterior circulation aneurysm sites. Afterwards, 110 patients were submitted to anterior circulation aneurysms microsurgery. During the surgery, the patient's head was positioned accordingly to the aneurysm location and the results from the cadaveric study. The effectiveness of the position was noted. Results We could determine mainly two patterns for head positioning for the anterior circulation aneurysms. Conclusion The best surgical exposure is related to specific head positions. The proper angle of microscopic view may minimize neurovascular injury and brain retraction.

  11. Upper anterior zone restoration with composites

    OpenAIRE

    Lamas Lara, César; CD, Docente del Área de Operatoria Dental y Endodoncia de la Facultad de Odontología de la UNMSM.; Angulo de la Vega, Giselle; CD, Alumna de la Especialidad de Rehabilitación Oral de la Facultad de Odontología de la UNMSM.

    2014-01-01

    The anterior sector problems are very common in our professional practice and became vital importance to make a suitable rehabilitation in these cases; we can not do a good rehabilitation if we do not know the basic characteristics, both aesthetic and functional. Today the composites are a valid alternative for the restoration of the anterior sector, since they offer to us a conservative and aesthetic possibility, but independently of the material to use we have to based on certain rules or p...

  12. 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

  13. 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.

  14. 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.

  15. Reduced event-related current density in the anterior cingulate cortex in schizophrenia.

    Science.gov (United States)

    Mulert, C; Gallinat, J; Pascual-Marqui, R; Dorn, H; Frick, K; Schlattmann, P; Mientus, S; Herrmann, W M; Winterer, G

    2001-04-01

    There is good evidence from neuroanatomic postmortem and functional imaging studies that dysfunction of the anterior cingulate cortex plays a prominent role in the pathophysiology of schizophrenia. So far, no electrophysiological localization study has been performed to investigate this deficit. We investigated 18 drug-free schizophrenic patients and 25 normal subjects with an auditory choice reaction task and measured event-related activity with 19 electrodes. Estimation of the current source density distribution in Talairach space was performed with low-resolution electromagnetic tomography (LORETA). In normals, we could differentiate between an early event-related potential peak of the N1 (90-100 ms) and a later N1 peak (120-130 ms). Subsequent current-density LORETA analysis in Talairach space showed increased activity in the auditory cortex area during the first N1 peak and increased activity in the anterior cingulate gyrus during the second N1 peak. No activation difference was observed in the auditory cortex between normals and patients with schizophrenia. However, schizophrenics showed significantly less anterior cingulate gyrus activation and slowed reaction times. Our results confirm previous findings of an electrical source in the anterior cingulate and an anterior cingulate dysfunction in schizophrenics. Our data also suggest that anterior cingulate function in schizophrenics is disturbed at a relatively early time point in the information-processing stream (100-140 ms poststimulus).

  16. 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

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

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    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.

  18. Anterior ischemic optic neuropathy following dengue fever.

    Science.gov (United States)

    Ramakrishnan, Reshma; Shrivastava, Saurabh; Deshpande, Shrikant; Patkar, Priyanka

    2016-01-01

    Dengue fever is caused by a flavivirus. This infection is endemic in the tropics and warm temperate regions of the world. Ocular manifestations of dengue fever include subconjunctival, vitreous, and retinal haemorrhages; posterior uveitis; optic neuritis; and maculopathies, haemorrhage, and oedema. However anterior ischemic optic neuropathy is a rare presentation. Optic nerve ischemia most frequently occurs at the optic nerve head, where structural crowding of nerve fibers and reduction of the vascular supply may combine to impair perfusion to a critical degree and produce optic disc oedema. Here we present a case of anterior ischemic optic neurapathy associated with dengue fever.

  19. Study of aqueous humour in anterior uveitis

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    Kalsy Jairaj

    1990-01-01

    Full Text Available Aetiological diagnosis of anterior uveitis was made clinically and substantiated with relevant investigations. Aqueous humour obtained under aseptic conditions, was analyzed for the cells study, culture and protein profile, using polyacrylamide gel electrophoresis. The results were analysed with the help of known clinical facts. Culture and smears were invariably negative, while the lymphocytes were present in varying numbers, polymorphs and macrophages afforded a useful clue for confirmatory diagnosis. The electrophoretic pattern of the proteins was related to the duration of the disease and was same in a group while it was distinctive among different groups of anterior uveitis.

  20. ANTERIOR OSTEOPHYTE IDENTIFICATION IN CERVICAL VERTEBRAE

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    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.

  1. Dual (type IV left anterior descending artery

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    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.

  2. PES and WES evaluation of CAD/CAM custom abutments and all ceramic crowns in the anterior teeth area%红、白美学评价 CAD/CAM 个性化基台与全瓷冠在前牙区的应用

    Institute of Scientific and Technical Information of China (English)

    张晓真; 周国兴; 戴文雍; 赵毅; 邱憬; 王洁; 汤春波

    2013-01-01

    Objective:To investigate the clinic application of computer aided design&computer aided manufacturing ( CAD/CAM) custom abutments and all ceramic crowns and evaluate their esthetic effect in the anterior teeth area according to the assessment criteria Pink Esthetic Score ( PES ) and White Esthetic Score ( WES ) .Methods:Totally 73 CAD/CAM custom abutments and all ceramic crowns were used in 51 implant-supported prosthesis cases .The esthetic prosthetic effect was evaluated according to the assessment cri-teria PES and WES.Results:The 3-month-follow-up results of totally 73 CAD/CAM custom abutments and all ceramic crowns of 51 pa-tients:the percentage of the PES scores of 10,8-9,6-7 and≤5 was 9.59%,71.23%,17.81%,and 1.37%,respectively;the percent-age of the WES scores of 10,8-9,6-7 and ≤5 was 39.73%,60.27%,0%,and 0%,respectively.The 6-month-follow-up results: the percentage of the PES scores of 10,8-9,6-7 and≤5 was 8.22%,69.86%,17.81%,and 4.11%,respectively;the percentage of the WES scores of 10,8-9,6-7 and≤5 was 36.99%,61.64%,1.37%,and 0%,respectively.The 1-year-follow-up results:the percentage of the PES scores of 10,8-9,6-7 and≤5 was 5.48%,68.49%,20.55%,and 5.48%,respectively;the percentage of the WES scores of 10,8-9,6-7 and ≤5 was 31.51%,64.38%,4.11%,and 0%,respectively.During the follow-up of 1 to 3 years,there was only one abutment got fractured when the torque control was installed ,and one loosened during observation .In all cases,the gingivae were in healthy condition ,and no further obvious gingival retreat or periimplantitis occurred .Conclusions:PES and WES are objective ,integrat-ed and comparable .CAD/CAM custom abutments and all ceramic crowns have good biocompatibility and chemical stability ,and can be more widely used in the anterior teeth area .However,their long term effects need to be confirmed by further follow-up.%目的:研究计算机辅助设计及计算机辅助制作( CAD/CAM )个性化基台及全瓷冠的临床

  3. 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

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

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    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

  5. 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.

  6. Causes of anterior cruciate ligament injuries

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    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.

  7. 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

  8. 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...

  9. 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

  10. 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

  11. 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...

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

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    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.

  13. Dynamic changes in optic disc morphology, choroidal thickness, anterior chamber parameters, and intraocular pressure during Valsalva maneuver

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    Alper Mete

    Full Text Available ABSTRACT Purpose: To investigate the effects of the Valsalva maneuver (VM on optic disc morphology, choroidal thickness, and anterior chamber parameters. Methods: This prospective observational study included 60 eyes of 60 healthy subjects. The anterior chamber parameters, including central corneal thickness (CCT, anterior chamber depth (ACD, anterior chamber angle (ACA, anterior chamber volume (ACV, pupil diameter (PD, axial length (AL, subfoveal and peripapillary choroidal thickness, optic disc parameters, and intraocular pressure (IOP, were measured at rest and during VM. Results: VM did not have any significant influence on AL, subfoveal and peripapillary choroidal thickness, optic disc area, rim area, cup area, cup-to-disc area ratio, vertical cup-to-disc ratio, rim volume, cup volume, and nerve head volume measurements (for all; p >0.05. IOP and PD significantly increased during VM (for both; p <0.001. VM significantly decreased CCT, ACD, ACA, and ACV values (for all; p <0.001. Moreover, the optic nerve cup volume decreased and the horizontal cup-to-disc ratio significantly increased during VM (for both; p <0.05. Conclusions: VM may cause transient changes in IOP, optic disc morphology, and anterior chamber parameters.

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

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    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.

  15. 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.

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

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    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.

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. Current approach in diagnosis and management of anterior uveitis

    Directory of Open Access Journals (Sweden)

    Agrawal Rupesh

    2010-01-01

    Full Text Available 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 appropriately. The present article will assist ophthalmologists in accurately diagnosing anterior uveitis, improving the quality of care rendered to patients with anterior uveitis, minimizing the adverse effects of anterior uveitis, developing a decision-making strategy for management of patients at risk of permanent visual loss from anterior uveitis, informing and educating patients and other healthcare practitioners about the visual complications, risk factors, and treatment options associated with anterior uveitis.

  2. Surgical Management of Intramyocardial Left Anterior Descending Artery.

    Science.gov (United States)

    De Salvatore, Sergio; Segreto, Antonio; Chiusaroli, Alessandro; Congiu, Stefano; Bizzarri, Federico

    2015-11-01

    An intramyocardial left anterior descending artery can be found in up to 30% of patients undergoing coronary artery bypass graft procedures. We review the various techniques available to identify an intramyocardial left anterior descending artery.

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

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    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.

  4. Effect of prolonged bed rest on the anterior hip muscles.

    Science.gov (United States)

    Dilani Mendis, M; Hides, Julie A; Wilson, Stephen J; Grimaldi, Alison; Belavý, Daniel L; Stanton, Warren; Felsenberg, Dieter; Rittweger, Joern; Richardson, Carolyn

    2009-11-01

    Prolonged bed rest and inactivity is known to cause muscular atrophy with previous research indicating that muscles involved in joint stabilisation are more susceptible. The anterior hip muscles are important for hip joint function and stability but little is known about the effects of prolonged inactivity on their function. This study investigated the effect of prolonged bed rest on the size of the anterior hip muscles and their pattern of recovery. The effect of resistive vibration exercise (RVE) as a countermeasure to muscle atrophy was also investigated. 12 male participants, randomly assigned to either a control or an exercise group, underwent 8 weeks of bed rest with 6 months follow-up. Changes in muscle cross-sectional area (CSA) of the iliacus, psoas, iliopsoas, sartorius and rectus femoris muscles were measured by magnetic resonance imaging at regular intervals during bed rest and recovery phases. CSAs of iliopsoas and sartorius decreased at the hip joint (piliacus, psoas, and rectus femoris CSAs were unchanged (p>0.05). No significant difference was found between the two groups for all muscles (all p>0.1), suggesting inefficacy of the countermeasure in this sample. These findings suggest that prolonged bed rest can result in the atrophy of specific muscles across the hip joint which may affect its stability and function.

  5. 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.

  6. Anterior diffuse scleritis diagnosed as conjunctivitis

    Directory of Open Access Journals (Sweden)

    K. P. Mashige

    2012-12-01

    Full Text Available This article presents a case of anterior diffuse scleritis that initially was diagnosed as conjunctivitis. Anterior diffuse scleritis (ADS is a potentially vision-threatening inflammation of the sclera whose etiology may include autoimmune and systemic conditions such as rheumatoid arthritis and tuberculosis. The signs and symptoms of ADS include pain, tearing, tenderness, redness, painful sensitivity to light and decreased visual acuity. Ocular and physical examinations including blood tests to rule out underlying causes are important. Medications such as corticosteroids, non-steroidal anti-inflam-matory drugs and possibly immune-suppressants are used in the management of ADS. If care is not taken, ADS can be mis-diagnosed as conjunctivitis because the redness is similar in both conditions. Such mis-diagnosis can be sight-threatening and therefore it is essential that primary eye care practitioners are cautious in all diagnoses of red eye conditions. (S Afr Optom 2012 71(1 51-54

  7. Cataract Surgery in Anterior Megalophthalmos: A Review

    Science.gov (United States)

    GALVIS, Virgilio; TELLO, Alejandro; M. RANGEL, Carlos

    2015-01-01

    Anterior megalophthalmos is characterized by megalocornea associated with a very broad anterior chamber and ciliary ring elongation. It is also called X-linked megalocornea. It is accompanied by early development of cataracts, zonular anomalies, and, rarely, vitreoretinal disorders. Subluxation of a cataract can occur in cataract surgery because of zonular weakness. In addition, in most patients, standard intraocular lens (IOL) decentration is a risk because of the enlarged sulcus and capsular bag. These unique circumstances make cataract surgery challenging. To date, several approaches have been developed. Implantation of a retropupillary iris-claw aphakic intraocular lens may be a good option because it is easier than suturing the IOL and can have better and more stable anatomic and visual outcomes, compared to other techniques. PMID:27350950

  8. [Esthetic restorations of primary anterior teeth].

    Science.gov (United States)

    Elqadir, A Jamil; Shapira, J; Ziskind, K; Ram, D

    2013-04-01

    Esthetic treatment of primary teeth is one of the greatest challenges to pediatric dentists. A variety of restorative options using full coverage are available for anterior primary teeth. In the last half century the emphasis on treatment of severely decayed primary teeth shifted from extraction to restoration. In the past, restorations consisted of placement of stainless steel crowns on severely decayed teeth. However, they are esthetically unacceptable today. Over the last decade parents expect a higher esthetic standard for their children's primary teeth. Thus, the restoration should provide esthetic appearance and durability in addition to restoring function. The purpose of this review is to describe the types of full coverage options for anterior primary teeth currently available.

  9. 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.)

  10. 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%.

  11. Anterior Abdominal Wall Leiomyoma Arising De Novo in a Perimenopausal Woman

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    Hamed A. Al-Wadaani

    2012-07-01

    Full Text Available Extrauterine or extraintestinal leiomyomas are extremely uncommon especially in the pre-peritoneal area or within the anterior abdominal wall muscles. These tumors have been ascribed to intraoperative seeding during resection of a fibroid or a leiomyoma of gut, to exogenous hormone replacement therapy or a major derangement of glucose and/or lipid metabolism. So far, there is no published report of de novo origin of anterior abdominal wall pure leiomyoma in the literature. The author herein reports a case of perimenopausal multiparous woman without any listing of previous gynecological surgery or hormone therapy who presented with a large pre-peritoneal intramuscular leiomyoma of the anterior abdominal wall. The patient underwent complete primary resection with amelioration of her symptoms.

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

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    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

  13. Anterior Tibial Artery Pseudoaneurysm: Case Report

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    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

  14. THERAPY OF FIBRINOUS PLASTIC ANTERIOR UVEITIS

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    A. L. Onishchenko

    2015-01-01

    Full Text Available Aim. To analyze the efficacy of modified pupillary massage technique using cycloplegic agent Appamide Plus in the treatment of anterior uveitis. Patients and methods. 45 patients (25 men and 20 women aged 21‑69 with endogenous uveitis (51 eyes were enrolled in the study. Etiology of uveitis was identified in 57.7 % of cases: herpes simplex virus (22.2 %; systemic disorders — rheumatoid arthritis, Reiter syndrome, Bechterew’s disease, psoriasis (17.7 %; local infection — purulent periodontitis or sinusitis (11 %. Patients were divided into two groups. Group I received basic therapy in combination with traditional pupillary massage. Group II received basic therapy in combination with modified pupillary massage using Appamide Plus (muscarinic receptor antagonist and alpha adrenergic agonist and plasma exchange with cell mass ozonation. Results. Inflammation of the uveal tract was prevented in all patients. In group I (traditional pupil massage, posterior synechiae persisted in 26 % of cases. In group II (pupil massage using Appamide Plus, anterior chamber humor was transparent, posterior synechiae were broken, normal pupillary response was re-established. Additionally, inflammatory exudate in the anterior chamber and endothelial precipitates resolved by 3.3 days earlier than in group I (р < 0.05. Visual outcomes were also better in Appamide Plus group. T cell-mediated immunity study revealed initial CD3+ cell and T cell subpopulation deficiency. Relative and absolute references of T cells and their subpopulations tended to decrease even when uveitis signs reduced. Conclusions. T cell-mediated immunity depression is probably due to pharmacotherapy. Appamide Plus eye drops are highly effective for therapeutic mydriasis and pupillary massage in the course of anterior uveitis treatment to prevent synechiae formation in enlarged or small pupil.

  15. Anterior sacral meningocele presenting as constipation

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    Anup Mohta

    2011-01-01

    Full Text Available Anterior sacral meningocele (ASM is a rare form of spinal dysraphism in children. Usually asymptomatic, it can present as constipation, urinary problems or rarely neurological symptoms. High index of suspicion with careful clinical examination is necessary to make early diagnosis. Magnetic resonance imaging is the investigation of choice. We describe a successfully managed young child with ASM associated with rib and vertebral defects.

  16. Specialized core stability exercise: a neglected component of anterior cruciate ligament rehabilitation programs.

    Science.gov (United States)

    Shi, Dong-liang; Li, Jing-long; Zhai, Hua; Wang, Hui-fang; Meng, Han; Wang, Yu-bin

    2012-01-01

    The incidence of anterior cruciate ligament injury has continued to increase over the last two decades. This injury is associated with abnormal gait patterns and osteoarthritis of the knee. In order to accelerate recovery, the introduction of core stability exercises into the rehabilitation program is proposed. The theory underlying the use of core stability exercise relates to the neuroplasticity that follows anterior cruciate ligament injury. Neuroplasticity in lumbar, thoracic, cervical and brain regions diminish activation in the contralateral thalamus, postparietal cortex, SM1, basal ganglia-external globus pallidus, SII, cingulated motor area, premotor cortex, and in the ipsilateral cerebellum and SM1 and increase activation in pre-SMA, SIIp, and pITG, indicating modifications of the CNS. In addition, the neuroplasticity can regulate the movement of trunk muscles, for example, sternocleidomastoid and lower trapezius muscles. Core stability also demonstrates a negative correlation with the incidence of anterior cruciate ligament injury. Therefore, we propose that core stability exercises may improve the rehabilitation of anterior cruciate ligament injuries by increasing core motor control. Specialized core stability exercises aimed at rectifying biomechanical problems associated with gait and core stability may play a key role in the management of anterior cruciate ligament injury.

  17. 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

  18. Anterior tooth root morphology and size in Neanderthals: taxonomic and functional implications.

    Science.gov (United States)

    Le Cabec, Adeline; Gunz, Philipp; Kupczik, Kornelius; Braga, José; Hublin, Jean-Jacques

    2013-03-01

    Comparing modern humans and Neanderthals, we have previously shown that recent modern humans (RMH) and Neanderthals differ in anterior root lengths, and that this difference cannot be explained by group differences in overall mandibular size. Here, we first document the evolutionary changes of root size and shape of the anterior upper and lower dentition in a broad chronological and geographical framework. We then use the size and shape differences between RMH and Neanderthals to classify several isolated teeth from Kebara cave and Steinheim, and to interpret the anterior tooth roots of the Tabun C2 mandible. Our samples comprise permanent mandibular and maxillary incisors and canines from early Homo, Neanderthals, as well as extant and fossil modern humans (N = 359). In addition to root length, we measured cervical root diameter and area, total root volume, root pulp volume and root surface area from μCT scans. We quantified root shape variation using geometric morphometrics. Our results show that Neanderthals have not only significantly larger anterior roots than RMH overall, but also different root shapes for each tooth type. In the context of the 'teeth-as-tools' hypothesis, this could be an adaptation to better sustain high or frequent loads on the front teeth. We demonstrate that the two isolated incisors stored with the Steinheim skull are very likely recent. Tabun C2 shows an anterior dentition similar in size and shape to Neanderthals while its molar roots are non-Neanderthal. Two of the five isolated teeth from Kebara are classified as Neanderthals. Interestingly, early modern humans overlap with Neanderthals and RMH in root size and shape. Anterior roots of the Lower and Middle Pleistocene specimens are at least as large as Neanderthals, suggesting that Neanderthals retained a primitive pattern, which should prompt caution in the assessment of the earliest forms of modern humans.

  19. 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.

  20. 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.)

  1. 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.

  2. 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.

  3. Giant aneurysm of the distal anterior cerebral artery simulating brain tumor on CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Shigemori, Minoru; Kawaba, Tomoyuki; Kuramoto, Shinken (Kurume Univ., Fukuoka (Japan). School of Medicine); Ogata, Takeyuki; Yoshimura, Kyoko

    1982-08-01

    A successfully treated case with a giant aneurysm of the distal anterior cerebral artery which simulated brain tumor on computerized tomography (CT) is reported. In a 69-year-old woman suffering with a mild headache and a weakness in the left leg, a plain skull film revealed a ballooning of the sella turcica and an erosion of the dorsum. A CT scan showed a round or oval high-density area at the medial site of the right frontal lobe which was associated with an extensive low-density area. Curviliner calcification was also noted. A marked attenuation of the medial site of the mass lesion was demonstrated with contrast enhancement. A left-carotid angiogram demonstrated a large aneurysm at the distal-branching point of the anterior cerebral artery. Radical treatment for the aneurysm was performed. The postoperative course was uneventful, and the low-density area around the aneurysm disappeared within 6 weeks after the operation.

  4. Toxic anterior-segment syndrome (TASS

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    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. Outcomes and stability in patients with anterior open bite and long anterior face height treated with temporary anchorage devices and a maxillary intrusion splint

    Science.gov (United States)

    Scheffler, Nicole R.; Proffit, William R.; Phillips, Ceib

    2015-01-01

    Introduction Temporary skeletal anchorage devices now offer the possibility of closing anterior open bites and decreasing anterior face height by intruding maxillary posterior teeth, but data for treatment outcomes are lacking. This article presents outcomes and posttreatment changes for consecutive patients treated with a standardized technique. Methods The sample included 33 consecutive patients who had intrusion of maxillary posterior teeth with a maxillary occlusal splint and nickel-titanium coil springs to temporary anchorage devices in the zygomatic buttress area, buccal and apical to the maxillary molars. Of this group, 30 had adequate cephalograms available for the period of treatment, 27 had cephalograms including 1-year posttreatment, and 25 had cephalograms from 2 years or longer. Results During splint therapy, the mean molar intrusion was 2.3 mm. The mean decrease in anterior face height was 1.6 mm, less than expected because of a 0.6-mm mean eruption of the mandibular molars. During the postintrusion orthodontics, the mean change in maxillary molar position was a 0.2-mm extrusion, and there was a mean 0.5-mm increase in face height. Positive overbite was maintained in all patients, with a slight elongation (<2 mm) of the incisors contributing to this. During the 1 year of posttreatment retention, the mean changes were a further eruption of 0.5 mm of the maxillary molars, whereas the mandibular molars intruded by 0.6 mm, and there was a small decrease in anterior face height. Changes beyond 1 year posttreatment were small and attributable to growth rather than relapse in tooth positions. Conclusions Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior open bites, but 0.5 to 1.5 mm of reeruption of these teeth is likely to occur. Controlling the vertical position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height

  7. Electron microscopic observations of the anterior pituitary gland. Part I. The neurons in the "transitional zone" of the anterior pituitary gland.

    Science.gov (United States)

    Mabuchi, Yoshio; Shirasawa, Nobuyuki; Sakuma, Eisuke; Wada, Ikuo; Horiuchi, Osamu; Kikuchi, Motoshi; Sakamoto, Atsushi; Herbert, Damon C; Soji, Tsuyoshi

    2008-06-01

    Since [Westlud, K.N., Chils, G.V., 1982. Localization of serotonin fibers in the rat adenohypophysis. Endocrinology 111, 1761-1763] initially identified the serotonin nerve fibers in the anterior pituitary gland, attention has been paid to the rostral zone of the anterior lobe into which nerve fibers enter and subsequently spread to deeper regions of the lobe. The rostral zone is the trifurcated junction of the partes tuberalis, intermedia and distalis, and has the important role(s) for hormone secretion via the "transitional zone" [Sato, G, Shirasawa, N, Sakuma, E, Sato, Y, Asai, Y, Wada, I, Horiuchi, O, Sakamoto, A, Herbert, DC, Soji, T, 2005a. Intercellular communications within the rat anterior pituitary. XI: An immunohistochemical study of distributions of S-100 positive cells in the anterior pituitary of the rat. Tissue and Cell 37, 269-280.]. The objective of this study was to focus on the ultrastructure of this "zone." All of the animals studied were fixed by perfusion with glutaraldehyde via the left ventricle of the heart and examined by electron microscopy. In the "transitional zone," a cluster of neuronal elements was observed between the folliculo-stellate cell-rich area and the anterior lobe. This cluster consisted of myelinated fibers, unmyelinated fibers, neuroendocrine fibers, large cells, and supporting cells. The large cells were perikarya of neurons which made a "ganglion-like" structure with associated satellite cells. Agranular, folliculo-stellate cells were intermingled among the elements. This is the first report that neuronal elements form clusters in the "transitional zone." A relationship of the unmyelinated and neuroendocrine fibers in the basal layer and in the "transitional zone" is discussed.

  8. The Anterior Cingulate Cortex and Pain Processing

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    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.

  9. 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.

  10. Tunnel widening in anterior cruciate ligament reconstruction

    DEFF Research Database (Denmark)

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

    1999-01-01

    .1% in the patella tendon group (P = film measurements. Tunnel widening did not correlate with the clinical findings, knee scores, KT-1000 or isokinetic muscle strength. Tunnel widening is marked in the hamstring group. Tunnel widening does not correlate with instability......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...

  11. [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.

  12. Comparative analysis of anterior and posterior contrast injection approaches for shoulder MR arthrograms in adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Gupton, Theodore B.; Cahill, Anne M. [The Children' s Hospital of Philadelphia, Division of Interventional Radiology, Department of Radiology, Philadelphia, PA (United States); Delgado, Jorge [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Jaramillo, Diego [Stanford University Medical Center, Diagnostic Radiology, Palo Alto, CA (United States); Chauvin, Nancy A. [The Children' s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Musculoskeletal Imaging, Department of Radiology, Philadelphia, PA (United States)

    2016-12-15

    There is no consensus in the literature concerning the optimal approach for performing a fluoroscopically guided shoulder arthrogram injection in a pediatric population. To compare adequacy of capsular injection and radiation doses between fluoroscopically guided anterior and posterior glenohumeral joint contrast injections in adolescents. We evaluated imaging in 67 adolescents (39 boys, 28 girls; mean age 16.0 years; range 11.7-19.1 years) who underwent an anterior approach glenohumeral contrast injection with subsequent MR imaging, and 67 age- and gender-matched subjects (39 boys, 28 girls; mean age 16.0 years; range 11.1-19.2 years) who underwent a posterior approach injection during the period June 2010 to September 2015. Two pediatric radiologists independently evaluated all MR shoulder arthrograms to assess adequacy of capsular distention and degree of contrast extravasation. We recorded total fluoroscopic time, dose-area product (DAP) and cumulative air kerma (CAK). There were no significant differences in age, gender, height, weight or body mass index between the populations (P-values > 0.6). The amount of contrast extravasation between the groups was not significantly different (P = 0.27). Three anterior injections (4.5%) and one posterior (1.5%) were suboptimal (P = 0.62). Fluoroscopy time was not different: 1.1 min anterior and 1.3 min posterior (P = 0.14). There was a significant difference in CAK (0.7 mGy anterior and 1.1 mGy posterior; P = 0.007) and DAP (5.3 μGym{sup 2} anterior and 9.4 μGym{sup 2} posterior; P = 0.008). Inter-rater agreement was excellent (Cohen kappa >0.81). Both techniques were technically successful. There was no difference in the fluoroscopy time for either approach. The radiation dose was higher with the posterior approach but this is of questionable clinical significance. (orig.)

  13. 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.

  14. Late spontaneous resolution of a double anterior chamber post deep anterior lamellar keratoplasty

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    Andrea Passani

    2017-01-01

    Full Text Available A 31-year-old healthy male underwent deep anterior lamellar keratoplasty with big-bubble technique for treatment of keratoconus in his right eye. One week after surgery, he presented with detachment of the endothelium-Descemet complex with formation of a double anterior chamber, despite the apparent absence of an intraoperative Descemet membrane rupture. A subsequent intervention with the intent to relocate the corneal graft button was not effective, because the detachment appeared again one day later. The authors hypothesized that, at the time of the stromal dissection with big bubble technique, a small amount of air penetrated into the anterior chamber, creating a false pathway through the trabecular meshwork. The aqueous humor then penetrated the graft flowing through the false pathway, causing the endothelium-Descemet detachment. The persistence of that pathway, even after the intervention of graft repositioning, caused the failure of the latter procedure and persistence of the double chamber. We decided to wait and observe. The double anterior chamber spontaneously resolved in approximately three months.

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

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    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.

  16. 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.

  17. 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

  18. 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

  19. Anterior cutaneous nerve entrapment syndrome: management challenges

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    Chrona E

    2017-01-01

    Full Text Available Eleni Chrona,1,2 Georgia Kostopanagiotou,1 Dimitrios Damigos,3 Chrysanthi Batistaki1 1Second Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” Hospital, Athens, 2Department of Anesthesiology, General Hospital of “Ag. Panteleimon,” Piraeus, 3Department of Medical Psychology, Medical School of Ioannina, University of Ioannina, Ioannina, Greece Abstract: Anterior cutaneous nerve entrapment syndrome (ACNES is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case–control studies, case series, or case reports, and two were randomized controlled trials. The presently available management strategies for ACNES include trigger point injections (diagnostic and therapeutic, ultrasound-guided blocks, chemical neurolysis, and surgical ­neurectomy, in combination with systemic medication, as well as some emerging techniques, such as radiofrequency ablation and neuromodulation. An increased awareness of the syndrome and the use of specific diagnostic criteria for its recognition are required to facilitate an early and successful management. This review compiles the proposed ­management strategies for ACNES. Keywords: anterior cutaneous nerve entrapment syndrome, intercostal, neuralgia, management

  20. 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.

  1. 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)

  2. Penghentian Karies Gigi Sulung Anterior (Laporan Penelitian

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    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.

  3. A Rare Nasal Bone Fracture: Anterior Nasal Spine Fracture

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    Egemen Kucuk

    2014-04-01

    Full Text Available Anterior nasal spine fractures are a quite rare type of nasal bone fractures. Associated cervical spine injuries are more dangerous than the nasal bone fracture. A case of the anterior nasal spine fracture, in a 18-year-old male was presented. Fracture of the anterior nasal spine, should be considered in the differential diagnosis of the midface injuries and also accompanying cervical spine injury should not be ignored.

  4. 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.

  5. 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....... 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....

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

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    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.

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

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    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

  8. Early Diagnosis of Keratoconus with Orbscan- Ⅱ Anterior System

    Institute of Scientific and Technical Information of China (English)

    李新宇; 刘磊; 邱良秀

    2002-01-01

    Summary: Orbscan- Ⅱ anterior system was used for early diagnosis of keratoconus. 48 Eyes of 24patients with suspicious keratoconus were examined by Orbscan-Ⅱ anterior system from Dec.1999 to Dec. 2000 and followed up. The values of Diff and anterior chamber depth (ACD) wererecorded. Results indicated that values of Diff and ACD were increased in 4 eyes of 2 patients withkeratoconus trend during follow-up. Taking advantage of Orbscan- Ⅱ anterior system to observethe values of Diff and ACD can early diagnose the sub-clinical keratoconus. The values of Diff andACD can sensitively report the progression of keratoconus.

  9. Morphogenesis of the anterior segment in the zebrafish eye

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    Link Brian A

    2005-06-01

    Full Text Available Abstract Background The ocular anterior segment is critical for focusing incoming light onto the neural retina and for regulating intraocular pressure. It is comprised of the cornea, lens, iris, ciliary body, and highly specialized tissue at the iridocorneal angle. During development, cells from diverse embryonic lineages interact to form the anterior segment. Abnormal migration, proliferation, differentiation, or survival of these cells contribute to diseases of the anterior segment such as corneal dystrophy, lens cataract, and glaucoma. Zebrafish represent a powerful model organism for investigating the genetics and cell biology of development and disease. To lay the foundation for genetic studies of anterior segment development, we have described the morphogenesis of this structure in zebrafish. Results As in other vertebrates, the zebrafish anterior segment derives from diverse origins including surface ectoderm, periocular mesenchyme, and neuroepithelium. Similarly, the relative timing of tissue differentiation in the anterior segment is also conserved with other vertebrates. However, several morphogenic features of the zebrafish anterior segment differ with those of higher vertebrates. These include lens delamination as opposed to invagination, lack of iris muscles and ciliary folds, and altered organization in the iridocorneal angle. In addition, substantial dorsal-ventral differences exist within the zebrafish anterior segment. Conclusion Cumulatively, our anatomical findings provide a reference point to utilize zebrafish for genetic studies into the mechanisms of development and maintenance of the anterior segment.

  10. 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

  11. Síndrome tóxica do segmento anterior Toxic anterior segment syndrome

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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.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.

  12. RETAINED STONE PIECE IN ANTERIOR CHAMBER

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    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

  13. 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).

  14. Anterior uveitis and diabetes mellitus: immunological study.

    Science.gov (United States)

    Castagna, I; Famà, F; Salmeri, G

    1995-01-01

    The association between anterior uveitis (AU) and diabetes mellitus (DM) has always been known. The purpose of this study was to estimate the incidence of this association and to consider a possible role of the cell-mediated immune system. During the years 1989-1992, 196 diabetics (66 patients affected by type I DM and 130 by type II DM) were studied. The study of the lymphocytic subsets and the measurement of the circulating immunocomplexes and autoantibodies (ANA, AMA, ADNA, ASMA, APCA) were carried out, and the results were compared with those of a control group. The results underline the correlation between AU and type I DM. Many immunological reactions could play a crucial role: the high levels of CD8 subsets found could be an expression of the unstable lymphocytic equilibrium.

  15. Endoscopic anterior decompression in cervical disc disease

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    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.

  16. 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.

  17. Etiological aspects of anterior open bite

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    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. .

  18. 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.

  19. 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.

  20. Dopaminergic Neurons Controlling Anterior Pituitary Functions: Anatomy and Ontogenesis in Zebrafish.

    Science.gov (United States)

    Fontaine, Romain; Affaticati, Pierre; Bureau, Charlotte; Colin, Ingrid; Demarque, Michaël; Dufour, Sylvie; Vernier, Philippe; Yamamoto, Kei; Pasqualini, Catherine

    2015-08-01

    Dopaminergic (DA) neurons located in the preoptico-hypothalamic region of the brain exert a major neuroendocrine control on reproduction, growth, and homeostasis by regulating the secretion of anterior pituitary (or adenohypophysis) hormones. Here, using a retrograde tract tracing experiment, we identified the neurons playing this role in the zebrafish. The DA cells projecting directly to the anterior pituitary are localized in the most anteroventral part of the preoptic area, and we named them preoptico-hypophyseal DA (POHDA) neurons. During development, these neurons do not appear before 72 hours postfertilization (hpf) and are the last dopaminergic cell group to differentiate. We found that the number of neurons in this cell population continues to increase throughout life proportionally to the growth of the fish. 5-Bromo-2'-deoxyuridine incorporation analysis suggested that this increase is due to continuous neurogenesis and not due to a phenotypic change in already-existing neurons. Finally, expression profiles of several genes (foxg1a, dlx2a, and nr4a2a/b) were different in the POHDA compared with the adjacent suprachiasmatic DA neurons, suggesting that POHDA neurons develop as a distinct DA cell population in the preoptic area. This study offers some insights into the regional identity of the preoptic area and provides the first bases for future functional genetic studies on the development of DA neurons controlling anterior pituitary functions.

  1. 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.

  2. Experimental Study on the Prevention of Anterior Segment Ischemia by Preservation of Anterior Ciliary Vessels

    Institute of Scientific and Technical Information of China (English)

    Yanna Li; Guanghuan Mai; Zhijian Wang; Xinping Yu; Huanyun Yu; Yan Guo; Xiaoming Lin; Daming Deng; Ying Kang

    2003-01-01

    Purpose: To observe the effect of preserving anterior ciliary vessels (ACVs) on anteriorsegments of rabbit eyes undergoing tenotomy of extraocular muscles.Methods: Thirty-two adult New Zealand white rabbits were divided into four groups.Same procedures were done in both eyes in each group except that left eyes underwentpreservation of ACVs. In the first group medial and lateral recti, in the second group,superior and inferior recti, in the third group, medial, lateral and superior or inferior rectiand in the fourth group, all four recti, underwent tenotomy. Slit-lamp examination,intraocular pressure (IOP) measurement, total protein and lactic acid quantification inaqueous humor were done in all eyes pre- and post-operatively. By four weeks afteroperation, the eyes were enucleated for histological examination and electron microscopy.All data were analyzed using SPSS version 10.Results: In the left eyes of both group 1 and group 2, no inflammatory response wasobserved. In the left eyes of group 3 and 4, we observed mild inflammatory response withslit-lamp examination, which disappeared in one wk. However, we did not findsignificant changes in IOP, total protein and lactic acid of aqueous humor, histology andelectron microscopic examination in these groups. In the right eyes in group 2, 3 and 4,we observed moderate to severe inflammatory changes, a few even developed anteriorsegment ischemia, appeared as decreased IOP, increased total protein and lactic acid inaqueous humor, along with pathological and electron-microscopic changes.Conclusion: Simultaneous tenotomy of three or four recti or two vertical recti on one eyemay decrease anterior segment blood flow even lead to ischemia. ACVs preservation mayprotect the blood circulation in anterior segment. Our study suggests that ACVspreservation in strabismus surgeries especially those involving multi-recti tenotomies mayprevent potential anterior segment ischemia.

  3. 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.

  4. 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.

  5. Review for the generalist: evaluation of anterior knee pain

    Directory of Open Access Journals (Sweden)

    Houghton Kristin M

    2007-05-01

    Full Text Available Abstract Anterior knee pain is common in children and adolescents. Evaluation and management is challenging and requires a thorough history and physical exam, and understanding of the pediatric skeleton. This article will review common causes of chronic anterior knee pain in the pediatric population with a focus on patellofemoral pain.

  6. [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.

  7. Modified Anchor Shaped Post Core Design for Primary Anterior Teeth

    OpenAIRE

    R. Rajesh; Kusai Baroudi; K. Bala Kasi Reddy; Praveen, B. H.; V. Sumanth Kumar; Amit, S

    2014-01-01

    Restoring severely damaged primary anterior teeth is challenging to pedodontist. Many materials are tried as a post core but each one of them has its own drawbacks. This a case report describing a technique to restore severely damaged primary anterior teeth with a modified anchor shaped post. This technique is not only simple and inexpensive but also produces better retention.

  8. Modified Anchor Shaped Post Core Design for Primary Anterior Teeth

    Directory of Open Access Journals (Sweden)

    R. Rajesh

    2014-01-01

    Full Text Available Restoring severely damaged primary anterior teeth is challenging to pedodontist. Many materials are tried as a post core but each one of them has its own drawbacks. This a case report describing a technique to restore severely damaged primary anterior teeth with a modified anchor shaped post. This technique is not only simple and inexpensive but also produces better retention.

  9. Modified anchor shaped post core design for primary anterior teeth.

    Science.gov (United States)

    Rajesh, R; Baroudi, Kusai; Reddy, K Bala Kasi; Praveen, B H; Kumar, V Sumanth; Amit, S

    2014-01-01

    Restoring severely damaged primary anterior teeth is challenging to pedodontist. Many materials are tried as a post core but each one of them has its own drawbacks. This a case report describing a technique to restore severely damaged primary anterior teeth with a modified anchor shaped post. This technique is not only simple and inexpensive but also produces better retention.

  10. [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.

  11. Anterior urethral recurrence of superficial bladder cancer: its clinical significance.

    Directory of Open Access Journals (Sweden)

    Saika T

    2003-12-01

    Full Text Available The aim of this study was to reveal the clinical features of anterior urethral recurrence in patients with superficial bladder cancer, and to determine the appropriate treatment. Three hundred and three patients with superficial bladder cancer, who were newly diagnosed and initially treated conservatively in our hospital between 1965 and 1990, were followed for at least 5 years and their clinical outcomes were analyzed. Clinical factors, including anterior urethral recurrence, were evaluated statistically regarding tumor progression. Eight patients (2.6% had anterior urethral recurrence following superficial bladder cancer. Twenty-four patients (7.9% had tumor progression and 149 (49.2% had tumor recurrence. In a multivariate analysis using a logistic model, anterior urethral recurrence was the most important factor, followed by histological grade. Four of 5 patients who were treated for anterior urethral recurrent tumors by transurethral resection showed progression and died of the cancer within one year. Two of the remaining three patients who underwent radical cysto-urethrectomy at the time of anterior urethral recurrence survived. Anterior urethral recurrence following superficial bladder cancer is a predictor for rapid subsequent malignant progression. Once there is anterior urethral recurrence, radical intensive therapy, including radical cysto-urethrectomy, should be carried out immediately.

  12. Anterior commissure absence without callosal agenesis: a new brain malformation.

    Science.gov (United States)

    Mitchell, T N; Stevens, J M; Free, S L; Sander, J W; Shorvon, S D; Sisodiya, S M

    2002-04-23

    The authors report a novel human brain malformation characterized by the absence of the anterior commissure without callosal agenesis, but associated with gross unilateral panhemispheric malformation incorporating subependymal heterotopia, subcortical heterotopia, and gyral abnormalities including temporal malformation and polymicrogyria. In contrast, a normal anterior commissure was found in 125 control subjects and in 113 other subjects with a range of brain malformations.

  13. Agenesis of internal carotid artery associated with congenital anterior hypopituitarism

    Energy Technology Data Exchange (ETDEWEB)

    Moon, W.-J. [Department of Diagnostic Radiology, Samsung Medical Center, Seoul (Korea); Institute of Neuroradiology, University of Frankfurt (Germany); Porto, L.; Lanfermann, H.; Zanella, F.E. [Institute of Neuroradiology, University of Frankfurt (Germany); Weis, R. [Department of Pediatric Neurology, University of Frankfurt (Germany)

    2002-02-01

    We report a rare case of unilateral agenesis of the internal carotid artery in association with congenital anterior hypopituitarism. The collateral circulation is supplied by a transsellar intercavernous anastomotic vessel connecting the internal carotid arteries. These abnormalities are well depicted on MRI and MRA. The agenesis of the internal carotid artery may explain the pathogenesis of some of congenital anterior hypopituitarism. (orig.)

  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. 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.)

  16. Anterior endoderm and head induction in early vertebrate embryos.

    Science.gov (United States)

    de Souza, F S; Niehrs, C

    2000-05-01

    Early work on the formation of the vertebrate body axis indicated the existence of separate head- and trunk-inducing regions in Spemann's organizer of the amphibian gastrula. In mammals some head-organizing activity may be located in anterior visceral (extraembryonic) endoderm (AVE). By analogy, the equivalent structure in the Xenopus laevis gastrula, the anterior endoderm, has been proposed to be the amphibian head organizer. Here we review recent data that challenge this notion and indicate that the involvement of AVE in head induction seems to be an exclusively mammalian characteristic. In X. laevis and chick, it is the prechordal endomesoderm that is the dominant source of head-inducing signals during early gastrulation. Furthermore, head induction in mammals needs a combination of signals from anterior primitive endoderm, prechordal plate, and anterior ectoderm. Thus, despite the homology of vertebrate anterior primitive endoderm, a role in head induction seems not to be conserved.

  17. 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.

  18. Maxillary anterior and mandibular posterior residual ridge resorption in patients wearing a mandibular implant-retained overdenture

    NARCIS (Netherlands)

    Tymstra, N.; Raghoebar, G. M.; Vissink, A.; Meijer, H. J. A.

    2011-01-01

    P>The mandibular implant-retained overdenture could improve masticatory function compared to the conventional complete denture. However, increased forces exerted by the overdenture could increase residual ridge resorption of the maxillary anterior and mandibular posterior areas. The aim of this stud

  19. 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

  20. 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

  1. 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

  2. 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.

  3. Anterior cutaneous nerve entrapment syndrome: management challenges

    Science.gov (United States)

    Chrona, Eleni; Kostopanagiotou, Georgia; Damigos, Dimitrios; Batistaki, Chrysanthi

    2017-01-01

    Anterior cutaneous nerve entrapment syndrome (ACNES) is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case–control studies, case series, or case reports, and two were randomized controlled trials. The presently available management strategies for ACNES include trigger point injections (diagnostic and therapeutic), ultrasound-guided blocks, chemical neurolysis, and surgical neurectomy, in combination with systemic medication, as well as some emerging techniques, such as radiofrequency ablation and neuromodulation. An increased awareness of the syndrome and the use of specific diagnostic criteria for its recognition are required to facilitate an early and successful management. This review compiles the proposed management strategies for ACNES. PMID:28144159

  4. [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.

  5. Anterior Interhemispheric Approach for Olfactory Groove Meningioma

    Directory of Open Access Journals (Sweden)

    Imam Hidayat

    2016-09-01

    Full Text Available Objective: To evaluate the surgical technique with bifrontal interhemispheric approach for total removal of tumor in olfactory groove meningioma (OGM. Methods: This study described a case of a 38-year-old woman with bilateral blindness, anosmia, and behaviour changes. Imaging studies show a tumor mass in midfrontal base. Surgery using a bifrontal interhemispheric approach was performed and total removal was achieved and postoperative computed tomography (CT scan was performed to confirm the result. Histopathological findings established a diagnosis of meningioma. Results: A coronal skin incision behind the hairline was utilized. The scalp was elevated, taking care to reserve the vascularized pericranium medial to the linea temporalis of each side, and preserving the 2 supraorbital nerves. Eight burr holes were used, with the two initial holes made on each side of the orbitotemporal region, and the other four holes at the midline. A bifrontal craniotomy was performed. The tumor was first detached from its attachment with bipolar cautery and debulked. During this step, the main tumor feeder arteries from the anterior and posterior ethmoidal artery were interrupted, and the tumor devascularized. Total tumor removal through surgical intervention was achieved and confirmed by head CT-scan postoperatively. Conclusions: This case report supports the suitability of the bifrontal interhemispheric approach for OGM resection with additional radiation therapy.

  6. Management of ruptured anterior communicating artery aneurysms presenting with sudden paraplegia

    Directory of Open Access Journals (Sweden)

    Jiu-hong MA

    2016-10-01

    Full Text Available Objective  To explore the causes of ruptured anterior communicating artery aneurysms presenting with paraplegia, and summarize the key points of diagnosis and treatment methods. Methods  A total of 260 patients with ruptured anterior communicating artery aneurysms were received medical treatment in the Department of Neurosurgery, Shanxi Provincial People's Hospital from Jan. 2012 to Mar. 2015. Of which 6 patients were clinically presented with paraplegia, their clinical data including CT/MR/DSA were retrospectively analyzed, and based on the analysis, aneurysm embolization and anti-vasospasm treatment were performed. Results  Besides headache and discomfort in the neck, 5 of the 6 patients were with double lower limbs paraplegia, and the another one presented quadriplegia. By symptomatic treatment of aneurysm embolization and anti vasospasm, the myodynamia of the paraplegic limbs recovered from 0-Ⅰto Ⅳ-Ⅴgrade, and 2 of the 6 patients spent a shorter recovery time (about 2 weeks, the other 4 recovered in 3 months. The limbs myodynamia of the 6 patients recovered completely in half-and one year follow up. Conclusions  The mechanism of ruptured anterior communicating artery aneurysms presenting with paraplegia may be the insufficient blood supply to the primary motor area and supplementary motor area (SMA of brain cortex caused by aneurysms rupture. Aneurysm embolization should be performed in clinical treatment, supplemented with anti vasospasm and symptomatic treatment of improving neurological function. DOI: 10.11855/j.issn.0577-7402.2016.09.14

  7. [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.

  8. 动力化前路方形区钛板螺钉系统固定伴有对侧骨盆前环不稳的髋臼双柱骨折的站位有限元分析%Finite element analysis of standing position in both-column with posterior hemi-transverse lesion fractures of the acetabulum fixed by dynamic anterior plate-screw system for quadrilateral area

    Institute of Scientific and Technical Information of China (English)

    林冠林; 陈庄洪; 蔡贤华; 刘曦明; 雷建银; 王志华; 张宝成

    2015-01-01

    Objective To explore biomechanical stability of fractures of the acetabulum fixed by dynamic anterior plate-screw system for quadrilateral area (DAPSQ) when pelvic ring was unstable.Methods To prepare right side of the anterior column with posterior hemi-transverse lesion fractures of the acetabulum (pelvis) by finite element analysis,DAPSQ (A),building on the left side of the superior ramus of pubis fracture and inferior ramus of pubis model on the basis of A model,prepare two kinds of model of the left side of the superior ramus fractures of pubis with fixed (B) and titanium plate fixation (C).Then,the same physiological load was exerted on different model respectively.At the end,the none-line solution was analyzed,analysis of the stress and displacement in model.Results After fracture fixation through the lateral and longitudinal displacement and the stress nephogram found after analysis and comparison,the transverse and longitudinal displacement is small with DAPSQ internal fixation when the stability of pelvic ring,accord with standard of reset,uniform stress distribution,no obvious phenomenon of highly concentrated,fixed intensity bigger,fixed the pelvis after more stable.But when accompanied by unstable pelvic ring road ahead for DAPSQ fracture line of vertical and horizontal displacement of the present B > C > A,A,B,C stations,the longitudinal displacement respectively (1.315 ±0.171),(1.490 ±0.247),(1.334 ±0.160) mm,lateral displacement of stations respectively (1.185 ±0.700),(1.337 ±0.080),(1.198 ± 0.103) mm.Conclusion The pelvic ring must be stable when treatment of anterior column with posterior hemi-transverse lesion fixed by DAPSQ.%目的 利用有限元技术探讨当对侧骨盆前环不稳时,动力化前路方形区钛板螺钉系统(DAPSQ)内固定治疗髋臼双柱骨折的生物力学稳定性.方法 利用有限元分析技术建立正常人体全骨盆有限元模型并进行有限元验证,建立3种骨折内固定模型:A:DAPSQ固

  9. 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.

  10. 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.

  11. Anterior cingulate integrity: executive and neuropsychiatric features in Parkinson's disease.

    Science.gov (United States)

    Lewis, Simon J G; Shine, James M; Duffy, Shantel; Halliday, Glenda; Naismith, Sharon L

    2012-09-01

    Patients with advanced Parkinson's disease (PD) commonly suffer with significant executive dysfunction and concomitant visual hallucinations. Although the underlying pathophysiology remains poorly understood, numerous studies have highlighted the strong association between these neuropsychiatric features, suggesting common neural pathways. Although previous neuroimaging studies have identified widespread volume loss across a number of cortical regions, to date, no studies have utilized proton magnetic resonance spectroscopy to provide insights into how neurometabolic changes may relate to such symptoms. Twenty patients with PD and 20 healthy controls underwent spectroscopy to determine the N-acetyl aspartate/creatine (NAA/Cr) ratio, which reflects the degree of neuronal integrity in neurodegenerative diseases. Voxels were obtained from the anterior cingulate cortex (ACC), an area critical for a wide range of executive mechanisms as well as from a control volume in the posterior cingulate cortex (PCC). Compared to controls, patients with PD had lower NAA/Cr ratios in the ACC. In turn, lower NAA/Cr ratios significantly correlated with poorer executive function on tasks of attentional set-shifting and response inhibition, as well as more-severe psychotic symptoms and poorer performance on the Bistable Percept Paradigm, a neuropsychological probe of visual hallucinations. NAA/Cr ratios were significantly lower in hallucinators, compared to nonhallucinators, within the ACC, but did not differ in the PCC. These results suggest that loss of neuronal integrity within the ACC plays an important role in the pathophysiology underlying executive functioning and visual hallucinations in PD. © 2012 Movement Disorder Society.

  12. Anterior Inferior Iliac Spine (AIIS) and Subspine Hip Impingement

    Science.gov (United States)

    Carton, Patrick; Filan, David

    2016-01-01

    Summary Background Abnormal morphology of the anterior inferior iliac spine (AIIS) and the subspine region of the acetabular rim are increasingly being recognised as a source of symptomatic extra-articular hip impingement. This review article aims to highlight important differences in the pathogenesis, clinical presentation and management of extra-articular hip impingement from both the AIIS and subspine bony regions, and the outcome following surgical intervention. Methods A literature review was undertaken to examine the supporting evidence for AIIS and subspine hip impingement. A narrative account of the Author’s professional experience in this area, including operative technique for arthroscopic correction, is also presented. Results Abnormal morphology of the AIIS and subspine region has been classified using cadaveric, radiological and arthroscopic means; the clinical presentation and operative treatment has been documented in several case series studies. Dual pathology is often present - recognition and treatment of both intra- and extra-articular components are necessary for good postoperative outcome. Conclusions AIIS and sub-spine hip impingement should be considered as distinct pathological entities, which may also co-exist. Symptom relief can be expected following arthroscopic deformity correction with the treatment of concomitant intra-articular pathology. Failure to recognise and treat the extra-articular component may affect postoperative outcome. Level of evidence V. PMID:28066737

  13. Clinical approach to anterior adhesive restorations using resin composite veneers.

    Science.gov (United States)

    Mangani, Francesco; Cerutti, Antonio; Putignano, Angelo; Bollero, Raffaele; Madini, Lorenzo

    2007-01-01

    Scientific progress in adhesive dentistry has led to more conservative techniques, both direct and indirect, to solve esthetic problems in anterior teeth. This article will discuss only indirect techniques, which are clearly superior in complex cases in which it will be difficult to recreate harmonious tooth shape and color. After reviewing the literature and highlighting the properties of this technique, the indications and benefits compared to the direct technique will be assessed. This is followed by a step-by-step description of operative procedures, from treatment planning to relining and polishing of the cemented adhesive restoration. The long-term success of veneers depends mainly on the tooth preparation, which should be confined to enamel, involve proximal contact areas, maintain the cervical enamel margin, and incorporate the incisal edge to increase veneer resistance and enable correct placement. Although no clinical follow-up similar to that of ceramic materials is available, the latest-generation resin composites offer interesting features. They can withstand mechanical stress, have excellent esthetic properties, and, most importantly, can be repaired intraorally without impairing their physicochemical and mechanical properties.

  14. 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.

  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

    2016-01-01

    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

  16. 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.

  17. 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.

  18. Anterior cruciate ligament remnant and its values for preservation

    Directory of Open Access Journals (Sweden)

    Takeshi Muneta

    2017-01-01

    Full Text Available Controversy surrounds the remnant-preserving anterior cruciate ligament surgery. Advantages of remnant preservation have been reported in regard to better healing and knee function, although no consensus has been reached. This review article discussed the value and meaning of anterior cruciate ligament remnant preservation in several sections such as effects on healing, remnant classification, biomechanical evaluation, relation to proprioception, animal studies, and clinical studies. We hope that this review will facilitate further discussion and investigation for better treatment of anterior cruciate ligament injuries. So far, the current reviews have not provided sufficient scientific evidence to support the value of preserving the remnant.

  19. Management of anterior dental crossbite with removable appliances

    Directory of Open Access Journals (Sweden)

    Ayca Tuba Ulusoy

    2013-01-01

    Full Text Available This case report describes the treatment of an 8-year-old girl with anterior dental crossbite using a series of removable appliances to bring the teeth into a normal position. Clinical presentation and intervention: A removable acrylic appliance with a bite plate incorporating a screw was used to correct the anterior dental crossbite and align the incisors. The subsequent eruption of the maxillary left lateral incisor on the palatinal side was treated with a second acrylic plate incorporating a labiolingual spring. After an 8-month period, the anterior crossbite involving multiple incisors was corrected.

  20. Symptomatic Type IV Dual Left Anterior Descending Coronary Artery

    Directory of Open Access Journals (Sweden)

    Kyriacos Papadopoulos MD

    2016-12-01

    Full Text Available Dual left anterior descending coronary artery is a rare congenital anomaly with 4 subtypes. Double left anterior descending coronary artery originating from the left main stem and the right coronary artery (type IV dual left anterior descending artery has been reported to occur in 0.01% to 0.7% of patients undergoing cardiac catheterization. We report a case of a 49-year-old woman who was found to have this anomaly during coronary angiography. The patient had been complaining of chest pain that mimics angina pectoris and exercise tolerance test was positive for myocardial ischemia.

  1. Multi drug resistant tuberculosis presenting as anterior mediastinal mass

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    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.

  2. Anterior Cruciate Ligament Injuries in Wakeboarding

    Science.gov (United States)

    Starr, Harlan M.; Sanders, Brett

    2012-01-01

    Background: Wakeboarding is an increasingly popular sport that involves aggressive stunts with high risk for lower extremity injury, including anterior cruciate ligament (ACL) rupture. Little has been reported on prevalence or mechanism of ACL injury while wakeboarding. Hypothesis: The prevalence of ACL injury in wakeboarding approaches that of other high-risk sports. Analyzing the mechanism of ACL injury may aid in future efforts of prevention. Study Design: Descriptive epidemiology study. Methods: In sum, 1580 surveys were sent internationally to professional and amateur wakeboarders. The survey questioned the participants on their history of an ACL tear while wakeboarding and asked them to describe the mechanism of injury and treatment. Results: A total of 123 surveys were returned. Of this group, 52 (42.3%) acknowledged having had an ACL tear while wakeboarding. The majority described feeling a pop or buckle after attempting to land a high jump. Only 5 participants (13.5%) described a rotational mechanism created by catching the board edge in the water. Thirty-seven participants (71.15%) said that the injury ruined their ability to wakeboard before reconstruction, and 41 (78.85%) had the injury repaired surgically. Conclusion: The prevalence of ACL tears in this data set, 42.3%, is the highest reported in the literature for wakeboarding and one of the highest for any sport. The main mechanism of injury appears to involve axial compression while one lands in a provocative position; it is not related to a rotational force created by fixed bindings. The injury should be surgically repaired to effectively continue the sport. Further study is needed to determine if wakeboarding represents a high-risk sport for ACL injury. Clinical Significance: Wakeboarding may be a high-risk sport for ACL injury. Noncontact axial compression appears to be the main mechanism of injury. PMID:23016104

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

    Energy Technology Data Exchange (ETDEWEB)

    Do Nascimento, Eduarda Helena Leandro [Dept. of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo (Brazil); Ddos Anjos Pontual, Maria Luiza; Dos Anjos Pontual, Andra; Da Cruz Perez, Danyel Elias; De Moraes Ramos-Perez, Flavia Maria [Dept. of Clinical and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco (UFPE), Pernambuco (Brazil); Figueiroa, Jose Natal [Instituto de Medicina Integral Professor Fernando Figueira - IMIP, Pernambuco (Brazil); Frazao, Marco Antonio Gomes [Dept. of Oral Radiology, Recife Dental School (FOR), Pernambuco (Brazil)

    2016-06-15

    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). 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. 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). 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.

  4. 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

  5. Crowned odontoid process and osteoarthrosis of the anterior atlantoaxial joint

    Energy Technology Data Exchange (ETDEWEB)

    Skaane, P.; Klott, K.J.

    1981-01-01

    Crowned odontoid process and osteoarthrosis of the anterior atlantoaxial joint. The so-called peridentale aureole ( crowned odontoid ), a horseshoelike calcification around the odontoid process, can occasionally be shown on transbuccal views of the occipito-atlantoaxial region, but is commonly only seen on a.p. tomography in patients with osteoarthrosis of the anterior atlantoxial joint. Tomographic examinations reveal that these irregular horseshoe-like calcifications around the odontoid peg represent mainly the osteophyte formation on the superior border of the anterior arch of the atlas. These calcifications are often surrounding a smaller calcification on the tip of the odontoid peg sometimes with a bucket-handle appearance corresponding to the ostephyte formation on the odontoid process. The peridentale aureole or crowned odontoid process is easily overlooked unless tomography is performed, and misinterpretations are possible if the radiologist is not familiar with this appearance of osteoarthrosis and some other joint diseases of the anterior atlantoaxial joint.

  6. Anterior chest wall involvement in patients with pustulosis palmoplantaris.

    Science.gov (United States)

    Jurik, A G

    1990-01-01

    With the aim of determining the frequency and radiographic features of anterior chest wall involvement in patients with pustulosis palmoplantaris, a questionnaire was sent to 107 patients. Ninety-three patients returned the questionnaire, five of whom were excluded from further analysis due to the appearance of psoriatic lesions. Twenty-five (28%) of the remaining 88 patients reported pain and/or swelling of joints or bones in the anterior chest wall. All were examined radiographically, using tomography, and a group of 20 patients without anterior chest wall complaints were examined similarly. Sixteen of the patients with, but none of the patients without, complaints were found to have arthro-osteitis of the anterior chest wall, consisting of diffuse sclerosis of the manubrium sterni in one patient, localized sclerosis in seven patients, and sequelae of arthritis of the sternoclavicular, upper sternocostal and/or manubriosternal joint in eight patients.

  7. 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.

  8. 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.

  9. Restoration of primary anterior teeth: review of the literature.

    Science.gov (United States)

    Lee, Jacob K

    2002-01-01

    This paper reviews the published data on restorations of primary anterior teeth. The discussion includes Class III restorations, Class V restorations, various forms of full coronal restorations, atraumatic restorative technique (ART) and recommendations for future research.

  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. Sandwich-like reconstruction of anterior skull base defects

    Institute of Scientific and Technical Information of China (English)

    WANG Zhengmin; WANG Dehui

    2002-01-01

    @@ RESULTS From October, 1984 to October, 1998, 116 patients underwent transcranial or transcranial-facial approach for the resection of malignant or benign aggressive tumor, and sandwich-like repairs were performed for the anterior skull base defect.

  12. 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.

  13. 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.

  14. Anterior sacral meningocoele presenting as a peri-anal abscess.

    Science.gov (United States)

    Buxton, N; Bassi, S; Firth, J

    2002-06-01

    Anterior sacral meningoceole is a rare occurrence and presentation as a perianal abscess has not been previously reported. The case is presented and the condition discussed. The potential risks of failing to establish the diagnosis, prior to surgery, are outlined.

  15. 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.

  16. The role of the anterior commissure in callosal agenesis.

    Science.gov (United States)

    Barr, Melodie S; Corballis, Michael C

    2002-10-01

    Two individuals with callosal agenesis (J.P. and M.M.) and 10 neurologically normal participants were tested on tasks requiring interhemispheric visual integration. M.M., whose anterior commissure was within normal limits, was much worse at matching colors and letters between visual fields than within visual fields, whereas J.P., whose anterior commissure was greatly enlarged, showed no evidence of interhemispheric disconnection. This suggests that in some cases of callosal agenesis, probably a minority, an enlarged anterior commissure may compensate for the lack of the corpus callosum. Neither acallosal participant showed interhemispheric disconnection on tasks requiring integration of location and orientation, however, suggesting that the anterior commissure plays no role in such tasks. These tasks may depend on subcortical commissures, such as the intertectal commissure.

  17. Acute exertional anterior compartment syndrome in an adolescent female.

    Science.gov (United States)

    Fehlandt, A; Micheli, L

    1995-01-01

    Acute compartment syndromes usually occur as a complication of major trauma. While the chronic exertional anterior tibial compartment syndrome is well described in the sports medicine literature, reports of acute tibial compartment syndromes due to physical exertion, or repetitive microtrauma, are rare. The case of an adolescent female who developed an acute anterior compartment syndrome from running in a soccer game is described in this report. Failure to recognize the onset of an acute exertional compartment syndrome may lead to treatment delay and serious complications. Whereas the chronic exertional anterior compartment syndrome is characterized by pain that diminishes with the cessation of exercise, the onset of the acute exertional anterior compartment syndrome is heralded by pain that continues, or increases, after exercise has stopped. Compartment pressure measurement confirms the clinical diagnosis and helps guide treatment. True compartment syndromes require urgent fasciotomy.

  18. 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....

  19. 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.

  20. 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...... and longitudinal changes including osteoarthritis (OA) features. Joint features assessed were acute osteochondral injury, traumatic and degenerative bone marrow lesions (BMLs), meniscus morphology and extrusion, osteophytes, collateral and cruciate ligaments including ACL graft, Hoffa-synovitis and effusion...

  1. [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.

  2. Resorption of labial bone in maxillary anterior implant

    OpenAIRE

    Cho, Young-Bum; Moon, Seung-Jin; Chung, Chae-Heon; Kim, Hee-Jung

    2011-01-01

    PURPOSE The purpose of this study was to evaluate the amount of resorption and thickness of labial bone in anterior maxillary implant using cone beam computed tomography with Hitachi CB Mercuray (Hitachi, Medico, Tokyo, Japan). MATERIALS AND METHODS Twenty-one patients with 26 implants were followed-up and checked with CBCT. 21 OSSEOTITE NT® (3i/implant Innovations, Florida, USA) and 5 OSSEOTITE® implants (3i/implant Innovations, Florida, USA) were placed at anterior region and they were posi...

  3. Neovascular glaucoma treatment with extraction of anterior chamber fibrovascular tissue.

    Science.gov (United States)

    Nadal, Jeroni; Carreras, Elisa; Kudsieh, Bachar; Canut, Maribel

    2013-08-01

    The use of antibody to vascular endothelial growth factor to treat neovascular glaucoma yields good anatomic results in most cases. However, this type of glaucoma can cause angle closure with decompensation of intraocular pressure secondary to fibrovascular tissue contraction in the anterior chamber. Our surgical technique treats the cause by removing the anterior chamber fibrous complex after administration of antibody to vascular endothelial growth factor, thus restoring the chamber angle.

  4. 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.

  5. Mirth and laughter elicited by electrical stimulation of the human anterior cingulate cortex.

    Science.gov (United States)

    Caruana, Fausto; Avanzini, Pietro; Gozzo, Francesca; Francione, Stefano; Cardinale, Francesco; Rizzolatti, Giacomo

    2015-10-01

    Laughter is a complex motor behavior that, typically, expresses mirth. Despite its fundamental role in social life, knowledge about the neural basis of laughter is very limited and mostly based on a few electrical stimulation (ES) studies carried out in epileptic patients. In these studies laughter was elicited from temporal areas where it was accompanied by mirth and from frontal areas plus an anterior cingulate case where laughter without mirth was observed. On the basis of these findings, it has been proposed a dichotomy between temporal lobe areas processing the emotional content of laughter and anterior cingulate cortex (ACC) and motor areas responsible of laughter production. The present study is aimed to understand the role of ACC in laughter. We report the effects of stimulation of 10 rostral, pregenual ACC (pACC) patients in which the ES elicited laughter. In half of the patients ES elicited a clear burst of laughter with mirth, while in the other half mirth was not evident. This large dataset allow us to offer a more reliable picture of the functional contribute of this region in laughter, and to precisely localize it in the cingulate cortex. We conclude that the pACC is involved in both the motor and the affective components of emotions, and challenge the validity of a sharp dichotomy between motor and emotional centers for laughing. Finally, we suggest a possible anatomical network for the production of positive emotional expressions.

  6. Reproducibility of Scleral Spur Identification and Angle Measurements Using Fourier Domain Anterior Segment Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Ricardo J. Cumba

    2012-01-01

    Full Text Available Purpose. To evaluate intraobserver and interobserver agreement in locating the scleral spur landmark (SSL and anterior chamber angle measurements obtained using Fourier Domain Anterior Segment Optical Coherence Tomography (ASOCT images. Methods. Two independent, masked observers (SR and AZC identified SSLs on ASOCT images from 31 eyes with open and nonopen angles. A third independent reader, NPB, adjudicated SSL placement if identifications differed by more than 80 μm. Nine months later, SR reidentified SSLs. Intraobserver and interobserver agreement in SSL placement, trabecular-iris space area (TISA750, and angle opening distance (AOD750 were calculated. Results. In 84% of quadrants, SR’s SSL placements during 2 sessions were within 80 μm in both the X- and Y-axes, and in 77% of quadrants, SR and AZC were within 80 μm in both axes. In adjudicated images, 90% of all quadrants were within 80 μm, 88% in nonopen-angle eyes, and 92% in open-angle eyes. The intraobserver and interobserver correlation coefficients (with and without adjudication were above 0.9 for TISA750 and AOD750 for all quadrants. Conclusions. Reproducible identification of the SSL from images obtained with FD-ASOCT is possible. The ability to identify the SSL allows reproducible measurement of the anterior chamber angle using TISA750 and AOD750.

  7. A Technique of Improved Medial Meniscus Visualization by Anterior Cruciate Ligament Graft Placement in Chronic Anterior Cruciate Deficient Knees.

    Science.gov (United States)

    Vertullo, Christopher J; Wijenayake, Lahann; Grayson, Jane E

    2016-04-01

    It is customary to perform medial meniscus repair before anterior cruciate ligament (ACL) graft placement when undertaken as a combined procedure. However, in chronic ACL-deficient knees, intraoperative anterior tibiofemoral translation can cause the medial meniscus repair to be more technically challenging. Intraoperative anterior tibiofemoral translation can both reduce the visualization of the medial meniscus and make its reduction unstable. An operative sequence alteration of ACL graft placement and tensioning before medial meniscal repair improves medial meniscus visualization in chronically ACL-deficient knees by using the ACL graft's ability to prevent anterior tibiofemoral translation. The technique sequence is as follows: (a) the medial meniscus is reduced, (b) ACL reconstruction is undertaken using a hamstring graft without final tibia fixation,

  8. Purkinje cell activity in the cerebellar anterior lobe after rabbit eyeblink conditioning

    Science.gov (United States)

    Green, John T.; Steinmetz, Joseph E.

    2005-01-01

    The cerebellar anterior lobe may play a critical role in the execution and proper timing of learned responses. The current study was designed to monitor Purkinje cell activity in the rabbit cerebellar anterior lobe after eyeblink conditioning, and to assess whether Purkinje cells in recording locations may project to the interpositus nucleus. Rabbits were trained in an interstimulus interval discrimination procedure in which one tone signaled a 250-msec conditioned stimulus-unconditioned stimulus (CS-US) interval and a second tone signaled a 750-msec CS-US interval. All rabbits showed conditioned responses to each CS with mean onset and peak latencies that coincided with the CS-US interval. Many anterior lobe Purkinje cells showed significant learning-related activity after eyeblink conditioning to one or both of the CSs. More Purkinje cells responded with inhibition than with excitation to CS presentation. In addition, when the firing patterns of all conditioning-related Purkinje cells were pooled, it appeared that the population showed a pattern of excitation followed by inhibition during the CS-US interval. Using cholera toxin-conjugated horseradish peroxidase, Purkinje cells in recording areas were found to project to the interpositus nucleus. These data support previous studies that have suggested a role for the anterior cerebellar cortex in eyeblink conditioning as well as models of cerebellar-mediated CR timing that postulate that Purkinje cell activity inhibits conditioned response (CR) generation during the early portion of a trial by inhibiting the deep cerebellar nuclei and permits CR generation during the later portion of a trial through disinhibition of the cerebellar nuclei. PMID:15897252

  9. Anterior cingulate dopamine turnover and behavior change in Parkinson’s disease

    Science.gov (United States)

    Gallagher, Catherine L; Bell, Brian; Palotti, Matthew; Oh, Jen; Christian, Bradley T.; Okonkwo, Ozioma; Sojkova, Jitka; Buyan-Dent, Laura; Nickles, Robert J.; Harding, Sandra J.; Stone, Charles K.; Johnson, Sterling C.; Holden, James E.

    2015-01-01

    Subtle cognitive and behavioral changes are common in early Parkinson’s disease. The cause of these symptoms is probably multifactorial but may in part be related to extra-striatal dopamine levels. 6-[18F]-Fluoro-L-dopa (FDOPA) positron emission tomography has been widely used to quantify dopamine metabolism in the brain; the most frequently measured kinetic parameter is the tissue uptake rate constant, Ki. However, estimates of dopamine turnover, which also account for the small rate of FDOPA loss from areas of specific trapping, may be more sensitive than Ki for early disease-related changes in dopamine biosynthesis. The purpose of the present study was to compare effective distribution volume ratio (eDVR), a metric for dopamine turnover, to cognitive and behavioral measures in Parkinson’s patients. We chose to focus the investigation on anterior cingulate cortex, which shows highest FDOPA uptake within frontal regions and has known roles in executive function. 15 Non-demented early-stage PD patients were pretreated with carbidopa and tolcapone, a central catechol-O-methyl transferase (COMT) inhibitor and then underwent extended imaging with FDOPA PET. Anterior cingulate eDVR was compared with composite scores for language, memory, and executive function measured by neuropsychological testing, and behavior change measured using two informant-based questionnaires, the Cambridge Behavioral Inventory and the Behavior Rating Inventory of Executive Function- Adult Version. Lower mean eDVR (thus higher dopamine turnover) in anterior cingulate cortex was related to lower (more impaired) behavior scores. We conclude that subtle changes in anterior cingulate dopamine metabolism may contribute to dysexecutive behaviors in Parkinson’s disease. PMID:25511521

  10. CT-guided celiac plexus block with absolute alcohol : the anterior approach

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Min; Lee, Mi Suk; Jang, Young Ik; Kim, Jeong Hoi; Ym, Seong Hee; Lee, Jin Hee [Namwon Medical Center, Namwon (Korea, Republic of); Han, Young Min; Kim, Chong Soo; Choi, Ki Chul [Chonbuk National Univ. College of Medicine, Chonju (Korea, Republic of)

    1997-07-01

    To evaluate the safety and efficacy of CT-guided celiac plexus block (CPB) using an anterior approach, and to determine the role of CT in this procedure. CPB was attempted in 15 patients(10 men and 5 women;mean age, 62.3 years) with intractable upper abdominal pain due to terminal malignancy of the pancreas, liver, bowel,and kidney. To permit an anterior approach, patients lied supine on the CT scan table during the procedure. One or two 21-guage needles were placed just anterior to the diaphragmatic crus at or between the levels of the celiac and superior mesenteric arteries and 10-40ml of 99.9% alcohol was injected. Pain relief following the procedure was assessed and pain was graded on a visual analogue scale (VAS) from 0 to 10. There were no technical failures and no neurologic or hemorrhagic complications. Abdominal pain during alcohol injection occurred in all patients, and transient hypotension in three. One patient with recurrent cancer of the pancreatic head died of sepsis five days after the procedure;the cause of sepsis was difficult to determine, but there was thought to be a biliary source of infection. Two days after block, 13 of 15 procedures(86.7%) had produced at least partial pain relief;in 12 patients, relief was good. With CT guidance, more directed positioning of the needle is possible, allowing alcohol to be deposited in specific ganglion areas. CT-guided celiac plexus block using an anterior approach was an easy and effective way of reducing intractable upper abdominal pain due to terminal malignancies. CT guidance allowed precise needle placement and a safer procedure.

  11. 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

  12. Humeral avulsion of the anterior shoulder stabilizing structures after anterior shoulder dislocation: demonstration by MRI and MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Tirman, P.F.J. [San Francisco Magnetic Resonance Center, San Francisco, CA (United States); Steinbach, L.S. [Department of Radiology, University of California, San Francisco, CA (United States); Feller, J.F. [Department of Veterans Affairs, David Grant USAF Medical Center, Travis Air Force Base, CA (United States); Stauffer, A.E. [Radiologic Imaging Associates, Mission Viejo, CA (United States)

    1996-11-01

    Objective. To demonstrate the MRI findings of an anterior shoulder capsular avulsion from the humerus, with or without subscapularis rupture, after anterior dislocation or severe abduction external rotation injury. Design and patients. We retrospectively reviewed the MRI and MR arthrographic examinations of seven patients who were identified at surgery with avulsion of the anterior shoulder stabilizers from the humerus. MRI was correlated with clinical history and surgical results. Results. MRI findings included: inhomogeneity or frank disruption of the anterior capsule at the humeral insertion (all), fluid intensity anterior to the shoulder (six patients), tear of the subscapularis tendon (six patients), dislocation of the biceps tendon (four patients), and a Hill-Sachs deformity (four patients). MR arthrography additionally found extravasation of contrast through the capsular defect (two patients). Conclusions. Our findings suggest that MRI is helpful for diagnosing humeral avulsion of the anterior glenohumeral capsule, especially when a tear of the subscapularis tendon insertion is present. MR arthrography may be of benefit for diagnosing capsular avulsion without associated subscapularis tendon abnormality. (orig.). With 4 figs.

  13. 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.

  14. Long anterior mandibular tooth roots in Neanderthals are not the result of their large jaws.

    Science.gov (United States)

    Le Cabec, Adeline; Kupczik, Kornelius; Gunz, Philipp; Braga, José; Hublin, Jean-Jacques

    2012-11-01

    Tooth root length has been shown to taxonomically distinguish Neanderthals from modern humans. However, this may result from differences in jaw size between both taxa, although most previous studies have revealed a very low or non-existent correlation between tooth size and jaw size in recent modern humans. We therefore investigated, within a broader taxonomical frame, to what extent measurements on the anterior tooth roots and the symphyseal region covary. Our samples comprise permanent mandibular incisors and canines from Mauer, Neanderthals, and extant and fossil modern humans sensu lato. Using micro-computed tomography, we took linear and cross-sectional surface area measurements of the roots and the symphyseal region and calculated the root volume. We also measured 3D landmarks to quantify the overall size of the mandible using centroid size. Furthermore, we analyzed the relationship between root size and symphyseal shape, based on Procrustes shape variables of semi-landmarks along the symphyseal outline. Our results show that Neanderthals have significantly larger anterior tooth roots than recent modern humans in terms of root length, mid-sagittal surface area and volume, even after correction for mandibular size. In contrast, symphyseal height and width do not differ significantly between both taxa, whereas, without scaling, the mid-sagittal symphyseal surface area and the centroid size of the mandible do differ. Importantly, no significant correlation was found between any of the root and symphyseal measurements after correction for overall mandibular size. The shape analyses revealed that Neanderthals have a vertical symphyseal profile with an evenly-thick symphysis, whereas recent modern humans display an unevenly-thick symphysis, comprising a pronounced incurvatio mandibularis and a bony chin. These results suggest a negative evolutionary allometry for the recent modern human anterior root size. Therefore, root length and other root dimensions can be

  15. 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

  16. 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.

  17. 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.)

  18. 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.

  19. [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.

  20. 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.

  1. 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

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. Anterior chamber lenses. Part II: A laboratory study.

    Science.gov (United States)

    Apple, D J; Hansen, S O; Richards, S C; Ellis, G W; Kavka-Van Norman, D; Tetz, M R; Pfeffer, B R; Park, R B; Crandall, A S; Olson, R J

    1987-03-01

    An analysis of 606 surgically removed anterior chamber intraocular lens (IOL) specimens revealed that 351 or 58% of these were small-diameter, round loop, closed-loop styles. Because of the extremely high percentage of IOLs with this design received in our laboratory and the correlation of clinical histories with our histopathologic findings, we have concluded that such IOLs do not provide the safety and efficacy achieved by other anterior chamber lens designs. The finely polished, one-piece, all-PMMA styles fared well in our study. Although these one-piece styles comprise well over 50% of the American market share of anterior chamber IOLs, they comprise only 14% of all anterior chamber IOLs accessioned in our laboratory, compared to 58% for closed-loop designs. We believe that implantation of anterior chamber lenses with small-diameter, round, closed loops is no longer warranted. Patients in whom these IOLs have already been implanted should be carefully followed. It is our opinion that the FDA should recall or closely monitor all IOLs of this design and that implantation of closed-loop lenses should be discontinued in the United States. Furthermore, we believe that an IOL deemed to be not medically sound or worthy of implantation in the United States should not be marketed or donated outside of this country.

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

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

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    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.

  9. 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.

  10. Unilateral persistent fetal vasculature coexisting with anterior segment dysgenesis.

    Science.gov (United States)

    Khokhar, Sudarshan; Gupta, Shikha; Arora, Tarun; Gogia, Varun; Dada, Tanuj

    2013-08-01

    Persistent fetal vasculature (PFV) is a common congenital developmental anomaly of the eye which results from failure of the embryological primary vitreous and hyaloid vasculature to regress by the time of birth (Int Ophthalmol Clin 48: 53-62, 2008). Typically, it is divided into anterior, posterior or combined types and is characterized by the presence of a vascular stalk located between the optic disc and the posterior lens capsule (Int Ophthalmol Clin 48: 53-62, 2008). Although it has been reported to manifest itself differently, in our case it presented in a microphthalmic eye as anterior segment dysgenesis with broad-based mid-peripheral synechiae, posterior embryotoxon, iridoschisis, ectropion uveae, hypotony and subluxated cataractous lens with a taut anterior hyaloid face which are rare associations with PFV.

  11. Anterior Segment Imaging in Ocular Surface Squamous Neoplasia

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    Sally S. Ong

    2016-01-01

    Full Text Available Recent advances in anterior segment imaging have transformed the way ocular surface squamous neoplasia (OSSN is diagnosed and monitored. Ultrasound biomicroscopy (UBM has been reported to be useful primarily in the assessment of intraocular invasion and metastasis. In vivo confocal microscopy (IVCM shows enlarged and irregular nuclei with hyperreflective cells in OSSN lesions and this has been found to correlate with histopathology findings. Anterior segment optical coherence tomography (AS-OCT demonstrates thickened hyperreflective epithelium with an abrupt transition between abnormal and normal epithelium in OSSN lesions and this has also been shown to mimic histopathology findings. Although there are limitations to each of these imaging modalities, they can be useful adjunctive tools in the diagnosis of OSSN and could greatly assist the clinician in the management of OSSN patients. Nevertheless, anterior segment imaging has not replaced histopathology’s role as the gold standard in confirming diagnosis.

  12. Complex aesthetic treatment on anterior maxillary teeth with malposition

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    Febriastuti Febriastuti

    2008-12-01

    Full Text Available Background: Complex aesthetic treatment on anterior teeth involves more than one caries tooth with malformed shape and malposition. Purpose: The purpose of this paper is to find the alternative treatment for anterior maxillary teeth with malposition. Case: In this case, a 25 year-old man with a peg shaped teeth and caries on several teeth and malposition can be treated with complex aesthetic treatment. Case management: Endodontic pulpectomy treatment on anterior maxillary teeth and post construction with splint porcelain fused to metal crowns on 11, 12, and 21, 22 to correct the shape and position into normal position. Conclusion: Malformed and malpositioned teeth with caries can be treated with complex aesthetic treatment.

  13. 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.

  14. Dysphagia Secondary to Anterior Osteophytes of the Cervical Spine.

    Science.gov (United States)

    Egerter, Alexander C; Kim, Eric S; Lee, Darrin J; Liu, Jonathan J; Cadena, Gilbert; Panchal, Ripul R; Kim, Kee D

    2015-10-01

    Study Design Retrospective case series. Objective Diffuse idiopathic skeletal hyperostosis (DISH) or Forestier disease involves hyperostosis of the spinal column. Hyperostosis involving the anterior margin of the cervical vertebrae can cause dysphonia, dyspnea, and/or dysphagia. However, the natural history pertaining to the risk factors remain unknown. We present the surgical management of two cases of dysphagia secondary to cervical hyperostosis and discuss the etiology and management of DISH based on the literature review. Methods This is a retrospective review of two patients with DISH and anterior cervical osteophytes. We reviewed the preoperative and postoperative images and clinical history. Results Two patients underwent anterior cervical osteophytectomies due to severe dysphagia. At more than a year follow-up, both patients noted improvement in swallowing as well as their associated pain. Conclusion The surgical removal of cervical osteophytes can be highly successful in treating dysphagia if refractory to prolonged conservative therapy.

  15. 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.

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

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    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. Refraction and eye anterior segment parameters in schizophrenic patients

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    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.

  18. 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.

  19. 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.

  20. 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

  1. Component rotation and anterior knee pain after total knee arthroplasty.

    Science.gov (United States)

    Barrack, R L; Schrader, T; Bertot, A J; Wolfe, M W; Myers, L

    2001-11-01

    All patients undergoing cruciate-retaining primary total knee arthroplasty for degenerative osteoarthritis at one center were studied prospectively. Clinical and radiographic followup was obtained at a minimum 5 years in 102 knees in 73 patients. Patients were asked specifically about the presence of the pain in the anterior aspect of the knee in the vicinity of the patella and rated the severity of the pain on a visual analog scale. Significant anterior knee pain rating at least 3 of 10 on the visual analog scale was present in 16 knees (13 patients). Eleven patients with 14 symptomatic knees agreed to undergo computed tomography scanning to accurately determine the rotation of the tibial and femoral components. The epicondylar axis and tibial tubercle were used as references using a previously validated technique. A control group of 11 asymptomatic patients (14 knees), matched for age, gender, and length of followup also underwent computed tomography scanning. All patients in both groups had normal axial alignment. There was a highly significant difference in tibial component rotation between the two groups with the patients with anterior knee pain averaging 6.2 degrees internal rotation compared with 0.4 degrees external rotation in the control group. There also was a significant difference in combined component rotation with the patients with anterior knee pain averaging 4.7 degrees internal rotation compared with 2.6 degrees external rotation in the control group. There was no significant difference in the degree of radiographic patellar tilt or patellar subluxation between the two groups. Patients with combined component internal rotation were more than five times as likely to experience anterior knee pain after total knee arthroplasty compared with those with combined component external rotation. Component malrotation is a significant factor in the development of anterior knee pain after total knee arthroplasty.

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

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    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

  3. Hyperlexia and ambient echolalia in a case of cerebral infarction of the left anterior cingulate cortex and corpus callosum.

    Science.gov (United States)

    Suzuki, Tadashi; Itoh, Shouichi; Hayashi, Mototaka; Kouno, Masako; Takeda, Katsuhiko

    2009-10-01

    We report the case of a 69-year-old woman with cerebral infarction in the left anterior cingulate cortex and corpus callosum. She showed hyperlexia, which was a distinctive reading phenomenon, as well as ambient echolalia. Clinical features also included complex disorders such as visual groping, compulsive manipulation of tools, and callosal disconnection syndrome. She read words written on the cover of a book and repeated words emanating from unrelated conversations around her or from hospital announcements. The combination of these two features due to a focal lesion has never been reported previously. The supplementary motor area may control the execution of established subroutines according to external and internal inputs. Hyperlexia as well as the compulsive manipulation of tools could be interpreted as faulty inhibition of preexisting essentially intact motor subroutines by damage to the anterior cingulate cortex reciprocally interconnected with the supplementary motor area.

  4. Aesthetic perception of single implants placed in the anterior zone. A cross-sectional study

    Science.gov (United States)

    Burgueño-Barris, Genís; Cortés-Acha, Berta; Valmaseda-Castellón, Eduard

    2016-01-01

    Background Several aesthetic indexes have been described to assess implant aesthetics. The aim of this study was to compare the aesthetic assessment made by dental professionals and students of single-tooth implants placed in the upper incisors. Material and Methods A cross-sectional survey study using a subjective questionnaire to assess the aesthetics in 3 implant supported single-tooth cases in the anterior maxilla was performed. The interviewed subjects were divided into 4 groups: dentists with experience in implant treatment, dentists without experience in implants and 3rd and 5th year dental students. The questionnaire consisted of 2 visual analogue scales (VAS) to evaluate aesthetics, the pink esthetic score (PES), the white esthetic score (WES) and the simplified papilla index (PI). Results One-hundred dentists and one-hundred dental students filled the aesthetic assessment questionnaire. The results showed that the subjects were more critical than reference values, specially concerning prosthetic issues. The differences between groups were more obvious in the case with the best result. On the other hand, few differences were detected in the remaining cases. Regarding soft tissue and crown features, experienced dentists in implant dentistry were the most demanding. Cronbach’s Alpha showed values ≥ 0,8 in the questionnaire in every case, which indicates an adequate reliability. Conclusions Dentists and dental students have different opinions when assessing aesthetics of single tooth implant supported cases. Experience and area of expertise seem to influence the evaluation of aesthetics in the anterior region. Key words:Dental implant, anterior area, aesthetics. PMID:27031072

  5. Anterior hippocampus: the anatomy of perception, imagination and episodic memory

    Science.gov (United States)

    Zeidman, Peter; Maguire, Eleanor A.

    2017-01-01

    The brain creates a model of the world around us. We can use this representation to perceive and comprehend what we see at any given moment, but also to vividly re-experience scenes from our past and imagine future (or even fanciful) scenarios. Recent work has shown that these cognitive functions — perception, imagination and recall of scenes and events — all engage the anterior hippocampus. Here we capitalise on new findings from functional neuroimaging to propose a model that links high-level cognitive functions to specific structures within the anterior hippocampus. PMID:26865022

  6. Anterior mediastinal paraganglioma: A case for preoperative embolization

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    Shakir Murtaza

    2012-07-01

    Full Text Available Abstract Background Paraganglioma is a rare but highly vascular tumor of the anterior mediastinum. Surgical resection is a challenge owing to the close proximity to vital structures including the heart, trachea and great vessels. Preoperative embolization has been reported once to facilitate surgical treatment. Case presentation We report a case of anterior mediastinal paraganglioma that was embolized preoperatively, and was resected without the need for cardiopulmonary bypass and without major bleeding complications. Conclusion We make a case to further the role of preoperative embolization in the treatment of mediastinal paragangliomas.

  7. Brain stimulation for intractable epilepsy: Anterior thalamus and responsive stimulation

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    Vibhor Krishna

    2014-01-01

    Full Text Available Despite medications, resective surgery, and vagal nerve stimulation, some patients with epilepsy continue to have seizures. In these patients, other approaches are urgently needed. The biological basis of stimulation of anterior thalamic nucleus and epileptogenic focus is presented. Results from two large randomized controlled trials Stimulation of Anterior Nucleus of Thalamus for Epilepsy (SANTE and Neuropace pivotal trial are discussed. Neuromodulation provides effective treatment for a select group of refractory epilepsy patients. Future investigations into the mechanism underlying ′response′ to brain stimulation are desired.

  8. Correction of anterior open bite in a case of achondroplasia

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    Karpagam S

    2005-01-01

    Full Text Available Treatment planning for patients with skeletal deformities is often considered challenging. This article reports a female patient with achondroplasia who presented with severe maxillary retrognathism and vertical excess along with anterior open bite. The clinical and cephalometric findings of the patient are detailed here. The treatment plan consisted of modified anterior maxillary osteotomy for simultaneous vertical and sagittal augmentation along with orthodontic intervention. The course of surgical-orthodontic treatment and the results are presented. This treatment is to be followed by correction of vertical maxillary excess after completion of growth. This paper concludes that the dentoalveolar component of a skeletal deformity can be handled independent of the craniofacial management.

  9. Traumatic Anterior Dislocation of Hip in a Child- Case Report

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    S Ahmad

    2015-03-01

    Full Text Available Traumatic hip dislocation in children is relatively rare accounting for about 5% of all hip dislocations. Most of the hip dislocations seen in children are of the posterior type but the much rarer anterior and anterior-inferior (obturator types have also been described. We present the case of an eight years old girl with an obturator type of hip dislocation following trivial trauma. She was treated with closed reduction and immobilisation in skin traction for three weeks. She was followed up closely for one year and did not develop any complications during that period.

  10. Anterior internal lenticonus accompanied by congenital nuclear cataract

    Institute of Scientific and Technical Information of China (English)

    LIU Zhe; SUN Chuan-bin; YAO Ke

    2011-01-01

    Internal lenticonus is a very rare morphologic abnormality of crystalline lens which has been reported in only several cases in the literature.We herein reported the clinical characteristics and surgical findings of the anterior internal lenticonus accompanied by congenital nuclear cataract.Cataract extraction accompanied with intraocular lens implantation was uneventfully performed,and a good visual outcome was achieved in this case.Viral infection during embryonal and fetal period might account for the formation of the anterior internal lenticonus and congenital nuclear cataract in our case.

  11. 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.

  12. 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.

  13. A root submergence technique for pontic site development in fixed dental prostheses in the maxillary anterior esthetic zone

    OpenAIRE

    Choi, Sunyoung; Yeo, In-Sung; Kim, Sung-Hun; Lee, Jai-Bong; Cheong, Chan Wook; Han, Jung-Suk

    2015-01-01

    Purpose This case report discusses the effect of a root submergence technique on preserving the periodontal tissue at the pontic site of fixed dental prostheses in the maxillary anterior aesthetic zone. Methods Teeth with less than ideal structural support for fixed retainer abutments were decoronated at the crestal bone level. After soft tissue closure, the final fixed dental prostheses were placed with the pontics over the submerged root area. Radiographic and clinical observations at the p...

  14. On the role of the anterior prefrontal cortex in cognitive 'branching': An fMRI study.

    Science.gov (United States)

    Chahine, George; Diekhof, Esther Kristina; Tinnermann, Alexandra; Gruber, Oliver

    2015-10-01

    The most anterior portion of prefrontal cortex (aPFC), more specifically Brodman Area 10 (BA10), has been implicated in 'branching operations', or the ability to perform tasks related to one goal, while keeping in working memory information related to a secondary goal. Such findings have been based on fMRI recordings under complex behavioral paradigms that compare 'branching' tasks with tasks where one goal is pursued at a time, but are limited by their complete reliance on verbal working memory and by small sample sizes. Here, we test the specificity of BA 10 to branching in similar behavioral paradigms but with a larger sample and in two different conditions involving verbal and visual working memory respectively. We find that BA 10 and other frontal and parietal brain areas are activated in all tasks, with an extent and level of significance increasing with the complexity of the task. We conclude that the activation of BA 10 is not specific to branching as previously hypothesized, but is related to the level of complexity of working memory performance. For further insight into the specific role of anterior portions of the frontal cortex we highlight the importance of simple control tasks with gradual and incremental increase in complexity.

  15. 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.

  16. 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.

  17. 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.

  18. Anterior Displacement of Lamina Cribrosa during Valsalva Maneuver in Young Healthy Eyes.

    Directory of Open Access Journals (Sweden)

    Yong Woo Kim

    Full Text Available To investigate lamina cribrosa (LC displacement during the Valsalva maneuver in young healthy eyes using enhanced depth imaging (EDI spectral-domain optical coherence tomography (SD-OCT.Forty-eight eyes of 48 young healthy volunteers (age range: 20-34 years underwent intraocular pressure (IOP measurement by Goldmann applanation tonometry as well as Cirrus HD-OCT scans before and during the Valsalva maneuver. The optic nerve head (ONH parameters (average retinal nerve fiber layer thickness, rim area, disc area, average C/D ratio, vertical C/D ratio, cup volume, anterior LC depth (LCD, subfoveal and peripapillary choroidal thickness, and neural canal opening diameter were measured on compensated OCT and compared during Valsalva challenge. The subjects were asked to take a five-minute break after each Valsalva maneuver.During the Valsalva maneuver, the IOP significantly increased, from 12.7 ± 3.0 mmHg to 16.0 ± 3.2 mmHg (P 0.05.The Valsalva maneuver induced anterior displacement of the LC, but did not alter the choroidal thickness or ONH morphology. The data describe the positional characteristics of the LC in response to the Valsalva maneuver in young healthy eyes.

  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. Anterior cruciate ligament: 3-D fiber anatomy, fluorescence arthroscopy & healing

    NARCIS (Netherlands)

    Nguyen, D.T.

    2015-01-01

    One of the current emphases in optimizing anterior cruciate ligament (ACL) reconstructions is closer mimicking the anatomy of the ACL. The aim of Chapter 2 and Chapter 3 is to develop and validate a methodology to quantify the 3-D collagen fiber orientation of ligaments, accurately and at a high res

  1. Anterior Colporrhaphy Technique and Approach Choices: Turkey Evaluation

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    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.

  2. Complications of the anterior approach to the cervical spine

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    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.

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

    DEFF Research Database (Denmark)

    Nakagawa, Yoshinao; Ratkevicius, Aivaras; Mizuno, Masao

    2005-01-01

    PURPOSE: The aim of this study was investigate ATP economy of force maintenance in the human tibialis anterior muscle during 60 s of anaerobic voluntary contraction at 50% of maximum voluntary contraction (MVC). METHODS: ATP turnover rate was evaluated using P magnetic resonance spectroscopy (P...

  4. A case of anterior ischemic optic neuropathy associated with uveitis

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    Sugahara M

    2013-05-01

    Full Text Available Michitaka Sugahara, Takayuki Fujimoto, Kyoko Shidara, Kenji Inoue, Masato Wakakura Inouye Eye Hospital, Tokyo, Japan Introduction: Here, we describe a patient who presented with anterior ischemic optic neuropathy (AION and subsequently developed uveitis. Case: A 69-year-old man was referred to our hospital and initially presented with best-corrected visual acuities (BCVA of 20/40 (right eye and 20/1000 (left eye and relative afferent pupillary defect. Slit-lamp examination revealed no signs of ocular inflammation in either eye. Fundus examination revealed left-eye swelling and a pale superior optic disc, and Goldmann perimetry revealed left-eye inferior hemianopia. The patient was diagnosed with nonarteritic AION in the left eye. One week later, the patient returned to the hospital because of vision loss. The BCVA of the left eye was so poor that the patient could only count fingers. Slit-lamp examination revealed 1+ cells in the anterior chamber and the anterior vitreous in both eyes. Funduscopic examination revealed vasculitis and exudates in both eyes. The patient was diagnosed with bilateral panuveitis, and treatment with topical betamethasone was started. No other physical findings resulting from other autoimmune or infectious diseases were found. No additional treatments were administered, and optic disc edema in the left eye improved, and the retinal exudates disappeared in 3 months. The patient's BCVA improved after cataract surgery was performed. Conclusion: Panuveitis most likely manifests after the development of AION. Keywords: anterior ischemic optic neuropathy, uveitis

  5. Left Anterior Descending Artery-Pulmonary Artery Fistula

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    Turan Ege

    2011-12-01

    Full Text Available Despite the fact that coronary arteriovenous fistulas constitute approximately half (48% of coronary artery anomalies, they are rarely seen anomalies. In this report,we aim to present a coronary arteriovenous fistula case detected during a coronary angiography between left anterior descending artery and pulmonary artery.

  6. Anterior orbital varix presenting as a lacrimal sac mucocele.

    Science.gov (United States)

    Nasr, A M; Huaman, A M

    1998-05-01

    A 35-year-old woman was referred to the Oculoplastics Clinic because of a left nasal swelling and intermittent tearing of 1 year's duration. The clinical examination and echographic and radiologic findings were consistent with an anterior venous anomaly. Complete surgical excision was performed and histopathology confirmed the diagnosis of a varix.

  7. 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…

  8. 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

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

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    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.

  10. Rare times rare: The hyponatremia, rhabdomyolysis, anterior compartment syndrome sequence.

    Science.gov (United States)

    Dubin, Ina; Gelber, Moshe; Schattner, Ami

    2016-05-01

    Primary polydipsia occurs in up to 25% of patients with chronic psychiatric disorders (especially schizophrenia), related to the disease, its treatment or both. Urine output fails to match intake >10 L/day and water intoxication may develop. Rhabdomyolysis is a rare complication of hyponatremia, and an acute anterior compartment syndrome of the leg, an emergency, may be very rarely associated.

  11. Anterior cingulate cortex involvement in subclinical social anxiety.

    Science.gov (United States)

    Duval, Elizabeth R; Hale, Lisa R; Liberzon, Israel; Lepping, Rebecca; N Powell, Joshua; Filion, Diane L; Savage, Cary R

    2013-12-30

    We demonstrated differential activation in the anterior cingulate cortex (ACC) between subjects with high and low social anxiety in response to angry versus neutral faces. Activation in the ACC distinguished between facial expressions in the low, but not the high, anxious group. The ACC's role in threat processing is discussed.

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

    NARCIS (Netherlands)

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

    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

  13. 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.

  14. Innovation in prediction planning for anterior open bite correction.

    Science.gov (United States)

    Almuzian, Mohammed; Almukhtar, Anas; O'Neil, Michael; Benington, Philip; Al Anezi, Thamer; Ayoub, Ashraf

    2015-05-01

    This study applies recent advances in 3D virtual imaging for application in the prediction planning of dentofacial deformities. Stereo-photogrammetry has been used to create virtual and physical models, which are creatively combined in planning the surgical correction of anterior open bite. The application of these novel methods is demonstrated through the surgical correction of a case.

  15. Value, search, persistence and model updating in anterior cingulate cortex

    NARCIS (Netherlands)

    Kolling, N.; Wittmann, M.K.; Behrens, T.E.J.; Boorman, E.D.; Mars, R.B.; Rushworth, M.F.S.

    2016-01-01

    Dorsal anterior cingulate cortex (dACC) carries a wealth of value-related information necessary for regulating behavioral flexibility and persistence. It signals error and reward events informing decisions about switching or staying with current behavior. During decision-making, it encodes the avera

  16. 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 e...

  17. 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

  18. Esthetic rehabilitation of crowded and protruded anterior dentition

    Directory of Open Access Journals (Sweden)

    Cecilia G. J. lunardhi

    2009-03-01

    Full Text Available Background: Recent trends put estheticrehabilitationas a demandingtreatmentin order to correct malpositionedanteriordentition. This is enhanced by the patient’s background, especially careers that require prime appearance for the public. Purpose: To describe that even though there are many treatment alternatives and procedures, esthetic rehabilitation on crowded and protruded anterior dentition using endodontic treatment, cast posts and all ceramic crowns, can improve patient’s appearance. Case: This article presents a case report on esthetic rehabilitation of crowded and protruded anterior dentition. Treatment was done due to patient’s refusal in receiving orthodontic treatment. The patient requested esthetic rehabilitation as an expectation for faster and instant esthetic result. Case management: Endodontic treatment was done to the involved dentition prior to the final restoration. Cast posts and all ceramic crowns were used as final restoration to correct the crowded and protruded anterior teeth. Conclusion: Esthetic rehabilitation can be done successfully on crowded and protruded anterior dentition. Instant result could be achieved by this treatment. This is supported by the fact that dentists should be aware of not only choosing the right treatment and materials but also patient’s expectations and conditions.

  19. Breast Reinnervation: DIEP Neurotization Using the Third Anterior Intercostal Nerve

    Directory of Open Access Journals (Sweden)

    Aldona J. Spiegel, MD

    2013-11-01

    Conclusion: DIEP flap neurotization using the third anterior intercostal nerve is an effective technique to provide a significant increase in sensory recovery for breast reconstruction patients, while adding minimal surgical time. Additionally, the use of a nerve conduit produces increased sensory recovery when compared direct coaptation.

  20. 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.

  1. 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.

  2. 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...

  3. 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...

  4. 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...

  5. 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

  6. Esthetic Rehabilitation of Anterior Teeth with Laminates Composite Veneers

    OpenAIRE

    Dino Re; Gabriele Augusti; Massimo Amato; Giancarlo Riva; Davide Augusti

    2014-01-01

    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...

  7. Anastomoselaekage efter lav anterior resektion for cancer recti

    DEFF Research Database (Denmark)

    Bülow, S; Moesgaard, F A; Billesbølle, P;

    1997-01-01

    the routine use of a peroperative leakage test and selective use of prophylactic ostomy in cases of unsatisfactory anastomosis. Furthermore, it is recommended that low anterior resection for rectal cancer is limited to few surgeons in each department in order to ensure a uniform quality and hopefully also...

  8. 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.

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

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    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.

  10. Anterior and posterior centers jointly regulate Bombyx embryo body segmentation.

    Science.gov (United States)

    Nakao, Hajime

    2012-11-15

    Insect embryo segmentation is largely divided into long and short germ types. In the long germ type, each segment primordium is represented on a large embryonic rudiment of the blastoderm, and segmental patterning occurs nearly simultaneously in the syncytium. In the short germ type, however, only anterior segments are represented in the small embryonic rudiment, usually located on the egg posterior, and the rest of the segments are added sequentially from the posterior growth zone in a cellular context. The long germ type is thought to have evolved from the short germ type. It is proposed that this transition, which appears to have occurred multiple times over the course of evolution, was realized through the acquisition of a localized anterior instruction center. Here, I examined the early segmentation process in the silkmoth Bombyx mori, a lepidopteran insect, in which the mechanisms of anterior-posterior (AP) axis formation have not been well analyzed. In this insect, both the long germ and short germ features have been reported. The mRNAs for two key genes involved in insect AP axis formation, orthodenticle (Bm-otd) and caudal (Bm-cad), are localized maternally in the germ anlage, where they act as anterior and posterior instruction centers, respectively. RNAi studies indicate that, while Bm-cad affects the formation of all the even skipped (Bm-eve) stripes, there is also anterior Bm-eve stripe formation activity that involves Bm-otd. Thus, there is redundancy in Bm-eve stripe formation activity that must be coordinated. Some genetic interactions, identified either experimentally or hypothetically, are also introduced, which might enable robust AP formation in this organism.

  11. The management of over closured anterior teeth due to attrition

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    Eha Djulaeha

    2009-12-01

    Full Text Available Background: Tooth is the hardest tissue in human body, that can be injured because of attrition process. For old people, denture attrition process is caused by psysiological process relating with the mastication function which also supported by some bad habits such an bruxism, premature contact, and consuming habit of abrasive food. Attrition or abrasion can also be happened with patien’t dentition who does not have teeth subtutition for long time due the lost of their maxillary as well as mandibulary. The pasient will loose their vertical dimension of occlusion, injure, and the lower jaw becomes over closed which is called over closure. Purpose: This article reported the management of over closured anterior teeth due to attrition. Case: a seventy six year old woman patient came to Prosthodontic Clinic in Faculty of Dentistry, Airlangga University, to rehabilitate her upper and lower severe attrited anterior teeth and her posterior teeth. The patient has experienced of wearing acrylic removable mandibular partial denture ten years ago. Unfortunaly, the denture was uncomfortable, and she did not wear it anymore since five years ago. Case management: The severe attrition of anterior teeth with the lost of occlusal vertical dimension can be treated by improving the occlusal vertical dimension gradually. The treatment is then followed by the increasing of the height of the anterior teeth by lengthening the crown teeth of upper jaw with 12 units of span bridge and the acrylic removable partial denture of lower jaw. Conclusion: The severe attrition of anterior teeth with the lost of occlusal vertical dimension can be treated by improving the occlusal vertical dimension gradually, using long span bridge and acrylic removable partial denture.

  12. Diagnóstico e tratamento do lenticone anterior

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    Ana Luiza Biancardi

    2011-08-01

    Full Text Available Relato de caso de um paciente de 18 anos com sindrome de Alport apresentando perda visual progressiva. A biomicroscopia revelou lenticone anterior bilateral. O paciente realizou tomografia de córnea e segmento anterior com o sistema Scheimpflug (Pentacam e aberrometria e topografia corneana (i-Trace. O paciente foi submetido à facoemulsificação com implante de lente intraocular peça única hidrofóbica (Acrysof® SN60AT. As imagens de Scheimpflug documentaram o lenticone anterior. A aberrometria total mostrou acentuado astigmatismo miópico com acentuada aberração esférica negativa, havendo grande impacto das aberrações de alta ordem (HOA na conversão da letra E de Snellen. O mapa de integração da aberrometria do olho todo com a topografia corneana mostrou maior semelhança das aberrrações totais com as aberrações intraoculares do que com as aberrações da superfície anterior da córnea. Após a cirurgia, o paciente apresentou acuidade visual corrigida igual a 20/20 em ambos os olhos, as imagens de Scheimpflug revelaram lentes intraoculares tópicas e os mapas diferenciais revelaram resolução da miopia e redução das aberrações da alta ordem (total e interna. Os exames de imagem foram úteis para demonstrar o impacto do lenticone anterior na qualidade visual e a resolução das aberrações ópticas após a cirurgia.

  13. Morphological character of cervical spine for anterior transpedicular screw fixation

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    Rong-Ping Zhou

    2013-01-01

    Full Text Available Background: Anterior cervical interbody grafts/cages combined with a plate were frequently used in multilevel discectomies/corpectomies. In order to avoid additional posterior stabilization in patients who undergo anterior reconstructive surgery, an anterior cervical transpedicular screw fixation, which offers higher stability is desirable. We investigated in this study the anatomical (morphologic characters for cervical anterior transpedicular screw fixation. Materials and Methods: Left pedicle parameters were measured on computed tomography (CT images based on 36 cervical spine CT scans from healthy subjects. The parameters included outer pedicle width (Distance from lateral to medial pedicle surface in the coronal plane, outer pedicle height (OPH (Distance from upper to lower pedicle surface in the sagittal plane, maximal pedicle axis length (MPAL, distance transverse insertion point (DIP, distance of the insertion point to the upper end plate (DIUP, pedicle sagittal transverse angle (PSTA and pedicle transverse angle (PTA at C3 to C7. Results: The values of outer pedicle width and MPAL in males were larger than in females from C3 to C7. The OPH in males was larger than in females at C3 to C6, but there was no difference at C7. The DIP and PTA were significantly greater in males than in females at C3, but there was no difference in the angle at C4-7. The PSTA was not statistically different between genders at C3, 4, 7, but this value in males was larger than females at C5, 6. The DIUP was significantly greater in males at C3, 4, 6, 7 but was non significant at C5. Conclusions: The placement of cervical anterior transpedicular screws should be individualized for each patient and based on a detailed preoperative planning.

  14. 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.

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

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    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.

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

    OpenAIRE

    Rachele Censi; Virna Vavassori; Andrea Enrico Borgonovo; Dino Re

    2014-01-01

    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 executi...

  17. Interhemispheric Connections between the Primary Visual Cortical Areas via the Anterior Commissure in Human Callosal Agenesis

    OpenAIRE

    van Meer, Nathalie; Houtman, Anne C.; Van Schuerbeek, Peter; Vanderhasselt, Tim; Milleret, Chantal; ten Tusscher, Marcel P.

    2016-01-01

    Aim: In humans, images in the median plane of the head either fall on both nasal hemi-retinas or on both temporal hemi-retinas. Interhemispheric connections allow cortical cells to have receptive fields on opposite sides. The major interhemispheric connection, the corpus callosum, is implicated in central stereopsis and disparity detection in front of the fixation plane. Yet individuals with agenesis of the corpus callosum may show normal stereopsis and disparity vergence. We set out to study...

  18. Fibrolipoma of the Anterior Abdominal Wall: an Atypical Presentation; Fibrolipoma de la pared abdominal anterior de presentacion atipica

    Energy Technology Data Exchange (ETDEWEB)

    Lorente, R.M.; Diaz, J. M.; Valle, Y. del; Gallego, I. [Hospital Universitario Santa Cristina. Madrid (Spain)

    2004-07-01

    Fibrolipoma is a type of lipoma that contains fibrous tissue. We present the case of an unusually large anterior abdominal wall fibrolipoma presenting rarely seem radiological characteristics which hinder its radiological diagnosis. We present the findings in ultrasound scan CT, surgery and pathological anatomy, as well as the lesion's differential diagnosis. (Author) 12 refs.

  19. 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.

  20. Defining the anterior nucleus of the thalamus (ANT as a deep brain stimulation target in refractory epilepsy: Delineation using 3 T MRI and intraoperative microelectrode recording

    Directory of Open Access Journals (Sweden)

    T. Möttönen

    2015-01-01

    Conclusions: ANT is delineated in 3 T MRI by visualization of a thin white matter lamina between ANT and other nuclear groups that lack spiking activity. Direct targeting in the anterior thalamic area is superior to indirect targeting due to extensive individual variation in the location of ANT. Without detailed imaging information, however, a single trajectory MER has little localizing value.

  1. The anterior olfactory nucleus and piriform cortex of the echidna and platypus.

    Science.gov (United States)

    Ashwell, Ken W S; Phillips, Jennifer M

    2006-01-01

    The cyto- and chemoarchitecture of the anterior olfactory nucleus and piriform cortex of the short-beaked echidna and platypus were studied to determine: (1) if these areas contain chemically distinct subdivisions, and (2) if the chemoarchitecture of those cortical olfactory regions differs from therians. Nissl and myelin staining were applied in conjunction with enzyme reactivity for NADPH diaphorase and acetylcholinesterase, and immunoreactivity for calcium-binding proteins (parvalbumin, calbindin and calretinin) and tyrosine hydroxylase. Golgi impregnations were also available for the echidna. In the echidna, the anterior olfactory nucleus is negligible in extent and merges at very rostral levels with a four-layered piriform cortex. Several rostrocaudally running subregions of the echidna piriform lobe could be identified on the basis of Nissl staining and calcium-binding protein immunoreactivity. Laminar-specific differences in calcium-binding protein immunoreactivity and NADPH-d-reactive neuron distribution were also noted. Neuron types identified in echidna piriform cortex included pyramidal neurons predominating in layers II and III and non-pyramidal neurons (e.g., multipolar profusely spiny and neurogliaform cells) in deeper layers. Horizontal cells were identified in both superficial and deep layers. By contrast, the platypus had a distinct anterior olfactory nucleus and a three-layered piriform cortex with no evidence of chemically distinct subregions within the piriform cortex. Volume of the paleocortex of the echidna was comparable to prosimians of similar body weight and, in absolute volume, exceeded that for eutherian insectivores such as T. ecaudatus and E. europaeus. The piriform cortex of the echidna shows evidence of regional differentiation, which in turn suggests highly specialized olfactory function.

  2. 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.

  3. 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.

  4. 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

  5. Ligamento Cruzado Anterior Mucoide. [Mucoid degeneration of the anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Juan Pablo Bonifacio

    2013-05-01

    Full Text Available Objetivo  Realizar una actualización del LCA mucoide y describir nuestra experiencia en el diagnóstico y tratamiento quirúrgico. Material y Métodos Se describen los aspectos clínicos, fisiopatológicos, los hallazgos de imágenes y el tratamiento quirúrgico de esta patología de acuerdo a las series publicadas.Además se incluye un estudio retrospectivo realizado entre el año 2004-2011, que incluyo 27 pacientes con un promedio de edad de 55 años (rango 34-68 años. Clínicamente fueron evaluados con la escala de dolor, rango de movilidad y estabilidad con maniobras clínicas y el artrómetro  KT-1000. Se realizaron radiografías y Resonancia magnética pre y postoperatorias. Los resultados funcionales postoperatorios fueron evaluados con la escalas de Lysholm, IKDC, y la evaluación subjetiva del dolor. Se tomaron muestras para biopsia. Resultados La escala de evaluación analógica del dolor mejoro en un promedio de 6 puntos. El rango de movilidad mejoro en un promedio de  26 °.  La estabilidad de la rodilla no fue comprometida. Las escalas de evaluación funcional  obtuvieron un IKDC de A en el 50% de los pacientes, de B en el 33 % y 17 %  de C. El Lysholm fue de 95 puntos. La escala de evaluación subjetiva fue muy buena a excelente en la mayoría. No hubo complicaciones postoperatorias. Conclusión El estudio de imágenes  para su diagnóstico preoperatorio es la Resonancia Magnética; los hallazgos son característicos, no deben ser confundidos con desgarros del LCA. El diagnóstico definitivo es histológico. El tratamiento artroscópico creemos que es efectivo, reproducible y con una baja tasa de complicaciones. Conclusiones La resonancia magnética es el estudio por imágenes para el diagnóstico preoperatorio; los hallazgos son característicos y no deben confundirse con desgarros del ligamento cruzado anterior. El diagnóstico definitivo es histológico. Creemos que el tratamiento artroscópico es eficaz

  6. Anterior internal impingement of the shoulder in rugby players and other overhead athletes

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    Siddharth R. Shah, MBBS, MSc Sports Medicine (UK, MRCS-Ed

    2017-04-01

    Conclusion: This series of anterior internal impingement, which we believe is the largest in the literature to date, demonstrates the value of an to assess and successfully treat overhead athletes with anterior impingement syndrome.

  7. 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

  8. 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

  9. A contemporary approach for treatment planning of horizontally resorbed alveolar ridge: Ridge split technique with simultaneous implant placement using platelet rich fibrin membrane application in mandibular anterior region.

    Science.gov (United States)

    Parthiban, Prathahini S; Lakshmi, R Vijaya; Mahendra, Jaideep; Sreekumar, K; Namasivayam, Ambalavanan

    2017-01-01

    Treatment of edentulous sites with horizontal atrophy represents a clinical situation in which the positioning of endosseous implants might be complex or sometimes impossible without a staged regenerative approach. This case report presents management of horizontally deficient mandibular anterior ridge with a contemporary approach to treatment planning and application of platelet-rich fibrin membrane for ridge split technique and simultaneous implant placement. Implants in anterior mandibular area are considered to be most predictable, stable, with high success rate and patients' satisfaction with implant esthetics. In contrast to traditional ridge augmentation techniques, ridge splitting allows for immediate implant placement following surgery and eradicates the possible morbidity from a second surgical site.

  10. 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.

  11. Visualization of Tear Clearance Using Anterior Segment Optical Coherence Tomography and Polymethylmethacrylate Particles.

    Science.gov (United States)

    Zheng, Xiaodong; Yamaguchi, Masahiko; Kamao, Tomoyuki; Sakane, Yuri; Goto, Tomoko; Shiraishi, Atsushi; Ohashi, Yuichi

    2016-11-01

    We previously reported 2 new methods, anterior segment optical coherence tomography (AS-OCT) and polymethylmethacrylate particles suspended in fluorescein solution (PPF), for the evaluation of tear clearance and rapid tear flow after blinking (tear Krehbiel flow). Here, we investigated age-related OCT tear clearance and tear film thickness (TFT) and the potential correlation of OCT tear clearance and PPF velocity indicative of tear Krehbiel flow. Normal subjects separated into young and older groups received 5 μL of saline solution into the lower conjunctival sac, and an image of the central lower eyelid tear meniscus was captured by AS-OCT immediately and 30 seconds after natural blinking. Tear meniscus height (TMH) and tear meniscus area (TMA) were measured, and their percentage decrease was defined as OCT clearance rate. A Spectralis OCT Anterior Segment Module captured the central corneal tear film layer for TFT measurements. OCT clearance rates were significantly higher in young versus older subjects (P = 0.0002). When all subjects were analyzed, age was significantly and negatively correlated with TMH clearance rate (r = -0.4928, P = 0.0003) and TMA clearance rate (r = -0.4596, P = 0.0008). TFT values were significantly and negatively correlated with age (r = -0.6662, P clearance rates and PPF velocity (TMH rate: r = 0.2926, P = 0.0392; TMA rate: r = 0.3274, P = 0.0205). AS-OCT and PPF might be novel techniques for quantitative evaluation of tear clearance and Krehbiel flow.

  12. 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.

  13. 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.)

  14. The method for staining of anterior lens capsule in cases with small and rigid pupils

    Directory of Open Access Journals (Sweden)

    V. Kumar

    2014-07-01

    Full Text Available Purpose: to evaluate the safety and effectiveness of proposed method for staining with trypan blue anterior lens capsule in cases with small and rigid pupils.Methods: the safety and effectiveness of the proposed method was evaluated in 169 cases having small and rigid pupils of III and IV grade. Surgical steps included: irrigation of anterior chamber with small amount of air, enough to block the pupil; irrigation of posterior chamber with little amount of dye followed by aspiration of air bubble. the excess dye came out and stained the capsule in pupillary area.Results: No difficulty was encountered in irrigating the posterior chamber with dye. Uneven staining of the capsule was noticed in 16 cases (9.5%. In 3 cases (1.8% extensive staining of iris and posterior capsule was observed. Continuous curvilinear capsulorhexis was performed successfully in 97.6% cases. In 4 cases there was radial run of the rhexis extending up to posterior capsule. Postopera- tive inflammation of 1st and 2nd degree was observed in 5.9 and 23.1% cases, which was related to unavoidable trauma to iris tissue during pupil stretching.Conclusion: the proposed method of capsule staining in cases with small and rigid pupils is safe and effective.

  15. The method for staining of anterior lens capsule in cases with small and rigid pupils

    Directory of Open Access Journals (Sweden)

    V. Kumar

    2012-01-01

    Full Text Available Purpose: to evaluate the safety and effectiveness of proposed method for staining with trypan blue anterior lens capsule in cases with small and rigid pupils.Methods: the safety and effectiveness of the proposed method was evaluated in 169 cases having small and rigid pupils of III and IV grade. Surgical steps included: irrigation of anterior chamber with small amount of air, enough to block the pupil; irrigation of posterior chamber with little amount of dye followed by aspiration of air bubble. the excess dye came out and stained the capsule in pupillary area.Results: No difficulty was encountered in irrigating the posterior chamber with dye. Uneven staining of the capsule was noticed in 16 cases (9.5%. In 3 cases (1.8% extensive staining of iris and posterior capsule was observed. Continuous curvilinear capsulorhexis was performed successfully in 97.6% cases. In 4 cases there was radial run of the rhexis extending up to posterior capsule. Postopera- tive inflammation of 1st and 2nd degree was observed in 5.9 and 23.1% cases, which was related to unavoidable trauma to iris tissue during pupil stretching.Conclusion: the proposed method of capsule staining in cases with small and rigid pupils is safe and effective.

  16. Reconstruction of anterior skull base defects using frontalis muscle galea aponeurotica skull pedicle flaps

    Institute of Scientific and Technical Information of China (English)

    Kun Liu; Guanghui Wang; Hong Zhang; Yuping Wu; Yangcheng Lv; Jingsong Liu; Jieke Ma; Cheng Li; Jiang Zhu

    2013-01-01

    Objective: The aim of our study was to reconstruct soft and hard tissue perforating defects of the anterior skull base in a 1-stage surgical procedure with a combined craniofacial approach. Methods: Soft and hard tissue defects of the anterior skull base were successfully reconstructed in 43 patients during a 1-stage surgery through the use of frontalis muscle galea aponeurotica skull flaps with 1 or 2 vascularized pedicles. The skull flap areas were up approximately 7 cm × 14 cm. Results: Intracranial infection and cerebrospinal fluid leakage were not observed in the 43 patients, and all incisions healed. Of 33 malignant tumor patients, 25 patients received follow-up examinations for longer than 2 years, and 18 patients survived for 2 years. Conclusion: Frontalis muscle galea aponeurotica skull pedicle flaps provided a constant blood supply and resulted in soft and thin tissue. The pedicle flaps, together with the external cranial bone plate, strengthened the support, but still allowed for bending and shaping. In addition, the flap harvesting approach was consistent with surgery approach, without aesthetic compromises.

  17. 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

  18. 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.

  19. Anterior temporal white matter lesions in myotonic dystrophy with intellectual impairment: an MRI and neuropathological study

    Energy Technology Data Exchange (ETDEWEB)

    Ogata, A.; Tashiro, K. [Department of Neurology, Hokkaido University School of Medicine, North-14, West-5, Kita-ku, Sapporo 060 (Japan); Terae, S. [Department of Radiology, Hokkaido University School of Medicine, Sapporo (Japan); Fujita, M. [Department of Pathology, Hokkaido University School of Medicine, Sapporo (Japan)

    1998-07-01

    We studied 12 patients with myotonic dystrophy using MRI and the Mini-mental state examination (MMSE), to see it specific MRI findings were associated with intellectual impairment. We also compared them with the neuropathological findings in an autopsy case of MD with intellectual impairment. Mild intellectual impairment was found in 8 of the 12 patients. On T 2-weighted and proton density-weighted images, high-intensity areas were seen in cerebral white matter in 10 of the 12 patients. In seven of these, anterior temporal white-matter lesions (ATWML) were found; all seven had mild intellectual impairment (MMSE 22-26), whereas none of the four patients with normal mentation had ATWML. In only one of the eight patients with intellectual impairment were white-matter lesions not found. Pathological findings were severe loss and disordered arrangement of myelin sheaths and axons in addition to heterotopic neurons within anterior temporal white matter. Bilateral ATWML might be a factor for intellectual impairment in MD. The retrospective pathological study raised the possibility that the ATWML are compatible with focal dysplasia of white matter. (orig.) With 4 figs., 1 tab., 21 refs.

  20. 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.

  1. Right Ventricular Involvement in either Anterior or Inferior Myocardial Infarction

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    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.

  2. 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.

  3. 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...

  4. 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.

  5. Anterior superior instability with rotator cuff tearing: SLAC lesion.

    Science.gov (United States)

    Savoie, F H; Field, L D; Atchinson, S

    2001-07-01

    Anterosuperior instability of the shoulder may occur from a variety of pathologic lesions. We describe a specific entity, the SLAC (superior labrum, anterior cuff) lesion that involves an association of anterior-superior labral tear with a partial supraspinatus tear. We retrospectively isolated a group of 40 patients with this lesion. The presenting complaints, physical examination findings, surgical findings, and results were isolated. Overhead activities were the most common etiology; load and shift instability testing and whipple rotator cuff testing were the most common physical examination findings. Surgical repair was successful in 37 of the 40 patients. The SLAC lesion is a definable clinical entity with predictable history, examination, surgical pathology, and satisfactory results from surgery.

  6. 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

  7. Dilemmas in Treatment of Recurrent Recalcitrant Dental Anterior Open Bite.

    Science.gov (United States)

    Palencar, Adrian J

    2016-01-01

    An anterior open bite is one of the most difficult occlusal abnormalities to treat. Quite often this aberration entails dental component and/or skeletal component. The skeletal open bite will require intrusion of the posterior sextants with the assistance of bite blocks, temporary anchorage devices, high pull headgear, and as a last resort - orthognathic surgery. The orthodontic treatment should be augmented with the orofacial myofunctional therapy. In this article, the author describes 3 different variations of treatment of the dental anterior open bite, first on acrylic models, and then on the actual patients. Consideration should be given to patients with a 'short upper lip," and in this case, surgical correction should be entertained.

  8. Anterior cervical fusion and Caspar plate stabilization for cervical trauma.

    Science.gov (United States)

    Caspar, W; Barbier, D D; Klara, P M

    1989-10-01

    A technique for anterior cervical iliac graft fusion with standardized, commercially available screw and plate fixation (Caspar plating) has been developed. The step-by-step procedure, as well as the instruments designed to facilitate the procedure, are described in this report. Sixty cases of cervical trauma (fractures, subluxations, ligamentous instability, or a combination of these problems) were treated with Caspar plating. All patients obtained fusion, and stability was achieved immediately after surgery without external stabilization. No unusual surgical complications occurred, and the most dreaded complication of dural penetration by drilling or screw placement was not observed. This report details the neurological presentation, anatomical lesions, surgical therapy, and outcome of these patients. Caspar plating combines the advantage of an anterior surgical approach with immediate postoperative stabilization without external stabilization. This advantage persists even in the presence of posterior ligamentous instability. The technique is an important addition to the surgical treatment of cervical trauma.

  9. 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

  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. Esthetic Rehabilitation of Anterior Teeth with Laminates Composite Veneers

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    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.

  12. Esthetic rehabilitation of anterior teeth with laminates composite veneers.

    Science.gov (United States)

    Re, Dino; Augusti, Gabriele; Amato, Massimo; Riva, Giancarlo; Augusti, Davide

    2014-01-01

    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.

  13. 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.

  14. 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.

  15. [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.

  16. 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.

  17. Septic arthritis of the knee following anterior cruciate ligament reconstruction

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    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.

  18. Anterior ischemic optic neuropathy precipitated by acute primary angle closure

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    Choudhari Nikhil

    2010-01-01

    Full Text Available A 59-year-old man with a history of longstanding systemic hypotension developed asymmetric non-arteritic anterior ischemic optic neuropathy (NAION apparently precipitated by bilateral sequential acute primary angle closure. NAION is very rarely reported in association with raised intraocular pressure. In contrast to optical coherence tomography, the failure of scanning laser polarimetry to detect axonal swelling was another interesting finding. Possible reasoning for these observations is discussed.

  19. Isokinetic profile of subjects with the ruptured anterior cruciated ligament

    OpenAIRE

    Drapšin Miodrag; Lukač Damir; Rašović Predrag; Drid Patrik; Klašnja Aleksandar; Lalić Ivica

    2016-01-01

    Background/Aim. All changes in the knee that appear after anterior cruciate ligament (ACL) lesion lead to difficulties in walking, running, jumping especially during sudden changes of the line of movement. This significantly impairs quality of life of these subjects and leads to decrease in physical activity. Knee injuries make 5% of all most severe acute sport injuries. The aim of the study was to determine strength of the thigh muscles in persons with uni...

  20. 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.

  1. Angle Class I malocclusion with anterior negative overjet

    OpenAIRE

    Paulo Ávila de Souza

    2016-01-01

    ABSTRACT This clinical case report describes the orthodontic treatment of an 8-year and 9-month old female patient with Angle Class I malocclusion, anterior crossbite and canine Class III relationship. Orthodontic treatment was carried out in two stages. The first one was orthopedic, while the second one included the use of a fixed appliance and the need for space gain for reshaping of maxillary lateral incisors. The two-stage treatment combined with multidisciplinary Restorative Cosmetic Den...

  2. Treatment of Rhinitis Sicca Anterior with Ectoine Containing Nasal Spray

    OpenAIRE

    Uwe Sonnemann; Olaf Scherner; Nina Werkhäuser

    2014-01-01

    Objectives. The safety and efficacy of ectoine nasal spray and ectoine nasal spray with dexpanthenol in the treatment of rhinitis sicca were evaluated in two studies. Design and Methods. Two noninterventional observational studies were performed to evaluate the efficacy and safety of a nasal spray containing ectoine (study 1) and ectoine/dexpanthenol (study 2) over a period of two weeks including comparable numbers of patients suffering from rhinitis sicca anterior. Patients and physicians we...

  3. Perawatan Estetik Kompleks Empat Gigi Anterior Maksila dengan Resorpsi Eksternal

    OpenAIRE

    2015-01-01

    Permasalahan estetik merupakan salah satu hal penting dalam perawatan kedokteran gigi restoratif dan harus sejalan dengan penampilan yang alami serta harmonis berdasarkan prinsip-prinsip estetik. Untuk menginformasikan perawatan restorasi estetik komplek dari empat gigi anterior maksila. Laki-laki berusia 17 tahun datang dengan fraktur insisal karena kecelakaan. Empat tahun yang lalu, gigi tersebut telah dirawat endodontik dan direstorasi dengan mahkota jaket namun tujuh hari yang lalu, mahko...

  4. Complications and Management of Deep Anterior Lamellar Keratoplasty

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    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

  5. Core Stabilization Training After Anterior Cruciate Ligament Reconstruction

    OpenAIRE

    Medeni, Özge Çınar; Bayramlar, Kezban; Baltacı, Gül; Yanmış, İbrahim

    2014-01-01

    Objectives: The aim of this study was to compare the effects of core stabilization exercises and conventional rehabilitation exercises after anterior cruciate ligament reconstruction in terms of knee joint laxity, knee muscle strength, postural stability and functional tests. Methods: Twenty eight patients reconstructed with hamstring tendon were included. Thirteen patients evaluated after a conventional rehabilitation and fifteen after a core stabilization programme. Single-limb postural sta...

  6. Mini-Open Latarjet Procedure for Recurrent Anterior Shoulder Instability

    OpenAIRE

    Numa Mercier; Dominique Saragaglia

    2011-01-01

    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.

  7. 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.

  8. Association of Cryptogenic Organizing Pneumonia in Bilateral Anterior Uveitis

    OpenAIRE

    Kaori Fujimoto; Miki Hiraoka; Shuichiro Inatomi; Hiroshi Ohguro

    2014-01-01

    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 hyp...

  9. 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.

  10. Anterior and posterior tibial anesthetic block in diabetic foot surgery.

    OpenAIRE

    José Julio Ojeda González; Evangelina Dávila Cabo; Remberto González Enoa; Obdulio Rodríguez García

    2004-01-01

    Fundament: Diabetes Mellitus is a disease of high and increasing prevalence and its complications follow a parallel course. Its morbidity is derived from its own complications which are produced at a long or short term and peripheral vascular disease hihglights among them.Objective: to check the usefulness of the anterior and posterior blockade of the tibia for the surgery of the diabetic foot. Method: Prospective study carried out from January to December 2003 at the University Hospital ¨Dr....

  11. 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.

  12. [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.

  13. Anterior segment intraocular metallic foreign body causing chronic hypopyon uveitis

    OpenAIRE

    Mete, Güler; Turgut, Yılmaz; Osman, Arslanhan; Gülşen, Ülkü; Hakan, Artaş

    2010-01-01

    Intraocular foreign body (IOFB) is a common association of penetrating ocular trauma. Early diagnosis and removal of IOFBs especially if they are metallic is very important to determine further management and the final result of treatment. Missed IOFB may present in different clinical aspects that may limit its detection and symptoms may only become apparent after a prolonged period of time. We report a case of a missed metallic intraocular foreign body in the anterior chamber over a 2-year p...

  14. Anterior internal fixation to treat vertical unstable pelvic fracture

    Institute of Scientific and Technical Information of China (English)

    王世松; 张鹏程; 杜敦进; 杨泗华

    2002-01-01

    With the Chinese development of industry, agriculture and communication, various traffic and work related accidents are increasing, leading to an increase in pelvic fractures. Among the different kinds of fractures, pelvic fracture is the third largest cause of death.1 The treatment of pelvic fractures is a “hot spot” and a difficult point in orthopedic surgery. Since 1998 we have treated 20 patients with vertical unstable pelvic fracture using anterior internal fixation. Satisfactory results have been obtained.

  15. Linguatula serrata in the anterior chamber of the eye

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    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.

  16. 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.

  17. Activation of anterior insula during self-reflection.

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    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.

  18. LOWER EXTREMITY MALALIGNMENTS AND ANTERIOR CRUCIATE LIGAMENT INJURY HISTORY

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    Rebecca A. Braham

    2004-12-01

    Full Text Available To identify if lower extremity malalignments were associated with increased propensity of a history of anterior cruciate ligament (ACL ruptures in males and females using a case control design. Twenty subjects (10 males, 10 females had a history of ACL injury and twenty (10 males, 10 females had no history of ACL injury. Subjects were assessed for navicular drop, quadriceps angle, pelvic tilt, hip internal and external rotation range of motion, and true and apparent leg length discrepancies. Statistical analysis was performed to identify differences in these measures in regard to injury history and gender, and to identify if any of these measures were predictive of ACL injury history. Increased navicular drop and anterior pelvic tilt were found to be statistically significant predictors of ACL injury history regardless of gender. Limbs that had previously suffered ACL ruptures were found to have increased navicular drop and anterior pelvic tilt compared to uninjured limbs. Based on the results of this retrospective study, the lower extremity malalignments examined do not appear to predispose females to tearing their ACLs more than males.

  19. Anterior uveitis following eyebrow epilation with alexandrite laser

    Directory of Open Access Journals (Sweden)

    Karabela Y

    2015-09-01

    Full Text Available Yunus Karabela,1 Mustafa Eliaçik2 1Department of Ophthalmology, Esenler Hospital, Istanbul Medipol University, Istanbul, Turkey; 2Department of Ophthalmology, Kadiköy Medipol Hospital, Istanbul Medipol University, Istanbul, Turkey Abstract: Ocular tissues are known to be sensitive to damage from exposure to laser emissions. This study reports the case of a female patient with acute unilateral anterior uveitis caused by alexandrite laser-assisted hair removal of the eyebrows. We report a 38-year-old female who presented with unilateral eye pain, redness, and photophobia after receiving alexandrite (755 nm laser epilation of both eyebrows. Best corrected visual acuity was 20/20 in both eyes. Right eye examination was normal. Left eye examination showed conjunctival injection and 2+/3+ cells in the anterior chamber. Intraocular pressure and fundus examination were normal. Topical steroids and cycloplegic drops were prescribed for 3 weeks. At the end of the 3-week follow-up, best corrected visual acuity was 20/20, and intraocular pressure and fundus examination were normal in both eyes. The left eye was white, and the anterior chamber was clear. The patient continues to be monitored. In conclusion, without adequate protective eyewear, laser hair removal of the eyebrows with alexandrite laser can lead to ocular damage. Keywords: uveitis, laser exposure, photothermolysis, laser hair removal, photoepilation

  20. Inferior Flap Tympanoplasty: A Novel Technique for Anterior Perforation Closure

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    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.

  1. Anticoagulant-induced hemarthrosis presenting as anterior shoulder dislocation.

    Science.gov (United States)

    Davis, Christine B; Nowak, Richard M

    2014-12-01

    This is a case of nontraumatic shoulder pain initially diagnosed on x-ray as an anterior dislocation. The patient was on anticoagulants and, in actuality, had severe hemarthrosis that caused the subluxation. Attempts to reduce the dislocation in this situation might have resulted in worsening of the intra-articular bleed. There has been only 1 similar reported case in the European Journal of Emergency Medicine in 2013 of a 53-year-old woman who was thought to have a nontraumatic anterior shoulder dislocation, and attempts were unsuccessful at reduction. Definitive therapy involved hemarthrosis aspiration. Others have reported spontaneous hemarthrosis due to anticoagulants; however, only 1 has reported an initial mistaken joint dislocation diagnosis. Nontraumatic hemarthrosis do occur in patients on anticoagulant therapy, and it is important to recognize that this can be misdiagnosed as a joint dislocation requiring reduction. In a patient who is on anticoagulants presenting with nontraumatic joint pain and anterior shoulder or possibly other dislocations on plain radiographs, it is pertinent to consider hemarthrosis.

  2. Unilateral anterior uveitis complicating zoledronic acid therapy in breast cancer

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    El Saghir Nagi S

    2005-12-01

    Full Text Available Abstract Background Zoledronic acid is very widely used in patients with metastatic bone disease and osteoporosis. Only one case of bilateral uveitis was recently reported related to its use. Case presentation We report the first case of severe unilateral anterior uveitis in a patient with breast cancer and an intraocular lens. Following zoledronic acid infusion, the patient developed severe and dramatic right eye pain with decreased visual acuity within 24 hours and was found to have a fibrinous anterior uveitis of moderate severity The patient was treated with topical prednisone and atropine eyedrops and recovered slowly over several months. Conclusion Internists, oncologists, endocrinologists, and ophtalmologists should be aware of uveitis as a possible complication of zoledronic acid therapy. Patients should be instructed to report immediately to their physicians and treatment with topical prednisone and atropine eyedrops should be instituted immediately at the onset of symptoms. This report documents anterior uveitis as a complication of zoledronic acid therapy. This reaction could be an idiosyncratic one but further research may shed more light on the etiology.

  3. 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

  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.

  5. Approach to the active patient with chronic anterior knee pain.

    Science.gov (United States)

    Atanda, Alfred; Ruiz, Devin; Dodson, Christopher C; Frederick, Robert W

    2012-02-01

    The diagnosis and management of chronic anterior knee pain in the active individual can be frustrating for both the patient and physician. Pain may be a result of a single traumatic event or, more commonly, repetitive overuse. "Anterior knee pain," "patellofemoral pain syndrome," and "chondromalacia" are terms that are often used interchangeably to describe multiple conditions that occur in the same anatomic region but that can have significantly different etiologies. Potential pain sources include connective or soft tissue irritation, intra-articular cartilage damage, mechanical irritation, nerve-mediated abnormalities, systemic conditions, or psychosocial issues. Patients with anterior knee pain often report pain during weightbearing activities that involve significant knee flexion, such as squatting, running, jumping, and walking up stairs. A detailed history and thorough physical examination can improve the differential diagnosis. Plain radiographs (anteroposterior, anteroposterior flexion, lateral, and axial views) can be ordered in severe or recalcitrant cases. Treatment is typically nonoperative and includes activity modification, nonsteroidal anti-inflammatory drugs, supervised physical therapy, orthotics, and footwear adjustment. Patients should be informed that it may take several months for symptoms to resolve. It is important for patients to be aware of and avoid aggravating activities that can cause symptom recurrence. Patients who are unresponsive to conservative treatment, or those who have an underlying systemic condition, should be referred to an orthopedic surgeon or an appropriate medical specialist.

  6. Radical resection of giant chondrosarcoma of the anterior chest wall

    Directory of Open Access Journals (Sweden)

    Stanić Vojkan

    2008-01-01

    Full Text Available Background. Chondrosarcomas represent approximately 30% of primary malignant bone tumors, the most frequent of which is on anterior thoracic wall. Case report. We presented a case of 50-year-old man suffering from a slowgrowing, painless giant chondrosarcoma of the anterior chest wall. A wide resection was performed to excise the tumor including attached skin, right breast, ribs, sternum, soft tissues and parietal pleura. Mediastinum was not affected by the tumor. After resecting a 26 × 20 × 22 cm segment, the chest wall defect was reconstructed with a Marlex mesh and extensive latissimus dorsi myocutaneous flap pedicled on the right thoracodorsal vessels. Histopatology diagnosis was chondrosarcoma G 2−3. The mechanics of ventilation was not altered and respiratory function was normal from the immediate postoperative period. Three years after the operation postoperative results showed no local recurrence and excellent functional and aesthetic results were evident. Respiratory function remained unaltered. Conclusion. According to the results it can be concluded that the use of Marlex mash and myocutaneous flap is good method for stabilization of the chest wall and enough to avoid paradoxical respiratory movements in managing giant chondrosarcoma of the anterior chest wall.

  7. 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.

  8. Dysphagia Due to Anterior Cervical Spine Osteophyte: A Case Report

    Directory of Open Access Journals (Sweden)

    Hossein Mashhadinezhad

    2010-07-01

    Full Text Available Introduction: Degenerative changes of the cervical spine are more common in elderly, but anterior cervical osteophytes that cause problems in swallowing are rare. The most common cause of this problem is DISH disease (diffuse idiopathic skeletal hyperostosis. Trauma is also suggested as a potential cause in osteophyte formation. Case Report: We report a rare case of anterior cervical osteophyte with problems in swallowing that was caused by cervical spine trauma in a car accident 4 years ago, treated with a cervical collar. Dysphagia was the initial symptom of the disease. Barium swallowing showed a large cervical osteophyte at the C3-C4 level with compression effect on the esophagus. X-ray, CT scan and MRI of the cervical spine confirmed the osteophyte and its correlation with the esophagus. Endoscopic study of esophagus and stomach also ruled out other disorders. Surgical osteophytectomy was performed. Conclusion: Up to now, only two cases of post-traumatic anterior cervical osteophyte have been cited in the literature. In this report, we introduce an unusual case of dysphagia caused by cervical spine trauma.

  9. How do mammillary body inputs contribute to anterior thalamic function?

    Science.gov (United States)

    Dillingham, Christopher M.; Frizzati, Aura; Nelson, Andrew J.D.; Vann, Seralynne D.

    2015-01-01

    It has long been assumed that the main function of the mammillary bodies is to provide a relay for indirect hippocampal inputs to the anterior thalamic nuclei. Such models afford the mammillary bodies no independent role in memory and overlook the importance of their other, non-hippocampal, inputs. This review focuses on recent advances that herald a new understanding of the importance of the mammillary bodies, and their inputs from the limbic midbrain, for anterior thalamic function. It has become apparent that the mammillary bodies’ contribution to memory is not dependent on afferents from the subicular complex. Rather, the ventral tegmental nucleus of Gudden is a vital source of inputs that support memory processes within the medial mammillary bodies. In parallel, the lateral mammillary bodies, via their connections with the dorsal tegmental nucleus of Gudden, are critical for generating head-direction signals. These two parallel, but distinct, information streams converge on the anterior thalamic nuclei and support different aspects of spatial memory. PMID:25107491

  10. Flexural strength and microhardness of anterior composites after accelerated aging

    Science.gov (United States)

    Pala, Kanşad; Tuncer, Safa; Demirci, Mustafa; Öznurhan, Fatih; Serim, Merve

    2017-01-01

    Background This study aimed to evaluate the flexural strength and microhardness of three different anterior composites after 10 000 thermocycles. Material and Methods The mechanical properties of a nano-fill composite (Filtek Ultimate Universal Restorative (FUR) (Enamel)), a nano-hybrid composite (Clearfil Majesty ES2 (ES2) (Enamel)), and a micro-hybrid composite (G Aenial Anterior (GAA)) were investigated in this study. For the microhardness test, 8-mm diameter and 2-mm thickness composite discs were used (n = 10), and for the flexural strength test, 25x2x2 mm bar-shaped specimens were prepared (n = 13). The specimens were tested at 24 h and after 10 000 thermocycles. Data were analyzed using two-way analysis of variance and the post-hoc Tukey test (p .05). Pearson correlation analysis revealed that there was a negative relationship between the mean hardness and flexural strength values (correlation coefficient = -0.367, p = .043). After 10 000 thermocycles, microhardness values of each material and flexural strength of ES2 and GAA decreased significantly according to 24 h. Conclusions The nano-fill composite FUR displayed significantly higher microhardness values. However, each resin composite was statistically similar for flexural strength values. Ten thousand thermocycles significantly affected microhardness and flexural strength. Key words:Flexural strength, microhardness, anterior composites. PMID:28298986

  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. Evaluation of idiopathic scoliosis by anterior and posterior arthrodesis

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    Jean Carlo Frigotto Queruz

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate comparatively surgical treatment of adolescent idiopathic scoliosis type 5CN by anterior and posterior approach.METHODS: The study consists of a comparative retrospective study of two groups of patients with the thoracolumbar spine arthrodesis technique by anterior and posterior approach. Twenty and two patients were sequentially selected, 11 operated by anterior approach - called Group I - and 11 by posterior approach - Group II. Anamnesis and physical examination were performed, as well as length of hospital stay and ICU stay, degree of correction, comorbidities and pre and postoperative radiographic images data were gathered.RESULTS: The mean age was 13.7 years in Group I and 14 years in Group II. The average hospital stay was 5.81 days for Group I and 5 for Group II. The average ICU stay was 2.81 and 2 days, respectively. Considering the operated levels, Group I presented an average of 4.81 vertebrae (4-6 levels, and Group II presented an average of 6.36 vertebrae (5-11 levels. Complications did not show statistically significant difference.CONCLUSION: Despite the limited number of patients in groups, it was demonstrated that the posterior approach reduces the number of days of hospitalization and ICU stay. However, it was found increased levels included in the arthrodesis.

  13. Anterior dental evolution in the Australopithecus anamensis-afarensis lineage.

    Science.gov (United States)

    Ward, Carol V; Plavcan, J Michael; Manthi, Fredrick K

    2010-10-27

    Australopithecus anamensis is the earliest known species of the Australopithecus-human clade and is the likely ancestor of Australopithecus afarensis. Investigating possible selective pressures underlying these changes is key to understanding the patterns of selection shaping the origins and early evolution of the Australopithecus-human clade. During the course of the Au. anamensis-afarensis lineage, significant changes appear to occur particularly in the anterior dentition, but also in jaw structure and molar form, suggesting selection for altered diet and/or food processing. Specifically, canine tooth crown height does not change, but maxillary canines and P(3)s become shorter mesiodistally, canine tooth crowns become more symmetrical in profile and P(3)s less unicuspid. Canine roots diminish in size and dimorphism, especially relative to the size of the postcanine teeth. Molar crowns become higher. Tooth rows become more divergent and symphyseal form changes. Dietary change involving anterior dental use is also suggested by less intense anterior tooth wear in Au. afarensis. These dental changes signal selection for altered dietary behaviour and explain some differences in craniofacial form between these taxa. These data identify Au. anamensis not just as a more primitive version of Au. afarensis, but as a dynamic member of an evolving lineage leading to Au. afarensis, and raise intriguing questions about what other evolutionary changes occurred during the early evolution of the Australopithecus-human clade, and what characterized the origins of the group.

  14. 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...... departments of obstetrics and gynaecology in Norway, Sweden, Finland, and Denmark. POPULATION: A total of 138 women, of 55 years of age or older, admitted for stage ≥2 anterior vaginal wall prolapse. METHODS: The women scheduled for primary anterior vaginal wall prolapse surgery were randomised between......-7) and the Pelvic Floor Distress Inventory (PFDI-20). MAIN OUTCOME MEASURES: Objective cure, defined as POP-Q stage

  15. Correction of post-traumatic anterior open bite by injection of botulinum toxin type A into the anterior belly of the digastric muscle: case report

    OpenAIRE

    2013-01-01

    Post-traumatic anterior open bite can occur as a result of broken balance among the masticatory muscles. The superior hyoid muscle group retracts the mandible downward and contributes to the anterior open bite. Denervation of the digastric muscle by injection of botulinum toxin type A (BTX-A) can reduce the power of the digastric muscle and help to resolve the post-traumatic anterior open bite. A patient with a bilateral angle fracture had an anterior open bite even after undergoing three ope...

  16. Anchorage Areas

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — An anchorage area is a place where boats and ships can safely drop anchor. These areas are created in navigable waterways when ships and vessels require them for...

  17. Perawatan gigi impaksi anterior rahang atas pada remaja (The treatment of maxillary anterior impacted teeth in adolescent

    Directory of Open Access Journals (Sweden)

    Herdi Eko Pranjoto

    2005-09-01

    Full Text Available The incidence of impacted tooth in adolescent is usually found by oral surgeon or orthodontist during their sequence of treatments. The maxillary anterior teeth, especially canine and third lower molar are the most common impacted teeth found as the result of their eruption disturbances. The surgical technique principle is to facilitate the impacted tooth, so that it can be erupted by creating a window and take the bone obstructed surrounding the tooth crown surgically and afterward it is orthodontically tracted. In a case of third molar germ which is predicted to be impacted in mesio version position, germinectomy is preferred to prevent anterior mechanical drive during its development which may cause mal-alignment of the mandibular teeth. Germinectomy which is usually easier than odontectomy, the germ position, and less complication after the surgical intervention are three factors that should be considered in making decision.

  18. Outcomes of Phacoemulsification with Anterior Chamber Maintainer in Vitrectomized Eyes

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    Elif Betül Türkoğlu

    2012-07-01

    Full Text Available Pur po se: To evaluate the outcomes of phacoemulsification with anterior chamber maintainer in vitrectomized eyes with complicated cataract. Ma te ri al and Met hod: Twenty eyes of 20 patients who developed complicated cataract after pars plana vitrectomy (PPV were included in the study. Phacoemulsification with clear corneal incision and foldable intraocular lens implantation was performed. In group 1, anterior chamber maintainer (ACM was used during phacoemusification and in group 2, ACM was not used. Pre- and postoperative visual acuities as well as per- and postoperative complications were reviewed retrospectively. Re sults: Anterior chamber maintainer was used during the surgery in 12 (60% cases and was not used in 8 (40% cases. Phacoemulsification was performed 16.5±9.2 (4-40 months after PPV. Best-corrected visual acuities were between hand motions and 0.4 preoperatively and between counting fingers from 1 meter and 1.0 postoperatively in group 1. Best-corrected visual acuities were between hand motions and 0.1 preoperatively and between counting fingers from 1 meter and 0.8 postoperatively in group 2. Posterior capsule was ruptured in 1 eye peroperatively in group 1. In group 2, phacoemulsification was more difficult due to deep anterior chamber in 8 eyes and intraoperative complications were iris sphincter rupture in 1 eye and posterior capsule rupture in 1 eye. Mild corneal edema in 7 (58.3% eyes, fibrin reaction in 2 (16.6%, intraocular lens decentralization in 1 (8.3% and posterior capsule opacification in 4 (33.3% eyes were the postoperative complications in group 1. Mild corneal edema in 5 (62.5% eyes, fibrin reaction in 1 (12.5% and posterior capsule opacification in 2 (25% eyes were the postoperative complications in group 2. Dis cus si on: Complicated cataracts which may develop after PPV can be treated safely with phacoemulsification. Continuous irrigation during the surgery may provide a stable anterior chamber and prevents

  19. 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

  20. Is the Learning Curve of Robotic Low Anterior Resection Shorter Than Laparoscopic Low Anterior Resection for Rectal Cancer?

    OpenAIRE

    Park, Eun Jung; Kim, Chang Woo; Cho, Min Soo; Kim, Dong Wook; MIN, BYUNG SOH; Baik, Seung Hyuk; Lee, Kang Young; Kim, Nam Kyu

    2014-01-01

    Abstract As robotic surgery was developed with ergonomic designs, there are expectations that the technical advantages of robotic surgery can shorten the learning curve. However, there is no comparative study, so far, to evaluate the learning curve between robotic and laparoscopic rectal cancer surgeries. Therefore, the aim of this study is to compare the learning curve of robotic low anterior resection (LAR) with laparoscopic LAR for rectal cancer. Patients who underwent robotic or laparosco...

  1. 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

  2. Epidural anterior petrosectomy with subdural visualization of sphenobasal vein via the anterior transpetrosal approach--technical case report.

    Science.gov (United States)

    Ichimura, Shinya; Yoshida, Kazunari; Kagami, Hiroshi; Inaba, Makoto; Orii, Maaya; Kitamura, Yohei; Saga, Isako; Toda, Masahiro

    2012-10-01

    The drainage of the superficial middle cerebral vein (SMCV) is classified into four subtypes. The sphenobasal vein (SBV) drains from the SMCV to the pterygoid venous plexus at the temporal skull base. Epidural procedures in the standard anterior transpetrosal approach (ATPA) may damage the route of the SBV. We report a case in which modified surgical procedures via the ATPA were used to preserve the SBV. A 45-year-old man complained of right facial pain. Magnetic resonance images revealed a right cerebellopontine tumor suggestive of an epidermoid cyst. Right carotid angiography revealed that the SMCV drained into the pterygoid venous plexus via the SBV. The convexity dura mater of the temporal lobe was cut and the anterior part of the temporal lobe was retracted subdurally. The SBV was visualized from the subdural side. The basal dura mater of the temporal lobe posterior to the SBV was cut and the posterior part of the temporal lobe was retracted epidurally. After dissecting the dura mater medial to the greater petrosal nerve and to the edge of the petrous apex, the petrous apex was exposed and drilled out without injuring the SBV. The superior petrous sinus and the tentorium were cut. The tumor compressed the root exit zone of the trigeminal nerve. The tumor was grossly totally removed. The modified ATPA (epidural anterior petrosectomy with subdural visualization of the SBV) is effective in preserving the SBV.

  3. 白内障超声乳化摘出术后OCT测量的眼前节结构改变%The changes of ocular anterior segment configuration following phacoemulsification determined by anterior segment OCT

    Institute of Scientific and Technical Information of China (English)

    郑虔

    2016-01-01

    Cataract is a main blinding eye disease worldwide,follwed by glaucoma.Expension of lens volume occurs in early stage of age-related cataractous eyes,which is a risk factor of Primary angle-closure glaucoma,and phacoemulsification is a feasible approach to remove it.However,how to select the timing of operation and determine the prognosis is the major challenge for ophthalmologists.In order to evaluate the influence of phacoemulsification on ocular anterior segment configuration,we collected the information of 17 articles that quantitatively analyzed the ocular anterior segment parameter changes after phacoemulsification,determined by anterior segment OCT (AS-OCT).Total 866 eyes that received phacoemulsification for age-related cataract were included in the following-up duration for 6 months,and the results showed that the mean anterior chamber depth (ACD),anterior chamber volume (ACV),anterior chamber angle (ACA),angle opening distance 500 μm anterior to the scleral spur (AODS00),angle opening distance 750 μm anterior to the scleral spur (AOD750),trabecular-iris space area 500 μm from scleral spur (TISA500),trabecular-iris space area 750 μm from scleral spur(TISA750),and angle recess area 750 μm anterior to the scleral spur (ARA 750) were increased,but the mean anterior chamber width (ACW) and iris thickness measured at 750 μm (IT750) were not significantly changed,while the postoperative iris curvature (I-Curv),iris cross-sectional area and convex hull of iris segments were decreased after phacoemulsification.In addition,the postoperative ACD,TISA500 showed positive correlations to preoperative lens thickness,and the ACD and AOD500 in 3 months after operation were positively correlated to the preoperative lens value (LV).This systematic review concluded that phacoemulsification could be used for the treatment of glaucoma by relieving pupillary block,reducing the iris oppression,deepening the anterior chamber and opening anterior chamber angle.%目前,白内

  4. Alien Hand Sign and Other Cognitive Deficits following Ruptured Aneurysm of the Anterior Communicating Artery

    Directory of Open Access Journals (Sweden)

    Alan J. Parkin

    1991-01-01

    Full Text Available We describe a right-handed patient who suffered a ruptured aneurysm of the anterior communicating artery (ACoA which was clipped successfully. Computerized tomography indicated a low density area in the genu of the corpus callosum and the infero-lateral aspect of the left frontal lobe. On recovery the patient's most notable deficit was the “alien hand sign” whereby the left hand would frequently interfere with the actions of the right hand. Problems in response initiation were also evident. There was significant memory loss and performance was impaired on some tests of frontal lobe function. Discussion centres on the functional locus of the alien hand sign but other aspects of the patient's deficits are also considered.

  5. A case of anterior cerebral artery dissection caused by scuba diving.

    Science.gov (United States)

    Fukuoka, Takuya; Kato, Yuji; Ohe, Yasuko; Deguchi, Ichiro; Maruyama, Hajime; Hayashi, Takeshi; Tanahashi, Norio

    2014-08-01

    A 51-year-old man was admitted with right hemiparesis during scuba diving, without headache. Brain magnetic resonance (MR) imaging depicted high-intensity areas in the left superior frontal and cingulate gyri on diffusion-weighted imaging. Dissection of the anterior cerebral artery (ACA) was detected using axial MR angiography and 3-dimensional MR cisternography. Dissection of the ACA during and after scuba diving has not been reported before. Dissection of the arteries should be included in the differential diagnosis when neurologic symptoms occur both during and after scuba diving, even if the patient does not experience headache. Furthermore, the combination of MR cisternography and MR angiography is useful to detect ACA dissection.

  6. Tectonic deep anterior lamellar keratoplasty in impending corneal perforation using cryopreserved cornea.

    Science.gov (United States)

    Jang, Ji Hye; Chang, Sung Dong

    2011-04-01

    We report a case of tectonic corneal transplantation for impending corneal perforation to preserve anatomic integrity using cryopreserved donor tissue. An 82-year-old woman exhibiting impending corneal perforation suffered from moderate ocular pain in the left eye for one week. After abnormal tissues around the impending perforation area were carefully peeled away using a Crescent blade and Vannas scissors, the patient received tectonic deep anterior lamellar keratoplasty using a cryopreserved cornea stored in Optisol GS® solution at -70℃ for four weeks. At six months after surgery, the cornea remained transparent and restored the normal corneal thickness. There were no complications such as corneal haze or scars, graft rejection, recurrent corneal ulcer, and postoperative rise of intraocular pressure. Cryopreserved donor lamellar tissue is an effective substitute in emergency tectonic lamellar keratoplasty, such as impending corneal perforation and severe necrotic corneal keratitis.

  7. Contrasting reward signals in the orbitofrontal cortex and anterior cingulate cortex.

    Science.gov (United States)

    Wallis, Jonathan D; Kennerley, Steven W

    2011-12-01

    Damage to the orbitofrontal cortex (OFC) and anterior cingulate cortex (ACC) impairs decision making, but the underlying value computations that cause such impairments remain unclear. Both the OFC and ACC encode a wide variety of signals correlated with decision making. The current challenge is to determine how these two different areas support decision-making processes. Here, we review a series of experiments that have helped define these roles. A special population of neurons in the ACC, but not the OFC, multiplex value information across decision parameters using a unified encoding scheme, and encode reward prediction errors. In contrast, neurons in the OFC, but not the ACC, encode the value of a choice relative to the recent history of choice values. Together, these results suggest complementary valuation processes: OFC neurons dynamically evaluate current choices relative to the value contexts recently experienced, while ACC neurons encode choice predictions and prediction errors using a common valuation currency reflecting the integration of multiple decision parameters.

  8. Anterior Kidney of the Yellow Mystus, Hemibagrus filamentus (Fang and Chaux, 1949

    Directory of Open Access Journals (Sweden)

    Sinlapachai SENARAT

    2013-12-01

    Full Text Available There is no available report on histological observation of the anterior kidney of the yellow mystus Hemibagrus filamentus (Fang and Chaux, 1949. Thus, the histology of the anterior kidney of specimens from the Tapee river, Chawang district, Nakhon Si Thammarat province, Thailand, was investigated under a light microscope in this study. The results revealed that the anterior kidney of H. filamentus consists of 3 distinct parts; pro, mid and hind anterior kidneys. Based upon different observations of the excretory portion and tissue types, this presented study is considered to be the first such report from Thailand. The pro-anterior kidney comprises of interregnal and exclusively hematopoietic tissues. The mid-anterior kidney is moderately composed of hematopoietic tissue and an increase of the melanomacrophage center (MMC with renal tubules. The last part of is the anterior kidney, which contains mainly renal tubules with a lesser amount of interstitial hematopoietic, which an increase in the glomerulus.

  9. Synovial C-Shaped Tibial Footprint of the Anterior Cruciate Ligament

    Science.gov (United States)

    Janovsky, César; Kaleka, Camila Cohen; Alves, Maria Teresa Seixas; Ferretti, Mario; Cohen, Moises

    2016-01-01

    Background: Although numerous anatomic studies about the anterior cruciate ligament (ACL) structure and attachments have been performed, these studies have not reached consensus on the ACL footprint. Purpose: To investigate the existing controversy regarding the morphology of the tibial ACL insertion (footprint) and confirm histologically that the tibial ACL footprint is not completely filled with ligament tissue. Study Design: Descriptive laboratory study. Methods: The tibial ACL footprint was dissected from 20 different fresh-frozen cadaveric knees (all males; mean age, 68.8 ± 5.4 years [range, 55-80 years]; mean weight, 78 ± 6.6 kg [range, 45-93 kg]). Two knees, 1 with severe osteoarthritis and 1 with previous knee surgery, were excluded. The tibial ACL insertion was observed, and this area was longitudinally divided into 4 parallel slices (0%-25%, 25-50%, 50%-75%, and 75%-100%), embedded in paraffin wax, and stained with hematoxylin-eosin, alcian blue, and picrosirius-polarization. The specimens were measured using a microscope to determine the distances from the anterior to the posterior border of the ACL ligament tibial insertion and the distance from the posterior border to the end of the ligament fibers of the ACL ligament tibial insertions. Results: The 18 evaluated knee specimens confirmed the finding of a C-shaped tibial insertion of the ACL. The measurements showed that the ligament (vertical parallel collagen fibers) occupied only 30.8% of the complete insertion. The remaining area was filled with synovial tissue, demonstrating histologically the “C” shape. Conclusion: This study confirms macroscopically the C-shaped tibial insertion of the ACL and shows histologically that synovial tissue is an indirect insertion filling the major part of the footprint. Clinical Relevance: This anatomic study suggests a different shape of the ACL tibial footprint, which may be useful for new perspectives regarding ACL reconstruction surgery research. PMID

  10. Mean Glenoid Defect Size and Location Associated With Anterior Shoulder Instability

    Science.gov (United States)

    Gottschalk, Lionel J.; Bois, Aaron J.; Shelby, Marcus A.; Miniaci, Anthony; Jones, Morgan H.

    2017-01-01

    Background: There is a strong correlation between glenoid defect size and recurrent anterior shoulder instability. A better understanding of glenoid defects could lead to improved treatments and outcomes. Purpose: To (1) determine the rate of reporting numeric measurements for glenoid defect size, (2) determine the consistency of glenoid defect size and location reported within the literature, (3) define the typical size and location of glenoid defects, and (4) determine whether a correlation exists between defect size and treatment outcome. Study Design: Systematic review; Level of evidence, 4. Methods: PubMed, Ovid, and Cochrane databases were searched for clinical studies measuring glenoid defect size or location. We excluded studies with defect size requirements or pathology other than anterior instability and studies that included patients with known prior surgery. Our search produced 83 studies; 38 studies provided numeric measurements for glenoid defect size and 2 for defect location. Results: From 1981 to 2000, a total of 5.6% (1 of 18) of the studies reported numeric measurements for glenoid defect size; from 2001 to 2014, the rate of reporting glenoid defects increased to 58.7% (37 of 63). Fourteen studies (n = 1363 shoulders) reported defect size ranges for percentage loss of glenoid width, and 9 studies (n = 570 shoulders) reported defect size ranges for percentage loss of glenoid surface area. According to 2 studies, the mean glenoid defect orientation was pointing toward the 3:01 and 3:20 positions on the glenoid clock face. Conclusion: Since 2001, the rate of reporting numeric measurements for glenoid defect size was only 58.7%. Among studies reporting the percentage loss of glenoid width, 23.6% of shoulders had a defect between 10% and 25%, and among studies reporting the percentage loss of glenoid surface area, 44.7% of shoulders had a defect between 5% and 20%. There is significant variability in the way glenoid bone loss is measured, calculated

  11. Elastic Knee Sleeves Limit Anterior Tibial Translation in Healthy Females

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    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

  12. Measurement of anterior and posterior circulation flow contributions to cerebral blood flow. An ultrasound-derived volumetric flow analysis.

    Science.gov (United States)

    Boyajian, R A; Schwend, R B; Wolfe, M M; Bickerton, R E; Otis, S M

    1995-01-01

    Ultrasound-derived volumetric flow analysis may be useful in answering questions of basic physiological interest in the cerebrovascular circulation. Using this technique, the authors have sought to describe quantitatively the complete concurrent flow relations among all four arteries supplying the brain. The aim of this study of normal subjects was to determine the relative flow contributions of the anterior (internal carotid arteries) and posterior (vertebral arteries) cerebral circulation. Comparisons between the observed and theoretically expected anterior and posterior flow distribution would provide an opportunity to assess traditional rheological conceptions in vivo. Pulsed color Doppler ultrasonography was used to measure mean flow rates in the internal carotid and vertebral arteries in 21 normal adults. The anterior circulation (internal carotid arteries bilaterally) carried 82% of the brain's blood supply and comprised 67% of the total vascular cross-sectional area. These values demonstrate precise concordance between observations in vivo and the theoretically derived (Hagen-Poiseuille) expected flow distribution. These cerebrovascular findings support the traditional conception of macroscopic blood flow. Further studies using ultrasound-derived volumetric analysis of the brain's arterial flow relations may illuminate the vascular pathophysiology underlying aging, cerebral ischemia, and dementias.

  13. Contrast sensitivity in deep anterior lamellar keratoplasty versus penetrating keratoplasty Sensibilidade ao contraste entre transplante lamelar anterior profundo e transplante penetrante de córnea

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    Carlos Anchieta Castro Cardoso da Silva

    2007-01-01

    Full Text Available PURPOSE: To compare the measurements of contrast sensitivity at a distance in patients submitted to penetrating keratoplasty versus patients submitted to deep anterior lamellar keratoplasty for keratoconus treatment. METHODS: Contrast sensitivity of 15 subjects submitted to penetrating keratoplasty and 15 subjects submitted to deep anterior lamellar keratoplasty have been analyzed through the Functional Acuity Contrast Test (F.A.C.T® 301. RESULTS: There was no statistically significant difference between the measurements for penetrating keratoplasty and deep anterior lamellar keratoplasty. CONCLUSION: Contrast sensitivity was similar among the subjects submitted to penetrating keratoplasty and to deep anterior lamellar keratoplasty for keratoconus treatment.OBJETIVO: Comparar as medidas de sensibilidade ao contraste à distância entre pacientes submetidos à ceratoplastia penetrante e pacientes submetidos à ceratoplastia lamelar anterior profunda para tratamento do ceratocone. MÉTODOS: Sensibilidades ao contraste de 15 pacientes submetidos à ceratoplastia penetrante e de 15 pacientes submetidos à ceratoplastia lamelar anterior profunda foram analisadas através do Functional Acuity Contrast Test (F.A.C.T® 301. RESULTADOS: Não existiu diferença estatisticamente significante entre as medidas em ceratoplastia penetrante e ceratoplastia lamelar anterior profunda. CONCLUSÃO: Sensibilidade ao contraste foi similar entre os pacientes submetidos à ceratoplastia penetrante e à ceratoplastia lamelar anterior profunda para tratamento do ceratocone.

  14. Percutaneous Anterior Column Fixation for Acetabulum Fractures, Does It Have to Be Difficult?-The New Axial Pedicle View of the Anterior Column for Percutaneous Fixation.

    Science.gov (United States)

    Zhang, Lihai; Zhang, Wei; Mullis, Brian; Liu, Daohong; Xiong, Qi; Lv, Houchen; Ji, Xinran; Peng, Ye; Tang, Peifu

    2016-01-01

    Anterior column percutaneous screw fixation can be challenging. The purpose of this new technique is to offer a rapid, simple, and safe method to place an anterior screw. The authors used a 3-dimensional reconstruction simulation, cadaver study, and a clinical case series to demonstrate this new alternative to standard previously described techniques.

  15. Evaluation of anterior segment parameters and possible influencing factors in normal subjects using a dual Scheimpflug analyzer.

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    Xiaogang Wang

    Full Text Available PURPOSE: To investigate normal anterior segment parameters and analyze the possible influencing factors using a dual Scheimpflug system. SETTING: Department of Ophthalmology, Affiliated Sixth People's Hospital Shanghai Jiao Tong University, Shanghai, China. DESIGN: A prospective observational case series. METHODS: A total of 153 normal subjects (153 eyes were studied. The anterior segment parameters, including the central corneal thickness (CCT, anterior chamber depth (ACD, pupil diameter (PD, keratoconus prediction index (KPI, simulated keratometry (SimK values, anterior instantaneous curvature (AIC, posterior axial curvature (PAC, corneal eccentricity, total corneal power (TCP, axial curvature (AC, total corneal wavefront (TCW, high order aberration (HOA, and spherical aberration (SA, were determined using a dual Scheimpflug analyzer. RESULTS: The CCT and ACD were both negatively correlated with age (r = -0.203, p = 0.012; r = -0.589, p<0.001. There was no significant difference in the refractive indices of AIC and SimK. Compared with the negative correlation of HOA and SA (r = -0.358, p<0.001, a positive correlation was found between TCW and HOA (r = 0.561, p<0.001. Unlike the decreased tendency of AC, the TCP increased gradually from the center to the periphery in the central 8 mm diameter. TCP showed a significant correlation with AC in the analyzed area. CONCLUSIONS: AIC and SimK provide different information in clinic, but the refractive indices of them showed no difference in this healthy study population, and age should be considered when using CCT and ACD values.

  16. Sensitivity and Specificity of Posterior and Anterior Corneal Elevation Measured by Orbscan in Diagnosis of Clinical and Subclinical Keratoconus

    Science.gov (United States)

    Jafarinasab, Mohammad Reza; Shirzadeh, Ebrahim; Feizi, Sepehr; Karimian, Farid; Akaberi, Arash; Hasanpour, Hosein

    2015-01-01

    Purpose: To determine the sensitivity and specificity of anterior and posterior corneal elevation parameters as determined by Orbscan II (Bausch and Lomb, Rochester, NY, USA) in discriminating between (sub) clinical keratoconus (KCN) and normal corneas. Methods: This prospective case-control study included 28 eyes with subclinical KCN, 65 with clinical KCN and 141 normal corneas. Anterior and posterior corneal elevation was measured and compared in the central 5-mm corneal zone using Orbscan II. Results: Receiver operating curves (ROC) curve analyses for posterior corneal elevation showed predictive accuracy in both KCN and subclinical KCN with an area under the curve (AUC) of 0.97 and 0.69, respectively while optimal cutoff points were 51 μm for KCN and 35 μm for subclinical KCN. These values were associated with sensitivity and specificity of 89.23% and 98.58%, respectively, for KCN; and 50.00% and 88.65% for subclinical KCN. ROC curve analyses for anterior corneal elevation showed predictive accuracy in both KCN and subclinical KCN with AUC of 0.97 and 0.69, respectively while optimal cutoff points were 19 μm for KCN and 16 μm for subclinical KCN. These values were associated with sensitivity and specificity of 93.85% and 97.16%, respectively, for KCN; and 60.71% and 87.94% for subclinical KCN. Conclusion: Anterior and posterior corneal elevation data obtained by Orbscan II can well discriminate between KCN and normal corneas, however the reliability of their indices is lower in differentiating subclinical KCN from normal cases. PMID:26005546

  17. Segond fracture: involvement of the iliotibial band, anterolateral ligament, and anterior arm of the biceps femoris in knee trauma

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    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. Descriptive anatomy of the femoral portion of the iliopsoas muscle. Anatomical basis of anterior snapping of the hip.

    Science.gov (United States)

    Tatu, L; Parratte, B; Vuillier, F; Diop, M; Monnier, G

    2001-01-01

    Anterior hip snapping is a rare clinical observation. The physiopathological hypothesis currently held is a sudden slip of the iliopsoas tendon over the iliopectineal eminence. For symptomatic cases, a surgical technique is proposed. The aim of this work is to describe the anatomy of the femoral portion of the iliopsoas, which is the target of surgery. We have studied, through dissection of embalmed cadavers, the different components of the musculotendinous complex forming the femoral portion of the muscle and the gliding apparatus associated with it. The psoas major tendon exhibited a characteristic rotation. The iliacus tendon, more lateral, received the most medial iliacus muscular fibers, then fused with the main tendon. The most lateral fibers, starting in particular from the ventral portion of the iliac crest, ended up without any tendon on the anterior surface of the lesser trochanter and in the infratrochanteric region. The most inferior muscular fibers of the iliacus, starting from the arcuate line, joined the principal tendon of the psoas major passing around it by its ventromedial surface. An ilio-infratrochanteric muscular bundle was observed, in a deeper position, under the iliopsoas tendon; it arose from the interspinous incisure and on the anterior inferior iliac spine, ran along the anterolateral edge of the iliacus and inserted without any tendon onto the anterior surface of the lesser trochanter of the femur and in the infratrochanteric area. The iliopectineal bursa was studied on horizontal cross sections of a frozen pelvis and on 5 of the non-frozen preparations after dividing the iliopsoas tendon. The iliopectineal bursa had the shape of a 5 to 6-cm high and 3-cm wide cavity; in its upper part, it was divided into 2 compartments: a medial compartment for the main tendon and a lateral compartment for the accessory tendon.

  19. Direction of the formation of anterior lumbar vertebral osteophytes

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    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.

  20. Anterior urethral valves: not such a benign condition…

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    Omar eCruz-Diaz

    2013-11-01

    Full Text Available Purpose: Anterior urethral valves (AUV is an unusual cause of congenital obstruction of the male urethra, being 15 to 30 times less common than posterior urethral valves (PUV. It has been suggested that patients with congenital anterior urethral obstruction have a better prognosis than those with PUV.The long term prognosis of anterior urethral valves is not clear in the literature. In this report we describe our experience and long-term follow up of patients with AUV.Materials and methods: We retrospectively identified 13 patients who presented with the diagnosis of AUV in our institutions between 1994 and 2012. From the 11 patients included, we evaluated the gestational age, ultrasound and voiding cystourethrogram findings, age upon valve ablation, micturition pattern, creatinine and clinical follow up.Results: Between 1994 and 2012 we evaluated 150 patients with the diagnosis of urethral valves, where 11 patients (7.3% had AUV and an adequate follow up. Mean follow up is 6.3 years. 5 patients (45.4% had pre-natal diagnosis of AUV. The most common prenatal ultrasonographic finding was bilateral hydronephrosis and distended bladder.The mean gestational age was 37.6 weeks. Postnatally, 90% had trabeculated bladder, 80% hydronephrosis and 40% renal dysplasia. The most common clinical presentation was urinary tract infection in 5 patients (45.4%.7 patients (63.6% had primary transurethral valve resection or laser ablation and 3 patients (27.2% had primary vesicostomies. One boy (9.1% had urethrostomy with urethral diverticulum excision. 2 patients (18.2% developed end-stage renal disease (ESRD.Conclusions: Early urinary tract obstruction resulted in ESRD in 18% of our patient population. In our series, the complication rate and the evolution to renal failure are high and similar to patients with PUV. In patients with AUV we recommend long-term follow up and close evaluation of patient’s bladder and renal function.

  1. Clinical outcomes of pars plicata anterior vitrectomy: 2-year results

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    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.

  2. Microsurgical anatomy of the anterior cerebral artery in Indian cadavers

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    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.

  3. Novel spatula and dissector for safer deep anterior lamellar keratoplasty

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    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. Risk factors for bilateral anterior cruciate ligament injuries

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    Ristić Vladimir

    2015-01-01

    Full Text Available Introduction. The aim of this study has been to identify which risk factors can influence bilateral anterior cruciate ligament injury. Material and Methods. Thirty-two operated patients took part in this survey during the period of ten years. There were 5 women and 27 men, with average age of 30.46 years (19-55. The respondents filled in the questionnaire by answering the questions regarding the time when getting injured and operated, mechanism of injuries, genetic and anthropometric data, characteristics of sports and every day activities. Results. The incidence of reconstructed bilateral injuries in relation to unilateral ones was 2.3% (50/2168. The age of respondents and side of the injured knee did not correlate significantly with the achieved subjective physical activity level after the second knee surgery. The average time from the first injury to operation was 10 months and 4.3 years since that moment up to the injury of the other knee. It took more than 9 months on average until the reconstruction of contralateral anterior cruciate ligament. The most of athletes were injured in football matches. Three-quarters of athletes returned to competition activities after the first operation, which caused the same injury of the contralateral knee. Discussion and Conclusion. Anterior cruciate ligament rupture of the contralateral knee most often occurs in young active athletes within the first four years after the initial reconstruction. Its frequency is not affected by sex, side of extremity, genetic predisposition, type of sport, concomitant injuries and the choice of graft. Returning to the same or higher level of sports activities after the first reconstruction is one of the preconditions for injuring the other knee in the same way.

  5. 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.

  6. [Compressive optic neuropathy related to an anterior clinoid mucocele].

    Science.gov (United States)

    Arnavielle, S; Vignal-Clermont, C; Galatoire, O; Jacomet, P-V; Klap, P; Boissonnet, H; Berges, O; Morax, S

    2010-03-01

    Nasal sinus mucoceles are an uncommon cause of painful optic neuropathy. We report the case of a patient presenting an acute compressive optic neuropathy related to an anterior clinoid mucocele. The diagnosis was mainly made with CT and MRI, and the patient was treated with endoscopic endonasal transseptal surgery 10 days after the beginning of the disorder. Visual recovery was complete 3 days later. We review the literature on the etiologies of this type of pathology, the work-up, and the possible treatments.

  7. Congenital Subgaleal Cysts over the Anterior Fontanelle in Nigerians

    Science.gov (United States)

    Adeloye, Adelola; Odeku, E. Latunde

    1971-01-01

    Eighteen cases of a congenital cystic swelling located over the anterior fontanelle are described in Nigerian patients who were otherwise clinically normal, There was a female: male ratio of 2: 1. Radiologically and at operation, the cysts showed no evidence of intracranial connexion. Excision was curative. Of 14 cases which were histologically verified, all were dermoid cysts except one in which nerve tissue was present suggesting an encephalocele. Air cystography was the most useful diagnostic procedure. ImagesFIG. 2FIG. 3FIG. 4 PMID:5555494

  8. A perioperative rehabilitation program for anterior cruciate ligament surgery.

    Science.gov (United States)

    Arnold, T; Shelbourne, K D

    2000-01-01

    Rehabilitation programs have progressed alongside surgical advances in anterior cruciate ligament reconstruction. A perioperative program has been successfully used at our clinic for more than 10 years to reduce postoperative complications and return patients to activity safely and quickly. The four-phase program starts at the time of injury and preoperatively includes aggressive swelling reduction, hyperextension exercises, gait training, and mental preparation. Goals after surgery are to control swelling while regaining full knee range of motion. After quadriceps strengthening goals are reached, patients can shift to sport-specific exercises.

  9. 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

  10. Arthroscopic Management of Anterior, Posterior, and Multidirectional Shoulder Instabilities.

    Science.gov (United States)

    Field, Larry D; Ryu, Richard K N; Abrams, Jeffrey S; Provencher, Matthew

    2016-01-01

    Arthroscopic shoulder stabilization offers several potential advantages compared with open surgery, including the opportunity to more accurately evaluate the glenohumeral joint at the time of diagnostic assessment; comprehensively address multiple pathologic lesions that may be identified; and avoid potential complications unique to open stabilization, such as postoperative subscapularis failure. A thorough understanding of normal shoulder anatomy and biomechanics, along with the pathoanatomy responsible for anterior, posterior, and multidirectional shoulder instability patterns, is very important in the management of patients who have shoulder instability. The treating physician also must be familiar with diagnostic imaging and physical examination maneuvers that are required to accurately diagnose shoulder instability.

  11. Sensitivitas Gigi Anterior Perempuan Suku Sasak yang Melaksanakan Tradisi Ngasaq

    Directory of Open Access Journals (Sweden)

    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.

  12. 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.

  13. Anterior opercular syndrome induced by Epstein-Barr virus encephalitis.

    Science.gov (United States)

    Matsushima, Takashi; Nishioka, Kenya; Tanaka, Ryota; Yokoyama, Kazumasa; Hattori, Nobutaka

    2016-01-01

    We report a 19-year-old female presenting with fever, drooling, anarthria, and voluntary facial movement disruption, characteristic of anterior opercular syndrome (AOS). Serological examination revealed Epstein-Barr virus (EBV) infection following acute encephalitis with severe ataxia. A single-photon emission computerized tomography (SPECT) examination indicated hypoperfusion in the left perisylvian region, bilateral thalamus, occipital lobe, and cerebellum. This is the first report of AOS related to EBV encephalitis. SPECT was a useful method for detecting the damaged region of the operculum. In addition, AOS is a clinically distinct entity that may help us understand the mechanisms of language circuits within the operculum.

  14. Endodontic-orthodontic management of fractured anterior teeth.

    Science.gov (United States)

    Delivanis, P; Delivanis, H; Kuftinec, M M

    1978-09-01

    A case history is presented of a 10-year-old patient, who accidentally injured her maxillary central incisor. The fracture of the crown extended 2 mm below the crest of the alveolar bone. After a pulpotomy was done as a temporary measure, orthodontic appliances were placed by bonding brackets on the maxillary anterior teeth and fitting a sectional arch wire to extrude the fractured tooth. After successful extrusion, the fracture line was brought above the level of alveolar bone where successful restoration of the tooth by the acid-etch method could be accomplished.

  15. Anterior shoulder dislocation with axillary artery and nerve injury.

    Science.gov (United States)

    Razif, M A Mohamed; Rajasingam, V

    2002-12-01

    We report a rare case of left axillary artery injury associated with anterior dislocation of the left shoulder in a 25 yrs old male as a result of a road traffic accident. The shoulder dislocation was reduced. A left upper limb angiogram showed an obstructed left axillary artery. The obstructed segment was surgically reconstructed with a Dacron graft. Six months post operation in follow up, he was found to have good left shoulder function and no neurovascular deficit. This is an injury that could have been easily missed without a simple clinical examination.

  16. Negative Pressure Pulmonary Edema Associated with Anterior Cervical Spine Surgery

    Science.gov (United States)

    Yoneda, Masana; Tanaka, Yasuhito

    2014-01-01

    We report a very rare case of negative pressure pulmonary edema (NPPE) that occurred immediately after anterior cervical discectomy and fusion (ACDF). The patient was a 25-year-old man who sustained a facet fracture-dislocation of C5 during a traffic accident. After ACDF, he developed NPPE and needed mechanical ventilation. Fortunately, he recovered fully within 24 hours. NPPE is a rare postoperative complication that may occur after cervical spine surgery. The aims of this report are to present information regarding the diagnosis and emergent treatment of NPPE, and to review the previous literature regarding this serious complication. PMID:25558327

  17. Anterior cervical fusion with the Caspar instrumentation system.

    Science.gov (United States)

    Naito, M; Kurose, S; Oyama, M; Sugioka, Y

    1993-01-01

    We reviewed 106 consecutive patients who had undergone anterior cervical fusion with the Caspar instrumentation system between 1984 and 1989. Preoperative diagnoses were cervical spondylosis in 73 patients, a traumatic lesion in 12, ossification of the posterior longitudinal ligament in 9, cervical disc herniation in 6, and tumour or miscellaneous lesions in 6. In the 106 patients, 56 had two levels fused and 27 had three levels fused. At an average duration of follow-up of 4 years and 7 months, nonunion occurred in 3 of the 83 patients with multiple level fusions. Screw loosening occurred in 8 of the 106 patients, but there was no oesophageal perforation.

  18. 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.

  19. Orbital and anterior visual pathway infection and inflammation

    Energy Technology Data Exchange (ETDEWEB)

    Wyngaert, Roel de; Demaerel, Philippe [University Hospitals K.U. Leuven, Department of Radiology, Leuven (Belgium); Casteels, Ingele [University Hospitals K.U. Leuven, Department of Ophthalmology, Leuven (Belgium)

    2009-06-15

    Orbital and anterior visual pathway infection and inflammation represent approximately 10-15% of all orbital pathology. Both conditions can occur separately but occasionally they can be observed simultaneously. While the diagnosis of infection is usually straightforward, it is important to depict the lesions and to know the potential devastating complications. CT plays an important role in confirming the clinical suspicion of orbital infection. The diagnosis and differential diagnosis of inflammation is more challenging. Differentiating inflammation from lymphoproliferative diseases and tumours can be difficult. MR imaging plays an important role but a dedicated orbital imaging protocol is mandatory. (orig.)

  20. Anterior Segment Tomography with the Cirrus Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    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.

  1. 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.

  2. 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

  3. Laparoscopic repair of paraesophageal hernia with anterior gastropexy

    DEFF Research Database (Denmark)

    Daigle, Christopher R; Funch-Jensen, Peter; Calatayud, Dan

    2015-01-01

    despite significant dysphagia rates. We present our multicenter prospective data on laparoscopic PEH repairs using a modified Boerema anterior gastropexy without fundoplication. METHODS: We prospectively followed patients after modified Boerema PEH repair at three institutions. Patient demographics...... reflux necessitating PPI as needed, and 10 (9.9 %) had reflux requiring daily PPI. Our recurrence rate, assessed at postoperative endoscopy/barium swallow, was 16.8 %. Of these, 10 (9.9 %) were small segmental recurrences and 7 (6.9 %) were large recurrences. CONCLUSION: Herein, we demonstrate...

  4. Ameloblastic fibrodentinoma involving anterior maxilla: A rare case report

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    Shailaja Sankireddy

    2013-01-01

    Full Text Available Ameloblastic fibroma (AF and related lesions comprise a complex group of mixed odontogenic tumors. Ameloblastic fibrodentinoma (AFD is a rare tumor and is considered as a histological variant of AF showing inductive changes that lead to the formation of dentin. Although the most common site for this tumor is the posterior mandible, hereby we are reporting a case of AFD in the anterior maxillary region which is a very rare site for this group of tumors. The present case report highlights the clinical, radiological and histological presentation of AFD in order to raise awareness for the earlier diagnosis and precise management of this rare pathological entity.

  5. Anterior Ischemic Optic Neuropathy as a Manifestation of HELLP Syndrome

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    Boby Varkey Maramattom

    2014-01-01

    Full Text Available Thrombotic microangiopathies (TMAs are a group of disorders characterized by occurrence of thrombi of fibrin and/or platelets with microvascular occlusion and organ ischemia especially the kidney and brain. Hemolysis with a microangiopathic blood smear, elevated liver enzymes, and low platelet count (HELLP syndrome is a type of TMA peculiar to pregnancy and may be associated with neurological complications. Visual complications in HELLP are usually related to cortical blindness. We present the first case of HELLP associated with bilateral anterior ischemic optic neuropathy (AION and blindness which resolved with plasma exchange.

  6. 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.

  7. 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.

  8. 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...

  9. 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.

  10. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    Energy Technology Data Exchange (ETDEWEB)

    De Brito, Ana Caroline Ramos; Nejaim, Yuri; De Freitas, Deborah Queiroz [Dept. of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Sao Paulo (Brazil); De Oliveira Santos, Christiano [Dept. of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Sao Paulo (Brazil)

    2016-09-15

    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. 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. 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. 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.

  11. 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

  12. Computer-assisted 3D reconstruction of the terminal branches of the cerebral arteries. Pt. 1. Anterior cerebral artery

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    Gloger, S. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Gloger, A. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Vogt, H. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Kretschmann, H.J. (Dept. of Neuroanatomy, Hannover Medical School (Germany))

    1994-04-01

    We present a three-dimensional anatomical computer model of the terminal branches of the anterior cerebral artery, acquired from equidistant serial anatomical slices of three brains. The reconstructions provide a clear picture from all angles of the complicated course of the terminal branches of the cerebral arteries, which can help to identify them on conventional and magnetic resonance angiography. Our rendition of the cerebral arteries can also be matched with CT, MR or PET images to indicate the areas of extension of individual branches, allowing neuromorphological and functional correlation. (orig.)

  13. Encoding of movement in near extrapersonal space in primate area VIP

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    Frank eBremmer

    2013-02-01

    Full Text Available Many neurons in the macaque ventral intraparietal area (VIP are multimodal, i.e., they respond not only to visual but also to tactile, auditory and vestibular stimulation. Anatomical studies have shown distinct projections between area VIP and a region of premotor cortex controlling head movements. A specific function of area VIP could be to guide movements in order to head for and/or to avoid objects in near extra-personal space. This behavioral role would require a consistent representation of visual motion within 3-D space and enhanced activity for nearby motion signals. Accordingly, in our present study we investigated whether neurons in area VIP are sensitive to moving visual stimuli containing depth signals from horizontal disparity. We recorded single unit activity from area VIP of two awake behaving monkeys (M. mulatta fixating a central target on a projection screen. Sensitivity of neurons to horizontal disparity was assessed by presenting large field moving images (random dot fields stereoscopically to the two eyes by means of LCD shutter goggles synchronized with the stimulus computer. During an individual trial, stimuli had one of seven different disparity values ranging from 3 degrees uncrossed- (far to 3 degrees crossed- (near disparity in 1 degree steps. Stimuli moved at constant speed in all simulated depth planes. Different disparity values were presented across trials in pseudo-randomized order. 61% percent of the motion sensitive cells had a statistically significant selectivity for the horizontal disparity of the stimulus (p<0.05, distribution free ANOVA. 75% of them preferred crossed-disparity values, i.e. moving stimuli in near space, with the highest mean activity for the nearest stimulus. At the population level, preferred direction of visual stimulus motion was not affected by horizontal disparity. Thus, our findings are in agreement with the behavioral role of area VIP in the representation of movement in near extra

  14. 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.

  15. Evaluation of mandibular anterior alveolus in different skeletal patterns

    Directory of Open Access Journals (Sweden)

    Nga Hoang

    2016-07-01

    Full Text Available Abstract Background The boundaries for orthodontic tooth movement are set by the bony support of the dentition. This study compares the mandibular anterior alveolar housing in individuals with low, average, and high mandibular plane angles before orthodontic treatment and measures alveolar bone loss and root resorption after orthodontic treatment. Methods Pretreatment cone-beam computed tomography (CBCT images of 75 non-growing individuals, 25 in three groups: low-angle (sella-nasion to mandibular plane ≤28°, average-angle (30°–37°, and high-angle (≥39°, were analyzed. Buccolingual bone thickness was measured at the root apex, mid-root, and alveolar crest of the mandibular right central incisor. Pre- and posttreatment CBCT images of 11 low-angle, 20 average-angle, and 27 high-angle patients were compared to determine changes in the alveolus and mandibular incisor root after orthodontic treatment. Results The pretreatment anterior alveolar bone widths were significantly different, wider in low-angle than in average- and high-angle individuals (p value = 0.000. High-angle individuals also had greater posttreatment external root resorption, even though the bony housing changed minimally. Conclusions Negative sequelae of orthodontic treatment are more frequently found in individuals with high mandibular plane angles and could be linked to their thin pre-existing alveolar housing.

  16. 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.

  17. 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.

  18. Steal phenomenon through the anterior communicating artery in Moyamoya disease

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    Lim, Soo Mee [Ewha Womans University, Department of Radiology, Mok-dong Hospital, College of Medicine, Seoul (Korea); Chae, Eun Jin; Kim, Min Yeong; Kim, Sang Joon; Choi, Choong Gon; Pyun, Hae Wook; Suh, Dae Chul [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Kim, Jae Kyun [Seoul Veterans Hospital, Department of Radiology, Seoul (Korea); Ahn, Jae Sung; Ra, Young-Shin [University of Ulsan, Asan Medical Center, Department of Neurosurgery, College of Medicine, Seoul (Korea); Kim, Jong-Uk; Hahm, Kyung Don [University of Ulsan, Asan Medical Center, Department of Anesthesiology, College of Medicine, Seoul (Korea)

    2007-01-15

    Branch occlusion of the anterior cerebral artery (ACA) is regarded as a part of Moyamoya disease. The purpose of this study is to define the ACA steal phenomenon (SP) in Moyamoya disease and to evaluate temporal changes according to the disease progression. From 139 Moyamoya patients we defined ACASP as narrowing of the ipsilateral A1-2 junction while preserving the anterior communicating artery and supplying the contralateral ACA cortical branches with the development of leptomeningeal collaterals by the ipsilateral middle cerebral artery into the hypoperfused ipsilateral ACA territory. Direction of the steal related to the stage in both hemispheres by Suzuki classification was statistically analyzed using the binomial test based on binomial distribution. Follow-ups of ACASP were evaluated in five patients. We identified ACASP in 13 (9%) patients (male:female=7:6, mean age 18 years, range: 2-58 years) of the 139 study patients. The presenting pattern was ischemic in 12 and hemorrhagic in one. The direction of SP occurred from the hemisphere in the lower to the higher stage of Suzuki classification (two-tail P value=0.0002). After revascularization surgery, ACASP disappeared or diminished. ACASP may occur in bilaterally different stages of Moyamoya disease as a transient self-adaptive process. It regresses after revascularization surgery. (orig.)

  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. Anterior Hox Genes in Cardiac Development and Great Artery Patterning

    Directory of Open Access Journals (Sweden)

    Brigitte Laforest

    2014-03-01

    Full Text Available During early development, the heart tube grows by progressive addition of progenitor cells to the arterial and venous poles. These cardiac progenitor cells, originally identified in 2001, are located in the splanchnic mesoderm in a region termed the second heart field (SHF. Since its discovery, our view of heart development has been refined and it is well established that perturbation in the addition of SHF cells results in a spectrum of congenital heart defects. We have previously shown that anterior Hox genes, including Hoxb1, Hoxa1 and Hoxa3, are expressed in distinct subdomains of the SHF that contribute to atrial and subpulmonary myocardium. It is well known that Hox proteins exert their function through interaction with members of the TALE family, including Pbx and Meis factors. The expression profile of Pbx and Meis factors overlaps with that of anterior Hox factors in the embryonic heart, and recent data suggest that they may interact together during cardiac development. This review aims to bring together recent findings in vertebrates that strongly suggest an important function for Hox, Pbx and Meis factors in heart development and disease.