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Sample records for anteromedial temporosphenoidal encephalocele

  1. Case Report: Anteromedial temporosphenoidal encephalocele with a clinically silent lateral bony defect in the greater wing of the sphenoid

    International Nuclear Information System (INIS)

    Anteromedial temporosphenoidal encephalocele is the least common type of temporal encephalocele. It commonly presents with spontaneous cerebrospinal fluid rhinorrhea in adults. This article presents the CT cisternography and MRI findings of one such case, which also had an associated clinically silent defect in the greater wing of the sphenoid on the same side

  2. Encephaloceles

    Science.gov (United States)

    ... Trials Organizations What are Encephaloceles? Encephaloceles are rare neural tube defects characterized by sac-like protrusions of the brain ... families with a history of spina bifida and anencephaly in family members. Is there any treatment? Generally, ...

  3. Nasal encephaloceles

    NARCIS (Netherlands)

    Hoving, Eelco W.

    2000-01-01

    Nasal encephaloceles can be divided into frontoethmoidal and basal encephaloceles. Both conditions are very rare, but frontoethmoidal encephaloceles show a relatively high incidence (1:5,000) in Southeast Asia. The pathogenesis of encephaloceles may be explained by a disturbance in separation of sur

  4. Giant high occipital encephalocele

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2016-03-01

    Full Text Available Encephaloceles are rare embryological mesenchymal developmental anomalies resulting from inappropriate ossification in skull through with herniation of intracranial contents of the sac. Encephaloceles are classified based on location of the osseous defect and contents of sac. Convexity encephalocele with osseous defect in occipital bone is called occipital encephalocele. Giant occipital encephaloceles can be sometimes larger than the size of baby skull itself and they pose a great surgical challenge. Occipital encephaloceles (OE are further classified as high OE when defect is only in occipital bone above the foramen magnum, low OE when involving occipital bone and foramen magnum and occipito-cervical when there involvement of occipital bone, foramen magnum and posterior upper neural arches. Chiari III malformation can be associated with high or low occipital encephaloceles. Pre-operatively, it is essential to know the size of the sac, contents of the sac, relation to the adjacent structures, presence or absence of venous sinuses/vascular structures and osseous defect size. Sometimes it becomes imperative to perform both CT and MRI for the necessary information. Volume rendered CT images can depict the relation of osseous defect to foramen magnum and provide information about upper neural arches which is necessary in classifying these lesions.

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... here in the United States, which is the occipital encephalocele, or here in the back of the ... in other parts of the brain, for example occipital encephaloceles, we can sometimes be able to reduce ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... had this encephalocele, this mass in between his nose, and there are many different kinds of encephalocele. ... The two most common are either in the nose here in the front, which tend to be ...

  7. Anaesthetic management of giant encephalocele

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2015-12-01

    Full Text Available One of the several challenges to the anaesthesiologists, is management of child with difficult airway. Management of even normal airway in a neonate is different and complex as compared to airway of two year old child and that of adult. Definition of the difficult airway is related solely to tracheal intubation or problems with mask ventilation1.Among the different causes of difficult airway cranio facial and neoplastic anomalies are very common. We present a case report of difficult airway management in encephalocele patient. [Int J Res Med Sci 2015; 3(12.000: 3889-3892

  8. Parietal and occipital encephalocele in same child: A rarest variety of double encephalocele.

    Science.gov (United States)

    Sharma, Somnath; Ojha, Bal Krishan; Chandra, Anil; Singh, Sunil Kumar; Srivastava, Chhitij

    2016-05-01

    An encephalocele is a protrusion of the brain and/or meninges through a defect in the skull. Based on the location of the skull defect they are classified into sincipital, basal, occipital or parietal varieties. Occurrence of more than one Encephalocele in a patient is very rare and very few cases of double encephalocele are reported. We report an interesting case where a parietal and an occipital encephalocele were present together. The patient was a 2 months boy who was brought to us with complaints of two swelling on the scalp since birth. Neuroimaging studies confirmed it to be a case of double encephalocele. The rarity of the findings prompted us to report this case. The presentation and management of the case along with and review of the relevant literature is presented. PMID:26876766

  9. Fronto-nasal Encephalocele. A Case Report

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    Rafael Ferrer Montoya

    2013-06-01

    Full Text Available Encephalocele is a herniation of the brain tissue through a congenital or acquired defect of the skull. The congenital condition is caused by a neural-tube defect attributable to an interaction among several genes and environmental factors. Anterior encephalocele is a rare entity and its incidence varies depending on the geographic area. We report the case of a newborn with a tumour protruding through the fronto-nasal region with a central pedunculated polypoid formation, in addition to the presence of bilateral cleft lip and palate. Surgical treatment was decided after consulting the Neurosurgery Department. This case report is interesting due to the rarity of this entity.

  10. Pilocytic Astrocytoma Presenting as an Orbital Encephalocele: A Case Report

    OpenAIRE

    Bruzek, Amy; Shepherd, Daniel; Van Gompel, Jamie; Jentoft, Mark

    2015-01-01

    We describe the case of a 29-year-old male who presented with new-onset seizures. He was subsequently found to have an orbital encephalocele containing a focus of pilocytic astrocytoma. We believe that this is the first report of a pilocytic astrocytoma located within the orbit that did not originate from the optic pathway. It is also the first case of a pilocytic astrocytoma completely contained within an encephalocele. This case suggests a close pathological examination of encephaloceles fo...

  11. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... something that you determine at the time of surgery. The risk factors for trying to figure out if a ... larger encephaloceles and sphenoidal encephaloceles, sometimes that’s a risk either ... function is like before surgery and have a good sense of what it ...

  12. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... of this developing later on in life into cancer?” And, you know, my understanding is that there ... the encephalocele. Clearly, the arachnoid cyst is not cancer. This is a cyst, a bubble, a lining ...

  13. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... actually, in the skull and this resulted in brain protruding out in between the eyes. And I ... What an encephalocele is essentially a bit of brain herniating or pushing out through a whole in ...

  14. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... addressed from cleft surgical cleft palate to acute appendicitis, to a frontal Encephalocele to, you know, any ... something like this or, say, to someone having appendicitis is really a basic service that one needs, ...

  15. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... here was that he had this encephalocele, this mass in between his nose, and there are many ... that he had this large defect -- sorry, large mass in between his eyes. This is what led ...

  16. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... of looks a little bit like a spider web. 5 I think what we’ll see right ... in the procedure at this point. So Dr. Smith in this portion is removing the encephalocele. So ...

  17. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... of the slides just to lay some ground work for us about the frontal encephalocele. Yeah. This ... know, for laying a little bit of ground work. Let’s start looking at the surgery, and I ...

  18. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... was seen down in Haiti to have this large deformity in between his eyes. This is something ... about how Dumanel not only had this very large encephalocele but also had another surprise, which made ...

  19. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... of a frontal encephalocele and an arachnoid cyst. I’m John Meara from the Department of Plastic ... and David Walton from Partners in Health. Ed, I’m going to let you lead off, and ...

  20. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... bit about frontal encephaloceles and our approach to these. Sure. So as was mentioned by David, one ... be brought up here to Children’s, and sometimes these can be very complicated cases to manage. We’ ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... we’ll be elevating a flap that involves skin, subcutaneous tissue, and the periosteum. And one thing ... these children with encephaloceles are born without adequate skin coverage, and so that’s a bit more of ...

  2. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... frontal encephalocele and an arachnoid cyst. I’m John Meara from the Department of Plastic Surgery, and ... initially when Dumanel came to our attention. Actually, John Meara, who is here with us on our ...

  3. Spheno-orbital encephalocele: A rare entity – A case report and review of literature

    OpenAIRE

    Sharma, Mayur; Mally, Rahul; Velho, Vernon; Agarwal, Vivek

    2014-01-01

    Objective: To report a rare case of basal encephalocele (spheno-orbital encephalocele), managed successfully in our institute. This is one of the rarest type of encephaloceles with very little literature available. In this case, sphenoid dysplasia was not associated with type 1 Neurofibromatosis. Settings: Grant Medical College and Sir J.J Group of Hospitals, Byculla, Mumbai, Maharashtra, India. Methods: A 22 year old male presented with a history of protrusion of right eye since the age of 7...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... of encephalocele causes is something called the “long-nose deformity.” And so when you’re reconstructed the frontal orbital band O and the nose, that’s an important thing to address in reducing ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... encephalocele, the part of brain that isn’t healthy and isn’t, you know, functional anymore is ... bipolars,” is to cauterize the tissue between the healthy brain on the left and the unhealthy brain ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... Procedure to Treat Encephalocele and an Arachnoid Cyst Children's Hospital Boston, Boston, MA January 28, 2009 Welcome to this “OR-Live” webcast presentation, live from Children’s Hospital Boston, in Boston, Massachusetts. During the program ...

  7. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    Full Text Available ... removing this the brain or in the scull base, whether it’s an encephalocele, whether it’s something called ” ... the smelling nerves, and those run along the base of the skull and head out into the ...

  8. Pediatric encephaloceles: A series of 20 cases over a period of 3 years

    Directory of Open Access Journals (Sweden)

    Shashank Ravindra Ramdurg

    2015-01-01

    Full Text Available Background: Encephalocele is the protrusion of the cranial contents beyond the normal confines of the skull through a defect in the calvarium and is far less common than spinal dysraphism. The exact worldwide frequency is not known. Aims and Objectives: To determine the epidemiological features, patterns of encephalocele, and its postsurgical results. Materials and Methods: The study was carried from year July 2012 to June 2015. Patients with encephalocele were evaluated for epidemiological characteristics, clinical features, imaging characteristics, and surgical results. Results: 20 encephaloceles patients were treated during the study period. Out of these 12 (60% were male and 8 (40% female. Age range was 1 day to 6 years. The most common type of encephalocele was occipital 12 (60%, occipito-cervical 4 (20%, parietal 2 (10%, fronto-nasal 1 (5%, and fronto-naso-ethmoidal 1 (5%. One patient had a double encephalocele (one atretic and other was occipital with dermal sinus tract and limited dermal myeloschisis. Other associations: Chiari 3 malformation (2, meningomyeloceles (4, and syrinx (4. Three patients presented with rupture two of whom succumbed to meningitis and shock. Seventeen patients treated surgically did well with no immediate surgical mortality (except a case of Chiari 3 malformation who succumbed 6 months postsurgery to unrelated causes. Shunt was performed in 4 cases. Conclusion: The most common type of encephalocele is occipital in our set up. Early surgical management of encephalocele is not only for cosmetic reasons but also to prevent tethering, rupture, and future neurological deficits.

  9. A Rare Triad of Giant Occipital Encephalocele with Lipomyelomeningocele, Tetralogy of Fallot, and Situs Inversus.

    Science.gov (United States)

    Franco, Arie; Jo, Stephanie Y; Mehta, Amar S; Pandya, Dave J; Yang, Carina W

    2016-03-01

    Giant encephalocele is an uncommon congenital anomaly with very few published reports available in the English literature. Tetralogy of Fallot associated with situs inversus is also infrequently reported. To our knowledge there are no published reports of an association between giant encephalocele and Tetralogy of Fallot. The additional finding of situs inversus results in a rare pathologic triad, not heretofore described. PMID:27200165

  10. Transethmoidal encephalocele after reduction of high intracranial pressure in aqueductal stenosis.

    Science.gov (United States)

    Sharifi, Guive; Alavi, Ehsan; Jalessi, Maryam; Haddadian, Karim; Faramarzi, Faezeh

    2014-01-01

    Acquired non-traumatic transethmoidal encephaloceles are very infrequent lesions that are generally caused by a tumor or hydrocephalus. As far as we know, there is no reported case of encephalocele after CSF diversion in the literature. We present a 25-year-old woman with hydrocephalus due to aquiductal stenosis who was treated with endoscopic third ventriculostomy. Nine months later, she had developed rhinorrhea and on imaging she had a transethmoidal encephalocele. She underwent endonasal endoscopic repair of the defect and removal of herniated parenchyma. CSF diversion to parasellar cisterns is not a known iatrogenic cause of basal encephalocele and is not noted elsewhere as a complication of third ventriculostomy. However, as third ventriculostomy is performed usually for intracranial hypertension treatment and intracranial hypertension itself is a known but rare cause of lacunar skull defect and encephalocele, this co-incidence may occur. PMID:24535796

  11. The anteromedial GPi as a new target for deep brain stimulation in obsessive compulsive disorder.

    Science.gov (United States)

    Nair, Girish; Evans, Andrew; Bear, Renee E; Velakoulis, Dennis; Bittar, Richard G

    2014-05-01

    Deep brain stimulation (DBS) is now well established in the treatment of intractable movement disorders. Over the past decade the clinical applications have expanded into the realm of psychosurgery, including depression and obsessive compulsive disorder (OCD). The optimal targets for electrode placement in psychosurgery remain unclear, with numerous anatomical targets reported for the treatment of OCD. We present four patients with Tourette's syndrome and prominent features of OCD who underwent DBS of the anteromedial globus pallidus internus (GPi) to treat their movement disorder. Their pre-operative and post-operative OCD symptoms were compared, and responded dramatically to surgery. On the basis of these results, we propose the anteromedial (limbic) GPi as a potential surgical target for the treatment of OCD, and furnish data supporting its further investigation as a DBS target for the treatment of psychiatric conditions. PMID:24524950

  12. Intrarater and interrater reliability of the Anteromedial Reach Test in healthy participants

    OpenAIRE

    Bent, Nicholas

    2014-01-01

    Nicholas P Bent,1 Alison B Rushton,1 Chris C Wright,1 Emma-Jane Petherick,2 Mark E Batt3 1School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, 2School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, 3Centre for Sports Medicine, Nottingham University Hospitals, Nottingham, UK Background: The Anteromedial Reach Test is a performance-based outcome measure for evaluating dynamic knee stability in patients with anterior cruciate ligamen...

  13. Deep brain stimulation of the antero-medial globus pallidus interna for Tourette syndrome.

    Directory of Open Access Journals (Sweden)

    Perminder S Sachdev

    Full Text Available BACKGROUND: We have previously reported the results of Deep Brain Stimulation (DBS of the antero-medial globus pallidus interna (GPi for severe Tourette Syndrome (TS in 11 patients. We extend this case series to 17 patients and a longer follow-up to a maximum of 46 months. METHODS: 17 patients (14 male; mean age 29.1 years, range 17-51 years with severe and medically intractable TS were implanted with Medtronic quadripolar electrodes bilaterally in the antero-medial GPi. The primary outcome measure was the Yale Global Tic Severity Scale (YGTSS. Secondary outcome measures included the Yale-Brown Obsessive Compulsive Scale, Hamilton Depression Rating Scale, Gilles de la Tourette Quality of Life Scale and Global Assessment of Functioning. Follow up was at one month, three months and finally at a mean 24.1 months (range 8-46 months following surgery. RESULTS: Overall, there was a 48.3% reduction in motor tics and a 41.3% reduction in phonic tics at one month, and this improvement was maintained at final follow-up. 12 out of 17 (70.6% patients had a>50% reduction in YGTSS score at final follow up. Only 8 patients required ongoing pharmacotherapy for tics post-surgery. Patients improved significantly on all secondary measures. Adverse consequences included lead breakage in 4 patients, infection (1, transient anxiety (2, dizziness (1, poor balance (1 and worsening of stuttering (1. CONCLUSIONS: This case series provides further support that antero-medial GPi DBS is an effective and well tolerated treatment for a subgroup of severe TS, with benefits sustained up to 4 years.

  14. Intrarater and interrater reliability of the Anteromedial Reach Test in healthy participants

    Directory of Open Access Journals (Sweden)

    Bent NP

    2014-02-01

    Full Text Available Nicholas P Bent,1 Alison B Rushton,1 Chris C Wright,1 Emma-Jane Petherick,2 Mark E Batt3 1School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, 2School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, 3Centre for Sports Medicine, Nottingham University Hospitals, Nottingham, UK Background: The Anteromedial Reach Test is a performance-based outcome measure for evaluating dynamic knee stability in patients with anterior cruciate ligament injury. No previously published study has adequately evaluated intrarater or interrater reliability of the Anteromedial Reach Test, so the purpose of this study was to assess these measurement properties in healthy participants prior to their investigation in patients with anterior cruciate ligament injury. Methods: Two raters (A and B tested 39 healthy university staff and students (20 men, 19 women. For the intrarater reliability investigation, rater A tested participants on three separate test occasions (days 1, 2, and 3 at the same time of day. For the interrater reliability investigation, raters A and B independently tested participants on the same test occasion (day 3. Results: There was no significant systematic bias between test occasions or raters. Values of the intraclass correlation coefficient (2,1 were 0.96 for intrarater reliability of both the dominant leg and nondominant leg and 0.97 (dominant leg and 0.98 (nondominant leg for interrater reliability. Values for the standard error of measurement were 1.46 (dominant leg and 1.62 (nondominant leg for the intrarater investigation, and 1.26 (dominant leg and 1.04 (nondominant leg for the interrater investigation. At the 90% confidence level, the minimum detectable change was 3.8% and the error in an individual's score at a given point in time was ±2.7%. Conclusion: The Anteromedial Reach Test demonstrated excellent intrarater and interrater reliability in healthy participants. This provides a

  15. Progressive skin necrosis of a huge occipital encephalocele

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    Andarabi Yasir

    2008-01-01

    Full Text Available Objects: Progressive skin necrosis of giant occipital encephalocoele is an extremely rare complication found in neonates. Infection and ulceration of the necrosed skin may lead to meningitis or sepsis. We present here a neonate with giant occipital encephalocoele showing progressive necrosis during the first day of his life. Methods: A newborn baby was found to have a huge mass in the occipital region, which was covered by normal pink-purplish skin. During the last hours of the first day of his life, the sac started becoming ulcerated accompanied with a rapid color change in the skin, gradually turning darker and then black. The neonate was taken up for urgent excision and repair of the encephalocele. Two years after the operation, he appears to be well-developed without any neurological problems. Conclusion: Necrosis may have resulted from arterial or venous compromise caused by torsion of the pedicle during delivery or after birth. The high pressure inside the sac associated with the thin skin of the encephalocoele may be another predisposing factor. In view of the risk of ulceration and subsequent infection, urgent surgery of the necrotizing encephalocele is suggested.

  16. Encephalocele presented in late third trimester: a case report

    Directory of Open Access Journals (Sweden)

    Hemant G. Deshpande

    2014-04-01

    Full Text Available In present era, most of the NTDs are diagnosed at quite early gestation, thanks to advancement in imaging technology. So it is rare to see a case of NTD in late gestational age. Encephalocele is still rare type of NTD, when we come across such a case in late gestational period associated with another risk factor (Previous LSCS, it can really present a challenge for management. We had to face such a case requiring skillful management. A 23 year, G2 P1 L1 with previous LSCS was referred to our institution for severe anemia. USG showed 37 weeks single, live fetus with absence of cranial vault and irregular compressed cystic structure attached to vault attached in occipital region. Previous USG done at 12 weeks showed no abnormality, while USG at 27 weeks showed Acrania. Ideal management of this patient could have been done if this anomaly was diagnosed before 20 weeks where option of MTP was clearly available. Though with high resolution technical and instrument and with expert sonologist encephalocele can be diagnosed by 14 weeks. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 460-462

  17. Operative Treatment of Terrible Triad of the Elbow via Posterolateral and Anteromedial Approaches.

    Directory of Open Access Journals (Sweden)

    Hong-Wei Chen

    Full Text Available The aim of the study was to explore the clinical outcome of posterolateral and anteromedial approaches in treatment of terrible triad of the elbow. The study involved 12 patients with closed terrible triad of the elbow treated by posterolateral and anteromedial approaches between January 2010 and June 2012. The mechanism of injury included fall from height in 9 patients and traffic accident in 3. According to O'Driscoll classification for fractures of the ulnar coronoid, there were 11 patients with type Ⅰ and 1 with type Ⅱ fractures. According to Mason classification for fractures of the radial head, there were 3 patients with type Ⅰ, 7 with type Ⅱ and 2 with type Ⅲ fractures. All patients were followed up for 12-27 months (average 15.5 months, which showed no pain or severe pain in all patients except for 2 patients with mild pain. At the last follow-up, the mean flexion was for 125°(range, 90°-140°, the mean extension loss for 20°(range, 0°-70°, the mean pronation for 66°(range, 20°-85° and the mean supination for 60°(range, 30°-85°. The bony union time was 8-14 weeks (average 11 weeks and the elbows were stable in flexion-extension and varus-valgus in all patients. The elbows maintained a concentric reduction of both the ulnotrochlear and the radiocapitellar articulation. Mild heterotopic ossification of the elbow occurred in 3 patients at 6 months after operation and mild degenerative change in 1 patient at 18 months after operation. The Broberg and Morrey elbow performance score was 82 points (range, 58-98 points. The results were excellent in 6 patients, good in 4, fair in 1 and poor in 1, with excellence rate of 83.3%. The results showed that the combined posterolateral and anteromedial approaches can facilitate the reduction and fixation of terrible triad of the elbow. Repair of radial head, coronoid, medial and lateral collateral ligaments can sufficiently restore the elbow stability, allow early postoperative

  18. Basal encephalocele associated with morning glory syndrome: case report Encefalocele basal associada a síndrome "morning glory": relato de caso

    OpenAIRE

    Ivanete Minotto; Nitamar Abdala; Adriana Aparecida Siviero Miachon; Angela Maria Spinola e Castro; Paulo Imamura; Roberto Gomes Nogueira

    2007-01-01

    The basal encephaloceles refer to rare entities and they correspond to herniation of brain tissue through defects of skull along the cribiform plate or the sphenoid bone. A rare morning glory syndrome, with characteristic retinal defect has been reported in association with basal encephaloceles. Hypophysis hormonal deficiencies may occur. We accounted for a pituitary dwarfism with delayed diagnosed transsphenoidal encephalocele associated with morning glory syndrome, showing the alterations f...

  19. Basal sphenoethmoidal encephalocele in association with midline cleft lip and palate: case report

    International Nuclear Information System (INIS)

    Association of basal sphenoethmoidal encephalocele with midline cleft lip and palate is extremely rare. The authors report the case of a nine-year-old girl presenting a midline facial cleft with meningocele that was noticeable through the palatine defect as a medial intranasal pulsatile mass. An analysis of clinical and radiological findings of the present case of cranial dysraphism is carried out. (author)

  20. Nasal endotracheal intubation in a premature infant with a nasal encephalocele.

    OpenAIRE

    Bannister, C M; Kashab, M; Dagestani, H; Placzek, M

    1993-01-01

    After a difficult nasal intubation a premature infant leaked cerebrospinal fluid (CSF) from one nostril. After developing bacterial meningitis, the baby was referred for neurosurgical management of the CSF fistula. Transaxial computed tomograms demonstrated a nasal encephalocele, but coronal scans were needed to show the defect in the cribriform plate.

  1. Basal sphenoethmoidal encephalocele in association with midline cleft lip and palate: case report

    Energy Technology Data Exchange (ETDEWEB)

    Holanda, Maurus Marques de Almeida; Rocha, Artur Bastos; Santos, Rayan Haquim Pinheiro [Universidade Federal da Paraiba (UFPB), Joao Pessoa, PB (Brazil); Furtado, Paulo Germano Cavalcanti [Universidade Federal da Paraiba (UFPB), Joao Pessoa, PB (Brazil). Dept. de Pediatria e Genetica

    2011-11-15

    Association of basal sphenoethmoidal encephalocele with midline cleft lip and palate is extremely rare. The authors report the case of a nine-year-old girl presenting a midline facial cleft with meningocele that was noticeable through the palatine defect as a medial intranasal pulsatile mass. An analysis of clinical and radiological findings of the present case of cranial dysraphism is carried out. (author)

  2. Impingement fracture of the anteromedial tibial margin: a radiographic sign of combined posterolateral complex and posterior cruciate ligament disruption

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, A.P.; King, D.; Gibbon, A.J. [York District Hospital (United Kingdom)

    2001-02-01

    Marginal fractures of the tibial plateau are associated with a high incidence of soft tissue injuries to the stabilising structures of the knee joint. Injuries to the anterior cruciate ligament are associated with the Segond fracture and impingement fractures of the posteromedial tibial plateau. Recognition of these fractures aids diagnosis of these injuries. Marginal fractures of the tibial plateau associated with posterior cruciate ligament injuries are less common, though recently a ''reverse'' Segond fracture has been recognised. We describe a fracture of the anteromedial tibial plateau associated with complete disruption of the posterior cruciate ligament and posterolateral complex. (orig.)

  3. Impingement fracture of the anteromedial tibial margin: a radiographic sign of combined posterolateral complex and posterior cruciate ligament disruption

    International Nuclear Information System (INIS)

    Marginal fractures of the tibial plateau are associated with a high incidence of soft tissue injuries to the stabilising structures of the knee joint. Injuries to the anterior cruciate ligament are associated with the Segond fracture and impingement fractures of the posteromedial tibial plateau. Recognition of these fractures aids diagnosis of these injuries. Marginal fractures of the tibial plateau associated with posterior cruciate ligament injuries are less common, though recently a ''reverse'' Segond fracture has been recognised. We describe a fracture of the anteromedial tibial plateau associated with complete disruption of the posterior cruciate ligament and posterolateral complex. (orig.)

  4. MR imaging of anteromedial and posterolateral bundles of anterior cruciate ligament of knee joint

    International Nuclear Information System (INIS)

    Objective: To improve the visualization of anteromedial and posterolateral bundles of anterior cruciate ligament (ACL) and investigate the optimal MRI plane for the bundles at a 3.0 T MR scanner. Methods: MR images of 149 knee joints were reviewed retrospectively. Display rates of AMB, PLB and their different parts (the top portion,the middle portion and the low portion) on MR different planes including axial, sagittal and coronal planes were analyzed and their differences were compared with the χ2 section method. Results: There was no statistical difference in the display rates of two bundles of ACL between axial plane (115/149, 77.2%) and coronal plane (103/149, 69.1%) (χ2=2.4606, P>0.0125). Statistical differences were found between axial and sagittal plane, coronal plane and sagittal plane (21/149, 14.1%) (χ2=119.5138, 92.8695 respectively, P<0.0125). There was a statistical difference for the top portion of ACL between axial plane (104/149, 69.8%) and coronal plane, sagittal (0/149,0) and coronal planes (7/149, 4.7%) (χ2=135.081, 159.7526 respectively, P<0.0125), between sagittal and coronal planes (χ2=7.1684, P<0.0125). For the middle portion of ACL, there was no statistical difference between axial plane (108/149, 72.5%) and coronal plane (94/149, 63.1%) (χ2=3.0120, P>0.0125), while statistical differences were found between axial and sagittal plane,coronal planes and sagittal plane (10/149, 6.7%) (χ2=134.7454, 104.2173 respectively, P<0.0125). For the low portion of ACL, there was no statistical difference between axial plane (103/149, 69.1%) and coronal plane (101/149, 73.8%) (χ2=0.8065, P>0.0125), while statistical differences were detected between axial and sagittal plane,coronal planes and sagittal plane (18/149, 12.1%) (χ2=100.5300, 115.9132, P<0.0125). The different parts of ACL displayed low intensity on different MR planes and normal morphology. Conclusions: ACL can be displayed on conventional MR planes at a 3.0 T MR scanner to some extent

  5. SEPTO-OPTICDYSPLASIA WITH AN ANTERIOR ENCEPHALOCELE AND INTACT SEPTUM PELLUCIDUM: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Z. Razavi

    2008-10-01

    Full Text Available ObjectiveThe diagnosis of de Morsier syndrome or septo-optic dysplasia is made on the basis of the diagnosis of optic nerve hypoplasia. Septo-optic dysplasia is defined by a variable combination of dysgenesis of midline brain structures including optic nerve hypoplasia and hypothalamic-pituitary dysfunction often associated with a wide variety of brain malformations of cortical development.The importance of direct ophthalmoscopy of optic nerve abnormalities is stressed, as well as of magnetic resonance imaging, which has become a guideline in the classification of  this syndrome This article reports a 19-year-old female with bilateral optic nerve  hypoplasia,anterior encephalocele and intact septum pellucidum. She was diagnosed withdiabetes insipidus, short stature and the history of seizure.Keywords: De morsier syndrome, Septo-optic dysplasia, Encephalocele, Short stature, Optic nerve hypoplasia

  6. Intraorbital Encephalocele Presenting with Exophthalmos and Orbital Dystopia : CT and MRI Findings

    OpenAIRE

    Asil, Kiyasettin; Gunduz, Yasemin; Yaldiz, Can; Aksoy, Yakup Ersel

    2015-01-01

    A 15-year-old female patient with progressive pulsatile exophthalmos caused by intraorbital encephalocele was evaluated with computed tomography (CT) and magnetic resonance imaging (MRI) in our clinic. She had no history of trauma or reconstructive surgery. When she was a little girl, she had undergone surgery for congenital glaucoma on the right eye. On the three-dimensional image of CT, a hypoplasic bone defect was observed in the greater wing of the right sphenoid bone. MRI and CT scan sho...

  7. Anterior cruciate ligament (ACL reconstruction with quadriceps tendon autograft and press-fit fixation using an anteromedial portal technique

    Directory of Open Access Journals (Sweden)

    Akoto Ralph

    2012-08-01

    Full Text Available Abstract Background This article describes an arthroscopic anterior cruciate ligament (ACL reconstruction technique with a quadriceps tendon autograft using an anteromedial portal technique. Methods A 5 cm quadriceps tendon graft is harvested with an adjacent 2 cm bone block. The femoral tunnel is created through a low anteromedial portal in its anatomical position. The tibial tunnel is created with a hollow burr, thus acquiring a free cylindrical bone block. The graft is then passed through the tibial tunnel and the bone block, customized at its tip, is tapped into the femoral tunnel through the anteromedial portal to provide press-fit fixation. The graft is tensioned distally and sutures are tied over a bone bridge at the distal end of the tibial tunnel. From the cylindrical bone block harvested from the tibia the proximal end is customized and gently tapped next to the graft tissue into the tibial tunnel to assure press fitting of the graft in the tibial tunnel. The distal part of the tibial tunnel is filled up with the remaining bone. All patients were observed in a prospective fashion with subjective and objective evaluation after 6 weeks, 6 and 12 months. Results Thirty patients have been evaluated at a 12 months follow-up. The technique achieved in 96.7% normal or nearly normal results for the objective IKDC. The mean subjective IKDC score was 86.1 ± 15.8. In 96.7% the Tegner score was the same as before injury or decreased one category. A negative or 1+ Lachman test was achieved in all cases. Pivot-shift test was negative or (+ glide in 86.7%. The mean side-to-side difference elevated by instrumental laxity measurement was 1.6 ± 1.1 mm. Full ROM has been achieved in 92.3%. The mean single one-leg-hop index was 91.9 ± 8.0 at the follow-up. Conclusions Potential advantages include minimum bone loss specifically on the femoral side and graft fixation without implants.

  8. Anteromedial Marginal Fracture of Medial Tibial Plateau without Significant Knee Ligamentous Injury in Hypermobility Patient: a Case Report and Review of Literature

    Science.gov (United States)

    Chanasit, Prakasit; Sa-ngasoongsong, Paphon; Chanplakorn, Pongsthorn; Jaovisidha, Suphaneewan; Suphachatwong, Chanyut; Wajanavisit, Wiwat

    2013-01-01

    Anteromedial rim fracture of medial tibial plateau is a rare fracture pattern with only a small number of case reports in the literature. However, it is highly likely that is associated with specific significant soft tissue injuries, especially posterior and posterolateral corner structure, and medial meniscus injury. It is thought this fracture is caused by hyperextension and varus rotation mechanism. The previous reports highlight the typical pattern of severe concomitant knee ligament injury associated with this fracture that always require surgical repair to restore knee stability and function. In this report, we present an unusual case with a history of generalized joint laxity and acute anteromedial marginal fracture of medial tibial plateau without associated significant ligament damage, together with a literature review of this condition. We believe this case report introduces new insights into this unique fracture pattern. PMID:23888202

  9. Anteromedial marginal fracture of medial tibial plateau without significant knee ligamentous injury in hypermobility patient: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Prakasit Chanasit

    2013-06-01

    Full Text Available Anteromedial rim fracture of medial tibial plateau is a rare fracture pattern with only a small number of case reports in the literature. However, it is highly likely that is associated with specific significant soft tissue injuries, especially posterior and posterolateral corner structure, and medial meniscus injury. It is thought this fracture is caused by hyperextension and varus rotation mechanism. The previous reports highlight the typical pattern of severe concomitant knee ligament injury associated with this fracture that always require surgical repair to restore knee stability and function. In this report, we present an unusual case with a history of generalized joint laxity and acute anteromedial marginal fracture of medial tibial plateau without associated significant ligament damage, together with a literature review of this condition. We believe this case report introduces new insights into this unique fracture pattern.

  10. Anteromedial Marginal Fracture of Medial Tibial Plateau without Significant Knee Ligamentous Injury in Hypermobility Patient: a Case Report and Review of Literature

    OpenAIRE

    Prakasit Chanasit; Paphon Sa-ngasoongsong; Pongsthorn Chanplakorn; Suphaneewan Jaovisidha; Chanyut Suphachatwong; Wiwat Wajanavisit

    2013-01-01

    Anteromedial rim fracture of medial tibial plateau is a rare fracture pattern with only a small number of case reports in the literature. However, it is highly likely that is associated with specific significant soft tissue injuries, especially posterior and posterolateral corner structure, and medial meniscus injury. It is thought this fracture is caused by hyperextension and varus rotation mechanism. The previous reports highlight the typical pattern of severe concomitant knee ligament inju...

  11. The ultrasonographic diagnosis of fetal encephalocele at 13th gestational week

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    Šorak Marija

    2010-01-01

    Full Text Available Background. Encephalocele presents a rare anomaly of central nervous system, developed as a consequence of neural tube closing defect during early embrional development, and it is described by a baggy formation which prolaborates through the pores of the scull, filled with brain tissue, cerebrospinal liquor and entwined with meninges. According to literature search, until this day, the earliest it can be ultrasonically detected is the 13th gestation week, with the appliance of three-dimensional ultrasound. Case report. We presented 25 years old patient, ultrasonically diagnosed with occipital fetal encephalocela at the 13th gestation week. A gestation sack was located in the right uteral corn of the two-corned uterus with one cervix. The diagnosis was confirmed also by trippled value of alpha-fetoprotein in maternal serum: 75,98 IU/mL. Conclusion. Ultrasonic examination is the method of choice for prenatal detection of a fetal anomaly. It is possible to diagnose encephalocele if it prominates above the limits of the scull.

  12. SEPTO-OPTICDYSPLASIA WITH AN ANTERIOR ENCEPHALOCELE AND INTACT SEPTUM PELLUCIDUM: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Z. Razavi

    2008-06-01

    Full Text Available ObjectiveThe diagnosis of de Morsier syndrome or septo-optic dysplasia is made on the basis of the diagnosis of optic nerve hypoplasia. Septo-optic dysplasia is defined by a variable combination of dysgenesis of midline brain structures including optic nerve hypoplasia and hypothalamic-pituitary dysfunction often associated with a wide variety of brain malformations of cortical development.The importance of direct ophthalmoscopy of optic nerve abnormalities is stressed, as well as of magnetic resonance imaging, which has become a guideline in the classification of  this syndrome This article reports a 19-year-old female with bilateral optic nerve  hypoplasia,anterior encephalocele and intact septum pellucidum. She was diagnosed withdiabetes insipidus, short stature and the history of seizure.

  13. Goldenhar syndrome, anterior encephalocele, and aqueductal stenosis following fetal primidone exposure.

    Science.gov (United States)

    Gustavson, E E; Chen, H

    1985-08-01

    Fetal exposure to primidone was associated with Goldenhar syndrome, hemifacial microsomia, tetralogy of Fallot, aqueductal stenosis, and anterior encephalocele in this male infant. No similar cases in anticonvulsant-exposed pregnancies were found on literature review, despite the increased incidence of other anomalies following such exposure. Goldenhar syndrome, especially related to rare central nervous system anomalies, is reviewed. Experimental production of hemifacial microsomia by a folic acid antagonist, triaxene, is mediated via hemorrhage in the fetus. Intraventricular hemorrhage was noted in this infant as were dilated lateral and third ventricles. The hemorrhagic diathesis and/or the folic acid depletion of newborns following fetal anticonvulsant exposure may have been the underlying mechanism. PMID:4035586

  14. ENDOTRACHEAL INTUBATION IN A CHILD HAVING OCCIPITAL ENCEPHALOCELE WITH BILATERAL CLEFT LIP AND CLEFT PALATE: A CASE REPORT

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    Shridhar N

    2014-11-01

    Full Text Available : Basically endotracheal intubation in pediatric age group especially in infants is difficult due to large head, relatively large tongue, anteriorly placed larynx, longer and stiffer epiglottis which protrudes at 450 angle and short neck. When such pediatric patient comes with craniofacial congenital malformations, the management of airway becomes more challenging. Here we report a case of occipital encephalocele associated with bilateral cleft lip and cleft palate coming for V P shunt procedure.

  15. Coronoid process of the ulna: paleopathologic and anatomic study with imaging correlation. Emphasis on the anteromedial ''facet''

    Energy Technology Data Exchange (ETDEWEB)

    Freitas Valle de Lemos Weber, Marcio [University of California, Department of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States); Santa Maria, Rio Grande do Sul (Brazil); Barbosa, Diogo Miranda; Belentani, Clarissa; Negrao Ramos, Pedro Miguel; Trudell, Debra; Resnick, Donald [University of California, Department of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States)

    2009-01-15

    The purpose of this study was to provide a detailed description of the anatomy of the coronoid process of the ulna and to use magnetic resonance (MR) images and anatomic correlation with cadavers to show the macroscopic configuration of this structure. Photography and high-resolution radiography were performed in 26 ulna specimens from the collection of a local museum. MR imaging of the coronoid process of 11 cadaveric elbows was performed. The images were compared with those seen on anatomic sectioning. The anteromedial rim of the coronoid process of the ulna had a regular surface, without osseous irregularities or facets in 69.2% of the specimens. In 30.8% of the specimens, the anteromedial rim was not regular and a small ridge could be identified. The insertion site of the joint capsule was onto the anterior aspect of the coronoid process, at an average distance of 5.9 mm distal to the tip. The attachment of the anterior band of the ulnar collateral ligament at the sublime tubercle was flush with the articular margin in 63.6% of the specimens. In 36.4% of the specimens, a more distal attachment, with a separation between the undersurface of the ligament and the adjacent tubercle, was seen. The brachialis tendon was attached to the coronoid process at a mean distance of 12.1 mm distal to the tip. The coronoid process of the ulna is a small osseous structure with a complex anatomy and presents some anatomical variations. (orig.)

  16. A Case of Schizencephaly and Septo-Optic Dysplasia Presenting with Anterior Encephalocele

    Directory of Open Access Journals (Sweden)

    Kaveh FADAKAR

    2013-01-01

    Full Text Available How to cite this article: Fadakar K, Dadkhahfar S, Esmaeili A, Keyhanidoust Z. A Case of Schizencephaly and Septo-Optic Dysplasia Presenting with Anterior Encephalocele. Iran J Child Neurol Autumn 2012; 6(4:47-50. AbstractSchizencephaly is a rare central nervous system disorder with variable presentations. Here we report a patient with a huge bilateral schizencephaly and septo-optic dysplasia presenting with anterior encephalocele. References:Yakovlev PI, Wadsworth RC. Schizencephalies; a study of the congenital clefts in the cerebral mantle; clefts with hydrocephalus and lips separated. J Neuropathol Exp Neurol. 1946 Jul;5(3:169-206.Yakovlev PI, Wadsworth RC. Schizencephalies; a study of the congenital clefts in the cerebral mantle; clefts with fused lips. J Neuropathol Exp Neurol. 1946 Apr;5:116-30.Brunelli S, Faiella A, Capra V, Nigro V, Simeone A,Cama A et al. Germline mutations in the homeobox gene EMX2 in patients with severe schizencephaly. Nat Genet. 1996 Jan;12(1:94-6.Montenegro MA, Guerreiro MM, Lopes-Cendes I,Guerreiro CA, Cendes F. Interrelationship of genetics and prenatal injury in the genesis of malformations of cortical development. Arch Neurol. 2002 Jul;59(7:1147-53.Granata T, Freri E, Caccia C, Setola V, Taroni F,Battaglia G. Schizencephaly: clinical spectrum, epilepsy, and pathogenesis. J Child Neurol. 2005 Apr;20(4:313-8.Lee HK, Kim JS, Hwang YM, Lee MJ, Choi CG, Suh DC et al. Location of the primary motor cortex in schizencephaly. AJNR Am J Neuroradiol. 1999 Jan;20(1:163-6.De Morsier G. [Studies on malformation of cranio-encephalic sutures. III. Agenesis of the septum lucidum with malformation of the optic tract]. Schweiz Arch Neurol Psychiatr. 1956;77(1:267-92.Hoyt WF, Kaplan SL, Grumbach MM, Glaser JS. Septo-optic dysplasia and pituitary dwarfism. Lancet. 1970 Apr;1(7652:893-4.Webb EA, Dattani MT. Septo-optic dysplasia. Eur J Hum Genet. 2010 Apr;18(4:393-7.Ellenberger C Jr, Runyan TE

  17. Contribution of thin slice (1 mm) oblique coronal proton density-weighted MR images for assessment of anteromedial and posterolateral bundle damage in anterior cruciate ligament injuries

    International Nuclear Information System (INIS)

    Purpose: To evaluate the diagnostic efficacy of using additional oblique coronal 1 mm proton density-weighted (PDW) MR imaging of the knee for detection and grading anterior cruciate ligament (ACL), anteromedial bundle (AMB) and posterolateral bundle (PLB) injuries. Materials and methods: We prospectively assessed preoperative MR images of 50 patients (36 men, 14 women; age range, 18–62 years). First, we compared the diagnostic performance of routine sagittal (3 mm) and additional oblique coronal images (1 mm) for ACL tears. Then, we compared the tear types (AMB or PLB) and grade presumed from oblique coronal MR imaging with arthroscopy. Results: Arthroscopy revealed ACL tear in 24 (48%) patients. There was significant difference between sagittal images and arthroscopy results for ACL tear recognition (p 0.05). Conclusion: Addition of thin slice oblique coronal images to conventional sequences could better contribute to better verifying the presence of ACL tear and in determining its grade

  18. Redução cirúrgica da luxação do quadril em pacientes com artrogripose múltipla congênita: acesso anteromedial Open reduction of hip dislocation in patients with arthrogryposis multiplex congenita: an anteromedial approach

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Munhoz da Rocha

    2010-01-01

    Full Text Available OBJETIVO: Avaliar os resultados do tratamento cirúrgico da luxação do quadril através do acesso anteromedial em pacientes com artrogripose múltipla congênita (AMC. MÉTODOS: Retrospectivamente foram revisados os prontuários e radiografias de sete crianças com AMC que apresentavam luxação do quadril, totalizando 10 quadris luxados. Foi avaliada a mobilidade articular pré e pós-operatória através da somatória do arco de mobilidade articular em flexão e abdução. Radiograficamente foram avaliados, no pré-operatório, o ângulo acetabular e a altura do colo do fêmur e, no pós-operatório, a continuidade do arco de Shenton, ângulo de Sharp e ângulo CE (centro borda. Quando foi identificada a necrose avascular, esta foi classificada segundo Ogden e Bucholz. RESULTADOS: A média de idade das crianças na ocasião da cirurgia era de 5,5 meses (três a 11 meses. O seguimento médio dos pacientes foi de 9,5 anos (dois a 13 anos. A média de amplitude de movimento da somatória do arco de mobilidade articular em flexão e abdução no exame pré-operatório foi de 108° (70 a 155° e no pós-operatório foi de 125° (75° a 175°. Na última avaliação, oito quadris estavam centrados e dois subluxados. Dois quadris foram submetidos a uma osteotomia de ilíaco do tipo Salter. Dois quadris apresentaram sinais significativos de necrose avascular Ogden tipo IV. Oito quadris foram considerados como bons resultados e dois como regulares. CONCLUSÃO: Consideramos a via anteromedial uma boa opção para tratamento da luxação de quadril em pacientes de baixa idade com artrogripose múltipla congênita.OBJECTIVE: To evaluate the results of the surgical treatment of hip dislocation through the anteromedial approach in patients with arthrogryposis multiplex congenita (AMC. METHODS: A retrospective review of the charts and radiographs of 7 children with AMC that presented dislocation of the hiprevised, totalling 10 dislocated hips. : Pre and

  19. Contribution of thin slice (1 mm) oblique coronal proton density-weighted MR images for assessment of anteromedial and posterolateral bundle damage in anterior cruciate ligament injuries

    Energy Technology Data Exchange (ETDEWEB)

    Gokalp, Gokhan, E-mail: drgokhangokalp@yahoo.com [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Demirag, Burak, E-mail: bdemirag@uludag.edu.tr [Department of Orthopedy, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Nas, Omer Fatih, E-mail: omerfatihnas@gmail.com [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Aydemir, Mehmet Fatih, E-mail: fatiha@yahoo.com [Department of Orthopedy, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Yazici, Zeynep, E-mail: zyazici@uludag.edu.tr [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey)

    2012-09-15

    Purpose: To evaluate the diagnostic efficacy of using additional oblique coronal 1 mm proton density-weighted (PDW) MR imaging of the knee for detection and grading anterior cruciate ligament (ACL), anteromedial bundle (AMB) and posterolateral bundle (PLB) injuries. Materials and methods: We prospectively assessed preoperative MR images of 50 patients (36 men, 14 women; age range, 18–62 years). First, we compared the diagnostic performance of routine sagittal (3 mm) and additional oblique coronal images (1 mm) for ACL tears. Then, we compared the tear types (AMB or PLB) and grade presumed from oblique coronal MR imaging with arthroscopy. Results: Arthroscopy revealed ACL tear in 24 (48%) patients. There was significant difference between sagittal images and arthroscopy results for ACL tear recognition (p < 0.001). No significant difference was detected for oblique coronal images when compared with arthroscopy results (p = 0.180). Sensitivity and specificity values for ACL tear diagnosis were 37.04% and 95.65% for sagittal images; 74.07% and 91.30% for oblique coronal images. There was no significant difference between arthroscopy and oblique coronal MR images in grading AMB and PLB injuries (p > 0.05). Conclusion: Addition of thin slice oblique coronal images to conventional sequences could better contribute to better verifying the presence of ACL tear and in determining its grade.

  20. Basal encephalocele associated with morning glory syndrome: case report Encefalocele basal associada a síndrome "morning glory": relato de caso

    Directory of Open Access Journals (Sweden)

    Ivanete Minotto

    2007-12-01

    Full Text Available The basal encephaloceles refer to rare entities and they correspond to herniation of brain tissue through defects of skull along the cribiform plate or the sphenoid bone. A rare morning glory syndrome, with characteristic retinal defect has been reported in association with basal encephaloceles. Hypophysis hormonal deficiencies may occur. We accounted for a pituitary dwarfism with delayed diagnosed transsphenoidal encephalocele associated with morning glory syndrome, showing the alterations found in retinography, computed tomography and magnetic resonance imaging.As encefaloceles basais são entidades raras e correspondem a herniações do tecido cerebral através de um defeito do crânio, ao longo da lâmina crivosa etmoidal ou do osso esfenoidal. A rara síndrome morning glory, com alterações de fundo de olho características pode apresentar-se associada à encefalocele basal. Deficiências hormonais hipofisárias podem ocorrer. Relatamos caso de nanismo hipofisário com encefalocele transesfenoidal de diagnóstico tardio associada à síndrome de morning glory, mostrando as alterações na retinografia, tomografia computadorizada e ressonância magnética.

  1. Reconstrucción del ligamento cruzado anterior desde el portal anteromedial; evaluación de la fijación femoral en un modelo cadavérico

    OpenAIRE

    Torres Claramunt, Raúl; Cáceres i Palou, Enric

    2011-01-01

    Objectiu. Valorar el risc de lesió de les estructures posterolaterals del genoll realitzant una reconstrucció del Lligament Encreuat Anterior (LEA) mitjançant plàstia d'isquiotibials i fixació femoral am sistema Cross-Pin. Material. 10 genolls cadavèrics frescs. Reconstrucció artroscòpica del LEA mitjançant túnel anatòmic des del portal anteromedial. Dissecció anatòmica del genoll mesurant distàncies del Cross-Pin al Lligament Col·lateral Lateral (LCL), tendó popliti, nervi peroneo i tendó ga...

  2. Estudio comparativo de la estabilidadrotacional y traslacional de dos técnicas quirúrgicas de reconstrucción del ligamento cruzado anterior mediante cirugía guiada por navegador: técnica monotúnel no anatómica vs técnica anteromedial anatómica

    OpenAIRE

    Minguell Monyart, Joan

    2015-01-01

    Purpose: To compare anteromedial (AM) and one-tunnel or modified transtibial (TT) ACL reconstruction techniques from a biomechanical and anatomic point of view as well as short-term results with a minimum of one-year follow-up. Hypothesis: AM technique better reproduces anatomical and biomechanical aspects of the knee providing thusly a better clinical result. Methods: Prospective randomized study of 106 patients with a chronic rupture of the ACL (55 patients underwent AM technique and ...

  3. Facts about Encephalocele

    Science.gov (United States)

    ... the Aorta Hypoplastic Left Heart Syndrome Pulmonary Atresia Tetralogy of Fallot Total Anomalous Pulmonary Venous Return Transposition of the ... Coarctation of the Aorta Hypoplastic left heart syndrome Tetralogy of Fallot Other types of heart defects Omphalocele Spina Bifida ...

  4. 膝关节前交叉韧带前内侧束和后外侧束的MR成像研究%MR imaging of anteromedial and posterolateral bundles of anterior cruciate ligament of knee joint

    Institute of Scientific and Technical Information of China (English)

    刘霞; 程瑾; 李绪斌; 杜湘珂; 孙燕萍

    2012-01-01

    目的 提高对膝关节前交叉韧带前内侧束和后外侧束的影像认识,并探讨其3.0T MR的理想常规成像显示平面.方法 回顾性分析149例正常膝关节的3.0TMR图像,采用x2分割法分析前交叉韧带、前内侧束和后外侧束双束结构及双束上、中、下各段在MR矢状面、冠状面、横断面各成像平面显示率的差异.结果 前交叉韧带前内侧束和后外侧束双束结构显示率,横断面(115/149,77.2%)与冠状面(103/149,69.1%)比较,×2=2.4606,P>0.0125;横断面、冠状面分别与矢状面(21/149,14.1%)比较,x2值分别为119.5138、92.8695,P值均<0.0125.前内侧束和后外侧束双束上段显示率,横断面( 104/149,69.8%)与冠状面(7/149,4.7%)、矢状面(0/149,0)及冠状面与矢状面分别比较,x2值分别为135.0813、159.7526、7.1684,P值均<0.0125.前内侧束和后外侧束双束中段显示率,横断面(108/149,72.5%)与冠状面(94/149,63.1%)比较,x2=3.0120,P>0.0125;横断面、冠状面分别与矢状面( 10/149,6.7%)比较,x2值分别为134.7454、104.2173,P值均<0.0125.前内侧束和后外侧束双束下段显示率,横断面(103/149,69.1%)与冠状面(110/149,73.8%)比较,x2=0.8065,P>0.0125;横断面、冠状面分别与矢状面(18/149,12.1%)比较,x2值分别为100.5300、115.9132,P值均<0.0125.前交叉韧带双束各段在MRI各序列上均呈低信号,形态、走行正常.结论 3.0TMR常规扫描平面能够在一定程度上显示前交叉韧带的双束结构,横断面和冠状面是较为理想的显像平面.%Objective To improve the visualization of anteromedial and posterolateral bundles of anterior cruciate ligament (ACL) and investigate the optimal MRI plane for the bundles at a 3.0 T MR scanner.Methods MR images of 149 knee joints were reviewed retrospectively.Display rates of AMB,PLB and their different parts (the top portion,the middle portion and the low portion) on MR different planes including axial

  5. Central nervous system malformations anencephaly and encephalocele: A report of two cases (Malformaciones del sistema nervioso central anencefalia y encefalocele: Reporte de dos casos

    Directory of Open Access Journals (Sweden)

    Peñaloza-Valenzuela Juan José

    2011-11-01

    Full Text Available It is reported one case of anencephaly and one encephalocele. Theyare defects of neural tube phenotypically different, with differentprognosis and different therapeutic approach, they were at HospitalMaterno Infantil Germán Urquidi of Cochabamba.The first case is a 19 year old primigravida who comes with laborfor 8 hours, with gestation of 23 weeks, without any antenatalcare, with stable vital signs, uterine height 19 cm, product indifferent situation UD 3/10/30/++, fetal heart rate inaudible, 4 cm of central cervical dilatation, intact membranes, pelvic pole. She isadmitted with diagnoses of: G1D0, 23 weeks pregnancy, stillbirth,labor, it was attended a stillbirth delivery of female sex weighing985 grams, APGAR 0, with no brain nor cranial, exophthalmos andspina bifida.The second case is a 21-year second pregnancy woman remittedto Vinto Hospital she was asymptomatic with uterine height of 20cm, fetus in a longitudinal, pelvic presentation, fetal heart rate of140 x min without dynamic uterine or cervical changes. She wasadmitted with diagnoses of: G2 D1, 25 weeks pregnancy, live fetusand congenital malformation. The laboratories report: Urinarytract infection, toxoplasmosis, cytomegalovirus and high alphafetoprotein.Ultrasound matches occipital cephalocele and acrania.Delivery is induced obtaining a male death product with a weight of1086 g, height of 37 cm, APGAR 0, with solution of continuity inthe occipital region in which the brain protrudes with its meninges,and scalp.Both patients enrolled in the puerperium favorably. -RESUMEN: Se presenta un caso de anencefalia y otro de encefalocele; defectos de cierre del tubo neural fenotípicamente distintos, con diferente pronóstico y distinto manejo terapéutico, atendidos en el Hospital Materno Infantil Germán Urquidi de Cochabamba.El 1er caso corresponde a una primigesta de 19 años que acude contrabajo de parto de 8 horas, con gestación de 23 semanas; sin ningúncontrol prenatal; con signos

  6. MRI 3DMEDIC features of anteromedial bundle or posterolateral bundle tears of the anterior cruciate ligament of the knee%前交叉韧带前内侧束或后外侧束损伤的MRI3D-MEDIC表现

    Institute of Scientific and Technical Information of China (English)

    陈新; 潘晶晶; 王丛颖; 牛琰鑫

    2011-01-01

    Objective To research MR imaging findings of anteromedial bundle( AMB) and posterolateral bundle( PLB) tears of anterior cruciate ligament (ACL) of the knee. Methods 41 cases of partial ACL tears including 22 cases of AMB tears and 19 cases of PLB tears confirmed by arthroscopy or surgery underwent MRI 3-dimensional multi echo data imaging combination ( MRI 3D-MEDIC) examination and MR imaging findings of AMB tears and PLB tears were observed on oblique coronal , sagital images and axial images of multiplain reconstruction . Results It was high specificity signs of AMB tear or PI_B tear that the normal architecture of the"人"type of ACL on oblique coronal images and reverse"V" type of ACL on axial images were broken showed by MRI,and PLB tear in 10 cases manifestated a lateral bundle disappear as a sign of single bundle and AMB tear in 10 cases manifestated a medial bundle disappear also as a sign of single bundle. Conclusion It is feasible to make MRI 3D-MEDIC to diagnose AMB or PLB tears of the anterior cruciate ligament.%目的 探讨前交叉韧带(anterior cruciate ligament,ACL)前内侧束(anteromedial bundle,AMB)或后外侧束(posterolateral bundle,PLB)撕裂的MRI表现.方法 本组41例,经膝关节镜或手术证实为ACL部分撕裂,其中AMB撕裂22例,PLB撕裂19例,使用MRI多回波数据组合(multipleecho data image combination sequence,MEDIC)三维梯度回波序列扫描,经斜矢状,横轴和斜冠状面图像重建,观察AMB或PLB撕裂后的MRI表现.结果 19例PLB撕裂和22例AMB撕裂,在MRI斜冠状位层面上显示ACL正常的"人"字形结构被破坏及在横轴层面显示正常的倒"V"字形结构被破坏;10例PLB撕裂表现为外侧束或外侧臂消失呈单束或单臂征;10例AMB撕裂表现为内侧束或内侧臂消失亦呈单束或单臂征.结论 MRI 3DMEDIC 三维梯度回波序列扫描可显示AMB或PLB撕裂.

  7. Arthroscopic patellar retinaculum adjustment and tibial tubercle anteromedial transfer in recurrent patellofemoral dislocations%胫骨结节内移抬高术联合关节镜下髌骨支持带调整术治疗复发性髌骨脱位的疗效研究

    Institute of Scientific and Technical Information of China (English)

    付国建; 李苏皖; 刘朝晖; 张国桥; 陈小强

    2014-01-01

    Objective To evaluate the results of a tibial tubercle anteromedial transfer technique and arthroscopic patellar retinaculum adjustment in the treatment of recurrent patellofemoral dislocations . Methods The study included 12 knees of 12 patients ( eight males , four females;mean age of 20 years;range, 17 to 28 years ) who were operated on by the same surgeon for the patellofemoral alignment disorders.All the knees were treated by arthroscopic patellar retinaculum adjustment including the medial retinaculum placation , lateral retinaculum releasing , and the tibial tubercle anteromedial transfer .The follow-up period was from three weeks to 12 months postoperatively .The axial radiographic scans were done to measure the bone healing at the site of osteotomy , the patellar congruence angle and patellar index;Lysholm knee score , IKDC score and Kujala score were also evaluated .Results The mean follow-up period was two years ( range, one to five years ) .The radiographic scans showed that the osteotomy site achieved bone healing in three to six months after the surgery .The function of the knee was very well .The medial shift of the patella was 1°-2°postoperatively.At each postoperative time point, the positive apprehension test of patella , the patellar congruence angle , and the patellar index were statistically significant ( P0.05).In the 6th and 12th month after the surgery, IKDC, Lysholm, and Kujala scores were significantly improved compared with the preoperative ones , and the differences were statistically significant (P0.05).The postoperative Kujala score of the 12th month was remarkably improved, compared to that of the 6th month, and the difference was statistically significant .Conclusion The arthroscopic patellar retinaculum adjustment including the medial retinaculum plication , the lateral retinaculum releasing , and the tibial tubercle anteromedial transfer , may provide successful results in the treatment of the recurrent dislocation of the patella

  8. Analysis of in-hospital death-related factors for acute encephalocele in patients with craniocerebral injury for craniotomy:a report of 183 cases%颅脑损伤开颅术中急性脑膨出患者的院内死亡相关因素分析(附183例报告)

    Institute of Scientific and Technical Information of China (English)

    何建青; 时忠华; 王玉海; 张春雷; 陈磊; 陈军辉; 朱军

    2015-01-01

    Objective To investigate the in-hospital death-related factors for acute encephalocele in patients with craniocerebral injury for craniotomy in order to provide evidence for clinical treatment and prognosis determination.Methods The clinical data of 183 patients with craniocerebral injury occurring acute encephalocele during craniotomy treated at the Department of Neurosurgery,the 101 st Hospital of PLA from August 2008 to July 2014 were analyzed retrospectively.The correlations of the factors including sex,age,preoperative hypoxia,preoperative blood pressure,preoperative Glasgow coma scale (GCS) scores,preoperative pupil status,brain swelling,preoperative intracranial pressure (ICP),causes of encephalocele,postoperative pupillary status,postoperative ICP,postoperative GCS,coagulation mechanism,blood glucose,and complications of the patients of in-hospital deaths were analyzed.Results The prognosis was assessed according to the Glasgow outcome scale (GOS) scores after procedure; there were 135 patients in a death group (namely death cases) and 48 in a survival group (including good recovery,moderate disability,severe disability,and vegetative cases).The postoperative GCS scores,glucose,causes of encephalocele,and postoperative pupillary status were closely associated with the inhospital death in patients with acute encephalocele in craniocerebral injury operation (P < 0.05).There was significant difference in postoperative ICP between the survival group and the death group (P < 0.05).Conclusion The postoperative GCS,glucose,causes of encephalocele,postoperative pupillary status,postoperative ICP and postoperative complications could be used as the important indexes for predicting inhospital death of acute encephalocele in craniocerebral injury for craniotomy.%目的 探讨颅脑损伤开颅术中急性脑膨出患者的院内死亡相关因素,为临床治疗及预后判断提供依据.方法 回顾性分析2008年8月至2014年7月解放军第101

  9. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... around the world. All right. Well thank you. Let’s go back to the video and discuss where we ... can provide that type of follow up. So let’s go back to the video for a moment there. ...

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    Full Text Available ... screen and open the door to informed medical care. “OR-Live,” the vision of improving health. Well ... charity that’s based in Boston, focused on health care actually, remediating health inequalities amongst the poor in ...

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    Full Text Available ... trained pediatric anesthetists that all they do all day is deal with children. The physiology is different. ... And then there were like one or two days of ICU observations. In terms of what the ...

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    Full Text Available ... on remediating health inequalities amongst the rural and urban poor, including a program here in Boston. But ... poor. They are farmers that I do subsistence farming, and so -- excuse me -- most of the care ...

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    Full Text Available ... re fortunate enough today to have Dr. Ed Smith from the Department of Neurosurgery, and David Walton ... be essentially a perfect contour. 3 And Dr. Smith is going to remove that bone for me, ...

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    Full Text Available ... the capitol city, which can be difficult to access, shunts can be pretty dicey in term of ... can break, that can clog. If you have access to a health care system nearby where the ...

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    Full Text Available ... medical care. “OR-Live,” the vision of improving health. Well good afternoon. Welcome to Boston. This is ... of Neurosurgery, and David Walton from Partners in Health. Ed, I’m going to let you lead ...

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    Full Text Available ... then spinal fluid can leak out along the track from the catheter. We tend to have a ... the special senses?” And I’ll let you field that. Yeah. So obviously what senses are affected ...

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    Full Text Available ... in Boston. And Dumanel initially came to our attention about a little over a year ago when ... actually that’s initially when Dumanel came to our attention. Actually, John Meara, who is here with us ...

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    Full Text Available ... and he is going to be able to use that to configure the forehead. And he’ll ... couple of them this rapid sequence. Do you use any adjunctive measures to seal the dura, fibrin ...

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    Full Text Available ... so CFS leak, infection, which you mentioned, the importance of adequate closure. There could be infections of ... what you’re going to see is my team is dissecting around the external portion of the ...

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    Full Text Available ... OR-Live makes it easy for you to learn more. Just click on the “request information” button on your webcast screen and open the door to informed medical care. “OR-Live,” ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... But essentially what we have is a young child, and if you look at the slide we ... particularly to these patients? So obviously with any child that’s undergoing surgery, one of the things that ...

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    Full Text Available ... did the procedure take, and what does the future hold for the child? And I think in ... of ICU observations. In terms of what the future holds, you know, I think we already know, ...

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    Full Text Available ... the tissue between the healthy brain on the left and the unhealthy brain on the right, represented by the dotted line, as you can ... really see on the video here on the left-hand side you have a nice healthy looking brain, and on the right-hand side you have sort of a grayish ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... that I’m sort of picking this filmy substance, this arachnoid, basically, off the carotid artery. This ... what’s the best way to address it. Our goals were to try to treat the cyst, treat ...

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    Full Text Available ... the globe. It was originally founded by Paul Farmer, Ophelia Dahl, Todd McCormick and others in 1983. ... However, there family is extremely poor. They are farmers that I do subsistence farming, and so -- excuse ...

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    Full Text Available ... service that one needs, really, to consider one’s self-having access to care. 7 And so we ... Again, there’s a lot of specific variables that change from case to case, but that’s a rough ...

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    Full Text Available ... that’s appropriate for that venue and collaborated with academic medical centers for care that really can’t ... colleague, Mark Proctor, who has a lot of experience with these cases, yourself, Gary Rogers, a number ...

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    Full Text Available ... the dura, the meninges, and by establishing an edge there, we’ll have a sharp edge, which we can sew to and establish that ... or at the site where you remove the edge of the brain. As an example of that ...

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    Full Text Available ... with Operation Smile and actually focused on finding patients with cleft lip and cleft palates. However, we ... a radio announcement where we were actually seeking patients with any kind of deformity, facial deformity, and ...

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    Full Text Available ... working on between the eye nerve, the optic nerve up above, and the carotid artery, the big blood vessel down below. And as I work in there, you can see that you make a nice hole, and the hope this will allow the spinal fluid to drain away. Well, Ed, thank you. ...

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    Full Text Available ... understanding is that there is no risk. But what’s your understanding of that? Yeah. So I don’t ... neurosurgical colleagues. And what was their feeling and what was your feeling about, you know, the pros and cons ...

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    Full Text Available ... potentially coordinate over e-mail or phone or Internet with the staff here back at Children’s Hospital. ... reconstruction. And I want to touch on one issue here, and that is, one of the deformities ...

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    Full Text Available ... you and I were concerned about whether we should do this sequentially, whether you should deal with the arachnoid cyst and then wait ... be handled at first -- or at once, I should say. And I know that you spent some ...

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    Full Text Available ... easier to sort of tackle either garden-variety stuff that comes in off the street or complex stuff that comes in from halfway around the world. ... a very important barrier that keeps the good stuff for the brain in and the bad stuff ...

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    Full Text Available ... it’s not supposed to go, it’s no longer functional brain. It will not develop into cancer or ... isn’t healthy and isn’t, you know, functional anymore is off to the right. What we’ ...

  16. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... can tell you that from the standpoint of managing shunts in Haiti, it’s actually very difficult. And ... here at Children’s. We also have a big group of neurosurgeons, all of who are pediatric fellowship ...

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    Full Text Available ... really highlighted sort of benefit of having a team approach, which maybe John can talk a little ... and, subsequently, brain pressure, that you have a team that’s dedicated, and we work with a very ...

  18. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... but also had another surprise, which made his management a little bit more complex. So one thing ... shunts can be pretty dicey in term of management. Uh-huh. I would comment that, you know, ...

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    Full Text Available ... 28, 2009 Welcome to this “OR-Live” webcast presentation, live from Children’s Hospital Boston, in Boston, Massachusetts. ... thank you. And I think later in the presentation I’d like to talk to you a ...

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    Full Text Available ... inequalities amongst the poor in developing nations and right here in Boston. And Dumanel initially came to ... and you see on the image on the right a very large area of black empty space, ...

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    Full Text Available ... so that nothing scary happens while we’re operating, and then once we had him in position, ... in terms of length of time, the actual operating time, I believe was four to five hours ...

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    Full Text Available ... to make referrals, make appointments, or request more information. Just click on the buttons on your webcast ... to learn more. Just click on the “request information” button on your webcast screen and open the ...

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    Full Text Available ... right a very large area of black empty space, which is an arachnoid cyst. And in listening ... again on the slide some arrows indicating the space I’m working on between the eye nerve, ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... an arachnoid cyst. And in listening to Dumanel’s history when we talk with him, it became apparent ... kind of work you see here on the screen, by opening the cyst up, by allowing it ...

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to have ... for any of the types of brain tumor surgery or other types of craniofacial repairs ... with the plastic surgeons quite a bit. I have another interesting ...

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    Full Text Available ... there just briefly was the head frame that holds him in place so that nothing scary happens ... the procedure take, and what does the future hold for the child? And I think in terms ...

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    Full Text Available ... comment from Aaron here asking, “What is the risk of this developing later on in life into ... know, my understanding is that there is no risk. But what’s your understanding of that? Yeah. So ...

  8. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... birth and seemed to get progressively larger over time. As you can see from the graphic, there ... then they get referred up here, and many times the treatment for them is surgery. When Dumanel ...

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    Full Text Available ... many complications that can arise and, again, many emergencies that can arise in children with shunts. You ... so that’s a bit more of a neurosurgical emergency. In Dumanel’s case, he was fortunate to have ...

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    Full Text Available ... nice because then you don’t have a foreign body in there for the rest of the ... can avoid it. The idea being the fewer foreign materials you have the better. But there are ...

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    Full Text Available ... ones that are symptomatic, the ones that do cause problems, what we have to do is somehow ... able to identify the ones that are problem causes and which ones aren’t, and clearly in ...

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    Full Text Available ... him prepared. And, Ed, very briefly, any anesthetic issues particularly to these patients? So obviously with any ... But obviously people have all kinds of surgical issues that need to be addressed from cleft surgical ...

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    Full Text Available ... community health workers.” And they help us; the physicians, nurses, et cetera, be able to treat patients ... getting frequent follow-up appointments both by the physician in the clinic, and we have people going ...

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    Full Text Available ... had a radio announcement where we were actually seeking patients with any kind of deformity, facial deformity, ... that will have the bone graft that provides support for the nose. And you’ll see that ...

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    Full Text Available ... on the right a very large area of black empty space, which is an arachnoid cyst. And ... could not be completely removed, what are the statistics that it could refill?” So when you were ...

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    Full Text Available ... the central plateau of Haiti with our Haitian staff. We do have Haitian surgeons who, you know, ... taking care of the Haitians, our own medical staff, taking care of people of Haiti. That’s a ...

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    Full Text Available ... The hope here is that we want to preserve all the healthy neural tissue that we can, ... Fortunately with his case, we were able to preserve the olfactory nerves, and as best we can ...

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    Full Text Available ... partnering with Operation Smile and actually focused on finding patients with cleft lip and cleft palates. However, ... that something abnormal has gone on, and the diagnosis is usually made with an imaging study like ...

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    Full Text Available ... see our most complex patients. It’s a fascinating model and it’s been highly successful. So I guess ... patient and make sure that the post-op management is appropriate and that is very comforting, given ...

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    Full Text Available ... rough estimate would be to say about two-thirds of patients to three-quarters of patients who ... term cure, and about a quarter to a third end up needing a shunt. Again, there’s a ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... essentially. And so if someone has a chronic disease like HIV or tuberculosis or heart failure ... can directly observe therapy, meaning the patients will never miss a dose ...

  2. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... again, we’re really doing what we call “horizontal” -- actually much more than just horizontal care. Meaning, you know, I’ll compare and ... of public health. Did you want to comment? Well let me just interject for a minute so ...

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    Full Text Available ... you know, Partners in Health does a wide diversity of procedures down there, and the very special ... who are pediatric fellowship trained -- I mean pediatric board certified pediatric surgeons, and we were able to ...

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    Full Text Available ... in terms of length of time, the actual operating time, I believe was four to five hours ... for the audience to understand the accompan’ture system in Haiti and what a wonderful idea that ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... the defect between the nose, which is the hole where the brain came through on the image on the left, but we also found that Dumanel had a little bit of a surprise for us, and you see on the image on the right a very large area of black empty space, which is an arachnoid cyst. And ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... the completed reconstruction on the left. That’s a CT scan and the diagram on the right. But I ... the end, and I had shown that final CT scan, which showed that bone graft. And that’s critical ...

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    Full Text Available ... it would leak under the skin, which could affect wound healing, or if there was any connections ... are involved in the nose, for example, may affect the eye nerves and vision. So in those ...

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to ... know what a shunt is, it’s a little plastic tube that goes from the cyst down to ...

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    Full Text Available ... large deformity in between his eyes. This is something that was noticed since birth and seemed to ... they’re seen, people tend to recognize that something abnormal has gone on, and the diagnosis is ...

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    Full Text Available ... here, or for any of the types of brain tumor surgery or other types of craniofacial repairs where you have to remove part of the tissue surrounding the brain, this is a very important part of the ...

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    Full Text Available ... needed to obviously do follow up on a continuous basis pretty closely for the next, you know, ... so CFS leak, infection, which you mentioned, the importance of adequate closure. There could be infections of ...

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    Full Text Available ... needed to obviously do follow up on a continuous basis pretty closely for the next, you know, ... Again, there’s a lot of specific variables that change from case to case, but that’s a rough ...

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    Full Text Available ... garden-variety stuff that comes in off the street or complex stuff that comes in from halfway ... as you saw from 15 the pictures. The main nerves that are involved in that region are ...

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    Full Text Available ... be elevating a flap that involves skin, subcutaneous tissue, and the periosteum. And one thing I might ... it’s decompressed appropriately and also to disconnect the tissue from the brain. So we have two very ...

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    Full Text Available ... the drain. So we usually have a pretty good way to assess prior to removal, as we did with Dumanel, to know that he would be a candidate and probably would fly with the drain out. You know, David, I think it’s important for our audience to get a better sense. I know you’ve come to know ...

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    Full Text Available ... can see from the graphic, there is a hole, actually, in the skull and this resulted in ... the defect between the nose, which is the hole where the brain came through on the image ...

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    Full Text Available ... video where we are actually using plates and screws, but the interesting thing to mention here is ... I would have been using titanium plates and screws, but now we’re using resorbable plates and ...

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    Full Text Available ... mass in between his eyes. This is what led to the initial diagnosis and had him brought ... the opposite side of his body, and this led to us talking about a little bit about ...

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    Full Text Available ... could comment on, you know, what is the role of surgery in Partners and Health? How important ... Children’s to have a lot of multi-disciplinary teams where it’s not just the surgeons looking at ...

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    Full Text Available ... who are pediatric fellowship trained -- I mean pediatric board certified pediatric surgeons, and we were able to ... patient and make sure that the post-op management is appropriate and that is very comforting, given ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... the brain. So we have two very different aspects of how we do it, and one of ... now what we’re doing, this is an aspect of the operation called the “craniotomy,” and the ...

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    Full Text Available ... do all day is deal with children. The physiology is different. What’s particularly important, though, is that ... called a “coronal incision,” and it goes from ear to ear. And you notice that it’s not ...

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    Full Text Available ... that something abnormal has gone on, and the diagnosis is usually made with an imaging study like ... eyes. This is what led to the initial diagnosis and had him brought up here to Children’s. ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... to someone having appendicitis is really a basic service that one needs, really, to consider one’s self- ... of the care in Haiti is fee-for-service. And so whenever -- you know, he spent many, ...

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    Full Text Available ... garden-variety stuff that comes in off the street or complex stuff that comes in from halfway ... cavity that can fill up with blood or old tissue. So those are some potential complicated from ...

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    Full Text Available ... public charity that’s based in Boston, focused on health care actually, remediating health inequalities amongst the poor in ... really have a good understanding of the Haitian health care delivery system, you know, with a child like ...

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    Full Text Available ... something, you know, that requires something of monetary value, they then sell these items that can, you ... it’s important to highlight the fact that the value of a cow there is about the average ...

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    Full Text Available ... the risk of this developing later on in life into cancer?” And, you know, my understanding is ... in there for the rest of the child’s life. So that’s the new frontal segment there that ...

  9. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Science.gov (United States)

    ... on remediating health inequalities amongst the rural and urban poor, including a program here in Boston. But ... a lot easier to sort of tackle either garden-variety stuff that comes in off the street ...

  10. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... on remediating health inequalities amongst the rural and urban poor, including a program here in Boston. But ... a lot easier to sort of tackle either garden-variety stuff that comes in off the street ...

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    Full Text Available ... from Antonio. He said, “What is the earliest age you would do this procedure?” And that’s a ... anywhere from about one to two years of age. All right. Great. I think it would maybe ...

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    Full Text Available ... The reason that I feel comfortable and the reason that, you know, Ed and I feel comfortable doing this is that we have an excellent partner in Partners in Health, and they’re able to monitor this patient and make sure that the post-op management is appropriate and that is very comforting, given ...

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    Full Text Available ... we’re oriented all the way to the right where you see the child’s head, and then what we’re looking is ... outside of one of those clinics. And so right when we identify a child or an adult with a problem such as ...

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    Full Text Available ... management a little bit more complex. So one thing I think would be good to talk about now a little bit is ... interestingly, he had this weakness on the opposite side of his body because it’s a very large cyst and seems to be pushing on the brain. The other thing is probably he had a little bit of ...

  15. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... can tell you that from the standpoint of managing shunts in Haiti, it’s actually very difficult. And ... we can sometimes be able to reduce the risk of spinal fluid leaking after surgery. Now I ...

  16. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... you know, Partners in Health does a wide diversity of procedures down there, and the very special ... Children’s to have a lot of multi-disciplinary teams where it’s not just the surgeons looking at ...

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    Full Text Available ... you know, Partners in Health does a wide diversity of procedures down there, and the very special ... in life into cancer?” And, you know, my understanding is that there is no risk. But what’s ...

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    Full Text Available ... here at Children’s. We also have a big group of neurosurgeons, all of who are pediatric fellowship ... a whole lot of thinking from many different groups, but we had the infrastructure in place to ...

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    Full Text Available ... let me just say we have some interesting e-mails coming in already, and maybe we can ... an additional workup and then potentially coordinate over e-mail or phone or Internet with the staff ...

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    Full Text Available ... up here to Children’s. As part of the evaluation, as I mentioned, what is normally done is ... bone, and you can see us using an instrument for this. And the idea is to kind ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... little bit about how we got into the process of planning his surgery and what we went ... when Dumanel presented to us during the screening process, you know, we readily and immediately identified this ...

  2. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... to Dumanel, I think he’s got an excellent prognosis. David, we have an interesting question here. It ... determine at the time of surgery. The risk factors for trying to figure out if a cyst ...

  3. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... lose the pressure on his brain and hopefully cure the arachnoid cyst. When people are found to ... cysts fenestrated, have a lifetime or long-term cure, and about a quarter to a third end ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... ago, Ed and I would have been using titanium plates and screws, but now we’re using ... midline because of their displacement. So this is titanium wire, which is very nocuous. The body doesn’ ...

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to have ... know what a shunt is, it’s a little plastic tube that goes from the cyst ... that at the same time during surgery, if we’re able to open this up, ...

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    Full Text Available ... so CFS leak, infection, which you mentioned, the importance of adequate closure. There could be infections of ... patient and make sure that the post-op management is appropriate and that is very comforting, given ...

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    Full Text Available ... go is there are two sort of important goals with surgery here. One is the very important ... do with his well being. And the second goal of surgery is to control the cyst inside ...

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    Full Text Available ... this is a very important part of the structure -- part of the repair and something which, you know, we work together with the plastic surgeons quite a bit. I have another interesting question here. We’ve touched on a number of issues. But Abu Bacher asks, “What is a common complication ...

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    Full Text Available ... up here to Children’s. As part of the evaluation, as I mentioned, what is normally done is ... something of monetary value, they then sell these items that can, you know, generate some income for ...

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    Full Text Available ... see our most complex patients. It’s a fascinating model and it’s been highly successful. So I guess ... made out of. So after 12, 18, 24 months, that plate and screw actually just disappear, which ...

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    Full Text Available ... previously is a 501C3 charity. We, for the purposes of this discussion, I’ll focus on primarily ... them, and they came for a very specific purpose, which was to focus on cleft lip and ...

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    Full Text Available ... manage him surgically and really highlighted sort of benefit of having a team approach, which maybe John ... children aren’t just little adults. And we benefit here at Children’s, obviously, from having trained pediatric ...

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    Full Text Available ... any other major risks that we need to be concerned with? Well I think any time you operate on the ... You know, and I guess my comment would be in this case, no, everything went very well and, Ed, you already commented on the potential ...

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    Full Text Available ... still -- while the child is still in the nursery. On the other hand, there are other kids ... some basic imaging in terms of X-rays, infectious workup to make that he was a ... has a chronic disease like HIV or tuberculosis or heart failure or ...

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    Full Text Available ... December, that he’s doing extremely well. And the motor function on his left side is improving. I’ ... What are your thoughts about extensive improvement of motor function. Well, you know, the hope here is ...

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    Full Text Available ... do is somehow deflate it to make the water inside of it, the spinal fluid that even ... had a balloon inside your sink, and normally water can flow around the balloon and drain down ...

  17. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... we treat very shortly after birth while the mother is still -- while the child is still in ... that is very, very low in order of single percentage points or less. In terms of the ...

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to have Dr. Ed Smith from the Department of Neurosurgery, and David Walton from Partners in Health. Ed, I’m going to let you lead ...

  19. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... that are actually made out of the same material that the suture material is made out of. So after 12, 18, ... avoid it. The idea being the fewer foreign materials you have the better. But there are times ...

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    Full Text Available ... good understanding of the Haitian health care delivery system, you know, with a child like this who ... If you have access to a health care system nearby where the tube can be fixed and ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... get referred up here, and many times the treatment for them is surgery. When Dumanel was diagnosed ... help administer these medications. They can directly observe therapy, meaning the patients will never miss a dose ...

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    Full Text Available ... you determine at the time of surgery. The risk factors for trying to figure out if a cyst is going to be recur or become a problem center on a couple different things. ... years are at slightly higher risk; the size of the cyst, the bigger the ...

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    Full Text Available ... the collaboration that we have with Children’s to send children who have very, very complicated issues here ... they need to buy -- if they need to send their kid to school or if they need ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... live a long life without having subsequent neurosurgical issues. David asks, “Is there any inevitable neurologic damage after the surgery?” You know, and I guess my comment would ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... webcast screen and open the door to informed medical care. “OR-Live,” the vision of improving health. ... of taking care of the Haitians, our own medical staff, taking care of people of Haiti. That’s ...

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    Full Text Available ... continual medical care in the sense of getting medicines every day, but he is getting frequent follow- ... of our patients sometimes are on blood-thinning medicines or aspirin, you want to make sure that’s ...

  7. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... determine at the time of surgery. The risk factors for trying to figure out if a cyst is going to be recur or become a problem center on a couple different things. First of all, the age of the child, and as I mentioned, kids under the age of one or two years are at slightly higher risk; the size ...

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    Full Text Available ... essentially. And so if someone has a chronic disease like HIV or tuberculosis or heart failure or ... to that earlier in the sense that the eyes are too far apart because of the protrusion ...

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    Full Text Available ... do all day is deal with children. The physiology is different. What’s particularly important, though, is that ... to get a sense of what the bony anatomy is like, which is relevant not just to ...

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    Full Text Available ... with Children’s and with you, John, looking to increase the capacity to do surgery. Not something, say, ... the other things we can do, and also increase our ability to deliver this kind of care. ...

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    Full Text Available ... a very close team of neuro- anesthetists to help us with this. And what you saw there ... like you and other come down to Haiti, help our Haitian surgeons with different ways of looking ...

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    Full Text Available ... an arachnoid cyst. And in listening to Dumanel’s history when we talk with him, it became apparent ... the risk of this developing later on in life into cancer?” And, you know, my understanding is ...

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    Full Text Available ... terms of his ability to live a long life without having subsequent neurosurgical issues. David asks, “Is there any inevitable neurologic damage after the surgery?” You know, and I guess my ...

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    Full Text Available ... potentially coordinate over e-mail or phone or Internet with the staff here back at Children’s Hospital. ... to learn more. Just click on the “request information” button on your webcast screen and open the ...

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    Full Text Available ... do with these little blue, essentially tweezers, called “bipolars,” is to cauterize the tissue between the healthy ... of what we’re dissecting here with the bipolars, the little cautery equipment. The hope here is ...

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    Full Text Available ... well, then fluid can leak out through the seams basically and build up pressure underneath the scalp, and that pressure can inhibit healing and make the hole repair at risk. So as you see at the bottom of the video screen here, there’s that white tube, and I mentioned earlier there was an external ...

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    Full Text Available ... care. “OR-Live,” the vision of improving health. Well good afternoon. Welcome to Boston. This is the ... went through and the steps to do that. Well, thank you both, you know, for laying a ...

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    Full Text Available ... open this up, it would allow for better healing for the child, reduce the number of operations ... leak under the skin, which could affect wound healing, or if there was any connections potentially down ...

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    Full Text Available ... there were like one or two days of ICU observations. In terms of what the future holds, ... time. As we mentioned, Dumanel was in the ICU for two days, and then, you know, stayed ...

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    Full Text Available ... could comment on, you know, what is the role of surgery in Partners and Health? How important ... so CFS leak, infection, which you mentioned, the importance of adequate closure. There could be infections of ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... know, I think there’s a lot of different things about his health-care delivery which is very important in terms of ... And I think one of the most important things is to highlight the fact that, you ... surgical care, for example, that’s appropriate for that venue and ...

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    Full Text Available ... I know you’ve come to know the family very well. What are the, you know, so ... terms of monetary significance, you know, to the family, what was done, because I don’t think ...

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    Full Text Available ... then what we’re looking is that red structure right there is a major artery called the “ ... this is a very important part of the structure -- part of the repair and something which, you ...

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    Full Text Available ... door to informed medical care. “OR-Live,” the vision of improving health. Well good afternoon. Welcome to Boston. This is the Children’s Hospital of Boston Craniofacial webcast. We’re going ...

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    Full Text Available ... which made his management a little bit more complex. So one thing I think would be good ... of different folks, sometimes otolaryngology. These are sometimes complex lesions, and we have a lot of different ...

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    Full Text Available ... door to informed medical care. “OR-Live,” the vision of improving health. Well good afternoon. Welcome to ... in terms of the control his of his vision, his ability for his nose to grow well. ...

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    Full Text Available ... in the community. They do a number of things. They’re called -- essentially they’re called “accompan’tures” or “community health workers.” And they help us; the physicians, nurses, et cetera, be able to treat patients in their homes essentially. And so if someone has a chronic ...

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    Full Text Available ... so CFS leak, infection, which you mentioned, the importance of adequate closure. There could be infections of ... a permanent drain. Are there any other major risks that we need to be concerned with? Well ...

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    Full Text Available ... benefit here at Children’s, obviously, from having trained pediatric anesthetists that all they do all day is ... big group of neurosurgeons, all of who are pediatric fellowship trained -- I mean pediatric board certified pediatric ...

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    Full Text Available ... of looks a little bit like a spider web. 5 I think what we’ll see right ... to someone having appendicitis is really a basic service that one needs, really, to consider one’s self- ...

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    Full Text Available ... horizontal” -- actually much more than just horizontal care. Meaning, you know, I’ll compare and contrast what ... Smile came to do for that particular trip. Meaning Operation Smile came, you know, we’re collaborating ...

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    Full Text Available ... has inside their brain, get into the normal pathways of spinal fluid. And the analogy I would ... can drain the spinal fluid in the normal pathway, and hopefully by doing that we will allow ...

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to have ... something that you determine at the time of surgery. The risk factors for trying to figure out if a ...

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    Full Text Available ... I’m John Meara from the Department of Plastic Surgery, and we’re fortunate enough today to have ... plates. They’re clear plates. They look like plastic, but they are actually ... That gives the body adequate time to reform and redeposit bone in ...

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    Full Text Available ... the eyes there. That is one of our anesthesia folks there who is working on getting him ... very important that 2 as part of undergoing anesthesia and all the shifts that happen with blood ...

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    Full Text Available ... relationship with children’s Hospital Boston, and after several months of getting visas and passports, et cetera, Dumanel ... see our most complex patients. It’s a fascinating model and it’s been highly successful. So I guess ...

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    Full Text Available ... I’m curious. What are your thoughts about extensive improvement of motor function. Well, you know, the ... know, his possessions, which in rural Haiti, include livestock or land, et cetera. And actually Recondo, he ...

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    Full Text Available ... these items that can, you know, generate some income for them. But, again, it was really all ... a cow there is about the average annual income in Haiti, so he was willing to give ...

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    Full Text Available ... Hospital Boston, in Boston, Massachusetts. During the program it’s easy for you to make referrals, make appointments, ... whole in the skull to some place where it’s not supposed to be. There are many different ...

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    Full Text Available ... HIV or tuberculosis or heart failure or 10 diabetes, these community health workers who are actually people in the town or village in which the patients live, can help administer these medications. They can directly observe therapy, meaning the patients will never miss a dose ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

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    Full Text Available ... have Dr. Ed Smith from the Department of Neurosurgery, and David Walton from Partners in Health. Ed, ... know that a number of us from the Neurosurgery Department, including my colleague, Mark Proctor, who has ...

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    Full Text Available ... Haiti, again, we’re really doing what we call “horizontal” -- actually much more than just horizontal care. ... used there. And notice in the what we call the “frontal orbital band O” there’s going to ...

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    Full Text Available ... skull deformities that maybe you see in your practice here at Children’s. Well I think that’s a ... Thank you for watching this “OR-Live” webcast presentation from Children’s Hospital Boston, in Boston, Massachusetts. OR- ...

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    Full Text Available ... that, you know, Partners in Health does a wide diversity of procedures down there, and the very ... sort of help us address that from the word go. I don’t know if you want ...

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    Full Text Available ... to have this large deformity in between his eyes. This is something that was noticed since birth ... resulted in brain protruding out in between the eyes. And I wonder, Dave, if you can talk ...

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    Full Text Available ... external drain, before we remove it, we can challenge the child by raising or lowering the drain ... patient and make sure that the post-op management is appropriate and that is very comforting, given ...

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    Full Text Available ... work for the hospitals who live in the community. They do a number of things. They’re called -- essentially they’re called “accompan’tures” or “community health workers.” And they help us; the physicians, ...

  8. Reabilitação após reconstrução do ligamento cruzado anterior pela porta anteromedial com enxerto de isquiotibiais

    OpenAIRE

    Alves, João

    2011-01-01

    Este relatório, realizado no âmbito do Mestrado em Fisioterapia, decorreu no Esmoriz Ginásio Clube (EGC), entre 28 de Setembro de 2010 e 30 de Abril de 2011. É composto, fundamentalmente, por duas partes. A primeira refere-se a uma descrição do estágio desportivo em geral, onde começamos por fazer uma caracterização da modalidade desportiva, do clube e dos atletas. Esta última, de um modo geral e, também, por posições no campo. Analisou-se, de forma epidemiológica, as lesões de...

  9. Medline Plus

    Full Text Available ... Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst (Children's Hospital Boston, Boston, MA, 1/28/2009) ... Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst (Children's Hospital Boston, Boston, MA, 1/28/2009) ...

  10. Evaluation of Anteromedial and Posterolateral Bundle of Anterior Cruciate Ligament by MR Imaging%正常前交叉韧带前内侧束和后外侧束的MRI表现

    Institute of Scientific and Technical Information of China (English)

    潘晶晶; 陈新

    2007-01-01

    目的: 探讨MRI显示前交叉韧带(ACL)前内侧束(AMB)和后外侧束(PLB)的方法及其正常表现.材料和方法: 对20例正常志愿者及40例经手术或膝关节镜证实无ACL损伤者行T2*WI对比的三维梯度回波多回波成像(3D-MEDIC)检查,通过多平面重建(MPR)显示ACL的AMB和PLB的形态.结果: (1)横轴面: ACL自股骨端向胫骨端走行过程中形态逐渐变化: 近股骨附着层面呈带状;中部层面呈不对称的倒"V"形,PLB大于AMB;胫骨附着层面呈倒"U"字形.(2)平行ACL的斜冠状面: AMB和PLB呈"人"字形分布.(3)在斜冠状位平行ACL的斜矢状面: 51例(85%)可区分出前内侧束(AMB)和后外侧束(PLB).结论: 利用高分辨三维MR成像多平面重建技术能够帮助显示ACL的主要AMB和PLB分支.

  11. Ocular findings in conjoined (Siamese) twins.

    Science.gov (United States)

    Mansour, A M; Mansour, N; Rosenberg, H S

    1991-01-01

    Conjoined twinning is a rare form of congenital anomaly. The ocular findings in six sets of conjoined twins as well as those reported elsewhere include abnormal optic nerve decussation, pseudosynophthalmos, microphthalmia, abnormal eyelids, orbital encephalocele, occipital encephalocele, and eyelid coloboma. These findings are interpreted as due to deformations from appositional fusion-related factors or malformations from developmental factors. PMID:1955960

  12. Medline Plus

    Full Text Available ... Presbyterian Hospital, New York, NY, 7/15/2008) Neural Tube Defects Craniofacial Procedure to Treat Encephalocele and an Arachnoid ... Presbyterian Hospital, New York, NY, 2/11/2009) Neural Tube Defects Craniofacial Procedure to Treat Encephalocele and an Arachnoid ...

  13. Genetics Home Reference: Knobloch syndrome

    Science.gov (United States)

    ... Knobloch syndrome is a skull defect called an occipital encephalocele , which is a sac-like protrusion of ... the bone at the base of the skull (occipital bone). Some affected individuals have been diagnosed with ...

  14. Urban-Rural Variation in the Occurrence of Neural Tube Defects in Texas

    Science.gov (United States)

    This study examined the pattern and magnitude of urban-rural variation in anencephaly, spina bifida without anencephaly, and encephalocele in Texas using four different indicators of urban-rural status for the period 1999 to 2003.

  15. The Chiari III malformation: an unusual and asymptomatic variant in an 11-year old child

    International Nuclear Information System (INIS)

    Chiari III malformation is an extremely rare condition, and is characterized by the hindbrain herniation into a low occipital or high cervical encephalocele together with the pathologic and imaging features of the Chiari II malformation. In this report, an unusual variant of the Chiari III malformation was diagnosed in an 11-year-old girl. She had an encephalocele operation when she was a newborn, and has been asymptomatic since then. The clinical and imaging findings of this case were presented

  16. Endoscope-Assisted Trans-Sphenoidal Approach for Treatment of Sternberg's Canal

    OpenAIRE

    Maselli, Giuliano; Ricci, Alessandro; Galzio, Renato J.

    2012-01-01

    We report an uncommon case of a 45-year-old woman who presented with spontaneous rhinorrhea. A computed tomography (CT) scan of the head revealed an abnormally large sphenoid sinus associated with a parasellar bony defect (Sternberg's canal) through which magnetic resonance imaging could detect an encephalocele of the right temporal lobe. An endoscope-assisted trans-sphenoidal approach was performed and, with the aid of image guided surgery, reduction of the encephalocele was obtained and fol...

  17. The comparative study of the anterior cruciate ligament in oblique coronal thin anatomical section and MRI

    International Nuclear Information System (INIS)

    Objective: To compare the normal anatomy of the anterior cruciate ligament (ACL) of fresh frozen cadaveric knee specimen in oblique coronal thin-slice section with oblique coronal magnetic resonance imaging. Methods: One fresh cadaveric knee specimen was scanned with MR T1-weighted spin- echo sequence, then the specimen was frozen and sliced with a band saw along the oblique coronal plane into 1.0-mm-thick sections that corresponded to the MR images, MR images including oblique coronal T1-weighted and T2-weighted images of 50 normal the knee joints were retrospectively reviewed to observe the MR imaging features of the cruciate ligament. Results: Anteromedial and posterolaterai bundles of ACL were clearly depicted on both anatomic slices and MR images. The anteromedial bundles originated from the posteromedial aspect of the lateral femoral condyle, coursing through the lateral intercondylar notch in an anterior, inferior, and medial direction, and inserted on the anteromedial aspect of the intercondylar eminence. The posterolateral bundles originated from the anteromedial aspect of the lateral femoral condyle, passing laterally and inferiorly through the lateral intercondylar notch, and inserted on the posterolateral side of the intercondylar eminence. The full length of ACL of all 50 individuals was showed on MR images. MRI clearly differenitated the anteromedial and posterolateral bundles of ACL and depicted the full length of the bundles, similar to the findings on sectional anatomy. Conclusion: Oblique coronal MR imaging is the best way to demonstrate ACL and should be used for clinically suspected injury of ACL. (authors)

  18. Different Effect between Unilateral and Bilateral Decompressive Craniectomy on Acute Encephalocel During Surgery in Patients with Unilateral Severe Brain Injury%单、双侧去骨瓣减压对单侧重型颅脑损伤术中脑膨出的疗效差异

    Institute of Scientific and Technical Information of China (English)

    郭浩; 袁晖; 尹昌林; 徐世伟; 刘明华; 文亮

    2012-01-01

    Objective: To investigate the effect of the knowledge of nutrition and health education intervention on improving post-partum knowledge and behavior. Methods: The subjects,the late pregnancy women ofQingdao, were randomly divided into intervention group and control group. The objects of intervention group had accepted the education of nutritional and health knowledge. Results: The awareness rate of most nutritional health knowledge of the intervention group was significantly higher than those in the control group. The intervention group subjects from medical staff, books and magazines for nutrition and health knowledge (83.1%, 72.3%) were significantly higher than those in the control group (65.2%, 56%). Women in the intervention group object had intaked more potato, fish, soy products, green leafy vegetables, nuts, dietary fiber, niacin, calcium and vitamin C and lower egg, cholesterolthan those in control group. Conclusion: Targeted nutritional health education can improve the knowledge level of puerperal women and promote healthy dietary behavior. Therefore, targeted nutritional health and knowledge education should be promoted.%目的:探讨在单侧或以单侧为主的重型颅脑损伤病例中,何种手术方式更适宜处理手术中出现的急性脑膨出.方法:对我科自2008年5月至2010年12月收治的以单侧为主的重型颅脑损伤且术中出现急性脑膨出的52例临床资料进行回顾性分析,研究单、双侧去骨瓣减压术对患者颅内压( IcP)及伤后6个月时的GOS评分的影响.结果:单侧去骨瓣减压患者29例,分为恢复良好组(GOS 4-5分,n=6),不良组(GOS 2-3分,n=9)和死亡组(GOS 1分,n=14);双侧去骨瓣减压患者23例亦分为恢复良好组(n=6),不良组(n=12)和死亡组(n=5);两种减压术的死亡率差异显著(P<o.05).单侧和双侧去骨瓣减压术均明显降低ICP(P<0.05),但双侧减压的存活组其术后ICP( 17.2±4.2 mmHg)显著低于单侧减压的存活组(25.0±5.4mmHg)(P<0.05).结论:对以单侧为主的重型颅脑损伤,同次行双侧去骨瓣减压术较单侧减压更能有效降低术中急性脑膨出所致高颅压,降低死亡率.

  19. Folate and neural tube defects - Recommendations from a Danish working group

    DEFF Research Database (Denmark)

    Rasmussen, Lone Banke; Andersen, Niels Lyhne; Andersson, G.; Lange, A. P.; Rasmussen, K.; Skak-Iversen, L.; Skovby, F.; Ovesen, L.

    1998-01-01

    A working group was established to evaluate the need for an increased folate intake in Danish women to decrease the risk of neural tube defects (NTDs). NTD are birth defects a which include anencephaly, encephalocele and spina bifida. In Denmark the incidence is about 1.4 per 1,000 pregnancies...

  20. Anatomical reconstruction of the anterior cruciate ligament: a logical approach

    Directory of Open Access Journals (Sweden)

    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.

  1. NASO FRONTAL LESIONS IN THE MIDLINE OF CHILDREN

    Directory of Open Access Journals (Sweden)

    Juan Antonio Lugo Machado

    2015-04-01

    Full Text Available Congenital nasofrontal lesions of the midline are rare congenital abnormalities such as dermoid cysts, nasal gliomas and encephaloceles, with an occurrence of 1: 20,000 to 40,000 births. Its importance lies in the connection to the central nervous system. The biopsy of the lesions with intracranial communication, produce cerebrospinal fluid leaks or meningitis. Objective: To determine the prevalence of midline nasofrontal lesions in a tertiary hospital of regional referral and it´s relationship with other malformations. Material and Methods: Study Design: Transversal retrospective. Male and female patients aged 1 month to 13 years of age with congenital lesions of the nasofrontal midline, treated at Children's Hospital from 1990 to 2005. Sample: was obtained by a non-probabilistic sample of consecutive cases. Through the Statistical Package for the Social Sciences (SPSS version 13.0 which included descriptive statistics: median as a measure of central tendency and frequency distribution and proportion as a measure of dispersion. Results: a review of clinical records was conducted from 1990 to 2005, finding 38 of 67 records reviewed, 29 files were excluded because they correspond to the diagnosis of occipital encephalocele. Prevalence was 38 cases in 15 years. The gender distribution of nasofrontal midline lesions was slightly higher in females with 22 cases and 16 cases in males. The midline nasofrontal lesions found were midline encephalocele, gliomas and dermoid cysts. In our review most encephaloceles were not associated with the central nervous system and 11 cases did have an associated disorder; 5 cases with hydrocephalus and / or temporal or occipital cysts and 6 cases with nondevelopment of the corpus callosum plus hydrocephalus. Conclusion: Our prevalence was 38 cases in 15 years. Nasofrontal midline lesion disgnosis are usually made in the first months of life. Among the types of midline nasofrontal lesions, the most common type found

  2. Lower urinary tract function in patients with pituitary adenoma compressing hypothalamus

    OpenAIRE

    Yamamoto, T; Sakakibara, R; Uchiyama, T.; Liu, Z.; Ito, T; Yamanishi, T.; Hattori, T

    2005-01-01

    Background: The micturition reflex is under the tonic influence of suprapontine structures including the anteromedial frontal cortex, basal ganglia, and hypothalamus. However, there have been few reports about the role of the hypothalamus on the lower urinary tract (LUT) function in humans.

  3. Pubic apophysitis

    DEFF Research Database (Denmark)

    Sailly, Matthieu; Whiteley, Rod; Read, John W;

    2015-01-01

    BACKGROUND: Sport-related pubalgia is often a diagnostic challenge in elite athletes. While scientific attention has focused on adults, there is little data on adolescents. Cadaveric and imaging studies identify a secondary ossification centre located along the anteromedial corner of pubis beneat...... apophyseal stress (or 'apophysitis') as an important differential consideration in the adolescent athlete who presents with groin pain....

  4. The spread of injectate during saphenous nerve block at the adductor canal

    DEFF Research Database (Denmark)

    Andersen, H L; Andersen, S L; Tranum-Jensen, J

    2015-01-01

    comparative dissections of the same limbs. RESULTS: The spread of the injectates was determined by the fascial limits and the muscles surrounding the adductor canal. The anteromedial limit of the adductor canal (the roof) was found to be a continuous fascia, with a thin proximal part and a thicker distal part...

  5. Morphological Study of the Supracondylar Process of the Humerus and Its Clinical Implications

    OpenAIRE

    C., Shivaleela; B.S., Suresh; G.V., Kumar; S., Lakshmiprabha

    2014-01-01

    Background: The supracondylar process of the humerus, which is also called the supra-epitrochlear, epicondylar, epicondylic process or a supratrochlear spur, is a hook-like, bony spine of variable size that may project distally from the anteromedial surface of the humerus. It represents the embryologic vestigial remnant of climbing animals and seen in many reptiles, most marsupials, cats, lemurs and American monkeys.

  6. Drywall stilt dermatosis.

    Science.gov (United States)

    Lewis, E J; Prawer, S E; Crutchfield, C E

    1996-12-01

    We describe a previously unreported occupational dermatosis occurring in a worker employed in drywall installation and finishing. This 50-year-old man presented with bilaterally symmetrical, parallel, linear crusted erosions on his anteromedial legs after wearing drywall stilts. The pathophysiology of this condition is considered. PMID:8970774

  7. [Prevalence of neural tube defects and estimation of cases averted in the post-fortification period in Argentina].

    Science.gov (United States)

    Bidondo, María P; Liascovich, Rosa; Barbero, Pablo; Groisman, Boris

    2015-12-01

    Periconceptional intake of folic acid has demonstrated to be effective to reduce the frequency of neural tube defects, and food fortification has been one of the strategies implemented to increase it. An update is herein presented on the reduced prevalence of neural tube defect cases in the post-fortification period in Argentina and an estimation of cases averted in the 2005-2013 period as a result of this intervention. When comparing the prevalence observed in the post-fortification period to that reported in the pre-fortification period, anencephaly and encephalocele decreased by 66%, and spina bifida, by 47%, which were significant reductions. The estimated number of cases averted was higher for anencephaly, followed by spina bifida; encephalocele showed the lowest number of cases averted given that the prevalence of this defect was smaller. The decrease observed in the prevalence supports findings from previous studies on the impact of fortification. PMID:26593794

  8. Arnold-Chiari Malformation Type III With Meningoencephalocele: A Case Report

    OpenAIRE

    Jeong, Dae Ho; Kim, Chang Hwan.; Kim, Myeong Ok; Chung, Hyung; Kim, Tae Hyun; Jung, Han Young

    2014-01-01

    Arnold-Chiari malformation type III (CM III) is an extremely rare anomaly with poor prognosis. An encephalocele with brain anomalies as seen in CM II, and herniation of posterior fossa contents like the cerebellum are found in CM III. The female infant was a twin, born at 33 weeks, weighing 1.7 kg with a huge hydrocele on the craniocervical junction. After operations were performed, she was referred to the department of rehabilitation medicine for poor motor development, swallowing dysfunctio...

  9. A Rare Cause of Fetal Neck Mass: Cervical Lymphangioma

    OpenAIRE

    Hicran Acar; Işıl Turan Bakırcı; Basak Baksu; Orkun Cetin; Mertihan Kurdoglu

    2016-01-01

    ntroduction: Fetal neck masses are rare. In general, cystic hygroma is the most frequent form of fetal neck masses. It is essential to differentiate between different pathologies since this will affect prenatal counselling, antenatal and postnatal management. We aimed to present a case of cervical lymphangioma who was referred to our perinatology outpatient clinic with a diagnosis of an occipital encephalocele. Case Presentation: A 26-year-old nulliparous woman was referred to our perinato...

  10. NEURAL TUBE DEFECTS PREVALENCE IN A HOSPITAL-BASED STUDY IN URMIA

    OpenAIRE

    I. Abdi Rad; H.R. Farrokh-Islamlou; M. Khoshkalam

    2008-01-01

    AbstractObjectiveNeural tube defects including anencephaly, encephalocele, and spina bifida are major congenital malformations with multifactorial etiology, and with a great variation in their prevalence in different populations. The study on the prevalence of these malformations may be helpful in planning strategies for their prevention. The aim of this epidemiologic descriptive study was to determine the prevalence of neural tube defects and to describe their birth characteristics in Motahh...

  11. Assessment of fetal malformations in the first trimester of pregnancy by three-dimensional ultrasonography in the rendering mode. Pictorial essay.

    Science.gov (United States)

    Araujo Júnior, Edward; Rolo, Liliam Cristine; Tonni, Gabriele; Haeri, Sina; Ruano, Rodrigo

    2015-03-01

    We present our experience in the contribution of three-dimensional ultrasonography, using the rendering mode, to the prenatal diagnosis of congenital anomalies including neurological defects (acrania/anencephaly, encephalocele, holoprosencephaly), facial anomalies (cyclopia and facial clefts), abdominal wall defects (omphalocele and gastroschisis) and defects of extremities (fetal muscle-skeletal dysplasias). Three-dimensional ultrasonography may contribute to improve the prenatal diagnosis with further revision of the fetal images, allowing a better prenatal counsel to the parents. PMID:25745664

  12. The range of neural tube defects in southern India.

    OpenAIRE

    Kulkarni, M L; Mathew, M A; Reddy, V

    1989-01-01

    During a prospective study of 3500 consecutive births from November 1985 to January 1987 at three hospitals, 40 babies were found to have neural tube defects, an extremely high incidence (11.4/1000 births). The defects comprised anencephaly (n = 18), meningomyelocele (n = 11), Arnold-Chiari deformity (n = 3), encephalocele (n = 3), iniencephaly (n = 2), and one each of occipital meningocele, spina bifida occulta, and anencephaly with rachischisis. There were significant differences in inciden...

  13. Oral findings in Midline Syndrome: a case report and literature review

    OpenAIRE

    Tallón-Walton, Victòria; Nieminen, Pekka; Arte, Sirpa; Ustrell i Torrent, Josep Maria, 1953-; Carvalho Lobato, Patricia; Manzanares Céspedes, María Cristina

    2010-01-01

    We describe a female patient with a midline syndrome. The patient presents agenesis of the corpus callosum, encephalocele, iris coloboma, hypertelorism, submucosal cleft palate and dental anomalies. Despite being very characteristic, her phenotypical traits do not coincide exactly with those reported to date in the literature. The karyotype and the molecular cytogenetic study do not show mutations. We identify the presence of dental anomalies in the mother and other family members, not being ...

  14. Nasal heterotopia versus pilocytic astrocytoma: A narrow border.

    Science.gov (United States)

    Ellouze, N; Born, J; Hoyoux, C; Michotte, A; Retz, C; Tebache, M; Piette, C

    2015-08-01

    Failure of the anterior neuropore can lead to three main types of anomalies: nasal dermal sinus, encephalocele and nasal glioma or heterotopia. In this report, we describe a case of intracranial and extracranial glial heterotopia that probably resulted from a common failure of anterior neuropore development. We describe the prenatal radiological assessment based on ultrasound and MRI results, and consider their limitation for early fetal diagnosis. We also discuss the embryogenesis and the possible pathogenic mechanisms involved. PMID:26072230

  15. An association study between SUFU gene polymorphisms and neural tube defects.

    Science.gov (United States)

    Lu, Xiaolin; Wang, Zhen; Wang, Jianhua; Shangguan, Shaofang; Bao, Yihua; Lu, Ping; Wang, Li

    2014-06-01

    Neural tube defects (NTDs) in mammals are rooted in aberrant neural tube closure during early embryogenesis, which is caused by multiple environmental and genetic factors. The Sonic Hedgehog pathway is involved in the induction of the floor plate and participates in formation of the neural tube. Mutation of the suppressor of fused gene (SUFU), an essential repressor of Sonic Hedgehog signaling pathway, can result in NTDs. A case-control study was designed to compare the frequencies of the polymorphism at four sites in the SUFU gene in control and NTDs group, as well as in subtype groups, including anencephaly, spina bifida and encephalocele. We also explored the association between polymorphism and NTDs risk in a high prevalence population in China. Rs10786691, but not the other three SNPs, had an association between polymorphisms and NTDs. The heterozygous AG allele of rs10786691 was significantly related with NTDs and encephalocele (OR = 1.60, 95% CI: 1.04-2.48, p = 0.034; OR = 2.83, 95% CI: 1.07-7.47, p = 0.036). In female but not male fetuses, the AG genotype of rs10786691 increased the risk of NTDs (OR = 1.88, 95% CI: 1.03-3.41, p = 0.040). The SUFU rs10786691 A>G polymorphism may be a potential risk factor for NTDs and encephalocele in this high-risk population, but the association between the polymorphism and NTDs was probably influenced by gender. PMID:24070372

  16. Transnasal endoscopic repair of pediatric meningoencephalocele

    Directory of Open Access Journals (Sweden)

    Amit Kumar Keshri

    2016-01-01

    Full Text Available Introduction: Encephaloceles in relation to the nose are rare lesions affecting the skull base. In the pediatric population, majority are congenital lesions manifesting as nasal masses requiring surgical intervention. Materials and Methods: A retrospective study of 6 consecutive patients below 12 years of age with intranasal meningoencephalocele treated by endonasal endoscopic approach at our tertiary centre was done. The follow up period ranged from 6 months to 2 years. A detailed clinical and radiological evaluation of these cases was done. Endonasal endoscopic repair (gasket seal/fat plug was carried out in all cases. Results: Out of 6 patients, 4 patients had post-traumatic and rest 2 cases had congenital meningo-encephaloceles. All patients were asymptomatic in post-operative follow up period. One patient had minor complication of nasal alar collapse due to intra-operative adherence of encephalocele to cartilaginous framework. Conclusion: Transnasal endoscopic repair of anterior skull base meningoencephalocele is a minimally invasive single stage surgery, and has advantage in terms of lesser hospital stay, cost of treatment, and better cosmesis. The repair technique should be tailored to the size of defect to provide a water-tight seal for better outcome.

  17. Neural correlates of automatic beliefs about gender and race.

    Science.gov (United States)

    Knutson, Kristine M; Mah, Linda; Manly, Charlotte F; Grafman, Jordan

    2007-10-01

    Functional MRI was used to identify the brain areas underlying automatic beliefs about gender and race, and suppression of those attitudes. Participants (n = 20; 7 females) were scanned at 3 tesla while performing the Implicit Association Test (IAT), an indirect measure of race and gender bias. We hypothesized that ventromedial prefrontal cortex areas (PFC) would mediate gender and racial stereotypic attitudes, and suppression of these beliefs would recruit dorsolateral prefrontal cortex (DLPFC) and the anterior cingulate cortex (ACC). Performance data on the IAT revealed gender and racial biases. Racial bias was correlated with an explicit measure of racism. Results showed activation of anteromedial PFC and rostral ACC while participants implicitly made associations consistent with gender and racial biases. In contrast, associations incongruent with stereotypes recruited DLPFC. Implicit gender bias was correlated with amygdala activation during stereotypic conditions. Results suggest there are dissociable roles for anteromedial and dorsolateral PFC circuits in the activation and inhibition of stereotypic attitudes. PMID:17133388

  18. Anatomic double-bundle anterior crucial ligament reconstruction with G-ST

    OpenAIRE

    Kuroda, Ryosuke; Matsushita, Takehiko

    2011-01-01

    The anterior cruciate ligament (ACL) consists of two primal functional bundles, anteromedial bundle and posterolateral bundles. Those two bundles play different functional roles and contribute differently to knee stability throughout the range of motion. Recent advancement in studies of anatomy and biomechanics of ACL has led surgeons to perform double-bundle ACL reconstruction to obtain better stability and kinematics. Consequently, variable surgical techniques of double-bundle ACL reconstru...

  19. The evolution of ACL reconstruction over the last fifty years

    OpenAIRE

    Chambat, Pierre; Guier, Christian; Sonnery-Cottet, Bertrand; Fayard, Jean-Marie; Thaunat, Mathieu

    2013-01-01

    Anterior cruciate ligament (ACL) reconstruction has evolved considerably over the past 30 years. This has largely been due to a better understanding of ACL anatomy and in particular a precise description of the femoral and tibial insertions of its two bundles. In the 1980s, the gold standard was anteromedial bundle reconstruction using the middle third of the patellar ligament. Insufficient control of rotational laxity led to the development of double bundle ACL reconstruction. This concept, ...

  20. Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Using In Situ Hamstring Graft With 4 Tunnels

    OpenAIRE

    Wagih, Ahmad M.

    2013-01-01

    A careful review of the literature suggests that a significant number of patients undergoing anterior cruciate ligament (ACL) reconstruction have less-than-optimal results. Although overall outcomes of ACL reconstruction are favorable, there remains considerable room for improvement. Anatomically, the ACL consists of 2 major functional bundles, the anteromedial bundle and the posterolateral bundle. Biomechanically, both bundles contribute significantly to the anterior and rotational stability...

  1. Suspensory Anterior Tibial Fixation in the Anatomic Transtibial Posterior Cruciate Ligament Reconstruction

    OpenAIRE

    Elazab, Ashraf; Lee, Yong Seuk; Kang, Seo Goo

    2016-01-01

    The transtibial technique is the most relevant among many surgical techniques for posterior cruciate ligament reconstruction, and many types of fixation devices are used for tibial fixation according to the technique and the length of the graft. However, bone density in the fixation areas should be taken into consideration when choosing the fixation device to achieve rigid and stable fixation. However, density is not a substantial issue for anteromedial cortical fixation using a cortical susp...

  2. Sagittal realignment osteotomy for increased posterior tibial slope after opening-wedge high tibial osteotomy: a case report

    OpenAIRE

    Kimura, Yuka; Ishibashi, Yasuyuki; Tsuda, Eiichi; Fukuda, Akira; Tsukada, Harehiko

    2009-01-01

    A 40 year old welder who underwent opening-wedge high tibial osteotomy for correction of alignment in a varus knee developed persistent pain with loss of knee extension. The posterior tibial slope increased from 9 degrees to 20 degrees after the osteotomy and caused the anteromedial knee pain and limited extension. The patient then underwent a revision osteotomy using a closing wedge technique to correct tibial slope. The osteotomy was performed, first from the medial cortex in the lateral di...

  3. Tibial osteomyelitis following intraosseous infusion: a case report

    OpenAIRE

    Dogan, Ali; Irmak, Hasan; Harman, Mustafa; Ceylan, Abdullah; Akpinar, Fuat; Tosun, Nihat

    2004-01-01

    Fluids, medications, and blood products can be rapidly administered via intraosseous infusion under emergency conditions, particularly to pediatric patients aged from 0 to 2 years. A five-month-old infant who had been hospitalized with a diagnosis of sepsis developed swelling and hyperemia at the infusion site 10 days after an intraosseous infusion in the right proximal tibia. Physical examination showed a serous discharge from a fistula on the anteromedial side of the right proximal cruris. ...

  4. Anterior Cruciate Ligament Reconstruction Using a Flexible Reamer System

    OpenAIRE

    Fitzgerald, Judd; Saluan, Paul; Richter, Dustin L.; Huff, Nathan; Schenck, Robert C.

    2015-01-01

    Anatomic reconstruction of the anterior cruciate ligament (ACL) has been shown to improve stability of the knee, particularly rotational stability, potentially leading to superior clinical outcomes and a shorter return to sport. Nonanatomic ACL reconstruction has been linked to graft failure and abnormal cartilage loading thought to contribute to progression of degenerative joint disease. Use of the far anteromedial portal (FAMP) to uncouple the tibial and femoral tunnels has led to improved ...

  5. Neuronal fiber tracts connecting the brain and ventral nerve cord of the early Drosophila larva

    OpenAIRE

    Cardona, Albert; Larsen, Camilla; Hartenstein, Volker

    2009-01-01

    Using a combination of dye injections, clonal labeling, and molecular markers we have reconstructed the axonal connections between brain and ventral nerve cord of the first instar Drosophila larva. Out of the approximately 1400 neurons that form the early larval brain hemisphere, less than 50 cells have axons descending into the ventral nerve cord. Descending neurons fall into four topologically defined clusters located in the antero-medial, antero-lateral, dorsal, and baso-posterior brain, r...

  6. The anterior thalamus provides a subcortical circuit supporting memory and spatial navigation

    OpenAIRE

    Jankowski, Maciej M.; Ronnqvist, Kim C.; Tsanov, Marian; Vann, Seralynne D.; Wright, Nicholas F.; Erichsen, Jonathan T.; Aggleton, John P.; O'Mara, Shane M.

    2013-01-01

    The anterior thalamic nuclei (ATN), a central component of Papez' circuit, are generally assumed to be key constituents of the neural circuits responsible for certain categories of learning and memory. Supporting evidence for this contention is that damage to either of two brain regions, the medial temporal lobe and the medial diencephalon, is most consistently associated with anterograde amnesia. Within these respective regions, the hippocampal formation and the ATN (anteromedial, anterovent...

  7. Lower extremity thrust and non-thrust joint mobilization for patellofemoral pain syndrome: a case report

    OpenAIRE

    Simpson, Brad G; Simon, Corey B

    2014-01-01

    A 40-year old female presented to physical therapy with a one-year history of insidious right anteromedial and anterolateral knee pain. Additionally, the patient had a history of multiple lateral ankle sprains bilaterally, the last sprain occurring on the right ankle 1 year prior to the onset of knee pain. The patient was evaluated and given a physical therapy diagnosis of patellofemoral pain syndrome (PFPS), with associated talocrural and tibiofemoral joint hypomobility limiting ankle dorsif...

  8. Neglected reverse Essex-Lopresti injury with ulnar nerve

    OpenAIRE

    Singh Ajay Pal; Dhammi Ish Kumar; Jain Anil Kumar

    2011-01-01

    【Abstract】A 45 year old woman was diagnosed as having anteromedial radial head dislocation and distal radius fracture five months after her injury on right forearm. The radial head dislocation led to ulnar nerve compression. She had severe restriction of her elbow movements. She was treated with arthrolysis, decompression of the ulnar nerve and radial head resection. The reverse Essex Lopresti injury and radial head dislocation compressing the ulnar nerve has not been ...

  9. Comparison of two methods of femoral tunnel preparation in single-bundle anterior cruciate ligament reconstruction: a prospective randomized study Comparação entre dois métodos de preparação de túnel femoral na reconstrução do ligamento cruzado anterior em feixe único: estudo prospectivo randomizado

    OpenAIRE

    Qiang Zhang; Shu Zhang; Rui Li; Ya Liu; Xuecheng Cao

    2012-01-01

    PURPOSE: To prospectively compare therapeutic effect of femoral tunnel preparation through the tibial tunnel and the anteromedial (AM) portal in single-bundle anterior cruciate ligament (ACL) reconstruction. METHODS: Between June 2008 and October 2010, 76 patients underwent single-bundle ACL reconstruction by autogenous grafting of semitendinosus and gracilis tendon. All cases were randomly divided into two groups according to the method of femoral tunnel preparation: transtibial (TT) group (...

  10. Anterior cruciate ligament reconstruction with double bundle versus single bundle: experimental study Reconstrução do ligamento cruzado anterior com duplo feixe versus feixe único: estudo experimental

    OpenAIRE

    Roberto F. Mota e Albuquerque; Sandra Umeda Sasaki; Marco Martins Amatuzzi; Fabio Janson Angelini

    2007-01-01

    OBJECTIVE: To test an intra-articular reconstruction of the anterior cruciate ligament of the knee in 10 human cadavers by replacing 2 anterior cruciate ligament bundles, with the purpose of producing a surrogate that would be structurally more similar to the anatomy of the anterior cruciate ligament and would provide the knee with more stability. METHODS: We reconstructed the anteromedial and posterolateral bundles using a quadriceps muscle tendon graft that included a patellar bone segment....

  11. Pubic apophysitis: a previously undescribed clinical entity of groin pain in athletes

    OpenAIRE

    Sailly, Matthieu; Whiteley, Rod; Read, John W.; Giuffre, Bruno; Johnson, Amanda; Hölmich, Per

    2015-01-01

    Background Sport-related pubalgia is often a diagnostic challenge in elite athletes. While scientific attention has focused on adults, there is little data on adolescents. Cadaveric and imaging studies identify a secondary ossification centre located along the anteromedial corner of pubis beneath the insertions of symphysial joint capsule and adductor longus tendon. Little is known about this apophysis and its response to chronic stress. Aim We report pubic apophysitis as a clinically relevan...

  12. Aneurysm and infundibular dilatation at an unusual origin of the ophthalmic artery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Soo; Kim, Eui Jong; Lee, Kyung Mi; Choi, Woo Suk [Dept. of Radiology, Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2014-10-15

    The ophthalmic artery usually arises from the anteromedial or superomedial aspect of the internal carotid artery. Rarely does it arise from the medial or posteromedial aspect of the internal carotid artery. In this paper, the authors report two cases of aneurysm and infundibular dilatation found at unusual sites of origin in the ophthalmic artery and review the literature about possible etiologies contributing to the anatomic variations.

  13. Lateral Clavicular Autograft for Repair of Reverse Hill-Sachs Defect

    OpenAIRE

    Shenoy, Ravikiran; Kamineni, Srinath

    2011-01-01

    Posterior dislocations of the shoulder joint can result in an impression fracture over the anteromedial humeral head, termed the reverse Hill-Sachs lesion, the presence of which can contribute to recurrent dislocations. Methods described to repair this defect include using allografts, iliac crest and coracoid process autografts, and bone graft substitutes. We describe a novel technique using the lateral end of the ipsilateral clavicle as an autograft in a 78 year old man with a reverse Hill S...

  14. Knee rotational laxity and proprioceptive function 2 years after partial ACL reconstruction

    OpenAIRE

    Chouteau, Julien; Testa, Rodolphe; Viste, Anthony; MOYEN, Bernard

    2012-01-01

    The aim of our study was to evaluate knee rotational laxity and proprioceptive function 2 years after partial anterior cruciate ligament (ACL) reconstruction. According to our hypothesis, partial ACL reconstruction could restore knee laxity and function to the intact level. Methods : We conducted a study in fifteen consecutive patients undergoing partial ACL reconstruction. Fifteen anteromedial bundle tears were identified intra-operatively. Partial ACL reconstructions were performed by the s...

  15. Anterolateralni utesnitveni sindrom gležnja: Ankle impingement syndrome:

    OpenAIRE

    Frangež, Igor; Senekovič, Vladimir; Žnidaršič, Marta

    2011-01-01

    lnversion injuries of the ankle are common and most are managed adequately by functional treatment. A significant number will, however, remain symptomatic. Ankle impingement syndrome is clinicaly evident as pain, which is elicited by full range of motion in ankle joint because of the mechanical impidgement in the joint. Ankle impingement can result from trauma, infection, inflammation or from degenerative process. The impingement syndrome can be anterolateral, anteromedial, posterior, made of...

  16. Ebstein Anomalisi Olan Bir Hastada Carpentier Yönteminden Modifiye Edilen Yeni Bir Cerrahi Onarım

    OpenAIRE

    Karaçelik, Mustafa; Sert, Cengiz; Özenç, Selim; Köksal, Hakan; Güvenli, Yalçın; Özbek, Cengiz

    2013-01-01

    A new procedure for correction of Ebstein's anomaly that restores to near normal the anatomic and physiologic function of the tricuspid valve and the right ventricle is reported. Through a surgical approach, the displaced anterior leaflet was detached from the annulus. Most of the atrialized portion of the right ventricular wall was suspended; the tricuspid annulus was plicated anteromedially. The leaflet was then reattached to the native anterior annulus. Tricuspid valve was repaired using a...

  17. Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures

    OpenAIRE

    Rajasekhar Gali; Sathya Kumar Devireddy; Kishore Kumar Rayadurgam Venkata; Sridhar Reddy Kanubaddy; Chaithanyaa Nemaly; Mallikarjuna Dasari

    2016-01-01

    Introduction: Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications. Purpose: This retrospective clinical...

  18. Aneurysm and infundibular dilatation at an unusual origin of the ophthalmic artery

    International Nuclear Information System (INIS)

    The ophthalmic artery usually arises from the anteromedial or superomedial aspect of the internal carotid artery. Rarely does it arise from the medial or posteromedial aspect of the internal carotid artery. In this paper, the authors report two cases of aneurysm and infundibular dilatation found at unusual sites of origin in the ophthalmic artery and review the literature about possible etiologies contributing to the anatomic variations.

  19. Epidemiologic study of neural tube defects in Los Angeles County. II. Etiologic factors in an area with low prevalence at birth

    Energy Technology Data Exchange (ETDEWEB)

    Sever, L.E.

    1982-01-01

    Epidemiologic characteristics of neural tube defect (NTD) births occurring in Los Angeles County, California, residents during the period 1966-1972 are presented. The prevalence at birth was 0.52/1000 births for anencephalus, 0.51/1000 for spina bifida, and 0.08/1000 for encephalocele, rates considered to be low for a predominantly white population. We hypothesized that environmental (nongenetic) factors are of less etiologic importance in a low-prevalence population than in areas or time periods with high prevalence. We tested that hypothesis by examining epidemiologic characteristics of NTDs in Los Angeles County and comparing them with high-prevalence populations. The data did not support a major etiologic role for environmental factors: (1) no significant differences between rates by month of birth or conception; (2) no significant association with maternal age or parity for anencephalus; for spina bifida a significant maternal age effect (P < 0.01) and for encephalocele a parity effect (P < 0.02); and (3) no significant relationship with father's occupational class for either anencephalus or encephalocele but a marginally significant (P < 0.05) inverse association for spina bifida when a statistic based on ordinal relationships was used. Findings supporting the importance of genetic factors in etiology included: (1) a high percentage of males; (2) a higher twin concordance rate than in high-prevalence populations; and (3) an anencephalus rate among blacks comparable with rates for blacks in other United States populations. Our findings in conjunction with those from other areas and times of low prevalence suggest environmental factors play a relatively insignificant role in the etiology of NTDs in such populations.

  20. Evidence for the "midline" hypothesis in associated defects of laterality formation and multiple midline anomalies.

    Science.gov (United States)

    Gilbert-Barness, E; Debich-Spicer, D; Cohen, M M; Opitz, J M

    2001-07-15

    A male infant was liveborn at 38 weeks of gestation to a G4P1AB2, 22-year-old, mother. Polyhydramnios and multiple congenital anomalies were noted by ultrasonography; the infant died 5 min after birth. At autopsy, the infant had multiple defects of blastogenesis including midline anomalies with asplenia and abnormalities of laterality formation. The laterality defects were unusual in that they combined asplenia with hypoplastic, symmetrically unilobate lungs and bilateral hyparterial bronchi more consistent with polysplenia, abdominal situs inversus with midline stomach, symmetric liver, and left gallbladder. No intracardiac abnormalities were present, but there was azygous continuation of the inferior vena cava. Additional multiple midline defects included bronchoesophageal fistula, duodenal atresia, absence of posterior leaf of diaphragm; horseshoe adrenal gland; microcephaly; Dandy-Walker anomaly with agenesis of cerebellar vermis and occipital encephalocele; holoprosencephaly with orbital encephalocele, midline defect of the orbital plate of the skull, bilateral anophthalmia, double proboscis with bilateral choanal atresia, midline upper lip and palatal cleft; single-lobed thyroid; hypoplastic external genitalia with midline cleft of scrotum, long tapering fingers, and defects of the cranium at the sites of orbital and occipital encephaloceles. Defects of laterality frequently are associated with other complex midline anomalies, which both result from a disturbance of pattern formation during blastogenesis, i.e., the induction of the progenitor fields. The latter are the result of the establishment of upstream expression domains of growth and transcription factors and other morphogens. Many of these and other genetic systems, expressed asymmetrically around the midline, are responsible for laterality formation and are the result of upstream and subsequent downstream gene expression cascades through the expression of genes such as HOX genes; bFGF; transforming

  1. Bilateral optic disc pit with maculopathy in a patient with cleft lip and cleft palate

    Science.gov (United States)

    Seth, Anisha; Gupta, Rajat; Gupta, Anika; Raina, Usha K; Ghosh, Basudeb

    2015-01-01

    Optic disc pit (ODP) is small, gray-white, oval depression found at the optic nerve head. It is a congenital defect that occurs due to imperfect closure of superior edge of the embryonic fissure. Cleft lip and palate are also congenital midline abnormalities occurring due to defect in the fusion of frontonasal prominence, maxillary prominence and mandibular prominence. There is only one case report describing the occurrence of ODP in a young patient with cleft lip and palate who also had basal encephalocele. We describe a 52-year-old patient with congenital cleft lip and palate with bilateral ODP with maculopathy but without any other midline abnormality. PMID:26044478

  2. Congenital midline nasofrontal masses.

    Science.gov (United States)

    Saettele, Megan; Alexander, Alan; Markovich, Brian; Morelli, John; Lowe, Lisa H

    2012-09-01

    Congenital midline nasal masses are uncommon anomalies including nasal dermoids/epidermoids, nasal glial heterotopias and encephaloceles. These lesions can occur at the nasal bridge, extend intranasally and have intracranial extension with communication to the subarachnoid space. Therefore, accurate diagnosis of these lesions is critically important for presurgical planning and prevention of potentially fatal complications. Neuroimaging is essential in the evaluation of congenital midline nasal masses to identify the specific type of lesion, evaluate for the presence of intracranial extension and allow for appropriate presurgical planning. PMID:22648391

  3. Prevalence and prenatal diagnosis of neural tube defects in Nova Scotia in 1980-84.

    OpenAIRE

    Winsor, E J; Brown, B. S.

    1986-01-01

    A survey of the records of all hospitals with obstetric services in Nova Scotia revealed that during 1980-84 there were 122 pregnancies involving a neural tube defect. The mean rate was 2/1000 births. Of the affected fetuses or infants 54% had spina bifida, 35% had anencephaly and 11% had encephalocele. The records showed that in the early part of the period studied at least one prenatal ultrasonographic examination had been performed in 60% of the pregnancies; in 1984 the rate was 74%. When ...

  4. A missense mutation in TMEM67 causes Meckel-Gruber syndrome type 3 (MKS3): a family from China.

    Science.gov (United States)

    Zhang, Manli; Cheng, Jing; Liu, Aijun; Wang, Longxia; Xiong, Lihua; Chen, Meixia; Sun, Yi; Li, Jianzhong; Lu, Yu; Yuan, Huijun; Li, Yali; Lu, Yanping

    2015-01-01

    Meckel-Gruber syndrome (MKS) is a lethal autosomal recessive condition characterized by renal cysts and variably associated features, including developmental anomalies of the central nervous system (typically encephalocele), hepatic ductal dysplasia and cysts, and polydactyly. Genetic heterogeneity has been demonstrated at eleven loci, MKS1-11. Here, we present the clinical and molecular characteristics of a Chinese MKS3 family with occipital encephalocele and kidney enlargement. DNA sequencing of affected fetuses revealed a homozygous c.1645C>T substitution in exon 16 of TMEM67, leading to a p.R549C substitution in meckelin. The R549 residue is highly conserved across human, rat, mouse, zebrafish, chicken, wolf and platypus genomes. Hha I restriction analysis demonstrated that the c.1645C>T mutation was absent in 200 unrelated control chromosomes of Chinese background, supporting the hypothesis that it represents causative mutation, not rare polymorphism. Our data provide additional molecular and clinical information for establishing a better genotype-phenotype understanding of MKS. PMID:26191240

  5. A Rare Cause of Fetal Neck Mass: Cervical Lymphangioma

    Directory of Open Access Journals (Sweden)

    Hicran Acar

    2016-01-01

    Full Text Available ntroduction: Fetal neck masses are rare. In general, cystic hygroma is the most frequent form of fetal neck masses. It is essential to differentiate between different pathologies since this will affect prenatal counselling, antenatal and postnatal management. We aimed to present a case of cervical lymphangioma who was referred to our perinatology outpatient clinic with a diagnosis of an occipital encephalocele. Case Presentation: A 26-year-old nulliparous woman was referred to our perinatology clinic at 38 weeks’ gestation with an ultrasound diagnosis of occipital encephalocele so that postnatal surgery could be planned at our hospital. During obstetric ultrasonography examination, we identified a 4.7×4.5 cm, multiloculated cystic mass on the left lateral side of the fetal neck. The provisional diagnosis was lymphangioma. Fetal magnetic resonance (MR revealed a multiloculated cystic mass with smooth counters of 4.5×3.5×3.0 cm in size, originating from the soft tissues of the left side of the neck and it was not connected with the cervical spinal canal. The pathology report confirmed cervical lymphangioma. Conclusions: We would like to highlight the importance of differential diagnosis and follow up scans for any neck mass identified during scan to reach the final accurate diagnosis. This will enable that fetal neck masses could be diagnosed correctly in a more cautious manner.

  6. O comprimento dos túneis femorais varia com a flexão do joelho na reconstrução anatômica do ligamento cruzado anterior Femoral tunnels' length changes with knee flexion angle in anatomical anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Julio Cesar Gali

    2012-04-01

    Full Text Available OBJETIVO: O propósito de nosso trabalho foi avaliar o efeito que o grau de flexão do joelho, durante a perfuração dos túneis femorais, pode causar no comprimento desses túneis, na reconstrução anatômica do ligamento cruzado anterior. MÉTODOS: Medimos o comprimento dos túneis femorais anteromedial e posterolateral do ligamento cruzado anterior, em 20 peças anatômicas de joelhos desemparelhadas, 10 direitas e 10 esquerdas, todas com a cartilagem e ligamentos cruzados íntegros. Os túneis foram perfurados com os joelhos flexionados a 90, 110 e 130 graus de flexão, através do portal anteromedial acessório, com uma broca de 2,5mm. Os estudos estatísticos foram realizadas pela análise de variância de Friedman e pelo teste de Mann-Whitney. RESULTADO: A média dos comprimentos dos túneis femorais anteromediais medidos com os joelhos flexionados a 90, 110 e 130 graus foram 33,7 ± 3,72mm, 37,4 ± 2,93mm e 38,8 ± 3,31mm, respectivamente. Para o comprimento dos túneis posterolaterais, os resultados obtidos a 90, 110 e 130 graus foram 32,1 ± 4,24mm, 37,3 ± 4,85mm e 38,4 ± 2,51mm, respectivamente. A análise de variância de Friedman mostrou diferença significativa entre os comprimentos dos túneis perfurados com 90 e 110 graus de flexão das peças, porém não mostrou diferença significativa entre os obtidos com flexão de 110e 130 graus (p OBJECTIVE: The objective of our study was to evaluate the effect that knee flexion angle while femoral tunnels are being drilled may have on the length of these tunnels, in anatomical reconstruction of the anterior cruciate ligament. METHODS: We measured the lengths of anteromedial and posterolateral tunnels for the anterior cruciate ligament in 20 unpaired anatomical knee specimens (10 right and 10 left knees, all with the cartilage and cruciate ligaments intact. Tunnels were drilled with the knees flexed at 90º, 110º and 130º, through the accessory anteromedial portal, with a 2.5 mm

  7. Methods for the correction of vascular artifacts in PET O-15 water brain-mapping studies

    International Nuclear Information System (INIS)

    While positron emission tomographic (PET) measurements of regional cerebral blood flow (rCBF) can be used to map brain regions that are involved in normal and pathological human behaviors, measurements in the anteromedial temporal lobe can be confounded by the combined effects of radiotracer activity in neighboring arteries and partial-volume averaging. The authors now describe two simple methods to address this vascular artifact. One method utilizes the early frames of a dynamic PET study, while the other method utilizes a coregistered magnetic resonance image (MRI) to characterize the vascular region of interest (VROI). Both methods subsequently assign a common value to each pixel in the VROI for the control scan and the activation scan. To study the vascular artifact and to demonstrate the ability of the proposed methods correcting the vascular artifact, four dynamic PET scans were performed in a single subject during the same behavioral state. For each of the four scans, a vascular scan containing vascular activity was computed as the summation of the images acquired 0--60 s after radiotracer administrations, and a control scan containing minimal vascular activity was computed as the summation of the images acquired 20--80 s after radiotracer administration. t-score maps calculated from the four pairs of vascular and control scans were used to characterize regional blood flow differences related to vascular activity before and after the applications of each vascular artifact correction method. Both methods eliminated the observed differences in vascular activity, as well as the vascular artifact observed in the anteromedial temporal lobes. Using PET data from a study of normal human emotion, these methods permitted us to identify rCBF increases in the anteromedial temporal lobe free from the potentially confounding, combined effects of vascular activity and partial-volume averaging

  8. Chronic Posttraumatic Dislocation of Radial Head With Ulnar Nerve Entrapment in a Child: A Case Report and Literature Review.

    Science.gov (United States)

    Cai, Jiangyu; Wang, Wei; Yu, Shiyang; Yan, Hede; Zhan, Yulin; Fan, Cunyi

    2016-06-01

    We present an unusual case of chronic posttraumatic anteromedial dislocation of radial head with direct ulnar nerve entrapment in a child. Ulnar nerve decompression, open reduction of the radial head, and annular ligament reconstruction using a palmaris longus tendon graft were performed, and a satisfactory functional outcome was achieved at the 15-month follow-up. Through a review of literature, we conclude that early diagnosis and management for radial head dislocation are recommended to avoid nerve symptoms. Besides, open reduction and annular ligament reconstruction with a palmaris longus tendon graft would be an alternative surgery during chronic phase. PMID:27171922

  9. Reconstrução anatômica do LCA com duplo feixe: primeiros 40 casos Anatomical ACL reconstruction with double bundle: first 40 cases

    OpenAIRE

    Ari Zekcer; Ricardo Soares da Silva; Mario Carneiro Filho

    2011-01-01

    OBJETIVO: Discutir a técnica de reconstrução anatômica do ligamento cruzado anterior (LCA) com duplo feixe, a curva de aprendizado e os resultados preliminares. MÉTODOS: Quarenta pacientes com lesão do LCA foram submetidos à reconstrução anatômica com duplo feixe, utilizando-se do tendão semitendinoso para refazer a banda anteromedial (AM) e gracilis para refazer a banda posterolateral (PL) do joelho. RESULTADOS: Tivemos dois casos de limitação de extensão, sendo que em um deles foi necessári...

  10. Study of supracondylar process of humerus

    Directory of Open Access Journals (Sweden)

    Ravi Vandana

    2014-01-01

    Full Text Available The supra condylar process is occasional beak like projection from anteromedial surface of distal 1/3 rd of humerus. It appears to be phylogenetic remnant of complete osseous bridge found in reptiles, marsupials, cats, lemurs and new world monkeys. Among 133 dried humeri studied only one right humerus showed SCP (incidence 0.75% whose dimensions were recorded and photographed. SCP is usually clinically silent but can be the cause for median or ulnar nerve and brachial artery compression syndrome especially when associated with Struthers ligament. Therefore the knowledge of presence of SCP is important for clinicians and radiologists along with anatomists and anthropologists.

  11. Non-Hodgkin’s lymphoma: unexpected cause of shoulder pain. A systematic review of the literature

    OpenAIRE

    Caporale, Manlio Fabio; Gambino, Giovanni Francesco; Larosa, Fabio Saverio; Del Buono, Angelo; Di Segni, Federico

    2013-01-01

    The non-Hodgkin lymphoma (NHL) is one of the most common shoulder neoplasms, especially the diffuse large B cell lymphoma (DLBCL). We report a rare case of shoulder pain in a 80-year-old man presenting with a six-month history of continuous severe pain to the right shoulder. Routine laboratory studies were normal. Shoulder MRI showed an in-growing inhomogeneous lesion in the anteromedial aspect of the right humeral head extended within the cortical bone of the humerus (osteolitic lesion), nex...

  12. O comprimento dos túneis femorais varia com a flexão do joelho na reconstrução anatômica do ligamento cruzado anterior Femoral tunnels' length changes with knee flexion angle in anatomical anterior cruciate ligament reconstruction

    OpenAIRE

    Julio Cesar Gali; Heetor Campora de Sousa Oliveira; Bruno Asprino Ciâncio; Marcos Vianna Palma; Ricardo Kobayashi; Edie Benedito Caetano

    2012-01-01

    OBJETIVO: O propósito de nosso trabalho foi avaliar o efeito que o grau de flexão do joelho, durante a perfuração dos túneis femorais, pode causar no comprimento desses túneis, na reconstrução anatômica do ligamento cruzado anterior. MÉTODOS: Medimos o comprimento dos túneis femorais anteromedial e posterolateral do ligamento cruzado anterior, em 20 peças anatômicas de joelhos desemparelhadas, 10 direitas e 10 esquerdas, todas com a cartilagem e ligamentos cruzados íntegros. Os túneis foram p...

  13. Propeller Flap Reconstruction in Post Oncological Thigh Defect: "The Move in Flap".

    Science.gov (United States)

    Nambi, G I; Salunke, Abhijeet Ashok

    2015-06-01

    Reconstruction of soft tissue defects of the limb after tumor resection is challenging question for oncosurgeons. The management differs from reconstruction of post traumatic defects due to the complexity of the primary surgery and subsequent radiation. The conventional propeller flap is based on a perforator which is located close to the defect; but in present case the perforator was located far away from the defect. So we describe it as "Move in flap" as the flap rotated a large volume of soft tissue lying between the defect and the perforator. We present a case of post oncological thigh defect with reconstruction using a propeller flap based on distal anteromedial perforator. PMID:26405422

  14. Response properties of cat AMLS neurons to optic flow stimuli

    Institute of Scientific and Technical Information of China (English)

    LI; Baowang(李宝旺); LI; Bing(李兵); CHEN; Hui(陈辉); XU; Ying(徐颖); DIAO; Yuncheng(刁云程)

    2002-01-01

    Spiral and translation stimuli were used to investigate the response properties of cat AMLS (anteromedial lateral suprasylvian area) neurons to optic flow. The overwhelming majority of cells could be significantly excited by the two modes of stimuli and most responsive cells displayed obvious direction selectivity. It is the first time to find a visual area in mammalian brain preferring rotation stimuli. Two representative hypotheses are discussed here on the neural mechanism of optic flow analysis in visual cortex, and some new viewpoints are proposed to explain the experimental results.

  15. NEURAL TUBE DEFECTS PREVALENCE IN A HOSPITAL-BASED STUDY IN URMIA

    Directory of Open Access Journals (Sweden)

    I. Abdi Rad

    2008-10-01

    Full Text Available AbstractObjectiveNeural tube defects including anencephaly, encephalocele, and spina bifida are major congenital malformations with multifactorial etiology, and with a great variation in their prevalence in different populations. The study on the prevalence of these malformations may be helpful in planning strategies for their prevention. The aim of this epidemiologic descriptive study was to determine the prevalence of neural tube defects and to describe their birth characteristics in Motahhari hospital, Urmia, West Azerbaijan.Materials and MethodsA cross-section observational study was carried on the hospital-based charts of consecutive 13997 live-births and 124 stillbirths during the period January 2001 through June 2005. The defects categorized based on the domains of anencephaly, spina bifida, and encephalocele according to standard definitions.ResultsDuring this period, 117 cases were detected with neural tube defects, giving an overall  prevalence of 8.29/1000. Of 117 cases, 81 (69.23% cases were seen among stillbirths and 36 (30.77% cases among live-births, that is, the prevalence of neural tube defects for stillbirths and live-births were 653.2/1000 and 2.57/1000 respectively. The yearly prevalence varies between 6.99/1000 and 9.82/1000 over the 4.5-year period. The major lesion was  anencephaly with prevalence of 5.52/1000 (66.67% of all neural tube defects. Approximately, two-thirds (66.09% of cases were found in females. Weights of 73.36% of anencephalic cases wereless than 1000 grams.ConclusionIn this study, the prevalence of neural tube defects is among the highest reported rates. There was a significance difference in the prevalence of anencephaly, as the most prevalent NTD, between live-births and stillbirths. These findings may necessitate an intensive approach to periconceptional folic acid supplementation as a possible strategy to reduce the prevalence of these defects. Keywords: Prevalence, Neural Tube Defects, Anencephaly

  16. Identification and description of the axillary web syndrome (AWS) by clinical signs, MRI and US imaging.

    Science.gov (United States)

    Leduc, O; Fumière, E; Banse, S; Vandervorst, C; Clément, A; Parijs, T; Wilputte, F; Maquerlot, F; Ezquer Echandia, M; Tinlot, A; Leduc, A

    2014-12-01

    The Axillary Web Syndrome (AWS) follows surgery for breast neoplasia and consists of one, or more frequently two or three, cords of subcutaneous tissue. Cords originate from the axilla, spread to the antero-medial surface of the arm down to the elbow and then move into the antero-medial aspect of the forearm and sometimes into the root of the thumb. The purpose of this study was to compare two techniques, ultrasound (US) and Magnetic Resonance Imaging (MRI) for their sensitivity and accuracy in identifying AWS cords and to provide insights to the origin of this pathology. US examinations were performed on fifteen patients using a high frequency probe (17 MHz). We first palpated and marked the cord with location aided by maximum abduction. To identify the cord with MRI (1.5 Tesla), a catheter filled with a gel detectable under MRI was placed on the skin at the site of the cord. We found that in some US cases, the dynamic abduction maneuver was essential to facilitate detection of the cord. This dynamic method on ultrasound confirmed the precise location of the cord even if it was located deeper in the hypodermis fascia junction. US and MRI images revealed features of the cords and surrounding tissues. Imaging the cords was difficult with either of the imaging modalities. However, US seemed to be more efficient than MRI and allowed dynamic evaluation. Overall analysis of our study results supports a lymphatic origin of the AWS cord. PMID:25915977

  17. Double-bundle depiction of the anterior cruciate ligament at 3 Tesla

    International Nuclear Information System (INIS)

    Magnetic resonance imaging on 3 Tesla (3T MRI) with arthroscopic correlation has proven to adequately identify the anteromedial bundle (AMB) and posterolateral bundle (PLB) in cadaver knees. The purpose of this study was to describe the depiction of ACL bundle anatomy on 3T MRI in daily practice. In a retrospective cohort study, we included 50 consecutive patients who underwent standard 3T MRI of the knee and had an intact ACL. Two musculoskeletal radiologists independently reviewed all scans for depiction of ACL bundle anatomy using standardized forms. Descriptive statistics were used. Twenty-three right knees (46%) and 27 left knees (54%) were included in the study. Mean age of the patients was 35 years (range 12 to 68 years); 37 patients were male (74%). ACL bundle anatomy was best depicted in the axial plane in 44 knees (88%) and in the coronal plane in six knees (12%). Two bundles were seen in 47 knees (94%). The AMB was completely seen in 45 knees (90%). The PLB was completely seen in 40 knees (80%). Both bundles were completely seen in 37 knees (76%). The double-bundle anatomy of the ACL is visualized in 94% of patients on 3T MRI. Because of potentially associated clinical benefits, we advocate to report separately on the anteromedial bundle and posterolateral bundle in case of anterior cruciate ligament injury of the knee. (orig.)

  18. Median nerve SEP after a high medullary lesion: preserved N18 and absent P14 components (case report PESS do nervo mediano após lesão bulbar alta: componente N18 preservado e P14 ausente. Relato de caso

    Directory of Open Access Journals (Sweden)

    G. M. MANZANO

    1999-06-01

    Full Text Available Median nerve SEPs recorded from a patient with a high medullary lesion are described. The lesion involved the anteromedial and anterolateral right upper third of the medulla, as documented by MRI. Forty one days after the lesion, left median nerve SEP showed preserved N18 and absent P14 and N20 components; stimulation of the right median nerve evoked normal responses. These findings agree with the proposition that low medullary levels are involved in the generation of the N18 component of the median nerve SEP.Descrevemos os potenciais evocados somatossensitivos obtidos por estimulação dos nervos medianos em um paciente apresentando uma lesão localizada, envolvendo as porções anteromedial e anterolateral do terço superior do bulbo, documentada por ressonância nuclear magnética. Quarenta e um dias após o estabelecimento da lesão os potenciais evocados por estimulação do nervo mediano esquerdo evidenciaram ausência dos componentes P14 e N20 e preservação do componente N18; após estimulação do nervo mediano direito as respostas apresentaram-se normais. Estes achados estão de acordo com a sugestão de que as porções baixas do bulbo estão envolvidas na geração do componente N18.

  19. Temporal pole signal abnormality on MR imaging in temporal lobe epilepsy with hippocampal sclerosis: a fluid-attenuated inversion-recovery study

    International Nuclear Information System (INIS)

    Objective: To determine the frequency and regional involvement of temporal pole signal abnormality (TPA) in patients with hippocampal sclerosis (HS) using fluid-attenuated inversion-recovery (FLAIR) MR imaging, and to correlate this feature with history. Method: Coronal FLAIR images of the temporal pole were assessed in 120 patients with HS and in 30 normal subjects, to evaluate gray-white matter demarcation. Results: Ninety (75%) of 120 patients had associated TPA. The HS side made difference regarding the presence of TPA, with a left side prevalence (p=0.04, χ2 test). The anteromedial zone of temporal pole was affected in 27 (30%) out of 90 patients. In 63 (70%) patients the lateral zone were also affected. Patients with TPA were younger at seizure onset (p=0.018), but without association with duration of epilepsy. Conclusion: Our FLAIR study show temporal pole signal abnormality in 3/4 of patients with HS, mainly seen on the anteromedial region, with a larger prevalence when the left hippocampus was involved. (author)

  20. Temporal pole signal abnormality on MR imaging in temporal lobe epilepsy with hippocampal sclerosis: a fluid-attenuated inversion-recovery study; Anormalidade de sinal na imagem por RM do polo temporal na epilepsia do lobo temporal com esclerose hipocampal: um estudo pela sequencia inversao recuperacao com supressao da agua livre (FLAIR)

    Energy Technology Data Exchange (ETDEWEB)

    Carrete Junior, Henrique; Abdala, Nitamar; Szjenfeld, Jacob; Nogueira, Roberto Gomes [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem; Lin, Katia; Caboclo, Luis Otavio; Centeno, Ricardo Silva; Sakamoto, Americo Ceiki; Yacubian, Elza Marcia Targas [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Neurologia e Neurocirurgia

    2007-09-15

    Objective: To determine the frequency and regional involvement of temporal pole signal abnormality (TPA) in patients with hippocampal sclerosis (HS) using fluid-attenuated inversion-recovery (FLAIR) MR imaging, and to correlate this feature with history. Method: Coronal FLAIR images of the temporal pole were assessed in 120 patients with HS and in 30 normal subjects, to evaluate gray-white matter demarcation. Results: Ninety (75%) of 120 patients had associated TPA. The HS side made difference regarding the presence of TPA, with a left side prevalence (p=0.04, {chi}{sup 2} test). The anteromedial zone of temporal pole was affected in 27 (30%) out of 90 patients. In 63 (70%) patients the lateral zone were also affected. Patients with TPA were younger at seizure onset (p=0.018), but without association with duration of epilepsy. Conclusion: Our FLAIR study show temporal pole signal abnormality in 3/4 of patients with HS, mainly seen on the anteromedial region, with a larger prevalence when the left hippocampus was involved. (author)

  1. Double-bundle depiction of the anterior cruciate ligament at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Adriaensen, M.E.A.P.M. [Atrium Medical Center Parkstad, Department of Radiology, Heerlen (Netherlands); Hogan, B. [Sports Surgery Clinic, Department of Radiology, Dublin (Ireland); Al-Bulushi, H.I.J. [Armed Forces Hospital, Department of Radiology, Muscat (Oman); Kavanagh, E.C. [Mater Misericordiae Hospital, Department of Radiology, Dublin (Ireland)

    2012-07-15

    Magnetic resonance imaging on 3 Tesla (3T MRI) with arthroscopic correlation has proven to adequately identify the anteromedial bundle (AMB) and posterolateral bundle (PLB) in cadaver knees. The purpose of this study was to describe the depiction of ACL bundle anatomy on 3T MRI in daily practice. In a retrospective cohort study, we included 50 consecutive patients who underwent standard 3T MRI of the knee and had an intact ACL. Two musculoskeletal radiologists independently reviewed all scans for depiction of ACL bundle anatomy using standardized forms. Descriptive statistics were used. Twenty-three right knees (46%) and 27 left knees (54%) were included in the study. Mean age of the patients was 35 years (range 12 to 68 years); 37 patients were male (74%). ACL bundle anatomy was best depicted in the axial plane in 44 knees (88%) and in the coronal plane in six knees (12%). Two bundles were seen in 47 knees (94%). The AMB was completely seen in 45 knees (90%). The PLB was completely seen in 40 knees (80%). Both bundles were completely seen in 37 knees (76%). The double-bundle anatomy of the ACL is visualized in 94% of patients on 3T MRI. Because of potentially associated clinical benefits, we advocate to report separately on the anteromedial bundle and posterolateral bundle in case of anterior cruciate ligament injury of the knee. (orig.)

  2. Double bundle arthroscopic Anterior Cruciate Ligament reconstruction with remnant preserving technique using a hamstring autograft

    Directory of Open Access Journals (Sweden)

    Ochi Mitsuo

    2011-12-01

    Full Text Available Abstract Background Preservation of the Anterior Cruciate Ligament (ACL remnant is important from the biological point of view as it enhances revascularization, and preserves the proprioceptive function of the graft construct. Additionally, it may have a useful biomechanical function. Double bundle ACL reconstruction has been shown to better replicate the native ACL anatomy and results in better restoration of the rotational stability than single bundle reconstruction. Methods We used the far anteromedial (FAM portal for creation of the femoral tunnels, with a special technique for its preoperative localization using three dimensional (3D CT. The central anteromedial (AM portal was used to make a longitudinal slit in the ACL remnant to allow visualization of the tips of the guide pins during anatomical creation of the tibial tunnels within the native ACL tibial foot print. The use of curved hemostat allow retrieval of the wire loop from the apertures of the femoral tunnels through the longitudinal slit in the ACL remnant thereby, guarding against impingement of the reconstruction graft against the ACL remnant as well as the roof of the intercondylar notch. Conclusion Our technique allows for anatomical double bundle reconstruction of the ACL while maximally preserving the ACL remnant without the use of intra-operative image intensifier.

  3. Three new species of Protogyrodactylus Johnston & Tiegs, 1922 (Monogenoidea: Dactylogyridae) from the gills of the longtail silverbiddy Gerres longirostris (Teleostei: Gerreidae) in the Red Sea.

    Science.gov (United States)

    Galli, Paolo; Kritsky, Delane C

    2008-03-01

    Twenty-one specimens of the longtailed silverbiddy Gerres longirostris (Gerreidae) were examined for dactylogyrid parasites from the Nabq Managed Resource Protected Area, Ras Mohammed National Park (Red Sea) near Sharm El-Sheikh, South Sinai, Egypt. The diagnosis of Protogyrodactylus Johnston & Tiegs, 1922 was amended, and three new species, P. federicae n. sp., P. zullinii n. sp. and P. alatus n. sp., were recovered and described; the prevalence of each species was 100%. P. federicae most closely resembled P. alienus Bychowsky & Nagibina, 1974, but differed from it by possessing two anteromedial projections on the ventral bar, a claw-like ventral anchor sclerite and spatulate dorsal bars. P. zullini was most similar to P. quadratus Johnston & Tiegs, 1922, from which it differed by having a distal hook on the superficial root of the dorsal anchor, an evenly curved ventral anchor shaft and point, and a flange on the bulbous base of the male copulatory organ. P. alatus was closest to P. youngi Bychowsky & Nagibina, 1974, from which it differed by having delicate anchors and two prominent anteromedial processes on the ventral bar. PMID:18210221

  4. 前交叉韧带斜冠状面薄层解剖断面与MRI表现对照研究%The comparative study of the anterior cruciate ligament in oblique coronal thin anatomical section and MRI

    Institute of Scientific and Technical Information of China (English)

    陈伟; 陆明; 王健; 丁仕义; 杨柳; 王晓宇; 文亚名; 邱明国

    2008-01-01

    Objective To compare the normal anatomy of the anterior cruciate ligament (ACL) of fresh frozen cadaveric knee specimen in oblique coronal thin-slice section with oblique coronal magnetic resonance imaging. Methods One fresh cadaveric knee specimen was scanned with MR T1-weighted spinecho sequence.then the specimen was frozen and sliced with a band saw along the oblique coronal plane into 1.0-mm-thick sections that corresponded to the MR images,MR images including oblique coronal T1-weighted and T2-weighted images of 50 normal the knee joints were retrospectively reviewed to observe the MR imaging features of the cruciate ligament. Results Anteromedial and posterolateral bundles of ACL were clearly depicted on both anatomic slices and MR images.The anteromedial bundles originated from the posteromedial aspect of the lateral femoral condyle,coursing through the lateral intercondylar notch in an anterior,inferior,and medial direction,and inserted on the anteromedial aspect of the intercondylar eminence. The posterolateral bundles originated from the anteromedial aspect of the lateral femoral condyle,passing laterally and inferiorly through the lateral intercondylar notch,and inserted on the posterolateral side of the intercondylar eminence.The full length of ACL of all 50 individuals was showed on MR images.MRI clearly differenitated the anteromedial and posterolateral bundles of ACL and depicted the full length of the bundles.similar to the findings on sectional anatomy.Conclusion Oblique coronal MR imaging is the best way to demonstrate ACL and should be used for clinically suspected injury of ACL.%目的 对冰冻膝关节前交叉韧带(ACL)斜冠状面薄层解剖断面与正常人膝关节MRI特点进行对照研究,为ACL损伤分级诊断建立基础.方法 1例(1只)膝关节标本行斜冠状面MRI确定角度,冰冻后沿斜冠状面1 mm层厚铣切,观察ACL薄层解剖特点.选择50名正常人对其ACL进行MR斜冠状

  5. Intracranial sonography in infancy.

    Science.gov (United States)

    Harmat, G

    1985-01-01

    Neonates and older infants were subjected to sonography through the anterior fontanelle with grey-scale compound scanner. The patients were referred to us from neurosurgery or showed clinical symptoms of perinatal CNS damage (ventricular or intracerebral haemorrhage, subdural effusion, etc.) or malformations (meningomyelocele, encephalocele, cystic brain, cerebral dysgenesis, etc.). Sonography is the simplest non-invasive diagnostic method to exclude suspected hydrocephalus in cases of macrocephalus, or when the head of premature infants grows more rapidly than the rest of the body. When screening showed alterations, sonography was performed weekly or fortnightly according to the extent of deviation from the normal. In cases of progressive hydrocephalus, when shunt surgery was indicated, ultrasound was used to monitor the operation of the shunt. In early age, ultrasound is a tool equal in value to CT, but is far less expensive and the examination can safely be repeated at any time. PMID:3885973

  6. NASOPHARYNGEAL BRANCHIAL CYST CAUSING STRIDOR IN NEONATE: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Jaskaran Singh

    2014-05-01

    Full Text Available Neonates may present with various causes of stridor. Nasopharyngeal cysts are rare congenital lesions causing difficulty in breathing. Differential diagnosis of nasopharyngeal cysts include thornwalds cyst, rathke cleft and craniopharyngioma, teratoma, epidemoid cysts, dermoid cyst, nasopharyngeal encephalocele, infected cyst and branchial cyst. Though branchial cysts are very rarely present in nasopharynx, they are easy to diagnose on MRI and fall under the category of preventable causes of neonatal stridor. Their surgical excision is the treatment of choice but sometimes owing to the other prematurities present the neonate period is not always the best time to operate. We report a case of a newborn child with nasopharyngeal branchial cyst presenting with stridor and managed conservatively with aspiration

  7. Epidemiologic study of neural tube defects in Los Angeles County. I. Prevalence at birth based on multiple sources of case ascertainment

    Energy Technology Data Exchange (ETDEWEB)

    Sever, L.E. (Pacific Northwest Lab., Richland, WA); Sanders, M.; Monsen, R.

    1982-01-01

    Epidemiologic studies of the neural tube defects (NTDs), anencephalus and spina bifida, have for the most part been based on single sources of case ascertainment in past studies. The present investigation attempts total ascertainment of NTD cases in the newborn population of Los Angeles County residents for the period 1966 to 1972. Design of the study, sources of data, and estimates of prevalence rates based on single and multiple sources of case ascertainment are here discussed. Anencephalus cases totaled 448, spina bifida 442, and encephalocele 72, giving prevalence rates of 0.52, 0.51, and 0.08 per 1000 total births, respectively, for these neural tube defects - rates considered to be low. The Los Angeles County prevalence rates are compared with those of other recent North American studies and support is provided for earlier suggestions of low rates on the West Coast.

  8. Frecuencia de los defectos del tubo neural en Asturias: impacto del diagnóstico prenatal Prevalence of neural tube defects in Asturias (Spain: impact of prenatal diagnosis

    Directory of Open Access Journals (Sweden)

    Enrique García López

    2009-12-01

    Full Text Available Objetivo Describir la frecuencia de defectos del tubo neural (DTN -anencefalia, espina bífida y encefalocele-en Asturias, su evolución temporal y el impacto del diagnóstico prenatal. Métodos: Se estudiaron los casos de DTN en nacidos y abortos inducidos durante el período 1990-2004, utilizando la base de datos del Registro de Defectos Congénitos de Asturias, de base poblacional. Se calcularon las tasas de prevalencia total y al nacimiento. Resultados: La prevalencia total de DTN fue de 12,2 casos por 10.000 nacidos (5,9 anencefalias, 5,0 espinas bífidas y 1,3 encefaloceles y mostró una tendencia ligeramente descendente, con un descenso significativo de la espina bífida, mientras que las cifras de anencefalia y encefalocele se mantuvieron estables. Finalizaron en aborto inducido tras el diagnóstico prenatal el 88% de los casos (anencefalia 96,7%; espina bífida 80%; encefalocele 84,6%, lo que determinó una prevalencia al nacimiento muy baja (1,4 DTN por 10.000 nacidos. Conclusiones: En Asturias, en los últimos 15 años se ha producido un descenso selectivo en la prevalencia total de espina bífida de causa no aclarada. La prevención secundaria, mediante los programas de diagnóstico prenatal y la consiguiente interrupción del embarazo, fue el motivo del marcado descenso de la frecuencia en los nacidos; la simple recomendación de suplementación periconcepcional con ácido fólico no parece haber logrado el efecto buscado.Objective: To describe the frequency and prevalence trend for neural tube defects (NTD (anencephaly, spina bifida and encephalocele in Asturias (Spain, as well as the impact of prenatal diagnosis programs. Methods: All cases of NTD in births and induced abortions were studied, using data from the Registry of Congenital Defects of Asturias for 1990-2004. Total and birth prevalence rates were calculated. Results: The prevalence of NTD for 1990-2004 was 12.2 per 10,000 births (5.9 anencephaly, 5.0 spina bifida and 1

  9. Optimal serum and red blood cell folate concentrations in women of reproductive age for prevention of neural tube defects: World Health Organization guidelines.

    Science.gov (United States)

    Cordero, Amy M; Crider, Krista S; Rogers, Lisa M; Cannon, Michael J; Berry, R J

    2015-04-24

    Neural tube defects (NTDs) such as spina bifida, anencephaly, and encephalocele are serious birth defects of the brain and spine that occur during the first month of pregnancy when the neural tube fails to close completely. Randomized controlled trials and observational studies have shown that adequate daily consumption of folic acid before and during early pregnancy considerably reduces the risk for NTDs. The U.S. Public Health Service recommends that women capable of becoming pregnant consume 400 µg of folic acid daily for NTD prevention. Furthermore, fortification of staple foods (e.g., wheat flour) with folic acid has decreased folate-sensitive NTD prevalence in multiple settings and is a highly cost-effective intervention. PMID:25905896

  10. Recurrent Posttraumatic Meningitis due to Nontypable Haemophilus influenzae: Case Report and Review of the Literature

    DEFF Research Database (Denmark)

    Kunze, W; Müller, L; Kilian, Mogens;

    2007-01-01

    We report a case of relapsing Haemophilus influenzae meningitis in a boy at the age of nearly 3 years and 4.2 years who had been successfully vaccinated against H. influenzae serotype b (Hib). The pathogen was a nonencapsulated (nontypable) H. influenzae strain of biotypes III and VI, respectively......-shunts, implants and traumas are often found. To obtain further information on potential new disease patterns H. influenzae isolates from cerebrospinal fluid should be examined for capsule production and, if relevant, further characterized by capsular typing........ A rhinobasal impalement injury with development of a posttraumatic encephalocele is considered to be the predisposing condition. Review of the literature reveals that in patients systemically infected by nonencapsulated H. influenzae strains predisposing factors such as cerebrospinal fluid...

  11. Tecto-Cerebellar Dysraphia Manifesting as Occipital Meningocoele Associated with Congenital Melanocytic Nevi and Pectus Excavatum

    Directory of Open Access Journals (Sweden)

    Amit Agrawal

    2010-03-01

    Full Text Available Background: Only few reported cases of tectocerebellar dysraphia with occipital encephalocele have been reported in the literature. Case Presentation: Three month baby boy, the first child of healthy, consanguineous parents presented with a small swelling over the occipital region since birth. The child also used to have apneic spells without cyanosis and spontaneous recovery. CT scan showed absence of the cerebellar vermis, absence of tectum and the 4th ventricle communicating with the occipital menigocoele sac and an occipital bone defect. The excision of the encephalocoele sac was performed, however the child continued to have apneic spells and did not do well.Conclusion:In our child irregular respiration probably was the manifestation of the tecto-cerebellar dysraphia syndrome complex and associated shunt malfunction followed by seizures decompensated the physiology of the child leading to fatal outcome.

  12. Application of inferior major bone flap craniotomy decompression in brain injury

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To summarize the application of inferior major boneflap craniotomy decompression in brain injury operation.Methods: A retrospective analysis was done in 218 cases with brain injuries who were admitted to our department from January 1995 to December 1999 and treated with the inferior major bone flap craniotomy decompression.Results: Of 218 cases, 121 cases (55.50%) were cured according to GOS, 39 (18.30%) were with good recovery or moderate disability, 13 (5.60%) with severe deformity, 3 (1.40%) vegetative life, the rest 42 (19.20%) died after operation; no encephalocele or incarceration were found.Conclusions: The inferior major bone flap craniotomy decompression can remove hematoma timely and completely, is better than general craniotomy decompression and has a positive effect on brain injuries especially when bone flap is small.

  13. Risk factors, organ weight deviation and associated anomalies in neural tube defects: A prospective fetal and perinatal autopsy series

    Directory of Open Access Journals (Sweden)

    Asaranti Kar

    2015-01-01

    Full Text Available Introduction: Neural tube defects (NTD are a group of serious birth defects occurring due to defective closure of neural tube during embryonic development. It comprises of anencephaly, encephalocele and spina bifida. We conducted this prospective fetal autopsy series to study the rate and distribution of NTD, analyze the reproductive factors and risk factors, note any associated anomalies and evaluate the organ weights and their deviation from normal. Materials and Methods: This was a prospective study done over a period of 6 years from August, 2007 to July, 2013. All cases of NTDs delivered as abortion, still born and live born were included. The reproductive and risk factors like age, parity, multiple births, previous miscarriage, obesity, diabetes mellitus, socioeconomic status and use of folic acid during pregnancy were collected.Autopsy was performed according to Virchow′s technique. Detail external and internal examination were carried out to detect any associated anomalies. Gross and microscopic examination of organs were done. Results: Out of 210 cases of fetal and perinatal autopsy done, 72 (34.28% had NTD constituting 49 cases of anencephaly, 16 spina bifida and 7 cases of encephalocele. The mothers in these cases predominantly were within 25-29 years (P = 0.02 and primy (P = 0.01. Female sex was more commonly affected than males (M:F = 25:47, P = 0.0005 There was no history of folate use in majority of cases. Organ weight deviations were >2 standard deviation low in most of the cases. Most common associated anomalies were adrenal hypoplasia and thymic hyperplasia. Conclusion: The authors have made an attempt to study NTD cases in respect to maternal reproductive and risk factors and their association with NTD along with the organ weight deviation and associated anomalies. This so far in our knowledge is an innovative study which was not found in literature even after extensive search.

  14. Diagnosis, treatment and long-term outcome in fetal hydrocephalus

    International Nuclear Information System (INIS)

    The objective of this study was to evaluate the method of prenatally estimating an appropriate clinical outcome in fetal hydrocephalus. Retrospective study, single institute (Osaka National Hospital). Hundred and seventeen cases with fetal hydrocephalus treated at Osaka National Hospital from 1992 to 2010 were analysed. Of the 117 cases analysed, 38% are diagnosed as isolated ventriculomegaly (IVM), 51% as other types of malformation (30 cases of myelomeningocele, 4 cases of holoprosencephaly, 4 of Dandy Walker syndrome, 10 of arachnoid cyst and 6 of encephalocele etc.) and 11% as secondary hydrocephalus. They are diagnosed between 17 and 40 weeks of gestation (average 27 weeks), 17% diagnosed between 17 and 21 weeks, 30% between 22 and 27 weeks and 53% after 28 weeks. With the exception of 9 aborted cases and 30 unknown cases too young to be evaluated or lost due to lack of follow-up, final outcome was analyzed in 78 cases. Of these 78 cases, 15% died in utero or after birth, 23% showed severe retardation, 17% moderate retardation, 26% mild retardation, and 19% showed good outcome. Long term consequences were mostly influenced by basic disease and accompanied anomalies. Hydrocephalus associated with arachnoid cyst, atresia of Monro, corpus callosum agenesis and hydrocephalus due to fetal intracranial hemorrhage are categorized in the good outcome group. On the other hand, holoprosencephaly, hydrocephalus associated with encephalocele, syndromic hydrocephalus and hydrocephalus due to fetal virus infection are categorized in the poor outcome group. In order to accurate diagnosis and proper counseling, establishment of diagnosis protocol and treatment policy for fetal hydrocephalus including not only fetal sonography, fetal MRI, toxoplasma, rubella, cytomegalovirus, herpes simplex (TORCH) screening test but also chromosomal and gene testing is required. (author)

  15. Posterolateral dislocation of the knee: Recognizing an uncommon entity.

    Science.gov (United States)

    Woon, Colin Yl; Hutchinson, Mark R

    2016-06-18

    Posterolateral dislocations of the knee are rare injuries. Early recognition and emergent open reduction is crucial. A 48-year-old Caucasian male presented with right knee pain and limb swelling 3 d after sustaining a twisting injury in the bathroom. Examination revealed the pathognomonic anteromedial "pucker" sign. Ankle-brachial indices were greater than 1.0 and symmetrical. Radiographs showed a posterolateral dislocation of the right knee. He underwent emergency open reduction without an attempt at closed reduction. Attempts at closed reduction of posterolateral dislocations of the knee are usually impossible because of incarceration of medial soft tissue in the intercondylar notch and may only to delay surgical management and increase the risk of skin necrosis. Magnetic resonance imaging is not crucial in the preoperative period and can lead to delays of up to 24 h. Instead, open reduction should be performed once vascular compromise is excluded. PMID:27335816

  16. ELONGATED STYLOID PROCESS: A REPORT OF TWO CADAVERIC CASES

    Directory of Open Access Journals (Sweden)

    Komala Nanjundaiah

    2014-06-01

    Full Text Available Introduction: Styloid process is a part of temporal bone. It measures 2 to 3 cms in length and lies antero-medial to the mastoid process. An elongated styloid process can compress the vital vessels and nerves close to it. This can lead to pain, foreign body sensation in the pharyngeal region and can also cause dysphagia. Observation: During routine dissection, we encountered elongated styloid process in two cadavers. In one it was unilateral and in another it was bilateral. The measurements of the elongated styloid process were taken using digital Vernier slide calipers. Conclusion: The awareness of the embryological cause and the clinical implications of an elongated styloid process are important for accurate diagnosis and treatment

  17. Marginal fractures of the medial tibial plateau: possible association with medial meniscal root tear

    International Nuclear Information System (INIS)

    We report two cases of marginal fractures of the medial tibial plateau associated with medial meniscal root tears. Both patients sustained knee dislocations, with complete tears of the posterior horn medial meniscal root. One sustained a ''reverse Segond fracture''; the other sustained an ''anteromedial impingement fracture'' of the tibial plateau. The meniscal root tears were arthroscopically confirmed and repaired. In the first patient, the integrity of the meniscal root repair was confirmed at a 6-month follow-up arthroscopy for lysis of adhesions. In the second patient, follow-up MRI at 10 months demonstrated a healed meniscal root. The association of medial meniscal root tear with marginal fractures of the medial tibial plateau has not been previously reported. (orig.)

  18. Longitudinal stress fracture: patterns of edema and the importance of the nutrient foramen

    Energy Technology Data Exchange (ETDEWEB)

    Craig, Joseph G.; Widman, David; Holsbeeck, Marnix van [Department of Radiology, Henry Ford Hospital, Detroit, MI 48202 (United States)

    2003-01-01

    We reviewed the MR appearances of six cases of longitudinal stress fracture of the lower extremity.Results. One fracture was in the femur and five were in the tibia. Four of the tibial fractures showed edema starting in the mid-tibia at the level of the nutrient foramen with the fracture on the anteromedial cortex. The other tibial fracture started at the nutrient foramen. Three fractures (two tibial and the femur fracture) showed eccentric marrow edema; all fractures showed either eccentric periosteal reaction or soft tissue edema.Conclusion. Primary diagnosis of longitudinal stress fracture is made by finding a vertical cleft on one or more axial images. Secondary signs of position of the nutrient foramen and patterns of edema may be useful. (orig.)

  19. Marginal fractures of the medial tibial plateau: possible association with medial meniscal root tear

    Energy Technology Data Exchange (ETDEWEB)

    Engelsohn, Eliyahu [Jacobi Medical Center, Department of Radiology, Bronx, NY (United States); Umans, Hilary [Jacobi Medical Center, Department of Radiology, Bronx, NY (United States); Jacobi Medical Center, Department of Orthopedic Surgery, Ardsley, NY (United States); DiFelice, Gregory S. [Jacobi Medical Center, Department of Orthopedic Surgery, Ardsley, NY (United States)

    2007-01-15

    We report two cases of marginal fractures of the medial tibial plateau associated with medial meniscal root tears. Both patients sustained knee dislocations, with complete tears of the posterior horn medial meniscal root. One sustained a ''reverse Segond fracture''; the other sustained an ''anteromedial impingement fracture'' of the tibial plateau. The meniscal root tears were arthroscopically confirmed and repaired. In the first patient, the integrity of the meniscal root repair was confirmed at a 6-month follow-up arthroscopy for lysis of adhesions. In the second patient, follow-up MRI at 10 months demonstrated a healed meniscal root. The association of medial meniscal root tear with marginal fractures of the medial tibial plateau has not been previously reported. (orig.)

  20. Longitudinal stress fracture: patterns of edema and the importance of the nutrient foramen

    International Nuclear Information System (INIS)

    We reviewed the MR appearances of six cases of longitudinal stress fracture of the lower extremity.Results. One fracture was in the femur and five were in the tibia. Four of the tibial fractures showed edema starting in the mid-tibia at the level of the nutrient foramen with the fracture on the anteromedial cortex. The other tibial fracture started at the nutrient foramen. Three fractures (two tibial and the femur fracture) showed eccentric marrow edema; all fractures showed either eccentric periosteal reaction or soft tissue edema.Conclusion. Primary diagnosis of longitudinal stress fracture is made by finding a vertical cleft on one or more axial images. Secondary signs of position of the nutrient foramen and patterns of edema may be useful. (orig.)

  1. Double free-flap for a bimalleolar defect of lower leg and ankle

    Directory of Open Access Journals (Sweden)

    Naren Shetty

    2016-01-01

    Full Text Available Double free-flaps are necessary when tissue cover cannot be sufficed with a single flap. The other factors to be considered when using two free flaps for resurfacing of distal limb defects are the availability of more than one recipient vessel, the risk of distal limb ischaemia and the donor site morbidity of double flap harvest. If these factors are adequately addressed, double free-flaps can be safely executed for resurfacing distal limb defects with minimal morbidity. We report the simultaneous harvest and transfer of the anterolateral and anteromedial thigh flaps inset and vascularised as double free-flaps to resurface a large bimalleolar defect in a 14-year-old boy with no additional morbidity as compared to that of a single free tissue transfer.

  2. Posterolateral dislocation of the knee: Recognizing an uncommon entity

    Science.gov (United States)

    Woon, Colin YL; Hutchinson, Mark R

    2016-01-01

    Posterolateral dislocations of the knee are rare injuries. Early recognition and emergent open reduction is crucial. A 48-year-old Caucasian male presented with right knee pain and limb swelling 3 d after sustaining a twisting injury in the bathroom. Examination revealed the pathognomonic anteromedial “pucker” sign. Ankle-brachial indices were greater than 1.0 and symmetrical. Radiographs showed a posterolateral dislocation of the right knee. He underwent emergency open reduction without an attempt at closed reduction. Attempts at closed reduction of posterolateral dislocations of the knee are usually impossible because of incarceration of medial soft tissue in the intercondylar notch and may only to delay surgical management and increase the risk of skin necrosis. Magnetic resonance imaging is not crucial in the preoperative period and can lead to delays of up to 24 h. Instead, open reduction should be performed once vascular compromise is excluded. PMID:27335816

  3. Old Disease…New Location…Surgeons Be Alerted

    Directory of Open Access Journals (Sweden)

    K. B. Ashok

    2011-04-01

    Full Text Available Echinococcus granulosus causes a zoonotic infection called Cystic Echinococcosis (CE. Surgeons meet with hydatid cysts of the liver and lungs with reasonable frequency. However hydatid cyst may appear in other parts of the body too.A 30 yrs old lady presented with a smooth slow-growing subcutaneous nodule on the anteromedial side of the right thigh with no detectable primary site in the liver or lung. The case subsequently diagnosed as hydatid cyst of muscle and radical surgery was done under coverage of anihelminthic drug.The common practice in this type of case is to do FNAC taking the lesion to be a soft tissue neoplasm. The aim of this case presentation is to make aware of the fact that in a case of diffuse non-tender swelling with history of gradual increase in size hydatid cyst also has to be considered in the differential diagnosis.

  4. Radiological evidence for the triple bundle anterior cruciate ligament.

    Science.gov (United States)

    MacKay, James W; Whitehead, Harry; Toms, Andoni P

    2014-10-01

    The anterior cruciate ligament (ACL) has traditionally been described as having two bundles--one anteromedial and one posterolateral. This has been challenged by studies proposing the existence of a third, intermediate, bundle with distinct functional significance, an arrangement that has been described in a number of domesticated animal species. No radiological evidence for the triple bundle ACL has previously been described. A prevalence study was carried out on 73 consecutive human knee magnetic resonance (MR) studies to determine the number of visible bundles, excluding individuals with a history of ACL injury or mucoid degeneration. A triple bundle ACL was demonstrated in 15 out of 73 human knees (20.5%, 95% confidence interval 12.9-31.2%). This is the first radiological description of the human triple bundle ACL. There was MR imaging evidence of a triple bundle ACL in approximately one fifth of human knees in this study. PMID:24890455

  5. Patellotibial contusions in anterior cruciate ligament tears.

    Science.gov (United States)

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

    2014-02-01

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

  6. Ankle impingement syndromes

    International Nuclear Information System (INIS)

    Soft-tissue and osseous impingement syndromes can be an important cause of chronic ankle pain, particularly in the professional athlete. The classification of ankle impingement syndromes is based to their anatomical location around the tibiotalar joint. The most important impingement syndromes are anterolateral, anterior and posterior impingement with more recent studies describing posteromedial and anteromedial impingement. Usually conventional radiography is the first imaging technique to be performed as it allows assessment of potential bone abnormalities, particularly in anterior and posterior joint compartments. Computed tomography (CT) only plays a role in the assessment of the posterior impingement. Magnetic resonance (MR) imaging is regarded as the modality of choice as it is able to demonstrate both osseous and soft tissue changes, such as bone marrow edema, capsular and ligametous thickening, and localized synovitis. (orig.)

  7. A STUDY OF SUPRACONDYLAR PROCESS OF HUMERUS

    Directory of Open Access Journals (Sweden)

    Prabahita

    2012-11-01

    Full Text Available ABSTRACT: BACKGROUND: Supracondylar process, in human, is a rare, anomalous, beak-like bony process on the anteromedial surface of the humerus. It represents the embryologic vestigial remnant of climbing animals and seen in many reptiles, most marsupials, cats, lemurs and American monkeys. Aim is to study the supracondylar process of humerus. MATERIALS AND METHODS: 80 adult dry humeri were collected from Anatomy Department, Gauha ti Medical College and were examined. RESULTS: Out of 80 humeri, we found one humerus of left sid e with a bony projection from antero- medial surface of its distal shaft. The bone was th en examined, studied, photographed and its dimensions were recorded. CONCLUSION: Knowledge of this variation may be of great importa nce to anatomists and anthropologists, because of possib le link to the origins and relations of the human races

  8. Fat collections related to the intrahepatic inferior vena cava: CT features

    International Nuclear Information System (INIS)

    Purpose: To evaluate fat collections related to inferior vena cava, their causes, and to make a review of the literature about these benign incidental findings. Materials and Methods: Two thousands and one hundred thoracoabdominal CT scans were performed between May 2000 and March 2001. We used a PQ 5000 spiral CT scanner. The studies were performed with and without contrast media. Results: We found three cases of fat collections related to inferior vena cava (IVC). They were located posteromedial and anteromedial to IVC. Conclusion: Fat collections related to the IVC are benign incidental findings. The knowledge with regards to these findings should preclude erroneous diagnosis of intracaval thrombus, intracaval lipomas or secondary extensions of tumors. (author)

  9. Orbital Chondroma: A rare mesenchymal tumor of orbit

    Directory of Open Access Journals (Sweden)

    Ruchi S Kabra

    2015-01-01

    Full Text Available While relatively common in the skeletal system, cartilaginous tumors are rarely seen originating from the orbit. Here, we report a rare case of an orbital chondroma. A 27-year-old male patient presented with a painless hard mass in the superonasal quadrant (SNQ of left orbit since 3 months. On examination, best-corrected visual acuity of both eyes was 20/20, with normal anterior and posterior segment with full movements of eyeballs and normal intraocular pressure. Computerized tomography scan revealed well defined soft tissue density lesion in SNQ of left orbit. Patient was operated for anteromedial orbitotomy under general anesthesia. Mass was excised intact and sent for histopathological examination (HPE. HPE report showed lobular aggregates of benign cartilaginous cells with mild atypia suggesting of benign cartilaginous tumor - chondroma. Very few cases of orbital chondroma have been reported in literature so far.

  10. An unusual case of sub-condylar bilateral fracture and bilateral post-traumatic temporomandibular ankylosis.

    Science.gov (United States)

    Matteini, C; Belli, E

    2001-01-01

    A case of bilateral sub-condylar fracture with wide stump dislocation associated with a central facial trauma, fracture-intrusion of the rhino-orbital-maxillary complex and a parasymphyseal mandibular fracture, is reported. After surgery and inter-maxillary fixation an unusual temporo-mandibular ankylosis developed. Maximum mouth opening, lateral and protrusive movements were severely limited. Surgical treatment of ankylosis was requested and performed. The originality of this case lies in the atypical lateral dislocation of condylar neck fractured stumps to the zygomatic arches and in the later appearance of ankylosis between the glenoid fossa, zygomatic arch, condylar neck stump, and the condylar process displaced anteromedially. The ankylosed blocks were resected, displaced condyles were also removed due to the strong adhesion with the ankylotic tissue and the lack of any anatomical continuity or connection with the glenoid fossa. Functional therapy allowed the resolution of the functional limitation. PMID:11723434

  11. MR Imaging of Ankle Impingement Syndromes

    Directory of Open Access Journals (Sweden)

    Seyed Hassan Mostafavi

    2010-05-01

    Full Text Available Ankle impingement syndromes are characterized by painful friction of joint tissues. This is both the cause and the effect of altered joint biomechanics. The leading causes of impingement lesions are posttraumatic ankle injuries, usually ankle sprains, resulting in chronic ankle pain. "nBased on anatomic and clinical viewpoints, there are five types of ankle impingement syndromes:"n1. Anterolateral"n2. Anterior"n3. Anteromedial"n4. Posteromedial"n5. Posterior"nCareful analyses of patient history and signs and symptoms at physical examination can suggest a specific diagnosis in most patients. MR imaging and MR arthrography are the most useful imaging methods for detecting the osseous and soft-tissue abnormalities present in these syndromes and for ruling out other potential causes of chronic ankle pain. "nThis presentation summarizes the MR imaging, and MR arthrography findings of ankle impingement syndromes.

  12. Ankle impingement syndromes; Impingement-Syndrome am Sprunggelenk

    Energy Technology Data Exchange (ETDEWEB)

    Eiber, Matthias; Woertler, Klaus [Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Roentgendiagnostik

    2010-06-15

    Soft-tissue and osseous impingement syndromes can be an important cause of chronic ankle pain, particularly in the professional athlete. The classification of ankle impingement syndromes is based to their anatomical location around the tibiotalar joint. The most important impingement syndromes are anterolateral, anterior and posterior impingement with more recent studies describing posteromedial and anteromedial impingement. Usually conventional radiography is the first imaging technique to be performed as it allows assessment of potential bone abnormalities, particularly in anterior and posterior joint compartments. Computed tomography (CT) only plays a role in the assessment of the posterior impingement. Magnetic resonance (MR) imaging is regarded as the modality of choice as it is able to demonstrate both osseous and soft tissue changes, such as bone marrow edema, capsular and ligametous thickening, and localized synovitis. (orig.)

  13. Neglected reverse Essex-Lopresti injury with ulnar nerve

    Directory of Open Access Journals (Sweden)

    Singh Ajay Pal

    2011-04-01

    Full Text Available 【Abstract】A 45 year old woman was diagnosed as having anteromedial radial head dislocation and distal radius fracture five months after her injury on right forearm. The radial head dislocation led to ulnar nerve compression. She had severe restriction of her elbow movements. She was treated with arthrolysis, decompression of the ulnar nerve and radial head resection. The reverse Essex Lopresti injury and radial head dislocation compressing the ulnar nerve has not been reported in English language literature to the best of our knowledge. A mechanism is proposed for the injury. In acute presentations, restoration of both the radioulnar joints should be done and neglected nature of such injury leads to suboptimal outcomes. Key words: Radius fracture; Unar nerve; Elbow joint

  14. Comparison of transtibial and transportal techniques in drilling femoral tunnels during anterior cruciate ligament reconstruction using 3D-CAD models

    Directory of Open Access Journals (Sweden)

    Tashiro Y

    2014-04-01

    Full Text Available Yasutaka Tashiro,1 Ken Okazaki,1 Munenori Uemura,2 Kazutaka Toyoda,2 Kanji Osaki,1 Hirokazu Matsubara,1 Makoto Hashizume,2 Yukihide Iwamoto1 1Department of Orthopaedic Surgery, 2Department of Advanced Medical Initiatives, Kyushu University Hospital, Fukuoka, Japan Purpose: The purpose of this study was to assess the differences in bone tunnel apertures between the trans-accessory medial portal (trans-AMP technique and the transtibial (TT technique in double-bundle anterior cruciate ligament reconstruction. The extent of ovalization and the frequency of overlap of the two tunnel apertures were compared. Methods: The simulation of femoral tunnel drilling with the TT and the trans-AMP techniques was performed using three-dimensional computer aided design models from two volunteers. The incidence angle of drilling against the intercondylar wall, the femoral tunnel position, the ovalization, and the overlap were analyzed. The aperture and location of the tunnels were also examined in real anterior cruciate ligament reconstruction cases (n=36. Results: The surgical simulation showed that a lower drill incident angle induced by the TT technique made the apertures of two tunnels more ovalized, located anteromedial tunnels in a shallower position to prevent posterior wall blow out, and led to a higher frequency of tunnel overlap. The trans-AMP group had tunnel places within the footprint and had less ovalization and overlap. The results of analysis for tunnels in the clinical cases were consistent with results from the surgical simulation. Conclusion: In the TT technique, the shallow anteromedial tunnel location and more ovalized tunnel aperture can lead to a higher frequency of tunnel overlap. Compared with the TT technique, the trans-AMP technique was more useful in preparing femoral tunnels anatomically and avoiding tunnel ovalization and overlapping in double-bundle anterior cruciate ligament reconstruction. Keywords: anterior cruciate ligament

  15. Clinical and imaging features of intra-articular osteoid osteoma in the femoral neck

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical and imaging characteristics of osteoid osteoma in femoral neck and to improve diagnostic accuracy of this disease. Methods: Twenty-one patients (18 males and 3 females, age, 7-26 years, median age, 13 years) with pathologically proven osteoid osteoma of the femoral neck were retrospectively analyzed for their clinical profile and radiologic features. CT and X-ray examinations were performed in all patients, 10 of them performed post-contrast CT scan and 4 of them performed MRI examinations. Results: Nineteen patients had hip pain (pain worse at night in 11, and 8 received salicylates treatment with good response), and 2 patients only with intermittent claudication. The duration ranged from 2 months to 54 months (median duration 12 months). X-ray: Nidus was seen on plain film in 10 cases, 18 cases showed different degrees of bone sclerosis of the nidus. CT: Nidus was demonstrated in all cases. Among them, 8 were intracortical, 6 were subperiosteal, 7 were endosteal. Twenty cases showed different degrees of bone sclerosis of the nidus-extra-articular anteromedial cortical surface of the femur neck. Nineteen cases showed 'vascular groove sign'. MRI: Nidus was seen in 4 cases. Bone sclerosis was low signal on all sequences. Three cases had joint effusion, 4 cases had bone marrow edema, and 2 cases had synovial thickening. Conclusions: Although osteoid osteoma of femoral neck has non-specific clinical features, the radiographic findings are usually typical. The nidus of osteoid osteoma is often located within the joint. Bony sclerosis occurs at the area of extra-articular anteromedial cortical surface of the femur neck.CT examination remains an optimal method to identify the nidus. (authors)

  16. Preservation of episodic memory in semantic dementia: The importance of regions beyond the medial temporal lobes.

    Science.gov (United States)

    Irish, Muireann; Bunk, Steffie; Tu, Sicong; Kamminga, Jody; Hodges, John R; Hornberger, Michael; Piguet, Olivier

    2016-01-29

    Episodic memory impairment represents one of the hallmark clinical features of patients with Alzheimer's disease (AD) attributable to the degeneration of medial temporal and parietal regions of the brain. In contrast, a somewhat paradoxical profile of relatively intact episodic memory, particularly for non-verbal material, is observed in semantic dementia (SD), despite marked atrophy of the hippocampus. This retrospective study investigated the neural substrates of episodic memory retrieval in 20 patients with a diagnosis of SD and 21 disease-matched cases of AD and compared their performance to that of 35 age- and education-matched healthy older Controls. Participants completed the Rey Complex Figure and the memory subscale of the Addenbrooke's Cognitive Examination-Revised as indices of visual and verbal episodic recall, respectively. Relative to Controls, AD patients showed compromised memory performance on both visual and verbal memory tasks. In contrast, memory deficits in SD were modality-specific occurring exclusively on the verbal task. Controlling for semantic processing ameliorated these deficits in SD, while memory impairments persisted in AD. Voxel-based morphometry analyses revealed significant overlap in the neural correlates of verbal episodic memory in AD and SD with predominantly anteromedial regions, including the bilateral hippocampus, strongly implicated. Controlling for semantic processing negated this effect in SD, however, a distributed network of frontal, medial temporal, and parietal regions was implicated in AD. Our study corroborates the view that episodic memory deficits in SD arise very largely as a consequence of the conceptual loading of traditional tasks. We propose that the functional integrity of frontal and parietal regions enables new learning to occur in SD in the face of significant hippocampal and anteromedial temporal lobe pathology, underscoring the inherent complexity of the episodic memory circuitry. PMID:26683384

  17. Free combined composite flaps using the lateral circumflex femoral system for repair of massive defects of the head and neck regions: an introduction to the chimeric flap principle.

    Science.gov (United States)

    Koshima, I; Yamamoto, H; Hosoda, M; Moriguchi, T; Orita, Y; Nagayama, H

    1993-09-01

    Chimeric composite flaps combined using microanastomoses consist of two or more flaps or tissues, each with an isolated pedicle and a single vascular source. Free combined chimeric flaps using the lateral circumflex femoral system were used to treat massive composite defects of the head and neck in 10 cases. A combined anterolateral thigh flap and vascularized iliac bone graft based on the lateral circumflex femoral system and the deep circumflex iliac system was the most commonly used combination. An anteromedial thigh flap and a paraumbilical perforator-based flap were also combined with this principal combination. The advantages of this chimeric flap over other osteocutaneous flaps are: (1) The flap is relatively thin and the pedicle vessels are up to 10 cm longer and are wider than those of other flaps for easier harvesting of the flap. (2) It is unnecessary to reposition the patient. (3) The vascular pedicle to the skin can be separated from that of the bone. (4) The donor site is not close to the recipient site. (5) The donor scar is in an unexposed area. (6) The skin territory of this flap is extremely wide. (7) A combined anterolateral and anteromedial thigh flap and vascularized iliac bone graft can be easily obtained as an extended combined osteocutaneous flap. (8) Other neighboring skin flaps, such as a groin flap, a paraumbilical perforator-based flap, or a medial thigh flap, can be combined with this chimeric flap because several major muscle branches to be anastomosed derive from the lateral circumflex femoral system. Chimeric composite flaps using the lateral circumflex femoral system are considered suitable for the repair of massive composite defects of the head and neck. PMID:8341739

  18. Ankle post-traumatic osteoarthritis: a CT arthrography study in patients with bi- and trimalleolar fractures

    Energy Technology Data Exchange (ETDEWEB)

    Kraniotis, Pantelis; Petsas, Theodore [University Hospital of Patras, Department of Radiology, Rion, Patras (Greece); Maragkos, Spyridon; Tyllianakis, Minos [University Hospital of Patras, Department of Orthopedics, Rion, Patras (Greece); Karantanas, Apostolos H. [University Hospital, Heraklion, Department of Medical Imaging, Stavrakia, Crete (Greece)

    2012-07-15

    To detect radiographically occult cartilage lesions using CT arthrography (CTa) in patients with malleolar fractures treated with open reduction internal fixation and to correlate the lesions with the functional outcome score. Twenty-one patients (13 men and 8 women, mean age 35 years, range 16-55) underwent ankle CTa after a mean postoperative period of 565 days (range 271-756). CTa images were analyzed by two radiologists. Articular surface post-traumatic collapse and subsequent cartilage defects or erosions were recorded in millimeters and in a binary mode (i.e., present if >50% of cartilage thickness) respectively. The functional outcome was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) score by two orthopaedic surgeons. The statistical analysis correlated the AOFAS score with both imaging parameters and was performed with ANOVA using the MedCalc statistical package, version 11.3. Of the total of 12 articular surface steps recorded, 2/12 (16.67%) were anterolateral, 4/12 (33.33%) posterolateral, 5/12 (41.67%) anteromedial, and 1/12(8.33%) posteromedial. Of the total of 42 cartilage lesions, 7/42 (16.67%) were anterolateral, 14/42 (33.33%) posterolateral, 12/42 (28.57%) anteromedial, and 9/42 (21.43%) posteromedial. The mean AOFAS score was 8.67 (range 5.95-9.70). There was no statistically significant correlation between the AOFAS score and the post-traumatic internal derangement of the ankle joint (p = 0.524). CTa detects radiographically silent cartilage lesions in patients with fractures of the ankle joint. There is no correlation of the extent of lesions and the patient's AOFAS score. (orig.)

  19. Effect of morphine applied by intrapallidal microdialysis on the release of dopamine in the nucleus accumbens.

    Science.gov (United States)

    Anagnostakis, Y; Spyraki, C

    1994-01-01

    The effect of morphine, administered intrapallidally, on extracellular concentrations of DA, DOPAC, and HVA in the nucleus accumbens and striatum was studied in the behaving rat using the in vivo microdialysis technique. Unilateral application of morphine hydrochloride was performed through microdialysis probes into the rat ventral pallidum (10 microliters of 0, 2.6, 4.0, 13.0, and 26.0 mM) or globus pallidus (10 microliters of 0 and 26.0 mM). The levels of DA, DOPAC, and HVA were measured using the HPLC with EC detection in dialysates collected from the nucleus accumbens, anteromedial, and anterolateral striatum. Samples were taken every 45 min over 3 h before and over 5 h after morphine or vehicle administration. Administration of morphine into the ventral pallidum resulted in increased DOPAC and HVA concentrations in the nucleus accumbens. Pretreatment with naloxone (1 mg/kg, SC) abolished this effect of morphine. Administration of morphine into the globus pallidus resulted in increased DA, DOPAC, and HVA concentrations in the nucleus accumbens and DA in the anteromedial striatum. The levels of DA and metabolites in anterolateral striatum remained rather unchanged following morphine administered into the ventral pallidum or the globus pallidus. The changes in DA neurotransmission into the nucleus accumbens induced by morphine application into the ventral pallidum and globus pallidus are reminiscent of a phasic and tonic release of DA respectively. The results show that intrapallidal morphine increases DA neurotransmission in nucleus accumbens and suggest that the effect of morphine is mediated by ventral pallidum/mesolimbic and globus pallidus/thalamocortical pathways, depending on the site of injection. PMID:8055351

  20. ACL mismatch reconstructions: influence of different tunnel placement strategies in single-bundle ACL reconstructions on the knee kinematics.

    Science.gov (United States)

    Herbort, Mirco; Lenschow, Simon; Fu, Freddie H; Petersen, Wolf; Zantop, Thore

    2010-11-01

    To evaluate the influence of tibial and femoral tunnel position in ACL reconstruction on knee kinematics, we compared ACL reconstruction with a tibial and femoral tunnel in anteromedial (AM-AM reconstruction) and in posterolateral footprint (PL-PL reconstruction) with a reconstruction technique with tibial posterolateral and femoral anteromedial tunnel placement (PL-AM reconstruction). In 9 fresh-frozen human cadaveric knees, the knee kinematics under simulated Lachman (134 N anterior tibial load) and a simulated pivot shift test (10 N/m valgus and 4 N/m internal tibial torque) were determined at 0°, 30°, 60°, and 90° of flexion. Kinematics were recorded for intact, ACL-deficient, and single-bundle ACL reconstructed knees using three different reconstruction strategies in randomized order: (1) PL-AM, (2) AM-AM and (3) PL-PL reconstructions. Under simulated Lachman test, single-bundle PL-AM reconstruction and PL-PL reconstructions both showed significantly increased anterior tibial translation (ATT) at 60° and 90° when compared to the intact knee. At all flexion angles, AM-AM reconstruction did not show any statistical significant differences in ATT compared to the intact knee. Under simulated pivot shift, PL-AM reconstruction resulted in significantly higher ATT at 0°, 30°, and 60° knee flexion and AM-AM reconstructions showed significantly higher ATT at 30° compared to the intact knee. PL-PL reconstructions did not show any significant differences to the intact knee. AM-AM reconstructions restore the intact knee kinematics more closely when compared to a PL-AM technique resembling a transtibial approach. PL-PL reconstructions showed increased ATT at higher flexion angles, however, secured the rotational stability at all flexion angles. Due to the independent tibial and femoral tunnel location, a medial portal technique may be superior to a transtibial approach. PMID:20461359

  1. Etiology, pathogenesis and prevention of neural tube defects.

    Science.gov (United States)

    Padmanabhan, Rengasamy

    2006-06-01

    Spina bifida, anencephaly, and encephalocele are commonly grouped together and termed neural tube defects (NTD). Failure of closure of the neural tube during development results in anencephaly or spina bifida aperta but encephaloceles are possibly post-closure defects. NTD are associated with a number of other central nervous system (CNS) and non-neural malformations. Racial, geographic and seasonal variations seem to affect their incidence. Etiology of NTD is unknown. Most of the non-syndromic NTD are of multifactorial origin. Recent in vitro and in vivo studies have highlighted the molecular mechanisms of neurulation in vertebrates but the morphologic development of human neural tube is poorly understood. A multisite closure theory, extrapolated directly from mouse experiments highlighted the clinical relevance of closure mechanisms to human NTD. Animal models, such as circle tail, curly tail, loop tail, shrm and numerous knockouts provide some insight into the mechanisms of NTD. Also available in the literature are a plethora of chemically induced preclosure and a few post-closure models of NTD, which highlight the fact that CNS malformations are of hetergeneitic nature. No Mendelian pattern of inheritance has been reported. Association with single gene defects, enhanced recurrence risk among siblings, and a higher frequency in twins than in singletons indicate the presence of a strong genetic contribution to the etiology of NTD. Non-availability of families with a significant number of NTD cases makes research into genetic causation of NTD difficult. Case reports and epidemiologic studies have implicated a number of chemicals, widely differing therapeutic drugs, environmental contaminants, pollutants, infectious agents, and solvents. Maternal hyperthermia, use of valproate by epileptic women during pregnancy, deficiency and excess of certain nutrients and chronic maternal diseases (e.g. diabetes mellitus) are reported to cause a manifold increase in the

  2. Standard large trauma craniotomy for severe traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    L(U) Li-quan 吕立权; JIANG Ji-yao 江基尧; YU Ming-kun 于明琨; HOU Li-jun 侯立军; CHEN Zhi-gang 陈志刚; ZHANG Guang-ji 张光霁; ZHU Cheng 朱诚

    2003-01-01

    Objective: To study the effect of standard large trauma craniotomy(SLTC) on outcomes of patients with severe traumatic brain injury (TBI) (GCS≤8).Methods: 230 patients with severe TBI were randomly divided into two groups.115 patients underwent SLTC (10 cm×12 cm) as an SLTC group, and other 115 patients underwent temporo-parietal or fronto-temporal craniotomy (6 cm×8 cm) according to the position of hematomas as a routine craniotomy (RC) group.Other treatments were identical in two groups.According to Glasgow outcome scale (GOS), the prognosis of the patients was evaluated and the complications were compared between two groups.Results: 27 patients got good outcome and moderate disability (23.5%), 40 severe disability and vegetative survival (34.8%), and 48 died (41.7%) in SLTC group.21 patients got good outcome and moderate disability (18.3%), 28 severe disability and vegetative survival (24.3%), and 66 died (57.4%) in RC group.The incidence of incision hernia was lower in SLTC group than in RC group.However, the incidence of operative encephalocele, traumatic epilepsy and intracranial infection were not different in two groups.Conclusions: Standard large trauma craniotomy significantly reduces the mortality of patients with severe TBI without serious complications, but does not improve the life quality of the patients.

  3. Meckel-Gruber Syndrome: a population-based study on prevalence, prenatal diagnosis, clinical features, and survival in Europe

    DEFF Research Database (Denmark)

    Barisic, Ingeborg; Boban, Ljubica; Loane, Maria;

    2015-01-01

    regional differences were observed. There were 145 (75.9%) terminations of pregnancy after prenatal diagnosis, 13 (6.8%) fetal deaths, 33 (17.3%) live births. In addition to cystic kidneys (97.7%), encephalocele (83.8%) and polydactyly (87.3%), frequent features include other central nervous system...... anomalies (51.4%), fibrotic/cystic changes of the liver (65.5% of cases with post mortem examination) and orofacial clefts (31.8%). Various other anomalies were present in 64 (37%) patients. As nowadays most patients are detected very early in pregnancy when liver or kidney changes may not yet be developed...... or may be difficult to assess, none of the anomalies should be considered obligatory for the diagnosis. Most cases (90.2%) are diagnosed prenatally at 14.3±2.6 (range 11-36) gestational weeks and pregnancies are mainly terminated, reducing the number of LB to one-fifth of the total prevalence rate...

  4. Fetal central nervous system anomalies: fast MRI vs ultrasonography

    International Nuclear Information System (INIS)

    Objective: To evaluate the ability of fast MRI to detect fetal central nervous system (CNS) anomalies and to compare its performance with that of prenatal ultrasonography (US). Methods Forty-eight pregnant women were detected by conventional prenatal US and MRI. Twenty-two fetuses with CNS anomalies were conformed by autopsy and follow-up. The MR and US appearances of fetal CNS structure were compared to each other and to that of autopsy. Results: A total of 26 CNS anomalies were identified by autopsy (n=17) and follow-up (n=9) including anencephaly (n=6), rachischisis (n=2), encephalocele (n=3), congenital hydrocephalus (n=7), alobar holoprosencephaly (n=1), porencephalia (n=3), arachnoid cyst (n=2) and choroids plexus cyst (n=2). US diagnosed 24 CNS anomalies, the correct diagnostic rate was 92.3%, the false-positive rate was 3.8%, the missed-diagnostic rate was 3.8%. MRI diagnosed 23 CNS anomalies, the correct-diagnostic rate was 88.5%, the false-positive rate was 3.8% ,the missed-diagnostic rate was 7.7%. There was no difference between US and MRI (P>0.05), but MRI have larger FOV, higher tissues resolution, and can demonstrate gray-white matter in detail. Conclusions: MR imaging has a similar sensitivity to that of US in the detection of fetal CNS anomalies. (authors)

  5. Postoperative assessment of surgical results using three dimensional surface reconstruction CT (3D-CT) in a craniofacial anomaly

    International Nuclear Information System (INIS)

    In 1983, Michael W. Vannier and Jeffrey L. Marsh developed a computer method that reconstructs three dimensional (3D) born and soft tissue surfaces, given a high resolution CT scan-series of the facial skeleton. This method has been applied to craniofacial anomalies, basal encephaloceles, and musculoskeletal anomalies. In this study, a postoperative assessment of the craniofacial surgical results has been accomplished using this 3D-CT in 2 children with craniofacial dysmorphism. The authors discuss the advantages of this 3D-CT imaging method in the postoperative assessments of craniofacial anomalies. Results are detailed in the following listing : 1) a postoperative 3D-CT reveals the anatomical details corrected by the craniofacial surgery more precisely and stereographically than conventional radiological methods ; 2) secondary changes of the cranium after the surgery, such as bony formation in the area of the osteotomy and postoperative asymmetric deformities, are detected early by the 3D-CT imaging technique, and, 3) 3D-CT mid-sagittal and top axial views of the intracranial skull base are most useful in postoperative assessments of the surgical results. Basesd on our experience, we expect that three dimensional surface reconstructions from CT scans will become to be used widely in the postoperative assessments of the surgical results of craniofacial anomalies. (author)

  6. 中国30个县(市)1993~2000年神经管畸形在出生人群中的患病率及变动趋势分析%Prevalence of neural tube defects at birth in 30 counties and cities of China, 1993-2000

    Institute of Scientific and Technical Information of China (English)

    叶荣伟; 李松; 郑俊池; 洪世欣; 陈新; 王太梅; 任爱国; 王丽娜; 李竹

    2002-01-01

    Objective:To describe the prevalence rates of neural tube defects (NTD) and yearly trends (1993-2000) in China. Methods: All the data were obtained from the Birth Defects Surveillance System in thirty counties/cities of China. The calculation of NTD prevalence rates and time trend analyses were based on the data for live (L) and stillbirths (S) only, the denominator used was total births (L+S). Linear regression analysis of the prevalence rate over years has been used to measure time trends. Results: In the period of 1993-2000, there were 1 264 neural tube defects among 1 189 126 total births in 30 counties/cities in China. The overall neural tube defects rate was 10.63 per 10000 births, and rates were higher (18.99 per 10 000 births) in the year 1993, lower (6.05 per 10 000 births) in 1998. The prevalence rates of anencephaly, spina bifida and encephalocele were 4.71,4.39 and 1.53 per 10 000 births respectively. Of all index NTD cases, anencephaly and spina bifida were most frequent, making up 44.3% and 41.3%, and encephalocele represented 14.4%. The stillbirth proportion was 69.3% over all index NTD cases, 95.4% in anencephaly cases, 43.7% in spina bifida, and 62.6% in encephalocele cases. Linear trend analysis indicated a significant decline for NTD rate (F=11.818, β=-0.814,P=0.014). Analysis by specific defect showed significant declines for the rates of anencephaly (P=0.004) and spina bifida (P=0.026), but no significant annual variation of encephalocele (P=0.227). Results of comparing with data reported from other surveillance systems (1994-1999) showed that the highest NTD rate (9.41 per 10000 births) was seen in China, nearly7 times the lowest rate (1.44 per 10000 births) in England and Wales. Conclusion: The overall neural tube defects rate in 30 counties/cities of China presented a significant downward trend between 1993 and 2000, and China still had the higher neural tube defects prevalence. %目的:描述中国30个县(市)1993

  7. Advances in Etiology of Neural Tube Defects%神经管缺陷的病因学研究进展

    Institute of Scientific and Technical Information of China (English)

    谢远杰; 赵国军; 莫中成; 龙治峰

    2009-01-01

    Neural tube defects (NTDs) are a group of complex congenital defects of the CNS, commonly including anencephaly, spina bifida and encephaloceles which arise from the malformations of neural tube closure during the process of neurulation. Both environmental and genetic factors are involved in the etiology of NTDs, and many of them have been identified as risk factors of neural tube defects. Despite exhaustive research efforts, little is known about the actual genetic mechanisms governing the primary events involved in neural tube defects. We will review these factors in details.%脊柱裂、无脑儿和脑膜脑膨出通常被统称为神经管缺陷(neural tube defects,NTDs),是在神经胚形成过程中由于神经管闭合异常导致的中枢神经系统先天性疾病.其病因极其复杂,目前认为与神经管发育有关的基因异常和诸多环境因素均能导致NTDs,尽管很多学者对NTDs的病因做了大量的研究,但目前对于导致人NTDs的关键病因仍知之甚少.本文就目前研究最多的与神经管缺陷有关的基因和环境因素作一综述.

  8. Genetic spectrum of Saudi Arabian patients with antenatal cystic kidney disease and ciliopathy phenotypes using a targeted renal gene panel

    Science.gov (United States)

    Al-Hamed, Mohamed H; Kurdi, Wesam; Alsahan, Nada; Alabdullah, Zainab; Abudraz, Rania; Tulbah, Maha; Alnemer, Maha; Khan, Rubina; Al-Jurayb, Haya; Alahmed, Ahmed; Tahir, Asma I; Khalil, Dania; Edwards, Noel; Al Abdulaziz, Basma; Binhumaid, Faisal S; Majid, Salma; Faquih, Tariq; El-Kalioby, Mohamed; Abouelhoda, Mohamed; Altassan, Nada; Monies, Dorota; Meyer, Brian; Sayer, John A; Albaqumi, Mamdouh

    2016-01-01

    Background Inherited cystic kidney disorders are a common cause of end-stage renal disease. Over 50 ciliopathy genes, which encode proteins that influence the structure and function of the primary cilia, are implicated in cystic kidney disease. Methods To define the phenotype and genotype of cystic kidney disease in fetuses and neonates, we correlated antenatal ultrasound examination and postnatal renal ultrasound examination with targeted exon sequencing, using a renal gene panel. A cohort of 44 families in whom antenatal renal ultrasound scanning findings in affected cases included bilateral cystic kidney disease, echogenic kidneys or enlarged kidneys was investigated. Results In this cohort, disease phenotypes were severe with 36 cases of stillbirth or perinatal death. Extra renal malformations, including encephalocele, polydactyly and heart malformations, consistent with ciliopathy phenotypes, were frequently detected. Renal gene panel testing identified causative mutations in 21 out of 34 families (62%), where patient and parental DNA was available. In the remaining 10 families, where only parental DNA was available, 7 inferred causative mutations were found. Together, mutations were found in 12 different genes with a total of 13 novel pathogenic variants, including an inferred novel variant in NEK8. Mutations in CC2D2A were the most common cause of an antenatal cystic kidney disease and a suspected ciliopathy in our cohort. Conclusions In families with ciliopathy phenotypes, mutational analysis using a targeted renal gene panel allows a rapid molecular diagnosis and provides important information for patients, parents and their physicians. PMID:26862157

  9. Neuroembryology and functional anatomy of craniofacial clefts

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    Ewings Ember

    2009-10-01

    Full Text Available The master plan of all vertebrate embryos is based on neuroanatomy. The embryo can be anatomically divided into discrete units called neuromeres so that each carries unique genetic traits. Embryonic neural crest cells arising from each neuromere induce development of nerves and concomitant arteries and support the development of specific craniofacial tissues or developmental fields. Fields are assembled upon each other in a programmed spatiotemporal order. Abnormalities in one field can affect the shape and position of developing adjacent fields. Craniofacial clefts represent states of excess or deficiency within and between specific developmental fields. The neuromeric organization of the embryo is the common denominator for understanding normal anatomy and pathology of the head and neck. Tessier′s observational cleft classification system can be redefined using neuroanatomic embryology. Reassessment of Tessier′s empiric observations demonstrates a more rational rearrangement of cleft zones, particularly near the midline. Neuromeric theory is also a means to understand and define other common craniofacial problems. Cleft palate, encephaloceles, craniosynostosis and cranial base defects may be analyzed in the same way.

  10. Accuracy of Ultrasound in Detection of Gross Prenatal Central Nervous System Anomalies after the Eighteenth Week of Gestation

    Directory of Open Access Journals (Sweden)

    M. Tahmasebi

    2007-10-01

    Full Text Available Background/Objective: Ultrasound (US detection of prenatal central nervous system (CNS anatomic anomalies is very important in making decision about therapeutic termination. In the present study, the accuracy of US in detection of gross prenatal CNS anatomic anomalies has been investigated."nPatients and Methods: 3012 pregnant women were scanned after 18 weeks of gestation by an expert operator in a referring center. All delivered fetuses were followed after birth through clinical examination and sonography."nResults: In this study, the accuracy of US in detection of gross CNS anatomic anomalies of fetuses after 18 weeks gestation was found to be 100%. The sensitivity, specificity, positive and negative predictive values of US were 100%. In sonographic examination of these 3012 pregnant women, 36 fetuses were detected with CNS anomalies, some of whom had more than one anomaly. Gross CNS anomalies observed included microcephaly, hydrocephaly, anencephaly, holoprosencephaly, ventriculomegaly, meningocele, encephalocele, lissencephaly, agenesis of corpus callosum, bilateral choroid plexus cysts and hypoplastic cerebellum."nConclusion: US is highly operator dependent and operator experience may be the most determinant affecting the results. Sonographic scanning after 18 weeks of gestation is associated with the best results.

  11. Melatonin prevents neural tube defects in the offspring of diabetic pregnancy.

    Science.gov (United States)

    Liu, Shangming; Guo, Yuji; Yuan, Qiuhuan; Pan, Yan; Wang, Liyan; Liu, Qian; Wang, Fuwu; Wang, Jingjing; Hao, Aijun

    2015-11-01

    Melatonin, an endogenous neurohormone secreted by the pineal gland, has a variety of physiological functions and neuroprotective effects. However, its protective role on the neural tube defects (NTDs) was not very clear. The aim of this study was to investigate the effects of melatonin on the incidence of NTDs (including anencephaly, encephalocele, and spina bifida) of offspring from diabetic pregnant mice as well as its underlying mechanisms. Pregnant mice were given 10 mg/kg melatonin by daily i.p. injection from embryonic day (E) 0.5 until being killed on E11.5. Here, we showed that melatonin decreased the NTDs (especially exencephaly) rate of embryos exposed to maternal diabetes. Melatonin stimulated proliferation of neural stem cells (NSCs) under hyperglycemic condition through the extracellular regulated protein kinases (ERK) pathway. Furthermore, as a direct free radical scavenger, melatonin decreased apoptosis of NSCs exposed to hyperglycemia. In the light of these findings, it suggests that melatonin supplementation may play an important role in the prevention of neural malformations in diabetic pregnancy. PMID:26475080

  12. Prevalence of Perinatal Central Nervous System Anomalies in East Azarbaijan-Iran

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    M. Ghavami

    2011-06-01

    Full Text Available Background/Objective: Central nervous system (CNS anomalies are the most serious congenital abnormalities. Ultrasound examination is an effective and noninvasive modality for prenatal diagnosis of these anomalies. The purpose of the current study was to determine thefrequency of CNS and associated abnormalities.Patients and Methods: A total of 22500 pregnant women who were referred by obstetricians/ gynecologists for routine work up of pregnancy were scanned over a period of 3 years by two expert sonologists in a referral center using high resolution ultrasound unit.Results: After transabdominal sonographic examination of 22500 pregnant women, 112 (0.5%fetuses were detected with CNS anomalies, some of whom had more than one anomaly. Forty-one (37% Chiari malformations, 26 (23% monro and aqueductal stenosis cases, 18 (16% anencephaly cases, nine (8% encephaloceles, seven (6% microcephalies, five (4% Dandywalker syndromes,two (2% arachnoid cysts, two (2% agenesis of corpus callosum cases, one (1% holoprosencephaly and one (1% schizencephaly were reported in our study.Conclusion: According to our results, Chiari malformation and ydrocephalus were the most prevalent anomalies of CNS congenital abnormalities in East Azarbaijan, Iran. An accurate diagnosis depends upon fetal age, amniotic fluid volume, fetal position, operator experience and careful evaluation of the associated malformations, which are often present.

  13. Serum Zinc Level in Newborns with Neural Tube Defects in Gorgan

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    AA Keshtkar

    2006-07-01

    Full Text Available Background: Neural tube defects (NTD are a group of congenital malformations that include spina bifida, anencephaly and encephalocele. Some investigations have indicated that Zinc deficiency is one of the causative factors of NTDs. This study was done to determine the relation between neural tube defect and neonatal serum Zinc level in Gorgan - North of Iran. Methods: This case-control study was carried out on 23 newborns with NTD and 35 healthy newborns, in Dezyani hospital in Gorgan- north of Iran. Serum zinc level was assessed with spectrophotometery. Data was analyzed by SPSS soft ware. Findings: Mean of serum Zinc levels in case and control groups were 8 (±3.9 mol/Lit and 12.3 (±4 Mol/Lit, respectively (p<0.001. Zinc deficiency was found in 43.5% of the cases and 8.6% of the controls (2 =9.73, p=0.002. The logistic regression analysis has shown an association between the presence of NTDs and zinc deficiency (OR=8.2, 95%CI: 1.9-34.7. Conclusion: This study showed that Zinc deficiency was thought to be one of the most important factors in the NTDs etiology in this area.

  14. Craniofacial abnormalities among patients with Edwards Syndrome

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    Rafael Fabiano M. Rosa

    2013-09-01

    Full Text Available OBJECTIVE To determine the frequency and types of craniofacial abnormalities observed in patients with trisomy 18 or Edwards syndrome (ES. METHODS This descriptive and retrospective study of a case series included all patients diagnosed with ES in a Clinical Genetics Service of a reference hospital in Southern Brazil from 1975 to 2008. The results of the karyotypic analysis, along with clinical data, were collected from medical records. RESULTS: The sample consisted of 50 patients, of which 66% were female. The median age at first evaluation was 14 days. Regarding the karyotypes, full trisomy of chromosome 18 was the main alteration (90%. Mosaicism was observed in 10%. The main craniofacial abnormalities were: microretrognathia (76%, abnormalities of the ear helix/dysplastic ears (70%, prominent occiput (52%, posteriorly rotated (46% and low set ears (44%, and short palpebral fissures/blepharophimosis (46%. Other uncommon - but relevant - abnormalities included: microtia (18%, orofacial clefts (12%, preauricular tags (10%, facial palsy (4%, encephalocele (4%, absence of external auditory canal (2% and asymmetric face (2%. One patient had an initial suspicion of oculo-auriculo-vertebral spectrum (OAVS or Goldenhar syndrome. CONCLUSIONS: Despite the literature description of a characteristic clinical presentation for ES, craniofacial alterations may be variable among these patients. The OAVS findings in this sample are noteworthy. The association of ES with OAVS has been reported once in the literature.

  15. Differential Diagnosis of Chronic Rhinosinusitis with Nasal Polyps.

    Science.gov (United States)

    London, Nyall R; Reh, Douglas D

    2016-01-01

    Nasal polyps are semi-translucent mucosal outgrowths of the paranasal sinuses which typically arise in the setting of chronic rhinosinusitis (CRS). Nasal polyps are also associated with asthma, aspirin sensitivity, cystic fibrosis and allergic fungal rhinosinusitis (AFS). The majority of nasal polyps are bilateral and characterized by tissue edema and eosinophil infiltration. Patients with nasal polyps often present with complaints including nasal obstruction, congestion, rhinorrhea or altered sense of smell. The differential diagnosis ranges from benign masses such as schneiderian papilloma, antrochoanal polyp, angiofibroma and encephalocele to malignant neoplasms such as squamous cell carcinoma (SCC), esthesioneuroblastoma, nasal lymphoma and rhabdomyosarcoma. These lesions may have a similar appearance as nasal polyps and particular attention to an alternative diagnosis for nasal polyps should be entertained if the mass is unilateral or congenital in nature. Workup for patients with a unilateral mass should include radiographic imaging, possible biopsy and careful follow-up when appropriate. Here, we review the disease etiology of nasal polyps and describe the approach to the patient with nasal polyps with emphasis on differential diagnosis and workup. PMID:27466841

  16. Comparison of two methods of femoral tunnel preparation in single-bundle anterior cruciate ligament reconstruction: a prospective randomized study Comparação entre dois métodos de preparação de túnel femoral na reconstrução do ligamento cruzado anterior em feixe único: estudo prospectivo randomizado

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    Qiang Zhang

    2012-08-01

    Full Text Available PURPOSE: To prospectively compare therapeutic effect of femoral tunnel preparation through the tibial tunnel and the anteromedial (AM portal in single-bundle anterior cruciate ligament (ACL reconstruction. METHODS: Between June 2008 and October 2010, 76 patients underwent single-bundle ACL reconstruction by autogenous grafting of semitendinosus and gracilis tendon. All cases were randomly divided into two groups according to the method of femoral tunnel preparation: transtibial (TT group (n=38 and anteromedial (AM group (n=38. Lysholm knee score and the KT-1000 anterior laxity at 30° of pre-and post-operation were assessed for two groups. RESULTS: Sixty-five patients (TT group, 34; AM group, 31 were followed up for more than 12 months, with a follow-up rate of 86%. The Lysholm knee score and the KT-1000 anterior laxity 12 months after operation were significantly better than before reconstruction. The Lysholm knee score and the KT-1000 anterior laxity were not significantly different between the TT and AM groups after operation. CONCLUSION: Femoral tunnel preparation through tibial tunnel or the anteromedial portal in single-bundle anterior cruciate ligament reconstruction shows same therapeutic effects.OBJETIVO: Comparar prospectivamente o efeito terapêutico da preparação do túnel femoral através do túnel tibial (TT ou da porta ântero-medial(AM na reconstrução do ligamento cruzado anterior(LCA em feixe único. MÉTODOS: Entre junho de 2008 e outubro de 2010, 76 pacientes foram submetidos à reconstrução do LCA em feixe único pelo enxerto autógeno de tendão semitendíneo egrácil.Todos os casos foram divididos aleatoriamente em dois grupos de acordo como método de preparação do túnel femoral: grupo transtibial (TT (n=38 e grupo ântero-medial (AM (n=38. Foi usado o escore Lysholm para joelho. O relaxamento anterior do joelho a 30° sob força tênsil de 133,32N foi determinado com o medidor KT-1000 no pré e no p

  17. Assessment of the diagnostic value of dual-energy CT and MRI in the detection of iatrogenically induced injuries of anterior cruciate ligament in a porcine model

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) is the standard of reference for the non-invasive evaluation of ligament injuries of the knee. The development of dual-energy CT (DE-CT) made it possible to differentiate between tissues of different density by two simultaneous CT measurements with different tube voltages. This approach enables DE-CT to discriminate ligament structures without intra-articular contrast media injection. The aims of this study were on the one hand to determine the delineation of the anterior cruciate ligament (ACL) and on the other hand to assess the diagnostic value of DE-CT and MRI in the detection of iatrogenically induced injury of the ACL in a porcine knee joint model. Twenty porcine hind legs, which were placed in a preformed cast in order to achieve a standardized position, were scanned using DE-CT. Thereafter, a 1.5-T MRI using a standard protocol was performed. The imaging procedures were repeated with the same parameters after inducing defined lesions (total or partial incision) on the ACL arthroscopically. After post-processing, two radiologists and two orthopedic surgeons first analyzed the delineation of the ACL and then, using a consensus approach, the iatrogenically induced lesions. The result of the arthrotomy was defined as the standard of reference. The ACL could be visualized both on DE-CT and MRI in 100% of the cases. As for the MRI, the sensitivity and specificity of detecting the cruciate ligament lesion respectively compared with the defined arthrotomy was 66.7% and 78.6% for intact cruciate ligaments, 100% and 75% in the case of a complete lesion, 33.3% and 78.6% for lesions of the anteromedial bundle, and 0% and 100% for lesions of the posterolateral bundle. In comparison, DE-CT demonstrated a sensitivity and specificity of 66.7% and 71.4% in the case of intact cruciate ligaments, 75% and 68.8% in the case of completely discontinued ACLs, 0% and 92.9% in the case of lesions of the anteromedial bundle, and 25% and 87.5% in the

  18. Positioning of the femoral tunnel for arthroscopic reconstruction of the anterior cruciate ligament: comparative study of 2 techniques Posicionamento do túnel femoral na reconstrução artroscópica do LCA: estudo comparativo de duas técnicas

    Directory of Open Access Journals (Sweden)

    Roberto Freire da Mota Albuquerque

    2007-01-01

    Full Text Available OBJECTIVE: To compare the accuracy of positioning of the femoral tunnel in reconstructing the anterior cruciate ligament by means of 2 techniques: tibial tunnel and anteromedial portal. METHOD: Femoral tunnels were drilled in 20 knees from human cadavers by means of arthroscopy. Group I had the femoral tunnel drilled via a trans-tibial tunnel, and Group II via the anteromedial portal. Four variables were measured: A posterior wall thickness; B tunnel positioning at the notch; C tunnel inclination in relation to the femoral axis; and D distance between the wire guide exit and the lateral epicondyle. RESULTS: As above, respectively, A 2.23 mm for group I and 2.36 mm for group II (P =.54; B 25.5° for group I and 30.0° for group II (P =.23; C 23.9° for group I and 32.0° for group II (P =.02; D 7.8 cm for group I and 3.9 cm for group II (P OBJETIVO: Comparar a acurácia do posicionamento do túnel femoral na reconstrução do ligamento cruzado anterior através de duas vias: túnel tibial e portal ântero - medial. MÉTODO: Foram perfurados túneis femorais em vinte joelhos de cadáveres humanos por via artroscópica. Grupo I: túnel femoral por acesso trans túnel tibial. Grupo II: via portal ântero-medial. Quatro variáveis foram estudadas: A espessura da parede posterior; B posicionamento do túnel no intercôndilo; C angulação do túnel em relação ao eixo do fêmur; D distância entre a saída do fio guia e o epicôndilo lateral. RESULTADO: A grupo I: 2,23 mm, grupo II: 2,36 mm (p=0,543; B grupo I: 25,5º, grupo II: 30º (p=0,226; C grupo I: 23,9º, grupo II: 32º (p= 0,014; D grupo I: 7,8 cm, grupo II 3,9 cm (p<0,001. CONCLUSÃO: As duas técnicas obteveram o posicionamento desejado da entrada do túnel femoral e espessura adequada da cortical posterior. A perfuração via portal ântero-medial pode propiciar maior proteção contra rotura da parede posterior.

  19. [Specifics of the blood supply of the sinoatrial node].

    Science.gov (United States)

    Onciu, M; Tuţă, Liliana-Ana; Baz, R; Leonte, T

    2006-01-01

    The present study aims to identify the heart nodal system blood supply sources and especially those of the sinoatrial node. It included 50 unpreserved and preserved human hearts from subjects of both sexes (40 males and 10 females) aged 12 to 68, of Romanian (42) and non-Romanian origin (8). The used denominations are those recommended by DiDio & Wakefield, based on splitting of the atrial walls into four quadrants (right and left, both anterior and posterior) which are further divided into three parts (medial, middle and lateral). We used special dissection techniques and plastic mass injections followed by corrosion. Our results confirm the opinion shared by most authors, in favour of the predominance of the origin of sinoatrial node artery from the right coronary artery. The sinoatrial node was supplied by a unique source represented by the right coronary artery in 37 cases (74%) and by the circumflex artery in 8 cases (16%), and by a double source represented by two branches of the right coronary artery in 2 cases (4%) and of both coronary arteries in 3 cases (6%). The direct arterial branches to the sinoatrial node were represented mainly by the right anteromedial atrial artery with origin from the right coronary artery level with the medial third of the right anterior quadrant of the atrial wall. From the left coronary system, the left anteromedial artery is the one responsible with the sinoatrial node supply; the source is the circumflex artery and its origin is the medial third of the left anterior quadrant. Contrary to DiDio et al., we found in addition to the mainly unilateral blood supply, the bilateral one. We didn't find any case with a sinoatrial node artery originating from the trunk of the left coronary artery, or with an extracardiac origin. We may state there are no significant differences of the origin and distribution of the sinoatrial node artery related to sex or country of origin. Thus, we cannot fully confirm the theories about the influence

  20. Effect of tunnel placements on clinical and magnetic resonance imaging findings 2 years after anterior cruciate ligament reconstruction using the double-bundle technique

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    Suomalainen P

    2014-08-01

    Full Text Available Piia Suomalainen,1 Tommi Kiekara,2 Anna-Stina Moisala,1 Antti Paakkala,2 Pekka Kannus,3 Timo Järvelä4 1Division of Orthopaedics and Traumatology, Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital, Tampere, 2Medical Imaging Centre, Tampere University Hospital, Tampere, 3Injury and Osteoporosis Research Center, UKK Institute, Tampere, 4Arthroscopic and Sports Medicine Center Omasairaala, Helsinki, Finland Purpose: The purpose of the study reported here was to find out if the clinical and magnetic resonance imaging (MRI findings of a reconstructed anterior cruciate ligament (ACL have an association. Our hypothesis, which was based on the different functions of the ACL bundles, was that the visibility of the anteromedial graft would have an impact on anteroposterior stability, and the visibility of the posterolateral graft on rotational stability of the knee. Methods: This study is a level II, prospective clinical and MRI study (NCT02000258. The study involved 75 patients. One experienced orthopedic surgeon performed all double-bundle ACL reconstructions. Two independent examiners made the clinical examinations at 2-year follow-up: clinical examination of the knee; KT-1000, International Knee Documentation Committee and Lysholm knee evaluation scores; and International Knee Documentation Committee functional score. The MRI evaluations were made by two musculoskeletal radiologists separately, and the means of these measurements were used. Results: We found that the location of the graft in the tibia had an impact on the MRI visibility of the graft at 2-year follow-up. There were significantly more partially or totally invisible grafts if the insertion of the graft was more anterior in the tibia. No association was found between the clinical results and the graft locations. Conclusion: Anterior graft location in the tibia can cause graft invisibility in the MRI 2 years after ACL reconstruction, but this

  1. Temporal pole signal abnormality on MR imaging in temporal lobe epilepsy with hippocampal sclerosis: a fluid-attenuated inversion-recovery study Anormalidade de sinal na imagem por RM do pólo temporal na epilepsia do lobo temporal com esclerose hipocampal: um estudo pela seqüência inversão recuperação com supressão da água livre (FLAIR

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    Henrique Carrete Junior

    2007-09-01

    Full Text Available OBJECTIVE: To determine the frequency and regional involvement of temporal pole signal abnormality (TPA in patients with hippocampal sclerosis (HS using fluid-attenuated inversion-recovery (FLAIR MR imaging, and to correlate this feature with history. METHOD: Coronal FLAIR images of the temporal pole were assessed in 120 patients with HS and in 30 normal subjects, to evaluate gray-white matter demarcation. RESULTS: Ninety (75% of 120 patients had associated TPA. The HS side made difference regarding the presence of TPA, with a left side prevalence (p=0.04, chi2 test. The anteromedial zone of temporal pole was affected in 27 (30% out of 90 patients. In 63 (70% patients the lateral zone were also affected. Patients with TPA were younger at seizure onset (p=0.018, but without association with duration of epilepsy. CONCLUSION: Our FLAIR study show temporal pole signal abnormality in 3/4 of patients with HS, mainly seen on the anteromedial region, with a larger prevalence when the left hippocampus was involved.OBJETIVO: Determinar a freqüência e o envolvimento regional da anormalidade de sinal do pólo temporal (APT em pacientes com esclerose hipocampal (EH utilizando seqüência inversão recuperação com supressão da água (FLAIR por RM, e correlacioná-la com a história. MÉTODO: Foram analisadas as imagens coronais FLAIR dos pólos temporais de 120 pacientes com EH e de 30 indivíduos normais, para avaliar a demarcação entre substâncias branca e cinzenta. RESULTADOS: Noventa (75% dos 120 pacientes tinham APT associada. Houve prevalência do lado esquerdo (p=0.04, chi2 teste na relação entre APT e o lado da EH. A zona ântero-medial estava acometida em 27 (30% destes pacientes. Em 63 (70% pacientes também a zona lateral estava acometida. Pacientes com APT apresentaram início da epilepsia quando mais jovens (p=0.018, porém sem associação com a sua duração. CONCLUSÃO: A seqüência FLAIR mostra haver ATP em 3/4 dos pacientes com EH

  2. Assessment of the diagnostic value of dual-energy CT and MRI in the detection of iatrogenically induced injuries of anterior cruciate ligament in a porcine model

    Energy Technology Data Exchange (ETDEWEB)

    Fickert, S.; Niks, M.; Lehmann, L. [University Medical Center Mannheim, Center of Orthopaedics and Traumatology, Mannheim (Germany); Dinter, D.J.; Hammer, M.; Weckbach, S.; Schoenberg, S.O.; Jochum, S. [University Medical Center Mannheim, Department of Clinical Radiology and Nuclear Medicine, Mannheim (Germany)

    2013-03-15

    Magnetic resonance imaging (MRI) is the standard of reference for the non-invasive evaluation of ligament injuries of the knee. The development of dual-energy CT (DE-CT) made it possible to differentiate between tissues of different density by two simultaneous CT measurements with different tube voltages. This approach enables DE-CT to discriminate ligament structures without intra-articular contrast media injection. The aims of this study were on the one hand to determine the delineation of the anterior cruciate ligament (ACL) and on the other hand to assess the diagnostic value of DE-CT and MRI in the detection of iatrogenically induced injury of the ACL in a porcine knee joint model. Twenty porcine hind legs, which were placed in a preformed cast in order to achieve a standardized position, were scanned using DE-CT. Thereafter, a 1.5-T MRI using a standard protocol was performed. The imaging procedures were repeated with the same parameters after inducing defined lesions (total or partial incision) on the ACL arthroscopically. After post-processing, two radiologists and two orthopedic surgeons first analyzed the delineation of the ACL and then, using a consensus approach, the iatrogenically induced lesions. The result of the arthrotomy was defined as the standard of reference. The ACL could be visualized both on DE-CT and MRI in 100% of the cases. As for the MRI, the sensitivity and specificity of detecting the cruciate ligament lesion respectively compared with the defined arthrotomy was 66.7% and 78.6% for intact cruciate ligaments, 100% and 75% in the case of a complete lesion, 33.3% and 78.6% for lesions of the anteromedial bundle, and 0% and 100% for lesions of the posterolateral bundle. In comparison, DE-CT demonstrated a sensitivity and specificity of 66.7% and 71.4% in the case of intact cruciate ligaments, 75% and 68.8% in the case of completely discontinued ACLs, 0% and 92.9% in the case of lesions of the anteromedial bundle, and 25% and 87.5% in the

  3. The SIGN nail for knee fusion: technique and clinical results

    Directory of Open Access Journals (Sweden)

    Anderson Duane Ray

    2016-01-01

    Full Text Available Purpose: Evaluate the efficacy of using the SIGN nail for instrumented knee fusion. Methods: Six consecutive patients (seven knees, three males with an average age of 30.5 years (range, 18–50 years underwent a knee arthrodesis with SIGN nail (mean follow-up 10.7 months; range, 8–14 months. Diagnoses included tuberculosis (two knees, congenital knee dislocation in two knees (one patient, bacterial septic arthritis (one knee, malunited spontaneous fusion (one knee, and severe gout with 90° flexion contracture (one knee. The nail was inserted through an anteromedial entry point on the femur and full weightbearing was permitted immediately. Results: All knees had clinical and radiographic evidence of fusion at final follow-up and none required further surgery. Four of six patients ambulated without assistive device, and all patients reported improved overall physical function. There were no post-operative complications. Conclusion: The technique described utilizing the SIGN nail is both safe and effective for knee arthrodesis and useful for austere environments with limited fluoroscopy and implant options.

  4. Limb salvage treatment for Gollop-Wolfgang complex (femoral bifurcation, complete tibial hemimelia, and hand ectrodactyly).

    Science.gov (United States)

    Wada, Akifusa; Nakamura, Tomoyuki; Fujii, Toshio; Urano, Noriko; Yanagida, Haruhisa; Takamura, Kazuyuki; Taketa, Mayuki; Oketani, Yutaka; Kubota, Hideaki

    2013-09-01

    We reported the findings from three patients with Gollop-Wolfgang complex and demonstrated the results of five limb salvage treatments for this condition. All three femoral bifurcations were accompanied by ipsilateral complete tibial hemimelia. Two patients showed contralateral complete or partial tibial hemimelia, and one patient had hand ectrodactyly. The five limb salvage treatments included resection of the anteromedial bifurcated femur in three limbs, foot centralization in five limbs, tibiofibular fusion in one limb with partial tibial hemimelia, fibular transfer (Brown's procedure) in three limbs with complete tibial hemimelia, and callus distraction lengthening in one limb. The duration from the first operation to the final follow-up ranged from 3.5 to 5.4 years. None of the three knees treated by fibular transfer achieved a successful functional result, but all of the knees were ultimately able to withstand weight bearing. Early knee disarticulation and resection of the protruded bifurcated femur, followed by fitting of a modern prosthesis is likely to be the best treatment for patients with Gollop-Wolfgang syndrome. We note that limb salvage treatment is an alternative in patients who opt to retain their feet and refuse amputation. PMID:23660549

  5. MRI of double-bundle ACL reconstruction: evaluation of graft findings

    International Nuclear Information System (INIS)

    To demonstrate the magnetic resonance imaging (MRI) findings of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction grafts. Sixty-six patients with DB ACL reconstruction were evaluated with MRI 2 years postoperatively. Graft thickness was measured separately by two musculoskeletal radiologists. The MRI findings of graft disruption, signal intensity (SI) changes, cystic degeneration, arthrofibrosis, and impingement were analyzed. The statistical significance of the association between MRI findings was calculated. The mean anteromedial (AM) graft thickness was reduced 9% and the mean posterolateral (PL) graft thickness was reduced 18% from the original graft thickness. Disruption was seen in 3% of AM grafts and 6% of PL grafts and a partial tear in 8 and 23%, respectively. Both grafts were disrupted in 3% of patients. Increased SI was seen in 14% of intact AM grafts and in 60% of partially torn AM grafts (p = 0.032). In PL grafts the increased SI was seen in 51% of the intact grafts and in 93% of the partially torn grafts (p = 0.005). Cystic degeneration was seen in 8% of AM grafts and in 5% of PL grafts. Diffuse arthrofibrosis was seen in 5% of patients and a localized cyclops lesion in 3% of patients. Impingement of the AM graft was seen in 8% of patients. Both grafts were disrupted in 3% of patients. Also, the frequencies of other complications were low. The use of orthogonal sequences in the evaluation of the PL graft SI seems to cause volume-averaging artefacts. (orig.)

  6. A new species of the genus Amolops (Amphibia: Ranidae) from southeastern Tibet, China

    Science.gov (United States)

    JIANG, Ke; WANG, Kai; YAN, Fang; XIE, Jiang; ZOU, Da-Hu; LIU, Wu-Lin; JIANG, Jian-Ping; LI, Cheng; CHE, Jing

    2016-01-01

    A new species of the genus Amolops Cope, 1865 is described from Nyingchi, southeastern Tibet, China, based on morphological and molecular data. The new species, Amolops nyingchiensis sp. nov. is assigned to the Amolops monticola group based on its skin smooth, dorsolateral fold distinct, lateral side of head black, upper lip stripe white extending to the shoulder. Amolops nyingchiensis sp. nov. is distinguished from all other species of Amolops by the following combination of characters: (1) medium body size, SVL 48.5-58.3 mm in males, and 57.6-70.7 mm in females; (2) tympanum distinct, slightly larger than one third of the eye diameter; (3) a small tooth-like projection on anteromedial edge of mandible; (4) the absence of white spine on dorsal surface of body; (5) the presence of circummarginal groove on all fingers; (6) the presence of vomerine teeth; (7) background coloration of dorsal surface brown, lateral body gray with yellow; (8) the presence of transverse bands on the dorsal limbs; (9) the presence of nuptial pad on the first finger in males; (10) the absence of vocal sac in males. Taxonomic status of the populations that were previously identified to A. monticola from Tibet is also discussed. PMID:26828032

  7. MRI pattern of infarcts in basal ganglia region in patients with tuberculous meningitis

    International Nuclear Information System (INIS)

    This study aimed to evaluate the pattern of infarct in basal ganglia region in tuberculous meningitis (TBM) and ischemic strokes and its sensitivity and specificity in the diagnosis of these disorders. Patients with TBM and ischemic strokes in basal ganglia region were retrospectively evaluated from our tuberculous meningitis and ischemic stroke registry. Magnetic resonance imaging findings were grouped into anterior (caudate, genu, anterior limb of internal capsule, anteromedial thalamus) and posterior (lentiform nuclei, posterior limb of internal capsule, posterolateral thalamus). The sensitivity and specificity of these patterns in diagnosing TBM and ischemic stroke were evaluated. There were 24 patients in each group. Infarct in TBM was purely anterior in eight patients and in ischemic stroke purely posterior in 18 patients. The frequency of caudate infarct was significantly higher in TBM compared to ischemic stroke (37.5% vs 8.3%). In TBM patients, purely posterior infarcts were present in seven patients; three had associated risk factors of ischemic stroke. The sensitivity of pure anterior infarct in the diagnosis of TBM was 33%, specificity 91.66%. For ischemic stroke, the sensitivity of posterior infarct was 75% and specificity 70.83%. TBM patients having infarcts in posterior region should be looked for associated risk factors of ischemic stroke. (orig.)

  8. Osteolipoma independent of bone tissue: a case report

    Science.gov (United States)

    Alderete, Joseph F; Kose, Ozkan; Ozcan, Ayhan; Cicek, Ilker; Basbozkurt, Mustafa

    2009-01-01

    Introduction Lipomas are the most common benign soft tissue tumors and appear in any part of the body. They typically consist of mature adipose tissue. Osteolipoma is an extremely rare histologic variant of lipoma that contains mature lamellar bone within the tumor and osteolipoma independent of bone tissue are very rare. We report a case of histologically confirmed osteolipoma independent of bone located in the thigh. Case presentation A 47-year-old male presented with a progressively enlarging, painful mass which approximately 10 cm × 8 cm over the anteromedial aspect of his right thigh. Plain films, Computerized Tomography, Magnetic Resonance Imaging and ultrasound guided needle biopsy were performed. Given the benign imaging characteristics and fine needle aspiration, an excisional biopsy was undertaken. The definitive pathologic diagnosis was intramuscular osteolipoma without evidence of malignancy. No recurrence was observed after 18 months follow up. Conclusion Although ossifying lipomas are very rare, it is important to keep them in mind when a lesion with adipose tissue in combination with ossification is encountered. PMID:19918398

  9. Morphological study in internal derangement of the temporomandibular joint with MRI. The relationships between the state of the articular disc and limitation of motion of the mandibular head

    International Nuclear Information System (INIS)

    In this study, we used MRI to investigate the relationships between these factors in temporomandibular joint (TMJ) patients, especially with regard to the range of condylar movement. Bone configurations and articular disc conditions were analyzed in a total of 367 TMJ of 255 internal derangement patients using MRI. We examined the influence of articular disc condition on functional disorder and identified the tendencies of the pathology of patients with internal derangements. Anterolateral displacement was more frequent than anteromedial displacement, and lateral rotary displacement was more frequent than medial rotary displacement. Therefore, the articular disc displaced more readily laterally, rather than medially. With regard to the relationship between the articular disc configuration and reduction, enlargement of the posterior band and biconvex discs showed a tendency for articular disc displacement that did not reduce, while discs with even thickness showed a tendency of articular disc displacement which would reduce. Folding and biconvexity tended to limit condylar movement while less limitation occurred with discs of even thickness. In cases of disc displacement without reduction, there was a significantly higher percentage of cases with limited condylar movement than in cases of displacement with reduction. (K.H.)

  10. Minimally Invasive Transforaminal Lumbar Interbody Fusion at L5-S1 through a Unilateral Approach: Technical Feasibility and Outcomes

    Science.gov (United States)

    Choi, Won-Suh; Kim, Jin-Sung; Ryu, Kyeong-Sik; Hur, Jung-Woo; Seong, Ji-Hoon

    2016-01-01

    Background. Minimally invasive spinal transforaminal lumbar interbody fusion (MIS-TLIF) at L5-S1 is technically more demanding than it is at other levels because of the anatomical and biomechanical traits. Objective. To determine the clinical and radiological outcomes of MIS-TLIF for treatment of single-level spinal stenosis low-grade isthmic or degenerative spondylolisthesis at L5-S1. Methods. Radiological data and electronic medical records of patients who underwent MIS-TLIF between May 2012 and December 2014 were reviewed. Fusion rate, cage position, disc height (DH), disc angle (DA), disc slope angle, segmental lordotic angle (SLA), lumbar lordotic angle (LLA), and pelvic parameters were assessed. For functional assessment, the visual analogue scale (VAS), Oswestry disability index (ODI), and patient satisfaction rate (PSR) were utilized. Results. A total of 21 levels in 21 patients were studied. DH, DA, SLA, and LLA had increased from their preoperative measures at the final follow-up. Fusion rate was 86.7% (18/21) at 12 months' follow-up. The most common cage position was anteromedial (15/21). The mean VAS scores for back and leg pain mean ODI scores improved significantly at the final follow-up. PSR was 88%. Cage subsidence was observed in 33.3% (7/21). Conclusions. The clinical and radiologic outcomes after MIS-TLIF at L5-S1 in patients with spinal stenosis or spondylolisthesis are generally favorable. PMID:27433472

  11. Neuronal fiber tracts connecting the brain and ventral nerve cord of the early Drosophila larva.

    Science.gov (United States)

    Cardona, Albert; Larsen, Camilla; Hartenstein, Volker

    2009-08-01

    By using a combination of dye injections, clonal labeling, and molecular markers, we have reconstructed the axonal connections between brain and ventral nerve cord of the first-instar Drosophila larva. Out of the approximately 1,400 neurons that form the early larval brain hemisphere, less than 50 cells have axons descending into the ventral nerve cord. Descending neurons fall into four topologically defined clusters located in the anteromedial, anterolateral, dorsal, and basoposterior brain, respectively. The anterolateral cluster represents a lineage derived from a single neuroblast. Terminations of descending neurons are almost exclusively found in the anterior part of the ventral nerve cord, represented by the gnathal and thoracic neuromeres. This region also contains small numbers of neurons with axons ascending into the brain. Terminals of the ascending axons are found in the same basal brain regions that also contain descending neurons. We have mapped ascending and descending axons to the previously described scaffold of longitudinal fiber tracts that interconnect different neuromeres of the ventral nerve cord and the brain. This work provides a structural framework for functional and genetic studies addressing the control of Drosophila larval behavior by brain circuits. PMID:19459219

  12. MRI of double-bundle ACL reconstruction: evaluation of graft findings

    Energy Technology Data Exchange (ETDEWEB)

    Kiekara, Tommi; Paakkala, Antti [Tampere University Hospital, Medical Imaging Centre, Tampere (Finland); Jaervelae, Timo [Sports Clinic and Hospital Mehilaeinen, Tampere (Finland); Huhtala, Heini [University of Tampere, School of Health Sciences, Tampere (Finland)

    2012-07-15

    To demonstrate the magnetic resonance imaging (MRI) findings of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction grafts. Sixty-six patients with DB ACL reconstruction were evaluated with MRI 2 years postoperatively. Graft thickness was measured separately by two musculoskeletal radiologists. The MRI findings of graft disruption, signal intensity (SI) changes, cystic degeneration, arthrofibrosis, and impingement were analyzed. The statistical significance of the association between MRI findings was calculated. The mean anteromedial (AM) graft thickness was reduced 9% and the mean posterolateral (PL) graft thickness was reduced 18% from the original graft thickness. Disruption was seen in 3% of AM grafts and 6% of PL grafts and a partial tear in 8 and 23%, respectively. Both grafts were disrupted in 3% of patients. Increased SI was seen in 14% of intact AM grafts and in 60% of partially torn AM grafts (p = 0.032). In PL grafts the increased SI was seen in 51% of the intact grafts and in 93% of the partially torn grafts (p = 0.005). Cystic degeneration was seen in 8% of AM grafts and in 5% of PL grafts. Diffuse arthrofibrosis was seen in 5% of patients and a localized cyclops lesion in 3% of patients. Impingement of the AM graft was seen in 8% of patients. Both grafts were disrupted in 3% of patients. Also, the frequencies of other complications were low. The use of orthogonal sequences in the evaluation of the PL graft SI seems to cause volume-averaging artefacts. (orig.)

  13. Static and dynamic postural stability in subjects with and without chronic low back pain

    Directory of Open Access Journals (Sweden)

    Heta Haresh Thakkar

    2015-09-01

    Methods: Thirty subjects (15 Chronic Low back Pain and 15 Normal subjects were recruited randomly who's demographic are not varied. The static and dynamic postural stability test namely postural sway meter and Star excursion balance test were analyzed. Data were analyzed using test of homogeneity and Independent sample t test. Results: Descriptive statistics reflected homogeneity of the study population. Independent sample t-test was used to compare values for static and dynamic stability between chronic low back pain and Normal subjects. It showed a statistically significant (P<0.05 difference in posterior and left lateral direction with t-value of -2.720 and -1.601 respectively for static stability. On the other hand, dynamic postural stability (SEBT showed significant difference in all direction except on right leg; anteromedial, anterolateral and right and left posterior direction. Conclusions: Chronic low back pain group showed reduction in static and dynamic postural stability as compared to normals'. [Int J Res Med Sci 2015; 3(9.000: 2405-2409

  14. The Anterior Thalamus Provides A Subcortical Circuit Supporting Memory And Spatial Navigation

    Directory of Open Access Journals (Sweden)

    Shane M O‘Mara

    2013-08-01

    Full Text Available The anterior thalamic nuclei, a central component of Papez’ circuit, are generally assumed to be key constituents of the neural circuits responsible for certain categories of learning and memory. Supporting evidence for this contention is that damage to either of two brain regions, the medial temporal lobe and the medial diencephalon, is most consistently associated with anterograde amnesia. Within these respective regions, the hippocampal formation and the anterior thalamic nuclei (anteromedial, anteroventral, anterodorsal are the particular structures of interest. The extensive direct and indirect hippocampal-anterior thalamic interconnections and the presence of theta-modulated cells in both sites further support the hypothesis that these structures constitute a neuronal network crucial for memory and cognition. The major tool in understanding how the brain processes information is the analysis of neuronal output at each hierarchical level along the pathway of signal propagation coupled with neuroanatomical studies. Here, we discuss the electrophysiological properties of cells in the anterior thalamic nuclei with an emphasis on their role in spatial navigation. In addition, we describe neuroanatomical and functional relationships between the anterior thalamic nuclei and hippocampal formation.

  15. THIRD HEAD OF BICEPS BRACHII WITH ANATOMICAL CONSIDERATION AND CLINICAL IMPLICATION- A CASE REPO RT

    Directory of Open Access Journals (Sweden)

    Mujahid Ansari

    2013-02-01

    Full Text Available ABSTRACT: Biceps brachii is a double headed muscle. In terms o f number and morphology of its head, it is one of the most variable muscles in the human body. Most common variation is third head, but four, five or even seven heads have been reported. In the present case report third head of biceps brachii was found on the flexo r compartment of left arm of an adult female cadaver .The third head of biceps br achii originated from the anteromedial surface of the humerus below the insertion o f coracobrachialis and which descended and merged with the other two heads to form com mon tendon and was inserted on to the radial tuberosity . Third heads might be significa nt in producing the strong flexion as well as supination of forearm. They may cause compression of neurovascular structures because of their close relationship to brachial artery and medi an nerve. Variant biceps brachii may confuse a surgeon who performs procedures on the arm and may lead to iatrogenic injuries. The surgeons and traumatologists have to keep such muscu lar variations in mind.

  16. Atypical multiple system atrophy is a new subtype of frontotemporal lobar degeneration: frontotemporal lobar degeneration associated with α-synuclein.

    Science.gov (United States)

    Aoki, Naoya; Boyer, Philip J; Lund, Cheryl; Lin, Wen-Lang; Koga, Shunsuke; Ross, Owen A; Weiner, Myron; Lipton, Anne; Powers, James M; White, Charles L; Dickson, Dennis W

    2015-07-01

    Multiple system atrophy (MSA) is a sporadic neurodegenerative disease clinically characterized by cerebellar signs, parkinsonism, and autonomic dysfunction. Pathologically, MSA is an α-synucleinopathy affecting striatonigral and olivopontocerebellar systems, while neocortical and limbic involvement is usually minimal. In this study, we describe four patients with atypical MSA with clinical features consistent with frontotemporal dementia (FTD), including two with corticobasal syndrome, one with progressive non-fluent aphasia, and one with behavioral variant FTD. None had autonomic dysfunction. All had frontotemporal atrophy and severe limbic α-synuclein neuronal pathology. The neuronal inclusions were heterogeneous, but included Pick body-like inclusions. The latter were strongly associated with neuronal loss in the hippocampus and amygdala. Unlike typical Pick bodies, the neuronal inclusions were positive on Gallyas silver stain and negative on tau immunohistochemistry. In comparison to 34 typical MSA cases, atypical MSA had significantly more neuronal inclusions in anteromedial temporal lobe and limbic structures. While uncommon, our findings suggest that MSA may present clinically and pathologically as a frontotemporal lobar degeneration (FTLD). We suggest that this may represent a novel subtype of FTLD associated with α-synuclein (FTLD-synuclein). PMID:25962793

  17. 肘前侧入路治疗尺骨冠突骨折的解剖与临床研究%Anatomical and clinical study of a novel anterial cubital approach for ulnar coronoid fractures

    Institute of Scientific and Technical Information of China (English)

    赵宝成; 袁天祥; 马信龙; 张金利; 马宝通; 马剑雄; 袁武; 胡芳科; 孙翔

    2015-01-01

    Objective To investigate the feasibility of a noval anterior cubital approach for the coronoid via flexor⁃prona⁃tor teres interval and assess the clinical result. Methods Five formalin⁃fixed adult cadaver elbows were used. Through a single universal anteromedial longitudinal skin incision, the coronoid tip was exposed via pronator and flexor carpiradialis interval, and coronoid anteromedial facet and base via palm longus and flexor carpi ulnaris interval. The distances from the entry point to the muscles or branching point of the nerves to the line passing through medial and lateral epicondyles, as well as the length were mea⁃sured with regard to the motor nerve branches arising from median nerve to pronator teres, flexor carpiradialis, palm longus and flexor digiti superficialis, as well as the most proximal two motor branches to flexor carpi ulnaris arising from ulnar nerve. From September 2013 to August 2014, 4 male patients with ulnar coronoid fracture were treated operatively through the above anterior cubital approach in our hospital. They were all left side involved, with an average age of 32 years (range, 16-42 years). According to O’Driscoll classification, there were two cases of type Ib and two cases IIb respectively. They were all treated by open reduction and internal fixation through flexor⁃pronator teres interval. Results At cubital fossa, there were 2-3 branches to the pronator teres mostly, 1 branch to flexor carpiradialis and palm longus arising from median nerve. The branch to the flexor digiti superficia⁃lis usually was long and thick, and divided into 2-5 short twigs near muscle. The branch to palm longus had the same trunk with that to flexor digiti superficialis. The branch to flexor digiti superficialis was the most proximal among those passed through the in⁃terval of pronator teres and flexor carpiradialis, and its entry point to the muscle had an averaged distance of 37.22 mm to the line passing through medial and lateral

  18. Reward, motivation, and emotion systems associated with early-stage intense romantic love.

    Science.gov (United States)

    Aron, Arthur; Fisher, Helen; Mashek, Debra J; Strong, Greg; Li, Haifang; Brown, Lucy L

    2005-07-01

    Early-stage romantic love can induce euphoria, is a cross-cultural phenomenon, and is possibly a developed form of a mammalian drive to pursue preferred mates. It has an important influence on social behaviors that have reproductive and genetic consequences. To determine which reward and motivation systems may be involved, we used functional magnetic resonance imaging and studied 10 women and 7 men who were intensely "in love" from 1 to 17 mo. Participants alternately viewed a photograph of their beloved and a photograph of a familiar individual, interspersed with a distraction-attention task. Group activation specific to the beloved under the two control conditions occurred in dopamine-rich areas associated with mammalian reward and motivation, namely the right ventral tegmental area and the right postero-dorsal body and medial caudate nucleus. Activation in the left ventral tegmental area was correlated with facial attractiveness scores. Activation in the right anteromedial caudate was correlated with questionnaire scores that quantified intensity of romantic passion. In the left insula-putamen-globus pallidus, activation correlated with trait affect intensity. The results suggest that romantic love uses subcortical reward and motivation systems to focus on a specific individual, that limbic cortical regions process individual emotion factors, and that there is localization heterogeneity for reward functions in the human brain. PMID:15928068

  19. Randall Selitto pressure algometry for assessment of bone-related pain in rats

    DEFF Research Database (Denmark)

    Falk, S.; Ipsen, D. H.; Appel, C. K.;

    2015-01-01

    Background: Deep pain is neglected compared with cutaneous sources. Pressure algometry has been validated in the clinic for assessment of bone-related pain in humans. In animal models of bone-related pain, we have validated the Randall Selitto behavioural test for assessment of acute and patholog...... a way to measure bone-related pain in animal models and could provide a supplement to the traditional behavioural tests and a means to study deep pain. © 2014 European Pain Federation - EFIC®.......Background: Deep pain is neglected compared with cutaneous sources. Pressure algometry has been validated in the clinic for assessment of bone-related pain in humans. In animal models of bone-related pain, we have validated the Randall Selitto behavioural test for assessment of acute and...... pathological bone pain and compared the outcome with more traditional pain-related behaviour measures. Methods: Randall Selitto pressure algometry was performed over the anteromedial part of the tibia in naïve rats, sham-operated rats, and rats inoculated with MRMT-1 carcinoma cells in the left tibia, and the...

  20. Posteromedial Corner of the Knee: The Neglected Corner.

    Science.gov (United States)

    Lundquist, Ryan B; Matcuk, George R; Schein, Aaron J; Skalski, Matthew R; White, Eric A; Forrester, Deborah M; Gottsegen, Christopher J; Patel, Dakshesh B

    2015-01-01

    The posteromedial corner of the knee (PMC) is an important anatomic structure that is easily seen but often overlooked on magnetic resonance (MR) images. Whereas the posterolateral corner has been referred to as the "dark side of the knee" by some authors owing to widespread lack of knowledge of its complex anatomy, even less is written about the PMC; yet it is as important as the posterolateral corner in multiligament injuries of the knee. The PMC lies between the posterior margin of the longitudinal fibers of the superficial medial collateral ligament (MCL) and the medial border of the posterior cruciate ligament (PCL). The anatomy of the PMC can be complex and the literature describing it can be confusing, at times oversimplifying it and at other times adding unnecessary complexity. Its most important structures, however, can be described more simply as five major components, and can be better shown with illustrations that emphasize the anatomic distinctions. Injuries to the PMC are important to recognize, as disruption of the supporting structures can cause anteromedial rotational instability (AMRI). Isolated PMC injuries are rare; most occur in conjunction with injuries to other important stabilizing knee structures such as the anterior cruciate ligament (ACL) and PCL. Unrecognized and unaddressed injury of the PMC is one of the causes of ACL and PCL graft failures. Recognition of PMC injuries is critical, as the diagnosis will often change or require surgical management. PMID:26172356

  1. Congenital bizarre parosteal osteochondromatous proliferation in unusual location and age: a case report.

    Science.gov (United States)

    Sökücü, Sami; Aycan, Osman Emre; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

    2016-01-01

    Bizarre parosteal osteochondromatous proliferation (BPOP, also known as Nora's lesion) is a rare, benign, locally aggressive condition defined as osteochondromatous exostosis arising from the bony cortex. BPOP presents predominantly in the 2nd and 3rd decades of life, and commonly arises from the periosteum of metacarpals and metatarses, though rare locations have been reported, including the long bones, the maxillae, the bones of calvaria, and the sesamoids. The case of an osteochondromatous lesion in an infant with an intra-abdominal mass arising from the iliac wing, an atypical location of benign solitary lesions, is reported. Benign solitary lesions are exceptional in this age group. The parents of the patient, who was born in term at 3600 grams, discovered a mass in the left groin and observed decreased movement in the lower left extremity. No history of trauma was reported. When the patient was 5 months of age, AP pelvic X-ray, computed tomography, and magnetic resonance imaging revealed a bony mass displacing intra-abdominal organs anteromedially. Biopsy reported an osteocartilaginous lesion with calcified mature cartilaginous fragments surrounded by plasmacytoid, monotone, fibrinoid cells in myxoid background. Differential diagnosis included osteochondroma, osteochondromyxoma, BPOP, fibrocartilaginous mesenchymoma, chondromyxoid fibroma, periosteal chondroma, soft tissue chondroma, myositis ossificans, and juxtacortical chondroma. Biopsy of the resected specimen determined a diagnosis of BPOP. At 6-month postoperative follow-up, neither symptoms nor complaints related to the mass were present. PMID:26854060

  2. The Effects of Patellar Taping on Dynamic Balance and Reduction of Pain in Athletic Women with Patellofemoral Pain Syndrome(PFPS

    Directory of Open Access Journals (Sweden)

    N Khoshraftare Yazdi

    2012-08-01

    Full Text Available Introduction: Patellofemoral pain syndrome(PFPS is the most common overuse syndrome in athletes. It is one of the causes of anterior knee pain in athletic population who attend to the sport medical clinics. Patellofemoral is more common among female athletes especially adolescents and young adults. Patellar taping provides an effective treatment in alleviating the symptoms of a high proportion of subjects who suffer from PFPS, though the mechanisms of pain reduction have not completely been established following its application. The purpose of this study was to investigate the effects of taping on dynamic balance and reduction of pain in athletic women with patellofemoral pain syndrome. Methods: Fifteen female athletes with patellofemoral pain syndrome participated in the study. Therefore, dynamic balance was assessed using a SEBT(Star Excursion Balance Test before and after application of patellar taping. The severity of pain was measured by VAS(Visual Analog Scale. Results: The results of variance analysis by VAS(p<0/008 in repeated measure indicated a statistically significant improvement in pain and in knee function in anterior, anteromedial, medial, posteromedial and anterolateral directions(p<0/05. Conclusion: The study results confirmed a significant improvement in reducing pain and increasing function (dynamic balance of female athletes with patellofemoral pain syndrome after patellar taping.

  3. The Effects of Plyometric Type Neuromuscular Training on Postural Control Performance of Male Team Basketball Players.

    Science.gov (United States)

    Asadi, Abbas; Saez de Villarreal, Eduardo; Arazi, Hamid

    2015-07-01

    Anterior cruciate ligament injuries are common in basketball athletes; common preventive programs for decreasing these injures may be enhancing postural control (PC) or balance with plyometric training. This study investigated the efficiency of plyometric training program within basketball practice to improve PC performance in young basketball players. Sixteen players were recruited and assigned either to a plyometric + basketball training group (PT) or basketball training group (BT). All players trained twice per week, but the PT + BT followed a 6-week plyometric program implemented within basketball practice, whereas the BT followed regular practice. The star excursion balance test (SEBT) at 8 directions (anterior, A; anteromedial, AM; anterolateral, AL; medial, M; lateral, L; posterior, P; posteromedial, PM; and posterolateral, PL) was measured before and after the 6-week period. The PT group induced significant improvement (p ≤ 0.05) and small to moderate effect size in the SEBT (A = 0.95, AM = 0.62, AL = 0.61, M = 0.36, L = 0.47, P = 0.27, PM = 0.25, PL = 0.24). No significant improvements were found in the BT group. Also, there were significant differences between groups in all directions except PM and PL. An integrated plyometric program within the regular basketball practice can lead to significant improvements in SEBT and consequently PC. It can be recommended that strength and conditioning professionals use PT to enhance the athletes' joint awareness and PC to reduce possible future injuries in the lower extremity. PMID:25563677

  4. Certain Actions from the Functional Movement Screen Do Not Provide an Indication of Dynamic Stability.

    Science.gov (United States)

    Lockie, Robert G; Callaghan, Samuel J; Jordan, Corrin A; Luczo, Tawni M; Jeffriess, Matthew D; Jalilvand, Farzad; Schultz, Adrian B

    2015-09-29

    Dynamic stability is an essential physical component for team sport athletes. Certain Functional Movement Screen (FMS) exercises (deep squat; left- and right-leg hurdle step; left- and right-leg in-line lunge [ILL]; left- and right-leg active straight-leg raise; and trunk stability push-up [TSPU]) have been suggested as providing an indication of dynamic stability. No research has investigated relationships between these screens and an established test of dynamic stability such as the modified Star Excursion Balance Test (mSEBT), which measures lower-limb reach distance in posteromedial, medial, and anteromedial directions, in team sport athletes. Forty-one male and female team sport athletes completed the screens and the mSEBT. Participants were split into high-, intermediate-, and low-performing groups according to the mean of the excursions when both the left and right legs were used for the mSEBT stance. Any between-group differences in the screens and mSEBT were determined via a one-way analysis of variance with Bonferroni post hoc adjustment (p excursion, r = 0.37; left-leg ILL and left stance leg posteromedial excursion, r = 0.46). The mSEBT clearly indicated participants with different dynamic stability capabilities. In contrast to the mSEBT, the selected FMS exercises investigated in this study have a limited capacity to identify dynamic stability in team sport athletes. PMID:26557187

  5. Ultrasound guided block of the saphenous neuroma following use of an AFO in a patient with paraplegia. A case report.

    Science.gov (United States)

    Kesikburun, S; Köroğlu Omaç, Ö; Yaşar, E; Yilmaz, B; Kenan Tan, A

    2014-04-01

    The saphenous nerve is the terminal branch of the femoral nerve and a pure sensory nerve that provide sensation to medial leg. Injury to saphanous nerve following trauma or surgery of the knee can result in formation of a painful neuroma along its distribution. We present a case of saphenous neuroma following use of an ankle-foot orthosis (AFO) in a patient with paraplegia. A 36-year-old patient with paraplegia who was capable of walking independently with his AFO presented to our department with a 3-month history of pain in his left calf. Examination revealed tenderness, paresthesias and positive Tinel sign over the anteromedial aspect of the calf. Ultrasonographic examination of the painful area showed a mass with heterogenous echogenity which was consistent with a saphenous neuroma at the site where fastener band of AFO compressed to skin. We performed a nerve block with steroid and local anesthetic injection under ultrasound guidance to the neuroma. The patient reported pain relief following injection. The use of the AFO may cause a painful saphenous neuroma which is an unusual cause of extremity pain in patients with paraplegia. Ultrasound may be a beneficial diagnostic tool and a guidance for the therapeutic interventions in this condition. PMID:24398411

  6. Traumatic Fracture in a patient of Osteopoikilosis with review of literature

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    Rohan Bansal

    2013-04-01

    Full Text Available Introduction: Osteopoikilosis or osteopathia condensans disseminata is a rare hereditary autosomal dominant sclerosing bone dysplasia. Patients are usually asymptomatic and the diagnosis is usually made incidentally on radiographs which show presence of symmetric, multiple, well defined, small ovoid areas of increased radiodensity clustered in peri-articular osseous regions with propensity for epiphyseal and metaphyseal involvement. There are no increased risks of pathological fracture in a case of osteopoikilosis and traumatic fracture healing in a case of osteopoikilosis is similar to fracture occurring in other normal patients. Case Report: A 34 years male, electrician came with history of accidental fall from height while working in office leading to development of pain and swelling over left lower leg and ankle diagnosed with Ruedi-Allgower classification type I pilon fracture(without fibula fracture no distal neuro-vascular deficit. Patient was offered surgical treatment in form of open reduction and internal fixation of tibial fracture by plate osteosynthesis using antero-medial approach , showed complete union and was followed up for eight months. Conclusion: Osteopoikilosis has a benign course and it should always be kept as a possible differential diagnosis for osteoblastic metastasis to avoid diagnositic dilemma. Diagnosis can be settled by routine x-rays ( for type ,extent and site of lesions, bones affected, clinical features of patient , histopathology and other systemic or pre-existing conditions. Keywords: Fracture , Osteopoikilosis , union, Pilon, Osteoblastic metastasis

  7. The jugular foramen: microsurgical anatomy and operative approaches.

    Science.gov (United States)

    Katsuta, T; Rhoton, A L; Matsushima, T

    1997-07-01

    The jugular foramen, based on these studies of microsurgical anatomy, is divided into three compartments: two venous and a neural or intrajugular compartment. The venous compartments consist of a larger posterolateral venous channel, the sigmoid part, which receives the flow of the sigmoid sinus, and a smaller anteromedial venous channel, the petrosal part, which receives the drainage of the inferior petrosal sinus. The petrosal part forms a characteristic venous confluens by also receiving tributaries from the hypoglossal canal, petroclival fissure, and vertebral venous plexus. The petrosal part empties into the sigmoid part through an opening in the medial wall of the jugular bulb between the glossopharyngeal nerve anteriorly and the vagus and accessory nerves posteriorly. The intrajugular or neural part, through which the glossopharyngeal, vagus, and accessory nerves course, is located between the sigmoid and petrosal parts at the site of the intrajugular processes of the temporal and occipital bones, which are joined by a fibrous or osseous bridge. The glossopharyngeal, vagus, and accessory nerves penetrate the dura on the medial margin of the intrajugular process of the temporal bone to reach the medial wall of the internal jugular vein. The operative approaches, which access the foramen and adjacent areas and are demonstrated in a stepwise manner, are the postauricular transtemporal, retrosigmoid, extreme lateral transcondylar, and preauricular subtemporal-infratemporal approaches. PMID:9218307

  8. Clinical study for findings of pneumothoraces on the plain chest film

    International Nuclear Information System (INIS)

    Two hundred and fifty cases of pneumothoraces in intensive care unit in the last seven and half years were reviewed. In intensive care unit, plain chest films are likely to be obtained on supine position that make difficult to diagnose pneumothorax, because of unusual distribution of air in the pleural cavity. In our institution, they were obtained in supine position in 75 %. In our series of 207 supine chest cases, anteromedial and subpulmonic recesses were involved in 11.6 % and 25.6 % respectively. Twenty five cases (12 %) showed unusual location of air. Several radiographic signs have been previously described to recognize this condition. Basilar hyperlucency was most reliable sign (100 %) of detecting subpulmonary pneumothorax. Double diaphragm sign (60 %) and distinct cardiac apex (46.6 %) were also reliable signs. Almost all cases of unusual pneumothoraces were recognized on supine radiographs. However, CT was useful to detect unusual pneumothorax in patient with pneumomediastinum or pulmonary contusion. Unusual pneumothoraces were seen only in traumatized patients. The importance of careful observation of plain chest films to detecte unusual pneumothorax in patients with blunt chest trauma was stressed. (author)

  9. Anatomical study of the positioning of guide wires for the reconstruction of the two bands of the anterior cruciate ligament using transtibial technique Estudo anatômico do posicionamento dos fios-guia para a reconstrução das duas bandas do ligamento cruzado anterior pela técnica transtibial

    Directory of Open Access Journals (Sweden)

    Christiano Saliba Uliana

    2012-05-01

    Full Text Available PURPOSE: To determine whether it is possible and the difficulty of anatomical placement of guide wires for reconstruction of the two bands of the anterior cruciate ligament using transtibial technique and to measure the angle and positioning of the anatomic tibial guide wires for this technique. METHODS: Ten cadaver knees were dissected and a guide wire was positioned in the center of origin and insertion of each band. Were collected measurements of the distance from: 1 the entry point of the guide wire on tibial tuberosity; 2 the medial end of the tibia; 3 the tibial articular surface. Were also measured the medial and caudal angles of the guide wires. RESULTS: For the anteromedial band the medial angle was 19±5º and the caudal was 44±4º.The distances were 20±2 mm from anterior tuberosity, 26±5 mm from the tibial plateau and 25±5 mm from the medial end of the tibia. For the posterolateral band the medial angle was 26±5º and the caudal one was 36±8°. The distances were 31±6 mm for the anterior tuberosity, 24±4 mm for the tibial plateau and 17±7 mm from the end of the tibia. CONCLUSIONS: It is possible to position the guide wires of the two bands to reconstruct the anterior cruciate ligament using transtibial technique. The parameters for the proper positioning of the guide wire from anteromedial band is caudal angle of 44º with entry point 20 mm from anterior tuberosity; for the posterolateral band the caudal angle is 36º; from the tibial tuberosity the distance is 31 mm. This technique is difficult to perform leaving its questionable reproducibility.OBJETIVOS: Determinar se é possível o posicionamento anatômico dos fios-guia para reconstrução das duas bandas do ligamento cruzado anterior pela técnica transtibial, sua dificuldade técnica e medir o posicionamento angular dos parâmetros anatômicos dos fios-guia tibiais para esta técnica. MÉTODOS: Dez joelhos de cadáveres foram dissecados e um fio guia foi posicionado no

  10. MRI pattern of infarcts in basal ganglia region in patients with tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Nair, P.P.; Kalita, J.; Misra, U.K. [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Neurology, Lucknow (India); Kumar, S. [Sanjay Gandhi Postgraduate Institute of Medical sciences, Department of Radiology, Lucknow (India)

    2009-04-15

    This study aimed to evaluate the pattern of infarct in basal ganglia region in tuberculous meningitis (TBM) and ischemic strokes and its sensitivity and specificity in the diagnosis of these disorders. Patients with TBM and ischemic strokes in basal ganglia region were retrospectively evaluated from our tuberculous meningitis and ischemic stroke registry. Magnetic resonance imaging findings were grouped into anterior (caudate, genu, anterior limb of internal capsule, anteromedial thalamus) and posterior (lentiform nuclei, posterior limb of internal capsule, posterolateral thalamus). The sensitivity and specificity of these patterns in diagnosing TBM and ischemic stroke were evaluated. There were 24 patients in each group. Infarct in TBM was purely anterior in eight patients and in ischemic stroke purely posterior in 18 patients. The frequency of caudate infarct was significantly higher in TBM compared to ischemic stroke (37.5% vs 8.3%). In TBM patients, purely posterior infarcts were present in seven patients; three had associated risk factors of ischemic stroke. The sensitivity of pure anterior infarct in the diagnosis of TBM was 33%, specificity 91.66%. For ischemic stroke, the sensitivity of posterior infarct was 75% and specificity 70.83%. TBM patients having infarcts in posterior region should be looked for associated risk factors of ischemic stroke. (orig.)

  11. Can anterior junction line be used to distinguish right middle from right upper lobe on CT scan?

    International Nuclear Information System (INIS)

    To evalvate the usefulness on a CT chest scan, of the anterior junction line as an anatomical landmark to distinguish the right middle and the right upper lobe We found that the anterior junction line has a constant anatomical relationship with the right upper and middle lobe, and with this in mind, analysed connvcntional CT films of 86 patients with normal lung(group A) and 30 with architectural distortion(group B). On a series of slices, we compared the location of slice 1 with that of slice 2(slice 1:the slice which includes the lowest portion of the anterior junction line, slice 2:the initial slice, in which the right middle lobe occupies the whole of the lung anterior to the right major fissure). In group A(n=86), the right upper lobe, as seen in the anteromedial zone of slice 1, was present in 83 cases(96.5%). The right upper lobe on slice 1 was absent in two cases(2.3%) in which a minor fissure was almost completely abent. In group B(n=30), the right upper lobe on slice 1 was absent in 19 cases(63.3%). We suggest that on a CT chest scan, the anterior junction line can be used as an anatomical landmark in the differentiation of the right middle from the right upper lobe, and as an indicator of the presence of architectural distortion

  12. Subpleural lung cysts in Down syndrome: prevalence and association with coexisting diagnoses

    International Nuclear Information System (INIS)

    Although subpleural cysts are known to be associated with Down syndrome, their etiology and prevalence remains unknown. To determine the prevalence of subpleural cysts in children with Down syndrome and the association with prematurity, congenital heart disease (CHD), extracorporeal membrane oxygenation (ECMO), and chronic ventilator support. A review of the CT examinations of 25 children with Down syndrome was performed to determine the presence, location, and distribution of cysts along with associated abnormalities. Charts were reviewed and coexistent diagnoses and past treatments were recorded. The prevalence of subpleural cysts was 36% with no significant association with CHD, ECMO, or chronic ventilator support. An association was found in the two children with a history of prematurity. The cysts were most commonly found in the anteromedial portion of the lung. Subpleural cysts are common in Down syndrome and should not be confused with another pathological process. An association with prematurity was found, but the low number of children in this study makes the connection uncertain. The etiology remains unclear, but it has been hypothesized that the cysts are associated with lung hypoplasia. (orig.)

  13. The effects of hyperammonemia in learning and brain metabolic activity.

    Science.gov (United States)

    Arias, Natalia; Fidalgo, Camino; Felipo, Vicente; Arias, Jorge L

    2014-03-01

    Ammonia is thought to be central in the development of hepatic encephalopathy. However, the specific relation of ammonia with brain energy depletions and learning has not been studied. Our work attempts to reproduce an increase in rat cerebral ammonia level, study the hyperamonemic animals' performance of two learning tasks, an allocentric (ALLO) and a cue guided (CG) task, and elucidate the contribution of hyperammonemia to the differential energy requirements of the brain limbic system regions involved in these tasks. To assess these goals, four groups of animals were used: a control (CHA) CG group (n = 10), a CHA ALLO group (n = 9), a hyperammonemia (HA) CG group (n = 7), and HA ALLO group (n = 8). Oxidative metabolism of the target brain regions were assessed by histochemical labelling of cytochrome oxidase (C.O.). The behavioural results revealed that the hyperammonemic rats were not able to reach the behavioural criterion in either of the two tasks, in contrast to the CHA groups. The metabolic brain consumption revealed increased C.O. activity in the anterodorsal thalamus when comparing the HA ALLO group with the CHA ALLO group. Significant differences between animals trained in the CG task were observed in the prelimbic, infralimbic, parietal, entorhinal and perirhinal cortices, the anterolateral and anteromedial striatum, and the basolateral and central amygdala. Our findings may provide fresh insights to reveal how the differential damage to the brain limbic structures involved in these tasks differs according to the degree of task difficulty. PMID:24415107

  14. An evoked potential mapping of transcallosal projections in the cat

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    A. Cukiert

    1989-03-01

    Full Text Available In ten adult cats anesthetized with ketamine hydrochloride the neocortex was exposed and rectangular pulses (1msec, 0.5 Hz and variable intensity were applied to discrete points of one side and transcallosal evoked potentials were recorded from the other. The stimulation and recording positions were determined on a cartesian map of most of the exposable neocortical areas and the potentials were analysed as to their components, voltage and latency. Passive spread and electrotonic potentials and the effects of increasing frequency were also analysed. The results showed large transcallosal potentials in some areas and an increase of potentials in the caudorostral direction, attaining the highest values in anteromedial areas of the suprasylvian gyrus. Confirming anatomical studies, a few silent spots were found in the motor and somesthetic cortex and in restricted posterior regions of the visual cortex, where small or zero voltages occurred. While causing weak contralateral potentials, stimulation of some posterior sites provoked high voltage potentials in anterior regions of the side being stimulated and in the corresponding area of the opposite site. These posterior sites are. poorly interconnected by the corpus callosum. The L-shaped indirect connection described in this work may be involved in some types of epilepsy and may explain the effectiveness of partial callosotomy in their treatment.

  15. DBS in tourette syndrome: rationale, current status and future prospects.

    Science.gov (United States)

    Visser-Vandewalle, V

    2007-01-01

    Tourette syndrome is a neuropsychiatric disorder with onset in early childhood and characterized by tics, often associated with behavioural abnormalities. Symptoms often disappear before or during adulthood. Treatment consists of psychotherapy or pharmacotherapy. A small percentage of patients is treatment refractory. After the introduction of deep brain stimulation (DBS) of the thalamus as a new therapeutical approach in 1999, several other brain nuclei have been targeted in a small number of patients, like the globus pallidus internus, anteromedial and ventroposterolateral part, and the nucleus accumbens. In the published reports, a tic reduction rate of at least 66% is described. The effects of DBS on associated behavioural disorders are more variable. The number of treated patients is small and it is unclear whether the effects of DBS are dependent on the target nucleus. The pathophysiology of Tourette syndrome is not well understood. On the basis of our current knowledge of cortico-basal ganglia-thalamocortical circuits, an explanation for the beneficial effects of DBS on tics is proposed. It is concluded that a meticulous evaluation of the electrode position, and a blinded assessment of the clinical effects on tics and behavioural disorders, is absolutely mandatory in order to identify the best target of DBS for Tourette syndrome. PMID:17691307

  16. Deep brain stimulation for Tourette syndrome.

    Science.gov (United States)

    Visser-Vandewalle, V; Kuhn, J

    2013-01-01

    Tourette syndrome is a neuropsychiatric disorder characterized by motor and vocal tics, often associated with behavioral disorders, with typical onset in early childhood. In most patients, the symptoms decrease spontaneously when adulthood is reached, or can be treated with behavioral therapy or medication. Only a small proportion of patients are candidates for surgical treatment. In 1999, thalamic deep brain stimulation (DBS) was introduced for intractable Tourette syndrome. Since then, a diversity of targets have been used, located mainly at the level of the medial part of the thalamus, in the globus pallidus internus (anteromedial limbic and posteroventrolateral motor part), the globus pallidus externus, and the internal capsule/nucleus accumbens. The pathophysiology of Tourette syndrome is still a matter of considerable debate. Current knowledge of cortical-basal ganglia-thalamocortical circuits provides explanations for the beneficial effects of DBS on tics. Inclusion and exclusion criteria have been formulated to identify good candidates for DBS. Because of the small number of patients, there is a strong need for multicenter double-blind trials with standard protocols. PMID:24112899

  17. Investigation and macroscopic anatomical study of referred pain in patients with hip disease.

    Science.gov (United States)

    Sakamoto, Junya; Morimoto, Yosuke; Ishii, Shun; Nakano, Jiro; Manabe, Yoshitaka; Okita, Minoru; Tsurumoto, Toshiyuki

    2014-02-01

    [Purpose] The aim of this study was to examine the incidence and patterns of referred pain in patients with hip disease, as well as the nerve distribution in the hip and knee joints of 2 cadavers. [Subjects and Methods] A total of 113 patients with hip joint disease were included in the investigation. The incidence of regional pain and referred pain patterns were evaluated before and after arthroplasty. Two cadavers were macroscopically observed to verify the nerve innervation of the hip and knee joints. [Results] Anterior knee pain was observed preoperatively in 13.3% (in resting) and 33.6% (in motion) of the patients, which was comparable with the incidence of greater trochanter pain. In addition, the preoperative incidence rates of knee pain in resting and motion markedly decreased postoperatively. Of note is the remarkable incidence of pain radiating to the ventral lower limb. An anteromedial innervation was determined in the cadavers by the articular branches of the obturator and femoral nerve, which supply small branches to the knee joints. [Conclusion] Our results suggest that the distribution of the incidence of pain among the patients with hip disease is diverse owing to the sensory distribution of the femoral and obturator nerves. PMID:24648632

  18. Meniscal repair using the Polysorb Meniscal Stapler XLS.

    Science.gov (United States)

    Oberlander, Michael A; Chisar, Michael A

    2005-09-01

    We present our technique of repair of meniscal tears in 11 patients using a newly designed stapler, the Polysorb Meniscal Stapler XLS (USS Sports Medicine, Norwalk, CT), to increase the effectiveness and ease of repair of tears in the vascular zone while limiting potential complications. The low-profile stapler comes with a reloadable pistol grip device and a disposable straight or 15 degrees upcurved shaft with a single preloaded 10-mm staple. Standard anteromedial and anterolateral portals were used, along with a superomedial portal for inflow. The portal was enlarged slightly to facilitate introduction of the cannula or the stapler directly into the knee. The nose of the stapler was applied to the superior surface of the inner edge of the meniscal tear. The sharp points on the tip of the nose were used to manipulate the inner edge and coapt the tear site. Firm pressure was applied to the meniscal tissue, and the nose of the stapler was embedded in the inner edge of the meniscus no more than 2 to 3 mm from the tear (as measured along the meniscal surface). The handle was pulled slowly as the staple engaged the meniscal tissue. This step was repeated every 3 to 4 mm to ensure ideal tear stabilization. PMID:16171646

  19. Dynamic variation of incidence of neural tube defects during 2002 to 2010 in Shandong province%2002-2010年山东省神经管缺陷发生率的动态变化

    Institute of Scientific and Technical Information of China (English)

    周凤荣; 李舸; 陈志欣; 张蓬; 范媛媛; 郝宝珍

    2012-01-01

    [目的]了解2002-2010年山东省神经管缺陷(neural tube defects,NTDs)发生率的变化趋势,为进一步开展预防工作提供依据. [方法]采用以医院为基础的监测方法收集资料,调查对象为孕28周至生后7d的围产儿,对2002-2010年全省17市出生缺陷监测网监测的642 282例围产儿,242例NTDs病例进行回顾性分析. [结果]NTDs发生率由2002年6.8/万下降到2010年的2.1/万,9年下降了69.1%,年下降率13.7%,农村NTDs下降幅度为75%,城市为61.1%;脊柱裂、脑膨出发生率分别下降了70.8%、80.0%. [结论]山东NTDs发生率呈下降趋势,农村下降幅度大于城市;脊柱裂、脑膨出发生率下降较快,进一步加强预防和产前诊断是降低发生率的有效措施.%[Objective] To study the variation trend in incidence of neural tube defects (NTDs) during 2002 to 2010 in Shandong Province. {Methods] Data were collected by hospital-based monitoring, with women of gestation of 28 weeks to seven days after birth as study subjects. And 642 282 perinates were monitored in the Provincial Birth Defect Monitoring Network in 17 regions all over the province,and 242 cases of NTDs during 2002 to 2010 were recorded and analyzed. [Results] Incidence of NTDs was 2. 1 per 10 000 in 2010,69. 1% reduction from 6. 8 per 10 000 in 2002,and yearly average reduction of 13. 7%. Incidence of NTDs decreased by 61. 1% and 75% in rural and urban areas,respectively,and incidence of spina bifida and encephalocele fell by 70. 8% and 80. 0%,respectively. [Conclusions] Incidence of NTDs showed a falling trend in Shandong province,more decrease in rural areas than in urban areas,and incidences of spina bifida and encephalocele fell faster. Babies with NTDs were in poor birth quality,higher perinatal mortality and poor prognosis. Effective preventive measures and prenatal diagnosis should be strengthened to reduce the occurrences of neural tube defects.

  20. Morphological evaluation of fetus CNS and its related anomalies; The advantages and limitations of prenatal diagnosis by means of MRI, US, and CT

    Energy Technology Data Exchange (ETDEWEB)

    Oi, Shizuo; Tamaki, Norihiko; Matsumoto, Satoshi; Katayama, Kazuaki; Mochizuki, Matsuto (Kobe Univ. (Japan). School of Medicine)

    1989-08-01

    The fetal central nervous system was evaluated morphologically by ultrasonography (US), magnetic resonance imaging (MRI), and CT scan to analyze the prenatal diagnostic value for anomalies. A total of 31 patients with 42 lesions had been diagnosed during the preceding 7 years. The patients included 24 with hydrocephalus, three with anencephaly, three with myeloschisis, three with holoprosencephaly, three with an encephalocele, two with a Dandy-Walker cyst, one with hydroencephalodysplasia, one with an intracranial neoplasm, one with sacrococcygeal teratoma, and one with sacral agenesis. Compared with US and MRI, CT proved to be more accurate in the detection of spine and cranium-bone morphology. This finding seems to be valuable in the diagnosis of spina bifida, cranium bifidum and some cases of hypertensive hydrocephalus, especially in the axial view. MRI was definitely superior in the anatomico-pathological diagnosis of cerebral dysgenesis, ventriculomegaly, intracranial tumors, and other brain parenchymal changes in view of multi-dimensional analysis. MRI performed poorly in the diagnosis of spine and cranium morphology. A super-conducting MRI system is still insufficient to demonstrate the spinal cord of a fetus. US used routinely and multidimensional slices were valuable for screening the CNS abnormalies. Intracranial hematomas had a specific echogenecity on US. However, US sometimes failed to demarcate the cerebral parenchymal or subdural morphological changes because its artifacts had hyperchoic shadows. While US, MRI, and CT were valuable diagnostic tools in the morphological evaluation of fetal CNS anomalies, each modality has different advantages and disadvantages. Diagnostic advandage,depending on the nature of the anamoly, can be achieved by using the complementary imaging modalities.

  1. Morphological evaluation of fetus CNS and its related anomalies

    International Nuclear Information System (INIS)

    The fetus central nervous system was evaluated morphologically by ultrasonography (US), magnetic resonance imaging (MRI), and CT scan to analyze the prenatal diagnostic value for CNS anomalies. A total of 31 patients with 42 lesions had been diagnosed during the preceding 7 years. The patients included 24 with hydrocephalus, three with anencephaly, three with myeloschisis, three with holoprosencephaly, three with an encephalocele, two with a Dandy-Walker cyst, one with hydroencephalodysplasia, one with an intracranial neoplasm, one with sacrococcygeal teratoma, and one with sacral agenesis. Compared with US and MRI, CT proved to be more accurate in the detection of spine and cranium-bone morphology. This finding seems to be valuable in the diagnosis of spina bifida, cranium bifidum and some cases of hypertensive hydrocephalus, especially in the axial view. MRI was definitely superior in the anatomico-pathological diagnosis of cerebral dysgenesis, ventriculomegaly, intracranial tumors, and other brain parenchymal changes in view of multi-dimensional analysis. The most considerable disadvantage of MRI in the diagnosis of a fetus CNS anomaly is the poor information about spine and cranium morphology. A super-conducting MRI system is still insufficient to demonstrate the spinal cord of a fetus. US was routinely used, and the multidimensional slices were useful for screening the CNS abnormalies. Some of the fetus brain lesions, such as intracranial hematomas, had a specific echogenecity on US. However, US sometimes failed to demarcate the cerebral parenchymal or subdural morphological changes because its artifacts had hyperchoic shadows. While US, MRI, and CT were valuable diagnostic tools in the morphological evaluation of fetus CNS and its related anomalies, each modality has different diagnostic advantages and disadvantages. Improvement can be expected when these diagnostic imaging modalities are complementary, depending upon the nature of the anatomy. (J.P.N.)

  2. Neural Tube Defects in Native Fars Ethnicity in Northern Iran

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    MJ Golalipour

    2010-09-01

    Full Text Available "nBackground: Neural tube defects (NTD are one of the leading causes of infant mortality worldwide. This study was de­signed to determine the prevalence of NTDs among native Fars ethnic groups during 1998-2005, and to identify maternal and demographic factors associated with NTDs. "nMethods: We performed a descriptive cross-sectional hospital-based study in Dezyani Hospital, Gorgan, North of Iran, since January 1998 until December 2005. The design was based on a sample of 30,639 births of native Fars ethnic groups. Data were analyzed by using spss V13.5 software and were compared with the chi-square test."nResults: The prevalence of NTDs in Native Fars during the 8-year period was 25.4 per 10000 births (95% confidence inter­val: 20.1-31.8. The prevalence of NTDs was 20.6/10000 and 30.6/10000 in males and females respectively but this differ­ence was not significant. The prevalence of spina bifida, anencephaly and encephalocele were 12.7, 11.4 and 1.3 per 10000 respec­tively. The rate of NTD was 48.9/10000 in newborns with mothers aged > 35 years. The highest rate of NTDs and spina bi­fida was in 2002. The highest and lowest rate of anencephaly was in 2005 and 2003 respectively. Twenty eight percent of the parents had consanguineous marriages. Degree relatedness 3, 4, 5 and 6 of consanguineous marriages were 12.8%, 9%, 3.8%, 2.5%, respectively. Also 47.5% of the parents resided in rural areas.  "nConclusion: This investigation showed that the rate of NTDs in Native Fars was higher in Iran. In addition, this rate is higher than the Canada and Ukraine and lower than Chinese people.

  3. The evaluation of cases with pneumothorax in the neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Müsemma Karabel

    2013-09-01

    Full Text Available Objectives: Early diagnosis and treatment is essentialin reducing mortality in newborns with pneumothorax. Inthis study, newborns with a diagnosis of pneumothorax inneonatal intensive care unit of our hospital were evaluatedand aimed to increase the awareness of physicians.Methods: 12 cases with pneumothorax were evaluatedretrospectively. The gender, birth weight, gestational age,mode of delivery, the presence of underlying disease,pneumothorax localization, implementation of the surfactantand mechanical ventilation and existence or absenceof mortality were recorded.Results: During the study, pneumothorax was detected12 patients. Male/female ratio was 1.4. Eight of the patientshad born with cesarean delivery, the mean birthweight of cases was 2623±912 g and, 66.7% of caseswere term babies. Pneumothorax was observed in thefirst week of life in all patients and it occurred spontaneouslyin 4 patients. The frequency of bilateral pneumothoraxwas 41.7%. For the treatment, closed tube drainagewas performed in 9 patients. The overall mortality ratewas 66.7%. Half of the patients who died had congenitalanomalies such as diaphragmatic eventration (n=1,hydrocephalus (n=1, encephalocel (n=1, non-immunehydrops fetalis (n=1.Conclusion: Additional congenital anomalies, such asPDAs and persistent pulmonary hypertension were foundto be effective on mortality in neonates with pneumothorax.Although, it is a life-threatening condition, the emergencytreatment is life saving. Therefore, in patients withrisk factors, keeping pneumothorax in mind is also thefirst step of the treatment. J Clin Exp Invest 2013; 4 (3:289-292Key words: Newborn, respiratuar distress, pneumothorax,treatment, outcome

  4. The child with a cephalocele: etiology, neuroimaging, and outcome.

    Science.gov (United States)

    Martínez-Lage, J F; Poza, M; Sola, J; Soler, C L; Montalvo, C G; Domingo, R; Puche, A; Ramón, F H; Azorín, P; Lasso, R

    1996-09-01

    We report a series of 46 children who were treated for one of the diverse forms of cranium bifidum during a period of 22 years. The purpose of the survey was to investigate pathogenetic factors involved in the development of cranial dysraphism and to analyze clinical and pathological factors that influence the patients' outcome. We also investigated the existence of associated intracranial anomalies, in a systematic way, using modern methods of neuroimaging, and related the findings to the patients' final results. The lesions were classified as encephalocele (n = 15), cranial meningocele (n = 3), atretic cephalocele (n = 26), cranium bifidum occultum (n = 1), and exencephaly (n = 1). There was an excess of the atretic form of cephaloceles in our series, a fact that probably reflects geographical variations described for cephaloceles in general. The location of the lesions was occipital in 29 children, parietal in 16, and temporal and frontobasal in one case each. In seven cases there was parental consanguinity. A familial history of malformations of the central nervous system was encountered in eight instances. Associated systemic abnormalities were present in 23 patients, while central nervous system anomalies were found in 36 children. Cephalocele repair was undertaken on 35 occasions. There were no surgical fatalities in the series. The mean follow-up time was of 7 years. Overall mortality for the whole group was of 17/46 or 36%. Twenty of the 29 survivors had no neurological sequelae, but only 18 children exhibited a competitive intelligence level. A good outcome was found to correlate well with: an average head size at birth, a normal initial neurological condition, operability of the lesions, and an absence of disorders of the neuronal migration. Neurological outcome depended also on the occurrence or not of hydrocephalus, while the intelligence level was mainly related to the absence of cerebral tissue within the sac of the malformation. PMID:8906370

  5. The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the role of MR imaging of the fetus to improve sonographic prenatal diagnosis of congenital anomalies. In 40 fetuses (not consecutive cases) with an abnormality diagnosed with ultrasound, additional MR imaging was performed. The basic sequence was a T2-weighted single-shot half Fourier (HASTE) technique. Head, neck, spinal, thoracic, urogenital, and abdominal fetal pathologies were found. This retrospective, observational study compared MR imaging findings with ultrasonographic findings regarding detection, topography, and etiology of the pathology. The MR findings were evaluated as superior, equal to, or inferior compared with US, in consent with the referring gynecologists. The role of these findings in relation to pregnancy management was studied and compared with postnatal follow-up in 30 of 40 babies. Fetal MRI technique was successful in 36 of 39 examinations and provided additional information in 21 of 40 fetuses (one twin pregnancy with two members to evaluate). More precise anatomy and location of fetal pathology (20 of 40 cases) and additional etiologic information (8 of 40 cases) were substantial advantages in cerebrospinal abnormalities [ventriculomegaly, encephalocele, vein of Galen malformation, callosal malformations, meningo(myelo)cele], in retroperitoneal abnormalities (lymphangioma, renal agenesis, multicystic renal dysplasia), and in neck/thoracic pathology [cervical cystic teratoma, congenital hernia diaphragmatica, congenital cystic adenomatoid lung malformation (CCAM)]. This improved parental counseling and pregnancy management in 15 pregnancies. In 3 cases, prenatal MRI findings did not correlate with prenatal ultrasonographic findings or neonatal diagnosis. The MRI provided a more detailed description and insight into fetal anatomy, pathology, and etiology in the vast majority of these selected cases. This improved prenatal parental counseling and postnatal therapeutic planning. (orig.)

  6. When folic acid fails: Insights from 20 years of neural tube defect surveillance in South Carolina.

    Science.gov (United States)

    Bupp, Caleb P; Sarasua, Sara M; Dean, Jane H; Stevenson, Roger E

    2015-10-01

    Neural tube defects (NTDs) are the most common of the severe malformations of the brain and spinal cord. Increased maternal intake of folic acid (FA) during the periconceptional period is known to reduce NTD risk. Data from 1046 NTD cases in South Carolina were gathered over 20 years of surveillance. It was possible to determine maternal periconceptional FA use in 615 NTD-affected pregnancies. In 163 occurrent (26.9%) and two recurrent (22%) NTD cases, the mothers reported periconceptional FA use. These women were older and more likely to be white. Maternal periconceptional FA usage was reported in 40.4% of cases of spina bifida with other anomalies but in only 25.2% of isolated spina bifida cases (P = 0.02). This enrichment for associated anomalies was not noted among cases of anencephaly or of encephalocele. Among the 563 subsequent pregnancies to mothers with previous NTD-affected pregnancies, those taking FA had a 0.4% NTD recurrence rate, but the recurrence without FA was 8.5%. NTDs with other associated findings were less likely to be prevented by FA, suggesting there is a background NTD rate that cannot be further reduced by FA. Nonetheless, the majority (73.9%) of NTDs in pregnancies in which the mothers reported periconceptional FA use were isolated NTDs of usual types. Cases in which FA failed in prevention of NTDs provide potential areas for further study into the causation of NTDs. The measures and techniques implemented in South Carolina can serve as an effective and successful model for prevention of NTD occurrence and recurrence. PMID:26108864

  7. Neural tube defects in Costa Rica, 1987-2012: origins and development of birth defect surveillance and folic acid fortification.

    Science.gov (United States)

    Barboza-Argüello, María de la Paz; Umaña-Solís, Lila M; Azofeifa, Alejandro; Valencia, Diana; Flores, Alina L; Rodríguez-Aguilar, Sara; Alfaro-Calvo, Thelma; Mulinare, Joseph

    2015-03-01

    Our aim was to provide a descriptive overview of how the birth defects surveillance and folic acid fortification programs were implemented in Costa Rica-through the establishment of the Registry Center for Congenital Anomalies (Centro de Registro de Enfermedades Congénitas-CREC), and fortification legislation mandates. We estimated the overall prevalence of neural tube defects (i.e., spina bifida, anencephaly and encephalocele) before and after fortification captured by CREC. Prevalence was calculated by dividing the total number of infants born with neural tube defects by the total number of live births in the country (1987-2012).A total of 1,170 newborns with neural tube defects were identified from 1987 to 2012 (1992-1995 data excluded); 628 were identified during the baseline pre-fortification period (1987-1991; 1996-1998); 191 during the fortification period (1999-2002); and 351 during the post-fortification time period (2003-2012). The overall prevalence of neural tube defects decreased from 9.8 per 10,000 live-births (95 % CI 9.1-10.5) for the pre-fortification period to 4.8 per 10,000 live births (95 % CI 4.3-5.3) for the post-fortification period. Results indicate a statistically significant (P < 0.05) decrease of 51 % in the prevalence of neural tube defects from the pre-fortification period to the post-fortification period. Folic acid fortification via several basic food sources has shown to be a successful public health intervention for Costa Rica. Costa Rica's experience can serve as an example for other countries seeking to develop and strengthen both their birth defects surveillance and fortification programs. PMID:24952876

  8. Supplement use and other characteristics among pregnant women with a previous pregnancy affected by a neural tube defect - United States, 1997-2009.

    Science.gov (United States)

    Arth, Annelise; Tinker, Sarah; Moore, Cynthia; Canfield, Mark; Agopian, Aj; Reefhuis, Jennita

    2015-01-16

    Neural tube defects (NTDs) include anomalies of the brain (anencephaly and encephalocele) and spine (spina bifida). Even with ongoing mandatory folic acid fortification of enriched cereal grain products, the U.S. Preventive Services Task Force recommends that women of childbearing potential consume a daily supplement containing 400 µg-800 µg of folic acid. Women with a prior NTD-affected pregnancy have an increased risk for having another NTD-affected pregnancy, and if they are planning another pregnancy, the recommendation is that they consume high-dosage folic acid supplements (4.0 mg/day) beginning ≥4 weeks before conception and continuing through the first 12 weeks of pregnancy. To learn whether folic acid supplementation (from multivitamins or single- ingredient supplements) was commonly used during pregnancy by women with a previous NTD-affected pregnancy, supplement use was assessed among a convenience sample of women with a previous NTD-affected pregnancy who participated in the National Birth Defects Prevention Study (NBDPS), a case-control study of major birth defects in the United States. Characteristics of women who previously had an NTD-affected pregnancy and whose index pregnancy (pregnancy included in NBDPS) was either affected by an NTD (N = 17) (i.e., recurrence-cases) or resulted in a live-born infant without a major birth defect (N = 10) (i.e., recurrence-controls) were assessed. Taking a supplement that included folic acid was more common among recurrence-control mothers (80%) than recurrence-case mothers (35%). The recommendation that women should take folic acid supplements just before and during early pregnancy is not being followed by many women and offers an opportunity for NTD prevention, especially among women who are at a higher risk because they have had a previous pregnancy affected by an NTD. PMID:25590679

  9. Giant dacryocystomucopyocele in an adult: a review of lacrimal sac enlargements with clinical and histopathologic differential diagnoses.

    Science.gov (United States)

    Perry, Lynn J P; Jakobiec, Frederick A; Zakka, Fouad R; Rubin, Peter A D

    2012-09-01

    Dacryocystocele is an umbrella term that refers to any diffuse, centrifugal enlargement of the lacrimal sac that results from combined proximal and distal obstructions in the tear drainage system. In adults, the presence of mucus in the cyst's contents leads to the modified term of dacryocystomucocele. If infection supervenes, which almost always occurs in protracted cases and adds the clinical dimension of a dacryocystitis, then a dacryocystomucopyocele is created. Dacryocystocele and its congeners are much rarer in adults than in children. We describe a 95-year-old woman with an acquired, enormous dacryocystomucopyocele, larger than any previously reported, that developed over 25 years and produced globe displacement with an associated conspicuous enlargement of the nasolacrimal duct. The aspirated sac fluid was mucopurulent and harbored low-virulence bacterial organisms of the Prevotella and Petosteptococcus species. In infants, dacryocystoceles are transitory as the result of spontaneously reversible factors. In adults, secondary proximal irreversible fibrotic strictures or bony changes around the nasolacrimal duct typically arise from chronic inflammation or low grade infection. Other possible causations of duct obstruction, in addition to florid mucosal edema, include encroachment on the duct by enlarged contiguous ethmoid air cells; a sinus mucocele or sinusitis; idiopathic, post-traumatic or dysplastic bony remodeling of the wall of the duct; and a neoplasm-all of which require some form of surgical intervention, typically dacryocystorhinostomy. The differential diagnosis of medial canthal swellings centered on the lacrimal sac spans malformations, diverticula, dermoid/epidermoid cysts, sac inflammations/infections causing swelling without generalized sac enlargement, encephaloceles and primary epithelial tumors, as well as extrinsic tumors impinging on the sac. PMID:22784678

  10. The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis.

    Science.gov (United States)

    Breysem, L; Bosmans, H; Dymarkowski, S; Schoubroeck, D Van; Witters, I; Deprest, J; Demaerel, P; Vanbeckevoort, D; Vanhole, C; Casaer, P; Smet, M

    2003-07-01

    The aim of this study was to evaluate the role of MR imaging of the fetus to improve sonographic prenatal diagnosis of congenital anomalies. In 40 fetuses (not consecutive cases) with an abnormality diagnosed with ultrasound, additional MR imaging was performed. The basic sequence was a T2-weighted single-shot half Fourier (HASTE) technique. Head, neck, spinal, thoracic, urogenital, and abdominal fetal pathologies were found. This retrospective, observational study compared MR imaging findings with ultrasonographic findings regarding detection, topography, and etiology of the pathology. The MR findings were evaluated as superior, equal to, or inferior compared with US, in consent with the referring gynecologists. The role of these findings in relation to pregnancy management was studied and compared with postnatal follow-up in 30 of 40 babies. Fetal MRI technique was successful in 36 of 39 examinations and provided additional information in 21 of 40 fetuses (one twin pregnancy with two members to evaluate). More precise anatomy and location of fetal pathology (20 of 40 cases) and additional etiologic information (8 of 40 cases) were substantial advantages in cerebrospinal abnormalities [ventriculomegaly, encephalocele, vein of Galen malformation, callosal malformations, meningo(myelo)cele], in retroperitoneal abnormalities (lymphangioma, renal agenesis, multicystic renal dysplasia), and in neck/thoracic pathology [cervical cystic teratoma, congenital hernia diaphragmatica, congenital cystic adenomatoid lung malformation (CCAM)]. This improved parental counseling and pregnancy management in 15 pregnancies. In 3 cases, prenatal MRI findings did not correlate with prenatal ultrasonographic findings or neonatal diagnosis. The MRI provided a more detailed description and insight into fetal anatomy, pathology, and etiology in the vast majority of these selected cases. This improved prenatal parental counseling and postnatal therapeutic planning. PMID:12695920

  11. The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Breysem, L.; Bosmans, H.; Dymarkowski, S.; Demaerel, P.; Vanbeckevoort, D.; Smet, M. [Department of Radiology, University Hospitals, Herestraat 49, 3000, Leuven (Belgium); Schoubroeck, D.Van; Witters, I.; Deprest, J. [Department of Obstetrics and Gynecology, University Hospitals, Herestraat 49, 3000, Leuven (Belgium); Vanhole, C.; Casaer, P. [Department of Pediatrics, University Hospitals, Herestraat 49, 3000, Leuven (Belgium)

    2003-07-01

    The aim of this study was to evaluate the role of MR imaging of the fetus to improve sonographic prenatal diagnosis of congenital anomalies. In 40 fetuses (not consecutive cases) with an abnormality diagnosed with ultrasound, additional MR imaging was performed. The basic sequence was a T2-weighted single-shot half Fourier (HASTE) technique. Head, neck, spinal, thoracic, urogenital, and abdominal fetal pathologies were found. This retrospective, observational study compared MR imaging findings with ultrasonographic findings regarding detection, topography, and etiology of the pathology. The MR findings were evaluated as superior, equal to, or inferior compared with US, in consent with the referring gynecologists. The role of these findings in relation to pregnancy management was studied and compared with postnatal follow-up in 30 of 40 babies. Fetal MRI technique was successful in 36 of 39 examinations and provided additional information in 21 of 40 fetuses (one twin pregnancy with two members to evaluate). More precise anatomy and location of fetal pathology (20 of 40 cases) and additional etiologic information (8 of 40 cases) were substantial advantages in cerebrospinal abnormalities [ventriculomegaly, encephalocele, vein of Galen malformation, callosal malformations, meningo(myelo)cele], in retroperitoneal abnormalities (lymphangioma, renal agenesis, multicystic renal dysplasia), and in neck/thoracic pathology [cervical cystic teratoma, congenital hernia diaphragmatica, congenital cystic adenomatoid lung malformation (CCAM)]. This improved parental counseling and pregnancy management in 15 pregnancies. In 3 cases, prenatal MRI findings did not correlate with prenatal ultrasonographic findings or neonatal diagnosis. The MRI provided a more detailed description and insight into fetal anatomy, pathology, and etiology in the vast majority of these selected cases. This improved prenatal parental counseling and postnatal therapeutic planning. (orig.)

  12. Agnathia-holoprosencephaly associated with a 46,XY,-21,+t(21q;21q) karyotype

    Energy Technology Data Exchange (ETDEWEB)

    Niedermeyer, K.K.; McCorquodale, M.M.; Burton, B.K. [Univ. of Illinois, Chicago, IL (United States)

    1994-09-01

    We report an unusual case of agnathia-holoprosencephaly associated with Down syndrome due to a 21/21 translocation. The patient presented prenatally at 21 wks gestation. A fetal ultrasound revealed multiple CNS anomalies including hydrocephalus, compressed cerebellum, absent septum pellucidum and possible cranial meningocele or encephalocele. High resolution ultrasound & fetal karyotype were recommended. The patient refused & elected to have a pregnancy termination. Chromosomal analysis performed on products of conception revealed a 46,XY,-21,+t(21q;21q) karyotype. Fluorescence in situ hybridization was performed and confirmed the 21/21 translocation chromosome. An autopsy revealed agnathia and multiple CNS anomalies including absence of the septum pellucidum, absence of the corpus callosum, arhinencephaly, an occiptal meningoencephalocele, dilation of the lateral ventricles, and extensive dysgenesis & heterotopias of the central cerebrum & mid-brain. Additional abnormalities included a persistent left superior vena cava, atrial & ventricular septal defects, irregular length of the fingers with absence of the middle phalanges of the right 2nd and 5th & left 5th digits and bilateral simian creases. Agnathia can be an isolated abnormality but often is associated with holoprosencephaly and/or situs inversus. The majority of familial case of agnathis-holoprosencephaly was caused by an inherited unbalanced translocation resulting in duplication of 6p and monosomy of 18p. Our patient had a translocation form of trisomy 21 but did not have a phenotype consistent with Down syndrome. Trisomy 21 has not been previously reported in other cases of agnathia-holoprosencephaly. Whether the chromosomal abnormality caused the phenotypic abnormalities or if it is a coincidental finding cannot be determined.

  13. Endoscopic third ventriculostomy

    Directory of Open Access Journals (Sweden)

    Yad Ram Yadav

    2012-01-01

    Full Text Available Endoscopic third ventriculostomy (ETV is considered as a treatment of choice for obstructive hydrocephalus. It is indicated in hydrocephalus secondary to congenital aqueductal stenosis, posterior third ventricle tumor, cerebellar infarct, Dandy-Walker malformation, vein of Galen aneurism, syringomyelia with or without Chiari malformation type I, intraventricular hematoma, post infective, normal pressure hydrocephalus, myelomeningocele, multiloculated hydrocephalus, encephalocele, posterior fossa tumor and craniosynostosis. It is also indicated in block shunt or slit ventricle syndrome. Proper Pre-operative imaging for detailed assessment of the posterior communicating arteries distance from mid line, presence or absence of Liliequist membrane or other membranes, located in the prepontine cistern is useful. Measurement of lumbar elastance and resistance can predict patency of cranial subarachnoid space and complex hydrocephalus, which decides an ultimate outcome. Water jet dissection is an effective technique of ETV in thick floor. Ultrasonic contact probe can be useful in selected patients. Intra-operative ventriculo-stomography could help in confirming the adequacy of endoscopic procedure, thereby facilitating the need for shunt. Intraoperative observations of the patent aqueduct and prepontine cistern scarring are predictors of the risk of ETV failure. Such patients may be considered for shunt surgery. Magnetic resonance ventriculography and cine phase contrast magnetic resonance imaging are effective in assessing subarachnoid space and stoma patency after ETV. Proper case selection, post-operative care including monitoring of ICP and need for external ventricular drain, repeated lumbar puncture and CSF drainage, Ommaya reservoir in selected patients could help to increase success rate and reduce complications. Most of the complications develop in an early post-operative, but fatal complications can develop late which indicate an importance of

  14. Limb body wall complex or body stalk complex or cyllosomas: a case report

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    S. Saritha

    2013-04-01

    Full Text Available Limb body wall complex (LBWC is also called Body stalk complex and Cyllosomas. We present this rare congenital malformation complex highlighting the importance of early sonographic imaging findings in LBWC along with differentiation from other anterior abdominal wall defects. Limb body wall complex / Body stalk anomaly refers to a rare complicated polymalformative fetal malformation syndrome of uncertain etiology and results in head, heart, lung, diaphragm, kidney or gonadal abnormalities. LBWC was first described by Van Allen et al; in (1987. The two of the three following anomalies must be present to establish the diagnosis: 1. Exencephaly / Encephalocele with facial clefts, 2. Thoraco-Abdominoschisis / ventral body wall defects and 3. Limb defects. LBWC arises as a result of early amnion disruptions or error in embryonic development. If all components of the syndrome are present, the condition is lethal. LBWC is invariably fatal and incompatible with life. No case of postnatal survival is reported so far. Serum alpha-fetoprotein measurement and ultrasonography examination is the key to the prenatal diagnosis and followed by medical termination of pregnancy. It presents two distinct phenotypes described by Russo et al (1993 and later Cusi et al in (1996, according to the foetoplacental relationships: 1. Placento-cranial and 2.Placento-abdominal types. Among the 168 live births at S.V.S. Medical College & hospital Mahabubnagar (INDIA during the period of 2010-2011 we came across an aborted female fetus. It was weighing 1800gms, 30 weeks of gestation diagnosed by antenatal ultrasonography as ventral body wall defect. It was associated with ompholocele, severe scoliosis and limb defects. Its confirmation of the diagnosis of Limb body wall complex with Placento-abdominal type was done by postmortem fetography. [Int J Res Med Sci 2013; 1(2.000: 132-137

  15. Osteotomia proximal da tíbia: estabilização da abertura medial com enxerto tricortical de ilíaco Proximal tibial osteotomy: stabilization of the medial opening with atricortical iliac bone graft

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    Roberto da Cunha Luciano

    2010-01-01

    Full Text Available OBJETIVO: Avaliação radiográfica do alinhamento do membro inferior, nos planos frontal e sagital, após osteotomia alta da tíbia. Para estabilização da osteotomia foi utilizado enxerto tricortical de ilíaco e parafuso de posicionamento. MÉTODOS: Estudo prospectivo envolvendo 46 pacientes com idade entre 17 e 61 anos, sendo 42 portadores de geno varo secundário à osteoartrose e quatro por outras causas. A telerradiografia foi realizada para planejamento cirúrgico, utilizando o método de Frank Noyes modificado por Fugizawa. Foi realizado acesso cirúrgico convencional de 3cm para retirada do enxerto tricortical de ilíaco. A osteotomia foi realizada sob controle de radioscopia, por incisão anteromedial de 3cm com liberação da porção superficial do ligamento colateral medial. O enxerto foi colocado na porção posterior da osteotomia, para manter inalterado o slope tibial. O parafuso cruzou a osteotomia ortogonalmente para proteger a cortical lateral. Foram estabelecidos critérios radiográficos pré e pós-operatórios para avaliação dos resultados. RESULTADOS: Houve consolidação em 100% dos casos e manutenção do eixo mecânico, obtido no intraoperatório, em 94%. A inclinação posterior do platô tibial, no plano sagital, variou entre 7º e 12º. A mobilidade articular foi restabelecida em todos os pacientes operados. Onze pacientes apresentaram dor temporária no local da retirada do enxerto; no entanto, nenhum apresentou parestesia. A incidência de complicações foi de 8% (infecção, perda da correção, fratura articular. CONCLUSÃO: A técnica mostrou-se reprodutível, simples, biológica, precisa e com baixos custos, podendo ser uma alternativa às técnicas já existentes.OBJECTIVE: Roentgenographic assessment of lower limb alignment, in the frontal and sagittal planes, after a high tibial osteotomy. To stabilize the osteotomy, a tricortical iliac graft was used along with a positioning screw. METHODS

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

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    Hong-yu XING

    2013-11-01

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

  17. Neurological manifestations and PET studies of the thalamic vascular lesions

    International Nuclear Information System (INIS)

    We divided 38 patients with cerebrovascular disease of the thalamus into 5 groups according to the site of the thalamic lesions as confirmed by X-ray CT and/or MRI. In 16 patients, we examined the cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) by positron emission tomography (PET). In the anteromedial thalamic lesion group, patients displayed disturbances of spontaneity, memory, reading and writing. CBF and CMRO2 were decreased in the frontal, parietal and temporal lobes on the side of the lesion. In the dorsolateral thalamic lesion group, ataxic hemiparesis was a characteristic symptom. CBF and CMRO2 were decreased in frontoparietal lobes on the side of the lesion. In the group with lesions confined to the nucleus ventralis posterioris thalami, the main symptoms were sensory disturbance, with cheiro-oral sensory syndrome being particularly evident. CBF and CMRO2 were decreased in the parietal lobe on the side of the lesion. In the group with posterolateral thalamic lesions without pulvinar involvement, patients exhibited thalamic syndrome without thalamic pain. CBF and CMRO2 were decreased in the frontoparietal and temporal lobes on the side of the lesion. In contrast, in the group with posterolateral thalamic lesions with pulvinar involvement, all patients showed thalamic pain. The decrease in CBF and CMRO2 extended to the inferomedial region of the temporal lobe in addition to the area of decreased CBF and CMRO2 observed in the group with posterolateral thalamic lesions without pulvinar involvement. Based on these results, we speculate that the neurological manifestations of thalamic vascular disease are associated with a decrease in cortical CBF and CMRO2 secondary to the thalamic lesions. (author)

  18. A two-choice strategy through a medial tibial approach for the treatment of pilon fractures with posterior or anterior fragmentation

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    Di Giorgio Luigi

    2013-10-01

    Full Text Available 【Abstract】Objective: The anterolateral approach to the tibia has been popularized for the management of tibial pilon fractures. For complex fracture patterns a combined anterolateral/anteromedial approach is suitable buta high rate of complicat ion has been reported. In our retrospective study a two-choice strategy adopting a medial tibial approach was proposed for the treatment of pilon fractures with anterior or posterior fragmentation. Methods: Based on an anatomic study of tibial pilon fractures, we retrospectively analyzed the fractures with primary posterior, posterior-lateral or anterior, anterior-lateral (Tillaux-Chaput involvement of the distal tibia. This retrospective study consisted of 18 patients with a closed tibial plafond fracture. The inclusion criteria were: (1 presence of an anterior/anterolateral type fragment or a posterior (Volkmann type fragment involving >25% of the articular surface, (2 a minimum follow-upof 12 months, (3 a fibula f racture associated with a medial column fracture of the distaltibia, and (4 soft tissue conditions at the time of operation that did not compromise the choice of surgical access (Tscher ne classi fication for closed fr actures: grade 0 and grade 1. Tibial plafond fractures were classified into two groups: one presenting anterior and the other with posterior rim (Volkmann fragments. Resul ts: Most patients achieved a good clinical recovery in terms of range of motion and Olerud-Molander scale scores. Only three patient s presented a grade 2 osteoarthritis at the 12 month follow-up. Conclusion: Our two-choice strategy highlights concepts which have been previously debated and described in the literature. But a new extended protocol for surgical approach to the distal tibia, including more fracture patterns and their association should be further investigated. Key words: Tibial fractures; Fracture fixation; Surgical procedures, operative; Intraoperative complications

  19. Pain following double-bundle anterior cruciate ligament reconstruction: Correlation with morphological graft findings and dynamic contrast-enhanced MRI

    International Nuclear Information System (INIS)

    Aim: To determine the relationship between knee pain following anterior cruciate ligament (ACL) graft placement with morphological graft findings and dynamic contrast enhancement as assessed at MRI. Material and methods: Following institutional review board approval, 37 consecutive patients with double-bundle ACL reconstruction were enrolled. Thirteen patients had pain and 24 were asymptomatic. Imaging was performed using a 1.5 T MRI machine an average of 7.6 months after surgery. Graft-related (increase signal intensity, abnormal orientation, discontinuity, cystic degeneration, anterior translation of lateral tibia, arthrofibrosis), and non-graft related causes of knee pain (meniscal tear, cartilage injury, loose bodies, and synovitis) were evaluated. During dynamic contrast enhancement analysis, peak enhancement (ePeak) was calculated by placing a region of interest at the osteoligamentous interface of each bundle. Student's t-test was used for continuous variables analysis and chi-square or Fisher's exact test was used for categorical variables analysis. Results: There was no difference between symptomatic and asymptomatic patients regarding morphological graft-related or non-graft-related causes of knee pain. For dynamic contrast enhancement analysis, symptomatic patients had significantly lower ePeak values than asymptomatic patients in the anteromedial (p = 0.008) and posterolateral (p = 0.001) bundles or when using the higher ePeak value in either bundle (p = 0.003). Conclusion: Morphological ACL graft findings as assessed at MRI could not be used to distinguish between symptomatic and asymptomatic patients. However, lower ePeak values had a significant association with knee pain. This may indicate poor neovascularization of the graft, potentially leading to graft failure. - Highlights: • Morphologic graft findings of MRI are poorly associated with knee pain. • Lower contrast enhancement values are significantly associated with knee pain

  20. Characterization of cognitive deficits in rats overexpressing human alpha-synuclein in the ventral tegmental area and medial septum using recombinant adeno-associated viral vectors.

    Directory of Open Access Journals (Sweden)

    Hélène Hall

    Full Text Available Intraneuronal inclusions containing alpha-synuclein (a-syn constitute one of the pathological hallmarks of Parkinson's disease (PD and are accompanied by severe neurodegeneration of A9 dopaminergic neurons located in the substantia nigra. Although to a lesser extent, A10 dopaminergic neurons are also affected. Neurodegeneration of other neuronal populations, such as the cholinergic, serotonergic and noradrenergic cell groups, has also been documented in PD patients. Studies in human post-mortem PD brains and in rodent models suggest that deficits in cholinergic and dopaminergic systems may be associated with the cognitive impairment seen in this disease. Here, we investigated the consequences of targeted overexpression of a-syn in the mesocorticolimbic dopaminergic and septohippocampal cholinergic pathways. Rats were injected with recombinant adeno-associated viral vectors encoding for either human wild-type a-syn or green fluorescent protein (GFP in the ventral tegmental area and the medial septum/vertical limb of the diagonal band of Broca, two regions rich in dopaminergic and cholinergic neurons, respectively. Histopathological analysis showed widespread insoluble a-syn positive inclusions in all major projections areas of the targeted nuclei, including the hippocampus, neocortex, nucleus accumbens and anteromedial striatum. In addition, the rats overexpressing human a-syn displayed an abnormal locomotor response to apomorphine injection and exhibited spatial learning and memory deficits in the Morris water maze task, in the absence of obvious spontaneous locomotor impairment. As losses in dopaminergic and cholinergic immunoreactivity in both the GFP and a-syn expressing animals were mild-to-moderate and did not differ from each other, the behavioral impairments seen in the a-syn overexpressing animals appear to be determined by the long term persisting neuropathology in the surviving neurons rather than by neurodegeneration.

  1. Mapping neurotransmitter networks with PET: an example on serotonin and opioid systems.

    Science.gov (United States)

    Tuominen, Lauri; Nummenmaa, Lauri; Keltikangas-Järvinen, Liisa; Raitakari, Olli; Hietala, Jarmo

    2014-05-01

    All functions of the human brain are consequences of altered activity of specific neural pathways and neurotransmitter systems. Although the knowledge of "system level" connectivity in the brain is increasing rapidly, we lack "molecular level" information on brain networks and connectivity patterns. We introduce novel voxel-based positron emission tomography (PET) methods for studying internal neurotransmitter network structure and intercorrelations of different neurotransmitter systems in the human brain. We chose serotonin transporter and μ-opioid receptor for this analysis because of their functional interaction at the cellular level and similar regional distribution in the brain. Twenty-one healthy subjects underwent two consecutive PET scans using [(11)C]MADAM, a serotonin transporter tracer, and [(11)C]carfentanil, a μ-opioid receptor tracer. First, voxel-by-voxel "intracorrelations" (hub and seed analyses) were used to study the internal structure of opioid and serotonin systems. Second, voxel-level opioid-serotonin intercorrelations (between neurotransmitters) were computed. Regional μ-opioid receptor binding potentials were uniformly correlated throughout the brain. However, our analyses revealed nonuniformity in the serotonin transporter intracorrelations and identified a highly connected local network (midbrain-striatum-thalamus-amygdala). Regionally specific intercorrelations between the opioid and serotonin tracers were found in anteromedial thalamus, amygdala, anterior cingulate cortex, dorsolateral prefrontal cortex, and left parietal cortex, i.e., in areas relevant for several neuropsychiatric disorders, especially affective disorders. This methodology enables in vivo mapping of connectivity patterns within and between neurotransmitter systems. Quantification of functional neurotransmitter balances may be a useful approach in etiological studies of neuropsychiatric disorders and also in drug development as a biomarker-based rationale for targeted

  2. A follow-up study of CT scan after the rupture of giant aneurysm of the bifurcation of an internal carotid artery

    International Nuclear Information System (INIS)

    A 42-year-old female with a giant intracranial aneurysm of the right IC bifurcation is reported. She had experienced severe headache with nausea and vomiting on July 6, 1984, and was admitted to a certain hospital. She was then transferred to our hospital on July 23; she was asymptomatic then. There was no neurological deficit, and a craniogram showed no abnormal findings. A plain CT scan, however, showed a round, homogenous, slightly high-density area on the right basal ganglia, and it was intensely enhanced by the infusion of a contrast medium. The right anterior horn was compressed to the anteromedial side. By the angiographical study, we found a large aneurysmal shadow with a bleb on its top, arising from the right IC bifurcation. While she waited for an operation, meanwhile undergoing reported Matas tests, the aneurysm began to bleed again. Suddenly generalized convulsions and the rapidly progressing left hemiparesis occurred, and she lost consciousness. The CT scan at that time showed a ring-shaped high-density area surrounding the aneurysms, accompanied by perifocal edema and a midline shift. An urgent operation was performed, but she died three days after the second attack. The autopsy showed a ruptured saccular aneurysm (3.5 x 4.0 x 4.0 cm in size) on the right IC bifurcation, with its neck extending to the M1 portion. There was neither calcification on the wall nor any organized thrombosis. Giant aneurysms usually affect the surrounding brain tissue as mass lesions. In this case, though, there was no sign or symptoms of any compression of the brain tissue or cranial nerves, though a CT scan soon after the rupture showed progressive perifocal edema. This suggests that there had been a previous disturbance of the autoregulation of the surrounding brain tissue, caused by the mass effect of the giant aneurysm. (author)

  3. Spinal cord stimulation modulates cerebral function: an fMRI study

    Energy Technology Data Exchange (ETDEWEB)

    Moens, M. [Universitair Ziekenhuis Brussel, Department of Neurosurgery and Center for Neuroscience, Brussels (Belgium); Sunaert, S.; Peeters, R. [UZ Leuven, Katholieke Universiteit Leuven, Department of Radiology, Leuven (Belgium); Marien, P. [ZNA Middelheim General Hospital, Department of Neurology, Antwerp (Belgium); Vrije Universiteit Brussel, Department of Clinical and Experimental Neurolinguistics, Brussels (Belgium); Brouns, R.; Smedt, A. de [Universitair Ziekenhuis Brussel, Department of Neurology and Center for Neuroscience, Brussels (Belgium); Droogmans, S. [Universitair Ziekenhuis Brussel, Department of Cardiology, Brussels (Belgium); Schuerbeek, P. van [Universitair Ziekenhuis Brussel, Department of Radiology, Brussels (Belgium); Poelaert, J. [Universitair Ziekenhuis Brussel, Department of Anesthesiology, Brussels (Belgium); Nuttin, B. [UZ Leuven, Katholieke Universiteit Leuven, Department of Neurosurgery, Leuven (Belgium)

    2012-12-15

    Although spinal cord stimulation (SCS) is widely used for chronic neuropathic pain after failed spinal surgery, little is known about the underlying physiological mechanisms. This study aims to investigate the neural substrate underlying short-term (30 s) SCS by means of functional magnetic resonance imaging in 20 patients with failed back surgery syndrome (FBSS). Twenty patients with FBSS, treated with externalized SCS, participated in a blocked functional magnetic resonance imaging design with stimulation and rest phases of 30 s each, repeated eight times in a row. During scanning, patients rated pain intensity over time using an 11-point numerical rating scale with verbal anchors (0 = no pain at all to 10 = worst pain imaginable) by pushing buttons (left hand, lesser pain; right hand, more pain). This scale was back projected to the patients on a flat screen allowing them to manually direct the pain indicator. To increase the signal-to-noise ratio, the 8-min block measurements were repeated three times. Marked deactivation of the bilateral medial thalamus and its connections to the rostral and caudal cingulate cortex and the insula was found; the study also showed immediate pain relief obtained by short-term SCS correlated negatively with activity in the inferior olivary nucleus, the cerebellum, and the rostral anterior cingulate cortex. Results indicate the key role of the medial thalamus as a mediator and the involvement of a corticocerebellar network implicating the modulation and regulation of averse and negative affect related to pain. The observation of a deactivation of the ipsilateral antero-medial thalamus might be used as a region of interest for further response SCS studies. (orig.)

  4. T1ρ MRI detects cartilage damage in asymptomatic individuals with a cam deformity.

    Science.gov (United States)

    Anwander, Helen; Melkus, Gerd; Rakhra, Kawan S; Beaulé, Paul E

    2016-06-01

    Hips with a cam deformity are at risk for early cartilage degeneration, mainly in the anterolateral region of the joint. T1ρ MRI is a described technique for assessment of proteoglycan content in hyaline cartilage and subsequently early cartilage damage. In this study, 1.5 Tesla T1ρ MRI was performed on 20 asymptomatic hips with a cam deformity and compared to 16 healthy control hips. Cam deformity was defined as an alpha angle at 1:30 o'clock position over 60° and/or at 3:00 o'clock position over 50.5°. Hip cartilage was segmented and divided into four regions of interest (ROIs): anterolateral, anteromedial, posterolateral, and posteromedial quadrants. Mean T1ρ value of the entire weight bearing cartilage in hips with a cam deformity (34.0 ± 4.6 ms) was significantly higher compared to control hips (31.3 ± 3.2 ms, p = 0.050). This difference reached significance in the anterolateral (p = 0.042) and posteromedial quadrants (p = 0.041). No significant correlation between the alpha angle and T1ρ values was detected. The results indicate cartilage damage occurs in hips with a cam deformity before symptoms occur. A significant difference in T1ρ values was found in the anterolateral quadrant, the area of direct engagement of the deformity, and in the posteromedial quadrant. To conclude, T1ρ MRI can detect early chondral damage in asymptomatic hips with a cam deformity. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1004-1009, 2016. PMID:26573964

  5. The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy.

    Science.gov (United States)

    McKee, Ann C; Cairns, Nigel J; Dickson, Dennis W; Folkerth, Rebecca D; Keene, C Dirk; Litvan, Irene; Perl, Daniel P; Stein, Thor D; Vonsattel, Jean-Paul; Stewart, William; Tripodis, Yorghos; Crary, John F; Bieniek, Kevin F; Dams-O'Connor, Kristen; Alvarez, Victor E; Gordon, Wayne A

    2016-01-01

    Chronic traumatic encephalopathy (CTE) is a neurodegeneration characterized by the abnormal accumulation of hyperphosphorylated tau protein within the brain. Like many other neurodegenerative conditions, at present, CTE can only be definitively diagnosed by post-mortem examination of brain tissue. As the first part of a series of consensus panels funded by the NINDS/NIBIB to define the neuropathological criteria for CTE, preliminary neuropathological criteria were used by 7 neuropathologists to blindly evaluate 25 cases of various tauopathies, including CTE, Alzheimer's disease, progressive supranuclear palsy, argyrophilic grain disease, corticobasal degeneration, primary age-related tauopathy, and parkinsonism dementia complex of Guam. The results demonstrated that there was good agreement among the neuropathologists who reviewed the cases (Cohen's kappa, 0.67) and even better agreement between reviewers and the diagnosis of CTE (Cohen's kappa, 0.78). Based on these results, the panel defined the pathognomonic lesion of CTE as an accumulation of abnormal hyperphosphorylated tau (p-tau) in neurons and astroglia distributed around small blood vessels at the depths of cortical sulci and in an irregular pattern. The group also defined supportive but non-specific p-tau-immunoreactive features of CTE as: pretangles and NFTs affecting superficial layers (layers II-III) of cerebral cortex; pretangles, NFTs or extracellular tangles in CA2 and pretangles and proximal dendritic swellings in CA4 of the hippocampus; neuronal and astrocytic aggregates in subcortical nuclei; thorn-shaped astrocytes at the glial limitans of the subpial and periventricular regions; and large grain-like and dot-like structures. Supportive non-p-tau pathologies include TDP-43 immunoreactive neuronal cytoplasmic inclusions and dot-like structures in the hippocampus, anteromedial temporal cortex and amygdala. The panel also recommended a minimum blocking and staining scheme for pathological evaluation

  6. Pattern of regional cortical thinning associated with cognitive deterioration in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Javier Pagonabarraga

    Full Text Available BACKGROUND: Dementia is a frequent and devastating complication in Parkinson's disease (PD. There is an intensive search for biomarkers that may predict the progression from normal cognition (PD-NC to dementia (PDD in PD. Mild cognitive impairment in PD (PD-MCI seems to represent a transitional state between PD-NC and PDD. Few studies have explored the structural changes that differentiate PD-NC from PD-MCI and PDD patients. OBJECTIVES AND METHODS: We aimed to analyze changes in cortical thickness on 3.0T Magnetic Resonance Imaging (MRI across stages of cognitive decline in a prospective sample of PD-NC (n = 26, PD-MCI (n = 26 and PDD (n = 20 patients, compared to a group of healthy subjects (HC (n = 18. Cortical thickness measurements were made using the automatic software Freesurfer. RESULTS: In a sample of 72 PD patients, a pattern of linear and progressive cortical thinning was observed between cognitive groups in cortical areas functionally specialized in declarative memory (entorhinal cortex, anterior temporal pole, semantic knowledge (parahippocampus, fusiform gyrus, and visuoperceptive integration (banks of the superior temporal sulcus, lingual gyrus, cuneus and precuneus. Positive correlation was observed between confrontation naming and thinning in the fusiform gyrus, parahippocampal gyrus and anterior temporal pole; clock copy with thinning of the precuneus, parahippocampal and lingual gyrus; and delayed memory with thinning of the bilateral anteromedial temporal cortex. CONCLUSIONS: The pattern of regional decreased cortical thickness that relates to cognitive deterioration is present in PD-MCI patients, involving areas that play a central role in the storage of prior experiences, integration of external perceptions, and semantic processing.

  7. V-Y and rotation flap for reconstruction of the epicanthal fold.

    Science.gov (United States)

    Shin, Yong Ho; Hwang, Pil Joong; Hwang, Kun

    2012-07-01

    Epicanthoplasty is commonly performed on Asian eyelids. Consequently, overcorrection may appear. The aim of this study was to introduce a method of reconstructing the epicanthal fold and to apply this method to the patients. A V flap with an extension (eagle beak shaped) was designed on the medial canthal area. The upper incision line started near the medial end of the double-fold line, and it followed its curvature inferomedially. For the lower incision, starting at the tip (medial end) of the flap, a curvilinear incision was designed first diagonally and then horizontally along the lower blepharoplasty line. The V flap was elevated as thin as possible. Then, the upper flap was deeply undermined to make it thick. The lower flap was made a little thinner than the upper flap. Then, the upper and lower flaps were approximated to form the anteromedial surface of the epicanthal fold in a fashion sufficient to cover the red caruncle. The V flap was rotated inferolaterally over the caruncle. The tip of the V flap was sutured to the medial one-third point of the lower margin. The inferior border of the V flap and the residual lower margin were approximated. Thereafter, the posterolateral surface of the epicanthal fold was made. From 1999 to 2011, 246 patients were operated on using this method. Among them, 62 patients were followed up. The mean intercanthal distance was increased from 31.7 to 33.8 mm postoperatively. Among the 246 patients operated on, reoperation was performed for 6 patients. Among the 6 patients reoperated on, 3 cases were due to epicanthus inversus, 1 case was due to insufficient reconstruction, 1 case was due to making an infold, and 1 case was due to reopening the epicanthal fold.This V-Y and rotation flap can be a useful method for reconstruction of the epicanthal fold. PMID:22801149

  8. The effects of traditional and enforced stopping speed and agility training on multidirectional speed and athletic function.

    Science.gov (United States)

    Lockie, Robert G; Schultz, Adrian B; Callaghan, Samuel J; Jeffriess, Matthew D

    2014-06-01

    This study investigated the effects of a traditional speed and agility training program (TSA) and an enforced stopping program emphasizing deceleration (ESSA). Twenty college-aged team sport athletes (16 males, 4 females) were allocated into the training groups. Pretesting and posttesting included: 0-10, 0-20, 0-40 m sprint intervals, change-of-direction, and acceleration test (CODAT), T-test (multidirectional speed); vertical, standing broad, lateral, and drop jumps, medicine ball throw (power); Star Excursion Balance Test (posteromedial, medial, anteromedial reaches; dynamic stability); and concentric (240° · s(-1)) and eccentric (30° · s(-1)) knee extensor and flexor isokinetic testing (unilateral strength). Both groups completed a 6-week speed and agility program. The ESSA subjects decelerated to a stop within a specified distance in each drill. A repeated measures analysis of variance determined significant (p ≤ 0.05) within- and between-group changes. Effect sizes (Cohen's d) were calculated. The TSA group improved all speed tests (d = 0.29-0.96), and most power tests (d = 0.57-1.10). The ESSA group improved the 40-m sprint, CODAT, T-test, and most power tests (d = 0.46-1.31) but did not significantly decrease 0-10 and 0-20 m times. The TSA group increased posteromedial and medial excursions (d = 0.97-1.89); the ESSA group increased medial excursions (d = 0.99-1.09). The ESSA group increased concentric knee extensor and flexor strength, but also increased between-leg knee flexor strength differences (d = 0.50-1.39). The loading associated with stopping can increase unilateral strength. Coaches should ensure deceleration drills allow for appropriate sprint distances before stopping, and athletes do not favor 1 leg for stopping after deceleration. PMID:24169474

  9. Plantar talar head contusions and osteochondral fractures: associated findings on ankle MRI and proposed mechanism of injury

    International Nuclear Information System (INIS)

    To evaluate the significance of plantar talar head injury (PTHI) in predicting osseous and soft tissue injuries on ankle MRI. The IRB approved this HIPAA-compliant retrospective study. The study group consisted of 41 ankle MRIs with PTHI that occurred at our institution over a 5 1/2 year period. Eighty MRIs with bone injuries in other locations matched for age, time interval since injury, and gender formed a control group. Injuries to the following structures were recorded: medial malleolus, lateral malleolus/distal fibula, posterior malleolus, talus, calcaneus, navicular, cuboid, lateral, medial and syndesmotic ligaments, spring ligament complex, and extensor digitorum brevis (EDB) muscle. Twenty separate logistic regressions determined which injuries PTHI predicted, using the Holm procedure to control for family-wise alpha at 0.05. PTHI strongly predicted the occurrence of injuries involving the anterior process of the calcaneus [24 % of cases, odds ratio (OR) 12.66], plantar components of the spring ligament (27 %, OR 9.43), calcaneal origin of the EDB and attachment of the dorsolateral calcaneocuboid ligament (22 %, OR 7.22), cuboid (51 %, OR 6.58), EDB (27 %, OR 5.49), anteromedial talus (66 %, OR 4.78), and posteromedial talus (49 %, OR 4.48). PTHI strongly predicted lack of occurrence of syndesmotic ligament injury (OR 19.6). The PTHI group had a high incidence of lateral ligamentous injury (78 %), but not significantly different from the control group (53 %). PTHI is strongly associated with injury involving the transverse tarsal joint complex. We hypothesize it results from talo-cuboid and/or talo-calcaneal impaction from a supination injury of the foot and ankle. (orig.)

  10. Changes in brain oxidative metabolism induced by inhibitory avoidance learning and acute administration of amitriptyline.

    Science.gov (United States)

    González-Pardo, Héctor; Conejo, Nélida M; Arias, Jorge L; Monleón, Santiago; Vinader-Caerols, Concepción; Parra, Andrés

    2008-05-01

    The effects of antidepressant drugs on memory have been somewhat ignored, having been considered a mere side effect of these compounds. However, the memory impairment caused by several antidepressants could be considered to form part of their therapeutic effects. Amitriptyline is currently one of the most prescribed tricyclic antidepressants, and exerts marked anticholinergic and antihistaminergic effects. In this study, we evaluated the effects of inhibitory avoidance (IA) learning and acute administration of amitriptyline on brain oxidative metabolism. Brain oxidative metabolism was measured in several limbic regions using cytochrome oxidase (CO) quantitative histochemistry. Amitriptyline produced a clear impairment in the IA task. In animals exposed only to the apparatus, amitriptyline decreased CO activity in nine brain regions, without affecting the remaining regions. In animals that underwent the IA training phase, amitriptyline reduced CO activity in only three of these nine regions. In animals treated with saline, IA acquisition increased CO activity in the medial prefrontal cortex, the prelimbic cortex, and the medial mammillary body, and diminished it in the medial septum and the nucleus basalis of Meynert with respect to animals exposed only to the IA apparatus. In animals treated with amitriptyline, IA acquisition did not modify CO activity in any of these regions, but increased it in the anteromedial nucleus of the thalamus, the diagonal band of Broca, and the dentate gyrus. The results reveal a pattern of changes in brain oxidative metabolism induced by IA training in saline-treated animals that was clearly absent in animals submitted to the same behavioural training but treated with amitriptyline. PMID:18313125

  11. Reconstrução anatômica do LCA com duplo feixe: primeiros 40 casos Anatomical ACL reconstruction with double bundle: first 40 cases

    Directory of Open Access Journals (Sweden)

    Ari Zekcer

    2011-01-01

    Full Text Available OBJETIVO: Discutir a técnica de reconstrução anatômica do ligamento cruzado anterior (LCA com duplo feixe, a curva de aprendizado e os resultados preliminares. MÉTODOS: Quarenta pacientes com lesão do LCA foram submetidos à reconstrução anatômica com duplo feixe, utilizando-se do tendão semitendinoso para refazer a banda anteromedial (AM e gracilis para refazer a banda posterolateral (PL do joelho. RESULTADOS: Tivemos dois casos de limitação de extensão, sendo que em um deles foi necessária a realização de artrólise artroscópica, e um caso de trombose venosa profunda. CONCLUSÃO: A reconstrução do LCA com duplo feixe se mostrou factível, apesar de apresentar uma maior curva de aprendizado; e as vantagens da técnica proposta ainda deverão ser comprovadas se comparada com a técnica de feixe único.OBJECTIVE: To discuss the technique of anatomical reconstruction of the anterior cruciate ligament (ACL with double beam, the learning curve and preliminary results. METHODS: Forty patients with ACL injury underwent reconstruction with anatomical double-bundle, using the semitendinosus tendon to remake the band anterior medial (AM and gracile to remake the band posterior lateral (PL of the knee. RESULTS: We had two cases of limitation of extension, and in one of them were necessary to perform arthroscopic artrolise, and one case of deep vein thrombosis. CONCLUSION: ACL reconstruction with double bundle proved feasible, despite having a higher learning curve, and the advantages of the proposed technique still must be proven compared to the single-beam technique.

  12. Comparison between plain chest film and CT in estimating the size of pneumothorax

    International Nuclear Information System (INIS)

    Regarding the patients diagnosed as having traumatic and spontaneous pneumothorax at our emergency center within the past 6 years we examined the distribution of pneumothorax shown by plain chest film and CT, and compared the pneumothorax rate evaluated by Kircher's method with plain chest film and that by one slice method with CT, which was based on full slice integration method with CT. Occult pneumothorax was found in 47.6% of traumatic cases and 11.1% of spontaneous cases. The distribution of pneumothoraces showed no significant differences. However, as compared with classical pneumothorax, the ratio of pneumothoraces in the apicolateral recess in the occult pneumothoraces tended to be lower, whereas the ratio of the ones in the anteromedial recess and in the subpulmonic recess tended to be comparatively high. The plain chest film of occult pneumothorax had been taken on supine position in most cases of traumatic pneumothorax and in more than half the cases of spontaneous pneumothorax. This was considered to be the cause of the unique distribution of pneumothorax. The pneumothorax rate evaluated by Kircher's method tended to be underestimated in comparison with the basic rate, where the correlation coefficient was R=0.84 for traumatic pneumothorax and R=0.14 for spontaneous pneumothorax. Especially in the cases of low pneumothorax rate the correlation was poor. The pneumothorax rate calculated by one slice method produced better figures with the correlation coefficient of R=0.92 for traumatic pneumothorax and R=0.85 for spontaneous pneumothorax. The one slice method was considered to be effective in evaluation of the degree of serious cases, and also for the choice of treatment modality for pneumothorax. (author)

  13. Comparison between plain chest film and CT in estimating the size of pneumothorax

    Energy Technology Data Exchange (ETDEWEB)

    Seto, Yuichi [Saint Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

    1995-08-01

    Regarding the patients diagnosed as having traumatic and spontaneous pneumothorax at our emergency center within the past 6 years we examined the distribution of pneumothorax shown by plain chest film and CT, and compared the pneumothorax rate evaluated by Kircher`s method with plain chest film and that by one slice method with CT, which was based on full slice integration method with CT. Occult pneumothorax was found in 47.6% of traumatic cases and 11.1% of spontaneous cases. The distribution of pneumothoraces showed no significant differences. However, as compared with classical pneumothorax, the ratio of pneumothoraces in the apicolateral recess in the occult pneumothoraces tended to be lower, whereas the ratio of the ones in the anteromedial recess and in the subpulmonic recess tended to be comparatively high. The plain chest film of occult pneumothorax had been taken on supine position in most cases of traumatic pneumothorax and in more than half the cases of spontaneous pneumothorax. This was considered to be the cause of the unique distribution of pneumothorax. The pneumothorax rate evaluated by Kircher`s method tended to be underestimated in comparison with the basic rate, where the correlation coefficient was R=0.84 for traumatic pneumothorax and R=0.14 for spontaneous pneumothorax. Especially in the cases of low pneumothorax rate the correlation was poor. The pneumothorax rate calculated by one slice method produced better figures with the correlation coefficient of R=0.92 for traumatic pneumothorax and R=0.85 for spontaneous pneumothorax. The one slice method was considered to be effective in evaluation of the degree of serious cases, and also for the choice of treatment modality for pneumothorax. (author).

  14. Donor-Site Morbidity Following Free Tissue Harvest from the Thigh: A Systematic Review and Pooled Analysis of Complications.

    Science.gov (United States)

    Lakhiani, Chrisovalantis; DeFazio, Michael V; Han, Kevin; Falola, Reuben; Evans, Karen

    2016-06-01

    Background Donor-site morbidity significantly influences patient satisfaction and quality of life following reconstructive surgery. The relevant donor-site morbidities associated with more commonly utilized thigh-based flaps are reviewed. Methods A systematic search of the MEDLINE and Cochrane databases from 1994 to 2014 was conducted to identify all reports of "anterolateral thigh (ALT)," "vastus lateralis (VL)," "anteromedial thigh (AMT)," "transverse upper gracilis (TUG)," tensor fascia latae (TFL)," "gracilis," and "rectus femoris (RF)," flaps. Only studies that investigated donor-site outcomes related to pain, paresthesia, wound dehiscence, infection, hematoma, seroma, contour deformity, and/or objective functional performance were included. Case series or anecdotal reports with less than five flaps, non-English, and animal studies were excluded. Results A total of 116 articles representing 4,554 flaps were reviewed, including 2,922 ALT/VL, 148 AMT, 436 TUG, 278 TFL, 527 gracilis, and 243 RF flaps. The most frequently cited donor-site complication was paresthesia (range: 0-36.4%), followed by wound dehiscence (range: 0.9-8.3%), contour deformity (range: 0-5.2%), pain (range: 0-6.3%), and seroma (range: 0.4-2.0%). Despite mixed results regarding functional performance, pooled-analysis of dynamometric studies demonstrated a significant reduction in strength only after RF flap harvest (21%). Conclusions Donor-site morbidity for thigh-flaps is minimal and appears to be well-tolerated by the majority of patients. Nevertheless, the appropriate flap selection is highly individualized, and patients must be informed of potential complications and morbidities specific to each flap. We have established the most current review of donor-site morbidity for thigh-based flaps to aid the surgeon in this important discussion. PMID:27144952

  15. Cortical hemoglobin concentration changes underneath the coil after single-pulse transcranial magnetic stimulation: a near-infrared spectroscopy study.

    Science.gov (United States)

    Furubayashi, Toshiaki; Mochizuki, Hitoshi; Terao, Yasuo; Arai, Noritoshi; Hanajima, Ritsuko; Hamada, Masashi; Matsumoto, Hideyuki; Nakatani-Enomoto, Setsu; Okabe, Shingo; Yugeta, Akihiro; Inomata-Terada, Satomi; Ugawa, Yoshikazu

    2013-03-01

    Using near-infrared spectroscopy (NIRS) and multichannel probes, we studied hemoglobin (Hb) concentration changes when single-pulse transcranial magnetic stimulation (TMS) was applied over the left hemisphere primary motor cortex (M1). Seventeen measurement probes were centered over left M1. Subjects were studied in both active and relaxed conditions, with TMS intensity set at 100%, 120%, and 140% of the active motor threshold. The magnetic coils were placed so as to induce anteromedially directed currents in the brain. Hb concentration changes were more prominent at channels over M1 and posterior to it. Importantly, Hb concentration changes at M1 after TMS differed depending on whether the target muscle was in an active or relaxed condition. In the relaxed condition, Hb concentration increased up to 3-6 s after TMS, peaking at ∼6 s, and returned to the baseline. In the active condition, a smaller increase in Hb concentrations continued up to 3-6 s after TMS (early activation), followed by a decrease in Hb concentration from 9 to 12 s after TMS (delayed deactivation). Hb concentration changes in the active condition at higher stimulus intensities were more pronounced at locations posterior to M1 than at M1. We conclude that early activation occurs when M1 is activated transsynaptically. The relatively late deactivation may result from the prolonged inhibition of the cerebral cortex after activation. The posterior-dominant activation at higher intensities in the active condition may result from an additional activation of the sensory cortex due to afferent inputs from muscle contraction evoked by the TMS. PMID:23274310

  16. Distal tibial fracture: An ideal indication for external fixation using locking plate

    Institute of Scientific and Technical Information of China (English)

    Jing-wei Zhang; Nabil A.Ebraheim; Ming Li; Xian-Feng He; Joshua Schwind; Li-Mei Zhu; Yi-Hui Yu

    2016-01-01

    Objective:To evaluate the feasibility and efficiency of one-stage external fixation by using locking plate in distal tibial fractures.Methods:In this non-control prospective study,28 patients with distal tibial fractures were included and underwent one-stage external fixation by using locking plate.There were 21 males and 7 females,with a mean age of 43 years (19-63).According to AO/OTA fracture classification,there were 9 cases of Type A1,9 of Type A2,10 of Type A3 fractures.There were 21 close and 7 open fractures.The locking plate was placed on the anteromedial aspect of the tibia with 4-5 bicortical screws inserted in both distal metaphysis and diaphysis.The radiographic and clinic results were evaluated.Results:All patients were followed up for the average of 16 months (ranging from 12 to 21 months).The average surgery duration was 38 (25-60) minutes.The mean time to fracture healing were 14.6 ± 2.67,17.5 ± 3.66,and 18.4 ± 3.37 (p < 0.05) weeks in type A1,A2,and A3 fractures respectively.By the end of the follow-ups,the mean AOFAS score were 96.11 ± 2.32,92.67 ± 1.80 and 92.00 ± 2.06 (p > 0.05) in type A1,A2,and A3 fractures respectively.None of nonunion,deep infection,or breakage of screw or plate were observed.Conclusions:Distal tibial fracture was the ideal indication for external fixation using locking plate.The external plating is characterized by ease of performance,less invasive,fewer soft tissue impingement,improved cosmesis,and convenient for removal.

  17. Disturbed temporal lobe circulation due to compression by pituitary adenoma

    International Nuclear Information System (INIS)

    The objective of this study was to clarify the pathophysiology of temporal lobe-related symptoms in pituitary adenoma by investigating temporal lobe circulation in pituitary adenoma with single photon emission computed tomography (SPECT). The subjects were 37 patients with pituitary adenoma (74 regions in the bilateral temporal lobes) who underwent 123I-iofetamine (IMP) SPECT before treatment. Using imaging analysis software 3D-SSP, the temporal lobes were evaluated in the bottom view on SPECT using the following method. Regions of interest (ROI) were established in the anteromedial (AM), posteromedial (PM), anterolateral (AL), and posterolateral (PL) regions of the temporal lobe, and the activity ratio (AR) of the counts/pixel in each ROI to those throughout the entire brain was determined. The AR in the 37 patients was compared with that in 37 healthy volunteers. Furthermore, the temporal lobes in patients with pituitary adenoma were classified according to the presence or absence of compression caused by the tumor, pituitary apoplexy, and hormone production, and evaluated. The AR in the AM and AL was significantly lower in the pituitary adenoma than in the healthy group (both, p<0.001). In the pituitary adenoma group, the AR in the AM, AL, and PL was significantly lower in the compression than in the non-compression group (p<0.05, p<0.05, and p<0.01, respectively). Classification based on the presence or absence of pituitary apoplexy or hormone production did not significantly differ with the AR values. We conclude that pituitary adenoma causes hypoperfusion in the temporal lobe at a high frequency, and direct compression by the tumor is a cause of regional cerebral blood flow (rCBF) reduction. (author)

  18. Plantar talar head contusions and osteochondral fractures: associated findings on ankle MRI and proposed mechanism of injury

    Energy Technology Data Exchange (ETDEWEB)

    Gorbachova, Tetyana; Wang, Peter S.; Hu, Bing [Einstein Medical Center Philadelphia, Department of Radiology, Philadelphia, PA (United States); Horrow, Jay C. [Drexel University, Department of Anesthesiology and Perioperative Medicine, Philadelphia, PA (United States)

    2016-06-15

    To evaluate the significance of plantar talar head injury (PTHI) in predicting osseous and soft tissue injuries on ankle MRI. The IRB approved this HIPAA-compliant retrospective study. The study group consisted of 41 ankle MRIs with PTHI that occurred at our institution over a 5 1/2 year period. Eighty MRIs with bone injuries in other locations matched for age, time interval since injury, and gender formed a control group. Injuries to the following structures were recorded: medial malleolus, lateral malleolus/distal fibula, posterior malleolus, talus, calcaneus, navicular, cuboid, lateral, medial and syndesmotic ligaments, spring ligament complex, and extensor digitorum brevis (EDB) muscle. Twenty separate logistic regressions determined which injuries PTHI predicted, using the Holm procedure to control for family-wise alpha at 0.05. PTHI strongly predicted the occurrence of injuries involving the anterior process of the calcaneus [24 % of cases, odds ratio (OR) 12.66], plantar components of the spring ligament (27 %, OR 9.43), calcaneal origin of the EDB and attachment of the dorsolateral calcaneocuboid ligament (22 %, OR 7.22), cuboid (51 %, OR 6.58), EDB (27 %, OR 5.49), anteromedial talus (66 %, OR 4.78), and posteromedial talus (49 %, OR 4.48). PTHI strongly predicted lack of occurrence of syndesmotic ligament injury (OR 19.6). The PTHI group had a high incidence of lateral ligamentous injury (78 %), but not significantly different from the control group (53 %). PTHI is strongly associated with injury involving the transverse tarsal joint complex. We hypothesize it results from talo-cuboid and/or talo-calcaneal impaction from a supination injury of the foot and ankle. (orig.)

  19. A comparative study of the trabecular bony architecture of the talus in humans, non-human primates, and Australopithecus.

    Science.gov (United States)

    DeSilva, Jeremy M; Devlin, Maureen J

    2012-09-01

    This study tested the hypothesis that talar trabecular microarchitecture reflects the loading patterns in the primate ankle joint, to determine whether talar trabecular morphology might be useful for inferring locomotor behavior in fossil hominins. Trabecular microarchitecture was quantified in the anteromedial, anterolateral, posteromedial, and posterolateral quadrants of the talar body in humans and non-human primates using micro-computed tomography. Trabecular bone parameters, including bone volume fraction, trabecular number and thickness, and degree of anisotropy differed between primates, but not in a manner entirely consistent with hypotheses derived from locomotor kinematics. Humans have highly organized trabecular struts across the entirety of the talus, consistent with the compressive loads incurred during bipedal walking. Chimpanzees possess a high bone volume fraction, consisting of plate-like trabecular struts. Orangutan tali are filled with a high number of thin, connected trabeculae, particularly in the anterior portion of the talus. Gorillas and baboons have strikingly similar internal architecture of the talus. Intraspecific analyses revealed no regional differences in trabecular architecture unique to bipedal humans. Of the 22 statistically significant regional differences in the human talus, all can also be found in other primates. Trabecular thickness, number, spacing, and connectivity density had the same regional relationship in the talus of humans, chimpanzees, gorillas, and baboons, suggesting a deeply conserved architecture in the primate talus. Australopithecus tali are human-like in most respects, differing most notably in having more oriented struts in the posteromedial quadrant of the body compared with the posterolateral quadrant. Though this result could mean that australopiths loaded their ankles in a unique manner during bipedal gait, the regional variation in degree of anisotropy was similar in humans, chimpanzees, and gorillas

  20. Certain Actions from the Functional Movement Screen Do Not Provide an Indication of Dynamic Stability

    Directory of Open Access Journals (Sweden)

    Lockie Robert G.

    2015-09-01

    Full Text Available Dynamic stability is an essential physical component for team sport athletes. Certain Functional Movement Screen (FMS exercises (deep squat; left- and right-leg hurdle step; left- and right-leg in-line lunge [ILL]; left- and right-leg active straight-leg raise; and trunk stability push-up [TSPU] have been suggested as providing an indication of dynamic stability. No research has investigated relationships between these screens and an established test of dynamic stability such as the modified Star Excursion Balance Test (mSEBT, which measures lower-limb reach distance in posteromedial, medial, and anteromedial directions, in team sport athletes. Forty-one male and female team sport athletes completed the screens and the mSEBT. Participants were split into high-, intermediate-, and low-performing groups according to the mean of the excursions when both the left and right legs were used for the mSEBT stance. Any between-group differences in the screens and mSEBT were determined via a one-way analysis of variance with Bonferroni post hoc adjustment (p < 0.05. Data was pooled for a correlation analysis (p < 0.05. There were no between-group differences in any of the screens, and only two positive correlations between the screens and the mSEBT (TSPU and right stance leg posteromedial excursion, r = 0.37; left-leg ILL and left stance leg posteromedial excursion, r = 0.46. The mSEBT clearly indicated participants with different dynamic stability capabilities. In contrast to the mSEBT, the selected FMS exercises investigated in this study have a limited capacity to identify dynamic stability in team sport athletes.

  1. Two new species of Aristocleidus (Monogenea) from the gills of the Mexican mojarra Eugerres mexicanus (Perciformes, Gerreidae) from southwestern Mexico

    Science.gov (United States)

    Mendoza-Franco, Edgar F.; Osorio, Marina Tapia; Caspeta-Mandujano, Juan Manuel

    2015-01-01

    Aristocleidus mexicanus n. sp. and Aristocleidus lacantuni n. sp. are described from the gills of the Mexican mojarra Eugerres mexicanus (Gerreidae, Perciformes) from the Rio Lacantún basin, Chiapas State, Mexico. These new species differ from previously described congeneric species in the characteristics of several structures, including: (a) ventral anchors, with differences in length (i.e. 46–50 µm in A. mexicanus vs. 38–43 µm, 34–37 µm, and 26–33 µm in Aristocleidus hastatus Mueller, 1936, Aristocleidus sp. of Mendoza-Franco, Violante-González & Roche 2009, and Aristocleidus lamothei Kritsky & Mendoza-Franco, 2008, respectively) and shape (i.e. slightly angular union of elongate arcing shaft and point in A. mexicanus vs. point and shaft united at a conspicuous angular bend in A. hastatus and Aristocleidus sp., and evenly curved shaft and point in A. lamothei); (b) male copulatory organ, i.e. a coiled tube with less than one ring in A. mexicanus and A. lacantuni (vs. a coiled tube of about 1½ in Aristocleidus sp.); (c) distal end of the accessory piece (ornate in A. mexicanus vs. distally flattened and trifid in A. hastatus and A. lamothei, respectively); (d) vaginal tube (moderately long in A. mexicanus vs. short in A. lamothei and looping in Aristocleidus sp.); and (e) ventral bar (anteromedial process with terminal horn-like ornamentation in A. lacantuni vs. ornamentation absent in the other species). This study reports for the first time species of Aristocleidus from freshwater environments in Mexico. PMID:26605987

  2. Spinal cord stimulation modulates cerebral function: an fMRI study

    International Nuclear Information System (INIS)

    Although spinal cord stimulation (SCS) is widely used for chronic neuropathic pain after failed spinal surgery, little is known about the underlying physiological mechanisms. This study aims to investigate the neural substrate underlying short-term (30 s) SCS by means of functional magnetic resonance imaging in 20 patients with failed back surgery syndrome (FBSS). Twenty patients with FBSS, treated with externalized SCS, participated in a blocked functional magnetic resonance imaging design with stimulation and rest phases of 30 s each, repeated eight times in a row. During scanning, patients rated pain intensity over time using an 11-point numerical rating scale with verbal anchors (0 = no pain at all to 10 = worst pain imaginable) by pushing buttons (left hand, lesser pain; right hand, more pain). This scale was back projected to the patients on a flat screen allowing them to manually direct the pain indicator. To increase the signal-to-noise ratio, the 8-min block measurements were repeated three times. Marked deactivation of the bilateral medial thalamus and its connections to the rostral and caudal cingulate cortex and the insula was found; the study also showed immediate pain relief obtained by short-term SCS correlated negatively with activity in the inferior olivary nucleus, the cerebellum, and the rostral anterior cingulate cortex. Results indicate the key role of the medial thalamus as a mediator and the involvement of a corticocerebellar network implicating the modulation and regulation of averse and negative affect related to pain. The observation of a deactivation of the ipsilateral antero-medial thalamus might be used as a region of interest for further response SCS studies. (orig.)

  3. Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures

    Directory of Open Access Journals (Sweden)

    Rajasekhar Gali

    2016-01-01

    Full Text Available Introduction: Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications. Purpose: This retrospective clinical case record study was done to evaluate the preauricular transmasseteric anteroparotid (P-TMAP approach for open reduction and extracorporeal fixation of displaced and dislocated high condylar fractures of the mandible. Patients and Methods: This retrospective study involved search of clinical case records of seven patients with displaced and dislocated high condylar fractures treated by open reduction and extracorporeal fixation over a 3-year period. The parameters assessed were as follows: a the ease of access for retrieval, reimplantation and fixation of the proximal segment; b the postoperative approach related complications; c the adequacy of anatomical reduction and stability of fixation; d the occlusal changes; and the e TMJ function and radiological changes. Results: Accessibility and visibility were good. Accurate anatomical reduction and fixation were achieved in all the patients. The recorded complications were minimal and transient. Facial nerve (buccal branch palsy was noted in one patient with spontaneous resolution within 3 months. No cases of sialocele or Frey's syndrome were seen. Conclusion: The P-TMAP approach provides good access for open reduction and extracorporeal fixation of severely displaced condylar fractures. It facilitates retrieval, transplantation, repositioning, fixing the condyle and also reduces the chances of requirement of a vertical ramus osteotomy. It gives straight-line access to condylar head and ramus thereby

  4. Two new species of Aristocleidus (Monogenea from the gills of the Mexican mojarra Eugerres mexicanus (Perciformes, Gerreidae from southwestern Mexico

    Directory of Open Access Journals (Sweden)

    Mendoza-Franco Edgar F.

    2015-01-01

    Full Text Available Aristocleidus mexicanus n. sp. and Aristocleidus lacantuni n. sp. are described from the gills of the Mexican mojarra Eugerres mexicanus (Gerreidae, Perciformes from the Rio Lacantún basin, Chiapas State, Mexico. These new species differ from previously described congeneric species in the characteristics of several structures, including: (a ventral anchors, with differences in length (i.e. 46–50 µm in A. mexicanus vs. 38–43 µm, 34–37 µm, and 26–33 µm in Aristocleidus hastatus Mueller, 1936, Aristocleidus sp. of Mendoza-Franco, Violante-González & Roche 2009, and Aristocleidus lamothei Kritsky & Mendoza-Franco, 2008, respectively and shape (i.e. slightly angular union of elongate arcing shaft and point in A. mexicanus vs. point and shaft united at a conspicuous angular bend in A. hastatus and Aristocleidus sp., and evenly curved shaft and point in A. lamothei; (b male copulatory organ, i.e. a coiled tube with less than one ring in A. mexicanus and A. lacantuni (vs. a coiled tube of about 1½ in Aristocleidus sp.; (c distal end of the accessory piece (ornate in A. mexicanus vs. distally flattened and trifid in A. hastatus and A. lamothei, respectively; (d vaginal tube (moderately long in A. mexicanus vs. short in A. lamothei and looping in Aristocleidus sp.; and (e ventral bar (anteromedial process with terminal horn-like ornamentation in A. lacantuni vs. ornamentation absent in the other species. This study reports for the first time species of Aristocleidus from freshwater environments in Mexico.

  5. Two new species of Aristocleidus (Monogenea) from the gills of the Mexican mojarra Eugerres mexicanus (Perciformes, Gerreidae) from southwestern Mexico.

    Science.gov (United States)

    Mendoza-Franco, Edgar F; Osorio, Marina Tapia; Caspeta-Mandujano, Juan Manuel

    2015-01-01

    Aristocleidus mexicanus n. sp. and Aristocleidus lacantuni n. sp. are described from the gills of the Mexican mojarra Eugerres mexicanus (Gerreidae, Perciformes) from the Rio Lacantún basin, Chiapas State, Mexico. These new species differ from previously described congeneric species in the characteristics of several structures, including: (a) ventral anchors, with differences in length (i.e. 46-50 µm in A. mexicanus vs. 38-43 µm, 34-37 µm, and 26-33 µm in Aristocleidus hastatus Mueller, 1936, Aristocleidus sp. of Mendoza-Franco, Violante-González & Roche 2009, and Aristocleidus lamothei Kritsky & Mendoza-Franco, 2008, respectively) and shape (i.e. slightly angular union of elongate arcing shaft and point in A. mexicanus vs. point and shaft united at a conspicuous angular bend in A. hastatus and Aristocleidus sp., and evenly curved shaft and point in A. lamothei); (b) male copulatory organ, i.e. a coiled tube with less than one ring in A. mexicanus and A. lacantuni (vs. a coiled tube of about 1½ in Aristocleidus sp.); (c) distal end of the accessory piece (ornate in A. mexicanus vs. distally flattened and trifid in A. hastatus and A. lamothei, respectively); (d) vaginal tube (moderately long in A. mexicanus vs. short in A. lamothei and looping in Aristocleidus sp.); and (e) ventral bar (anteromedial process with terminal horn-like ornamentation in A. lacantuni vs. ornamentation absent in the other species). This study reports for the first time species of Aristocleidus from freshwater environments in Mexico. PMID:26605987

  6. Treatment of terrible tyriad of the elbow:a cohort study%肘关节“恐怖三联征”的治疗:成组病例报告

    Institute of Scientific and Technical Information of China (English)

    樊军; 罗意; 隆晓涛; 万革; 王蕾

    2016-01-01

    at least 6 months;(5 )The time from injury to surgery should be less than 3 weeks. Exclusion criteria:(1)other dislocations or injuries such as olecranal fracture,etc.;(2 )the affected limb is accompanied with neurovascular injuries or fractures in other parts;(3 )elbow dysfunction before injury;(4 )patients with conservative treatment.Fracture types:Mason classification was applied in the radial head fracture and Regan-Morry classification was applied in the ulnar coronoid process fracture.Surgical method:the patient was on supine position with a thin pad under the ipsilateral scapula.The affected limb was flexed and put on the chest.Under tourniquet control,the lateral incision of elbow was firstly made till deep fascia and the lateral intramuscular septum was separated to further expose the radial head,lateral collateral ligament and joint capsule.Attention should be paid to protect the radial nerve.Then the anteromedial incision was made to separate the flexor till the elbow joint capsule of anteromedial side and expose the medial collateral ligament and the fragments of ulnar coronoid process.The articular cavity was irrigated to clean blood blot and tiny fragments of bone and cartilage.The repair was carried out by the following orders:ulnar coronoid process → medial collateral ligament and anteromedial joint capsule → fracture of radial head →lateral collateral ligament → common extensor origin.The fractures of ulnar coronoid process and radial head were fixed with mini screw plate system,Herbert screws,cannulated screws or different sutures according to classification and fragment size. The medial and lateral collateral ligaments were reconstructed with suture anchors or sutures and then the elbow was immobilized with the hinged brace after surgery.Postoperative management:The patient was asked to move the ipsilateral fingers as the anesthesia faded.The flexion and extension exercises of fingers could train the isometric contraction of forearm muscles

  7. Prevalence of birth defects and risk-factor analysis from a population-based survey in Inner Mongolia, China

    Directory of Open Access Journals (Sweden)

    Zhang Xingguang

    2012-08-01

    Full Text Available Abstract Background Birth Defects are a series of diseases that seriously affect children's health. Birth defects are generally caused by several interrelated factors. The aims of the article is to estimate the prevalence rate and types of birth defects in Inner Mongolia, China, to compare socio-demographic characteristics among the children with birth defects and to analyze the association between risk factors and birth defects. Methods Data used in this study were obtained through baseline survey of Inner Mongolia Birth Defects Program, a population-based survey conducted from 2005 to 2008. The survey used cluster sampling method in all 12 administrative districts of Inner Mongolia. Sampling size is calculated according to local population size at a certain percentage. All live births, stillbirths and abortions born from October 2005 to September 2008, whose families lived in Inner Mongolia at least one year, were included. The cases of birth defects were diagnosed by the clinical doctors according to their experiences with further laboratory tests if needed. The inclusion criteria of the cases that had already dead were decided according to death records available at local cites. We calculated prevalence rate and 95% confidence intervals of different groups. Outcome variable was the occurrence of birth defects and associations between risk factors and birth defects were analyzed by using Poisson regression analysis. Results 976 children with birth defects were diagnosed. The prevalence rate of birth defects was 156.1 per 10000 births (95%CI: 146.3-165.8. The prevalence rate of neural tube defect (20.1 per 10000 births including anencephaly(6.9 per 10000, spina bifida (10.6 per 10000, and encephalocele (2.7 per 10000 was the highest, followed by congenital heart disease (17.1 per 10000. The relative risk (RR for maternal age less than 25 was 2.22 (95%CI: 2.05, 2.41. The RR of the ethnic Mongols was lower than Han Chinese (RR: 0.84; 95%CI: 0

  8. Trisomy 2p: Analysis of unusual phenotypic findings

    Energy Technology Data Exchange (ETDEWEB)

    Lurie, I.W.; Ilyina, H.G.; Gurevich, D.B. [Belorussian Research Institute of Hereditary Disease, Minsk (Russian Federation)] [and others

    1995-01-16

    We present three probands with partial trisomies 2p21-23 due to ins(4;2)(q21;p21p23) pat, 2p23-pter due to t(2;4)(p23;q35)mat, and 2p21-pter due to t(2;11)(p21;q23.3)mat. More than 50 cases of partial trisomy 2p have been reviewed and some abnormalities, unusual for most other types of structural autosomal imbalance, have been found in patients with inherited forms of 2p trisomy and in their non-karyotyped sibs. Neural tube defects (anencephaly, occipital encephalocele, and spina bifida) were found in five probands and 4/6 affected non-karyotyped sibs. The only triplicated segment common to all was 2p24. Different forms of {open_quotes}broncho-pulmonary a/hypoplasia{close_quotes} (including two cases of lung agenesis) were described in four patients (overlapping triplicated segment was 2p21-p25). Three patients (with overlapping triplicated segment 2p23-p25) had diaphragmatic hernia. Abnormal rotation of the heart or L-transposition of large vessels (with or without visceral heterotaxia) was found in two infants (overlapping triplicated segment 2p23-p24). In two patients with common triplicated segment 2p22.3-p25, neuroblastoma has been described. The occurrence of all these defects may be explained either by the action of the same gene(s) mapped to 2p24 or by action of some independent factors located in different segments of the short arm. Although the latter hypothesis is much less probable, it can not be rejected at the present time. We propose the existence of a genetic system controlling surveillance of an abnormal embryo to explain the phenotypic differences between patients with the same imbalance within a family. In some {open_quotes}restrictive{close_quotes} combinations the abnormal embryos will die, although in {open_quotes}permissive{close_quotes} combinations they can survive. 47 refs., 2 figs., 3 tabs.

  9. ANALYSIS OF NEURAL TUBE DEFECT AND RELATIVE FACTORS THROUGH PRENATAL ULTRASONOGRAPHIC SCREENING%超声诊断胎儿神经管畸形及其相关发病因素分析

    Institute of Scientific and Technical Information of China (English)

    王欣业; 任雁林; 李采青; 王义成; 温德惠

    2011-01-01

    Objective To investigate peripartum women having babies with neural tube defects by ultrasound diagnoses and to explore its influence factors. Methods The questionnaire was conducted for 89 peripartum women having babies with neural tube defects by ultrasound diagnoses during 2005 to 2009 in our hospital, and its influence factors were analyzed. Results Of the investigated women who had babies with neural tube defects, hydrocephalus with spina bifida was 37 cases, spina bifida 5 cases,encephalocele 9 cases, uncover brain abnormalities and anencephalus 28 cases, and anencephalus with spina bifida 10 cases. Pregnancy season, diet habit and different demographic characteristics were related with the neural tube defects. Conclusion It is necessary to give up unhealthy diet habit and pay attention to strengthen nutrition, supplement folic acid regularly in order to prevent neural tube defects.%目的 通过超声检查和流行病调查了解胎儿神经管畸形分类,分析其相关发病因素.方法 回顾性分析2005-2009年超声筛查确诊为胎儿神经管畸形89例,进行问卷调查,材料汇总,对比分析.结果 胎儿神经管畸形89例,其中脑积水合并脊柱裂 37例,脊柱裂5例,脑膨出 9 例,露脑畸形和无脑儿28例,无脑儿合并脊柱裂10例.神经管畸形发病因素与孕妇受孕季节、生活饮食习惯及人口学特征等密切相关.结论 改变不合理生活饮食习惯,孕期加强营养,按时服用叶酸增补剂可预防神经管畸形发生.

  10. Proximal tibial osteophytes and their relationship with the height of the tibial spines of the intercondylar eminence: paleopathological study

    International Nuclear Information System (INIS)

    Tibial spiking (i.e., spurring of tibial spines), eburnation, and osteophytes are considered features of osteoarthritis. This investigation employed direct inspection of the medial and lateral tibial plateaus in paleopathological specimens to analyze the frequency and morphological features of osteoarthritis and to define any relationship between the size of osteophytes and that of the intercondylar tibial spines. A total of 35 tibial bone specimens were evaluated for the degree of osteoarthritis and presence of eburnation. Each plateau was also divided into four quadrants and the presence and size of bone outgrowths were recorded in each quadrant. The ''medial/lateral tibial intercondylar spine index'' for each specimen was calculated as follows: (medial/lateral intercondylar tibial spine height)/(anteroposterior width of the superior tibial surface). The relationships between medial and lateral tibial height indexes with the degree of osteoarthritis were then tested. Osteophytes were observed more frequently in the anterior quadrants of both tibial plateaus than in the posterior quadrants (29 vs 16 for the medial tibial plateau [p = 0.01] and 28 vs 20 for the lateral tibial plateau [p = 0.04]). Eburnation was seen more frequently in the posterior regions of both tibial plateaus than in the anterior regions (17 vs 5, p < 0.01). In specimens with no signs of osteoarthritis the lateral intercondylar tibial index was significantly lower than that in specimens with some degree of osteoarthritis (p = 0.02). The medial intercondylar tibial index of the specimens with no signs of osteoarthritis was not significantly different from that of the specimens with some degree of osteoarthritis (p = 0.45). There was a positive correlation between the lateral spine height index and the overall grading of osteoarthritis, (r = 0.6, p < 0.01). In the anteromedial and posteromedial quadrants of the lateral tibial plateau, the association between the lateral intercondylar tibial spine

  11. Proximal tibial osteophytes and their relationship with the height of the tibial spines of the intercondylar eminence: paleopathological study

    Energy Technology Data Exchange (ETDEWEB)

    Hayeri, Mohammad Reza [Children' s National Medical Center, Department of Radiology, Washington, DC (United States); Shiehmorteza, Masoud; Trudell, Debra J.; Resnick, Donald [University of California San Diego, Department of Radiology, San Diego, CA (United States); Hefflin, Tori [Museum of Man San Diego, San Diego, CA (United States)

    2010-09-15

    Tibial spiking (i.e., spurring of tibial spines), eburnation, and osteophytes are considered features of osteoarthritis. This investigation employed direct inspection of the medial and lateral tibial plateaus in paleopathological specimens to analyze the frequency and morphological features of osteoarthritis and to define any relationship between the size of osteophytes and that of the intercondylar tibial spines. A total of 35 tibial bone specimens were evaluated for the degree of osteoarthritis and presence of eburnation. Each plateau was also divided into four quadrants and the presence and size of bone outgrowths were recorded in each quadrant. The ''medial/lateral tibial intercondylar spine index'' for each specimen was calculated as follows: (medial/lateral intercondylar tibial spine height)/(anteroposterior width of the superior tibial surface). The relationships between medial and lateral tibial height indexes with the degree of osteoarthritis were then tested. Osteophytes were observed more frequently in the anterior quadrants of both tibial plateaus than in the posterior quadrants (29 vs 16 for the medial tibial plateau [p = 0.01] and 28 vs 20 for the lateral tibial plateau [p = 0.04]). Eburnation was seen more frequently in the posterior regions of both tibial plateaus than in the anterior regions (17 vs 5, p < 0.01). In specimens with no signs of osteoarthritis the lateral intercondylar tibial index was significantly lower than that in specimens with some degree of osteoarthritis (p = 0.02). The medial intercondylar tibial index of the specimens with no signs of osteoarthritis was not significantly different from that of the specimens with some degree of osteoarthritis (p = 0.45). There was a positive correlation between the lateral spine height index and the overall grading of osteoarthritis, (r = 0.6, p < 0.01). In the anteromedial and posteromedial quadrants of the lateral tibial plateau, the association between the lateral

  12. Bone signal abnormality, as seen on knee joint MRI : relationship between its location and associated injury

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Nam; Kim, Baek Hyun; Jung, Hoe Seok; Na, Eui Sung; Seol, Hye Young; Cha, In Ho; Lim, Hong Chul [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-07-01

    The purpose of the study was to evaluate the relationship between the location of bone signal abnormality and associated injury, as seen on MR, in patients with acute knee joint injury. Materials and Methods: Thirty-six patients with acute knee injury and bone signal abnormalities on MR were included in this study. The femur and tibia were each divided into six compartments, namely the anteromedial, medial, posteromedial,anterolateral, lateral, and posterolateral ; these were obtained in each knee joint. We evaluated the location of bone signal abnormality and the corresponding arthroscopic or operative findings of injury to ligaments and menisci. Cases with signal abnormalities involving more than three compartments were excluded. Results : Bone signal abnormalities were demonstrated in 51 compartments. Most(84%, 43/51) were noted in the lateral half of the knee joint, the most common location being the tibio- posterolateral compartment(13/51). The femoro-lateral(11/51) and tibio- anterolateral compartment(8/51) were the next most common locations. All cases(13/13)with bone signal abnormality in the tibio- posterolateral compartment had tears at the anterior cruciate ligament,while 9 of 11 cases(81%) with abnormality in the femoro- lateral compartment had tears at the anterior cruciate ligament. Six of eight cases(75%) with signal abnormality in the tibio- anterolateral compartment had tears at the posterior cruciate ligament ; 31 of 43 cases (72%) with abnormality in the lateral half of the knee joint had tears at the medial collateral ligament. Six of eight cases(75%) with signal abnormality in the medial half of the knee joint had tears at the medial meniscus, but no lateral meniscal tear was found. Among patients with signal abnormality in the lateral half of the knee joint, the tear was lateral meniscal in nine of 43 cases(21%) and medial meniscal in six of 43(14%). Conclusion : The location of bone signal abnormality, as seen on knee MR, inpatients with

  13. Characterization of muscular involvement in patients with Duchenne muscular dystrophy by magnetic resonance imaging%Duchenne型肌营养不良症患者肌肉磁共振成像特征的演变

    Institute of Scientific and Technical Information of China (English)

    陈维; 冯善伟; 冯慧宇; 张成

    2014-01-01

    目的 研究Duchenne肌营养不良症(Duchenne muscular dystrophy,DMD)患者随疾病发展肌肉受累的顺序及程度.方法 用多重连接依赖性探针扩增技术(multiplex ligation-dependent probeamplification,MLPA)检测患者dystrophin基因的突变情况.采用磁共振成像(magnetic resonanceimaging,MRI)对患者双侧大腿肌肉进行扫描并分析图像.结果 MLPA检测发现6例患者均携带dystrophin基因的缺失或重复突变.DMD患者肌肉受累的顺序依次为:臀大肌、大收肌、股四头肌、股直肌和股二头肌,而半膜肌、半腱肌、缝匠肌、股薄肌选择性受累,程度依次减轻.结论 MRI检查可以客观地反映DMD患者骨骼肌受累的顺序、范围和程度,并且反映不同阶段受损骨骼肌的病理改变,可能成为检查和诊断的重要手段.患者病情的严重程度与突变性质无明显关联.%Objective To study the order and degree of muscular affection in patients with Duchenne muscular dystrophy (DMD) during the course of disease.Methods Multiplex ligation dependent probe amplification (MLPA) was used to detect potential mutation of dystrophin gene.Magnetic resonance imaging (MRI) was used to scan the anteromedial aspect of thigh muscles.Results All of the 6 patients were found to have deletion or duplication mutations.The order of affection has been gluteus maximus,adductor magnus,quadriceps femoris,rectus femoris and biceps muscle of the thigh,while semimembranous muscle,semitendinosus,sartorius muscle and musculus gracilis are selectively affected and in a decreasing order.Conclusion MRI can reflect the order,extent and degree of skeletal muscle involvement in patients with DMD,and can reflect pathological changes of damaged skeletal muscle at each stage,which may provide an important means for patient examination and diagnosis.No apparent correlation between the severity of disease and the nature of mutations was noted.

  14. Soft tissue tenodesis of the long head of the biceps tendon associated to the Roman Bridge repair

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    Maffulli Nicola

    2008-06-01

    Full Text Available Abstract Background Rotator cuff tears are frequently associated with pathologies of the long head of the biceps tendon (LHBT. Tenotomy and tenodesis of the LHBT are commonly used to manage disorders of the LHBT. Methods We present an arthroscopic soft tissue LHBT tenodesis associated with a Roman Bridge (double pulley – suture bridges repair Results Two medial row 5.5-mm Bio-Corkscrew suture anchors (Arthrex, Naples, FL, double-loaded with No. 2 FiberWire sutures (Arthrex, Naples, FL, are placed in the medial aspect of the footprint. A shuttle is passed through an anterior point of the rotator cuff and through the LHBT by means of a Penetrator or a BirdBeak suture passer (Arthrex, Naples, FL. A tenotomy of the LHBT is performed. All the sutures from the anteromedial anchor are passed through a single anterior point in the rotator cuff using a shuttle technique. All the sutures from the posteromedial anchor are passed through a single posterior point in the rotator cuff. The sutures in the medial row are tied using the double pulley technique. A suture limb is retrieved from each of the medial anchors and manually tied as a six-throw surgeon's knot over a metal rod. The two free suture limbs are pulled to transport the knot over the top of the tendon bridge. The two free suture limbs are then used to produce suture bridges over the tendon, using a Pushlock (Arthrex, Naples, FL, placed 1 cm distal to the lateral edge of the footprint. The same double pulley – suture bridges technique is repeated for the other two suture limbs from the two medial anchors. Conclusion This technique allows to perform a double pulley – suture bridges repair for a rotator cuff tear, associated with a soft tissue tenodesis for the management of LHBT pathology. The tenodesis of the LHBT is performed just with the passage of a shuttle inside the LHBT, after passing it through the anterior portion of the rotator cuff, with successive detachment of the LHBT from the

  15. Anterior cruciate ligament reconstruction in a patient with Athetoid cerebral palsy: a case report

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    Tajima Takuya

    2012-10-01

    Full Text Available Abstract Recent years have seen ACL reconstruction performed in a broad range of patients, regardless of age, sex or occupation, thanks to great advances in surgical techniques, instrumentation and the basic research. Favorable results have been reported; however, we have not been able to locate any reports describing ACL reconstruction in patients with athetoid cerebral palsy. We present herein a previously unreported anterior cruciate ligament (ACL reconstruction performed in a patient with athetoid cerebral palsy. The patient was a 25-year-old woman with level II athetoid cerebral palsy according to the Gross Motor Function Classification System. She initially injured her right knee after falling off a bicycle. Two years later, she again experienced right-knee pain and a feeling of instability. A right-knee ACL tear and avulsion fracture was diagnosed upon physical examination and confirmed with magnetic resonance imaging (MRI and X-ray examination at that time. An ACL reconstruction using an autologous hamstring double-bundle graft was performed for recurrent instability nine years after the initial injury. Cast immobilization was provided for 3 weeks following surgery and knee extension was restricted for 3 months with the functional ACL brace to prevent hyperextension due to involuntary movement. Partial weight-bearing was started 1 week postoperatively, with full weight-bearing after 4 weeks. The anterior drawer stress radiography showed a 63% anterior displacement of the involved tibia on the femur six months following the surgery, while the contralateral knee demonstrated a 60% anterior displacement of the tibia. The functional ACL functional brace was then removed. A second-look arthroscopy was performed 13 months after the ACL reconstruction, and both the anteromedial and posterolateral bundles were in excellent position as per Kondo’s criteria. The Lachman and pivot shift test performed under anesthesia were also negative. An

  16. Aetiology and mechanisms of injury in medial tibial stress syndrome: Current and future developments.

    Science.gov (United States)

    Franklyn, Melanie; Oakes, Barry

    2015-09-18

    Medial tibial stress syndrome (MTSS) is a debilitating overuse injury of the tibia sustained by individuals who perform recurrent impact exercise such as athletes and military recruits. Characterised by diffuse tibial anteromedial or posteromedial surface subcutaneous periostitis, in most cases it is also an injury involving underlying cortical bone microtrauma, although it is not clear if the soft tissue or cortical bone reaction occurs first. Nuclear bone scans and magnetic resonance imaging (MRI) can both be used for the diagnosis of MTSS, but the patient's history and clinical symptoms need to be considered in conjunction with the imaging findings for a correct interpretation of the results, as both imaging modalities have demonstrated positive findings in the absence of injury. However, MRI is rapidly becoming the preferred imaging modality for the diagnosis of bone stress injuries. It can also be used for the early diagnosis of MTSS, as the developing periosteal oedema can be identified. Retrospective studies have demonstrated that MTSS patients have lower bone mineral density (BMD) at the injury site than exercising controls, and preliminary data indicates the BMD is lower in MTSS subjects than tibial stress fracture (TSF) subjects. The values of a number of tibial geometric parameters such as cross-sectional area and section modulus are also lower in MTSS subjects than exercising controls, but not as low as the values in TSF subjects. Thus, the balance between BMD and cortical bone geometry may predict an individual's likelihood of developing MTSS. However, prospective longitudinal studies are needed to determine how these factors alter during the development of the injury and to find the detailed structural cause, which is still unknown. Finite element analysis has recently been used to examine the mechanisms involved in tibial stress injuries and offer a promising future tool to understand the mechanisms involved in MTSS. Contemporary accurate diagnosis

  17. Bone signal abnormality, as seen on knee joint MRI : relationship between its location and associated injury

    International Nuclear Information System (INIS)

    The purpose of the study was to evaluate the relationship between the location of bone signal abnormality and associated injury, as seen on MR, in patients with acute knee joint injury. Materials and Methods: Thirty-six patients with acute knee injury and bone signal abnormalities on MR were included in this study. The femur and tibia were each divided into six compartments, namely the anteromedial, medial, posteromedial,anterolateral, lateral, and posterolateral ; these were obtained in each knee joint. We evaluated the location of bone signal abnormality and the corresponding arthroscopic or operative findings of injury to ligaments and menisci. Cases with signal abnormalities involving more than three compartments were excluded. Results : Bone signal abnormalities were demonstrated in 51 compartments. Most(84%, 43/51) were noted in the lateral half of the knee joint, the most common location being the tibio- posterolateral compartment(13/51). The femoro-lateral(11/51) and tibio- anterolateral compartment(8/51) were the next most common locations. All cases(13/13)with bone signal abnormality in the tibio- posterolateral compartment had tears at the anterior cruciate ligament,while 9 of 11 cases(81%) with abnormality in the femoro- lateral compartment had tears at the anterior cruciate ligament. Six of eight cases(75%) with signal abnormality in the tibio- anterolateral compartment had tears at the posterior cruciate ligament ; 31 of 43 cases (72%) with abnormality in the lateral half of the knee joint had tears at the medial collateral ligament. Six of eight cases(75%) with signal abnormality in the medial half of the knee joint had tears at the medial meniscus, but no lateral meniscal tear was found. Among patients with signal abnormality in the lateral half of the knee joint, the tear was lateral meniscal in nine of 43 cases(21%) and medial meniscal in six of 43(14%). Conclusion : The location of bone signal abnormality, as seen on knee MR, inpatients with

  18. Outcome of double bundle anterior cruciate ligament reconstruction using crosspin and aperture fixation

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    Deepak Joshi

    2014-01-01

    Full Text Available Background: Double bundle anterior cruciate ligament (DBACL reconstruction is said to reproduce the native anterior cruciate ligament (ACL anatomy better than single bundle anterior cruciate ligament, whether it leads to better functional results is debatable. Different fixation methods have been used for DBACL reconstruction, the most common being aperture fixation on tibial side and cortical suspensory fixation on the femoral side. We present the results of DBACL reconstruction technique, wherein on the femoral side anteromedial (AM bundle is fixed with a crosspin and aperture fixation was done for the posterolateral (PL bundle. Materials and Methods: Out of 157 isolated ACL injury patients who underwent ACL reconstruction, 100 were included in the prospective study. Arthroscopic DBACL reconstruction was done using ipsilateral hamstring autograft. AM bundle was fixed using Transfix (Arthrex, Naples, FL, USA on the femoral side and bio interference screw (Arthrex, Naples, FL, USA on the tibial side. PL bundle was fixed on femoral as well as on tibial side with a biointerference screw. Patients were evaluated using KT-1000 arthrometer, Lysholm score, International Knee Documentation Committee (IKDC Score and isokinetic muscle strength testing. Results: The KT-1000 results were evaluated using paired t test with the P value set at 0.001. At the end of 1 year, the anteroposterior side to side translation difference (KT-1000 manual maximum showed mean improvement from 5.1 mm ± 1.5 preoperatively to 1.6 mm ± 1.2 ( P < 0.001 postoperatively. The Lysholm score too showed statistically significant ( P < 0.001 improvement from 52.4 ± 15.2 (range: 32-76 preoperatively to a postoperative score of 89.1 ± 3.2 (range 67-100. According to the IKDC score 90% patients had normal results (Category A and B. The AM femoral tunnel initial posterior blow out was seen in 4 patients and confluence in the intraarticular part of the femoral tunnels was seen in 6

  19. The importance of early arthroscopy in athletes with painful cartilage lesions of the ankle: a prospective study of 61 consecutive cases

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    Riyami Masoud

    2006-09-01

    Full Text Available Abstract Background Ankle sprains are common in sports and can sometimes result in a persistent pain condition. Purpose Primarily to evaluate clinical symptoms, signs, diagnostics and outcomes of surgery for symptomatic chondral injuries of the talo crural joint in athletes. Secondly, in applicable cases, to evaluate the accuracy of MRI in detecting these injuries. Type of study: Prospective consecutive series. Methods Over around 4 years we studied 61 consecutive athletes with symptomatic chondral lesions to the talocrural joint causing persistent exertion ankle pain. Results 43% were professional full time athletes and 67% were semi-professional, elite or amateur athletes, main sports being soccer (49% and rugby (14%. The main subjective complaint was exertion ankle pain (93%. Effusion (75% and joint line tenderness on palpation (92% were the most common clinical findings. The duration from injury to arthroscopy for 58/61 cases was 7 months (5.7–7.9. 3/61 cases were referred within 3 weeks from injury. There were in total 75 cartilage lesions. Of these, 52 were located on the Talus dome, 17 on the medial malleolus and 6 on the Tibia plafond. Of the Talus dome injuries 18 were anteromedial, 14 anterolateral, 9 posteromedial, 3 posterolateral and 8 affecting mid talus. 50% were grade 4 lesions, 13.3% grade 3, 16.7% grade 2 and 20% grade 1. MRI had been performed pre operatively in 26/61 (39% and 59% of these had been interpreted as normal. Detection rate of cartilage lesions was only 19%, but subchondral oedema was present in 55%. At clinical follow up average 24 months after surgery (10–48 months, 73% were playing at pre-injury level. The average return to that level of sports after surgery was 16 weeks (3–32 weeks. However 43% still suffered minor symptoms. Conclusion Arthroscopy should be considered early when an athlete presents with exertion ankle pain, effusion and joint line tenderness on palpation after a previous sprain

  20. Measurement of double-bundle structure of anterior cruciate ligament using 3D cube T2 WI MR imaging%3DCubeT2WIMRI测量前交叉韧带双束结构的研究

    Institute of Scientific and Technical Information of China (English)

    程瑾; 刘霞; 王屹; 杜湘珂

    2012-01-01

    目的:应用3D Cube T2WI核磁共振成像斜冠状位重建图像显示前交叉韧带(anterior cruciate ligament,ACL)双束结构,并测量其解剖指标.方法:19例经临床确诊的健康志愿者行双膝关节3D Cube T2加权MRI检查.分别在斜冠状位重建图像测量前内侧束(anteromedial bundle,AMB)和后外侧束(posterolateral bundle,PLB)的股骨止点、胫骨止点宽度、韧带长度及走行角度.应用Mann-Whitney test比较AMB和PLB的长度,止点宽度和走行角度在不同性别间的差异,并进一步对测量所产生的差异进行Logistic回归分析.结果:AMB和PLB的平均长度分别为31.01mm和25.38mm;股骨止点平均宽度为10.6mm和9.47mm;胫骨止点平均宽度为11.28mm和8.49 mm;走行角度平均为72.01°和64.97°.AMB、PLB的股骨止点、胫骨止点宽度及走行角度在不同性别间无显著性差异(P>0.05).然而,男性AMB和PLB韧带长度大于女性(P<0.05);经Logistic回归分析显示这种差异与身高成正相关(P<0.05).结论:各向同性3D Cube T2加权序列及其重建图像所显示的ACL双束结构;以及股骨止点宽度、胫骨止点宽度、长度及走行角度的精确测量结果,可为个性化制定ACL双束重建术方案提供有价值的依据.%Objective: To assess and measure the double-bundle structure of anterior cruciate ligament (ACL) using 3D Cube T2 weighted Magnetic Resonance (MR) imaging. Methods: Nineteen healthy volunteers with intact ACLs underwent anatomic MR acquisition including 3D Cube T2 weighed imaging. The anatomic characteristics of the anteromedial bundle (AMB) and the posterolateral bundle (PLB) were assessed. The lengths, course angles of the ligaments, and the widths of the femoral and tibial attachments were measured and compared using Mann-Whitney test. The factors associated with differences in measurements were analyzed by Logistic regression test. Results: The median lengths of AMBs and PLBs were 31.01 and 25. 38 mm; widths of

  1. Treatment strategies for grade Ⅱ supination adduction ankle fractures%旋后内收型Ⅱ度踝关节骨折的治疗策略

    Institute of Scientific and Technical Information of China (English)

    俞光荣; 樊健; 周家钤; 李海丰; 杨云峰; 黄轶刚

    2011-01-01

    fractures. Anteromedial approach to the medial malleolus was taken to expose the vertical medial malleolus fractures and tibial plafond for exploring damage to distal articular surface of the tibia and that to cartilage of the talus. Open reduction and internal fixation with impaction of the articular fragment and possible bone grafting were applied to restore the height of the collapsed tibia. Medial mallcolus fractures were anatomically reduced and the intra-articular cartilage debris removed under direct vision. Repair of the lateral ligament injuries was decided acoording to the stability of the ligament. Different internal fixation was chosen according to fracture displacement of the block size and degree of lateral malleolus fractures. Fracture union, internal fixation and osteoarthritis were detected by X-ray examination. The range of ankle motion was measured. Maryland foot score was taken to assess the ankle function.Results Twenty-three patients were followed up postoperatively for a mean period of 27.9 months ( range, 6-47 months). Two prominent screws were removed from one patient five months after operation because of loosening. Bony fusion was achieved in all patients after an average period of 2.9 months ( range, 2.3-5.1 months). X-ray examination revealed no other internal fixation loosening or osteoarthritis. The average range of motion was 13 degrees of dorsiflexion (range, 6-17 degrees) and 36 degrees of plantarflexion (range, 27-46 degrees). According to Maryland foot score, ankle function was excellent in 19 patients and good in four, with excellence rate of 100%.Conclusions Understanding injury mechanism of supination adduction ankle fracture, strengthening the diagnosis and treatment of damage of tibial plafond articular surface height, cartilage and talar articular surface cartilage can effectively reduce the incidence of complications such as osteoarthritis. Anteromedial incision allows excellent exposure of the medial tibial plafond for clearance

  2. Prevalência de defeitos de fechamento de tubo neural no Vale do Paraíba, São Paulo Prevalence of neural tube defects in Vale do Paraíba, São Paulo, Brazil

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    Luiz Fernando C. Nascimento

    2008-12-01

    Full Text Available OBJETIVO: Estimar a prevalência de defeitos de fechamento do tubo neural no Vale do Paraíba paulista e identificar possíveis fatores maternos e neonatais associados a tais defeitos. MÉTODOS: Realizou-se um estudo transversal com dados secundários obtidos na Secretaria Estadual da Saúde referentes aos nascimentos ocorridos em 2004 no Vale do Paraíba paulista, que compreende 35 municípios e conta com população de 2 milhões de habitantes. Anencefalia, encefalocele e espina bífida (mielocele e mielomeningocele foram considerados defeitos de fechamento do tubo neural. As variáveis maternas foram: idade, escolaridade, cor da pele, número de consultas no pré-natal, número de filhos vivos e relato de óbito fetal prévio. As variáveis relativas ao recém-nascido foram: peso, idade gestacional e escore de Apgar. Realizou-se comparação das médias por meio do teste t de Student e obtiveram-se os valores das razões de chance com intervalos de confiança de 95%. RESULTADOS: Foram analisados 33.653 nascidos vivos. Trinta e oito recém-nascidos com o defeito foram encontrados (1,13/1.000 nascidos vivos, sendo 23 casos de espina bífida. Houve associação com baixo peso ao nascimento, prematuridade e menores escores de Apgar de cinco minutos. CONCLUSÕES: A prevalência desta anomalia foi inferior à de outros estudos nacionais e sua presença esteve associada ao baixo peso, à prematuridade e à baixa vitalidade ao nascer.OBJECTIVE: To estimate the prevalence of neural tube defects in Vale do Paraíba, São Paulo, Brazil, and to identify possible maternal and neonatal variables associated with these defects. METHODS: This cross-sectional study used secondary records of the Health Department of São Paulo State related live births during 2004 in Vale do Paraíba, São Paulo, Brazil. This region has 35 cities and 2 million inhabitants. Anencephaly, encephalocele and spina bifida (myelocele and myelomeningocele were considered as neural tube

  3. Prevalence study on the ultrasonography screening for neural tube defects in the secondary prevention%超声检查在神经管缺陷二级预防中的应用现况研究

    Institute of Scientific and Technical Information of China (English)

    卢庆彬; 孟才; 高莉洁; 宫蕊; 孙喜红; 王志萍; 王金桃; 赵仲堂

    2011-01-01

    Objective To explore the utilization and effectiveness of ultrasound screening for neural tube defects (NTDs),so that to provide scientific evidences for the secondary prevention of NTDs.MethodsFour hundred and fifty-nine women who delivered or gestated NTDs babies or fetuses were randomly selected from Shandong Province and Shanxi Province,and the related information was collected with structured questionnaire by trained interviewers.Results Of the 459 cases,the ultrasonography utilization rate was 98.7%,and 6 cases (1.3%) never took examinations by ultrasonography during the whole pregnancy period.The total diagnosis rate of ultrasound screening for NTDs was 85.9%,and those of anencephalus,spina bifida and encephalocele were 96.4%,79.6% and 73.8% respectively (P0.05).Conclusions The detection rates of NTDs and the subtypes by ultrasonography are low at different pregnant periods and in different medical institutions.It is important to increase the utilization rate of ultrasound screening by pregnant women and improve the NTDs diagnostic level of primary health care institutions,so that to improve the efficacy of secondary prevention strategy for NTDs in China.%目的 探讨超声筛查神经管缺陷(neural tube defects,NTDs)及各亚型的应用现状及其效果,为制定适宜的NTDs二级预防模式提供科学依据.方法 选取山东省和山西省八地(市)孕育NTDs胎儿妇女459例,对其孕期超声检查情况进行流行病学调查,分析NTDs及各亚型的确诊情况及其影响因素.结果 ①研究对象超声检查使用率为 98.7%,6例(1.3%)在孕期从未进行超声检查.②超声筛查NTDs总确诊率为 85.9% (389/453),无脑儿、脊柱裂和脑膨出分别为 96.4%、79.6%和 73.8% (P0.05).结论 各医疗机构和不同孕期NTDs及各亚型超声检出率均较低.相关卫生部门应采取措施进一步提高超声检查使用率,提高NTDs超声检出率,重点做好基层医疗机构的产前超声筛查,以更

  4. The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas; CT und MRT des erworbenen Cholesteatoms: Prae- und postoperative Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Krestan, C.; Czerny, C. [Abteilung fuer Osteologie, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria); Gstoettner, W. [Univ.-Klinik fuer Hals-Nasen-Ohren-Heilkunde, Frankfurt (Germany); Franz, P. [Univ.-Klinik fuer Hals-Nasen-Ohren-Heilkunde, Wien (Austria)

    2003-03-01

    The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas will be described in this paper. The pre- and postoperative imaging of the temporal bone was performed with HRCT and MRI. HRCT and MRI were performed in the axial and coronal plane. MRI was done with T2 weighted and T1 weighted sequences both before and after the intravenous application of contrast material. All imaging findings were confirmed clinically or surgically. The preoperative cholesteatoma-caused complications depicted by HRCT included bony erosions of the ossicles, scutum, facial canal in the middle ear, tympanic walls including the tegmen tympani, and of the labyrinth. The preoperative cholesteatoma-caused complications depicted by MRI included signs indicative for labyrinthitis, and brain abscess. Postoperative HRCT depicted bony erosions caused by recurrent cholesteatoma, bony defects of the facial nerve and of the labyrinth, and a defect of the tegmen tympani with a soft tissue mass in the middle ear. Postoperative MRI delineated neuritis of the facial nerve, labyrinthitis, and a meningo-encephalocele protruding into the middle ear. HRCT and MRI are excellent imaging tools to depict either bony or soft tissue complications or both if caused by acquired cholesteatomas. According to our findings and to the literature HRCT and MRI are complementary imaging methods to depict pre- or postoperative complications of acquired cholesteatomas if these are suspected by clinical examination. (orig.) [German] In dieser Arbeit wird die Rolle der hochaufloesenden Computertomographie (HRCT) und der Magnetresonanztomographie (MRT) zur Abklaerung prae- und postoperativ bedingter Komplikationen erworbener Cholesteatome beschrieben. Die Bildgebung wurde sowohl mit der HRCT als auch mit der MRT durchgefuehrt. Die HRCT und die MRT wurden in axialer und koronaler Ebene (auch

  5. Equoterapia na reabilitação da meningoencefalocele: estudo de caso Hyppotherapy in meningoencephalocele rehabilitation: a case study

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    Sissa Mara Nicodemo Sanches

    2010-12-01

    . Outcome measures were obtained by means of the Berg and Tinetti balance scales and the Brazilian version of the Pediatric Evaluation of Disability Inventory (for general functional abilities, all applied before and after therapy, and at an 8-week follow-up assessment. Results showed the child's significantly improved balance and motor coordination, which reflected on functional movement control, basic for performing daily living activities. Functional gain was also perceived by the child's mother. This study provides a new insight into hippotherapy as a useful physical therapy modality for improving motor and functional ability of children with encephalocele.

  6. Defectos del tubo neural en productos de abortos espontáneos

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    María Luisa Hernández

    2009-03-01

    tedra de Histología y Embriología de la Universidad del Zulia, Maracaibo. Results: A total of 55 products were evaluated, 27 (49.09 % male, 21 (38.18 % females, and 7(12.43 % no identified by morphological characteristics external genitals. Only 5 (9.09 % had neural tube defects and the anomalies find were: anencephaly, spina bifida lumbosacral, iniencephaly and encephalocele. Conclusion: The identification of the neural tube defects in the products of spontaneous abortion will permit accurate counseling to the parents about the recurrence risk, the particular care required in further gestations, the possibility of prenatal diagnosis and to apply prevention methods.

  7. Impacto de la fortificación de alimentos con ácido fólico en los defectos del tubo neural en Costa Rica Impact of the fortification of food with folic acid on neural tube defects in Costa Rica

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    María de la Paz Barboza Argüello

    2011-07-01

    Full Text Available OBJETIVO: Evaluar el impacto de la fortificación de alimentos con ácido fólico en las tendencias de las prevalencias de los defectos del tubo neural (DTN y la tasa de mortalidad infantil (TMI por este trastorno en Costa Rica. MÉTODOS: Se analizaron los datos de vigilancia del Centro de Registro de Enfermedades Congénitas y el Centro Centroamericano de Población. Se consideraron defectos del tubo neural la anencefalia, la espina bífida y el encefalocele. Se examinaron las tendencias durante 1987-2009, así como las diferencias de tasas (intervalo de confianza [IC] 95% de prevalencia y mortalidad antes de la fortificación de alimentos con ácido fólico y hasta 12 años después de su implementación. Se determinó el aporte de la fortificación al descenso en la TMI general. RESULTADOS: En 1987-1997, previo al período de fortificación de alimentos con ácido fólico, la prevalencia de DTN fue de 12/10 000 nacidos (IC95%: 11,1-12,8, mientras que en 2009 fue de 5,1/10 000 nacidos (3,3-6,5. La TMI por DTN en 1997 fue de 0,64/1 000 nacimientos (46-0,82 y en 2009 de 0,19/1 000 (0,09-0,3. La TMI por DTN y su prevalencia disminuyeron en forma significativa, 71% y 58% respectivamente (P OBJECTIVE: Evaluate the impact of the fortification of food with folic acid on prevalence trends for neural tube defects (NTD and the infant mortality rate (IMR associated with this disorder in Costa Rica. METHODS: The surveillance data from the Congenital Disease Registry Center and the Central American Population Center were analyzed. The neural tube defects considered were anencephaly, spina bifida, and encephalocele. The trends from 1987-2009, as well as the differences in prevalence and mortality rates prior to and up to 12 years after food fortification with folic acid, were examined (95% confidence interval [CI]. The contribution of fortification to the decrease in the overall IMR was determined. RESULTS: During 1987-1997, prior to the period of food

  8. Brain tissue aspiration neural tube defect Aspiração de tecido cerebral em casos de defeitos de fechamento do tubo neural

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    Luiz Cesar Peres

    2005-09-01

    Full Text Available The study aimed to find out how frequent is brain tissue aspiration and if brain tissue heterotopia could be found in the lung of human neural tube defect cases. Histological sections of each lobe of both lungs of 22 fetuses and newborn with neural tube defect were immunostained for glial fibrillary acidic protein (GFAP. There were 15 (68.2% females and 7 (31.8% males. Age ranged from 18 to 40 weeks of gestation (mean= 31.8. Ten (45.5% were stillborn, the same newborn, and 2 (9.1% were abortuses. Diagnosis were: craniorrhachischisis (9 cases, 40.9%, anencephaly (8 cases, 36,4%, ruptured occipital encephalocele and rachischisis (2 cases, 9.1% each, and early amniotic band disruption sequence (1 case, 4.5%. Only one case (4.5% exhibited GFAP positive cells inside bronchioles and alveoli admixed to epithelial amniotic squames. No heterotopic tissue was observed in the lung interstitium. We concluded that aspiration of brain tissue from the amniotic fluid in neural tube defect cases may happen but it is infrequent and heterotopia was not observed.O objetivo do estudo foi identificar qual a freqüência de aspiração de tecido cerebral e a existência de heterotopia nos pulmões de casos humanos de defeito de fechamento do tubo neural através da reação imuno-histoquímica para proteína fibrilar glial ácida (GFAP em cortes histológicos de todos os lobos de ambos os pulmões de 22 casos de fetos e neonatos com defeito de fechamento do tubo neural. Havia 15 casos femininos (68,2% e 7 masculinos (31,8%, com idade gestacional variando de 18 a 40 semanas (média= 31,8, sendo natimortos e neomortos 10 (45,5% cada e 2 (9,1% abortos. Os diagnósticos foram: Craniorraquisquise (9 casos, 40,9%, anencefalia (8 casos, 36,4%, encefalocele occipital rota e raquisquise (2 casos, 9,1% e 1 (4,5%caso de seqüência de disruptura amniótica precoce. Somente 1 caso (4,5% apresentou células positivas dentro de bronquíolos e alvéolos em meio a células epiteliais

  9. Atualização sobre o tratamento neurocirúrgico do transtorno obsessivo-compulsivo Update on neurosurgical treatment for obsessive compulsive disorder

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    Antonio Carlos Lopes

    2004-03-01

    Full Text Available O transtorno obsessivo-compulsivo (TOC responde aos tratamentos habituais (fármacos e psicoterapia em cerca de 60 a 80% dos casos. Existe, assim, uma parcela de pacientes resistente aos tratamentos usuais, mesmo que adequadamente conduzidos, com grave prejuízo psicossocial. Nestas situações, a neurocirurgia pode ser indicada. Existem cinco técnicas cirúrgicas disponíveis, com as seguintes taxas de melhora global pós-operatória: capsulotomia anterior (38 a 100%; cingulotomia anterior (27 a 57%; tractotomia subcaudado (33 a 67%; leucotomia límbica (61 a 69% e talamotomia central lateral com palidotomia anteromedial (62,5%. A capsulotomia anterior pode ser realizada através de diferentes técnicas: neurocirurgia padrão, radiocirurgia ou estimulação cerebral profunda. Na neurocirurgia padrão, circuitos neurais são interrompidos por radiofreqüência via trepanação no crânio. Na radiocirurgia, uma lesão actínica é induzida sem a necessidade de abertura do crânio. A estimulação cerebral profunda consiste na implantação de eletrodos ativados a partir de estimuladores. A literatura indica taxas relativamente baixas de eventos adversos e complicações, sendo raramente descritas alterações neuropsicológicas e de personalidade. Cumpre ressaltar, no entanto, a falta de ensaios clínicos randomizados que comprovem a eficácia e investiguem os eventos adversos ou complicações dos procedimentos cirúrgicos acima mencionados. Concluindo, há um recente aprimoramento das neurocirurgias dos transtornos psiquiátricos graves no sentido de torná-las cada vez mais eficazes e seguras. Estas cirurgias, quando adequadamente indicadas, podem trazer alívio substancial ao sofrimento de pacientes com TOC grave.Responses to pharmacotherapy and psychotherapy in obsessive-compulsive disorder (OCD range from 60 to 80% of cases. However, a subset of OCD patients do not respond to adequately conducted treatment trials, leading to severe

  10. 骨移植重建肩关节后脱位合并肱骨头前内侧骨缺损的临床疗效分析%The clinical outcome of anatomical reconstruction with bone graft for humeral head impression fractures after posterior shoulder dislocation

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    徐德兴; 陈昌礼; 陈硕

    2012-01-01

    目的 自体或异体骨移植方法解剖重建肩关节后脱位伴有前内侧骨缺损,恢复肱骨头关节面形态,为肩关节后脱位的诊治提供一种有效、可靠方法.方法 6例患者纳入本次研究,患者平均年龄46.3(35~65)岁,所有患者肩关节后脱位伴有25%~45%肱骨头关节面前内侧骨缺损,2例患者伴有小结节撕脱性骨折,1例患者小结节联合外科颈骨折.6例患者中5例发生肩关节脱位延迟诊断,延迟诊断时间平均71.2(36~105)d.所有患者均采用自体或异体骨移植来解剖修复肱骨头前内侧骨缺损,恢复肱骨头关节面形态.结果 所有患者术后随访16.8(6~30)个月,优秀5例,良好1例,Constant评分平均为84.8(76~90)分,随访时无复发性肩关节脱位、移植骨塌陷以及肩关节不稳表现.结论 采用自体/异体骨移植、重建肱骨头形态是一种有效、可靠方法,能够恢复良好肩关节功能及稳定性.%There had an anatomical reconstruction with bone autograft/allograft for humeral head impression fractures after posterior shoulder dislocation . It provide a valid and good method for the diagnosis and treatment of posterior shoulder dislocation. Methods Six patients with an average age of 46. 3years (35 ~ 65 ) at time of surgery were included. All patients had a 25% ~45% anteromedial humeral head articular surface defect associated with five missed locked posterior shoulder dislocation. Two patients had an less tuberosity fracture,one patient had an additional less tuberosity and surgical neck fracture . For five patients the time span between the injury and the diagnosis is 71. 2 days,ranged between 36 and 105 days, all patients used an anatomical repair with bone autograft/allograft for humeral head impression fractures after posterior shoulder dislocation. Results At a mean time follow-up of 16. S months (6 to 30) , the result was found to be excellent for five patients and good for one patient with a mean

  11. 颞下颌关节紊乱病患者口腔不良习惯与髁突骨质改变相关性的影像学研究%Relationship between oral habits and temporomandibular joint radiographic findings showed by cone beam computed tomography in temporomandibular disorder patients

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    张伟华; 余丽霞; 王晓冬; 李晓箐

    2012-01-01

    Objective The purpose of this retrospective study was to investigate the relationship between oral habits and temporomandibular joint (TMJ) bony change of temporomandibular disorder (TMD) patients. Methods One hundred and six TMD patients diagnosed according to Research Diagnostic Criteria (RDC/TMD) were selected. All the patients had undergone cone beam computed tomography (CBCT) imaging of TMJ, and their oral habits had been investigated. The associations between oral habits and TMJ radiographic findings were analysed. Results Among 106 patients, the incidence of bruxism, clenching, chewing on one side and being fond of hard food were high. Preferring to hard food increased the risk of ill -defined cortical bone change. Hobby of hard food increased the risk of bony changes in the anterolateral and posterolateral part of the condyle, as well as in the articular tubercle. Chewing on one side could increase the risk of bony changes in the anteromedial aspect of articular fossa. Conclusion Oral habits of TMD patients were associated with type and position TMJ bony change.%目的 研究颞下颌关节病患者口腔不良习惯与颞下颌关节髁突骨质改变之间的关系.方法 选取诊断为颞下颌关节紊乱病的患者106例,问卷调查患者的口腔不良习惯,并行双侧颞下颌关节锥形束CT成像,分析患者口腔不良习惯与颞下颌关节髁突骨质影像学改变的相关性.结果 106例患者中,口腔不良习惯以偏侧咀嚼、紧咬牙、夜磨牙和喜食硬物较常见.经统计学分析,喜食硬物是出现髁突骨皮质模糊消失型改变的危险因素(P =0.019,OR=2.570).喜食硬物是髁突前外侧(P =0.025,OR =2.298)、髁突后外侧(P =0.023,OR =2.692)及关节结节(P=0.020,OR =3.067)易出现骨质改变的危险因素.偏侧咀嚼习惯则是关节窝前内侧(P=0.013,OR =0.311)易出现骨质改变的危险因素.结论 口腔的不良习惯与颞下颌关节骨质改变的类型及部位有一定相关性.

  12. 青龙满族自治县围产儿出生缺陷情况分析及对策研究

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    王民; 肖斌; 孟晓丽; 刘凤楼; 李淑民

    2016-01-01

    Objective Understand the present situation of perinatal birth defects qinglong manchu autonomous county, tofind the cause of perinatal birth defects, explore study of the various measures to prevent birth defects, which will provide a scientific basis for regional service decision of eugenic and superior nurture.Methods Relying on national free pregnancy eugenics health check project, from January 2013 to September 2015, collecting reproductive health care to qinglong manchu autonomous county hospital to participate in national free pregnant eugenics health check after the project plan of 20271 pregnant women of childbearing age, around the pregnancy pregnancy follow-up found abnormal termination of the fetus, and data on the retrospective statistical analysis.Results Found a total of 156 cases of perinatal birth defects of perinatal birth defects 7.69‰, and a downward trend in 3 years. Perinatal birth defects in the main line, spina bifida, anencephaly encephalocele, congenital hydrocephalus, etc.; Lead to the main factors of perinatal birth defects of the economy, the living environment, living habits, access to health services, for the master degree of knowledge of eugenic and superior nurture, taking of nutrients during pregnancy, etc.Conclusion In order to reduce the perinatal birth defects, we must strengthen eugenics health knowledge propaganda, improve women of childbearing age consciousness of eugenic and superior nurture, through the national free eugenics health examination before childbirth programs at the same time, actively promote prenatal screening technology,strengthen the efforts in prenatal screening and prenatal diagnosis, actively carry out women take folic acid, pregnancy and the early stages of pregnancy to prevent birth defects "tertiary prevention measures”, can effectively prevent the occurrence of perinatal birth defects, reduce the incidence of birth defects.%目的:了解青龙满族自治县围产儿出生缺陷现状,寻找

  13. Efeito da fortificação alimentar com ácido fólico na prevalência de defeitos do tubo neural Efecto de la fortificación alimentaria con ácido fólico en la prevalencia de defectos del tubo neural Effects of folic acid fortification on the prevalence of neural tube defects

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    Sâmya Silva Pacheco

    2009-08-01

    defectos del cierre del tubo neural fueron definidos de acuerdo con el Códigos Internacional de Enfermedades- 10ª Revisión: anencefalia, encefalocele y espina bífida. Se compararon las prevalencias en los períodos anterior (2000 - 2004 y posterior (2005-2006 al período obligatorio de fortificación. Se analizó la tendencia temporal de las prevalencias trimestrales de defectos del cierre del tubo neural por las pruebas de Mann-Kendall y Sen's Slope. RESULTADOS: No se identificó tendencia de reducción en la ocurrencia del hecho (Teste de Mann-Kendall; p= 0,270; Sen's Slope = - 0,008 en el período estudiado. No hubo diferencia estadísticamente significativa entre las prevalencias de defectos de cierre del tubo neural en los períodos anterior y posterior a la fortificación de los alimentos con ácido fólico de acuerdo con las características maternas. CONCLUSIONES: A pesar de que no haya sido observada reducción de los defectos de cierre del tubo neural posterior al período obligatorio de fortificación de alimentos con ácido fólico, los resultados encontrados no permiten descartar el beneficio del mismo en la prevención de esta malformación. Son necesarios estudios evaluando mayor período y considerando el nivel de consumo de los productos fortificados por las mujeres en edad fértil.OBJECTIVE:To analyze the effect of folic acid-fortified foods on the prevalence of neural tube defects in live newborns. METHODS: Longitudinal study with newborns from the city of Recife, Northeastern Brazil, between 2000 and 2006. Data analyzed were obtained from the Sistema Nacional de Informações de Nascidos Vivos (National Information System on Live Births. Neural tube defects were defined in accordance with the International Classification of Diseases, 10th revision (ICD-10: anencephaly, encephalocele, and spina bifida. Prevalences from the periods before (2000-2004 and after (2005-2006 the mandatory fortification period were compared. Time trend of three

  14. Defeitos de fechamento do tubo neural e fatores associados em recém-nascidos vivos e natimortos Neural tube defects and associated factors among liveborn and stillborn infants

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    Marcos J.B. Aguiar

    2003-04-01

    evaluate the prevalence and factors associated to neural tube defects in liveborn and stillborn infants delivered at the Hospital das Clínicas, UFMG, from January 8, 1999 to July 31, 2000. METHODS: this is a descriptive study, based on a database, according to the Latin-American Collaborative Study of Congenital Malformation (ECLAMC rules. Reports on liveborn and stillborn infants with congenital anomalies were prepared including information about morphological description, necropsy results, complementary exams, family, social and pregnancy histories and other clinical data. Each malformed liveborn infant originated a control of the same sex, without malformations. The liveborn and stillborn infants with neural tube defects delivered during that period were classified according to their defect and the presence or absence of associated defects. The liveborn and stillborn infants with neural tube defects were compared to newborns without neural tube defects according to their weight and sex and their mother's age and parity. Epi-Info 6.0 Program was used for the statistical analysis of the results. RESULTS: the prevalence of neural tube defects was 4.73 to 1,000 deliveries (89:18,807; it was significantly higher among stillborn infants (23.7:1,000 than among liveborn infants (4.16:1,000, p < 0.001. Neural tube defects were more often found among low weight liveborn infants (< 2,500 g, p < 0.001 and less frequently among women who had had more than three gestations, p = 0.007. No association was found regarding newborn's sex or maternal age. There was no association with newborn's sex and weight, maternal parity or age among stillborn infants. The most common neural tube defects were myelomeningocele (47.2%, anencephaly (26.9% and encephalocele (16.9%. The defects were found as isolated anomalies in 71.1% of the liveborn and 38.5% of the stillborn infants; they were part of a syndrome in 9.2% (liveborn and 7.7% (stillborn. CONCLUSIONS: the neural tube defect prevalence found

  15. 复杂肱骨远端骨折手术治疗的临床探讨%Clinical evaluation of operative treatment of complicated distal humerus fractures

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    赵龙; 宋有鑫; 崔成喜; 张宇轩; 张宝琦; 龚平; 武云鹤; 尚瑞松; 陈宾

    2014-01-01

    Background Distal humeral fracture is a severe damage around the elbow joint,and is often seen in young adults.It accounts for 2% of all adult fractures and about 50% of all humerus fractures.It′s one of the fractures that is difficult to deal with.The types of distal humeral fracture are divergent. Distal humerus fractures are often comminuted which make operative reduction difficult.Secondary loss of reduction and elbow ankylosis are common postoperative complications. All these difficulties make the distal humerus fracture one of the unresolved problems in fracture treatment.This study is to evaluate the clinical outcome of complex distal humeral fractures treated by operation.Methods (1)General data:twenty-four cases of operative treated distal humerus fractures in author′s hospital from January 2004 to December 2013 were included in this study.There were 1 5 males and 9 females,aging from 1 7 to 73,averaged 41.AO/OTA Classification:A3:9 cases;B1, B2:6 cases;C3:9 cases.Two cases were combined with nerve injury.Two cases had histories of high blood pressure and diabetes.(2 ) Operative method:The patient was placed in the supine position,and the elbow to be operated on was positioned at 90°of abduction and supported on a lucent operating table.A pneumatic tourniquet was placed as proximally as possible on the arm.With the elbow flexed at about 60°,the first incision was made about 7 cm proximal to the tip of the medial epicondyle.In the initial cases,the ulnar nerve was isolated,released from the ulnar nerve groove, and protected carefully.In later cases,the nerve was only exposed.The medial and anteromedial side of the distal humerus was exposed through the opening between the brachial muscle and the medial intermuscular septum.The common origin of the flexor muscles was partially dissected and reflected distally,leaving a 5-mm strut to be re-sutured in situ at completion of surgery.The anterior capsule was incised.The articular surface of the trochlea was

  16. Study on Osseous Landmarks of ACL Insertion on the Femur%前交叉韧带股骨止点相关骨性标志的解剖学研究

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    李永会; 金利新; 孙康

    2011-01-01

    目的:定量观察分析ACL股骨止点相关骨性标志,明确其解剖特点,为临床提供客观可视的解剖依据.方法:对3例福尔马林处理和2例新鲜冰冻的成人膝关节标本进行解剖研究.屈膝90°行前抽屉试验,根据ACL纤维张力情况区分前内束和后外束,观察两束在膝关节屈伸过程中的张力变化特性,然后从股骨止点切断韧带,观察有无骨性标志,并测量相关数据.对100例(男46例,女54例)成人股骨的外侧髁内侧面后1/3RPACL股骨止点处进行观察,测量其相关骨性标志数据.结果:5例膝关节标本均发现两个骨性标志,即长骨嵴和短骨嵴.100例股骨的股骨止点前方有一由股骨近端后方斜向前下至股骨远端的长骨嵴,其中62例标本股骨止点内有一短小的骨嵴,将止点分为坡度不同的两部分.有18例短骨嵴起自长嵴的转折处,即长嵴的1/2处,长、短骨嵴长度分别为15.11±2.64 mm和6.42±1.7 mm,长骨嵴与髁间窝顶线夹角为69°±7.28°,长骨嵴起自髁间窝顶线自前向后75.5%处,长短骨嵴夹角为69.48°±24.03°.结论:ACL股骨止点存在相关骨嵴,即前缘前方的长骨嵴,部分有两束股骨止点间的短骨嵴.这为临床ACL解剖重建提供了客观向导.%Objective The purpose of this study was qualitatively and quantitatively to determine the osseous landmark of femoral insertion of the ACL. Methods Three human cadaveric knees disposaled in formalin and 2 frozen cadaveric knees were anatomized. The anteromedial bundle and posterolateral bundle of ACL were abscised at the attachment site of femur, and then the osseous landmark on femoral insertion was determined. In addition, posterior 1/3 of medial surfaces of femoral lateral condyles in vivo of 100 adults (46 male, 54 female) were also observed. Data of the osseous landmarks related to the femoral insertion were collected. Results There were two osseous landmarks related to the femoral insertion in the 5 knees (long

  17. The design of a new unicompartmental ultra high molecular weight polyethylene prosthesis and the biomechanical study on its stability%新型单髁聚乙烯假体的设计及其稳定性的生物力学研究

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    鲁世保; 李之芳; 王庆一; 胥少汀; 李放; 姜金卫; 李增洲

    2001-01-01

    Objective To Compare the stability of a newly designed unicompartmental pure polyethylene prosthesis with the currently used ones. Methods Three kinds of unicondylar pure polyethylene prosthesis were investigated. The three kinds of prosthesis have the same shallow dish structure in the superior surface; however, the structures of the undersurface are different. The smooth typed prosthesis has a smooth undersurface, ‘ # ’ shape prosthesis has a under surface with grooves, which is used clinically at present, and the newly designed three peg prosthesis has three pegs anteriorly, posteriorly, and medially. Eighteen tibia specimens were divided into three groups randomly, all prostheses were cemented onto the medial compartment of the tibias. Each specimen was tested in a biomechanical machine(CSS- 1101). A 147 N and 981 N load was applied anteromedially. The anterior and posterior micromovements were measured for 1,2,3,4,5,10,15,20,25,30 cycles at the load of 147 N and 981 N. Results There was no significant difference between three peg prosthesis and ‘ # ’ shape prosthesis during anterior and posterior micromovements at a load of 147 N. But at a 981 N load , the micromovements of three peg prostheses were significantly lower than that of ‘ # ’ shape prosthesis. Conclusion The stability of the newly designed three peg prosthesis was better than that of ‘ # ’ shape prosthesis currently used clinically.%目的比较新型单髁聚乙烯假体与临床常用假体的稳定性,为新型假体应用于临床提供试验依据。方法试验中使用三种类型的单髁胫骨聚乙烯假体:光滑型、“井”字型及“三柱”型。三种假体的上表面均为浅碟形,底面的结构各不相同:光滑型假体的底面光滑,无任何立体构型;“井”字型假体是临床使用的假体,其底面带有“井”字形分布的沟槽;“三柱”型假体是新型假体,其底面带有三个短柱,分别位于底

  18. 异体胫前肌腱"Y"形双束双隧道重建后十字韧带的疗效分析%Posterior cruciate ligament reconstruction by double bundle-double tunnel Y-shape of the anterior tibialis tendon allograft

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    黄华扬; 郑小飞; 李凭跃; 张余; 王泽锦

    2010-01-01

    Objective To investigate the clinical results of posterior cruciate ligament (PCL) reconstruction by double bundle-double tunnel Y-shape of the anterior tibialis tendon allograft. Methods From March 2001 to January 2008, 47 patients underwent PCL reconstruction were included. The allogeneic adult anterior tibialis tendon was prepared into the Y-shape double bundles with the length of 130 mm; A bundle was defined as A-side; B-side was two short bundle (B1, B2 bundle). A bundle was 70 mm in length with a diameter of 10-12 mm. B1 bundle (anterolateral bundle) was 55 mm long with a diameter of 6 mm; B2 bundle(posteromedial bundle) was about 50 mm with a diameter of 6 mm. The allograft ligament was installed through the antero-medial approach. Absorbable interface screws were fixed in the tibial tunnel firstly, and then in the femoral tundles. When being fixed, anterolateral bundle was in flexion of 90°, postero-medial bundle was in 30°. Assisted exercise with knee an angle-locked walking aid had continued for 8-10 weeks. Results The average operating time were 45 min. The average follow-up time was 49.5 months. Preoperative Lachmann was positive in all cases while Lachmann was negative in 39 cases, weakly positive in 5 cases, and positive in 4 cases postoperatively. Post-operative KT-1000 testing, Lysholm score and Tegner activity levels has improved significantly compare with the pre-operative ones. Conclusion The double folded bundles of adult anterior tibialis tendon has sufficient length and diameter for posterior cruciate ligament reconstruction with power tension. The methods of ligament passing through the tunnel has improved to ease the procedure.%目的 探讨异体胫前肌腱"Y"形双柬双隧道移植重建后十字韧带(posterior cruciate ligament,PCL)的临床效果.方法 2001年3月至2008年1月,采用将异体胫前肌腱编织成"Y"形双束韧带的方法治疗PCL损伤患者,其中47例具有完整随访资料,男39例,女8例;年龄18~43

  19. 不同方法修复踝关节外侧副韧带慢性损伤的稳定性评价☆%Repairing ankle lateral collateral ligament chronic injury using different methods:A stability assessment

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    焦晨; 胡跃林; 郭秦炜; 王成; 梅宇; 谢兴; 杨渝平; 陈临新; 江东

    2013-01-01

    BACKGROUND: There are many repair and reconstruction methods to restore the stability of lateral ankle joint. OBJECTIVE: To compare the mechanical changes of modified Karlsson procedure and modified Broström procedure for the treatment of lateral chronic ankle instability. METHODS: Seventy-three patients with lateral chronic ankle instability were enrol ed, among whom, 43 consecutive patients were treated with modified Broström procedure and fol owed-up for average (50.8±26.5) months, and 30 consecutive patients underwent modified Karlsson procedure and fol owed-up for (49.5±11.1) months. Chondral lesions, American Orthopaedic Foot and Ankle Society score, Mazur score, Tegner score, satisfaction score and re-injury situation were recorded before and after treatment. Objective examinations including drawer test and inversion stress test were also done for assessment. RESULTS AND CONCLUSION: 38.4% patients had chondral lesions, and 40.5% lesions occurred in the anteromedial facet of the talocrural joint (talus zone I and tibia region I). Mazur score and Tegner score were significantly improved postoperatively in modified Broström group and modified Karlsson group. There were no significant differences on Mazur score and Tegner score between two groups. The improved American Orthopaedic Foot and Ankle Society score in the modified Karlsson group was significantly higher than that in the modified Broström group. The drawer test and inversion stress test were negative in two groups, except positive in one patient in modified Broström group. The treatment time in the modified Karlsson group was significantly shorter than that in the modified Broström group, and there was no significant difference in satisfaction score between two groups. There were two cases of re-injury in modified Broström group while one case in modified Karlsson group. Modified Karlsson procedure has the treatment effect similar to modified Broström procedure, but it is easier to operate.%

  20. STUDY ON THE MECHANISM OF NERVE STIMULATION SIGN IN LOWER EXTREMITIES BY INFRARED THERMAL IMAGING IN LUMBAR DISC HERNIATION%腰椎间盘突出症的红外热像“下肢神经刺激征象”机制探讨

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    贾和平; 张大伟; 周文生; 金瑞林

    2013-01-01

    0.97 and 6.45 ± 1.05, respectively before treatment and 1.33 ± 0.64 and 1.30 ± 0.73 after treatment in the affected lower extremites of the two groups. The ITIs in the two groups showed NSSLE in the affected lower extremites before treatment, the greater the pain intensity was, the more significant NSSLE was. NSSLEs were not seen in 1st group and 11 cases of 2nd group, but were seen in nine cases of 2nd group after treatment, and were obviously in anteromedial or posterior region of the affected lower extremities of the nine cases. Conclusion: The main mechanism of NSSLE by ITI in LDH was a kind of spinal cord reflex resulted from pain stimulation, leading to sympathetic vasoconstriction reaction in the affected lower extremites, not the results of stimulation of sympathetic fibers in the lumbosacral roots or sinus vertebral nerve; the stimulation to lumbar paravertebral sympathetic trunk and communicating branches leads to vasoconstriction in the affected lower extremites was the secondary mechanism of NSSLE in LDH.

  1. 七分区法关节镜下滑膜全切术治疗类风湿性肘关节炎的中期随访结果%Seven-division Arthroscopic Synovectomy for Rheumatoid Elbow: Mid-term Follow-up Results

    Institute of Scientific and Technical Information of China (English)

    程序; 崔国庆; 闫辉; 杨渝平; 王健全; 何震明

    2012-01-01

    目的 评价七分区法关节镜下滑膜全切术治疗类风湿性肘关节炎的疗效.方法 2002 ~2008年,行关节镜下滑膜切除肘关节清理术治疗类风湿性肘关节炎11例,共13个肘关节,4例左侧,5例右侧,2例双侧.平均病程60个月(5 ~120个月).手术通过近端前内及前外入路、软点入路和后外入路,使用关节镜进行滑膜全切.在关节镜下,将肘关节分为内侧区、外侧区、桡骨头前下区、鹰嘴窝、后外区、桡骨头后下区和后内侧区,共七区,逐区切除滑膜.术前术后进行Mayo评分及HSS评分.结果 随访时间12 ~72个月,平均34.6月.术后7个月复发1例,再次行手术治疗.其余10例12个肘关节屈肘角度由102.1°±15.9°增加至123.3°±21.4°(t=- 3.275,P=0.007),伸肘角度由33.8° ±21.4°改善至20.0°±17.8°(t =3.572,P=0.004).HSS评分由48.8±18.1分改善为87.9±15.9分(t=-8.125,P=0.000).Mayo评分由39.6±16.6分改善为92.9±13.9分(t=-9.918,P=0.000).结论 关节镜下滑膜全切术是治疗类风湿性肘关节炎的有效手段之一,多入路七分区法切除肘关节类风湿性滑膜对于提高疗效、降低复发率有一定意义,可有效缓解疼痛,增加肘关节活动度,术后Mayo评分及HSS评分均有显著提高.%Objective To evaluate the outcomes of arthroscopic synovectomy with seven-division method for elbows with rheumatoid arthritis. Methods Between 2002 and 2008, we performed arthroscopic synovectomy on 13 elbows (11 patients) with rheumatoid arthritis (4 on the left side, 5 on the right, and 2 cases of bilateral). The average disease course of the patients was 60 months (5 to 120 months). Anteromedial, anterolateral, soft spot, and posterolateral routes were employed to conduct arthroscopic synovectomy. Synovium was removed step by step in the following seven areas: media, lateral, anteroinfehor radial head, olecranon fossa, posterolateral, posteroinferior radial head, and posteromedial areas. The Mayo and

  2. 关节镜下四骨道双束固定治疗急性肩锁关节Rockwood Ⅴ型脱位%Arthroscopic fixation in the treatment of Rockwood Ⅴ acute acromioclavicular joint dislocation

    Institute of Scientific and Technical Information of China (English)

    陆伟; 王大平; 朱伟民; 欧阳侃; 柳海峰; 彭亮权; 李皓; 冯文哲

    2014-01-01

    -designed 4-tunnel double-bundle locator is applied.The 4-tunnel double-bundle acromioclavicular joint fixation is carried out with the method of two Endobutton loops in each of two groups.The technique includes the following 5 parts:① Acromioclavicular joint exploration and exposure of subcoracoid surface: make the routine posterior approach of acromioclavicular joint with arthroscope of 70°,4.5 mm and guide the anterior approach.Gradually separate the anteromedial joint capsule with radiofrequency coblation from the inside of the subscapularis tendon above to the subcoracoid surface.Clean the soft tissue on its lower surface to expose the coracoid neck.② Acromioclavicular joint exploration,acromioclavicular joint disc excision and partial excision and plasty of the clavicular lateral end:make a 2-3 cm transverse incision above the acromioclavicular joint parallel to the clavicle,layered the cut,expose the acromioclavicular joint, remove ruptured joint disc, and rub the clavicular lateral end. Afterwards, reduce the acromioclavicular joint and fix it temporarily with Kirschner wire.③ The self-designed locator (Patent No.ZL 20132021 7047.4)is adopted.Put the head of the locator on the lower surface of coracoid neck,and the transverse bar and 2.4 mm guide pin are arranged on the clavicular surface.The guide pin is inserted into the hole A,drilling through the subcoracoid surface with a 3.5 mm hollow drill for reaming.Adjust the transverse bar to the pre-determined angle of scapular axis and coronal section 6 mm away from hole A,and then ream the hole B with 2.4 mm guide pin inserted.④ After connecting the ring with an Endobutton button plate and 3 Utra-braid sutures (Smith & Nephew,Andover, Ma),pull in the 3 line from hole A below the coracoid process,and then pull out from the bone tunnel on the clavicular end to maintain the Endobutton plate on the subcoracoid surface.The Utra-braid suture penetrates into the other piece of Endobutton plate and then gets pulled out

  3. 肘关节镜辅助下复位固定治疗尺骨冠状突骨折%Elbow arthroscope assisted reduction and fixation treatment for coronoid fracture

    Institute of Scientific and Technical Information of China (English)

    杨顺; 向明; 杨国勇; 陈杭; 胡小川; 唐浩琛

    2014-01-01

    neurovascular structure in front of the elbow closely packed,operation through blood vessels or nerve gap is safe,and the vice injury occures easily;(2 )the position of coronary is deep,it is very difficulty to touch the fracture line,because there is a lot of soft tissue,in this case it is difficult to touch the front clear fracture line and clean.If the soft tissue on the coronary was cleaned radically,including the attachment point of the medial collateral ligament,the brachial muscle,and the joint capsule,the meaning of reduction will lose;(3)fragment of coronal fractures tend to be small,the compaction fingers from the anterior part may occupy the fixing position again;(4) surgery of open reduction is a kind of great trauma,easily lead to heterotopic ossification and larger scars left,affecting beautiful appearance.With the deep understanding of the anatomy of elbow function and the improvement of elbow function requirements of patients,and minimally invasive surgery is more and more become a safe and effective treatment of intra-articular fractures.Because arthroscopy surgery has the advantages of little trauma and quick recovery in recent years,the application in the elbow fracture has made rapid progress.In acute elbow trauma,elbow arthroscopy technology can not only clean up small pieces fragment including cartilage ones,but also compete reduction and internal fixation of fracture feasiblly.And radial head fractures,olecranon fractures, coronoid process fractures,humerus condyle fracture reduction and internal fixation were reported. Adams reported 7 cases of ulna coronary condyle fracture appling elbow arthroscopy technology for reduction and fixation,final follow-up showed the curative effect is satisfied,with no heterotopic ossification and elbow arthritis.Operation approach of elbow arthroscopy are anterolateral approach and anteromedial approach in the position of elbow flexion.Because:(1 )there is safest distance of ulnar nerve and median nerve in anterolateral