WorldWideScience

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. 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

  3. MANAGEMENT OF HUGE ENCEPHALOCELE

    Directory of Open Access Journals (Sweden)

    Rajeev

    2015-11-01

    Full Text Available Among all neural tube defects, encephalocele incidents are 1 in 5000 live births. (1 Newborn with encephalocele may be associated with other congenital malformations. Encephalocele patient’s management pose many challenge to neurosurgeon due to other associated anomalies that may present like ventriculocele, Dandy Walker and Arnold-Chiari malformation, and difficult positioning airway management to anaesthesiologist. We discuss a case of huge encephalocele and its management

  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. 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

  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. 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 ...

  8. Large occipito-cervical encephalocele with Chiari III malformation

    Directory of Open Access Journals (Sweden)

    S Ambekar

    2011-01-01

    Full Text Available Chiari type III is the rarest of the Chiari malformations and is usually associated with high morbidity and mortality. Treatment consists of primary closure of the encephalocele with or without cerebro-spinal fluid (CSF shunting. In our case, the patient was treated with ventriculoperitoneal shunt followed by excision of the encephalocele. We propose that large encephaloceles should be treated with CSF shunting prior to repair of the sac so as to achieve optimal result.

  9. 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...

  10. 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 ...

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. 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 ...

  15. 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 ...

  16. 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 ...

  17. 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 ...

  18. Congenital spinal tumor in a patient with encephalocele and hydrocephalus: a case report

    Directory of Open Access Journals (Sweden)

    Mahjoub Fatemeh

    2011-01-01

    Full Text Available Abstract Introduction Encephalocele is a rare congenital abnormality of the central nervous system, where brain tissue protrudes from a defect in the skull. Some anomalies are associated with encephalocele. However, the association of spinal teratoma and encephalocele has not been reported in the English literature. Case presentation We report the case of an Iranian girl with a history of encephalocele surgery, who, at the age of four years, developed an intramedullary spinal teratoma, and discuss the pathogenesis of this association. Conclusion To the best of our knowledge, this is the first report of an association between encephalocele and spinal teratoma.

  19. Mammoth orbitofrontal neurofibromatosis with herniating meningo-encephalocele

    Directory of Open Access Journals (Sweden)

    Dhanraj Prema

    2010-01-01

    Full Text Available We are presenting a mammoth orbito-frontal neurofibroma with a herniating meningo-encephalocele in a 23 year old African male. The tumour measured 87cm Χ 54cm and occupied the right orbito-temporo-facial region and had destroyed the right orbit. A pre operative embolization of the feeding vessels was followed by a one stage near total excision of the tumour and repair of the meningo-encephalocele in hypotensive anaesthesia. The excised tumour weighed 8 Kg and, to the best of our knowledge, is the largest orbito-facial neurofibroma reported in literature.

  20. Biomechanical Study of the Fixation Strength of Anteromedial Plating for Humeral Shaft Fractures

    Directory of Open Access Journals (Sweden)

    Yin-Feng Zheng

    2016-01-01

    Conclusions: Anteromedial plating was superior to anterolateral or posterior plating in all mechanical tests except in AP four-point bending fatigue tests compared to the anterolateral plating group. We can suggest that anteromedial plating is a clinically safe and effective way for humeral shaft fractures.

  1. 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 ...

  2. 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 ...

  3. Irreducible Anteromedial Dislocation of Radial Head with Biceps Tendon Interposition

    Directory of Open Access Journals (Sweden)

    Vicente J. Climent-Peris

    2016-01-01

    Full Text Available The case presents an isolated irreducible anteromedial dislocation of radial head due to biceps tendon interposition on a 14-year-old female patient. After an unsuccessful closed reduction, a lateral approach of the left elbow was carried out through Kocher’s interval. Given that no pathology was found on the radiohumeral joint, the approach was extended distally. This revealed that the biceps tendon was displaced laterally around the radial neck, preventing the reduction. Once the tendon was taken back to its anatomical position, the radial head reduction was performed successfully. The patient achieved a complete functional recovery. Possible injury mechanisms are discussed, as well as the importance of identifying such a rare injury.

  4. 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.

  5. 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

  6. 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

  7. Ultrastructural features of dopamine axon terminals in the anteromedial and the suprarhinal cortex of adult rat.

    Science.gov (United States)

    Séguéla, P; Watkins, K C; Descarries, L

    1988-02-23

    The ultrastructural features and synaptic relationships of dopamine (DA) axon terminals were examined in the prefrontal cortex of adult rat after immunocytochemical staining with a highly specific polyclonal antiserum directed against DA-glutaraldehyde-lysyl-protein conjugate (donated by M. Geffard). Single and serial ultrathin sections were obtained from the deep layers of the anteromedial and the suprarhinal DA fields. The DA axon terminals from both regions averaged 0.7 micron in diameter, contained a mixed population of small, round and clear synaptic vesicles associated with a few larger dense-cored or fully immunostained vesicles, and frequently exhibited synaptic contacts which were exclusively made on dendritic shafts and spines. These synapses were mostly of the symmetrical type (80%) and were more often seen on dendritic shafts than spines, particularly in the suprarhinal (89%) compared with the anteromedial cortex (62%). As estimated either by stereological extrapolation from single sections or by direct observation in serial sections, the synaptic incidence of these DA varicosities was significantly greater in the anteromedial than suprarhinal DA field. In the longest series of thin sections, a junctional complex could be observed on 93% of the DA varicosities from the anteromedial cortex but only on 56% in the suprarhinal cortex. Such an inter-regional disparity in the relational characteristics of the DA input will need to be taken into account in elucidating the role and properties of this monoamine in cerebral cortex.

  8. Distance Reached in the Anteromedial Reach Test as a Function of Learning and Leg Length

    Science.gov (United States)

    Bent, Nicholas P.; Rushton, Alison B.; Wright, Chris C.; Batt, Mark E.

    2012-01-01

    The Anteromedial Reach Test (ART) is a new outcome measure for assessing dynamic knee stability in anterior cruciate ligament-injured patients. The effect of learning and leg length on distance reached in the ART was examined. Thirty-two healthy volunteers performed 15 trials of the ART on each leg. There was a moderate correlation (r = 0.44-0.50)…

  9. 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

  10. 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.

  11. Biomechanical Study of the Fixation Strength of Anteromedial Plating for Humeral Shaft Fractures

    Institute of Scientific and Technical Information of China (English)

    Yin-Feng Zheng; Jun-Lin Zhou; Xiao-Hong Wang; Lei Shan; Yang Liu

    2016-01-01

    Background:Open reduction and internal fixation with plate and screws are the gold standard for the surgical treatment of humeral shaft fractures,this study was to compare the mechanical properties of anteromedial,anterolateral,and posterior plating for humeral shaft fractures.Methods:A distal third humeral shaft fracture model was constructed using fourth-generation sawbones (#3404,composite bone).Atotal of 24 sawbones with a distal third humeral shaft fracture was randomly divided into three Groups:A,B,and C (n =8 in each group) for anteromedial,anterolateral,and posterior plating,respectively.All sawbones were subjected to horizontal torsional fatigue tests,horizontal torsional and axial compressive fatigue tests,four-point bending fatigue tests in anteroposterior (AP) and mediolateral (ML) directions and horizontal torsional destructive tests.Results:In the horizontal torsional fatigue tests,the mean torsional angle amplitude in Groups A,B,and C were 6.12°,6.53°,and 6.81°.In horizontal torsional and axial compressive fatigue tests,the mean torsional angle amplitude in Groups A,B,and C were 5.66°,5.67°,and 6.36°.The mean plate displacement amplitude was 0.05 mm,0.08 mm,and 0.10 mm.Group A was smaller than Group C (P < 0.05).In AP four-point bending fatigue tests,the mean plate displacement amplitude was 0.16 mm,0.13 mm,and 0.20 mm.Group B was smaller than Group C (P < 0.05).In ML four-point bending fatigue tests,the mean plate displacement amplitude were 0.16 mm,0.19 mm,and 0.17 mm.In horizontal torsional destructive tests,the mean torsional rigidity in Groups A,B,and C was 0.82,0.75,and 0.76 N.m/deg.The yielding torsional angle was 24.50°,25.70°,and 23.86°.The mean yielding torque was 18.46,18.05,and 16.83 N·m,respectively.Conclusions:Anteromedial plating was superior to anterolateral or posterior plating in all mechanical tests except in AP four-point bending fatigue tests compared to the anterolateral plating group.We can suggest that

  12. 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)

  13. 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...

  14. 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

  15. 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

  16. A novel technique in airway management of neonates with occipital encephalocele.

    Science.gov (United States)

    Rangaswamy, N; Pramanik, A K

    2014-11-01

    Airway stabilization in neonates with occipital encephalocele (OE) is critical during surgery or if they develop hypoxic-respiratory failure. Endotracheal intubation can be challenging due to difficulty in positioning the head in a patient with large occipital mass. We describe a novel technique for positioning neonates with large OE using a commonly used hospital apparatus which facilitated appropriate positioning of the baby and successful endotracheal intubation with ease and no additional staff.

  17. 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...

  18. Comparing Transtibial and Anteromedial Drilling Techniques for Single-bundle Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    Sukur, Erhan; Akman, , Yunus Emre; Senel, , Ahmet; Unkar, Ethem Ayhan; Topcu, , Huseyin Nevzat; Ozturkmen, , and Yusuf

    2016-01-01

    Background: Among the many factors that determine the outcome following anterior cruciate ligament (ACL) reconstruction, the position of the femoral tunnel is known to be critically important and is still the subject of extensive research. Objective: We aimed to retrospectively compare the outcomes of arthroscopic ACL reconstruction using transtibial (TT) or anteromedial (AMP) drilling techniques for femoral tunnel placement. Methods: ACL reconstruction was performed using the TT technique in 49 patients and the AMP technique in 56 patients. Lachman and pivot-shift tests, the Lysholm Knee Scale, International Knee Documentation Committee (IKDC) score, Tegner activity scale and visual analog scale (VAS) were used for the clinical and functional evaluation of patients. Time to return to normal life and time to jogging were assessed in addition to the radiological evaluation of femoral tunnel placement. Results: In terms of the Lysholm, IKDC, Tegner score, and stability tests, no significant differences were found between the two groups (p > 0.05). Statistical analysis revealed reduced time to return to normal life and jogging in the AMP group (p < 0.05). The VAS score was also significantly reduced in the AMP group (p < 0.05). The position of the femoral tunnel was anatomically appropriate in 51 patients in the AMP group and 5 patients in the TT group. Conclusion: The AMP technique is superior to the TT technique in creating anatomical femoral tunnel placement during single-bundle ACL reconstruction and provides faster recovery in terms of return to normal life and jogging at short-term follow-up. PMID:27733884

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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

  1. 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.

  2. Perinatal factors associated with neural tube defects (anencephaly [correction of anancephaly], spina bifida and encephalocele).

    Science.gov (United States)

    Ogata, A J; Camano, L; Brunoni, D

    1992-01-01

    The objective of the present study was to determine the presence of risk factors for the occurrence of neural tube defects. Data for 33,535 births which occurred at Hospital do Servidor Público Estadual de São Paulo from July 1973 to December 1986 were collected in a prospective manner as recommended by "Estudo Colaborativo Latino-Americano de Malformações Congênitas" (ECLAMC, Collaborative Latin American Study on Congenital Malformations). Twenty-six cases of neural tube defects were detected (0.77/1000 births). Of these, 11 were cases of spina bifida (0.39/1000 births), 9 of anencephaly (0.27/1000 births) and 6 of encephalocele (0.18/1000 births). We observed a higher frequency of polyhydramnios, premature labor, Apgar scores of less than 7 at the first and fifth minutes, low birth weight and intrauterine growth retardation.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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

  5. 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...

  6. 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.)

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. Intestinal atresia, encephalocele, and cardiac malformations in infants with 47,XXX: Expansion of the phenotypic spectrum and a review of the literature.

    Science.gov (United States)

    Bağci, Soyhan; Müller, Andreas; Franz, Axel; Heydweiller, Andreas; Berg, Christoph; Nöthen, Markus M; Bartmann, Peter; Reutter, Heiko

    2010-01-01

    Identification of the 47,XXX karyotype often occurs adventitiously during prenatal fetal karyotyping in cases of advanced maternal age. Although most females with 47,XXX appear healthy at birth, various types of congenital malformations have been reported, of which urinary tract anomalies are the most frequent. We report on 2 newborns with 47,XXX and congenital cardiac defects, one of whom had duodenal atresia and the other an occipital encephalocele. This expands the spectrum of malformations reported in association with the triple-X syndrome. We also present a review of the literature on non-urinary tract malformations in females with 47,XXX. We conclude that prenatal identification of the 47,XXX karyotype is an indication for detailed fetal ultrasonography which should include examination of multiple organ systems. Such prenatal screening for possible associated congenital malformations should help to ensure optimal perinatal clinical management of 47,XXX cases.

  12. 重症颅脑损伤术中急性脑膨出45例临床分析%Analysis of Acute Encephalocele during Severe Craniocerebral Injury

    Institute of Scientific and Technical Information of China (English)

    郁明惠; 李伟生; 钱兴龙; 陆黎春

    2012-01-01

    Objective To discuss the causes and treatment of acute encephalocele during the operation of severe craniocerebral injury.Methods We reviewed and analyzed the clinical data of 45 patients with craniocerebral trauma who received craniotomy with the occurrence of acute encephalocele.Result All of 45 patients were evaluated in Glasgow outcome scale(GOS) after operation:7 patients reach favorable recovery(15.6%),7 cases with moderate disabled(15.6%),2 cases with severe disabled(4.4%),6 patients were in persistentvegetativestate(PVS)(13.3%),and 23 cases dead eventually(51.1%).Conclusion The main causes of acute encephalocele during the operation of severe craniocerebral injury were delayed intracranial haematoma and acute diffuse brain swelling.Processing of delayed intracranial haematoma,dural mesh incision,bilateral bone disc and other severe craniocerebral injury intraoperative acute encephalocele caused of heavy residual rate and mortality can be reduced.%目的 探讨重症颅脑损伤术中急性脑膨出的病因和术中处理.方法 对45例颅脑外伤开颅术中出现急性脑膨出的临床资料进行回顾分析.结果 45例术后根据格拉斯哥预后评分(GOS)评定:恢复良好7例(15.6%),轻残7例(15.6%),重残2例(4.4%),植物生存6例(1 3.3%),死亡23例(51.1%).结论 迟发性颅内血肿和急性弥漫性脑肿胀是重症颅脑损伤开颅术中发生急性脑膨出的主要原因.迟发性颅内血肿的处理、硬脑膜网状切开、双侧去骨瓣等可以降低重症颅脑外伤术中急性脑膨出的致重残率和病死率.

  13. Clinical outcomes in the single-bundle anterior cruciate ligament reconstruction using antero-medial portal technique%前内侧入路解剖重建单束前交叉韧带的临床评估

    Institute of Scientific and Technical Information of China (English)

    张勇; 朱明生; 杨林; 谢伟杰

    2016-01-01

    Objective To assess the position and clinical outcomes of the reconstructed single-bundle anterior cruci-ate ligament ( ACL) through anteromedial portal ( AMP) techniques .Methods Arthroscopic single-bundle ACL re-construction with autologous hamstring tendon was performed using AMP technique in 25 patients.The bone tunnel position, upward angle , tension of graft were measured from magnetic resonance imaging examination and plain radio-graphs ,11 healthy subjects were used as a control group .The clinical outcome was assessed by the Lysholm knee score.Results The lateral radiographs demonstrate the femoral tunnels were anterior to the intersection of the inter -condylar roof and the femoral posterior cortex line , and the tibial tunnels were posterior to the slope of the intercondy-lar roof.The upward dip of ACL measured from MRI were 50.82°±4.57°.The center of the bibial tunnel was loca-ted 0.50 ±0.04 of the entire sagittal length of the tibial plateau from the anterior edge of the tibia ,compared with the control group about the two terms data , there was not significant difference ( P>0.05 ) .The follow-up period was 13~44 months.The Lysholm score increased from 64.76 ±7.16 points to 92.20 ±4.29 points (P<0.01).Con-clusions ACL reconstruction through anteromedial portal technique is closer to anatomy reconstruction , which pro-vides satisfactory radiological and early clinical outcomes .%目的:评估关节镜下经前内侧入路解剖重建单束前交叉韧带( ACL)的位置、形态及临床效果。方法对25例ACL断裂患者在关节镜下经前内侧入路应用解剖重建技术行单束ACL重建术,移植物应用自体腘绳肌腱。术后行X线、MRI检查,了解骨道情况,观察移植物形态及张力,并与11例健侧膝关节的正常ACL进行对比。应用Lysholm评分系统评估膝关节功能。结果术后X线片显示股骨隧道内口位于髁间窝顶与股骨后缘皮质线交叉点前缘,胫骨

  14. 术中窦汇区迟发性硬膜外血肿致急性脑膨出的治疗%The treatment of malignant encephalocele caused by acute epidural hematoma around confluens sinuum in operation

    Institute of Scientific and Technical Information of China (English)

    徐勤义; 董吉荣; 蔡学见; 王玉海; 刘斌; 时忠华; 金东; 冯毅; 何建青

    2010-01-01

    目的 探讨颅脑损伤患者术中窦汇区迟发性硬膜外血肿所致急性脑膨出的临床特点及诊治经验.方法 回顾我院2007年5月至2009年5月收治的10例颅脑损伤患者,均为开颅术中发现急性脑膨出,术中复查头颅CT明确窦汇区迟发性硬膜外血肿的诊断后,取顶枕部"U"形切口,做窦汇区骨瓣成形加自体筋膜加压修补术.结果 根据GOS评分判断愈后:中残2例,重残1例,植物生存1例,死亡6例.结论 窦汇区硬膜外血肿做跨窦骨瓣成形术,骨瓣足够大,出血点完全暴露,再用自体筋膜加压修补术彻底止血,是理想的手术方法 .早期诊断及正确的手术方法 是救治成功的关键.%Objective To investigate the characteristics of malignant encephalocele caused by acute epidural hematoma around confluens sinuum during operation. Method Ten patients admitted from May 2007 to May 2009 in our hospital was reviewed. All cases presented malignant encephalocele during operation and acute epidural hematoma around confluens sinuum after CT scan. We made craniotomy with a bone flap under U - shape incision and self - fascia was used to patch compressively for hemostasis. Results According to the GOS score 2 cases had satisfactory outcome with moderately disability, 1 severe disability, 1 vegetative state, 6 dead.Conclusion Patients with acute epidural hematoma around confluens sinuum might be made craniotomy in a big enough bone - flap so that bleeding point exposed wholly and stopped bleeding by self - fascia patch repair compressively. Early diagnosis and correct operative technique might be key point for successful remedy.

  15. A clinical analysis of individualized anatomical anterior cruciate ligament reconstruction through anteromedial portal technique%经前内侧入路个体化解剖重建前交叉韧带的临床分析

    Institute of Scientific and Technical Information of China (English)

    张理选; 李映姗; 张华胜; 郭汉明; 王新光; 康明

    2015-01-01

    目的:分析经前内侧入路建立股骨骨道进行前交叉韧带(ACL)个体化解剖重建的临床疗效。方法自2012年1月~2013年7月,共有52例患者在关节镜下单束解剖重建膝关节 ACL,重建后用相同的方法进行康复锻炼,对所有患者进行随访,常规查 Lachman 试验,膝关节屈伸活动度,轴移试验,Lysholm 膝关节评分,并进行比较。结果所有患者的膝关节屈伸活动度都在正常范围以内,没有出现韧带撞击现象,患者术后进行 Lachman 试验显示Ⅰ度阳性2例,轴移试验均阴性。膝关节 Lysholm 评分:重建前、后膝关节 Lysholm 评分差异有统计学意义(P <0.001)。结论经前内侧入路能更精确地寻找 ACL 的股骨解剖止点并进行个体化解剖重建,操作手法简单且能较快恢复膝关节功能,对恢复膝关节的稳定性起到了很好的作用。%Objective To observe the clinical efficacy of the anatomical reconstruction of anterior cruciate ligament (ACL)through anteromedial (AM)portal femoral bone tract technique. Methods January 2012~July 2013 fifty-two cases underwent arthroscopy-guided anatomic single-bundle ACL reconstruction.All the patients did the same recovery exercises and were followed up.Traditional physical examination such as Lachman test,anterior draw test and pivot shift test were conducted for all these patients after the surgery. Lysholm knee joint score was done.And the obtained data was compared between the two groups. Results The flexion-extension motions of all knee joints were in the normal range.No ligament impact occurred.The pivot shift test results were negative in all cases.Post-operative Lachman test results showed 2 cases were grade I positive.Compared of pre-construction Lysholm knee joint scores to post-construction yielded statis-tical difference (P <0.001). Conclusion It seemed to be better to match the native femoral ACL footprint through AM portal,and reconstruct individualized anatomic ACL.It is a

  16. Clinical analysis of transplantation of single-bundle four-strand hamstring tendon via anteromedial approach for anterior cruciate ligament reconstruction%经前内侧入路单束四股腘绳肌腱重建前交叉韧带的临床分析

    Institute of Scientific and Technical Information of China (English)

    曹雪飞; 甄平

    2014-01-01

    Objective:To assess clinical effects of arthroscopic reconstruction of anterior cruciate ligament (ACL) using single-bundle four-strand hamstring tendon via anteromedial approach. Methods:20 cases of ACL fracture patients were treated with the single-bundle four-strand hamstring tendon via anteromedial approach for anterior cruciate ligament reconstruction, and guided them with functional exercises after operation. Lysholm score standard was used for the subjective function of the knee: before the operation, 6 months and 12 months after the operation. Results: The 20 cases were followed up for 12-18 months with an average of 14 months. The Lysholm score was improved from (53. 5±6. 9) points before the operation to (88. 4±5. 2) points (6 months after the operation) and (91. 6±4. 2) points (12 months after the operation), and the differences were statistically significant (P<0. 01). Conclusions:The arthroscopic reconstruction of anterior cruciate ligament using the single-bundle four-strand hamstring tendon via anteromedial ap-proach is an important method to maintain the stability of knee and recover the knee function, and worthy of strongly clinical research and extension.%目的:探讨关节镜下经前内侧入路( anteromedial,AM)行自体单束四股腘绳肌腱重建前交叉韧带( anterior cruciate ligament, ACL)的临床疗效。方法:对收治的20例 ACL 断裂患者采用 AM 法行自体单束四股腘绳肌腱重建前交叉韧带,术后指导患者行功能锻炼。采取 Lysholm 评分标准对患者术前、术后6个月、12个月膝关节主观功能进行评分。结果:随访20例患者,随访时间12~18个月,平均14个月。患者术前 Lysholm 评分(53.5±6.9),术后6个月 Lysholm 评分为(88.4±5.2),术后12个月 Lysholm 评分为(91.6±4.2),差异有统计学意义(P<0.01)。结论:关节镜下 AM 法行自体单束四股腘绳肌腱重建前交叉韧带是维持膝关节稳定、恢复膝关节功能的重要方法,值得临床研究推广。

  17. 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

  18. 驾驶摩托车致膝关节前内侧旋转不稳定的手术治疗%SURGICAL TREATMENT OF ANTERO-MEDIAL ROTATORY INSTABILITY OF KNEE JOINT CAUSED BY MOTORCYCLE

    Institute of Scientific and Technical Information of China (English)

    周炎; 丰峰; 瞿新丛; 方祖怡; 刘祥; 潘晓辉; 许来峰

    2012-01-01

    Objective To discuss the effectiveness of operation technique for antero-medial rotatory instability (AMRI) of the knee joint caused by motorcycle. Methods Between June 2007 and December 2009, 32 cases of AMRI caused by motorcycle were treated. There were 28 males and 4 females with an average age of 35.5 years (range, 20-50 years). The interval between injury and surgery was 5-10 days (mean, 7 days). The anterior cruciate ligament (ACL) was injured at the attachment point of the condyles crest; the medial collateral ligament (MCL) was injured at central site in 19 cases, at medial condyles of femur in 10 cases, and at medial condyles of tibia in 3 cases, which were all closed injuries. The bone avulsion of condyles crest was fixed by steel wire and MCL was repaired. Results Red swelling and a little effusion occurred at the incision in 1 case, and the other incisions healed by first intention. Traumatic arthritis of the knee occurred in 5 cases. Thirty-two cases were followed up 16-22 months (mean, 18.5 months). The X-ray examination showed that the fracture union time was 5-8 weeks (mean, 6 weeks) after operation. At last follow-up, the extension of knee joint was 0° and the flexion of the knee joint was 110-170° (mean, 155°). According to the synthetic evaluating standard of International Knee Documentation Committee, 24 cases were rated as A level, 6 cases as B, 1 case as C, and 1 case as D at last follow-up. Lysholm knee score was 85.93 ± 3.76 at last follow-up, which was significantly higher (t=53.785, P=0.000) than preoperative score 37.54 ± 3.43. Conclusion In patients with AMRI caused by motorcycle, steel wire is used to fix the bone avulsion of condyles crest and MCL should be repaired simultaneously as far as possible. And associating with the early postoperative functional exercise, the short-term effectiveness is satisfactory, but long-term effectiveness still need further follow-up observation.%目的 探讨手术治疗驾驶摩托车致膝关

  19. 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

  20. 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.

  1. 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

  2. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  3. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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, ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  7. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  8. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  9. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  10. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  11. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  12. Nasal encephalocele in a child with Beckwith-Wiedemann syndrome

    NARCIS (Netherlands)

    Broekman, Marike L. D.; Hoving, Eelco W.; Kho, Kuan H.; Speleman, Lucienne; Sen Han, K.; Hanlo, Patrick W.

    2008-01-01

    Beckwith-Wiedemann syndrome (BWS) is a rare congenital syndrome characterized by gigantism, macroglossia, exophthalmos, postpartum hypoglycemia, and multiple midline defects such as omphalocele. The authors describe, to the best of their knowledge, the first case of a child in whom BWS was diagnosed

  13. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  14. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  15. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  16. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  17. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  18. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  19. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  20. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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, ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  2. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  3. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  4. 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 ... to someone having appendicitis is really a basic service that one needs, really, to consider one’s self- ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  7. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  8. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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, ...

  9. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  10. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  11. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  12. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  13. 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 ...

  14. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  15. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  16. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  17. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  18. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  19. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  20. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  1. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  2. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  3. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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, ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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, ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  6. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  7. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  8. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  9. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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, ...

  10. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  11. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  12. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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’ ...

  13. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  14. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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, ...

  15. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  16. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  17. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  18. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  19. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  20. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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

    Medline Plus

    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 ...

  2. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  3. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  4. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  5. Craniofacial Procedure to Treat Encephalocele and an Arachnoid Cyst

    Medline Plus

    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 ...

  6. Periventricular nodular heterotopia, frontonasal encephalocele, corpus callosal dysgenesis and arachnoid cyst: A constellation of abnormalities in a child with epilepsy

    Directory of Open Access Journals (Sweden)

    Prasad Krishnan

    2014-01-01

    Full Text Available A 7-year-old male child presented with poorly controlled generalized tonic-clonic seizures. On examination, he was mentally retarded, deaf and had a swelling at the root on the nose. Computed tomography scan done previously revealed a left temporal arachnoid cyst (AC due to which he was referred for surgery. However, magnetic resonance imaging revealed a constellation of abnormalities - all of which could be responsible for his seizures. The combination of periventricular nodular heterotopias with encepaholcele is rarely described in the literature, and more infrequently so its combination with AC and callosal dysgenesis - the Chudley-Mccullough syndrome. We describe the case and review relevant literature on this subject.

  7. 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.

  8. 前交叉韧带中前内束与后外束功能上的差异研究%Differences of the function between the anteromedial bundle and posterolateral bundle of the anterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    田鑫铎; 尹文哲; 孙敏; 叶义杰; 江磊磊; 任聪

    2013-01-01

    Objective To investigate the trauma mechanism, injury characteristics, early diagnosis and treatment of the drivers with steering wheel injuries. Methods The clinical data of 122 patients who suffered from steering wheel injuries in our hospital from Jan. 2007 to Dec. 2011 were analyzed retrospectively. Results Among these 122 patients, there were 27 patients with cranial or cervical trauma,64 patients with chest trauma,56 patients with abdomen trauma,41 patients with extremities,pelvic or spine fracture. There were 81 patients with poly-trauma. Totally 115 patients were survived. The survival rate was 94. 3% ( 115/122) and the mortality was 5.1% (7/122) . The main cause of death was the injuries with cranial trauma. Conclution Steering wheel injuries in drivers usually were severe and accompanied with high poly-trauma rate. Mostly severe thoracoabdominal trauma need surgical treatment. .Blunt cardiac injuries and p anc re at ico duodenal injuries are easy to be miss-diagnosed and mis-diagnosed,so doctors should pay more attention to these conditions. iagnoseu,so doctors snoulu. pay more attention to tnese conditions.%目的 研究前交叉韧带(ACL)中前内束(AMB)与后外束(PLB)在维持膝关节稳定性方面所起的不同作用.方法 对12具新鲜冰冻尸体的膝关节标本在分别屈曲0°、15°、30°、60°及90°下对胫骨施加100N的前负荷及在0°、15°、30°下5Nm的胫骨内旋负荷,使两束韧带拉伸并带动电阻应变片形变引起阻值改变,从而引起输出电压值的变化.结果 在对胫骨施加100N前负荷的条件下,AMB在屈膝60°和90°时的原位拉力显著>屈膝0°和15°时(P屈膝30°、60°和90°时(PAMB(PPLB(PPLB(P0.05).结论 虽然在ACL 的双束中AMB起主要作用,但PLB的辅助作用仍不可忽视,其体现在膝关节接近伸直位维持前向和内旋稳定性方面.

  9. MRI evaluation of the knee post double bundle ACL reconstruction: Association of graft findings and comparison with arthroscopy

    Directory of Open Access Journals (Sweden)

    Mohammed Farghally Amin

    2016-06-01

    Conclusion: Increased signal intensity within the anteromedial or posterolateral bundles of a double bundle ACL reconstruction is frequently associated with a partial tear. Impingement of the anteromedial graft is frequently associated with partial tear and increased signal intensity which is proved by arthroscopy/surgery. A low incidence of other complications is seen.

  10. 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 ...

  11. 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...

  12. 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.

  13. Neurosurgical conditions and procedures in infancy are associated with mortality and academic performances in adolescence

    DEFF Research Database (Denmark)

    Hansen, Tom G; Pedersen, Jacob K; Henneberg, Steen W;

    2015-01-01

    and the control group 14 698 individuals. Hydrocephalus (n = 130), craniotomy (n = 43), and myelomeningocele/encephalocele children (n = 55) had a higher mortality (18.5.0%, 18.6%, and 7.3%, respectively) vs controls (1.3%; P ... significantly lower than controls in hydrocephalus and craniotomy (P = 0.0043 and P = 0.0077) but not myelomeningocele/encephalocele children (P = 0.2785); the proportion of available test scores were significantly lower in all three groups (40.8%, 60.0%, and 67.3%, respectively) vs 86.8% in controls (P

  14. 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.

  15. 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

  16. 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....

  17. Prefrontal cortex and hippocampus in behavioural flexibility and posttraumatic functional recovery

    DEFF Research Database (Denmark)

    Rytter, Hana Malá; Andersen, Lykke Grønbech; Christensen, Rie Friis;

    2015-01-01

    Within one experiment and one T-maze, we examined the consequences of (i) bilateral lesions of the anteromedial prefrontal cortex (PFC), (ii) bilateral transections of the fimbria-fornix (FF), or (iii) combined lesions of both PFC and FF (COMB) on rats' ability to perform reversal or set-shifting...

  18. A Fetus with Iniencephaly Delivered at the Third Trimester

    Directory of Open Access Journals (Sweden)

    Esra Cinar Tanriverdi

    2015-01-01

    Full Text Available Iniencephaly is an uncommon neural tube defect, having retroflexion of the head without a neck and severe distortion of the spine. Iniencephaly is classified into two groups, iniencephaly apertus (with encephalocele and iniencephaly clausus (without encephalocele. Incidence ranges from 0.1 to 10 in 10.000 pregnancies and it is seen more frequently in girls. Most of the fetuses with this defect die before birth or soon after birth, while those with the milder forms may live through childhood. Recurrence risk is around 1–5%. Family should be offered termination to reduce maternal risks and counseled for folic acid supplementation before the next planned pregnancy. Here we present a rare case of iniencephaly clausus which was diagnosed at 18th week of gestation by ultrasonography and delivered in the third trimester of pregnancy due to rejection of termination.

  19. 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...

  20. 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...

  1. 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.

  2. Olfactory receptor and neural pathway responsible for highly selective sensing of musk odors.

    Science.gov (United States)

    Shirasu, Mika; Yoshikawa, Keiichi; Takai, Yoshiki; Nakashima, Ai; Takeuchi, Haruki; Sakano, Hitoshi; Touhara, Kazushige

    2014-01-01

    Musk odorants are used widely in cosmetic industries because of their fascinating animalic scent. However, how this aroma is perceived in the mammalian olfactory system remains a great mystery. Here, we show that muscone, one musk odor secreted by various animals from stink glands, activates a few glomeruli clustered in a neuroanatomically unique anteromedial olfactory bulb. The muscone-responsive glomeruli are highly specific to macrocyclic ketones; interestingly, other synthetic musk odorants with nitro or polycyclic moieties or ester bonds activate distinct but nearby glomeruli. Anterodorsal bulbar lesions cause muscone anosmia, suggesting that this region is involved in muscone perception. Finally, we identified the mouse olfactory receptor, MOR215-1, that was a specific muscone receptor expressed by neurons innervating the muscone-responsive anteromedial glomeruli and also the human muscone receptor, OR5AN1. The current study documents the olfactory neural pathway in mice that senses and transmits musk signals from receptor to brain.

  3. 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...

  4. 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. ...

  5. 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 ...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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.

  11. 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...

  12. 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...

  13. 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.

  14. 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.

  15. ANAESTHETIC CHALLENGES IN THE MANAGEMENT OF PEDIATRIC ENCEPHALOCOELE REPAIR: RETROSPECTIVE CASE SERIES

    Directory of Open Access Journals (Sweden)

    Ravindra Giri

    2015-02-01

    Full Text Available INTRODUCTION: 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. 1 Anaesthetic challenges in management of occipital meningoencephalocele include securing the airway with intubation in lateral position, intraoperative prone position and its associated complications, careful securing of the endotracheal tube and accurate assessment of blood loss. These babies also have associated congenital anomalie s, gastrointestinal malrotation, renal anomalies, cardiac malformations and tracheoesophageal fistula, making anaesthetic management even more difficult. Meticulous anaesthetic management is crucial for early repair of encephalocoele to prevent any sequel. 2 METHODS: To identify the anaesthetic challenges, perioperative and postoperative complications during encephalocele repair, 20 cases were studied retrospectively from 2012 to 2014 at Department of Anaesthesia , Department of Neurosurgery, MR Medical College, Gulbarga. RESULTS: 20 cases of encephalocoele repair were undertaken during the study period. Out of these 12 (60% were male and 8(40% female. Age range was 1 day to 6 years. Most common type of encephalocele was occipital 12(60%, which posed a difficulty during positioning & intubation, followed by occipito - cervical 4(20%, Parietal 2(10%, Fronto - nasal 1(5% & Fronto - naso - ethmoidal 1(5%. Most of the patients were extubated successfully on table, only one patient required post - operative ventilator support for a day. Peri - operative complications included bronchospasm (15%, followed by hypotension, tachycardia, laryngospasm, hypoxia, accidental extubation (10% each & bradycardia, endobronchial intubation (5%. CONCLUSION: Children with Encephalocoele are prone to have peri - operative complications which can be managed by meticulous anaesthetic managenement. 3 Early surgical management of encephalocoele is not

  16. 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

  17. 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

  18. 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

    Meckel-Gruber Syndrome is a rare autosomal recessive lethal ciliopathy characterized by the triad of cystic renal dysplasia, occipital encephalocele and postaxial polydactyly. We present the largest population-based epidemiological study to date using data provided by the European Surveillance of...... diagnosis is important for timely counseling of affected couples regarding the option of pregnancy termination and prenatal genetic testing in future pregnancies.European Journal of Human Genetics advance online publication, 3 September 2014; doi:10.1038/ejhg.2014.174....

  19. Multidisciplinary staged surgical management of bifrontal meningoencephalocele with long-term follow-up.

    Science.gov (United States)

    Blount, Jeffrey P; Gordon, Amber S; Foreman, Paul M; Grant, John H

    2013-04-01

    The authors report on an infant with a bifrontal encephalocele that was associated with multisuture craniosynostosis, spasticity, and a progressively severe epilepsy. They describe the initial presentation, genetic screening results, staged multidisciplinary operative plans, clinical course, complications, and long-term surgical and developmental follow-up. To their knowledge, the comprehensive surgical management of this type of complicated congenital cranial anomaly has not been previously described. Surgical management was staged and multidisciplinary and required careful attention to all 3 components of the condition: 1) hydrocephalus, 2) frontal meningoencephalocele, and 3) epilepsy. PMID:23350678

  20. Spontaneous defects between the mastoid and posterior cranial fossa.

    Science.gov (United States)

    Rereddy, Shruthi K; Mattox, Douglas E

    2016-01-01

    Conclusions Spontaneous defects between the mastoid and the posterior cranial fossa are exceedingly rare. Patients with these lesions may have a lower BMI compared to those with middle cranial fossa encephaloceles, but are otherwise demographically similar. This study recommends repair via a transtemporal approach to allow for examination of the entire posterior face of the temporal bone. Objective To describe cases of spontaneous posterior cranial fossa defects. Methods This study reviewed all cases of spontaneous posterior fossa defects presenting to a tertiary referral center over the last decade and described clinical presentation, imaging, operative findings, and outcomes. We also compared these lesions to those previously reported in the literature as well as the more common spontaneous encephaloceles of the middle cranial fossa. Results This study identified five cases with a mean age of 61.4 years, female-to-male ratio of 4:1, and a mean BMI of 31. Three cases presented with spontaneous pneumocephalus, one with CSF otorrhea, and one as an incidental imaging finding. Four defects were found medial to the sigmoid sinus and one was in the lateral retrosigmoid air cells.

  1. 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.

  2. A newborn with very rare von Voss-Cherstvoy syndrome: a case report

    Science.gov (United States)

    Sharma, Deepak; Gupta, Basudev; Shastri, Sweta; Sharma, Pradeep

    2016-01-01

    Introduction von Voss-Cherstvoy syndrome is a part of a group of syndromes with radial and hematologic abnormalities, and until now approximately ten cases have been reported in the literature. This syndrome is characterized by a triad of radial ray defects, occipital encephalocele, and urogenital abnormalities. Case presentation We report a neonate from Indian ethnicity who was diagnosed with von Voss-Cherstvoy syndrome. The neonate had radial ray defect, occipital encephalocele, tetralogy of Fallot, and bilateral agenesis of kidney, ureter, and bladder. The neonate was suspected to have von Voss-Cherstvoy syndrome on the basis of clinical features, which was further confirmed by fibroblast analysis showing somatic mosaicism for del(13q). Conclusion von Voss-Cherstvoy syndrome is a very rare syndrome that can be suspected on the basis of typical clinical features and confirmed by fibroblast analysis showing somatic mosaicism for del(13q). This adds a second case of this chromosome anomaly described in this syndrome. PMID:27499650

  3. 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

  4. 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.

  5. 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...

  6. 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.

  7. 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

  8. 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)

  9. Hypertensive thalamic hemorrhage. Clinical symptoms and outcomes in 40 cases

    Energy Technology Data Exchange (ETDEWEB)

    Munaka, Masahiro; Nishikawa, Michio; Hirai, Osamu; Kaneko, Takaaki; Watanabe, Syu; Fukuma, Jun; Handa, Hajime

    1988-12-01

    In the past six years, we have had experience with 40 patients with hypertensive thalamic hemorrhages, as verified by CT scan at our hospital within 24 hours. These patients were classified into the following three groups according to the location of the bleeding point and the size of the hematoma: (1) anteromedial (4 cases), (2) posterolateral (16 cases), and (3) massive (20 cases). The (1) and (2) hematomas were small (less than 3 cm in diameter), while those in (3) were large (more than 3 cm in diameter). Twenty cases (50% of all the thalamic hematomas) were small hematomas. The characteristic clinical symptoms of the anteromedial type were a mild disturbance of consciousness and thalamic dementia, while those of the posterolateral type were motor and sensory disturbance, and thalamic aphasia, respectively. Twenty cases (50%) were large hematomas. The clinical symptoms of these cases were mainly consciousness disturbance; 7 of them expired. Based on this experience, it may be considered that the patients whose hematoma size was larger than 3 cm had a poor prognosis and that the patients with the posterolateral type had a poor functional diagnosis.

  10. 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.

  11. 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

  12. Pre-tibial synovial cyst after reconstruction of the anterior cruciate ligament: case report,

    Directory of Open Access Journals (Sweden)

    Luís Eduardo Pedigoni Bulisani

    2014-12-01

    Full Text Available Arthroscopic reconstruction of the anterior cruciate ligament has been modernized through new surgical techniques and new materials. When tibial fixation is performed using an absorbable screw, complications may occur, such as formation of a pre-tibial cyst. The case described here is about a patient who presented an anteromedial synovial cyst in his right knee, three years after having undergone ACL reconstruction. The patient did not present any pain nor any complaints other than a mass that progressively increased in size, worsened after physical activities. Imaging examinations were requested: simple radiography of the knee and magnetic resonance. Anteromedial imaging of the knee showed a mass with well-delimited borders and internal fluid content, suggestive of a synovial cyst, with communication with the joint cavity through the tibial tunnel, without presenting enlargement or absorption of the bone tunnel. The cyst was surgically resected and the tibial tunnel occlusion was performed using a bone plug. The diagnosis of a synovial cyst was subsequently confirmed through the results from the anatomopathological examination. The patient presented good clinical evolution, with disappearance of the symptoms and a return to physical activities.

  13. 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)

  14. 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.

  15. 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.

  16. Manual khalifa therapy in patients with completely ruptured anterior cruciate ligament in the knee: First results from near-infrared spectroscopy

    Directory of Open Access Journals (Sweden)

    Gerhard Litscher

    2013-01-01

    Full Text Available Background: Manual Khalifa therapy has been practiced in Hallein, Austria, for more than 30 years; however, there are no scientific results available on the topic. Aims: The goal of the present study was to investigate possible acute effects of Khalifa therapy on regional oxygen saturation of knee tissues in patients with completely ruptured anterior cruciate ligament. Materials and Methods: We investigated 10 male patients (mean age ± standard deviation (SD 35.9 ± 6.1 year using a four-channel oximeter. The sensors were applied anterolaterally and anteromedially, beside the patella, on both the injured and the healthy (control knee. Results: The results of the controlled study showed that values of oxygen saturation on the knee with the ruptured ligament were significantly increased (P < 0.001 immediately after Khalifa therapy, whereas the values on the control knee showed insignificant increases. Baselines values of the anterolateral side of the injured knee were significantly (P < 0.001 different from those of the anterolateral side of the control knee. The same effect was present on the anteromedial side; however, with a lower degree of significance (P < 0.05. Conclusions: Khalifa therapy was clinically successful in all 10 patients. Further, investigations and analyzes are necessary to explain the underlying mechanism.

  17. 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.)

  18. 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

  19. 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

  20. 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.

  1. Neural tube defect and folic acid.

    Science.gov (United States)

    Wani, M A

    2000-01-01

    Neural tube defect (NTD) is a group of congenital anomalies, which include anencephaly, encephalocele, iniencephaly, meningocele, myelomeningocele, myeloschisis, lipomeningocele, and rashischisis. Congenital malformations of the central nervous system constitute more than half of all congenital malformations with an incidence of 1-2/1000 births. The condition is thought to arise from multifactorial etiology with a distinct genetic predisposition. This paper discusses the pathogenesis of NTD and explores the use of folic acid for the prevention of this serious congenital malformation. Two studies, which have shown a significant protective effect of folic acid use on NTD prevention in high-risk mothers, are cited. In considering the effectiveness of folic acid supplementation on NTD prevention, obstetricians, pediatricians, neonatologists, and family doctors are called to initiate a collective effort to increase awareness among women in the childbearing age on the need of daily multivitamin intake with folic acid prior to pregnancy.

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

    DEFF Research Database (Denmark)

    Rasmussen, Lone Banke; Andersen, Niels Lyhne; Andersson, G.;

    1998-01-01

    in Denmark will decrease if the folate intake in fertile women increases. All women planning pregnancy should receive dietary counselling. Women who do not eat according to the Nordic Nutrition Recommendations. and women a with an increased risk due to diseases are recommended a supplement of 400 mu g folic......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......, in the few studies which calculate folate intake from the diet, a lower risk of NTD with higher intake of folate from the diet has been found. The folate intake can be increased by the diet, by folic acid supplements or by fortification of food a with folic acid. It is concluded that the incidence of NTDs...

  3. Two Hundred Thirty-Six Children With Developmental Hydrocephalus: Causes and Clinical Consequences.

    Science.gov (United States)

    Tully, Hannah M; Ishak, Gisele E; Rue, Tessa C; Dempsey, Jennifer C; Browd, Samuel R; Millen, Kathleen J; Doherty, Dan; Dobyns, William B

    2016-03-01

    Few systematic assessments of developmental forms of hydrocephalus exist. We reviewed magnetic resonance images (MRIs) and clinical records of patients with infancy-onset hydrocephalus. Among 411 infants, 236 had hydrocephalus with no recognizable extrinsic cause. These children were assigned to 1 of 5 subtypes and compared on the basis of clinical characteristics and developmental and surgical outcomes. At an average age of 5.3 years, 72% of children were walking independently and 87% could eat by mouth; in addition, 18% had epilepsy. Distinct patterns of associated malformations and syndromes were observed within each subtype. On average, children with aqueductal obstruction, cysts, and encephaloceles had worse clinical outcomes than those with other forms of developmental hydrocephalus. Overall, 53% of surgically treated patients experienced at least 1 shunt failure, but hydrocephalus associated with posterior fossa crowding required fewer shunt revisions. We conclude that each subtype of developmental hydrocephalus is associated with distinct clinical characteristics, syndromology, and outcomes, suggesting differences in underlying mechanisms.

  4. 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.

  5. Occipital meningoencephalocele with Cleft Lip, Cleft Palate and Limb Abnormalities- A Case Report.

    Science.gov (United States)

    Ganapathy, Arthi; T, Sadeesh; Swer, Mary Hydrina; Rao, Sudha

    2014-12-01

    A 21-week-old still born female fetus with occipital encepholocele, cleft lip and cleft palate was received from the Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry and was studied in detail. It was born to Primigravida, of a second degree consanguineous marriage, with unremarkable family history. The biometric measurements were noted which corresponded to the age of the fetus. Further the fetus was embalmed and dissected. On examination an encephalocele of 2.7×1.5 cm was seen in the occipital region with a midline defect in the occipital bone and herniated brain tissue. Other anomalies observed were right unilateral cleft lip, right cleft palate, and bilateral syndactyly of the lower limbs and associated Congenital Talipus Equino Varus of the right foot. Other internal organs were developed appropriate for the age of the fetus.

  6. 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

  7. MMPs 在膝前交叉韧带不同分束表达水平的实验研究%Experimental Study of The Expression Levels of MMPs in Bundles of Anterior Cruciate Liga-ment

    Institute of Scientific and Technical Information of China (English)

    王靖; 戴畅; 王愉思

    2016-01-01

    【目的】通过检测前交叉韧带(ACL)前内侧束和后外侧束基质金属蛋白酶(MMPs)的表达水平,探索 ACL 的潜在修复和重塑位点。【方法】从10具自愿捐赠的新鲜尸体上取膝关节,并取出膝关节 ACL ,提取总 RNA ,并反转录成 cDNA 后,应用实时定量 PCR(RT‐PCR)检测前内侧束和后外侧束中与肌腱修复相关的常见 MMPs 基因;将 ACL 的前内侧束和后外侧束两个功能纤维束标本固定、石蜡包埋,利用 MMP‐2和MMP‐3的多克隆抗体为一抗,进行免疫组化实验;将前内侧束和后外侧束两个功能纤维束中的组织分别收集,匀浆后提取总蛋白,用 Western blotting 分析不同分束中 MMP‐2、MMP‐3的表达量。【结果】MM P‐2、MMP‐3在前内侧束和后外侧束中的表达具有显著的差异,而 MMP‐1、MMP‐10、MMP‐13、MMP‐23等基因,在 ACL 不同束中的表达没有明显区别;免疫组化和 Western blotting 显示 MMP‐2在前内侧束比后外侧束表达高,MMP‐3在前内侧束比后外侧束表达低。【结论】膝关节 ACL 前内侧束具有较好的重塑能力,其胫骨止点前方更有可能成为临床肌腱重建的潜在位点。%Objective]To detect the expression level of MMPs in the anteromedial and posterolateral bun‐dles of anterior cruciate ligament and to explore the potential place for clinical tendon reconstruction of anterior cruciate ligament .[Methods]The knees and anterior cruciate ligaments (ACL) were cut out from 10 fresh ca‐davers that were donated voluntarily .The total RNA was extracted and reverse transcribed into cDNA ,then real‐time quantitative PCR was used to detect the MMP genes associated with tendon recovery in the anterome‐dial and posterolateral bundles of the ACL .Meanwhile the samples of anteromedial and posterolateral bundles of the anterior cruciate ligament were fixed and paraffin‐embedded .Immunohistochemistry

  8. Tectal codification of eye movements in goldfish studied by electrical microstimulation. f.

    Science.gov (United States)

    Salas, C; Herrero, L; Rodriguez, F; Torres, B

    1997-05-01

    This work compares the tectal codification of eye movements in goldfish with those reported for other vertebrate groups. Focal electrical stimulation was applied in various tectal zones and the characteristics of evoked eye movements were examined as a function of (i) the position of the stimulation over the tectal surface, (ii) the initial position of the eyes and (iii) the parameters (pulse rate, current strength, duration) of the stimulus. In a large medial zone, stimulation within the intermediate and deep layers of the tectum evoked contraversive saccades of both eyes, whose direction and amplitude were roughly congruent with the retinotopic representation of the visual world within overlying layers. These saccades were minimally influenced by the initial position of the eye in the orbit. The topographical arrangement of evoked saccades and body movements suggests that this tectal zone triggers orienting responses in a similar way to those described in other vertebrates. Stimulations applied within the caudal tectum also evoked contraversive saccades, but in disagreement with the overlying retinotopic map--the vertical component was absent. Taken together with electrically evoked body movements reported in free-swimming fish, these saccades could reveal that this zone is involved in escape responses. When stimulations were applied within the anteromedial zone of the tectum, contraversive movements of both eyes appeared much more dependent on initial eye position. Saccades elicited from this area displayed characteristics of "goal-directed saccades" which were similar to those described in the cat. The generation of goal-directed movements from the anteromedial zone suggests that this portion of the goldfish optic tectum has a different intrinsic organization or is connected with the brainstem saccade generator in a different fashion than the medial zone. Finally, stimulation of the extreme anteromedial zone evoked convergent eye movements. These movements and

  9. Comparative study of patellar subluxation syndrome and normal group using axial radiography and CT

    Energy Technology Data Exchange (ETDEWEB)

    Kitagawa, Mamoru; Tomonaga, Kunio; Egawa, Tadashi; Nakamura, Yasushi; Gotoh, Shoji; Mihara, Shigeru (Nagasaki Municipal Hospital (Japan))

    1989-10-01

    A comparative study was conducted on the 20 knees of 10 females with normal knee joints (age, 22-35 years) and on 7 knees of 7 patients with subluxation syndrome (age, 15-24 years), using axial radiography and CT. In axial radiography where the angle of knee flexion was 30 deg or 60 deg, no significant difference was recognized between the two groups with respect to tilting angle, patellofemoral angle, congruence angle and lateral shift. However, a significant difference was found using CT. Thus, CT was considered useful for diagnosis. Because of these results, all 7 cases underwent surgery for detachment of the lateral side and tightening of the medial side. Three cases underwent shifting of the tibial tuberosity to the anteromedial side, resulting in a favourable outcome. Here, we report the study. (author).

  10. Iliotibial band irritation caused by the EndoButton after anatomic double-bundle anterior cruciate ligament reconstruction: report of two cases.

    Science.gov (United States)

    Taketomi, Shuji; Inui, Hiroshi; Hirota, Jinso; Nakamura, Kensuke; Sanada, Takaki; Masuda, Hironari; Tanaka, Sakae; Nakagawa, Takumi

    2013-08-01

    Two patients underwent arthroscopic anatomic double-bundle anterior cruciate ligament (ACL) reconstruction using the EndoButton for femoral fixation. The femoral tunnels were created by the inside-out technique through a far anteromedial portal. The patients postoperatively developed moderate lateral knee pain without instability. At the second-look arthroscopic evaluation, the two EndoButtons were removed. Both patients were completely asymptomatic several months after implant removal, implying that the EndoButtons caused the mechanical irritation in the iliotibial band. This is the first report describing removal of EndoButtons because of pain caused by friction with the iliotibial band. In anatomic ACL reconstruction, if the femoral tunnel exit is positioned near the lateral femoral epicondyle, care should be taken to prevent iliotibial band friction syndrome that could result because of the EndoButton.

  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. 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 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 effect of morphine was investigated. Randall Selitto measures of cancer-induced bone pain were supplemented by von Frey testing, weight-bearing and limb use test. Contribution of cutaneous nociception to Randall Selitto measures were examined by local anaesthesia. Results: Randall Selitto pressure...

  14. 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

  15. Cushing’s Syndrome Secondary to isolated Micronodular Adrenocortical Disease (iMAD) associated with Rapid Onset Weight Gain and Negative Abdominal MRI Findings in a 3 year old Male

    Science.gov (United States)

    Henry, Rohan K.; Keil, Margaret F.; Stratakis, Constantine A.; Fechner, Patricia Y.

    2011-01-01

    Cushing’s syndrome (CS) is uncommon in childhood. CS may be either dependent or independent of adrenocorticotrophic hormone (ACTH). ACTH independent micronodular adrenocortical (MAD) disease may present in the second to third decade of life or between ages 2–3years. It may occur in isolation, or as a part of the Carney complex and it represents an elusive entity to diagnose. We present a 3 year 7 month old boy with isolated MAD (iMAD). Abdominal CT revealed prominent mildly lobulated anteromedial margin of adrenals with nodular appearance. Cardiac echo, thyroid and testicular ultrasounds performed as a work up for Carney complex were normal. Bilateral adrenalectomy confirmed MAD as the cause of CS. We present the history’ and identification of a unique case of iMAD. PMID:20662336

  16. Complex reconstruction after wide excision of juvenile aponeurotic fibromatoses of upper one-third of leg.

    Science.gov (United States)

    Akhtar, Md Sohaib; Basari, Rabeya; Khan, A H; Khurram, Mohd Fahud

    2014-08-01

    Juvenile musculoaponeurotic fibromatoses are benign tumors which arise from musculoaponeurotic stromal cells. They rarely occur in lower extremity and more rarely in children. They are locally invasive tumors with a high incidence of recurrence after surgery. Hence, wide local excision is the treatment of choice for such tumors. However, complex reconstruction is often required to cover the resulting soft tissue defect. This report presents a 12-year-old boy with a juvenile musculoaponeurotic fibromatosis in the anteromedial aspect of the upper third of a left leg. Following wide local excision, two local flaps, medial gastrocnemius and a distally based peroneal artery perforator flap, were used to reconstruct the soft tissue defect. Reconstruction has provided an acceptable functional and cosmetic result.

  17. 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.

  18. 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.)

  19. 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

  20. 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

  1. 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

  2. Neglected reverse Essex-Lopresti injury with ulnar nerve compression

    Institute of Scientific and Technical Information of China (English)

    Ajay Pal Singh; Ish Kumar Dhammi; Anil Kumar Jain

    2011-01-01

    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.

  3. Functional interrelationship of brain aging and delirium.

    Science.gov (United States)

    Rapazzini, Piero

    2016-02-01

    Theories on the development of delirium are complementary rather than competing and they may relate to each other. Here, we highlight that similar alterations in functional brain connectivity underlie both the observed age-related deficits and episodes of delirium. The default mode network (DMN) is a group of brain regions showing a greater level of activity at rest than during attention-based tasks. These regions include the posteromedial-anteromedial cortices and temporoparietal junctions. Evidence suggests that awareness is subserved through higher order neurons associated with the DMN. By using functional MRI disruption of DMN, connectivity and weaker task-induced deactivations of these regions are observed both in age-related cognitive impairment and during episodes of delirium. We can assume that an acute up-regulation of inhibitory tone within the brain acts to further disrupt network connectivity in vulnerable patients, who are predisposed by a reduced baseline connectivity, and triggers the delirium.

  4. 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.

  5. 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

    BACKGROUND: The spread of injectate during a saphenous nerve block at the adductor canal has not been clearly described. METHODS: We examined the spread of 15 ml dyed injectate during ultrasound-guided saphenous nerve blocks at the adductor canal in 15 unembalmed cadavers' lower limbs followed...... by 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...... and reached 1-2 cm into the popliteal fossa. Injections superficial to the adductor canal spread over the femoral artery within the subsartorial fat compartment resembling the injections within the canal but with ultrasonographic distinct features. These injections spread only half the length of the adductor...

  6. 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

  7. Technique of Arthroscopic Treatment of Impingement After Total Ankle Arthroplasty.

    Science.gov (United States)

    Gross, Christopher E; Neumann, Julie A; Godin, Jonathan A; DeOrio, James K

    2016-04-01

    Rates of medial and/or lateral gutter impingement after total ankle replacement are not insignificant. If impingement should occur, it typically arises an average of 17 months after total ankle replacement. Our patient underwent treatment for right ankle medial gutter bony impingement with arthroscopic debridement 5 years after her initial total ankle replacement. Standard anteromedial and anterolateral portals and a 30° 2.7-mm-diameter arthroscope were used. An aggressive soft-tissue and bony resection was performed using a combination of curettes, a 3.5-mm shaver, a 5.5-mm unsheathed burr, a drill, and a radiofrequency ablator. This case shows that arthroscopic treatment is an effective and potentially advantageous alternative to open treatment of impingement after total ankle replacement. In addition, symptoms of impingement often improve in a short amount of time after arthroscopic debridement of the medial and/or lateral gutter.

  8. Open Reduction of Subcondylar Fractures Using a New Retractor

    Directory of Open Access Journals (Sweden)

    Akira Sugamata

    2011-01-01

    Full Text Available Many operative approaches have been described for the open reduction of subcondylar fractures and rigid fixation. However, fracture portions are deep and embedded among facial nerves so that visual surgery in this region is extremely limited. Once the operative field is exposed, the displacement of the condylar head is often dislocated by the anteromedial pull of the lateral pterygoid muscle and the fracture end of the condylar process is pulled up to the mandibular fossa by contraction of the masseter muscle. We made a new retractor to achieve a better field of view. It is possible to pull down the condylar process by opening the tips of the retractor using the specially made wrench system without special effort and keep the condylar process in the same position during reduction. In using this retractor, the fracture stumps were clearly exposed and more easily reposited.

  9. Three dimensional assessment of condylar surface changes and remodeling after orthognathic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Hye; Lee, Jin Woo; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Dental Research Institute, Seoul National University, Seoul (Korea, Republic of); Shin, Jae Myung [Dept. of Oral and Maxillofacial Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of)

    2016-03-15

    This study was performed to evaluate condylar surface changes and remodeling after orthognathic surgery using three-dimensional computed tomography (3D CT) imaging, including comparisons between the right and left sides and between the sexes. Forty patients (20 males and 20 females) who underwent multi-detector CT examinations before and after surgery were selected. Three-dimensional images comprising thousands of points on the condylar surface were obtained before and after surgery. For the quantitative assessment of condylar surface changes, point-to-point (preoperative-to-postoperative) distances were calculated using D processing software. These point-to-point distances were converted to a color map. In order to evaluate the types of condylar remodeling, the condylar head was divided into six areas (anteromedial, anteromiddle, anterolateral, posteromedial, posteromiddle, and posterolateral areas) and each area was classified into three types of condylar remodeling (bone formation, no change, and bone resorption) based on the color map. Additionally, comparative analyses were performed between the right and left sides and according to sex. The mean of the average point-to-point distances on condylar surface was 0.11±0.03 mm. Bone resorption occurred more frequently than other types of condylar remodeling, especially in the lateral areas. However, bone formation in the anteromedial area was particularly prominent. No significant difference was found between the right and left condyles, but condylar surface changes in males were significantly larger than in females. This study revealed that condylar remodeling exhibited a tendency towards bone resorption, especially in the lateral areas. Condylar surface changes occurred, but were small.

  10. The results of Oxford unicompartmental knee arthroplasty in the United States

    Science.gov (United States)

    Emerson, R. H.; Alnachoukati, O.; Barrington, J.; Ennin, K.

    2016-01-01

    Aims Approved by the Food and Drug Administration in 2004, the Phase III Oxford Medial Partial Knee is used to treat anteromedial osteoarthritis (AMOA) in patients with an intact anterior cruciate ligament. This unicompartmental knee arthroplasty (UKA) is relatively new in the United States, and therefore long-term American results are lacking. Patients and Methods This is a single surgeon, retrospective study based on prospectively collected data, analysing a consecutive series of primary UKAs using the Phase III mobile-bearing Oxford Knee and Phase III instrumentation. Between July 2004 and December 2006, the senior author (RHE) carried out a medial UKA in 173 patients (213 knees) for anteromedial osteoarthritis or avascular necrosis (AVN). A total of 95 patients were men and 78 were women. Their mean age at surgery was 67 years (38 to 89) and mean body mass index 29.87 kg/m2 (17 to 62). The mean follow-up was ten years (4 to 11). Results Survivorship of the Oxford UKA at ten years was 88%, using life table analysis. Implant survivorship at ten years was 95%. The most common cause for revision was the progression of osteoarthritis in the lateral compartment. The mean knee score element of the American Knee Society Score (AKSS) was 50 pre-operatively and increased to 93 post-operatively. The mean AKSS function score was 56 pre-operatively rising to 78 post-operatively Conclusion This ten-year follow-up study of the Oxford UKA undertaken in the United States shows good survivorship and excellent function in a wide selection of patients with AMOA and AVN. Cite this article: Bone Joint J 2016;98-B(10 Suppl B):34–40. PMID:27694514

  11. 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

  12. 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.)

  13. 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

  14. 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.

  15. 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.

  16. 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)

  17. Neuroembryology and functional anatomy of craniofacial clefts

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. 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

  20. Craniofacial abnormalities among patients with Edwards Syndrome

    Directory of Open Access Journals (Sweden)

    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.

  1. Cerebral hemodynamics and functional prognosis in hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Hirai, Osamu; Nishikawa, Michio; Watanabe, Shu; Yamakawa, Hiroyasu; Kinoshita, Yoshimasa; Uno, Akira; Handa, Hajime (Hamamatsu Rosai Hospital, Shizuoka (Japan))

    1989-11-01

    The functional outcome of cerebral hemodynamics in the chronic stage of juvenile hydrocephalus was determined using single photon emission computed tomography (SPECT). Five patients including three with aqueductal stenosis, one with post-meningitic hydrocephalus, and one case with hydrocephalus having developed after repair of a huge occipital encephalocele. Early images of cerebral blood flow (CBF) were obtained 25 minutes after intravenous injection of 123-I-iodoamphetamine (IMP), and late images were scanned 3 hours later. Cerebral blood volume (CBV) was also measured using {sup 99m}Tc in three patients. Twenty cases with adult communicating hydrocephalus were also investigated from the point of view of shunt effectiveness. Although there was no remarkable change in the cerebrovascular bed in the juvenile cases, CBF of the remnant brain parenchyma was good irrespective of the degree of ventricular dilatation. There was a periventricular-related IMP uptake in each case; however, it somehow matched the ventricular span. Functional outcome one to 23 years after the initial shunt operation was good in every case, despite multiple shunt revisions. Redistribution on late images had no bearing on clinical states. In adult cases, 8 patients with effective shunting demonstrated a relatively localized periventricular low perfusion, with preoperative increased cerebrospinal fluid (CSF) pressure. On the contrary, 12 patients with no improvement with or without ventricular-reduced IMP uptake, despite low CSF pressure. The present study indicates that periventricular hemodynamics may play an important role in cerebral function compromised by hydrocephalus. (J.P.N.).

  2. 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

  3. 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

    Directory of Open Access Journals (Sweden)

    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

  4. Mapping of Learned Odor-Induced Motivated Behaviors in the Mouse Olfactory Tubercle.

    Science.gov (United States)

    Murata, Koshi; Kanno, Michiko; Ieki, Nao; Mori, Kensaku; Yamaguchi, Masahiro

    2015-07-22

    An odor induces food-seeking behaviors when humans and animals learned to associate the odor with food, whereas the same odor elicits aversive behaviors following odor-danger association learning. It is poorly understood how central olfactory circuits transform the learned odor cue information into appropriate motivated behaviors. The olfactory tubercle (OT) is an intriguing area of the olfactory cortex in that it contains medium spiny neurons as principal neurons and constitutes a part of the ventral striatum. The OT is therefore a candidate area for participation in odor-induced motivated behaviors. Here we mapped c-Fos activation of medium spiny neurons in different domains of the mouse OT following exposure to learned odor cues. Mice were trained to associate odor cues to a sugar reward or foot shock punishment to induce odor-guided approach behaviors or aversive behaviors. Regardless of odorant types, the anteromedial domain of the OT was activated by learned odor cues that induced approach behaviors, whereas the lateral domain was activated by learned odor cues that induced aversive behaviors. In each domain, a larger number of dopamine receptor D1 type neurons were activated than D2 type neurons. These results indicate that specific domains of the OT represent odor-induced distinct motivated behaviors rather than odor stimuli, and raise the possibility that neuronal type-specific activation in individual domains of the OT plays crucial roles in mediating the appropriate learned odor-induced motivated behaviors. Significance statement: Although animals learn to associate odor cues with various motivated behaviors, the underlying circuit mechanisms are poorly understood. The olfactory tubercle (OT), a subarea of the olfactory cortex, also constitutes the ventral striatum. Here, we trained mice to associate odors with either reward or punishment and mapped odor-induced c-Fos activation in the OT. Regardless of odorant types, the anteromedial domain was

  5. 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

    Directory of Open Access Journals (Sweden)

    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

  6. 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.

  7. [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

  8. 食管癌术后声带麻痹的CT表现及病因分析%Analysis of CT findings and the cause of vocal cord paralysis after resection of esophageal carcinoma

    Institute of Scientific and Technical Information of China (English)

    宋涛; 李辛; 胡鸿涛; 黎海亮

    2012-01-01

    Objective To analyse CT performances of vocal cord paralysis after resection of esophageal carcinoma and its relation-ship with mediastinal lymph node metastasis, in order to improve the recognition of the imaging manifestations of it. Methods 40 cases of vocal cord paralysis clinically after resection of esophageal carcinoma confirmed were retrospectively analysed. Results CT findings of vocal cord paralysis included: thickening and anteromedial displacement of the ipsilateral aryepiglottic folds, ipsilateral piriform sinus dilatation in 34 cases (85%) ;vocal cord atrophy and lateral displacement,ipsilateral laryngeal ventricle dilatation in 31 cases(77. 5%) ; anteromedial displacement of the ipsilateral arytenoid cartilage in 16 cases(40%) etc. Mediastinal lymph node me-tastasis in 38 cases(95%) and anastomotic recurrence of esophageal carcinoma in 4 cases(10%). Conclusion CT scan is helpful in diagnosing vocal cord paralysis and its etiology.%目的 分析食管癌术后声带麻痹的CT表现及其与纵隔淋巴结转移的关系,提高对其影像学表现的认识.方法 回顾性分析临床诊断为食管癌术后并发声带麻痹的40例患者的CT资料.结果 声带麻痹CT表现:患侧杓会厌皱襞增厚、向前内侧移位,同侧梨状隐窝扩大34例 (85%);患侧声带萎缩外展,同侧喉室扩大31例 (77.5%);患侧杓状软骨向前内侧移位16例 (40%)等.38例(95%)患者发现纵隔淋巴结转移,4例(10%)患者发现吻合口复发.结论 CT检查为声带麻痹的确诊提供了重要依据,而且有助于明确引起声带麻痹的原因.

  9. 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

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

    Directory of Open Access Journals (Sweden)

    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

  11. Extensive multiple glomus tumor of the lower leg with a long term follow-up:1 case report%小腿广泛多发血管球瘤长期随访一例报告

    Institute of Scientific and Technical Information of China (English)

    严磊; 冉兵; 李亮; 雷军; 蔡林

    2015-01-01

    Objective To enhance the cognition of clinical, radiological and pathological features of multiple glomus tumor ( MGT ).Methods Medical history and clinical data of 1 case with MGT were analyzed and related literature was reviewed.Results A 52-year-old female patient of extensive MGT in the left lower leg underwent 6 times of surgery during the past 16 years. The remission stage ranged from 1 month to 8 years. Tumors had not been resected completely at the ifrst and fourth operations because of the small size and extensive or deep location, and the pain in the anteromedial left lower leg and around the knee joint recurred again within 1 month. A more complete surgical plan was carried out at the second and sixth operations. The patient did not complain about pain or other uncomfortable feelings during the 10 months follow-up after the latest operation.Conclusions Pathological and radiological features of MGT are typical presentations of glomus tumor, and MGT is more likely to be incompletely resected compared with solitary glomus tumor ( GT ) for the reason of small size, extensive distribution, deep location and atypical symptoms. Surgical method is one of the crucial factors to the tumor’s recurrence, and a wide and complete resection is mote favorable for MGT.

  12. Panoramic Image of Mandibular Condyle According to Head Position

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Hwa; Choi, Soon Chul [Dept. of Oral Radiology, College of Dentistry, Seoul National, Seoul (Korea, Republic of)

    1990-08-15

    Panoramic radiography is convenient in clinic and visualizes those areas which other technique do not give. But the technique has limitation of image distortion which results from the relationship of the ramus to the focal trough and from the direction of the central ray. This study is, using 7 dry skulls, to determine the effect of rotation of patient's head on reducing those distortion and determine the magnification ratio of images of mandibular condyle in rotated patient head position. The obtained results were as follows: 1. Generally, in panoramic radiography the anterolateral portion of the mandibular condyle was best to be visualized. 2. There are no significant difference between the image readability of anteromedial portion and that of antercentral portion of the mandibular condyle. 3. Anterolateral portion of the mandibular condyle was better visualized in rotated head position by 20 degree or horizontal condylar inclination than in conventional position or in rotated head position by 10 degree. 4. The magnification ratio of the anteroposterior diameter in the image of mandibular condyle was least in the rotated head position by horizontal inclination of the mandibular condyle and was largest by 20 degree.

  13. 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.

  14. 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

  15. 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.)

  16. 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

  17. A pattern formed by preferential orientation of tangential fibres in layer I of the rabbit's cerebral cortex.

    Science.gov (United States)

    Fleischhauer, K; Laube, A

    1977-12-01

    1. The tangential organization of layer I has been studied in frozen sections impregnated according to a modified Liesegang method and in Bodian impregnated paraffin sections cut tangentially to the dorsal surface of the rabbit's cerebral cortex. 2. It is shown that sublamina tangentialis of layer I contains a system of parallel nerve fibres forming a distinct pattern in the tangential plane. 3. This pattern has been reconstructed for a large region of the dorsal surface of the cerebral cortex including the striate areas as well as the peristriate, parietal and precentral agranular regions and parts of the retrosplenial area. 4. In most parts of the region investigated, the tangential fibres of layer I are oriented in an antero-medial to postero-lateral direction, forming an angle of about 50 degrees with the sagittal plane. 5. Deviations from this pattern are found in the furrows formed by the lateral sulcus and the frontal impression and also in the caudal part of the retrosplenial area. In these regions, which are characterized by comparatively steep changes of the cortical relief, the fibres course in a more sagittal direction.

  18. A CASE REPORT OF MULTIPLE ARTERIAL ANOMALIES IN A CADAVE R

    Directory of Open Access Journals (Sweden)

    Anbumani

    2015-03-01

    Full Text Available During routine dissection in our department, multiple arterial variations were observed in a cadaver. The following arterial variations are present. They are, superficial brachioulnar artery, which originated at the level of junction of upper and middle th ird of arm. It runs a superficial course anterior to median nerve in the arm and terminates in the formation of superficial palmar arch. The brachial artery terminated as radial and common interosseous artery. Subscapular artery and circumflex humeral arte ry arose as a common trunk from the third part of axillary artery. The circumflex humeral artery later divides into anterior circumflex humeral and posterior circumflex humeral arteries. The right common carotid artery bifurcated into internal carotid arte ry anteromedially and external carotid artery posterolaterally at the level of upper lamin a of th yroid cartilage. A proper knowledge of variations in the arterial pattern is a must for a good treatment outcome, especially in the fields like vascular surge ry, reconstructive surgery, cardiac surgery, angiogram, arterial cannulation, arterio - venous fistula for renal dialysis. etc.

  19. 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

  20. 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

  1. Representation of Sound Objects within Early-Stage Auditory Areas: A Repetition Effect Study Using 7T fMRI.

    Directory of Open Access Journals (Sweden)

    Sandra Da Costa

    Full Text Available Environmental sounds are highly complex stimuli whose recognition depends on the interaction of top-down and bottom-up processes in the brain. Their semantic representations were shown to yield repetition suppression effects, i. e. a decrease in activity during exposure to a sound that is perceived as belonging to the same source as a preceding sound. Making use of the high spatial resolution of 7T fMRI we have investigated the representations of sound objects within early-stage auditory areas on the supratemporal plane. The primary auditory cortex was identified by means of tonotopic mapping and the non-primary areas by comparison with previous histological studies. Repeated presentations of different exemplars of the same sound source, as compared to the presentation of different sound sources, yielded significant repetition suppression effects within a subset of early-stage areas. This effect was found within the right hemisphere in primary areas A1 and R as well as two non-primary areas on the antero-medial part of the planum temporale, and within the left hemisphere in A1 and a non-primary area on the medial part of Heschl's gyrus. Thus, several, but not all early-stage auditory areas encode the meaning of environmental sounds.

  2. Representation of Sound Objects within Early-Stage Auditory Areas: A Repetition Effect Study Using 7T fMRI.

    Science.gov (United States)

    Da Costa, Sandra; Bourquin, Nathalie M-P; Knebel, Jean-François; Saenz, Melissa; van der Zwaag, Wietske; Clarke, Stephanie

    2015-01-01

    Environmental sounds are highly complex stimuli whose recognition depends on the interaction of top-down and bottom-up processes in the brain. Their semantic representations were shown to yield repetition suppression effects, i. e. a decrease in activity during exposure to a sound that is perceived as belonging to the same source as a preceding sound. Making use of the high spatial resolution of 7T fMRI we have investigated the representations of sound objects within early-stage auditory areas on the supratemporal plane. The primary auditory cortex was identified by means of tonotopic mapping and the non-primary areas by comparison with previous histological studies. Repeated presentations of different exemplars of the same sound source, as compared to the presentation of different sound sources, yielded significant repetition suppression effects within a subset of early-stage areas. This effect was found within the right hemisphere in primary areas A1 and R as well as two non-primary areas on the antero-medial part of the planum temporale, and within the left hemisphere in A1 and a non-primary area on the medial part of Heschl's gyrus. Thus, several, but not all early-stage auditory areas encode the meaning of environmental sounds. PMID:25938430

  3. Hamstring tendons insertion - an anatomical study

    Directory of Open Access Journals (Sweden)

    Cristiano Antonio Grassi

    2013-09-01

    Full Text Available OBJECTIVE: To study the anatomy of the hamstring tendons insertion and anatomical rela-tionships. METHODS: Ten cadaver knees with medial and anterior intact structures were selected. The dissection was performed from anteromedial access to exposure of the insertion of the flexor tendons (FT, tibial plateau (TP and tibial tuberosity (TT. A needle of 40 × 12 and a caliper were used to measure the distance of the tibial plateau of the knee flexor tendons insertion at 15 mm from the medial border of the patellar tendon and tibial tuberosity to the insertion of the flexor tendons of the knee. The angle between tibial plateau and the insertion of the flexor tendons of the knee (A-TP-FT was calculated using Image Pro Plus software. RESULTS: The mean distance TP-FT was 41 ± 4.6 mm. The distance between the TT-FT was 6.88 ± 1 mm. The (A-TP-FT was 20.3 ± 4.9°. CONCLUSION: In the anterior tibial flexor tendons are about 40 mm from the plateau with an average of 20°.

  4. 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

  5. Corticospinal Tract Compression by Hematoma in a Patient with Intracerebral Hemorrhage: A Diffusion Tensor Tractography and Functional MRI Study

    Science.gov (United States)

    Jang, Sung-Ho; Lee, Mi Young; Ahn, Sang Ho; Kim, Joong Hwi; Jeong, Dong-Hoon; Choi, Byung Yeun; Lee, Dong Gyu

    2006-01-01

    The purpose of this study was to demonstrate corticospinal tract compression that was due to a hematoma by using diffusion tensor tractography (DTT) and functional MRI (fMRI) in a patient with an intracerebral hemorrhage (ICH). A 23-year-old right-handed woman presented with severe paralysis of her right extremities at the onset of a spontaneous ICH. Over the first three days from onset, the motor function of the affected upper and lower extremities rapidly recovered to the extent that she was able to overcome applied resistance to the affected limbs, and her limbs regained normal function 3 weeks after onset. The tract of the right hemisphere originated from the primary sensori-motor cortex (SM1) and it passed through the known corticospinal tract pathway. However, the tract of the left hemisphere was similar to that of the right hemisphere except that it was displaced to the antero-medial side by the hematoma at the cerebral peduncle. Only the contralateral SM1 area centered on the precentral knob was activated during affected (right) or unaffected (left) hand movements, respectively. In conclusion, fMRI and DTT demonstrated a corticospinal tract compression due to hematoma in this patient. We conclude that the combined use of these two modalities appears to improve the accuracy of investigating the state of the corticospinal tract. PMID:16502496

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Normal and shear stresses on a residual limb in a prosthetic socket during ambulation: comparison of finite element results with experimental measurements.

    Science.gov (United States)

    Sanders, J E; Daly, C H

    1993-01-01

    Interface stresses on a below-knee amputee residual limb during the stance phase of gait calculated using an analytical finite element model were compared with experimental interface stress measurements. The model was quasi-static and linear. Qualitatively, shapes of analytical and experimental interface stress waveforms were similar in that they were double-peaked with some distinct features apparent. However, quantitatively analytical resultant shear stress magnitudes were less than experimental values at all transducer measurement sites. Analytical normal stresses were less than experimental values at postero-proximal, postero-distal, and anteromedial proximal sites, but were greater than experimental values at antero-lateral distal and antero-lateral proximal sites. Anterior resultant shear angles were directed more distally in the model than in clinical data, an expected result since there was no relief for the tibial crest in the model. Model sensitivity analyses to shank loads showed interface normal and resultant shear stresses were most sensitive to axial force, sagittal bending moment, or sagittal shear force. The finite element model presented in this paper is significant because it contributes toward development of an analytical modeling technique to predict interface stress distributions for proposed prosthetic designs, provides insight into physical explanations of features apparent in interface stress waveforms (thereby enhancing understanding of interface mechanics), and provides insight into nonlinear characteristics that need to be added to improve the model.

  9. 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

  10. 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.

  11. 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.)

  12. 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

  13. 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

  14. Assessing instantaneous synchrony of nonlinear nonstationary oscillators in the brain.

    Science.gov (United States)

    Fine, Ananda S; Nicholls, David P; Mogul, David J

    2010-01-30

    Neuronal populations throughout the brain achieve levels of synchronous electrophysiological activity as a consequence of both normal brain function as well as during pathological states such as in epileptic seizures. Understanding this synchrony and being able to quantitatively assess the dynamics with which neuronal oscillators across the brain couple their activity is a critical component toward decoding such complex behavior. Commonly applied techniques to resolve relationships between oscillators typically make assumptions of linearity and stationarity that are likely not to be valid for complex neural signals. In this study, intracranial electroencephalographic activity was recorded bilaterally in both hippocampi and in anteromedial thalamus of rat under normal conditions and during hypersynchronous seizure activity induced by focal injection of the epileptogenic agent kainic acid. Nonlinear oscillators were first extracted using empirical mode decomposition. The technique of eigenvalue decomposition was used to assess global phase synchrony of the highest energy oscillators. The Hilbert analytical technique was then used to measure instantaneous phase synchrony of these oscillators as they evolved in time. To test the reliability of this method, we first applied it to a system of two coupled Rössler attractors under varying levels of coupling with small frequency mismatch. The application of these analytical techniques to intracranially recorded brain signals provides a means for assessing how complex oscillatory behavior in the brain evolves and changes during both normal activity and as a consequence of diseased states without making restrictive and possibly erroneous assumptions of the linearity and stationarity of the underlying oscillatory activity.

  15. Outcome of anterior cruciate ligament reconstruction with emphasis on sex-related differences.

    Science.gov (United States)

    Ahldén, M; Sernert, N; Karlsson, J; Kartus, J

    2012-10-01

    The aim of this retrospective study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using the four-strand semitendinosus-gracilis (ST/G) autograft in male (n=141) vs female (n=103) patients. The patients were operated on between 1996 and 2005, using interference screw fixation and drilling the femoral tunnel through the anteromedial portal. The pre-operative assessments and demographics, apart from age (males 29 years, females 26 years; P=0.02), were comparable at the time of surgery. At 25 (23-36) months post-operatively, no significant differences were found between the study groups in terms of anterior side-to-side knee laxity, manual Lachman test, Tegner activity level, Lysholm knee score, range of motion or donor-site morbidity. Both study groups improved significantly in most clinical assessments and functional scores compared with their pre-operative values. Two years after ACL reconstruction using ST/G autografts, there were no significant differences between male and female patients in terms of clinical outcome or functional scores.

  16. The outcome at 15 years of endoscopic anterior cruciate ligament reconstruction using hamstring tendon autograft for 'isolated' anterior cruciate ligament rupture.

    Science.gov (United States)

    Bourke, H E; Gordon, D J; Salmon, L J; Waller, A; Linklater, J; Pinczewski, L A

    2012-05-01

    The purpose of this study was to report the outcome of 'isolated' anterior cruciate ligament (ACL) ruptures treated with anatomical endoscopic reconstruction using hamstring tendon autograft at a mean of 15 years (14.25 to 16.9). A total of 100 consecutive men and 100 consecutive women with 'isolated' ACL rupture underwent four-strand hamstring tendon reconstruction with anteromedial portal femoral tunnel drilling and interference screw fixation by a single surgeon. Details were recorded pre-operatively and at one, two, seven and 15 years post-operatively. Outcomes included clinical examination, subjective and objective scoring systems, and radiological assessment. At 15 years only eight of 118 patients (7%) had moderate or severe osteo-arthritic changes (International Knee Documentation Committee Grades C and D), and 79 of 152 patients (52%) still performed very strenuous activities. Overall graft survival at 15 years was 83% (1.1% failure per year). Patients aged surgery and patients with > 2 mm of laxity at one year had a threefold increase in the risk of suffering a rupture of the graft (p = 0.002 and p = 0.001, respectively). There was no increase in laxity of the graft over time. ACL reconstructive surgery in patients with an 'isolated' rupture using this technique shows good results 15 years post-operatively with respect to ligamentous stability, objective and subjective outcomes, and does not appear to cause osteoarthritis.

  17. A Comparison between Clinical Results of Selective Bundle and Double Bundle Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    Yoo, Yon-Sik; Song, Si Young; Yang, Cheol Jung; Ha, Jong Mun; Kim, Yoon Sang

    2016-01-01

    Purpose The purpose of this study was to compare the clinical outcomes of arthroscopic anatomical double bundle (DB) anterior cruciate ligament (ACL) reconstruction with either selective anteromedial (AM) or posterolateral (PL) bundle reconstruction while preserving a relatively healthy ACL bundle. Materials and Methods The authors evaluated 98 patients with a mean follow-up of 30.8±4.0 months who had undergone DB or selective bundle ACL reconstructions. Of these, 34 cases underwent DB ACL reconstruction (group A), 34 underwent selective AM bundle reconstruction (group B), and 30 underwent selective PL bundle reconstructions (group C). These groups were compared with respect to Lysholm and International Knee Documentation Committee (IKDC) score, side-to-side differences of anterior laxity measured by KT-2000 arthrometer at 30 lbs, and stress radiography and Lachman and pivot shift test results. Pre- and post-operative data were objectively evaluated using a statistical approach. Results The preoperative anterior instability measured by manual stress radiography at 90° of knee flexion in group A was significantly greater than that in groups B and C (all pACL tears offers comparable clinical results to DB reconstruction in complete ACL tears. PMID:27401652

  18. A pattern formed by preferential orientation of tangential fibres in layer I of the rabbit's cerebral cortex.

    Science.gov (United States)

    Fleischhauer, K; Laube, A

    1977-12-01

    1. The tangential organization of layer I has been studied in frozen sections impregnated according to a modified Liesegang method and in Bodian impregnated paraffin sections cut tangentially to the dorsal surface of the rabbit's cerebral cortex. 2. It is shown that sublamina tangentialis of layer I contains a system of parallel nerve fibres forming a distinct pattern in the tangential plane. 3. This pattern has been reconstructed for a large region of the dorsal surface of the cerebral cortex including the striate areas as well as the peristriate, parietal and precentral agranular regions and parts of the retrosplenial area. 4. In most parts of the region investigated, the tangential fibres of layer I are oriented in an antero-medial to postero-lateral direction, forming an angle of about 50 degrees with the sagittal plane. 5. Deviations from this pattern are found in the furrows formed by the lateral sulcus and the frontal impression and also in the caudal part of the retrosplenial area. In these regions, which are characterized by comparatively steep changes of the cortical relief, the fibres course in a more sagittal direction. PMID:603078

  19. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Biko, David M. [Pennsylvania Hospital, Department of Radiology, Philadelphia, PA (United States); Schwartz, Michael; Anupindi, Sudha A. [Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Altes, Talissa A. [Children' s Hospital of Philadelphia, Philadelphia, PA (United States); University of Virginia, Charlottesville, VA (United States)

    2008-03-15

    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.)

  1. Neural basis of interpersonal traits in neurodegenerative diseases.

    Science.gov (United States)

    Sollberger, Marc; Stanley, Christine M; Wilson, Stephen M; Gyurak, Anett; Beckman, Victoria; Growdon, Matthew; Jang, Jung; Weiner, Michael W; Miller, Bruce L; Rankin, Katherine P

    2009-11-01

    Several functional and structural imaging studies have investigated the neural basis of personality in healthy adults, but human lesions studies are scarce. Personality changes are a common symptom in patients with neurodegenerative diseases like frontotemporal dementia (FTD) and semantic dementia (SD), allowing a unique window into the neural basis of personality. In this study, we used the Interpersonal Adjective Scales to investigate the structural basis of eight interpersonal traits (dominance, arrogance, coldness, introversion, submissiveness, ingenuousness, warmth, and extraversion) in 257 subjects: 214 patients with neurodegenerative diseases such as FTD, SD, progressive nonfluent aphasia, Alzheimer's disease, amnestic mild cognitive impairment, corticobasal degeneration, and progressive supranuclear palsy and 43 healthy elderly people. Measures of interpersonal traits were correlated with regional atrophy pattern using voxel-based morphometry (VBM) analysis of structural MR images. Interpersonal traits mapped onto distinct brain regions depending on the degree to which they involved agency and affiliation. Interpersonal traits high in agency related to left dorsolateral prefrontal and left lateral frontopolar regions, whereas interpersonal traits high in affiliation related to right ventromedial prefrontal and right anteromedial temporal regions. Consistent with the existing literature on neural networks underlying social cognition, these results indicate that brain regions related to externally focused, executive control-related processes underlie agentic interpersonal traits such as dominance, whereas brain regions related to internally focused, emotion- and reward-related processes underlie affiliative interpersonal traits such as warmth. In addition, these findings indicate that interpersonal traits are subserved by complex neural networks rather than discrete anatomic areas.

  2. Surgical approaches for total knee arthroplasty.

    Science.gov (United States)

    Vaishya, Raju; Vijay, Vipul; Demesugh, Daniel Mue; Agarwal, Amit Kumar

    2016-01-01

    There are various surgical approaches to the knee joint and its surrounding structures and such approaches are generally designed to allow the best access to an area of pathology whilst safeguarding important surrounding structures. Controversy currently surrounds the optimal surgical approach for total knee arthroplasty (TKA). The medial parapatellar arthrotomy, or anteromedial approach, has been the most used and has been regarded as the standard approach for exposure of the knee joint. It provides extensive exposure and is useful for open anterior cruciate ligament reconstruction, total knee replacement, and fixation of intra-articular fractures. Because this approach has been implicated in compromise of the patellar circulation, some authors have advocated the subvastus, midvastus, and trivector approaches for exposure of the knee joint. While these approaches expose the knee from the medial side, the anterolateral approach exposes the knee joint from the lateral side. With careful planning and arthrotomy selection, the anterior aspect of the joint can be adequately exposed for TKA in different clinical scenarios. PMID:27182142

  3. 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

  4. 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.

  5. Association of different uncus lesions on magnetic resonance imaging with epilepsy

    Directory of Open Access Journals (Sweden)

    Bilge Öztoprak

    2016-09-01

    Full Text Available SUMMARY Objective: Uncus is the hook-like most anteromedial portion of the parahippocampal gyrus and is a part of the limbic system. It is the only gyrus, together with the amygdala, that contains nuclei and is associated with seizures accompanied by olfactory hallucinations. The aim of this study is to examine the relationship between different uncus lesions detected by magnetic resonance imaging (MRI and epilepsy/seizures. Method: 33 patients with unilateral or bilateral uncus lesions on MRI obtained between March 2008 through May 2014 were enrolled in the study. MR images and clinical charts of patients were retrospectively investigated for MRI findings and presence of epilepsy/seizures. Results: Bilateral uncus involvement was observed in herpes encephalitis (n=5, autoimmune limbic encephalitis (n=2, mesial temporal sclerosis (n=3, metastasis (n=1 and Rasmussen encephalitis (n=1, whereas unilateral involvement of the uncus was seen in glial tumors (n=4, metastases (n=4, mesial temporal sclerosis (n=4, cavernous angioma (n=2, dysembryoplastic neuroepithelial tumor (DNET, n=5, herpes encephalitis (n=1, and autoimmune limbic encephalitis (n=1. Epilepsy/seizures were present in two-thirds of patients. However, none of the 5 patients with a metastatic uncus lesion showed epilepsy/seizures. Conclusions: Many uncus pathologies can be detected by MRI and most of them are associated with epilepsy. Keywords: Epilepsy, Hippocampus; Magnetic resonance imaging; Uncus; Uncinate gyrus

  6. Four-headed biceps brachii muscle with variant course of musculocutaneous nerve: anatomical and clinical insight

    Directory of Open Access Journals (Sweden)

    Aggarwal A

    2009-10-01

    Full Text Available A rare case of four-headed biceps brachii muscle with variation in the course of musculocutaneous nerve was observed in left arm of a 48-year-old embalmed male cadaver. One of the extra head (third was fleshy throughout, originated from anteromedial surface of shaft of humerus and merged with the deep surface of short head. Fourth thin tendinous head originated just below lesser tuberosity of humerus and joined with the third head. Both accessory heads were lying under cover of short head of biceps. Musculocutaneous nerve was coursing between two supernumerary heads and subsequently between third head and short head of biceps brachii muscle. Origin of third head from shaft of humerus led to passage of nerve between this head and short head, before acquiring normal position between biceps brachii and brachialis muscles, and emerging out as lateral cutaneous nerve of forearm. Intramuscular course of nerve may be a potential site for nerve compression by hypertrophied biceps associated with strenuous regular physical activity of biceps or weight lifting.

  7. A Comparison between Clinical Results of Selective Bundle and Double Bundle Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    Yoo, Yon-Sik; Song, Si Young; Yang, Cheol Jung; Ha, Jong Mun; Kim, Yoon Sang

    2016-01-01

    Purpose The purpose of this study was to compare the clinical outcomes of arthroscopic anatomical double bundle (DB) anterior cruciate ligament (ACL) reconstruction with either selective anteromedial (AM) or posterolateral (PL) bundle reconstruction while preserving a relatively healthy ACL bundle. Materials and Methods The authors evaluated 98 patients with a mean follow-up of 30.8±4.0 months who had undergone DB or selective bundle ACL reconstructions. Of these, 34 cases underwent DB ACL reconstruction (group A), 34 underwent selective AM bundle reconstruction (group B), and 30 underwent selective PL bundle reconstructions (group C). These groups were compared with respect to Lysholm and International Knee Documentation Committee (IKDC) score, side-to-side differences of anterior laxity measured by KT-2000 arthrometer at 30 lbs, and stress radiography and Lachman and pivot shift test results. Pre- and post-operative data were objectively evaluated using a statistical approach. Results The preoperative anterior instability measured by manual stress radiography at 90° of knee flexion in group A was significantly greater than that in groups B and C (all panterior instability measured by KT-2000 arthrometer, pivot shift, or functional scores. Conclusion Selective bundle reconstruction in partial ACL tears offers comparable clinical results to DB reconstruction in complete ACL tears. PMID:27401652

  8. 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

  9. Anatomic assessment of femoral tunnel by transtibial drilling technique in double-bundle anterior cruciate ligament reconstruction: an in vivo study

    Institute of Scientific and Technical Information of China (English)

    XU Hu; ZHANG Chun-li; LI Guang-zheng; WANG Ying-chun; FAN Hong-bin; ZHU Qin-sheng

    2013-01-01

    Objective:To evaluate the anatomy of femoral tunnels created by simulated transtibial technique in double-bundle anterior cruciate ligament (ACL) reconstruction.Methods:Two tibial tunnels,anteromedial (AM) and posterolateral (PL),were drilled 45° and 55° to tibial plateau respectively.On the femoral side,the AM and PL tunnels were drilled through anteriomedial portal.After the four tunnels were established,the shaft of a reamer was introduced into the joint through tibial tunnel and reached against the lateral wall of intercondylar notch.The position that the reamer shaft can reach was marked and recorded.Results:Neither femoral AM nor PL tunnel opening can be fully or partially reached by the reamer shaft through the tibial AM tunnel in all cases.The evaluation through the tibial PL tunnel showed that only in 8 of 50 cases (16%) the femoral AM tunnel opening and in 4 cases (8%) the PL opening can be fully reached.On the other hand,in 12 cases (24%) the femoral AM tunnel opening and in 10 cases (20%) the PL opening can be partially reached by the shafts through the tibial PL tunnel.Conclusion:The result strongly suggests that transtibial technique is not well competent for femoral tunnel drilling in anatomic double-bundle ACL reconstruction as we have hypothesized.

  10. Imaging of facial anomalies.

    Science.gov (United States)

    Castillo, M; Mukherji, S K

    1995-01-01

    Anomalies of the face may occur in its lower or middle segments. Anomalies of the lower face generally involve the derivatives of the branchial apparatus and therefore manifest as defects in the mandible, pinnae, external auditory canals, and portions of the middle ears. These anomalies are occasionally isolated, but most of them occur in combination with systemic syndromes. These anomalies generally do not occur with respiratory compromise. Anomalies of the midface may extend from the upper lip to the forehead, reflecting the complex embryology of this region. Most of these deformities are isolated, but some patients with facial clefts, notably the midline cleft syndrome and holoprosencephaly, have anomalies in other sites. This is important because these patients will require detailed imaging of the face and brain. Anomalies of the midface tend to involve the nose and its air-conducting passages. We prefer to divide these anomalies into those with and without respiratory obstruction. The most common anomalies that result in airway compromise include posterior choanal stenoses and atresias, bilateral cysts (mucoceles) of the distal lacrimal ducts, and stenosis of the pyriform (anterior) nasal aperture. These may be optimally evaluated with computed tomography (CT) and generally require immediate treatment to ensure adequate ventilation. Rare nasal anomalies that also result in airway obstruction are agenesis of the pharynx, agenesis of the nose, and hypoplasia of the nasal alae. Agenesis of the nasopharynx and nose are complex anomalies that require both CT and magnetic resonance imaging (MRI). The diagnosis of hypoplasia of the nasal alae is a clinical one; these anomalies do not require imaging studies. Besides facial clefts, anomalies of the nose without respiratory obstruction tend to be centered around the nasofrontal region. This is the site of the most common sincipital encephaloceles. Patients with frontonasal and nasoethmoidal encephaloceles require both

  11. Value of B-type ultrasound in management of patients sustaining craniocerebral injury in Wenchuan earthquake%B超在地震灾害颅脑损伤中的应用

    Institute of Scientific and Technical Information of China (English)

    刘伦波; 唐运涛; 陈宏刚; 冯爱平; 王双; 梅华; 刘弟模

    2009-01-01

    目的 探讨地震灾害中B超在颅脑损伤术中及术后的应用价值.方法 对于地震灾害中颅脑损伤患者术中急性脑膨出,怀疑有多发性颅内血肿者,应用B型超声仪实时扫查,术后经骨缺损或颅骨钻孔处进行水平、冠状、或滑行扫查.结果 在地震灾害中共进行了58例开颅手术,24例术中进行了B超扫查,不同部位的颅内血肿或积血18例,同侧脑内血肿2例,B超引导下手术清除血肿14例.58例手术患者口术后28例同时进行CT和B超检查,检查结果基本一致.结论 术中B超扫查可以定位多发性颅内血肿,对明确术中急性脑膨出的原因具有重要意义;术后经骨缺损扫查能准确检出迟发性血肿,能快速及时准确的指导医生进行手术,提高救治成功率.%Objective To investigate the value of B-type ultrasound during and after operations in patients sustaining craniocerebral injury in Wenchuan earthquake. Methods The patients with suspected multiple intracranial hematomas due to intraoperative acute encephalocele were referred for B-type ultrasonic examination. After the operation, B-type ultrasonic examination was performed at the cranial defects or the site of cranial drilling by horizontal coronal or sweep scanning. Results Open cranial surgery was performed in 58 cases of craniocerebral injury resulting from the earthquake. Intraoperative B-type ultrasound was used in 24 cases, and intracranial hematomas or hemorrhage in different brain regions were found in 18 cases. Hematomas in the injured hemisphere were found in 2 cases, and ultrasound-guided hematoma clearance was performed in 14 cases. In 28 cases, postoperative B ultrasonic examination was carried out along with CT scanning, and the results demonstrated basic agreement between the two medalities. Conclusions Intraoperative B-type ultrasound may help accurately localize multiple intracranial hematomas and can be crucial to identify the causes of intraoperative acute

  12. 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.

  13. 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.)

  14. 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.

  15. Agenesia da artéria carótida interna: relato de caso Agenesis of the internal carotid artery: a case report

    Directory of Open Access Journals (Sweden)

    William da Silva Neves

    2008-02-01

    Full Text Available Relata-se, aqui, caso de uma adolescente de 14 anos de idade que apresentou episódio isolado de síncope, sem outros sintomas. No exame de ressonância magnética observou-se, nos cortes nos planos axial e coronal ponderados em T2, ausência do flow void da artéria carótida interna direita na sua porção intracavernosa. Realizou-se, então, angiorressonância magnética técnica time-of-flight, que mostrou ausência da artéria carótida interna direita, o que foi comprovado com a angiorressonância magnética de vasos cervicais e com angiotomografia computadorizada, que mostrou, nos cortes axiais, agenesia do canal carotídeo direito. Tal achado é relatado na literatura, em associação com outras anomalias, como encefaloceles transesfenoidais e aneurismas do polígono de Willis. No presente caso, não foram observadas tais associações. A paciente permaneceu assintomática.The present paper reports a case of a 14-year-old-female adolescent who presented a single episode of syncope, without any other symptom. Axial and coronal T2-weighted magnetic resonance imaging demonstrated an absent right internal carotid artery flow void. A subsequent magnetic resonance angiography utilizing the time-of-flight technique showed absence of the right internal carotid artery. This finding was confirmed by magnetic resonance angiography of the cervical vessels, and axial computed tomography angiography showed agenesis of the right carotid canal. The literature reports such finding in association with other anomalies such as transsphenoidal encephaloceles and circle of Willis aneurysms. These associations were not observed in the present case. The patient remained asymptomatic.

  16. 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

  17. 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

  18. 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

  19. 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 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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.

  2. 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.)

  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. Joubert syndrome: A model for untangling recessive disorders with extreme genetic heterogeneity

    Science.gov (United States)

    R, Bachmann-Gagescu; JC, Dempsey; IG, Phelps; BJ, O’Roak; DM, Knutzen; TC, Rue; GE, Ishak; CR, Isabella; N, Gorden; J, Adkins; EA, Boyle; N, de Lacy; D, O’Day; A, Alswaid; AR, Devi; L, Lingappa; C, Lourenço; L, Martorell; À, Garcia-Cazorla; H, Ozyürek; G, Haliloğlu; B, Tuysuz; M, Topçu; P, Chance; MA, Parisi; I, Glass; J, Shendure; D, Doherty

    2016-01-01

    Background Joubert syndrome (JS) is a recessive neurodevelopmental disorder characterized by hypotonia, ataxia, cognitive impairment, abnormal eye movements, respiratory control disturbances, and a distinctive mid-hindbrain malformation. JS demonstrates substantial phenotypic variability and genetic heterogeneity. This study provides a comprehensive view of the current genetic basis, phenotypic range and gene-phenotype associations in JS. Methods We sequenced 27 JS-associated genes in 440 affected individuals (375 families) from a cohort of 532 individuals (440 families) with JS, using molecular inversion probe-based targeted capture and next generation sequencing. Variant pathogenicity was defined using the Combined Annotation Dependent Depletion (CADD) algorithm with an optimized score cut-off. Results We identified presumed causal variants in 62% of pedigrees, including the first B9D2 mutations associated with JS. 253 different mutations in 23 genes highlight the extreme genetic heterogeneity of JS. Phenotypic analysis revealed that only 34% of individuals have a “pure JS” phenotype. Retinal disease is present in 30% of individuals, renal disease in 25%, coloboma in 17%, polydactyly in 15%, liver fibrosis in 14% and encephalocele in 8%. Loss of CEP290 function is associated with retinal dystrophy, while loss of TMEM67 function is associated with liver fibrosis and coloboma, but we observe no clear-cut distinction between JS-subtypes. Conclusion This work illustrates how combining advanced sequencing techniques with phenotypic data addresses extreme genetic heterogeneity to provide diagnostic and carrier testing, guide medical monitoring for progressive complications, facilitate interpretation of genome-wide sequencing results in individuals with a variety of phenotypes, and enable gene-specific treatments in the future. PMID:26092869

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

    Directory of Open Access Journals (Sweden)

    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

  7. Radiological and therapeutic study of posterior bicondylar tibial plateau fractures%胫骨平台后侧双髁骨折的影像学研究及治疗分析

    Institute of Scientific and Technical Information of China (English)

    楚宇鹏; 孔建中; 施俊武; 李武

    2012-01-01

    目的 探讨胫骨平台后侧双髁骨折的影像学特点、骨折块形态特征及其治疗方法.方法 选取2005年3月-2009年2月胫骨平台后侧双髁骨折47例,运用Starpacs系统在CT片上精确测量骨折特点和骨折块的形态.回顾性研究47例患者经胫骨平台前外侧入路联合前内侧入路、外侧髁钢板加内侧髁拉力螺钉内固定的治疗效果. 结果 后内侧髁为劈裂骨折,移位较小,骨折不稳定,骨折块呈倒三棱体,较完整;后外侧髁骨折为压缩性骨折.常伴有膝关节软组织损伤.术后Rasmussen影像学评分:优24例,良18例,可3例,差2例;Rasmussen功能评分:优13例,良27例,可2例,差5例. 结论 后内侧髁骨折块形态与Hohl“E”型骨折描述相似,后外侧髁骨折为压缩性骨折.经前外侧联合前内侧入路可以Ⅰ期植骨内固定骨折,同时修复合并损伤,达到良好的影像学结果及临床疗效.%Objective To investigate the radiological characteristics,morphological characteristics of fracture fragments and treatments of posterior bicondylar tibial plateau fractures.Methods A total of 47 patients with posterior bicondylar tibial plateau fractures treated between March 2005 and February 2009 were enrolled in the study.Characteristics of fractures and morphologies of fracture fragments were measured precisely with CT-chip Starpacs system.A retrospective study was carried out on the therapeutic results of the 47 patients undergone lateral condylar plate and medial condylar lag screw fixation via anterolateral combined with anteromedial tibial plateau approaches.Results Posteromedial condylar fracture was split one with small displacement,but the fracture was unstable.In the meantime,the fracture fragments were inverted three prism in shape and remained quite intact.Posterolateral condylar fracture was compression one and was often associated with soft tissue injury of knee joints.According to the Rasmussen radiology score,the results

  8. 关节镜外侧半月板下入路技术用于外侧半月板前角层裂下层的切除%Arthroscopic Resection of the Inferior Leaf of the Anterior Horn through Sub-meniscal Route for Horizontal Tear of the Lateral Meniscus

    Institute of Scientific and Technical Information of China (English)

    闫辉; 崔国庆; 敖英芳

    2012-01-01

    Objective To evaluate the efficacy of arthroscopic partial meniseectomy via sub-meniscal route for unstable inferior leaf of the anterior horn in horizontal tear of the lateral meniscus. Methods Between January 2008 and December 2010, 10 patients with horizontal tear in the anterior horn of the lateral meniscus underwent arthroscopic partial meniscectomy through submeniscal route. Three routes, anteromedial, anterolateral, and sub-meniscal route, were employed in our patients. An arthroscope was placed via an anteromedial route, and then the superior leaf of the anterior horn was averted by a probe through the anterolateral route for a better visualization of the lesion. Finally the inferior leaf of the anterior horn was excised with a punch through the sub-meniscal route. Results No postoperative complications occurred in our patients. They were followed up for 12 -45 months with a mean of 18.9 months, during which, 9 patients had the pain in the knee joints disappeared completely, and the other occasionally had the knee joint pain after doing sports. The flexion range of the knee joints recovered to a normal range in all the 10 patients, and the Lysholm score increased from 68.7 ± 12. 9 preoperation to 94. 4 ±5.7 ( paired t test, t=7.79, P = 0.00). Conclusion Sub-meniscal route provides a safe and effective alternative for resection of the interior leaf of the anterior horn for horizontal tear of the lateral meniscus.%目的 探讨关节镜外侧半月板下入路切除外侧半月板前角下层的效果. 方法 2008年1月~2010年12月,对10例外侧半月板前角层裂采用关节镜外侧半月板下入路切除外侧半月板前角层裂中不稳定的下层.采用3个入路:膝前外侧入路,前内侧入路及外侧半月板下入路.自前内侧入路置入关节镜观察;经前外侧入路使用探沟翻转层裂上层,并尽可能显露下层;经外侧半月板下入路使用直头Punch(篮钳)切除半月板前角层裂的下层. 结果

  9. 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

    Directory of Open Access Journals (Sweden)

    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

  10. Clinical anatomy of the tibial insertion of the anterior cruciate ligament%前交叉韧带胫骨附着处临床解剖学研究

    Institute of Scientific and Technical Information of China (English)

    何国超; 汪青春; 向孝兵; 胡星荣

    2011-01-01

    Objective To study the morphological features of the tibial attachment of anterior cruciate ligament (ACL) and discuss the significance of parameters of ACL attachment on suitable styles of ACL reconstruction. Methods Ten formalin fixed adult knee joint specimens were dissected. The anteromedial bundle (AMB) and the posterolateral bundle (PLB) of ACL were identified according to the extension-flexion tensions of ACL. And then, ACL was resected from the tibial attachment site. The anatomical parameters of tibial attachment were measured and analyzed by Photoshop software. Results ACL can be divided into the anteromedial and posterolateral bundles functionally. The irregular shape of the ACL tibial insertion involved in the reversed triangle, oval and quadrilateral shapes. The anteroposterior and transverse diameters of ACL tibial insertion were (17.89±2.44)mm and (13.85 ± 1.79)mm respectively. The area of the tibial attachment of the AMB and the PLB were (101.18±32.28) mm2 and (77.61±19.86)mm2 respectively, and the distance between the gravity points of AMB and PLB was (8.03±1.51)mm. Conclusions This study shows an useful measurement through the improved digital photographs. Parameters of tibial insertion of ACL obtained by this way is a valuable reference for selecting adequate ACL reconstruction skill.%目的 研究前交叉韧带(ACL)胫骨附着处的解剖形态学特点,并探讨ACL胫骨附着处测量值埘选择ACL重建方式的意义.方法 对10例福尔马林处理的成人膝关节标本进行解剖.在屈伸膝关节时根据ACL纤维张力区分前内束和后外束,然后从胫骨附着处切断韧带,用Photoshop软件测量附着处的相关数据.结果 ACL存在着两个不同的功能束,即前内束和后外束;胫骨附着处的形状不规则,可分为倒三角形、椭1形及四边形三种;ACL胫骨附着处的前后径与横径分别为(17.89±2.44)mm、(13.85±1.79)mm;前内束和后外束胫骨附着处的面积分别为(101.18±32

  11. 关节镜下经前内侧入路行前交叉韧带重建术的临床疗效%The Clinical Efficacy of Arthroscopic Anterior Medial Approach for Anterior Cruciate Ligament Reconstruction

    Institute of Scientific and Technical Information of China (English)

    魏宁波; 郭志强; 杨帅胜

    2016-01-01

    Objective Discussion was before arthroscopic anteromedial cross ligament reconstruction methods and effects. Methods Retrospective analysis of the medial joint line of endoscopic anterior cruciate ligament anatomic single-bundle reconstruction of 32 cases of patients with anterior cruciate ligament rupture data were preoperatively, 1 year postoperatively using Lysholm knee score for overall function assessed after the physical understanding of the front cruciate ligament reconstruction of knee function and stability of the fracture.Results After 1 year follow-up, 32 cases of knee anterior drawer test was negative, Lachman test was negative in 30 patients, two cases Lachman test was positive, forward about 0.5cm; pivot shift test was negative in all cases; according to Lysholm knee score criteria: excellent in 27 cases, good in 5 cases, good rate of 100%. All patients recovered their daily work, joint stability improved significantly.ConclusionAfter anteromedial before anatomic single-bundle anterior cruciate ligament reconstruction excellent rate, postoperative joint function recovery, better able to ensure the stability of the knee motion.%目的:探讨关节镜下经前内侧入路前交叉韧带重建的方法及疗效。方法回顾分析关节镜下经前内侧入路行前交叉韧带单束解剖重建术的32例前交叉韧带断裂患者资料,分别在术前、术后1年采用Lysholm评分对膝关节的整体功能进行评估,通过体格检查了解前交叉韧带断裂重建后膝关节功能及稳定性。结果术后1年随访结果,32例膝关节前抽屉试验阴性,30例患者Lachman试验阴性,2例Lachman试验阳性,前移0.5cm左右;所有病例轴移试验阴性;按Lysholm膝关节功能评分标准:优27例,良5例,优良率达100%。术后所有患者均恢复日常工作,关节稳定性明显改善。结论经前内侧入路单束解剖重建前交叉韧带优良率高,术后关节功能恢复好,能更好保

  12. 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.)

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

    Directory of Open Access Journals (Sweden)

    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

  14. 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.

  15. Torvosaurus gurneyi n. sp., the largest terrestrial predator from Europe, and a proposed terminology of the maxilla anatomy in nonavian theropods.

    Directory of Open Access Journals (Sweden)

    Christophe Hendrickx

    Full Text Available The Lourinhã Formation (Kimmeridgian-Tithonian of Central West Portugal is well known for its diversified dinosaur fauna similar to that of the Morrison Formation of North America; both areas share dinosaur taxa including the top predator Torvosaurus, reported in Portugal. The material assigned to the Portuguese T. tanneri, consisting of a right maxilla and an incomplete caudal centrum, was briefly described in the literature and a thorough description of these bones is here given for the first time. A comparison with material referred to Torvosaurus tanneri allows us to highlight some important differences justifying the creation of a distinct Eastern species. Torvosaurus gurneyi n. sp. displays two autapomorphies among Megalosauroidea, a maxilla possessing fewer than eleven teeth and an interdental wall nearly coincidental with the lateral wall of the maxillary body. In addition, it differs from T. tanneri by a reduced number of maxillary teeth, the absence of interdental plates terminating ventrally by broad V-shaped points and falling short relative to the lateral maxillary wall, and the absence of a protuberant ridge on the anterior part of the medial shelf, posterior to the anteromedial process. T. gurneyi is the largest theropod from the Lourinhã Formation of Portugal and the largest land predator discovered in Europe hitherto. This taxon supports the mechanism of vicariance that occurred in the Iberian Meseta during the Late Jurassic when the proto-Atlantic was already well formed. A fragment of maxilla from the Lourinhã Formation referred to Torvosaurus sp. is ascribed to this new species, and several other bones, including a femur, a tibia and embryonic material all from the Kimmeridgian-Tithonian of Portugal, are tentatively assigned to T. gurneyi. A standard terminology and notation of the theropod maxilla is also proposed and a record of the Torvosaurus material from Portugal is given.

  16. 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

  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. 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)

  19. 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).

  20. A survival analysis of 1084 knees of the Oxford unicompartmental knee arthroplasty

    Science.gov (United States)

    Bottomley, N.; Jones, L. D.; Rout, R.; Alvand, A.; Rombach, I.; Evans, T.; Jackson, W. F. M.; Beard, D. J.; Price, A. J.

    2016-01-01

    Aims The aim of this to study was to compare the previously unreported long-term survival outcome of the Oxford medial unicompartmental knee arthroplasty (UKA) performed by trainee surgeons and consultants. Patients and Methods We therefore identified a previously unreported cohort of 1084 knees in 947 patients who had a UKA inserted for anteromedial knee arthritis by consultants and surgeons in training, at a tertiary arthroplasty centre and performed survival analysis on the group with revision as the endpoint. Results The ten-year cumulative survival rate for revision or exchange of any part of the prosthetic components was 93.2% (95% confidence interval (CI) 86.1 to 100, number at risk 45). Consultant surgeons had a nine-year cumulative survival rate of 93.9% (95% CI 90.2 to 97.6, number at risk 16). Trainee surgeons had a cumulative nine-year survival rate of 93.0% (95% CI 90.3 to 95.7, number at risk 35). Although there was no differences in implant survival between consultants and trainees (p = 0.30), there was a difference in failure pattern whereby all re-operations performed for bearing dislocation (n = 7), occurred in the trainee group. This accounted for 0.6% of the entire cohort and 15% of the re-operations. Conclusion This is the largest single series of the Oxford UKA ever reported and demonstrates that good results can be achieved by a heterogeneous group of surgeons, including trainees, if performed within a high-volume centre with considerable experience with the procedure. Cite this article: Bone Joint J 2016;(10 Suppl B):22–7. PMID:27694512

  1. 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

  2. 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

  3. 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.

  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. Connections of the juxtaventromedial region of the lateral hypothalamic area in the male rat.

    Directory of Open Access Journals (Sweden)

    Joel D Hahn

    2015-05-01

    Full Text Available Evolutionary conservation of the hypothalamus attests to its critical role in the control of fundamental behaviors. However, our knowledge of hypothalamic connections is incomplete, particularly for the lateral hypothalamic area (LHA. Here we present the results of neuronal pathway-tracing experiments to investigate connections of the LHA juxtaventromedial region, which is parceled into dorsal (LHAjvd and ventral (LHAjvv zones. Phaseolus vulgaris leucoagglutinin (PHAL, for outputs and cholera toxin B subunit (CTB, for inputs coinjections were targeted stereotaxically to the LHAjvd/v. RESULTS: LHAjvd/v connections overlapped highly but not uniformly. Major joint outputs included: Bed nuc. stria terminalis (BST, interfascicular nuc. (BSTif and BST anteromedial area, rostral lateral septal (LSr- and ventromedial hypothalamic (VMH nuc., and periaqueductal gray. Prominent joint LHAjvd/v input sources included: BSTif, BST principal nuc., LSr, VMH, anterior hypothalamic-, ventral premammillary-, and medial amygdalar nuc., and hippocampal formation (HPF field CA1. However, LHAjvd HPF retrograde labeling was markedly more abundant than from the LHAjvv; in the LSr this was reversed. Furthermore, robust LHAjvv (but not LHAjvd targets included posterior- and basomedial amygdalar nuc., whereas the midbrain reticular nuc. received a dense input from the LHAjvd alone. Our analyses indicate the existence of about 500 LHAjvd and LHAjvv connections with about 200 distinct regions of the cerebral cortex, cerebral nuclei, and cerebrospinal trunk. Several highly LHAjvd/v-connected regions have a prominent role in reproductive behavior. These findings contrast with those from our previous pathway-tracing studies of other LHA medial and perifornical tier regions, with different connectional behavioral relations. The emerging picture is of a highly differentiated LHA with extensive and far-reaching connections that point to a role as a central coordinator of behavioral

  7. MR-imaging of anterior tibiotalar impingement syndrome: Agreement, sensitivity and specificity of MR-imaging and indirect MR-arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Haller, Joerg [Department of Radiology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Ludwig Boltzmann Institute for Osteology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Bernt, Reinhard [Department of Radiology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria)]. E-mail: reinhard.bernt@wgkk.sozvers.at; Seeger, Thomas [Department of Trauma Surgery, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Weissenbaeck, Alexander [Department of Trauma Surgery, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Tuechler, Heinrich [Ludwig Boltzmann Institute for Hematology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Resnick, Donald [Department of Radiology, VA Medical Center, UCSD, 3350 La Jolla Village Dr, San Diego, CA 92161 (United States)

    2006-06-15

    Objective: To clarify the role of MR-imaging in the diagnosis of anterior ankle impingement syndromes. Materials and methods: We prospectively examined 51 consecutive patients with chronic ankle pain by MR-imaging. Arthroscopy was performed in 29 patients who previously underwent non-enhanced MR-imaging; in 11 patients, indirect MR-arthrography additionally was performed. MR-examinations were correlated with clinical findings; MR and arthroscopy scores were statistically compared, agreement was measured. Results: Arthroscopy demonstrated granulation tissue in the lateral gutter (38%) and anterior recess (31%), lesions of the anterior tibiofibular (31%) and the anterior talofibular ligament (21%) as well as intraarticular bodies (10%). Stenosing tenosynovitis and a ganglionic cyst were revealed as extraarticular causes for chronic ankle pain by MR-examination (17%). Agreement of MR-imaging and arthroscopy was fair for the anterior talofibular ligament and the anterior joint cavity (kappa 0.40). Major discrepancy was found for non-enhanced MR scans (kappa 0.49) when compared with indirect MR-arthrography (kappa 0.03) in the anterior cavity. The sensitivity for lesions of the anterior talofibular and calcaneofibular ligament and the anterior cavity (0.91-0.87) detected by MR-imaging was superior in comparison to lesions of the anterior tibiofibular ligament and anteromedial cavity (0.50-0.24). Conclusion: MR-imaging provides additional information about the mechanics of chronic ankle impingement rather than an accurate diagnosis of this clinical entity. The method is helpful in differentiating extra- from intra-articular causes of ankle impingement. Indirect MR-arthrography has little or no additional value in patients with ankle impingement syndrome.

  8. 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.)

  9. 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

  10. A prospective randomised study of anatomical single-bundle versus double-bundle anterior cruciate ligament reconstruction: quantitative evaluation using an electromagnetic measurement system.

    Science.gov (United States)

    Araki, Daisuke; Kuroda, Ryosuke; Kubo, Seiji; Fujita, Norifumi; Tei, Katsumasa; Nishimoto, Koji; Hoshino, Yuichi; Matsushita, Takehiko; Matsumoto, Tomoyuki; Nagamune, Koki; Kurosaka, Masahiro

    2011-03-01

    We conducted a prospective randomised study of anatomical single-bundle (A-SB group) versus double-bundle (A-DB group) anterior cruciate ligament (ACL) reconstruction using the hamstrings tendons. Twenty patients with unilateral ACL deficiency were randomised into two groups. We created the bone tunnels at the position of the original insertion of the anteromedial bundle footprint and posterolateral bundle footprint in the A-DB group and at the central position between these two bundles in the A-SB group. All of the patients were tested before ACL reconstruction and one year after surgery. The KT-1000 measurements, isokinetic muscle peak torque and heel-height difference were evaluated and the general knee condition was assessed by Lysholm score. For pre- and postoperative stability assessment, we used the six-degrees-of-freedom of knee kinematic measurement system using an electromagnetic device (the EMS) for quantitative assessment during the Lachman test and the pivot shift test. There were no significant differences in the KT-1000 measurements, isokinetic muscle peak torque, heel-height difference, and Lysholm score at one-year follow-up between these two groups. The EMS data showed there were significant differences in the acceleration of the pivot shift test between the operated knee and the contralateral normal knees in the A-SB group. In conclusion, clinical outcomes were equally good in both groups. However, the EMS data showed the anatomical double-bundle ACL reconstruction tended to be biomechanically superior to the single-bundle reconstruction.

  11. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Luigi Di Giorgio; Georgios Touloupakis; Emmanouil Theodorakis; Luca Sodano

    2013-01-01

    Objective:The anterolateral approach to the tibia has been popularized for the management of tibial pilon fractures.For complex fracture pattems a combined anterolateral/anteromedial approach is suitable but a high rate of complication has been reported.In our retrospective study a two-choice strategy adopting a medial tibial approach was proposed for the treatment ofpilon fractures with anterior or posterior fragmentation.Methods:Based on an anatomic study oftibial 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-up of 12 months,(3) a fibula fracture associated with a medial column fracture of the distal tibia,and (4) soft tissue conditions at the time of operation that did not compromise the choice of surgical access (Tscherne classification for closed fractures:grade 0 and grade 1).Tibial plafond fractures were classified into two groups:one presenting anterior and the other with posterior rim (Volkmann) fragments.Results:Most patients achieved a good clinical recovery in terms of range of motion and Olerud-Molander scale scores.Only three patients 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.

  13. 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

  14. The regional distribution of T2-relaxation times in MR images of the substantia nigra and crus cerebri

    Energy Technology Data Exchange (ETDEWEB)

    Maenz, Constantin; Bender, Benjamin; Ernemann, Ulrike; Klose, Uwe [University of Tuebingen, Department of Diagnostic and Interventional Neuroradiology, Tuebingen (Germany); Godau, Jana; Berg, Daniela [University of Tuebingen, Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Tuebingen (Germany)

    2010-08-15

    When scanning the size of the substantia nigra (SN), for example in Parkinson's disease, it is important to precisely locate its true anatomic location. The hypointense areas on T2-weighted magnetic resonance images (T2w) at the level of the upper midbrain are usually labeled as the SN. Recent studies showed that the line of demarcation between the SN and the crus cerebri (CC) in T2w images seems not to be clear. The purpose of our study was to evaluate the depiction of the SN and the CC on calculated R2 maps by analyzing the regional distribution of T2 values in both regions. In 36 healthy subjects, triple echo turbo spin echo were obtained at 1.5 T and R2 maps calculated. Proton density-weighted turbo spin echo images (PDw) were used as reference. The CC and SN were manually traced on PDw sections (CCP and SNP) and also the hyperintense areas on the R2 maps, suggestive of the SN (DT2). The obtained volumes were evaluated in terms of total size, intersections size, and residual areas, as well as the corresponding T2 values. DT2 corresponded to anterolateral parts of the SNP and showed an extension to anteromedial part of the CC. The intersections between DT2 and CCP and DT2 and SNP presented both decreased but different T2 values (102 {+-} 5 and 95 {+-} 4 ms). An exact differentiation of the SN from the CC is not possible on the basis of T2w images but rather on the basis of the underlying calculated T2 values from the triple echo sequence. (orig.)

  15. 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.)

  16. 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.

  17. An extrahippocampal projection from the dentate gyrus to the olfactory tubercle

    Directory of Open Access Journals (Sweden)

    Künzle Heinz

    2005-05-01

    Full Text Available Abstract Background The dentate gyrus is well known for its mossy fiber projection to the hippocampal field 3 (CA3 and its extensive associational and commissural connections. The dentate gyrus, on the other hand, has only few projections to the CA1 and the subiculum, and none have clearly been shown to extrahippocampal target regions. Results Using anterograde and retrograde tracer techniques in the Madagascan lesser hedgehog tenrec (Afrosoricidae, Afrotheria it was shown in this study that the dentate hilar region gave rise to a faint, but distinct, bilateral projection to the most rostromedial portion of the olfactory tubercle, particularly its molecular layer. Unlike the CA1 and the subiculum the dentate gyrus did not project to the accumbens nucleus. A control injection into the medial septum-diagonal band complex also retrogradely labeled cells in the dentate hilus, but these neurons were found immediately adjacent to the heavily labeled CA3, while the tracer injections into the rostromedial tubercle did not reveal any labeling in CA3. Conclusion The dentate hilar neurons projecting to the olfactory tubercle cannot be considered displaced cells of CA3 but represent true dentato-tubercular projection neurons. This projection supplements the subiculo-tubercular projection. Both terminal fields overlap among one another as well as with the fiber terminations arising in the anteromedial frontal cortex. The rostromedial olfactory tubercle might represent a distinct ventral striatal target area worth investigating in studies of the parallel processing of cortico-limbic information in tenrec as well as in cat and monkey.

  18. [Anterior cruciate ligament-plasty using the "U-dos" technique].

    Science.gov (United States)

    Morales-Trevizo, C; Paz-García, M; Leal-Berumen, I; Leal-Contreras, C; Berumen-Nafarrate, E

    2013-01-01

    The knee is a compound diarthrodial joint, vulnerable to serious injuries such as ligament injuries of: medial collateral ligament, lateral collateral ligament, anterior cruciate ligament and posterior cruciate ligament, as cruciate ligaments limit rotation movement in the joint. The purpose of our study was to create a new technique to treat injuries of the anterior cruciate ligament, which is composed of two bundles--anteromedial and posterolateral--trying to achieve an anatomical reconstruction that allows for a normal biomechanical recovery. This technique reduces the use of fixation material and costs. The diagnosis of anterior cruciate ligament injuries was made with the pivot shift test. There are currently two repair methods for anterior cruciate ligament injuries: single bundle or double bundle repair; none of these techniques is considered as the gold standard, as their results are very similar. This paper describes a technique used for the treatment of anterior cruciate ligament injuries, known as "U-dos", and its clinical results. Cross-sectional, observational study that enrolled 20 patients with total anterior cruciate ligament injuries who underwent anterior cruciate ligament plasty using the "U-dos" technique between June 2009 and June 2010. The technique requires the use of bone bank allograft, in this case of the anterior tibial ligament. Patients were assessed using the Lysholm scale and the pivot shift test. Our results show that all the pivot shift tests were negative and assessments according to the Lysholm scale were from normal to excellent in 95% of cases (19/20). Only one failure was reported, with avulsion of the graft attachment which required a surgical intervention.

  19. 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

    Directory of Open Access Journals (Sweden)

    Roberto F. Mota e Albuquerque

    2007-01-01

    Full Text Available 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. The anteromedial bundle was replaced in 10 knees (5 right and 5 left knees from different cadavers by a quadriceps-bone tendon graft, and the anteromedial and posterolateral bundles were replaced in the matching pairs of these knees. In the latter, the bone segment was fixed to the tibia, and the tendinous portion of the graft was divided longitudinally creating two 5-mm wide bundles that were inserted individually into the femur through 2 independent bone tunnels. Then, the knees were tested mechanically to evaluate the tibial anterior dislocation in relation to the femur, as well as the rigidity of the graft. The control group was formed by the knees with intact anterior cruciate ligaments, before being resected to be reconstructed. RESULTS: The results obtained did not show superiority of double-bundle reconstruction over single-bundle reconstruction, and neither technique provided the knee with the same stability and rigidity of the intact anterior cruciate ligament. CONCLUSION: Our hypothesis, based on the anatomy and biomechanics of the knee, that reconstruction of the anterior cruciate ligament using 2 bundles would result in a more anatomic reconstruction and provide better containment of the anterior tibial translation was not supported by the results of this study.OBJETIVO: Testar uma técnica de reconstrução intra-articular do ligamento cruzado anterior do joelho em 10 cadáveres humanos com substituição de dois feixes do ligamento cruzado

  20. 合并肘关节脱位的成人后孟氏骨折的形态特征及治疗%Morphology and surgical treatment of posterior Monteggia fracture with associated ulnohumeral dislocation

    Institute of Scientific and Technical Information of China (English)

    王建卫; 潘志军; 李杭; 郑强; 冯刚; 李建兵

    2016-01-01

    with posterior Monteggia fractures and associated elbow dislocation were retrospectively reviewed from January 2011 to December 2013.11 patients were included,with 43.3 years old on average.10 were resulted from high-energy injuries.According to the Jupiter classification,Ⅱ A fracture-dislocation 9 cases,Ⅱ B fracture-dislocation 1 case and Ⅱ C fracture-dislocation 1 case.The general medical data,morphological properties,and the surgical methods.Functional outcomes were followed up.Results These cases had several intrinsic morphologic features:fractures of the coronoid tip and its anteromedial aspect;dislocation of the olecranon from the trochlear notch;fracture of the radial head and disruption of the lateral collateral ligament;a normal proximal radioulnar joint.Operation was carried out with emphasis on elbow stability restoration.All patients underwent the primary operations in the supine position and a routine posterior approach was used.An additional anterior approach was used in 1 case (Ⅱ B).The coronoid tip was first fixed,followed by the anteromedial coronoid fragment,the radial head,the olecranon,and then the LCL.An anatomic olecranon plate was used as the fundamental fixation device.Anteromedial coronoid fractures were mostly fixed with a T-shaped metacarpal plate.The coronoid tip fractures were fixed with screw,Kwire or suture,and the injured LCL was repaired with suture anchors.Ten of the 11 patients were followed up with a mean period of 22.7 months.The extension-flexion motion ranged from 45°-140° (104° average),and the pronation-supination motion ranged from 45° 180° (128° average).According to the Broberg and Morrey functional index,the excellent to good ratio was 70%.Conclusion Patients with posterior Monteggia fracture and associated ulnohumeral dislocation have small and comminuted coronoid fractures,and mostly have a normal PRUJ relationship.It might experience a different mechanism to those of the posterior Monteggia fracture

  1. 超声在产前诊断胎儿颅脑疾病中的应用%Application of ultrasonography in screening the defects of fetal brain and skull

    Institute of Scientific and Technical Information of China (English)

    焦光琼; 徐惠英; 洪向丽; 殷舫; 谭晶

    2010-01-01

    Objective To explore the application of three-dimensional (3D) ultrasonography in screening the defects of fetal brain and skull.Methods Thirty-one cases of the fetal were detected in 3D ultrasonography.The ultrasonic data were compared with magnetic resonance imaging(MRI) and pathology.Results Among 31 cases according to 3D ultrasonography,there were 2 of anencephaly, 1 of exencephaly,2 of encephalocele,5 of holoprosencephaly,2 of arachnoidcyst, 1 of vein of Galen aneurysm,2 of agenesis of the corpus callosum, 1 of schizencephaly, 3 of Dandy-Walker syndrome, 7 of ventriculomegaly, and 5 of enlargement of cisterna magna.Compared with the results of MRI,the diagnostic accordance rate was 100% by 3D,it was 93.5% by 2D.Conclusions The structure of fetal brain and skull were viewed more clearly in 3D ultrasonography than 2D ultrasonography and the defects of fetal brain and skull can screened more exactly.%目的 探讨超声检查在产前诊断胎儿颅脑疾病中的应用价值.方法 对31例患胎儿颅脑疾病孕妇行二维超声、三维超声、磁共振检查,并与病理结果对照分析.结果 31例胎儿超声提示2例无脑儿,1例露脑,2例脑膨出,5例全前脑,2例蛛网膜囊肿,1例Galen静脉瘤,2例胼胝体发育不全,1例脑裂,3例Dandy-Walker畸形,7例侧脑室扩张,5例颅后窝池增宽,通过磁共振检查核对,三维超声诊断符合率100%,二维超声诊断符合率93.5%.结论 超声检查在胎儿颅脑疾病中有很高价值,三维超声比二维超声检查更直观.

  2. 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.

  3. 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.

  4. 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

  5. 海洛因对大鼠胚胎发育的影响%Effect of Heroin on Embryonic Development in Rats

    Institute of Scientific and Technical Information of China (English)

    谢明仁; 张璟; 俞文; 俞发荣

    2013-01-01

    为探讨海洛因对大鼠胚胎发育的影响.研究雌性Wistar大鼠受孕后的不同时间给予不同剂量的海洛因,于妊娠第20天,剖腹观察胚胎发育的情况.结果表明:给予海洛因20 mg/kg组胎鼠中脑导水管和左右脑室增宽,大脑半球、腰椎骨、肋骨、肢掌骨发育不全,胎鼠侧脑室扩大、大脑皮质、颞叶、双侧被盖区及结合臂发育不全,枕骨缺如,脑膨出,椎骨裂开,肋骨骨化不全,四肢远端骨未骨化;30 mg/kg组未见胚胎形成.结果表明:海洛因对大鼠胚胎脑及骨骼发育有明显的毒性作用,致畸程度随给药剂量增加而增大.%Our Objective was to investigate the effect of heroin on embryonic development in rats. Female Wistar rats after conception for different times were given different doses of heroin and on the 20th day, they were dissected to observe their embryonic development. It was shown that given heroin 20 mg/kg the midbrain aqueduct and ventricles of the fetal rat got widened; its cerebral hemispheres, lumbar vertebrae, ribs and limb metacarpals were not fully developed; its lateral ventricle got enlarged;its cerebral cortex,the temporal lobe, the bilateral cap and combined arms were in hypoplasia; its occipital encephalocele was absent, its vertebrae and ribs cracked;the ossification of its ribs was incomplete and the distant bones of the limbs were not yet ossified. With the dose of heroin 30 mg/kg no embryo was found. It was concluded that heroin had apparent toxic effects on embryonic rat's brain and bone development. As the dose increases, the teratogens got more serious.

  6. 双侧去骨瓣减压术在救治双侧不对称性重型颅脑损伤中的临床研究%Clinical research of bilateral decompressive craniectomy in treating bilateral asymmetrical severe craniocerebral injury

    Institute of Scientific and Technical Information of China (English)

    郑艳梅

    2012-01-01

    Objective To investigate the clinical efficacy of bilateral decompressive craniectomy in the treatment of bilateral asymmetrical severe craniocerebral injury. Methods 61 cases of patients with bilateral asymmetrical severe craniocerebral injury, who treated in our hospital from April 2008 to December 2011, were randomly divided into two groups. 30 patients in control group were cured with unilateral standard large trauma craniotomy, 31 patients in observation group were cured with bilateral decompressive craniectomy. And the Glasgow Outcome Score (GOS) was evaluated for all patients in both groups 3 months after treatment, then every clinical index and prognosis of patients were compared between two groups. Results After treatment, intracranial pressure of patients in both groups reduced significantly, and intracranial pressure of patients in observation group was significantly lower than that in control group. Incidence of acute intraopera-tive encephalocele and incidence of postoperative incisional hernia of observation group patients were significantly lower than that of control group patients. Good rate (35.5%) of observation group patients was significantly higher than that of control group patients (13.3%). Case fatality rate (9.7%) of observation group patients was significantly lower than that of control group patients (40%). Postoperative complication rate (16.1%) of observation group patients was significantly lower than that of control group patients (46.7%). All the differences were statistically significant (P < 0.05). Conclusion Bbilat-eral decompressive craniectomy in the treatment of bilateral asymmetrical severe craniocerebral injury patients can significantly improve the clinical indices and prognosis of those patients, and reduce the intracranial pressure, the incidence of a-cute intraoperative encephalocele, the incidence of postoperative incisional hernia, the incidence of postoperative complications and the case fatality rate of patients. And

  7. EFFECT OF ATHLETIC TAPING AND KINESIOTAPING® ON MEASUREMENTS OF FUNCTIONAL PERFORMANCE IN BASKETBALL PLAYERS WITH CHRONIC INVERSION ANKLE SPRAINS

    Science.gov (United States)

    Karatas, Nihan; Baltaci, Gul

    2012-01-01

    Background: Chronic inversion ankle sprains are common in basketball players. The effect of taping on functional performance is disputed in the literature. Kinesiotaping® (KT®) is a new method that is being used as both a therapeutic and performance enhancement tool. To date, it appears that no study has investigated the effect of ankle KT® on functional performance. Purpose: To investigate the effects of different types of taping (KT® using Kinesio Tex®, athletic taping) on functional performance in athletes with chronic inversion sprains of the ankle. Study Design: Crossover Study Design Methods: Fifteen male basketball players with chronic inversion ankle sprains between the ages of 18 and 22 participated in this study. Functional performance tests (Hopping test by Amanda et al, Single Limb Hurdle Test, Standing Heel Rise test, Vertical Jump Test, The Star Excursion Balance Test [SEBT] and Kinesthetic Ability Trainer [KAT] Test) were used to quantify agility, endurance, balance, and coordination. These tests were conducted four times at one week intervals using varied conditions: placebo tape, without tape, standard athletic tape, and KT®. One-way ANOVA tests were used to examine difference in measurements between conditions. Bonferroni correction was applied to correct for repeated testing. Results: There were no significant differences among the results obtained using the four conditions for SEBT (anterior p=0.0699; anteromedial p=0.126; medial p=0.550; posteromedial p=0.587; posterior p=0.754; posterolateral p=0.907; lateral p=0.124; anterolateral p=0.963) and the KAT dynamic measurement (p=0.388). Faster performance times were measured with KT® and athletic tape in single limb hurdle test when compared to placebo and non-taped conditions (Athletic taping- placebo taping: p=0.03; athletic taping- non tape p=0.016;KT®- Placebo taping p=0.042; KT®-Non tape p=0.016). In standing heel rise test and vertical jump test, athletic taping led to decreased

  8. 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

  9. 前交叉韧带方位角变化的解剖学测量研究%Anatomical Study of the ACL Azimuth Angle Change

    Institute of Scientific and Technical Information of China (English)

    罗令; 孙晓峰; 张杰; 刘洋波; 禹晓东; 黄文华

    2015-01-01

    目的:探讨前交叉韧带(anterior cruciate ligament,ACL)在膝关节不同屈曲角度时的方位角变化,为ACL损伤诊断和重建研究提供解剖学支持.方法:成人膝关节标本10具,解剖观察ACL形态,用Photoshop软件测量膝关节不同屈曲角度下ACL方位角变化.结果:0°、30°位膝关节中ACL胫骨角大于ACL股骨角,有显著性差异(P<0.01);60°、90°位膝关节中的ACL胫骨角小于股骨角,有显著性差异(P<0.01).膝关节0°、30°、60°、90°ACL胫骨角由大渐小,各角度间均有显著性差异(均P<0.01).膝关节0°和30°的ACL股骨角比60°和90°时小,有显著性差异(均P<0.01),0°与30°间无显著性差异(P>0.05),60°小于90°,有显著性差异(P<0.01).结论:ACL于膝关节0°和30°位时,后外侧束(posterolateral bundle,PLB)发挥主要作用,ACL诊断或重建主要参考胫骨角;60°、90°时ACL前内侧束(anteromedial bundle,AMB)发挥主要作用,ACL诊断或重建主要参考股骨角.ACL方位角可作为ACL损伤诊断和手术重建的重要参考.

  10. 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

  11. 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

  12. Outcome of double bundle anterior cruciate ligament reconstruction using crosspin and aperture fixation

    Directory of Open Access Journals (Sweden)

    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

  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

    Directory of Open Access Journals (Sweden)

    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

    Directory of Open Access Journals (Sweden)

    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. Bone tunnel diameter measured with CT after anterior cruciate ligament reconstruction using double-bundle auto-hamstring tendors: Clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Soo Jeong; Yoon, Young Cheol; Bae, So Young; Wang, Joon Ho [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    To evaluate the correlation between bone tunnel diameter after anterior cruciate ligament (ACL) reconstruction measured by computed tomography (CT) using multiplanar reconstruction (MPR) and stability or clinical scores. Forty-seven patients (41 men and 6 women, mean age: 34 years) who had undergone ACL reconstruction with the double bundle technique using auto-hamstring graft and had subsequently received CT scans immediately after the surgery (T1: range, 1-4 days, mean, 2.5 days) and at a later time (T2: range, 297-644 days, mean, 410.4 days) were enrolled in this study. The diameter of each tunnel (two femoral and two tibial) at both T1 and T2 were independently measured using MPR technique by two radiologists. Stability and clinical scores were evaluated with a KT-2000 arthrometer, International Knee Documentation Committee objective scores, and the Lysholm score. Statistical analysis of the correlation between the diameter at T2 or the interval diameter change ratio ([T2 - T1] / T1) and clinical scores or stability was investigated. The tibial bone tunnels for the anteromedial bundles were significantly widened at T2 compared with T1 (observer 1, 0.578 mm to 0.698 mm, p value of < 0.001; observer 2, 0.581 mm to 0.707 mm, p value of < 0.001). There was no significant correlation between the diameter at T2 and stability or clinical scores and between the interval change ratio ([T2 - T1] / T1) and stability or clinical scores (corrected p values for all were 1.0). Intraobserver agreement for measurements was excellent (> 0.8) for both observers. Interobserver agreement for measurement was excellent (> 0.8) except for the most distal portion of the femoral bone tunnel for anterior medial bundle in immediate postoperative CT, which showed moderate agreement (concordance correlation coefficient = 0.6311).Neither the diameter nor its change ratio during interval follow-up is correlated with stability or clinical scores.

  17. MRI VERSUS ARTHROSCOPY: A COMPARISON OF FINDINGS

    Directory of Open Access Journals (Sweden)

    Somashekhara Reddy

    2016-06-01

    Full Text Available The purpose of this study is to correlate the findings of Magnetic Resonance Imaging with Arthroscopy in internal derangements of knee and to assess the sensitivity, specificity and accuracy of Magnetic Resonance Imaging in comparison to Arthroscopy. METHODS AND MATERIALS Fifty six patients with history of suspected internal derangement of knee were evaluated prospectively with MRI and correlated with arthroscopy during a one and half a year period from March 2012 to September 2013.1.5 Tesla MRI machine using a closed extremity coil is used. Sequences used in MRI of the knee include Turbo-spin echo (TSE, FFE (Gradient echo and Short Tau Inversion Recovery (STIR sequences in Axial, Sagittal and Coronal planes using a slice thickness of 3 mm with a 0.3 mm slice gap. Arthroscopy of the knee with standard anteromedial and anterolateral portals with the patient in supine position done in all the cases. RESULTS The diagnostic sensitivity, specificity and accuracy of MRI in detecting cruciate ligament and meniscal injuries as compared to Arthroscopy are as follows: Anterior Cruciate Ligament (ACL: 97.29%, 89.47%, 94.64%; Posterior Cruciate Ligament (PCL: 100%, 100%, 100%; Medial Meniscus (MM: 100%, 93.33%, 98.21% and Lateral Meniscus (LM: 93.10, 92.59, 92.85. Most common lesions found were ACL and Medial Meniscal tears (posterior horn of MM being the most common site. SUMMARY AND CONCLUSION  MRI is a useful non-invasive modality having high sensitivity, specificity and accuracy in diagnosing cruciate ligament and meniscal injuries.  MRI should be considered as the first line of investigation in all patients with suspected internal derangements of knee.  MRI being easily available and non-invasive is useful as a pre-operative screening modality, thus improves the quality of diagnostic and therapeutic arthroscopies and further reduces the morbidity.  Arthroscopy is the standard diagnosing tool in all patients with suspected internal

  18. The importance of early arthroscopy in athletes with painful cartilage lesions of the ankle: a prospective study of 61 consecutive cases

    Directory of Open Access Journals (Sweden)

    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

  19. Operative treatment of talar body fractures%距骨体骨折的手术治疗

    Institute of Scientific and Technical Information of China (English)

    何锦泉; 马宝通; 庞贵根; 舒衡生; 张亚非; 陈新; 曾宪铁

    2011-01-01

    Objective To investigate the results and related key points in operative treatment of talar body fractures. Methods From April 2002 to July 2008, 44 patients with talar body fractures underwent the operation. There were 3 females and 41 males. The mean age of the patients was 31.7 years. The fractures occurred on the left side in 26 patients and on the right side in 18 patients. According to Sneppen classification, 24 type Ⅱ, 20 type V. Eleave cases were open fractures, according to the Gustilo-Anderson classification, there were 3 cases in type Ⅰ , 7 in type Ⅱ, 1 type in Ⅲ A. The mean interval between injury and surgical treatment for open fractures and close fractures was 5.3 hours and 8.9 days. The mechanism of injury was a fall from the height in 18 patients, a traffic accident in 13 patients, a crush injury in 8 patients, a sprain injury in 4 patients and a cut injury in 1 patient. Anteromedial approach was used for 15 close fractures, anterolateral approach for 3 and combined anteromedial-anterolateral approach for 15. K-wires fixation were utilized for 3 fractures, screws and temporary K-wires fixation for 5 cases, bioabsorbable screws for 2fractures, cannulated screws for 30 fractures and cannulated screws and threaded cancellous screws for 4cases. Results Thirty-five patients were followed up 21 to 89 months (average, 44.5 months). Necrosis of incision was found in 4 cases, wound infection occurred in 1 case. All fractures had achieved bone union;the average healing time was 22 weeks. Functional results were assessed according to AOFAS score, the average score was 77.3, There were 11 patients in excellent results, 13 in good, 10 in fair and 1 in poor. The overall excellent and good rate was 68.6%. Avascular necrosis occurred in 5 cases. Traumatic arthritis occurred in 19 cases. Arthrodesis was needed in 5 cases. Conclusion The timing and approach of surgery is determined by the condition of the talar fractures and soft tissue. Anatomical reduction

  20. 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

  1. Surgical treatment for patients of simple elbow dislocations with posteromedial instability%后内侧不稳定简单型肘关节脱位患者的手术治疗

    Institute of Scientific and Technical Information of China (English)

    冯明光; 王海洋; 江旭未; 许文峰; 麦佳佳

    2016-01-01

    the ligament, joint capsule and tendon were recorded. Relations between injuries of soft tissues and the elbow and correspondent violence were defined. Postoperative progressive functional rehabilitation training with the brace was conducted under the protection of the elbow. Regular outpatient follow-up was conducted.Results Avulsion injury was 100% for the medial collateral ligament and anteromedial capsule, 60% for the lfexor tendon and 30% for the biceps tendon. The elbow injury occurred in supination, abduction and valgus position. In the latest follow-up, the overall mean Mayo Elbow Performance Score was 93.2, ulnar nerve injury occurred in 5 elbows, and heterotopic calciifcation was noted in 1 patient.Conclusions Elbow extension and supination under axial hyperextension and valgus stress is the injury mechanism of simple elbow dislocations with posteromedial instability. It mainly involves anteromedial stable structure. Early repair with wired screws can achieve satisfactory results.

  2. 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

  3. 股骨颈关节囊内骨样骨瘤的临床及影像特点%Clinical and imaging features of intra-articular osteoid osteoma in the femoral neck

    Institute of Scientific and Technical Information of China (English)

    曾泳瀚; 程晓光; 栾贻新; 顾翔; 李江涛

    2012-01-01

    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 pefformed 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.%目的 分析股骨颈骨样骨瘤的临床及影像特点,提高对本病的诊断水平.方法 回顾性分析21例经手术病理证实的股骨颈骨样骨瘤的临床及影像学资料.其中男18例、女3例;年龄7~26岁,中位年龄13岁.所有病例均行常规X线及CT检

  4. 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

    Directory of Open Access Journals (Sweden)

    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

  5. 妇女怀孕前后被动吸烟与神经管畸形关系的病例对照研究%Maternal passive smoking and the risk of neural tube defects: a case-control study in Shanxi province,China

    Institute of Scientific and Technical Information of China (English)

    李智文; 刘建蒙; 任爱国; 张乐; 郭湛英; 李竹

    2008-01-01

    目的 探讨母亲怀孕前后被动吸烟与子代发生神经管畸形(NTD)危险性的关系.方法 资料来源于北京大学生育健康研究所在山西省平定、昔阳、太谷和泽州4个县开展的以人群为基础的出生缺陷病例对照研究.病例为2003年1月到2007年6月监测到的515例NTD病例(其中无脑儿236例,脊柱裂237例,脑膨出42例),对照组为同期在同地区调查的682例无体表出生缺陷的婴儿.研究人员在妇女分娩一周内问卷调查妇女怀孕前后的被动吸烟及其他信息.用非条件logistic回归模型调整混杂因素.结果 与无被动吸烟的妇女相比,怀孕前后有被动吸烟的妇女生育NTD的危险性(OR值)为1.84(95%CI:1.39~2.44).妇女被动吸烟频度与子代发生NTD危险性之间存在显著的剂量反应关系.与无被动吸烟的妇女相比,偶尔有被动吸烟的妇女和每天有被动吸烟的妇女生育NTD的OR值分别为1.51和2.44(趋势x2=24.9,P<0.001).结论 妇女怀孕前后被动吸烟增加生育NTD患儿的危险性.%Objective To explore the relationship between maternal passive smoking during early pregnancy and the risk of neural tube defects (NTDs). Methods Data was derived from a populationbased case-control study on birth defects in Shanxi province. The study subjects included 515 NTDs defects cases (236 cases of anencephaly, 237 spina bifida and 42 encephalocele) ascertained during January 2003 and June 2007 in the study areas and 682 normal controls randomly selected in the same residence during the same period as cases. Results The risk of NTDs in their offspring was 1.84 (95 % CI : 1.39-2.44) for mothers with passive smoking history during peri-conceptional period. There was a marked dose-response relation between maternal passive smoking and the risk of NTDs in offspring. Compared to the women without passive smoking, the NTDs risk in offspring was 1.51 for women with occasional passive smoking and 2.44 for women with passive

  6. 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

  7. 预见性与相继性双侧去骨瓣减压治疗重型颅脑损伤疗效的差异%Clinical features and surgical treatment of traumatic intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    徐勇; 林爱明; 刘佳骐; 鲁虎臣; 马骏

    2014-01-01

    observed. Results After treatment,incidence of acute intraoperative encephalocele and incidence of postoperative incisional hernia of observation group patients were significantly lower than those of control group, the differences were statistically significant(P0.05).Complication occurrence rate of observation group was lower than that of control group, the differences were statistically significant(P<0.05).Conclusion The active bilateral decompressive craniectomy in the treatment of severe craniocerebral injurycan effectively improve the prognosis of patients, and reduce the incidence of postoperative complications.And it is worthy to recommand its clinical application.

  8. 标准大骨瓣减压术治疗大面积脑梗死随机对照临床研究%Randomized controlled clinical research in treatment of massive cerebral infarction with standard hemicraniec-tomy

    Institute of Scientific and Technical Information of China (English)

    黎华清; 黎志洲; 张旺明

    2015-01-01

    ,postoperative encephalocele,epilepsia)(P < 0. 05),while the patients in treated group also had less operative time and operative blood loss than control group(P < 0. 05). Conclusion Performing standard hemicraniectomy - endocranium enlarged plasty for patient with massive cerebral infarction will reduce postoperative complications,improve quality of life,shorten operative time and reduce the amount of bleeding during the repair of Ⅱ phase skull defect.

  9. Equoterapia na reabilitação da meningoencefalocele: estudo de caso Hyppotherapy in meningoencephalocele rehabilitation: a case study

    Directory of Open Access Journals (Sweden)

    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.

  10. 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

  11. Aneurismectomia do ventrículo esquerdo: avaliação tardia Left ventricular aneurysmectomy: late follow-up

    Directory of Open Access Journals (Sweden)

    José Luiz Dancini

    1996-03-01

    Full Text Available Com o objetivo de avaliar tardiamente o efeito da aneurismectomia do ventrículo esquerdo quanto a sintomatologia e função ventricular global, foram analisados 40 pacientes consecutivos operados de agosto/87 a novembro/94, com um período de seguimento de 12 a 99 meses. A localização mais comum foi a ântero-medial e a maioria dos pacientes apresentava um quadro misto de angina e ICC. A pd2VE média preoperatoria foi de 25,9 mmHg. Cinco (12,5% faleceram durante a internação, por insuficiência miocárdica aguda e 6 (15%, durante o pós-operatório tardio. Quando se divide a série em dois grupos, aqueles operados de 1991 a 1994 (últimos 22 pacientes mostram uma sobrevida de 91% ao final de 4 anos. Dos 29 sobreviventes, 12 (30% encontram-se assintomáticos, enquanto que 42,5% cursam com algum grau de angina ou ICC. O ecocardiograma bidimensional demonstrou normalização dos diâmetros ventriculares, das frações de ejeção e encurtamento em apenas 43% dos casos. Ao final de um ano, somente 50% dos pacientes estão livres de sintomas. Em conclusão, a aneurismectomia do ventrículo esquerdo promoveu melhora sintomática na maioria dos pacientes, com mortalidade aceitável, embora não totalmente confirmada pelos índices de função global ao ecocardiograma bidimensional.Forty consecutive patients operated on between August 1987 and November 1994 were analysed, aiming at the late assessment of left ventricular aneurysmectomy in terms of symptomatology and global ventricular function. The follow-up ranged from 12 to 99 months. The most common location was anteromedial and most of the patients had both angina and CHF. The average preoperative LVEDP was 25.9 mmHg. Five patients (12.5% died during hospitalization, due to acute myocardial failure, and 6 (15% during the late postoperative period. When the series is divided into two groups, the survival rate among those operated on between 1991 and 1994 (the last 22 patients is 91 % after 4

  12. 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

    Institute of Scientific and Technical Information of China (English)

    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

  13. Outcomes of Autologous Chondrocyte Implantation in the Knee following Failed Microfracture

    Science.gov (United States)

    Riff, Andrew Joseph; Yanke, Adam Blair; Tilton, Annemarie K.; Cole, Brian J.

    2016-01-01

    patellar anteromedialization, 9 patients underwent meniscal allograft, and 6 underwent realignment ostetomies (5 HTO, 1 DFO). Follow-up was available on 84 of 92 patients (91%) at an average length of follow-up of 47 months (range, 24-102 months). The control group of patients was well matched with regard to age, gender, BMI, workers compensation status, and preoperative subjective scores. Failure, defined by need for further cartilage restoration or knee arthroplasty, occurred in 8 patients (3 osteochondral allograft, 3 TKA, 1 revision ACI, 1 Denovo NT). Seventeen additional patients underwent reoperation for intra-articular debridement. There was no difference between the failure rate (8.7% v. 2.9%, p=0.21) or reoperation rate (27.2% v. 27.2%, p=0.98) in the study and control groups. For the study group, significant improvements were witnessed postoperatively for all measured questionairre parameters. No significant differences were witnessed between the study and control groups (p>0.05) with regard to any of the postoperative subjective parameters (Figure). Conclusion: In patients with discrete articular cartilage lesions of the knee and history of failed microfracture, ACI may render favorable clinical outcomes comparable to primary ACI. While other series have demonstrated inferior results following previous microfracture, our series suggests that in appropriately selected patients ACI may be used successfully as a second line treatment following failed microfracture.

  14. Tibial Tubercle Osteotomy for Anterior Knee Pain

    Science.gov (United States)

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

    2016-01-01

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

  15. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  16. 黄颡鱼(Pelteobagrus fulvidraco)鳃的超微结构研究%FINE STRUCTURE OF GILLS IN TELEOST (PELTEOBAGRUS FULVIDRACO)

    Institute of Scientific and Technical Information of China (English)

    罗芬; 陈礼强; 康斌

    2011-01-01

    应用光学和电子显微成像技术对黄颡鱼鳃的表面形态特征、鳃小片血管分布及其内部超微结构进行了观察。结果表明,黄颡鱼鳃耙呈长锥形,鳃弓表面具棘状小刺,鳃小片呈褶皱状,镶嵌排列在长条形鳃丝两侧。光镜可观察到鳃小片两侧红色的入鳃和出鳃动脉以及中部片状毛细血管网。鳃耙、鳃弓、鳃丝及鳃小片表面均被扁平上皮细胞覆盖,其表面微嵴形态结构各异。鳃弓和鳃丝表面有线粒体密集细胞和粘液细胞开口,鳃小片表面未发现分泌细胞开口但附着大量粘液。鳃小片主要由单层或数层上皮细胞和由支持细胞包裹的血管腔构成。线粒体密集细胞分布于鳃小片边缘和血管周围,可分为两个亚型。黄颡鱼鳃上皮细胞和线粒体密集细胞的超微结构特征与其相应的呼吸功能和体内离子转运、能量代谢生理功能相适应。%Using optical and electron microscopic imaging techniques, we studied the fine structure of gills in teleost (Pelteobagrus fulvidraco), including surface morphology, lamellar vascular distribution, and internal ultrastructure of gill iliamerit. The results showed that the prick-shaped gill rakers were presented on the anteromedial side of the arch opposite to the gill filaments, and abundant small spines were presented on the dorsal surface of the gill arch. Many gill lamellae were arranged on both sides of each filament, and interwove with each other. The red afferent filamental artery, the efferent filamental artery, and the capillary network of lamellae were clearly observed under an optical microscope. The gill rakers, gill arches, and branchial filaments were all covered by a layer of stratified epithelium, whereas distinct morphology of microridges were presented on the surface of pavement cells. In the stratified epithelium, the pillar cells, the mucous cells, the pavement cells, and the mitochon- dria-rich cells

  17. 关节镜下单束重建治疗前交叉韧带部分断裂的临床研究%Single-bundle augmentation technique in treatment of partial anterior cruciate ligament injury

    Institute of Scientific and Technical Information of China (English)

    谭平先; 叶淦湖; 侯之启; 王晋; 任绍东; 周国新

    2012-01-01

    目的 探讨关节镜下单束重建治疗前叉韧带部分断裂的临床疗效及手术方法.方法 回顾性分析2007年6月至2009年10月关节镜下应用单束重建治疗前叉韧带部分断裂12例患者的资料.12例患者中,男9例,女3例,平均年龄37岁.根据IKDC、Lysholm膝关节功能评分进行功能恢复评估.结果 12例患者平均随访13个月,所有患者术后均无感染.术后最后一次随访时Lachman试验(﹢)、前抽屉实验(-)2例,其他患者前抽屉试验、Lachman试验均为阴性.11例膝关节屈伸活动度正常,1例膝关节伸直缺失10°,IKDC评级:11例正常,1例接近正常.术前IKDC主观评分(48.33±12.77),Lysholm膝关节功能评分(55.42±15.01);术后末次随访IKDC主观评分(91.42±4.94),Lysholm膝关节功能评分(95.33±6.02),差异有统计学意义(P<0.01).结论 关节镜下单束单隧道重建治疗前叉韧带部分断裂的短期临床疗效满意,保留残存纤维束重建虽然有一定难度,但手术在熟练的关节镜技术下可以顺利施行.%Objective To investigate the surgical skills and short term clinical outcomes of arthroscopic single-bundle augmentation technique in treatment of partial cruciate ligament (ACL) injury. Methods From June 2007 to October 2009, 12 patients with partial curciate ligament injury were treated with single bundle reconstruction, preserving the intact ACL bundle as well. 10 cases underwent reconstruction with autologous hamstring ligament, and two cases with allogenic tendon. The International Knee Documentation Committee ( IKDC ) , Lysholm knee score and Lachman test were used to measure the knee function preoperatively and postoperatively. Results The ACL tear involved the anteromedial bundle ( AMB) in eight cases, and the posterolateral bundle (PLB) in four cases. The mean IKDC subjective evaluation scores were (48.33 ± 12.77) preoperatively and (91.42 ±4.94) at the last follow-up (P<0.01). The mean Lysholm knee scores were (55

  18. [The effect of central anatomical single-bundle versus anatomical double-bundle reconstruction of the anterior cruciate ligament on knee stability. a clinical study].

    Science.gov (United States)

    Komzák, M; Hart, R; Smíd, P; Puskeiler, M

    2014-01-01

    PURPOSE OF THE STUDY A comparison of the efficacy of central anatomical single-bundle (CASB) reconstruction with that of double-bundle (DB) repair of the anterior cruciate ligament (ACL) in relation to knee stability in anteroposterior translation (APT), internal rotation (IR) and external rotation (ER) of the joint. MATERIAL AND METHODS A total of 40 patients were evaluated; 20 had ACL reconstruction by the CASB technique using hamstrings and 20 underwent DB repair surgery. The average age was 31.3 years, and the group included 22 men and 18 women with 19 right and 21 left knees. The KT-1000 test was used to assess the amount of APT in the knee and rotational deviations were measured by the Rolimeter. In the DB patients, measurements were performed before surgery (on joints with ACL injury), then after reconstruction of the anteromedial (AM) or the posterolateral (PL) bundle and subsequently after repair of both ACL bundles. The CASB patients were assessed before and after graft insertion. RESULTS The average APT value was 18.5 mm for the pre-operative knees and it fell to 8.9 mm after AM bundle reconstruction. However, when the PL bundle was inserted in the first place, the average APT value was 13.1 mm only. The average values recorded after the DB and CASB reconstructions were 6.1 mm and 9.1 mm, respectively. The average IR range of motion in the pre-operative joints was 18.6 degrees. After AM bundle reconstruction it was 13.9 degrees and after PL bundle repair it was 15.3 degrees. In DB reconstruction the average IR value achieved 10.4 degrees, and in CASB repair surgery it was 13.7 degrees. The average ER range of motion in the pre-operative joints was 17.8 degrees. After AM bundle reconstruction it was 14.5 degrees and after PL bundle repair it was 14.9 degrees. In DB reconstruction the average ER value achieved 11.4 degrees, and in CASB repair surgery it was 14.5 degrees. DISCUSSION Rotational stability of the knee after ACL reconstruction is one of the

  19. 后外侧入路钢板固定治疗后踝骨折的临床疗效分析%Clinical efficiency of posterior malleolus fractures by plate fixation via the posterolateral approach

    Institute of Scientific and Technical Information of China (English)

    叶书熙; 杨成亮; 熊然; 王华; 李涛; 韩卫雨; 樊仕才

    2013-01-01

    Objective To study the role of the anteromedial bundle ( AMB) and posterolateral bundle (PLB) of the anterior cruciate ligament ( ACL) in maintaining knee joint stability. Methods In this study,12 fresh-frozen human cadaveric knees were tested under two kinds of external loading conditions including a 100N anterior tibial load with the knee at 0°,15° ,30° ,60°and 90°of flexion; and a 5Nm pronation load with the knee at 0° , 15°and 30° of flexion. The two bunches of ligament were pulled tight that led the strain gauge to deformation, and changed output voltage value. Results In response to a 100N anterior tibial load,the situ force in the AMB was significantly greater at 60°and 90°than at full extension and 15°of flexion(P 0. 05) . Conclusion Though the AMB plays an important role in the ACL,the role of PLB should, not be ignored, in maintaining anterior and internal rotational stability at low flexion angles.%目的 探讨后外侧入路钢板固定后踝骨折的手术方法及临床疗效.方法 2008年5月~2012年3月,采用后外侧入路钢板固定治疗后踝骨折37例.根据Lauge-Hansen踝关节骨折分型,旋后外旋型23例,旋前外展型6例,旋前外旋型8例.术后定期门诊随访,观察骨折愈合及踝关节功能情况.结果 本组患者手术时间为63~105min,平均82.0min;所有患者均获随访,随访时间13~17个月,平均14.5个月.所有患者切口均Ⅰ期愈合,X线片检查示所有骨折均获骨性愈合,随访期间未见内固定物移位、松动或断裂;末次随访时,踝关节功能根据Phillips踝关节评分标准,本组评分为110~150分,平均141.0分;获优21例、良好11例、一般3例、差2例;优良率为86.5%.结论 采用后外侧入路钢板固定治疗后踝骨折,创伤小,手术显露清晰,可直接地精确复位关节面,并进行稳定固定.

  20. Posterior lumbar interbody fusion using one diagonal fusion cage with transpedicular screw/rod fixation.

    Science.gov (United States)

    Zhao, Jie; Hou, Tiesheng; Wang, Xinwei; Ma, Shengzhong

    2003-04-01

    Posterior lumbar interbody fusion (PLIF) using threaded cages has gained wide popularity for lumbosacral spinal disease. Our biomechanical tests showed that PLIF using a single diagonal cage with unilateral facetectomy does add a little to spinal stability and provides equal or even higher postoperative stability than PLIF using two posterior cages with bilateral facetectomy. Studies also demonstrated that cages placed using a posterior approach did not cause the same increase in spinal stiffness seen with pedicle screw instrumentation, and we concluded that cages should not be used posteriorly without other forms of fixation. On the other hand, placement of two cages using a posterior approach does have the disadvantage of risk to the bilateral nerve roots. We therefore performed a prospective study to determine whether PLIF can be accomplished by utilizing a single diagonal fusion cage with the application of supplemental transpedicular screw/rod instrumentation. Twenty-seven patients underwent a PLIF using one single fusion cage (BAK, Sulzer Spine-Tech, Minneapolis, MN, USA) inserted posterolaterally and oriented anteromedially on the symptomatic side with unilateral facetectomy and at the same level supplemental fixation with a transpedicular screw/rod system. The internal fixation systems included 12 SOCON spinal systems (Aesculap AG, Germany) and 15 TSRH spinal systems (Medtronic Sofamor Danek, USA). The inclusion criteria were grade 1 to 2 lumbar isthmic spondylolisthesis, lumbar degenerative spondylolisthesis, and recurrent lumbar disc herniations with instability. Patients had at least 1 year of low back pain and/or unilateral sciatica and a severely restricted functional ability in individuals aged 28-55 years. Patients with more than grade 2 spondylolisthesis or adjacent-level degeneration were excluded from the study. Patients were clinically assessed prior to surgery by an independent assessor; they were then reassessed at 1, 3, 6, 12, 18, and 24

  1. 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

    Directory of Open Access Journals (Sweden)

    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

  2. 孕妇血清叶酸和维生素B12水平与子代神经管畸形发生的关系%Maternal serum level of vitamin B12 and folate and the risk of fetal neural nube defects

    Institute of Scientific and Technical Information of China (English)

    谢华; 任玉秀; 梁晋魁; 赵莉

    2010-01-01

    vitamin B12 and folate levels were detected compared with the control group. While, in those complicated with anencephaly, only lower levels of maternal folate were shown. There was no statistical significance in maternal serum concentrations of vitamin B12 and folate between those cases with encephalocele and controls. Higher risk of NTDs were found in pregnant women with lower level of vitamin B12 and folate (AOR = 2. 58, 95% CI: 1. 20-5. 51; AOR= 2. 76, 95%CI: 1. 30-5. 87). Conclusions Deficiency or insufficiency of folate or vitamin B12 is associated with the increased risk of NTD, especially in high risk population.

  3. 青龙满族自治县围产儿出生缺陷情况分析及对策研究

    Institute of Scientific and Technical Information of China (English)

    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

  4. A clinical investigation of the mechanism of growing skull fractures in children%儿童颅骨生长性骨折的机制再探讨及早期手术

    Institute of Scientific and Technical Information of China (English)

    鲍南; 徐织; 杨波; 宋云海; 陈成

    2012-01-01

    Objective Many theories have been offered to explain growing skull fractures (GSFs),such as dural tears,arachnoid herniation,increased intracranial pressure,bone absorption due to the ischemia of the fracture line,and delayed or ceased bone growth.These theories,however,are limited by certain inadequacies.In this prospective study,we sought to uncover the mechanisms of GSFs,and their treatment method in children.Methods Ten patients with GSFs who received treatment at our hospital between November 2000 and June 2010 were retrospectively analyzed.The age at injury,duration from the time of injury to the appearance of the GSFs,fracture width,and imaging characteristics were analyzed.Cranioplasty was carried out,while duraplasty was not performed.Results The age at injury ranged from 2 to 21 months,and the age at surgery ranged from 3 to 5 years.The injuries included 7 fail injuries and 3 automobile collision injuries.All were linear skull fractures.The duration from the time of injury to the appearance of a GSFs was < 1 month in 4 cases and < 2 months in 6 cases.Six patients had frontal bone fractures,2 had parietal bone fractures,and 2 had occipital bone fractures.The fracture width ranged from 1.5 to 2.5 cm.The growing fractures became stationary just after the onset,without further progression.Computed tomography (CT) revealed 4 cases of encephalocele underneath the fracture and 6 cases of encephalomalacia due to brain contusion.Follow - up ranged from 1 to 7 years.Titanium plate fixation was stable,without loosening or displacement.There were no skull deformities in any patient.Conclusion GSFs usually occur in young children.The dural tear and the rapid growth of the brain in young children produce an outward expansion force,which plays a crucial role in GSFs development.It is possible that the current theories such as arachnoid herniation,increased intracranial pressure,bone absorption due to ischemia of the fracture line,and delayed or ceased bone growth

  5. 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

    Institute of Scientific and Technical Information of China (English)

    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

  6. 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

    Institute of Scientific and Technical Information of China (English)

    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

  7. Radial interlocking intramedullary nailing fixation and anatomical characteristics of the deep branch of the radial nerves%桡骨交锁钉固定与桡神经深支相关的解剖学特点

    Institute of Scientific and Technical Information of China (English)

    言湛军; 郑祖根; 董启榕

    2009-01-01

    interlocking screw at 1.5 cm lower the articular surface of radial head from the posterolateral to anteromedial approach should be selected.%背景:交锁髓内钉在治疗桡骨多段骨折、骨不连、骨质疏松性骨折上显示独特的优越性,但置入远端锁钉可能会损伤桡神经深支.目的:对桡神经深支与交锁钉内固定时的相关解剖进行分析.设计、时间及地点:观察测量实验,于2002-11/12在苏州大学附属第二医院骨科实验室完成.材料:成人前臂尸体标本44侧由苏州大学解剖教研室提供.游标卡尺由振华教学仪器厂生产.方法:前臂标本44侧解剖显露桡神经深支,将肱骨外上髁与Lister结节连线和桡骨头关节面凹,关节面凹下1.0,1.5,2.0cm,桡神经深支穿入旋后肌平面,桡神经深支跨越桡骨平面等6个面的交点,依次标记为A,B,C,D,E,F 6个点.主要观察指标:测量关节面凹下1.0,1.5,2.0 cm 3个定点在屈肘前臂旋前、中立、旋后位与桡神经深支的水平距离.结果:关节面凹下1.0,1.5,2.0cm 3个定点离桡神经深支的距离依次减小;进钉点选定后,在前臂按旋前、中立、旋后位顺序依次变化时,进钉点离桡神经深支的距离越来越远.结论:桡骨交锁髓内钉固定时,宜于屈肘前臂中立位,在肱骨外上髁与Lister结节连线上,距桡骨头关节面凹约1.5 cm的位置,由前臂后外侧向前内侧插入远端交锁螺丝钉较为安全.

  8. Diagnosis and treatment of elbow varus posteromedial rotational instability%肘关节内翻-后内侧旋转不稳定的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    蒋协远; 查晔军; 公茂琪; 刘兴华; 张力丹; 高志强; 王满宜

    2012-01-01

    Objective To report the early surgical outcomes of treating elbow varus posteromedial rotational instability (EVPRI),a pattern of traumatic elbow instability which has been recently described but incompletely understood. Methods From December 2009 to April 2011,11 male patients with an EVPRI pattern were surgically treated in our hospital.Their average age was 33.8 (from 22 to 40) years.They had 4 left and 7 right elbows affected.All had tenderness at the medial and lateral sides of the elbow and varus angulation of the elbow without dislocation.Their preoperative stress view X-rays and CT scans showed widened humeroradial joint space and fracture of the anteromedial facet of the coronoid process.We confirmed the diagnosis by applying yarus,pronated and axial stresses onto the forearm to evoke elbow dislocation,under fluoroscopy after anesthesia.In the initial operative treatment,the coronoid was repaired with a plate and K-wires applied to the medial surface of the coronoid,and a hinged external fixator was applied at the lateral side without repairing the lateral collateral ligament.Early rehabilitation was encouraged. Results All were followed up for an average of 14.4 (from 6 to 26) months.Each obtained an excellent result according to the Mayo Elbow Performance Index and recovered excellent elbow function.The average flexion was 137.8° ± 4.4° (from 130°to 140°), average extension 5.6°±7.3° (from 0 to 20°), average range of extension-flexion 132.2°±9.7° (from 120° to 140°),average pronation 87.8°±6.7° (from 70° to 90°),average supination 88.9° ± 3.3° (from 80° to 90°),and average range of rotation 176.7° ± 10.0° (from 150° to 180°).No complications such as varus subluxation of the elbow,infection and arthrosis occurred in this group. Conclusions Since EVPRI is a distinct type of elbow fracture-dislocation that must be recognized and adequately treated to restore good elbow function,inadequate or conservative treatment may cause

  9. Anatomy of anterolateral portals of elbow arthroscopy%肘关节镜前外侧入路的解剖学研究

    Institute of Scientific and Technical Information of China (English)

    吴关; 鲁谊

    2016-01-01

    anterior position than the conventional approach, or we delivered implants at a more anterior position than the conventional approach to perform fracture fixation.Our findings are reported below.Methods Ten fresh upper limb specimens were selected, all males,mean age 58 years (43 to 78 years),all elbow joints free of external deformities,surgical scars or mobility limitation.Study tools included anatomical instruments (scalpel,forceps,scissors, toothed forceps etc.),4 mm diameter Steinmann pins,20 ml disposable syringes,18-Gauge epidural needles,and vernier caliper (accuracy of 0.1 mm).Surgical procedure:flex the elbow at 90°,fix the upper arm on operation table,mark important anatomical landmarks individually including epicondyle of the humerus and radial head etc., mark the sites of conventional lateral elbow arthroscopic approach and experimental (improved ) lateral elbow arthroscopic approach. Choose of the conventional approach was in accordance with previous literatures,and improved approach was 5 mm anterior to the conventional approach. Conventional approaches included proximal anterolateral approach (2 cm proximal and 1 cm anterior to the humeral epicondyle),anterolateral approach (1 cm anterior to the humeral epicondyle),and lateral approach (3 cm distal and 1 cm anterior to the humeral epicondyle ). A 18-Gauge epidural needle was used for puncture via the anteromedial approach,inject normal saline into the joint to expand articular capsule,make a small incision on the previously marked 3 conventional approach sites and 3 experimental approach sites, expand subcutaneous tissues using straight forceps.Under 90° elbow flexion or forearm at neutral position respectively,insert a 4 mm diameter Steinmann pin into center of the joint,remove all skin and subcutaneous tissues of lower 1/3 upper arm and upper 1/3 forearm to dissect the radial nerve.Under 90°elbow flexion position,the shortest distance between the radial nerve and adjacent Steinmann pin was measured

  10. 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

  11. Efficacy and safety of "Five-Sequential-Portal Method" in elbow arthroscopy%肘关节镜"序贯五入路法"的有效性与安全性分析

    Institute of Scientific and Technical Information of China (English)

    汪华清; 唐康来; 龚继承; 谭晓康; 许建中

    2008-01-01

    into the "soft spot" to make the first portal. The second portal was established anterolaterally under the arthroscopy in the first portal. The third portal was established an-teromedially through the second portal, passing the coronoid process, to make the incision of skin by the in-side-out technique. The forth and the fifth portals were established posterolaterally and postcromcdially on both sides of the triceps tendon. The joint was explored in sequence and an etiotropic procedure was taken. After surgery, rehabilitation exercises were performed under algesia controller. The Mayo elbow-performance indexes before and after surgery were compared. Results In this group, 46 patients were followed up for 6 to 34 (average, 11.65) months. The preoperative Mayo elbow-performance indexes ranged from 45 to 85 (average, 66.8±11.5) points. Fourteen cases were rated as good, 21 fair, and 11 poor. The postoperative Mayo el-bow-performance indexes ranged from 55 to 100 (average, 84.5±10.5) points. Sixteen cases were rated as excellent, 21 good, 8 fair, and 1 poor. Two patients had transient nerve palsy, involving one ulnar nerve and one deep branch of the radial nerve, but recovered in 3 months. Condusions Our "Five-Sequential-Portal Method" can ensure satisfactory exposure and clear view in elbow arthroseopy. The portals are safe, leading to low incidence of postoperative complications. It is recommendable in clinic.

  12. 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

    Institute of Scientific and Technical Information of China (English)

    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

  13. Surgical treatment of postoperative deep wound infection after posterior lumbar interlumbar fusion of the lumbar stenosis%腰椎管狭窄症椎体间植骨融合术后急性切口深部感染的处理

    Institute of Scientific and Technical Information of China (English)

    王兆红; 吴德慧; 马超; 戴维享

    2012-01-01

    Objective;To evaluate the clinical effects of double-bundle reconstruction of anterior cruciate ligament (ACL) using hamstring tendon auto graft under arthroscopy. Methods: From April 2009 to March 2010 ,25 patients (13 males and 12 females) with ACL deficiency were treated with arthroscopy,ranging in age from 17 to 43 years,with an average of 25.8 years. There were 17 patients caused by sports injuries,6 patients caused by accidental falling,and 2 patients caused by traffic injury. The average duration of the disease was 3 months. The main symptom was knee instability in 8 patients,and knee pain and swelling in other patients. Pivot shift test was positive in 15 cases,and Lachman test was positive in 25 cases,the ADT (anterior drawer test) was positive in 25 cases. The anterior transition of the tibia measured by KT2000 instrument was (7.1 ±2.4) mm more than the contralateral knee. The average Lysholm score was 40.0±5.4. The Tegner activity scores averaged 3.2+0.7. The double tibial tunnels and double femoral tunnels were drilled on the footprint of the ACL to reconstruct the anteromedial and posterolateral bundles under arthroscopy. Tendons were fixed with Endo-buttons at the femoral side and with biodegradable interference screw at the tibial side. Postoperative symptoms and signs were observed during follow-up period. The anterior transition of the tibia was measured by KT2000,and the Lysholm score and Tegner scores were used for evaluating knee function. Statistically analyzed was performed with SPSS 15.0. Results:All the patients were followed up,and the duration ranged trom 24 to 35 months (averaged,27 months).At the latest follow-up,there was no positive pivot shift,while the Lachman test and ADT were negative or positive of grade I. The average Lysholm score of the 25 cases was 40.0±5.4 before operation, and 85.0± 4.5 at the latest follow-up,3.2±0.7 before operation and 7.5±0.2 at the latest follow-up for Tegner activity score. Statistically, the

  14. Repairing ankle lateral collateral ligament chronic injury using different methods:A stability assessment%不同方法修复踝关节外侧副韧带慢性损伤的稳定性评价☆

    Institute of Scientific and Technical Information of China (English)

    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.%

  15. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  16. 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

    Institute of Scientific and Technical Information of China (English)

    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

  17. Perforator-based chimeric anterolateral thigh flap for head and neck reconstruction after en bloc resection%股前外侧穿支嵌合皮瓣修复头颈肿瘤根治术后缺损

    Institute of Scientific and Technical Information of China (English)

    徐中飞; 代炜; 张恩礁; 段维轶; 刘法昱; 谭学新; 黄绍辉; 秦兴军; 孙长伏

    2012-01-01

    PURPOSE; To discuss and report the operative techniques for harvesting perforator-based chimeric flap in anterolateral thigh region and the advantages for head and neck reconstruction after en bloc resection. METHODS: A retrospective review was performed of perforator -based chimeric anterolateral thigh (ALT)flap for head and neck reconstruction since December of 2007 to March of 2011. 66 perforator-based chimeric flaps were harvested including a skin paddle and a muscular flap supplied by one mother pedicle-descending branch of lateral circumflex femoral artery(d- LCFA). 32 flaps were used for the mobile tongue and floor of mouth reconstruction, 30 flaps for base of the tongue and parapharyngeal walls, two for the buccal skin, one for hemimandible and one for parotid. The muscular flap were used to eliminate the dead space of submandibular area. Flaps size ranged from 7cmx4cm to 16cmx7cm and muscular flap was 3cm x4cm approximately. The complications and functions of both donor and recipient sites were recorded and the operative techniques of perforator-based chimeric flap elevation were generalized. RESULTS: All 65 flaps survived completely and the total survival percentage was 98.5%. Only one flap failed and was removed 5 days postoperatively. No complications (fistula, infection, hematoma, seroma et al) were observed in recipient and donor sites. Two anteromedial thigh flaps (AMT) were used for reconstruction due to no sizable perforators in the ALT region. All cases were followed up for 0.5-3 years. The flaps didn't atrophy after six months and the contour was satisfactory. The functions of speech and swallow were recovered well. All the donor sites were closed primarily and the scar was not obvious. The leg's function recovered well. CONCLUSIONS: Using a combination of retrograde and antegrade dissection is a safe and versatile method for harvesting a perforator-based chimeric flap. A chimeric flap including multiple components can meet therequirements of

  18. Wide resection and knee joint reconstruction for malignant tumors of the proximal tibia%胫骨上端恶性骨肿瘤广泛切除与重建

    Institute of Scientific and Technical Information of China (English)

    杨志平; 杨强; 李昕; 李振峰; 李建民

    2011-01-01

    bone tumors of proximal tibia,27 males and 18 females,28 years in average (range, 12 -62 years). The tumors,including 25 osteosarcomas,7 malignant giant cell tumors,6 chondrosarcomas,3 malignant fibrous histiocytomas,3 fibrosarcomas and 1 lymphoma were treated with wide resection which performed through anteromedial incision in 30 cases and anterolateral incision in 15. The superior tibiofibuiar joints were involved and the proximal tibia resected en bloc in 13. Two knee joints were involved and extraarticuler resection were performed. Partial tumorous bone was devitalized and replanted in 5 cases and the anterior tibial vessels were ligated in 28. The involved knee joints were reconstructed with domestic-made prostheses and soft tissue coverage was improved by medial or lateral gastrocnemius flap and sagittal split anterior tibial muscle flap in some patients which tibia was removed longer. Neoadjuvant chemotherapy were performed to the patients with osteosarcoma and malignant fibrous histiocytoma. [ Result] With an average follow-up of 4.6 years ( range,8 months -9 years ),local recurrences occurred in four cases and lung metastases in six cases. One patients with malignant fibrous histiocytoma of proximal tibia had metastasis to L* after 6 years postoperatively and was treated with total en bloc spondylectomy. The complications related to the prostheses included peri-prosthetic infection in 3, prosthetic dis-location in 3, prosthesis loosening in 2, peri-prosthesis fracturein 1 and prosthetic fracture in 1. The average range of motion were 92 degrees (50 - 120 degrees) with the 4.4 degrees (0 - 20 degrees) of average extension lag. According to the Musculoskeletal Tumor Society ( MSTS ) Scoring system, the average functional score was 76.7%. [ Conclusion ] Wide resection and reconstruction for malignant tumor of proximal tib-la I- highly demanding. To achieve the goal of Limb salvage and _■■?." function, il is necessary to employ standard reseolion lech

  19. Arthroscopic fixation in the treatment of Rockwood Ⅴ acute acromioclavicular joint dislocation%关节镜下四骨道双束固定治疗急性肩锁关节Rockwood Ⅴ型脱位

    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

    coracoid neck is the center between the two preparatively drilled bone tunnels.Make the cross line vertical to line P,and the bone tunnels are located in the I and II quadrant.The distance between two bone tunnels is 6 mm.(3 )Surgical techniques:According to the data of preoperative measurement of bone tunnel,the self-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

  20. 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

  1. 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