WorldWideScience

Sample records for arteria descendente anterior

  1. Implante de stents farmacológicos na artéria descendente anterior: indicadores de eventos tardios Implante de Stents farmacológicos en la arteria descendente anterior: indicadores de eventos tardíos Pharmacological stent deployment in the left anterior descending artery: late event indicators

    Directory of Open Access Journals (Sweden)

    Marcelo de Freitas Santos

    2009-01-01

    ógicos en las lesiones ateroscleróticas de la arteria descendente anterior e identificar, entre las características clínicas, angiográficas y de ultrasonido intravascular, cuales son las que permiten predecir riesgos de eventos cardiacos MÉTODOS: De mayo de 2002 a agosto de 2005, se trataron a 205 pacientes con implante de 236 stents farmacológicos guiados por ultrasonido intravascular. RESULTADOS: Con un seguimiento promedio de 711 días, la tasa de trombosis del stent fue del 0,48%, la misma que se observó para infarto agudo de miocardio o cirugía de revascularización. La tasa de revascularización de la lesión tratada fue del 7,31% y la tasa global de eventos fue del 10,24%. Los indicadores de eventos, conforme análisis multivariada, fueron el implante de más de un stent en la misma arteria, lesiones concéntricas y área mínima intrastent medida por el ultrasonido intravascular menor que 3,88 mm². CONCLUSIÓN: Tomando como base los datos obtenidos con esta investigación, concluimos que la revascularización de la arteria descendente anterior con implante de stents farmacológicos, elegidos y optimizados por el ultrasonido intravascular, presenta un bajo índice de eventos tardíos. El implante de dos stents farmacológicos para el tratamiento de las lesiones largas fue el principal factor independiente para la ocurrencia de eventos tardíos. El área luminal final mayor que 3,88 mm², obtenida en los segmentos de pequeños diámetros de referencia es un indicador independiente de evolución libre de eventos.BACKGROUND: The efficacy of pharmacological stents in decreasing the incidence of cardiac events is not homogeneous for all lesions or patient subgroups. OBJECTIVE: 1 To evaluate the late clinical evolution of patients submitted to pharmacological stent implantation in atherosclerotic lesions of the left anterior descending artery; 2 to identify, among the clinical, angiographic and intravascular ultrasonographic characteristics, the ones predictive of

  2. Disección de arterias coronarias asociada con el consumo de cocaína

    OpenAIRE

    Guillermo Marchetti; Juan Arellano; Flavio Salvaggio; Luis Gariglio; Gabriel Pérez Baztarrica; Alejandro Botbol; Rafael Porcile

    2008-01-01

    La disección espontánea de arterias coronarias es en extremo rara y escasamente documentada en la bibliografía mundial. Una de las causas en pacientes jóvenes es la adicción a la cocaína. Se presenta el caso de un paciente con historia de consumo reciente de cocaína que ingresa derivado por infarto de miocardio para cinecoronariografía y angioplastia. En la cinecoronariografía se evidencia una disección espontánea de la arteria descendente anterior con flujo TIMI III. Debido al contexto clíni...

  3. Diagnóstico y tratamiento de los aneurismas saculares de la arteria cerebral anterior

    Directory of Open Access Journals (Sweden)

    Raúl F. Matera

    1956-12-01

    Full Text Available Hacemos un estudio anátomo-funcional de la arteria cerebral anterior recalcando la importancia que tiene la ligadura de esta arteria. Sintetizamos la patogenia de los aneurismas en cuatro hechos fundamentales: los aneurismas vestigiales originados en brotes vasculares no desarrollados o que no han involucionado normalmente; la falta de desarrollo de la túnica elástica en la zona de bifurcación de los grandes vasos; la arterioesclerosis; los procesos inflamatorios de la túnica media (sífilis y micosis. Hacemos un estudio clínico de los aneurismas del complejo cerebral-comunicante anterior, llamando la atención sobre aquellos en los que, a las hemorragias subaracnoidales, se asocian manifestaciones en el fondo de ojo, trastornos psíquicos y fenómenos motores. Llamamos la atención sobre las formas pseudo-tumorales quiasmáticas y los denominados aneurismas trombosantes que originan el síndrome progresivo fronto-cíngulo-calloso. Estudiamos la radiología simple de los aneurismas de esta región, llamando la atención sobre las calcificaciones cirsoideas suprasellares y los fenómenos de erosión de la silla turca. Llamamos la atención sobre la importancia de la arteriografía para confirmar el diagnóstico, estudiar la circulación colateral, el tamaño, la forma y el pedículo del aneurisma, elementos fundamentales para el plan operatório. En el tratamiento quirúrgico descartamos, por ineficaz, la ligadura de la carótida interna en el cuello. Es fundamental el abordaje intracraneano por vía subfrontal en los aneurismas de la porción précomunicante y comunicante con desarrollo hacia abajo, mientras que, la via sagital-frontal se utilizará en los aneurismas de desarrollo hacia arriba ya sea de la comunicante o de la porción distal de la arteria cerebral anterior o sus ramas. Insistimos sobre un hecho muy importante cual es la anestesia y, en especial, el uso de la hipotensión controlada, insistiendo de que la tensión se

  4. Disección de arterias coronarias asociada con el consumo de cocaína

    Directory of Open Access Journals (Sweden)

    Guillermo Marchetti

    2008-01-01

    Full Text Available La disección espontánea de arterias coronarias es en extremo rara y escasamente documentada en la bibliografía mundial. Una de las causas en pacientes jóvenes es la adicción a la cocaína. Se presenta el caso de un paciente con historia de consumo reciente de cocaína que ingresa derivado por infarto de miocardio para cinecoronariografía y angioplastia. En la cinecoronariografía se evidencia una disección espontánea de la arteria descendente anterior con flujo TIMI III. Debido al contexto clínico del paciente se decide tratamiento farmacológico (aspirina, clopidogrel, heparina de bajo peso molecular y nitritos, entre otros y nuevo estudio en 7 días, que evidenció la resolución de la disección del vaso.

  5. O acometimento isquêmico obstrutivo na cardiomiopatia hipertrófica do tipo septal assimétrico com envolvimento da artéria descendente anterior

    Directory of Open Access Journals (Sweden)

    Albanesi Fº Francisco Manes

    1997-01-01

    Full Text Available OBJETIVO: Avaliar o papel da doença arterial coronária (DAC com comprometimento da artéria descendente anterior (ADA na cardiomiopatia hipertrófica (CMH e sua repercussão na evolução, visto ser controverso o significado da necrose e fibrose do septo interventricular (SIV nesta cardiomiopatia. MÉTODOS: Entre 158 pacientes com CMH, selecionamos 6 (3,79% com CMH e DAC com lesão obrigatória de ADA, sendo 4 homens, entre 52 e 70 (x= 65,16 nos, 4 com a forma obstrutiva da CMH. O tempo de diagnóstico da CMH foi de 78 a 182 (x=141 meses e da DAC de 1 dia a 106 (x= 42 meses. Os pacientes foram acompanhados com avaliações clínicas e exames complementares periódicos. RESULTADOS: A forma de apresentação da DAC foi em 5 com angina instável e um com infarto do miocárdio. A ADA estava comprometida entre 60 a 100%, sendo em um lesão única e nos 5 restantes com lesão em 2 ou mais vasos. Na evolução, 3 foram submetidos a revascularização miocárdica (RM, um associada a miomectomia septal, um a angioplastia e 2 somente a tratamento clínico. No período de observação de 76 a 124 meses após o diagnóstico da DAC, ocorreu um óbito. No fim do estudo observamos redução nos valores médios do SIV de 1,53 para 1,40cm, gradiente de pressão entre o corpo e a via de saída do ventrículo esquerdo (VE de 56 para 15,75mmHg, com discreto aumento no diâmetro diastólico do VE de 4,55 para 4,85cm e do diâmetro sistólico de 2,83 para 3,13cm, sem alterar a dimensão do átrio esquerdo (4,13cm. CONCLUSÃO: A DAC da ADA é bem tolerada na CMH septal assimétrica, participando do processo fibrótico septal e melhorando o desempenho cardíaco, não representando problema adverso na evolução da CMH.

  6. Estudio de la afectación del ventrículo derecho en el infarto anterior reperfundido

    OpenAIRE

    Rumiz González, Eva

    2015-01-01

    La afectación del ventrículo derecho (VD) en el seno de un infarto agudo de miocardio de localización inferior, es de sobra conocida. Sin embargo, la vascularización de la cara anterior del VD depende de ramas de la arteria descendente anterior (ADA), siendo escasos los trabajos que estudian la afectación del VD que se produce durante un infarto agudo de miocardio de localización anterior. Evaluamos la afectación del VD que se produce tras la oclusión del ADA en un grupo experimental de 9 cer...

  7. Cerebellar infarction in vascular territory of arteria cerebelli superior

    Directory of Open Access Journals (Sweden)

    Savić Dejan

    2010-01-01

    Full Text Available Introduction. Cerebellar vascular diseases are focal cerebrovascular diseases in posterior circulation - vertebrobasilar system. The cerebellum is supplied by three main arteries arising from the vertebrobasilar system: arteria cerebelli inferior posterior, arteria cerebelli inferior anterior and arteria cerebelli superior. Cerebelar infarctions are rare but unpredictable disorders. The aim of this study was determination of main risk factors, clinical presentation and prognosis of the cerebellar infarctions in distal vascular territory of the arteria cerebelli superior. Material and methods. We evaluated 60 patients hospitalized after acute cerebellar infarction among other hospitalized patients in five year period. In 18 patients computerized tomography demonstrated infarction in distal vascular territory of the arteria cerebelli superior. All patients underwent clinical and other diagnostic investigations (computerized tomography, electrocardyography and standard blood tests and were questioned by phone after finishing hospital treatment. Results. Cerebellar infarcts in distal vascular territory of arteria cerebeli superior was 30% of all cerebellar infarcts. The most frequent risk factor was hypertension (66. 7%. Symptomatology and clinical signs were heterogenous but the most frequent were instability (77.8%, vertigo (72.2% and vomiting (55.6% followed by ataxia of the limbs (77.8% and the body (61.1%, nystagmus (55.6% and disarthria (33.3% in clinical presentation. All patients had good recovery in hospital and one year afterwards. Discussion. Infarctions in distribution of arteria cerebelli superior are rare and have multiple risk factors and various clinical features in majority of other studies as in this one. Mass effects are present in several studies but none in this one which reflects contraversions present in other published investigations. Conclusion. Cerebellar infarctions in vascular territory of arteria cerebelli superior have

  8. Historia natural de la oclusión aguda de gran arteria de la circulación cerebral anterior : serie clínica de 120 pacientes.

    OpenAIRE

    Hernández Pérez, María; Dàvalos Errando, Antoni; Escudero Rubí, Domingo

    2012-01-01

    : Para estudiar la historia natural del ictus isquémico por oclusión de gran vaso de la circulación anterior se seleccionó una muestra prospectiva de pacientes con ictus agudo que no recibieron terapias de reperfusión en los que se confirmó una oclusión de gran vaso de la circulación anterior mediante Dúplex transcraneal. El 74% de los pacientes tuvo mal pronóstico. Los pacientes con oclusión de la a.carótida interna terminal y de la a.cerebral media proximal tuvieron peor pronóstico funciona...

  9. Valoración mediante TC multidetector de las variantes anatómicas en las arterias coronarias.

    Directory of Open Access Journals (Sweden)

    Silvana Sarria

    2009-11-01

    Full Text Available Objetivos: El objetivo de este estudio es mostrar que el TC multidetector es un método útil para valorar las anomalías de las arterias coronarias, pues ofrece una visión tridimensional, identifica orígenes anómalos y curso anatómico en relación con los grandes vasos, y se convierte así en una herramienta eficaz con la que pueden contar el cardiólogo, el hemodinamista o el cirujano de corazón para planear un procedimiento intervencionista. Metodología: Se revisaron retrospectivamente 1180 estudios coronarios con TC multidetector realizados durante el período de noviembre 1 de 2002 a abril 30 de 2006, evaluándose el origen, forma del ostium y recorrido de las arterias coronarias. Hallazgos: Se detectaron 26 (2.2% pacientes con anormalidades anatómicas de las arterias coronarias, 14 hombres y 12 mujeres, con una edad promedio de 60 años, 23 (88.46% de estos pacientes fueron remitidos para valoración por dolor torácico y sospecha de evento coronario agudo. Entre las anormalidades anatómicas de las arterias coronarias se encontraron: ausencia de tronco izquierdo, (4; dos arterias coronarias derechas con ostium individual, (1; arteria circunfleja con origen en seno derecho, (2; y trayecto retrocardiaco, (1; duplicación de vasos, (6; nacimiento anterior de la arteria coronaria derecha, (1; arteria coronaria derecha con origen en el seno de Valsalva izquierdo y trayecto interarterial, (4; puente intramiocárdico, (3; salida retroaórtica de la arteria circunfleja, (1; salida de los tres vasos del seno coronario derecho, (1; ostium alto de la arteria coronaria derecha, (1; fístula arteriovenosa, (1; y rama de la arteria mamaria derecha a la primera diagonal, (1. Conclusión: El TC multidetector ofrece una clara visualización del origen y curso de las arterias coronarias anómalas con una visión anatómica en tercera dimensión que no es posible determinar con angiografía convencional y es especialmente útil para determinar la

  10. Valoración mediante TC multidetector de las variantes anatómicas en las arterias coronarias

    Directory of Open Access Journals (Sweden)

    Silvana Sarria

    2007-09-01

    Full Text Available Objetivos: El objetivo de este estudio es mostrar que el TC multidetector es un método útil para valorar las anomalías de las arterias coronarias, pues ofrece una visión tridimensional, identifica orígenes anómalos y curso anatómico en relación con los grandes vasos, y se convierte así en una herramienta eficaz con la que pueden contar el cardiólogo, el hemodinamista o el cirujano de corazón para planear un procedimiento intervencionista.Metodología: Se revisaron retrospectivamente 1180 estudios coronarios con TC multidetector realizados durante el período de noviembre 1 de 2002 a abril 30 de 2006, evaluándose el origen, forma del ostium y recorrido de las arterias coronarias. Hallazgos: Se detectaron 26 (2.2% pacientes con anormalidades anatómicas de las arterias coronarias, 14 hombres y 12 mujeres, con una edad promedio de 60 años, 23 (88.46% de estos pacientes fueron remitidos para valoración por dolor torácico y sospecha de evento coronario agudo. Entre las anormalidades anatómicas de las arterias coronarias se encontraron: ausencia de tronco izquierdo, (4; dos arterias coronarias derechas con ostium individual, (1; arteria circunfleja con origen en seno derecho, (2; y trayecto retrocardiaco, (1; duplicación de vasos, (6; nacimiento anterior de la arteria coronaria derecha, (1; arteria coronaria derecha con origen en el seno de Valsalva izquierdo y trayecto interarterial, (4; puente intramiocárdico, (3; salida retroaórtica de la arteria circunfleja, (1; salida de los tres vasos del seno coronario derecho, (1; ostium alto de la arteria coronaria derecha, (1; fístula arteriovenosa, (1; y rama de la arteria mamaria derecha a la primera diagonal, (1. Conclusión: El TC multidetector ofrece una clara visualización del origen y curso de las arterias coronarias anómalas con una visión anatómica en tercera dimensión que no es posible determinar con angiografía convencional y es especialmente útil para determinar la

  11. Angiotomografia coronariana multislice na avaliação da origem anômala das artérias coronarianas Angiotomografía coronaria multislice en la evaluación del origen anómalo de las arterias coronarias Multislice coronary angiotomography in the assessment of coronary artery anomalous origin

    Directory of Open Access Journals (Sweden)

    Daniel Rocha Rabelo

    2012-03-01

    Full Text Available Fundamento: A origem anômala das artérias coronarianas é uma entidade relativamente rara, podendo se apresentar de várias formas clínicas e evoluir de forma adversa. A angiotomografia multislice das artérias coronarianas vem ganhando espaço na prática clínica diária, representando importante método propedêutico, com grande potencial na avaliação anatômica dessas artérias. Objetivo: O objetivo deste estudo é descrever os achados angiotomográficos e a evolução de pacientes com origem anômala das artérias coronarianas. Métodos: Durante o período de janeiro de 2008 a março de 2011, foram avaliados consecutivamente 404 pacientes encaminhados para realização de angiotomografia das coronárias por diversos motivos, com tempo médio de seguimento de 21 meses. Resultados: Nove pacientes (2,2% apresentaram origem anômala das artérias coronárias, sendo quatro com origem anômala da artéria circunflexa (Cx em Coronária Direita (CD, dois com origem anômala da CD (um com origem de CD em Cx, e um com origem de CD em seio coronariano esquerdo, um paciente com tronco coronariano único (descendente anterior e Cx saindo do seio coronariano esquerdo, um com trajeto anômalo do tronco da coronária esquerda entre aorta e artéria pulmonar e um paciente apresentando tronco coronariano esquerdo originando-se do seio coronariano direito. Dos pacientes avaliados, um paciente recebeu um cardiodesfibrilador implantável; um paciente evoluiu com morte súbita durante internação hospitalar; e os outros não tiveram intercorrências. Conclusão: A angiotomografia multislice das coronárias representa método propedêutico minimamente invasivo que possibilita detectar a origem, o curso e terminação das anomalias de origem das artérias coronarianas com excelente acurácia, possibilitando o correto diagnóstico e auxiliando no planejamento terapêutico.RESUMEN FUNDAMENTO: El origen anómalo de las arterias coronarias es una entidad

  12. Diagnostic evaluation of rare lesions of the arteria poplitea; Zur Diagnostik seltener Erkrankungen der Arteria poplitea

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R.; Christopoulos, G.; Froehner, S. [Inst. fuer Diagnostische und Interventionelle Radiologie (Germany); Binder, F.; Schweiger, H. [Abt. fuer Gefaesschirurgie der Herz- und Gefaessklinik GmbH Bad Neustadt an der Saale (Germany)

    2001-07-01

    Clinical and radiological findings of six patients are discussed who, due to a specific pathology of the arteria poplitea, developed claudicatio primarily in the lower leg. Applying MS-CT and MRI, the following lesions of the arteria poplitea wer found: bilateral aneurysm verum (1 case), unilateral aneurysm spurium (1 case), the arteria magna syndrome (1 case), entrapment syndrome (2 cases), and cystic adventitia degeneration. The outstanding diagnostic value of MR angiography combined with MR imaging is explained. Good knowledge of the specific pathology of the arteria poplitea is pre-requisite of efficient diagnostic evaluation, and prevention of thromboembolic complications, or ineffective therapy. (orig./CB) [German] Vorgestellt werden die klinischen und radiologischen Befunde von sechs Patienten, die auf dem Boden einer speziellen Pathologie der A. poplitea mit einer unterschenkelbetonten Claudicatio symptomatisch wurden. Mittels MS-CT und MR-Tomographie wurden an der A. poplitea die Befunde eines beidseitigen Aneurysma verum, eines unilateralen Aneurysma spurium, das Syndrom der Arteria magna, in zwei Faellen ein Entrapment-Syndrom sowie eine zystische Adventitiadegeneration nachgewiesen. Zur Diagnostik an der Poplitealarterie wird die herausragende Bedeutung der MR-Angiographie in Kombination mit der MR-Tomographie erlaeutert. Zur sicheren Diagnosefindung ist die Kenntnis der speziellen Krankheitsbilder der A. poplitea Voraussetzung, um thrombembolische Komplikationen im popliteokruralen Segment und ineffektive Therapiemassnahmen zu vermeiden. (orig.)

  13. Diagnostic evaluation of rare lesions of the arteria poplitea

    International Nuclear Information System (INIS)

    Clinical and radiological findings of six patients are discussed who, due to a specific pathology of the arteria poplitea, developed claudicatio primarily in the lower leg. Applying MS-CT and MRI, the following lesions of the arteria poplitea wer found: bilateral aneurysm verum (1 case), unilateral aneurysm spurium (1 case), the arteria magna syndrome (1 case), entrapment syndrome (2 cases), and cystic adventitia degeneration. The outstanding diagnostic value of MR angiography combined with MR imaging is explained. Good knowledge of the specific pathology of the arteria poplitea is pre-requisite of efficient diagnostic evaluation, and prevention of thromboembolic complications, or ineffective therapy. (orig./CB)

  14. Absence of the Arteria Profunda Femoris Ausencia de la Arteria Femoral Profunda

    Directory of Open Access Journals (Sweden)

    I Otag

    2012-06-01

    Full Text Available At arteria femoralis, arteria profunda femoris is the main branch feeding the thigh. After iliofemoral embryological evolution many variations can be seen in this vessel. The absence of a. profunda femoris is one of the rare seen variation among these variations. Knowing the anatomy and variations of a. profunda femoris well, is important in low extremity ischemia, vessel surgery and angiography applications. In this study, 1036 films belonging to low extremity found in the Radiology department of School of Medicine of Cumhuriyet University were examined as retrospective. Among these films at four of them of male cases, absence of a. profunda femoris was detected. In cases at ages of 32, 37, 47 and 53 respectively, in the first and second case at the right low extremity there was no a. profunda femoris and at the left low extremity it was seen that a. circumflexus femoris medialis and a. circumflexus femoris lateralis emerged from a. profunda femoris. In the third case it was detected that at left low extremity a. profunda femoris did not exist, and at right low extremity a. circumflexus femoris lateralis emerged from a. profunda femoris, and a. circumflexus femoris medialis emerged from a. femoralis. In the fourth case at left low extremity there was no a. profunda femoris and at right low extremity it was seen that at a. profunda femoris and a. femoralis were in unsteady course. The absence of a. profunda femoris had 0,4%. The results were discussed by comparing with literature data.La arteria femoral profunda, se origina de la arteria femoral, siendo la rama principal que alimenta al muslo. Después de la evolución embriológica de las aa. iliofemorales, muchas variaciones pueden verse en este vaso. La ausencia de una a. femoral profunda es una rara variación observada dentro de estas variaciones. Conocer la anatomía y las variaciones de la a. femoral profunda, es importante para la isquemia de los miembros inferiores, cirugía vascular y

  15. Plummer-Vinson syndrome combined with arteria lusoria

    International Nuclear Information System (INIS)

    Role of X-ray methods in diagnosis of Plummer-Vinson syndrome combined with arteria lusoria is described. X-ray patterns of esophagus illustrating its pathological changes are presented. Concrete recommendations for diagnosis of the above-mentioned disease in carrying out X-ray investigations are given

  16. Origen pulmonar anómalo de la arteria circunfleja en un paciente adulto

    Directory of Open Access Journals (Sweden)

    Ricardo L. Levin

    2009-01-01

    Full Text Available RESUMENEl origen anómalo de las arterias coronarias constituye una entidad poco frecuente y enpacientes adultos resulta excepcional el hallazgo de una arteria circunfleja naciendo desdela arteria pulmonar. Se presenta un caso de origen aberrante de la arteria circunfleja desdela rama derecha de la arteria pulmonar, detectado por métodos semiinvasivos (ecocardiogramatransesofágico y angiotomografía coronaria multicorte. Debido a las características clínicas del paciente, joven deportista, sintomático por angor, con prueba funcionalpositiva para isquemia y el origen pulmonar de la arteria circunfleja, se decidió efectuartratamiento quirúrgico con reimplante del ostium coronario en la aorta. La evoluciónposoperatoria resultó favorable.REV ARGENT CARDIOL 2009;77:524-526.

  17. Arteria sinuosa del colon: su importancia en la circulación colateral intestinal

    Directory of Open Access Journals (Sweden)

    Edgar Giovanni Corzo Gómez,

    2008-04-01

    Full Text Available La circulación colateral de la vascularización mesentéricaha sido bien descrita. La arteria Marginal o arteria deDrummond, se ubica paralela al borde mesentérico delintestino grueso, y el arco de Riolan, conecta la ramaizquierda de la arteria cólica media con la rama ascendentede la arteria cólica izquierda a través de una porción de laarteria Marginal. Recientemente Moskowitz y colabora-dores describieron la arteria mesentérica sinuosa, como unnuevo vaso colateral con grandes implicacionesquirúrgicas. El objetivo de este artículo es describir laimportancia clínica y quirúrgica de esta arteria.

  18. La inflexibilidad descendente de los precios y la teoría de la empresa

    OpenAIRE

    Beker, Víctor A.

    1985-01-01

    La inflexibilidad descendente de los precios nominales es un hecho de la realidad económica contemporánea responsable de algunos de los fenómenos de mayor importancia en el comportamiento de las economías de mercado. Se analizan las razones para la existencia de tal inflexibilidad. Se determina que tal comportamiento se verifica en aquellos mercados donde los oferentes actúan como fijadores de precio y en los que, además, no se cumplen algunos de los supuestos usuales de la teoría microeconóm...

  19. Mediastinite descendente necrosante pós-angina de Ludwig Necrotizing descending mediastinitis afetr Ludwig angina

    Directory of Open Access Journals (Sweden)

    MARICÉLIA BROMMELSTROET

    2001-09-01

    Full Text Available A angina de Ludwig é uma infecção do espaço submandibular originada, em geral, da infecção do 2º ou 3º molar inferior. Como conseqüência, pode causar mediastinite descendente necrosante, que representa uma forma grave e rara de infecção mediastinal, a qual exige diagnóstico precoce e tratamento cirúrgico para reduzir a alta mortalidade associada a esta doença. Dois casos de mediastinite descendente necrosante pós-angina de Ludwig foram tratados com excelentes resultados em nosso hospital. A drenagem mediastinal transcervical está justificada em pacientes com doença limitada ao mediastino superior. Porém, sepse com comprometimento extenso do mediastino requer drenagem através de toracotomia sem demora.Ludwig's angina is an infection of the submandibular space generally caused by an infection of the 2nd or 3rd lower molar. As a consequence, descending necrotizing mediastinitis, a rare and severe form of mediastinal infection, may occur. The descending necrotizing mediastinitis represents a rare form of mediastinal infection. It presents a high mortality and to decrease that rate it is necessary prompt diagnosis and surgical treatment. Two cases of descending necrotizing mediastinitis due to Ludwig's angina were treated with excellent results in our hospital. The transcervical mediastinal drainage is justified in patients with disease limited to the upper mediastinum. Even so, when there is extensive involvement of the whole mediastinum it is suitable the accomplishment of a wide thoracotomy.

  20. Brachiomedian artery (arteria brachiomediana) revisited: a comprehensive review

    Science.gov (United States)

    Kachlik, David; Konarik, Marek; Riedlova, Jitka; Baca, Vaclav

    2016-01-01

    This article reviews in detail the superficial brachiomedian artery (arteria brachiomediana superficialis), a very rare variant of the main arterial trunks of the upper limb. It branches either from the axillary artery or the brachial artery, descends superficially in the arm (similar to the course of the superficial brachial artery) and continues across the cubital fossa, runs superficially in the forearm, approaches the median nerve and enters the carpal canal to reach the hand. It usually terminates in the superficial palmar arch. The first drawing was published, in 1830, and the first description was published, in 1844. Altogether, to our knowledge, only 31 cases of a true, superficial brachiomedian artery have been reported (Some cases are incorrectly reported as superficial brachioradiomedian artery or superficial brachioulnomedian artery). Based on a meta-analysis of known, available studies, the incidence is 0.23% in Caucasians and 1.48% in Mongolians. Knowing whether or not this arterial variant is present is important in clinical medicine and relevant for: The catheterization via the radial or ulnar artery; harvesting the vascular pedicle for a forearm flap based on the radial, ulnar or superficial brachiomedian arteries; the possible collateral circulation in cases of the arterial closure; and the surgical management of carpal tunnel syndrome. Its presence can elevate the danger of an injury to the superficially located variant artery or of an accidental injection. PMID:27131025

  1. Brachiomedian artery (arteria brachiomediana) revisited: a comprehensive review.

    Science.gov (United States)

    Kachlik, David; Konarik, Marek; Riedlova, Jitka; Baca, Vaclav

    2016-01-01

    This article reviews in detail the superficial brachiomedian artery (arteria brachiomediana superficialis), a very rare variant of the main arterial trunks of the upper limb. It branches either from the axillary artery or the brachial artery, descends superficially in the arm (similar to the course of the superficial brachial artery) and continues across the cubital fossa, runs superficially in the forearm, approaches the median nerve and enters the carpal canal to reach the hand. It usually terminates in the superficial palmar arch. The first drawing was published, in 1830, and the first description was published, in 1844. Altogether, to our knowledge, only 31 cases of a true, superficial brachiomedian artery have been reported (Some cases are incorrectly reported as superficial brachioradiomedian artery or superficial brachioulnomedian artery). Based on a meta-analysis of known, available studies, the incidence is 0.23% in Caucasians and 1.48% in Mongolians. Knowing whether or not this arterial variant is present is important in clinical medicine and relevant for: The catheterization via the radial or ulnar artery; harvesting the vascular pedicle for a forearm flap based on the radial, ulnar or superficial brachiomedian arteries; the possible collateral circulation in cases of the arterial closure; and the surgical management of carpal tunnel syndrome. Its presence can elevate the danger of an injury to the superficially located variant artery or of an accidental injection. PMID:27131025

  2. Cervicoplastia anterior Anterior cervicoplasty

    Directory of Open Access Journals (Sweden)

    Lucas Gomes Patrocínio

    2004-10-01

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

  3. A ARTE NA GASTRONOMIA DOS DESCENDENTES ITALIANOS NA (REGIÃO DE TUBARÃO) NO SUL DE SANTA CATARINA

    OpenAIRE

    Zanelato, Rosângela Nandi; Mota, Rosimar Ramos da

    2014-01-01

    O presente trabalho caracteriza-se como um estudo descritivo e exploratório, realizado através de pesquisa bibliográfica e de campo. A pesquisa bibliográfica foi embasada pelos teóricos Vettoretti, Rizzoli, Cabral, Montanari, Dall’alba entre outros. Contém uma pesquisa de campo, na qual vinte pessoas descendentes de italianos contribuíram respondendo dez questões sobre os alimentos que produzem, os que não podem faltar na mesa, bem como, bebidas e temperos que consomem. O trabalho evidência p...

  4. Erhalt der Arteria rectalis superior in der Divertikulitis-Chirurgie

    OpenAIRE

    Schachtebeck, Michael

    2016-01-01

    Background: Preservation of the superior rectal artery (SRA) in sigmoid resection continues to be a matter of debate. The practical relevance of preserving the SRA has not been thoroughly investigated and randomized controlled trials are largely missing. In tubular sigmoid resection the SRA is preserved. The artery can be preserved in anterior resection, too. Vascular supply to bowel anastomosis has been determined as an important factor for postoperative healing. This thesis investigates the...

  5. ETIOLOGÍA DEL TIZÓN DESCENDENTE DE LAS RAMAS DE AZUCENA HÍBRIDA (Lilium spp. EN VILLA GUERRERO, ESTADO DE MÉXICO

    Directory of Open Access Journals (Sweden)

    S. G. Leyva-Mir

    2009-01-01

    Full Text Available El tizón descendente de las ramas en azucena híbrida (Lilium spp., es una enfermedad que recientemente apareció en la región de Villa Guerrero, Estado de México. El síntoma principal consiste en una necrosis descendente de los tallos, resultando en una muerte prematura de plantas, teniendo como consecuencia la ausencia de flores. El objetivo de este estudio fue identificar el agente causal de esta enfermedad. Mediante los postulados de Koch se comprobó que la enfermedad fue causada por el hongo Botrytis cinerea.

  6. Detection and treatment of an aneurysma spurium of the arteria hepatica dextra after laparoscopic cholecystectomy

    OpenAIRE

    Kirschberg, Oliver; Scheding, Andreas; Saers, Thomas; Krakamp, Bernd

    2013-01-01

    Background Massive upper gastrointestinal hemorrhage can be the dominant symptom of decompensated liver cirrhosis, varices and ulcerations in the upper gastrointestinal tract. Postoperative complications are known to lead to these bleedings. Commonly, emergency endoscopy will be performed. Here we report of a patient with extensive bleeding caused by an aneurysma spurium of the arteria hepatica dextra induced by a laparoscopic cholecystectomy. The condition was diagnosed by the Doppler ultras...

  7. Variante anatómica: origen de la arteria hepática derecha de la arteria mesentérica superior

    Directory of Open Access Journals (Sweden)

    David Rodríguez Palomo

    2011-03-01

    Full Text Available Este trabajo describe la presencia de la variante anatómica que presenta la arteria hepática derecha como rama de la arteria mesentérica superior en un caso incidental de disección en la Escuela de Medicina de la Universidad de Costa Rica, dicha variante se presenta desde un 6,4% hasta un 18% por lo que debe siempre tenerse en cuenta durante cualquier cirugía hepatobiliar y más aún si se trata de cirugía de trasplante hepático. Así mismo se revisa el tema y su importancia clínica.This paper describes the presence of anatomical variation has the right hepatic artery as a branch of the artery superior mesenteric artery a case incidental to the School of Medicine, University of Costa Rica, said variant is present from 6.4% to 18% and should be always be taken into account during any hepatobiliary surgery and more so if it is liver transplant surgery. It also reviews the issue and its clinical significance.

  8. METODOLOGÍA PARA EL DISEÑO ÓPTIMO DE EVAPORADORES DE PELÍCULA DESCENDENTE

    Directory of Open Access Journals (Sweden)

    Christian O. Díaz-Ovalle

    2013-01-01

    Full Text Available En este trabajo se presenta un modelo como una forma de solución del problema en base a las especificaciones geométricas de los evaporadores de película descendente. El modelo incluye balances de masa y energía en una forma general para cualquier secuencia; y, correlaciones de transferencia de calor para el cálculo del área de transferencia de calor. Así, el diseño óptimo es posible considerando el costo de los tubos en la longitud, diámetro y costo de energía. El problema es formulado como MINLP para minimizar el costo total al seleccionar un diámetro óptimo. Los resultados muestran una aceptable aplicación sobre un proceso real.

  9. Flußvermittelte Vasodilatation (FMD der Arteria brachialis: Methodik und klinischer Stellenwert

    Directory of Open Access Journals (Sweden)

    Frick M

    2002-01-01

    Full Text Available Frühe Diagnose und Risikostratifizierung sind wichtige Ziele in der Prävention der koronaren Herzkrankheit. Die Endotheldysfunktion tritt im Frühstadium der Atherosklerose auf und ist klinisch als Störung der endothelabhängigen Vasodilatation erfaßbar. 1992 wurde erstmals eine nichtinvasive Methode beschrieben, welche mittels hochauflösenden Ultraschalls die flußvermittelte Vasodilatation (FMD der Arteria brachialis als Parameter der Endothelfunktion bestimmt. Aufgrund der vermeintlich einfachen, nicht-invasiven Durchführung ist dieser Test trotz fehlender internationaler Standardisierung und unterschiedlicher methodischer Ansätze in einer Vielzahl von Studien angewandt worden. Zusätzlich wurden in den letzten Jahren immer mehr Faktoren beschrieben, die das Ergebnis der FMD beeinflussen. Die vorliegende Arbeit gibt einen Überblick über Voraussetzungen zur Durchführung der Bestimmung der Endothelfunktion an der Arteria brachialis und zeigt mögliche Einflußfaktoren auf. Zudem wird eine detaillierte Vorgehensweise bei der Messung der Endothelfunktion vorgegeben, die zu einer Standardisierung dieser Methode auf nationaler Ebene führen soll.

  10. Anterior tarsaltunnelsyndrom

    DEFF Research Database (Denmark)

    Miliam, Palle B; Basse, Peter N

    2009-01-01

    Anterior tarsal tunnel syndrome is a rare entrapment neuropathy of the deep peroneal nerve beneath the extensor retinaculum of the ankle. It may be rare because it is underrecognized clinically.We present a case regarding a 29-year-old man, drummer, who for one and a half year experienced clinical...

  11. Tratamiento de la compresión del tronco de la arteria coronaria izquierda en pacientes con hipertensión pulmonar

    OpenAIRE

    2011-01-01

    La angina de pecho es un síntoma frecuente en pacientes con hipertensión pulmonar (HP) de cualquier etiología. Aunque su fisiopatología no está aclarada, las causas propuestas son: la isquemia subendocárdica por aumento del estrés parietal del ventrículo derecho, la dilatación de la arteria pulmonar por incrementos transitorios de la presión pulmonar y la compresión extrínseca del tronco de la arteria coronaria izquierda (TCI) por la arteria pulmonar (AP) dilatada. Se presentan tres casos que...

  12. Avaliação da Velocidade Média na Aorta Torácica Descendente em Fetos com Anemia

    Directory of Open Access Journals (Sweden)

    Taveira Marcos Roberto

    2001-01-01

    Full Text Available Objetivo: verificar se existe correlação significativa entre a velocidade média na dopplerfluxometria da artéria aorta torácica descendente e o grau de anemia fetal. Métodos: estudo prospectivo, transversal, no qual foram analisados 66 fetos de gestantes isoimunizadas, em que se realizou a cordocentese para a realização de transfusões intra-uterinas pela via intravascular (66,7%. Nos fetos que foram submetidos à transfusão intra-uterina pela via intraperitoneal, ou naqueles casos em que não houve necessidade de tratamento intra-uterino (33,3%, a determinação da concentração de hemoglobina do cordão foi realizada pela punção do cordão umbilical, no momento da interrupção da gestação. Neste grupo de fetos estudados, foi realizado exame dopplerfluxométrico da artéria aorta torácica descendente, sendo calculada a velocidade média de fluxo. Foi realizado estudo de associação entre as variáveis. Foram também calculados os valores de sensibilidade, especificidade, valores preditivos positivo e negativo. Resultados: observou-se correlação significativa e inversa entre a velocidade média na artéria aorta torácica descendente e o nível de hemoglobina fetal. A velocidade média na dopplerfluxometria da artéria aorta torácica descendente apresentou sensibilidade de 47,5% para anemia fetal moderada (Hg<10 g/dL, com o teste exato de Fisher apresentando valor de p<0,01, e de 54,5% para anemia fetal grave (Hg<7,0 g/dL, com um valor de p=0,01. Conclusões: houve associação significativa entre a velocidade média na aorta torácica descendente e o grau de diagnóstico de anemia fetal.

  13. Puntuación de calcio en arterias coronarias y presencia de estenosis angiográficamente significativas Calcium scoring in coronary arteries and presence of angiographically significant stenosis

    Directory of Open Access Journals (Sweden)

    Vladimir Mendoza Rodríguez

    2007-09-01

    Full Text Available La presencia de calcio en las arterias coronarias es patognomónica de aterosclerosis. Agatston diseñó un método para cuantificar el puntaje de calcio coronario mediante la tomografía para determinar la asociación entre el grado de calcificación en las arterias coronarias determinado por tomografía de 64 cortes y la presencia de estenosis coronarias significativas (ECS diagnosticadas por coronariografía invasiva (CI. Se estudiaron 153 pacientes, los cuales estaban programados para CI. Previo a la CI se les cuantificó el puntaje de calcio por arteria y por paciente. El 91,7 % de los pacientes con puntaje ≤ 10 UA (unidades Agatston no presentó ECS contra 8,3 % con puntaje ≥ 401 UA (p The presence of calcium in the coronary arteries is pathognomonic of atherosclerosis. Agatston designed a method to quantify the coronary calcium scoring by tomography to determine the association between the degree of calcification in the coronary arteries by 64-slice computed tomography and the presence of significant coronary stenosis (SCS diagnosed by invasive coronariography (IC. 153 patients that were scheduled for IC were studied. The calcium scoring was quantified by patient and by artery before performing the IC. 91.7 % of the patients with scoring £10 UA (Agatston units did not present SCS versus 8.3 % with scoring ³ 401 UA (p< .0001. 2.4 % with scoring 10 UA in the trunk of the left coronary presented SCS versus 75 % with scoring 401 UA (p < 0.0001. 5.5 % with scoring 10 UA in the anterior descending artery has SCS versus 87.5 % with scoring 401 UA (p < 0.0001. Similar behavior was observed in the rest of the arteries. It was concluded that there was association between the calcium degree scoring in the coronary arteries diagnosed by computed tomography and the presence of SCS diagnosed by IC.

  14. Pseudo-aneurisma post-traumático de tronco de arteria coronaria izquierda

    Directory of Open Access Journals (Sweden)

    Melina M. Gallo

    2011-08-01

    Full Text Available El pseudo-aneurisma de arteria coronaria es extremadamente raro. Su historia natural es poco conocida y su tratamiento discutido. Se presenta el caso de un paciente con pseudo-aneurisma de tronco de la coronaria izquierda e infarto antero-apical del ventrículo izquierdo cinco años después de un paro cardíaco secundario a un traumatismo no penetrante de tórax. Se consideró entonces que la lesión no era pasible de corrección percutánea o quirúrgica por lo que se optó por tratamiento médico conservador. Una angiografía coronaria por tomografía computarizada multicorte realizada 10 años después del evento inicial mostró ausencia de progresión de la lesión.

  15. Doppler de arterias uterinas en semana 11 – 13 6/7 como predictor de desenlaces materno - perinatales adversos

    OpenAIRE

    Mejía Pérez, Dauris Lineth; Olaya Trujillo, Diego Alejandro

    2016-01-01

    Este es un estudio de Cohorte prospectiva longitudinal, realizado en una población de mujeres gestantes de bajo riesgo. Se incluyeron pacientes con posibilidad de seguimiento durante 18 meses, se reclutaron entre la semanas 11 a 13 6/7, Se hizo medición de índices de pulsatilidad y resistencia de las arterias uterinas derecha e izquierda. Se determinaron por seguimiento e historia clínica los siguientes desenlaces maternos perinatales: trastornos hipertensivos asociados al e...

  16. Simulación fluido-térmica de un reactor de gasificación de lecho fijo descendente

    OpenAIRE

    Felisart Serlavóss, Bernat

    2013-01-01

    El proyecto consta de un estudio preliminar de las tecnologías de gasificación existentes y un posterior análisis de los procesos de gasificación en los reactores de lecho fijo con flujo descendente a equicorriente (downdraft) como son la pirolisis, oxidación del combustible y reducción de los gases creados. Se estudian las fuentes renovables posibles como combustible para su uso en la gasificación, se centra en los residuos agrícolas provenientes del maíz como son su coronta y sus cañas, ...

  17. Phacoemulsification in anterior megalophthalmos.

    Science.gov (United States)

    Lee, Graham A; Hann, Joshua V; Braga-Mele, Rosa

    2006-07-01

    This case outlines the phacoemulsification technique used to overcome the challenge of the hyperdeep anterior chamber, weak zonules, abnormal anterior capsule, and large capsular bag. Key steps included trypan blue staining of the anterior capsule, a large capsulorhexis, prolapse of the nucleus into the anterior chamber with phacoemulsification anterior to the capsulorhexis, and a posterior chamber-placed iris-clip intraocular lens. Successful visual rehabilitation is achievable in these anatomically challenging eyes. PMID:16857490

  18. Optimización en el uso del colgajo de segunda perforante intercostal de la arteria mamaria interna Optimizing the use of the second intercostal perforator flap of the internal mammary artery

    Directory of Open Access Journals (Sweden)

    D. Sicilia Castro

    2012-06-01

    Full Text Available El colgajo en isla basado en perforantes de la arteria mamaria interna (colgajo IMAP se emplea de manera reciente como técnica reconstructiva en cabeza y cuello. El objetivo de esta revisión es corroborar las posibilidades del arco de rotación de dicho colgajo cuando se realiza una amplia disección de su pedículo vascular. Presentamos 4 pacientes de edades comprendidas entre 46 y 75 años, todos ellos varones, con defectos faríngeos parciales, en los que empleamos un colgajo pediculado basado en la segunda perforante de la arteria mamaria interna para reconstrucción del defecto faríngeo. El tamaño medio del defecto a cubrir fue de 3,2 cm (desviación estándar +/- 1,5 cm en sentido horizontal y 4,5 cm (desviación estándar +/- 2,2 cm en sentido vertical. En todos los casos se disecó un colgajo en isla con un tamaño medio de 6 X 8 cm. La longitud media del pedículo fue de 5,5 cm (desviación estándar +/- 1,51 cm. En todos los casos fue posible sellar el defecto faríngeo sin necesidad de resecar costilla o de incorporar parte de la arteria mamaria interna correspondiente. El colgajo IMAP es un colgajo rápido de realizar que permite la reconstrucción de defectos faríngeos parciales de la región anterior del cuello y hasta la base de la lengua sin necesidad de resección costal o incorporación parcial de los vasos mamarios.The island flap based on perforators of the internal mammary artery (IMAP flap is recently used in reconstruction of head and neck defects. The aim of this review is to verify the possibilities of the arc of rotation of the flap when it's necessary to carry out an extensive dissection of the vascular pedicle. We present reconstruction of partial pharyngeal defects in 4 patients, aged between 46 and 75 years and all men, using a pedicle flap based on the second perforator of the internal mammary artery. The average size of the defect was 3.2 cm (SD +/- 1.5 cm horizontally and 4.5 cm (SD +/- 2.2 cm vertically. In

  19. Dissektion der Arteria carotis als Ursache ischämischer zerebrovaskulärer Ereignisse - Fallberichte und Diskussion

    Directory of Open Access Journals (Sweden)

    Tentschert S

    2003-01-01

    Full Text Available Dissektionen der kraniozervikalen Gefäße, inbesondere der Arteria carotis, zählen zu den häufigsten Ursachen ischämischer zerebrovaskulärer Ereignisse bei jüngeren Patienten. Die ischämische Symptomatik wird durch eine Wühlblutung in die Gefäßwand verursacht, welche entweder zu einer Minderung des zerebralen Blutflusses und/oder zu einer lokalen Thrombosierung mit nachfolgender Embolisation führt. Karotisdissektionen können durch ein mechanisches Trauma hervorgerufen werden, sie entstehen aber auch spontan oder sind dann bei einem Teil der Patienten mit Bindegewebserkrankungen assoziiert. Zu den häufigsten Symptomen zählen Kopfschmerzen, zervikaler Schmerz und Horner-Syndrom. Die zerebrale Ischämie führt meist zu einer transienten ischämischen Attacke (TIA oder zu einem ischämischen Infarkt im Stromgebiet der Arteria cerebri media der betroffenen Seite. Auch eine Amaurosis fugax kann auftreten. Trotz neuer technischer Möglichkeiten stellen Dissektionen der hirnversorgenden Gefäße nach wie vor eine diagnostische Herausforderung dar. Die digitale Subtraktionsangiographie gilt derzeit noch als Goldstandard zur Diagnostik, wird aber in vielen Fällen zunehmend durch neue nichtinvasive bildgebende Verfahren ersetzt oder ergänzt. Stenose oder Verschluß des betroffenen Gefäßes bilden sich in den meisten Fällen innerhalb von zwei Monaten nach dem Ereignis zurück. Therapeutische Maßnahmen haben vor allem die Verhinderung embolischer Komplikationen zum Ziel. Die gegenständliche Arbeit soll anhand von Fallbeispielen und einer Literaturübersicht klinisch relevante Aspekte und Probleme bei Diagnostik und Therapie der Dissektion der Arteria carotis aufzeigen.

  20. Punciones repetidas de la arteria radial para cateterismo cardíaco Repeated radial artery puncture for cardiac catheterization

    Directory of Open Access Journals (Sweden)

    Eduardo Magariños

    2007-06-01

    Full Text Available La punción percutánea de la arteria radial para la realización de procedimientos por cateterismo ha ganado aceptación debido a una eficacia similar a la obtenida con el acceso femoral. En el presente trabajo evaluamos los resultados obtenidos con la punción repetida de esta arteria. En un total de 182 accesos radiales se realizaron 17 punciones repetidas, y mediante ellas, 20 procedimientos (9 coronariografías y 11 angioplastias. Se obtuvo éxito del acceso en 15 punciones repetidas (88.2% y éxito del procedimiento en todos los casos cuando logramos éxito del acceso. Si bien el grupo es pequeño es suficiente para mostrar que la punción repetida de la arteria radial es factible y permite una alta tasa de éxito de los procedimientos con una disminución ostensible de las complicaciones locales.The radial artery approach for percutaneous cardiac interventions has gained worldwide acceptance due to the similar results obtained by the femoral artery access. In this paper, we report our experience with repeated puncture of the radial artery. One hundred and eighty two radial artery access procedures were performed, in 17 interventions the puncture was repeated once or twice, with a total of 20 therapeutic catheterizations (9 coronary angiographies, 11 angioplasties. There was no therapeutic failure through the radial approach but, we successfully gained access in 88.2% (15/17 of the re-interventions cases. Although an experience with a low number of cases, we had a very high successful therapeutic rate, and also a remarkable lowering of local complications, this shows the feasibility and potential of this technique.

  1. El grosor íntima-media de la arteria femoral superficial como marcador de la aterosclerosis y de la enfermedad arterial periférica

    OpenAIRE

    Arnedo Valero, Gemma

    2016-01-01

    1-Introducción: El grosor íntima-media (GIM) de la arteria carótida, medido con eco-doppler, es considerado un marcador precoz de las enfermedades cardiovasculares121. La enfermedad arterial periférica es una enfermedad altamente costosa y prevalente1-3. El gold-estándar para su diagnóstico es el índice tobillo-brazo (ITB). Éste guarda una estrecha relación con los eventos cardiovasculares y su pronóstico132. La exploración con eco-doppler de la arteria femoral superficial es má...

  2. Factor de crecimiento vascular endotelial total y Doppler de las arterias uterinas en preeclampticas y embarazadas normotensas sanas

    OpenAIRE

    Eduardo Reyna-Villasmil; Jorly Mejia-Montilla; Joel Santos-Bolívar; Duly Torres-Cepeda; Yolimar Navarro-Briceño; Nadia Reyna-Villasmil; Ismael Suarez-Torres

    2014-01-01

    El objetivo de la investigación fue establecer las concentraciones de factor de crecimiento vascular endotelial (VEGF) total en preeclámpticas y embarazadas normotensas, y relacionar los valores de los hallazgos Doppler de las arterias uterinas con las concentraciones plasmáticas. Se seleccionaron 160 sujetos. Se incluyeron 47 preeclámpticas severas (grupo A), 33 preeclámpticas leves (grupo B) y un grupo control con edades similares a los grupos de estudio de 80 embarazadas sanas (grupo C). L...

  3. Parálisis del plexo braquial por pseudoaneurisma de la arteria axilar tras luxación de hombro

    OpenAIRE

    Escuder Capafons, M.C.; Monllau García, Juan Carlos; Ballester Soleda, Jorge

    1997-01-01

    Las lesiones del plexo braquial y de las arterias subclavia y axilar son complicaciones poco frecuentes, pero importantes, de los traumatismos dé la cintura escapular. Las lesiones neurovasculares son más frecuentes en heridas penetrantes, pero son raras en traumatismos cerrados. Cuando la sintomatología neurológica se desarrolla insidiosamente, días o semanas después del traumatismo, hay que pensar en una lesión vascular. Presentamos un caso de parálisis del plexo braquial tar...

  4. Endovascular treatment of splenic artery aneurysms; Trattamento endovascolare degli aneurismi dell'arteria splenica

    Energy Technology Data Exchange (ETDEWEB)

    Lagana, Domenico; Carrafiello, Gianpaolo; Mangini, Monica; Fontana, Federico; Dizonno, Massimiliano; Fugazzola, Carlo [Insubria Univ., Varese (Italy). Cattedra di radiologia; Castelli, Patrizio [Insubria Univ., Varese (Italy). Chirurgia vascolare

    2005-07-15

    techniques, endovascular treatment is feasible in nearly all SAAs. It ensures good immediate and long term results, and no doubt presents some advantages in comparison to surgical treatment, as it less invasive and allows the preservation of splenic function. [Italian] Scopo. Verificare l'efficacia del trattamento endovascolare degli aneurismi dell'arteria splenica (AAS). Materiale e metodi. Nel periodo compreso tra maggio 2000 e giugno 2003 sono stati trattati 11 AAS veri in 9 pazienti (7 femmine e 2 maschi; eta media 58 anni), 8 sacciformi e 3 fusiformi, 4 localizzati al tratto medio, 5 al tratto distale e 2 intrasplenici. La diagnosi e stata effettuata con eco color Doppler e/o angio-TC ed e risultata occasionate in 7 pazienti e conseguente a dolore in ipocondrio sinistro in 1 caso; un AAS e stato riscontrato in fase di fissurazione. Quattro AAS sono stati esclusi mediante embolizzazione della sacca con microspirali, con preservazione della continuita dell'asse vascolare; in 2 casi e stata associata l'iniezione transcatetere di cianoacrilato. In 4 casi e stata effettuata una legatura endovascolare, con ischemia settoriaie della milza. Un AAS fisstirato e stato trattato in urgenza con embolizzazione massiva mediante cianoacrilato dell'arteria splenica. I 2 aneurismi intrasplenici sono stati esclusi, l'uno mediante embolizzazione dell'arteria afferente con cianoacrilato e l'altro con iniezione transcatetere di trombina nella sacca aneurismatica. Risultati. E stata ottenuta la devascolarizzazione completa di tutti gli AAS (in 10/11 al termine della procedura; in 1/11 al controllo TC, effettuato dopo 3 giorni). Il follow-up (durata media 18 mesi; range 6-36 mesi) e stato espletato con eco color Doppler e/o angio-TC a 3, 6, 12 mesi e successivamente una volta all'anno; la completa esclusione degli aneurismi e stata confermata in 11/11 casi. Le complicanze riscontrate sono state: 4 casi di pleurite sinistra di modesta entita; febbre

  5. Origem das artérias dos nós sinoatrial e atrioventricular em população do sul da Índia: um estudo angiográfico Origen de las arterias de los nódulos sinusal y atrioventricular en población del Sur de la India: un estudio angiográfico Origin of the sinoatrial and atrioventricular nodal arteries in South Indians: an angiographic study

    Directory of Open Access Journals (Sweden)

    Lakshmi Ramanathan

    2009-05-01

    Full Text Available FUNDAMENTO: Estudar o suprimento arterial do sistema condutor e sua correlação com a dominância das artérias coronárias em população do sul da Índia. OBJETIVO: Determinar angiograficamente as origens da artéria do nó sinoatrial (AnSA e artéria do nó atrioventricular (AnAV em indianos. MÉTODOS: O ESTudo incluiu 300 pacientes consecutivos (114 do sexo feminino e 186 do sexo masculino; idade média, 55 anos, habitantes da região costeira ao sul da Índia, submetidos a cineangiocoronariografia devido a sintomas como dor no peito, angina pectoris ou teste ergométrico positivo. As angiografias incluíram ambas as artérias coronárias (direita e esquerda em posição oblíqua anterior direita e esquerda. A origem da AnSA e AnAV a partir das artérias coronárias foi observada e correlacionada à dominância arterial. RESULTADOS: O nó SA (sinoatrial recebeu suprimento pela artéria coronária direita (ACD em 53% dos casos, pelo ramo circunflexo (Cx da artéria coronária esquerda (ACE em 42,66% dos casos, e em 4,33% dos casos esse nó foi irrigado por ambas as artérias coronárias. O nó AV (atrioventricular também recebeu suprimento sanguíneo com mais frequência da ACD (72,33% dos casos do que do ramo Cx da ACE (27,66%. Surpreendentemente, em nenhum caso este nó recebeu suprimento de ambas as artérias coronárias. CONCLUSÃO: Os Resultados do presente estudo podem auxiliar os cirurgiões cardíacos, sobretudo em cirurgias relacionadas a valvopatias, devido à franca proximidade entre os ramos nodais e o complexo valvar.FUNDAMENTO: Estudiar el suministro arterial del sistema conductor y su correlación con la dominancia de las arterias coronarias en población del Sur de la India. OBJETIVO: Determinar angiográficamente los orígenes de la arteria del nódulo sinusal (AnSA y la arteria del nódulo atrioventricular (AnAV en indios. MÉTODOS: El estudio incluyó 300 pacientes consecutivos (114 del sexo femenino y 186 del sexo

  6. Colgajo de perforantes de la arteria colateral cubital inferior para defectos por quemadura eléctrica en fosa cubital

    Directory of Open Access Journals (Sweden)

    I. González-Alaña

    2014-09-01

    Full Text Available Las quemaduras eléctricas producen lesiones profundas, especialmente las debidas a la entrada y salida de la corriente y al arco voltaico, que pueden dejar expuestas estructuras nobles y afectar áreas de flexo-extensión, como la fosa antecubital. Los defectos resultantes pueden cubrirse mediante colgajos libres o pediculados de brazo y antebrazo. Entre las distintas opciones quirúrgicas, el colgajo medial del brazo evita la interrupción de los ejes vasculares mayores y la secuela en la zona donante es discreta. Sin embargo, su uso está poco extendido por considerarse un colgajo de difícil disección debido a la variabilidad anatómica de las arterias colaterales cubitales superior e inferior que lo irrigan. Presentamos la cobertura para un defecto secundario a quemadura eléctrica en la fosa antecubital mediante un colgajo medial del brazo basado en las ramas perforantes de la arteria colateral cubital inferior. Aunque confirmamos en este caso la variabilidad vascular, la disección resultó sencilla y el resultado estético y funcional fue excelente.

  7. Coesão e diversificação: os descendentes da nobreza na França, no final do século XX

    Directory of Open Access Journals (Sweden)

    Monique de Saint Martin

    2002-10-01

    Full Text Available Como analisar um antigo grupo, o dos descendentes da nobreza, inventado e reinventado diversas vezes no curso de sua história, suprimido da Constituição e a seguir reabilitado de modo mais ou menos visível, e que, na França, bem como em outros países, não cessa de se desagregar? Como pensar a extrema diversidade e a unidade relativa desse conjunto, das quais é preciso também indagar se são ou não fictícias? Mais, talvez, que os recursos simbólicos comuns, o que contribui para a manutenção de uma forma de coesão é a densidade das relações e das trocas de toda sorte entre eles. Mas essa coesão tende a tornar-se cada vez mais difícil. No atual estado da pesquisa, parece que os descendentes da nobreza não podem ser analisados como um corpo nem como um grupo relativo ­ ainda que essas interpretações mereçam atenção ­, e sim como um espaço, sob condição de que se examine a dinâmica e os processos que o atravessam.How should one analyze the descendants of the nobility in France? This ancient group has been invented and re-invented many times along its history. The Constitution suppressed it, then later on it was quite visibly rehabilitated, and it is always becoming disaggregated, in France as well as in other countries. How should one approach both this group's extreme diversity and its relative unity, which also have to be questioned as to their fictitiousness? Maybe the dense relationships and exchanges of all sorts between the descendants of the nobility contribute to the maintenance of some form of cohesion more than the symbolic resources they have in common. But this cohesion is becoming ever more difficult. At the present moment of the research, it seems that the descendants of the nobility cannot be analyzed neither as a body nor as a relative group ­ even though these interpretations deserve attention ­ but rather as a space, as long as the dynamism and the processes that crosscut it are analyzed as well.

  8. Bilateral anterior shoulder dislocation

    OpenAIRE

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

    2013-01-01

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

  9. Ruptured thoracic aortic aneurysm in patient with systemic lupus erythematosus Aneurisma roto da aorta descendente em paciente com lúpus eritematoso sistêmico

    Directory of Open Access Journals (Sweden)

    Daniel Oliveira De Conti

    2011-03-01

    Full Text Available It is reported a ruptured descending thoracic aortic aneurysm in a 25-year-old systemic lupus erythematosus woman who underwent 19 years steroid therapy. She was treated with 2 endovascular stent-grafts, discharged from hospital 13 days after the procedure in good health. Three months later she returned with hemorrhagic shock due to high digestive hemorrhage secondary to an aortic-esophageal fistula. She underwent to an open emergency surgery, and died during the post-operative period.Paciente de 25 anos, do sexo feminino, portadora de lúpus eritematoso sistêmico, fazendo uso de corticoesteroide havia 19 anos, deu entrada em unidade de emergência com aneurisma roto de aorta torácica descendente. Foi submetida a tratamento endovascular com 2 stents, recebeu alta hospitalar no 13º dia de pós-operatório, em boas condições de saúde. Três meses depois, retornou em choque hemorrágico secundário a hemorragia digestiva alta. Feito o diagnóstico de fístula aorto-esofágica, foi submetida à cirurgia aberta de emergência, indo a óbito durante o período pós-operatório.

  10. The Aberrant Right Subclavian Artery (Arteria Lusoria): The Morphological and Clinical Aspects of One of the Most Important Variations—A Systematic Study of 141 Reports

    OpenAIRE

    Michał Polguj; Łukasz Chrzanowski; Kasprzak, Jarosław D.; Ludomir Stefańczyk; Mirosław Topol; Agata Majos

    2014-01-01

    The most important abnormality of the aortic arch is arguably the presence of an aberrant right subclavian artery (arteria lusoria). If this vessel compresses the adjacent structures, several symptoms may be produced. The aim of the study is to present the morphological and clinical aspects of the aberrant right subclavian artery. Three different databases searched for a review of pertinent literature using strictly predetermined criteria. Of 141 cases, 15 were cadaveric and 126 were clinical...

  11. Anterior Cruciate Ligament (ACL) Injuries

    Science.gov (United States)

    ... Help a Friend Who Cuts? Anterior Cruciate Ligament (ACL) Injuries KidsHealth > For Teens > Anterior Cruciate Ligament (ACL) ... and Recovery Coping With an ACL Injury About ACL Injuries A torn anterior cruciate ligament (ACL) is ...

  12. Efeitos da remoção da túnica adventícia da aorta descendente em suínos

    Directory of Open Access Journals (Sweden)

    Almondi Fagundes

    2012-04-01

    Full Text Available OBJETIVO: Investigar os efeitos da remoção da adventícia da aorta em suínos. MÉTODOS: O experimento foi realizado com oito suínos. Removeu-se a camada adventícia da aorta descendente. Após a eutanásia com duas, quatro, seis e oito semanas, o segmento aórtico era removido. Após, eram feitos cortes histológicos com a coloração de hematoxilina e eosina (HE e pelo método de Weigert - Van Gieson. RESULTADOS: Após duas semanas identificou-se um leve desarranjo do terço externo da túnica média. Nos animais sacrificados após quatro semanas observou-se um desarranjo estrutural dos terços externos da túnica média. Após seis semanas observou-se necrose da parede aórtica. Finalmente, após oito semanas além da fibrose da parede aórtica identificou-se a destruição da lâmina elástica interna. CONCLUSÃO: A remoção da adventícia da aorta em suínos levou à alterações degenerativas da média, determinando perda da estrutura da parede aórtica que é variável em sua localização, intensidade e forma, dependendo do tempo a partir do qual se estabeleceu a lesão isquêmica.

  13. Estudo da coagulação aplicada à filtração direta descendente Evaluating coagulation applied to direct downflowing filtration

    Directory of Open Access Journals (Sweden)

    Eliane Prado Cunha Costa dos Santos

    2007-12-01

    Full Text Available Neste trabalho compara-se o desempenho dos coagulantes Cloreto Férrico, Sulfato de Alumínio, Sulfato Férrico e Hidróxi-Cloreto de Alumínio - isoladamente ou combinados com polímeros catiônicos - na redução da cor aparente, turbidez e fitoplâncton visando ao tratamento por filtração direta descendente. Os ensaios foram realizados em reatores estáticos e em unidade piloto, empregando água captada em reservatório de acumulação. Os resultados obtidos com os coagulantes analisados nas dosagens recomendadas para filtração direta forneceram valores de cor aparente e turbidez em acordo com a Portaria 518/2004 do Ministério da Saúde. Não foi significativa a diferença, para o nível de significância de 5%, entre os coagulantes testados em escalas de bancada e piloto.The present work compares several coagulants (alum, ferric chloride, ferric sulfate, and aluminum hydrochloride - each by itself or with cationic polymers applied to in line downflowing direct filtration, as to their effectiveness in reducing apparent color, turbidity, and phytoplankton. The tests were carried out in static reactors and in a pilot unit, using natural water drawn from the reservoir of a water treatment plant. Coagulants used in dosages recommended for direct filtration yielded values of apparent color and turbidity that complied with Brazilian government regulations. There was no significant difference among them in either bench or pilot scale at a 95% reliability interval.

  14. Origen anómalo de la coronaria izquierda en la arteria pulmonar: resultados de la cirugía correctora

    Directory of Open Access Journals (Sweden)

    Andrés J. Schlichter

    2010-01-01

    Full Text Available IntroducciónEl origen anómalo de la arteria coronaria izquierda en la arteria pulmonar es una cardiopatía congénita rara que produce isquemia miocárdica con disfunción ventricular izquierda e insuficiencia mitral de grado variable. Las técnicas actuales han modificado la historia natural de esta enfermedad mediante el restablecimiento de un sistema de doble irrigación coronaria.ObjetivosEvaluar la experiencia institucional en la corrección quirúrgica del origen anómalo de la coronaria izquierda en la arteria pulmonar.Material y métodosEntre febrero de 2000 y mayo de 2008 fueron operados 13 pacientes con este diagnóstico. Seis eran menores de 1 año; mediana: 2,5 años; rango: 45 días a 21 años. Antes de la cirugía, el 61% de los pacientes presentaban insuficiencia cardíaca, el 69% signos de infarto y el 84% cardiomegalia moderada a grave. La fracción de acortamiento promedio era del 26,07% y existía insuficiencia mitral moderada a grave en el 46% de los casos. El diagnóstico se confirmó por cateterismo en 11 pacientes.En un paciente se realizó cirugía de Takeuchi y en los 12 restantes se efectuó el reimplante de la coronaria izquierda en la aorta. En un paciente se realizó plástica mitral. Seis recibieron perfusión y cardioplejía de la coronaria anómala por la arteria pulmonar.ResultadosLa mortalidad al presente, con un seguimiento promedio de 74,76 meses, es del 0%. Ningún paciente presentaba insuficiencia cardíaca al alta. En 9 de los 11 pacientes con cardiomegalia, ésta se redujo. La fracción de acortamiento promedio posoperatoria fue del 39,92%. La insuficiencia mitral disminuyó en todos los que la presentaban, excepto en uno. Ninguno presentó insuficiencia grave en el posoperatorio alejado.ConclusionesLos resultados de la cirugía correctora del origen anómalo de la coronaria izquierda en la arteria pulmonar son excelentes en todos los grupos etarios, con mejoría significativa de la función mioc

  15. Anterior cervical plating

    Directory of Open Access Journals (Sweden)

    Gonugunta V

    2005-01-01

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

  16. Anterior knee pain

    Science.gov (United States)

    Patellofemoral syndrome; Chondromalacia patella; Runner's knee; Patellar tendinitis; Jumper's knee ... or playing soccer). You have flat feet. Anterior knee pain is more ... skiers, bicyclists, and soccer players who exercise often ...

  17. Anterior knee pain

    Science.gov (United States)

    ... or playing soccer). You have flat feet. Anterior knee pain is more common in: People who are overweight People who have had a dislocation, fracture, or other injury to the kneecap Runners, jumpers, ...

  18. VARIACIONES DE LA ARTERIA DEL NODO SINOATRIAL EN POBLACIÓN COLOMBIANA Sino-atrial node artery variation in a sample of the Colombian population

    Directory of Open Access Journals (Sweden)

    Yobany Quijano-Blanco

    2012-03-01

    Full Text Available Antecedentes. El conocimiento exacto de la integración anatomofisiológica del sistema de conducción del corazón, es fundamental para la comprender la fisiopatología, el diagnóstico y el manejo de muchas de las complicaciones de la enfermedad coronaria y de las cardiopatías en general. Uno de los aspectos fundamentales, más variable y con mayores repercusiones clínicas corresponde al origen y recorrido de las arterias encargadas de irrigar el nódulo sinoatrial. Objetivo. Determinar el origen, recorrido y distribución de las arterias que irrigan el nódulo sinoatrial en una muestra de población colombiana. Material y métodos. La muestra de análisis fueron 60 bloques cardiopulmonares y digestivos seleccionados a través de muestreo por conveniencia. A estos se les realizó una disección convencional de los genitales para la determinación del sexo y posteriormente se procedió con la disección de las arterias coronarias específicamente de la arteria del nódulo sinoatrial, con el fin de establecer su origen y recorrido. Resultados. Como hallazgo principal se encontró que el origen de la arteria del nódulo sinoatrial en 75% provenía de la coronaria derecha, un 15% procedía de la arteria circunfleja y el 10% restante fue codominante. En cuanto al trayecto 86,6% fueron lineales, mientras 13,4% tuvieron formas alternas como Y, doble Y o en tridente. Conclusiones. Se evidenció predominio del origen de la arteria del nódulo sinoatrial en la coronaria derecha, hallazgo coincidente con investigaciones similares e independiente de la procedencia geográfica y el origen racial. Sin embargo, en este estudio se evidenciaron recorridos no reportados en la literatura como la distribución en Y, en doble Y, en K invertida y en tridente.Background. Accurate knowledge regarding the cardiac conduction system's anatomical-physiological integration is essential for understanding the pathophysiology, diagnosis and management of many complications

  19. Infarto agudo del miocardio en un recién nacido Acute myocardial infarction in a newborn

    OpenAIRE

    Raúl Santiago Castellanos; Sucel Tamayo Heal; Norka Ibis Hernández Begué; Eliecer Padres Hung; Leonor Méndez Leyva

    2012-01-01

    Se describe el caso clínico de un recién nacido que presentó infarto agudo de miocardio con evolución desfavorable y fallecimiento a las 31 horas del nacimiento en el Servicio de Neonatología del Hospital Ginecoobstétrico Docente "Tamara Bunke Bider" de Santiago de Cuba. La autopsia clínica reveló un defecto congénito del trayecto intramiocárdico de la arteria coronaria descendente anterior izquierda en las primeras 24 horas de iniciados los síntomas y choque cardiogénico, como causas básica ...

  20. Resolución microquirúrgica de aneurisma de arteria cubital en paciente pediátrico

    Directory of Open Access Journals (Sweden)

    A. Aguilera-Salgado

    2015-09-01

    Full Text Available Presentamos el caso clínico de un paciente varón de 6 años de edad con antecedente de caída desde su propia altura un mes antes de su valoración en consulta, en donde se identifica una tumoración pulsátil en región hipotenar de mano derecha, no dolorosa y no fija a planos profundos. El ultrasonido doppler informa de una tumoración con pared definida, heterogénea, con flujo sanguíneo a través de la misma. En base a los antecedentes y a los resultados del ultrasonido se decide intervenir quirúrgicamente para evitar posibles complicaciones, encontrando un aneurisma de la arteria cubital de 3 x 3 cm de diámetro, no trombosado, que resecamos, practicando reconstrucción mediante injerto venoso término-terminal. El paciente evolucionó sin complicaciones.

  1. Congenital anterior urethral diverticulum.

    Science.gov (United States)

    Singh, Sanjeet Kumar; Ansari, Ms

    2014-09-01

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

  2. Síndrome de atrapamiento de la arteria poplítea con aneurisma: reporte de un caso Popliteal entrapment syndrome caused by an aneurism: Case report

    Directory of Open Access Journals (Sweden)

    Tania Buccolini

    2010-06-01

    Full Text Available La verdadera prevalencia del síndrome de atrapamiento de la arteria poplítea es desconocida; se estima en un 0.16%. Se considera la principal causa de claudicación intermitente en jóvenes deportistas sin factores de riesgo cardiovasculares. Se caracteriza por la compresión extrínseca de la arteria poplítea, ya sea por defecto anatómico de las estructuras músculo-tendinosas o por hipertrofia de los músculos gemelos, lo cual ocasiona el atrapamiento y síntomas de parestesias, frialdad y claudicación intermitente en la extremidad comprometida. La compresión crónica de la arteria puede llevar a daño irreversible con formación de trombos y aneurismas y a la consiguiente amputación de la extremidad, por lo que el diagnóstico y el tratamiento oportunos son de gran importancia para el paciente.The true prevalence of the popliteal artery entrapment syndrome is unknown, it is estimated to be 0.16%. It is considered as the main cause of intermittent claudication in young athletes without cardiovascular risk factors. It is characterized by the extrinsic compression of the popliteal artery either caused by defects of the muscle-tendon structures or by the hypertrophy of the gastrocnemius muscle leading to the arterial entrapment and symptoms of paresthesia, intermittent claudication and coldness of the affected limb. Chronic compression of the artery may lead to irreversible damage with formation of thrombi and aneurysms and the subsequent amputation of the limb. Therefore, correct diagnosis and treatment are of great importance for the patient.

  3. Estudio de los mecanismos contráctiles de la musculatura lisa vascular en arterias mesentéricas humanas y su modificación por el envejecimiento : papel del retículo sarcoplásmico

    OpenAIRE

    Navarro Dorado, Jorge

    2013-01-01

    Se ha realizado un estudio de los procesos contráctiles de la musculatura lisa vascular en arterias humanas, comprobando las posibles implicaciones del retículo sarcoplásmico en el proceso contráctil y las diferencias que pudieran existir debidas al envejecimiento. Para ello se han utilizado arterias mesentéricas humanas de pacientes de diferentes edades, realizando el estudio con cuatro técnicas distintas: miografía vascular, para la medición de los procesos contráctiles arteriales, microsco...

  4. Adaptación del algoritmo MARACAS para segmentación de la arteria carótida y cuantificación de estenosis en imágenes TAC

    OpenAIRE

    Doré Vincent; Zuluaga Maria; Orkisz Maciej; Hernandez Marcela; Morales Pinzón Alfredo

    2010-01-01

    En este artículo se describen las adaptaciones hechas al algoritmo MARACAS para segmentar y cuantificar estructuras vasculares en imágenes TAC de la arteria carótida. El algoritmo MARACAS, que está basado en un modelo elástico y en un análisis de los valores y vectores propios de la matriz de inercia, fue inicialmente diseñado para segmentar una sola arteria en imágenes ARM. Las modificaciones están principalmente enfocadas a tratar las especificidades de las imágenes TAC, así como la presenc...

  5. Disección espontánea de arteria ilíaca asociada a ejercicio y uso de ergotamina Spontaneous dissection of iliac artery related with excercise and ergotamine. A case report

    OpenAIRE

    Juan Pablo Fuenzalida G; Angel Puentes R; Sebastián Terrazas F; Sandra Osorio V; Jorge Vergara C.; Eitan Schwartz Y; Rubén Soumastre Ch

    2012-01-01

    Introducción: La disección espontánea de la arteria ilíaca es un cuadro muy poco frecuente asociado a diferentes etiologías que habitualmente se presenta como isquemia de la extremidad comprometida. Caso clínico: Se reporta el caso de un paciente masculino de 48 años con antecedente de consumo crónico de ergotamina, quien mientras practicaba deporte presenta cuadro de isquemia aguda de la extremidad inferior izquierda. Angio tomografía computada demostró disección espontánea de la arteria ilí...

  6. Origen y morfología de la arteria braquial profunda en 14 cadáveres de la universidad de costa rica y de la universidad de ciencias médicas

    Directory of Open Access Journals (Sweden)

    Eduardo Delvo

    2012-09-01

    Full Text Available En este estudio se trata de observar la variabilidad del origen y morfología de la Arteria Braquial Profunda. Se utilizaron 14 cadáveres, a los cuáles se les midió el largo y diámetro de la Arteria Braquial Profunda antes de su bifurcación en Arteria Colateral Radial y Colateral Media en ambos brazos. El 21,4% presentó el origen de la Arteria junto con ramas musculares, el 14,3% de manera bilateral un origen común de la Arteria Braquial Profunda y la Arteria Circunfleja Humeral Posterior,el 7,2% una bifurcación temprana de la Arteria Braquial en Arterial Radial y Ulnar a nivel del tercio proximal del antebrazo y el 7,2% la misma variación a nivel del tercio medio. La longitud y diámetro de la Arteria en el estudio en promedio fue de 84,78 mm con un diametro de 1,66 mm en la izquierda y de 83,26 mm con un diametro de1,68 mm en la derecha, las diferencias presentadas no son estadísticamente significativas. El conocimiento de las diferencias anatómicas s de importancia en la practica clínica y quirúrgicaIn this review the objetive was to analize the variability of the origen and morphology of the Deep Braquial Artery. For it we used 14 bodies, in which we measure the lenght and diameter of the selected artery before the bifurcation of the radial collateral artery and medial collateral artery in both arms. The 21,4% of the cases the origen was presented along with the muscular branches, in the 14,3% was presented bilateral a common origen of Deep Braquial Artery and Posterior Humeral Circumflex Artery, in the 7,2% was presented an early bifurcation of Deep Braquial Artery in radial and ulnar at the third proximal of the forearm, in 7,2% the same modification was observed but at the middle third of the forearm. The lenght and diameter of the artery in promedy found was 84,78mm with a diameter of 1,66mm in the left side and 83,26mm with a diameter of 1,68mm in the right side, the diference found, were not of statiscally significant. The

  7. Anterior vaginal wall repair

    Science.gov (United States)

    ... symptoms will go away. This improvement will often last for years. Alternative Names A/P repair; Vaginal wall repair; Anterior and/ ... writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Contact ... Institutes of Health Page last updated: 23 August 2016

  8. [Toxic anterior segment syndrome].

    Science.gov (United States)

    Cornut, P-L; Chiquet, C

    2011-01-01

    Toxic anterior segment syndrome (TASS) is a general term used to describe acute, sterile postoperative inflammation due to a non-infectious substance that accidentally enters the anterior segment at the time of surgery and mimics infectious endophthalmitis. TASS most commonly occurs acutely following anterior segment surgery, typically 12-72h after cataract extraction. Anterior segment inflammation is usually quite severe with hypopyon. Endothelial cell damage is common, resulting in diffuse corneal edema. No bacterium is isolated from ocular samples. The causes of TASS are numerous and difficult to isolate. Any device or substance used during the surgery or in the immediate postoperative period may be implicated. The major known causes include: preservatives in ophthalmic solutions, denatured ophthalmic viscosurgical devices, bacterial endotoxin, and intraocular lens-induced inflammation. Clinical features of infectious and non-infectious inflammation are initially indistinguishable and TASS is usually diagnosed and treated as acute endophthalmitis. It usually improves with local steroid treatment but may result in chronic elevation of intraocular pressure or irreversible corneal edema due to permanent damage of trabecular meshwork or endothelial cells. PMID:21176994

  9. Pulskurvenanalyse in der Arteria ophthalmica als Funktion von Alter, Geschlecht, kardio-vaskulärer Risikofaktoren, Glaukom, Verdacht auf Glaukom und okulärer Hypertension

    OpenAIRE

    Fiermann, Thomas

    2009-01-01

    Die Analyse der Pulskurvenform liefert direkte Informationen über die Gefäßbeschaffenheit an der Arteria ophthalmica und deren distalem Stromgebiet. Alter, Geschlecht, arterielle Hypertonie, Diabetes mellitus, Glaukome und Nikotinkonsum verändern die Pulskurvenform im Sinne einer „Voralterung“. Der SK und der SI könnten als Maß für die Bestimmung des biologischen Gefäßalters bei Männern und Frauen verwendet werden. Neben den bekannten Risiko-Scoren erweitert die SK- und SI-Berechnung die vask...

  10. Seudoaneurismas iatrogénicos de arteria femoral: factores de riesgo, prevención y opciones terapéuticas

    OpenAIRE

    Luis Meneses

    2011-01-01

    Los Seudoaneurimas (SA) iatrogénicos de la arteria femoral, se han vuelto más frecuentes debido al aumento en la complejidad de los procedimientos que requieren introductores cada vez de mayor diámetro, asociado a terapias anticoagulantes y/o antiagregantes de largo plazo. El tratamiento estándar de este tipo de lesiones fue por mucho tiempo la cirugía, sin embargo, han aparecido nuevas opciones menos invasivas, como el seguimiento activo, la compresión guiada bajo ultrasonido o la inyección ...

  11. Tamizaje y prevención de pre-eclampsia guiado por Doppler de arterias uterinas: revisión sistemática de la literatura

    OpenAIRE

    Nicolás Sáez O; Jorge Carvajal C

    2012-01-01

    Antecedentes: La pre-eclampsia (PE) es una enfermedad grave asociada al embarazo con una prevalencia de ~3%. La identificación de las mujeres en riesgo podría mejorar el resultado materno y perinatal. La estimación de riesgo individual de PE permitiría ofrecer un tratamiento preventivo para ésta [ej: aspirina (AAS)]. Se ha descrito el Doppler de arterias uterinas (DAUt) en primer y segundo trimestre como un método de tamizaje de PE. Objetivo: Recopilar la evidencia disponible sobre el uso del...

  12. Pseudoaneurisma de arteria renal principal asociado a fistula cecal tras nefrectomia radical: caso clínico y revisión de la literatura

    OpenAIRE

    A. Hernando Arteche; C. Alpuente Roman; R. Martin del Toro; A. Pérez-Piqueras Gómez; F. Sainz González; JA. Cabrera Cabrera

    2014-01-01

    Las complicaciones vasculares secundarias al tratamiento quirúrgico del cáncer de riñón localizado son más frecuentes cuando se realiza una cirugía conservadora de nefronas. Sin embargo, la nefrectomía radical no está exenta de ellas. Presentamos el caso de un pseudoaneurisma de la arteria renal principal con comunicación fistulosa a colon ascendente tras nefrectomía radical. El paciente debutó con un episodio de shock hipovolémico debido a hemorragia digestiva baja.

  13. Pseudoaneurisma de arteria renal principal asociado a fistula cecal tras nefrectomia radical: caso clínico y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    A. Hernando Arteche

    2014-06-01

    Full Text Available Las complicaciones vasculares secundarias al tratamiento quirúrgico del cáncer de riñón localizado son más frecuentes cuando se realiza una cirugía conservadora de nefronas. Sin embargo, la nefrectomía radical no está exenta de ellas. Presentamos el caso de un pseudoaneurisma de la arteria renal principal con comunicación fistulosa a colon ascendente tras nefrectomía radical. El paciente debutó con un episodio de shock hipovolémico debido a hemorragia digestiva baja.

  14. Muerte súbita cardíaca en mujer joven Sudden cardiac death in young woman

    Directory of Open Access Journals (Sweden)

    M. Salguero Villadiego

    2003-10-01

    Full Text Available Presentamos un caso de muerte súbita cardíaca en una mujer joven sin patología arteriosclerótica en las arterias coronarias. En el miocardio y el aparato valvular no se preciaban alteraciones morfológicas. En la arteria coronaria desce ndente anterior se advierte un hematoma disecante que produce una oclusión completa de la luz vascular sin que existan evidencias morfológicas de degeneración quística de la media. Diagnóstico: Disección espontánea de la arteria coronaria descendente anterior.We present a case of sudden cardiac death in a young woman without arteriosclerotic pathology in the coronary arteries. In the myocardium and the valvular apparatus morphologic alterations were not appreciated. In the anterior coronary descending artery there is noticeable a dissecting hematoma that produces a complete occlusion of the vascular light without any morphologic evidence of cystic degeneracy of the tunica media. iagnosis: spontaneous dissection of the anterior coronary descending artery.

  15. Anterior cruciate ligament (ACL) injury

    Science.gov (United States)

    Cruciate ligament injury - anterior; ACL injury; Knee injury - anterior cruciate ligament (ACL) ... confirm the diagnosis. It may also show other knee injuries. First aid for an ACL injury may include: ...

  16. Anterior Cruciate Ligament Injury

    OpenAIRE

    Vilaseca, Tomas; Chahla, Jorge; Rodriguez, Gustavo Gomez; Arroquy, Damián; Herrera, Gonzalo Perez; Orlowski, Belen; Carboni, Martín

    2015-01-01

    Objectives: The objective of this study was to analyze whether it is more frequent the presence of a decreased range of motion in the hips of recreational athletes with primary injury of the anterior cruciate ligament (ACL) than in a control group of volunteers without knee pathology. Methods: We included prospectively recreational athletes between 18 and 40 years with an acute ACL injury between January 2011 and January 2013. They were compared with a control group of volunteers recreational...

  17. The Aberrant Right Subclavian Artery (Arteria Lusoria: The Morphological and Clinical Aspects of One of the Most Important Variations—A Systematic Study of 141 Reports

    Directory of Open Access Journals (Sweden)

    Michał Polguj

    2014-01-01

    Full Text Available The most important abnormality of the aortic arch is arguably the presence of an aberrant right subclavian artery (arteria lusoria. If this vessel compresses the adjacent structures, several symptoms may be produced. The aim of the study is to present the morphological and clinical aspects of the aberrant right subclavian artery. Three different databases searched for a review of pertinent literature using strictly predetermined criteria. Of 141 cases, 15 were cadaveric and 126 were clinically documented. The gender distribution of the subjects was 55.3% female and 44.7% male. The mean age of the patients at symptoms onset was 49.9±19.4 years for all patients but 54.0±19.6 years and 44.9±18.1 years for female and male subjects, respectively (P=0.0061. The most common symptoms in this group were dysphagia (71.2%, dyspnea (18.7%, retrosternal pain (17.0%, cough (7.6%, and weight loss (5.9%. The vascular anomalies coexisting with an arteria lusoria were truncus bicaroticus (19.2%, Kommerell’s diverticulum (14.9%, aneurysm of the artery itself (12.8%, and a right sided aortic arch (9.2%. In conclusion, compression of adjacent structures by an aberrant right subclavian artery needs to be differentiated from other conditions presenting dysphagia, dyspnea, retrosternal pain, cough, and weight loss.

  18. The Aberrant Right Subclavian Artery (Arteria Lusoria): The Morphological and Clinical Aspects of One of the Most Important Variations—A Systematic Study of 141 Reports

    Science.gov (United States)

    Chrzanowski, Łukasz; Kasprzak, Jarosław D.; Stefańczyk, Ludomir; Topol, Mirosław; Majos, Agata

    2014-01-01

    The most important abnormality of the aortic arch is arguably the presence of an aberrant right subclavian artery (arteria lusoria). If this vessel compresses the adjacent structures, several symptoms may be produced. The aim of the study is to present the morphological and clinical aspects of the aberrant right subclavian artery. Three different databases searched for a review of pertinent literature using strictly predetermined criteria. Of 141 cases, 15 were cadaveric and 126 were clinically documented. The gender distribution of the subjects was 55.3% female and 44.7% male. The mean age of the patients at symptoms onset was 49.9 ± 19.4 years for all patients but 54.0 ± 19.6 years and 44.9 ± 18.1 years for female and male subjects, respectively (P = 0.0061). The most common symptoms in this group were dysphagia (71.2%), dyspnea (18.7%), retrosternal pain (17.0%), cough (7.6%), and weight loss (5.9%). The vascular anomalies coexisting with an arteria lusoria were truncus bicaroticus (19.2%), Kommerell's diverticulum (14.9%), aneurysm of the artery itself (12.8%), and a right sided aortic arch (9.2%). In conclusion, compression of adjacent structures by an aberrant right subclavian artery needs to be differentiated from other conditions presenting dysphagia, dyspnea, retrosternal pain, cough, and weight loss. PMID:25105156

  19. The aberrant right subclavian artery (arteria lusoria): the morphological and clinical aspects of one of the most important variations--a systematic study of 141 reports.

    Science.gov (United States)

    Polguj, Michał; Chrzanowski, Łukasz; Kasprzak, Jarosław D; Stefańczyk, Ludomir; Topol, Mirosław; Majos, Agata

    2014-01-01

    The most important abnormality of the aortic arch is arguably the presence of an aberrant right subclavian artery (arteria lusoria). If this vessel compresses the adjacent structures, several symptoms may be produced. The aim of the study is to present the morphological and clinical aspects of the aberrant right subclavian artery. Three different databases searched for a review of pertinent literature using strictly predetermined criteria. Of 141 cases, 15 were cadaveric and 126 were clinically documented. The gender distribution of the subjects was 55.3% female and 44.7% male. The mean age of the patients at symptoms onset was 49.9 ± 19.4 years for all patients but 54.0 ± 19.6 years and 44.9 ± 18.1 years for female and male subjects, respectively (P = 0.0061). The most common symptoms in this group were dysphagia (71.2%), dyspnea (18.7%), retrosternal pain (17.0%), cough (7.6%), and weight loss (5.9%). The vascular anomalies coexisting with an arteria lusoria were truncus bicaroticus (19.2%), Kommerell's diverticulum (14.9%), aneurysm of the artery itself (12.8%), and a right sided aortic arch (9.2%). In conclusion, compression of adjacent structures by an aberrant right subclavian artery needs to be differentiated from other conditions presenting dysphagia, dyspnea, retrosternal pain, cough, and weight loss. PMID:25105156

  20. Alguns aspectos da mortalidade entre japoneses e seus descendentes residentes no município de São Paulo, Brasil Some aspects of mortality in Japanese and their descendants in the city of S. Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Sabina Léa Davidson Gotlieb

    1974-12-01

    Full Text Available São analisadas algumas características da mortalidade entre imigrantes japoneses e seus descendentes residentes no município de São Paulo, comparando-as com a população do Japão e geral do município de São Paulo. Os imigrantes japoneses e seus descendentes apresentam padrão de mortalidade de nível intermediário entre o do local de origem e o de destino, aproximando-se mais do nível de saúde do Japão. A mortalidade infantil entre os descendentes dos imigrantes, nascidos no município de São Paulo, é bem inferior à do município de São Paulo. O risco de morrer por lesões vasculares que afetam o sistema nervoso central é mais alto no Japão. Por outro lado, o risco de morrer por doenças cardíacas é muito mais alto no município de São Paulo. Os imigrantes japoneses apresentam-se num nível intermediário de mortalidade pelas causas acima referidas. Tal fato sugere atuação de fatores ambientais, levando os imigrantes a adquirirem padrão de mortalidade do local de destino.Some mortality characteristics of Japanese immigrants and their descendants living in the city of S. Paulo, Brazil, are analysed. Comparison between these characteristics and those among the populations of Japan and the city of S. Paulo has been made. The Japanese immigrants and their descendants have an intermediate pattern of mortality ranking between the pattern of Japan and the S. Paulo one, being closer to the former. The infant mortality rate among the Japanese born in S. Paulo is much lower than the S. Paulo rate. The death rate for vascular lesions affecting the Central Nervous System is higher in Japan. On the other hand, the death rate for diseases of the heart (except rheumatic heart disease is much higher in S. Paulo. The association of a low death rate for diseases of the heart with a high death rate for vascular lesions affecting the Central Nervous System is observed. The Japanese immigrants tend to occupy an intermediate mortality level

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

    Directory of Open Access Journals (Sweden)

    Erdmann, Alfons

    2014-04-01

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

  2. Anterior knee pain

    International Nuclear Information System (INIS)

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

  3. The anterior cingulate cortex

    Directory of Open Access Journals (Sweden)

    Pavlović D.M.

    2009-01-01

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

  4. Multidisciplinary management of anterior diastemata

    DEFF Research Database (Denmark)

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

    2007-01-01

    Anterior diastemata may compromise the harmony of a patient's smile. Consideration of etiologic factors, previous gingival conditioning, and individual treatment planning are essential in the proper management of anterior diastemata. An integrated orthodontic-restorative approach may enhance the...... aesthetic results when orthodontic therapy itself is not feasible. This article presents integrated orthodonticrestorative solutions of anterior diastemata, associated with the conditioning of the gingival tissue with composite resin, and discusses the most relevant aspects related to their etiology and...

  5. Arteria lusoria associée à un tronc bi carotidien: à propos d'un cas et revue de la littérature

    Science.gov (United States)

    Khnaba, Safae; Menany, Meryem; Moukinebillah, Mouna; Amil, Touriya; Radouane, Bouchayb

    2015-01-01

    L'arteria lusoria ou artère sous Clavière droite retro-œsophagienne constitue la malformation de l'arc aortique la plus fréquente, elle peut être associée à d'autres anomalies congénitales du cœur et des gros vaisseaux, notamment le tronc bi carotidien qui constitue un tronc commun donnant naissance aux deux artères carotides primitives internes. Nous rapportons le cas d'une patiente chez qui on a diagnostiqué un adénocarcinome gastrique, le scanner thoraco-abdominopelvien réalisé dans le cadre de son bilan d'extension a permis la découverte fortuite d'une artère aberrante retro-œsophagienne associé à un tronc bi carotidien. PMID:27047617

  6. Anterior cruciate ligament reconstruction

    International Nuclear Information System (INIS)

    This paper determines the efficacy of MR imaging in evaluation of the anterior cruciate ligament (ACL) following reconstructive surgery. Forty-three MR examinations were performed in 33 patients who had undergone previous arthroscopic ACL reconstruction with patellar bone-tendon- bone autografts (postoperative period, 1-24 months; mean, 5.2 months). Of the 40 studies performed in clinically stable knees (30 patients), MR demonstrated a well-defined, signal void ACL graft in 36. Of the three studies performed in three patients with clinical ACL laxity or suspected tear, the neoligament was of intermediate definition in one and nondiscernible in the other two. As in the native knee, buckling of the PCL was suggestive of ACL insufficiency. Bone tunnel placement, patellar tendon changes, and joint effusions were also evaluated

  7. Anterior hip pain.

    Science.gov (United States)

    O'Kane, J W

    1999-10-15

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

  8. Resolución exitosa de la Estenosis Congénita de las dos ramas de la Arteria Pulmonar en un adulto mediante el uso de stents

    Directory of Open Access Journals (Sweden)

    José Solano V

    2013-06-01

    Full Text Available La estenosis de las arterias pulmonares son rara vez diagnosticadas en edad adulta, convirtiéndose su tratamiento en una compleja situación con diferentes posibilidades terapéuticas. Las causas mas frecuentes corresponden a las adquiridas, siendo la mas común la hipertensión pulmonar trombo embolica crónica, quedando un reducido numero de casos congénitos asociado principalmente a síndromes genéticos y malformaciones cardiacas asociadas. El tratamiento quirúrgico convencional puede convertirse en un desafío dadas las condiciones anatómicas y funcionales encontradas en estadios avanzados propias del diagnostico tardío y en especial en el caso presentado el cual esta iniciando la sétima década de la vida. La posibilidad de resolución percutánea de estas lesiones cobra importancia a la luz de la amplia utilización de esta en pacientes pediátricos, implementando el uso cada vez mayor de balones con dilatación percutánea y la utilización de stents cada vez más sofisticados con buenos resultados. Se presenta nuestro primer caso de resolución percutánea de lesiones coronarias y de arteria pulmonar bilateral en un paciente previamente programado para cirugía de reparación con parche y by pass coronario , el cual evoluciono en forma satisfactoria recobrando su actividad normal a las pocas horas del procedimiento.

  9. Embolización de la arteria esplénica como tratamiento del hiperesplenismo en pacientes hemofílicos, HIV-1 y HCV seropositivos

    Directory of Open Access Journals (Sweden)

    M. E. Corti

    2003-06-01

    Full Text Available La trombocitopenia es una anomalía usual e importante en pacientes con coinfección por HIV-1/HCV. La esplenomegalia es un hallazgo frecuente en estos pacientes y, usualmente, causa hiperesplenismo y trombocitopenia. Analizamos los resultados clínicos de un método invasivo mínimo (embolización de la arteria esplénica para el tratamiento de la trombocitopenia secundaria al hiperesplenismo y refractaria a otras terapias en dos pacientes hemofílicos, infectados por el HIV-1 y con cirrosis causada por la infección crónica por HCV. Estos resultados sugieren que la embolización de la arteria esplénica es un método seguro, poco traumático y efectivo para el tratamiento de la esplenomegalia y el hiperesplenismo en pacientes con coinfección por HIV-1/HCV.Thrombocytopenia is an important and common hematological abnormality in patients with HIV-1/HCV coinfection. Splenomegaly is a frequent finding in these patients and usually causes hypersplenism and thrombocytopenia. We analyzed the clinical results of a minimal invasive treatment (splenic artery embolization for thrombocytopenia secondary to hypersplenism and refractory to other therapies in two hemophiliac patients, HIV seropositive and with cirrhosis due to chronic HCV infection. The results suggest that splenic artery embolization is a safe, relatively atraumatic and effective method for the treatment of splenomegaly and hypersplenism in selected patients with HIV-1/HCV coinfection.

  10. Arteria poplitea afklemningssyndrom

    DEFF Research Database (Denmark)

    Lyndrup, Peter; Meyer, Joan N; Schroeder, T V

    1994-01-01

    Popliteal artery entrapment syndrome (PAES) should be suspected in young persons without predisposing factors to arteriosclerosis, who present with unilateral claudication in the calf and foot. This entity results from a developmental abnormal relation between the popliteal artery and the medial...... head of the gastrocnemius muscle. PAES is mostly found in young sportsmen or young soldiers with well-developed muscles. The onset of the symptoms is often sudden, occurring during an episode of intense lower extremity activity. The diagnosis is best established by a thorough clinical examination...

  11. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... and E-poly antioxidant-infused technology during a hip replacement through the anterior supine intramuscular approach. “OR- ... Dr. Keith Berend perform an anterior approach total hip replacement with the patient on a regular OR ...

  12. Cirurgia da aorta descendente e tóraco-abdominal com técnica de oclusão proximal isolada da aorta ("open distal" Surgical treatment of descending thoracic and thoracoabdominal aorta with the "open distal" technique

    Directory of Open Access Journals (Sweden)

    Bayard Gontijo Filho

    1995-09-01

    Full Text Available O presente relato apresenta a experiência obtida em um período de 4 anos (jan/91 - jan/95 com a técnica "open distal" descrita por Cooley, em 1990³, para tratamento cirúrgico de doenças da aorta torácica descendente e aorta tóraco-abdominal. Nesse período foram realizadas 35 operações (25 para aorta descendente e 10 para aorta tóraco-abdominal. Os aneurismas de origem degenerativa e as dissecções aórticas ocorreram em freqüência semelhante (48,5% e 40%, respectivamente; em 8 pacientes havia rotura da aorta, parcialmente tamponada pelo pulmão (5 casos, órgãos abdominais (2 casos e esófago (1 caso. O acesso cirúrgico foi obtido por toracotomia póstero-lateral esquerda ou tóraco-freno-laparotomia. Heparina foi usada na dose de 1,5 mg/kg e todo sangue do campo cirúrgico foi coletado a um reservatório e reinfundido pela veia femoral. Houve 4 (11.4% óbitos hospitalares e 2 (5,8% pacientes portadores de aneurisma tóraco-abdominal desenvolveram paraplegia. A morbi-mortalidade do grupo foi diretamente relacionada à condição clínica per-operatória e à extensão do segmento aórtico acometido. Na nossa opinião, a técnica "open distal" é um método alternativo simples e eficaz no tratamento cirúrgico das doenças da aorta descendente e tóraco-abdominal. Em casos de ressecções extensas com períodos longos de oclusão aórtica, métodos para proteção medular deverão ser avaliadosSince Jan/91 we have been using the "open distal" technique (ODT described by Cooley, for surgical treatment of diseases of the descending thoracic and thoracoabdominal aorta. From jan/91 to jan/95, the technique was used in 35 instances (25 for descending aorta and 10 for thoracoabdominal aorta. Degenerative aneurysms and aortic dissections had similar incidence in this group (48.5% and 40.0%, respectively. In 8 patients the aorta was ruptured which was partially occluded by the lung (5 cases, abdominal organs (2 cases and esophagus (1

  13. Estudo da motilidade espontânea de segmentos de cólon ascendente, transverso e descendente de ratos, em banhos fisiológicos para órgãos isolados Study of spontaneous motility of parts of colon in physiologic chamber for isolated organ, in rats

    OpenAIRE

    Francisco Rodrigues de Sales; Alcino Lázaro da Silva

    2004-01-01

    OBJETIVO: Identificar as diferenças na freqüência, amplitude de contrações, traçados negativos e forma das ondas. MÉTODOS: Fez-se um estudo da motilidade espontânea de segmentos de cólon ascendente, transverso e descendente de ratas, em banhos fisiológicos para órgãos isolados. RESULTADOS: Verificou-se grande variabilidade de freqüências e amplitudes das contrações registradas. Embora tenha havido predominância de contrações fortes no cólon descendente e de contrações menores no cólon transve...

  14. Determinación de las características anatómicas de las arterias coronarias de cerdo mediante técnica de inyección con látex

    Directory of Open Access Journals (Sweden)

    Guillermo Rivera

    2015-06-01

    Full Text Available Objetivo: Determinar las características anatómicas de las arterias coronarias del cerdo, mediante inyección con látex. Materiales y métodos: Se usaron 100 corazones de cerdo. Se insertaron sondas Nelaton a través de las arterias coronarias y se les inyectó solución de látex y tinta china. Se determinó el diámetro y el punto de origen para la coronaria derecha, coronaria izquierda, interventricular paraconal y circunfleja. Se cuantificaron el número de ramas diagonales, marginales ventriculares izquierdas y postero laterales. Se determinó frecuencia de ramus intermedius y tipo de dominancia. Se realizó análisis estadístico con un error estándar del 5%, con el Epidat 3,1. Resultados: El 100% de los orígenes anatómicos de las arterias coronarias fueron normales. La dominancia mas frecuente fue la derecha, 73%. El promedio de número de ramas marginales izquierdas, diagonales y posterolaterales fue de 3. La frecuencia de ramus intermedius fue de 12%. El calculo de chi cuadrado de Pearson mostró significancia entre el ramus intermedius y número de ramas marginales izquierdas (p=0,0009. Conclusiones: Las características anatómicas de las arterias coronarias del cerdo son similares a las del humano. El ramus intermedius se comporta como una primera rama marginal izquierda y no como una primera rama diagonal como lo afirman algunos autores.

  15. Anterior Approach Total Hip Replacement

    Medline Plus

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

  16. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... an anterior approach total hip replacement with the patient on a regular OR table supine. My name ... less invasive without being small incision surgery. Obese patients can be easier due to less distribution of ...

  17. Anterior Approach Total Hip Replacement

    Medline Plus

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

  18. Anterior approach for knee arthrography

    International Nuclear Information System (INIS)

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

  19. Travoprost Induced Granulomatous Anterior Uveitis

    OpenAIRE

    Patrick Chiam

    2011-01-01

    Purpose. To report a case of granulomatous anterior uveitis caused by travoprost. Methods. Single observational case report. Results. A 71-year-old who was fit and healthy presented with bilateral granulomatous anterior uveitis 2 months after he was started on travoprost in both eyes. There was no past history of uveitis. Blood test and radiological investigation were unremarkable. Travoprost was stopped. The uveitis resolved on topical steroid treatment. A rechallenge with travoprost was att...

  20. Update on anterior ankle impingement

    OpenAIRE

    Vaseenon, Tanawat; Amendola, Annunziato

    2012-01-01

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

  1. Anterior chamber depth during hemodialysis

    Directory of Open Access Journals (Sweden)

    Gracitelli CPB

    2013-08-01

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

  2. Lembranças do país da cocanha entre os descendentes de imigrantes italianos no início do século XX: o Brasil imaginado

    Directory of Open Access Journals (Sweden)

    Silvana Bagno

    2009-04-01

    Full Text Available Este estudo aborda o tema da imigração italiana à luz do imaginário daqueles que se dirigiam em massa para o Brasil em busca de um mundo novo, paradisíaco, perseguindo o sonho de um Paraíso Terrestre, o país imaginário da Cocanha. Enquanto modalidade de pesquisa fenomenológica, procura desvelar as "lembranças" das memórias dos descendentes dos imigrantes italianos quanto ao que seus antepassados imaginavam encontrar no Brasil, quando aqui chegassem. O tema é ilustrado a partir de obras literárias, valendo-se do personagem Nanetto Pipetta, jovem imigrante clandestino vêneto, cujas aventuras eram publicadas semanalmente em capítulos no jornal gaúcho Stafetta Riograndense, nos anos 1924-1925. O imaginário sobre o Brasil como o país da Cocanha para o imigrante italiano, encontra neste personagem sua expressão fiel, mantendo acesa a chama da esperança de uma vida melhor para si e para as gerações futuras.

  3. Colgajos de perforantes de las arterias epigástricas inferiores profunda y superficial Deep and superficial inferior epigastric artery perforator flaps

    Directory of Open Access Journals (Sweden)

    A. R. Gagnon

    2006-12-01

    Full Text Available Con el desarrollo de los colgajos miocutáneos de recto abdominal (TRAM, el abdomen inferior ha sido reconocido como la principal área dadora de tejidos autólogos de alta calidad, especialmente útiles en reconstrucción mamaria. Más recientemente la habilidad para obtener componentes adiposocutáneos similares sin sacrificar el músculo recto ha revolucionado el campo de la Cirugía Reconstructiva. El advenimiento de los colgajos de perforantes ha permitido a los cirujanos plásticos lograr los mismos buenos resultados estéticos que con los colgajos miocutáneos tradicionales, pero con un considerable descenso en la morbilidad del área donante. Con los colgajos de perforantes de la arteria epigástrica inferior profunda (DIEP y de la arteria epigástrica inferior superficial (SIEA, los pacientes han incrementado sus opciones de reconstrucción. Este artículo revisa la anatomía quirúrgica de la pared abdominal relativa a los colgajos SIEA y DIEP. Se explican detalladamente los pasos principales para la preparación preoperatoria, la técnica quirúrgica y los cuidados postoperatorios. Se discuten las ventajas y desventajas y se presen- tan los trucos técnicos que pueden ayudar a mejorar el resultado final. Además se ilustran con ayuda de casos clínicos las indicaciones típicas y atípicas.Following the development of the transverse rectus abdominis myocutaneous (TRAM flap, the lower abdomen has been recognized as a prime source of high quality autogenous tissue, especially useful in breast reconstruction. More recently, the ability to harvest a similar adipocutaneous component without sacrifice of the rectus muscle has revolutionized the field of reconstructive surgery. The advent of perforator flaps has allowed plastic surgeons to achieve the same highly esthetic results as with the former myocutaneous flaps while significantly decreasing the donor site morbidity. With the deep inferior epigastric artery perforator (DIEP flap and

  4. Coronary artery abnormalities in pediatric patients: classification. Anomalías de las arterias coronarias en pacientes pediátricos: clasificación.

    Directory of Open Access Journals (Sweden)

    José Jesús García Mendiola

    Full Text Available Coronary artery anomaly is defined as any anatomical pattern that is apart from the normal element in regard to their origin, number, distribution and course. Through different mechanisms, it could be the cause of t thoracic pain, sudden death, myocardiopathy, syncope, myocardial infarction and ventricular fibrillation. These constitute a group of malformations which can be classified into, congenital, acquired and associated to other cardiac entities malformations. Due to the importance of this topic for cardiologists and specifically to pediatric cardiologists, this bibliographical revision about abnormalities classification is carried out.
    Se define como anomalía de las arterias coronarias a cualquier patrón anatómico que se aparte de lo normal en lo referente a su origen, número, distribución y trayecto. Mediante diferentes mecanismos, pueden ser la causa de dolor torácico, muerte súbita, miocardiopatía, síncope, infarto de miocardio y fibrilación ventricular. Constituyen un grupo de malformaciones que pueden clasificarse en: congénitas, adquiridas y asociadas a otras entidades cardiacas. Por la importancia que reviste para cardiólogos en general y sobre todo para cardiólogos pediatras, se realiza una revisión bibliográfica acerca de la clasificación de estas anomalías.

  5. Manejo de lesión traumática de arteria femoral con injerto autólogo de vena safena en zona de operaciones

    Directory of Open Access Journals (Sweden)

    M. Gascón Hove

    2015-03-01

    Full Text Available Tanto en el ámbito civil como en el militar, las lesiones vasculares de las extremidades inferiores son frecuentes y potencialmente mortales. Las medidas de soporte iniciales para combatir el shock, una actitud quirúrgica técnicamente correcta encaminada a reparar precozmente la vascularización del miembro y un control postoperatorio estricto y continuo son los pilares básicos del tratamiento. En condiciones óptimas, las tasas de amputación y de mortalidad se hallan por debajo del 10 y del 4%, respectivamente. Presentamos a continuación un caso de un militar afgano con una lesión con pérdida de substancia de la arteria femoral en el que se consiguió una revascularización inicial con un shunt temporal. Tras ser estabilizado y evacuado al ROLE 2 de Herat, se realizó un injerto autólogo de la vena safena contralateral.

  6. Pseudo-aneurisma post-traumático de tronco de arteria coronaria izquierda Post-traumatic false (pseudo aneurysm of the left main coronary artery

    Directory of Open Access Journals (Sweden)

    Melina M. Gallo

    2011-08-01

    Full Text Available El pseudo-aneurisma de arteria coronaria es extremadamente raro. Su historia natural es poco conocida y su tratamiento discutido. Se presenta el caso de un paciente con pseudo-aneurisma de tronco de la coronaria izquierda e infarto antero-apical del ventrículo izquierdo cinco años después de un paro cardíaco secundario a un traumatismo no penetrante de tórax. Se consideró entonces que la lesión no era pasible de corrección percutánea o quirúrgica por lo que se optó por tratamiento médico conservador. Una angiografía coronaria por tomografía computarizada multicorte realizada 10 años después del evento inicial mostró ausencia de progresión de la lesión.Coronary pseudo-aneurysm is an extremely rare entity. Its natural history is scarcely known and its treatment is controversial. We report a case of pseudo-aneurysm of the left main coronary artery associated with an antero-apical infarct of the left ventricle diagnosed five years after a cardiac arrest following a non-penetrating thoracic trauma. The patient was treated conservatively because percutaneous or surgical correction were not considered suitable for this lesion. A multidetector computed tomography coronary angiogram performed 10 years after the initial event showed no evidence of progression.

  7. Travoprost Induced Granulomatous Anterior Uveitis

    Science.gov (United States)

    Chiam, Patrick

    2011-01-01

    Purpose. To report a case of granulomatous anterior uveitis caused by travoprost. Methods. Single observational case report. Results. A 71-year-old who was fit and healthy presented with bilateral granulomatous anterior uveitis 2 months after he was started on travoprost in both eyes. There was no past history of uveitis. Blood test and radiological investigation were unremarkable. Travoprost was stopped. The uveitis resolved on topical steroid treatment. A rechallenge with travoprost was attempted in one eye. The inflammation recurred in this eye only. This subsided with the cessation of travoprost alone without topical steroid. Conclusion. This is the first case report of travoprost causing granulomatous anterior uveitis. The uveitis recurred with a rechallenge. Changing the prostaglandin analogue to another topical treatment may be adequate to cease the inflammation. PMID:22606464

  8. Transesophageal access to the cardiac cavities and descending thoracic aorta via echoendoscopy: An experimental study Acceso transesofágico a cavidades cardiacas y aorta torácica descendente mediante ecoendoscopia: Estudio experimental

    Directory of Open Access Journals (Sweden)

    A. López Martín

    2009-09-01

    trabajo pretenden evaluar la anatomía cardiaca, su abordaje, la seguridad del procedimiento experimental y los cambios morfológicos e histológicos derivados. Material y métodos: se ha trabajado con dos animales adultos de la especie porcina a los que se han practicado diversos abordajes a cavidades cardiacas y aorta torácica descendente con excelentes resultados. Resultados: se han identificado y abordado diversas estructuras cardiacas (aurícula derecha, aurícula izquierda, ventrículo izquierdo, válvulas cardiacas y grandes vasos. El uso de contraste intracavitario y desde una vía venosa periférica ha permitido asegurar los espacios anatómicos estudiados. Durante los procedimientos se ha monitorizado la aparición de arritmias, el comportamiento hemodinámico, la posibilidad de infección mediante la obtención de hemocultivos antes y después de aquellos y la respuesta a las punciones. Conclusiones: el presente trabajo nos ha permitido evaluar el acceso al corazón desde la luz esofágica mediante ultrasonografía endoscópica, con unos resultados muy similares a los observados en la literatura, ofreciendo dos novedades como la punción de la aurícula derecha a través del tabique interauricular y de la aorta torácica descendente, de forma fácil y aparentemente segura.

  9. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... during a hip replacement through the anterior supine intramuscular approach. “OR-Live,” the vision of improving health. ... the approach are operating through an internervous and intramuscular anatomic interval. It’s not necessary to detach any ...

  10. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... got coming out in “JBJS,” the early six-week recovery is dramatically different between a direct lateral abductor splitting approach and this anterior supine approach. Let me get this head on. My experience, these patients have full leg control in about 24 hours. Yeah. They can get out of bed and ...

  11. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... the anterior supine intramuscular approach. “OR-Live,” the vision of improving health. Good evening and welcome to ... should know that this is done under direct vision. Yeah. You are seeing everything you’re doing. ...

  12. Adaptación del algoritmo MARACAS para segmentación de la arteria carótida y cuantificación de estenosis en imágenes TAC

    Directory of Open Access Journals (Sweden)

    Doré Vincent

    2010-12-01

    Full Text Available En este artículo se describen las adaptaciones hechas al algoritmo MARACAS para segmentar y cuantificar estructuras vasculares en imágenes TAC de la arteria carótida. El algoritmo MARACAS, que está basado en un modelo elástico y en un análisis de los valores y vectores propios de la matriz de inercia, fue inicialmente diseñado para segmentar una sola arteria en imágenes ARM. Las modificaciones están principalmente enfocadas a tratar las especificidades de las imágenes TAC, así como la presencia de bifurcaciones. Los algoritmos implementados en esta nueva versión se clasifican en dos niveles. 1 Los procesamientos de bajo nivel (filtrado de ruido y de artificios direccionales, presegmentación y realce destinados a mejorar la calidad de la imagen y presegmentarla. Estas técnicas están basadas en información a priori sobre el ruido, los artificios y los intervalos típicos de niveles de gris del lumen, del fondo y de las calcificaciones. 2 Los procesamientos de alto nivel para extraer la línea central de la arteria, segmentar el lumen y cuantificar la estenosis. A este nivel, se aplican conocimientos a priori sobre la forma y anatomía de las estructuras vasculares. El método fue evaluado en 31 imágenes suministradas en el concurso “Carotid Lumen Segmentation and Stenosis Grading Grand Challenge” 2009. Los resultados obtenidos en la segmentación arrojaron un coeficiente de similitud de Dice promedio de 80.4% comparado con la segmentación de referencia, y el error promedio de la cuantificación de estenosis fue 14.4%.

  13. ANGIOPLASTIA PERCUTÁNEA CON STENT EN EL TRONCO PRINCIPAL DE LA ARTERIA CORONARIA IZQUIERDA / Percutaneous angioplasty with stent in the left main coronary artery

    Directory of Open Access Journals (Sweden)

    Javier Almeida Gómez

    2012-10-01

    Full Text Available ResumenIntroducción y objetivos: La afectación significativa del tronco común izquierdo, es la más letal de las presentaciones de la enfermedad arterial coronaria. El tratamiento de elección, es la cirugía de derivación aorto-coronaria. En varios estudios multicéntricos, se sugiere la posibilidad de tratar la enfermedad de tronco mediante el intervencionismo coronario percutáneo con implantación de prótesis endoluminal o stent. El objetivo de esta investigación fue caracterizar la angioplastia percutánea con stent en el tronco principal de la arteria coronaria izquierda. Método: Se realizó un estudio observacional, descriptivo y transversal en 21 pacientes con angioplastia percutánea con stent en el tronco principal de la arteria coronaria izquierda, realizadas en el laboratorio de Hemodinámica y Cardiología Intervencionista del Hospital "Hermanos Ameijeiras", entre enero 2010 y julio 2011. Resultados: No existió diferencia significativa en el sexo. Predominó el grupo de edad entre 50-64 años (47,6 % y el color de la piel blanca (76,19 %. El factor de riesgo cardiovascular más encontrado fue la HTA (85,71 %, seguido de dislipidemia (47,61 %. El diagnóstico más observado fue la angina de esfuerzo estable, 14 casos (66,66 %. La lesión en el cuerpo del tronco (12 pacientes, 57,1 %, fue la más encontrada, seguida de la ostial (8 casos. El tipo de stent más utilizado fue el liberador de fármacos (61,9 %, y solamente 4 pacientes presentaban troncos protegidos quirúrgicamente. Conclusiones: La mayor cantidad de casos fueron electivos, con predominio de los troncos no protegidos. El factor de riesgo coronario más encontrado fue la HTA. Se encontró asociación significativa entre la diabetes mellitus y la localización ostial de la lesión tratada. / AbstractIntroduction and Objectives: Significant impairment of the left main coronary artery is the most lethal presentation of coronary artery disease. The treatment of choice

  14. Utilidad de la derivación aVR en la identificación de la arteria responsable en el infarto inferior

    Directory of Open Access Journals (Sweden)

    Yanina B. Castillo Costa

    2006-01-01

    Full Text Available El ECG es el método más simple para el diagnóstico de infarto inferior (IAMinf; sin embargo, su utilidad disminuye para determinar el vaso responsable. Objetivos 1. Analizar la utilidad del desnivel del ST en aVR en la identificación de oclusión de las arterias coronaria derecha (CD o circunfleja (CX. 2. Evaluar la utilidad agregada a los criterios clásicos. Material y métodos Se incluyeron en el estudio 65 pacientes con IAMinf a quienes se les realizó una cinecoronariografía (CCG durante la internación. Se analizaron los criterios clásicos, así como el desnivel del ST en aVR: ?ST =?1 mm, ?ST =?1 mm o nivelado (isoST a 0,08 seg del punto J y se calcularon la sensibilidad (S, la especificidad (E, el valor predictivo positivo (VPP, el valor predictivo negativo (VPN y el likelihood ratio (LR. Se incluyó la derivación aVR en un análisis multivariado para determinar su valor agregado a los criterios clásicos. Resultados La CD fue responsable de la oclusión en 47 pacientes (72% y la CX en 18 (28%. Signos clásicos : CD : la relación del ?STD3/D2 =?1 se halló en 52 pacientes (91,5%; p = 0,001 e ?STD1-aVL =?1 mm en 34 (61%; p 1 en 13 pacientes (50%; p = 0,001 y ?STV5-V6 =?1 mm en 12 (44%; p < 0,001. Derivación aVR : CD : ?ST o isoST en 46 pacientes (81%; p < 0,001; CX : ?ST =?1 mm en 19 (56%; p < 0,001. En el análisis multivariado, el ?ST o isoST en aVR identificó a la CD (OR IC 95% 4,7 (1,1-19,8; p = 0,03, mientras que el ?ST aVR identificó a la CX. Se propone un algoritmo diagnóstico para CD que refleja el valor aditivo de aVR a la presencia de los signos clásicos: ?ST o isoST en aVR (VPP 94%; LR+: 2. Conclusión La derivación aVR es una herramienta útil para la identificación de la arteria responsable en el IAMinf, ya que brinda información diagnóstica adicional a los signos clásicos.

  15. Aprendizaje máquina aplicado a la segmentación de imágenes ecográficas de la arteria carótida para la medida del grosor íntima-media

    OpenAIRE

    Menchón Lara, Rosa María

    2015-01-01

    [ESP] Las enfermedades cardiovasculares son la principal causa de mortalidad, morbilidad y discapacidad a nivel mundial. Gran parte de estas patologías derivan de la aterosclerosis, una enfermedad que afecta a las arterias de mediano y gran calibre provocando su endurecimiento y pérdida de elasticidad. La aterosclerosis se caracteriza por el engrosamiento de la capa más interna de las paredes arteriales debido al depósito de materia grasa, colesterol y otras sustancias. Por tanto, produce un ...

  16. 38 CFR 3.379 - Anterior poliomyelitis.

    Science.gov (United States)

    2010-07-01

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

  17. Estudo da motilidade espontânea de segmentos de cólon ascendente, transverso e descendente de ratos, em banhos fisiológicos para órgãos isolados Study of spontaneous motility of parts of colon in physiologic chamber for isolated organ, in rats

    Directory of Open Access Journals (Sweden)

    Francisco Rodrigues de Sales

    2004-01-01

    Full Text Available OBJETIVO: Identificar as diferenças na freqüência, amplitude de contrações, traçados negativos e forma das ondas. MÉTODOS: Fez-se um estudo da motilidade espontânea de segmentos de cólon ascendente, transverso e descendente de ratas, em banhos fisiológicos para órgãos isolados. RESULTADOS: Verificou-se grande variabilidade de freqüências e amplitudes das contrações registradas. Embora tenha havido predominância de contrações fortes no cólon descendente e de contrações menores no cólon transverso, todos os tipos de ondas foram encontrados nos três segmentos. CONCLUSÕES: O cólon apresenta motilidade muito variável, não permitindo identificar padrão característico inconfundível para cada um dos três segmentos, ascendente, transverso e descendente. O cólon transverso apresentou maior quantidade de traçados negativos, menor amplitude de contrações e menor freqüência de contrações. O cólon descendente apresentou o menor número de traçados negativos e a maior média de amplitude de contrações dos três segmentos.PURPOSE: The aim was to identify the difference in frequency, amplitude of contractions, negative tracing and shape of the waves. METHODS: We made one study of spontaneous motility of parts of colon from mouse, in physiologic chamber for isolated organ. RESULTS: It was found the biggest frequence variability and amplitude of contractions registered. Although there has been predominancy of strong contractions in the descending colon and weaker contractions in the transverse one, all kinds of waves were found in the three segments. CONCLUSIONS: The colon shows variable motility, which does not permit identify the unmistakable characteristic pattern for each of the three segments, ascendent, transverse and descending. The transverse colon shows a bigger quantity of negative traces, smaller amplitude of contractions and less frequency of contractions. The descending colon showed a smaller number of

  18. Pediatric anterior cruciate ligament reconstruction

    OpenAIRE

    McConkey, Mark O.; Bonasia, Davide Edoardo; Amendola, Annunziato

    2011-01-01

    An increasing number of anterior cruciate ligament (ACL) injuries are seen in children now than in the past due to increased sports participation. The natural history of ACL deficient knees in active individuals, particularly in children is poor. Surgical management of ACL deficiency in children is complex due to the potential risk of injury to the physis and growth disturbance. Delaying ACL reconstruction until maturity is possible but risks instability episodes and intra-articular damage. S...

  19. Anterior impingement syndrome in dancers

    OpenAIRE

    O’Kane, John William; Kadel, Nancy

    2007-01-01

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

  20. Efecto de la velocidad de deformación en la recristalización dinámica de un cobre ETP durante su compresión en caliente con temperatura descendente

    Directory of Open Access Journals (Sweden)

    Torrente, G.

    2011-12-01

    Full Text Available The main purpose of this project is to establish the effect of strain rate in the dynamic recrystallization of an ETP copper during its hot deformation with descending temperature. For this, there were made some tests of hot compression until true deformations close to one, with four strain rates while the temperature was descending. The tests that were made to the two lowest strain rates, showed a multiple peaks dynamic recrystallization with a rise of the tension instead it reaches the steady state, maybe due a continuous decline of the temperature.With the increase of rate the rest of the tests showed simple peak recrystallization and recovering respectively. The experimental results were compared with the results of a simulation based on the Damped Cosine Avrami Model. The simulation produced results closed to those measured during the multiple peaks dynamic recrystallization. These suggest that the application of this Model may be extended to multiple peaks dynamic recrystallization processes with changeable temperature.

    En el presente trabajo se estudia el efecto de la velocidad de deformación en la recristalización dinámica de un cobre electrolítico puro durante su deformación en caliente con temperatura descendente. Para ello, se realizaron ensayos de compresión en caliente hasta deformaciones verdaderas cercanas a uno, con cuatro velocidades de deformación, mientras descendía la temperatura. Los ensayos realizados a las dos velocidades de deformación más bajas mostraron recristalización dinámica de picos múltiples con un ascenso de la tensión en lugar del estado de saturación, debido probablemente al continuo descenso de la temperatura. Con el aumento de la velocidad, los ensayos restantes mostraron recristalización de pico simple y solo restauración, respectivamente. Los resultados experimentales se compararon con los de una simulación basada en el modelo cosenoidal amortiguado de Avrami. La simulación arroj

  1. Hiperplasia epitelial focal (doença de Heck em descendente de índios brasileiros: relato de caso Focal epithelial hyperplasia (Heck's disease in Brazilian indian descent: report of a case

    Directory of Open Access Journals (Sweden)

    Pedro Paulo de Andrade Santos

    2007-12-01

    Full Text Available A hiperplasia epitelial focal, ou doença de Heck, é uma enfermidade rara, benigna, que afeta a mucosa oral de crianças e adultos jovens de diversas regiões do mundo e em diferentes grupos étnicos, como indígenas e esquimós. Apresenta correlação com o papilomavírus humano (HPV no qual os tipos 13 e 32 têm sido consistentemente detectados nessas lesões. Este artigo relata um caso de uma paciente de 18 anos de idade, descendente de índios potiguares, que compareceu ao serviço de estomatologia da Universidade Federal do Rio Grande do Norte (UFRN, exibindo lesões bem definidas, arredondadas, planas, localizadas em cavidade oral, com tempo de evolução de aproximadamente dois anos. As lesões foram submetidas a biópsias incisionais, constatado-se no exame histopatológico alterações epiteliais, como acantose, cristas epiteliais em forma de "taco de golfe" além de células mitosóides. Esses achados histopatológicos foram compatíveis com a hipótese clínica de hiperplasia epitelial focal (doença de Heck.The focal epithelial hyperplasia or Heck's disease is a benign rare pathology, that affects children and young adults oral mucosal in many world regions, and different ethnic groups, for example Indians and Eskimos. Presents correlation with the subtypes 13 and 32 of human papillomavirus (HPV. This article report a case of an 18-year-old patient, descent of potiguar indian, attended in stomatology service of Federal University of Rio Grande do Norte (UFRN, presenting well defined lesions, round, plane, localized in oral cavity with an evolution of two years. The lesions were submitted to incisional biopsies, verifying in histopathologic exam, epithelial alterations, like acanthosis, epithelial projections in "parquet block of golf" beyond mitosoid cells. These histopathological findings were compatible with clinical hypothesis of focal epithelial hyperplasia (Heck's disease.

  2. Exploración de las arterias coronarias de pacientes con síndrome de Tako-Tsubo con tomografía multislice: lesiones e inferencias fisiopatológicas

    Directory of Open Access Journals (Sweden)

    Omar Santaera

    2009-01-01

    Full Text Available Existen numerosos casos comunicados sobre la disfunción ventricular izquierda reversibleprecipitada por estrés emocional, pero su mecanismo no se conoce. En esta presentación sedescribe la evaluación de dos pacientes que consultaron con un cuadro clínico típico desíndrome de Tako-Tsubo, dolor precordial luego de un estrés emocional, disfunción ventricularizquierda transitoria y arterias coronarias angiográficamente normales. Con el objetivo deprofundizar el conocimiento de las arterias coronarias y la fisiopatología de esta enfermedad,a ambas se les realizó una tomografía multislice, en la que se evidenciaron lesionescoronarias similares a las halladas en accidentes de placa responsables de síndromescoronarios agudos. Si bien estos hallazgos deben completarse con estudios posteriores conun número mayor de pacientes, sugieren que al menos un subgrupo de pacientes con síndromede Tako-Tsubo tiene un sustrato fisiopatológico similar a los síndromes coronariosagudos.REV ARGENT CARDIOL 2009;77:227-230.

  3. Absence of scalenus anterior muscle.

    OpenAIRE

    Murakami S; Horiuchi K; Yamamoto C; Ohtsuka A; Murakami T.

    2003-01-01

    A rare anomaly of the scalenus muscles is described. In this case, the right scalenus anterior muscle was absent. As a substitute for this muscle, some aberrant muscle slips arose from the lower vertebrae and descended in front of the ventral rami of the lower cervical nerves. These aberrant slips then ran between the ventral rami of the the eighth cervical and first thoracic nerves, and were fused with the right scalenus medius muscle. Thus, the subclavian artery and vein ran in front of the...

  4. Lesiones del ligamento cruzado anterior

    OpenAIRE

    Alejandro Álvarez López; Yenima García Lorenzo

    2015-01-01

    Fundamento: el ligamento cruzado anterior desempeña un papel muy importante en la estabili-dad de la rodilla. La incidencia de esta afección es alta en pacientes que practican deportes de contacto y de no ser tratados de forma adecuada, los resultados son desfavorables. Objetivo: profundizar en los factores necesarios para el tratamiento adecuado de enfermos con esta lesión y evitar las complicaciones. Método: se realizó una revisión bibliográfica de un total de 300 artículos publicados en Pu...

  5. Reconhecimento de padrão temporal e escuta dicótica em descendentes de japoneses, falantes e não-falantes da língua japonesa Temporal Processing and Dichotic Listening in bilingual and non-bilingual descendants

    Directory of Open Access Journals (Sweden)

    Raquel Mari Onoda

    2006-12-01

    Full Text Available A exposição de um indivíduo a duas línguas diferentes poderia trazer benefícios ao desenvolvimento auditivo. OBJETIVO: Analisar o comportamento auditivo em testes de reconhecimento de padrões temporais (Teste de Padrão de Freqüência e de Duração e de escuta dicótica de dissílabos familiares (Teste Dicótico de Dígitos e não-familiares (Teste Dicótico de Dissílabos Alternados/ SSW em português em descendentes de japoneses, que moram no Brasil, falantes ou não da língua japonesa, comparando-os ao desempenho de brasileiros não-descendentes de orientais e que não possuem contato com o idioma japonês. MÉTODO: 60 sujeitos, com idade entre 17 e 40 anos, escolaridade superior ao terceiro ano do Ensino Médio, reunidos em três grupos: GJJ, descendentes de japoneses falantes do português Brasileiro e do Japonês; GJP, descendentes de japoneses falantes do português e não-falantes do Japonês; GBP, não-descendentes de orientais falantes do português. Foram submetidos a um questionário e aos testes de processamento temporal quanto à freqüência (TPF e duração (TPD, teste dicótico de dígitos (TDD e SSW. RESULTADOS: GJJ e GJP apresentaram melhor desempenho no TPF em relação ao TPD e tiveram no TPF média de acertos maior do que o grupo GBP. O grupo GJJ, no teste SSW apresentou média de acertos significantemente superior ao GJP e ao GBP. CONCLUSÃO: A experienciação auditiva fornecida pelo bilingüismo (idioma japonês e português brasileiro facilitou o desempenho no SSW.The aim of this study was to analyze the auditory behavior in Pitch(PPS and Duration(DPSPattern Sequence tests and in the Dichotic Listening (Dichotic Digits Test/DDT of familiar and unfamiliar words (Staggered Spondaic Words/SSW in Japanese descendants that speak Japanese and Japanese descendants that do not speak Japanese, and to compare these findings with a group of non-Japanese descendants who have no contact with the Japanese language. METHOD

  6. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

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

  7. Dolor anterior de la rodilla

    Directory of Open Access Journals (Sweden)

    Alejandro Álvarez López

    2010-01-01

    Full Text Available Introducción:el dolor anterior de la rodilla constituye una importante causa de consulta en la especialidad de Ortopedia y Traumatología. La incidencia de otras enfermedades relacionadas con este síntoma es cada vez mayor, ejemplo de ello es la condromalacia de rótula, tendinitis patelar, osteoartritis patelofemoral entre otras, el diagnóstico de estas enfermedades se debe al cúmulo de experiencia y a la introducción de técnicas y equipos imagenológicos de avanzada. Desarrollo: se realizó una revisión bibliográfica sobre el dolor anterior de la rodilla, con especial énfasis en las teorías involucradas en su fisiopatología, entre las que se encuentran la mala-alineación patelo-femoral, equilibrio de la homeostasis tisular y aumento de la presión intra-ósea, además de brindar brevemente el cuadro clínico de la enfermedad. Para finalizar se expone el enfoque terapéutico que se basa fundamentalmente en el tratamiento conservador, se mencionan además las modalidades de tratamiento quirúrgico.

  8. Positioning of anterior teeth in removable dentures

    Directory of Open Access Journals (Sweden)

    Strajnić Ljiljana

    2002-01-01

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

  9. Pharyngocutaneous fistula after anterior cervical spine surgery

    OpenAIRE

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

    2009-01-01

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

  10. Herniation of the anterior lens capsule

    Directory of Open Access Journals (Sweden)

    Pereira Nolette

    2007-01-01

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

  11. Perawatan Gigitan Terbalik Anterior Dengan Menggunakan Inclined Plane

    OpenAIRE

    Siregar, Wilda A.

    2008-01-01

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

  12. Absence of scalenus anterior muscle.

    Directory of Open Access Journals (Sweden)

    Murakami S

    2003-06-01

    Full Text Available A rare anomaly of the scalenus muscles is described. In this case, the right scalenus anterior muscle was absent. As a substitute for this muscle, some aberrant muscle slips arose from the lower vertebrae and descended in front of the ventral rami of the lower cervical nerves. These aberrant slips then ran between the ventral rami of the the eighth cervical and first thoracic nerves, and were fused with the right scalenus medius muscle. Thus, the subclavian artery and vein ran in front of the aberrant slips, together with the ventral ramus of the first thoracic nerve. The aberrant muscle slips issued 2 accessory bundles. One bundle ran between the ventral rami of the fourth and fifth cervical nerves and was fused with the scalenus medius muscle; the other bundle ran between the ventral rami of the fifth and sixth cervical nerves and was fused with the scalenus medius muscle.

  13. Toxic Anterior Segment Syndrome (TASS

    Directory of Open Access Journals (Sweden)

    Özlem Öner

    2011-12-01

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

  14. Colgajo de perforantes de arteria epigrástica superior para cobertura de defecto cutáneo preesternal Covergae of a presternal skin defect with a superior epigastric perforator Flap

    Directory of Open Access Journals (Sweden)

    E. García Tutor

    2008-06-01

    Full Text Available Los colgajos basados en arterias perforantes representan hoy en día una muy buena alternativa para la reconstrucción y cobertura de defectos cutáneos. Sus numerosas ventajas tales como la mínima morbilidad de la zona donante, su fácil recuperación postquirúrgica, su gran versatilidad y la simplicidad que presentan tanto en su planteamiento prequirúrgico como en la técnica misma, han sido algunos de los motivos por los que durante la última década su uso ha tenido un desarrollo notable, siendo quizás el colgajo DIEP el mayor representante de este grupo. Recientemente se ha descrito un tipo de colgajo de similares características basado en arterias perforantes de la arteria epigástrica superior para la cobertura de defectos de la región preesternal baja. En el trabajo actual presentamos un caso clínico en el que una lesión en dicha zona previamente sometida a radioterapia es tratada con este colgajo, obteniendo una cobertura completa de la herida y un resultado estético aceptable.Perforator flaps nowadays represent a very good therapeutic alternative for reconstruction and coverage of skin defects. Their advantages such as the minimal morbidity of the donor site, their good and easy postsurgical recovery, great versatility and rather simple surgical approach and technique are some of the reasons why these flaps have been rapidly developed over the last decade, being the flap based on perforator from de deep inferior epigastric artery, DIEP flap, probably their main model. A flap of similar characteristics based on perforators coming from the superior epigastric artery has been recently described for the coverage of the lower sternum region. In this article we present a clinical case in which a wound in this area that had been previously exposed to radiotherapy is treated with a superiorepigastric perforator flap, achieving complete coverage of the defect and an acceptable aesthetic result.

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

    Directory of Open Access Journals (Sweden)

    Su-Na Lee

    2014-01-01

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

  16. Totally thrombosed giant anterior communicating artery aneurysm

    Directory of Open Access Journals (Sweden)

    V R Roopesh Kumar

    2015-01-01

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

  17. Anterior capsular rupture following blunt ocular injury

    OpenAIRE

    Gremida, Anas; Kassem, Iris; Traish, Aisha

    2011-01-01

    A 10-year-old boy suffered a large, oblique anterior capsular tear following blunt injury to his right eye. The boy was followed daily for hyphema resolution and progressive traumatic cataract formation. After the hyphema had resolved, the lens was removed using an anterior approach and an intraocular lens was placed with excellent visual outcome.

  18. Dentulous Appliance for Upper Anterior Edentulous Span

    OpenAIRE

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

    2013-01-01

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

  19. Anterior cervical hypertrichosis: a sporadic case.

    Science.gov (United States)

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

    2016-03-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature. PMID:27103865

  20. Evaluación a largo plazo del impacto funcional y estructural de la arteria radial post acceso en intervencionismo coronario Long term evaluation of functional and structural changes of the radial artery used as access for cardiac interventional procedures

    Directory of Open Access Journals (Sweden)

    Pablo Pedreros

    2010-08-01

    Full Text Available Resumen: Antecedentes: El acceso radial es una alternativa aceptable y segura para procedimientos endovasculares. Sin embargo no existe una clara evaluación de la integridad de la arteria radial (AR post procedimiento. Objetivo: Evaluar el impacto funcional y estructural a largo plazo de la punción y colocación del introductor vascular en arteria radial (AR post intervencionismo coronario. Método: Se estudian 33 pacientes con cardiopatía coronaria a quienes se realizó coronadografía y/o angioplastía vía radial. A los 6-10 meses de seguimiento se analizó las características ecográficas funcionales y estructurales de la AR comparándola con la AR contralateral. Resultados: Con el seguimiento se observan 3 AR ocluidas (9%. No se encontró un aumento significativo del grosor de la pared a nivel distal (zona de punción, 0,36 ± 0,22 vs 0,28 ± 0,08mm; el diámetro fue similar a nivel distal 2,6 ± 0,7mm vs 2,8 ± 0,35mm (ns y proximal 2,8 ± 0,35 vs 2,5 ± 0,7mm. No hay diferencia significativa en la velocidad peak sistólica (VPS, en la AR puncionada vs la control 54 ± 16 vs 50 ± 14 cm/seg ni en los índices de resistencia 0,83 ± 0,1 vs 0,87 ±0,1. Conclusiones: La utilización de la vía radial para intervencionismo coronario ocasiona en un bajo porcentaje la oclusión esta arteria. En las arterias que permanecen permeables no se encontró a largo plazo un impacto sobre las características estructurales ni funcionales.Background: the radial artery is a common and safe access site for endovascular procedures. There has been no adequate evaluation of the radial artery integrity following the procedure. Aim: to evaluate the long term functional and structural status of the radial artery use for cardiac interventional procedures Methods: 33 patients with coronary artery disease had coronary angiography and/or PTCA using the radial artery approach. After 6-10 months the functional and structural status of the artery was evaluated by

  1. Tratamiento endovascular exitoso de aneurisma de aorta torácica secundario a infección de catéter de arteria umbilical en un recién nacido pretérmino

    OpenAIRE

    Evelyn Borchert; Guillermo Lema; Daniel Springmuller; Katia González; Win T Chang; Rodrigo González; Francisco Garay

    2015-01-01

    Los aneurismas aórticos en la población pediátrica son poco frecuentes. El uso de catéteres de arteria umbilical en neonatos se ha asociado a infección y en algunas oportunidades a formación de aneurismas aórticos. La reparación quirúrgica de estos aneurismas es una forma de terapia; sin embargo, la intervención percutánea con stents pudiese proveer una vía alternativa de tratamiento con menores complicaciones. El objetivo de este reporte es dar a conocer el alcance terapéutico de un procedim...

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

    Science.gov (United States)

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

    2016-01-01

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

  3. Anterior retropharyngeal approach to the cervical spine.

    OpenAIRE

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

    2001-01-01

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

  4. Mini-open anterior lumbar interbody fusion.

    Science.gov (United States)

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

    2016-07-01

    In deformity surgery, anterior lumbar interbody fusion provides excellent biomechanical support, creates a broad surface area for arthrodesis, and induces lordosis in the lower lumbar spine. Preoperative MRI, plain radiographs, and, when available, CT scan should be carefully assessed for sacral slope as it relates to pubic symphysis, position of the great vessels (especially at L4/5), disc space height, or contraindication to an anterior approach. This video demonstrates the steps in an anterior surgical procedure with minimal open exposure. The video can be found here: https://youtu.be/r3bC4_vu1hQ . PMID:27364424

  5. Secondary anterior crocodile shagreen of Vogt.

    Science.gov (United States)

    Tripathi, R C; Bron, A J

    1975-01-01

    The clincopathological features and pathogenesis of secondary mosaic degeneration of the cornea (anterior crocodile shagreen of Vogt) are described. The structural basis for the normal anterior corneal mosaic pattern seems to lie in the particular arrangement of many prominent collagen lamellae of the anterior stroma that thake an oblique course to gain insertion into Bowman's layer. Since, at normal intraocular pressure, Bowman's layer is under tension, when viewed from the anterior surface the cornea appears smooth. By releasing the tension, however, a reproducible polygonal ridge pattern becomes manifest. It is suggested that a prolonged phthisical state of the eye is one condition wherein the mosaic pattern may become permanent and that, as a secondary event, this is followed by irregular calcification of Bowman's layer which particularly involves the ridges projecting into the epithelium. Biomicroscopically these ridges corresponded to the branching reticular arrangement of the mosaic opacities. Images PMID:1079137

  6. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

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

  7. Trypan blue dye for anterior segment surgeries

    OpenAIRE

    Jhanji, V; Chan, E.; Das, S.; Zhang, H; Vajpayee, R B

    2011-01-01

    Use of vital dyes in ophthalmic surgery has gained increased importance in the past few years. Trypan blue (TB) has been a popular choice among anterior segment surgeons mainly due to its safety, ease of availability, and remarkable ability to enable an easy surgery in difficult situations mostly related to visibility of the targeted tissue. It is being used in cataract surgery since nearly a decade and its utilization has been extended to other anterior segment surgeries like trabeculectomy ...

  8. GAMMAGRAFÍA CON 99TC-MIBI PARA DETERMINAR LA EFECTIVIDAD DE LA HEBERQUINASA PARA REPERFUNDIR LA ARTERIA RELACIONADA CON EL INFARTO / 99tc-mibi gammagraphy to determine Heberkinase effectiveness in the reperfusion of the infarction-related artery

    OpenAIRE

    Marilyn Ramírez Méndez; Luis Castañeda Casarvilla; Iguer F. Aladro Miranda; Francisco Luis Moreno-Martínez; Carlos M. Osorio Gómez; Rudy Hernández Ortega; Marisel I. Noda Valledor

    2010-01-01

    Resumen Introducción y objetivos: La utilización de técnicas nucleares para la determinación de la permeabilidad de la arteria relacionada con el infarto, es de gran importancia clínica. El objetivo de esta investigación fue conocer el estado de la perfusión miocárdica del territorio dependiente de la irrigación de esa arteria y determinar la presencia o no de su reapertura después de la trombólisis. Método: Se realizó una investigación experimental puntual con una muestra de 10 pacientes con...

  9. Functional Outcomes of Primary Anterior Cruciate Ligament Reconstruction with Tibialis Anterior Allograft

    OpenAIRE

    Başar, Selda; Büyükafşar, Enes; Hazar, Zeynep; Ataoğlu, Baybars; Kanatlı, Ulunay

    2014-01-01

    Objectives: Allografts have potential advantages in primary anterior cruciate ligament reconstruction (ACLR), including the absence of donor site morbidity, shorter operative times, improved cosmesis, and easier rehabilitation. There is limited and conflicting outcome data for ACLR with tibialis anterior allograft. The purpose of this study was to evaluate the functional outcomes of ACLR with tibialis anterior allograft. Methods: We retrospectively evaluated patients underwent ACLR using with...

  10. Anterior Eye Imaging with Optical Coherence Tomography

    Science.gov (United States)

    Huang, David; Li, Yan; Tang, Maolong

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

  11. Lesiones del ligamento cruzado anterior

    Directory of Open Access Journals (Sweden)

    Alejandro Álvarez López

    2015-01-01

    Full Text Available Fundamento: el ligamento cruzado anterior desempeña un papel muy importante en la estabili-dad de la rodilla. La incidencia de esta afección es alta en pacientes que practican deportes de contacto y de no ser tratados de forma adecuada, los resultados son desfavorables. Objetivo: profundizar en los factores necesarios para el tratamiento adecuado de enfermos con esta lesión y evitar las complicaciones. Método: se realizó una revisión bibliográfica de un total de 300 artículos publicados en Pubmed, Hinari y Medline mediante el localizador de información Endnote, de ellos se utilizaron 52 citas selecciona-das para realizar la revisión, 48 de ellas de los últimos cinco años donde se incluyeron seis libros. Desarrollo: se discuten los aspectos relacionados con el diagnóstico clínico e imaginológico. Se aborda la clasificación de esta lesión en cuanto a varios aspectos como: tiempo, lesión de ligamentos u ósea, aislada o combinada y parcial o total. Se mencionan los parámetros para obtener resultados satisfac-torios al considerar factores como la edad del enfermo, lesiones asociadas y tiempo de la lesión. Se relacio-nan los requisitos para la selección del implante y se mostró las ventajas y desventajas de cada tipo de in-jerto. Las complicaciones de esta cirugía están relacionadas con la técnica quirúrgica y médicas. Conclusiones: las lesiones del ligamento son entidades traumáticas que afectan por lo general a pacientes jóvenes. Para lograr un resultado satisfactorio en el tratamiento es necesario el conocimiento de su anatomía, clasificación, tipo de injerto a emplear según sus ventajas y desventajas.

  12. Doppler de las arterias pulmonares fetales posterior al uso de betametasona para la maduración pulmonar (Fetal lung arteries Doppler after to use of betamethasone for lung maturation

    Directory of Open Access Journals (Sweden)

    Keibis Jiménez Castillejo

    2014-06-01

    Full Text Available Resumen (español El objetivo de la investigación fue determinar las modificaciones del Doppler de las arterias pulmonares fetales posterior al uso de betametasona para la maduración pulmonar. Se realizó una investigación de tipo explicativa, prospectiva y longitudinal con un diseño cuasi-experimental y una muestra no probabilística intencional de 106 pacientes que acudieron a la consulta Pre-natal de Alto Riesgo del Hospital Central “Dr. Urquinaona". Una vez seleccionadas las pacientes se les administró inyecciones intramusculares de betametasona (12 mg/día por dos días consecutivos. Se realizaron las mediciones de índice de pulsatilidad, índice de resistencia y relación sistólico / diastólica de las arterias pulmonares fetales. Se observó disminución significativa de los valores promedio del índice de pulsatilidad en la segunda medición comparado con la medición inicial (p < 0,05. Sin embargo, el promedio de la tercera medición no mostró diferencia significativas con los valores iniciales (p = ns. El índice de resistencia disminuyó en la segunda medición para luego aumentar en la tercera medición comparado con el valor inicial (p < 0,05 para las dos mediciones. El valor promedio de la relación sistólico / diastólica presentó disminución significativa durante la segunda medición para luego presentar un aumento significativo al momento de la tercera medición comparado con el valor inicial (p < 0,05 para las dos mediciones. Se concluye que el uso de betametasona para la inducción de la maduración pulmonar produce modificaciones en las mediciones Doppler de las arterias pulmonares fetales. Abstract (english The objective of research was to determine Doppler modifications of fetal pulmonary arteries after use of betamethasone for lung maturation. An explicative, prospective and longitudinal research was done with a quasi-experimental design and an intentional non-probabilistic sample of 106 patients who assisted

  13. Floating anterior lens capsule: an unusual case of true exfoliation

    OpenAIRE

    Riffle, John

    2010-01-01

    A rare case of delamination and replication of the anterior lens capsule into prominent floating folds in the anterior chamber approximately 55 years after a penetrating injury to the eye and anterior lens capsule is reported. Classically, true exfoliation of the anterior lens capsule has been reported in individuals who have been exposed to intense heat over a prolonged period. However, more recently cases of true exfoliation of the anterior lens capsule have been reported in patients who ha...

  14. Aphasia following anterior cerebral artery occlusion

    International Nuclear Information System (INIS)

    We have report two cases of aphasia that had infarcts in the distribution of the left or right anterior cerebral artery, as confirmed by computed tomography. Case 1 is a right-handed, 65-year-old man in whom computerized tomographic scanning revealed an infarction of the territory of the left anterior cerebral artery after the clipping of the anterior communicating artery aneurysm. The standard language test of aphasia (SLTA) revealed non-fluent aphasia with dysarthria, good comprehension, almost normal repetition with good articulation, and a defectiveness in writing. This syndrome was considered an instance of transcortical motor aphasia. Although three years had passed from the onset, his aphasia did not show any improvement. Case 2 is a 37-year-old man who is right-handed but who can use his left hand as well. He was admitted because of subarachnoid hemorrhage from an anterior communicating aneurysm. Because of postoperative spasm, an infarction in the distribution of the right anterior cerebral artery developed. He was totally unable to express himself vocally, but he could use written language quite well to express his ideas and had a good comprehension of spoken language. This clinical picture was considered that of an aphemia. After several weeks, his vocalization returned, but the initial output was still hypophonic. (J.P.N.)

  15. Avaliação da trajetória dos parafusos bicorticais pela técnica de harms e melcher em relação à artéria carótida interna: estudo experimental em cadáveres Evaluación de la trayectoria de los tornillos bicorticales en la técnica de harms y melcher en relación con la arteria carótida interna: un estudio experimental en cadáveres Evaluation of the trajectory of the bicortical screws in relation to the internal carotid artery, in fixation by the harms and melcher technique: an experimental study in cadavers

    Directory of Open Access Journals (Sweden)

    Guilherme Zanini Rocha

    2011-01-01

    Full Text Available OBJETIVO: O objetivo deste trabalho é estudar, em peças anatômicas; a relação entre os parafusos bicorticais pela técnica de Harms e Melcher e a artéria carótida interna. MÉTODOS: Nossa amostra consiste em cinco cadáveres. RESULTADOS: Os resultados encontrados foram: a média da menor distância entre o orifício de saída do parafuso e a borda medial da artéria carótida interna direita foi de 11,55 mm (com variação de 10,05 a 14,23 mm, enquanto do lado esquerdo a média foi de 7,50 mm (variando de 2,75 a 12,42 mm. A média da menor distância entre a borda posterior da artéria carótida interna e a cortical anterior da massa lateral de C1 à direita foi de 4,24 mm (variando de 2,08 a 7,48 mm, enquanto do lado esquerdo a média obtida foi de 2,98 mm (com variação de 1,83 a 3,83 mm. CONCLUSÃO: Os resultados encontrados estão de acordo com os estudos similares existentes na literatura que enfatizam a necessidade de uma avaliação imaginológica criteriosa da posição anatômica da artéria carótida interna antes da utilização de parafusos bicorticais na massa lateral de C1 por via posterior.OBJETIVO: O objetivo de este estudio es, en las piezas anatómicas, la relación entre los tornillos bicorticales, mediante la técnica de Harms y Melcher, y la arteria carótida interna. MÉTODOS: La muestra se compone de cinco cadáveres. RESULTADOS: Los resultados fueron: la distancia más corta promedio, entre la salida del tornillo y el borde medial de la arteria carótida interna derecha, fue 11,55 mm (rango de 10,05 a 14,23 mm, mientras que, en la izquierda, el promedio fue 7,50 mm (rango 2,75 a 12,42 mm. La distancia más corta promedio, entre el borde posterior de la arteria carótida interna y la cortical anterior C1 de la derecha, fue 4,24 mm (que van desde 2,08 hasta 7,48 mm, mientras que, en el lado izquierdo, el promedio fue 2,98 mm. (que van desde 1,83 hasta 3,83 mm. Conclusión: Los resultados son consistentes con

  16. THYMOLIPOMA: A RARE, LARGE ANTERIOR MEDIASTINAL MASS

    Directory of Open Access Journals (Sweden)

    Premananth

    2015-07-01

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

  17. Estudo comparativo da cicatrização de enterorrafias em planos aposicional e invaginante no cólon descendente de eqüinos Comparative study between appositional and inverting pattern for closure of descending colon enterotomies in equines

    Directory of Open Access Journals (Sweden)

    F.A. Lucas

    2001-10-01

    Full Text Available O estudo foi conduzido com o objetivo de comparar o processo cicatricial do cólon descendente de eqüinos, quando submetido a duas técnicas de sutura, uma em plano aposicional e outra em dois planos com invaginação. Foram utilizados 15 eqüinos sadios e a intervenção cirúrgica foi realizada com os animais em decúbito lateral direito, sob anestesia geral inalatória. O acesso à cavidade abdominal foi feito pelo flanco esquerdo, e após exteriorização do cólon descendente, realizaram-se duas enterotomias de 5cm de extensão cada, distanciadas 20cm uma da outra. Os animais foram aleatoriamente distribuídos em cinco grupos de três animais cada e sacrificados aos 3, 7, 14, 21 e 35 dias pós-operatório. O exame necroscópico revelou presença de aderências nos dois padrões de sutura. Em nove eqüinos foram observadas aderências no padrão de sutura aposicional (60,0% ± 12,6 e em quatro no padrão com invaginação (26,6 % ± 11,4. Não foi verificada interferência com o trânsito intestinal em nenhum paciente. O exame histopatológico revelou regeneração da camada mucosa a partir do sétimo dia de pós-operatório em ambos os tipos de sutura. O fio de poliglactina 910 empregado nas enterorrafias do cólon descendente se mostrou resistente, de fácil manuseio e com boa capacidade para manter os nós aplicados, causando moderada reação inflamatória do tipo granulomatosa.This trial was carried out in order to compare the healing process of the descending colon in horses, submitted to two distinctive suture techniques - appositional pattern and inverting pattern. Fifteen healthy horses were used and the surgical intervention was accomplished with the animals in right lateral recumbency, under inhalatory anesthesia. The abdominal cavity approach was done by the left flank, and after exteriorization of the descending colon, two enterotomies, 5cm long, and 20cm apart one from each other were done. The horses were randomly distributed

  18. Lifestyle changes in descendants of parents with diabetes type 2 Cambio en los patrones de vida en descendientes de progenitores con diabetes mellitus tipo 2 del noreste de Mexico Mudança em os padrões de vida em descendentes de progenitores com diabetes mellitus tipo 2 do nordeste do México

    Directory of Open Access Journals (Sweden)

    Rosalinda Guerra-Juárez

    2007-10-01

    Full Text Available This study aimed to explore the disposition of diabetic parents' descendents in changing eating and physical activity patterns. It was based on the heritability concept and Prochaska's Transtheoretical Model. This is a descriptive-correlational study; participants included 30 parents, randomly selected, and 60 children. Results and conclusion: 68% of the children was classified as obese, 42% with insulin resistance, and 15% with carbohydrate intolerance. None of the risk factors was associated with the stages of change. The heritability factor was 1.37%; more people younger than 40 and women report decreasing in the consumption of fat food (Xi² = 6.04, p = .020; and 4.41, p = .040, respectively. These results suggest a high influence of environmental factors on the participants' unhealthy life styles.El objetivo general del estudio fue explorar la disposición al cambio de patrones alimentarios y actividad física en descendientes de progenitores con diabetes mellitus tipo 2 (DMT2, aplicando un diseño descriptivo correlacional. La base teórica la constituyó el componente genético heredabilidad (h² y el Modelo Transteorético de Prochaska; participaron 30 progenitores con DMT2 y 60 descendientes. Resultados y Conclusión: El 68% de los descendientes fueron obesos, 60% con riesgo de enfermedad cardiovascular, 42% con resistencia a la insulina (RI y 15% intolerantes a la glucosa; ninguno de los factores de riesgo se asoció con las etapas de cambio. El componente genético para RI fue mínimo (h² = 1.37%. Una mayor proporción de menores de 40 años (p = .020 y de mujeres "contemplan" disminuir el consumo de grasas (p = .040. Estos resultados sugieren un mayor peso de factores del medio ambiente sobre el estilo de vida nocivo de los participantes.O objetivo geral do estudo foi explorar à disposição à mudança dos padrões alimentares e atividade física nos descendentes de progenitores com diabetes mellitus tipo 2 (DMT2. Aplicou-se un

  19. Presença de microfonismo coclear no peate-clique: diagnóstico diferencial entre espectro da neuropatia auditiva e perdas auditivas cocleares descendentes em crianças Presence of cochlear microphonics in click-ABR: differential diagnosis between auditory neuropathy spectrum disorder and steeply sloping cochlear hearing loss in children

    Directory of Open Access Journals (Sweden)

    Gabriela Ribeiro Ivo Rodrigues

    2010-12-01

    Full Text Available TEMA: diagnóstico diferencial entre espectro da neuropatia auditiva e perdas auditivas cocleares descendentes em crianças com presença de microfonismo coclear no PEATE-clique. PROCEDIMENTOS: este relato de caso descreve os resultados da avaliação audiológica de duas crianças atendidas no Centro "Audição na Criança" da Divisão de Educação e Reabilitação dos Distúrbios da Comunicação da Pontifícia Universidade Católica de São Paulo (CeAC/DERDIC/PUCSP que apresentaram microfonismo coclear no registro do PEATE-clique. As crianças foram submetidas às avaliações utilizando-se o PEATE-clique, o registro das emissões otoacústicas e a avaliação audiológica tonal, com a técnica da Audiometria de Reforço Visual. RESULTADOS: as avaliações comportamental, eletroacústica e eletrofisiológica revelaram que as crianças apresentam perda auditiva sensorioneural (coclear com configuração descendente, de modo que a presença do microfonismo coclear no registro do PEATE-clique era provavelmente gerada pela preservação da cóclea nas frequências baixas. CONCLUSÃO: os casos apresentados mostram que na ausência das emissões otoacústicas e presença do microfonismo coclear, não se deve interpretar isoladamente cada exame, para que não ocorram equívocos no diagnóstico, que pode ser confundido com o Espectro da Neuropatia Auditiva. O microfonismo coclear pode aparecer em outras condições, tais como em perdas auditivas cocleares descendentes.BACKGROUND: differential diagnosis between auditory neuropathy spectrum disorder andsteeply sloping cochlear hearing loss in children with presence of cochlear microphonics for click-ABR. PROCEDURES: this case report describes the results of the audiological evaluation for two children assisted at Centro "Audição na Criança" of Divisão de Educação e Reabilitação dos Distúrbios da Comunicação of Pontifícia Universidade Católica of São Paulo (CeAC/DERDIC/PUCSP with presence

  20. Anterior tooth relations in Kenyan Africans.

    Science.gov (United States)

    Hassanali, J; Pokhariyal, G P

    1993-04-01

    Dental plaster casts of 235 Maasai, 116 Kikuyu and 61 Kalenjin children aged 3-16 yr were studied to determine the incidence and magnitude of diastemas, overbite, overjet and anterior open bite. The highest prevalence of diastema was amongst the Maasai (61.3%), of overbite (84%) and overjet (99%) amongst the Kikuyu, and of anterior open bite amongst Kalenjin (24%), with values greater than 0.4 mm up to 11.5 mm. Comparison of the mean values showed that diastema (1.77 mm) and overjet (4.4 mm) were greatest in Maasai, overbite (3.53 mm) in Kalenjin, and anterior open bite (3.50 mm) in Kikuyu. In the total sample, the prevalence and mean of diastema were 49%, 1.68 mm; of overbite 77.4%, 2.96 mm; of overjet 88.6%, 3.83 mm; and of anterior open bite 16.5%, 2.69 mm (with values between 0.4-11.5 mm), while 5.5% had an edge-to-edge bite (-0.5-0.5 mm). The prevalence of diastema decreased whilst its magnitude increased with age. The mean values of overbite and overjet increased, while those for anterior open bite decreased with age. The mean values of diastema, overbite and overjet were greater amongst the females, but the difference was significant only for overjet. The high prevalence and greater values of measurements of anterior tooth relations may be related to variable growth of the bimaxillary dentoalveolar complex and soft tissue influences. This may be important in orthodontic treatment planning, dental prostheses and other clinical dental treatments in Kenyan populations. PMID:8517805

  1. ANTERIOR OSTEOPHYTE IDENTIFICATION IN CERVICAL VERTEBRAE

    Directory of Open Access Journals (Sweden)

    A. T. Chougale

    2011-06-01

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

  2. Roentgenographic findings following anterior cervical fusion

    International Nuclear Information System (INIS)

    We reviewed the pre- and postoperative lateral cervical roentgenograms in 90 patients who had anterior fusions and compared their findings with age and sex-matched people without neck problems. The average interval from surgery to review was 5 years. Preoperatively, all patients had a higher incidence of degenerative spondylosis at the levels to be fused than their asymptomatic counterparts. Postoperatively, there was no difference in the incidence of degenerative change between the operated and the control group at the levels above and below the fusion with the exception of anterior osteophyte formation which was more frequent in those with fusions. (orig.)

  3. Effect of protein and vitamin B deficiency on the morpho-quantitative aspects of the myenteric plexus of the descending colon of adult rats Efeito da carência de proteínas e vitaminas do complexo B sobre aspectos morfoquantitativos do plexo mioentérico do colo descendente de ratos adultos

    Directory of Open Access Journals (Sweden)

    Eduardo José de Almeida Araújo

    2003-06-01

    Full Text Available We carried out this work with the purpose of studying the effects of protein and vitamin B deficiency on the morphologic and quantitative aspects of the myenteric plexus of the descending colon of adult Rattus norvegicus. Twenty-eight rats were divided in two groups, one of them receiving chow with 22% protein level (control and the other fed with chow having 8% protein level without vitamin B supplementation, during 120 days. Whole-mounts of the descending colon were prepared and stained with Giemsa, NADH-diaphorase and NADPH-diaphorase. The undernourished rats had a body weight 11.84% less than the control group. Relative to the controls, the experimental group had a colonic area 48% smaller, 51.9% less Giemsa-stained neurons, 28.3% less NADH-diaphorase positive neurons and 24.2% less NADPH-diaphorase positive neurons.Realizamos este estudo com o objetivo de avaliar os efeitos da desnutrição protéica e da carência de vitaminas do complexo B sobre os aspectos morfológicos e quantitativos do plexo mioentérico do colo descendente de Rattus norvegicus adultos. Vinte e oito ratos foram divididos em dois grupos, sendo oferecida para um dos grupos ração com teor protéico de 22% (controle e, para outro, ração com teor protéico de 8% sem suplementação de vitaminas do complexo B, durante 120 dias. Elaboramos os preparados de membrana do colo descendente e os coramos pelo método de Giemsa, pela técnica da NADH diaforase e da NADPH diaforase. Os ratos desnutridos apresentaram peso corporal 11,84% menor que o grupo controle. Em relação ao controle, observou-se uma redução da área do colo do grupo experimental de 48%, e de 51,9% dos neurônios corados por Giemsa, 28,3% dos neurônios NADH-diaforase positivos e 24,2% neurônios NADPH-diaforase.

  4. Biopsia de la arteria temporal: revisión de indicaciones y técnica quirúrgica para cirujanos plásticos Temporal artery biopsy: review of indications and surgical technique for plastic surgeons

    Directory of Open Access Journals (Sweden)

    A. Rodríguez Lorenzo

    2007-06-01

    Full Text Available La arteritis de células gigantes (ACG es una vasculitis que presenta complicaciones graves si no es diagnosticada y tratada precozmente con corticoides a altas dosis. La biopsia de la arteria temporal (BAT es la técnica diagnóstica estandarizada utilizada para confirmar la enfermedad. Se trata de una técnica sencilla y con poca morbilidad. No obstante, en la actualidad existe una controversia sobre su indicación en pacientes con sospecha clínica de arteritis sin síntomas craneales debido a la baja tasa de positividad de la biopsia. Presentamos en este trabajo una serie de 28 pacientes en los que se realizaron 30 BAT con el objetivo de revisar las indicaciones y describir la técnica quirúrgica utilizada.Giant cell arteritis is a vasculitis that presents serious complications if it is not diagnosed and treated prematurely with corticosteroids to high dose. The temporal artery biopsy is the gold estandar technique of diagnosis used to confirm the disease. It is a simple technique with little morbidity. Nevertheless, currently there is a controversy on its indication in patients with clinical suspicion of arteritis without craneal symptoms because of the downward rate of positiveness of the biopsy. We present in this work a serie of 28 patients in which 30 biopsies were carried out with the objective to review the indications and to describe the surgical technique utilized.

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

    Directory of Open Access Journals (Sweden)

    Miesje K. Purwanegara

    2015-09-01

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

  6. Anterior retropharyngeal approach to the cervical spine.

    Directory of Open Access Journals (Sweden)

    Behari S

    2001-10-01

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

  7. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

    Frobell, Richard B; Roos, Harald P; Roos, Ewa M; Roemer, Frank W; Ranstam, Jonas; Lohmander, Stefan

    2013-01-01

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

  8. Anterior Chamber Live Loa loa: Case Report.

    Science.gov (United States)

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

    2016-01-01

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

  9. Anterior Chamber Live Loa loa: Case Report

    Science.gov (United States)

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

    2016-01-01

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

  10. Novel Insights into Anterior Cruciate Ligament Injury

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan)

    2011-01-01

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

  11. Anorgasmia in anterior spinal cord syndrome.

    OpenAIRE

    Berić, A; Light, J K

    1993-01-01

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

  12. Anterior process fractures of the calcaneus

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-07-01

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

  13. Causes of anterior cruciate ligament injuries

    Directory of Open Access Journals (Sweden)

    Ristić Vladimir

    2010-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

    Hadi Makhmalbaf; Ali Moradi; Saeid Ganji; Farzad Omidi-Kashani

    2013-01-01

      Background: The knee joint is prone to injury because of its complexity and weight-bearing function. Anterior cruciate ligament (ACL) ruptures happen in young and physically active population and can result in instability, meniscal tears, and articular cartilage damage. The aim of this study is to evaluate the accuracy of Lachman and anterior drawer test in ACL injury in compare with arthroscopy.   Methods: In a descriptive, analytical study from 2009 to 2013, 653 patients who were suspecte...

  16. The anterior insular and anterior cingulate cortices in emotional processing for self-face recognition

    OpenAIRE

    Morita, Tomoyo; Tanabe, Hiroki C.; Akihiro T Sasaki; Shimada, Koji; Kakigi, Ryusuke; Sadato, Norihiro

    2013-01-01

    Individuals can experience embarrassment when exposed to self-feedback images, depending on the extent of the divergence from the internal representation of the standard self. Our previous work implicated the anterior insular cortex (AI) and the anterior cingulate cortex (ACC) in the processing of embarrassment; however, their exact functional contributions have remained uncertain. Here, we explored the effects of being observed by others while viewing self-face images on the extent of embarr...

  17. Produção de geléia real por abelhas Apis mellifera italianas, africanizadas e descendentes de seus cruzamentos - DOI: 10.4025/actascianimsci.v27i1.1254 Royal jelly production by Italian and Africanized honeybees Apis mellifera, descendants of their crossing - DOI: 10.4025/actascianimsci.v27i1.1254

    Directory of Open Access Journals (Sweden)

    Regina Helena Nogueira Couto

    2005-03-01

    Full Text Available Este experimento objetivou comparar a produção de geléia real de abelhas descendentes de rainhas italianas irmãs, inseminadas com zangões africanizados (T1, ou com zangões italianos (T2, e de rainhas africanizadas irmãs, fecundadas no vôo (T3, comparando-a com fatores ambientais. As operárias híbridas (T1 aceitaram mais larvas transferidas (45,41 %, embora a diferença não tenha sido significativa, e depositaram maior (P This work aimed at comparing royal jelly production among descendants of Italian queen sisters inseminated by Africanized drones (T1, Italian drones (T2 and Africanized queen sisters in natural mating (T3. The workers cross-bred (T1 accepted more transferred larvae (45.41% but there was no significant difference. They deposited more (P < 0.05 royal jelly in each cup (243.5 mg than Italians (T2 – 31.36% and 214.7 mg and Africanized workers (T3 – 33.63% and 209.3 mg, respectively. The result showed a best production in each colony which suggests heterosis. These parameters showed positive relation with pollen and workers quantities and with environmental temperature. The best production occurred in February and March, period of absence of flower in orange and eucalyptus culture in this region

  18. Anterior capsule tear after laser iridotomy complicating phacoemulsification

    OpenAIRE

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Maria Angélica Pavão Dimantas

    2003-01-01

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

  20. Displaced fracture through the anterior atlantal synchondrosis

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-09-01

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

  1. Anterior Cruciate Ligament Injuries in Growing Skeleton

    OpenAIRE

    AlHarby, Saleh W.

    2010-01-01

    Anterior cruciate ligament (ACL) injuries in the adult patients are thoroughly studied and published in orthopedic literature. Until recently, little was known about similar injuries in skeletally growing patients. The more frequent involvement of this age group in various athletic activities and the improved diagnostic modalities have increased the awareness and interest of ACL injuries in skeletally immature patients. ACL reconstruction in growing skeleton is controversial and carries some ...

  2. Biomechanics and anterior cruciate ligament reconstruction

    OpenAIRE

    Vercillo Fabio; Dede Ozgur; Wu Changfu; Woo Savio; Noorani Sabrina

    2006-01-01

    Abstract For years, bioengineers and orthopaedic surgeons have applied the principles of mechanics to gain valuable information about the complex function of the anterior cruciate ligament (ACL). The results of these investigations have provided scientific data for surgeons to improve methods of ACL reconstruction and postoperative rehabilitation. This review paper will present specific examples of how the field of biomechanics has impacted the evolution of ACL research. The anatomy and biome...

  3. Current Trends in Anterior Cruciate Ligament Reconstruction

    OpenAIRE

    Kim, Ha Sung; Seon, Jong Keun; Jo, Ah Reum

    2013-01-01

    The advances in the knowledge of anatomy, surgical techniques, and fixation devices have led to the improvement of anterior cruciate ligament (ACL) reconstruction over the past 10 years. Nowadays, double bundle and anatomical single bundle ACL reconstruction that more closely restores the normal anatomy of the ACL are becoming popular. Although there is still no definite conclusion whether double bundle ACL reconstruction provides better clinical results than single bundle reconstruction, the...

  4. Familial predisposition to anterior cruciate ligament injury

    OpenAIRE

    Kenichi Goshima; Katsuhiko Kitaoka; Junsuke Nakase; Hiroyuki Tsuchiya

    2014-01-01

    Although several risk factors for anterior cruciate ligament (ACL) injury have been evaluated in the literature, there are few reports on familial predisposition. This study investigated the familial predisposition to ACL injury. The study included 350 patients who underwent ACL reconstruction between January 2005 and September 2008. All patients were surveyed by telephone or a written questionnaire about family history (FH) of ACL injury, sports played by family members, and mechanisms of in...

  5. Foreign Body Embedded in Anterior Chamber Angle

    OpenAIRE

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

    2012-01-01

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

  6. Anterior Cruciate Ligament Injuries in Wakeboarding

    OpenAIRE

    Starr, Harlan M.; Sanders, Brett

    2012-01-01

    Background: Wakeboarding is an increasingly popular sport that involves aggressive stunts with high risk for lower extremity injury, including anterior cruciate ligament (ACL) rupture. Little has been reported on prevalence or mechanism of ACL injury while wakeboarding. Hypothesis: The prevalence of ACL injury in wakeboarding approaches that of other high-risk sports. Analyzing the mechanism of ACL injury may aid in future efforts of prevention. Study Design: Descriptive epidemiology study. M...

  7. Risk Factors for Anterior Cruciate Ligament Injury

    OpenAIRE

    Smith, Helen C.; Vacek, Pamela; Johnson, Robert J.; Slauterbeck, James R.; Hashemi, Javad; Shultz, Sandra; Beynnon, Bruce D.

    2012-01-01

    Context: Injuries to the anterior cruciate ligament (ACL) are immediately disabling and are associated with long-term consequences, such as posttraumatic osteoarthritis. It is important to have a comprehensive understanding of all possible risk factors for ACL injury to identify individuals who are at risk for future injuries and to provide an appropriate level of counseling and programs for prevention. Objective: This review, part 2 of a 2-part series, highlights what is known and still unkn...

  8. Erlotinib-related bilateral anterior uveitis

    OpenAIRE

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

    2011-01-01

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

  9. Anterior segment dysgenesis in mosaic Turner syndrome

    OpenAIRE

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

    1997-01-01

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

  10. Anterior uveitis and its relation to stress

    OpenAIRE

    MULHOLLAND, B; Marks, M; Lightman, S

    2000-01-01

    BACKGROUND/AIMS—Idiopathic recurrent acute anterior uveitis (RAAU) is a common reason for attendance at ophthalmic casualty departments. Patients who suffer with this condition may have multiple recurrent episodes which are often debilitating and necessitate time off work. If recurrences are identified early and treatment initiated rapidly, the inflammation can be minimised and settles quickly on topical treatment with a speedy functional recovery by the patient. It has been our clinical impr...

  11. Bilateral anterior uveitis secondary to erlotinib

    OpenAIRE

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

    2010-01-01

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

  12. Multimodal emotion perception after anterior temporal lobectomy

    OpenAIRE

    Valérie Milesi; Chiara Cristinzio; Margitta Seeck

    2014-01-01

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

  13. Guideline on anterior cruciate ligament injury

    OpenAIRE

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

    2012-01-01

    textabstractThe Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steering group of the Dutch Orthopaedic Association. • What is the role of physical examination and additional diagnostic tools? • Which patient-related outcome measures should be used? • Wh...

  14. Novel Insights into Anterior Cruciate Ligament Injury

    OpenAIRE

    Meuffels, Duncan

    2011-01-01

    textabstractAnterior cruciate ligament (ACL) injury is one of the most common sports injuries of the knee. ACL reconstruction has become, standard orthopaedic practice worldwide with an estimated 175,000 reconstructions per year in the United States.6 The ACL remains the most frequently studied ligament in orthopaedic research. Hundreds of papers are published each year related to the ACL. However, the treatment options and techniques are still developing and increasing, indicating the diffic...

  15. Psychological Aspects of Anterior Cruciate Ligament Injuries

    OpenAIRE

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

    2016-01-01

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

  16. Anterior Tibial Artery Pseudoaneurysm: Case Report

    Directory of Open Access Journals (Sweden)

    Funda Tor

    2012-06-01

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

  17. Origen anómalo de la arteria coronaria izquierda en el seno aórtico derecho y muerte súbita: a propósito de dos casos Anomalous origin of the left coronary artery from the right aortic sinus and sudden death: two cases report

    Directory of Open Access Journals (Sweden)

    L. Saldaña

    2009-01-01

    Full Text Available La persistencia de una estructura coronaria embriológica, el fallo del desarrollo normal o el error en la ubicación de su origen pueden dar lugar a una anomalía de las arterias coronarias. Estas malformaciones son poco frecuentes (0.2-1.2% pero conllevan un riesgo significativo de arritmias, angina, infarto y muerte súbita, riesgo que es mayor durante la infancia y la adolescencia. Presentamos 2 casos de muerte súbita (niño de 8 años y adolescente de 15 años ocurrida durante e inmediatamente después de una actividad física importante. En ambos casos, la autopsia puso de manifiesto la existencia de una anomalía en el origen de la arteria coronaria izquierda consistente en la salida del seno derecho con un curso retroaórtico del vaso anómalo. Al mismo tiempo se realiza una revisión de las anomalías congénitas de las arterias coronarias como causa de muerte súbita.Anomalies in the coronary arteries may result from rudimentary persistence of an embryologic coronary arterial structure, failure of development or misplacement of the vessel connection. These malformations are very infrequent (0.2-1% but determine a significant risk for arrhythmias, angina, infarction and sudden death. This risk is even higher during infancy and adolescence. We report two cases of sudden death (8 and 15 year-old children, which occurred following and during strenuous physical exercise. In both cases, autopsy revealed an anomalous origin of the left main coronary artery from right aortic sinus, with a retroaortic course of the anomalous artery. Furthermore, a review of the congenital anomalies of the coronary arteries and sudden death is performed.

  18. Anterior approaches to the upper thoracic spine

    International Nuclear Information System (INIS)

    The upper thoracic spine region is difficult to access from an anterior approach because of the surrounding bones (ribs, sternum and scapulae) and organs (heart, lung and great vessels). The outcomes of 37 consecutive cases with lesions in the upper thoracic spine region (T1-4) were reviewed to study surgical approaches to the upper thoracic spine. We used anterior approaches in 13 cases. A full sternotomy was performed in 6 cases (5 cases ossification of posterior longitudinal ligament (OPLL), 1 case herniated disc), a high thoracotomy was performed in 6 cases (3 cases herniated disc, 2 cases spinal cord tumor, 1 case TB spine), and a partial resection of a unilateral sternoclavicular joint was performed in 1 case. A sternotomy is thought to be useful for OPLL in the T1-3 region, whereas a high thoracotomy is recommended for unilateral anterior lesions and lesions extending below the T3/4 level. Reconstructive CT sagittal images can supply useful anatomical informations for selecting a surgical approach. (author)

  19. Doppler-guided hemorrhoidal artery ligation in the management of symptomatic hemorrhoids Ligadura de las arterias hemorroidales guiada por Doppler en el tratamiento de las hemorroides sintomáticas

    Directory of Open Access Journals (Sweden)

    J. M. Ramírez

    2005-02-01

    Full Text Available Objective: the aim of this study is to clinically test the efficacy of a new approach for patients having symptomatic grade III and IV hemorrhoids. Material and method: 32 patients (17 females complaining of grade III or IV hemorrhoids were included in the study. A specially designed proctoscope coupled with a Doppler transducer on its tip was used to identify the hemorrhoidal arteries, which were afterwards suture ligated. Operating time as well as per- and post-operative complications were anlyzed. Follow-up was planned following discharge after 1 week, 1 month, 6 months and 1 year. Results: mean operation time was 27 (range 18-43 minutes, and 5 (range 4-7 arteries were located on average. No patient had severe or moderate postoperative pain, with anal discomfort being the main complaint. Rectal bleeding and tenesmus were the commonest post-operative complications. After one year of follow-up, 19 patients were free of symptoms and 6 of them had significant symptom relief. According to grade, the technique failed in just 3 grade III patients, but in as many as 4 grade IV hemorrhoid cases. Conclusions: doppler-guided hemorrhoid artery ligation is an easy-to-perform technique that is well accepted by patients and has good results for grade III hemorrhoids.Objetivo: el objetivo de este trabajo es valorar en la clínica la eficacia de una nueva técnica quirúrgica para el tratamiento de las hemorroides de grado III y IV. Material y método: se incluyen en el estudio 32 pacientes (17 mujeres, 27 presentaban hemorroides de grado III y 5 de grado IV. Para la técnica se utilizó un prostoscopio transparente que incorpora un transductor Doppler en su extremo para localizar las arterias hemorroidales que se ligan mediante puntos que engloban la mucosa y submucosa. Se analizó el tiempo de intervención y las complicaciones intra y postoperatorias, así como las recidivas. Los pacientes fueron controlados al alta, a la semana, mes, 6 meses y al año de

  20. Doppler de arterias uterinas en la predicción de trastornos hipertensivos del embarazo en un grupo de pacientes que asisten a tamizaje integrado en semana 11- 13 6/7 . En una unidad de alto riesgo obstétrico

    OpenAIRE

    González Rodríguez, Juan; Gómez, Marco Antonio

    2013-01-01

    Objetivo: Describir la utilidad diagnóstica y el poder de detección del índice de pulsatilidad anormal de las arterias uterinas durante el primer trimestre del embarazo en relación con la aparición de trastornos hipertensivos asociados al embarazo. Metodología: Estudio retrospectivo, longitudinal con alcances de tipo descriptivo de gestantes con embarazo único que se presentaron a control prenatal en obstetricia y ginecología y a quienes se les realizó tamizaje integrado entre las 11 y136/7 s...

  1. Functional Outcomes of Primary Anterior Cruciate Ligament Reconstruction with Tibialis Anterior Allograft

    Science.gov (United States)

    Başar, Selda; Büyükafşar, Enes; Hazar, Zeynep; Ataoğlu, Baybars; Kanatlı, Ulunay

    2014-01-01

    Objectives: Allografts have potential advantages in primary anterior cruciate ligament reconstruction (ACLR), including the absence of donor site morbidity, shorter operative times, improved cosmesis, and easier rehabilitation. There is limited and conflicting outcome data for ACLR with tibialis anterior allograft. The purpose of this study was to evaluate the functional outcomes of ACLR with tibialis anterior allograft. Methods: We retrospectively evaluated patients underwent ACLR using with tibialis anterior allograft between 2005 and 2013. Totally 12 patients who were performed suspensory fixation technique were included in this study (range: 25-43 years). Exclusion criteria included double bundle, bone tendon bone technique and revision surgery. Clinical outcomes were measured by subject part of International Knee Documentation Committee (IKDC) and Lysholm scores. Results: A significant increase was reported in all the clinical scores. In particular, the IKDC-subjective score increased from a basal value of 45.5±12.7 to 84.3±5.50 at the 12 months' evaluation (p<0.05). The Lysholm score revealed a significant improvement from 49.7±14.2 to 83.5±20.5 at the 12 months' evaluation (p<0.05). Conclusion: ACLR with tibialis anterior allograft is an effective treatment for correcting loss of function and increasing quality of life.

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

    Directory of Open Access Journals (Sweden)

    Osman Köse

    2013-01-01

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

  3. Embolización selectiva de la arteria carótida externa en el manejo de pacientes con tumoraciones benignas en la cavidad nasal y la cara, primeras experiencias en el Hospital México

    Directory of Open Access Journals (Sweden)

    José Luis Solano- Villarroel

    2007-01-01

    Full Text Available Justificación: El angiofibroma juvenil nasofaríngeo es uno de los tumores benignos de la cavidad nasal más comunes en los adolescentes, el cual causa epistaxis recurrente, obstrucción nasal, rinorrea y otras manifestaciones clínicas. Los hemangiomas faciales son tumoraciones benignas muy frecuentes en la infancia, y secundariamente al tumor los pacientes pueden presentar deformidades faciales e inclusive sangrados intermitentes. En la actualidad, la embolización de la arteria carótida externa está siendo más utilizada en el manejo de estos pacientes, ya que es un procedimiento mínimamente invasivo y produce una evolución clínica más favorable en los pacientes; también se ha descrito una menor pérdida sanguínea durante el procedimiento quirúrgico y en el postoperatorio, con disminución de la mortalidad. Además, proporciona al paciente una recuperación más pronta y acorta la estancia hospitalaria. Objetivo: Describir las primeras experiencias con la embolización de la arteria carótida externa en pacientes con angiofibroma juvenil nasofaringeo y hemangiomas faciales, en el Hospital México. Resultados: Cuando se hizo la embolización prequirúrgica de los angiofibromas juveniles nasofaringeos, la resección del tumor en pacientes cursó sin ninguna complicación. Además, los pacientes no tuvieron sangrado durante el postoperatorio inmediato. Tras la embolización de las pacientes con hemangiomas se documenta mejoría clínica, disminuyendo la lesión macroscópica en la cara y los sangrados secundarios al hemangioma (en un caso. En ambas enfermedades la recuperación de los pacientes fue muy satisfactoria, sin presentarse ninguna complicación y con una estancia hospitalaria muy corta. Conclusión: Desde hace varios años la embolización prequirúrgica ha sido utilizada en el extranjero como coadyuvante en el manejo de diversas condiciones. Actualmente, está siendo implementada en el medio para el manejo de diferentes

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Anant Kumar Garg

    2012-04-01

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

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

    OpenAIRE

    Antonio Egydio de Carvalho Junior; Cíntia Kelly Bittar; Osny Salomão; João Batista de Miranda; André Ninomiya; Daniel Bento Silva

    2010-01-01

    OBJETIVO: Análise retrospectiva da etiopatogenia, diagnóstico e opções de tratamento nos casos de tendinopatias do compartimento anterior do tornozelo (TCAT). MÉTODO: No período de setembro de 1998 a fevereiro de 2009, 13 pacientes foram operados por tendinopatia do compartimento anterior do tornozelo. A casuística constou de 10 pacientes do sexo masculino e três do feminino. O lado direito foi acometido em 12 pés e um do esquerdo. A média de idade foi de 35 anos (15-67). A etiologia foi trau...

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

    OpenAIRE

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

    2009-01-01

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

  8. Infections after reconstructions of anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Ristić Vladimir

    2014-01-01

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

  9. Toxic anterior-segment syndrome (TASS

    Directory of Open Access Journals (Sweden)

    Cetinkaya S

    2014-10-01

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

  10. Selection of operative procedures for anterior plagiocephaly

    International Nuclear Information System (INIS)

    The purposes of this study were to evaluate long-term results after surgical treatment for anterior plagiocephaly and to identify factors that might influence these results. And according to these results selection of operative procedures for plagiocephaly was discussed. From April 1, 1985 to December 31, 2002, 12 children with anterior plagiocephaly were treated by craniofacial surgery (frontoorbital advancement) or distraction osteogenesis in Saitama Children's Medical Center. Distraction osteogenesis was applied in 3 patients with mild deformities. Preoperative severity of the craniofacial deformities, the time of operations, operative methods and long-term results were analyzed in these cases. Preoperative deformities were classified by the classification system developed by Di Rocco C et al (1988) and surgical results were graded according to the grading system reported by Wagner JD et al (1995) at the end of follow-up period. Follow-up ranged from 1 to 12 years (mean 6.2±4.9). Morphological long-term surgical results in 12 cases with plagiocephaly as follows; excellent in 8 cases, good in 3 cases and poor in 1 case. At the end of follow-up, excellent craniofacial configurations were obtained in 8 cases operated on in less than 1 year after birth or with mild craniofacial deformities (grade II) preoperatively. And also complete normalization of endocranial base asymmetries on 3D-CTs were recognized in cases operated on in less than 1 year after birth regardless of surgical procedures. These results suggest that early craniofacial surgery is necessary for an infant to attain complete normalization of the craniofacial dysmorphology of anterior plagiocephaly in spite of operative methods. (author)

  11. Biological fixation in anterior cruciate ligament surgery

    Directory of Open Access Journals (Sweden)

    Chih-Hwa Chen

    2014-04-01

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

  12. Anomalías congénitas de la arteria aorta: Evaluación mediante tomografía computada multicorte en neonatos y niños Congenital abnormalities of aortic artery: Assessment in neonates and early childhodd with multislice tomography

    Directory of Open Access Journals (Sweden)

    Diego Haberman

    2009-09-01

    Full Text Available Para la evaluación de los defectos congénitos de la arteria aorta, los métodos de imágenes utilizados tradicionalmente son la ecocardiografia y la radiología simple. La angiotomografía computada multicorte aparece como un método de relevancia en el diagnóstico de estas entidades, permitiendo evaluar en forma no invasiva, rápida y precisa las distintas anormalidades, otorgando de esta manera información sumamente útil a los cirujanos cardiovasculares para definir la estrategia quirúrgica. En el presente artículo revisamos las aplicaciones de la angiotomografia computada multicorte en la evaluación de las malformaciones congénitas de la arteria aorta más frecuentes en el periodo neonatal y en la primera infancia.In the evaluation of aortic artery congenital abnormalities, the echocardiography and the plain X ray are the traditionally used imaging methods. Multislice angiotomography appears as an important method in diagnosis of these different diseases allowing evaluate these entities in a non invasive, fast and accurate form, giving to cardiovascular surgeons very important information to delineate the surgical strategy. In this article, we review the applications of multislice angiotomography in the evaluation of most frequent congenital anomalies of aorta artery, performed in neonates and early childhood.

  13. Grande fístula bilateral da artéria coronária: a escolha do tratamento clínico Gran fístula bilateral de la arteria coronaria: la selección del tratamiento clínico Large bilateral coronary artery fistula: the choice of clinical treatment

    Directory of Open Access Journals (Sweden)

    Luciana Oliveira Cascaes Dourado

    2009-09-01

    Full Text Available Relatamos o caso de um paciente do sexo feminino, assintomática, com grande fístula bilateral da artéria coronária-artéria pulmonar. O monitoramento clínico foi a opção escolhida para tratamento. Discutimos os pormenores das opções terapêuticas, enfatizando a tendência excessiva de utilizar a abordagem cirúrgica e a grande escassez de acompanhamentos clínicos de longo prazo em pacientes assintomáticos.Relatamos el caso de un paciente del sexo femenino, asintomática, con gran fístula bilateral de la arteria coronaria-arteria pulmonar. El monitoreo clínico fue la opción elegida para el tratamiento. Discutimos los pormenores de las opciones terapéuticas, enfatizando la tendencia excesiva de utilizar el abordaje quirúrgico y la gran escasez de seguimientos clínicos de largo plazo en pacientes asintomáticos.

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

    Directory of Open Access Journals (Sweden)

    Hadi Makhmalbaf

    2013-12-01

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

  15. MRI of anterior cruciate ligament autografts

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-09-01

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

  16. Approach-avoidance activation without anterior asymmetry

    Directory of Open Access Journals (Sweden)

    AnderoUusberg

    2014-03-01

    Full Text Available Occasionally, the expected effects of approach-avoidance motivation on anterior EEG alpha asymmetry fail to emerge, particularly in studies using affective picture stimuli. These null findings have been explained by insufficient motivational intensity of, and/or overshadowing interindividual variability within the responses to emotional pictures. These explanations were systematically tested using data from 70 students watching 5 types of affective pictures ranging from very pleasant to unpleasant. The stimulus categories reliably modulated self-reports as well as the amplitude of late positive potential, an ERP component reflecting orienting towards motivationally significant stimuli. The stimuli did not, however, induce expected asymmetry effects either for the sample or individual participants. Even while systematic stimulus-dependent individual differences emerged in self-reports as well as LPP amplitudes, the asymmetry variability was dominated by stimulus-independent interindividual variability. Taken together with previous findings, these results suggest that under some circumstances anterior asymmetry may not be an inevitable consequence of core affect. Instead, state asymmetry shifts may be overpowered by stable trait asymmetry differences and/or stimulus-independent yet situation-dependent interindividual variability, possibly caused by processes such as emotion regulation or anxious apprehension.

  17. Penghentian Karies Gigi Sulung Anterior (Laporan Penelitian

    Directory of Open Access Journals (Sweden)

    Titi Pratiwi Indra Yoga

    2015-10-01

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

  18. Microanatomy of the perforators of the anterior communicating artery complex.

    Science.gov (United States)

    Camuscu, H; Dujovny, M; Abd el-Bary, T; Beristain, X; Viñas, F C

    1997-12-01

    We describe the microanatomy of the perforating arteries arising from the anterior communicating artery complex (5 mm distal of the anterior cerebral artery, the anterior communicating artery, and 5 mm proximal of the distal anterior cerebral artery). Thirteen unfixed human brains were used in this study. The origin and number of perforators are described, as is the site of brain penetration, and results are correlated with previous studies. The hemodynamics of blood flow in relation to the formation of an anterior communicating artery aneurysm and different surgical approaches are mentioned. The neuropsychological outcome after aneurysm clipping with regards to the pattern of blood supply from the anterior cerebral artery complex is also discussed. PMID:9427956

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

    Science.gov (United States)

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

    1999-07-15

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

  20. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

    OpenAIRE

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

    2004-01-01

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

  1. Complications of the anterior approach to the cervical spine

    OpenAIRE

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

    2014-01-01

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

  2. Current approach in diagnosis and management of anterior uveitis

    OpenAIRE

    Agrawal Rupesh; Murthy Somasheila; Sangwan Virender; Biswas Jyotirmay

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Hamid Khakshoor

    2011-01-01

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

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

    OpenAIRE

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

    2010-01-01

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

  5. Rehablitation of mandibular fracture with anterior teeth loss

    OpenAIRE

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

    2011-01-01

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

  6. Audit on necessity of radiographs in anterior shoulder dislocations

    OpenAIRE

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

    2008-01-01

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

  7. Winging of scapula due to serratus anterior tear

    Directory of Open Access Journals (Sweden)

    Varun Singh Kumar

    2014-10-01

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

  8. Síndrome tóxica do segmento anterior Toxic anterior segment syndrome

    Directory of Open Access Journals (Sweden)

    Luiz Filipe de Albuquerque Alves

    2013-02-01

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

  9. Tunnel widening in anterior cruciate ligament reconstruction

    DEFF Research Database (Denmark)

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

    1999-01-01

    We report a prospective series evaluating the incidence and degree of tunnel widening in a well-matched series of patients receiving a hamstring or patella tendon graft for anterior cruciate ligament (ACL) deficiency. We correlated tunnel widening with clinical factors, knee scores, KT-1000 and...... similar endoscopic procedure and accelerated postoperative rehabilitation. Tunnel widening was determined using standardized anteroposterior (AP) and lateral X-rays adjusted for magnification. A limited series of MRIs was performed to validate these measurements. There was a significant difference in the...... degree of tunnel widening between the two groups. The mean increase in femoral tunnel area in the hamstring group was 100.4% compared with a decrease of 25% in the patella tendon group (P = <0.0001). In the tibial tunnel the mean increase in the hamstring group was 73.9% compared with a decrease of 2...

  10. Mechanisms of anterior cruciate ligament injury

    International Nuclear Information System (INIS)

    The anterior cruciate ligament (ACL) may be injured by various mechanisms. Each mechanism is know to produce specific combinations of ligamentous and meniscal abnormalities. This paper reports that this project was undertaken to evaluate the ability of MR imaging to characterize fully these different patterns of ACL injury. Two hundred fifty knee MR examinations in patients with suspected ACL injury were reviewed retrospectively. The presence of ACL injury and associated ligamentous, capsular, meniscal, and bone marrow abnormalities were correlated with the clinical history and mechanism of injury. Surgical or arthroscopic follow-up was available in all patients. As expected, ACL injuries were found to have a broad spectrum of associated abnormalities identified by MR imaging. Several mechanism-specific patterns of ligamentous and meniscal injury were observed; however, patterns of bone marrow edema and injury proved to be the most useful in predicting the mechanism of injury

  11. Concrescent triplets involving primary anterior teeth

    Directory of Open Access Journals (Sweden)

    Urvashi Sharma

    2013-01-01

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

  12. MR imaging of anterior cruciate ligament tears

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-09-01

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

  13. MR imaging of anterior cruciate ligament tears

    International Nuclear Information System (INIS)

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

  14. MR imaging evaluation of anterior cruciate ligaments

    International Nuclear Information System (INIS)

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

  15. 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

  16. RETAINED STONE PIECE IN ANTERIOR CHAMBER

    Directory of Open Access Journals (Sweden)

    ZvornicaninJasmin, Nadarevic-VodencarevicAmra

    2015-04-01

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

  17. Foreign Body Embedded in Anterior Chamber Angle

    Directory of Open Access Journals (Sweden)

    Shmuel Graffi

    2012-01-01

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

  18. Endoscopic anterior decompression in cervical disc disease

    Directory of Open Access Journals (Sweden)

    Yad Ram Yadav

    2014-01-01

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

  19. Anterior humeral circumflex artery avulsion with brachial plexus injury following an isolated traumatic anterior shoulder dislocation.

    Science.gov (United States)

    Shah, Rohi; Koris, Jacob; Wazir, Akhlaq; Srinivasan, Shyamsundar S

    2016-01-01

    A 70-year-old man presented to accident and emergency with an isolated anteriorly dislocated shoulder, in the absence of a concomitant fracture. There was no neurovascular deficit at presentation, and the shoulder was reduced under sedation, using the Kocher's technique. Following this, the patient developed signs of hypovolaemic shock. Clinical examination revealed an expanding fullness in the deltopectoral area, with compromise of the limb neurovascular status. CT imaging confirmed an expanding haematoma from the axillary vessels, restricting left lung expansion. Once resuscitated, the patient was transferred to theatre for exploration of the bleeding vessels. Intraoperative findings included an avulsed anterior circumflex humeral artery that was subsequently ligated. Postoperatively, the patient developed axillary, radial, median and ulnar nerve neuropraxia, which improved clinically prior to discharge. The patient was ultimately discharged home after a lengthy inpatient stay. PMID:26969353

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

    Directory of Open Access Journals (Sweden)

    Maria José Araújo da Cunha Guimarães

    2009-04-01

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

  1. Dysphagia due to anterior cervical osteophytosis: case report

    OpenAIRE

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

    2014-01-01

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

  2. Cataract Surgery in Eyes with Shallow Anterior Chamber

    OpenAIRE

    Hüseyin Bayramlar; Remzi Karadağ; Ünsal Sarı

    2014-01-01

    Shallow anterior chamber may be encountered in an eye planned for cataract surgery as well as during phacoemulsification. In both situations, cataract surgery is a challenging case. In this article, we tried to review the situations and management of shallow anterior chamber in cataract surgery. (Turk J Ophthalmol 2014; 44: 388-91

  3. Cataract Surgery in Eyes with Shallow Anterior Chamber

    Directory of Open Access Journals (Sweden)

    Hüseyin Bayramlar

    2014-10-01

    Full Text Available Shallow anterior chamber may be encountered in an eye planned for cataract surgery as well as during phacoemulsification. In both situations, cataract surgery is a challenging case. In this article, we tried to review the situations and management of shallow anterior chamber in cataract surgery. (Turk J Ophthalmol 2014; 44: 388-91

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-09-15

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

  5. Anterior chamber cholesterolosis in a patient with retinoblastoma.

    Science.gov (United States)

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

    2016-01-01

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

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

    Medline Plus

    Full Text Available ... United States to have recurrence of her cervical cancer in the anterior portion of the cervix and the anterior vagina and it invading into ... involving the posterior bladder, the vagina and the cervix completely ... negative for cancer. She was surgically cured with this procedure that ...

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

    Science.gov (United States)

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

    2016-01-01

    Zebrafish with defective Nodal signaling have a phenotype analogous to the fatal human birth defect anencephaly, which is caused by an open anterior neural tube. Previous work in our laboratory found that anterior open neural tube phenotypes in Nodal signaling mutants were caused by lack of mesendodermal/mesodermal tissues. Defects in these mutants are already apparent at neural plate stage, before the neuroepithelium starts to fold into a tube. Consistent with this, we found that the requirement for Nodal signaling maps to mid-late blastula stages. This timing correlates with the timing of prechordal plate mesendoderm and anterior mesoderm induction, suggesting these tissues act to promote neurulation. To further identify tissues important for neurulation, we took advantage of the variable phenotypes in Nodal signaling-deficient sqt mutant and Lefty1-overexpressing embryos. Statistical analysis indicated a strong, positive correlation between a closed neural tube and presence of several mesendoderm/mesoderm-derived tissues (hatching glands, cephalic paraxial mesoderm, notochord, and head muscles). However, the neural tube was closed in a subset of embryos that lacked any one of these tissues. This suggests that several types of Nodal-induced mesendodermal/mesodermal precursors are competent to promote neurulation. genesis 54:3-18, 2016. © 2016 Wiley Periodicals, Inc. PMID:26528772

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

    Science.gov (United States)

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

    1998-10-01

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

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

    Science.gov (United States)

    Ashwell, Ken W S

    2016-04-01

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

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

    NARCIS (Netherlands)

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

    2006-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ramon Coral Ghanem

    2004-08-01

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

  12. MRI of anterior cruciate ligament healing

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-03-01

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

  13. Approaching the ruptured anterior cruciate ligament.

    Science.gov (United States)

    Sarraf, Khaled M; Sadri, Amir; Thevendran, Gowreeson; Vedi, Vikas

    2011-08-01

    Anterior cruciate ligament (ACL) disruptions are common injuries that currently hold a fearsome reputation among athletes of all abilities and disciplines. Indeed, if the diagnosis is missed at first presentation, it is difficult to attribute ongoing instability and recurrent injury to an ACL tear. Classically, patients then often improve shortly before repeatedly reinjuring their knee. At some point, the knee may lock, necessitating an arthroscopic meniscectomy. Tragically, this then hastens the progression of joint arthrosis and the decline of the joint function. While the burden of responsibility does not lie solely with the junior doctor or the general practitioner, it is often at the first consultation that the natural history of this devastating injury is decided. The ability to recognise, institute early management and reassure patients with ACL tears about the future is an invaluable asset to the non-specialist junior doctor. Once diagnosed, the responsibility of advising and further counselling of patients with ACL injuries is best left to the orthopaedic knee specialist. Family practitioners and emergency room doctors should not feel pressured to offer advice on specialist areas such as return to sports without reconstruction or indeed the need for reconstruction. Indeed, decisions to return to sports with ACL-deficient knees have all too often led to disastrous reinjury events to the articular cartilage and/or the menisci. PMID:21097944

  14. Guideline on anterior cruciate ligament injury.

    Science.gov (United States)

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

    2012-08-01

    The Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steering group of the Dutch Orthopaedic Association. What is the role of physical examination and additional diagnostic tools? Which patient-related outcome measures should be used? What are the relevant parameters that influence the indication for an ACL reconstruction? Which findings or complaints are predictive of a bad result of an ACL injury treatment? What is the optimal timing for surgery for an ACL injury? What is the outcome of different conservative treatment modalities? Which kind of graft gives the best result in an ACL reconstruction? What is the optimal postoperative treatment concerning rehabilitation, resumption of sports, and physiotherapy? These 8 questions were answered and recommendations were made, using the "Appraisal of Guidelines for Research and Evaluation" instrument. This instrument seeks to improve the quality and effectiveness of clinical practical guidelines by establishing a shared framework to develop, report, and assess. The steering group has also developed 7 internal indicators to aid in measuring and enhancing the quality of the treatment of patients with an ACL injury, for use in a hospital or practice. PMID:22900914

  15. Specificity of systolic anterior motion of anterior mitral leaflet for hypertrophic cardiomyopathy. Prevalence in large population of patients with other cardiac diseases.

    OpenAIRE

    Maron, B. J.; Gottdiener, J S; Perry, L W

    1981-01-01

    The value of systolic anterior motion of the anterior mitral leaflet as a diagnostic marker for hypertrophic cardiomyopathy has been questioned because of its reported occurrence in other heart diseases. To determine the true specificity of systolic anterior motion for hypertrophic cardiomyopathy, 721 echocardiograms from patients with a wide variety of cardiac diseases were reviewed for its presence or absence under basal conditions. Systolic anterior motion of the anterior mitral leaflet wa...

  16. Anterior segment parameters and eyelids in systemic sclerosis.

    Science.gov (United States)

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

    2016-08-01

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

  17. Infarto do miocárdio causado por lesão arterial coronariana após trauma torácico fechado Infarto de miocardio causado por lesión arterial coronaria post traumatismo torácico cerrado Myocardial infarction caused by coronary artery injury after a blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Márcio Silva Miguel Lima

    2009-07-01

    Full Text Available Relatamos o caso de um indivíduo do sexo masculino de 29 anos de idade, vítima de um acidente de carro no qual sofreu trauma torácico fechado, evoluindo com insuficiência cardíaca congestiva. O paciente apresentava boa saúde previamente, sem sintomas de doença cardiovascular. Na avaliação inicial, o eletrocardiograma mostrou ondas Q nas derivações precordiais e o ecocardiograma mostrou disfunção ventricular esquerda importante. A angiografia coronária mostrou uma lesão na artéria coronária descendente anterior esquerda (ADE, com acinesia da parede anterior na ventriculografia com contraste. A tomografia computadorizada por emissão de fóton único (SPECT com Tálio-201 não mostrou viabilidade. O paciente foi mantido em tratamento clínico com boa evolução.Relatamos el caso de un individuo del sexo masculino, de 29 años de edad, víctima de accidente automovilístico en el cual sufrió traumatismo torácico cerrado, evolucionando con insuficiencia cardíaca congestiva. El paciente presentaba buena salud previamente, sin síntomas de enfermedad cardiovascular. En la evaluación inicial, el electrocardiograma mostró ondas Q en las derivaciones precordiales y el ecocardiograma mostró disfunción ventricular izquierda importante. La angiografía coronaria mostró una lesión en la arteria coronaria descendente anterior izquierda (ADI, con acinesia de la pared anterior en la ventriculografía de contraste. La tomografía computada por emisión de fotón único (SPECT con Talio-201 no mostró viabilidad. El paciente fue mantenido en tratamiento clínico con buena evolución.We report the case of a 29-year-old man, victim of a car accident, who suffered a severe blunt chest trauma, with evolving congestive heart failure. He had previously had a good overall health status, with no symptoms of cardiovascular disease. At the initial assessment, the electrocardiogram showed Q waves in the precordial leads and the echocardiogram

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  19. Multi drug resistant tuberculosis presenting as anterior mediastinal mass

    Directory of Open Access Journals (Sweden)

    Parmarth Chandane

    2016-01-01

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

  20. Bilateral anterior choroidal artery infarction presenting with progressive somnolence.

    Science.gov (United States)

    van Son, Brechtje; Vandevenne, Jan; Viaene, Pieter

    2014-09-01

    A 55-year-old woman was admitted with a 3 days history of increasing lethargy with bradyphrenia and apathy. She progressively developed severe somnolence with marked abulia, right hemiparesis, right hemianopsia, and pseudobulbar palsy. Brain magnetic resonance imaging showed the rare image of bilateral acute anterior choroidal artery infarction. Pseudobulbar mutism and in rare cases abulia have been described in acute anterior choroidal artery infarction contralateral to an older lesion in mirror position. Although neurologic deterioration is not infrequent in anterior choroidal artery territory infarcts, the absence of focal neurologic signs on admission is rare and did not raise suspicion of acute stroke. PMID:25106836

  1. Fibrinous anterior uveitis following laser in situ keratomileusis

    Directory of Open Access Journals (Sweden)

    Parmar Pragya

    2009-01-01

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

  2. Gravid med spontan ruptur af arteria uterina

    DEFF Research Database (Denmark)

    Jònsdòttir, Fjòla; Pinborg, Anja; Wilken-Jensen, Charlotte

    2014-01-01

    Pregnant women with acute abdominal pain are a clinical challenge. We present a rare but potential life-threatening condition of a pregnant woman with acute abdominal pain. The woman was in gestational week 37 with severe abdominal pain and was admitted to the labour ward. She became haemo......-dynamic instable 24 hours after vaginal delivery, and emergency laparotomi revealed a spontaneous rupture of the right uterine artery. Spontaneous rupture of the uterine artery is rare but should be considered as a possible cause of acute abdominal pain in pregnant women....

  3. Multimodal emotion perception after anterior temporal lobectomy

    Directory of Open Access Journals (Sweden)

    Valérie eMilesi

    2014-05-01

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

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

    LENUS (Irish Health Repository)

    Walker, Cameron

    2009-12-01

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

  5. Dysphagia due to anterior cervical osteophytosis: case report

    Directory of Open Access Journals (Sweden)

    Frederico Miguel Santos Silva Marquez Correia

    2014-12-01

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

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

    Medline Plus

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

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

    Medline Plus

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

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

    NARCIS (Netherlands)

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

    2007-01-01

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

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

    Medline Plus

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

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

    Directory of Open Access Journals (Sweden)

    Kevin Reinard

    2015-01-01

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

  11. QUADROS CONCEITUAIS DO CETICISMO ANTERIOR A SEXTO EMPÍRICO

    Directory of Open Access Journals (Sweden)

    Rodrigo Pinto de Brito

    2013-08-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    M.L. Sreenivas Kumar

    2012-07-01

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

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

    Medline Plus

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

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

    Medline Plus

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-11-01

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

  18. Simple self-reduction method for anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Reiner Wirbel

    2014-01-01

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

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

    Medline Plus

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

  20. Dirofilaria in the anterior chamber: A rare occurrence

    Directory of Open Access Journals (Sweden)

    Rupali Chopra

    2012-01-01

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

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

    Medline Plus

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jacob A Udell

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

  4. Torque control during lingual anterior retraction without posterior appliances

    OpenAIRE

    Mo, Sung-Seo; Kim, Seong-Hun; Sung, Sang-Jin; Chung, Kyu-Rhim; Chun, Yun-Sic; Kook, Yoon-Ah; Nelson, Gerald

    2013-01-01

    Objective To evaluate the factors that affect torque control during anterior retraction when utilizing the C-retractor with a palatal miniplate as an exclusive source of anchorage without posterior appliances. Methods The C-retractor was modeled using a 3-dimensional beam element (0.9-mm-diameter stainless-steel wire) attached to mesh bonding pads. Various vertical heights and 2 attachment positions for the lingual anterior retraction hooks (LARHs) were evaluated. A force of 200 g was applied...

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

    OpenAIRE

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

    2013-01-01

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

  6. STUDY OF ANTERIOR CRUCIATE LIGAMENT INJURY AND ITS MANAGEMENT

    OpenAIRE

    Tummala Venkata; Makkena Ravi; Purushotham; Yalamanchili Sumanth; Surapaneni Suresh; Kopuri Ravi

    2016-01-01

    BACKGROUND The anterior cruciate ligament is the weaker of the two cruciate ligaments stabilizing the knee joint, and therefore gets torn easier than the posterior cruciate ligament. OBJECTIVE To determine pattern of anterior cruciate ligament injury and its management in a tertiary care center. MATERIALS AND METHODS A prospective study was carried out for two years, 28 patients with ACL injury were included. A detailed history regarding the pattern of in...

  7. Anterior uveitis secondary to type II essential cryoglobulinemia

    OpenAIRE

    Nicholson, Laura; Sobrin, Lucia

    2013-01-01

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

  8. Increased CD40 ligand in patients with acute anterior uveitis

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  9. Anterior cerebral artery territory infarctions presenting with ascending tetraparesis.

    Science.gov (United States)

    Okamoto, Kensho; Hamada, Eri; Okuda, Bungo

    2004-01-01

    We describe a patient with ascending tetraparesis following stroke. The patient presented initially with spastic paraparesis which acutely evolved to tetraparesis with abulia. Magnetic resonance imaging revealed acute infarctions in the bilateral medial frontal regions but not in the brainstem or spinal cord. Multiple infarctions in the anterior cerebral artery territory appeared to originate from artery to artery embolism. The present case provides distinct clinical features of anterior cerebral artery syndrome which mimic myelopathy or brainstem lesions. PMID:17903956

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

    OpenAIRE

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

    2007-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    2014-01-01

    Despite medications, resective surgery, and vagal nerve stimulation, some patients with epilepsy continue to have seizures. In these patients, other approaches are urgently needed. The biological basis of stimulation of anterior thalamic nucleus and epileptogenic focus is presented. Results from two large randomized controlled trials Stimulation of Anterior Nucleus of Thalamus for Epilepsy (SANTE) and Neuropace pivotal trial are discussed. Neuromodulation provides effective treatment for a se...

  13. Anterior Urethral Valves: Not Such a Benign Condition…

    OpenAIRE

    Cruz-Diaz, Omar; Salomon, Anahi; Rosenberg, Eran; Moldes, Juan Manuel; de Badiola, Francisco; Labbie, Andrew Scott; Gosalbez, Rafael; Castellan, Miguel Alfredo

    2013-01-01

    Purpose: Anterior urethral valves (AUVs) is an unusual cause of congenital obstruction of the male urethra, being 15–30 times less common than posterior urethral valves (PUVs). It has been suggested that patients with congenital anterior urethral obstruction have a better prognosis than those with PUV, with less hydronephrosis, and a lower incidence of chronic renal insufficiency (5 vs. 30%). The long-term prognosis of AUVs is not clear in the literature. In this report we describe our experi...

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

    OpenAIRE

    Karpagam S; Rabin K; Mathew George; Koshy Santhosh

    2005-01-01

    Treatment planning for patients with skeletal deformities is often considered challenging. This article reports a female patient with achondroplasia who presented with severe maxillary retrognathism and vertical excess along with anterior open bite. The clinical and cephalometric findings of the patient are detailed here. The treatment plan consisted of modified anterior maxillary osteotomy for simultaneous vertical and sagittal augmentation along with orthodontic intervention. The course of ...

  15. Intrusion of anterior teeth to improve smile esthetics

    OpenAIRE

    Chandrasekharan, Deepak; Balaji, S. M.

    2010-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  17. Neglected Traumatic Locked Anterior Shoulder Fracture-Dislocation

    OpenAIRE

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

    2015-01-01

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

  18. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    OpenAIRE

    Patil, Mallanagouda N

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-15

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

  20. Complication of toxic anterior segment syndrome after IOL implantation

    OpenAIRE

    Juan Guo

    2014-01-01

    AIM: To evaluate the treatment process of toxic anterior segment syndrome(TASS)and to found out the effective treatment, aetiological agent and prognosis.METHODS: A total of 6 cases(7 eyes)were suspected with TASS by clinical situations. Bacterial infectious endophthalmitis could be ruled out by anterior chamber and vitreous body paracentesis. All patients were treated with local application of antibiotics and glucocorticoid eyedrops, and some patients were treated with intravitreal injection...

  1. Fibrinous anterior uveitis following laser in situ keratomileusis

    OpenAIRE

    Parmar, Pragya; Salman, Amjad; Rajmohan, M; Jesudasan, Nelson CA

    2009-01-01

    A 29-year-old woman who underwent laser in situ keratomileusis (LASIK) for myopic astigmatism in both eyes presented with severe pain, photophobia and decreased visual acuity in the left eye eight days after surgery. Examination revealed severe anterior uveitis with fibrinous exudates in the anterior chamber, flap edema and epithelial bullae. Laboratory investigations for uveitis were negative and the patient required systemic and intensive topical steroids with cycloplegics to control the in...

  2. Anterior chamber flare after trabeculectomy and after phacoemulsification

    OpenAIRE

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

    2000-01-01

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

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

    Science.gov (United States)

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

    1997-05-01

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

  4. Pré-condicionamento isquêmico e monitorização da função medular na abordagem da aorta torácica descendente Ischemic preconditioning and spinal cord function monitoring in the descending thoracic aorta approach

    Directory of Open Access Journals (Sweden)

    Bernardo Assumpção de Mônaco

    2007-03-01

    Full Text Available OBJETIVOS: Avaliar a eficácia do pré-condicionamento isquêmico (PI agudo, guiado por potenciais evocados somatossensoriais (PESS, como método de proteção medular em cães e analisar o valor dos PESS na monitorização da função medular. MÉTODOS: Foram utilizados 28 cães submetidos à isquemia medular obtida pelo pinçamento da aorta torácica descendente. No grupo C45, o tempo de oclusão aórtica foi de 45 min (n = 7; no grupo PI45, os cães foram submetidos ao PI antes do pinçamento aórtico por 45 min (n = 7. No grupo C60, os cães foram submetidos a 60 min de oclusão aórtica (n = 7 e no grupo PI60, os cães foram submetidos ao PI, seguido pelo pinçamento aórtico por 60 min. Os ciclos de PI foram determinados pelas alterações dos PESS. RESULTADOS: Os índices de Tarlov dos grupos pré-condicionados foram significativamente melhores que os dos grupos de controle (p = 0,005. Observou-se paraplegia em três cães do C45 e em seis do C60, enquanto todos os cães do PI45 permaneceram neurologicamente normais, assim como quatro do grupo PI60. Houve correlação entre o tempo de recuperação dos PESS após a reperfusão aórtica e o estado neurológico pós-operatório (p = 0,011, com sensibilidade e especificidade de 0,75 e 0,83, respectivamente. CONCLUSÃO: O PI agudo repetitivo, baseado na monitorização do PESS, induziu proteção à isquemia medular causada pelo pinçamento aórtico prolongado. A monitorização do PESS parece ser um bom método de detecção precoce do comprometimento isquêmico medular.OBJECTIVES: To evaluate the effectiveness of acute ischemic preconditioning (IP, based on somatosensory evoked potentials (SSEP monitoring, as a method of spinal cord protection and to asses SSEP importance in spinal cord neuromonitoring. METHODS: Twenty-eight dogs were submitted to spinal cord ischemic injury attained by descending thoracic aorta cross-clamping. In the C45 group, the aortic cross-clamping time was 45 min (n

  5. FACTORES CLÍNICOS Y DEL PROCEDIMIENTO RELACIONADOS CON LA TROMBOSIS DE STENT / Clinical and procedural factors related to stent thrombosis

    Directory of Open Access Journals (Sweden)

    Ronald Aroche Aportela

    2012-03-01

    Full Text Available Resumen Introducción y objetivos: La trombosis del stent es una de las complicaciones posterior al intervencionismo coronario percutáneo, asociada a una elevada mortalidad y morbilidad. A pesar del uso de la doble terapia antiplaquetaria (aspirina y clopidogrel y la optimización de la técnica, su incidencia no ha desaparecido. El objetivo de esta investigación fue determinar los factores de riesgo de trombosis de los stent metálicos convencionales. Método: Se realizó un estudio descriptivo-retrospectivo. De las 2.014 arterias revascularizadas en el Centro de Investigaciones Médico-Quirúrgicas de La Habana, Cuba; entre agosto de 1997 y febrero de 2009, se seleccionaron las 289 reestudiadas. Resultados: La trombosis de los stent metálicos convencionales estuvo presente en 20 arterias, de las cuales 11 resultaron ser la descendente anterior, y su mayor incidencia se presentó en las primeras 24 horas y después de los 30 días. La diabetes mellitus se comportó como un factor de riesgo de trombosis (OR* = 3,06, así como la presión de liberación de menos de 10 atmósferas (OR = 3,70 y las lesiones complejas de los tipos B2 y C (OR = 8,80, todos con significación estadística (p < 0,05. Conclusiones: La mayor incidencia de trombosis de los stent metálicos convencionales fue en el primer día de la revascularización, después de la terminación de la doble terapia de antiagregación plaquetaria y en la arteria descendente anterior. La diabetes mellitus, las lesiones complejas y las bajas presiones de liberación del stent, se comportaron como factores de riesgo de trombosis con resultados estadísticamente significativos. Abstract Introduction and Objectives: Stent thrombosis is a complication after percutaneous coronary intervention associated with high mortality and morbidity. Despite the use of dual antiplatelet therapy (aspirin and clopidogrel and optimization of the technique, its incidence has not disappeared. The objective of

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-15

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

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

    OpenAIRE

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

    2014-01-01

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

  10. Ophthalmohelioses and peripheral light focusing by the anterior eye

    Science.gov (United States)

    Coroneo, Minas T.

    1994-07-01

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

  11. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

    Directory of Open Access Journals (Sweden)

    Jung-Ju Huang

    2004-07-01

    Full Text Available Background: In multilevel spinal cord compression caused by cervical spondylosis, surgeonsface the choice of performing a posterior route as a laminectomy orlaminoplasty, or an anterior route as multiple adjacent interbody decompressionsor corpectomies. The anterior cervical operation is not considered bysome clinicians because of concerns about complications and the complexityof multilevel anterior cervical surgery.Methods: In this retrospective study, 14 patients with multilevel cervical spondylosiswho were operated on via an anterior route were enrolled to evaluate thecomplexity, safety, and clinical results. The collected parameters were operationtime, blood loss, hospital days, and early and late complications forevaluating the operative complexity, radiographic follow-up for evaluatingfusion, graft problems, implants problems, and the recovery rate using theJapanese Orthopaedic Association score (JOA score for evaluating the operativeresults.Results: The mean operation time was 363.4 min, and blood loss was 431.4 ml. Anearly complication was noted in 1 patient with combined deep vein thrombosisand a pulmonary embolism. Late complications were screw breakage in1 patient and screw loosening in 5 patients. The mean duration of follow-upwas 21.9 months. The mean recovery rate of the JOA score was 38.8% postoperativelyand 51.9% at the final follow-up. The fusion rate was 100% inthis series.Conclusions: Anterior cervical decompression and fusion for multilevel stenosis requires alonger operation time than posterior procedures; however, the clinical resultsare satisfactory.

  12. Minimally invasive total hip arthroplasty with the anterior approach

    Directory of Open Access Journals (Sweden)

    Bal B

    2008-01-01

    Full Text Available Background: Total hip athroplasty with the anterior surgical approach is advised because the dissection is entirely within intermuscular planes. In this report we describe a minimally invasive technique of anterior total hip arthroplasty, with the early outcomes. Materials and Methods: The technique of minimally invasive total hip arthroplasty with anterior approach (Smith-Petersen is described. We reviewed data on 100 consecutive patients who underwent anterior total hip arthroplasty with uncemented components. Mean patient age was 61 years (range 33-91. Mean patience BMI 29.8 (range 18.1-51.8. Results: Minumum follow up duration is 10 months. The mean duration of surgery was 53 min (range 34-87 with mean blood loss 185 cc (range 65-630, and the mean incision length was 10.4 cm. Clinical and radiographic outcomes were similar to historical outcomes of standard total hip arthroplasty. Conclusions: With proper surgeon training, minimally invasive total hip replacement with the anterior surgical interval is safe and efficacious.

  13. Association of Cryptogenic Organizing Pneumonia in Bilateral Anterior Uveitis

    Directory of Open Access Journals (Sweden)

    Kaori Fujimoto

    2014-11-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  15. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens

    Science.gov (United States)

    Spierer, Oriel; O'Brien, Terrence P.

    2016-01-01

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

  16. Endocarditis por Brucella abortus: Reporte del primer caso en C.R

    Directory of Open Access Journals (Sweden)

    Manuel Antonio Villalobos-Zúñiga

    2011-09-01

    Full Text Available Paciente masculino de 36 años de edad, proveniente de la zona rural de Costa Rica, con un cuadro clínico de 8 meses de evolución de fiebre, mialgias, artralgias, pérdida de peso y lumbalgia; referido por la detección de un soplo de insuficiencia aórtica. El ecocardiograma reveló endocarditis de la válvula aórtica, y se obtuvieron 4 hemocultivos positivos por Brucella abortus biotipo 3, con serologías negativas por brucelosis. Se inició tratamiento con antibióticos y luego se le realizó un reemplazo valvular aórtico; 4 meses después ingresó con dolor torácico que se atribuyó a una oclusión de la arteria descendente anterior, demostrada angiográficamente, por posible embolismo. En la actualidad cursa clínicamente estable con manejo médico para su cardiopatía, sin recaída infecciosa.

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

    Directory of Open Access Journals (Sweden)

    Antonio Egydio de Carvalho Junior

    2010-01-01

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

  18. Clinical Applications of Anterior Segment Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Su-Ho Lim

    2015-01-01

    Full Text Available Anterior segment optical coherence tomography (AS-OCT was recently developed and has become a crucial tool in clinical practice. AS-OCT is a noncontact imaging device that provides the detailed structure of the anterior part of the eyes. In this review, the author will discuss the various clinical applications of AS-OCT, such as the normal findings, tear meniscus measurement, ocular surface disease (e.g., pterygium, pinguecula, and scleromalacia, architectural analysis after cataract surgery, post-LASIK keratectasia, Descemet’s membrane detachment, evaluation of corneal graft after keratoplasty, corneal deposits (corneal dystrophies and corneal verticillata, keratitis, anterior segment tumors, and glaucoma evaluation (angle assessment, morphological analysis of the filtering bleb after trabeculectomy, or glaucoma drainage device implantation surgery. The author also presents some interesting cases demonstrated via AS-OCT.

  19. Palpation for muscular tenderness in the anterior chest wall

    DEFF Research Database (Denmark)

    Christensen, Henrik Wulff; Vach, Werner; Manniche, Claus; Haghfelt, Torben; Hartvigsen, Lisbeth; Høilund-Carlsen, Poul Flemming

    2003-01-01

    OBJECTIVE: To asses the interobserver and intraobserver reliability (in terms of day-to-day and hour-to-hour reliability) of palpation for muscular tenderness in the anterior chest wall. DESIGN: A repeated measures designs was used. SETTING: Department of Nuclear Medicine, Odense University...... Hospital, Denmark. PARTICIPANTS: Two experienced chiropractors examined 29 patients and 27 subjects in the interobserver part, and 1 of the 2 chiropractors examined 14 patients and 15 subjects in the intraobserver studies. INTERVENTION: Palpation for muscular tenderness was done in 14 predetermined areas...... of the anterior chest wall with all subjects sitting. Each dimension was rated as absent or present for tenderness or pain for each location. All examinations were carried out according to a standard written procedure. RESULTS: Based on a pooled analysis of data from palpation of the anterior chest...

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    OBJECTIVE: The study aimed to identify risk factors for clinical anastomotic leakage (AL) after anterior resection for rectal cancer in a consecutive national cohort. METHOD: All patients with an initial first diagnosis of colorectal adenocarcinoma were prospectively registered in a national...... database. The register included 1495 patients who had had a curative anterior resection between May 2001 and December 2004. The association of a number of patient- and procedure-related factors with clinical AL after anterior resection was analysed in a cohort design. RESULTS: Anastomotic leakages occurred...... in 163 (11%) patients. In a multivariate analysis, the risk of AL was significantly increased in patients with tumours located below 10 cm from the anal verge if no faecal diversion was undertaken (OR 5.37 5 cm (tumour level from anal verge), 95% CI 2.10-13.7, OR 3.57 7 cm, CI 1.81-7.07 and OR 1...

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

  3. Are the anterior negativities to grammatical violations indexing working memory?

    Science.gov (United States)

    Martín-Loeches, Manuel; Muñoz, Francisco; Casado, Pilar; Melcón, A; Fernández-Frías, C

    2005-09-01

    Anterior negativities obtained when a grammatical rule is violated may reflect highly automatic first-pass parsing processes, the detection of a morphosyntactic mismatch, and/or the inability to assign the incoming word to the current phrase structure. However, for some theorists these negativities rather reflect some aspect of working memory processes. Event-related brain potentials (ERPs) obtained for word category and morphosyntactic violations were directly compared with effects obtained when working memory is particularly demanded (embedding subject- or object-relative clauses), yielding a significant dissociation in terms of topography. Even though, the anterior negativities for grammatical violations vanished when relative clauses were embedded, suggesting that the processes reflected by anterior negativities related to grammatical violations and those related to working memory manipulations, even if different, are placing demands on a common pool of limited resources. PMID:16176373

  4. Refraction and eye anterior segment parameters in schizophrenic patients

    Directory of Open Access Journals (Sweden)

    Tongabay Cumurcu

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Strajnić Ljiljana

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Wen-xiang YUE

    2015-01-01

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

  7. ADAPTACIÓN DEL ALGORITMO MARACAS PARA SEGMENTACIÓN DE LA ARTERIA CARÓTIDA Y CUANTIFICACIÓN DE ESTENOSIS EN IMÁGENES TAC Adaptation of the MARACAS Algorithm for Carotid Artery Segmentation and Stenosis Quantification on CT Images

    Directory of Open Access Journals (Sweden)

    MARIA A ZULUAGA

    Full Text Available En este artículo se describen las adaptaciones hechas al algoritmo MARACAS para segmentar y cuantificar estructuras vasculares en imágenes TAC de la arteria carótida. El algoritmo MARACAS, que está basado en un modelo elástico y en un análisis de los valores y vectores propios de la matriz de inercia, fue inicialmente diseñado para segmentar una sola arteria en imágenes ARM. Las modificaciones están principalmente enfocadas a tratar las especificidades de las imágenes TAC, así como la presencia de bifurcaciones. Los algoritmos implementados en esta nueva versión se clasifican en dos niveles. 1. Los procesamientos de bajo nivel (filtrado de ruido y de artificios direccionales, presegmentación y realce destinados a mejorar la calidad de la imagen y presegmentarla. Estas técnicas están basadas en información a priori sobre el ruido, los artificios y los intervalos típicos de niveles de gris del lumen, del fondo y de las calcificaciones. 2. Los procesamientos de alto nivel para extraer la línea central de la arteria, segmentar el lumen y cuantificar la estenosis. A este nivel, se aplican conocimientos a priori sobre la forma y anatomía de las estructuras vasculares. El método fue evaluado en 31 imágenes suministradas en el concurso Carotid Lumen Segmentation and Stenosis Grading Grand Challenge 2009. Los resultados obtenidos en la segmentación arrojaron un coeficiente de similitud de Dice promedio de 80,4% comparado con la segmentación de referencia, y el error promedio de la cuantificación de estenosis fue 14,4%.This paper describes the adaptations of MARACAS algorithm to the segmentation and quantification of vascular structures in CTA images of the carotid artery. The MARACAS algorithm, which is based on an elastic model and on a multi-scale eigen-analysis of the inertia matrix, was originally designed to segment a single artery in MRA images. The modifications are primarily aimed at addressing the specificities of CT

  8. GAMMAGRAFÍA CON 99TC-MIBI PARA DETERMINAR LA EFECTIVIDAD DE LA HEBERQUINASA PARA REPERFUNDIR LA ARTERIA RELACIONADA CON EL INFARTO / 99tc-mibi gammagraphy to determine Heberkinase effectiveness in the reperfusion of the infarction-related artery

    Directory of Open Access Journals (Sweden)

    Marilyn Ramírez Méndez

    2010-12-01

    Full Text Available Resumen Introducción y objetivos: La utilización de técnicas nucleares para la determinación de la permeabilidad de la arteria relacionada con el infarto, es de gran importancia clínica. El objetivo de esta investigación fue conocer el estado de la perfusión miocárdica del territorio dependiente de la irrigación de esa arteria y determinar la presencia o no de su reapertura después de la trombólisis. Método: Se realizó una investigación experimental puntual con una muestra de 10 pacientes consecutivos, de ambos sexos y cualquier edad, que ingresaron en la Unidad de Cuidados Intensivos del Hospital Universitario "Dr. Celestino Hernández Robau" de Santa Clara, con el diagnóstico clínico y electrocardiográfico de infarto agudo de miocardio a los que se les administró tratamiento trombolítico con Estreptoquinasa Recombinante Cubana. Resultados: El 60 % pertenece al sexo masculino y el 70 % de la muestra presentaba edades superiores a los 50 años. Fue más frecuente la localización inferior del infarto (50 %, y el 70 % de la serie recibió tratamiento trombolítico en las primeras 6 horas de evolución. La evaluación gammagráfica de la perfusión miocárdica demostró 12 defectos de captación, la tercera parte de ellos (33,3 % se consideraron leves. Después de la aplicación del tratamiento trombolítico hubo una reducción del 50 % de los defectos de captación. Conclusiones: El estudio gammagráfico con 99Tc-MIBI fue útil para demostrar la recanalización de la arteria relacionada con el infarto, tras la utilización de tratamiento trombolítico con Estreptoquinasa Recombinante Cubana. / Abstract Introduction and objectives: Of great clinical importance is the use of nuclear techniques for determining the permeability of the infarction-related artery. The objective of this research was to know the myocardial perfusion state of the area dependent on the irrigation of this artery and to determine whether or not a reopening

  9. Perikymata spacing and distribution on hominid anterior teeth.

    Science.gov (United States)

    Dean, M C; Reid, D J

    2001-11-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Zeidman, Peter; Maguire, Eleanor A

    2016-03-01

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

  12. Agenesia do ligamento cruzado anterior – estudo de caso

    OpenAIRE

    Moreira, Andreia

    2010-01-01

    A agenesia do ligamento cruzado anterior é uma condição extremamente rara. Dada a importância desta estrutura na função muscular, cinética e cinemática do joelho, especula-se que muitas serão as alterações decorrentes desta patologia . Perante o caso de uma atleta com agenesia do ligamento cruzado anterior, este trabalho pretendeu estudar os possíveis défices resultantes desta condição e, perceber se as alterações encontradas no membro com agenesia constituem uma estratégia ...

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

    OpenAIRE

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

    2003-01-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Karpagam S

    2005-01-01

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

  16. A chondrosarcoma in the anterior mediastinum mimicking a thymoma

    International Nuclear Information System (INIS)

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

  17. A chondrosarcoma in the anterior mediastinum mimicking a thymoma

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  18. Anterior celiac plexus block for interventional biliary procedures

    International Nuclear Information System (INIS)

    This paper reports temporary celiac ganglion block for pain relief during biliary procedures performed without complication in 65 patients. The block was given from an anterior approach, with 30 mL of bupivacaine injected over the right T-12 pedicle. Fluoroscopy was used to guide the needle 2 cm anterior to the spine. Patients were assigned to one of three groups based on degree of anesthesia. In group 1, there was no benefit (20%); in group 2, moderate regional anesthesia (22%); and in group 3, excellent anesthesia (58%). The procedure may be performed at the start of or any time during the examination and provides satisfactory regional anesthesia in 80% of patients

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Mandeep S Dhillon

    2011-01-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  2. Endoscopic fetal urethrotomy for anterior urethral valves: a preliminary report.

    Science.gov (United States)

    Sago, Haruhiko; Hayashi, Satoshi; Chiba, Toshio; Ueoka, Katsuhiko; Matsuoka, Kentaro; Nakagawa, Atsuko; Kitagawa, Michihiro

    2008-01-01

    Anterior urethral valves are a rare congenital anomaly associated with distal urethral obstruction, which can result in a poor prognosis. We report on the endoscopic creation of a fetal urethrotomy for obstructive uropathy resulting from anterior urethral valves. A 33-year-old woman was evaluated at 17 weeks gestation due to fetal megacystis. The diagnosis of anterior urethral valves was confirmed by the characteristic sonographic feature of a dilated membranous penile urethra. Oligohydramnios with normal-appearing kidneys and favorable urinary electrolytes led to fetal intervention. Ablation on the ventral site of the fetal penis for a cutaneous urethrotomy was performed using a YAG laser under a 1-mm fetoscope at 19 weeks gestation. Urine was drained from the incision and the dilated penis and the distended bladder shrunk with an increase in amniotic fluid. However, the fetus died unexpectedly on postoperative day 3, and chorioamnionitis was suspected as the etiology. While the outcome was unfavorable, our preliminary experience shows that fetal urethrotomy for obstructive uropathy can be achieved in utero using an endoscopic laser approach. Further experience will be required to evaluate the therapeutic value of this new procedure in the management of fetal anterior urethral valves. PMID:18648205

  3. Anterior ischemic optic neuropathy in patients undergoing hemodialysis

    NARCIS (Netherlands)

    DoorenbosBot, ACC; Geerlings, W; Houtman, IA

    1996-01-01

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

  4. Genetic studies in congenital anterior midline cervical cleft

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  5. Usurering af osteosyntesemateriale gennem øsofagus efter anterior cervikalkirurgi

    DEFF Research Database (Denmark)

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

    can give false negative results. We present a case of a 74-year-old male, who was readmitted with sepsis and abscess in the operation area three weeks after anterior cervical surgery. Veillonella parvula was found in the abscess material and computed tomography confirmed the diagnosis of oesophageal...

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

    Directory of Open Access Journals (Sweden)

    Aldona J. Spiegel, MD

    2013-11-01

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

  7. Complications of the anterior approach to the cervical spine

    Directory of Open Access Journals (Sweden)

    Marcelo Lemos Vieira da Cunha

    2014-09-01

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

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

    Science.gov (United States)

    Dubin, Ina; Gelber, Moshe

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Leonardo Provetti Cunha

    2014-04-01

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

  10. Anterior Cingulate Cortex in Schema Assimilation and Expression

    Science.gov (United States)

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

    2012-01-01

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

  11. Left Anterior Descending Artery-Pulmonary Artery Fistula

    Directory of Open Access Journals (Sweden)

    Turan Ege

    2011-12-01

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

  12. Spindle neurons of the human anterior cingulate cortex

    Science.gov (United States)

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

    1995-01-01

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

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

    OpenAIRE

    Murat Yalcin

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  15. The anterior process of the malleus in Cetartiodactyla.

    Science.gov (United States)

    Maier, Wolfgang; Ruf, Irina

    2016-02-01

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

  16. Instrumental design for anterior fixation of dorsal and lumbar spine

    International Nuclear Information System (INIS)

    This is an experimental work; the main purpose is design a system for anterior fixation of thoracolumbar spine. The system includes screws, rods and transverse connectors. Mechanical tests to the system with axial and rotation charges showed elevated resistance and plasticity. The process include the development of elements for application of the system

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

    Medline Plus

    Full Text Available ... as the planes we're going through, this space of retzius. Here I can see with the structures of the medial and bocal ligament, the urethras ... cautery and the bleeding will stop. Again, the structures here, the 12 ... here we've completed the space of retzius, which means the space that's anterior ...

  18. Anterior cruciate ligament reconstruction complicated by pyoderma gangrenosum

    OpenAIRE

    Bagouri, E; Smith, Jon; Geutjens, G

    2012-01-01

    We report a case of pyoderma gangrenosum as a complication of an anterior cruciate ligament reconstruction in a patient with inflammatory bowel disease, which was misdiagnosed initially as a post-operative wound infection. An early dermatology opinion and skin biopsy should be considered in cases of suspected infection where thorough surgical debridement and antimicrobial therapy has failed to improve the clinical picture.

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

    Medline Plus

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

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

    NARCIS (Netherlands)

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

    2007-01-01

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

  1. Accessory thyroid in the anterior mediastinum: case report

    International Nuclear Information System (INIS)

    A case of accessory thyroid in the anterior mediastinum, physically separated from the thyroid gland, is reported. The mediastinal thyroid was incidentally discovered during the preoperative evaluation of a patient with breast carcinoma. The extreme rarity of the case is outlined

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

    Science.gov (United States)

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

    2014-03-01

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

  3. Anterior thalamus in cognition: an intracerebral recording study

    Czech Academy of Sciences Publication Activity Database

    Štillová, K.; Bočková, M.; Jurák, Pavel; Chládek, Jan; Chrastina, J.; Halámek, Josef; Telecká, S.; Říha, I.; Rektor, I.

    Brno: Česká a slovenská společnost pro klinickou neurofyziologii, 2015. s. 129. [European Congress on Clinical Neuro­physiology /15./. 30.09.2015-04.10.2015, Brno] Institutional support: RVO:68081731 Keywords : DBS * anterior thalamic nuclei * memory processes * memory recognition * intracerebral EEG Subject RIV: FH - Neurology

  4. Absence of sensory function in the reconstructed anterior cruciate ligament

    DEFF Research Database (Denmark)

    Krogsgaard, Michael R; Fischer-Rasmussen, Torsten; Dyhre-Poulsen, Poul

    2011-01-01

    Cruciate ligaments provide sensory information that cause excitatory as well as inhibitory effects to the activity of the muscles around the knee. The aim of the study was to determine whether these muscular reflexes are reestablished after anterior cruciate ligament (ACL) re-construction. Wire e...

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

    Directory of Open Access Journals (Sweden)

    Sugahara M

    2013-05-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2008-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Yashavantha Kumar C

    2013-01-01

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

  9. Simple self-reduction method for anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    Reiner Wirbel; Martin Ruppert; Elmar Schwarz; Bernhard Zapp

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2016-02-01

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

  11. Diagnóstico e tratamento do lenticone anterior

    Directory of Open Access Journals (Sweden)

    Ana Luiza Biancardi

    2011-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Jorge Faber

    2008-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

  14. Anterior Urethral Valve and Diverticulum in a Neonate with Febrile Urinary Tract Infection

    OpenAIRE

    Song, Jin Hyun; Lee, Min Ho; Lee, Ji Hye; Lee, Chang Ho; Jeon, Youn Soo; Lee, Nam Kyu; Kim, Doo Sang

    2012-01-01

    Anterior urethral valve is a rare congenital anomaly that can cause obstructive uropathy. Herein, we report a case of an anterior urethral valve that led to the development of febrile urinary tract infection in a neonate.

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

    Directory of Open Access Journals (Sweden)

    Milankov Miroslav

    2003-01-01

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

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

    OpenAIRE

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

    2006-01-01

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

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

    OpenAIRE

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Shoji Fukuta

    2015-01-01

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

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

    OpenAIRE

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

    2009-01-01

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

  20. Evaluation of local muscle soreness treatment with anterior bite splint made of soft putty impression material

    OpenAIRE

    Harry Laksono; Sherman Salim

    2013-01-01

    Background: Local muscle soreness is the most common temporomandibular disorders complaint of patients seeking treatment in the dental clinics. The emergency treatment that can be done in the clinics to manage this disorder is by making anterior bite splint. Anterior bite splint is usually made of acrylic, but currently there is a soft putty impression material that can also be used for making anterior bite splint. The effectiveness of soft putty anterior bite splint in local muscle soreness ...

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

    OpenAIRE

    Merle Neethling-du Toit; Richard de villiers

    2008-01-01

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

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

    OpenAIRE

    Raman Aulakh

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mandal Anil

    2002-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

  5. An Intra-tendonous ganglion cyst causing impingement between the anterior cruciate ligament and anterior root of the medial meniscus: a case report

    OpenAIRE

    Guolong, Mei; Zhi, Gao; Yong, Hu

    2013-01-01

    Background There are several reports of symptomatic ganglion cysts near the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and lateral and medial meniscus, but symptomatic ganglia arising from the anterior horn of the medial meniscus to the ACL have not been reported. Here we report the arthroscopic resection of a ganglion cyst arising from the anterior horn of the medial meniscus with a meniscal tear to the ACL. Case presentation A 43-year-old female presented with a 10...

  6. Treatment of ruptured anterior communicating artery aneurysms with GDCs

    International Nuclear Information System (INIS)

    Objective: To summarize 45 cases of ruptured anterior communicating artery aneurysms treated with GDCs. Methods: All aneurysms were embolized with GDCs. Results: Complete embolization was achieved in 25 aneurysms, subtotal in 14, and partial in 6. Two cases were cured by the second time embolization. One case of recurrent aneurysm after G DC treatment was curved by surgical clipping. Brain infarction was noted in 7 cases after the endovascular procedure, and one of them died of pneumonia, another one remained in permanent coma. 1-20 months follow up showed stable result. 4 of 5 cases with multi-intracranial aneurysms had been treated with on of this procedure. Conclusions: The result of endo vascular treatment of anterior communicating artery aneurysms in the early period after rupture was good. Although there was a relatively high risk of local brain infarction, the clinical outcome was satisfactory

  7. Hubungan Rasio Anterior dengan Overjet dan Overbite pada Perawatan Orthodontik

    Directory of Open Access Journals (Sweden)

    J. A. Budiman

    2015-10-01

    Full Text Available The important role of the tooth size information is in making diagnosis and treatment plan of the cases with malocclusion. A lot of studies have been done in this aspect such as about tooth size with its variation, and also the ratio of maxillary to mandibular tooth size. The most famous tooth size analysis is Bolton analysis with his anterior ratio and overall ratio. Because the accordance of those ratio is not found in all orthodontic cases, some studies (Korbitz, Neff, Moyers and Steadman tried to relate the anterior ratio with the amount of overjet and overbite in orthodontic treatment. Those relationship was found strong, but there are also other analysis that should be considered in treating orthodontic cases.

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

    Directory of Open Access Journals (Sweden)

    Yusuf Kurtuluş Duransoy

    2013-01-01

    Full Text Available Although anterior cervical arthrodesis is an effective procedure for the treatment of cervical disorders, the method has some complications. Here, we describe this rare complication of cervical instrumentation with a literature review. A 23-year-old male patient was operated for a C6-C7 dislocation. At postoperative month 10, he presented with hemoptysis and dysphagia. Cervical roentgenograms showed anterior migrations of one broken screw and a plate-locking screw at the C6 corpus. One screw was missing. We concluded that the missing screw had perforated the esophagus and had been eliminated spontaneously through the gastrointestinal tract. No screw should migrate. Even loose screws should be noted in follow-up X-ray studies. If such findings are detected, a second operation for revision should be considered as soon as possible to prevent potentially fatal complications.

  9. Traumatic rupture of the tibialis anterior tendon: A case report

    Directory of Open Access Journals (Sweden)

    Maria Elisa Rodrigues

    2013-06-01

    Full Text Available OBJECTIVE: The autors report a case of a traumatic rupture of the tibialis anterior tendon (TTA that was early diagnosed and treated in the emergency service. This is a rare clinical entity with few cases reported in the literature. CASE REPORT: A 66-year old female presented at the emergency service complaining about pain at the anterior aspect of her ankle and inability to walk normally, after a fall. Physical examination revealed clinical signs for TTA rupture, which was later confirmed by ultrasound. Surgical treatment was performed immediately â€" the tendon was anchored into the medial cuneiform with a soft tissue-to-bone anchor. The follow-up revealed good functional result. CONCLUSION: Physical examination and a high index of suspicion are important when facing a patient who had sustained an ankle trauma. The TTA rupture is a diagnosis to consider because unrecognized ruptures led to important functional deficits and poor functional results.

  10. An anatomical evaluation of the serratus anterior plane block.

    Science.gov (United States)

    Mayes, J; Davison, E; Panahi, P; Patten, D; Eljelani, F; Womack, J; Varma, M

    2016-09-01

    The serratus anterior plane block has been described for analgesia of the hemithorax. This study was conducted to determine the spread of injectate and investigate the anatomical basis of the block. Ultrasound-guided serratus anterior plane block was performed on six soft-fix embalmed cadavers. All cadavers received bilateral injections, on one side performed with 20 ml latex and on the other with 20 ml methylene blue. Subsequent dissection explored the extent of spread and nerve involvement. Photographs were taken throughout dissection. The intercostal nerves were involved on three occasions with dye, but not with latex. The lateral cutaneous branches of the intercostal nerve contained dye and latex on all occasions. The serratus plane block appears to be mediated through blockade of the lateral cutaneous branches of the intercostal nerves. Anatomically, serratus plane block does not appear to be equivalent to paravertebral block for rib fracture analgesia. PMID:27440171

  11. MR for assessing anterior cruciate ligament reconstructions by tendon grafts

    International Nuclear Information System (INIS)

    150 patients were examined via magnetic resonance (MR) after anterior cruciate (ACL) ligament reconstruction (76 patellar tendon grafts, 53 semitendinosous tendon grafts and 21 sutures). The results of MR were compared with clinical tests (Lachman, pivot-shift and anterior drawer test), in 2 cases with the operative findings, and in one case with arthroscopy findings. In 91% of patients with a clinically stable knee we found a continuous low-intensity ligamental structure. 10 patients were examined twice or more between 8 days and 6 months after surgery. Ligamental structures of low signal intensity did not significantly change their MR characteristics. MR is a valuable noninvasive method for evaluating ligament reconstructions. (orig./GDG)

  12. Anterior insular cortex regulation in autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Andrea Caria

    2015-03-01

    Full Text Available Autism spectrum disorders (ASDs comprise a heterogeneous set of neurodevelopmental disorders characterized by dramatic impairments of interpersonal behavior, communication, and empathy. Recent neuroimaging studies suggested that ASD are disorders characterized by widespread abnormalities involving distributed brain network, though clear evidence of differences in large-scale brain network interactions underlying the cognitive and behavioral symptoms of ASD are still lacking. Consistent findings of anterior insula cortex hypoactivation and dysconnectivity during tasks related to emotional and social processing indicates its dysfunctional role in ASD. In parallel, increasing evidence showed that successful control of anterior insula activity can be attained using real-time fMRI paradigms. More importantly, successful regulation of this region was associated with changes in behavior and brain connectivity in both healthy individuals and psychiatric patients. Building on these results we here propose and discuss the use of real-time fMRI neurofeedback in ASD aiming at improving emotional and social behavior.

  13. Anterior insular cortex regulation in autism spectrum disorders.

    Science.gov (United States)

    Caria, Andrea; de Falco, Simona

    2015-01-01

    Autism spectrum disorders (ASDs) comprise a heterogeneous set of neurodevelopmental disorders characterized by dramatic impairments of interpersonal behavior, communication, and empathy. Recent neuroimaging studies suggested that ASD are disorders characterized by widespread abnormalities involving distributed brain network, though clear evidence of differences in large-scale brain network interactions underlying the cognitive and behavioral symptoms of ASD are still lacking. Consistent findings of anterior insula cortex hypoactivation and dysconnectivity during tasks related to emotional and social processing indicates its dysfunctional role in ASD. In parallel, increasing evidence showed that successful control of anterior insula activity can be attained using real-time fMRI paradigms. More importantly, successful regulation of this region was associated with changes in behavior and brain connectivity in both healthy individuals and psychiatric patients. Building on these results we here propose and discuss the use of real-time fMRI neurofeedback in ASD aiming at improving emotional and social behavior. PMID:25798096

  14. Anterior spinal artery syndrome of the cervical hemicord.

    Science.gov (United States)

    Baumgartner, R W; Waespe, W

    1992-01-01

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

  15. Low anterior anastomotic dehiscence following preoperative irradiation with 6000 rads

    Energy Technology Data Exchange (ETDEWEB)

    Blake, D.P.; Bubrick, M.P.; Kochsiek, G.G.; Feeney, D.A.; Johnston, G.R.; Strom, R.L.; Hitchcock, C.R.

    1984-03-01

    Twenty mongrel dogs received 6000 rads of irradiation to the rectum and colon using the Nominal Standard Dosage Equation. Three weeks after irradiation each dog underwent anterior resection of the rectosigmoid with reconstruction randomized to either an EEA stapled or a two layer handsewn anastomosis. Each dog was studied digitally and by barium enema at the time of surgery, on the seventh postoperative day, and at autopsy. Five clinically significant leaks and three radiographic leaks occurred in the EEA stapled anastomoses. The handsewn anastomoses had five clinically significant leaks and two radiographic leaks. The data indicate that low anterior resection with either an EEA stapled or handsewn anastomosis cannot be done safely after 6000 rad preoperative irradiation.

  16. Low anterior anastomotic dehiscence following preoperative irradiation with 6000 rads

    International Nuclear Information System (INIS)

    Twenty mongrel dogs received 6000 rads of irradiation to the rectum and colon using the Nominal Standard Dosage Equation. Three weeks after irradiation each dog underwent anterior resection of the rectosigmoid with reconstruction randomized to either an EEA stapled or a two layer handsewn anastomosis. Each dog was studied digitally and by barium enema at the time of surgery, on the seventh postoperative day, and at autopsy. Five clinically significant leaks and three radiographic leaks occurred in the EEA stapled anastomoses. The handsewn anastomoses had five clinically significant leaks and two radiographic leaks. The data indicate that low anterior resection with either an EEA stapled or handsewn anastomosis cannot be done safely after 6000 rad preoperative irradiation

  17. Endovascular treatment of anterior cranial fossa dural arteriovenous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Lv, Xianli; Li, Youxiang; Wu, Zhongxue [Beijing Neurosurgical Institute, Beijing (China); Capital Medical University, Beijing Tiantan Hospital, Beijing (China)

    2008-05-15

    We describe the technique and results of the endovascular treatment of anterior cranial fossa dural arteriovenous fistulas (DAVF) in four symptomatic patients. Catheterization was via the superior sagittal sinus in two patients and via the ophthalmic artery in two patients. Embolization was performed using detachable platinum coils in the former two patients and a liquid embolic system (Onyx-18, MTI) in the latter. We were able to reach the fistula site and to embolize the arteriovenous shunting zone in all of the patients. The final angiogram showed complete occlusion of the DAVFs, and all patients recovered completely. No complications related to either approach were observed. Endovascular treatment of anterior cranial fossa DAVFs is feasible by either transvenous or transarterial access. (orig.)

  18. Endovascular treatment of anterior cranial fossa dural arteriovenous fistula

    International Nuclear Information System (INIS)

    We describe the technique and results of the endovascular treatment of anterior cranial fossa dural arteriovenous fistulas (DAVF) in four symptomatic patients. Catheterization was via the superior sagittal sinus in two patients and via the ophthalmic artery in two patients. Embolization was performed using detachable platinum coils in the former two patients and a liquid embolic system (Onyx-18, MTI) in the latter. We were able to reach the fistula site and to embolize the arteriovenous shunting zone in all of the patients. The final angiogram showed complete occlusion of the DAVFs, and all patients recovered completely. No complications related to either approach were observed. Endovascular treatment of anterior cranial fossa DAVFs is feasible by either transvenous or transarterial access. (orig.)

  19. Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

    DEFF Research Database (Denmark)

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

    2014-01-01

    longitudinal changes including osteoarthritis (OA) features. Joint features assessed were acute osteochondral injury, traumatic and degenerative bone marrow lesions (BMLs), meniscus morphology and extrusion, osteophytes, collateral and cruciate ligaments including ACL graft, Hoffa-synovitis and effusion......OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN......: Baseline and follow-up 1.5 T MRI examinations from 20 patients of the KANON study, a randomized controlled study comparing a surgical and non-surgical treatment strategy, were assessed for up to six longitudinal visits using a novel MRI scoring system incorporating acute structural tissue damage and...

  20. [The anterior tarsal tunnel syndrome: a case report].

    Science.gov (United States)

    Milants, C; Wang, F C; Gomulinski, L; Ledon, F; Petrover, D; Bonnet, R; Crielaard, J M; Kaux, J F

    2015-01-01

    The anterior tarsal tunnel syndrome is a rare entrapment neuropathy of the deep peroneal nerve beneath the inferior extensor retinaculum of the ankle. It is frequently unrecognized and may lead to misdiagnosis and delayed treatment. We report the case of a 77 year old patient complaining of symptoms of an anterior tarsal tunnel syndrome with neuropathic pain located at the dorsal part of the foot, without any sensorimotor loss. The ENMG was in favour of a motor impairment of the deep peroneal nerve. MRI exploration of the ankle showed a millimetric bony overgrowth of the upper pole of the navicular bone, irritative to the deep peroneal nerve. Infiltration at overgrowth of the navicular provided a partial and temporary decrease in pain symptoms. Surgical nerve decompression was then considered. PMID:26376569

  1. [Modern surgery of meningiomas affecting anterior visual pathways].

    Science.gov (United States)

    Grimm, F; Ebner, F H; Honegger, J

    2013-05-01

    Meningiomas are the most common form of primary intracranial tumors. If the anterior visual pathways are affected clinical visual compromise, visual field defects, oculomotor nerve disturbances or propotosis are predominant. Meningiomas of the anterior visual pathway remain therapeutically challenging due to the direct anatomical relationship to the circulus arteriosus cerebri, the cavernous sinus and cranial nerves. The therapy of choice is microsurgical resection. In many cases a curative approach can be achieved with modern surgical techniques and simultaneously maintaining patient quality of life. Problematic are cases in which resection would be associated with the risk of clinical impairment and in these cases radiotherapy is an important therapeutic option. In cases involving complex invasiveness an interdisciplinary treatment to control local clinical symptoms is favored. PMID:23604251

  2. Anterior hypothalamic lesions and pubertal development in female rhesus monkeys.

    Science.gov (United States)

    van der Werff ten Bosch, J J; Dierschke, D J; Terasawa, E; Slob, A K

    1983-03-01

    Electrolytic lesions were made in the anterior hypothalamus of 8 prepubertal female rhesus monkeys, aged 1.1-1.7 years. Six unoperated females served as controls. No effects were found of the lesions upon age and body weight at menarche or at first ovulation, as estimated by blood levels of progesterone and laparoscopic observations. From these findings it appears that the neural control of puberty in the female rhesus may not be exerted through the anterior hypothalamus, in contrast with the rat and ferret. Further, an attempt was made to identify biometric correlates of hormonal changes during puberty. Firstly, the well known dip in growth rate, about 0.4 years before menarche, was observed. Secondly, there was a marked spurt in growth of the nipples starting at 0.2 years before menarche. The close temporal association between accelerated nipple growth and menarche suggests that both of these developmental characteristics result from changes in (presumably ovarian) steroid hormone secretion. PMID:6838715

  3. Organic mood disorder following left anterior temporal lobectomy with amygdalohippocampectomy

    Directory of Open Access Journals (Sweden)

    Nishanth J Haridas

    2015-01-01

    Full Text Available One third of patients with antiepileptic-resistant temporal lobe epilepsy (TLE will have to undergo surgery for a better seizure control. Anterior temporal lobectomy (ATL is done for mesial temporal sclerosis that is the most common histopathological lesion associated with TLE. Psychiatric manifestations following ATL are not uncommon with depressive symptoms more common with left ATL and manic symptoms following right ATL. Mr. A is a 42-year-old left cerebral dominant (Confirmed by WADA test male with no past history of psychiatric illness who had undergone anterior temporal lobectomy with amygdalohippocampectomy. He started having manic episodes post operatively which subsided with antipsychotics. He had multiple such episodes over the next 13 years with minimal inter episodic symptoms. This is a rare instance of manic symptoms following left-sided ATL that emphasizes the need for better understanding of the cerebral laterality of affective symptoms.

  4. Anastomoselaekage efter lav anterior resektion for cancer recti

    DEFF Research Database (Denmark)

    Bülow, S; Moesgaard, F A; Billesbølle, P; Harling, H; Holm, J; Madsen, M R; Myrhøj, T; Nymann, T; Okholm, M; Qvist, N; Riber, C

    1997-01-01

    A series of 377 consecutive patients were operated upon with low anterior resection for rectal cancer in the nine Danish departments of surgical gastroenterology during 1992-1993. A retrospective analysis was carried out to calculate the frequency of anastomotic leakage and to evaluate factors of...... a higher leakage rate (p = 0.02), whereas departments with a low number of rectal cancer surgeons had a low rate of anastomotic leakage (p = 0.02). In conclusion, the rather high frequency of anastomotic leakage calls for further clinical and pathogenetic research in this field. Until then, we...... recommend the routine use of a peroperative leakage test and selective use of prophylactic ostomy in cases of unsatisfactory anastomosis. Furthermore, it is recommended that low anterior resection for rectal cancer is limited to few surgeons in each department in order to ensure a uniform quality and...

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

    Directory of Open Access Journals (Sweden)

    Firoozeh Abtahi

    2016-06-01

    Full Text Available Background: Unlike left ventricular function, less attention has been paid to Right Ventricular (RV function after Myocardial Infarction (MI. Objectives: The current study aimed to compare RV function in patients with inferior and anterior MI. Patients and Methods: During the study period, 60 patients consecutively presented to the Emergency Department with chest pain were divided into two groups based on their electrocardiographic findings. Accordingly, 25 patients had inferior MI (IMI group and 35 ones had anterior MI (AMI group. Echocardiography was performed 48 hours after starting the standard therapy. Conventional echocardiographic parameters and Tissue Doppler Imaging (TDI measurements were acquired from the standard views. Student t-test and the chi-square test were respectively used for comparisons of the normally distributed continuous and categorical variables in the two groups. Besides, P < 0.05 was considered to be statistically significant.

  6. Síndrome tóxica do segmento anterior

    OpenAIRE

    Luiz Filipe de Albuquerque Alves; Marcelo Jarczun Kac; Tiago Bisol; Bruno Franco Fernandes; Demian Temponi Eskenazi

    2013-01-01

    A síndrome tóxica do segmento anterior (STSA) é uma severa reação inflamatória aguda causada por agente não infeccioso que entra no segmento anterior, resultando em lesão celular tóxica com necrose e apoptose mediado por resposta imunológica. Neste relato de caso de STSA são enfatizadas as causas mais comuns para o aparecimento da síndrome, apontam para os cuidados que devem ser tomados no processo de esterilização do material cirúrgico além de revisar a melhor conduta diante desses casos. Em...

  7. Intravitreal Bevacizumab in Nonarteritic Anterior Ischemic Optic Neuropathy

    Directory of Open Access Journals (Sweden)

    Ebadollah Heidari

    2014-01-01

    Full Text Available Purpose: To evaluate the effect of intravitreal injection of Bevacizumab on improving visual function in patients with Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION. Methods: In a prospective interventional case series, 11 eyes with vision loss due to (NAION in less than 15 days of attack were studied. Visual acuity, perimetry and optic nerve head changes were evaluated 1 week post-intravitreal injection of 1.25mg/0.1 mL Bevacizumab. Results: 5 of patients had improved visual acuity. In all patients optic disc edema resolved either completely or remarkably in 1 week, but there was no significant change in perimetric values. Conclusion: This case series suggest that intravitreal injection of Bevacizumab may be beneficial in treatment of NAION. Keywords: Intravitreal Bevacizumab; Non-arteritic anterior ischemic optic neuropathy; Perimetry 

  8. Radiographic evaluation of anterior dislocation of the shoulder

    International Nuclear Information System (INIS)

    To establish radiographic criteria to choose the most appropriate technique of reduction for each type of anterior glenohumeral dislocation, and to determine the type of dislocation which requires general anesthesia. Material and Methods: Radiography in two different projections was performed in 67 patients with antero-inferior shoulder dislocations before a reduction attempt. The method proposed by Boss-Holzach-Matter was used as the primary technique for all shoulder dislocations. Results: Most subcoracoid dislocations (84.4%) could be reduced by the Boss-Holzach-Matter method while only a few subglenoid dislocations (15.8%) were reducible by this technique. Displaced associated fractures significantly reduced the success rate of the reduction attempts. Conclusion: Anterior dislocations of the shoulder require different methods of reduction depending upon the type (sub-group) of dislocation. Reduction of subglenoid dislocations with associated greater tuberosity fracture should be performed under general anesthesia to avoid head-splitting fracture

  9. Laringectomia frontal anterior: técnica de Tucker. Estudo retrospectivo Anterior frontal laryngectomy: Tucker's technique. A retrospective study

    Directory of Open Access Journals (Sweden)

    Giordania Gomes Campos

    2004-04-01

    Full Text Available O carcinoma epidermóide da laringe é a sexta neoplasia mais comum, sendo uma das neoplasias malignas mais freqüentes na cabeça e pescoço, ocupando o segundo lugar imediatamente após o câncer da cavidade oral. FORMA DE ESTUDO: Estudo clínico retrospectivo. MATERIAL E MÉTODO: Entre os anos de 1991 e 2003, 24 pacientes portadores de lesões glóticas envolvendo a comissura anterior foram submetidos a laringectomia frontal anterior com epiglotoplastia descrita por Tucker e colaboradores no ano de 1979. RESULTADO: Nossos resultados confirmam aqueles encontrados em outras publicações. Não ocorreram mortes no pós-operatório e o seguimento foi relativamente simples. Todos os pacientes foram decanulizados e recuperaram um efetivo trato digestivo e aéreo. CONCLUSÃO: Nossos achados mostram que a laringectomia pela técnica de Tucker é uma cirurgia efetiva para o tratamento dos carcinomas glóticos que acometem a comissura anterior e a porção membranosa das cordas vocais com a motilidade preservada, pois tais lesões não devem ser tratadas pela ressecção endoscópica trans-oral ou por uma laringectomia fronto lateral.Squamous cell carcinoma of the larynx is the sixth most common neoplasia, being the second neoplasia of the head and neck, after oral cancer. STUDY DESIGN: Retrospective clinical study chart review. MATERIAL AND METHOD: From 1991 to 2003, 24 patients whose glottic lesions involving anterior comissure were operated with a reconstructive anterior frontal laryngectomy with epiglotoplasty, such as described by Tucker et al in 1979. RESULTS: Our functional results confirm those reported in the previous publications. There were no post-operative mortalities and follow-up was usually uncomplicated. All patients underwent decanulation and were able to eat by tract normal. CONCLUSION: Our findings show that partial laryngectomy by Tucker's technique is an effective surgical approach for glottic carcinoma at the anterior comissure

  10. Luxação glenoumeral anterior bilateral: caso clínico Bilateral anterior glenohumeral dislocation: clinical case

    Directory of Open Access Journals (Sweden)

    Luís Pires Silva

    2011-01-01

    Full Text Available A luxação glenoumeral anterior bilateral é uma ocorrência rara. Apresentamos um caso de luxação glenoumeral anterior bilateral com origem após uma queda da própria altura. O interesse desta publicação reside no fato de se tratar de uma raridade clínica com poucos casos descritos na literatura. Paciente do sexo feminino com 89 anos recorre ao serviço de urgência (SU após queda referindo dor intensa e incapacidade de mobilização de ambos os ombros. Ao exame objetivo apresentava sinais clínicos suspeitos de luxação glenoumeral anterior bilateral confirmados por radiografia. Ambas as luxações foram reduzidas no SU pela técnica de Milch modificada, com sucesso. Quando existe uma força simétrica e síncrona sobre os ombros e estes se apresentarem dolorosos e com limite funcional significativo, a suspeita de luxação glenoumeral bilateral, embora rara, é um diagnóstico diferencial a ter em conta.Bilateral anterior glenohumeral dislocation is a rare occurrence. We present a case of bilateral anterior glenohumeral dislocation caused by a fall. The interest in publishing this case is that this is a clinical rarity with few cases reported in the literature. An 89-year-old female patient was brought to the emergency department after a fall, complaining of intense pain in both shoulders and inability to move them. Objective examination showed clinical signs giving the suspicion of bilateral anterior glenohumeral dislocation, which was confirmed by x-ray imaging. Both dislocations were successfully reduced in the emergency department using the modified Milch technique. When a synchronous and symmetrical force has acted on both shoulders and these are painful with significant functional limitation, the suspicion of bilateral glenohumeral dislocation is a differential diagnosis to be considered, even though it is rare.

  11. Prevention of anterior cruciate ligament injury in the female athlete

    OpenAIRE

    Silvers, Holly Jacinda; Mandelbaum, Bert R.

    2007-01-01

    The relationships of gender, age and training to the incidence of anterior cruciate ligament (ACL) injury are pivotal to developing a comprehensive neuromuscular and proprioceptive training programme to decrease ACL injuries in female athletes. A prophylactic neuromuscular and proprioceptive training programme may have direct benefit in decreasing the number of ACL injuries in female athletes. This research foundation endorses further epidemiological and biomechanical studies to determine the...

  12. Anatomic double-bundle anterior cruciate ligament recon-struction

    OpenAIRE

    Dai, Xue-Song

    2012-01-01

    【Abstract】Objective: To retrospectively evaluate the early results of anatomic double-bundle anterior cruci-ate ligament (ACL) reconstruction and compare with the results of native ACL of the contralateral knee. Methods: The results of a consecutive series of 118 patients receiving arthroscopic ACL reconstruction were evaluated. Eight patients were lost to the latest follow-up, leaving a total of 110 patients available for study within at least 3 years’ clinical fol...

  13. Pseudo-Anterior Interosseous Nerve Syndrome by Multiple Intramuscular Injection

    OpenAIRE

    Kim, Min Young; Kim, Dong Hwee; Park, Byung Kyu; Kim, Baik Hyun

    2013-01-01

    Blind intramuscular injection might cause severe neurovascular injury if it would be performed with insufficient knowledge of anatomy around the injection area. We report a case of pseudo-anterior interosseous syndrome caused by multiple intramuscular steroid injections around the antecubital area. The patient had weakness of the 1st to 3rd digits flexion with typical OK sign. Muscle atrophy was noted on the proximal medial forearm, and sensation was intact. The electrophysiologic studies sho...

  14. Can intramuscular corticosteroid injection cause nonarteritic anterior ischemic optic neuropathy?

    OpenAIRE

    Bakbak B; Ozturk BT; Gedik S; Koktekir BE; Gonul S

    2013-01-01

    Berker Bakbak, Banu Turgut Ozturk, Sansal Gedik, Bengu Ekinci Koktekir, Saban Gonul Selcuk University Medical Faculty, Department of Ophthalmology, Konya, Turkey Abstract: A 56-year-old man noted a sudden decrease of vision in his right eye 4 hours after intramuscular triamcinolone acetonide (TA) injection. A diagnosis of unilateral nonarteritic anterior ischemic optic neuropathy (NAION) was made, and the patient was counseled to discontinue using TA. Examination for possible risk factors rev...

  15. Anterior-posterior asymmetry in iris mechanics measured by indentation.

    Science.gov (United States)

    Whitcomb, Julie E; Amini, Rouzbeh; Simha, Narendra K; Barocas, Victor H

    2011-10-01

    Indentation and histological analysis of the porcine iris were done to assess the relative stiffness of the anterior (stroma) and posterior (dilator and sphincter) layers. The dimensions of the constituent structures were documented histologically by staining with a monoclonal anti-human α-smooth muscle actin antibody to determine the location of the stroma, sphincter, and dilator. Intact porcine irides (4-8 h post-mortem) were bisected into two equal C-shaped halves to indent both surfaces. Indentation experiments were performed using a 1 mm cylindrical indenter tip. The load-displacement curve for each experiment was used to estimate effective instantaneous and equilibrium moduli for the anterior and posterior surfaces of the tissue. A total of 18 irides (9 pairs) with 3-5 indentations per iris surface was performed. The average thickness of the samples was 550 μm; the indentation depth was limited to 60-100 μm depending on the thickness of the sample at each point. Posterior surface indentation gave larger forces than anterior, with the resulting instantaneous modulus of 6.0 ± 0.6 kPa versus 4.0 ± 0.5 kPa (mean ± 95% CI, n = 45, p poroelasticity, we conclude that the posterior components of the iris - dilator, pigment epithelium, and sphincter - are on average stiffer than the stroma and anterior border layer. PMID:21787771

  16. Morphometric Analysis of Bone Resection in Anterior Petrosectomies.

    Science.gov (United States)

    Ahmed, Osama; Walther, Jonathan; Theriot, Krystle; Manuel, Morganne; Guthikonda, Bharat

    2016-06-01

    Introduction The anterior petrosectomy is a well-defined skull base approach to lesions such as petroclival meningiomas, posterior circulation aneurysms, petrous apex lesions (chondrosarcomas, cholesteatomas), ventrolateral brainstem lesions, clival chordomas, trigeminal neurinomas, and access to cranial nerves III, IV, V, and VII. Methods and Materials Fourteen anterior petrosectomies on eight cadaveric heads were performed in a skull base dissection laboratory. Predissection and postdissection thin-cut computed tomography scans were obtained to compare the bone resection. A computer program was used (InVivo5, Anatomage, San Jose, California, United States) to measure the bone resection and the improved viewing angle. Results The average bone removed in each plane was as follows: anterior to posterior plane was 10.57 mm ± 2.00 mm, superior to inferior was 9.39 mm ± 1.67 mm, and lateral to medial was 17.46 mm ± 4.64 mm. The average increased angle of view was 13.01 ± 2.35 degrees (Table 1). The average volume was 1786.94 ± 827.40 mm(3). Conclusions Anterior petrosectomy is a useful approach to access the ventrolateral brainstem region. We present a cadaveric study quantitating the volume of bone resection and improvement in the viewing angle. These data provide useful preoperative information on the utility of this skull base approach and the gain in the viewing angle after bony removal. PMID:27175319

  17. 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 ...

  18. Bone graft substitutes in anterior cervical discectomy and fusion

    OpenAIRE

    Chau, Anthony M.T.; Mobbs, Ralph J.

    2009-01-01

    Anterior cervical discectomy with fusion is a common surgical procedure for patients suffering pain and/or neurological deficits and unresponsive to conservative management. For decades, autologous bone grafted from the iliac crest has been used as a substrate for cervical arthrodesis. However patient dissatisfaction with donor site morbidity has led to the search for alternative techniques. We present a literature review examining the progress of available grafting options as assessed in hum...

  19. Occlusion of the anterior cerebral artery after head trauma

    OpenAIRE

    2013-01-01

    Intracranial arterial occlusion is rarely encountered in association with head injury. Only six cases of traumatic occlusion of the anterior cerebral artery (ACA) have previously been reported. In this paper, the authors describe a case of a posttraumatic occlusion of ACA. A 35-year-old male presented to the emergency room with severe head injury. Computed tomography (CT) scan displayed diffuse brain swelling with multiple skull fractures. Follow up CT scan showed extensive cerebral infarctio...

  20. Break into left anterior descending coronary artery suggest myocardial bridging.

    Science.gov (United States)

    Siniscalchi, Carmine; Basaglia, Manuela; Gaibazzi, Nicola

    2016-01-01

    A 67 year-old woman presented with stable effort angina. A resting electrocardiogram was inconclusive. High-dose dipyridamole contrast-echocardiography shows normal left ventricular wall motion after 0.84mg/kg/6min dipyridamole. At rest a turbolent flow demonstrable by color aliasing, appeared in the territory of the left anterior descending coronary artery (LAD) during the diastolic phase. PMID:27163904

  1. Anterior Cruciate Ligament injury, Patient Variables, Outcomes and Knee Osteoarthritis

    OpenAIRE

    Neuman, Paul

    2010-01-01

    The ruptured anterior cruciate ligament (ACL) leads to immediate symptoms that severely affect the individual and receives great attention among the scientific community, yet there is still no consensus on the optional form of treatment. An ACL injury is also a well known high risk factor for the development of knee osteoarthritis (OA) some decades later. Knee OA development after an ACL injury is multi-factorial. All patient variables must be further explored before better guidelines on ACL ...

  2. Lower Extremity Malalignments and Anterior Cruciate Ligament Injury History

    OpenAIRE

    Braham, Rebecca A.; Jennifer H. Dorfman; Jay Hertel

    2004-01-01

    To identify if lower extremity malalignments were associated with increased propensity of a history of anterior cruciate ligament (ACL) ruptures in males and females using a case control design. Twenty subjects (10 males, 10 females) had a history of ACL injury and twenty (10 males, 10 females) had no history of ACL injury. Subjects were assessed for navicular drop, quadriceps angle, pelvic tilt, hip internal and external rotation range of motion, and true and apparent leg length discrepancie...

  3. Anterior Cruciate Ligament Injury Prevention Training in Female Athletes

    OpenAIRE

    Noyes, Frank R.; Barber Westin, Sue D.

    2012-01-01

    Context: Many anterior cruciate ligament (ACL) injury prevention training programs have been published, but few have assessed the effects of training on both ACL injury rates and athletic performance tests. Objective: To determine if ACL injury prevention programs have a positive influence on both injury rates and athletic performance tests in female athletes. Data sources: In August 2011, a search was conducted (1995–August 2011) of the PubMed, Science Direct, and CINAHL databases. Study sel...

  4. Basic science of anterior cruciate ligament injury and repair

    OpenAIRE

    Kiapour, A. M.; Murray, M. M.

    2014-01-01

    Injury to the anterior cruciate ligament (ACL) is one of the most devastating and frequent injuries of the knee. Surgical reconstruction is the current standard of care for treatment of ACL injuries in active patients. The widespread adoption of ACL reconstruction over primary repair was based on early perception of the limited healing capacity of the ACL. Although the majority of ACL reconstruction surgeries successfully restore gross joint stability, post-traumatic osteoarthritis is commonp...

  5. Controversies in Knee Rehabilitation: Anterior Cruciate Ligament Injury

    OpenAIRE

    Failla, Mathew J.; Arundale, Amelia J.H.; Logerstedt, David S.; Snyder-Mackler, Lynn

    2015-01-01

    Controversy in management of athletes exists after anterior cruciate ligament injury and reconstruction. Consensus criteria for evaluating successful outcomes following ACL injury include no re-injury or recurrent giving way, no joint effusion, quadriceps strength symmetry, restored activity level and function, and returning to pre-injury sports. Using these criterions, we will review the success rates of current management strategies after ACL injury and provide recommendations for the couns...

  6. Acute anterior uveitis following intravitreal bevacizumab but not subsequent ranibizumab

    OpenAIRE

    Antonopoulos C; Stem M; Comer GM

    2011-01-01

    Christina Antonopoulos1, Maxwell Stem2, Grant M Comer21Department of Ophthalmology, Boston University, Boston, MA, USA; 2WK Kellogg Eye Center, Department of Ophthalmology, University of Michigan, Ann Arbor, MI, USAPurpose: Previous reports have identified noninfectious uveitis as a potential sequela following both intravitreal bevacizumab and ranibizumab injections. We present two unique cases of acute anterior uveitis following intravitreal bevacizumab that did not occur with subsequent ran...

  7. Complications and Management of Deep Anterior Lamellar Keratoplasty

    Directory of Open Access Journals (Sweden)

    Banu Torun Acar

    2014-10-01

    Full Text Available Objectives: To report the intraoperative and postoperative follow-up complications and management of these in deep anterior lamellar keratoplasty (DALK surgery. Materials and Methods: Two hundred eighty-four eyes of 252 patients followed up in our cornea clinic who underwent DALK using Anwar’s big-bubble technique with healthy Descemet’s membrane and endothelium were included in this study. Intraoperative and postoperative complications as well as the management and treatment of these complications were evaluated. Results: Big bubble was created in 220 (77.5% eyes of 284 eyes, and lamellar dissection was performed in 64 (22.5% eyes. Perforation occurred during trephination in 4 eyes, and the procedure was accomplished by penetrating keratoplasty (PK. Intraoperative microperforation occurred in 44 eyes. Perforation enlarged in 4 eyes and PK was performed. Operation was continued in 40 eyes with air injection into the anterior chamber. In postopertive follow-up period, double anterior chamber (DAC occurred in 32 of 40 eyes. DAC spontaneously regressed in 8 eyes, and air was given into the anterior chamber with a second surgical intervention in 24 eyes. DAC improved in 20 eyes. Four eyes underwent PK. Fungal keratitis evolved at the interface in one eye, because of no healing during the follow-up period, this eye underwent PK under antifungal therapy. Eyes with interface haze and Descemet’s membrane folds were followed. Conclusion: DALK is a difficult technique with a steep learning curve. In addition to the complications seen in PK, specific complications can occur in lamellar surgery. (Turk J Ophthalmol 2014; 44: 337-40

  8. 3D spectral imaging system for anterior chamber metrology

    Science.gov (United States)

    Anderson, Trevor; Segref, Armin; Frisken, Grant; Frisken, Steven

    2015-03-01

    Accurate metrology of the anterior chamber of the eye is useful for a number of diagnostic and clinical applications. In particular, accurate corneal topography and corneal thickness data is desirable for fitting contact lenses, screening for diseases and monitoring corneal changes. Anterior OCT systems can be used to measure anterior chamber surfaces, however accurate curvature measurements for single point scanning systems are known to be very sensitive to patient movement. To overcome this problem we have developed a parallel 3D spectral metrology system that captures simultaneous A-scans on a 2D lateral grid. This approach enables estimates of the elevation and curvature of anterior and posterior corneal surfaces that are robust to sample movement. Furthermore, multiple simultaneous surface measurements greatly improve the ability to register consecutive frames and enable aggregate measurements over a finer lateral grid. A key element of our approach has been to exploit standard low cost optical components including lenslet arrays and a 2D sensor to provide a path towards low cost implementation. We demonstrate first prototypes based on 6 Mpixel sensor using a 250 μm pitch lenslet array with 300 sample beams to achieve an RMS elevation accuracy of 1μm with 95 dB sensitivity and a 7.0 mm range. Initial tests on Porcine eyes, model eyes and calibration spheres demonstrate the validity of the concept. With the next iteration of designs we expect to be able to achieve over 1000 simultaneous A-scans in excess of 75 frames per second.

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

    Directory of Open Access Journals (Sweden)

    Numa Mercier

    2011-01-01

    Full Text Available Anterior shoulder instability is a common problem. The Latarjet procedure has been advocated as an option for the treatment of anteroinferior shoulder instability. The purpose of this paper is to explain our surgical procedure titled “Mini-open Latarjet Procedure.” We detailed patient positioning, skin incision, subscapularis approach, and coracoid fixation. Then, we reviewed the literature to evaluate the clinical outcomes of this procedure.

  10. Access related complications during anterior exposure of the lumbar spine

    OpenAIRE

    Fantini, Gary A; Pawar, Abhijit Y.

    2013-01-01

    The new millennium has witnessed the emergence of minimally invasive, non-posterior based surgery of the lumbar spine, in particular via lateral based methodologies to discectomy and fusion. In contrast, and perhaps for a variety of reasons, anterior motion preservation (non-fusion) technologies are playing a comparatively lesser, though incompletely defined, role at present. Lateral based motion preservation technologies await definition of their eventual role in the armamentarium of minimal...

  11. Complications of Anterior and Posterior Cervical Spine Surgery

    OpenAIRE

    Cheung, Jason Pui Yin; Luk, Keith Dip-Kei

    2016-01-01

    Cervical spine surgery performed for the correct indications yields good results. However, surgeons need to be mindful of the many possible pitfalls. Complications may occur starting from the anaesthestic procedure and patient positioning to dura exposure and instrumentation. This review examines specific complications related to anterior and posterior cervical spine surgery, discusses their causes and considers methods to prevent or treat them. In general, avoiding complications is best achi...

  12. A case report on desmoplastic ameloblastoma of anterior mandible

    OpenAIRE

    Sharma Lamichhane, Narayan; Liu, Qilin; Sun, Hongchen; Zhang, Wei

    2016-01-01

    Background Desmoplastic ameloblastoma (DA) is a rare variant that accounts for approximately 4–13 % of ameloblastoma, displaying significant differences in anatomical site, imaging, and histologic appearance. It has been included in WHO classification of head and neck tumor (WHO-2005) as a variant of ameloblastoma. The tumor resembles benign fibro-osseous lesion for being frequently occurring in the anterior region of jaws as a mixed radiopaque-radiolucent lesion. Case presentation We present...

  13. Acute anterior uveitis and Klebsiella aerogenes: a casual relationship?

    OpenAIRE

    Willshaw, H E

    1981-01-01

    This study was undertaken to investigate the hypothesis that episodes of anterior uveitis in patients with the HLA B27 antigen are triggered by the presence of Klebsiella aerogenes in the gastrointestinal tract. Forty patients were examined. While the recovery of klebsiella was greater in B27 positive patients with uveitis, the differences failed to reach statistical significance. The clinical state of patients with Klebsiella aerogenes in their faeces did not differ from that in whom klebsie...

  14. Tibiofemoral Alignment: Contributing Factors to Noncontact Anterior Cruciate Ligament Injury

    OpenAIRE

    Boden, Barry P.; Breit, Ilan; Sheehan, Frances T

    2009-01-01

    Background: The mechanisms of noncontact anterior cruciate ligament injury remain undefined. The purpose of this study was to identify the tibiofemoral alignment in the lateral compartment of the knee for three variations of a one-limb landing in noncontact sports activities: the safe, provocative, and exaggerated provocative positions. These positions were chosen on the basis of a previous study that measured the average joint angles of the limb at the point of ground contact for athletes wh...

  15. Anterior Segment Tomography with the Cirrus Optical Coherence Tomography

    OpenAIRE

    Rodrigues, Eduardo B.; Margara Johanson; Fernando M Penha

    2012-01-01

    Optical coherence tomography (OCT) is an optical acquisition method to examine biological tissues. In recent years, OCT has become an important imaging technology used in diagnosing and following macular pathologies. Further development enabled application of optical coherence tomography in evaluation of the integrity of the nerve fiber layer, optic nerve cupping, anterior chamber angle, or corneal topography. In this manuscript we overview the use of OCT in the clinical practice to enable co...

  16. Association of Cryptogenic Organizing Pneumonia in Bilateral Anterior Uveitis

    OpenAIRE

    Fujimoto, Kaori; Hiraoka, Miki; Inatomi, Shuichiro; Ohguro, Hiroshi

    2014-01-01

    Two female patients with histories of cancer who showed cryptogenic organizing pneumonia (COP) complications and bilateral anterior uveitis with hypopyon were examined. Both patients had suffered from COP and received intermitted systemic corticosteroid administration (SCA). The first patient, a 65-year-old woman with a history of breast cancer, showed bilateral uveitis with hypopyon. The topical corticosteroid treatment was ineffective. After SCA for the treatment of COP was started, the hyp...

  17. Fracture of the patella after the anterior cruciate ligament reconstruction

    OpenAIRE

    Milović Milan; Bojat Veselin; Kovačev Nemanja; Rašović Predrag; Milankov Miroslav

    2012-01-01

    Introduction. Fracture of the patella, after harvesting the central third of the patellar tendon for a bone-tendon-bone autograft, is a rare complication. Material and Methods. We made 1714 reconstructions of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and 7 patients had fracture of the patella (0.42%). The fracture was immediately recognized in the patients with vertical non-displaced patellar fracture and the broken screw osteosynthesis was ca...

  18. Surgical repair of intractable chylous ascites following laparoscopic anterior resection

    OpenAIRE

    Ha, Gi Won; Lee, Min Ro

    2015-01-01

    Chylous ascites is the accumulation of a milk-like peritoneal fluid rich in triglycerides and it is an unusual complication following surgical treatment of colorectal cancer. Conservative management is usually sufficient in patients with chylous ascites after surgery. However, we describe a patient with intractable chylous ascites after laparoscopic anterior resection for sigmoid colon cancer who failed initial conservative treatment. This patient was successfully managed by surgery.

  19. Class I malocclusion with anterior crossbite and severe crowding

    OpenAIRE

    Ritter, Daltro Enéas

    2014-01-01

    This article reports the orthodontic diagnosis and treatment planning carried out with a 14-year and 5-month-old female patient with esthetic and functional complaints. She presented an Angle Class I malocclusion, anterior crossbite and severe crowding in both maxillary and mandibular arches, in addition to a lightly concave straight facial profile. Orthodontic treatment did not require extraction. Crossbite was corrected by protrusion of upper teeth, which contributed to alignment and leveli...

  20. Audit on necessity of radiographs in anterior shoulder dislocations

    Directory of Open Access Journals (Sweden)

    K. Ahmadi, M.D

    2008-01-01

    Full Text Available AbstractBackground and Purpose: Anterior shoulder dislocation is the most common major joint dislocation. In most cases, this dislocation is being relocated in emergency departments. Routinely, pre and post reduction radiographs are performed. This study was done to determine the necessity of radiographs in the emergency department for management of patients with suspected anterior shoulder dislocation.Materials and Methods: In this case series study, 116 patients suspected of anterior shoulder dislocation were referred to Hazrat Rasoul Akram and Haftome Tir Hospitals emergency departments in Tehran, and were investigated for a one year period. The emergency physicians evaluated and documented the possibility of dislocation or relocation, before obtaining radiographs. Outcome measures were the assessment of joint positions on the x-rays by an orthopedic surgeon.Results: 84 cases (72% were male and 32 cases (28% were female. Mean age of the patients was 31.5±8.5 yrs. Thirty (30 patients had recurrent dislocations without traumatic mechanism (group 1 and eighty six (86 patients had no prior dislocation or a blunt mechanism of injury (group 2. The accuracy of the emergency physician’s assessment in dislocations was 100% in group 1 and 98% in group 2. False assessments occurred only in patients with fractures. There is no significant difference between emergency physicians and orthopedic surgeons in the assessment of dislocations and relocations, when the emergency physicians did accuralty diagnose them.Conclusion: Our study showed that the physicians are highly accurate in clinical determination of anterior shoulder dislocation and relocation. Pre-reduction films should be obtained when the mechanism of injury is trauma. Post-reduction films should be obtained in fracture-dislocations or when the physicians are uncertain of correct relocation.

  1. Hippocampal and Left Subcallosal Anterior Cingulate Atrophy in Psychotic Depression

    OpenAIRE

    Bijanki, Kelly Rowe; Hodis, Brendan; Brumm, Michael C.; Harlynn, Emily L.; McCormick, Laurie M.

    2014-01-01

    Background Psychotic depression is arguably the most diagnostically stable subtype of major depressive disorder, and an attractive target of study in a famously heterogeneous mental illness. Previous imaging studies have identified abnormal volumes of the hippocampus, amygdala, and subcallosal region of the anterior cingulate cortex (scACC) in psychotic depression, though studies have not yet examined the role of family history of depression in these relationships. Methods 20 participants wit...

  2. Ultrasonographic test for complete anterior cruciate ligament injury

    Directory of Open Access Journals (Sweden)

    Piotr Grzelak

    2015-01-01

    Full Text Available Background: Although ultrasound (US has a wide range of applications in orthopedic diagnostics, sonographic evaluation of traumatic anterior cruciate ligament (ACL insufficiency is still inadequate. There is a growing need for diagnostic tests that allow for simple and reliable assessment of ACL instability. This investigation aims to evaluate feasibility of sonographic technique for diagnosing complete ACL insufficiency. Materials and Methods: Eighty three consecutive patients suspected of ACL injury were examined with sonographic, dynamic test of anterior instability. The translation of the intercondylar eminence against the patellar tendon was measured in the injured and opposite (injured knee. Subsequent magnetic resonance imaging was performed on all patients. Forty-seven of them underwent a further arthroscopy. Five patients have been examined for the 2 nd time to evaluate interclass and intraclass agreement and bias. Results: Complete ACL insufficiency has been confirmed in 37 patients. In those individuals, the total anterior knee translation and the difference between two joints (side-to-side difference were significantly increased (8.67 mm standard deviation [SD] 2.65 mm in the affected knee versus 2.88 mm SD 1.26 mm in uninjured joint; P < 0.001. Based on a threshold of 2.0 mm for the side-to-side difference and 5.0 mm for the absolute translation, the sonographic test was found to have a sensitivity and specificity of 91.9% and 95.6%, respectively. Conclusions: The present technique supports the clinician with additional fast and noninvasive diagnostic procedure that can facilitate the evaluation of anterior knee instability.

  3. Multimodal emotion perception after anterior temporal lobectomy (ATL)

    OpenAIRE

    Milesi, Valérie; Cekic, Sezen; Péron, Julie; Frühholz, Sascha; Cristinzio, Chiara; Seeck, Margitta; Grandjean, Didier

    2014-01-01

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

  4. Effects of phacoemulsification on intraocular pressure and anterior chamber depth

    OpenAIRE

    LIU, XIN-QUAN; ZHU, HUA-YING; Su, Jing; HAO, XIAO-JUN

    2012-01-01

    The aim of this study was to investigate the effects of phacoemulsification with intraocular lens (IOL) implantation on intraocular pressure (IOP) and anterior chamber depth (ACD) in patients with cataract or cataract associated with primary angle closure (PAC). A total of 361 patients (481 affected eyes) with senile cataract (cataract group) and 44 patients (52 affected eyes) with cataract associated with PAC (cataract with PAC group) underwent phacoemulsification with IOL implantation from ...

  5. Anterior dental evolution in the Australopithecus anamensis–afarensis lineage

    OpenAIRE

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

    2010-01-01

    Australopithecus anamensis is the earliest known species of the Australopithecus–human clade and is the likely ancestor of Australopithecus afarensis. Investigating possible selective pressures underlying these changes is key to understanding the patterns of selection shaping the origins and early evolution of the Australopithecus–human clade. During the course of the Au. anamensis–afarensis lineage, significant changes appear to occur particularly in the anterior dentition, but also in jaw s...

  6. Infantile-onset glaucoma and anterior megalophthalmos in osteogenesis imperfecta.

    Science.gov (United States)

    Bohnsack, Brenda L

    2016-04-01

    Osteogenesis imperfecta (OI) is an inherited condition in which defects in type 1 collagen cause abnormalities in many tissues and organs, including bone, teeth, heart valves, and eyes. We describe a 6-month-old boy with OI who presented with anterior megalophthalmos of the right eye and infantile-onset glaucoma of the left eye. To our knowledge, this is the first reported case of these types of congenital eye anomalies in an infant with OI. PMID:26994503

  7. Esthetic Management of an Anterior Avulsed Tooth: A Case Report

    OpenAIRE

    AR, Prabhakar; Sugandhan,; KB, Roopa; Gulati, Akanksha

    2009-01-01

    Avulsion and luxation account for up to 16% of all traumatic injuries in the permanent dentition and 7.2% of injuries in the primary dentition. A range of treatment options are available that can help conserve the tooth after a traumatic episode. There are, however, occasions where loss of the traumatized tooth is inevitable with special regard to avulsion injuries. replantation of teeth having doubtful long-term prognosis. Following the traumatic loss of an anterior tooth it is important tha...

  8. Anterior chamber gas bubbles in open globe injury.

    Science.gov (United States)

    Barnard, E B G; Baxter, D; Blanch, R

    2013-01-01

    We present a case of a 40-year-old soldier who was in close proximity to the detonation of an improvised explosive device (IED). Bubbles of gas were visible within the anterior chamber of his left eye. The authors propose that intraocular gas, present acutely after trauma, is diagnostic of open globe injury and is of particular importance in remote military environments. PMID:24079202

  9. Linguatula serrata in the anterior chamber of the eye

    Directory of Open Access Journals (Sweden)

    Muna Bhende

    2014-01-01

    Full Text Available We report a case of intraocular Linguatula in healthy young female who presented with a history of trivial trauma, dislocated lens, inflammation and secondary glaucoma. A mobile worm was seen in the anterior chamber. Pars plana lensectomy and vitrectomy was planned to remove both the cataractous lens and the parasite during which the worm disappeared from view but was later recovered from the cassette fluid. It was identified as the nymphal form of Linguatula serrata (tongue worm.

  10. Anatomic anterior cruciate ligament reconstruction using an individualized approach

    Directory of Open Access Journals (Sweden)

    Carola F. van Eck

    2014-01-01

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

  11. Relationship between static anterior laxity using the KT-1000 and dynamic tibial rotation during motion in patients with anatomical anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Sato, Koji; Maeda, Akira; Takano, Yoshio; Matsuse, Hiroo; Ida, Hirofumi; Shiba, Naoto

    2013-01-01

    The anterior cruciate ligament (ACL) plays an important role in controlling knee joint stability, not only by limiting tibial anterior translation but also by controlling knee axial rotation. The aim of ACL reconstruction is to reduce excessive anterior joint laxity, hoping to restore normal tibiofemoral kinematics including knee axial rotation. The purpose of this study was to investigate the relationship between static anterior instability and tibial rotation during several activities in an anterior cruciate ligament reconstructed knee. Seven patients with unilateral ACL injury performed plain walking, running, landing and side step cutting tasks after ACL reconstruction with a mean follow-up of 14 months. The kinematic data for the 4 motions was measured using a motion analysis system and the point cluster technique. The evaluation period was defined to be from the first contact to removal of the tested leg from the ground. Maximum tibial internal rotation during tasks was calculated using the point cluster technique (PCT). Passive anterior tibial translation was measured using a KT-1000 arthrometer. Regression analysis was used to determine the correlation of the maximum internal rotation with the side-to-side difference of static anterior tibial translation measured using a KT-1000 arthrometer. During side step cutting maneuvers, maximum tibial internal rotation significantly showed negative correlation with static anterior tibial translation (pknee rotation kinematics. The normal anterior tibial translation obtained by ACL reconstruction is thought to be the key factor in successful restoration of normal knee kinematics. PMID:23925154

  12. LOWER EXTREMITY MALALIGNMENTS AND ANTERIOR CRUCIATE LIGAMENT INJURY HISTORY

    Directory of Open Access Journals (Sweden)

    Rebecca A. Braham

    2004-12-01

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

  13. Imaging of traumatic injury and impingement of anterior knee fat.

    Science.gov (United States)

    Lapègue, F; Sans, N; Brun, C; Bakouche, S; Brucher, N; Cambon, Z; Chiavassa, H; Larbi, A; Faruch, M

    2016-01-01

    Fat is not just used by the body as bulk tissue. In addition to its role in storing energy and regulating hormone action, fat is used in some parts of the body for its mechanical properties. The anatomy of anterior knee fat is more complex than it appears at first sight and is capable of withstanding considerable compressive and shear stress. Specific lesions occur when such mechanical stress exceeds the physiological limits and are yet little known. Superficial fat can be the site of either acute injury by closed degloving called the Morel-Lavallée lesion or chronic injury, when subject to repeat excessive shear forces, due to more complex and less well-defined disruptions that result in pseudo-bursitis. There are three main anterior, intracapsular and extrasynovial fat pads in the knee joint, which are the infrapatellar fat pad (IFP) or Hoffa's fat pad, the quadriceps fat pad and the prefemoral fat pad. The IFP plays an important role as a mechanical shock absorber and guides the patella tendon and even the patella itself during flexion-extension movements. In response to repeated excessive stress, an inflammatory reaction and swelling of the IFP is first observed, followed by a fibrotic reaction with metaplastic transformation into fibrous, cartilaginous or bone tissue. More rarely, the two other deep fat pads (quadriceps and prefemoral) can, if subject to repeated stress, undergo similar restructuring inflammatory reactions with metaplasia resulting in tissue hardening, anterior pain and partial loss of function. PMID:27118690

  14. Diagnosis and treatment of anterior uveitis: optometric management

    Directory of Open Access Journals (Sweden)

    Harthan JS

    2016-03-01

    Full Text Available Jennifer S Harthan,1 Dominick L Opitz,2 Stephanie R Fromstein,1 Christina E Morettin3 1Cornea Center for Clinical Experience, 2Ophthalmology Services and Practice Development, 3Urgent Eye Care Service, Illinois College of Optometry, Chicago, IL, USA Abstract: Anterior uveitis encompasses inflammation of the iris and/or ciliary body and is one of the most common types of ocular inflammation that primary eye care practitioners will encounter. Anterior uveitis may be caused by a variety of etiologies, including infectious, noninfectious, and masquerade diseases. The short-term and long-term treatment of uveitis should include the evaluation of location, duration, pathology, and laterality, in addition to presenting signs and symptoms of the disease. A complete review of systems, thorough examination, and laboratory testing, may assist the practitioner in narrowing the list of possible causes for the uveitis. This is imperative as once a list of diagnoses has been made, a targeted approach to treatment can be pursued. Keywords: anterior uveitis, iritis, inflammation

  15. Is biologic width of anterior and posterior teeth similar?

    Directory of Open Access Journals (Sweden)

    Amir Alireza Rasouli Ghahroudi

    2014-09-01

    Full Text Available The biologic width (BW includes attached epithelial cells and connective tissue attachment complex being very important in the periodontal health during prosthetic treatments as invading this zone can cause bone resorption and gingival recession. The present study investigated biologic width values in the normal periodontium in anterior and posterior teeth. 30 patients that referred from restorative department to periodontics department of Tehran University of medical sciences who need crown lengthening procedure on their teeth with no history of orthodontic, prosthodontic and periodontal treatment were randomly enrolled in this cross-sectional trial. Sulcus depths (SD as well as the distance between free gingival margin and the bone crest (FB of anterior and posterior teeth were measured by UNC-15 probe and compared. periodontium thickness was also assessed. The data were subjected to Student t test. Mean BW in the 43 anterior and 47 posterior teeth was measured and not significantly different (1.4651±0.39 mm vs. 1.6312±0.49 mm was observed; however, BW was significantly more in the teeth with thick periodontium compared to those with thin periodontium (1.703±0.5 vs. 1.408±0.35; P=0.002. BW not only is different in individuals but also could be dissimilar in different teeth and should be calculated independently prior to restorative treatments.

  16. Is biologic width of anterior and posterior teeth similar?

    Science.gov (United States)

    Rasouli Ghahroudi, Amir Alireza; Khorsand, Afshin; Yaghobee, Siamak; Haghighati, Farideh

    2014-01-01

    The biologic width (BW) includes attached epithelial cells and connective tissue attachment complex being very important in the periodontal health during prosthetic treatments as invading this zone can cause bone resorption and gingival recession. The present study investigated biologic width values in the normal periodontium in anterior and posterior teeth. 30 patients that referred from restorative department to periodontics department of Tehran University of medical sciences who need crown lengthening procedure on their teeth with no history of orthodontic, prosthodontic and periodontal treatment were randomly enrolled in this cross-sectional trial. Sulcus depths (SD) as well as the distance between free gingival margin and the bone crest (FB) of anterior and posterior teeth were measured by UNC-15 probe and compared. periodontium thickness was also assessed. The data were subjected to Student t test. Mean BW in the 43 anterior and 47 posterior teeth was measured and not significantly different (1.4651±0.39 mm vs. 1.6312±0.49 mm) was observed; however, BW was significantly more in the teeth with thick periodontium compared to those with thin periodontium (1.703±0.5 vs. 1.408±0.35; P=0.002). BW not only is different in individuals but also could be dissimilar in different teeth and should be calculated independently prior to restorative treatments. PMID:25325207

  17. Anterior spinal cord syndrome after initiation of treatment with atenolol.

    Science.gov (United States)

    Schneider, Gregory S

    2010-06-01

    Anterior spinal cord syndrome is a rare condition with a variety of precipitating factors. Patients typically complain of weakness or paralysis of the extremities, often accompanied by pain, but frequently without a history of trauma. A 48-year-old man presented to the emergency department complaining of neck pain and inability to move his legs in the absence of trauma. Several hours prior he had seen his private physician and was given a dose of atenolol for elevated blood pressure. He had not previously been on medications for hypertension. His neurological examination revealed bilateral paralysis of the lower extremities. In the upper extremities he had weakness and sensory loss at the level of C6. Rectal tone was decreased and without sensation. Cervical and thoracic spine magnetic resonance imaging showed spondylotic disc disease, with disc herniation at C6-7 causing severe spinal canal stenosis. Despite i.v. methylprednisolone, pressors, and a prolonged intensive care unit course, the patient was discharged 5 weeks later with continued neurological deficits. Anterior spinal cord syndrome results from compression of the anterior spinal artery and often occurs in the absence of traumatic injury. The recognition, management, and prognosis of this condition are discussed. PMID:18597977

  18. Brief communication: The distribution of perikymata on Qafzeh anterior teeth.

    Science.gov (United States)

    Guatelli-Steinberg, Debbie; Reid, Donald J

    2010-01-01

    Recent studies have suggested that Neandertals and modern humans differ in the distribution of perikymata (enamel growth increments) over their permanent anterior tooth crowns. In modern humans, perikymata become increasingly more compact toward the cervix than they do in Neandertals. Previous studies have suggested that a more homogeneous distribution of perikymata, like that of Neandertals, characterizes the anterior teeth of Homo heidelbergensis and Homo erectus as well. Here, we investigated whether Qafzeh anterior teeth (N = 14) differ from those of modern southern Africans, northern Europeans, and Alaskans (N = 47-74 depending on tooth type) in the percentage of perikymata present in their cervical halves. Using the normally distributed modern human values for each tooth type, we calculated Z-scores for the 14 Qafzeh teeth. All but two of the 14 Qafzeh teeth had negative Z-scores, meaning that values equal to these would be found in the bottom 50% of the modern human samples. Seven of the 14 would be found in the lowest 5% of the modern human distribution. Qafzeh teeth therefore appear to differ from those of modern humans in the same direction that Neandertals do: with generally lower percentages of perikymata in their cervical regions. The similarity between them appears to represent the retention of a perikymata distribution pattern present in earlier members of the genus Homo, but not generally characteristic of modern humans from diverse regions of the world. PMID:19902531

  19. Anatomic variations of anterior cerebral artery cortical branches.

    Science.gov (United States)

    Stefani, M A; Schneider, F L; Marrone, A C; Severino, A G; Jackowski, A P; Wallace, M C

    2000-01-01

    The anterior cerebral artery (ACA) is a major vessel responsible for the blood supply to the interhemispheric region. The ACA segment after the anterior communicating artery (AComA) origin is called the distal ACA and has central and cortical branches. The cortical branches are distributed in the different regions of the orbital and medial part of the brain. The objects of this study are the anatomical variations found in the distal ACA. In 76 hemispheres the ACA distal branches were injected with latex and dissected under microscope magnification. Vessel diameters and distances between vessel origins and anterior communicating artery were recorded and analyzed. Microsurgical dissection was carried out to demonstrate anatomic variations of these vessels. Average diameter of ACA at origin was 2.61 +/- 0.34 mm and average diameter of cortical branches diameter ranged from 0.79 +/- 0.27 mm to 1.84 +/- 0.3 mm. Distances between vessel origin and AComA ranged from 7.68 +/- 3.91 mm (orbitofrontal) to 112.6 +/- 11.63 mm (inferior internal parietal). This study found anatomical variations: a single (azygos) ACA was present in one case and three in three cases. Crossing branches of the distal ACA to the contralateral hemisphere were present in 26% of the cases. In some cases a single ACA may supply the posterior hemispheric region through crossing branches. This calls attention to potential bilateral brain infarcts due to a single unilateral ACA occlusion. PMID:10873213

  20. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Mallanagouda N Patil

    2013-04-01

    Full Text Available Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand. He complained of pain and difficulty in moving both the shoulders. On clinical examination, patient’s both upper limbs were abducted and externally rotated. Bilaterally shoulder contour was lost with flattening. Other classical signs of shoulder dislocation viz, Bryants test, Callway sign, Hamilton’s ruler test were positive. Diagnosis was confirmed on X rays. Both shoulders were reduced in emergency operation theater under general anaesthesia by Kocher’s method and were immobilised in sling. Conclusion: Though bilateral shoulder dislocations are commonly posterior, usually either secondary to convulsions or electric shock, anterior dislocation has to be kept in mind , especially in post traumatic injuries. This bilateral dislocation also presents with practical problems immobilization and day to day care of patients. Keywords: Simultaneous, bilateral, shoulder dislocation, traumatic.

  1. Activation of anterior insula during self-reflection.

    Directory of Open Access Journals (Sweden)

    Gemma Modinos

    Full Text Available BACKGROUND: Functional neuroimaging studies have suggested activation of midline frontoparietal brain regions to be at the core of self-related processes. However, although some studies reported involvement of the insula, little attention has been paid to this region as forming part of the "self"-network. METHODOLOGY/PRINCIPAL FINDINGS: Using functional magnetic resonance imaging (fMRI, we aimed at replicating and extending previous studies by scanning subjects whilst reflecting upon their own personal qualities as compared to those of an acquaintance. A third condition with statements about general knowledge was used to control for attention, semantic processing and decision making processes. The results showed a significant effect of task in brain activity, consistent with previous findings, by which both person conditions recruited a common set of medial prefrontal and posterior regions, yet significant differences between self and other were found in the medial prefrontal cortex (MPFC and the anterior cingulate cortex (ACC. Notably, significant neural activation in the left anterior insula was observed as uniquely associated with self-reflection. CONCLUSIONS/SIGNIFICANCE: The results provide further evidence for the specific recruitment of anterior MPFC and ACC regions for self-related processing, and highlight a role for the insula in self-reflection. As the insula is closely connected with ascending internal body signals, this may indicate that the accumulation of changes in affective states that might be implied in self-processing may contribute to our sense of self.

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

    Science.gov (United States)

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

    2010-10-27

    Australopithecus anamensis is the earliest known species of the Australopithecus-human clade and is the likely ancestor of Australopithecus afarensis. Investigating possible selective pressures underlying these changes is key to understanding the patterns of selection shaping the origins and early evolution of the Australopithecus-human clade. During the course of the Au. anamensis-afarensis lineage, significant changes appear to occur particularly in the anterior dentition, but also in jaw structure and molar form, suggesting selection for altered diet and/or food processing. Specifically, canine tooth crown height does not change, but maxillary canines and P(3)s become shorter mesiodistally, canine tooth crowns become more symmetrical in profile and P(3)s less unicuspid. Canine roots diminish in size and dimorphism, especially relative to the size of the postcanine teeth. Molar crowns become higher. Tooth rows become more divergent and symphyseal form changes. Dietary change involving anterior dental use is also suggested by less intense anterior tooth wear in Au. afarensis. These dental changes signal selection for altered dietary behaviour and explain some differences in craniofacial form between these taxa. These data identify Au. anamensis not just as a more primitive version of Au. afarensis, but as a dynamic member of an evolving lineage leading to Au. afarensis, and raise intriguing questions about what other evolutionary changes occurred during the early evolution of the Australopithecus-human clade, and what characterized the origins of the group. PMID:20855307

  3. Anterior dental evolution in the Australopithecus anamensis–afarensis lineage

    Science.gov (United States)

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

    2010-01-01

    Australopithecus anamensis is the earliest known species of the Australopithecus–human clade and is the likely ancestor of Australopithecus afarensis. Investigating possible selective pressures underlying these changes is key to understanding the patterns of selection shaping the origins and early evolution of the Australopithecus–human clade. During the course of the Au. anamensis–afarensis lineage, significant changes appear to occur particularly in the anterior dentition, but also in jaw structure and molar form, suggesting selection for altered diet and/or food processing. Specifically, canine tooth crown height does not change, but maxillary canines and P3s become shorter mesiodistally, canine tooth crowns become more symmetrical in profile and P3s less unicuspid. Canine roots diminish in size and dimorphism, especially relative to the size of the postcanine teeth. Molar crowns become higher. Tooth rows become more divergent and symphyseal form changes. Dietary change involving anterior dental use is also suggested by less intense anterior tooth wear in Au. afarensis. These dental changes signal selection for altered dietary behaviour and explain some differences in craniofacial form between these taxa. These data identify Au. anamensis not just as a more primitive version of Au. afarensis, but as a dynamic member of an evolving lineage leading to Au. afarensis, and raise intriguing questions about what other evolutionary changes occurred during the early evolution of the Australopithecus–human clade, and what characterized the origins of the group. PMID:20855307

  4. DIAGNOSIS AND MANAGEMENT OF ANTERIOR CSF LEAKS : OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Probal

    2015-05-01

    Full Text Available CSF leaks through the nose (CSF rhinorrhea may occur due to defects in the anterior, middle or posterior cranial fossa. Among them, anterior CSF leaks are most commonly encountered in clinical practice and may be traumatic or spontaneous in origin. A pro mpt diagnosis is essential as the main risk of a persistent leak is the chance of developing life threatening meningitis. Radiological imaging by non - contrast high - resolution CT scan is the initial investigation of choice and shows the site of leak in most cases. In case of recent onset leaks, a period of conservative management is indicated. If conservative management fails, then the traditional neurosurgical procedures like craniotomy and other open approaches were the most preferred line of management of such leaks till a few years back. But now endoscopic repair of these leaks has provided a better alternative because of reduced surgical morbidity, hospital stay and costs. We present our initial experience with seven cases of anterior CSF rhinorrhea whic h were encountered in a two year period in our institute. Two out of three cases with recent onset leaks healed spontaneously with medical management while five cases required endoscopic repair with two surgical failures.

  5. Microbiological profile of anterior chamber aspirates following uncomplicated cataract surgery

    Directory of Open Access Journals (Sweden)

    Prajna N

    1998-01-01

    Full Text Available Anterior chamber aspirate cultures were done for 66 patients who underwent either an uncomplicated intracapsular cataract extraction, extracapsular cataract extraction with posterior-chamber intraocular lens implantation, or phacoemulsification with posterior-chamber intraocular lens implantation. The aspirate was obtained at the time of wound closure. The aspirates were immediately transferred to the microbiology laboratory where one drop of the aspirate was placed on a glass slide for gram stain, and the remainder was unequally divided and inoculated into blood agar, chocolate agar and thioglycolate broth. The cultures were incubated at 37° C with 5% CO2 and held for 5 days. Of 66 patients 4 (6%, had smear-positive anterior chamber aspirates. None of the aspirates showed any growth on any of the 3 culture media used. None of the eyes in the study developed endophthalmitis. This study concludes that there is no contamination of the anterior chamber by viable bacteria after cataract surgery, irrespective of the mode of intervention.

  6. Anterior cervical decompression and fusion with caspar plate fixation

    International Nuclear Information System (INIS)

    Objective: To evaluate the role of anterior cervical decompression and fixation with Caspar plating in cervical spine injury on neurological outcome. Study Design: A case series. Place and Duration of Study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2008 to March 2011. Methodology: Thirty patients admitted with cervical spine injuries were inducted in the study. All cases were evaluated for their clinical features, level of injury and degree of neurological injury was assessed using Frankel grading. Pre and postoperative record with X-rays and MRI were maintained. Cervical traction was applied to patients with sub-luxation. All patients underwent anterior cervical decompression, fusion and Caspar plate fixation. The follow-up period was 6 months with clinical and radiological assessment. Results: Among 30 patients, 24 (80%) were males and 6 (20%) were females. Age ranged from 15 to 55 years. Causes of injury were road traffic accident (n = 20), fall (n = 8) and assault (n = 2). Commonest mode of injury was road traffic accident (66.6%). Postoperative follow-up showed that pain and neurological deficit were improved in 21 patients. There was no improvement in 7 patients, one patient deteriorated and one expired. All patients developed pain at donor site. Conclusion: Anterior decompression, fusion and fixation with Caspar plate is an effective method with good neurological and radiological outcome. However, it is associated with pain at donor site. (author)

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

    Directory of Open Access Journals (Sweden)

    Merle Neethling-du Toit

    2008-11-01

    Full Text Available Anterior approach ultrasound guided arthrogram injections are a quick reliable way of injecting contrast prior to MRI scan. We did a retrospective study on patients, previously injected and scanned at our clinic, to compare the more manifested posterior approach with the anterior approach. The success rate for successful intra-articular injections for the anterior approach far outweighs the posterior approach. Also the anterior approach is more tolerable for patients as the injections are much quicker and seemingly less painful. In our knowledge it is thus far better to perform anterior approach shoulder arthrogram injections than posterior approach injections

  8. Minimally invasive approaches for histological diagnosis of anterior mediastinal masses

    Institute of Scientific and Technical Information of China (English)

    FANG Wen-tao; XU Mei-ying; CHEN Gang; CHEN Yong; CHEN Wen-hu

    2007-01-01

    Background Anterior mediastinal masses include a wide variety of diseases from benign lesions to extremely malignant tumors. Management strategies are highly diverse and depend strongly on the histological diagnosis as well as the extent of the disease. We reported a prospective study comparing the usefulness of core needle biopsy and mini-mediastinotomy under local anesthesia for histological diagnosis in anterior mediastinal masses.Methods A total of 40 patients with masses of unknown histology and located either at or near the anterior mediastinum received biopsy prior to treatment. The diagnostic methods were core needle biopsy in 28 patients and biopsy through mini-mediastinotomy under local anesthesia in 15 patients (including 3 patients for whom core needle biopsy failed to yield a definite diagnosis).Results Histological diagnosis was achieved in 18 of the 28 patients receiving core needle biopsy. Of them, all 4 patients with pleural fibromas and 9 of the 12 patients (75%) with pulmonary mass were diagnosed definitively. In the remaining 12 patients with mediastinal mass, histological diagnosis was achieved in only 5 patients (41.7%). In contrast,biopsy through a mini-mediastinotomy failed in only 3 patients. In the remaining 12 patients with huge mediastinal masses, who underwent mini-mediastinotomy, a definitive histological diagnosis was reached by pathological and/or immunohistochemical study (diagnostic yield 85.7% in 12 of 14 cases of mediastinal mass, P=0.038 vs core needle biopsy). For the 9 patients with thymic epithelial tumors, the diagnostic yield was 40% (2 in 5 cases) for core needle biopsy and 83.3% (5 in 6 cases) for mini-mediastinotomy. There was no morbidity in patients receiving mini-mediastinotomy. In the 30 patients with biopsy-proven histological diagnosis, the results contributed to therapeutic decision making in 25 cases (83.3%).Conclusions Core needle biopsy is effective in the diagnosis of pulmonary and pleural diseases. Yet its

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

    Directory of Open Access Journals (Sweden)

    Robert Csapo, Simona Hosp, Ramona Folie, Robert Eberle, Michael Hasler, Werner Nachbauer

    2016-03-01

    Full Text Available Knee sleeves or braces represent auxiliary tools that have repeatedly been used by athletes, in an attempt to increase knee stability and, thus, reduce the risk of (recurrent ligamentous injuries. Since ACL injuries typically occur in situations involving either torsion or hyperextension of the knee, it has been speculated that braces might protect the ACL by countering excessive anterior translation of the tibia with respect to the femur (Beynnon et al., 1997. However, the preponderance of in vivo studies to test this hypothesis was performed in cohorts of patients suffering from existent ligamentous (Branch et al., 1988; Colville et al., 1986 or other knee injury (Beynnon et al., 1997; Fleming et al., 2000. This complicates the extrapolation of results to healthy subjects. Further, the braces used in these studies were mostly rigid constructs that consisted of either uni- or bilateral hinged bars (Rishiraj et al., 2009. Such braces might hinder performance (Veldhuizen et al., 1991 and would be rejected by the vast majority of healthy athletes. For these reasons, we would like to use this letter to the editor to report the results of our experiments investigating whether a relatively light elastic knee sleeve would limit the degree of anterior tibial translation in computerized arthrometry tests as performed in a sample of non-injured subjects. We recruited ten female college students (age: 23.4 ± 3.2 yrs, height: 1.68 ± 0.05 m, mass: 59.9 ± 5.5 kg who were free of acute or previous injury or any form of orthopaedic disease of the knee joints. The anterior displacement of the tibia was measured using the GNRB® computerized arthrometer (GeNouRob, Laval, France. With subjects lying in the supine position, the lower leg was firmly fixed with plastic caps mounted over the ankle joint and patella. An electrical pressure pad then exerted increasing pressure of up to 250 N on the calf, while a motion sensor, which was positioned on the ventral

  10. Grosor de la íntima-media de la arteria carótida en adolescentes obesos y su relación con el síndrome metabólico Intima-media thickness in obese adolescents and their relation with metabolic syndrome

    Directory of Open Access Journals (Sweden)

    C. Torrejón

    2012-02-01

    Full Text Available Introducción: Los adolescentes obesos presentan mayor riesgo cardiovascular (RCV. La medición del grosor de la intima-media (GIM arterial detecta tempranamente el compromiso vascular. Objetivo: Evaluar si los adolescentes obesos tienen mayor compromiso vascular medido por GIM que los adolescentes no obesos, y si este es mayor en aquellos con síndrome metabólico (SM. Metodología: Grupo estudio (GE, niños obesos, IMC/edad > p95, con y sin SM y grupo control, IMC/edad p10-85, sin patología nutricional ni endocrina. Se midieron concentraciones séricas de lípidos, prueba tolerancia oral a glucosa con insulinemia y ecografía de arteria carótida. Para evaluar diferencia entre grupos se utilizaron pruebas estadísticas paramétricas y no paramétricas. Resultados: Se evaluaron 45 adolescentes obesos (20 mujeres, 19 con SM, edad 13 (9-16 años y 18 controles (14 mujeres, edad 13 (11-16 años. GIM del bulbo carotideo y de la arteria carótida interna (ACI fueron significativamente mayores en GE que grupo control (0,54 vs 0,34; 0,34 vs 0,25, p Introduction: Obese adolescents have higher cardiovascular risk (CVR. Intima-media thickness (IMT detects early arterial vascular compromise. Objective: To evaluate whether obese adolescents have higher vascular compromise measured by IMT than nonobese adolescents, and if this is greater in those with metabolic syndrome (MS. Method: The study group (SG, obese children (BMI/age > p95, with and without MS and control group (CG, non-obese (BMI/age p10-85 and non nutritional or endocrine disease. We measured serum lipids, oral glucose tolerance test with insulin and carotid artery ultrasound. To evaluate the differences between test groups we used parametric and nonparametric statistics. Results: We evaluated 45 obese adolescents (20 women, 19 with MS, age 13 (9-16 years and 18 controls (14 women, aged 13 (11-16 years. IMT of carotid bulb and internal carotid artery (ICA were significantly higher in SG than CG

  11. Acute Anterior Uveitis and Spondyloarthritis: More Than Meets the Eye.

    Science.gov (United States)

    Khan, Muhammad A; Haroon, Muhammad; Rosenbaum, James T

    2015-09-01

    Ankylosing spondylitis (AS) and related forms of spondyloarthritis (SpA) are associated with some extra-articular features, and the most common symptomatic association is with acute anterior uveitis (AAU). Thus, approximately 40 % of patients with AS will experience a sudden onset of a unilateral anterior uveitis sometime during the course of their disease. Patients with AAU, especially those who are HLA-B27 positive, should be questioned about inflammatory low back pain and also evaluated for other clinical features of SpA. Since a prolonged delay in diagnosis is common among SpA patients and occurrence of AAU may be the reason for their first interaction with medical care, occurrence of AAU presents a unique opportunity for identifying such undiagnosed SpA patients. Therefore, a novel evidence-based algorithm called Dublin Uveitis Evaluation Tool (DUET) has been proposed to guide ophthalmologists and primary care physicians to refer appropriate AAU patients to rheumatologists. In a large two-phase study, approximately 40 % of patients presenting with idiopathic AAU were noted to have undiagnosed SpA, and DUET algorithm was noted to have excellent sensitivity (96 %) and specificity (97 %). It has a positive likelihood ratio (LR) 41.5 and negative LR 0.03. In most instances, the eye inflammation responds well to corticosteroid and mydriatic eye drops and without the need for additional therapy. Use of oral corticosteroids is reserved for patients, especially with associated chronic inflammatory bowel disease or psoriatic arthritis presenting with bilateral, chronic, anterior, and/or intermediate uveitis, and this treatment is rarely needed for more than a couple of weeks. A very small percentage may be more refractory to such treatment and require potential novel therapies, including the use of tumor necrosis factor blockers. PMID:26233598

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

    Directory of Open Access Journals (Sweden)

    Priya Narang

    2015-01-01

    Full Text Available Purpose: To demonstrate the safety and outcome of a surgical approach that uses pars plicata site for anterior vitrectomy during phacoemulsification procedure complicated by posterior capsule rupture and residual cortical matter. Design: Single center, retrospective, interventional, noncomparative study. Materials and Methods: Medical records of a consecutive series of 35 eyes of 35 patients who underwent pars plicata anterior vitrectomy (PPAV were reviewed. The main outcome measures were corrected and uncorrected distance visual acuity (CDVA, UDVA, early and late postoperative complications and intraocular pressure (IOP. Ultrasound biomicroscopic (UBM evaluation of sclerotomy site and spectral domain optical coherence tomography analysis for central macular thickness (CMT was performed. The final visual outcome at 2 years was evaluated. Results: At 2 years follow-up, the mean postoperative UDVA (logarithm of the minimum angle of resolution [logMAR] and CDVA (logMAR was 0.49 ± 0.26 and 0.19 ± 0.14, respectively. There was no significant change in the IOP (P = 0.061 and the mean CMT at 2 years was 192.5 ± 5.54 mm. The postoperative UBM image of the sclerotomy site at 8 weeks demonstrated a clear wound without any vitreous adhesion or incarceration. Intraoperative hyphema was seen in 1 (2.8% case and postoperative uveitis was seen in 2 (5.7% cases, which resolved with medications. No case of an iatrogenic retinal break or retinal detachment was reported. Conclusions: PPAV enables a closed chamber approach, allows thorough cleanup of vitreous in the pupillary plane and anterior chamber and affords better access to the subincisional and retropupillary cortical remnant with a significant visual outcome and an acceptable complication rate.

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

    Directory of Open Access Journals (Sweden)

    Gustavo ,2,3 Bonfadini

    2014-10-01

    Full Text Available Objective: We describe a novel spatula and dissector to facilitate the big-bubble technique in deep anterior lamellar keratoplasty (DALK. Methods: A 29-year-old man who was diagnosed with bilateral keratoconus underwent deep anterior lamellar keratoplasty (DALK. After 350μm partial thickness incision of the recipient cornea, the Bonfadini dissector was inserted at the deepest point in the peripheral incision and could be advanced to the center of the cornea safely because of its "semi-sharp" tip. After achieving the big-bubble (BB separation of Descemet membrane (DM from the overlying stroma, the anterior stromal disc was removed. Viscoelastic material was placed on the stromal bed to prevent uncontrolled collapse and perforation of DM during the paracentesis blade incision into the BB. We could detect the safe opening of the BB using the Bonfadini dissector by the leakage of air bubbles into the viscoelastic material. After injecting viscoelastic material into the BB space, we inserted the Bonfadini spatula into the bigbubble safely because of its curved profile and blunt edges. The groove along the length of the Bonfadini spatula enables safe and efficient incision or the residual stromal tissue using the pointed end of a sharp blade while protecting the underlying DM. After removal of posterior stroma, the donor button was sutured with 16 interrupted 10-0 nylon sutures. Results: This technique and the use of the Bonfadini spatula and dissector facilitate exposure of Descemet membrane. Conclusion: The smooth Bonfadini DALK spatula and dissector facilitate safe and efficient completion of DALK surgery.

  14. [Variability of the celiac artery and its branches in sheep].

    Science.gov (United States)

    Karmona, Kh; Kovachev, G

    1985-01-01

    Contrast matter was used with a total of 363 sheep fetuses, newborn lambs, and adult sheep to study the variability of the coeliac artery and its branches. It was found that the artery and some of its branches, such as arteria ruminalis sinistra, arteria reticularis, and arteria lienalis often showed variations, resp., deviations in their branching and distribution. Others, such as arteria ruminalis dextra and arteria hepatica showed no variations whatever. Both the coeliac artery and the anterior intestinal artery in the sheep were most often shown to branch from the aorta alone (in 71.07 per cent of the cases) as against the rarely observed common truncus coeliacomesentericus (in 28.93 per cent of the cases). The most commonly observed form of branching of arteria coeliaca seemed to be tripus coeliacus, while the branching with the formation of a short truncus hepatogastricus was comparatively a rare phenomenon. It was also established that the left ruminal artery was much more frequently the branch of truncus lienoruminalis than the branch of arteria gastrica sinistra. So far as the place in which arteria reticularis arose three variants were observed. Most frequently this artery was shown to be the branch of arteria gastrica sinistra. PMID:4013078

  15. 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.

  16. Anciliary findings of anterior cruciate ligament injuries on MR images

    International Nuclear Information System (INIS)

    Two MR findings have been noted in patients with documented anterior cruciate ligament (ACL) injuries: a cartilaginous defect in lateral femoral condyle and a posterosuperior bulge in the synovium adjacent to the proximal third of the ACL. The purpose of this paper is to assess the specificity of these findings, comparing a randomly chosen population with a group of patients with proved ACL ruptures. Twenty-three patients without any ACL abnormality on MR images were compared with a group of 22 patients with ACL lesions. Every ACL lesion was confirmed either arthroscopically or surgically. The control group included subjects with normal knees and various knee injuries

  17. Hubungan Rasio Anterior dengan Overjet dan Overbite pada Perawatan Orthodontik

    OpenAIRE

    J. A. Budiman; E. D. D. Yashadana; S. D. Sadoso; P. I. Masbirin

    2015-01-01

    The important role of the tooth size information is in making diagnosis and treatment plan of the cases with malocclusion. A lot of studies have been done in this aspect such as about tooth size with its variation, and also the ratio of maxillary to mandibular tooth size. The most famous tooth size analysis is Bolton analysis with his anterior ratio and overall ratio. Because the accordance of those ratio is not found in all orthodontic cases, some studies (Korbitz, Neff, Moyers and Steadman)...

  18. A checklist for endonasal transsphenoidal anterior skull base surgery.

    Science.gov (United States)

    Laws, Edward R; Wong, Judith M; Smith, Timothy R; de Los Reyes, Kenneth; Aglio, Linda S; Thorne, Alison J; Cote, David J; Esposito, Felice; Cappabianca, Paolo; Gawande, Atul

    2016-06-01

    OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and decrease complication rates. Although the authors' institution has instituted a general preoperative "time-out" designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for transnasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery uses a completely different conceptual approach, set-up, instrumentation, and operative procedure. Therefore, it can be associated with different types of complications as compared with open cranial surgery. The authors hypothesized that a detailed, procedure-specific, preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and maximize both teambuilding and operational efficiency. Thus, the object of this study was to develop such a checklist for endonasal transsphenoidal anterior skull base surgery. METHODS An expert panel was convened that consisted of all members of the typical surgical team for transsphenoidal endoscopic cases: neurosurgeons, anesthesiologists, circulating nurses, scrub technicians, surgical operations managers, and technical assistants. Beginning with a general checklist, procedure-specific items were added and categorized into 4 pauses: Anesthesia Pause, Surgical Pause, Equipment Pause, and Closure Pause. RESULTS The final endonasal transsphenoidal anterior skull base surgery checklist is composed of the following 4 pauses. The Anesthesia Pause consists of patient identification, diagnosis, pertinent laboratory studies, medications, surgical preparation, patient positioning, intravenous/arterial access, fluid management

  19. Anterior Cruciate Ligament Reconstruction in Ehlers-Danlos Syndrome

    Directory of Open Access Journals (Sweden)

    John Williams

    2015-01-01

    Full Text Available This report details the reconstruction of the anterior cruciate ligament in an 18-year-old man with Ehlers-Danlos syndrome (EDS. The reduced mechanical properties of the tissue in EDS can pose a challenge to the orthopaedic surgeon. In this case, we describe the use of a hamstring autograft combined with a Ligament Advanced Reinforcement System (LARS. There was a good radiographical, clinical, and functional outcome after two years. This technique gave a successful outcome in the reconstruction of the ACL in a patient with EDS and therefore may help surgeons faced with the same clinical scenario.

  20. Anterior Cruciate Ligament: Structure, Injuries and Regenerative Treatments.

    Science.gov (United States)

    Negahi Shirazi, Ali; Chrzanowski, Wojciech; Khademhosseini, Ali; Dehghani, Fariba

    2015-01-01

    Anterior cruciate ligament (ACL) is one of the most vulnerable ligaments of the knee. ACL impairment results in episodic instability, chondral and meniscal injury and early osteoarthritis. The poor self-healing capacity of ACL makes surgical treatment inevitable. Current ACL reconstructions include a substitution of torn ACL via biological grafts such as autograft, allograft. This review provides an insight of ACL structure, orientation and properties followed by comparing the performance of various constructs that have been used for ACL replacement. New approaches, undertaken to induce ACL regeneration and fabricate biomimetic scaffolds, are also discussed. PMID:26545750

  1. Coracoid syndrome: a neglected cause of anterior shoulder pain

    Science.gov (United States)

    GIGANTE, ANTONIO; BOTTEGONI, CARLO; BARBADORO, PAMELA

    2016-01-01

    Purpose the present prospective open-label study was designed to gain further insights into a condition thought to constitute a neglected but not uncommon syndrome characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process, not related to rotator cuff or pectoralis minor tendinopathy, long head of the biceps tendon disorders, or instability. The aim was to clarify its prevalence, clinical characteristics, differential diagnosis and response to corticosteroid injections. Methods patients with primary anterior shoulder pain precisely reproduced by deep pressure on the apex of the coracoid process were recruited. Patients with clinical or instrumental signs of other shoulder disorders were excluded. Patients were given an injection of triamcinolone acetonide 40 mg/ml 1 ml at the coracoid trigger point. They were evaluated after 15, 30 and 60 days and at 2 years using Equal Visual Analog Scale (EQ-VAS) and the Italian version of the Simple Shoulder Test (SST). Results between January 1 and December 31 2010, we treated 15 patients aged 26–66 years. The majority were women (86.67%). At 15 days, 6 (40%) patients reported complete resolution of their symptoms, while 9 (60%) complained of residual symptoms and received another injection. At 30 days, 14 (93.33%) patients were pain-free and very satisfied. At 2 years, the 14 patients who had been asymptomatic at 30 days reported that they had experienced no further pain or impaired shoulder function. The analysis of variance for repeated measures showed a significant effect of time on EQ-VAS and SST scores. Conclusions the present study documents the existence, and characteristics, of a “coracoid syndrome” characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process and showed that the pain is usually amenable to steroid treatment. This syndrome should be clearly distinguished from anterior shoulder pain due to other causes, in

  2. Superior labrum anterior to posterior tears in throwing athletes.

    Science.gov (United States)

    Lintner, David M

    2013-01-01

    Superior labrum anterior to posterior (SLAP) tears and partial undersurface tears of the rotator cuff are common in experienced throwers, may be adaptive, and are only occasionally symptomatic. Pain in the shoulder of a throwing athlete with an MRI-documented SLAP tear or partial undersurface tear of the rotator cuff can be managed nonsurgically, with attention to posterior capsular contracture, scapular dyskinesia, and rotator cuff strength. The results of the surgical repair of SLAP lesions in the throwing athlete, with or without rotator cuff repair, are inferior to those of nonsurgical treatment. The cause of pain in the throwing athlete must be accurately diagnosed without reliance on MRI findings. PMID:23395053

  3. Progressive bilateral anterior sacral meningoceles in Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Scheck, R.J. [Dept. of Radiology, Univ. Muenchen (Germany); Schramm, T. [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany); Gloning, K.P. [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany); Vogl, T. [Dept. of Radiology, Univ. Muenchen (Germany); Ostermayer, E. [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany)

    1995-08-01

    Anterior sacral meningoceles (ASM) in Marfan syndrome are rare. They may cause constipation, urinary frequency, dysmenorrhoea, and low back pain or numbness. This report describes bilateral ASM at the level of S1, S2 and S3 in a woman with Marfan syndrome who was admitted to the gynaecology department for evaluation of left lower abdominal pain. The magnetic resonance appearance of the meningoceles is discussed and compared with findings from transvaginal ultrasound and CT. As MRI offers excellent delineation of spinal and pelvic structures, it is the most useful technique available in establishing the diagnosis and planning the treatment of ASM. (orig.)

  4. Progressive bilateral anterior sacral meningoceles in Marfan syndrome

    International Nuclear Information System (INIS)

    Anterior sacral meningoceles (ASM) in Marfan syndrome are rare. They may cause constipation, urinary frequency, dysmenorrhoea, and low back pain or numbness. This report describes bilateral ASM at the level of S1, S2 and S3 in a woman with Marfan syndrome who was admitted to the gynaecology department for evaluation of left lower abdominal pain. The magnetic resonance appearance of the meningoceles is discussed and compared with findings from transvaginal ultrasound and CT. As MRI offers excellent delineation of spinal and pelvic structures, it is the most useful technique available in establishing the diagnosis and planning the treatment of ASM. (orig.)

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    OBJECTIVE: Investigate the 5-year longitudinal changes in bone curvature after acute anterior cruciate ligament (ACL) injury, and identify predictors of such changes. METHODS: In the KANON-trial (ISRCTN 84752559), 111/121 young active adults with an acute ACL tear to a previously un-injured knee...... MR images. Curvature (mm(-1)) was determined for femur, tibia, medial/lateral femur, trochlea, medial/lateral tibia. Age, sex, treatment, BMI, meniscal injury, osteochondral fracture on baseline MR images were tested for association. RESULTS: Over 5 years, curvature decreased in each region (P < 0...

  6. The anterior interhemispheric approach to a third ventricular cavernous malformation.

    Science.gov (United States)

    Martirosyan, Nikolay L; Kalani, M Yashar S; Nakaji, Peter; Spetzler, Robert F

    2016-01-01

    The anterior interhemispheric approach is a workhorse for treatment of lesions in the third ventricle. In this case, we demonstrate the utility of this approach for resecting a complex third ventricular cavernous malformation. We discuss patient positioning, optimal location of the craniotomy, and surgical resection techniques for safe removal of these lesions. We also demonstrate the importance of gravity retraction using the falx to prevent injury to the dominant frontal lobe. The video can be found here: https://youtu.be/38woc28er7M . PMID:26722693

  7. Anterior Segment Tomography with the Cirrus Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Eduardo B. Rodrigues

    2012-01-01

    Full Text Available Optical coherence tomography (OCT is an optical acquisition method to examine biological tissues. In recent years, OCT has become an important imaging technology used in diagnosing and following macular pathologies. Further development enabled application of optical coherence tomography in evaluation of the integrity of the nerve fiber layer, optic nerve cupping, anterior chamber angle, or corneal topography. In this manuscript we overview the use of OCT in the clinical practice to enable corneal, iris, ciliary body, and angle evaluation and diagnostics.

  8. Recurrent unicystic ameloblastoma in mandibular anterior teeth area

    International Nuclear Information System (INIS)

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

  9. Class I malocclusion with anterior crossbite and severe crowding

    Directory of Open Access Journals (Sweden)

    Daltro Enéas Ritter

    2014-04-01

    Full Text Available This article reports the orthodontic diagnosis and treatment planning carried out with a 14-year and 5-month-old female patient with esthetic and functional complaints. She presented an Angle Class I malocclusion, anterior crossbite and severe crowding in both maxillary and mandibular arches, in addition to a lightly concave straight facial profile. Orthodontic treatment did not require extraction. Crossbite was corrected by protrusion of upper teeth, which contributed to alignment and leveling of teeth, in addition to improving the patient's facial profile. The case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO as a requirement for the BBO certification.

  10. A Rare Complication of Tuberculous Meningitis Pediatric Anterior Glenohumeral Instability

    Directory of Open Access Journals (Sweden)

    Kerem Bilsel

    2012-01-01

    Full Text Available Dislocation and instability of the shoulder joint are rare occurrences in childhood. Traumatic, infectious, congenital, and neuromuscular causes of pediatric recurrent shoulder dislocations are reported before. Central nervous system infection in infancy may be a reason for shoulder instability during childhood. This situation, which causes a disability for children, can be treated successfully with arthroscopic stabilization of the shoulder and postoperative effective rehabilitation protocols. Tuberculous meningitis may be a reason for neuromuscular shoulder instability. We describe a 12-year-old child with a recurrent anterior instability of the shoulder, which developed after tuberculous meningitis at 18 months of age. We applied arthroscopic treatment and stabilized the joint.

  11. Anterior dislocation of shoulder in eclampsia:a case report

    Institute of Scientific and Technical Information of China (English)

    Seema Rawat; Sanjay Meena; Shreesh Kumar Gangari; Lalit Kumar Lohia

    2012-01-01

    This case report presents a 25-year-old female patient with anterior dislocation of right shoulder secondary to seizures as a complication of eclampsia.This is an unusual mechanism of injury,but similar to other uncontrolled muscular contractions caused by electroconvulsive therapy,etc.To the best of our knowledge only one such case has been reported in the English literature.Closed reduction under general anaesthesia was successfully achieved.High suspicion in patients complaining of pain over shoulder joint is necessary for early diagnosis of this condition.

  12. Anterior cruciate ligament injury in indoor ball games.

    Science.gov (United States)

    Ebstrup, J F; Bojsen-Møller, F

    2000-04-01

    Three videorecorded incidents of knee injuries inflicted during indoor ball games are reported. Injuries and especially anterior cruciate ligament ruptures seemed to be triggered in varus loaded knees by femural external rotation, or in valgus loaded knees by femural internal rotation with the pivot shifted to the lateral femurotibial compartment. The observations suggest that it may be to the players' advantage to be trained in not letting their knees sag medially or laterally during side-stepping or sudden changes in speed. PMID:10755283

  13. Does the Microbiome Cause B27-related Acute Anterior Uveitis?

    Science.gov (United States)

    Rosenbaum, James T; Lin, Phoebe; Asquith, Mark

    2016-08-01

    The microbiome is strongly implicated in a broad spectrum of immune-mediated diseases. Data support the concept that HLA molecules shape the microbiome. We provide hypotheses to reconcile how HLA-B27 might affect the microbiome and in turn predispose to acute anterior uveitis. These theories include bacterial translocation, antigenic mimicry, and dysbiosis leading to alterations in regulatory and effector T-cell subsets. Received 31 October 2015; revised 7 January 2016; accepted 8 January 2016; published online 22 March 2016. PMID:27002532

  14. Acute anterior uveitis as the initial presentation of alkaptonuria

    Directory of Open Access Journals (Sweden)

    Padhan P

    2009-01-01

    Full Text Available Alkaptonuria is a rare autosomal recessive metabolic disorder that may present with multi-system involvement such as ochronotic arthropathy, renal, urethral and prostatic calculi, cardiac valvular lesions and pigmentation of the skin, sclera, cartilage and other connective tissues. An association of the disease with uveitis has never been reported. We report the first case of alkaptonuria with ochronotic arthropathy presenting with recurrent acute anterior uveitis as the initial manifestation. The possible common link with the HLA-B27 gene is discussed.

  15. Intravitreal Bevacizumab in Nonarteritic Anterior Ischemic Optic Neuropathy

    OpenAIRE

    Ebadollah Heidari; Mohammad Reza Niyousha; Reza Heidari; Babak Rahimi-Aradabili; Farzad Hami Adl; Nooshin Bazzazi

    2014-01-01

    Purpose: To evaluate the effect of intravitreal injection of Bevacizumab on improving visual function in patients with Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION). Methods: In a prospective interventional case series, 11 eyes with vision loss due to (NAION) in less than 15 days of attack were studied. Visual acuity, perimetry and optic nerve head changes were evaluated 1 week post-intravitreal injection of 1.25mg/0.1 mL Bevacizumab. Results: 5 of patients had improved visual acui...

  16. Myosis in the operation of the YAG laser anterior capsulotomy

    Science.gov (United States)

    Li, Yong-Nian; Ni, Xiao-Wu; Lu, Jian; He, Anzhi

    1992-08-01

    In this paper, 30 cases of extracapsular cataract extractions with a Nd:YAG laser are reported. Myosis phenomenon in laser operation is observed and its producing mechanism is discussed. Laser ophthalmology was the earliest field in laser application research, and pulse Nd:YAG laser ophthalmic instruments have been developed rapidly because of unique advantages in the anterior and posterior capsulotomy and trabecula shaping method. Thirty cases of extracapsular cataract extractions with the assistance of a Nd:YAG laser are reported in this paper. In laser operation, myosis phenomenon is observed, and its production mechanism is discussed.

  17. Morphometric parameters as risk factors for anterior cruciate ligament injuries: A MRI case-control study

    Directory of Open Access Journals (Sweden)

    Stijak Lazar

    2014-01-01

    Full Text Available Background/Aim. The anterior cruciate ligament (ACL is the most frequently injured ligament of the knee, representing 50% of all knee injuries. The aim of this study was to determine the differences in the morphometry of knee injury patients with an intact and a ruptured anterior cruciate ligament. Methods. The study included 33 matched pairs of patients divided into two groups: the study group with the diagnosis of anterior cruciate ligament rupture, and the control group with the diagnosis of patellofemoral pain but no anterior cruciate ligament lesion. The patients were matched on the basis of 4 attributes: age, sex, type of lesion (whether it was profession- related, and whether the lesion was left- or right-sided. Measurements were carried out using magnetic resonance imaging (MRI. Results. The anterior and posterior edges of the anterior cruciate ligament in the control group were highly significantly smaller (p 0.05. The patients in the control group showed a shorter but wider anterior cruciate ligament in comparison to their matched pairs. The control group of patients was also characterized by the correlation between the width of the intercondylar notch and the width of the anterior cruciate ligament, which was not the case in the study group. Conclusions. According to the results of our study we can say that a narrow intercondylar notch contains a proportionally thin anterior cruciate ligament, but we cannot say that this factor necessarily leads to rupture of the anterior cruciate ligament.

  18. Lesão da artéria ilíaca esquerda durante laminectomia lombar: relato de caso Lesión de la arteria ilíaca izquierda durante laminectomia lombar: relato de caso Left iliac artery injury during lumbar laminectomy: case report

    Directory of Open Access Journals (Sweden)

    Wanderley Rodrigues Moreira

    2003-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Lesão da artéria ilíaca é uma ocorrência rara em laminectomias, porém, muito grave. O objetivo deste relato é apresentar um caso de lesão da artéria ilíaca esquerda, em paciente submetido a laminectomia lombar sob raquianestesia, que se manifestou clinicamente no pós-operatório imediato, sete horas após o início da cirurgia. RELATO DO CASO: Paciente do sexo masculino, estado físico ASA I, 31 anos, 68 kg, foi submetido à laminectomia lombar em decúbito ventral sob raquianestesia em L2-L3, com bupivacaína hiperbárica a 0,5% (20 mg e fentanil 25 µg. A cirurgia transcorreu normalmente e sete horas após o seu início, já no pós-operatório, o paciente apresentou hipotensão arterial, taquicardia, agitação e dor abdominal difusa. A tomografia abdominal mostrou aspecto compatível com hematoma retroperitoneal e a laparotomia exploradora revelou lesão da artéria ilíaca comum esquerda. Após a laparotomia, o paciente evoluiu bem. CONCLUSÕES: Na dependência do posicionamento e do estado físico, técnicas de anestesia geral se impõem. O caso chama atenção para o fato de que qualquer técnica anestésica que tenha sido realizada, o sangramento no campo operatório pode não ser real, na vigência de uma lesão vascular, porque este sangramento pode ser tardio. No presente caso, a manifestação clínica ocorreu sete horas após o início da cirurgia, quando o paciente já estava recuperado da anestesia. No entanto, o fenômeno (hipotensão arterial poderia ter ocorrido no per-operatório.JUSTIFICATIVA Y OBJETIVOS: Lesión de la arteria ilíaca es una ocurrencia rara en laminectomias, no obstante, muy grave. El objetivo de este relato es presentar un caso de lesión de la arteria ilíaca izquierda, en paciente sometido a laminectomia lombar sobre raquianestesia, que se manifestó clínicamente en el pós-operatorio inmediato, siete horas después del inicio de la cirugía. RELATO DEL CASO: Paciente

  19. OCLUSIÓN TOTAL CRÓNICA DEL TRONCO CORONARIO IZQUIERDO Y ESTENOSIS DE LA CORONARIA DERECHA / Chronic total occlusion of the left main coronary artery and right coronary artery stenosis

    Directory of Open Access Journals (Sweden)

    Roberto Bermúdez Yera

    2012-01-01

    Full Text Available ResumenLa estenosis del tronco coronario izquierdo se encuentra entre el 3-5 % de los pacientes a los que se les realiza una coronariografía, pero su oclusión total es rara (0,05-0,1 %. En este artículo presentamos el caso de un paciente de 42 años con oclusión total de este vaso, que presentaba además, una estenosis de 85 % en la arteria coronaria derecha y fue revascularizado quirúrgicamente de forma exitosa. Se implantaron 3 injertos, mamaria a la descendente anterior, y vena safena a una obtusa marginal y a la descendente posterior. Se presentan las imágenes angiográficas y de la cirugía, y se comentan las alternativas terapéuticas, donde lo más importante es individualizar el tratamiento, con el objetivo de brindar la mejor opción a cada paciente en particular. Para lograrlo es imprescindible una excelente relación del equipo de trabajo donde, como en este caso, el cardiólogo intervencionista y el cirujano cardiovascular se complementen, para el bien del paciente. AbstractThe left main coronary artery stenosis is found in 3-5 % of patients who undergo coronary angiography, but total occlusion is rare (0,05-0,1 %. In this article, the case of a 42-year-old patient with chronic total occlusion of the left main coronary artery is presented. This patient, who also had 85 % stenosis of the right coronary artery, was surgically and successfully revascularized. 3 grafts were implanted: mammary artery to the anterior descending artery and saphenous vein to the obtuse marginal and posterior descending artery. The angiographic and surgery images are shown, and treatment options are discussed, where the most important thing is to individualize treatment in order to provide the best option for each patient. It order to achieve this, an excellent team work is essential, in which, as in this case, the interventional cardiologist and cardiovascular surgeon complement each other for the good of the patient.

  20. Avaliação da artéria etmoidal anterior pela tomografia computadorizada no plano coronal Anterior ethmoidal artery evaluation on coronal CT scans

    Directory of Open Access Journals (Sweden)

    Soraia Ale Souza

    2009-02-01

    Full Text Available O conhecimento da localização da artéria etmoidal anterior (AEA constitui etapa importante na cirurgia do recesso do seio frontal e do etmóide anterior. A tomografia computadorizada (TC, em especial no plano coronal pode fornecer reparos anatômicos que identificam o trajeto da AEA. OBJETIVO: Identificar os reparos anatômicos que caracterizam o trajeto da AEA na parede medial da órbita e na parede lateral da fossa olfatória. Verificar a correlação entre a presença de pneumatização supra-orbitária e a visualização do etmoidal anterior (canal da AEA. CASUÍSTICA E MÉTODOS: Estudo retrospectivo de 198 tomografias computadorizadas dos seios paranasais no plano coronal do período de agosto a dezembro de 2006. RESULTADOS: Pneumatização supra-orbitária foi identificada em 35% (70 exames. O canal da AEA foi caracterizado em 41% (81 exames. O sulco etmoidal anterior foi visualizado em 98% (194 dos exames e o forame etmoidal anterior foi identificado em todos os exames (100%. CONCLUSÃO: O forame etmoidal anterior e o sulco etmoidal anterior foram referências anatômicas presentes em quase 100% dos exames avaliados. Houve correlação entre a presença de pneumatização supra-orbitária e a caracterização do canal da AEA.The anterior ethmoidal artery (AEA is an important point for frontal and ethmoid sinuses surgery. CT scans can identify landmarks to help the surgeon find the AEA. AIM: To identify the landmarks of the AEA on the orbital medial wall and on the lateral wall of the olfactory fossa. and to correlate the presence of supraorbital ethmoidal cells with spotting the anterior ethmoidal artery canal. MATERIALS AND METHODS: Retrospective review of 198 direct coronal paranasal sinuses computed tomography (CT scans from August to December, 2006. RESULTS: Supraorbital pneumatization was seen in 35% (70 scans. The AEA canal was seen in 41% (81 scans. The anterior ethmoidal sulcus was seen in 98% (194 scans and the anterior