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Sample records for arterias suprarrenales inferiores

  1. 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.

  2. PERFORATION OF INFERIOR ALVEOLAR NERVE BY MAXILLARY ARTERY. LA PERFORACION DEL NERVIO ALVEOLAR INFERIOR POR LA ARTERIA MAXILAR

    OpenAIRE

    Vanishree S Nayak; Ramachandra Bhat K; Prakash Billakanti Babu

    2011-01-01

    Infratemporal fossa is clinically important anatomical area for the delivery of local anesthetic agents in dentistry and maxillofacial surgery. Variations in the anatomy of the inferior alveolar nerve and maxillary artery were studied in infratemporal dissection. During routine dissection of the head in an adult male cadaver an unusual variation in the origin of the inferior alveolar nerve and its relationship with the surrounding structures was observed. The inferior alveolar nerve originate...

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

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

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    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.

  5. Disección espontánea de arteria ilíaca asociada a ejercicio y uso de ergotamina

    OpenAIRE

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

    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. Tratamiento híbrido de arteria subclavia derecha aberrante

    OpenAIRE

    Vargas S,Francisco; Mertens M,Renato; Sánchez C,Gonzalo; Bergoeing R,Michel; Kramer S,Albrecht; Mariné M,Leopoldo; Valdés E,Francisco

    2013-01-01

    Introducción: La arteria subclavia derecha aberrante es la malformación arterial más frecuente del arco aórtico. Su diagnóstico es habitualmente un hallazgo de estudios de imágenes solicitados por otras causas pero puede tener serias complicaciones si se obtiene en forma tardía. Caso clínico: Presentamos el caso de una mujer joven con diagnóstico de arteria subclavia lusoria dilatada sometida exitosamente a tratamiento híbrido electivo.

  7. LIGADURA DE LAS ARTERIAS ILIACAS INTERNAS (HIPOGASTRICAS) EN CIRUGIA OBSTETRICA

    OpenAIRE

    Torres A,Octavio; Bueno N,Francisco; González R,Reinaldo; Bronda M.,Alessandro

    2002-01-01

    Se presentan diez casos de ligadura de arteria hipogástrica de causa obstétrica. Describimos la técnica, se analiza las indicaciones, riesgos y complicaciones quirúrgicas. El procedimiento fue efectivo en controlar la hemorragia en todos los casos. La principal indicación fue la inercia uterina.

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

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    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.

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

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    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.

  10. Trombosis de la arteria renal en un recién nacido. Presentación de un caso y revisión

    OpenAIRE

    Ana Lucía Torres; Javier Torres; Jorge Andrés Cifuentes

    2009-01-01

    Se describe un neonato que presenta cifras tensionales elevadas y ausencia de pulsos en miembros inferiores en su cuarto día de vida después de la colocación de un catéter umbilical arterial, evidenciando trombosis en arteria aorta y renal izquierda. Se realizó gammagrafía con MAG 3 que mostró exclusión renal izquierda y angioresonancia de aorta y renal izquierda. Se inició manejo con heparina no fraccionada y estreptoquinasa durante 6 horas. Se recuperó totalmente el compromiso en miembros i...

  11. Trombosis de la arteria renal en un recién nacido. Presentación de un caso y revisión

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    Ana Lucía Torres

    2009-03-01

    Full Text Available Se describe un neonato que presenta cifras tensionales elevadas y ausencia de pulsos en miembros inferiores en su cuarto día de vida después de la colocación de un catéter umbilical arterial, evidenciando trombosis en arteria aorta y renal izquierda. Se realizó gammagrafía con MAG 3 que mostró exclusión renal izquierda y angioresonancia de aorta y renal izquierda. Se inició manejo con heparina no fraccionada y estreptoquinasa durante 6 horas. Se recuperó totalmente el compromiso en miembros inferiores, mejorando cifras tensionales a los pocos días. Estudios de seguimiento de función renal y crecimiento evidencian flujo de arteria renal izquierda y algo de función. Se describe mejoría con tratamiento anticoagulante y trombolítico de un riñón neonatal a pesar de sufrir isquemia prolongada.

  12. Trombosis de la arteria renal en un recién nacido. Presentación de un caso y revisión

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    Ana Lucía Torres

    2009-12-01

    Full Text Available Se describe un neonato que presenta cifras tensionales elevadas y ausencia de pulsos en miembros inferiores en su cuarto día de vida después de la colocación de un catéter umbilical arterial, evidenciando trombosis en arteria aorta y renal izquierda. Se realizó gammagrafía con MAG 3 que mostró exclusión renal izquierda y angioresonancia de aorta y renal izquierda. Se inició manejo con heparina no fraccionada y estreptoquinasa durante 6 horas. Se recuperó totalmente el compromiso en miembros inferiores, mejorando cifras tensionales a los pocos días. Estudios de seguimiento de función renal y crecimiento evidencian flujo de arteria renal izquierda y algo de función. Se describe mejoría con tratamiento anticoagulante y trombolítico de un riñón neonatal a pesar de sufrir isquemia prolongada.

  13. Brachiomedian artery (arteria brachiomediana revisited: a comprehensive review

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    David Kachlik

    2016-03-01

    Full Text Available 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.

  14. Bilateral inferior turbinate osteoma

    Science.gov (United States)

    Sahemey, R.; Warfield, A.T.; Ahmed, S.

    2016-01-01

    Osteomas are the most common benign osteoclastic tumours of the paranasal sinuses. However, nasal cavity and turbinate osteomas are extremely rare. Only nine middle turbinate, three inferior turbinate and one inferior turbinate osteoma cases have been reported to date. The present case report describes the management and follow-up of symptomatic bilateral inferior turbinate osteoma. A 60-year-old female presented with symptoms of bilateral nasal obstruction and right-sided epiphora. Radiological investigation found hypertrophic bony changes involving both inferior turbinates. The patient was managed successfully by endoscopic inferior turbinectomies in order to achieve a patent airway, with no further recurrence of tumour after 3 months postoperatively. To the best of our knowledge, this is the first reported case of bilateral inferior turbinate osteoma. We describe a safe and minimally invasive method of tumour resection, which has a better cosmetic outcome compared with other approaches. PMID:27534890

  15. EMBOLIZACIÓN DE ARTERIAS UTERINAS EN EL TRATAMIENTO DE MIOMAS UTERINOS SINTOMÁTICOS

    OpenAIRE

    Loyola Z,Soledad; Fava R,Mario; Macaya R,Rodrigo; MENESES Q,LUIS

    2007-01-01

    Los miomas uterinos pueden ser causa de menstruaciones abundantes y prolongadas, de síntomas por compresión de órganos vecinos e infertilidad. La embolización de arterias uterinas es una terapia mínimamente invasiva que se ha constituido en una alternativa terapéutica a la histerectomía y la miomectomía múltiple, para el tratamiento de miomas uterinos sintomáticos, en mujeres que no desean fertilidad futura. Esta consiste en ocluir ambas arterias uterinas mediante partículas, con el objetivo ...

  16. 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...

  17. Varices en Miembros Inferiores

    OpenAIRE

    Velásquez, Edna

    2015-01-01

    Insuficiencia venosa, es cuando las venas de las extremidades inferiores no son capaces de devolver al corazón toda la sangre que les llega y de hacerlo al ritmo y velocidad debidos, se puede afirmar que sufren insuficiencia venosa.

  18. Colgajo de perforante de arteria mamaria interna (IMAP en paciente con condronecrosis laríngea

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    A. Lorite-Álvaro

    2013-12-01

    Full Text Available La condronecrosis laríngea es una complicación rara y grave que aparece en pacientes sometidos a radioterapia. Presentamos el caso clínico de un paciente con condronecrosis laríngea severa tratada mediante desbridamiento y cobertura con colgajo de perforante de arteria mamaria interna (IMAP. El colgajo se basó en una perforante del segundo espacio intercostal, previa localización con doppler manual. La zona donante se cerró directamente. El colgajo fue viable en un 100%, permitió una adecuada cobertura del defecto y quedó bien adaptado al mismo. La zona donante cicatrizó sin incidencias. Consideramos que el colgajo de perforante de arteria mamaria interna pediculado permite una solución fiable y adecuada para pacientes con condronecrosis laríngea postradioterapia.

  19. Tabaquismo materno: impacto sobre el neonato, placenta y reactividad de la arteria umbilical

    OpenAIRE

    Morales, Silvina; Iveli, María Florencia; Rimorini, Laura; Roldán Palomo, Rocío; Enrique, Nicolás; Salemme, Silvia; Cecotti, Norma; Rebolledo, Alejandro; Apezteguia, María; Milesi, Verónica

    2008-01-01

    Introducción: el fumar tabaco durante el embarazo aumenta los riesgos en la salud materno-infanto juvenil provocando múltiples alteraciones atribuidas a la nicotina y al monóxido de carbono producidos por el cigarrillo. Objetivos: estudiar las consecuencias del tabaquismo materno sobre el recién nacido (RN), la placenta y la respuesta contráctil a la nicotina de la arteria umbilical (AU) "in vitro". Metodología: dos grupo...

  20. Gases en sangre de arteria umbilical de neonatos a término en altura

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    Wilfredo Villamonte

    Full Text Available Con el objetivo de determinar los valores normales de gases en sangre en la arteria umbilical de neonatos a término a 3400 m de altitud se hizo un estudio transversal, realizado en la sangre de la arteria umbilical de 300 neonatos a término, adecuados para la edad gestacional y cuyo parto se dio entre enero de 2010 a diciembre de 2011 en el Hospital Nacional Adolfo Guevara Velazco de EsSalud (Cusco, Perú. Se encontró que la media del pH de neonatos sanos a término fue de 7,33 ± 0,07, los valores para los percentiles 5 y 95 fueron 7,18 y 7,40 respectivamente. En conclusión, se han construido las tablas con los percentiles 5 al 95 para el pH, pO2, pCO2, SO2, p50, exceso de bases y HCO3, de la arteria umbilical de neonatos a término a 3400 m de altitud

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

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    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.

  2. Origen anómalo de la arteria coronaria izquierda originándose de la arteria pulmonar. Reporte de caso y revisión de literatura

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    José Jiménez Vega

    2007-01-01

    Full Text Available Se presenta el caso de un lactante de 2 meses de edad que consultó por tos y dificultad respiratoria; al ser admitido en el servicio de urgencias, el abordaje inicial fue de una infección respiratoria baja (bronquiolitis pero la evolución tórpida y la presencia de cardiomegalia hizo sospechar una cardiopatía, diagnosticándose origen anómalo de la arteria coronaria izquierda que nace de la arteria pulmonar, la cual fue tratada quirúrgicamente con resultado favorable.2 month old male who was brought to the emergency department with a history of non productive cold, was noticed with difficulty breathing. He was admitted with the possible diagnosis of bronquioloitis. The poor evolution of the patient, and the presence of cardiomegaly, made the physicians look for a cardiopathy, and a diagnosis of anomalous left coronary artery from the pulmonary artery was made. He was stabilized and then was taken to the operating room and had his anomalous coronary artery reimplanted to his aorta

  3. El origen anatómico de la arteria coronaria septal del hámster sirio es un carácter heredable

    OpenAIRE

    Soto Navarrete, María Teresa; Arqué Gibernau, José M; Durán Boyero, Ana Carmen; Fernández Domínguez, María Carmen; Fernández Corujo, Borja; Lorenzale García, Miguel; Sans-Coma, Valentín

    2016-01-01

    Introducción y objetivos: En los roedores, incluidos los empleados en el laboratorio, las arterias coronarias son intramiocárdicas. Normalmente se distinguen 3 arterias coronarias, la derecha, que irriga el corazón derecho, la izquierda, que irriga el corazón izquierdo, y la septal, que irriga el septo interventricular. En el hámster sirio, una especie empleada como modelo en estudios sobre anomalías congénitas de las arterias coronarias, la arteria septal se origina de la coronaria derecha o...

  4. Incarcerated inferior lumbar (Petit's) hernia.

    Science.gov (United States)

    Astarcioğlu, H; Sökmen, S; Atila, K; Karademir, S

    2003-09-01

    Petit's hernia is an uncommon abdominal wall defect in the inferior lumbar triangle. Colonic incarceration through the inferior lumbar triangle, which causes mechanical obstructive symptoms, necessitates particular diagnostic and management strategy. We present a rare case of inferior lumbar hernia, leading to mechanical bowel obstruction, successfully treated with prosthetic mesh reinforcement repair.

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

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    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. Isolated inferior mesenteric portal hypertension with giant inferior mesenteric vein and anomalous inferior mesenteric vein insertion

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    G Raghavendra Prasad

    2013-01-01

    Full Text Available Extrahepatic portal hypertension is not an uncommon disease in childhood, but isolated inferior mesenteric portal varices and lower gastrointestinal (GI bleed have not been reported till date. A 4-year-old girl presented with lower GI bleed. Surgical exploration revealed extrahepatic portal vein obstruction with giant inferior mesenteric vein and colonic varices. Inferior mesenteric vein was joining the superior mesenteric vein. The child was treated successfully with inferior mesenteric - inferior vena caval anastomosis. The child was relieved of GI bleed during the follow-up.

  7. Colgajo de perforante de arteria mamaria interna (IMAP) en paciente con condronecrosis laríngea

    OpenAIRE

    2013-01-01

    La condronecrosis laríngea es una complicación rara y grave que aparece en pacientes sometidos a radioterapia. Presentamos el caso clínico de un paciente con condronecrosis laríngea severa tratada mediante desbridamiento y cobertura con colgajo de perforante de arteria mamaria interna (IMAP). El colgajo se basó en una perforante del segundo espacio intercostal, previa localización con doppler manual. La zona donante se cerró directamente. El colgajo fue viable en un 100%, permitió una adecuad...

  8. SIGNIFICADO CLÍNICO DEL DOPPLER PATOLÓGICO EN LA ARTERIA CEREBRAL MEDIA EN FETOS DEL TERCER TRIMESTRE

    OpenAIRE

    2010-01-01

    Antecedentes: La flujometría Doppler fetal es usada de forma rutinaria y sistemática. Es incierta la utilidad clínica del Doppler de la arteria cerebral media (ACM) en fetos del tercer trimestre con crecimiento normal. Objetivo: Determinar los resultados perinatales en fetos del tercer trimestre con índice de pulsatilidad (IP) de la arteria cerebral media (ACM) bajo el percentil 5 comparado con fetos con Doppler cerebral normal. Método: Estudio de cohorte retrospectivo en fetos del tercer tri...

  9. Reembolización de arterias uterinas por hemorragia posparto en una segunda gestación

    OpenAIRE

    López V,Nuria; Vegas G,Gabriel; Arrieta B,Sara; Iglesias S,Carlos; González G,Antonio

    2012-01-01

    La hemorragia posparto es la principal causa de muerte obstétrica. Presentamos el caso de una gestación y parto normales tras la embolización bilateral de ambas arterias uterinas, por hemorragia posparto en la gestación anterior. La paciente requirió de una nueva embolización bilateral de arterias uterinas en esta segunda gestación con buen resultado obstétrico. La embolización arterial pélvica en el manejo de la hemorragia posparto refractaria al tratamiento médico, permite en ocasiones evit...

  10. Anatomía de la arteria temporal superficial: importancia quirúrgica: estudio piloto en cadáveres

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    J.J. Pradel-Mora

    2015-03-01

    Full Text Available El conocimiento preciso de los patrones vasculares permite mejorar los resultados de la reconstrucción regional del pabellón auricular y el diseño de colgajos regionales dependientes de la arteria temporal superficial para la reconstrucción facial. En México, no contamos en la actualidad con descripciones anatómicas de las variantes vasculares normales de la arteria temporal superficial. El objetivo de este trabajo es la descripción de las variantes anatómicas de la arteria temporal superficial a través de la disección de este vaso en 12 regiones tempo-parieto-occipitales en cadáveres. Nuestros resultados muestran que la arteria temporal superficial siempre se divide en dos ramas, una anterior y otra posterior, la distribución de ésta se sitúa en el cuarto más posterior de la región temporal, con una bifurcación alta. La distribución de la anatomía vascular, tomando en cuenta el calibre mayor de la arteria temporal superficial con respecto a la arteria auricular posterior, la ausencia de esta última en 4 de las regiones estudiadas, así como la distancia de dichos vasos con respecto al conducto auditivo externo, sugieren que en nuestra población la irrigación del pabellón auricular depende de la arteria temporal superficial, restándole importancia a la aportación del riego sanguíneo de esta región por parte de la arteria auricular posterior. Nuestro estudio arroja resultados que indican la existencia de variaciones importantes en la anatomía vascular regional que justifican la realización de estudios posteriores que permitan una descripción mas detallada de la misma para aumentar el éxito de las intervenciones quirúrgicas.

  11. Fontan pulsátil: Oclusión transcatéter de la arteria pulmonar permeable: Seguimiento a mediano plazo

    OpenAIRE

    Gamboa,Ricardo; Francisco P. Mollón; Ríos Méndez,Raúl E; Cayré,Raúl O; Cazzaniga,Mario; Arroyo,Graciela M; Gutiérrez,Diego F

    2008-01-01

    Objetivo: Reportamos la oclusión percutánea de la arteria pulmonar con flujo residual en pacientes con circuito tipo Fontan. Método: Niños de 9 y 11 años, SaO2 de 88 y 96% respectivamente, uno de ellos con cefalea y clase funcional II, ambos con anastomosis cavopulmonar total con tubo extracardíaco fenestrado y arteria pulmonar permeable (Fontan pulsátil). Un Amplatzer duct-occluder fue implantado en la arteria pulmonar ingresando desde la vena femoral. Control clínico, por imágenes y cateter...

  12. 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.

  13. Fibular free flap with arteria peronea magna: the role of preoperative balloon occlusion.

    Science.gov (United States)

    Rahmel, Benjamin B; Snow, Thomas M; Batstone, Martin D

    2011-03-01

    The free fibular osteocutaneous flap is a commonly used donor for reconstruction of mandibular defects. Vascular abnormalities and leg trauma are relative contraindications to the use of a fibular free flap. Peroneal arteria magna (PAM) is one such vascular abnormality that may preclude the use of the graft due to the high risk of lower-limb ischemia. Lower-limb angiography is the standard for assessing the lower-limb vascular anatomy; however, the indications remain controversial. Although balloon occlusion has been used to assess the vascular supply in distal bypass surgery, there have no reported cases of balloon occlusion to assess the viability of the distal extremity with PAM. Intraoperative assessment of vascular anatomy with an aborted harvest can lead to significant morbidity and cost. Balloon occlusion provides a relatively safe and minimally invasive technique for assessment of potential lower-limb ischemia in patients with PAM.

  14. Efecto de la endotelina-1 sobre las arterias tumorales de pacientes con neoplasia colorrectal Effect of endothelin-1 on tumor arteries in patients with colorectal cancer

    Directory of Open Access Journals (Sweden)

    E. Ferrero Herrero

    2008-06-01

    Full Text Available La endotelina-1 es un péptido vasoconstrictor producido por el endotelio vascular, cuyos niveles plasmáticos están aumentados en los pacientes con cáncer colorrectal y que puede participar en la regulación del flujo sanguíneo tumoral. Para estudiar si la respuesta a este péptido está alterada en las arterias tumorales, se obtuvieron, de 13 pacientes intervenidos quirúrgicamente por cáncer colorrectal, arterias mesentéricas irrigando el tumor y arterias mesentéricas de una región alejada del tumor, y asimismo se obtuvieron arterias mesentéricas de pacientes intervenidos por diverticulitis (n = 4 o enfermedad inflamatoria intestinal (n = 3. Las arterias mesentéricas se montaron en una preparación para el registro de la contracción isométrica en un baño de órganos, encontrándose que la endotelina-1 producía contracción en los tres tipos de arterias, pero la sensibilidad a este péptido fue mayor en las arterias irrigando el tumor que en las arterias alejadas del tumor o en las arterias de pacientes sin patología tumoral. Estos resultados indican que la endotelina-1 puede regular el flujo sanguíneo en los tumores colorrectales, produciendo una mayor vasoconstricción en las arterias que irrigan el tumor que en las arterias no tumorales.Endothelin-1 is an endothelium-derived vasoconstrictor peptide whose plasma levels are increased in patients with colorectal cancer, and which may be involved in tumor blood flow regulation. To study whether response to this peptide is altered in tumor arteries, mesenteric arteries supplying blood flow to colorectal tumors, and mesenteric arteries far from said tumors were obtained from 13 patients undergoing colectomy; mesenteric arteries were also obtained from patients with diverticulitis (n = 4 or inflammatory bowel disease (n = 3. Arteries were prepared for isometric tension recording in an organ bath, and in this preparation it was found that endothelin-1 induced contraction in all three

  15. Bypass coronario en un paciente con oclusión de la arteria iliaca izquierda: Precauciones a tomar en cuenta.

    OpenAIRE

    2015-01-01

    Se presenta el caso de un paciente varón de 82 años con Insuficiencia Cardiaca Congestiva (Fracción de Eyección de 20%) y Edema Agudo de Pulmón secundarios a Infarto Agudo de Miocardio extenso que requería cirugía de Bypass Coronario. Además, presentaba Enfermedad Oclusiva Aortoiliaca crónica con  oclusión total de la Arteria Iliaca Izquierda dependiente de circulación colateral a través de la Arteria Mamaria Interna Izquierda. Se decidió realizar la cirugía de bypass coronario sin utilizar di...

  16. Aneurysmatic dissection of an aberrant right subclavian artery; Disseziierendes Aneurysma einer aberranten Arteria subclavia dextra: Diagnose mittels Ultrafast-CT

    Energy Technology Data Exchange (ETDEWEB)

    Reittner, P. [Universitaetsklinik fuer Radiologie, Graz (Austria). Abt. fuer Allgemeine Radiologie; Stacher, R. [Universitaetsklinik fuer Radiologie, Graz (Austria). Abt. fuer Allgemeine Radiologie

    1996-01-01

    Diagnosis with Ultrafast-CT: An aneurysm of an aberrant right subclavian artery is a very rare cause for dysphagia. We describe such a case in a 67-year-old patient, diagnosed with Ultrafast-CT and discuss it together in concert with the embryology and the radiological findings. (orig.) [Deutsch] Eine aberrierende Arteria subclavia dextra ist eine seltene Ursache fuer Dysphagie. Anhand eines 67jaehrigen Patienten werden Embryologie und radiologische Charakteristika, diagnostiziert mittels Ultrafast-CT, diskutiert. (orig.)

  17. 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

  18. Noninverted images in inferior mirages

    NARCIS (Netherlands)

    van der Werf, S.Y.

    2011-01-01

    Inferior mirages over sun-exposed roads often appear in isolated strips at their near sides and the reflected scenery exhibits multiple images. This effect is explained as due to slight undulations of the road's surface. At the same time, some of these images, although they are reflections, are not

  19. Planificación preoperatoria de los colgajos de perforantes de la arteria epigàstrica inferior profunda (DIEP) mediante el estudio con el TAC de multidetectores

    OpenAIRE

    Masià Ayala, J. Jaume

    2009-01-01

    Tesis Doctoral realizada como compendio de publicaciones, basada en 6 trabajos: 1 capitulo de un libro publicado en USA (Perforator Flaps: Anatomy, Techniques. QMP 2006), 4 articulos publicados en las revistas de cirugía plástica con mayor factor de impacto (J Plast Reconstr Aesthetic Surg, Cir Plas Iberolatinoam, Ann Plast Surg, Plast Reconstr Surg) y 1 articulo publicado en una revista de radiología (Am J Roentgenol). Por su versatilidad, menor morbilidad y óptimos resultados, los colgajos ...

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

    Directory of Open Access Journals (Sweden)

    María L. Talavera

    2011-10-01

    Full Text Available 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 muestran la relación entre la angina de pecho y la compresión del TCI en pacientes con HP asociada a cardiopatías congénitas, tratados mediante implante de stent coronario.

  1. Endovascular Management of the Arteria Profunda Femoralis: Long-Term Angiographic and Clinical Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Karnabatidis, Dimitrios, E-mail: karnaby@med.upatras.gr; Spiliopoulos, Stavros; Pastromas, Georgios; Katsanos, Kostantinos; Siablis, Dimitrios [Patras University Hospital, School of Medicine, Department of Diagnostic and Interventional Radiology (Greece)

    2012-10-15

    Purpose: This study was designed to investigate the long-term angiographic and clinical outcomes of percutaneous transluminal angioplasty (PTA) of the arteria profunda femoralis (PFA), in a series of patients suffering from critical limb ischemia (CLI) or severe intermittent claudication (IC). Methods: Our department's database was searched to identify patients who underwent PTA or bail-out stenting of the PFA. Among the study's inclusion criteria were Rutherford categories 3-6 and {>=}70% stenosis of the PFA. Only de novo stenotic lesions were assessed. Primary endpoints were technical success, angiographic lesion primary patency, angiographic binary in-lesion restenosis, and target lesion recanalization (TLR) rates. Secondary endpoints included patient survival, limb salvage, and complication rates. Patient's baseline demographics, lesion, and procedural details were analyzed. Results: Between 2001 and 2011, 20 consecutive patients (17 males) with a mean age of 73 {+-} 9 (range 53-87) years underwent PTA or bail-out stenting in 23 PFA lesions. Critical limb ischemia was the indication in eight of 20 patients (40%). The mean lesion length was 31 {+-} 9.5 mm. The procedural technical success was 100% (23/23), whereas mean time angiographic and clinical follow-up was 26.8 {+-} 24.6 months. According to the Kaplan-Meier analysis, primary patency and binary restenosis rate were 95 and 86.1% respectively up to 8 years follow-up. No TLR procedures were performed. The 8-year patient survival and limb salvage rates were 87.5 and 84.7% respectively. Conclusions: PTA or stenting of focal, stenotic, PFA lesions, in patients suffering from CLI or IC, exhibit high long-term primary patency rates, as well as low binary restenosis and TLR rates. Large, multicenter studies are required to validate these results.

  2. 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.

  3. 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.

  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. ISOINMUNIZACION Rh: EVALUACION DE LA UTILIDAD DEL DOPPLER DE ARTERIA CEREBRAL MEDIA EN LA PREDICCION Y MANEJO DE ANEMIA FETAL

    OpenAIRE

    2003-01-01

    Se presenta la experiencia en el manejo de pacientes altamente sensibilizadas por incompatibilidad Rh, analizando la utilidad de la evaluación de la velocidad circulatoria fetal, por Doppler-color, a través de la medición de la velocidad máxima sistólica (VMS) de la arteria cerebral media (ACM). Se realizan 19 transfusiones intravasculares en 3 casos afectados por esta enfermedad. En 14 de ellas se encontró anemia fetal moderada o leve, la que fue diagnosticada correctamente en 13 oportunidad...

  6. Origen anómalo de la arteria pulmonar derecha y estenosis de vena pulmonar superior izquierda

    OpenAIRE

    Patiño Bahena,Emilia; Calderón-Colmenero,Juan; Ramírez,Samuel; García Montes,José Antonio; Meave, Aloha; Erdmenger,Julio; Zabal,Carlos; Buendía,Alfonso

    2006-01-01

    Se presenta una niña de 9 meses con historia de cianosis desde el período neonatal, la valoración cardiológica integral que incluyó angiocardiografía y angiorresonancia magnética estableció los siguientes diagnósticos: Origen anómalo de la rama derecha de la arteria pulmonar naciendo de la aorta ascendente, estenosis de vena pulmonar superior derecha, persistencia del conducto arterioso e hipertensión arterial pulmonar a nivel sistémico. Se llevó a cirugía correctiva de todos los defectos de ...

  7. Tratamiento quirúrgico del síndrome de atrapamiento de arteria poplítea : nuestra experiencia

    OpenAIRE

    Merino Díaz, B.; Salvador Calvo, Roberto; Revilla Calavia, Álvaro; Carpintero Mediavilla, L.; González Fajardo, José Antonio; Vaquero Puerta, Carlos

    2013-01-01

    Producción Científica El síndrome de atrapamiento de la arteria poplítea (SAAP) es una entidad poco frecuente cuya incidencia varía del 0,17 al 3,5 %. Objetivo: Revisamos a los pacientes tratados quirúrgicamente en nuestro servicio durante los últimos 15 años. Material y métodos: Estudio retrospectivo entre 1995 y 2009, en que se registraron variables demográfi cas, comorbilidad, clínica, exploración física, pruebas complementarias, tratamiento quirúrgico realizado, así c...

  8. 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...

  9. Anatomía del corazón y las arterias branquiales aferentes de las rayas (Chondrichthyes: Batoidea)

    OpenAIRE

    Abraham Kobelkowsky

    2012-01-01

    Se selecionó el corazón y el sistema branquial aferente de Dasyatis sabina como patrón morfológico de los Batoidea. Se compararon las cámaras del corazón y la ramificación de la aorta ventral en las arterias branquiales aferentes con las correspondientes de especies representativas de otras familias de batoideos, tales como: Narcine brasiliensis (Narcinidae), Rhinobatos lentiginosus (Rhinobatidae), Raja texana (Rajidae), Urobatis jamaicensis (Urolophidae), Gymnura micrura (Gymnuridae) y Mylio...

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

    OpenAIRE

    Tania Buccolini; Alberto Surur; Silvio Marchegiani; Luis Torrens; Claudia Bernal; Norberto Allende

    2010-01-01

    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 claudic...

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

    OpenAIRE

    Andrés J. Schlichter; María I. Román; Christian Kreutzer; Ignacio Lugones

    2010-01-01

    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 izquier...

  12. Tuberculosis pulmonar de campos inferiores

    OpenAIRE

    Alejandra González; Marcelo Fernández Casares; Matías Baldini; Alfredo Monteverde

    2010-01-01

    La tuberculosis (TB) que compromete sólo los campos pulmonares inferiores (TBCI) es poco frecuente en el adulto y en general está asociada a alguna causa de inmunodepresión. El objetivo de nuestro trabajo fue determinar la incidencia de TBCI en nuestra población y comparar sus características respecto de la TB pulmonar de localización habitual. Se estudiaron en forma retrospectiva en el período de 2004 a 2008, 42 pacientes con TBCI que fueron comparados con 84 pacientes con TB pulmonar de loc...

  13. ¿Tanta importancia tiene pasar por alto la arteria umbilical única?: Comentarios a partir de una sentencia judicial

    Directory of Open Access Journals (Sweden)

    A. Ortega Pérez

    2004-07-01

    Full Text Available El Tribunal Supremo ha condenado a varios obstetras por informar que el cordón umbilical tenía los tres vasos, desactivando así la búsqueda de enfermedades fetales que la arteria umbilical única (AUU habría desencadenado. La condena será éticamente correcta si la AUU está realmente asociada a tales enfermedades. En la población general se detecta un caso de AUU en cada 320 fetos estudiados ecográficamente. En el 68 % de esas detecciones se tratará de un hallazgo aislado, pero aún así aumenta el riesgo de parto prematuro, de peso bajo y de mortalidad perinatal. Por otra parte, el 17 % de estos fetos tendrán, además de la arteria única, cromosomopatías y el 31 % malformaciones anatómicas. Concluyendo, la AUU es realmente un marcador cardinal de riesgo de trastornos fetales, que debe buscarse activamente durante el seguimiento ecográfico del embarazo.

  14. Tuberculosis pulmonar de campos inferiores

    Directory of Open Access Journals (Sweden)

    Alejandra González

    2010-10-01

    Full Text Available La tuberculosis (TB que compromete sólo los campos pulmonares inferiores (TBCI es poco frecuente en el adulto y en general está asociada a alguna causa de inmunodepresión. El objetivo de nuestro trabajo fue determinar la incidencia de TBCI en nuestra población y comparar sus características respecto de la TB pulmonar de localización habitual. Se estudiaron en forma retrospectiva en el período de 2004 a 2008, 42 pacientes con TBCI que fueron comparados con 84 pacientes con TB pulmonar de localización habitual (grupo control. Se excluyeron pacientes con HIV. La TBCI representó el 6% del total de TB pulmonar. No se encontraron diferencias significativas en cuanto a edad, sexo, presencia de cavidades en la radiografía, días de evolución y nivel de albúmina. La TBCI tuvo significativamente mayor proporción de comorbilidades (p < 0.001, presencia de condensación (p < 0.001 y compromiso unilateral (p < 0.001 en la radiografía de tórax, junto con mayor número de internaciones (p = 0.02. Cabe destacar que sólo16 de los 42 pacientes con TBCI (38% tenían alguna comorbilidad demostrada. La TBCI puede presentarse aun sin comorbilidades asociadas y debe sospecharse en neumonías de evolución tórpida independientemente de su localización.

  15. Defining the non-inferiority margin and analyzing non-inferiority: An overview.

    Science.gov (United States)

    Althunian, Turki A; de Boer, Anthonius; Groenwold, Rolf H H; Klungel, Olaf H

    2017-03-02

    Non-inferiority trials are used to assess whether the effect of a new drug is not worse than an active comparator by more than a non-inferiority margin. If the difference between the new drug and the active comparator does not exceed this pre-specified margin, non-inferiority can be concluded. This margin must be specified based on clinical and statistical reasoning; however, it is considered as one the most challenging step in the design of non-inferiority trials. Regulators recommend that the margin should be defined based on the historical evidence of the active comparator (the latter is often the well-established standard treatment of the disease), which can be performed by different approaches. There are several factors and assumptions that need to be accounted for during the process of defining the margin and during the analysis of non-inferiority. Three methods are commonly used to analyze non-inferiority trials: the fixed-margin method, the point-estimate method, and the synthesis method. This article provides an overview of analyzing non-inferiority inferiority and choosing the non-inferiority margin.

  16. Clinical studies on inferior right hepatic veins

    Institute of Scientific and Technical Information of China (English)

    Xue Xing; Hong Li; Wei-Guo Liu

    2007-01-01

    BACKGROUND:Many small veins are called accessory, short hepatic veins in addition to the right, middle and left hepatic veins. The size of these veins varied from a pinhole to 1 cm; the size of inferior right hepatic veins (IRHVs) is thicker than that of short hepatic veins or more than 1 cm occasionally. Adults have a higher incidence rate of the IRHV. DATA SOURCES:A literature search of the PubMed database was conducted and research articles were reviewed. RESULTS:The size of IRHVs is related to the size of the right hepatic vein, i.e. the larger the diameter of the right hepatic vein, the smaller the diameter of the IRHVs, and vice versa. The IRHVs are divided into superior, medial and inferior groups, separately named the superior, medial and inferior right hepatic veins according to the position of the IRHV entering the inferior vena cava. The superior right hepatic vein mainly drains the superior part of segmentⅦ, and the medial right hepatic vein drains the middle part of segmentⅦ. A thicker IRHV mainly drains segmentⅥ and the inferior part of segmentⅦ and a thinner IRHV drains the inferior part of segmentⅤ. CONCLUSIONS:The clinical signiifcance of these studies on IRHVs is varied: (1) Hepatic caudate lobe resection could be introduced after study on the veins of that lobe. (2) It is very important to identify the draining region of the IRHV for guiding hepatic segmentectomy. The postero-inferior area of the right lobe can be preserved along with the hypertrophic IRHV even if the entire main right hepatic vein is resected during segmentectomy ofⅦ andⅧwith right hepatic vein resection for patients with primary liver cancer. (3) The ligation of the major hepatic vein for the treatment of juxtahepatic vein injury is recommended because of severe hemorrhagic shock and dififculty in

  17. 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

  18. Functional organization of the left inferior precentral sulcus: dissociating the inferior frontal eye field and the inferior frontal junction.

    Science.gov (United States)

    Derrfuss, J; Vogt, V L; Fiebach, C J; von Cramon, D Y; Tittgemeyer, M

    2012-02-15

    Two eye fields have been described in the human lateral frontal cortex: the frontal eye field (FEF) and the inferior frontal eye field (iFEF). The FEF has been extensively studied and has been found to lie at the ventral part of the superior precentral sulcus. Much less research, however, has focused on the iFEF. Recently, it was suggested that the iFEF is located at the dorsal part of the inferior precentral sulcus. A similar location was proposed for the inferior frontal junction area (IFJ), an area thought to be involved in cognitive control processes. The present study used fMRI to clarify the topographical and functional relationship of the iFEF and the IFJ in the left hemispheres of individual participants. The results show that both the iFEF and the IFJ are indeed located at the dorsal part of the inferior precentral sulcus. Nevertheless, the activations were spatially dissociable in every individual examined. The IFJ was located more towards the depth of the inferior precentral sulcus, close to the junction with the inferior frontal sulcus, whereas the iFEF assumed a more lateral, posterior and superior position. Furthermore, the results provided evidence for a functional double dissociation: the iFEF was activated only in a comparison of saccades vs. button presses, but not in a comparison of incongruent vs. congruent Stroop conditions, while the opposite pattern was found at the IFJ. These results provide evidence for a spatial and functional dissociation of two directly adjacent areas in the left posterior frontal lobe.

  19. Stentimplantation zur Behandlung von langstreckigen Verschlüssen der Arteria femoralis superficialis beidseites - Fallbericht eines Patienten mit Claudicatio intermittens

    Directory of Open Access Journals (Sweden)

    Schillinger M

    2004-01-01

    Full Text Available Die Einführung von selbstexpandierbaren Nitinol-Stents hat das Spektrum der endovaskulären Behandlungsmöglichkeiten im femoropoplitealen Stromgebiet deutlich erweitert. Die Ergebnisse der alleinigen Ballonangioplastie bei langstreckigen, ausgeprägt verkalkten Arteria femoralis superficialis (AFS-Verschlüssen sind erfahrungsgemäß schlecht, sodaß bei Claudicatio-Symptomatik meist entweder eine konservativ-medikamentöse Behandlung oder eine Bypass-Operation favorisiert werden. Mit der Applikation von Stainless-steel-Stents konnten zwar die initialen Resultate verbessert werden, aufgrund von häufig massiver neointimaler Proliferation waren jedoch die Langzeitergebnisse weiterhin nicht zufriedenstellend. Die Offenheitsraten von Nitinol-Stents im femoropoplitealen Bereich scheinen jedoch vielversprechend, sodaß diese Stents auch bei langstreckigen AFS-Verschlüssen bei Patienten mit Claudicatio intermittens zum Einsatz kommen könnten. Wir berichten hier über einen Patienten mit klinischen Beschwerden der Claudicatio intermittens im Stadium Fontaine IIb (Gehstrecke unter 200 m mit beidseits langstreckigen, ausgeprägt verkalkten AFS-Verschlüssen, die erfolgreich mit langstreckiger Stentimplantation therapiert werden konnten.

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

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    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. 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

  2. Lateralization Technique and Inferior Alveolar Nerve Transposition

    Directory of Open Access Journals (Sweden)

    Angélica Castro Pimentel

    2016-01-01

    Full Text Available Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics.

  3. Lateralization Technique and Inferior Alveolar Nerve Transposition

    Science.gov (United States)

    Sanches, Marco Antonio; Ramalho, Gabriel Cardoso; Manzi, Marcello Roberto

    2016-01-01

    Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics. PMID:27433360

  4. Portal Decompression Using the Inferior Mesenteric Vein

    Directory of Open Access Journals (Sweden)

    Paolo Gorini

    1998-01-01

    Full Text Available We report five patients with variceal hemorrhage, in three cases secondary to diffuse thrombosis of the portal, superior mesenteric and splenic veins. Mesenteric angiography demonstrated patency of the inferior mesenteric vein (IMV in each, and successful portal decompression by anastomosis of the IMV to the left renal vein (n=4 or the inferior vena cava (n=1 was accomplished. Bleeding was permanently controlled: four patients have survived from one to eight years post-operatively. Because shunt procedures utilizing the IMV are technically straightforward, subtotally decompress the portal system and avoid the right upper quadrant, they may be advantageous in certain clinical settings.

  5. Functional organization of the left inferior precentral sulcus: dissociating the inferior frontal eye field and the inferior frontal junction

    NARCIS (Netherlands)

    Derrfuss, J.; Vogt, V.L.; Fiebach, C.J.; Cramon, D.Y. von; Tittgemeyer, M.

    2012-01-01

    Two eye fields have been described in the human lateral frontal cortex: the frontal eye field (FEF) and the inferior frontal eye field (iFEF). The FEF has been extensively studied and has been found to lie at the ventral part of the superior precentral sulcus. Much less research, however, has focuse

  6. COMPARISON OF PARTIAL INFERIOR TURBINECTOMY AND SUBMUCOSAL DIATHERMY FOR HYPERTROPHIED INFERIOR TURBINATE IN ALLERGIC RHINITIS PATIENTS

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    Smitha Chandra

    2015-07-01

    Full Text Available BACKGROUND : The inferior turbinate is the first point of contact of allergen in the nose. In patients with allergic rhinitis the turbinate hypertrophies and its mucosa becomes purplish edematous. This leads to significant obstruction of airway. Hence reduction of this hypertrophied inferior turbinate is essential. AIM: To analyze & evaluate the efficacy of sub mucosal diathermy and partial inferior turbinectomy in the treatment of symptomatic hypertrophied inferior turbinates in allergic rhinitis patients in a rural setup. METHODS AND MATERIAL S: A prospective clinical study of 132 patients between age group of 15 - 55 years of eith er sex were enrolled in the study with bilateral Inferior. Turbinate Hypertrophy who had history of failed medical line of treatment. After informing , the patients were randomized into two groups to eliminate bias byallotting them alternately into the groups. Patients in Group I underwent. Submucosal diathermy and Group II patients underwent Partial Inferior. Turbinectomy. Postoperative follow up was done at regular intervals by objective& subjective assessment. STATISTICAL ANALYSIS USED: Friedman test and Ch i Square test were used for statistical analysis. RESULTS: In group I significant improvement of nasal airflow was seen in 14% patients & 85.9% had moderate improvement. In group II 41.3% of patients had significant improvement & 58.6% had moderate i mprovement. Statistically by analyzing the ranks of subjective nasal obstruction and objective nasal obstruction of Group - I & Group - IIwe conclude that Group - II subjects showed more improvement than Group I. CONCLUSIONS: Various surgical methods have been t ried for enlarged inferior turbinate secondary to allergic rhinitis. Of them the well - known techniques are s ubmucosal Diathermy & Partial Inferior Turbinectomy. In this study Partial Inferior Turbinectomy was found to be more effective in relieving nasal ob structionin allergic rhinitis patients for

  7. A case of inferior lumbar hernia

    Directory of Open Access Journals (Sweden)

    Vidhyasagar M. Sharma

    2013-02-01

    Full Text Available In this article we report a case of inferior lumbar hernia. The patient underwent preperitoneal meshplasty. The patient is well on follow up with no recurrence. The relevant literature has been reviewed and management discussed in brief. [Int J Res Med Sci 2013; 1(1.000: 33-35

  8. Iatrogenic injury to the inferior alveolar nerve

    DEFF Research Database (Denmark)

    Hillerup, Søren

    2008-01-01

    The purpose of this prospective, non-randomised, descriptive study is to characterise the neurosensory deficit and associated neurogenic discomfort in 52 patients with iatrogenic injury to the inferior alveolar nerve (IAN). All patients were examined and followed up according to a protocol assess...

  9. ADAPTACIÓN DEL ALGORITMO MARACAS PARA SEGMENTACIÓN DE LA ARTERIA CARÓTIDA Y CUANTIFICACIÓN DE ESTENOSIS EN IMÁGENES TAC

    Directory of Open Access Journals (Sweden)

    MARIA A. ZULUAGA

    2010-01-01

    Full Text Available En este artículo se describen las adaptaciones hechas al algoritmo MARACAS para seg- mentar y cuantificar estructuras vasculares en imágenes TAC de la arteria carótida. El al- goritmo 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 proce- samientos 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 es- tenosis. 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 con- curso 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 cuantifi- cación de estenosis fue 14,4%.

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

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    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.

  11. Colgajo libre córtico-perióstico de la arteria genicular descendente en el tratamiento de la seudoartritis distal de tibia

    OpenAIRE

    2010-01-01

    Presentamos un caso de un varón de 35 años con pseudoartrosis aséptica de tibia distal con escaso defecto óseo, intervenido previamente mediante recambio del material de osteosíntesis e injerto de cresta iliaca, que fracasó. Tras estudio de las diferentes opciones de tratamiento, se le propuso estabilizar el foco mediante enclavado endomedular y aumentar la capacidad osteogénica con un colgajo córtico-perióstico de la arteria genicular descendente, según la técnica de Sakai. Discusión: El man...

  12. 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

  13. The bihemispheric posterior inferior cerebellar artery

    Energy Technology Data Exchange (ETDEWEB)

    Cullen, Sean P. [Brigham and Women' s Hospital and Children' s Hospital, Department of Radiology and Neurosurgery, Boston, MA (United States); Ozanne, Augustin; Alvarez, Hortensia; Lasjaunias, Pierre [Service de Neuroradiologie Diagnostic et Therapeutique, Hopital de Bicetre-Universite Paris-sud Orsay (France)

    2005-11-01

    Rarely, a solitary posterior inferior cerebellar artery (PICA) will supply both cerebellar hemispheres. We report four cases of this variant. We present a retrospective review of clinical information and imaging of patients undergoing angiography at our institution to identify patients with a bihemispheric PICA. There were four patients: three males and one female. One patient presented with a ruptured arteriovenous malformation, and one with a ruptured aneurysm. Two patients had normal angiograms. The bihemispheric PICA was an incidental finding in all cases. The bihemispheric vessel arose from the dominant left vertebral artery, and the contralateral posterior inferior cerebellar artery was absent or hypoplastic. In all cases, contralateral cerebellar supply arose from a continuation of the ipsilateral PICA distal to the choroidal point and which crossed the midline dorsal to the vermis. We conclude that the PICA may supply both cerebellar hemispheres. This rare anatomic variant should be considered when evaluating patients with posterior fossa neurovascular disease. (orig.)

  14. Does Wal-Mart Sell Inferior Goods?

    OpenAIRE

    Emek Basker

    2008-01-01

    I estimate the aggregate income elasticity of Wal-Mart's and Target's revenues using quarterly data for 1997-2006. I find that Wal-Mart's revenues increase during bad times, whereas Target's revenues decrease, consistent with Wal-Mart selling "inferior goods" in the technical sense of the term. An upper bound on the aggregate income elasticity of demand for Wal-Mart's wares is -0.5.

  15. Aneurisma idiopático de la arteria pulmonar. Presentación de un caso y revisión de algunos aspectos clínicos.

    Directory of Open Access Journals (Sweden)

    Rafael Pila Pérez

    2011-10-01

    Full Text Available Se presenta el caso de un paciente masculino de 38 años de edad, fumador inveterado, con antecedentes de hipertensión arterial esencial, que ingresó en el Hospital Universitario Manuel Ascunce Doménech, de Camagüey, por presentar dolor precordial intenso. En la radiografía de tórax se encontró una imagen opaca bien delimitada a nivel parahiliar izquierdo, motivo por el cual se le practicaron diversas exploraciones complementarias como tomografía axial computarizada y ecocardiografía que revelaron la presencia de una dilatación aneurismática de la arteria pulmonar izquierda. El diagnóstico se concluyó como un aneurisma idiopático de la arteria pulmonar. Debido a que el paciente mejoró clínicamente y el tratamiento quirúrgico entrañaba mucho riesgo para su vida, se optó por el manejo conservador y control periódico.

  16. Inferior venacaval compression due to excessive abdominal packing

    Directory of Open Access Journals (Sweden)

    M.C.B. Santhosh

    2014-06-01

    Full Text Available Inferior venacaval compression is a common problem in late pregnancy. It can also occur due to compression of inferior venacava by abdominal or pelvic tumors. We report a case of acute iatrogenic inferior venacaval compression due to excessive abdominal packing during an intraabdominal surgery.

  17. Maxillary antral lavage using inferior meatal cannula anaesthesia.

    Science.gov (United States)

    Mochloulis, G; Hern, J D; Hollis, L J; Tolley, N S

    1996-08-01

    Antral puncture and lavage through the inferior meatus is a minor but common otolaryngological procedure, usually performed under local anaesthesia. We describe a new method of introducing local anaesthetic into the inferior meatus, via the use of a soft intravenous cannula connected to a syringe containing 10 per cent cocaine paste. We have called this new technique inferior meatal cannula anaesthesia (IMCA).

  18. Decompression of inferior alveolar nerve: case report.

    Science.gov (United States)

    Marques, Tiago Miguel Santos; Gomes, Joana Marques

    2011-01-01

    Paresthesia as a result of mechanical trauma is one of the most frequent sensory disturbances of the inferior alveolar nerve. This case report describes surgical treatment for paresthesia caused by a compressive phenomenon within the mandibular canal. The cause of the compression, a broken instrument left in the patient's mouth during previous endodontic therapy, was identified during routine radiography and computed tomography. Once the foreign object was removed by surgery, the paresthesia resolved quickly. This case highlights the potential for an iatrogenic mechanical cause of paresthesia.

  19. Rupture of hepatic artery aneurysm associated with ischemic hepatitis Rotura de arteria hepática aneurismática asociada con hepatitis isquémica

    Directory of Open Access Journals (Sweden)

    V.M. Santos

    2010-08-01

    Full Text Available Hepatic artery aneurysms are scarcely reported, mainly because of non-specific symptoms. More often, they are incidental findings during imaging studies to investigate other acute or chronic abdominal conditions. These aneurysms are usually detected in the sixth decade of life, predominantly among males. We report the case of a 69 year-old female with an unsuspected huge hepatic artery aneurysm associated with ischemic hepatitis. Suspicion of aneurysm arose during imaging studies to clarify the origin of jaundice and abdominal pain. After establishment of the diagnosis, but before open surgery, there was a spontaneous rupture of the aneurysm, which caused hemoperitoneum and death. The necropsy study confirmed ischemic hepatitis. Hepatic artery aneurysms are second among the visceral aneurysms, and may cause abdominal pain, jaundice, and hemorrhagic events. One should suspect abdominal aneurysms in elderly patients with unclear abdominal pain, and this hypothesis should be ruled out by imaging studies.La publicación de trabajos sobre aneurismas en la arteria hepática es escasa, debido a los síntomas no específicos y a que constituyen hallazgos incidentales durante investigación de otras condiciones abdominales agudas o crónicas. Estos aneurismas son más frecuentes en varones y en la sexta década de la vida. Presentamos el caso de una mujer de 69 años de edad que ingresa en el hospital con un aneurisma de arteria hepática no sospechado previamente, asociado con hepatitis isquémica. La sospecha de aneurisma empezó durante estudio de imágenes para aclaramiento del origen de ictericia y dolor abdominal. Después de confirmado el diagnóstico, pero antes de la operación planeada, ocurrió rotura espontánea del aneurisma causando hemoperitoneo y muerte. El estudio de necropsia confirmó hepatitis isquémica. Los aneurismas de la arteria hepática son los segundos entre los aneurismas viscerales y pueden causar dolor abdominal, ictericia

  20. 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...

  1. PAPEL DE LA MEDICIÓN DE LA VELOCIDAD SISTÓLICA MÁXIMA EN ARTERIA CEREBRAL MEDIA EN LA ISOINMUNIZACIÓN RHESUS

    OpenAIRE

    2010-01-01

    Objetivo: Evaluación del papel de la velocidad sistólica máxima en arteria cerebral media (VSM-ACM) en casos de isoinmunización Rh. Métodos: 67 casos de isoinmunización Rh, en el Hospital La Paz desde febrero del 2006 hasta agosto del 2009, con título de anticuerpos > 1:32, afectación en embarazo previo y/o casos de isoinmunización anti- Kell, en los que se ha realizado medición de la VSM-ACM. Resultados: La capacidad de detección de anemia moderada-severa en base a la medición de VSM-ACM pre...

  2. Hacer arteria carótida en el Laboratorio de Anatomía. Práctica y materialidad en una asignatura de Medicina

    Directory of Open Access Journals (Sweden)

    Santiago Martínez Medina

    2016-07-01

    Full Text Available Este artículo parte de la siguiente pregunta: ¿Cómo se hace un cuerpo en la asignatura de Anatomía? Me interesa el cuerpo como materialidad, experiencia y producto de una práctica bastante específica, de la cual surge como un ente natural y trascendente. Para referirme a la práctica de hacer un cuerpo, hago un análisis etnográfico de la asignatura en conjunto: observo los estudiantes, los profesores, los libros, las pinzas, las manos y los cadáveres usados. Este análisis es producto de mi participación durante más de un año en las clases y en los laboratorios de la asignatura de Anatomía, en dos facultades de Medicina, en la ciudad de Bogotá, Colombia. Se trata de una etnografía de una serie de movimientos corporales específicos, con los cuales se aprende a hacer anatomía humana, con un amplio rango de materialidades (cadáveres, libros, dispositivos virtuales, modelos tridimensionales, etcétera. Gracias a mi participación en este espacio de enseñanza, elaboré un diario de campo que luego transcribí, para someterlo a un análisis. En este, me interesa dar cuenta de aquellos momentos en los que una estructura anatómica es producto de las prácticas de la asignatura. Así, este artículo explora, en específico, la manera en que se hacen arterias en el anfiteatro de Anatomía. Mi pregunta no es cómo se identifican determinados vasos sanguíneos en el cuerpo humano, sino cómo se configuran sus distintas propiedades y particularidades en el laboratorio, incluido un nombre que los identifica. La cuestión no es, pues, epistemológica sino ontológica. De esta manera, en este artículo muestro que en el laboratorio surgen sensaciones y trayectorias materiales como si fueran arterias específicas. Para esto, se requiere de un espacio orientado y de la participación de múltiples entidades, heterogéneas y parcialmente conectadas, que enriquecen la experiencia de hacer una arteria en el laboratorio. As

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

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    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.

  4. Inferior alveolar nerve injuries associated with mandibular fractures.

    Science.gov (United States)

    Bede, Salwan Yousif Hanna; Ismael, Waleed Khaleel; Al-Assaf, Dhuha A; Omer, Saad Salem

    2012-11-01

    The study evaluates the incidence of inferior alveolar nerve injuries in mandibular fractures, the duration of their recovery, and the factors associated with them. Fifty-two patients with mandibular fractures involving the ramus, angle, and body regions were included in this study; the inferior alveolar nerve was examined for neurological deficit posttraumatically using sharp/blunt differentiation method, and during the follow-up period the progression of neural recovery was assessed. The incidence of neural injury of the inferior alveolar nerve was 42.3%, comminuted and displaced linear fractures were associated with higher incidence of inferior alveolar nerve injury and prolonged recovery time, and recovery of inferior alveolar nerve function occurred in 91%.Fractures of the mandible involving the ramus, angle, and body regions, and comminuted and displaced linear fractures are factors that increase the incidence of inferior alveolar nerve injuries. Missile injuries can be considered as another risk factor.

  5. Total laparoscopic retrieval of inferior vena cava filter

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    Ehsan Benrashid

    2015-08-01

    Full Text Available While there is some local variability in the use of inferior vena cava filters and there has been some evolution in the indications for filter placement over time, inferior vena cava filters remain a standard option for pulmonary embolism prophylaxis. Indications are clear in certain subpopulations of patients, particularly those with deep venous thrombosis and absolute contraindications to anticoagulation. There are, however, a variety of reported inferior vena cava filter complications in the short and long term, making retrieval of the filter desirable in most cases. Here, we present the case of a morbidly obese patient complaining of chronic abdominal pain after inferior vena cava filter placement and malposition of the filter with extensive protrusion outside the inferior vena cava. She underwent successful laparoscopic retrieval of her malpositioned inferior vena cava filters after failure of a conventional endovascular approach.

  6. Partial breast reconstruction with mini superficial inferior epigastric artery and mini deep inferior epigastric perforator flaps.

    Science.gov (United States)

    Spiegel, Aldona J; Eldor, Liron

    2010-08-01

    In this study, partial breast reconstruction was undertaken after breast conservation therapy using mini abdominal free flaps on both an immediate and delayed basis.Patient demographics, oncologic status, reconstructive data, and complications were collected from medical records.Twelve patients (age range 39-60) were included in this study with a mean follow-up time of 5 years. Ten mini superficial inferior epigastric artery flaps and 2 mini deep inferior epigastric perforator flaps were used (7 immediate and 5 delayed reconstructions). No flap lost, 1 minor abdominal wound dehiscence, and no local or distant recurrences were noted. Good to excellent results were reported by 91% of the women.In properly selected patients with high motivation toward breast conservation, tailored abdominal mini-free flaps can safely and satisfactorily be implemented for the reconstruction of partial mastectomy defects. Patients should be comprehensively educated on the potential future implications of using the abdominal donor site for partial breast reconstruction.

  7. Surgical extraction of impacted inferior third molars at risk for inferior alveolar nerve injury.

    Science.gov (United States)

    Gallesio, Cesare; Berrone, Mattia; Ruga, Emanuele; Boffano, Paolo

    2010-11-01

    The objective of the study was to prospectively assess the intraoperative findings and the radiographic signs of a study population of patients with impacted third molars at risk of inferior alveolar nerve injury. One hundred thirty-four patients with impacted mandibular third molars at risk for nerve injury were included in the study. Radiographic signs of possible close relationship between the 2 structures and intraoperative exposition or damage of the inferior alveolar nerve were recorded. The follow-up controls comprised clinical examinations and assessment for the sensation of the lower lip and chin. In 24 patients, a real contiguity was encountered between the third molars and nerve. Among these, intraoperative neural exposition was observed in 19 patients. Four patients complained of postoperative temporary hypoesthesia. No deficit of sensibility was found in cases with no exposition of the nerve. The accidental exposition of the inferior alveolar nerve is associated with an increased risk for neural injuries. At panoramic radiograph, the presence of signs of bifid and radiolucent apex, superimposition, and radiolucent root band should be considered at high risk for neural damage.

  8. PARTIAL INFERIOR TURBINECTOMY FOR INFERIOR TURBINATE HYPERTROPHY: REVIEW OF 30 CASES

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    Vishnu

    2016-05-01

    Full Text Available OBJECTIVES To compare the preoperative and postoperative subjective, objective parameters and postoperative complications of 30 patients with nasal obstruction due to inferior turbinate hypertrophy following partial inferior turbinectomy. PATIENTS AND METHODS A prospective observational study involving 30 patients with nasal obstruction due to inferior turbinate hypertrophy was done at SGMC, TVM from January 2014 to June 2015. Patients were evaluated preoperatively and postoperatively based on subjective and objective parameters. Postoperative evaluation was done at day 1, 1 week, 1 month and 3 months based on subjective and objective parameters and postoperative complications. RESULTS Snoring among the study population decreased from 26.7% to 10% at the end of 1 month and was further reduced 3.3% at the end of 3 months. Feeling of nasal obstruction, present in all patients, preoperatively was reduced to 36.7%, 16.7% and 3.3% at the end of 1 week, 1 month, and 3 months respectively. Among preoperative objective parameters, cold spatula test which was showing decreased fogging for all patients initially, following the procedure showed improvement in fogging in 70%, 90%, 100% of patients at the end of 1 week, 1 month and 3 months postoperatively. Anterior rhinoscopy showing large turbinate in all patients preoperatively, showed reduction in turbinate size in 70%, 86.73% and 96.7% at the end of 1 week, 1 month and 3 months respectively. Radiological evidence of enlarged inferior turbinate present in all patients was reduced to 3.3% at the end of 3 months. Occurrence of postoperative reactionary haemorrhage on day 1 was 43.3%. Nasal crust formation was not seen in 6.7% of the patients by the end of 3 months. Nasal pain was seen in 6.7% of the patients at the end of 1 week. Remote sequelae like synechiae and atrophic rhinitis were not reported in any of the patients during the assessment time period. CONCLUSION PIT is an effective technique for

  9. Through the looking glass: understanding non-inferiority

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    Wittes Janet T

    2011-05-01

    Full Text Available Abstract Non-inferiority trials test whether a new product is not unacceptably worse than a product already in use. This paper introduces concepts related to non-inferiority, and discusses the regulatory views of both the European Medicines Agency and the United States Food and Drug Administration.

  10. Disección traumática de la arteria carótida interna y embolismo cerebral en un jugador de fútbol. Reporte del primer caso.

    OpenAIRE

    Talledo Paredes, Luisa; Médico Residente de Cardiología. Servicio de Cardiología, Hospital Nacional Cayetano Heredia. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia.Lima.; Rotta Rotta, Aida; Médico Asistente. Servicio de Cardiología, Hospital Nacional Cayetano Heredia. Profesor Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia.Lima; Dueñas Carbajal, Roy; Médico Asistente. Servicio de Cardiología, Hospital Nacional Cayetano Heredia. Profesor Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia.Lima.; Medina Palomino, Félix; Médico Asistente. Servicio de Cardiología, Hospital Nacional Cayetano Heredia. Profesor Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia.Lima.; Anchante Hernández, Henry; Médico Asistente. Servicio de Cardiología, Hospital Nacional Cayetano Heredia. Profesor Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia.Lima.; Salazar Cáceres, Pedro; Jefe del Servicio de Cardiología, Hospital Nacional Cayetano Heredia. Lima.

    2012-01-01

    Reportamos el caso de un varón de 18 años quien sufrió contusión cervical por impacto con balón de fútbol. Tres días después fue hospitalizado con  hemiplejia derecha directa y afasia de expresión. La resonancia magnética cerebral mostró lesión isquémica izquierda en ganglios basales. El doppler carotideo evidenció trombo desde el origen de la arteria carótida común izquierda extendida a la arteria carótida interna izquierda (CII) y la angiotomografía documentó disección de CII (lesión traumá...

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

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    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.

  12. Inferior patellar pole fragmentation in children: just a normal variant?

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H.; Vogelius, Esben S.; Orth, Robert C.; Guillerman, R.P.; Jadhav, Siddharth P. [Texas Children' s Hospital, E.B. Singleton Pediatric Radiology, Houston, TX (United States)

    2015-06-15

    Fragmentary ossification of the inferior patella is often dismissed as a normal variant in children younger than 10 years of age. The purpose of this study was to determine whether fragmentary inferior patellar pole ossification is a normal variant or is associated with symptoms or signs of pathology using MRI and clinical exam findings as reference. A retrospective review was performed on 150 patients ages 5-10 years who underwent 164 knee radiography and MRI exams (45.1% male, mean age: 7.8 years). The presence or absence of inferior patellar pole fragmentation on radiography was correlated with the presence or absence of edema-like signal on MR images. Clinical notes were reviewed for the presence of symptoms or signs referable to the inferior patellar pole. These data were compared with a 1:1 age- and sex-matched control group without inferior pole fragmentation. Statistical analysis was performed using two-tailed t-tests. Forty of 164 (24.4%) knee radiographs showed fragmentary ossification of the inferior patella. Of these 40 knees, 62.5% (25/40) had edema-like signal of the inferior patellar bone marrow compared with 7.5% (3/40) of controls (P = 0.035). Patients with fragmentary ossification at the inferior patella had a significantly higher incidence of documented focal inferior patellar pain compared with controls (20% vs. 2.5%, P = 0.015). Inferior patellar pole fragmentation in children 5 to 10 years of age may be associated with localized symptoms and bone marrow edema-like signal and should not be routinely dismissed as a normal variant of ossification. (orig.)

  13. Tratamiento de la compresión del tronco de la arteria coronaria izquierda en pacientes con hipertensión pulmonar Treatment of compression of the left main coronary artery in patients with pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    María L. Talavera

    2011-10-01

    Full Text Available 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 muestran la relación entre la angina de pecho y la compresión del TCI en pacientes con HP asociada a cardiopatías congénitas, tratados mediante implante de stent coronario.Chest pain is a frequent symptom in patients with pulmonary hypertension of any etiology. Its pathophysiology has not been clearly established, the proposed causes are ischemia due to increased right ventricle wall stress, transient increased pulmonary hypertension resulting in acute pulmonary artery dilatation and external compression of the left main coronary artery (LMCA by a dilated pulmonary artery. We report and discuss here three cases where the association between chest pain and compression of the LMCA by a dilated pulmonary artery could be shown, and they were treated with coronary stenting.

  14. 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.

  15. Osteomyelitis der Wirbelsäule und Bildung eines Abzesses am linken Oberschenkel nach Implantation eines endovaskulären Strents in die Arteria femoralis superficialis sinistra

    Directory of Open Access Journals (Sweden)

    Brodmann M

    2000-01-01

    Full Text Available Die perkutane transluminale Angioplastie (PTA mit nachfolgender Implantation von selbstexpandierbaren intravaskulären Stents ist mittlerweile eine etablierte Methode zur Behandlung von arteriosklerotischen Läsionen geworden. Nachfolgende septische Komplikationen dieses Eingriffes, manches Mal mit tödlichem Ausgang, sind in der Literatur beschrieben, gelten jedoch als sehr selten. Daher gibt es auch eine sehr kontroversielle Meinung über die prophylaktische Gabe von Antibiotika bei der Implantation von Stents. Wir beschreiben einen Patienten, dem ein gecoverter Stent in die Arteria femoralis superficialis sinistra implantiert wurde und bei dem sich nachfolgend ein Abszeß um den Stent entwickelte. Der Patient hatte weder vor der Stentimplantation eine prophylaktische, noch im Anschluß eine begleitende antibiotische Therapie erhalten. Nach Diagnose des Abszesses wurde der Patient antibiotisch massiv abgedeckt und konnte in zufriedenstellendem Allgemeinzustand nach Hause entlassen werde. Zu Hause jedoch setzte der Patient seine antibiotische Therapie ab. Daraufhin entwickelte der Patient Zeichen einer schweren Allgemeinsepsis mit einer Spondylodiscitis im Bereich von TH 12 und L1 mit prae- und paravertebraler Infiltration, so wie auch einen Abszeß im Bereich des linken Musculus psoas.

  16. 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.

  17. Anterior transposition of the inferior oblique muscle as the initial treatment of a snapped inferior rectus muscle.

    Science.gov (United States)

    Aguirre-Aquino, B I; Riemann, C D; Lewis, H; Traboulsi, E I

    2001-02-01

    Snapping or tearing of an extraocular muscle refers to its rupture across its width, usually at the junction between muscle and tendon several millimeters behind the insertion. Tearing occurs during strabismus or retinal reattachment surgery, or after trauma. If the proximal end of the muscle cannot be located, transposition procedures are necessary to achieve ocular realignment. These surgical procedures carry the risk of anterior segment ischemia, especially in the elderly. Anterior transposition of the inferior oblique muscle has been used for the treatment of inferior oblique overaction, especially in the presence of a dissociated vertical deviation, and in patients with fourth nerve palsy. We transposed the inferior oblique muscle insertion in a 73-year-old woman with a snapped inferior rectus muscle.

  18. Effect of modified inferior oblique anterior transposition on dissociated vertical strabismus patients with inferior oblique muscle hyperfunction

    Directory of Open Access Journals (Sweden)

    Xi-Lang Wang

    2017-02-01

    Full Text Available AIM: To investigate the effect of anterior transposition of inferior oblique muscle on the treatment of dissociated vertical deviation(DVDin children with inferior oblique overaction(IOOAand unequal inferior oblique transposition of the treatment of IOOA with the eyes of the asymmetry of DVD efficacy, associated with the lower oblique hyperfunction DVD patients to provide more effective treatment. METHODS: Eighty patients with hyperfunction who were treated in our hospital from January 2014 to December 2015 were randomly selected and treated with anterior transposition of inferior oblique muscle. Patients were followed up for 1 to 30mo. We compared the vertical incline at the original incline from far(5m, near(33cmdistance and IOOA degree before and after operations, and the correlation between the two. We also compared the vertical incline at the original incline from far(5m, near(33cmdistance and IOOA degree before and after operations in 30 eyes(20 patientswith bilateral asymmetry DVD and IOOA who received unequal inferior oblique transposition. The incidence of antielevation syndrome(AESwas observed after operations. RESULTS: The mean prism diopters(PDat 5m before operations was 19.5±0.15, the average PD after operations was 3.5±0.18, at 5m the original incline was 16±0.21PD. The mean PD at 33cm was 18.6±0.20 before operation, 4.5±0.26 after operations, and 14.1±0.16 at 33cm the original incline, the difference was statistically significant(Pr=0.554, Pr=0.454, P PPCONCLUSION: Anterior transposition of the inferior oblique muscle has a good therapeutic effect on isolated vertical strabismus patients with inferior oblique hyperfunction. While the incidence of postoperative AES is low in patients received unequal inferior oblique muscle transposition.

  19. STUDY ON VARIATIONS OF INFERIOR SEGMENTAL BRANCH OF RENAL ARTERY

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    Chandragirish S

    2014-11-01

    Full Text Available Background: The segmental arteries of the kidney supply the organ in such a way that, each renal pole receives its own artery while, the anterior portion between the poles is supplied by an upper and lower segmental vessel. These two arteries also include in their territory the lateral edge of the kidney and adjacent to the strip of parenchyma on the dorsal or posterior aspect of the organ. The knowledge of inferior segmental branch of renal artery is very important for surgeries in its distribution area in kidney. Materials and Methods: 100 kidneys (Fifty pairs intact with abdominal aorta were collected from department of Forensic medicine, JSS Medical College and Mysore Medical College. For study of segmental variation Corrosion cast technique method was used. The variations of inferior segmental branch of renal artery were observed and recorded. Results: In present study type I inferior segmental branch of renal artery were found in - 59% cases, type II in - 6% cases, type III in - 28% cases, type IV in - 2% cases. Conclusion: The inferior segmental artery from the anterior division of the renal artery is the commonest event –arising in 59%. This is Type I, the normal type. It arises from the renal artery (28% or from the posterior division (6% or from the aorta (2%. The knowledge of inferior segmental branch of renal artery helpful in kidney transplantation and renal surgery because these type of surgeries success mainly depends on arterial ligations.

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

    Directory of Open Access Journals (Sweden)

    Haim Gavriel

    2013-01-01

    Full Text Available Objective. To report a novel tympanoplasty modification for anterior tympanic membrane perforation closure. Materials and Methods. A prospective study on 13 patients who underwent inferior tympanoplasty between December 2008 and May 2011 was carried out. In our technique, an inferior rather than a posterior flap is raised and the graft is laid from the inferior direction to obtain better access to the anterior part of the tympanic membrane perforation and provide better support. Results. A total of 13 patients underwent the novel inferior tympanoplasty technique with a mean age of 33 years. Six patients had undergone tympanoplasties and/or mastoidectomies in the past, 3 in the contralateral ear. A marginal perforation was observed in 3 cases, total perforation in 2 and subtotal in 1 case. The mean preoperative pure-tone average was 40.4 dB (10 to 90 dB, compared to 26.5 dB (10 to 55 dB postoperatively. All perforations were found to be closed but one (92.3% success rate. Conclusions. The inferior tympanoplasty technique provides a favorable outcome in terms of tympanic membrane closure and hearing improvement for anterior perforations, even in difficult and complex cases. It is based on a well-known technique and is easy to implement.

  1. The effects of inferior olive lesion on strychnine seizure

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, M.C.; Chung, E.Y.; Van Woert, M.H. (Mount Sinai School of Medicine, New York, NY (USA))

    1990-10-01

    Bilateral inferior olive lesions, produced by systemic administration of the neurotoxin 3-acetylpyridine (3AP) produce a proconvulsant state specific for strychnine-induced seizures and myoclonus. We have proposed that these phenomena are mediated through increased excitation of cerebellar Purkinje cells, through activation of glutamate receptors, in response to climbing fiber deafferentation. An increase in quisqualic acid (QA)-displaceable ({sup 3}H)AMPA ((RS)-alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid) binding in cerebella from inferior olive-lesioned rats was observed, but no difference in ({sup 3}H)AMPA binding displaced by glutamate, kainic acid (KA) or glutamate diethylester (GDEE) was seen. The excitatory amino acid antagonists GDEE and MK-801 ((+)-5-methyl-10,11-dihydro-5H-dibenzo(a,d)cyclo-hepten-5,10 imine) were tested as anticonvulsants for strychnine-induced seizures in 3AP inferior olive-lesioned and control rats. Neither drug effected seizures in control rats, however, both GDEE and MK-801 produced a leftward shift in the strychnine-seizure dose-response curve in 3AP inferior olive-lesioned rats. GDEE also inhibited strychnine-induced myoclonus in the lesioned group, while MK-801 had no effect on myoclonus. The decreased threshold for strychnine-induced seizures and myoclonus in the 3AP-inferior olive-lesioned rats may be due to an increase in glutamate receptors as suggested by the ({sup 3}H)AMPA binding data.

  2. Inferior oblique muscle paresis as a sign of myasthenia gravis.

    Science.gov (United States)

    Almog, Yehoshua; Ben-David, Merav; Nemet, Arie Y

    2016-03-01

    Myasthenia gravis may affect any of the six extra-ocular muscles, masquerading as any type of ocular motor pathology. The frequency of involvement of each muscle is not well established in the medical literature. This study was designed to determine whether a specific muscle or combination of muscles tends to be predominantly affected. This retrospective review included 30 patients with a clinical diagnosis of myasthenia gravis who had extra-ocular muscle involvement with diplopia at presentation. The diagnosis was confirmed by at least one of the following tests: Tensilon test, acetylcholine receptor antibodies, thymoma on chest CT scan, or suggestive electromyography. Frequency of involvement of each muscle in this cohort was inferior oblique 19 (63.3%), lateral rectus nine (30%), superior rectus four (13.3%), inferior rectus six (20%), medial rectus four (13.3%), and superior oblique three (10%). The inferior oblique was involved more often than any other muscle (pmyasthenia gravis can be difficult, because the disease may mimic every pupil-sparing pattern of ocular misalignment. In addition diplopia caused by paresis of the inferior oblique muscle is rarely encountered (other than as a part of oculomotor nerve palsy). Hence, when a patient presents with vertical diplopia resulting from an isolated inferior oblique palsy, myasthenic etiology should be highly suspected.

  3. 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

  4. Cuantificación del signo de la arteria cerebral media hiperdensa con TCMD Quantification of hyperdense middle cerebral artery sign by multidetector computed tomography (MDCT.

    Directory of Open Access Journals (Sweden)

    Francisco Meli

    2011-12-01

    Full Text Available Objetivos. Obtener una cuantificación absoluta y relativa de la densidad en el signo de la arteria cerebral media (ACM con el fin de lograr un valor objetivo para el diagnóstico temprano de isquemia cerebral aguda con TCMD. Materiales y Métodos. Se incluyeron 40 pacientes, 20 con sospecha de isquemia cerebral aguda (edad media 73,4 años y 20 pacientes controles (edad media 71,2 años, p=0,63, que se realizaron TC cerebral con un equipo de 64 filas de detectores. La cuantificación absoluta se realizó midiendo la densidad en UH en el segmento de la ACM visualmente de mayor densidad. También se midió la densidad en el mismo segmento de la ACM contralateral para calcular la diferencia entre ambas arterias (cuantificación relativa. Resultados. En pacientes casos, la densidad media de la ACM afectada (62,5 UH, IC 99%: 46,2-78,7 fue mayor que la de la ACM contralateral (39,3 UH, IC 99%: 33,3-45,3 (p=0,0004 y también fue mayor en comparación con la ACM en pacientes controles (44,7 UH, IC 99%: 37,4-52 (p=0,0045. En la cuantificación relativa, la diferencia media entre la densidad de la ACM afectada y la de ACM contralateral en los pacientes casos fue de 23,2 UH (IC 95%: 11,7-34,7, mientras que, en pacientes controles, la diferencia media entre la densidad de la ACM derecha y la ACM izquierda fue 5,2 UH (IC 95%: 2,4-8,4 (diferencia: 17,8 UH, p=0,0032, IC 95%: 6,8-28,8. Conclusión. Mostramos diferencias significativas (absolutas y relativas en la densidad de la ACM en pacientes con sospecha de isquemia cerebral aguda en comparación con sujetos normales.Purposes. To obtain absolute and relative quantification values of density in the middle cerebral artery (MCA sign, in order to obtain an objective value for an early diagnosis of acute ischemic stroke using MDCT. Material and Methods. Forty adult patients, 20 with suspected diagnosis of acute ischemic stroke (mean age: 73.4 years and 20 controls (mean age: 71.2 years, p=0.63, underwent brain

  5. 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%.

  6. Correlación y concordancia entre ecocardiografía y cateterismo cardiaco derecho para determinación de la presión sistólica de arteria pulmonar

    OpenAIRE

    Aguilera Pacheco, Emil Alberto; Conde Camacho, Rafael; Perez-Fernandez, Oscar-Mauricio

    2015-01-01

    Introducción. El cateterismo cardiaco derecho representa el estándar de referencia para el diagnóstico de hipertensión pulmonar, sin embargo el rendimiento de la ecocardiografía como estudio inicial ha mostrado buena correlación con las variables medidas por cateterismo. El presente estudio pretende describir el grado de correlación y concordancia entre la ecocardiografía y el cateterismo cardiaco derecho para la medición de la presión sistólica de la arteria pulmonar. Materiales y méto...

  7. Traumatic neuroma of the inferior alveolar nerve: a case report.

    Science.gov (United States)

    Arribas-García, Ignacio; Alcalá-Galiano, Andrea; Gutiérrez, Ramón; Montalvo-Moreno, Juan José

    2008-03-01

    Traumatic neuromas are rare entities which characteristically arise subsequently to surgery and are usually accompanied by pain, typically neuralgic. We present an unusual case of an intraosseous traumatic neuroma of the inferior alveolar nerve following tooth extraction. A 56-year-old man consulted for paresthesias and hyperesthesia in the left mandibular region following extraction of the left mandibular third molar (#38). The panoramic radiograph revealed a radiolucent lesion in the inferior alveolar nerve canal, and CT demonstrated the existence of a mass within the canal, producing widening of the same. Nerve-sparing excisional biopsy was performed. Histopathology and immunohistochemistry were consistent with traumatic neuroma of the left inferior alveolar nerve. After 3 years of follow-up, the patient is asymptomatic and there are no signs of recurrence.

  8. Agenesia de veia cava inferior associada à trombose venosa profunda Agenesis of inferior vena cava associated with deep venous thrombosis

    Directory of Open Access Journals (Sweden)

    Clovis Luis Konopka

    2010-09-01

    Full Text Available A agenesia da veia cava inferior é uma anomalia congênita rara, que foi recentemente identificada como um importante fator de risco para o desenvolvimento e a recorrência de trombose venosa profunda de membros inferiores em jovens. O objetivo deste trabalho foi relatar o caso de uma paciente que apresentou trombose venosa profunda dois meses após a realização de cirurgia de varizes. A angiotomografia computadorizada demonstrou a presença de anomalia venosa complexa com ausência da veia cava inferior.The agenesis of the inferior vena cava is a rare congenital anomaly, which was recently identified as an important risk factor for the development and recurrence of deep venous thrombosis especially in young people. The goal of this work was to report the case of a patient who presented deep venous thrombosis approximately two months after varicose vein surgery. The computerized angiotomography demonstrated the presence of a complex venous anomaly with absence of the inferior vena cava.

  9. Pseudo-dissection of ascending aorta in inferior myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Grahame K. Goode

    2011-06-01

    Full Text Available Acute aortic dissection is a cardiac emergency which can present as inferior myocardial infarction. It has high morbidity and mortality requiring prompt diagnosis and treatment. Rapid advances in noninvasive imaging modalities have facilitated the early diagnosis of this condition and in ruling out this potentially catastrophic illness. We report an interesting case of a 57 year- old -man who presented with inferior myocardial infarction requiring thrombolysis and temporary pacing wire for complete heart block. An echocardiogram was highly suspicious of aortic dissection. CT scan confirmed that the malposition of the temporary pacing wire through the aorta mimicked aortic dissection.

  10. Inferior glenohumeral joint dislocation with greater tuberosity avulsion

    Institute of Scientific and Technical Information of China (English)

    Mohd Faizan; Latif Zafar Jilani; Mazhar Abbas; Yasir Salam Siddiqui; Aamir Bin Sabir; M.K.A.Sherwani; Saifullah Khalid

    2015-01-01

    Inferior glenohumeral dislocation is the least common type of glenohumeral dislocations.It may be associated with fractures of the adjacent bones and neurovascular compromise.It should be treated immediately by close reduction.The associated neuropraxia usually recovers with time.Traction-counter traction method is commonly used for reduction followed by immobilization of the shoulder for three weeks.Here,we report a case of inferior glenohumeral joint dislocation with greater tuberosity fracture with transient neurovascular compromise and present a brief review of the literature.

  11. Maksilektomi Inferior pada Karsinoma Sel Skuamosa Palatum Durum

    Directory of Open Access Journals (Sweden)

    Sukri Rahman

    2016-01-01

    Full Text Available Abstrak          Karsinoma Palatum Durum adalah keganasan daerah kepala dan leher yang jarang terjadi dimana setengah diantaranya merupakan Karsinoma Sel Skuamosa. Pada fase awal keganasan ini dapat bersifat asimptomatis namun dapat juga menimbulkan gejala berupa ulkus yang terasa nyeri pada perkembangan penyakitnya. Operasi maksilektomi inferior merupakan salah satu pilihan tindakan yang dapat dilakukan dalam tatalaksana kasus ini, diikuti oleh pemberian radioterapi. Kasus ini dibuat untuk memahami penatalaksanaan karsinoma palatum durum. Dilaporkan kasus seorang laki-laki 45 tahun dengan diagnosis Karsinoma Sel Skuamosa Palatum Durum (Well to Moderately Differentiated Keratinized stadium IVa (T4aN0M0 dilakukan operasi maksilektomi inferior, namun tidak diikuti dengan radioterapi karena pasien menolak. Maksilektomi inferior merupakan pilihan pembedahan pada tumor yang terbatas pada palatum, lantai sinus maksila dan kavum nasi. Prognosis karsinoma sel skuamosa palatum durum cukup baik dan angka harapan hidup lima tahun akan bertambah bila dilakukan operasi diikuti dengan pemberian radioterapi. Kata kunci: Karsinoma sel skuamosa, maksilektomi inferior, radioterapi AbstractCarcinoma of the hard palate is a rare head and neck cancer in which half of it was Squamous Cell Carcinoma. In the initial phase of this malignancy may be asymptomatic, but can also cause symptoms such as painful ulcers in the development of the disease. Inferior maxillectomy is one of the choice of operation that can be performed, followed by radiotherapy to understand the management of carcinoma of the hard palate. Reported one case of a man 45 years old with diagnosis Squamous Cell Carcinoma of hard palate (Well to Moderately Differentiated Keratinized stage IVa (T4aN0M0 treated by inferior maxillectomy surgery, but not followed by radiotherapy because the patient refused. Inferior Maksilektomi is a surgical option in tumor that limited to the palate, floor of the

  12. Suprarenal symplastic leiomyoma of the inferior vena cava.

    Science.gov (United States)

    Kepenekci, Ilknur; Demirkan, Arda; Sözener, Ulas; Cakmak, Atil; Demirer, Seher; Alaçayir, Iskender; Ekinci, Cemil

    2009-01-01

    We report on a case of a leiomyoma in the inferior vena cava that appeared in the image to be located in the adrenal gland. En bloc excision of the tumor with the right adrenal gland and the involved segment of the vena cava was carried out. Histopathological work-up of the tumor revealed smooth muscle fibers and marked nuclear pleomorphism consistent with symplastic leiomyoma. This case report presents a distinct histological variant of the rarely seen primary smooth muscle tumor of the inferior vena cava.

  13. Transhepatic approach for extracardiac inferior cavopulmonary connection stent fenestration.

    LENUS (Irish Health Repository)

    Kenny, Damien

    2012-02-01

    We report on a 3-year-old male who underwent transcatheter stent fenestration of the inferior portion of an extracardiac total cavopulmonary connection in the setting of hypoplastic left heart syndrome. Transhepatic approach, following an unsuccessful attempt from the femoral vein facilitated delivery of a diabolo-shaped stent.

  14. An unusual delayed complication of inferior alveolar nerve block.

    Science.gov (United States)

    Smyth, Joanna; Marley, John

    2010-01-01

    Systemic and localised complications after administration of local anaesthetic for dental procedures are well recognised. We present two cases of patients with trismus and sensory deficit that arose during resolution of trismus as a delayed complication of inferior alveolar nerve block.

  15. Endodontic-related inferior alveolar nerve and mental foramen paresthesia.

    Science.gov (United States)

    Morse, D R

    1997-10-01

    Paresthesia is a condition that involves perverted sensations of pain, touch, or temperature. It has a variety of possible causes. This article presents a literature review and case reports of endodontically related inferior alveolar nerve and mental foramen paresthesia. Nondrug prevention methods and the dental uses of dexamethasone are also discussed.

  16. INFERIOR VENA-CAVA OBSTRUCTION AFTER ORTHOTOPIC LIVER-TRANSPLANTATION

    NARCIS (Netherlands)

    BROUWERS, MAM; DEJONG, KP; PEETERS, PMJG; BIJLEVELD, CMA; KLOMPMAKER, IJ; SLOOFF, MJH

    1994-01-01

    Post-operative inferior vena cava (IVC) obstruction is reported as an uncommon complication after orthotopic liver transplantation (OLT). We report 6 cases after 245 OLT's in the period between March '79 and December '92. Compression or torsion of the IVC or a technical problem were underlying cause

  17. [Resection of leiomyosarcoma of the inferior vena cava].

    Science.gov (United States)

    Zotov, S P; Pyshkin, S A; Malyshev, M Iu; Safuanov, A Kh; Borovikov, D A; Siniukov, D M; Tereshin, O S; Panov, I O

    2013-01-01

    Experience in treatment of leiomyosarcoma of the retrohepatic segment of the inferior vena cava at any separately taken clinic is scarce. Given a rare nature of the pathology involved, whose diagnosis and management require joint participation of various-specialty physicians, we have considered it wise to present our own clinical case report.

  18. INVOLVEMENT OF THE INFERIOR CAVAL VEIN IN ADRENAL METASTASIS

    NARCIS (Netherlands)

    VANDALEN, KC; VANDRIEL, MF; MENSINK, HJA

    1992-01-01

    A patient was referred to our hospital for resection of a large renal cell carcinoma with invasion of the inferior caval vein, diagnosed as such with CT, angiography and cavography. The history mentioned partial resection of the left lung for lung carcinoma 16 months before. At operation the tumor c

  19. Anatomía del corazón y las arterias branquiales aferentes de las rayas (Chondrichthyes: Batoidea Anatomy of the heart and afferent branchial arteries of the rays (Chondrichthyes: Batoidea

    Directory of Open Access Journals (Sweden)

    Abraham Kobelkowsky

    2012-04-01

    Full Text Available Se selecionó el corazón y el sistema branquial aferente de Dasyatis sabina como patrón morfológico de los Batoidea. Se compararon las cámaras del corazón y la ramificación de la aorta ventral en las arterias branquiales aferentes con las correspondientes de especies representativas de otras familias de batoideos, tales como: Narcine brasiliensis (Narcinidae, Rhinobatos lentiginosus (Rhinobatidae, Raja texana (Rajidae, Urobatis jamaicensis (Urolophidae, Gymnura micrura (Gymnuridae y Myliobatis sp. (Myliobatidae. El análisis comparativo permitió reconocer como carácter más notable, la ausencia de las arterias innominadas posteriores en los Myliobatiformes, con excepción de Gymnuridae. Asimismo, permitió observar la amplia similitud entre Rhinobatidae y Rajidae, y entre Urotrygonidae y Dasyatidae.The heart and the afferent branchial system of the ray, Dasyatis sabina was selected as a morphologic pattern of the Batoidea. A comparison of the heart and the ramification of the ventral aorta into the branchial afferent arteries was made with the corresponding in representative species of other families of Batoidea, such as: Narcine brasiliensis (Narcinidae, Rhinobatos lentiginosus (Rhinobatidae, Raja texana (Rajidae, Urobatis jamaicensis (Urolophidae, Gymnura micrura (Gymnuridae, and Myliobatis sp. (Myliobatidae. The comparative analysis allows recognizing as the most notably character, the absence of the posterior innominates arteries in the Myliobatiformes, with the exception of Gymnuridae. A high similitude between Rhinobatidae and Rajidae, and Urolophidae and Dasyatidae was recognized.

  20. 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.

  1. PEMANFAATAN BIJI KAKAO INFERIOR CAMPURAN SEBAGAI SUMBER ANTIOKSIDAN DAN ANTIBAKTERI

    Directory of Open Access Journals (Sweden)

    Yulianto Tri Chandra Kusuma

    2013-11-01

    Full Text Available [ENGLISH] There are about 30% of cocoa beans still classified as inferior or low quality beans due to diseases. Low-quality cocoa beans can be used as the source of polyphenolic substances. The purpose of this study was to determine the potency of inferior cocoa beans with various particle sizes as raw materials for polyphenol extraction, and the use of polyphenol-rich cocoa extracts as antioxidant and antibacterial substances. The research was conducted in two stages, namely preliminary research and primary research. This preliminary study aimed to obtain polyphenol-rich cocoa bean extract and to examine antioxidant activity using DPPH method. The next research was to conduct antibacterial test against Escherichia coli and Bacillus subtilis using well diffusion method treated using polyphenols of each type of various particle size (16 mesh, 25 mesh, 35 mesh with concentrations of 0 ppm, 25.000 ppm, 50.000 ppm, 75.000 ppm, 100.000 ppm. The plates were incubated at 37°C for 24 hours and the inhibition power against bacteria was observed. The results showed that the greater the concentration of polyphenol extracts and the smaller size of the filter powder cocoa resulted in the increase of bacterial growth inhibition area. Keywords: Polyphenol; Cocoa beans; Escherichia coli; Bacillus subtilis [INDONESIAN] Biji kakao inferior merupakan biji buah kakao bermutu rendah karena terserang penyakit dan belum termanfaatkan secara maksimal. Biji kakao berkualitas rendah dapat dimanfaatkan dengan cara mengekstrak kandungan polifenolnya. Tujuan penelitian ini adalah mengetahui potensi ekstrak polifenol biji kakao inferior dengan variasi ukuran partikel sebagai bahan yang memiliki aktivitas antioksidan dan penghambat pertumbuhan bakteri. Penelitian ini dilakukan dalam dua tahap, yaitu penelitian pendahuluan dan penelitian utama. Penelitian pendahuluan bertujuan untuk memperoleh esktrak polifenol dari biji kakao inferior campuran yang terserang penyakit

  2. Predictors of inferior outcome in community acquired bacterial meningitis.

    Science.gov (United States)

    Streharova, A; Krcmery, V; Kisac, P; Kalavsky, E; Holeckova, K; Lesnakova, A; Luzinsky, L; Adamkovicova, E; Pavlikova, Z; Spilakova, N; Kacunova, B; Dovalova, V; Wiczmandyova, O; Spanik, S; Liskova, A; Chovancova, D; Kovac, M; Ondrusova, A; Bauer, F; Benca, J; Rudinsky, B; Sramka, M; Kralova, J; Krsakova, J; Krumpolcova, M; Findova, L; Svabova, V; Sladeckova, V; Seckova, S; Saniova, J; Pavlicova, B; Taziarova, M; Bukovinova, P; Kolenova, A; Horvathova, E; Hvizdak, F; Luzica, R; Rolnikova, B; Bocakova, A; Grey, E; Bielova, M; Huttova, M; Sabo, I; Jalili, N

    2007-11-01

    The aim of this study was to assess mortality and sequellae within cases from Nationwide survey of community acquired meningitis and identify risk factors for inferior outcome. Risk factors such as underlying disease (diabetes mellitus, cancer, trauma, neonatal age, splenectomy, alcoholism, sepsis, other infections), etiology, clinical symptoms and outcome (death, improvement and cured after modifications of ATB therapy, cured without change of therapy, cured with neurologic sequellae) were recorded and analysed with univariate analysis (chi2 or t test for trends, CDC Atlanta 2004). Analysing risk factors for inferior outcome (death or cured with neurologic sequellae), we compared patients who died or survived with neurologic sequellae to all patients with community acquired bacterial meningitis. Univariate analysis showed that trauma (palcohol abuse (pdiabetes, S. aureus (pdiabetes mellitus (palcoholism (palcohol abuse (p<0.05), craniocerbral trauma (p<0.05) and less common in meningitis with pneumococcal etiology (p<0.05).

  3. 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.

  4. Electronic thermography for the assessment of inferior alveolar nerve deficit.

    Science.gov (United States)

    Gratt, B M; Shetty, V; Saiar, M; Sickles, E A

    1995-08-01

    Neurosensory deficit is one of the major complications encountered in oral and maxillofacial surgery. OBJECTIVES. To determine the efficacy of electronic thermography in objectively assessing neurosensory deficits of the inferior alveolar nerve. STUDY DESIGN. Three studies were conducted measuring skin temperature over the chin region of the face at 0.1 degree C accuracy. RESULTS. (1) Thermal symmetry of the chin region in normal subjects (delta T = 0.2 degree C, SD = 0.02 degree C); (2) Induction of transient thermal asymmetry by local anesthetic injection (delta T = +0.4 degree C, SD = 0.2 degree C); (3) nine subjects with neurologic alterations of the inferior alveolar nerve (delta T = +0.5 degree C, SD = 0.2 degree C). Statistically significant differences were found between control group and experimental groups at p alveolar nerve injury or by pharmacologic nerve block.

  5. Inferior turbinate osteoma as a cause of unilateral nose obstruction.

    Science.gov (United States)

    Grabovac, Stjepan; Hadzibegović, Ana Danić; Markesić, Josip

    2012-11-01

    Osteomas are benign, slow growing bone tumors often seen in paranasal sinuses, mostly in the frontal sinus, whereas they are rare in the nasal cavity. Inferior turbinate osteoma is extremely rare and our case is the third reported in the literature to date. Symptoms vary depending on the location, size and spreading and nasal obstruction is the most common symptom. Treatment of osteomas is surgical and is reserved only for rapidly growing osteomas with symptoms of infection or compression. Although endoscopic surgery is preferred modality, external approach with lateral rhinotomy should be considered with larger osteomas especially those that involve the ethmoid labyrinth. In cases like ours, when large osteoma is localized on the inferior nasal turbinate, sublabial incision through the vestibulum is very suitable approach because it provides wide access and good visibility and leaves no visible scar.

  6. Arteria iliaca interna transplantation to repair arteria iliacaexterna

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@CASE REPORT A 20-year-old man was admitted for blunt trauma to left lower abdomen and dysfunction of left lower limb for 8 h. Physical examination: skin contusion for 5 cm in diameter at the left iliac fossa, accompanied with subcutaneous extravasated blood, tenderness and rebound tenderness of left lower quadrant, no abnormality of rectum palpated by digital examination. The left lower limb was pale, paresthesia, paralysis and low skin temperature, but no pitting edema. The pulsation of the left femoral artery and dorsalis pedis artery could not be palpated. Color Doppler imaging showed no flow in lumen of the upper portion of the left external iliac artery for 5-6 cm in length. The diagnosis,was traumatic arterial occlusion of the left external iliac artery. Laparotomy was performed. Haematoma in left lower abdominal wall and retroperitoneum, partial sever of external and internal oblique muscle were found. Dissection of the common iliac artery, external and internal iliac artery showed normal pulsation of

  7. Las alteraciones posturales en miembros inferiores en el surf

    OpenAIRE

    2015-01-01

    Cuando el equilibrio neuromuscular no es óptimo durante la práctica de un deporte, es posible que, a largo plazo, aparezcan trastornos posturales que, dependiendo del tiempo de entrenamiento, pueden convertirse en un obstáculo para la salud. Es por esto, que mediante esta investigación he pretendido mostrar las alteraciones posturales que el surf puede llegar a provocar en quienes lo practican. Objetivo: Analizar las alteraciones posturales en los miembros inferiores de surfist...

  8. Truncal ataxia from infarction involving the inferior olivary nucleus.

    Science.gov (United States)

    Park, Jae Hyun; Ryoo, Sookyung; Moon, So Young; Seo, Sand Won; Na, Duk L

    2012-08-01

    Truncal ataxia in medullary infarction may be caused by involvement of the lateral part of the medulla; however, truncal ataxia in infarction involving the inferior olivary nucleus (ION) has received comparatively little attention. We report a patient with truncal ataxia due to medial medullary infarction located in the ION. A lesion in the ION could produce a contralateral truncal ataxia due to increased inhibitory input to the contralesional vestibular nucleus from the contralesional flocculus.

  9. Bruxism elicited by inferior alveolar nerve injury: a case report.

    Science.gov (United States)

    Melis, Marcello; Coiana, Carlo; Secci, Simona

    2012-02-01

    The aim of this case report is to describe the history of a patient who received an injury to the right inferior alveolar nerve after placement of a dental implant, with bruxism noted afterward. The symptoms were managed by the use of an occlusal appliance worn at night and occasionally during the day, associated with increased awareness of parafunction during the day to reduce muscle pain and fatigue. Paresthesia of the teeth, gingiva, and lower lip persisted but were reduced during appliance use.

  10. Coronectomy - A viable alternative to prevent inferior alveolar nerve injury

    Directory of Open Access Journals (Sweden)

    Alok Sagtani

    2015-12-01

    Full Text Available Background and Objectives: Coronectomy is a relatively new method to prevent the risk of Inferior Alveolar Nerve (IAN injury during removal of lower third molars with limited scientific literature among Nepalese patients. Thus, a study was designed to evaluate coronectomy regarding its use, outcomes and complications.Materials and Methods: A descriptive study was conducted from December 2012 to December 2013 among patients attending Department of Oral and Maxillofacial Surgery, College of Dental Sciences, BP Koirala Institute of Health Sciences, Dharan, Nepal for removal of mandibular third molars. After reviewing the radiograph for proximity of third molar to the IAN, coronectomy was advised. A written informed consent was obtained from the patients and coronectomy was performed. Patients were recalled after one week. The outcome measures in the follow-up visit were primary healing, pain, infection, dry socket, root exposure and IAN injury. The prevalence of IAN proximity of lower third molars and incidence of complications were calculated.Results: A total 300 mandibular third molars were extracted in 278 patients during the study period. Out of 300 impacted mandibular third molar, 41 (13.7% showed close proximity to inferior alveolar nerve . The incidence of complications and failed procedure was 7.4% among the patients who underwent coronectomy. During the follow up visit, persistent pain and root exposure was reported while other complications like inferior alveolar nerve injury, dry socket and infection was not experienced by the study patients.Conclusion: With a success rate of 92.6% among the 41 patients, coronectomy is a viable alternative to conventional total extraction for mandibular third molars who have a higher risk for damage to the inferior alveolar nerve.JCMS Nepal. 2015;11(3:1-5.

  11. [Surgical treatment of leiomyosarcoma of the inferior vena cava].

    Science.gov (United States)

    Zotov, S P; Panov, I O; Tereshin, O S; Vazhenin, A V

    2012-01-01

    The presented review of the literature is generalization of the currently existing data of foreign and Russian literature concerning treatment of a rare non-organic retroperitoneal tumour from smooth-muscle tissue, i. e., leiomyosarcoma of the inferior vena cava. The authors also formulate and lay down the basic principles of surgical interventions depending on the scope and level of the lesion, as well statistical analysis of the outcomes of surgical management of the this severely ill patient cohort.

  12. Optional inferior vena caval filters: where are we now?

    LENUS (Irish Health Repository)

    Keeling, A N

    2008-08-01

    With the advent of newer optional\\/retrievable inferior vena caval filters, there has been a rise in the number of filters inserted globally. This review article examines the currently available approved optional filter models, outlines the clinical indications for filter insertion and examines the expanding indications. Additionally, the available evidence behind the use of optional filters is reviewed, the issue of anticoagulation is discussed and possible future filter developments are considered.

  13. [Aneurysm of the anterior inferior cerebellar artery: case report].

    Science.gov (United States)

    Adorno, Juan Oscar Alarcón; de Andrade, Guilherme Cabral

    2002-12-01

    The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA) are considered rare, can cause cerebello pontine angle (CPA) syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.

  14. Distal posterior inferior cerebellar artery aneurysm in a child

    Directory of Open Access Journals (Sweden)

    J. Francisco Salomão

    1992-06-01

    Full Text Available The case of a 7-year-old boy presenting with recurrent episodes of subarachnoid hemorrhage due to a distal posterior inferior cerebellar artery aneurysm (PICA, successfully operated, is reported.' The low incidence of intracranial aneurysms in the first decade of life and the rare occurrence of distal PICA aneurysms are unusual features of this case. The theories regarding the origin of intracranial berry aneurysms are discussed.

  15. Thermographic assessment of reversible inferior alveolar nerve deficit.

    Science.gov (United States)

    Shetty, V; Gratt, B M; Flack, V

    1994-01-01

    The purpose of this study was to investigate thermography's potential as a diagnostic alternative for evaluating neurosensory deficits of the inferior alveolar nerve. Electronic thermography was used to evaluate the alterations in facial thermal patterns attendant to a conduction defect of the inferior alveolar nerve induced in 12 subjects using 2% lidocaine. The rates of onset and duration of sensory block, as visualized by thermography, were related to the results of conventional neurosensory testing. Comparison of the rate of response change within each measurement system revealed that changes in facial skin temperature manifest the induced deficit earlier than discriminative tests. Also, the prolonged elevation of thermal asymmetry suggested that electronic thermography has the ability to detect subtle changes in nerve function that are not discernible by physical neurosensory tests relying on patient response. Although cutaneous temperature increases were highest in the field of observation near the sensory distribution of the mental nerve, an inexplicable warming of the contralateral side of the face and neck was also observed. These attendant findings emphasize the need for further studies on the pathophysiologic mechanisms of facial thermal changes to better understand thermography's diagnostic accuracy and clinical utility for monitoring inferior alveolar nerve dysfunction.

  16. Inferior vestibular neuritis in a fighter pilot: a case report.

    Science.gov (United States)

    Xie, Su Jiang; Jia, Hong Bo; Xu, Po; Zheng, Ying Juan

    2013-06-01

    Spatial disorientation in airplane pilots is a leading factor in many fatal flying accidents. Spatial orientation is the product of integrative inputs from the proprioceptive, vestibular, and visual systems. One condition that can lead to sudden pilot incapacitation in flight is vestibular neuritis. Vestibular neuritis is commonly diagnosed by a finding of unilateral vestibular failure, such as a loss of caloric response. However, because caloric response testing reflects the function of only the superior part of the vestibular nerve, it cannot detect cases of neuritis in only the inferior part of the nerve. We describe the case of a Chinese naval command fighter pilot who exhibited symptoms suggestive of vestibular neuritis but whose caloric response test results were normal. Further testing showed a unilateral loss of vestibular evoked myogenic potentials (VEMPs). We believe that this pilot had pure inferior nerve vestibular neuritis. VEMP testing plays a major role in the diagnosis of inferior nerve vestibular neuritis in pilots. We also discuss this issue in terms of aeromedical concerns.

  17. Intraosseous schwannoma originating in inferior alveolar nerve: a case report.

    Science.gov (United States)

    Suga, Kenichiro; Ogane, Satoru; Muramatsu, Kyotaro; Ohata, Hitoshi; Uchiyama, Takeshi; Takano, Nobuo; Shibahara, Takahiko; Eguchi, Jun; Murakami, Satoshi; Matsuzaka, Kenichi

    2013-01-01

    Schwannomas (neurilemmomas) are benign neoplasms derived from Schwann cells of the neurilemma and appear most frequently on the auditory nerve or peripheral nerves of the skin. They arise in the oral and maxillofacial region infrequently, and very rarely in the center of the jaw. We herein present a case of a rare mandibular intraosseous schwannoma derived from the main trunk of the inferior alveolar nerve in a 33-year-old man. Fusiform expansion in the mandibular canal was observed and a mass showing the target sign in the mandibular canal was confirmed on T2-weighted and Gd contrastenhanced T1-weighted MRI. Based on these findings, an inferior alveolar nerve-derived schwannoma or other benign nervous system neoplasm was diagnosed. A buccal side cortical bone flap in the mandibular molar region was removed to expose the mass, which was then peeled away from the nerve fibers and completely removed. Some inferior alveolar nerve fibers that were connected to the mass were removed at the same time, but the remaining nerve fiber bundle was preserved. Histopathology confirmed the diagnosis of a schwannoma with Antoni type A and Antoni type B regions. Although the patient experienced extremely mild paresthesia in the skin over the mental region and mental foramen at immediately after surgery, this had almost entirely disappeared at 7 years and 4 months later, and there has been no tumor recurrence.

  18. [Inferior vertical nystagmus: is magnetic resonance imaging mandatory?].

    Science.gov (United States)

    Esteban-Sánchez, Jonathan; Rueda-Marcos, Almudena; Sanz-Fernández, Ricardo; Martín-Sanz, Eduardo

    2016-02-01

    Introduccion. La aparicion de un nistagmo vertical inferior clasicamente obliga a descartar una patologia vascular o de la union craneocervical mediante resonancia magnetica (RM). Estudios recientes demuestran una baja rentabilidad de esta prueba, ya que sugieren que este signo oculomotor puede tener una causa vestibular periferica, sobre todo cuando el paciente presenta un vertigo posicional paroxistico benigno (VPPB) del canal semicircular superior. Objetivo. Comprobar la rentabilidad de la RM en una poblacion de pacientes con nistagmo de posicion vertical inferior. Pacientes y metodos. Estudio retrospectivo de 42 pacientes consecutivos a los que se les realizo una historia clinica, exploracion fisica, y pruebas vestibulares caloricas y rotatorias. A todos ellos se les practico una RM craneal y cervical. Resultados. El 52% de los pacientes con nistagmo de posicion vertical inferior presentaba una clinica y exploracion fisica compatibles con VPPB del canal semicircular superior. La RM fue normal en un 67%, un 26% mostraba datos de espondilopatia y un 5% de microangiopatia cerebral no relacionados con la clinica del paciente. La prevalencia de malformacion de Arnold-Chiari de tipo I fue de un 9% en la poblacion estudiada, sin que nadie tuviera un antecedente reciente de VPPB. Los resultados obtenidos en las pruebas complementarias vestibulares no aportaron informacion adicional para llegar a un diagnostico etiologico. Conclusion. En los pacientes con un VPPB, la RM craneal y las pruebas vestibulares tienen una baja rentabilidad diagnostica, y se debe evaluar la necesidad real de esta prueba con el contexto clinico.

  19. Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

    OpenAIRE

    Gintaras Juodzbalys; Hom-Lay Wang; Gintautas Sabalys

    2011-01-01

    ABSTRACT Objectives The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveo...

  20. ¿Tanta importancia tiene pasar por alto la arteria umbilical única?: Comentarios a partir de una sentencia judicial Does ignoring the single umbilical artery have so much importance?: Commentaries concerning a judicial sentence

    Directory of Open Access Journals (Sweden)

    A. Ortega Pérez

    2004-07-01

    Full Text Available El Tribunal Supremo ha condenado a varios obstetras por informar que el cordón umbilical tenía los tres vasos, desactivando así la búsqueda de enfermedades fetales que la arteria umbilical única (AUU habría desencadenado. La condena será éticamente correcta si la AUU está realmente asociada a tales enfermedades. En la población general se detecta un caso de AUU en cada 320 fetos estudiados ecográficamente. En el 68 % de esas detecciones se tratará de un hallazgo aislado, pero aún así aumenta el riesgo de parto prematuro, de peso bajo y de mortalidad perinatal. Por otra parte, el 17 % de estos fetos tendrán, además de la arteria única, cromosomopatías y el 31 % malformaciones anatómicas. Concluyendo, la AUU es realmente un marcador cardinal de riesgo de trastornos fetales, que debe buscarse activamente durante el seguimiento ecográfico del embarazo.The Spanish Supreme Court has condemned several obstetricians after having informed that the umbilical cord of a fetus had the three vessels, therefore deactivating the search for fetal diseases that the single umbilical artery (SUA would have provoked. The sentence will be ethically correct only if SUA is really associated with such diseases. SUA is found in about 1 out of every 320 fetuses studied sonographically. In 68% of them, it will be an isolated finding, although it will increase the risks of premature delivery, low birthweight, and perinatal mortality. On the other hand, 17% of these fetuses will have, besides SUA, chromosomal alterations, and 31 % of them, structural malformations. In conclusion, SUA is an important marker of fetal disorders, and it has to be actively searched for during the ultrasonographic monitoring of the gestation.

  1. Hemianopsia altitudinal inferior por aracnoidite optoquiasmática

    Directory of Open Access Journals (Sweden)

    R. Melaragno Filho

    1949-09-01

    Full Text Available Os autores relatam o caso de um paciente de 48 anos de idade, queixando-se de falta de visão nas metades inferiores dos campos visuais, há aproximadamente um ano. A doença evoluiu progressivamente após sinusotomia maxilar e frontal. Os diversos exames complementares realizados nada revelaram de anormal. Reação de Wassermann sempre negativa no sangue. Ao exame oftalmoscópico ficou patenteado, em AO, franca atrofia, no setor superior das papilas e edema pronunciado em suas metades inferiores. O exame campimétrico revelou nítida hemianopsia altitudinal inferior. As demais funções neurológicas e o exame clínico geral nada mais demonstraram de anormal. A iodoventriculografia evidenciou sinais radiológicos de aracnoidite optoquiasmática. À intervenção cirúrgica, foi verificada a existência de aracnoidite intensa na região quiasmática, com compressão dos nervos ópticos e do próprio quiasma. Após a intervenção cirúrgica, exames oftalmoscópicos sucessivos demonstraram melhora franca da acuidade visual em AO e discreto aumento dos campos visuais. Finalizando, os AA. tecem considerações sôbre as prováveis causas etiológicas dêsse tipo de reação meníngea.

  2. Laparoscopic management of inferior lumbar hernia (Petit triangle hernia).

    Science.gov (United States)

    Ipek, T; Eyuboglu, E; Aydingoz, O

    2005-05-01

    Lumbar hernias are rare defects in the posterolateral abdominal wall that may be congenital or acquired. We present a case of laparoscopic approach to repair an acquired inferior triangle (Petit) lumbar hernia in a woman by using polytetrafluoroethylene mesh. The size of the hernia was 8 x 10 cm. The length of her hospital stay was 2 days. The patient resumed normal activities in less than 2 weeks. The main advantage of this approach is excellent operative visualization, thus avoiding injury to structures near the hernia during repair. Patients benefit from a minimally invasive approach with less pain, shortened hospital course, less analgesic requirements, better cosmetic result, and minimal life-style interference.

  3. Duplicate inferior vena cava filters: more is not always better.

    Science.gov (United States)

    Katyal, Anup; Javed, Muhammad Ali

    2016-01-01

    Duplication of the inferior vena cava (IVC) has been reported in literature. This achieves clinical significance in the setting of lower extremity venous thromboembolism with a contraindication for anticoagulation. We describe a case of lower extremity deep vein thrombosis with duplicate IVC. Anticoagulation was contraindicated in this case leading to successful treatment with double IVC filters. We conducted a PubMed search for all current English language published literature, where filters were placed in the presence of duplicate IVC. We suggest that patients with deep vein thrombosis should have an accurate assessment of venous anatomy before IVC filter placement. Duplication of IVC, although rare, should be considered as this has management implications.

  4. Evidence of mirror neurons in human inferior frontal gyrus.

    Science.gov (United States)

    Kilner, James M; Neal, Alice; Weiskopf, Nikolaus; Friston, Karl J; Frith, Chris D

    2009-08-12

    There is much current debate about the existence of mirror neurons in humans. To identify mirror neurons in the inferior frontal gyrus (IFG) of humans, we used a repetition suppression paradigm while measuring neural activity with functional magnetic resonance imaging. Subjects either executed or observed a series of actions. Here we show that in the IFG, responses were suppressed both when an executed action was followed by the same rather than a different observed action and when an observed action was followed by the same rather than a different executed action. This pattern of responses is consistent with that predicted by mirror neurons and is evidence of mirror neurons in the human IFG.

  5. Amiloidosis renal en paciente con osteomielitis de extremidad inferior

    Directory of Open Access Journals (Sweden)

    María Vicente Santos

    2012-09-01

    Full Text Available La amiloidosis secundaria (AA sistémica es una entidad frecuente, asociada con enfermedades inflamatorias e infecciones de larga evolución, así como con algunas neoplasias. Presentamos el caso de un varón de 58 años, con antecedente de úlcera en miembro inferior derecho de más de 30 años de evolución y con síndrome nefrótico secundario a amiloidosis AA.

  6. Inferior alveolar nerve paresthesia relieved by microscopic endodontic treatment.

    Science.gov (United States)

    Yatsuhashi, Takaaki; Nakagawa, Kan-Ichi; Matsumoto, Miho; Kasahara, Masataka; Igarashi, Tomoko; Ichinohe, Tatsuya; Kaneko, Yuzuru

    2003-11-01

    We experienced two cases of inferior alveolar nerve paresthesia caused by root canal medicaments, which were successfully relieved by microscopic endodontic treatment. In the first case, the paresthesia might have been attributable to infiltration of calcium hydroxide into the mandibular canal through the root canals of the mandibular left second molar tooth. In the second case, the paresthesia might have been attributable to infiltration of paraformaldehyde through the root canals of the mandibular right second molar tooth. The paresthesia was relieved in both cases by repetitive microscopic endodontic irrigation using physiological saline solution in combination with oral vitamin B12 and adenosine triphosphate.

  7. Inferior ST-Elevation Myocardial Infarction Associated with Takotsubo Cardiomyopathy

    Science.gov (United States)

    Koeth, Oliver; Zeymer, Uwe; Schiele, Rudolf; Zahn, Ralf

    2010-01-01

    Takotsubo cardiomyopathy (TCM) is usually characterized by transient left ventricular apical ballooning. Due to the clinical symptoms which include chest pain, electrocardiographic changes, and elevated myocardial markers, Takotsubo cardiomyopathy is frequently mimicking ST-elevation myocardial infarction in the absence of a significant coronary artery disease. Otherwise an acute occlusion of the left anterior descending coronary artery can produce a typical Takotsubo contraction pattern. ST-elevation myocardial infarction (STEMI) is frequently associated with emotional stress, but to date no cases of STEMI triggering TCM have been reported. We describe a case of a female patient with inferior ST-elevation myocardial infarction complicated by TCM. PMID:20811565

  8. Inferior ST-Elevation Myocardial Infarction Associated with Takotsubo Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Oliver Koeth

    2010-01-01

    Full Text Available Takotsubo cardiomyopathy (TCM is usually characterized by transient left ventricular apical ballooning. Due to the clinical symptoms which include chest pain, electrocardiographic changes, and elevated myocardial markers, Takotsubo cardiomyopathy is frequently mimicking ST-elevation myocardial infarction in the absence of a significant coronary artery disease. Otherwise an acute occlusion of the left anterior descending coronary artery can produce a typical Takotsubo contraction pattern. ST-elevation myocardial infarction (STEMI is frequently associated with emotional stress, but to date no cases of STEMI triggering TCM have been reported. We describe a case of a female patient with inferior ST-elevation myocardial infarction complicated by TCM.

  9. Renal transplantation in a child with thrombosed inferior vena cava

    Directory of Open Access Journals (Sweden)

    Surjeet Kumar

    2014-01-01

    Full Text Available The external iliac vein is commonly used in renal transplantation for vascular anastomosis of the allograft renal vein. However, there are rare instances when the transplant surgeon may encounter thrombosis of the ilio-caval vein during surgery, making renal transplantation a challenge. Often, these patients are considered unsuitable for renal transplantation. We report a case of thrombosis of the inferior vena cava in an asymptomatic pediatric patient in whom the splenic vein was used, at transplantation, for venous drainage. This case highlights that pre-operative Doppler screening should be performed in all potential renal transplant recipients.

  10. Inferior epigastric artery: Surface anatomy, prevention and management of injury.

    Science.gov (United States)

    Wong, Clare; Merkur, Harry

    2016-04-01

    The anatomical position of the inferior epigastric artery (IEA) subjects it to risk of injury during abdominal procedures that are close to the artery, such as laparoscopic trocar insertion, insertion of intra-abdominal drains, Tenckhoff(®) catheter (peritoneal dialysis catheter) and paracentesis. This article aims to raise the awareness of the anatomical variations of the course of the IEA in relation to abdominal landmarks in order to define a safer zone for laparoscopic ancillary trocar placement. Methods of managing the IEA injury as well as techniques to minimise the risk of injury to the IEA are reviewed and discussed.

  11. Leiomiossarcoma da veia cava inferior: relato de caso

    Directory of Open Access Journals (Sweden)

    Rafael Lemos Nascif

    2014-12-01

    Full Text Available Relatamos um caso de paciente do sexo feminino, 48 anos, com quadro clínico de dor abdominal de moderada intensidade e abaulamento do abdome. Ao exame físico constatou-se massa abdominal palpável. A tomografia computadorizada mostrou volumosa massa retroperitoneal, com realce heterogêneo e íntima relação com a veia cava inferior. Realizou-se ressecção em bloco da massa e do segmento invadido da veia cava. A histologia revelou leiomiossarcoma.

  12. Tuberculosis pulmonar de campos inferiores Lower lung field tuberculosis

    OpenAIRE

    Alejandra González; Marcelo Fernández Casares; Matías Baldini; Alfredo Monteverde

    2010-01-01

    La tuberculosis (TB) que compromete sólo los campos pulmonares inferiores (TBCI) es poco frecuente en el adulto y en general está asociada a alguna causa de inmunodepresión. El objetivo de nuestro trabajo fue determinar la incidencia de TBCI en nuestra población y comparar sus características respecto de la TB pulmonar de localización habitual. Se estudiaron en forma retrospectiva en el período de 2004 a 2008, 42 pacientes con TBCI que fueron comparados con 84 pacientes con TB pulmonar de loc...

  13. Monopolar intracochlear pulse trains selectively activate the inferior colliculus.

    Science.gov (United States)

    Schoenecker, Matthew C; Bonham, Ben H; Stakhovskaya, Olga A; Snyder, Russell L; Leake, Patricia A

    2012-10-01

    Previous cochlear implant studies using isolated electrical stimulus pulses in animal models have reported that intracochlear monopolar stimulus configurations elicit broad extents of neuronal activation within the central auditory system-much broader than the activation patterns produced by bipolar electrode pairs or acoustic tones. However, psychophysical and speech reception studies that use sustained pulse trains do not show clear performance differences for monopolar versus bipolar configurations. To test whether monopolar intracochlear stimulation can produce selective activation of the inferior colliculus, we measured activation widths along the tonotopic axis of the inferior colliculus for acoustic tones and 1,000-pulse/s electrical pulse trains in guinea pigs and cats. Electrical pulse trains were presented using an array of 6-12 stimulating electrodes distributed longitudinally on a space-filling silicone carrier positioned in the scala tympani of the cochlea. We found that for monopolar, bipolar, and acoustic stimuli, activation widths were significantly narrower for sustained responses than for the transient response to the stimulus onset. Furthermore, monopolar and bipolar stimuli elicited similar activation widths when compared at stimulus levels that produced similar peak spike rates. Surprisingly, we found that in guinea pigs, monopolar and bipolar stimuli produced narrower sustained activation than 60 dB sound pressure level acoustic tones when compared at stimulus levels that produced similar peak spike rates. Therefore, we conclude that intracochlear electrical stimulation using monopolar pulse trains can produce activation patterns that are at least as selective as bipolar or acoustic stimulation.

  14. Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

    Directory of Open Access Journals (Sweden)

    Gintaras Juodzbalys

    2011-01-01

    Full Text Available Objectives: The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement.Material and Methods: Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveolar nerve injury implant, inferior alveolar nerve damage, inferior alveolar nerve paresthesia and inferior alveolar nerve repair. The search was restricted to English language articles, published from 1972 to November 2010. Additionally, a manual search in the major anatomy, dental implant, periodontal and oral surgery journals and books were performed. The publications there selected by including clinical, human anatomy and physiology studies.Results: In total 136 literature sources were obtained and reviewed. Aetiological factors of inferior alveolar nerve injury, risk factors, mechanism, clinical sensory nerve examination methods, clinical symptoms and treatment were discussed. Guidelines were created to illustrate the methods used to prevent and manage inferior alveolar nerve injury before or after dental implant placement.Conclusions: The damage of inferior alveolar nerve during the dental implant placement can be a serious complication. Clinician should recognise and exclude aetiological factors leading to nerve injury. Proper presurgery planning, timely diagnosis and treatment are the key to avoid nerve sensory disturbances management.

  15. Preservation of the recipient inferior vena cava in liver transplantation.

    Science.gov (United States)

    Pereira, F; Herrera, J; Mora, N P; Nuño, J; Turrión, V S; Vicente, E; Ardaiz, J

    1994-01-01

    Twenty piggy-back (PB) liver transplantations (LT) were compared with 20 LT performed by the standard technique in order to evaluate whether or not the theoretical haemodynamic advantages of the preservation of the inferior vena cava (IVC) have any impact on the final results of the LT. Statistically significant differences were observed in the duration of the hepatectomy, which was longer for PB LT (192 min vs. 146 min), and in the duration of the anhepatic phase, which was shorter in that group (52 min vs. 76 min). There were no differences in the duration of the complete surgical procedure, consumption of blood products, incidence of postoperative acute renal failure, number of reoperations or survival.

  16. Inhibition and the right inferior frontal cortex: one decade on.

    Science.gov (United States)

    Aron, Adam R; Robbins, Trevor W; Poldrack, Russell A

    2014-04-01

    In our TICS Review in 2004, we proposed that a sector of the right inferior frontal cortex (rIFC) in humans is critical for inhibiting response tendencies. Here we survey new evidence, discuss ongoing controversies, and provide an updated theory. We propose that the rIFC (along with one or more fronto-basal-ganglia networks) is best characterized as a brake. This brake can be turned on in different modes (totally, to outright suppress a response; or partially, to pause), and in different contexts (externally, by stop or salient signals; or internally, by goals). We affirm inhibition as a central component of executive control that relies upon the rIFC and associated networks, and explain why rIFC disruption could generally underpin response control disorders.

  17. Infrahepatic inferior vena cava agenesis with bilateral renal vein thrombosis.

    Science.gov (United States)

    Skeik, Nedaa; Wickstrom, Kelly K; Schumacher, Clark W; Sullivan, Timothy M

    2013-10-01

    Congenital anomalies of the inferior vena cava (IVC) are rare and are estimated to be present in 0.07-8.7% of the general population. IVC agenesis (IVCA) is found in approximately 5% of cases of unprovoked lower extremity deep vein thrombosis in patients Renal vein thrombosis (RVT) is an extremely rare and unusual presentation of IVCA. We report a unique case of a 23-year-old previously healthy man presenting with infrahepatic IVCA-induced bilateral RVT with azygos and hemiazygos continuation. To our knowledge, this is the third reported case in the literature of IVCA-induced RVT and the first to affect the bilateral renal veins in the absence of any other thrombogenic risk factors or any lower extremity venous complications. We also present a literature review of IVCA-induced vein thrombosis and highlight the lack of literature to manage this condition.

  18. Pseudoaneurisma Ventricular Izquierdo en Cara Inferior con Flujo Bidireccional

    Directory of Open Access Journals (Sweden)

    Adrián J Da Silva-De Abreu

    2011-01-01

    Full Text Available Los pseudoaneurismas son complicaciones infrecuentes de los infartos del miocardio. Consisten en un saco pericárdico que comunica con la cavidad ventricular a través de un cuello de menor diámetro. Se presenta el caso de una paciente de 68 años de edad, con DM II e HTA, sufre Infarto Agudo del Miocardio en Mayo del 2008, presentando disnea y tos por una semana, con diaforesis profusa de inicio súbito y síncope sin dolor precordial. El electrocardiograma reporta zonas de isquemia transmural y subendocárdica en caras inferolateral y lateral alta; respectivamente, y zona eléctricamente inactivable en cara inferior. El ecocardiograma transtorácico muestra el ventrículo izquierdo con dilatación severa, disminución de la fracción de eyección (25% y un pseudoaneurisma de la pared inferior con cuello de 3 mm a través del cual se evidencia flujo bidireccional: de entrada al ventrículo durante la diástole y salida al pseudoaneurisma en sístole. El flujo bidireccional y el gasto cardíaco disminuido contribuyen a evitar el taponamiento cardiaco, sin embargo, en condiciones de mayor demanda el pseudoaneurisma podría perforarse y ocasionar dicha entidad. De ello, la importancia del diagnostico diferencial con los aneurismas verdaderos, lo cual permite llevar a cabo la terapéutica adecuada y evitar tal complicación. Palabras claves: Pseudoaneurisma, Infarto del Miocardio, Diabetes.

  19. Pseudoaneurisma Ventricular Izquierdo en Cara Inferior con Flujo Bidireccional

    Directory of Open Access Journals (Sweden)

    Adrián J Da Silva-De Abreu

    2009-01-01

    Full Text Available Los pseudoaneurismas son complicaciones infrecuentes de los infartos del miocardio. Consisten en un saco pericárdico que comunica con la cavidad ventricular a través de un cuello de menor diámetro. Se presenta el caso de una paciente de 68 años de edad, con DM II e HTA, sufre Infarto Agudo del Miocardio en Mayo del 2008, presentando disnea y tos por una semana, con diaforesis profusa de inicio súbito y síncope sin dolor precordial. El electrocardiograma reporta zonas de isquemia transmural y subendocárdica en caras inferolateral y lateral alta, respectivamente, y zona eléctricamente inactivable en cara inferior. El ecocardiograma transtorácico muestra el ventrículo izquierdo con dilatación severa, disminución de la fracción de eyección (25% y un pseudoaneurisma de la pared inferior con cuello de 3 mm a través del cual se evidencia flujo bidireccional, de entrada al ventrículo durante la diástole y salida al pseudoaneurisma en sístole. El flujo bidireccional y el gasto cardíaco disminuido contribuyen a evitar el taponamiento cardiaco, sin embargo, en condiciones de mayor demanda el pseudoaneurisma podría perforarse y ocasionar dicha entidad. De ello, la importancia del diagnostico diferencial con los aneurismas verdaderos, lo cual permite llevar a cabo la terapéutica adecuada y evitar tal complicación.

  20. Electrophysiological properties of inferior olive neurons: A compartmental model.

    Science.gov (United States)

    Schweighofer, N; Doya, K; Kawato, M

    1999-08-01

    As a step in exploring the functions of the inferior olive, we constructed a biophysical model of the olivary neurons to examine their unique electrophysiological properties. The model consists of two compartments to represent the known distribution of ionic currents across the cell membrane, as well as the dendritic location of the gap junctions and synaptic inputs. The somatic compartment includes a low-threshold calcium current (I(Ca_l)), an anomalous inward rectifier current (I(h)), a sodium current (I(Na)), and a delayed rectifier potassium current (I(K_dr)). The dendritic compartment contains a high-threshold calcium current (I(Ca_h)), a calcium-dependent potassium current (I(K_Ca)), and a current flowing into other cells through electrical coupling (I(c)). First, kinetic parameters for these currents were set according to previously reported experimental data. Next, the remaining free parameters were determined to account for both static and spiking properties of single olivary neurons in vitro. We then performed a series of simulated pharmacological experiments using bifurcation analysis and extensive two-parameter searches. Consistent with previous studies, we quantitatively demonstrated the major role of I(Ca_l) in spiking excitability. In addition, I(h) had an important modulatory role in the spike generation and period of oscillations, as previously suggested by Bal and McCormick. Finally, we investigated the role of electrical coupling in two coupled spiking cells. Depending on the coupling strength, the hyperpolarization level, and the I(Ca_l) and I(h) modulation, the coupled cells had four different synchronization modes: the cells could be in-phase, phase-shifted, or anti-phase or could exhibit a complex desynchronized spiking mode. Hence these simulation results support the counterintuitive hypothesis that electrical coupling can desynchronize coupled inferior olive cells.

  1. Blunt injury to the inferior gluteal artery: case report of a rare "near miss" event

    OpenAIRE

    Chen Wei; Pan Jinshe; Smith Wade R; Liu Huaijun; Zhang Qi; Zhang Yingze

    2008-01-01

    Abstract Traumatic injuries of the inferior gluteal artery are rare, the majority of which are aneurysms due to sharp or blunt trauma. We report the rare case of a "near miss" event of a patient with an acute hemorrhagic mass in the right buttock caused by blunt trauma to the inferior gluteal artery without "hard" clinical signs of vascular injury. Despite the unusual presentation, diffuse injury of the inferior gluteal artery branches was diagnosed by ultrasonography and angiography. This ar...

  2. Spiral CT in aplasia of the pre-renal inferior vena cava as a cause of phlebothrombosis from the femoral veins to the inferior vena cava; Spiral-CT einer Aplasie der praerenalen Vena cava inferior als Ursache einer Phlebothrombose von den Oberschenkelvenen bis in die Vena cava inferior

    Energy Technology Data Exchange (ETDEWEB)

    Schweiger, U. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Schedel, H. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Thiede, U. [Deutsches Herzzentrum Berlin (Germany). Arbeitsgruppe Digitale Bildbearbeitung; Felix, R. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany)

    1994-12-31

    The case report focuses on the computed tomography of the thrombotic okklusion of the inferior vena cava, venae iliacae and femorales communes due to congenital interruption of the prerenal inferior vena cava. The embryology of the abnormality was discussed. (orig.) [Deutsch] Anhand einer Fallstudie wurden die Moeglichkeiten der computertomographischen Diagnostik bei einer durch Teilplasie der `praerenalen` Vena cava inferior hervorgerufenen Thrombose der Vv. femorales superficiales et profundae, der grossen Beckenvenen und der Vena cava inferior erlaeutert. In der Diskussion wurde auf die Embryologie der Missbildung eingegangen. (orig.)

  3. 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

  4. 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

  5. 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

  6. Asociación de los indicadores antropométricos y de composición corporal en la predicción de la resistencia a la insulina en pacientes con enfermedad de las arterias coronarias

    Directory of Open Access Journals (Sweden)

    Larissa Pessoa Vila Nova

    Full Text Available Introducción: en los últimos años la importancia de identificar la resistencia a la insulina (RI en pacientes con enfermedades cardiovasculares isquémicas viene siendo debatida. Métodos alternativos, como los indicadores antropométricos y de composición corporal, han sido señalados como una buena opción y contribuyen para identificar anomalías metabólicas y prevenir complicaciones. Objetivo: asociar indicadores antropométricos y de composición corporal como predictores de la resistencia a la insulina (RI en pacientes con enfermedad de las arterias coronarias. Métodos: estudio transversal realizado en el hospital de referencia cardiológica de Pernambuco, en el periodo de junio a septiembre de 2014, con pacientes adultos y ancianos hospitalizados, de ambos sexos. Se verificaron los siguientes parámetros: estilo de vida, la presencia del síndrome metabólico (SM y otras comorbilidades. Se analizó la RI por el cálculo del HOMA-IR. Los pacientes se sometieron a la impedancia bioeléctrica (BIA y a las verificaciones antropométricas. Resultados: la muestra fue constituida por 75 pacientes con edad media de 63,75 ± 12,43 años, con un 64% de ancianos. Se encontró el diagnóstico de SM en el 65,3% de los pacientes, el 81,3% de sedentarios y el 37,4% con exceso de peso. Se diagnosticó la RI en el 28% de los pacientes. Se observó correlación entre el HOMA-IR y el diámetro abdominal sagital (DAS (r = 0,476; p = 0,016, el índice de masa corporal (r = 0,233; p = 0,040 y el porcentual de grasa corporal (r = 0,276; p = 0,016. Conclusión: el DAS fue el indicador antropométrico que presentó mejor correlación con la RI en pacientes con enfermedad de las arterias coronarias hospitalizados.

  7. Leiomioma benigno metastatizante de veia cava inferior: rara complicação tardia de histerectomia Benign metastasizing leiomyoma of inferior vena cava: a rare condition following hysterectomy

    Directory of Open Access Journals (Sweden)

    Marcos Filgueiras

    2008-08-01

    Full Text Available Large vessel tumors diagnosis is usually difficult. Benign metastasizing leiomyoma is a rare condition occurring inside peripheral vessels. There are few publications about this tumor inside inferior vena cava. A 54 years old female patient is presented with a previous hysterectomy for myomas. She complained of no specific symptoms 18 months after surgery. Computer tomography revealed a 7.5 x 3.5 x 4.0 cm mass at inferior vena cava and right psoas muscle. After surgical management and immunohistochemical screening biopsy, the diagnosis was benign metastasizing leiomyoma of inferior vena cava. The patient recovery was uneventful. Benign metastasizing leiomyoma of inferior vena cava is a very rare condition, and must be suspected in patients with primary leiomyosarcoma, especially in women previously submitted to hysterectomy for leiomyomatosis.

  8. Generalizing Screen Inferiority--Does the Medium, Screen versus Paper, Affect Performance Even with Brief Tasks?

    Science.gov (United States)

    Sidi, Yael; Ophir, Yael; Ackerman, Rakefet

    2016-01-01

    Screen inferiority in performance and metacognitive processes has been repeatedly found with text learning. Common explanations for screen inferiority relate to technological and physiological disadvantages associated with extensive reading on screen. However, recent studies point to lesser recruitment of mental effort on screen than on paper.…

  9. Simultaneous paresthesia of the lingual nerve and inferior alveolar nerve caused by a radicular cyst.

    Science.gov (United States)

    Hamada, Yoshiki; Yamada, Hiroyuki; Hamada, Akiko; Kondoh, Toshirou; Suzuki, Mami; Noguchi, Kazuhide; Ito, Ko; Seto, Kanichi

    2005-10-01

    The inferior alveolar nerve is sometimes affected by periapical pathoses and mandibular cysts. However, mandibular intraosseous lesions have not been reported to disturb the lingual nerve. A case of simultaneous paresthesia of the right lingual nerve and the right inferior alveolar nerve is presented. The possible mechanisms of this extremely uncommon condition are discussed.

  10. Deep venous thrombosis in a young woman with hypoplastic inferior vena cava.

    Science.gov (United States)

    Lavens, Matthias; Moors, Boudewijn; Thomis, Sarah

    2014-05-01

    We present a 33-year-old woman with deep venous thrombosis of the left iliac vein and the left lower limb. A computed tomography scan of her abdomen revealed a hypoplastic inferior vena cava and agenesis of the right kidney. Congenital anomalies of the inferior vena cava are uncommon and are sometimes an unrecognized cause of deep venous thrombosis.

  11. Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters

    Energy Technology Data Exchange (ETDEWEB)

    Iliescu, Bogdan; Haskal, Ziv J., E-mail: ziv2@mac.com [University of Maryland School of Medicine, Division of Vascular and Interventional Radiology (United States)

    2012-08-15

    Inferior vena cava (IVC) filters have proven valuable for the prevention of primary or recurrent pulmonary embolism in selected patients with or at high risk for venous thromboembolic disease. Their use has become commonplace, and the numbers implanted increase annually. During the last 3 years, in the United States, the percentage of annually placed optional filters, i.e., filters than can remain as permanent filters or potentially be retrieved, has consistently exceeded that of permanent filters. In parallel, the complications of long- or short-term filtration have become increasingly evident to physicians, regulatory agencies, and the public. Most filter removals are uneventful, with a high degree of success. When routine filter-retrieval techniques prove unsuccessful, progressively more advanced tools and skill sets must be used to enhance filter-retrieval success. These techniques should be used with caution to avoid damage to the filter or cava during IVC retrieval. This review describes the complex techniques for filter retrieval, including use of additional snares, guidewires, angioplasty balloons, and mechanical and thermal approaches as well as illustrates their specific application.

  12. PERIPHERAL HEARING LOSS CAUSES HYPEREXCITABILITY OF THE INFERIOR COLLICULUS

    Institute of Scientific and Technical Information of China (English)

    Sun Wei

    2013-01-01

    Growing evidence has been found to suggest that early development of the central auditory system is dependent on acoustic stimuli. Peripheral damage caused by noise exposure and ototoxic drugs can induce functional and anatomical changes along the auditory pathways. The inferior colliculus (IC) is a unique structure in the auditory system located between the primary auditory nuclei of the brainstem and the thala-mus. Damage to the IC inhibitory circuitry may affect central auditory processing and sound perception. Here, we review some of the striking electrophysiological changes in the IC that occur after noise exposure and ototoxic drug treatment. A common occurrence that emerges in the IC after peripheral damage is hyper-excitability of sound-evoked response. The hyperexcitability of the IC is likely related with reduced inhibi-tory response that requires normal peripheral inputs. Early age hearing loss can result in a long lasting in-creased susceptibility to audiogenic seizure which is related to hyperactivity in the IC evoked by loud sounds. Our studies suggest that hearing loss can cause increased IC neuron responsiveness which may be related to tinnitus, hyperacusis, and audiogenic seizure.

  13. Predictions Shape Confidence in Right Inferior Frontal Gyrus.

    Science.gov (United States)

    Sherman, Maxine T; Seth, Anil K; Kanai, Ryota

    2016-10-05

    It is clear that prior expectations shape perceptual decision-making, yet their contribution to the construction of subjective decision confidence remains largely unexplored. We recorded fMRI data while participants made perceptual decisions and confidence judgments, manipulating perceptual prior expectations while controlling for potential confounds of attention. Results show that subjective confidence increases as expectations increasingly support the decision, and that this relationship is associated with BOLD activity in right inferior frontal gyrus (rIFG). Specifically, rIFG is sensitive to the discrepancy between expectation and decision (mismatch), and higher mismatch responses are associated with lower decision confidence. Connectivity analyses revealed expectancy information to be represented in bilateral orbitofrontal cortex and sensory signals to be represented in intracalcarine sulcus. Together, our results indicate that predictive information is integrated into subjective confidence in rIFG, and reveal an occipital-frontal network that constructs confidence from top-down and bottom-up signals. This interpretation was further supported by exploratory findings that the white matter density of right orbitofrontal cortex negatively predicted its respective contribution to the construction of confidence. Our findings advance our understanding of the neural basis of subjective perceptual processes by revealing an occipitofrontal functional network that integrates prior beliefs into the construction of confidence.

  14. Skeletal stability after inferior maxillary repositioning without interpositional graft.

    Science.gov (United States)

    Santos, S E; Moreira, R W F; de Moraes, M; Asprino, L; Araujo, M M

    2012-04-01

    True vertical maxillary deficiency is a characteristic of short face syndrome. In these patients, inferior repositioning of the maxilla (IRM) is indicated to improve facial aesthetics and function, but this procedure has been described as the most unstable. The aim of this study was to evaluate the long term, post surgical stability of IRM, fixed with four 2.0mm L-shaped miniplates, without any type of graft. A cephalometric study was performed, analysing linear measurements (anterior nasal spine, the A point, top of the incisor, top of the buccal-mesial cusp of the first molar, and posterior nasal spine on an X-Y coordinate system) traced immediately preoperatively, immediately postoperatively and at least 6 months post operatively. Eight young adult patients who underwent IRM were studied. The average results of this study were: surgical movement of 4.65 mm at I point, 5.32 mm at anterior nasal spine (ANS) point, and 4.70 mm at A point and relapses of 1.60 mm (35%), 2.23 mm (43%) and 2.10 mm (46%), respectively. It was concluded, that IRM using this type of internal rigid fixation without graft is unstable.

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

    Science.gov (United States)

    Carton, Patrick; Filan, David

    2016-01-01

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

  16. 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.

  17. The Quantitative Analysis to Inferior Oil with Electronic Nose Based on Adaptive Multilayer Stochastic Resonance

    Directory of Open Access Journals (Sweden)

    Hong Men

    2011-09-01

    Full Text Available This study makes the three acryl glycerin polymers, oxidation three acryl glycerins, and low carbon number fatty acid as inferior oil feature index. Using double steady state stochastic resonance signal-to-noise ratio analysis methods make the quantitative analysis to inferior oil. This paper analyzes the stochastic resonance. Introduces the principle detection system structure based on adaptive multilayer stochastic resonance algorithm in inferior oil quantitativeanalysis; and make adaptive double stochastic resonance model and inferior oil as example, give the simulation and numerical analysis of this model of the system. The results show that the system can obtain more accurate quality the proportion of the inferior oil information. At the same time, this method can effectively solve the semiconductor gas sensors of the baseline drift problem. The method of stochastic resonance has a lot of application prospect in improving the system performance.

  18. Non-inferiority clinical trials: Practical issues and current regulatory perspective

    Directory of Open Access Journals (Sweden)

    Sandeep K Gupta

    2011-01-01

    Full Text Available Non-inferiority clinical trials are being performed with an increasing frequency now-a-days, because it helps in finding a new treatment that have approximately the same efficacy, but may offer other benefits such as better safety profile. Non-inferiority clinical trials aim to demonstrate that the test product is no worse than the comparator by more than a pre-specified small amount. There are several fundamental differences between non-inferiority and superiority trials. Some practical issues concerning the non-inferiority trials are assay sensitivity, choice of the non-inferiority margin, sample size estimation, choice of active-control, and analysis of non-inferiority clinical trials. For serious infections such as hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia, community-acquired bacterial pneumonia, and acute bacterial skin and skin structure infections, the United States Food and Drug Administration (US FDA has recently recommended that it is possible to define a reliable and consistent estimate of the efficacy of active treatment relative to placebo from available data, which can serve as the basis for defining a new inferiority margin for an active-controlled, non-inferiority trial. But for some indications with a high rate of resolution without antibacterial drug therapy such as acute bacterial sinusitis (ABS, acute bacterial exacerbation of chronic bronchitis (ABECB, and acute bacterial otitis media (ABOM, the US FDA has recommended that the available data will not support the use of a non-inferiority design and other trial designs (i.e., superiority designs should be used to provide the evidence of effectiveness in these three indications.

  19. [Massive inferior vena cava thrombosis in a patient with autosomal dominant polycystic hepatorenal disease].

    Science.gov (United States)

    Peces, R; Gil, F; Costero, O; Pobes, A

    2002-01-01

    We report a 68-year-old man with autosomal dominant polycystic kidney disease, who developed multiple venous thromboses (inferior vena cava, left renal vein and iliofemoral veins) caused by local compression of the intrahepatic inferior vena cava by hepatic cysts. To our knowledge this is the first reported case of inferior vena cava thrombosis caused by hepatic cysts compression. Doppler ultrasound, computed tomography, and magnetic resonance imaging were effective in documenting the venous thromboses and the underlying lesions non-invasively. Long-term anticoagulation was an efficient and safe treatment.

  20. Language outcomes after resection of dominant inferior parietal lobule gliomas.

    Science.gov (United States)

    Southwell, Derek G; Riva, Marco; Jordan, Kesshi; Caverzasi, Eduardo; Li, Jing; Perry, David W; Henry, Roland G; Berger, Mitchel S

    2017-01-06

    OBJECTIVE The dominant inferior parietal lobule (IPL) contains cortical and subcortical regions essential for language. Although resection of IPL tumors could result in language deficits, little is known about the likelihood of postoperative language morbidity or the risk factors predisposing to this outcome. METHODS The authors retrospectively examined a series of patients who underwent resections of gliomas from the dominant IPL. Postoperative language outcomes were characterized across the patient population. To identify factors associated with postoperative language morbidity, the authors then compared features between those patients who experienced postoperative deficits and those who experienced no postoperative language dysfunction. RESULTS Twenty-four patients were identified for analysis. Long-term language deficits occurred in 29.2% of patients (7 of 24): 3 of these patients had experienced preoperative language deficits, whereas new long-term language deficits occurred in 4 patients (16.7%; 4 of 24). Of those patients who exhibited preoperative language deficits, 62.5% (5 of 8) experienced long-term resolution of their language deficits with surgical treatment. All patients underwent intraoperative brain mapping by direct electrical stimulation. Awake, intraoperative cortical language mapping was performed on 17 patients (70.8%). Positive cortical language sites were identified in 23.5% of these patients (4 of 17). Awake, intraoperative subcortical language mapping was performed in 8 patients (33.3%). Positive subcortical language sites were identified in 62.5% of these patients (5 of 8). Patients with positive cortical language sites exhibited a higher rate of long-term language deficits (3 of 4, 75%), compared with those who did not (1 of 13, 7.7%; p = 0.02). Although patients with positive subcortical language sites exhibited a higher rate of long-term language deficits than those who exhibited only negative sites (40.0% vs 0.0%, respectively), this

  1. Surgical treatment for ruptured anterior inferior cerebellar artery aneurysms

    Directory of Open Access Journals (Sweden)

    TONG Xiao-guang

    2013-03-01

    Full Text Available Background Anterior inferior cerebellar artery (AICA aneurysm is an extremely raretumor, which can cause severe results after ruptured. This article retrospectively analyzed the clinical symptoms, imaging manifestations, surgical approaches, endovascular therapy and postoperative outcomes of 12 cases with AICA aneurysms, so as to provide reference for clinical practice. Methods Clinical data of patients with AICA aneurysms, who were treated in our hospital between June 2004 and June 2012, were carefully collected and studied. Glasgow Outcome Scale (GOS scores were used to evaluate the patients' living status. Results There were 12 patients (the average age was 54 years old with 13 ruptured aneurysms, accounting for 0.19% of all aneurysms (6467 cases treated in the same period. CT showed simple subarachnoid hemorrhage (SAH in 6 patients, simple ventricular hemorrhage in 1 patient and SAH complicated with ventricular hemorrhage in 5 patients. According to Hunt-Hess Grade, 2 patients were classified as Grade Ⅰ; 7 were Grade Ⅱ; 3 were Grade Ⅲ. Digital subtraction angiography (DSA showed there were 10 saccular aneurysms and 3 fusiform aneurysms. Three aneurysms were located in the proximal segment of AICA (the junction of AICA and basilar artery, 3 premeatal segment (first bifurcation of AICA, 3 meatal and 4 postmeatal. The mean diameter was 3.90 mm. Three patients with 4 aneurysms were treated with microsurgery, of which clipping was carried out in 2 patients with 3 aneurysms and trapping in 1 case. Other 9 patients were treated with endovascular therapy, of which 2 cases underwent coil embolization, 3 stent-assisted coil, and 4 parent artery occlusion (PAO. Postoperative complications included facial paralysis (1 case, dysphagia and coughing when drinking (1 case and contralateral hemianopia in both eyes (1 case. Follow-up was available in all of these cases for a mean of 36.41 months, with GOS scores 3 in 1 case, 4 in 2 cases and 5 in 9

  2. Tuberculosis pulmonar de campos inferiores Lower lung field tuberculosis

    Directory of Open Access Journals (Sweden)

    Alejandra González

    2010-10-01

    Full Text Available La tuberculosis (TB que compromete sólo los campos pulmonares inferiores (TBCI es poco frecuente en el adulto y en general está asociada a alguna causa de inmunodepresión. El objetivo de nuestro trabajo fue determinar la incidencia de TBCI en nuestra población y comparar sus características respecto de la TB pulmonar de localización habitual. Se estudiaron en forma retrospectiva en el período de 2004 a 2008, 42 pacientes con TBCI que fueron comparados con 84 pacientes con TB pulmonar de localización habitual (grupo control. Se excluyeron pacientes con HIV. La TBCI representó el 6% del total de TB pulmonar. No se encontraron diferencias significativas en cuanto a edad, sexo, presencia de cavidades en la radiografía, días de evolución y nivel de albúmina. La TBCI tuvo significativamente mayor proporción de comorbilidades (p Tuberculosis (TB that affects lower lung fields (LLFTB is infrequent in the adult population and is generally associated with immunodeficiency. The objective of our study was to determine the incidence of LLFTB in our patients population and compare the characteristics of these patients with those who presented TB of typical pulmonary localization. We studied 42 patients with LLFTB retrospectively between 2004 and 2008 and compared them to 84 patients with TB of typical localization (control group. HIV-positive patients were excluded. LLFTB represented 6% of the pulmonary TB cases. No significant differences were found with respect to age, sex, the presence of cavities in chest x-rays, days of evolution, and albumin levels. LLFTB had a significantly greater proportion of comorbilities (p < 0.001, the presence of condensation (p < 0.001, and unilateral involvement (p < 0.001, with a higher number of hospital admissions (p = 0.02. The observation that only 16 of the 42 patients with LLFTB (38% had a notable comorbility is important. Thus, LLFTB can be present without associated comorbilities and must be suspected in

  3. Inferior mesenteric artery branch avulsion from blunt trauma--CT findings. Case report.

    Science.gov (United States)

    Olson, M; Posniak, H; Gomes, G

    1992-01-01

    Mesenteric arterial injuries are uncommon following blunt abdominal trauma. We describe the computed tomography (CT) findings of a patient with avulsion of a branch of the inferior mesenteric artery following a low-speed motor vehicle accident.

  4. Permanent neurologic deficit after inferior alveolar nerve block: a case report.

    Science.gov (United States)

    Shenkman, Z; Findler, M; Lossos, A; Barak, S; Katz, J

    1996-10-01

    Permanent neurologic damage after an inferior dental nerve block is reported. Clinical manifestations included hemisensory syndrome, facial nerve palsy, hearing impairment, and ataxia. Possible mechanisms and preventive measures are discussed.

  5. Anterior and posterior inferior cerebellar artery infarction with sudden deafness and vertigo.

    Science.gov (United States)

    Murakami, Takenobu; Nakayasu, Hiroyuki; Doi, Mitsuru; Fukada, Yasuyo; Hayashi, Miwa; Suzuki, Takeo; Takeuchi, Yuichi; Nakashima, Kenji

    2006-12-01

    We report a patient with anterior and posterior inferior cerebellar artery infarction, which manifested as profound deafness, transient vertigo, and minimal cerebellar signs. We suspect that ischaemia of the left internal auditory artery, which originates from the anterior inferior cerebellar artery, caused the deafness and transient vertigo. A small lesion in the middle cerebellar peduncle in the anterior inferior cerebellar artery territory and no lesion in the dentate nucleus in the posterior inferior cerebellar artery territory are thought to explain the minimal cerebellar signs despite the relatively large size of the infarction. Thus a relatively large infarction of the vertebral-basilar territory can manifest as sudden deafness with vertigo. Neuroimaging, including magnetic resonance imaging, is strongly recommended for patients with sudden deafness and vertigo to exclude infarction of the vertebral-basilar artery territory.

  6. Progress and Outlook on Technologies for Processing Inferior Crude Oil in China

    Institute of Scientific and Technical Information of China (English)

    Yuan Qingtang

    2008-01-01

    The recent growth of the global petroleum refining industry and the main technologies and measures for China to process inferior crude oil were introduced. The main technologies and measures include the control over equipment corrosion induced by sour and acidic crude, in particular the corrosion of atmospheric and vacuum distillation units, the development of technology for processing inferior residue,and the development of desulfurization technology and sulfur recovery technology in the course of processing of petroleum products. In order to meet the needs for national economic development, China's refining enterprises will uninterruptedly develop and prefect technologies for processing inferior crude,enhance the process and equipment management, sum up the experience for better processing of inferior crude, so as to provide high-quality oil products and petrochemical feedstocks to public with better economic return.

  7. Deep Venous Thrombosis Associated With Inferior Vena Cava Abnormalities And Hypoplastic Kidney In Siblings

    Directory of Open Access Journals (Sweden)

    Duicu Carmen

    2016-06-01

    Full Text Available Congenital inferior vena cava anomalies have a reduced frequency in general population, many times being an asymptomatic finding. Patients caring such anomalies are at risk to develop deep vein thrombosis. In this paper, we present 2 siblings with deep venous thrombosis and inferior vena cava abnormalities, with a symptomatic onset at similar age. The inferior vena cava abnormality was documented by an angio-CT in each case. The thrombophilic workup was negative. Patients were treated with conservative therapy: low molecular weight heparin anticoagulants converted later to oral anticoagulant with resolution of symptoms and disappearance of the thrombus. Finally, in the absence of any risk factor in a young patient admitted with deep vein thrombosis investigations to exclude inferior vena cava anomalies are mandatory.

  8. Inflammatory trigeminal nerve and tract lesions associated with inferior alveolar nerve anaesthesia.

    Science.gov (United States)

    Blair, N F; Parratt, J D E; Garsia, R; Brazier, D H; Cremer, P D

    2013-11-01

    Inferior alveolar nerve blocks are commonly performed for dental anaesthesia. The procedure is generally safe with a low rate of complications. We report a patient with a reproducible, delayed-onset sensory deficit associated with contrast-enhancing lesions in the trigeminal nerve, pons and medulla following inferior alveolar nerve local anaesthesia. We propose that this previously undescribed condition is a form of Type IV hypersensitivity reaction.

  9. Sample Size Estimation for Non-Inferiority Trials: Frequentist Approach versus Decision Theory Approach.

    Directory of Open Access Journals (Sweden)

    A C Bouman

    Full Text Available Non-inferiority trials are performed when the main therapeutic effect of the new therapy is expected to be not unacceptably worse than that of the standard therapy, and the new therapy is expected to have advantages over the standard therapy in costs or other (health consequences. These advantages however are not included in the classic frequentist approach of sample size calculation for non-inferiority trials. In contrast, the decision theory approach of sample size calculation does include these factors. The objective of this study is to compare the conceptual and practical aspects of the frequentist approach and decision theory approach of sample size calculation for non-inferiority trials, thereby demonstrating that the decision theory approach is more appropriate for sample size calculation of non-inferiority trials.The frequentist approach and decision theory approach of sample size calculation for non-inferiority trials are compared and applied to a case of a non-inferiority trial on individually tailored duration of elastic compression stocking therapy compared to two years elastic compression stocking therapy for the prevention of post thrombotic syndrome after deep vein thrombosis.The two approaches differ substantially in conceptual background, analytical approach, and input requirements. The sample size calculated according to the frequentist approach yielded 788 patients, using a power of 80% and a one-sided significance level of 5%. The decision theory approach indicated that the optimal sample size was 500 patients, with a net value of €92 million.This study demonstrates and explains the differences between the classic frequentist approach and the decision theory approach of sample size calculation for non-inferiority trials. We argue that the decision theory approach of sample size estimation is most suitable for sample size calculation of non-inferiority trials.

  10. Exposed inferior alveolar neurovascular bundle during surgical removal of a residual cyst.

    Science.gov (United States)

    Boffano, Paolo; Gallesio, Cesare

    2010-01-01

    Iatrogenic neurodeficiency is one of the most distressing complications to any surgical procedure. The prediction of close proximity of the oral lesions to the inferior alveolar neurovascular bundle is extremely important. Furthermore, iatrogenic neurosensory dysfunctions of the facial region involve important medicolegal issues. In this report, we describe the case of a patient who did not show either paresthesia or anesthesia after the surgical removal of a mandibular residual cyst that exhibited adherence to the inferior alveolar nerve bundle.

  11. Spontaneous alignment of crowded inferior incisives after the extractionof temporary canines

    OpenAIRE

    Orellana Manrique, Tomás Oriel; Departamento Académico de Estomatología Pediátrica. Facultad de Odontología UNMSM. Lima Perú.; Calderón Cortez, Iván; Estudiante de pre grado. Facultad de Odontología UNMSM. Lima Perú.; Orellana Manrique, Martín; Estudiante de Maestría. Facultad de Odontología UNMSM. Lima Perú.

    2014-01-01

    This investigation evaluated the behavior of permanent inferior incisives after the primary canine’s extractions. The study was carried out in the Pediatric Clinic of Dental Faculty of San Marcos University. The sample was conformed by 10 patients, male and female children, between 8 and 9 years of age, with good general health, having Class I malocclusion and severe crowding of the inferior incisives. It was taken Cephalometric and Panoramic radiographies, as well as models to make the ortho...

  12. [Investigation of the age-dependent development of brachygnathia inferior in the East Friesian milk sheep].

    Science.gov (United States)

    Pielmeier, Ricarda; Kerkmann, Andrea; Distl, Ottmar

    2012-01-01

    Shortness of the lower jaw (brachygnathia inferior, underbite) is a common anomaly in sheep. In order to study the age-dependent development of brachygnathia inferior, data of 73 East Friesian milk sheep from a breeding experiment over six generations were analysed. Data were recorded in regular intervals of four weeks from birth up to an age of at least 25 weeks. Brachygnathia inferior was determined by the distance between the edge of the central incisor of the lower jaw and the anterior surrounding of the upper jaw (DIFF-UK) using a measuring tape. Four main types of brachygnathia inferior were distinguished using means, standard deviations and maximum values of the individual animals.The thresholds were a maximum and mean DIFF-UK of 0.5 cm and a standard deviation of 0.266 cm. A total of 14 sheep (main types 3 and 4) showed an obvious brachygnathia inferior with mean DIFF-UK larger than 0.5 cm whereof ten animals showed a large variation of DIFF-UK values (standard deviation > 0.226 cm). Mean DIFF-UK values of 59 sheep were smaller than 0.5 cm (main types 1 and 2). One of these 59 animals had during the first four weeks of life DIFF-UK values of 1 cm and than decreasing values reaching zero within the next nine months (main type 2). Five of the 58 animals with main type 1 had a perfect occlusion of jaws, all with DIFF-UK values at zero during the whole recording period. Parents with severe or mild brachygnathia inferior had severely affected progeny. Selection of sheep for breeding with a perfect occlusion of jaws decreases the risk to pass on the hereditary disposition for brachygnathia inferior. An early inspection of potential breeding animals is advisable to detect all cases of brachygnathia inferior even if the underbite decreases in the first year of life.

  13. Inferior Alveolar Nerve Injuries Following Implant Placement - Importance of Early Diagnosis and Treatment: a Systematic Review

    OpenAIRE

    Ilana Shavit; Gintaras Juodzbalys

    2014-01-01

    ABSTRACT Objectives The purpose of this article is to systematically review diagnostic procedures and risk factors associated with inferior alveolar nerve injury following implant placement, to identify the time interval between inferior alveolar nerve injury and its diagnosis after surgical dental implant placement and compare between outcomes of early and delayed diagnosis and treatment given based on case series recorded throughout a period of 10 years. Material and Methods We performed li...

  14. Monitorización ultrasonográfica de endarterectomía carotídea y angioplastia transluminal percutánea como procedimientos de revascularización carotídea en estenosis de alto grado de la arteria carótida interna extracraneal

    OpenAIRE

    Benavente Fernández, Lorena

    2014-01-01

    INTRODUCCIÓN El ictus aterotrombótico por ateromatosis carotídea, es el responsable del 15-20% de todos los ictus. Siendo la arteria carótida interna (ACI) un vaso principal para la irrigación del parénquima cerebral, cuando dicha ateromatosis condiciona una estenosis significativa con alto riesgo tromboembólico se plantea la necesidad de un tratamiento revascularizador. La endarterectomía carotídea (EAC) y la angioplastia endoluminal (ASC) con o sin implante de stent son las dos opciones ...

  15. 介入化疗栓塞术联合体外高频热疗治疗晚期肝癌临床观察%The clinical observation of transcatheter arteria chemoembolization combined with external high frequency thermotherapy for advanced hepatic cancer

    Institute of Scientific and Technical Information of China (English)

    郑剑霄; 吴万垠; 邓宏; 龙顺钦

    2009-01-01

    Objective To evaluate the efficacy and side effects of transeatheter arteria chemoembolization combined with external high frequency thermotherapy for advanced hepatic cancer.Methods Thirty nine patients were randomly divided into 2 groups ,one group with 19 cases,the other 20 cases.The observed group was treated by transcatheter arteria.chemoembolization combined with external high frequency thermotherapy,and the control group by ordinary transcatheter arteria chemoembolization.Result The response rate with the observed group and control group were 73.7%(14/19) and 40%(8/20)respeetively(P<0.05),and its side effects was not increased.There was no significant difference in the survival rate.Conclusions The short term efficacy of the advanced hepatic cancer is improved by transcatheter arteria chemoembolization combined with external high frequency thermotherapy and its side effects is not increased.%目的 比较介入化疗栓塞术联合体外高频热疗与单纯介入化疗栓塞术治疗晚期肝癌的疗效和毒副反应.方法 39例晚期原发性肝癌患者随机分为两组,观察组19例,对照组20例.观察组行介入化疗栓塞术联合体外高频热疗,对照组行单纯介入化疗栓塞术治疗.结果 观察组总有效率73.7%(14/19);对照组总有效率40%(8/20),观察组的治疗有效率较对照组明显提高(P<0.05),毒副反应未增加.0.5年、1年生存率两组差异无显著性(P>0.05).结论 介入化疗栓塞术联合体外高频热疗提高了晚期肝癌的近期疗效,且不增加毒副作用.

  16. Measuring the Pressure in the Superficial Inferior Epigastric Vein to Monitor for Venous Congestion in Deep Inferior Epigastric Artery Perforator Breast Reconstructions : A Pilot Study

    NARCIS (Netherlands)

    Smit, Jeroen M.; Audolfsson, Thorir; Whitaker, Iain S.; Werker, Paul M. N.; Acosta, Rafael; Liss, Anders G.

    2010-01-01

    During deep inferior epigastric artery perforator (DIEP) flap dissection, we noted that in many cases the superficial vein on the ipsilateral side of the flap was engorged and tense, and in others, it was empty. This led us to believe that the pressure is increased as the result of preferential outf

  17. Issues on the selection of non-inferiority margin in clinical trials

    Institute of Scientific and Technical Information of China (English)

    HOU Yan; WU Xiao-yan; LI Kang

    2009-01-01

    Objective The determination of non-inferiority margin is an important and confusing issue which directly influences the acceptability of a new medication. We reviewed the published literature, International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) Guidelines and Committee for Proprietary Medicinal Products (CPMP) papers on the selection of non-inferiority margin and the corresponding statistical tests in clinical trials, in order to provide practical recommendations and suggestions for establishing reference criteria for the non-inferiority margin in China.Data sources The literature on the selection of a non-inferiority margin and statistical tests was mainly extracted from relevant English articles on non-inferior clinical trials published from 1990 to 2007. The starting point (1990) was chosen due to lack of such papers published prior to 1990. This literature was searched via PubMed, Medline and Chinese Knowledge Information (CNKI). ICH guidelines and CPMP papers were downloaded from their official websites. The keywords "clinical trial", "non-inferiority" and "non-inferiority margin" were used.Study selection Forty-three original articles and critical reviews, ICH E10 guideline and CPMP papers were selected.Results The non-inferiority testing with treatment difference and ratio are commonly used, where the non-inferiority margin is determined with and without historical data. Traditionally, this margin is treated as a fixed value, while developed methods take the variation into account in the determination of this margin, on which the test depends is more convincing. The mixed margin consisting of a margin based on treatment difference and a margin based on treatment ratio can exactly control the type Ⅰ error at the desirable level and obtain a better power. In this review, we also provide some recommendations and suggestions for the selection of the non-inferiority margin in the western

  18. 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.

  19. 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

  20. 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.

  1. Comparison of inferior myocardial defect between planar and SPECT image of {sup 123}I-metaiodobenzylguanidine cardiac scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Hideki; Momose, Mitsuru; Kashikura, Kenichi; Matsumoto, Nobusuke; Saito, Katsumi; Asano, Ryuta; Hosoda, Saichi; Kusakabe, Kiyoko [Tokyo Women`s Medical Coll. (Japan)

    1995-02-01

    Discordant findings of inferior MIBG defect between SPECT and planar images were sometimes observed in the clinical studies. In this study, we compared inferior myocardial findings between planar and SPECT image of {sup 123}I-metaiodobenzyl-guanidine (MIBG) cardiac scintigraphy in 29 patients. All patients were estimated as normal in anterior accumulation of MIBG. The patients were divided into 3 groups according to the visual finding of inferior defect in the planar and SPECT image; normal group (normal inferior accumulation of MIBG both in the planar and SPECT image, N=10), discordance group (inferior MIBG defect was only observed in the SPECT image, but was not observed in the planar image, N=7), inferior defect group (inferior MIBG defect was observed both in the planar and SPECT image, N=12). Inferior/anterior count ratio of SPECT and planar image were 0.96{+-}0.11 vs. 0.97{+-}0.05 in normal group, 0.59{+-}0.21 vs. 0.99{+-}0.13 in discordance group, 0.46{+-}0.13 vs. 0.82{+-}0.04 in inferior defect group. Liver/heart count ratio was significantly higher in the discordance group (2.07{+-}0.49) than that in the normal (1.14{+-}0.15) and inferior defect group (1.45{+-}0.39). In phantom study, it has been reported that increased liver accumulation of MIBG causes artifactual inferior defect adjacent to the liver. These data indicate that increased liver/heart count ratio may cause artifactual inferior defect on MIBG SPECT image in the clinical studies. Planar image evaluation may be helpful to distinct the artifactual inferior defect on SPECT image. (author).

  2. Inferior Oblique Muscle Weakening: Is It Possible to Quantify Its Effects on Horizontal Deviations?

    Directory of Open Access Journals (Sweden)

    Hande Taylan Sekeroglu

    2012-01-01

    Full Text Available Objective. To evaluate and quantify the effect of inferior oblique muscle weakening on horizontal deviations. Methods. The medical files of patients who had undergone an inferior oblique weakening as a single procedure were all reviewed. The main measures were the type of inferior oblique overaction (IOOA, pre- and postoperative amount of IOOA, and horizontal deviations in primary position. Results. The study was conducted with 66 patients (30 males, 36 females. The median age was 11 years (1–49. Of the 66 patients, 30 (45.5% had primary and 36 (54.5% had secondary IOOA. The most common procedure was inferior oblique anteriorization in 32 patients (48.5%. The mean postoperative horizontal and vertical deviations and the amount of IOOA were decreased postoperatively ( for all. The median amount of correction of horizontal near and distance deviations was (0–20. The preoperative amount of IOOA, the presence of fourth nerve palsy, and the type of the weakening procedure had no significant effect on the amount of correction of horizontal deviations. Conclusion. The inferior oblique weakening procedures have secondary effects and warrant reduction of horizontal deviations in varying degrees. This should be borne in mind in planning a simultaneous horizontal muscle surgery and setting the surgical amount.

  3. Growth in the area of the inferior dental foramen of rats.

    Science.gov (United States)

    Engel, G; West, V C

    1983-01-01

    The object of the present investigation was to see if the bone around the inferior dental nerve remodelled during mandibular growth and development. The investigation was carried out by injecting 27 albino Lewis rats with three fluorescent bone seeking dyes--oxytetracycline HCl (OTC), alizarin red S (ARS), and 2,4 bis-[N,N'-di' (carbomethyl-aminomethyl)] fluorescein (DCAF)--and then studying the bone around the inferior dental foramen. The mandibles of the animals were studied both macroscopically and microscopically under ultraviolet light to investigate the growth processes occurring and to see if the inferior dental foramen was relocated during growth. A quantitative analysis utilizing two specimens was also carried out for the same purpose. The results of both the qualitative and the quantitative analyses showed that the bone around the inferior dental nerve remodeled during mandibular growth. The mandible grew in an upward and backward direction, and the inferior dental foramen was correspondingly relocated in an upward and backward direction to maintain exactly the same position relative to the condyle and the posterior border of the ramus. This study, then, supports Moss's concept of the "unloaded" nerve, and is in keeping with his view of mandibular growth based on the functional matrix theory.

  4. ROLE OF RADIO FREQUENCY IN THE MANAGEMENT OF INFERIOR TURBINATE HYPERTROPHY

    Directory of Open Access Journals (Sweden)

    Amarnath

    2014-10-01

    Full Text Available BACKGROUND: Surgery of inferior turbinates is a divisive subject. Surgical management includes functional and invasive procedures. Radiofrequency ablation –A Minimally invasive well-designed daycare nasal surgery which also preserves mucosal function of the inferior turbinate. OBJECTIVE: To appraise the efficacy of radiofrequency in the management of inferior turbinate hypertrophy. MATERIALS AND METHODS: current study is a prospective cram conducted in the Department of ENT from August 2013 to August 2014 with 100 patients who had nasal obstruction due to Inferior turbinate hypertrophy and obstinate to medical therapy. Patients were excluded if they had history or physical examination that indicate other causes of nasal obstruction like nasal polyp, nasal tumors, previous nasal surgeries, diabetes mellitus, severe nasal deformities, coagulopathy disorders, severe systemic diseases, radiotherapy to nose. The study was based on history of diagnosis, clinical examination, diagnostic nasal endoscopy and imaging. We used radio frequency generator BM-780II unit with power of 70watt radio wave emission in bipolar mode for 5-9seconds, stopped the emission once visual blanching of mucous membrane occurred. Postoperative follow up scheduled as follows: 1stmonth, 3rdmonth, 6thmonth, 12thmonth. RESULTS: Among 100 patients 92 patients completely relieved of symptoms, 8 patients showed no improvement based on both subjective and objective parameters. CONCLUSIONS: Simple, harmless, minimally invasive, daycare procedure advantages made the Radiofrequency tissue ablation procedure as one amongst the best apt surgical option for management of inferior turbinate hypertrophy and the current study added credit to its efficiency once again.

  5. Thermography for the clinical assessment of inferior alveolar nerve deficit: a pilot study.

    Science.gov (United States)

    Gratt, B M; Sickles, E A; Shetty, V

    1994-01-01

    Neurosensory deficit is a major complication encountered in maxillofacial surgery. This study assessed the ability of electronic thermography to identify inferior alveolar nerve deficits in a pilot clinical study. The study population comprised six patients with inferior alveolar nerve deficit and 12 normal subjects. Frontally projected facial thermograms were taken on 18 subjects and measured using an Agema 870 unit and thermal image computer. Mathematical analysis of thermal measurements included temperature and delta T calculations of the anatomic zone over the mental region of the face. Results included (1) high levels of thermal symmetry of the chin in normal subjects (delta T = 0.1 degree C, standard deviation = 0.1 degree C); (2) low levels of thermal symmetry in patients with inferior alveolar nerve deficits (delta T = +0.5 degree C, standard deviation = 0.2 degree C); (3) statistically significant differences in delta T values (t = 4.82, P > .001) in patients with inferior alveolar nerve deficit; and (4) absolute temperature variations of the mental region in both groups. This pilot study demonstrated thermal asymmetry in patients with inferior alveolar nerve deficit and suggests that electronic thermography has promise as a simple, objective, noninvasive method for evaluating nerve deficits. However, more extensive studies are needed before thermographic procedures are accepted clinically.

  6. Inferior Alveolar Nerve Injuries Following Implant Placement - Importance of Early Diagnosis and Treatment: a Systematic Review

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    Ilana Shavit

    2014-12-01

    Full Text Available Objectives: The purpose of this article is to systematically review diagnostic procedures and risk factors associated with inferior alveolar nerve injury following implant placement, to identify the time interval between inferior alveolar nerve injury and its diagnosis after surgical dental implant placement and compare between outcomes of early and delayed diagnosis and treatment given based on case series recorded throughout a period of 10 years. Material and Methods: We performed literature investigation through MEDLINE (PubMed electronic database and manual search through dental journals to find articles concerning inferior alveolar nerve injury following implant placement. The search was restricted to English language articles published during the last 10 years, from December 2004 to March 2014. Results: In total, we found 33 articles related to the topic, of which 27 were excluded due to incompatibility with established inclusion criteria. Six articles were eventually chosen to be suitable. The studies presented diagnostic methods of inferior alveolar nerve sensory deficit, and we carried out an assessment of the proportion of patients diagnosed within different time intervals from the time the injury occurred. Conclusions: Various diagnostic methods have been developed throughout the years for dealing with 1 quite frequent complication in the implantology field - inferior alveolar nerve injury. Concurrently, the importance of early diagnosis and treatment was proved repeatedly. According to the results of the data analysis, a relatively high percentage of the practitioners successfully accomplished this target and achieved good treatment outcomes.

  7. Prognostic significance of right bundle branch block in patients with acute inferior myocardial infarction

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    Iwasaki,Jun

    2009-02-01

    Full Text Available

    There is little information available concerning the influence of right bundle branch block (RBBB on the prognosis of patients with inferior myocardial infarction (MI. In this study we evaluated the influence of RBBB on the short-term prognosis of patients with inferior MI. Our study subjects were 1,265 hospitalized patients with Q wave MI. Patients were divided into 4 groups based on the presence or absence of RBBB and on the location of the infarction. RBBB was classified into 4 categories according to the timing of its appearance and its duration as new permanent, transient, old and age indeterminate. In-hospital death and pulmonary congestion were observed more frequently in patients with RBBB than in those without RBBB. Moreover, in inferior MI as in anterior MI, in-hospital death and pulmonary congestion occurred more frequently in new permanent RBBB patients than in patients with other types of RBBB. Multivariate regression analysis reveals that new permanent RBBB was a strong independent predictor for an adverse short-term prognosis in patients with inferior MI, as well as in patients with anterior MI. New permanent RBBB during inferior MI is a strong independent predictor for increased in-hospital mortality, regardless of the infarction location.

  8. Differences in superior thyroid artery and inferior thyroid artery blood flow spectrum parameters in subacute thyroiditis

    Institute of Scientific and Technical Information of China (English)

    Jin-Bo Li

    2016-01-01

    Objective:To study the differences in superior thyroid artery and inferior thyroid artery blood flow spectrum parameters in subacute thyroiditis. Methods:A Total of 40 cases of patients with subacute thyroiditis and 40 cases of healthy volunteers were selected for study and enrolled in pathology group and control group respectively, color Doppler ultrasonography was conducted to detect peak blood flow velocities (Vmax) of superior thyroid artery and inferior thyroid artery as well as resistance index (RI), and serum was collected to detect thyroid hormone contents, infection indexes and oxidative stress indexes. Results:Peak blood flow velocities Vmax of superior thyroid artery and inferior thyroid artery of pathology group were significantly higher than those of control group, and resistance index RI was not different from that of control group;FT3, FT4, TT3, TT4, ESR, CRP, PCT and MDA of pathology group were significantly higher than those of control group, and SOD and TAOC were significantly lower than those of control group;Vmax of superior thyroid artery and inferior thyroid artery were positively correlated with FT3, FT4, TT3, TT4, ESR, CRP, PCT and MDA, and negatively correlated with SOD and TAOC. Conclusion:Peak blood flow velocities (Vmax) of superior thyroid artery and inferior thyroid artery in subacute thyroiditis are significantly accelerated, Vmax has good consistency with thyroid hormone contents, infection indexes and oxidative stress indexes, and it can accurately assess the severity of the disease.

  9. Restoration of diaphragmatic function after diaphragm reinnervation by inferior laryngeal nerve; experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    de Barros Angelique

    2006-01-01

    Full Text Available Abstract Objectives To assess the possibilities of reinnervation in a paralyzed hemidiaphragm via an anastomosis between phrenic nerve and inferior laryngeal nerve in rabbits. Reinnervation of a paralyzed diaphragm could be an alternative to treat patients with ventilatory insufficiency due to upper cervical spine injuries. Material and method Rabbits were divided into five groups of seven rabbits each. Groups I and II were respectively the healthy and the denervated control groups. The 3 other groups were all reinnervated using three different surgical procedures. In groups III and IV, phrenic nerve was respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the trunk of the inferior laryngeal nerve. In group V, the fifth and fourth cervical roots were respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the nerve of the sternothyroid muscle (originating from the hypoglossal nerve. Animals were evaluated 4 months later using electromyography, transdiaphragmatic pressure measurements, sonomicrometry and histological examination. Results A poor inspiratory activity was found in quiet breathing in the reinnervated groups, with an increasing pattern of activity during effort. In the reinnervated groups, transdiaphragmatic pressure measurements and sonomicrometry were higher in group III with no significant differencewith groups IV and V. Conclusion Inspiratory contractility of an hemidiaphragm could be restored with immediate anastomosis after phrenic nerve section between phrenic nerve and inferior laryngeal nerve.

  10. Dual joint space arthrography in temporomandibular joint disorders: Comparison with single inferior joint space arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyung Sik; Chang, Duk Soo; Lee, Kyung Soo; Kim, Woo Sun; Sung, Jung Ho; Jun, Young Hwan [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)

    1989-02-15

    The temporomandibular joint(TMJ) is really a complex of two synovial space separated by fibrocartilaginous disc. Single inferior joint space arthrography is commonly performed for evaluation of TMJ disorders, which is known to be superior in demonstrating joint dynamics. But it reveals only the inferior surface of the disc. Therefore, dual space arthrography is superior to demonstrate the soft tissue anatomic feature of the joint such as disc position and shape. Authors performed 83 TMJ arthrograms in TMJ problems. Initially, the inferior joint space was done and then the superior space was sequentially contrasted. The follow results were noted: 1. In all cases, dual space arthrography revealed accurate disc shape and positions. 2. Concordant findings between the two techniques: 68 cases (82%). Discordance between the two techniques: 15 cases (18%) 3. Possible causes of discordance between inferior and dual space arthrography. a) Normal varians of anterior recess: 3 cases b) Posterior disc displacement: 4 cases c) Influence of the patient's head position change :4 cases d) False perforation: 2 cases e) Reduction change: 2 cases 4. In 5 cases with anterior displacement, dual space arthrography gave additional findings such as adhesion within the superior space, which could not be evaluated by single inferior space.

  11. [MASSIVE HEMORRHAGE FROM THE FISTULA FORMATION BETWEEN CUTANEOUS URETEROSTOMY AND INFERIOR EPIGASTRIC ARTERY: A CASE REPORT].

    Science.gov (United States)

    Fujinami, Hiroyuki; Shibuya, Tadamasa; Mori, Kenichi; Shin, Toshitaka; Sumino, Yasuhiro; Sato, Fuminori; Mimata, Hiromitsu; Sato, Yoshiyasu; Matsubara, Takanori; Sakamoto, Sadaaki; Kamei, Noritaka; Hongo, Tetsuo

    2015-04-01

    A 87-year-old man received radical nephroureterectomy for right renal pelvic cancer in 2009 and left cutaneous ureterostomy after radical cystectomy for bladder cancer in 2013. He visited the hospital for exchanging a 7 or 8 Fr single-J catheter every 2 to 4 weeks. Eleven months after the 2nd operation, massive bleeding from the stoma occurred when ureteral catheter was exchanged. Contrast-enhanced computed tomography showed that left inferior epigastric artery was located close to left ureter. Angiography of the left inferior epigastric artery didn't show an obvious fistula, but revealed the stoma was surrounded by ramified new blood vessels from left inferior epigastric artery. We suspected a rupture of the vessels and performed embolization for the branch of inferior epigastric artery to left ureter. This embolization made it possible for the bleeding to be controlled. Massive bleeding from the branch of inferior epigastric artery is very rare, and we report the case and review the literature.

  12. Importance of human right inferior frontoparietal network connected by inferior branch of superior longitudinal fasciculus tract in corporeal awareness of kinesthetic illusory movement.

    Science.gov (United States)

    Amemiya, Kaoru; Naito, Eiichi

    2016-05-01

    It is generally believed that the human right cerebral hemisphere plays a dominant role in corporeal awareness, which is highly associated with conscious experience of the physical self. Prompted by our previous findings, we examined whether the right frontoparietal activations often observed when people experience kinesthetic illusory limb movement are supported by a large-scale brain network connected by a specific branch of the superior longitudinal fasciculus fiber tracts (SLF I, II, and III). We scanned brain activity with functional magnetic resonance imaging (MRI) while nineteen blindfolded healthy volunteers experienced illusory movement of the right stationary hand elicited by tendon vibration, which was replicated after the scanning. We also scanned brain activity when they executed and imagined right hand movement, and identified the active brain regions during illusion, execution, and imagery in relation to the SLF fiber tracts. We found that illusion predominantly activated the right inferior frontoparietal regions connected by SLF III, which were not substantially recruited during execution and imagery. Among these regions, activities in the right inferior parietal cortices and inferior frontal cortices showed right-side dominance and correlated well with the amount of illusion (kinesthetic illusory awareness) experienced by the participants. The results illustrated the predominant involvement of the right inferior frontoparietal network connected by SLF III when people recognize postural changes of their limb. We assume that the network bears a series of functions, specifically, monitoring the current status of the musculoskeletal system, and building-up and updating our postural model (body schema), which could be a basis for the conscious experience of the physical self.

  13. Bilateral inferior dislocation of the hip——a case report

    Institute of Scientific and Technical Information of China (English)

    Kishan R Bhagwat; Bhavuk Garg; Sameer Aggarwal; Mandeep S Dhillon

    2012-01-01

    Inferior dislocation of the hip is the rarest type in hip dislocation.Very few cases have been reported in the anglophonic literature,most of which involved the pediatric age group.Surprisingly,we came across a 30-year-old patient with a bilateral inferior hip dislocation.He had sustained a road traffic accident and the attitude of both hip joints was flexion and abduction.The diagnosis was confirmed by radiographs which revealed the long axis of the femur at an angle of 110 (fight) degrees and 100 (left) degrees respectively away from the axis.Closed reduction under sedation was successfully performed.Skin traction for a period of 6 weeks was advised and the follow-up revealed an excellent result.We present the details of this case,the first of its kind along with a review of the literature,discussing the various modes and mechanisms of injury inducing inferior dislocation of the hip.

  14. [Several common types of counterfeit and inferior drugs in Chinese medicinal materials market].

    Science.gov (United States)

    Liu, Yimei; Chen, Keli

    2012-04-01

    Though there are many species of counterfeit and inferior drugs of Chinese Medicinal Materials in the market, the means of fabrication is common. According to our investigating and reports in the literature it is found that the counterfeits and inferior drugs exist in 4 styles: counterfeits, reused medicinal materials and their slices which have been extracted by boiling water or ethanol, medicinal materials and their slices which have been added with non-medicinal parts or chemicals, medicinal materials which have no enough growth time or have been reserved for a long time. Through summarizing the styles and their common characteristics of the counterfeits and inferior drugs,it is helpful to raise vigilance and detect them.

  15. Acute retroperitoneal bleeding due to inferior mesenteric artery aneurysm: Case report

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    Ferrón JA

    2010-06-01

    Full Text Available Abstract Background Visceral artery aneurysms (VAA, although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm associated with stenosis of the superior mesenteric artery (SMA and celiac trunk, successfully treated with surgery. Methods A 65-year-old man presented with abdominal pain and hypovolemic shock. Abdominal CT scan showed an aneurysm of the inferior mesenteric artery with retroperitoneal hematoma. In addition, an obstructive disease of the superior mesenteric artery and celiac axis was observed. Results Upon emergency laparotomy a ruptured inferior mesenteric artery aneurysm was detected. The aneurysm was excised and the artery reconstructed by end-to-end anastomosis. Conclusions This report discusses the etiology, presentation, diagnosis and case management of inferior mesenteric artery aneurysms.

  16. Blunt injury to the inferior gluteal artery: case report of a rare "near miss" event

    Directory of Open Access Journals (Sweden)

    Chen Wei

    2008-10-01

    Full Text Available Abstract Traumatic injuries of the inferior gluteal artery are rare, the majority of which are aneurysms due to sharp or blunt trauma. We report the rare case of a "near miss" event of a patient with an acute hemorrhagic mass in the right buttock caused by blunt trauma to the inferior gluteal artery without "hard" clinical signs of vascular injury. Despite the unusual presentation, diffuse injury of the inferior gluteal artery branches was diagnosed by ultrasonography and angiography. This article highlights the importance of considering an arterial injury following blunt trauma to the buttock with subsequent pain and swelling. Appreciation of this rare injury pattern is necessary in order to facilitate rapid diagnosis and appropriate treatment.

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

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

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

  18. Avoiding injury to the inferior alveolar nerve by routine use of intraoperative radiographs during implant placement.

    Science.gov (United States)

    Burstein, Jeffrey; Mastin, Chris; Le, Bach

    2008-01-01

    Injury to the inferior alveolar nerve during implant placement in the posterior atrophic mandible is a rare but serious complication. Although a preoperative computerized tomography scan can help determine the distance from the alveolar ridge to the nerve canal, variables such as magnification errors, ridge anatomy, and operator technique can increase the chance for complications. The routine use of intraoperative periapical radiographs during the drilling sequence is an inexpensive and reliable tool, allowing the operator to confidently adjust the direction and depth of the implant during placement. Most important, it helps avoid the risk of injury to the inferior alveolar nerve in cases in which there is limited vertical alveolar bone. Using this technique for 21 implants placed in the posterior atrophic mandible, with less than 10 mm of vertical bone to the inferior alveolar nerve canal, the authors observed no incidents of postoperative paresthesia.

  19. Variação anatômica venosa rara em membros inferiores

    Directory of Open Access Journals (Sweden)

    Melissa Andreia de Moraes Silva

    Full Text Available Resumo A anatomia do sistema venoso dos membros inferiores é uma das mais complexas no corpo humano. Devido a essa condição, é de extrema importância saber identificar variações que possam acometê-la, como as malformações congênitas. Em casos de agenesia de veias profundas, como uma malformação vascular rara, o quadro clínico pode manifestar-se com insuficiência venosa crônica, que pode evoluir com edema, hiperpigmentação e úlcera de membro inferior. Assim, em muitos casos, torna-se uma doença incapacitante e de difícil tratamento. Apresenta-se um caso de agenesia de segmento venoso femoropoplíteo no membro inferior direito em paciente de 36 anos de idade, que cursou com edema e varizes de grosso calibre no membro acometido.

  20. Acute inferior myocardial infarction with right ventricular infarction is more prone to develop cardiogenic shock.

    Science.gov (United States)

    Bari, M A; Roy, A K; Islam, M Z; Aditya, G; Bhuiyan, A S

    2015-01-01

    Cardiogenic shock is rare in isolated acute inferior myocardial infarction but there is relationship of cardiogenic shock with inferior myocardial infarction if associated with right ventricular infarction. A prospective study was carried out to see the association of cardiogenic shock with inferior myocardial infarction if associated with right ventricular infarction. This study was conducted from January 2011 to November 2011. A total of 100 cases were selected as study population which was taken from the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Among them 50 were in Group A and 50 were in Group B. Group A was the patients of acute myocardial infarction with right ventricular infarction. Group B was the patients of acute myocardial infarction without right ventricular infarction. It revealed that 9(18%) in Group A and 3(6%) in Group B developed cardiogenic shock which is statistically significant (pcardiogenic shock.

  1. INFERIOR TURBINECTOMY FOR NASAL OBSTRUCTION-STUDY O F 219 CASES

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    Santhosh

    2013-03-01

    Full Text Available ABSTRACT: OBJECTIVE : To determine the success rate of inferior turbine ctomy for nasal obstruction. To study complications of inferior turb inectomy. To study the histopathological changes in the inferior turbinate specimens. METHOD : This prospective, single blinded, randomized study of 219 consecutive patients carried out in two tertiary le vel centres from January 2010 to October 2011. The patients were asse ssed preoperatively and postoperatively both subjectively and objectively. The patients who were refractory to the directed conservative treatment for chronic nasal obstruction underwent i nferior turbinectomy on both sides and septoplasty if required. The inferior turbinectomy spe cimen was sent for histopathological examination. NOSE Questionnaires were used for subj ective assessment and rigid nasal endoscopy used for objective assessment. Follow up do ne at 1 week, 1 month and 6 months after surgery. Friedman test applied for assessment o f the improvement. RESULTS : 92 % (n=203 of patients relieved of nasal obstruction fo r which they approached. The improvement is statistically significant both subjectively and objectively. The common complications in present study is postoperative nasal synechia which o ccurred in 5% (n=10. Bleeding occurred in 4%(n=8. Dryness and crusting occurred in 2%(n=4 and foul odour in 2% (n=4. The present study also showed that most common cause for turbinate enlargement is chronic nonspecific inflammatory hypertrophy followed by aller gic turbinate hypertrophy. CONCLUSION : -The results show that inferior turbinectomy is t he good method of achieving relief from the nasal obstruction with minimal morb idity. Histopathological examination showed that most common cause of turbinate enlargem ent is chronic non specific turbinate hypertrophy and it proves beyond doubt that unnecessa ry excessive antiallergic treatment should be avoided in patients with chronic nasal obs truction KEY WORDS: inferior

  2. Significance of Radiological Variables Studied on Orthopantamogram to Pridict Post-Operative Inferior Alveoler Nerve Paresthesia After Third Molar Extraction

    OpenAIRE

    Pathak, Sachin; Mishra, Nitin; Rastogi, Madhur Kant; Sharma, Shalini

    2014-01-01

    Context: Removal of impacted third molar is a procedure that is often associated with post-operative complications. The rate of complications is somewhat high because of its proximity to the vital structures. Inferior alveolar nerve paresthesia is one of the common complications of impacted their molar surgery. This is due to intimate relationship between roots of mandibular third molar and inferior alveolar canal. To access the proximity of inferior alveolar canal to third molar many diagnos...

  3. Involvement of the right inferior longitudinal fascicle in visual hemiagnosia: a brain stimulation mapping study.

    Science.gov (United States)

    Fernández Coello, Alejandro; Duvaux, Sophie; De Benedictis, Alessandro; Matsuda, Ryosuke; Duffau, Hugues

    2013-01-01

    Neural foundations underlying visual agnosia are poorly understood. The authors present the case of a patient who underwent awake surgery for a right basal temporooccipital low-grade glioma in which direct electrostimulation was used both at the cortical and subcortical level. Brain mapping over the inferior longitudinal fascicle generated contralateral visual hemiagnosia. These original findings are in agreement with recent tractography data that have confirmed the existence of an occipitotemporal pathway connecting occipital visual input to higher-level processing in temporal lobe structures. This is the first report of a true transient visual hemiagnosia elicited through electrostimulation, supporting the crucial role of inferior longitudinal fascicle in visual recognition.

  4. Advanced Hepatocellular Carcinoma with Subtotal Occlusion of the Inferior Vena Cava and a Right Atrial Mass

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    Christian Steinberg

    2013-01-01

    Full Text Available Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.

  5. Estudo comparativo entre dois protocolos anestésicos envolvendo bloqueio do nervo alveolar inferior convencional e de Vazirani-Akinosi para exodontia de terceiro molar inferior

    Directory of Open Access Journals (Sweden)

    Danilo de Paula Ribeiro Borges

    Full Text Available INTRODUÇÃO: O bloqueio do nervo alveolar inferior (BNAI apresenta alta porcentagem de falha na Odontologia. A fim de melhorar esse índice, vêm-se estudando diferentes alternativas, como diferentes técnicas e soluções anestésicas. OBJETIVO: Avaliar duas diferentes técnicas - técnica convencional e de Vazirani-Akinosi - para o bloqueio do nervo alveolar inferior, bem como compará-las quanto à sua efetividade e quantificar o percentual de aspirações positivas nas duas diferentes técnicas. MATERIAL E MÉTODO: Foram avaliados 160 pacientes de ambos os sexos, sendo 80 submetidos ao bloqueio do nervo alveolar inferior de Vazirani-Akinosi e bloqueio do nervo bucal (G1, e 80 submetidos ao bloqueio do nervo alveolar inferior convencional e ao bloqueio do nervo bucal (G2. Em ambos os grupos, utilizou-se a combinação de articaína 4% com epinefrina 1:100.000 para bloqueio do nervo bucal, e lidocaína 2% com epinefrina 1:100.000 para bloqueio do nervo alveolar inferior. Foram avaliados: a quantidade de aspirações positivas, a eficácia da anestesia e o momento em que ocorreu a falha anestésica durante o procedimento cirúrgico. RESULTADO: Não houve diferenças estatisticamente significantes (p = 0,2453 entre os grupos G1 e G2 observando-se a eficácia e o índice de aspirações positivas, e o momento em que ocorreu a falha anestésica, observando-se uma maior eficácia de ambas as técnicas, quando comparadas com a literatura (90% CONCLUSÃO: Não houve diferença significativa entre o BNAI pela técnica convencional e o BNAI pela técnica de Vazirani-Akinosi quanto a quantidade de aspirações positivas e eficácia, sendo que o uso da articaína 4% com epinefrina 1:100.000 no bloqueio do nervo bucal possivelmente aumentou a eficácia anestésica de ambas as técnicas.

  6. 75 FR 9228 - Draft Guidance for Industry on Non-Inferiority Clinical Trials; Availability

    Science.gov (United States)

    2010-03-01

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft guidance for industry entitled ``Non- Inferiority Clinical Trials.'' This draft guidance provides sponsors and review staff in the Center for Drug Evaluation and Research (CDER) and the Center for Biologics Evaluation and Research (CBER) with the agency's interpretation of the underlying principles involved in the......

  7. Randomized Controlled Non-Inferiority Trial of a Telehealth Treatment for Chronic Stuttering: The Camperdown Program

    Science.gov (United States)

    Carey, Brenda; O'Brian, Sue; Onslow, Mark; Block, Susan; Jones, Mark; Packman, Ann

    2010-01-01

    Background: Although there are treatments that can alleviate stuttering in adults for clinically significant periods, in Australia there are barriers to the accessibility and availability of best-practice treatment. Aims: This parallel group, non-inferiority randomized controlled trial with multiple blinded outcome assessments investigated whether…

  8. Evaluation of macular thickness change after inferior oblique muscle recession surgery

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    Ece Turan-Vural

    2014-01-01

    Full Text Available Purpose: This study aimed to evaluate the changes in macular thickness following inferior oblique muscle recession surgery. Materials and Methods: Thirty-eight eyes from 21 patients undergoing ocular muscle surgery were included. Patients were grouped into three groups based on the type of surgical intervention: Group I (n = 12, inferior oblique recession surgery alone; Group II (n = 12, inferior oblique plus horizontal muscle surgery; Group III (n = 14, horizontal muscle surgery alone. Each eye was scanned using the optical coherence tomography (OCT device preoperatively and on the first postoperative day to measure macular thickness. Results: Following surgery, a significant increase in foveal thickness occurred in Group I (P < 0.05 and Group II (P < 0.01. In addition, a statistically significant difference was observed between the groups with regard to the increase in foveal thickness (P = 0.016, with significantly lower changes in Group III. Conclusion: Our findings suggested that inferior oblique muscle recession surgery is associated with an increase in macular thickness.

  9. Age-Related Increase in Inferior Frontal Gyrus Activity and Social Functioning in Autism Spectrum Disorder

    NARCIS (Netherlands)

    Bastiaansen, Jojanneke A.; Thioux, Marc; Nanetti, Luca; van der Gaag, Christiaan; Ketelaars, Cees; Minderaa, Ruud; Keysers, Christian

    2011-01-01

    Background: Hypoactivation of the inferior frontal gyrus during the perception of facial expressions has been interpreted as evidence for a deficit of the mirror neuron system in children with autism. We examined whether this dysfunction persists in adulthood, and how brain activity in the mirror ne

  10. [The syndrome of blepharophimosis-ptosis-dystopia of the inferior puncta lacrimalia and epicanthus].

    Science.gov (United States)

    Dumitrache, L

    1991-01-01

    The paper presents a family with 28 members belonging to four generations. 12 of them show an association of blepharophimosis--ptosis--dystopia of the inferior lacrimal points and epicanthus. 9 members of the family in the 3rd and 4th generations were examined and a dominant mode of transmission was evidenced.

  11. Intracellular responses to frequency modulated tones in the dorsal cortex of the mouse inferior colliculus

    NARCIS (Netherlands)

    H.R.A.P. Geis (H.-Rüdiger A.P.); J.G.G. Borst (Gerard)

    2013-01-01

    textabstractFrequency modulations occur in many natural sounds, including vocalizations. The neuronal response to frequency modulated (FM) stimuli has been studied extensively in different brain areas, with an emphasis on the auditory cortex and the central nucleus of the inferior colliculus. Here,

  12. Cementoblastoma benigno associado a segundo pré molar inferior : relato de caso

    OpenAIRE

    Mahl, Carlos Eduardo Winck; Gegler, Aderson; Fontanella, Vania Regina Camargo

    2003-01-01

    0 cementoblastoma benigno é uma lesao produtora de cemento que constitui apenas 1% dos tumores odontogenicos, na maioria dos casos esta associada a molares inferiores e acomete adultos jovens. Relata-se urn caso no qual observa-se uma apresentagao atipica quanto localizacao e faixa etaria.

  13. HISTOLOGICAL STUDIES OF THE EFFECTS OF MONOSODIUM GLUTAMATE ON THE INFERIOR COLLICULUS OF ADULT WISTAR RATS.

    Directory of Open Access Journals (Sweden)

    A.O. Eweka.

    2008-01-01

    Full Text Available Histological effects of Monosodium glutamate (MSG commonly used as food additive on the inferior colliculus (IC of adult Wistar rats were carefully studied. The rats of both sexes (n=24, average weight of 185g were randomly assigned into two treatments (n=16 and control (n=8 groups. The rats in the treatment groups received 3g and 6g of MSG thoroughly mixed with their feeds for fourteen days, while the control rats received equal amounts of feeds without MSG added. The rats were fed with growers' mash purchased from Edo Feeds and Flour Mill Ltd, Ewu, Edo State and were given water liberally. The rats were sacrificed on day fifteen of the experiment. The inferior colliculus was carefully dissected out and quickly fixed in 10% formal saline for routine histological study after H&E method.The histological findings after H&E methods indicated that the treated sections of the inferior colliculus showed some cellular degenerative changes, cellular hypertrophy, and autophagic vacuoles with some intercellular vacuolations appearing in the stroma, and some degree of neuronal hypertrophy when compared to the control sections.These findings indicate that MSG consumption may have a deleterious effect on the neurons of the inferior colliculus (IC. MSG may probably have adverse effects on the auditory sensibilities by its deleterious effects on the nerve cells of the IC of adult Wistar rats. It is recommended that further studies aimed at corroborating these observations be carried out.

  14. Related anomalies of origin of left vertebral and left inferior thyroid arteries

    Energy Technology Data Exchange (ETDEWEB)

    Sartor, K.; Freckmann, N.; Boeker, D.K.

    1981-01-01

    The known rare occurrence of related anomalies of origin of vertebral and inferior thyroid arteries appears not to be documented in the angiographic literature. Three cases with manifestation on the left side are presented. Embryology is discussed briefly. Knowledge of such anomalies is of importance to surgeons as well as angiographers.

  15. Inferior alveolar nerve paresthesia caused by a dentigerous cyst associated with three teeth.

    Science.gov (United States)

    Sumer, Mahmut; Baş, Burcu; Yildiz, Levent

    2007-09-01

    The dentigerous cyst is a common pathologic entity associated with an impacted tooth, usually third molars. They generally are asymptomatic, being found on routine dental radiographic examination. This report describes the case of a 43 year old male with a large dentigerous cyst associated with mandibular canine, first and second premolar teeth that caused paresthesia of the inferior alveolar nerve.

  16. Inferior Alveolar Nerve Injury after Mandibular Third Molar Extraction: a Literature Review

    Directory of Open Access Journals (Sweden)

    Rafael Sarikov

    2014-12-01

    Full Text Available Objectives: The purpose of this study was to systematically review the comprehensive overview of literature data about injury to the inferior alveolar nerve after lower third molar extraction to discover the prevalence of injury, the risk factors, recovery rates, and alternative methods of treatment. Material and Methods: Literature was selected through a search of PubMed electronic databases. Articles from January 2009 to June 2014 were searched. English language articles with a minimum of 6 months patient follow-up and injury analysis by patient’s reporting, radiographic, and neurosensory testing were selected. Results: In total, 84 literature sources were reviewed, and 14 of the most relevant articles that are suitable to the criteria were selected. Articles were analyzed on men and women. The influence of lower third molar extraction (especially impacted on the inferior alveolar nerve was clearly seen. Conclusions: The incidence of injury to the inferior alveolar nerve after lower third molar extraction was about 0.35 - 8.4%. The injury of the inferior alveolar nerve can be predicted by various radiological signs. There are few risk factors that may increase the risk of injury to the nerve such as patients over the age of 24 years old, with horizontal impactions, and extraction by trainee surgeons. Recovery is preferable and permanent injury is very rare.

  17. Prominence vs. Aboutness in Sequencing: A Functional Distinction within the Left Inferior Frontal Gyrus

    Science.gov (United States)

    Bornkessel-Schlesewsky, Ina; Grewe, Tanja; Schlesewsky, Matthias

    2012-01-01

    Prior research on the neural bases of syntactic comprehension suggests that activation in the left inferior frontal gyrus (lIFG) correlates with the processing of word order variations. However, there are inconsistencies with respect to the specific subregion within the IFG that is implicated by these findings: the pars opercularis or the pars…

  18. Diffusion tensor imaging of the inferior colliculus and brainstem auditory-evoked potentials in preterm infants

    Energy Technology Data Exchange (ETDEWEB)

    Reiman, Milla; Lehtonen, Liisa; Lapinleimu, Helena [Turku University Central Hospital, Department of Paediatrics, Turku (Finland); Parkkola, Riitta [Turku University Central Hospital, Department of Radiology and Turku PET Centre, Turku (Finland); Johansson, Reijo [Turku University Central Hospital, Department of Otorhinolaryngology, Turku (Finland); Jaeaeskelaeinen, Satu K. [Turku University Central Hospital, Department of Clinical Neurophysiology, Turku (Finland); Kujari, Harry [Turku University Central Hospital, Department of Pathology, Turku (Finland); Haataja, Leena [Turku University Central Hospital, Department of Paediatric Neurology, Turku (Finland)

    2009-08-15

    Preterm and low-birth-weight infants have an increased risk of sensorineural hearing loss. Brainstem auditory-evoked potentials (BAEP) are an effective method to detect subtle deficits in impulse conduction in the auditory pathway. Abnormalities on diffusion tensor imaging (DTI) have been shown to be associated with perinatal white-matter injury and reduced fractional anisotropy (FA) has been reported in patients with sensorineural hearing loss. To evaluate the possibility of a correlation between BAEP and DTI of the inferior colliculus in preterm infants. DTI at term age and BAEP measurements were performed on all very-low-birth-weight or very preterm study infants (n=56). FA and apparent diffusion coefficient (ADC) of the inferior colliculus were measured from the DTI. Shorter BAEP wave I, III, and V latencies and I-III and I-V intervals and higher wave V amplitude correlated with higher FA of the inferior colliculus. The association between the DTI findings of the inferior colliculus and BAEP responses suggests that DTI can be used to assess the integrity of the auditory pathway in preterm infants. (orig.)

  19. Aberrant network integrity of the inferior frontal cortex in women with anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Stephanie Kullmann

    2014-01-01

    These results suggest that AN patients have reduced connectivity within the cognitive control system of the brain and increased connectivity within regions important for salience processing. Due to its fundamental role in inhibitory behavior, including motor response, altered integrity of the inferior frontal cortex could contribute to hyperactivity in AN.

  20. Inferior alveolar nerve injury with laryngeal mask airway: a case report.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-01-01

    The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low; there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway use.

  1. Inferior fronto-temporo-occipital connectivity: a missing link between maltreated girls and neglectful mothers.

    Science.gov (United States)

    Rodrigo, María José; León, Inmaculada; Góngora, Daylin; Hernández-Cabrera, Juan A; Byrne, Sonia; Bobes, María A

    2016-10-01

    The neurobiological alterations resulting from adverse childhood experiences that subsequently may lead to neglectful mothering are poorly understood. Maternal neglect of an infant's basic needs is the most prevalent type of child maltreatment. We tested white matter alterations in neglectful mothers, the majority of whom had also suffered maltreatment in their childhood, and compared them to a matched control group. The two groups were discriminated by a structural brain connectivity pattern comprising inferior fronto-temporo-occipital connectivity, which constitutes a major portion of the face-processing network and was indexed by fewer streamlines in neglectful mothers. Mediation and regression analyses showed that fewer streamlines in the right inferior longitudinal fasciculus tract (ILF-R) predicted a poorer quality of mother-child emotional availability observed during cooperative play and that effect depended on the respective interactions with left and right inferior fronto-occipital fasciculi (IFO-R/L), with no significant impact of psychopathological and cognitive conditions. Volume alteration in ILF-R but not in IFO-L modulated the impact of having been maltreated on emotional availability. The findings suggest the altered inferior fronto-temporal-occipital connectivity, affecting emotional visual processing, as a possible common neurological substrate linking a history of childhood maltreatment with maternal neglect.

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

    NARCIS (Netherlands)

    Jabbi, Mbemba; Keysers, Christian

    2008-01-01

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

  3. Fatal thrombotic complications of hepatic cystic compression of the inferior vena: A case report

    Institute of Scientific and Technical Information of China (English)

    Ting-Kai Leung; Chi-Ming Lee; Hsin-Chi Chen

    2005-01-01

    Of 5% of patients who develop liver cysts, only 10-15%of them come for medical attention, typically because of dull right upper quadrant pain, abdominal bloating or early satiety. We treated a 77-year-old female with a rare complication of inferior vena cava thrombosis. The patient expired due to septic shock and multiple organ failure.

  4. "A Hidden Part of Me": Latino/a Students, Silencing, and the Epidermalization of Inferiority

    Science.gov (United States)

    Irizarry, Jason G.; Raible, John

    2014-01-01

    Using Critical Race Theory (CRT) and Latino/a Critical Race Theory (LatCrit) as analytical tools, this article examines the experiences of a seven Latino/a high school students at various points of engagement with the school-to-prison pipeline. Building on and extending Franz Fanon's (1952) concept of the epidermalization of inferiority, the…

  5. Permutation test for non-inferiority of the linear to the optimal combination of multiple tests.

    Science.gov (United States)

    Jin, Hua; Lu, Ying

    2009-03-01

    We proposed a permutation test for non-inferiority of the linear discriminant function to the optimal combination of multiple tests based on Mann-Whitney statistic estimate of the area under the receiver operating characteristic curve. Monte Carlo simulations showed its good performance.

  6. Moyamoya disease associated with an anterior inferior cerebellar artery arising from a persistent trigeminal artery

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, A.; Sawada, A.; Takase, Y.; Kudo, S. [Department of Radiology, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501 (Japan); Koizumi, T. [Department of Neurosurgery, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501 (Japan)

    2002-07-01

    The authors present a case of moyamoya disease associated with a persistent trigeminal artery from which the anterior inferior cerebellar artery arose. We reviewed previously reported cases of moyamoya disease associated with persistent carotid-basilar arterial anastomosis and investigated the embryology of this rare arterial variation. (orig.)

  7. Left Inferior Frontal Cortex and Syntax: Function, Structure and Behaviour in Patients with Left Hemisphere Damage

    Science.gov (United States)

    Tyler, Lorraine K.; Marslen-Wilson, William D.; Randall, Billi; Wright, Paul; Devereux, Barry J.; Zhuang, Jie; Papoutsi, Marina; Stamatakis, Emmanuel A.

    2011-01-01

    For the past 150 years, neurobiological models of language have debated the role of key brain regions in language function. One consistently debated set of issues concern the role of the left inferior frontal gyrus in syntactic processing. Here we combine measures of functional activity, grey matter integrity and performance in patients with left…

  8. Drenagem anômala de veia pulmonar inferior direita em veia cava inferior associada a apêndice hepático intracardíaco Anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to intrathoracic hepatic appendix

    Directory of Open Access Journals (Sweden)

    Carlos R Moraes

    1988-08-01

    Full Text Available Descreve-se o caso de uma paciente de 61 anos de idade, com drenagem anômala de veia pulmonar inferior direita em veia cava inferior, associada a apêndice hepático intratorácico, herniado através de fenda no diafragma. A correção cirúrgica foi realizada por anastomose direta da veia anômala com o átrio esquerdo, pela redução do apêndice hepático para a cavidade abdominal e, finalmente, pelo fechamento do defeito diafragmático. O pós-operatório decorreu sem qualquer complicação. Os autores chamam a atenção para a raridade do caso.The authors present a case of a 61-year-old woman with anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to an intrathoracic hepatic appendix herniated through a diaphragmatic defect. Surgical correction was obtained by direct anastomosis of the anomalous vein to the left atrium, reduction of the hepatic appendix to the abdominal cavity and closure of the diphragmatic defect. The postoperative course was unevenftul. The rarity of this condition is stressed.

  9. VALIDACIÓN DE LA RADIOGRAFÍA PANORÁMICA EN LA DETERMINACIÓN DE LA POSICIÓN DEL TERCER MOLAR INFERIOR RESPECTO AL CONDUCTO DENTARIO INFERIOR EN CRÁNEOS DE ADULTOS. AREQUIPA.2013

    OpenAIRE

    OCOLA TICONA, BERLIE CESAR

    2014-01-01

    RADIOGRAFÍA PANORÁMICA HISTORIA Y EVOLUCIÓN FUNDAMENTOS DE LA RADIOGRAFÍA PANORÁMICA TERCEROS MOLARES CRITERIOS GENERALES CASUÍSTICA ETIOLOGÍA ETIOPATOGENIA CONDICIONES ANATÓMICAS DIAGNOSTICO CLASIFICACIÓN DE LAS IMPACTACIONES DEL TERCER MOLAR RELACIÓN DEL TERCER MOLAR INFERIOR CON EL CONDUCTO DENTARIO INFERIOR FORMAS DE PREVENCIÓN

  10. Quality of reporting of clinical non-inferiority and equivalence randomised trials - update and extension

    Directory of Open Access Journals (Sweden)

    Schiller Petra

    2012-11-01

    Full Text Available Abstract Background Non-inferiority and equivalence trials require tailored methodology and therefore adequate conduct and reporting is an ambitious task. The aim of our review was to assess whether the criteria recommended by the CONSORT extension were followed. Methods We searched the Medline database and the Cochrane Central Register for reports of randomised non-inferiority and equivalence trials published in English language. We excluded reports on bioequivalence studies, reports targeting on other than the main results of a trial, and articles of which the full-text version was not available. In total, we identified 209 reports (167 non-inferiority, 42 equivalence trials and assessed the reporting and methodological quality using abstracted items of the CONSORT extension. Results Half of the articles did not report on the method of randomisation and only a third of the trials were reported to use blinding. The non-inferiority or equivalence margin was defined in most reports (94%, but was justified only for a quarter of the trials. Sample size calculation was reported for a proportion of 90%, but the margin was taken into account in only 78% of the trials reported. Both intention-to-treat and per-protocol analysis were presented in less than half of the reports. When reporting the results, a confidence interval was given for 85% trials. A proportion of 21% of the reports presented a conclusion that was wrong or incomprehensible. Overall, we found a substantial lack of quality in reporting and conduct. The need to improve also applied to aspects generally recommended for randomised trials. The quality was partly better in high-impact journals as compared to others. Conclusions There are still important deficiencies in the reporting on the methodological approach as well as on results and interpretation even in high-impact journals. It seems to take more than guidelines to improve conduct and reporting of non-inferiority and equivalence

  11. Primary percutaneous coronary intervention ameliorates complete atrioventricular block complicating acute inferior myocardial infarction

    Directory of Open Access Journals (Sweden)

    Lee SN

    2014-11-01

    Full Text Available Su Nam Lee, You-Mi Hwang, Gee-Hee Kim, Ji-Hoon Kim, Ki-Dong Yoo, Chul-Min Kim, Keon-Woong MoonDepartment of Internal Medicine, St Vincent’s Hospital, The Catholic University of Korea, Suwon, South KoreaObjective: Complete atrioventricular block (CAVB in acute inferior ST-segment elevation myocardial infarction (STEMI is associated with poor clinical outcomes after noninvasive treatment. This study was designed to determine the effect of primary percutaneous coronary intervention (PCI in patients with CAVB complicating acute inferior STEMI, at a single center.Methods: We enrolled 138 consecutive patients diagnosed with STEMI involving the inferior wall; of these, 27 patients had CAVB. All patients received primary PCI. The clinical characteristics, procedural data, and clinical outcomes were compared in patients with versus without CAVB. Results: Baseline clinical characteristics were similar between patients with and without CAVB. Patients with CAVB were more likely to present with cardiogenic shock, and CAVB was caused primarily by right coronary artery occlusion. Door-to-balloon time was similar between those two groups. After primary PCI, CAVB was reversed in all patients. The peak creatinine phosphokinase level, left ventricular ejection fraction and in-hospital mortality rate were similar between the two groups. After a median follow up of 318 days, major adverse cardiac events did not differ between the groups (8.1% in patients without CAVB; 11.1% in patients with CAVB (P=0.702.Conclusion: We conclude that primary PCI can ameliorate CAVB-complicated acute inferior STEMI, with an acceptable rate of major adverse cardiac events, and suggest that primary PCI should be the preferred reperfusion therapy in patients with CAVB complicating acute inferior myocardial infarction. Keywords: major adverse cardiac events, PCI-capable hospital

  12. Colgajo de pectoral mayor basado en perforantes internas inferiores: Doble plano invertido Pectoral muscle flap based on inferior-internal perforators: Inverted dual plane

    OpenAIRE

    V. O. Vassaro; A. H. Ali; D. M. Capponi

    2010-01-01

    El polo inferior de la mama en ocasiones puede estar afectado en su espesor por diferentes causas, como el simple paso del tiempo, resecciones oncológicas, extrusiones protésicas por infección, seromas, fístulas, etc. Describimos en este trabajo una alternativa quirúrgica para brindar una mayor cobertura al cuadrante ínferointerno de la glándula mamaria, utilizando un colgajo de músculo pectoral en su porción distal, basado en la irrigación de sus perforantes internas.Some times, the mammary ...

  13. 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....

  14. A randomized controlled, non-inferiority trial of modified natural versus artificial cycle for cryo-thawed embryo transfer

    NARCIS (Netherlands)

    Groenewoud, E. R.; Cohlen, B. J.; Al-Oraiby, A.; Brinkhuis, E. A.; Broekmans, F. J M; De Bruin, J. P.; Van Den Dool, G.; Fleisher, K.; Friederich, J.; Goddijn, M.; Hoek, A.; Hoozemans, D. A.; Kaaijk, E. M.; Koks, C. A M; Laven, J. S E; Van Der Linden, P. J Q; Manger, A. P.; Slappendel, E.; Spinder, T.; Kollen, B. J.; Macklon, N. S.

    2016-01-01

    studyquestion: Are live birth rates (LBRs) after artificial cycle frozen-thawed embryo transfer (AC-FET) non-inferior to LBRs after modified natural cycle frozen-thawed embryo transfer (mNC-FET)? summaryanswer: AC-FET is non-inferior to mNC-FET with regard to LBRs, clinical and ongoing pregnancy rat

  15. A RARE CASE OF EXTENSIVE THROMBOSIS OF INFERIOR VENA CAVA, PORTAL VEIN, SPLENIC VEIN AND SUPERIOR MESENTRIC VEIN

    Directory of Open Access Journals (Sweden)

    Giridhar

    2015-03-01

    Full Text Available While the most common presentation of venous thromboembolic disease is deep vein thrombosis (DVT or pulmonary thromboembolism, rarer manifestations are thrombosis of jugular vein, cerebral sinus and inferior vena cava. Here we are presenting a rare case of inferior vena caval thrombosis with multiple thrombus in portal vein, splenic vein and superior mesenteric vein

  16. A 75 years old man with edema and inferior gastrointestinal bleeding Hombre de 75 años con edemas y sangrado digestivo inferior

    Directory of Open Access Journals (Sweden)

    Gabriel Jaime Varela Aguirre

    2004-02-01

    Full Text Available The case of a 75 year old man is presented. He consulted because of generalized edema and the diagnosis of nephrotic syndrome was done. Histologic study of a renal biopsy reported a glomerulopathy of minimal changes. Treatment with steroids improved of proteinuria, but on reducing the doses, proteinuria returned. In a second hospitalization deep venous thrombosis and gastrointestinal bleeding were diagnosed. A cava vein filter was implanted, colonoscopy was performed and Polyposis Coli was found. A non Hodgkin lymphoma compatible with MANTLE CELL lymphoma (lymphomatous polyposis vs MALT lymphoma was reported in the colonic biopsy. Se presenta el caso de un hombre de 75 años, quien consultó por edemas generalizados originados en un síndrome nefrótico, secundario a una glomerulopatía clasificada como de cambios mínimos. Se le iniciaron esteroides con mejoría de su proteinuria, pero al disminuir las dosis de éstos, recayó, por lo que requirió nueva hospitalización en la que se le documentaron trombosis venosa profunda y sangrado por tracto gastrointestinal inferior. Se le implantó un filtro de vena cava inferior y se le practicó una colonoscopia, en la que se encontró poliposis coli. Al estudio histológico se reportó un linfoma no Hodgkin compatible con un linfoma del manto (poliposis linfomatoide versus linfoma marginal tipo MALT de bajo grado.

  17. Aneurisma da artéria cerebelar ântero-inferior: relato de caso Aneurysm of the anterior inferior cerebellar artery: case report

    Directory of Open Access Journals (Sweden)

    Juan Oscar Alarcón Adorno

    2002-12-01

    Full Text Available Os aneurismas intracranianos do sistema vértebro-basilar representam cerca de 5 a 10% de todos os aneurismas cerebrais. Os aneurismas da artéria cerebelar ântero-inferior (AICA são considerados raros, podendo causar síndrome do ângulo ponto cerebelar, com ou sem hemorragia subaracnóidea. Desde 1948, foram descritos poucos casos na literatura. Apresentamos o caso de uma paciente, de 33 anos, na qual, após investigação de quadro de hemorragia subaracnóidea, diagnosticou-se aneurisma sacular da AICA esquerda. Foi submetida a clipagem do aneurisma, com ótimo resultado pós operatório.The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA are considered rare, can cause cerebello pontine angle (CPA syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.

  18. Dissecção aguda de artéria coronária após troca de valva aórtica Disección aguda de arteria coronaria tras reemplazo de válvula aórtica Acute coronary artery dissection after aortic valve replacement

    Directory of Open Access Journals (Sweden)

    Fernando de Paula Machado

    2010-02-01

    Full Text Available A dissecção de aorta pode ocorrer tardiamente após cirurgia de troca de valva aórtica e raramente no primeiro mês pós-operatório. A dissecção de artéria coronariana é rara e normalmente ocorre depois de angiografia coronariana. Relata-se um caso raro de dissecção de artéria coronária, seguido de infarto do miocárdio, no pós-operatório imediato de troca de valva aórtica com correção e evolução bem-sucedidas.La disección de aorta puede ocurrir tardíamente tras cirugía de reemplazo de válvula aórtica y raramente en el primer mes postoperatorio. La disección de arteria coronaria es rara y normalmente ocurre después de angiografía coronaria. Se relata un caso raro de disección de arteria coronaria, seguido de infarto de miocardio, en el postoperatorio inmediato de reemplazo de válvula aórtica con corrección y evolución exitosas.Late aortic dissection can occur after aortic valve replacement surgery, but rarely in the first postoperative month. Coronary artery dissection is rare and usually occurs after coronary angiography. We report a rare case of coronary artery dissection followed by myocardial infarction in the immediate postoperative period of a successful aortic valve replacement with a good postoperative evolution.

  19. Idiopathic Pulmonary Artery Aneurysm. A Case Report and a Review on some Clinical Aspects. Aneurisma idiopático de la arteria pulmonar. Presentación de un caso y revisión de algunos aspectos clínicos.

    Directory of Open Access Journals (Sweden)

    Rafael Pila Pérez

    2011-10-01

    Full Text Available The case of a 38 years old male patient, inveterate smoker and with a history of idiopathic hypertension that was admitted to the University Hospital "Manuel Ascunce Domenech" in Camaguey because of intense chest pain is presented. The chest x-ray showed a well-defined opaque image at the left parahiliar. This supported the performance of several complementary examinations such as a computed tomography and an echocardiography that revealed the presence of an aneurismal dilatation of the left pulmonary artery. The concluding diagnosis was that of an idiopathic aneurysm of the pulmonary artery. Because the patient showed clinical improvements and the surgical treatment was of high risk for his life, it was decided to follow a conservative approach including regular monitoring.Se presenta el caso de un paciente masculino de 38 años de edad, fumador inveterado, con antecedentes de hipertensión arterial esencial, que ingresó en el Hospital Universitario Manuel Ascunce Doménech, de Camagüey, por presentar dolor precordial intenso. En la radiografía de tórax se encontró una imagen opaca bien delimitada a nivel parahiliar izquierdo, motivo por el cual se le practicaron diversas exploraciones complementarias como tomografía axial computarizada y ecocardiografía que revelaron la presencia de una dilatación aneurismática de la arteria pulmonar izquierda. El diagnóstico se concluyó como un aneurisma idiopático de la arteria pulmonar. Debido a que el paciente mejoró clínicamente y el tratamiento quirúrgico entrañaba mucho riesgo para su vida, se optó por el manejo conservador y control periódico.

  20. Multiple Stability of a Sparsely Encoded Attractor Neural Network Model for the Inferior Temporal Cortex

    Science.gov (United States)

    Kimoto, Tomoyuki; Uezu, Tatsuya; Okada, Masato

    2008-12-01

    We study a neural network model for the inferior temporal cortex, in terms of finite memory loading and sparse coding. We show that an uncorrelated Hopfield-type attractor and some correlated attractors have multiple stability, and examine the retrieval dynamics for these attractors when the initial state is set to a noise-degraded memory pattern. Then, we show that there is a critical initial overlap: that is, the system converges to the correlated attractor when the noise level is large, and otherwise to the Hopfield-type attractor. Furthermore, we study the time course of the correlation between the correlated attractors in the retrieval dynamics. On the basis of these theoretical results, we resolve the controversy regarding previous physiologic experimental findings regarding neuron properties in the inferior temporal cortex and propose a new experimental paradigm.

  1. Transvenous embolization of a dural carotid-cavernous sinus fistula via the inferior ophthalmic vein.

    Science.gov (United States)

    Michels, Kevin S; Ng, John D; Falardeau, Julie; Roberts, Warren G; Petersen, Bryan; Nesbit, Gary M; Barnwell, Stanley L

    2007-01-01

    A 76-year-old woman presented with an acute onset of right periocular pain, diplopia, ocular injection, progressive proptosis, and periocular swelling. She had an unremarkable past medical history, and the erythrocyte sedimentation rate and complete blood count were normal. A carotid-cavernous sinus fistula was suspected, and an MRI demonstrated enlargement of the superior ophthalmic vein posterior to the globe and enlargement of the inferior ophthalmic vein throughout its entire course. Cerebral arteriography demonstrated a dural cavernous sinus fistula. The inferior ophthalmic vein was accessed via the inferonasal orbital space and was catheterized for delivery of multiple platinum coils to the cavernous sinus fistula. Follow-up venograms demonstrated occlusion of the fistula. At 2-month follow-up, there was a residual sixth nerve palsy and resolution of symptoms, including proptosis and periocular swelling.

  2. Inferior alveolar nerve paresthesia caused by endodontic pathosis: a case report and review of the literature.

    Science.gov (United States)

    Giuliani, M; Lajolo, C; Deli, G; Silveri, C

    2001-12-01

    Sensory disturbances such as anesthesia, hypoesthesia, hyperesthesia, and paresthesia may be present in the oral cavity, stemming from many local and systemic factors. Paresthesia of the inferior alveolar nerve is quite rare because of the unique anatomy of this nerve. Among other effects, periapical lesions can damage the nerve, resulting in paresthesia of its innervated area. Only a few cases of paresthesia caused by these lesions are reported in the literature. In this report we present a case of paresthesia of the right inferior alveolar nerve; discuss the anatomy, pathobiology, and etiology; and suggest that a periapical lesion affecting the lower right second molar (No. 31) may have been the cause. The routine x-rays (intraoral and panorex) and the axial and cross-sectional tomographs of the mandible by means of computed tomography contribute to making this case a good example of nerve injury.

  3. Infection-related mental and inferior alveolar nerve paresthesia: literature review and presentation of two cases.

    Science.gov (United States)

    Morse, D R

    1997-07-01

    A review of the literature on infection-related mental and inferior alveolar nerve paresthesia is given. This is followed by 2 case reports. The first case is of a mandibular left second molar in which a chloropercha overfill puff occurred in the vicinity of the inferior alveolar canal. The tooth remained asymptomatic until 2 and 1/2 yr later, when the periapical lesion enlarged and swelling, pain, and paresthesia developed. The paresthesia resolved 2 weeks following periapical surgery. The second case is of a mandibular right first premolar in which paresthesia began 1 day after the initial endodontic treatment. The intracanal medication was formocresol on a cotton pellet that was squeezed dry. The paresthesia was treated by irrigation, antibiotics, and dexamethasone. The paresthesia lasted 7 weeks, and when it resolved the root canal was filled with gutta-percha/eucapercha. Almost 9 months later, the tooth remained asymptomatic.

  4. Subacute sclerosing panencephalitis with bilateral inferior collicular hyperintensity on magnetic resonance imaging brain

    Directory of Open Access Journals (Sweden)

    Maya Thomas

    2012-01-01

    Full Text Available Subacute sclerosing panencephalitis (SSPE is chronic encephalitis occurring after infection with measles virus. An 8-year-old boy presented with progressive behavioral changes, cognitive decline and myoclonic jerks, progressing to a bed bound state over 2 months. Magnetic resonance imaging (MRI brain showed T2-weighted hyperintensities in the subcortical areas of the left occipital lobe and brachium of the inferior colliculus on both sides. EEG showed bilateral, synchronous periodic discharges. Serum/cerebrospinal fluid measles IgG titer was significantly positive. The overall features were suggestive of SSPE. MRI finding of bilateral inferior colliculus changes on MRI without significant involvement of other commonly involved areas suggests an uncommon/rare imaging pattern of SSPE.

  5. An Interpretation of Jane Eyre’s Feeling of Inferiority at Gateshead in Jane Eyre

    Institute of Scientific and Technical Information of China (English)

    赵艳梅

    2015-01-01

    Jane Eyre has been the focus of numerous critics and scholars since its publication in 1847 and they have made a great contribution to the study of Jane Eyre, exploring it from different perspectives. Most of critics and readers regard Jane Eyre as an independent and brave feminism fighter to challenge the tradition in Victorian period while they tend to pay less attention to the invisible side of Jane Eyre. Jane Eyre is not always so brave and strong and confident to face her life, which can be discovered from her language and behavior when she confronts conflicts. This is Jane Eyre ’s feeling of inferiority. From the perspective of Alfred Adler’s individual psychology, this thesis studies Jane Eyre’s feeling of inferiority at Gateshead.

  6. Hypothenar hammer syndrome: Distal ulnar artery reconstruction with autologous inferior epigastric artery.

    Science.gov (United States)

    Smith, Hadley E; Dirks, Marco; Patterson, Robert B

    2004-12-01

    Digital artery embolization and ulnar artery thrombosis are consequences of repetitive trauma and can lead to digit loss and debility from ischemia and cold intolerance. We postulate that an arterial autograft is a theoretically superior conduit to traditional saphenous vein, and report reconstruction with inferior epigastric artery. Three adult male smokers, ages 39 to 49 years, had severe digital ischemia and cold-induced vasospasm. Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch, distal digital artery embolization, and normal proximal vasculature. All reconstructions were performed from the distal most patent ulnar artery at the wrist to the superficial palmar arch (1 patient) or sequentially to the involved common digital arteries (2 patients), with inferior epigastric artery. Handling characteristics and size match between the arterial autografts and bypassed arteries was excellent. Patency has been confirmed with duplex scanning at follow-up of 8 to 24 months, with resolution of cold intolerance and successful digital preservation.

  7. Exames por Imagem na Avaliação da Distância entre Terceiros Molares Inferiores e o Nervo Alveolar Inferior: Revisão de Literatura

    OpenAIRE

    2014-01-01

    TCC (graduação) - Universidade Federal de Santa Catarina. Centro de Ciências da Saúde. Odontologia. A cirurgia de extração do terceiro molar inferior é um dos procedimentos mais comuns dentre as cirurgias dento alveolares. Desta forma, tornam-se frequentes as complicações advindas deste procedimento cirúrgico, sendo a mais comum a lesão/trauma do nervo alveolar inferior, visto sua proximidade com o terceiro molar inferior, que pode acarretar em danos significativos para o paciente como a p...

  8. Estilos de personalidad, modos de afrontamiento y clima social familiar en pacientes amputados de miembro inferior

    OpenAIRE

    Díaz Acosta, Ana Gloria

    2015-01-01

    El objetivo de la presente investigación es relacionar estilos de personalidad, modos de afrontamiento al estrés y clima social familiar en pacientes amputados de miembro inferior. El estudio es de tipo correlacional; la muestra estuvo conformada por 100 participantes varones y 81 mujeres, que fueron atendidos en un establecimiento de salud de Lima y evaluados con los cuestionarios MIPS, COPE y escala FES. Los resultados indican que existe relación significativa entre estilos de personalidad,...

  9. Ionotropic Glutamate Receptor Expression in Preganglionic Neurons of the Rat Inferior Salivatory Nucleus

    OpenAIRE

    Kim, M.; Chiego, D.J.; Bradley, R.M.

    2007-01-01

    Glutamate receptor (GluR) subunit composition of inferior salivatory nucleus (ISN) neurons was studied by immunohistochemical staining of retrogradely labeled neurons. Preganglionic ISN neurons innervating the von Ebner or parotid salivary glands were labeled by application of a fluorescent tracer to the lingual-tonsilar branch of the glossopharyngeal nerve or the otic ganglion respectively. We used polyclonal antibodies to glutamate receptor subunits NR1, NR2A, NR2B, (NMDA receptor subunits)...

  10. Inferior vena cava aneurysm in an infant presenting with a renal mass.

    Science.gov (United States)

    Unzueta-Roch, José L; García-Abós, Miriam; Sirvent-Cerdá, Sara; de Prada, Inmaculada; Martínez de Azagra, Amelia; Ollero, Jose M; Madero-López, Luis

    2014-10-01

    Aneurysm of the inferior vena cava is a rare finding in the pediatric population. We report the case of a 5-month-old infant presenting with anemia, hypertension, and dehydration in the emergency room. A renal mass was found with ultrasound and MRI and a renal tumor was first considered. Histopathologic review of the surgical specimen led to the diagnosis of aneurysmal dilatation of the vena cava.

  11. Reciprocal ST segment changes in acute inferior myocardial infarction: Clinical, hemodynamic and angiographic implications

    Directory of Open Access Journals (Sweden)

    Hatem El Atroush

    2012-09-01

    Conclusion: The significance of reciprocal ST depression on the electrocardiogram during the course of inferior MI remains uncertain, opinion is divided as to whether it is a benign electrical phenomenon or a sign of a greater myocardial necrosis and more frequent left coronary artery disease, from our study we support the latter opinion. This simple ECG finding may be used to differentiate high risk patients for a more aggressive approach.

  12. Individual structural differences in left inferior parietal area are associated with schoolchildrens’ arithmetic scores

    Directory of Open Access Journals (Sweden)

    Yongxin eLi

    2013-12-01

    Full Text Available Arithmetic skill is of critical importance for academic achievement, professional success and everyday life, and childhood is the key period to acquire this skill. Neuroimaging studies have identified that left parietal regions are a key neural substrate for representing arithmetic skill. Although the relationship between functional brain activity in left parietal regions and arithmetic skill has been studied in detail, it remains unclear about the relationship between arithmetic achievement and structural properties in left inferior parietal area in schoolchildren. The current study employed a combination of voxel-based morphometry (VBM for high-resolution T1-weighted images and fiber tracking on diffusion tensor imaging (DTI to examine the relationship between structural properties in the inferior parietal area and arithmetic achievement in 10-year-old schoolchildren. VBM of the T1-weighted images revealed that individual differences in arithmetic scores were significantly and positively correlated with the grey matter (GM volume in the left intraparietal sulcus (IPS. Fiber tracking analysis revealed that the forceps major, left superior longitudinal fasciculus (SLF, bilateral inferior longitudinal fasciculus (ILF and inferior fronto-occipital fasciculus (IFOF were the primary pathways connecting the left IPS with other brain areas. Furthermore, the regression analysis of the probabilistic pathways revealed a significant and positive correlation between the fractional anisotropy (FA values in the left SLF, ILF and bilateral IFOF and arithmetic scores. The brain structure-behavior correlation analyses indicated that the GM volumes in the left IPS and the FA values in the tract pathways connecting left IPS were both related to children’s arithmetic achievement. The present findings provide evidence that individual structural differences in the left IPS are associated with arithmetic scores in schoolchildren.

  13. Inferior Prefrontal Cortex Mediates the Relationship between Phosphatidylcholine and Executive Functions in Healthy, Older Adults

    Directory of Open Access Journals (Sweden)

    Marta Karolina Zamroziewicz

    2016-09-01

    Full Text Available Objectives: This study examines the neural mechanisms that mediate the relationship between phosphatidylcholine and executive functions in cognitively intact older adults. We hypothesized that higher plasma levels of phosphatidylcholine are associated with better performance on a particular component of the executive functions, namely cognitive flexibility, and that this relationship is mediated by gray matter structure of regions within the prefrontal cortex (PFC that have been implicated in cognitive flexibility. Methods: We examined 72 cognitively intact adults between the ages of 65 and 75 in an observational, cross-sectional study to investigate the relationship between blood biomarkers of phosphatidylcholine, tests of cognitive flexibility (measured by the Delis-Kaplan Executive Function System Trail Making Test, and gray matter structure of regions within the PFC. A three-step mediation analysis was implemented using multivariate linear regressions and we controlled for age, sex, education, income, depression status, and body mass index.Results: The mediation analysis revealed that gray matter thickness of one region within the PFC, the left inferior PFC (Brodmann’s Area 45, mediates the relationship between phosphatidylcholine blood biomarkers and cognitive flexibility. Conclusion: These results suggest that the inferior PFC acts as a mediator of the relationship between phosphatidylcholine and cognitive flexibility in cognitively intact older adults. This report demonstrates a novel structural mediation between plasma phosphatidylcholine levels and cognitive flexibility. Future work should examine the potential mechanisms underlying this mediation, including phosphatidylcholine-dependent cell membrane integrity of the inferior PFC and phosphatidylcholine-dependent cholinergic projections to the inferior PFC.

  14. Amputados de la extremidad inferior: estudio prospectivo y resultados del tratamiento rehabilitador

    OpenAIRE

    Medina Estévez, Florián

    1999-01-01

    Programa: Avances en traumatología [ES]Hemos realizado un estudio prospectivo de todos los pacientes en los que se ha realizado cualquier tipo de amputación de la extremidad inferior durante el período comprendido entre el mes de enero de 1990 y septiembre de 1997 en el Hospital Universitario Nuestra Señora del Pino de Las Palmas de Gran Canaria, constituyendo un total de 262 casos.

  15. Anterior inferior iliac spine fracture: Another component of seat belt syndrome?

    Directory of Open Access Journals (Sweden)

    Paisal HUSSIN

    2013-04-01

    Full Text Available Seat belt syndrome occurs when seat belts are used improperly, and it is a cause of significant morbidity and mortality. The spectrum of seat belt syndrome includes spinal, intra-abdominal and vascular injury. Here, we report the case of anterior inferior iliac spine avulsion fracture in association with seat belt injuries in a 24-year old man involved in a head on motor vehicle collision. 

  16. Correction: Inferior alveolar nerve injury with laryngeal mask airway: a case report.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-11-30

    ABSTRACT: Following the publication of our article [Inferior alveolar nerve injury with laryngeal mask airway: a case report. Journal of Medical Case Reports 2011, 5:122] it was brought to our attention that we inadvertently used the registered trademark of the Laryngeal Mask Company Limited (LMA) as the abbreviation for laryngeal mask airway. A Portex(R) Soft Seal(R) Laryngeal Mask was used and not a device manufactured by the Laryngeal Mask Company.

  17. Prenatal Calcification of the Inferior Vena Cava and Renal Veins in a Normal Neonate

    Directory of Open Access Journals (Sweden)

    Daniel Ranch

    2006-01-01

    Full Text Available Prenatal calcification of the inferior vena cava (IVC and renal veins is a rare condition with unclear etiology and prognosis. It occurs with renal vein thrombosis in utero and is associated with congenital anomalies and abnormal prenatal hemodynamic status. We report a rare case of prenatal IVC and renal vein calcification in a normal neonate without any history of compromised prenatal or perinatal condition, or significant deterioration of kidney function.

  18. A case of renal cell carcinoma with an extensive inferior vena cava thrombosis

    Directory of Open Access Journals (Sweden)

    Majd Alfreijat

    2016-10-01

    Full Text Available Renal cell carcinoma (RCC is the most prevalent primary renal malignant neoplasm in adults. Most of the cases are usually found incidentally. It is commonly associated with venous thrombosis. We demonstrate a case of a RCC which was associated with an extensive thrombus that reached the upper part of the inferior vena cava (IVC. We also perform a brief literature review about the association between RCC and IVC thrombosis.

  19. Skin and mucosal ischemia as a complication after inferior alveolar nerve block

    Science.gov (United States)

    Aravena, Pedro Christian; Valeria, Camila; Nuñez, Nicolás; Perez-Rojas, Francisco; Coronado, Cesar

    2016-01-01

    The anesthetic block of the inferior alveolar nerve (IAN) is one of the most common techniques used in dental practice. The local complications are due to the failures on the anesthetic block or to anatomic variations in the tap site such as intravascular injection, skin ischemia and ocular problems. The aim of this article is to present a case and discuss the causes of itching and burning sensation, blanching, pain and face ischemia in the oral cavity during the IAN block.

  20. The impact of orientation filtering on face-selective neurons in monkey inferior temporal cortex

    OpenAIRE

    Jessica Taubert; Valerie Goffaux; Goedele Van Belle; Wim Vanduffel; Rufin Vogels

    2016-01-01

    Faces convey complex social signals to primates. These signals are tolerant of some image transformations (e.g. changes in size) but not others (e.g. picture-plane rotation). By filtering face stimuli for orientation content, studies of human behavior and brain responses have shown that face processing is tuned to selective orientation ranges. In the present study, for the first time, we recorded the responses of face-selective neurons in monkey inferior temporal (IT) cortex to intact and scr...

  1. Klippel-Trenaunay syndrome with gastrointestinal bleeding,splenic hemangiomas and left inferior vena cava

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Klippel-Trenaunay syndrome is a congenital vascular anomaly characterized by a triad of varicose veins,cutaneous capillary malformation,and hypertrophy of bone and(or)soft tissue.Gastrointestinal vascular malformations in Klippel-Trenaunay syndrome may present with gastrointestinal bleeding.The majority of patients with spleenic hemangiomatosis and/or left inferior vena cava are asymptomatic.We herein report a case admitted to the gastroenterology clinic with life-threatening hematochezia and symptomatic ir...

  2. Compartment syndrome in patients with massive venous thrombosis after inferior vena cava filter placement.

    Science.gov (United States)

    Mesfin, Addisu; Lum, Ying Wei; Nayfeh, Tariq; Mears, Simon C

    2011-03-11

    Massive venous thrombosis, which can occur acutely after inferior vena cava filter placement, has 2 forms: phlegmasia cerulea dolens and phlegmasia alba dolens. In phlegmasia cerulea dolens, complete occlusion of venous outflow occurs. In the milder phlegmasia alba dolens version, collateral venous flow out of the limb remains despite the venous thrombosis. This article presents, to our knowledge, the first 2 cases of massive venous thrombosis (1 phlegmasia cerulea dolens, 1 phlegmasia alba dolens) below inferior vena cava filters occurring after the acute period. Phlegmasia cerulea dolens and phlegmasia alba dolens can present as compartment syndrome. Prompt fasciotomies were performed, but the underlying massive venous thrombosis was not addressed surgically. Phlegmasia cerulea dolens and phlegmasia alba dolens have high morbidity and mortality. The patient with phlegmasia alba dolens required leg and thigh fasciotomies and eventually required an above-knee amputation. The patient with phlegmasia cerulea dolens developed compartment syndrome in the left leg, right leg, and right thigh. Although he underwent decompression of all of these compartments, he died from multiple organ failure. A multidisciplinary approach with the vascular service and the intensivists is required in the treatment of patients with massive venous thrombosis. Treatment goals include preventing additional propagation of the thrombus via anticoagulation, with strong consideration for catheter-directed thrombolysis or thrombectomy and fasciotomies for compartment syndrome. The orthopedic surgeon should keep phlegmasia cerulea dolens and phlegmasia alba dolens in the differential for compartment syndrome, especially in patients who have had a history of acute or chronic inferior vena cava filter placement.

  3. Role of suture anchors in management of fractures of inferior pole of patella

    Directory of Open Access Journals (Sweden)

    Anand Ashish

    2010-01-01

    Full Text Available Background: The traditional recommendation for displaced comminuted inferior pole fractures is excision of the comminuted pole followed by reattachment of the patellar tendon with transosseous suture. To the best of our knowledge there has been no previous published study mentioning the use of suture anchors for fracture inferior pole of patella. We present a retrospective analysis of five cases of patients doing well at final follow-up of two years. Materials and Methods: Five patients treated at our institute using suture anchors for repair of comminuted inferior pole fractures of patella between January 2007 to March 2007. (range 28 years-55 years. There were three males and two females. Results: The average follow-up was 25 months (range 24 months-26 months. The patients were evaluated for range of motion, strength, patellofemoral scores and any alteration of patellar height. The outcome of the procedure was assessed with use of the patellofemoral scoring system of Noyes et al, 5 as adapted by Saltzman et al. 6 The final patellofemoral score (maximum 100 points was 94.6 (range 93-96. Conclusion: We believe it is a novel extended indication of the use of suture anchors and should be in the armament of every trauma surgeon.

  4. Impaired Motor Learning in a Disorder of the Inferior Olive: Is the Cerebellum Confused?

    Science.gov (United States)

    Shaikh, Aasef G; Wong, Aaron L; Optican, Lance M; Zee, David S

    2017-02-01

    An attractive hypothesis about how the brain learns to keep its motor commands accurate is centered on the idea that the cerebellar cortex associates error signals carried by climbing fibers with simultaneous activity in parallel fibers. Motor learning can be impaired if the error signals are not transmitted, are incorrect, or are misinterpreted by the cerebellar cortex. Learning might also be impaired if the brain is overwhelmed with a sustained barrage of meaningless information unrelated to simultaneously appearing error signals about incorrect performance. We test this concept in subjects with syndrome of oculopalatal tremor (OPT), a rare disease with spontaneous, irregular, roughly pendular oscillations of the eyes thought to reflect an abnormal, synchronous, spontaneous discharge to the cerebellum from the degenerating neurons in the inferior olive. We examined motor learning during a short-term, saccade adaptation paradigm in patients with OPT and found a unique pattern of disturbed adaptation, quite different from the abnormal adaption when the cerebellum is involved directly. Both fast (seconds) and slow (minutes) timescales of learning were impaired. We suggest that the spontaneous, continuous, synchronous output from the inferior olive prevents the cerebellum from receiving the error signals it needs for appropriate motor learning. The important message from this study is that impaired motor adaptation and resultant dysmetria is not the exclusive feature of cerebellar disorders, but it also highlights disorders of the inferior olive and its connections to the cerebellum.

  5. Leiomyosarcoma of the inferior vena cava level II involvement: curative resection and reconstruction of renal veins

    Directory of Open Access Journals (Sweden)

    Wang Quan

    2012-06-01

    Full Text Available Abstract Leiomyosarcoma of the inferior vena cava (IVCL is a rare retroperitoneal tumor. We report two cases of level II (middle level, renal veins to hepatic veins IVCL, who underwent en bloc resection with reconstruction of bilateral or left renal venous return using prosthetic grafts. In our cases, IVCL is documented to be occluded preoperatively, therefore, radical resection of tumor and/or right kidney was performed and the distal end of inferior vena cava was resected and without caval reconstruction. None of the patients developed edema or acute renal failure postoperatively. After surgical resection, adjuvant radiation therapy was administrated. The patients have been free of recurrence 2 years and 3 months, 9 months after surgery, respectively, indicating the complete surgical resection and radiotherapy contribute to the better survival. The reconstruction of inferior vena cava was not considered mandatory in level II IVCL, if the retroperitoneal venous collateral pathways have been established. In addition to the curative resection of IVCL, the renal vascular reconstruction minimized the risks of procedure-related acute renal failure, and was more physiologically preferable. This concept was reflected in the treatment of the two patients reported on.

  6. Inferior dislocation of the hip: a case series and literature review

    Institute of Scientific and Technical Information of China (English)

    Sameer Aggarwal; Vishal Kumar; Kishan Ramachandra Bhagwat; Vokkaleri Shankaranarayana Shashikanth; Holalu Shankaralingegowda Ravikumar

    2012-01-01

    Inferior hip dislocation is the rarest type among all hip dislocations.Very few cases have been reported in the English literature.Most of the earlier reported cases involves the pediatric age group.No single case series could be found in the English literature.We came across 4 cases of inferior hip dislocation with a varied age profile (range 10 to 56 years,mean 33.8 years).Patients with this disease usually complained of pain and kept the thigh flexed and abducted.The diagnosis can be confirmed by radiographs which reveal that the long axis of the femur varies in alignment with respect to the spine from parallel to an angle almost 90° away from the axis.In our series,closed reduction was successful in all patients,either under sedation or general anaesthesia.Skin traction for a period of 6 weeks was applied in all of them and follow-up revealed pain-free,stable and mobile hips.In this study we present the details of these cases along with a review of literature discussing the various modes and mechanisms that produce inferior hip dislocation.

  7. Inferior dislocation of the hip: a case series and literature review

    Directory of Open Access Journals (Sweden)

    Aggarwal Sameer

    2012-11-01

    Full Text Available 【Abstract】 Inferior hip dislocation is the rarest type among all hip dislocations. Very few cases have been re-ported in the English literature. Most of the earlier reported cases involves the pediatric age group. No single case series could be found in the English literature. We came across 4 cases of inferior hip dislocation with a varied age profile (range 10 to 56 years, mean 33.8 years. Patients with this disease usually complained of pain and kept the thigh flexed and abducted. The diagnosis can be confirmed by radiographs which reveal that the long axis of the femur varies in alignment with respect to the spine from parallel to an angle almost 90° away from the axis. In our series, closed reduction was successful in all patients, either under seda-tion or general anaesthesia. Skin traction for a period of 6 weeks was applied in all of them and follow-up revealed pain-free, stable and mobile hips. In this study we present the details of these cases along with a review of literature discussing the various modes and mechanisms that pro-duce inferior hip dislocation. Key words: Hip dislocation; Therapeutics; Traction; Weight-bearing

  8. Corticofugal modulation of frequency tuning of inferior collicular neurons in big brown bat, Eptesicus fuscus

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    In order to explore the possible mechanism of corticofugal modulation of excitatory frequency tuning curves (EFTCs) of midbrain neurons, we examined the change of sharpness, frequency-intensity response area, minimum threshold of both EFTCs and inhibitory frequency tuning curves (IFTCs) of inferior collicular neurons during corticofugal modulation using two-tone inhibition paradigm and micro-electrical stimulation technique. Our data showed that corticofugal inhibition increased sharpness, minimum threshold, and decreased the frequency-intensity response area of EFTCs, at the same time it decreased the sharpness, minimum threshold but increased the frequency-intensity response area of IFTCs. The opposite results were observed for EFTCs and IFTCs of corticofugally facilitated inferior collicular neurons. During corticofugal inhibition, the per-cent change of frequency-intensity response area of EFTCs had significant correlation with the percent change of that of IFTCs. These data suggest that cortical neurons are likely to improve frequency information processing of inferior col-licular neurons by modulation of IFTCs.

  9. Demand on verbal working memory delays haemodynamic response in the inferior prefrontal cortex.

    Science.gov (United States)

    Thierry, Guillaume; Ibarrola, Danielle; Démonet, Jean-François; Cardebat, Dominique

    2003-05-01

    Event-related functional magnetic resonance imaging was used to test the involvement of the inferior prefrontal cortex in verbal working memory. Pairs of French nouns were presented to ten native French speakers who had to make semantic or grammatical gender decisions. Verbal working memory involvement was manipulated by making the categorization of the second noun optional. Decisions could be made after processing the first noun only (RELEASE condition) or after processing the two nouns (HOLD condition). Reaction times suggested faster processing for gender than for semantic category in RELEASE. Despite the absence of anatomical difference across tasks and conditions in the wide activated network, the haemodynamic response peak latencies of the inferior prefrontal cortex were significantly delayed in HOLD versus RELEASE while no such peak delay was observed in the superior temporal gyrus. Interestingly, this pattern did not interact with language tasks. This study shows that cognitive manipulation can influence haemodynamic time-course and suggests that the main cognitive process determining inferior prefrontal activation is verbal working memory rather than specific linguistic processes such as grammatical or semantic analysis.

  10. A Rare Location of Angiofibroma in the Inferior Turbinate in Young Woman

    Directory of Open Access Journals (Sweden)

    Salimov, Asif

    2015-01-01

    Full Text Available Introduction Juvenile nasopharyngeal angiofibroma is a rare benign neoplasm in the nasopharynx. The tumor tends to be locally aggressive and is typically seen in adolescent boys. Extranasopharyngeal angiofibromas have been reported sporadically in the literature. They most commonly originate from the maxillary sinus. Objectives A 26-year-old woman was referred to our clinic with intermittent epistaxis from the right nasal passage for the previous 2 months. Maxillofacial magnetic resonance imaging showed a lobular, contoured mass originating from the right inferior turbinate and hanging in the right nasal cavity, with dense contrast enhancement denoting hypervascularity. Resumed Report Vascular feeding of the mass was seen from the right internal maxillary artery with angiography, and this branch was embolized. On the following day, the patient underwent transnasal endoscopic excision of the mass. An approximately 3-cm-diameter mass was excised by partial turbinectomy, and the posterior edge of the remaining turbinate was cauterized. Conclusion Extranasopharyngeal angiofibromas are rarely seen, and the inferior turbinate is an extremely rare location for them. This young woman is the first case reported in the English literature of angiofibroma originating from the inferior turbinate. We should consider these neoplasms can be found in female, nonadolescent patients with extranasopharyngeal localization, and we should not perform biopsy because of its massive bleeding.

  11. 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

  12. [Agenesis of the infrarenal inferior vena cava with thrombosis of the renal vein in a fetus: a case report].

    Science.gov (United States)

    Raposo Rodríguez, L; Recio Rodríguez, M; Alvarez Moreno, E; López Azorín, M

    2012-01-01

    Agenesis of the inferior vena cava, especially of the infrarenal segment, is exceptional. This condition is thought to result from thrombosis during gestation rather than from a true congenital malformation. Agenesis of the inferior vena cava can be associated with renal vein thrombosis, which in turn is related to suprarenal hemorrhage in the fetus. We present a case of agenesis of the inferior vena cava with preservation of the hepatic segment, thrombosis of the left renal vein, and secondary bilateral suprarenal hemorrhage diagnosed prenatally using sonography and magnetic resonance imaging.

  13. Avaliação da inclinação do incisivo inferior através da tomografia computadorizada Computed tomographic evaluation of inferior incisor position

    Directory of Open Access Journals (Sweden)

    Leopoldino Capelozza Filho

    2008-12-01

    Full Text Available INTRODUÇÃO: durante muito tempo, a Ortodontia baseou-se em valores normativos obtidos através das análises cefalométricas existentes, utilizando a telerradiografia em norma lateral como exame principal no diagnóstico ortodôntico, ditando o plano de tratamento. O incisivo inferior, em particular, recebeu normas cefalométricas propostas por diversos autores, dentre eles Tweed. Entretanto, os exames radiográficos possuem limitações, pois, em uma imagem bidimensional de uma estrutura tridimensional, a superposição de determinadas estruturas ósseas e dentárias é constante. O advento da tomografia computadorizada disponibilizou meios diagnósticos mais precisos e confiáveis, principalmente pela possibilidade de obtenção da imagem das estruturas em três dimensões. Nesse contexto, parece razoável questionar os dados oriundos da análise clássica da radiografia lateral da face, com intuito de criar fatores de comparação com dados que passarão a ser gerados a partir da mesma imagem obtida pela tomografia. OBJETIVOS: para isso, propusemo-nos a avaliar o ângulo formado entre o longo eixo do incisivo inferior e o plano mandibular, a grandeza IMPA da cefalometria, na telerradiografia convencional e na tomografia computadorizada. MÉTODOS: dezenove pacientes selecionados para tratamento ortodôntico constituíram a amostra deste estudo, 12 do gênero feminino e 7 do masculino, com idades entre 16 anos e 4 meses e 28 anos e 2 meses. Após a coleta de dados, feita por dois examinadores, análises estatísticas para a obtenção dos erros intra e inter-examinadores foram feitas, utilizando nível de significância de 5%. RESULTADOS E CONCLUSÕES: concluiu-se que a obtenção dos valores para o ângulo formado entre o longo eixo do incisivo inferior e o plano mandibular (IMPA na telerradiografia lateral é um método confiável para uso clínico, porque embora apresente, como regra, valores menores que os encontrados em tomografia

  14. F6H8 as an Intraoperative Tool and F6H8/Silicone Oil as a Postoperative Tamponade in Inferior Retinal Detachment with Inferior PVR

    Directory of Open Access Journals (Sweden)

    Gian Marco Tosi

    2014-01-01

    Full Text Available Purpose. To evaluate the effectiveness and safety of perfluorohexyloctane (F6H8 for intraoperative flattening of the retina and of F6H8/silicone oil (SO 1000 cSt as a postoperative tamponade for inferior retinal detachment with inferior proliferative vitreoretinopathy. Methods. This is a retrospective review of 22 patients who underwent pars plana vitrectomy using F6H8 as an intraoperative tool to flatten the retina. At the end of the surgery a direct partial exchange between F6H8 and SO 1000 cSt was performed, tamponing the eye with different ratios of F6H8/SO (70/30, 60/40, 50/50, 40/30, and 30/70. Anatomical and functional results and complications were evaluated over the follow-up period (mean 22.63 months. Results. F6H8 was efficacious for intraoperative flattening of the retina. Twenty-one of the 22 patients achieved a complete retinal reattachment. Postoperative visual acuity (VA ranged from light perception to 20/70, with 72% of patients obtaining VA better than 20/400. No emulsification/inflammation was observed whatever the ratio of F6H8/SO used. With higher ratios of F6H8/SO (70/30 and 60/40 cloudiness of the tamponade was observed. A transparent mixture was present with all the other ratios. Conclusions. The surgical technique adopted is very simple and safe. The optimal F6H8/SO ratio seems to be between 50/50 and 30/70.

  15. Haemodynamic collapse in a patient with acute inferior myocardial infarction and concomitant traumatic acute spinal cord injury.

    Science.gov (United States)

    Kumagai, Naoto; Dohi, Kaoru; Tanigawa, Takashi; Ito, Masaaki

    2013-11-22

    A 71-year-old man suddenly collapsed and went into cardiopulmonary arrest. The cardiopulmonary resuscitation attempt succeeded in restoration of spontaneous circulation. The initial 12-lead electrocardiogram showed inferior acute myocardial infarction (AMI). The patient was initially diagnosed as having cardiogenic shock associated with inferior AMI. In spite of early coronary revascularisation, bradycardia and hypotension were sustained. After termination of sedation and extubation, he was found to have a quadriplegia and diagnosed with a cervical spinal cord injury (SCI). Therefore, the patient was finally diagnosed with neurogenic shock caused by acute cervical SCI due to the traumatic injury preceded by loss of consciousness complicating inferior AMI. We should recognise that SCI has unique haemodynamic features that mimic those associated with inferior AMI, but requires very different treatment.

  16. Factors associated with failure to identify the culprit artery by the electrocardiogram in inferior ST-elevation myocardial infarction

    DEFF Research Database (Denmark)

    Tahvanainen, Minna; Nikus, Kjell C; Holmvang, Lene;

    2011-01-01

    Right and left circumflex coronary artery occlusions cause inferior myocardial infarction. To improve the targeting of diagnostic and therapeutic measures individually, factors interfering with identification of the culprit artery by the electrocardiogram (ECG) were explored.......Right and left circumflex coronary artery occlusions cause inferior myocardial infarction. To improve the targeting of diagnostic and therapeutic measures individually, factors interfering with identification of the culprit artery by the electrocardiogram (ECG) were explored....

  17. Responses from two firing patterns in inferior colliculus neurons to stimulation of the lateral lemniscus dorsal nucleus

    Science.gov (United States)

    Li, Xiao-ting; Wang, Ning-yu; Wang, Yan-jun; Xu, Zhi-qing; Liu, Jin-feng; Bai, Yun-fei; Dai, Jin-sheng; Zhao, Jing-yi

    2016-01-01

    The γ-aminobutyric acid neurons (GABAergic neurons) in the inferior colliculus are classified into various patterns based on their intrinsic electrical properties to a constant current injection. Although this classification is associated with physiological function, the exact role for neurons with various firing patterns in acoustic processing remains poorly understood. In the present study, we analyzed characteristics of inferior colliculus neurons in vitro, and recorded responses to stimulation of the dorsal nucleus of the lateral lemniscus using the whole-cell patch clamp technique. Seven inferior colliculus neurons were tested and were classified into two firing patterns: sustained-regular (n = 4) and sustained-adapting firing patterns (n = 3). The majority of inferior colliculus neurons exhibited slight changes in response to stimulation and bicuculline. The responses of one neuron with a sustained-adapting firing pattern were suppressed after stimulation, but recovered to normal levels following application of the γ-aminobutyric acid receptor antagonist. One neuron with a sustained-regular pattern showed suppressed stimulation responses, which were not affected by bicuculline. Results suggest that GABAergic neurons in the inferior colliculus exhibit sustained-regular or sustained-adapting firing patterns. Additionally, GABAergic projections from the dorsal nucleus of the lateral lemniscus to the inferior colliculus are associated with sound localization. The different neuronal responses of various firing patterns suggest a role in sound localization. A better understanding of these mechanisms and functions will provide better clinical treatment paradigms for hearing deficiencies. PMID:27335563

  18. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Catherine; Trad, Clovis Simao [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Trad, Henrique Simao, E-mail: hstrad@terra.com.br [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Universidade de Sao Paulo (HC-FMRPUSP), Ribeirao Preto, SP (Brazil). Fac. de Medicina. Hospital das Clinicas; Mendonca, Silvana Machado [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil)

    2013-06-15

    Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications. (author)

  19. Responses from two firing patterns in inferior colliculus neurons to stimulation of the lateral lemniscus dorsal nucleus

    Directory of Open Access Journals (Sweden)

    Xiao-ting Li

    2016-01-01

    Full Text Available The γ-aminobutyric acid neurons (GABAergic neurons in the inferior colliculus are classified into various patterns based on their intrinsic electrical properties to a constant current injection. Although this classification is associated with physiological function, the exact role for neurons with various firing patterns in acoustic processing remains poorly understood. In the present study, we analyzed characteristics of inferior colliculus neurons in vitro, and recorded responses to stimulation of the dorsal nucleus of the lateral lemniscus using the whole-cell patch clamp technique. Seven inferior colliculus neurons were tested and were classified into two firing patterns: sustained-regular (n = 4 and sustained-adapting firing patterns (n = 3. The majority of inferior colliculus neurons exhibited slight changes in response to stimulation and bicuculline. The responses of one neuron with a sustained-adapting firing pattern were suppressed after stimulation, but recovered to normal levels following application of the γ-aminobutyric acid receptor antagonist. One neuron with a sustained-regular pattern showed suppressed stimulation responses, which were not affected by bicuculline. Results suggest that GABAergic neurons in the inferior colliculus exhibit sustained-regular or sustained-adapting firing patterns. Additionally, GABAergic projections from the dorsal nucleus of the lateral lemniscus to the inferior colliculus are associated with sound localization. The different neuronal responses of various firing patterns suggest a role in sound localization. A better understanding of these mechanisms and functions will provide better clinical treatment paradigms for hearing deficiencies.

  20. Responses from two ifring patterns in inferior colliculus neurons to stimulation of the lateral lemniscus dorsal nucleus

    Institute of Scientific and Technical Information of China (English)

    Xiao-ting Li; Ning-yu Wang; Yan-jun Wang; Zhi-qing Xu; Jin-feng Liu; Yun-fei Bai; Jin-sheng Dai; Jing-yi Zhao

    2016-01-01

    Theγ-aminobutyric acid neurons (GABAergic neurons) in the inferior colliculus are classiifed into various patterns based on their intrin-sic electrical properties to a constant current injection. Although this classiifcation is associated with physiological function, the exact role for neurons with various ifring patterns in acoustic processing remains poorly understood. In the present study, we analyzed characteristics of inferior colliculus neuronsin vitro, and recorded responses to stimulation of the dorsal nucleus of the lateral lemniscus using the whole-cell patch clamp technique. Seven inferior colliculus neurons were tested and were classiifed into two ifring patterns: sustained-regular (n = 4) and sustained-adapting ifring patterns (n = 3). The majority of inferior colliculus neurons exhibited slight changes in response to stimulation and bicuculline. The responses of one neuron with a sustained-adapting ifring pattern were suppressed after stimulation, but recovered to normal levels following application of theγ-aminobutyric acid receptor antagonist. One neuron with a sustained-regular pattern showed suppressed stimulation responses, which were not affected by bicuculline. Results suggest that GABAergic neurons in the inferior colliculus exhibit sustained-regular or sustained-adapting ifring patterns. Additionally, GABAergic projections from the dorsal nu-cleus of the lateral lemniscus to the inferior colliculus are associated with sound localization. The different neuronal responses of various ifring patterns suggest a role in sound localization. A better understanding of these mechanisms and functions will provide better clinical treatment paradigms for hearing deifciencies.

  1. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Catherine Yang

    2013-07-01

    Full Text Available Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications.

  2. Computational Modeling of Blood Flow in the TrapEase Inferior Vena Cava Filter

    Energy Technology Data Exchange (ETDEWEB)

    Singer, M A; Henshaw, W D; Wang, S L

    2008-02-04

    To evaluate the flow hemodynamics of the TrapEase vena cava filter using three dimensional computational fluid dynamics, including simulated thrombi of multiple shapes, sizes, and trapping positions. The study was performed to identify potential areas of recirculation and stagnation and areas in which trapped thrombi may influence intrafilter thrombosis. Computer models of the TrapEase filter, thrombi (volumes ranging from 0.25mL to 2mL, 3 different shapes), and a 23mm diameter cava were constructed. The hemodynamics of steady-state flow at Reynolds number 600 was examined for the unoccluded and partially occluded filter. Axial velocity contours and wall shear stresses were computed. Flow in the unoccluded TrapEase filter experienced minimal disruption, except near the superior and inferior tips where low velocity flow was observed. For spherical thrombi in the superior trapping position, stagnant and recirculating flow was observed downstream of the thrombus; the volume of stagnant flow and the peak wall shear stress increased monotonically with thrombus volume. For inferiorly trapped spherical thrombi, marked disruption to the flow was observed along the cava wall ipsilateral to the thrombus and in the interior of the filter. Spherically shaped thrombus produced a lower peak wall shear stress than conically shaped thrombus and a larger peak stress than ellipsoidal thrombus. We have designed and constructed a computer model of the flow hemodynamics of the TrapEase IVC filter with varying shapes, sizes, and positions of thrombi. The computer model offers several advantages over in vitro techniques including: improved resolution, ease of evaluating different thrombus sizes and shapes, and easy adaptation for new filter designs and flow parameters. Results from the model also support a previously reported finding from photochromic experiments that suggest the inferior trapping position of the TrapEase IVC filter leads to an intra-filter region of recirculating

  3. A mammometric comparison of modiifed Robertson versus Wise pattern inferior pedicle reduction mammoplasty

    Institute of Scientific and Technical Information of China (English)

    Victor Z Zhu; Ajul Shah; Rachel Lentz; Tracy Sturrock; Alexander F Au; Stephanie L Kwei

    2016-01-01

    Aim: The advent of 3D photoimaging and mammometrics has allowed for quantitative, volumetric breast analyses. This study uses 3D photoimaging and mammometrics to compare the postoperative morphometric outcomes of the modiifed Robertson technique to the more traditional Wise pattern inferior pedicle technique. Methods: Inferior pedicle reduction mammoplasty was performed using either a Wise pattern or modiifed Robertson skin incision. 3D photography and analysis were done at 1-3 months and 6-12 months postoperatively. Results: There were 14 breasts in the modiifed Robertson group (ROB) and 24 breasts in the Wise pattern group (WISE). There were no signiifcant differences in demographic data or amount of tissue resected. At 6-12 months, the modiifed Robertson cohort demonstrated increased superior pole fullness (62.9%ROB vs. 58.3%WISE, P=0.05). The Wise cohort, however, maintained greater maximum breast projection (5.52 cm ROB vs. 6.54 cm WISE, P=0.01) and increased medial pole fullness (29.6%ROB vs. 46.9%WISE, P<0.01). There was no difference in tissue shifting from the superior pole to the inferior pole over time (+3.36 superior pole%ROB vs.+1.42 superior pole%WISE, P=0.28). Areola surface area increased equally in both cohorts (+3.08 cm2 ROB vs.+2.59 cm2 WISE, P=0.77);however, the ifnal size of the areola was greater in the modiifed Robertson cohort (26.9 cm2 ROB vs. 21.6 cm2 WISE, P<0.01). Conclusion:Using 3D mammometrics, we found increased superior pole fullness in the modiifed Robertson group while the Wise pattern group demonstrated greater medial pole fullness and maximum breast projection.

  4. Intracellular responses to frequency modulated tones in the dorsal cortex of the mouse inferior colliculus

    Directory of Open Access Journals (Sweden)

    Ruediger eGeis

    2013-01-01

    Full Text Available Frequency modulations occur in many natural sounds, including vocalizations. The neuronal response to frequency modulated (FM stimuli has been studied extensively in different brain areas, with an emphasis on the auditory cortex and the central nucleus of the inferior colliculus. Here, we measured the responses to FM sweeps in whole-cell recordings from neurons in the dorsal cortex of the mouse inferior colliculus. Both up- and downward logarithmic FM sweeps were presented at two different speeds to both the ipsi- and the contralateral ear. Based on the number of action potentials that were fired, between 10-24% of cells were selective for rate or direction of the FM sweeps. A somewhat lower percentage of cells, 6-21%, showed selectivity based on EPSP size. To study the mechanisms underlying the generation of FM selectivity, we compared FM responses with responses to simple tones in the same cells. We found that if pairs of neurons responded in a similar way to simple tones, they generally also responded in a similar way to FM sweeps. Further evidence that FM selectivity can be generated within the dorsal cortex was obtained by reconstructing FM sweeps from the response to simple tones using three different models. In about half of the direction selective neurons the selectivity was generated by spectrally asymmetric synaptic inhibition. In addition, evidence for direction selectivity based on the timing of excitatory responses was also obtained in some cells. No clear evidence for the local generation of rate selectivity was obtained. We conclude that FM direction selectivity can be generated within the dorsal cortex of the mouse inferior colliculus by multiple mechanisms.

  5. The isolated inferior glenohumeral labrum injury, anterior to posterior (the ILAP: A case series

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    Val Irion

    2015-01-01

    Full Text Available Introduction: We describe the presentation, exam findings, surgical repair techniques, and short-term outcomes in a series of patients with isolated inferior labral tears. Materials and Methods : A retrospective chart review was performed at a large academic medical center. Isolated inferior labral tears were defined as between the 4 o′clock and 8 o′clock position of the glenoid as determined by direct arthroscopic visualization. Tears that were smaller were also included but were required to cross the 6 o′clock point, having anterior and posterior components. Patients were excluded if they had any other pathology or treatment of the shoulder. 1-year follow-up was required. Results: Of the 17 patients who met inclusion criteria for review, 12 were available for a minimum 1-year follow-up. Average total follow-up for patients to complete the phone interview/Oxford Shoulder Instability Score (OSIS was an average of 37.7 months (range: 16-79 months. Postoperatively, all reported symptom improvement or resolution since surgery. The mean preoperative pain on a scale of 0-10 was 6.3 (range: 0-10. Mean postoperative pain on a scale of 0-10 was 2.25 (range: 0-5. Eleven of 12 patients (91.7% had returned to the level of activity desired. The mean OSIS was 41.4 (median: 43; range: 27-47. Eleven of 12 patients (91.7% had good or excellent scores. Ten of 12 patients (83.3% had a feeling of stability in the shoulder. All 12 patients reached were satisfied with the procedure and would undergo surgery again in a similar situation. Conclusions: We have presented our series of patients with isolated inferior labral injury, and have shown that when surgically treated, outcomes of this uncommon injury are good to excellent and a full return to sports can be expected.

  6. Dysregulated left inferior parietal activity in schizophrenia and depression: functional connectivity and characterization

    Directory of Open Access Journals (Sweden)

    Veronika I. Müller

    2013-06-01

    Full Text Available The inferior parietal cortex (IPC is a heterogeneous region that is known to be involved in a multitude of diverse different tasks and processes, though its contribution to these often-complex functions is yet poorly understood. In a previous study we demonstrated that patients with depression failed to deactivate the left IPC during processing of congruent audiovisual information. We now found the same dysregulation (same region and condition in schizophrenia. By using task-independent (resting state and task-dependent (MACM analyses we aimed at characterizing this particular region with regard to its connectivity and function. Across both approaches, results revealed functional connectivity of the left inferior parietal seed region with bilateral IPC, precuneus and posterior cingulate cortex (PrC/PCC, medial orbitofrontal cortex (mOFC, left middle frontal (MFG as well as inferior frontal (IFG gyrus. Network-level functional characterization further revealed that on the one hand, all interconnected regions are part of a network involved in memory processes. On the other hand, sub-networks are formed when emotion, language, social cognition and reasoning processes are required. Thus, the IPC-region that is dysregulated in both depression and schizophrenia is functionally connected to a network of regions which, depending on task demands may form sub-networks. These results therefore indicate that dysregulation of left IPC in depression and schizophrenia might not only be connected to deficits in audiovisual integration, but is possibly also associated to impaired memory and deficits in emotion processing in these patient groups.

  7. Densiron® 68 as an intraocular tamponade for complex inferior retinal detachments

    Directory of Open Access Journals (Sweden)

    Hussain RN

    2011-05-01

    Full Text Available Rumana N Hussain, Somnath BanerjeeLeicester Royal Infirmary, Leicester, UKIntroduction: Densiron® 68 is a high-density liquid used to tamponade inferior retinal detachments. We present a case series of 12 patients treated with Densiron as an intraocular tamponade agent.Methods: A retrospective analysis of 12 eyes in 12 patients was carried out. The primary endpoint was anatomic reattachment of the retina following removal of Densiron oil.Results: All patients had inferior detachments; 33% had associated proliferative vitreoretinopathy (PVR. Densiron was utilized as a primary agent in five patients (42%; the remaining patients had prior unsuccessful surgery for retinal reattachment, including pars plana vitrectomy, cryotherapy, laser, encirclement, gas (C3F8 or C2F6, or silicone oil. Eleven patients (91% had successful reattachment of the retina at 3 months following removal of Densiron; one patient had extensive PVR, total retinal detachment, preretinal macula fibrosis, and chronic hypotony, and surgical intervention was unsuccessful. Six patients (50% had raised intraocular pressure (IOP, resolving in the majority of cases following Densiron removal; two patients had long-term raised IOP requiring topical or surgical therapy. Of the six phakic patients, 50% developed significant cataract in the operated eye. Of those with successful retinal reattachment, visual outcome was variable, with 36% patients gaining two to four lines on Snellen, 27% remaining objectively the same, and 36% losing one to two lines.Conclusion: The anatomic success rate is high (91% in patients requiring Densiron tamponade for inferior retinal detachments with or without evidence of PVR either as a primary or secondary intervention. A common complication is raised IOP; however, this most often resolves following removal of the oil.Keywords: intraocular tamponade, silicone oil, retinal detachment, retinal reattachments

  8. Diver CE versus Guardwire Plus for thrombectomy in patients with inferior myocardial infarction: a trial of aspiration of thrombus during primary angioplasty for inferior myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    YAN Hong-bing; ZHANG Hong; WANG Jian; LI Nan; ZHU Xiao-ling; GAO Hai; AI Hui; LI Xiang; YE Ming; CHI Yun-peng

    2007-01-01

    Background Different feasible and safe thrombectomy and distal protection devices have been used in clinical practice.The efficiency and safety of adjunct thrombectomy using Diver CE device (Invatec, Italy) versus Guardwire Plus device(Medtronic, USA) before percutaneous coronary intervention (PCI) were compared in patients with acute inferior ST-segment-elevation myocardial infarction (STEMI) for less than 12 hours, thrombolysis in myocardial infarction (TIMI)flow grade 0 to 1, and total occlusion of the proximal right coronary artery (≥3 mm in diameter) in a prospective randomized single-center study.Methods The primary end point was the magnitude of ST-segment resolution (STR) (>70%) measured immediately, 90minutes and 6 hours after PCI, myocardial blush grade and slow flow or no-reflow. Secondary end points were left ventricular end-diastolic volume (LVEDV), left ventricle ejection fraction (LVEF) and major adverse cardiac events (MACEs) including death, myocardial infarction, target vessel revascularization and stroke at 30 days.Results A total of 122 patients were equally divided into Diver CE group and Guardwire Plus group, which were comparable by age ((60± 14) years vs (60± 13) years), male (82% vs 84%), diabetes (31% vs 28%), previous coronary artery disease (25% vs 23%), onset-to-angiogram ((350± 185) min vs (345± 180) min), and use of glycoprotein Ⅱb/Ⅲa inhibitor (11% vs 13%). The magnitude of ST-segment resolution was similar in the two groups as ST-segment resolution >70% (57% vs 59%; P>0.05). Similar slow flow/no-reflow rates were observed in the Diver CE group (8%) and the Guardwire Plus group (7%). TIMI flow grade 3 was obtained in 95% vs 97% patients, respectively (P>0.05). Myocardial blush grade 3 was similar (70% vs 72%; P>0.05). Thirty-day clinical outcome was comparable (LVEF, 0.54±0.12 vs 0.53±0.11; death, 3% vs 3%; myocardial infarction, 2% vs 0%; and target vessel revascularization, 2% vs 2%; P>0.05,respectively

  9. Distal posterior inferior cerebellar artery aneurysm: case report Aneurisma da artéria cerebelar posterior e inferior distal: relato de caso

    Directory of Open Access Journals (Sweden)

    Ricardo Ramina

    2005-06-01

    Full Text Available The majority of posterior inferior cerebellar artery (PICA aneurysms are usually found on the bifurcation of the vertebral artery (VA - PICA junction. Aneurysms arising from more peripheral PICA segments named distal PICA aneurysm are uncommon. The major clinical manifestation is that of an intracranial bleeding and the site of hemorrhage is related to the PICA segment originating the aneurysm. Lesions originating from distal PICA segments, particularly those arising from the telovelotonsillar segment, are associated with hemorrhage extending into the ventricular system, mainly the IV ventricle. A case of a 50-year-old woman with sudden headaches and vomiting, and intraventricular hemorrhage (four ventricles caused by an aneurysm of the telovelotonsillar segment of the PICA, is presented. No signs of subarachnoidal hemorrhage were found in the computerized tomography. The aneurysm was clipped and the patient presented a favorable outcome. Anatomical aspects and clinical series are reviewed.A maioria dos aneurismas da artéria cerebelar posterior inferior (PICA é geralmente encontrada na junção artéria vertebral (VA - PICA. Aneurismas originando-se nos segmentos mais distais da PICA são considerados raros. A manifestação clínica em geral por hemorragia intracraniana, e o local desta está relacionado ao segmento que origina o aneurisma. Lesões localizadas em segmentos mais distais da PICA, em especial os originados do segmento telovelotonsilar, estão associados a hemorragias no sistema ventricular, particularmente no quarto ventrículo. Relatamos o caso de mulher de 50 anos de idade que desenvolveu quadro de cefaléia súbita e vômitos, com hemorragia nos quatro ventrículos, causada por ruptura de aneurisma localizado no segmento telovelotonsilar da PICA. Não havia sinais de hemorragia subaracnóidea na tomografia computadorizada de crânio. O aneurisma foi clipado e a paciente apresentou evolução favorável. Aspectos anatômicos e

  10. Ozonated water is inferior to propanol-based hand rubs for disinfecting hands.

    Science.gov (United States)

    Appelgrein, C; Hosgood, G; Dunn, A L; Schaaf, O

    2016-04-01

    Ozone is a strong oxidizing biocide that has broad-spectrum antimicrobial properties. The aim of the study was to compare the efficacy of ozone to a propanol-based hand rub for hand disinfection. Twenty subjects were enrolled in an in-vivo cross-over trial (prEN 12791). Subjects treated their hands with the reference procedure (propan-1-ol 60%) or with ozone (4 ppm). Post-wash bacterial counts were determined from one hand (immediate effect), and from the other hand that had been gloved for 3h (delayed effect). The investigation indicated that ozone is inferior to propan-1-ol 60% hand rub for hand asepsis.

  11. Renal angiomyolipoma with inferior vena caval thrombus in a 32-year-old male

    Directory of Open Access Journals (Sweden)

    Matthew W Christian

    2009-01-01

    Full Text Available Renal angiomyolipoma (AML rarely presents with evidence of extension into the renal vein, inferior vena cava (IVC or atrium. We report a case of a renal AML with a tumor thrombus to the IVC in a 32-year-old male. The patient subsequently underwent a right radical nephrectomy with IVC tumor thrombectomy. To our knowledge, there are four published cases of renal AML presenting with tumor thrombus in males. This case report describes the management of the youngest male ever to develop a renal AML with IVC tumor thrombus.

  12. Left Ventricular Pseudoaneurysm Following Inferior Myocardial Infarction: A Case for Conservative Management

    Science.gov (United States)

    Ludmir, Jonathan; Kapoor, Karan; George, Praveen; Khural, Jasjeet; Barr, Brian

    2016-01-01

    Left ventricular pseudoaneurysm is a rare complication of myocardial infarction that carries a high mortality rate. Although conventional wisdom suggests prompt surgical repair in order to mitigate risk of expansion and rupture, there are some data to support non-operative management in asymptomatic individuals with likely chronic pseudoaneurysms, particularly when surgical candidacy is poor. We present a case of a medically managed left ventricular pseudoaneurysm subsequent to inferior ST-segment elevation myocardial infarction with 6-month follow-up data. PMID:28197266

  13. Unerupted Primary Molar Teeth Positioned Inferior to the Permanent Premolar: A Case Report

    Directory of Open Access Journals (Sweden)

    A. Bagheri

    2012-01-01

    Full Text Available Primary tooth impaction is a rare finding during the development of primary dentition. Several factors contribute to the impaction of a deciduous tooth. This report describes the diagnosis and treatment of a 10-year-old boy who presented an impacted second primary mandibular molar. This tooth, located inferior to the second premolar together with an odontoma, was positioned superior to the premolar teeth. Treatment consisted of surgical removal of the impacted deciduoustooth and odontoma and placement of a passive lower lingual holdingarch. Periodic examination was indicated for follow- up. Early intervention was recommended to manage orofacial disfigurement and to avoid consequent problems.

  14. Glucocorticoides como profiláctico antinflamatorio en cirugía de terceras molares inferiores.

    OpenAIRE

    Manrique-Guzmán, Jorge; Facultad de Odontología de la Universidad Nacional Federico Villarreal. Lima.; Chávez-Reátegui, Beatriz; Facultad de Estomatología. Universidad Peruana Cayetano Heredia. Lima.; Manrique-Chávez, Jorge; Facultad de Estomatología. Universidad Peruana Cayetano Heredia. Lima.

    2014-01-01

    Objetivo: Comparar la presencia de inflamación aguda severa en pacientes con y sin medicación antes del procedimiento de exodoncia de terceros molares inferiores, atendidos en la Clínica Odontológica de la Universidad Nacional Federico Villarreal. Material y métodos: Se tomó como muestra 116 pacientes de ambos sexos, entre 21 y 45 años de edad los cuales fueron divididos en dos grupos aleatoriamente, solo uno recibió medicación con Glucocorticoides antes del tratamiento. Resultados: Se encont...

  15. [Recession of the inferior rectus muscle in superficial anesthesia in the treatment of thyroid orbitopathy].

    Science.gov (United States)

    Koniszewski, G; Zagórski, Z

    1989-06-01

    Recession of the inferior rectus in surface anaesthesia by 5% cocaine drops was performed in 8 patients with signs of hypotropia in the course of thyroid orbitopathia and with diplopia persisting after conservatory treatment and not corrected by prisms. This method enables us an accurate intraoperative settlement of the distance of recession and it may be recommended in cases metabolically normalized, with not too much advanced exophthalmos, with a stability of the motor disturbances for at least 6 months and without any signs of inflammation.

  16. Rectal cancer presenting tumor thrombosis in the inferior vena cava and common iliac vein: case report

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Sun Jung; Park, Seong Jin; Lee, Hae Kyung; Yi, Boem Ha; Park, Sung Il; Hong, Soo Jin; Kim, Hee Kyung; Park, Jeong Mi [Soonchunhyang University Hospital, Bucheon (Korea, Republic of)

    2008-10-15

    We report the radiologic findings of a rectal carcinoma case with tumor thrombus in the inferior vana cava and left common iliac vein of a 48-year-old woman. The patient complained of swelling in the left leg and consequently underwent a lymphoscintigraphy, CT venography, abdominal CT, PET-CT, pelvis MRI, and ultrasound doppler. The rectal cancer was determined via a colonoscopy. The tissue biopsy of tumor thrombus in the IVC was done during insertion of IVC filter and poorly differentiated adenocarcinoma was revealed by pathology.

  17. Dyslexic children lack word selectivity gradients in occipito-temporal and inferior frontal cortex

    Directory of Open Access Journals (Sweden)

    O.A. Olulade

    2015-01-01

    Full Text Available fMRI studies using a region-of-interest approach have revealed that the ventral portion of the left occipito-temporal cortex, which is specialized for orthographic processing of visually presented words (and includes the so-called “visual word form area”, VWFA, is characterized by a posterior-to-anterior gradient of increasing selectivity for words in typically reading adults, adolescents, and children (e.g. Brem et al., 2006, 2009. Similarly, the left inferior frontal cortex (IFC has been shown to exhibit a medial-to-lateral gradient of print selectivity in typically reading adults (Vinckier et al., 2007. Functional brain imaging studies of dyslexia have reported relative underactivity in left hemisphere occipito-temporal and inferior frontal regions using whole-brain analyses during word processing tasks. Hence, the question arises whether gradient sensitivities in these regions are altered in dyslexia. Indeed, a region-of-interest analysis revealed the gradient-specific functional specialization in the occipito-temporal cortex to be disrupted in dyslexic children (van der Mark et al., 2009. Building on these studies, we here (1 investigate if a word-selective gradient exists in the inferior frontal cortex in addition to the occipito-temporal cortex in normally reading children, (2 compare typically reading with dyslexic children, and (3 examine functional connections between these regions in both groups. We replicated the previously reported anterior-to-posterior gradient of increasing selectivity for words in the left occipito-temporal cortex in typically reading children, and its absence in the dyslexic children. Our novel finding is the detection of a pattern of increasing selectivity for words along the medial-to-lateral axis of the left inferior frontal cortex in typically reading children and evidence of functional connectivity between the most lateral aspect of this area and the anterior aspects of the occipito-temporal cortex. We

  18. Does intravenous administration of recombinant tissue plasminogen activator for ischemic stroke can cause inferior myocardial infarction?

    Directory of Open Access Journals (Sweden)

    Mostafa Almasi

    2016-06-01

    Full Text Available Recombinant tissue plasminogen activator (rTPA is one of the main portions of acute ischemic stroke management, but unfortunately has some complications. Myocardial infarction (MI is a hazardous complication of administration of intravenous rTPA that has been reported recently. A 78-year-old lady was admitted for elective coronary artery bypass graft surgery. On the second day of admission, she developed acute left hemiparesis and intravenous rTPA was administered within 120 minutes. Three hours later, she has had chest pain. Rescue percutaneous coronary intervention was performed on right coronary artery due to diagnosis of inferior MI, and the symptoms were resolved.

  19. Barremiano inferior en la base de la formación paja, barichara, santander - colombia

    OpenAIRE

    Patarroyo, Pedro

    2012-01-01

    Se da a conocer la distribución vertical de amonitas, dentro de los 10 m más bajos de la base de la Formación Paja, en cercanías a Barichara (Santander-Colombia).  Allí, se recuperaron Nicklesia nolani (Nickles) , Nicklesia sp., Nicklesia didayana didayana Bürgl, Nicklesia didayana multifida Bürgi, Nicklesia dumasiana (Orbigny), Valdedorsella sp., Pseudohaploceras incertumRiedel y Karsteniceras sp., cuya asociación representa el Barremiano inferior.

  20. Seminoma Presenting as Renal Mass, Inferior Vena Caval Thrombus, and Regressed Testicular Mass

    Directory of Open Access Journals (Sweden)

    Valary T. Raup

    2015-01-01

    Full Text Available Testicular cancer is the most common malignancy of men aged 15–40. Metastatic spread classically begins with involvement of the retroperitoneal lymph nodes, with metastases to the liver, lung, bone, and brain representing advancing disease. Treatment is based on pathologic analysis of the excised testicle and presence of elevated tumor markers. We report a case of a 34-year-old male presenting with back pain who was found to have a right renal mass with tumor extension into the inferior vena cava. Subsequent biopsy was consistent with seminoma. We review this rare case and discuss the literature regarding its diagnosis and management.

  1. Lateralization of the inferior alveolar nerve with simultaneous implant placement: surgical techniques.

    Science.gov (United States)

    Garg, A K; Morales, M J

    1998-01-01

    In the event of moderate to severe mandibular bone resorption posterior to the mental foramen, repositioning of the inferior alveolar nerve provides a greater amount of available bone for implant placement and reduces the risk of nerve injury. While neural paresthesia may initially occur, this altered sensation generally resolves spontaneously. Alveolar nerve repositioning may be possible in cases in which other procedures cannot be performed due to the extent of atrophy of the posterior mandibular alveolar crest. This article presents the surgical technique to achieve this objective.

  2. Infection-related inferior alveolar and mental nerve paresthesia: case reports.

    Science.gov (United States)

    Yeler, Hasan; Ozeç, Ilker; Kiliç, Erdem

    2004-04-01

    Nerve injury can be related to mechanical, chemical, and thermal factors. Infection-related paresthesia is usually related to mechanical pressure and ischemia associated with the inflammatory process. Another cause of paresthesia could be the toxic metabolic products of bacteria or inflammatory products released following tissue damage. This article presents cases of inferior alveolar and mental nerve paresthesia caused by an infected impacted tooth, an infected cyst, and periapical infection. The possible pathophysiologic mechanism of nerve injury, therapy, and prognosis for recovery are also discussed.

  3. Laparoscopic cholecystectomy in situs inversus totalis with "inferior" cystic artery:A case report

    Institute of Scientific and Technical Information of China (English)

    Sumihiro Kamitani; Yosihiro Tsutamoto; Kazuyoshi Hanasawa; Tohru Tani

    2005-01-01

    A 76-year-old man with known situs inversus totalis presented with left-sided discomfort. Abdominal ultrasonography and CT scan confirmed the diagnosis of a gallstone, as well as,situs inversus; the liver and gallbladder on the left side and the spleen on the right. The biliary system was thought to be left-right reversal, mirror image in the view of drip infusion cholangiogram and MRI. Laparoscopic cholecy stectomywas safely performed, despite of unexpected aberrant cystic artery running inferior to cystic duct of situs inversus.Laparoscopic surgeon should be careful for view of reversed relationships and also existence of other anomalies.

  4. Skin and mucosal ischemia as a complication after inferior alveolar nerve block

    Directory of Open Access Journals (Sweden)

    Pedro Christian Aravena

    2016-01-01

    Full Text Available The anesthetic block of the inferior alveolar nerve (IAN is one of the most common techniques used in dental practice. The local complications are due to the failures on the anesthetic block or to anatomic variations in the tap site such as intravascular injection, skin ischemia and ocular problems. The aim of this article is to present a case and discuss the causes of itching and burning sensation, blanching, pain and face ischemia in the oral cavity during the IAN block.

  5. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava.

    Science.gov (United States)

    Charlagorla, Pradeepkumar; Breinholt, John P

    2016-01-01

    Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC), atrial and visceral situs inversus, left-sided superior vena cava (SVC), and left-sided interrupted inferior vena cava (IVC) with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.

  6. Research progress in the application of inferior vena cava filter on acute venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    Ioannis Stefanidis; George Galyfos; Stavros Kerasidis; Ioannis Stamatatos; Georgios Geropapas; Sotirios Giannakakis; Georgios Kastrisios; Gerasimos Papacharalampous; Chrisostomos Maltezos

    2015-01-01

    Anticoagulant therapy using heparins or per os vitamin K antagonists has been the treatment of choice in patients with venous thromboembolic disease for decades. However, the introduction of inferior vena cava (IVC) filters recently has provided new therapeutic choices appropriate for specific groups of patients with venous thromboembolic disease. This review aims to present all current evidence on the indications and precautions for the proper IVC filters utilization. There is still a great challenge in identifying the proper populations that would benefit from an IVC filter implantation or extraction. New randomized trials are needed to produce safe and clear guidelines of proper use.

  7. Diseño de dispositivo adaptado a planos inclinables para la movilidad de miembros inferiores

    OpenAIRE

    2014-01-01

    El presente proyecto trata sobre el diseño de un dispositivo para la movilidad de los miembros inferiores, en concreto los pies y tobillos, adaptado a los planos inclinables. Se focaliza el uso tanto en tratamientos de rehabilitación como para aportar una nueva actividad para personas con discapacidad de grado parapléjico. Los beneficios que presenta este dispositivo son muchos, desde la mejora de la circulación sanguínea hasta una notable reducción de espasmos musculares. L...

  8. Apathy is associated with lower inferior temporal cortical thickness in mild cognitive impairment and normal elderly

    Science.gov (United States)

    Guercio, Brendan; Donovan, Nancy J.; Ward, Andrew; Schultz, Aaron; Lorius, Natacha; Amariglio, Rebecca E.; Rentz, Dorene M.; Johnson, Keith A.; Sperling, Reisa A.; Marshall, Gad A.

    2014-01-01

    Apathy is a common neuropsychiatric symptom in Alzheimer’s disease (AD) dementia and amnestic mild cognitive impairment (MCI) and is associated with cortical atrophy in AD dementia. This study investigated possible correlations between apathy and cortical atrophy in 47 individuals with MCI and 19 clinically normal elderly (CN). Backward elimination multivariate linear regression was used to evaluate the cross-sectional relationship between scores on the Apathy Evaluation Scale and thickness of several cortical regions and covariates. Lower inferior temporal cortical thickness was predictive of greater apathy. Greater anterior cingulate cortical thickness was also predictive of greater apathy, suggesting an underlying reactive process. PMID:25716491

  9. Tratamiento de la isquemia crítica de miembros inferiores

    OpenAIRE

    Samir Jozami; Mariano Albertal; Patricio Zaefferer; Guillermo Pfund; Gerardo Nau; Jorge Thierer; Alejandro Fabiani; Fernando Cura; Jorge Belardi; Lucio Padilla

    2010-01-01

    RESUMENIntroducciónLa isquemia crítica de miembros inferiores representa una manifestación extrema de laenfermedad vascular periférica crónica. La revascularización quirúrgica es el tratamientode elección para los pacientes con esta patología, ya que pese a ser un procedimiento invasivoreduce la tasa de amputación y de mortalidad. Sin embargo, tiene una tasa alta de complicaciones.Durante la última década, el perfeccionamiento y la introducción de nuevas tecnologíaspercutáneas han derivado en...

  10. Point-of-Care Ultrasound in Diagnosis and Treatment of Luxatio Erecta (Inferior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Abraham Flinders

    2016-06-01

    Why an emergency physician should be aware of this: POC-US is a useful tool for the emergency physician when confronted with shoulder dislocation. US not only confirms the dislocation, but also differentiates between anterior versus posterior versus inferior dislocation. POC-US can guide the placement of intraarticular lidocaine for anesthesia which then potentially reduces time, expense, and risk of procedural sedation. Finally, POC-US may reduce failed reductions by providing immediate visual confirmation and in the case of reductions performed under sedation, may prevent the need for repeat sedation.

  11. Free radial forearm adiposo-fascial flap for inferior maxillectomy defect reconstruction

    Directory of Open Access Journals (Sweden)

    Thankappan Krishnakumar

    2009-01-01

    Full Text Available A free radial forearm fascial flap has been described for intraoral reconstruction. Adiposo-fascial flap harvesting involves few technical modifications from the conventional radial forearm fascio-cutaneous free flap harvesting. We report a case of inferior maxillectomy defect reconstruction in a 42-year-old male with a free radial forearm adiposo-fascial flap with good aesthetic and functional outcome with minimal primary and donor site morbidity. The technique of raising the flap and closing the donor site needs to be meticulous in order to achieve good cosmetic and functional outcome.

  12. Base eletronica de dados clinicos e cirurgicos em isquemia cronica de membros inferiores

    Directory of Open Access Journals (Sweden)

    Carlos Seme Nejm Junior

    2013-09-01

    Full Text Available CONTEXTO: Um sistema eletrônico de protocolo seria capaz de armazenar dados clínicos e possibilitar futuras pesquisas, visando a rapidez, eficiência de cruzamentos e análise de tais dados. OBJETIVO: a criar uma base de dados clínicos cirúrgicos em doenças vasculares e, a partir desta, uma base em Isquemia Crônica de Membros Inferiores; b informatizar essa base sob forma de um protocolo eletrônico; c incorporar ao SINPE(c (Sistema Integrado de Protocolos Eletrônicos; d realizar um projeto piloto. MÉTODOS: Criou-se uma base teórica de dados clínicos sobre as doenças vasculares. O protocolo específico foi criado considerando-se as características individuais das doenças causadoras de Isquemia Crônica de Membros Inferiores. Após seu término, essa base eletrônica e informatizada seria incorporada ao SINPE(c. RESULTADOS: O usuário, previamente cadastrado, realizará o cadastro do paciente e selecionará, dentro do protocolo mestre, o protocolo específico em Isquemia Crônica de Membros Inferiores, para acesso aos seus respectivos dados clínicos. Orientado pelas alternativas diretas de preenchimento, o usuário seleciona apenas os dados pertencentes ao seu paciente. Estes podem ser resgatados para pesquisa, mostrando o número de coletas que satisfazem os parâmetros escolhidos e informações estatísticas sobre a mesma. CONCLUSÃO: a a criação da base teórica de dados clínicos e cirúrgicos em doenças vasculares e, a partir desta, em Isquemia Crônica de Membros Inferiores, foi factível; b a informatização da base teórica sob forma de protocolo eletrônico foi exequível; c o protocolo eletrônico mestre e específico poderá ser incorporado ao SINPE(c, d o projeto piloto foi criado com sucesso e testado através do módulo analisador do SINPE(c.

  13. Cement embolus trapped in the inferior vena cava filter during percutaneous vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Li, Zhi; Ni, Rui Fang; Zhao, Xin; Yang, Chao; Li, Ming Ming [First Affiliated Hospital of Soochow University, Suzhou (China)

    2013-06-15

    A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.

  14. Free deep inferior epigastric perforator flap used for management of post-pneumonectomy space empyema.

    Science.gov (United States)

    Manley, Kate; Gelvez, Sandra; Meldon, Charlotte J; Levai, Irisz; Malata, Charles M; Coonar, Aman S

    2013-04-01

    Various solutions exist for management of post-pneumonectomy space empyema. We describe the use of a free deep inferior epigastric perforator (DIEP) flap to fill the space and close a pleural window. Previously, flaps involving abdominal muscle or omentum have been used for this purpose. Abdominal surgery to harvest such flaps can impair ventilatory mechanics. The DIEP flap--harvested from the abdomen, and composed primarily of skin and muscle avoids this problem, thus is a desirable technique in patients with impaired lung function. We believe this is the first report of the DIEP flap to close a postpneumonectomy empyema space.

  15. [An exceptional case of renal angiomyolipoma extended to the inferior vena cava. Successfull surgical management].

    Science.gov (United States)

    Dinis da Gama, A; Cunha e Sá, Diogo; Alves, José Maria; Carneiro de Moura, J L; Lopez, Dolores; Fernandes, Afonso

    2008-01-01

    The clinical case of a 39 years old female is reported, with the diagnosis of tumor of the right kidney extending into the infra-hepatic vena cava, assuming the shape of a floating thrombus. The patient underwent right radical nephrectomy, followed by resection of the intra caval tumor. Both the procedure and post operative course were uneventfull. Histopathological evaluation of the specimens, associated to specific imunohistochemistry studies, confirmed the diagnosis of angiomyolipoma of the kidney. A review of the literature concluded that this is the 27th case published of a kidney angiomyolipoma extending into the inferior vena cava, thus justifying its presentation and divulgation.

  16. 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

  17. Penatalaksanaan Sinus Preaurikuler Tipe Varian Dengan Pit pada Heliks Desenden Postero-Inferior

    Directory of Open Access Journals (Sweden)

    Jacky Munilson

    2013-01-01

    Full Text Available AbstrakSinus preaurikuler merupakan kelainan kongenital berupa adanya lubang kecil pada telinga luar yangbiasanya terdapat di anterior dari heliks asendens. Disamping lokasi tersebut, sinus preaurikuler juga dapatditemukan posterior dari liang telinga luar yang dikenal sebagai sinus preaurikuler tipe varian. Sinus preaurikulertipe varian merupakan kasus yang jarang dilaporkan. Kebanyakan kasus tidak menunjukkan gejala, sebagianlainnya mengalami masalah infeksi berupa keluarnya cairan, atau terbentuknya abses. Penatalaksanaan sinuspreaurikuler adalah dengan pengangkatan sinus secara lengkap. Kekambuhan merupakan masalah yang dapattimbul jika tidak diangkat secara lengkap.Dilaporkan satu kasus sinus preaurikuler tipe varian dengan pitberada pada heliksdesendens postero-inferior dekatlobulus pada seorang anak laki-laki umur 3 tahun 6 bulan dan ditatalaksana dengan sinektomi.Kata kunci: Sinus preaurikuler, sinus preaurikuler tipe varian, sinektomi.AbstractPreauricular sinusis a congenital malformation that manifests as pit in the extenal ear, usually located in theanterior limb of ascending helix. In additional to these location, preauricular sinus can also be found in the posterior ofthe external ear canal, known as the preauricular sinus with variant type. Preauricular sinus variant type is a rarelyreported. Almost cases are asymptomatic, but others are infectious with discharge or abscess formation. Themanagement of preauricular sinus is excision sinus completely. Recurrence is the problem that happen if the excisionwas not complete.One case of preauricular sinus variant type with pit on the postero-inferior decending helixnearlobulus in a boy 3 years and 6 months old and managed bysinectomy.Keywords: Preauricular sinus, Preauricular sinus variant type, sinectom

  18. Motivationally significant self-control: enhanced action withholding involves the right inferior frontal junction.

    Science.gov (United States)

    O'Connor, David A; Upton, Daniel J; Moore, Jennifer; Hester, Robert

    2015-01-01

    In everyday life, people use self-control to withhold actions. This ability is particularly important when the consequences of action withholding have an impact on the individual's well-being. Despite its importance, it is unclear as to how the neural nodes implicated in action withholding contribute to this real-world type of self-control. By modifying an action withholding paradigm, the go/no-go task, we examined how the brain exerts self-control during a scenario in which the implications of withholding an action are meaningful and motivationally significant. A successfully withheld response contributed to long-term monetary rewards, whereas failure to withhold a response incurred an immediate monetary punishment. Compared with neutral action withholding, participants significantly improved their performance when these contingencies were applied. Crucially, although the right IFG and pre-SMA were found to promote overall action withholding, the enhancement in behavioral performance relative to a neutral condition was only reflected by a physiological change in a region encompassing the right inferior frontal junction and precentral gyrus. We speculate that the ability to flexibly modulate attention to goal-relevant stimuli is crucial to enhanced, motivationally driven action withholding and that this ability is subserved by the right inferior frontal junction. These findings suggest that control-modulating factors, rather than action withholding processes per se, can be critical to improving motivationally significant action withholding outcomes.

  19. Effect of removing superior spikelets on grain filling of inferior spikelets in rice

    Directory of Open Access Journals (Sweden)

    Cuicui You

    2016-08-01

    Full Text Available Abstract: Large-panicle rice cultivars often fail to reach their yield potential due to the poor grain filling of inferior spikelets (IS. Thus, it is important to determine the causes of poor IS grain filling. In this study, we attempted to identify whether inferior grain filling of large panicles is restricted by superior spikelets (SS and their physiological mechanism. SS were removed from two homozygous japonica rice strains (W1844 and WJ165 during flowering in an attempt to force photosynthate transport to the IS. We measured the effects of SS removal on seed setting rate, grain weight, grain filling rate, sucrose content, as well as hormone levels, activities of key enzymes, and expression of genes involved in sucrose to starch metabolism in rice IS during grain filling. The results showed that SS removal improved IS grain filling by increasing the seed setting rate, grain weight, sucrose content, and hormone levels. SS removal also enhanced the activities of key enzymes and the expression levels of genes involved in sucrose to starch metabolism. These results suggest that sucrose and several hormones act as signal substances and play a vital role in grain filling by regulating enzyme activities and gene expression. Therefore, IS grain filling is restricted by SS, which limit assimilate supply and plant hormones, leading to poor grain filling of IS.

  20. Culling phenotypically inferior trees in seed production area enhances seed and seedling quality of Acacia auriculiformis

    Institute of Scientific and Technical Information of China (English)

    V.Sivakuma; B.Gurudevsingh; R.Anandalakshmi; R.R.Warrier; S.Sekaran; Mulualem Tigabu; P.C.Odén

    2011-01-01

    Improvement in seed and seedling quality of Acacia auriculiformis after culling phenotypically inferior trees was studied in a 6-year old seed production area (SPA). A 5-ha plantation was identified, of which 2.3 ha was converted into SPA. The initial stocking, 1 612 trees·ha-1, was thinned down to 982 trees·ha-1 based on growth characteristics. The following fruiting season, seeds were collected from 10 randomly selected trees in culled and non-culled stands, and seed physical characters, germination and seedling traits were assessed. Seed weight,seed thickness and percentage germination increased by 32.1%, 4.43% and 22.37%, respectively in the culled stand compared to the non-culled stand. Culling also increased the speed of germination, seedling dry weight and seedling vigor index. Heritability values were high for seed weight (0.974) and seed thickness (0.948) while medium values were observed for percentage germination (0.577) and total dry weight (0.534).Predicted genetic gain was 11.13% and 11.22% for seed weight and percentage germination, respectively. The actual gain was 32.1, 51.9 and 22.9% for seed weight, percentage germination and total dry matter,respectively. In conclusion, SPAs established by culling inferior trees could serve as sources of good quality seeds for reforestation programs until genetically improved seeds are made available.

  1. Inhibition shapes selectivity to vocalizations in the inferior colliculus of awake mice

    Directory of Open Access Journals (Sweden)

    Zachary eMayko

    2012-10-01

    Full Text Available The inferior colliculus (IC is a major center for integration of auditory information as itreceives ascending projections from a variety of brainstem nuclei as well as descending projectionsfrom the thalamus and auditory cortex. The ascending projections are both excitatory andinhibitory and their convergence at the IC results in a microcircuitry that is important forshaping responses to simple, binaural, and modulated sounds in the IC. Here, we examined therole inhibition plays in shaping selectivity to vocalizations in the IC of awake, normal-hearingadult mice (CBA/CaJ strain. Neurons in the IC of mice show selectivity in their responses tovocalizations, and we hypothesized that this selectivity is created by inhibitory microcircuitryin the IC. We compared single unit responses in the IC to pure tones and a variety of ultrasonicmouse vocalizations before and after iontophoretic application of GABAA receptor (GABAARand glycine receptor (GlyR antagonists. The most pronounced effects of blocking GABAAR andGlyR on IC neurons were to increase spike rates and broaden excitatory frequency tuning curvesin response to pure tone stimuli, and to decrease selectivity to vocalizations. Thus, inhibitionplays an important role in creating selectivity to vocalizations in the inferior colliculus.

  2. Congenital rubella with agenesis of the inferior cerebellar vermis and total anomalous pulmonary venous drainage.

    Science.gov (United States)

    Cluver, C; Meyer, R; Odendaal, H; Geerts, L

    2013-08-01

    Congenital rubella infection has been associated with a number of abnormalities including cardiac, central nervous system and placental complications. We present a case with multiple fetal abnormalities detected on prenatal ultrasound, and confirmed postnatally, that included a single umbilical artery, severe tricuspid regurgitation, micrognathia and agenesis of the inferior cerebellar vermis. Postnatal echocardiography additionally revealed unobstructed total anomalous pulmonary venous drainage (TAPVD) into the coronary sinus. Placental examination showed signs of placentitis, and polymerase chain reaction on neonatal serum was positive for rubella. Following a multidisciplinary team review, it was decided to provide only supportive care, and the infant died at 6 months of age owing to a respiratory tract infection. To our knowledge, TAPVD and agenesis of the inferior cerebellar vermis have not been reported previously in association with congenital rubella infection. This case illustrates how congenital infection may present in atypical ways and stresses the importance of considering congenital infection in the differential diagnosis of fetal anomalies when multiple features are present.

  3. Concomitant pulmonary arteriovenous and inferior vena cava malformations. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Hawass, N.D.; Kolawole, T.M.; Badawi, M.G.

    1988-05-01

    A case of pulmonary arterio-venous malformation (AVM) presenting with dyspnoea diagnosed by computer tomography (CT) and pulmonary angiography is reported. Venous anomalies in the form of agenesis of the iliac veins and the inferior vena cava (IVC), were discovered through femoral venograms performed after technical difficulties were encountered at pulmonary angiography performed via the femoral route. These venous anomalies co-existed with normal but dilated azygos and hemiazygos systems, and with the azygos appearing as a right hilar mass lesion which showed the 'candy cane sign' on the lateral view on venography. A dilated varix at the confluence of the right renal vein and the IVC collaterals was also noted. This association of a pulmonary AVM and IVC agenesis has not been previously reported in the literature. The embryogenesis of the inferior vena cava and the azygos system is presented in an attempt to explain the rare association of these anomalies. The various techniques of diagnosing the disease entities, expecially by CT, are discussed. The rare co-existence of pulmonary AVM and the absence of the IVC is emphasized.

  4. Sensory impairment of the lingual and inferior alveolar nerves following removal of impacted mandibular third molars.

    Science.gov (United States)

    Gülicher, D; Gerlach, K L

    2001-08-01

    In a prospective study 1,106 impacted mandibular third molars were removed from 687 patients. Clinical, radiographic, and surgical factors were recorded. Postoperatively, we examined the modalities of common sensation in order to assess sensory deficit. The patients were followed up, until complete restitution occurred, or, if the sensibility failed to recover, for at least 6 months. A total of 3.6% of the operated sides demonstrated impairment of labial sensation, and 2.1% of lingual sensation. The vast majority of these disturbances subsided completely during the follow-up period. The incidence of persisting sensory diminution after 6 months was 0.91% for the inferior alveolar, and 0.37% for the lingual nerve. However, the degree of the persisting deficit was slight in most instances. The relationship between the recorded factors and the alteration of sensation was analysed by using the chi2 test. For the inferior alveolar nerve we found the patient's age, the development of the roots, the degree of impaction, and the radiographic position of the nerve canal to be significantly correlated to sensory deficit, as well as the surgical procedures in the depth of the socket and the intraoperative opening of the mandibular canal. As far as the lingual nerve is concerned, general anaesthesia and the individual operator were the main factors predictive of nerve damage.

  5. ERP adaptation provides direct evidence for early mirror neuron activation in the inferior parietal lobule.

    Science.gov (United States)

    Möhring, Nicole; Brandt, Emily S L; Mohr, Bettina; Pulvermüller, Friedemann; Neuhaus, Andres H

    2014-10-01

    Mirror neuron systems are frequently investigated by assessing overlapping brain activity during observation and execution of actions; however, distinct neuronal subpopulations may be activated that fall below the spatial resolution of magnetic resonance techniques. This shortfall can be resolved using repetition suppression paradigms that identify physiological adaptation processes caused by repeated activation of identical neuronal circuits. Here, event-related potentials were used to investigate the time course of mirror neuron circuit activation using repetition suppression within and across action observation and action execution modalities. In a lip-reading and speech production paradigm, the N170 component indexed stimulus repetition by adapting to both cross-modal and intra-modal repetitions in the left hemisphere. Neuronal source localization revealed activation of the left inferior parietal lobule during cross-modal relative to intra-modal trials. These results provide support for the position that the same neuronal circuits are activated in perceiving and performing articulatory actions. Moreover, our data strongly suggest that inferior parietal lobule mirror neurons are activated relatively early in time, which indicates partly automatic processes of linguistic perception and mirroring. Repetition suppression paradigms therefore help to elucidate neuronal correlates of different cognitive processes and may serve as a starting point for advanced electrophysiological research on mirror neurons.

  6. Long Term Follow-Up in Inferior Alveolar Nerve Transposition: Our Experience

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    Giulio Gasparini

    2014-01-01

    Full Text Available Introduction. Inferior alveolar nerve transposition (IANT is a surgical technique used in implantoprosthetic rehabilitation of the atrophic lower jaw which has not been well embraced because of the high risk of damage to the inferior alveolar nerve (IAN. There are cases in which this method is essential to obtain good morphologic and functional rebalancing of the jaw. In this paper, the authors present their experience with IANT, analyzing the various situations in which IANT is the only surgical preprosthetic option. Methods. Between 2003 and 2011, 35 patients underwent surgical IANT at our center. Thermal and physical sensitivity were evaluated in each patient during follow-up. The follow-up ranged from 14 to 101 months. Results and Conclusion. Based on our experience, absolute indications of IANT are as follows: (1 class IV, V, or VI of Cawood and Howell with extrusion of the antagonist tooth and reduced prosthetic free space; (2 class V or VI of Cawood and Howell with presence of interforaminal teeth; (3 class V or VI of Cawood and Howell if patient desires fast implantoprosthetic rehabilitation with predictable outcomes; (4 class VI of Cawood and Howell when mandibular height increase with inlay grafts is advisable.

  7. Attention, emotion, and deactivation of default activity in inferior medial prefrontal cortex

    DEFF Research Database (Denmark)

    Geday, Jacob; Gjedde, Albert

    2008-01-01

    Attention deactivates the inferior medial prefrontal cortex (IMPC), but it is uncertain if emotions can attenuate this deactivation. To test the extent to which common emotions interfere with attention, we measured changes of a blood flow index of brain activity in key areas of the IMPC with posi......Attention deactivates the inferior medial prefrontal cortex (IMPC), but it is uncertain if emotions can attenuate this deactivation. To test the extent to which common emotions interfere with attention, we measured changes of a blood flow index of brain activity in key areas of the IMPC...... with positron emission tomography (PET) of labeled water (H(15)2O) uptake in brain of 14 healthy subjects. The subjects performed either a less demanding or a more demanding task of attention while they watched neutral and emotive images of people in realistic indoor or outdoor situations. In the less demanding...... task, subjects used the index finger to press any key when a new image appeared. In the more demanding task, subjects chose the index or middle finger to press separate keys for outdoor and indoor scenes. Compared to the less demanding task, in a global search of all gray matter, the more demanding...

  8. The preperitoneal approach to the groin and the inferior epigastric vessels.

    Science.gov (United States)

    Read, R C

    2005-03-01

    Preperitoneal, a word coined by Nyhus in the 1960s, has been applied not only to posterior approaches that he, Stoppa, and Wantz popularized but to anterior exposures of the groin, which divide the transversalis fascia. This assumes that all give similar views of the easily cleaved space of Bogros. However, accumulated anatomical observations reveal the transversalis fascia as having not one but two layers. The inferior epigastric vessels run between rather than in the preperitoneal space, which is avascular and has its own fascia lining the peritoneum. Historical evidence shows that both the midline Cheatle-Henry and lateral Ugahary-Kugel approaches, which transect the abdominal wall, provide excellent exposure of the avascular preperitoneal space. However, neither the unilateral posterior McEvedy approach nor the anterior approach does, as only part of the musculature and fasciae are retracted. The inferior epigastric vasculature and posterior lamina transversalis fascia, which remain in situ, block the view. Unless they are disrupted or circumvented, neither of the latter approaches or subsequent repairs should be labeled preperitoneal.

  9. Digital versus conventional panoramic radiography in predicting inferior alveolar nerve injury after mandibular third molar removal.

    Science.gov (United States)

    Szalma, József; Lempel, Edina; Jeges, Sára; Olasz, Lajos

    2012-03-01

    The aim of the study was to compare the accuracy of conventional and digital panoramic radiography (OPG) in relation to 4 specific high-risk signs (interruption of the superior cortical line, diversion, narrowing of the canal, and dark band of the root), which would indicate a close anatomic relationship between third molar roots and the inferior alveolar canal.Four hundred mandibular third molar surgical removals after conventional and 272 after digital radiographs were evaluated in the study. The association between postoperative inferior alveolar nerve (IAN) paresthesia and the presence of any preoperative high-risk signs in the OPG was investigated. Bivariate and multivariate logistic regression analyses were completed to compare the accuracy of conventional and digital radiographic techniques detecting high-risk signs predicting possible IAN paresthesia.Digital OPG results showed significantly higher sensitivity in diversion (P = 0.014) and narrowing (P paresthesia, whereas low positive predictive values indicate both imaging techniques as inadequate screening methods for predicting IAN paresthesia after mandibular third molar removal.

  10. Perception of emotional expressions is independent of face selectivity in monkey inferior temporal cortex.

    Science.gov (United States)

    Hadj-Bouziane, Fadila; Bell, Andrew H; Knusten, Tamara A; Ungerleider, Leslie G; Tootell, Roger B H

    2008-04-08

    The ability to perceive and differentiate facial expressions is vital for social communication. Numerous functional MRI (fMRI) studies in humans have shown enhanced responses to faces with different emotional valence, in both the amygdala and the visual cortex. However, relatively few studies have examined how valence influences neural responses in monkeys, thereby limiting the ability to draw comparisons across species and thus understand the underlying neural mechanisms. Here we tested the effects of macaque facial expressions on neural activation within these two regions using fMRI in three awake, behaving monkeys. Monkeys maintained central fixation while blocks of different monkey facial expressions were presented. Four different facial expressions were tested: (i) neutral, (ii) aggressive (open-mouthed threat), (iii) fearful (fear grin), and (iv) submissive (lip smack). Our results confirmed that both the amygdala and the inferior temporal cortex in monkeys are modulated by facial expressions. As in human fMRI, fearful expressions evoked the greatest response in monkeys-even though fearful expressions are physically dissimilar in humans and macaques. Furthermore, we found that valence effects were not uniformly distributed over the inferior temporal cortex. Surprisingly, these valence maps were independent of two related functional maps: (i) the map of "face-selective" regions (faces versus non-face objects) and (ii) the map of "face-responsive" regions (faces versus scrambled images). Thus, the neural mechanisms underlying face perception and valence perception appear to be distinct.

  11. A new type of inferior vena cava filter and its animal experiment

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    This article explains the definition of pulmonary embolism as well as its causes and elaborates on a new type of inferior vena cava filter(VCF)we have developed. Shaped like a waistdrum,the VCF is mainly made of TiNi shape memory alloy-wire. It has a subulate wire frame which can intercept the thrombus on each side. Its medial body is made up of straight shape memory alloywire . Every pillar is bound by several shape memory alloy springs. This type of inferior vena cava filter has a good resistance to fatigue and is hard to be broken. Through animal experiments its framework has been proved to be lasting. Neither deformation nor fragmentation happened when the VCF had been kept in the body for a long time. The thrombus interception efficiency of our VCF is higher than imported VCFs. The filter is unfavorable for thrombosis. After implantation,the IVC was completely unimpeded and no displacement occurred. Moreover the VCF did little damage to the Wall of vein. Neither IVC perforation nor haematoma occurred after the operation.

  12. Força de membros inferiores como indicador de incapacidade funcional em idosos

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    Rafaela G. dos Santos

    2013-09-01

    Full Text Available O propósito deste estudo foi discriminar a quantidade de repetições no teste sentar e levantar da cadeira na estimativa da incapacidade funcional. Estudo epidemiológico de corte transversal com amostra probabilística de 622 indivíduos, idade > 60 anos. A capacidade funcional autopercebida foi analisada como variável dicotômica: ausência de dependência versus dependência na realização de atividade básicas (ABVD e instrumentais da vida diária (AIVD. Aplicou-se o teste sentar e levantar da cadeira durante 30 segundos (número de repetições máximas para avaliar a força de membros inferiores. O teste mostrou-se como discriminador da incapacidade funcional devido os valores apresentados pelas áreas sob as curvas ROC serem >0,60. O ponto de corte para determinar a incapacidade funcional nas ABVD foi < 10 repetições (homens e < 9 repetições (mulheres; nas AIVD < 14 repetições (homens e < 10 repetições (mulheres. A força de membros inferiores pode ser utilizada como preditor da incapacidade funcional nas ABVD e AIVD.

  13. Response bias reveals enhanced attention to inferior visual field in signers of American Sign Language.

    Science.gov (United States)

    Dye, Matthew W G; Seymour, Jenessa L; Hauser, Peter C

    2016-04-01

    Deafness results in cross-modal plasticity, whereby visual functions are altered as a consequence of a lack of hearing. Here, we present a reanalysis of data originally reported by Dye et al. (PLoS One 4(5):e5640, 2009) with the aim of testing additional hypotheses concerning the spatial redistribution of visual attention due to deafness and the use of a visuogestural language (American Sign Language). By looking at the spatial distribution of errors made by deaf and hearing participants performing a visuospatial selective attention task, we sought to determine whether there was evidence for (1) a shift in the hemispheric lateralization of visual selective function as a result of deafness, and (2) a shift toward attending to the inferior visual field in users of a signed language. While no evidence was found for or against a shift in lateralization of visual selective attention as a result of deafness, a shift in the allocation of attention from the superior toward the inferior visual field was inferred in native signers of American Sign Language, possibly reflecting an adaptation to the perceptual demands imposed by a visuogestural language.

  14. The clinical implications of variants of vena cava inferior and aorta on retroperitoneal surgery

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    S. V. Mukhtarulina

    2014-12-01

    Full Text Available Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 % patients. Supernumerary renal arteries and veins observed in 5 (4.9 % patients; retroaortic left renal vein type I and II – in 3 (3.0 % patients. Double vena cava inferior detected in 1 (1.0 % patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %, the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.

  15. The clinical implications of variants of vena cava inferior and aorta on retroperitoneal surgery

    Directory of Open Access Journals (Sweden)

    S. V. Mukhtarulina

    2014-01-01

    Full Text Available Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 % patients. Supernumerary renal arteries and veins observed in 5 (4.9 % patients; retroaortic left renal vein type I and II – in 3 (3.0 % patients. Double vena cava inferior detected in 1 (1.0 % patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %, the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.

  16. Functional heterogeneity of inferior frontal gyrus is shaped by linguistic experience.

    Science.gov (United States)

    Hsieh, L; Gandour, J; Wong, D; Hutchins, G D

    2001-03-01

    A crosslinguistic, positron emission tomography (PET) study was conducted to determine the influence of linguistic experience on the perception of segmental (consonants and vowels) and suprasegmental (tones) information. Chinese and English subjects (10 per group) were presented binaurally with lists consisting of five Chinese monosyllabic morphemes (speech) or low-pass-filtered versions of the same stimuli (nonspeech). The first and last items were targeted for comparison; the time interval between target tones was filled with irrelevant distractor tones. A speeded-response, selective attention paradigm required subjects to make discrimination judgments of the target items while ignoring intervening distractor tones. PET scans were acquired for five tasks presented twice: one passive listening to pitch (nonspeech) and four active (speech = consonant, vowel, and tone; nonspeech = pitch). Significant regional changes in blood flow were identified from comparisons of group-averaged images of active tasks relative to passive listening. Chinese subjects show increased activity in left premotor cortex, pars opercularis, and pars triangularis across the four tasks. English subjects, on the other hand, show increased activity in left inferior frontal gyrus regions only in the vowel task and in right inferior frontal gyrus regions in the pitch task. Findings suggest that functional circuits engaged in speech perception depend on linguistic experience. All linguistic information signaled by prosodic cues engages left-hemisphere mechanisms. Storage and executive processes of working memory that are implicated in phonological processing are mediated in discrete regions of the left frontal lobe.

  17. Dopamine D2-like receptors modulate unconditioned fear: role of the inferior colliculus.

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    Amanda Ribeiro de Oliveira

    Full Text Available BACKGROUND: A reduction of dopamine release or D2 receptor blockade in the terminal fields of the mesolimbic system clearly reduces conditioned fear. Injections of haloperidol, a preferential D2 receptor antagonist, into the inferior colliculus (IC enhance the processing of unconditioned aversive information. However, a clear characterization of the interplay of D2 receptors in the mediation of unconditioned and conditioned fear is still lacking. METHODS: The present study investigated the effects of intra-IC injections of the D2 receptor-selective antagonist sulpiride on behavior in the elevated plus maze (EPM, auditory-evoked potentials (AEPs to loud sounds recorded from the IC, fear-potentiated startle (FPS, and conditioned freezing. RESULTS: Intra-IC injections of sulpiride caused clear proaversive effects in the EPM and enhanced AEPs induced by loud auditory stimuli. Intra-IC sulpiride administration did not affect FPS or conditioned freezing. CONCLUSIONS: Dopamine D2-like receptors of the inferior colliculus play a role in the modulation of unconditioned aversive information but not in the fear-potentiated startle response.

  18. INFERIOR-SEPTAL MYOCARDIAL INFARCTION MISDIAGNOSED AS ANTERIOR-SEPTAL MYOCARDIAL INFARCTION: ELECTROCARDIOGRAPHIC, SCINTIGRAPHIC, AND ANGIOGRAPHIC CORRELATIONS

    Institute of Scientific and Technical Information of China (English)

    Ji-lin Chen; Zuo-xiang He; Zai-jia Chen; Jin-qing Yuan; Yue-qin Tian; Shu-bin Qiao; Rong-fang Shi; Yi-da Tang; Zong-lang Lu

    2007-01-01

    To explore the infarct sites in patients with inferior wall acute myocardial infarction (AMI) concomitant with ST segment elevation in leads V1-V3 and leads V3R-V5R.Methods Five patients diagnosed as inferior, right ventricular, and anteroseptal walls AMI at admission were enrolled. Electrocardiographic data and results of isotope 99mTc-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging and coronary angiography (CAG) were analyzed.Results Electrocardiogram showed that ST segment significantly elevated in standard leads Ⅱ, Ⅲ, aVF, and leads V1-V3 , V3R-V5R in all five patients. The magnitude of ST segment elevation was maximal in lead V1 and decreased gradually from lead V1 to V3 and from lead V1 to V3R-V5R. There was isotope 99mTc-MIBI myocardial perfusion imaging defect in inferior and basal inferior-septal walls. CAG showed that right coronary artery was infarct-related artery.Conclusions The diagnostic criteria for basal inferior-septal wall AMI can be formulated as follows: ( 1 ) ST segment elevates ≥2 mm in lead V1 in the clinical setting of inferior wall AMI; (2) the magnitude of ST segment elevation is the tallest in lead V1 and decreases gradually from lead V1 to V3 and from lead V1 to V3R-V5R. With two conditions above, the basal inferior-septal wall AMI should be diagnosed.

  19. Subcomponents and connectivity of the inferior fronto-occipital fasciculus revealed by diffusion spectrum imaging fiber tracking

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    Yupeng Wu

    2016-09-01

    Full Text Available The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF are still controversial. In this study, we aimed to investigate the connectivity, asymmetry and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI analysis was performed on ten healthy adults and a 90-subject DSI template (NTU-90 Atlas. In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous standard definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient

  20. Effect of hyperbaric oxygen therapy in rats with subtotal splenectomy preserving the inferior pole Efeito da oxigenoterapia hiperbárica em ratos submetidos à esplenectomia subtotal com preservação do polo inferior

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    Marcela Souza Lima Paulo

    2011-06-01

    Full Text Available PURPOSE: To evaluate the effect of hyperbaric oxygen therapy on the survival and weight of rats submitted to subtotal splenectomy and on the viability and growth of the inferior pole. METHODS: Forty Wistar rats underwent subtotal splenectomy with preservation of the inferior pole and distributed into two groups: Group A (n=20 - not treated with hyperbaric oxygen, Group B (n=20 - treated with hyperbaric oxygen. These groups were divided into two subgroups of 10 animals each, according to the time of euthanasia, 15th and 45th days. The survival and weight of the animals were recorded. The inferior pole was measured, weighed and morphologically analyzed. RESULTS: All animals survived. The weight of the animals increased in all subgroups, but decreased on the 10th day in the subgroups treated with hyperbaric oxygen (pOBJETIVO: Avaliar o efeito da oxigenoterapia hiperbárica na sobrevida e peso de ratos submetidos à esplenectomia subtotal e na viabilidade e crescimento do polo inferior. MÉTODOS: Quarenta ratos Wistar foram submetidos à esplenectomia subtotal com preservação do polo inferior e distribuídos em dois grupos: A (n=20 v - não tratados com oxigênio hiperbárico, B (n=20 - tratados. Esses grupos foram divididos em dois subgrupos de 10 animais cada, de acordo com a época de eutanásia: 15º e 45º dias. A sobrevida e peso dos animais foram anotadas. O pólo inferior foi medido, pesado e analisado morfologicamente. RESULTADOS: Todos os animais sobreviveram. O peso aumentou em todos os subgrupos, porém diminuiu no 10º dia nos subgrupos tratados com oxigênio hiperbárico (p<0,001. A viabilidade do polo inferior foi mais evidente nos animais tratados no 15º dia, porém não diferiu no 45º dia. O crescimento do polo inferior não ocorreu no 15º e sim no 45º dia pós-operatório, nos animais não tratados (p<0,01 e tratados (p<0,05. O aumento celular e vascular nos animais tratados foi mais significativo do que nos animais n

  1. Malformação de veia cava inferior e trombose venosa profunda: fator de risco de trombose venosa em jovens Inferior vena cava malformation and deep venous thrombosis: a risk factor of venous thrombosis in the young

    Directory of Open Access Journals (Sweden)

    Renan Roque Onzi

    2007-06-01

    Full Text Available A ausência da veia cava inferior, alteração no processo de formação embriológica que ocorre entre a sexta e a oitava semanas de gestação, é uma rara anomalia congênita. Porém, recentemente foi confirmada como sendo um fator de risco importante para o desenvolvimento de trombose venosa profunda, especialmente em jovens. Apresentamos um caso de trombose em veias cava inferior, ilíacas, femorais e poplíteas num jovem de 16 anos com agenesia de um segmento de veia cava infra-renal e veia renal esquerda retroaórtica.Absence of inferior vena cava, caused by aberrant development within the sixth to eighth weeks of gestation, is a rare congenital anomaly. However, it has been recently confirmed as a major risk factor for the development of deep venous thrombosis, especially in young patients. We report a case of inferior vena cava, iliac, femoral and popliteal vein thrombosis in a 16-year-old patient with inferior vena cava agenesis and retroaortic left renal vein.

  2. A light and electron microscopic study of the inferior olivary nucleus of the squirrel monkey, Saimiri sciureus.

    Science.gov (United States)

    Rutherford, J G; Gwyn, D G

    1980-01-01

    This study provides a description of the normal morphology of the inferior olive of the squirrel monkey, Saimiri sciureus, at the light and electron imcroscopic level. The cytoarchitecture of the inferior olive was maped from serial transverse sections stained with cresyl violet. In common with other mammals, the inferior olive of the squirrel monkey consists of three subdivisions. The medial accessory olive includes seven subnuclei. Both the dorsal and medial accessory olives extend through approximately 90% of the total length of the inferior olivary complex. The principal olive, consisting of a dorsal and ventral lamella continuous with one another laterally, extends through the rostral 55% of the inferior olive. It is somewhat less convoluted than the principal olive of the macaque (Bowman and Sladek, '73). In most other respects, the inferior olive of the two primates is quite similar. Two patterns of dendritic arborization are noted in Golgi preparations from the caudal principal and accessory olives. Dendrites streaming away from the soma, and dendrites curling around the soma in a "ball-like" pattern were observed in all three subdivisions of the inferior olive caudally. Simple spines are occasionally seen on the soma, and a few simple or club-shaped spines were noted on the proximal portion of the dendritic arborization. Spines are more numerous on distal portions of the dendritic tree, however, and include simple, filiform, club-shaped and occasionally complex, or racemous, spiny appendages. Viewed in the electron microscope, most inferior olivary neurons are seen to contain the typical organelles with the usual conformation and distribution. Rarely, a neuron with an indented nucleus and a thin rim of cytoplasm containing a paucity of organelles and a wispy endoplasmic reticulum is encountered. Axon terminals containing either clear round or clear pleomorphic vesicles are seen in all three olivary subdivisions. In a random survey of 706 axon terminals, 54

  3. Anatomy of Mandibular Vital Structures. Part I: Mandibular Canal and Inferior Alveolar Neurovascular Bundle in Relation with Dental Implantology

    Directory of Open Access Journals (Sweden)

    Hom-Lay Wang

    Full Text Available Objectives: It is critical to determine the location and configuration of the mandibular canal and related vital structures during the implant treatment. The purpose of the present study was to review the literature concerning the mandibular canal and inferior alveolar neurovascular bundle anatomical variations related to the implant surgery.Material and Methods: Literature was selected through the search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandibular canal, inferior alveolar nerve, and inferior alveolar neurovascular bundle. The search was restricted to English language articles, published from 1973 to November 2009. Additionally, a manual search in the major anatomy, dental implant, prosthetic and periodontal journals and books were performed.Results: In total, 46 literature sources were obtained and morphological aspects and variations of the anatomy related to implant treatment in posterior mandible were presented as two entities: intraosseous mandibular canal and associated inferior alveolar neurovascular bundle.Conclusions: A review of morphological aspects and variations of the anatomy related to mandibular canal and mandibular vital structures are very important especially in implant therapy since inferior alveolar neurovascular bundle exists in different locations and possesses many variations. Individual, gender, age, race, assessing technique used and degree of edentulous alveolar bone atrophy largely influence these variations. It suggests that osteotomies in implant dentistry should not be developed in the posterior mandible until the position of the mandibular canal is established.

  4. DOES THE INFERIOR FRONTAL SULCUS PLAY A FUNCTIONAL ROLE IN DECEPTION? A NEURONAVIGATED THETA-BURST TRANSCRANIAL MAGNETIC STIMULATION STUDY

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    Bruno eVerschuere

    2012-10-01

    Full Text Available Background. By definition, lying involves withholding the truth. Response inhibition may therefore be the cognitive function at the heart of deception. Neuroimaging research has shown that the same brain region that is activated during response inhibition tasks, namely the inferior frontal region, is also activated during deception paradigms. This led to the hypothesis that the inferior frontal region is the neural substrate critically involved in withholding the truth. Objective. We critically examine the functional necessity of the inferior frontal region in withholding the truth during deception. Method. We experimentally manipulated the neural activity level in right inferior frontal sulcus (IFS by means of neuronavigated continuous theta burst stimulation (cTBS. Individual structural magnetic resonance brain images (MRI were used to allow precise stimulation in each participant. Twenty-six participants answered autobiographical questions truthfully or deceptively before and after sham and real cTBS. Results. Deception was reliably associated with more errors, longer and more variable response times than truth telling. Despite the potential role of IFS in deception as suggested by neuroimaging data, the cTBS-induced disruption of right IFS did not affect response times or error rates, when compared to sham stimulation. Conclusions. The present findings do not support the hypothesis that the right inferior frontal sulcus is critically involved in deception.

  5. "A vengefulness of the impotent": the pain of in-group inferiority and schadenfreude toward successful out-groups.

    Science.gov (United States)

    Leach, Colin Wayne; Spears, Russell

    2008-12-01

    Nietzsche (1887/1967) suggested that the emotional pain individuals feel about their in-group's inferiority leads them to feel the pleasure of schadenfreude when a successful out-group fails. To test this idea, 2 studies examined a fictitious competition between real universities. Individuals' pain about their in-group's inferiority explained schadenfreude at the failure of a successful out-group better than dislike of the out-group, interest in the domain of competition, illegitimacy of the out-group's success, and illegitimacy of the in-group's inferiority. In addition, emotions regarding the out-group's success (i.e., envy, dislike-based anger, and illegitimacy-based anger) were weaker explanations of schadenfreude than the pain of in-group inferiority and anger based in this pain (which Nietzsche referred to as ressentiment). Thus, schadenfreude has more to do with the inferiority of the self than with the success of others. As well as providing evidence for a specific form of prejudice grounded in group-based emotions, this research also revives displacement explanations of prejudice toward 3rd parties.

  6. Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial

    Science.gov (United States)

    Montserrat-Bosch, Marta; Nogueira-Magalhães, Pedro; Arnabat-Dominguez, Josep; Valmaseda-Castellón, Eduard; Gay-Escoda, Cosme

    2014-01-01

    Objectives: To compare the efficacy and complication rates of two different techniques for inferior alveolar nerve blocks (IANB). Study Design: A randomized, triple-blind clinical trial comprising 109 patients who required lower third molar removal was performed. In the control group, all patients received an IANB using the conventional Halsted technique, whereas in the experimental group, a modified technique using a more inferior injection point was performed. Results: A total of 100 patients were randomized. The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation. Three failures were recorded, 2 of them in the experimental group. No relevant local or systemic complications were registered. Conclusions: Both IANB techniques used in this trial are suitable for lower third molar removal. However, performing an inferior alveolar nerve block in a more inferior position (modified technique) extends the onset time, does not seem to reduce the risk of intravascular injections and might increase the risk of lingual nerve injuries. Key words:Dental anesthesia, inferior alveolar nerve block, lidocaine, third molar, intravascular injection. PMID:24608204

  7. Regulation of self-renewing neural progenitors by FGF/ERK signaling controls formation of the inferior colliculus.

    Science.gov (United States)

    Dee, Alexander; Li, Kairong; Heng, Xin; Guo, Qiuxia; Li, James Y H

    2016-10-15

    The embryonic tectum displays an anteroposterior gradient in development and produces the superior colliculus and inferior colliculus. Studies suggest that partition of the tectum is controlled by different strengths and durations of FGF signals originated from the so-called isthmic organizer at the mid/hindbrain junction; however, the underlying mechanism is unclear. We show that deleting Ptpn11, which links FGF with the ERK pathway, prevents inferior colliculus formation by depleting a previously uncharacterized stem cell zone. The stem-zone loss is attributed to shortening of S phase and acceleration of cell cycle exit and neurogenesis. Expression of a constitutively active Mek1 (Mek1(DD)), the known ERK activator, restores the tectal stem zone and the inferior colliculus without Ptpn11. By contrast, Mek1(DD) expression fails to rescue the tectal stem zone and the inferior colliculus in the absence of Fgf8 and the isthmic organizer, indicating that FGF and Mek1(DD) initiate qualitatively and/or quantitatively distinctive signaling. Together, our data show that the formation of the inferior colliculus relies on the provision of new cells from the tectal stem zone. Furthermore, distinctive ERK signaling mediates Fgf8 in the control of cell survival, tissue polarity and cytogenetic gradient during the development of the tectum.

  8. Biomechanical properties of the anterior band of the inferior glenohumeral ligament under stress Propriedades biomecânicas da banda anterior do ligamento glenoumeral inferior submetido a estresse

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    José Atualpa Pinheiro Júnior

    2003-04-01

    Full Text Available This paper is aimed at studying the behavior of the band of inferior glenohumeral ligament subjected to uniaxial traction. Twenty ligaments were distributed in two groups: Group I ( ligaments with bony origin and insertion and Group II ( medial portion of the ligament. Uniaxial traction was applied to all tendons utilizing a traction machine develop in the Department of Physics of UFC. Hooke's Law was used for evaluation of ligament behavior during elastic phase and the Exponential stress-strain Law, for rigidity phase. All ligaments had the same behavior, presenting a phase of elasticity , followed by one of rigidity. After evaluation of the elastic phase , applying Hooke's Law, ligaments constants were 10.507 N/mm ( group I and 13.80 N/mm ( group II, suffering a straining of 2.83% and 2.84%,respectively, until the ligament became rigid. During rigidity phase, the constants were 511.56% N/mm (group I and 156.84% N/mm (group II. It is concluded that the ligament submitted to traction suffers a small elongation until becoming rigid along with an important increase in force constants during rigidity phase.Com o objetivo de estudar o comportamento da banda anterior do ligamento glenoumeral inferior quando submetido a tração uniaxial, estudaram-se 20 ligamentos glenoumerais, especificamente sua banda anterior, divididos em dois grupos: Grupo I, ligamento com origem e inserção óssea e Grupo II, parte média do ligamento. Realizou-se tração uniaxial em máquina desenvolvida no Departamento de Física da Universidade Federal do Ceará, sendo utilizada a Lei de Hooke para avaliação do comportamento do ligamento na fase elástica e a Lei Exponencial stress-strain, para fase de rigidez . Todos os ligamentos tiveram o mesmo comportamento, tendo apresentado uma fase de elasticidade, seguida de uma de rigidez. Após avaliação da fase elástica, utilizando a Lei de Hooke, os ligamentos apresentaram as constantes de 10,507 N/mm para o grupo I e de

  9. Amputações de extremidades inferiores por diabetes mellitus: estudo caso-controle

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    Gamba Mônica Antar

    2004-01-01

    Full Text Available OBJETIVO: As amputações de extremidades inferiores são cada vez mais freqüentes em pessoas com diabetes mellitus, tornando-se importante problema de saúde pública, no Brasil e no mundo. O estudo objetivou detectar fatores associados a amputações de extremidades inferiores, em pessoas com diabetes mellitus. MÉTODOS: Realizou-se estudo caso controle emparelhado. Foram identificados 117 pessoas com diabetes mellitus e submetidas a amputações de extremidades inferiores, na rede de serviços do Município de São Paulo. Os casos foram comparados com 234 controles, pessoas com diabetes mellitus, mas não submetidas a amputações. As variáveis consideradas no emparelhamento foram sexo, idade e duração da doença. Características sociodemográficas, de hábitos de vida, clínicas e relativas à educação em saúde em diabetes mellitus foram incluídas. Inicialmente, foi realizada análise univariada, verificando a presença de associações entre amputações e variáveis exploratórias. Foi utilizado modelo de regressão logística condicional para a análise multivariada, com adoção do odds ratio como medida de associação. RESULTADOS: Observou-se existência de associação entre amputação e hábito de fumar, última glicemia (superior a 200 mg/dl, presença da polineuropatia simétrica distal e da vasculopatia periférica. O tratamento do diabetes mellitus e o comparecimento às consultas de enfermagem foram importantes fatores associados à prevenção dessas amputações. CONCLUSÕES: O reconhecimento dos determinantes e dos fatores intervenientes para o acometimento desse agravo levarão à redução dos custos na área e à melhoria da qualidade da assistência prestada na rede de serviços de saúde pública.

  10. Blefaroplastia inferior: poderia a cirurgia proporcionar satisfação aos pacientes?

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    Giovanni André Pires Viana

    2012-12-01

    Full Text Available OBJETIVO: Foi realizado um estudo prospectivo com objetivo de avaliar os resultados de cinquenta pacientes submetidos a blefaroplastia inferior transcutânea, visando a análise do resultado clínico e a satisfação dos pacientes na Universidade Federal de São Paulo, entre abril de 2005 e maio de 2007. MÉTODOS: Os pacientes foram alocados aleatoriamente em dois grupos cirúgicos. O Grupo Cirúrgico 1 (Grupo Controle foi composto por 25 pacientes submetidos a blefaroplastia inferior tradicional e cantopexia lateral de rotina. O Grupo Cirúrgico 2 (Grupo Experimental foi composto por 25 pacientes submetidos a blefaroplastia inferior com transposição das bolsas adiposas e cantopexia lateral de rotina. Para avaliar os resultados obtidos foi utilizado a avaliação da autoestima dos pacientes, por meio da Escala de Autoestima de Rosenberg UNIFESP/EPM. O outro método utilizado foi solicitar a participação de três cirurgiões independentes que avaliaram as fotografias de pré e pós-operatório e com auxílio de uma escala topográfica, quantificaram os resultados. RESULTADOS: A média de idade foi de 48,8 anos, com predomínio do sexo feminino (96%. A análise das fotografias mostrou que 96% dos pacientes apresentaram melhora significativa. A autoestima melhorou de um escore médio no pré-operatório de 5,1 (desvio padrão = 4,1 para um valor médio de 3,6 (desvio padrão = 3,5 após 6 meses da cirurgia (p=0,001. CONCLUSÃO: Os autores concluíram que ambos os procedimentos seriam seguros e eficazes, com baixo índice de complicação, apresentando melhora da autoestima, visível após seis meses da cirurgia.

  11. Teaching alternatives to the standard inferior alveolar nerve block in dental education: outcomes in clinical practice.

    Science.gov (United States)

    Johnson, Thomas M; Badovinac, Rachel; Shaefer, Jeffry

    2007-09-01

    Surveys were sent to Harvard School of Dental Medicine students and graduates from the classes of 2000 through 2006 to determine their current primary means of achieving mandibular anesthesia. Orthodontists and orthodontic residents were excluded. All subjects received clinical training in the conventional inferior alveolar nerve block and two alternative techniques (the Akinosi mandibular block and the Gow-Gates mandibular block) during their predoctoral dental education. This study tests the hypothesis that students and graduates who received training in the conventional inferior alveolar nerve block, the Akinosi mandibular block, and the Gow-Gates mandibular block will report more frequent current utilization of alternatives to the conventional inferior alveolar nerve block than clinicians trained in the conventional technique only. At the 95 percent confidence level, we estimated that between 3.7 percent and 16.1 percent (mean=8.5 percent) of clinicians trained in using the Gow-Gates technique use this injection technique primarily, and between 35.4 percent and 56.3 percent (mean=47.5 percent) of those trained in the Gow-Gates method never use this technique. At the same confidence level, between 0.0 percent and 3.8 percent (mean=0.0 percent) of clinicians trained in using the Akinosi technique use this injection clinical technique primarily, and between 62.2 percent and 81.1 percent (mean=72.3 percent) of those trained in the Akinosi method never use this technique. No control group that was completely untrained in the Gow-Gates or Akinosi techniques was available for comparison. However, we presume that zero percent of clinicians who have not been trained in a given technique will use the technique in clinical practice. The confidence interval for the Gow-Gates method excludes this value, while the confidence interval for the Akinosi technique includes zero percent. We conclude that, in the study population, formal clinical training in the Gow-Gates and

  12. Hemorragia adrenal bilateral com trombose da veia renal direita e veia cava inferior em um recém-nascido Bilateral adrenal hemorrhage associated with right renal vein and inferior vena cava thrombosis in a newborn

    Directory of Open Access Journals (Sweden)

    Severino Aires de Araújo Neto

    2003-10-01

    Full Text Available Os autores apresentam um caso de um recém-nascido com um tipo raro de associação de hemorragia adrenal bilateral com trombose de veia renal direita e de veia cava inferior, em que os exames de ultra-sonografia e tomografia computadorizada exerceram papel crucial no estabelecimento do diagnóstico, orientação da conduta e seguimento do paciente.We report a rare case of coexisting bilateral adrenal hemorrhage, right renal vein and inferior vena cava thrombosis in a neonate. Imaging studies played an important role in the diagnosis, management, and follow-up of this patient.

  13. PERBANDINGAN ANTARA KOMBINASI LATIHAN STABILISASI BAHU DAN TRAKSI HUMERUS KE INFERIOR DENGAN KOMBINASI LATIHAN FUNGSIONAL BAHU DAN TRAKSI HUMERUS KE INFERIOR DALAM MENURUNKAN DISABILITAS BAHU DAN LENGAN PADA SUBACROMIAL IMPINGEMENT SYNDROME MAHASISWA AKAD

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    Mawaddah -

    2015-08-01

    Full Text Available Shoulder impingement causing interference on the motion of the shoulder joint activities and result in functional activity disorder. These injuries usually are caused by faulty movement, overuse, poor posture, occupational factors and trauma. This will cause a burden on one part of the body and cause imbalances in anatomy, which will eventually lead to disruption of the body that experienced work. This study aimed to investigate the effect of functional shoulder exercise and traction humerus to inferior with shoulder stabilization exercises and traction humerus to inferior to the decline in the shoulder and arm disabilities in subacromial impingement syndrome. This research method was experimental clinical trials with pre test and post test group design. Population student Academy Physiotherapy Widya Husada Semarang, which consists of 3 men and 12 women, aged between 18-21 years, divided into two groups. Group I was given Shoulder Stabilization exercises and Traction humerus to Inferior (n=7 and group II Functional Shoulder Exercise and Traction humerus to Inferior (n=8. This research was conducted for 3 weeks. Measurement of the value of disability shoulder and arm by using the Shoulder Pain and Disability Index (SPADI. The test results on the group I average value pre 34.17, SB = 6.31, and the average value of post 11.54, SB = 4.02, p = 0.001 found significant differences obtained test results paired sample t-test, and testing group II average value pre 40.18, SB = 3.53, and the average value of post 7.82, SB = 1.57, p = 0.001 found significant differences obtained test results paired sample t-test. Comparison of Group I and II, p = 0.005 there were significant differences, test results obtained independent sample t-test. Conclusions: The combination of shoulder stabilization exercises and traction humerus to inferior can reduce disability shoulder and arm on subacromial impingement syndrome. The combination functional shoulder exercise and

  14. Socioeconomic status and paranoia: the role of life hassles, self-mastery, and striving to avoid inferiority.

    Science.gov (United States)

    Anderson, Fraser; Freeman, Daniel

    2013-08-01

    Paranoid ideation is more common in the general population than previously thought, and it is associated with low socioeconomic status. Daily life hassles, self-mastery, and striving to avoid inferiority may partly account for this association, but these factors have not been examined in relation to paranoid thoughts. Two hundred fifteen individuals from the general population completed self-report assessments of paranoid thoughts during the last month, daily life hassles, self-mastery, striving to avoid inferiority, and socioeconomic classification. A greater number of daily hassles, low self-mastery, and insecure striving were all associated with greater levels of paranoid thinking. Each variable was associated with markers of socioeconomic status. This study demonstrates for the first time the association of paranoid thoughts with life hassles, self-mastery, and striving to avoid inferiority. Each of the factors examined may be a plausible candidate to account for why lower socioeconomic status is associated with greater perceptions of threat from other people.

  15. Variaciones de la anatomía del nervio dentario inferior. Revisión bibliográfica

    OpenAIRE

    Granollers Torrens, M.; Berini Aytés, Leonardo; Gay Escoda, Cosme

    1997-01-01

    La correcta identificación del conducto dentario inferior o conducto mandibular, por el que discurre el nervio dentario inferior, es esencial cuando se precisa realizar cualquier intervención de Cirugía Bucal en la región mandibular posterior. En este artículo se revisa la literatura publicada referida a la anatomía del nervio dentario inferior y se relaciona con las diferentes técnicas de diagnóstico por la imagen (radiología y tomografía) así como con la disección anatómica de mandíbulas de...

  16. Activation in the Right Inferior Parietal Lobule Reflects the Representation of Musical Structure beyond Simple Pitch Discrimination

    Science.gov (United States)

    Royal, Isabelle; Vuvan, Dominique T.; Zendel, Benjamin Rich; Robitaille, Nicolas; Schönwiesner, Marc; Peretz, Isabelle

    2016-01-01

    Pitch discrimination tasks typically engage the superior temporal gyrus and the right inferior frontal gyrus. It is currently unclear whether these regions are equally involved in the processing of incongruous notes in melodies, which requires the representation of musical structure (tonality) in addition to pitch discrimination. To this aim, 14 participants completed two tasks while undergoing functional magnetic resonance imaging, one in which they had to identify a pitch change in a series of non-melodic repeating tones and a second in which they had to identify an incongruous note in a tonal melody. In both tasks, the deviants activated the right superior temporal gyrus. A contrast between deviants in the melodic task and deviants in the non-melodic task (melodic > non-melodic) revealed additional activity in the right inferior parietal lobule. Activation in the inferior parietal lobule likely represents processes related to the maintenance of tonal pitch structure in working memory during pitch discrimination. PMID:27195523

  17. Vascular loops in the anterior inferior cerebellar artery, as identified by magnetic resonance imaging, and their relationship with otologic symptoms

    Directory of Open Access Journals (Sweden)

    Luiz de Abreu Junior

    Full Text Available Abstract Objective: To use magnetic resonance imaging to identify vascular loops in the anterior inferior cerebellar artery and to evaluate their relationship with otologic symptoms. Materials and Methods: We selected 33 adults with otologic complaints who underwent magnetic resonance imaging at our institution between June and November 2013. Three experienced independent observers evaluated the trajectory of the anterior inferior cerebellar artery in relation to the internal auditory meatus and graded the anterior inferior cerebellar artery vascular loops according to the Chavda classification. Kappa and chi-square tests were used. Values of p < 0.05 were considered significant. Results: The interobserver agreement was moderate. Comparing ears that presented vascular loops with those that did not, we found no association with tinnitus, hearing loss, or vertigo. Similarly, we found no association between the Chavda grade and any otological symptom. Conclusion: Vascular loops do not appear to be associated with otoneurological manifestations.

  18. Vascular loops in the anterior inferior cerebellar artery, as identified by magnetic resonance imaging, and their relationship with otologic symptoms*

    Science.gov (United States)

    de Abreu Junior, Luiz; Kuniyoshi, Cristina Hiromi; Wolosker, Angela Borri; Borri, Maria Lúcia; Antunes, Augusto; Ota, Vanessa Kiyomi Arashiro; Uchida, Daniela

    2016-01-01

    Objective To use magnetic resonance imaging to identify vascular loops in the anterior inferior cerebellar artery and to evaluate their relationship with otologic symptoms. Materials and Methods We selected 33 adults with otologic complaints who underwent magnetic resonance imaging at our institution between June and November 2013. Three experienced independent observers evaluated the trajectory of the anterior inferior cerebellar artery in relation to the internal auditory meatus and graded the anterior inferior cerebellar artery vascular loops according to the Chavda classification. Kappa and chi-square tests were used. Values of p < 0.05 were considered significant. Results The interobserver agreement was moderate. Comparing ears that presented vascular loops with those that did not, we found no association with tinnitus, hearing loss, or vertigo. Similarly, we found no association between the Chavda grade and any otological symptom. Conclusion Vascular loops do not appear to be associated with otoneurological manifestations. PMID:27818543

  19. FIFTH LUMBAR VERTEBRA ASSOCIATED WITH ABSENCE OF SPINOUS PROCESS, LAMINAE AND INFERIOR ARTICULAR PROCESSES. – CASE REPORT

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    Prathap Kumar

    2013-09-01

    Full Text Available Background: The vertebral disorders are the ones which lead to disability and lot of health problems. Since the lumbar part of the vertebral column is the main weight bearing and weight transmitting region, if there is a defective development, the area for muscle attachment and the strong bony structure for the transmission of weight would be missing leading to instability at an early age. In the present case dry and processed fifth lumbar vertebra, of unknown sex which presented the features with absence of spinous process, laminae and the inferior articular processes on both sides which were obtained for teaching the medical undergraduate students in M.S.Ramaiah Medical College, Bangalore. There was absence of spinous process, laminae and the inferior articular processes of fifth lumbar vertebra leading to a wide spina bifida with absence of laminae, inferior articular processes on both sides and spinous process of fifth lumbar vertebra which could be a developmental anomaly.

  20. Septic thrombophlebitis of the inferior mesenteric vein and associated mesenteric abscess complicating sigmoid diverticulitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Seong Jae; Lee, Hae Kyung; Yi, Beom Ha; Lee, Min Hee; Hong, Hyun Sook [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2013-07-15

    Thrombophlebitis occurs secondarily to inflammatory conditions of adjacent organs, and radiologic finding is essential for diagnosis. However, because of the rarity on clinical cases that involve the inferior mesenteric vein, many radiologists are unfamiliar with its location and appearance. We experience a case of septic thrombophlebitis with abscess complication sigmoid diverticulitis. CT scans reveals a low density thrombus and air in the inferior mesenteric vein, combining with perivascular fat infiltration, and focal wall defects with abscess formation. After surgical treatment, the abscess was not visible in the follow-up CT scans. Septic thrombophlebitis of the inferior mesenteric vein, although being a rare disease, should be diagnosed on CT according to the given unique location, the appearance of inflamed vein and the adjacent descending mesocolon.

  1. Transient Automatic Writing Behavior following a Left Inferior Capsular Genu Infarction

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    Keisuke Suzuki

    2009-05-01

    Full Text Available A 79-year-old, right-handed woman was admitted to the hospital with decreased spontaneity. Brain magnetic resonance imaging showed a left inferior capsular genu infarction. 99mTC-ECD single-photon emission computed tomography revealed a left-dominant diffuse hypoperfusionin the basal ganglia and frontal lobe. The patient showed abulia and increased writing activity without motor or sensory deficit. The writing was mainly perseverative, and words written along lines were legible and without spatial distortions. This augmented writing behavior disappeared on day 21. The writing characteristic was more similar to automatic writing behavior than hypergraphia. Dissociation between speech and writing behavior was present in our patient. We suggest that a disconnection within the frontal-subcortical circuit contributed to the development of motor perseveration in writing.

  2. A Dedicated Inferior Vena Cava Filter Service Line: How to Optimize Your Practice.

    Science.gov (United States)

    Karp, Jennifer K; Desai, Kush R; Salem, Riad; Ryu, Robert K; Lewandowski, Robert J

    2016-06-01

    Despite the increased placement of retrievable inferior vena cava filters (rIVCFs), efforts to remove these devices are not commensurate. The majority of rIVCFs are left in place beyond their indicated usage, and often are retained permanently. With a growing understanding of the clinical issues associated with these devices, the United States Food and Drug Administration (FDA) has prompted clinicians to remove rIVCF when they are no longer indicated. However, major obstacles exist to filter retrieval, chief among them being poor clinical follow-up. The establishment of a dedicated IVC filter service line, or clinic, has been shown to improve filter retrieval rates. Usage of particular devices, specifically permanent versus retrievable filters, is enhanced by prospective physician consultation. In this article, the rationale behind a dedicated IVC filter service line is presented as well as described the structure and activities of the authors' IVC filter clinic; supporting data will also be provided when appropriate.

  3. Angiojet thrombolysis and vena cava filter insertion in a case of a duplicated inferior vena cava

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    Stuart Blackwood

    2015-02-01

    Full Text Available Objectives: Duplication of the inferior vena cava (IVC complicates interventional procedures. This case report aims to shed light on this unusual anomaly and the preoperative considerations necessary when treatment of venous thromboembolism is undertaken. Methods: An IRB approved case report of a 58 year old woman presented emergently with right lower extremity phlegmasia due to extensive thrombosis of her right iliofemoral and infrarenal portion of her duplicated IVC. Results: The patient underwent IVC filter placement and rheolytic thrombectomy with thrombolysis using the Angiojet device followed by venoplasty and stenting of the iliofemoral system and right IVC. Complete symptomatic and radiographic resolution on duplex imaging was achieved at 1 year follow up. Conclusions: With adequate preoperative awareness of IVC anomalies and treatment options available satisfactory results can be achieved and complications minimized for this unique patient population.

  4. Spontaneous healing and complete disappearance of a ruptured posterior inferior cerebellar artery dissecting aneurysm.

    Science.gov (United States)

    Su, Tsung-Ming; Cheng, Ching-Hsiao; Chen, Wu-Fu; Hsu, Shih-Wei

    2014-05-01

    A 7-month-old baby presented with a 4-day history of drowsiness and vomiting after a falling accident. Magnetic resonance imaging demonstrated diffuse subarachnoid hemorrhage, intraventricular hemorrhage, and variable stages of subdural hematoma in bilateral occipital and left temporal subdural spaces. A partially thrombosed aneurysm was noted in the right craniocervical junction. Ophthalmological examination revealed bilateral retinal petechial hemorrhages. Conventional cerebral angiography revealed a dissecting aneurysm in the right posterior inferior cerebellar artery (PICA). Endovascular embolization was suggested, but the family refused. After conservative treatment, follow-up MRI revealed that the PICA aneurysm had remodeled and ultimately disappeared completely at the 10th month. This case illustrates the relatively plastic nature of intracranial aneurysms in pediatric patients. More studies are necessary to clarify the natural history of spontaneously thrombosed aneurysms to assist in their overall management.

  5. Apophysitis of the lower limbs: imaging findings; Apofisites dos membros inferiores: aspectos de imagem

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa, Priscila Rodrigues; Santos, Durval C. Barros; Longo, Carlos Henrique; Luna, Rodrigo de Castro; Kim, Nelson Ji Tae; Rosemberg, Laercio A.; Funari, Marcelo Gusmao Buarque [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil). Dept. de Imagem]. E-mail: pill-rb@uol.com.br

    2005-07-01

    Apophyses are secondary ossification centers that appear during growth. These ossification centers are under traction forces because of insertion of muscles and ligaments. When traction stress become greater in magnitude and frequency irritation of physis (growth plate) may occur resulting in apophysitis. Apophysitis injuries typically occur in active adolescents and usually presents as peri-articular pain associated with growth, skeletal immaturity, repetitive microtrauma and muscle-tendon imbalance. The most common types of apophysitis of the include Osgood-Schlatter disease (tibial tuberosity), apophysitis of the hip (iliac crest, ischial tuberosity), Sever's disease (posterior calcaneus), Sindig-Larsen-Johansson syndrome (inferior patella), and Iselin's disease (fifth metarsal base). The aim of this study was to show the main magnetic resonance imaging and X-rays findings in patients with these diseases and to discuss the frequent differential diagnosis. (author)

  6. Bilateral inferior vena cava filter insertion in a patient with duplication of the infrarenal vena cava.

    LENUS (Irish Health Repository)

    Leong, S

    2010-06-19

    BACKGROUND: Inferior vena cava (IVC) filter insertion is a commonly performed procedure for indications such as recurrent pulmonary emboli or contraindication to anticoagulation. Symptomatic duplication of the IVC is exceedingly rare with only a handful of cases being described in the literature. AIM: We report an unusual case of a patient with symptomatic duplication of the IVC. RESULT: A 53-year-old woman presented at our hospital for resection of a cerebral metastasis from a non-small cell lung cancer following a recent diagnosis of bilateral lower limb deep venous thrombosis. This required perioperative reversal of anticoagulation and IVC filter insertion. Conventional venography performed during filter insertion documented the existence of a duplicated IVC. CONCLUSION: We present a case of a symptomatic duplication of the IVC requiring filter insertion. We review the developmental anatomy of the IVC along with the diagnostic findings and management strategies available.

  7. Response inhibition of face stimuli linked to inferior frontal gyrus microstructure in adolescents

    DEFF Research Database (Denmark)

    Holm-Skjold, Jonathan; Baaré, William Frans Christiaan; Jernigan, Terry Lynne

    . Inhibition of negative faces has been shown to be more difficult than that of positive faces1,3. The brain network underlying response inhibition includes the right inferior frontal gyrus (IFG), right presupplementary motor area (preSMA), and superior longitudinal fasciculus (SLF) bilaterally 4–6. The white......The ability to inhibit inappropriate behavior is an essential cognitive and social skill. Response inhibition of pre-potent motor responses as measured with a stop-signal or a Go/Nogo task improves throughout adolescence1,2. Performance on these tasks can be modulated by the valence of task stimuli...... that better response inhibition (i.e. lower false alarm rate) of negative faces would be associated with higher FA in right IFG, right preSMA, and bilateral SLF in adolescents....

  8. Incidental Finding of Inferior Vena Cava Atresia Presenting with Deep Venous Thrombosis following Physical Exertion

    Directory of Open Access Journals (Sweden)

    Shalini Koppisetty

    2015-01-01

    Full Text Available Inferior vena cava atresia (IVCA is a rare but well described vascular anomaly. It is a rare risk factor for deep venous thrombosis (DVT, found in approximately 5% of cases of unprovoked lower extremity (LE DVT in patients <30 years of age. Affected population is in the early thirties, predominantly male, often with a history of major physical exertion and presents with extensive or bilateral DVTs. Patients with IVC anomalies usually develop compensatory circulation through the collateral veins with enlarged azygous/hemizygous veins. Despite the compensatory circulation, the venous drainage of the lower limbs is often insufficient leading to venous stasis and thrombosis. We describe a case of extensive and bilateral deep venous thrombosis following physical exertion in a thirty-six-year-old male patient with incidental finding of IVCA on imaging.

  9. Evidence-based outcomes following inferior alveolar and lingual nerve injury and repair: a systematic review.

    Science.gov (United States)

    Kushnerev, E; Yates, J M

    2015-10-01

    The inferior alveolar nerve (IAN) and lingual (LN) are susceptible to iatrogenic surgical damage. Systematically review recent clinical evidence regarding IAN/LN repair methods and to develop updated guidelines for managing injury. Recent publications on IAN/LN microsurgical repair from Medline, Embase and Cochrane Library databases were screened by title/abstract. Main texts were appraised for exclusion criteria: no treatment performed or results provided, poor/lacking procedural description, cohort deficit shows no improvement 90 days post-diagnosis. Nerve transection diagnosed intra-operatively should be repaired in situ; minor nerve injury repair can be delayed. No consensus exists regarding optimal methods and timing for IAN/LN repair. We suggest a schematic guideline for treating IAN/LN injury, based on the most current evidence. We acknowledge that additional RCTs are required to provide definitive confirmation of optimal treatment approaches.

  10. Iatrogenic injury to the inferior alveolar nerve: etiology, signs and symptoms, and observations on recovery.

    Science.gov (United States)

    Hillerup, S

    2008-08-01

    The purpose of this prospective, non-randomised, descriptive study is to characterise the neurosensory deficit and associated neurogenic discomfort in 52 patients with iatrogenic injury to the inferior alveolar nerve (IAN). All patients were examined and followed up according to a protocol assessing tactile, thermal, and positional perception as well as two-point discrimination and pain. In 48 patients with IAN injuries of differing etiologies who did not undergo surgery, 32 patients with injury associated with third molar surgery exhibited significant spontaneous improvement of sensory function. Recovery improvement of sensory function was insignificant in the patients with other etiologies. In most patients the level of sensory perception was such that microsurgical repair was only occasionally indicated. Four patients had microsurgical repair; the outcome was favourable in three. IAN injuries associated with third molar surgery, other dento-alveolar surgery or implant surgery occur sufficiently often to render prevention a key issue.

  11. Brachytherapy for the prevention of neointimal hyperplasia in the canine inferior vena cava after stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Isota, Masayuki; Kaminou, Toshio; Sakai, Yukimasa; Nakamura, Kenji; Yamada, Ryusaku [Osaka City Univ. (Japan). Medical School

    2002-06-01

    The aim of this study was to evaluate the efficacy of brachytherapy for preventing neointimal hyperplasia in the inferior vena cava (IVC) after stent placement. Sixteen beagles underwent Z-stent placement in the IVC and the aorta. For 8 of 16 beagles, irradiation (15 Gy) was delivered endoluminally to the stented segments of each vessel immediately after stent placement using the {sup 192}Ir. All animals were sacrificed after 6 weeks for morphometric and histopathologic examination. Morphometrically, neointimal thickness in the IVC of the radiation group was significantly decreased compared with the control group as well as that in the aorta (p<0.05). Histopathologic findings showed the neointima in the IVC of the control group contained markedly organization of thrombus and neovascularization though that in the IVC of the radiation group consisted mainly of smooth muscle cells without organization of thrombus and neovascularization. From these data intravenous irradiation may prevent clinical restenosis after stent placement. (author)

  12. Entrapment of Guide Wire in an Inferior Vena Cava Filter: A Technique for Removal

    Energy Technology Data Exchange (ETDEWEB)

    Abdel-Aal, Ahmed Kamel, E-mail: akamel@uabmc.edu; Saddekni, Souheil [University of Alabama at Birmingham, Department of Radiology (United States); Hamed, Maysoon Farouk [University of Alabama at Birmingham, Department of Anesthesia (United States); Fitzpatrick, Farley [Radiology Specialists of Louisville (United States)

    2013-04-15

    Entrapment of a central venous catheter (CVC) guide wire in an inferior vena cava (IVC) filter is a rare, but reported complication during CVC placement. With the increasing use of vena cava filters (VCFs), this number will most likely continue to grow. The consequences of this complication can be serious, as continued traction upon the guide wire may result in filter dislodgement and migration, filter fracture, or injury to the IVC. We describe a case in which a J-tipped guide wire introduced through a left subclavian access without fluoroscopic guidance during CVC placement was entrapped at the apex of an IVC filter. We describe a technique that we used successfully in removing the entrapped wire through the left subclavian access site. We also present simple useful recommendations to prevent this complication.

  13. Pseudoaneurysm of the inferior epigastric artery: a rare complication of laparoscopic ventral hernia repair.

    Science.gov (United States)

    Nichols-Totten, Kysha; Pollema, Travis; Moncure, Michael

    2012-02-01

    Pseudoaneurysm of the inferior epigastric artery (IEA) is a recognized complication of surgery; however, it is a very rare clinical occurrence. The anatomic position of the IEA subjects patients to possible IEA injury during abdominal wall procedures that are close to the artery, such as insertions of drains, Tenckhoff catheters, laparoscopic trocars, or paracentesis. Treatment options include open surgery, percutaneous coil embolization, embolization with N-butyl cyanoacrylate, sonographic-guided thrombin injection, or sonographic-guided compression. We report the first case of a pseudoaneurysm arising from the IEA after a laparoscopic ventral hernia repair. To our knowledge, 17 IEA pseudoaneurysms have been reported, only 3 of which were spontaneous. The pseudoaneurysm in our patient was successfully treated by percutaneous injection of thrombin by interventional radiology.

  14. Inferior alveolar nerve paresthesia after overfilling of endodontic sealer into the mandibular canal.

    Science.gov (United States)

    González-Martín, Maribel; Torres-Lagares, Daniel; Gutiérrez-Pérez, José Luis; Segura-Egea, Juan José

    2010-08-01

    The present study describes a case of endodontic sealer (AH Plus) penetration within and along the mandibular canal from the periapical zone of a lower second molar after endodontic treatment. The clinical manifestations comprised anesthesia of the left side of the lower lip, paresthesia and anesthesia of the gums in the third quadrant, and paresthesia and anesthesia of the left mental nerve, appearing immediately after endodontic treatment. The paresthesia and anesthesia of the lip and gums were seen to decrease, but the mental nerve paresthesia and anesthesia persisted after 3.5 years. This case illustrates the need to expend great care with all endodontic techniques when performing nonsurgical root canal therapy, especially when the root apices are in close proximity to vital anatomic structures such as the inferior alveolar canal.

  15. Matching categorical object representations in inferior temporal cortex of man and monkey.

    Science.gov (United States)

    Kriegeskorte, Nikolaus; Mur, Marieke; Ruff, Douglas A; Kiani, Roozbeh; Bodurka, Jerzy; Esteky, Hossein; Tanaka, Keiji; Bandettini, Peter A

    2008-12-26

    Inferior temporal (IT) object representations have been intensively studied in monkeys and humans, but representations of the same particular objects have never been compared between the species. Moreover, IT's role in categorization is not well understood. Here, we presented monkeys and humans with the same images of real-world objects and measured the IT response pattern elicited by each image. In order to relate the representations between the species and to computational models, we compare response-pattern dissimilarity matrices. IT response patterns form category clusters, which match between man and monkey. The clusters correspond to animate and inanimate objects; within the animate objects, faces and bodies form subclusters. Within each category, IT distinguishes individual exemplars, and the within-category exemplar similarities also match between the species. Our findings suggest that primate IT across species may host a common code, which combines a categorical and a continuous representation of objects.

  16. Giant partially thrombosed 4 th ventricular posterior inferior cerebellar artery aneurysm; microsurgical management

    Directory of Open Access Journals (Sweden)

    Forhad Hossain Chowdhury

    2014-01-01

    Full Text Available A 42-year-old woman presented with a 3-month history of progressive occipital headache, vomiting, walking difficulty, and repeated fall. She had no history of sudden and severe headache. She had positive cerebellar signs, predominantly on the right side. Computerized tomography (CT scan, CT angiogram, and magnetic resonance image (MRI of the brain showed suspected partially thrombosed giant 4 th ventricular posterior inferior cerebellar artery aneurysm. Patient developed severe hypersensitivity reaction during both CT scan and MRI after contrast injection. Though needed, digital subtraction angiogram (DSA of cerebral vessels was not done. The aneurysm was managed by microsurgical clipping of the aneurysm neck and partial excision of thrombosed aneurysm. Here, we report the details of management of these difficult giant aneurysm without DSA.

  17. Mandibular Inferior Cortical Bone Thickness on Panoramic Radiographs in Patients using Bisphosphonates

    Science.gov (United States)

    Torres, Sandra R.; Chen, Curtis S. K.; Leroux, Brian G.; Lee, Peggy P.; Hollender, Lars G.; Lloid, Michelle; Drew, Shane Patrick; Schubert, Mark M.

    2015-01-01

    Objective To detect dimensional changes in the mandibular cortical bone associated with bisphosphonate (BP) use and to correlate the measurements of the cortical bone with the cumulative dose of BP therapy. Methods Mandibular inferior cortical bone thickness (MICBT) was measured under the mental foramen from panoramic radiographs of subjects using BP with and without bisphosphonate related osteonecrosis of the jaws (BRONJ) and controls. Results The highest mean MICBT was observed in BRONJ subjects 6.81 (± 1.35 mm), when compared to subjects using BP 5.44 (± 1.09 mm) and controls 4.79 (± 0.85 mm; p<0.01). The mean MICBT of BRONJ subjects was significantly higher than that of subjects using BP without BRONJ. There was a correlation between MICBT and cumulative dose of zolendronate. Conclusion The MICBT on panoramic radiograph is a potentially useful tool for the detection of dimensional changes associated with BP therapy. PMID:25864820

  18. Pseudoadenomatous Hyperplasia of the Inferior Forniceal Conjunctiva Due To Prosthetic Irritation in an Anophthalmic Socket.

    Science.gov (United States)

    Jakobiec, Frederick A; Rashid, Alia; Massoud, Vicky; Fay, Aaron

    2016-01-01

    Secondary complications in an anophthalmic socket can include late appearing shrinkage due to scarring and squamous cell carcinoma. This article reports a 51-year-old man who 27 years after an enucleation developed an inability to retain his ocular prosthesis due to an acquired multilobular fleshy mass in his inferior fornix. The patient had worn his prosthesis without removal for years at a time. Microscopic evaluation of the excised lesion disclosed a pseudoadenomatous (pseudoglandular) hyperplasia of the conjunctival epithelium with myriad goblet cells and accompanying chronic inflammation. In cross section, these structures microscopically resembled an adenoma but were found to display multifocal origins from the surface epithelium resembling exaggerated pseudoglands of Henle. Simple excision without recurrence 6 months later has permitted a new prosthesis to be comfortably worn with stability.

  19. High baseline activity in inferior temporal cortex improves neural and behavioral discriminability during visual categorization

    Directory of Open Access Journals (Sweden)

    Nazli eEmadi

    2014-11-01

    Full Text Available Spontaneous firing is a ubiquitous property of neural activity in the brain. Recent literature suggests that this baseline activity plays a key role in perception. However, it is not known how the baseline activity contributes to neural coding and behavior. Here, by recording from the single neurons in the inferior temporal cortex of monkeys performing a visual categorization task, we thoroughly explored the relationship between baseline activity, the evoked response, and behavior. Specifically we found that a low-frequency (< 8 Hz oscillation in the spike train, prior and phase-locked to the stimulus onset, was correlated with increased gamma power and neuronal baseline activity. This enhancement of the baseline activity was then followed by an increase in the neural selectivity and the response reliability and eventually a higher behavioral performance.

  20. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava

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    Pradeepkumar Charlagorla

    2016-01-01

    Full Text Available Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC, atrial and visceral situs inversus, left-sided superior vena cava (SVC, and left-sided interrupted inferior vena cava (IVC with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.

  1. Topography of acoustic response characteristics in the midbrain inferior colliculus of Kunming mouse

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Topography of acoustic response characteristics of the midbrain inferior colliculus (IC) of the Kunming mouse was studied by using extracellular recording techniques. The characteristic frequency (CF) range represented in the different divisions of the IC differed markedly: 4-15 kHz in the dorsal cortex (DC), 10-70 kHz in the central nucleus (CN), and 4-35 kHz in the external cortex (EC). The CF in the CN increased from dorsal and lateral to ventral and medial, higher CFs represented at its ventromedial part and lower CFs at its dorsal part. The isofrequency contours of CFs were incurvate. Minimum thresholds (MT) of the auditory neurons in DC and the central part of CN were lower (about 10 dB SPL), but considerably higher in the dorsal and ventral region of EC. Results suggest that each of the divisions in the mouse IC may have different auditory functions.

  2. Spontaneous cluster activity in the inferior olivary nucleus in brainstem slices from postnatal mice

    DEFF Research Database (Denmark)

    Rekling, Jens C; Reveles Jensen, Kristian; Jahnsen, Henrik

    2012-01-01

    largely unknown. Here we show that the IO in in vitro slices from postnatal mice spontaneously generates clusters of neurons with synchronous Ca2+ transients. Neurons in the principal olive (PO), and the vestibular-related dorsomedial cell column (dmcc), showed an age-dependent increase in spontaneous......A distinctive property of the cerebellar system is olivocerebellar modules, where synchronized electrical activity in neurons in the inferior olivary nucleus (IO) evokes organized activity in the cerebellar cortex. However, the exact function of these modules, and how they are developed, is still...... calcium transients. The spatiotemporal activity pattern was occasionally organized in clusters of co-active neighbouring neurons, with regular (16/min) and irregular (2-3/min) repeating cluster activity in the dmcc and PO, respectively. IO clusters had a diameter of 100-170 µm, lasted ~1 s, and increased...

  3. Diversion of the inferior vena cava following repair of atrial septal defect causing hypoxemia.

    Science.gov (United States)

    Thompson, Ellen; Moritz, Dennis; Perdue, Romaine; Cansino, Silvestre

    2004-05-01

    Atrial septal defects (ASDs) are a common congenital abnormality, and operative repair is a routine, safe procedure. Diversion of the inferior vena cava (IVC) into the left atrium is an unusual complication following ASD closure. We report a case that illustrates the problem created by this right-to-left shunt. A middle-aged woman underwent ASD repair. She developed hypoxemia postoperatively. A transthoracic echocardiogram confirmed a right-to-left shunt, found only with agitated saline injected into the femoral vein, not into the basilic vein. Surgical reexploration revealed a residual ASD diverting IVC flow into the left atrium, which was repaired with a pericardial patch. Echocardiography with agitated saline injected from the femoral vein is an easy method to diagnose this uncommon complication.

  4. LMCA thrombosis presenting as inferior wall myocardial infarction successfully treated with intracoronary tenecteplase

    Directory of Open Access Journals (Sweden)

    Tom Devasia

    2016-01-01

    Full Text Available Received: 23/10/15, Reviewed: 9/11/15, Accepted: 8/12/15 Keywords: DOI: ABSTRACT We report a case of 40 year old male who presented with chest pain and diaphoresis. General and systemic examination was unremarkable. Electrocardiogram was suggestive of inferior wall myocardial infarction. Coronary angiogram revealed large thrombus in left main coronary artery. In view of risk of distal embolisation with thrombectomy, intracoronary tenecteplase was administered following which there was complete resolution of thrombus in left main system. A thorough workup of the cause including thrombotic panel (Protein C, Protein S was carried out and was negative. Patient made a successful recovery and is doing well on follow-up.

  5. Secondary hyperfunction of unoperated inferior oblique muscle after surgical treatment of strabismus.

    Science.gov (United States)

    Alexieva, G

    1994-01-01

    Secondary hyperfunction of the inferior oblique muscle IO of one of the eyes is a frequent complication after unilateral recession of the overacting IO of the fellow's eye. It is often observed in cases with bilateral asymmetric hyperfunction of the IO's when these are surgically decreased. The pathogenesis of this secondary hyperfunction is not sufficiently explained yet. We evaluated the condition of unoperated IO in 42 children with unilateral hyperfunction of the IO. In all cases the operation we performed was recession combined with a fixed anteroposition. During the two years follow up period we found no secondary hyperfunction of the unoperated oblique muscle in 31 of the children, mild level of elevation in 7 of them, middle--in 2, and severe in 2 of the children. This observation confirmed our conviction of refraining from simultaneous surgical intervention on both IO muscles when there is hyperfunction of one of them.

  6. Postpartum Uterine Bleeding from the Inferior Mesenteric Artery: Case Report and Review of the Literature.

    Science.gov (United States)

    Shin, Sun Mi; Yi, Kyong Wook; Chung, Hwan Hoon

    2015-01-01

    Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. The common causes of primary PPH include uterine atony, abnormal placentation, retained placenta, and birth canal injury. The inferior mesenteric artery (IMA) arises from the aorta and is the main artery to supply the descending and sigmoid colon, as well as the rectum. We present a case of immediate, severe uterine bleeding after a normal vaginal delivery; angiography determined that hemorrhage originated from the IMA, and there were no anastomoses between the IMA and other pelvic arteries. The patient was successfully managed by selective embolization of a distal branch of the IMA. Our case report presents a new and interesting variation of pelvic vascular anatomy; moreover, it is the first report to present a case of postpartum uterine bleeding originating from the IMA.

  7. Acute wiiitis representing as thrombosis of the inferior vena cava and left pelvic veins.

    Science.gov (United States)

    Brodmann, M; Gary, T; Hafner, F; Eller, P; Deutschmann, H; Pilger, E; Seinost, G

    2015-08-01

    Deep venous thrombosis as a result of venous wall injury provoked by trauma is a common finding. It often occurs in patients with sportive overstraining, caused by over fatigue of the body structures. In 2007, the entity of "acute wiiitis" was first described in a letter to the New England Journal of Medicine. Acute wiiitis sums up all affections, mainly skeletal and muscle affections, provoked by playing Nintendo Wii, a very common and loved video-game system. Deep venous thrombosis as a consequence of Nintendo Wii has not been described so far. We present a patient with a massive free floating thrombus of the left pelvic veins originating from the gluteal veins and reaching into the inferior vena cava after playing Nintendo Wii.

  8. Acute bilateral cerebellar infarction in the territory of the medial branches of posterior inferior cerebellar arteries.

    Science.gov (United States)

    Gurer, G; Sahin, G; Cekirge, S; Tan, E; Saribas, O

    2001-10-01

    The most frequent type of cerebellar infarcts involved the posterior inferior cerebellar artery (PICA) and superior cerebellar artery territories but bilateral involvement of lateral or medial branches of PICA is extremely rare. In this report, we present a 55-year-old male who admitted to hospital with vomiting, nausea and dizziness. On examination left-sided hemiparesia and ataxic gait were detected. Infarct on bilateral medial branch of PICA artery territories was found out with cranial magnetic resonance imaging (MRI) technique and 99% stenosis of the left vertebral artery was found out with digital subtraction arteriography. The patient was put on heparin treatment. After 3 weeks, his complaints and symptoms had disappeared except for mild gait ataxia.

  9. Utilization of Inferiorly Based Dermofat Flap in Breast Reconstruction after Simple Mastectomy due to Gigantomastia.

    Science.gov (United States)

    Bogdanov-Berezovsky, A; Krieger, Y; Shoham, Y; Silberstein, E

    2013-01-01

    Gigantomastia (GM) is a rare disabling condition characterized by excessive breast tissue growth. To date, there is no universal classification and definition of GM. At present, GM is determined as weight over 1.5 kg per breast (Dancey et al., 2008) or 3% or more of the patient's total body weight (Dafydd et al., 2011). The lack of generally acknowledged approach regarding GM is expressed by the different methods of its treatment ranging from hormonal prescription to mastectomy and subsequent complex breast reconstruction (Shoma et al., 2011). We describe a treatment approach, including simple mastectomy and immediate breast reconstruction by an inferiorly based dermofat flap with silicone implants and nipple grafting.

  10. Transient Automatic Writing Behavior following a Left Inferior Capsular Genu Infarction.

    Science.gov (United States)

    Suzuki, Keisuke; Miyamoto, Tomoyuki; Miyamoto, Masayuki; Hirata, Koichi

    2009-05-09

    A 79-year-old, right-handed woman was admitted to the hospital with decreased spontaneity. Brain magnetic resonance imaging showed a left inferior capsular genu infarction. (99m) TC-ECD single-photon emission computed tomography revealed a left-dominant diffuse hypoperfusionin the basal ganglia and frontal lobe. The patient showed abulia and increased writing activity without motor or sensory deficit. The writing was mainly perseverative, and words written along lines were legible and without spatial distortions. This augmented writing behavior disappeared on day 21. The writing characteristic was more similar to automatic writing behavior than hypergraphia. Dissociation between speech and writing behavior was present in our patient. We suggest that a disconnection within the frontal-subcortical circuit contributed to the development of motor perseveration in writing.

  11. Deactivation of the inferior colliculus by cooling demonstrates intercollicular modulation of neuronal activity

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    Llwyd David Orton

    2012-12-01

    Full Text Available The auditory pathways coursing through the brainstem are organised bilaterally in mirror image about the midline and at several levels the two sides are interconnected. One of the most prominent points of interconnection is the commissure of the inferior colliculus (CoIC. Anatomical studies have revealed that these fibres make reciprocal connections which follow the tonotopic organisation of the inferior colliculus (IC, and that the commissure contains both excitatory and, albeit fewer, inhibitory fibres. The role of these connections in sound processing is largely unknown. Here we describe a method to address this question in the anaesthetised guinea pig. We used a cryoloop placed on one IC to produce reversible deactivation while recording electrophysiological responses to sounds in both ICs. We recorded single units, multi-unit clusters and local field potentials (LFPs before, during and after cooling. The degree and spread of cooling was measured with a thermocouple placed in the IC and other auditory structures. Cooling sufficient to eliminate firing was restricted to the IC contacted by the cryoloop. The temperature of other auditory brainstem structures, including the contralateral IC and the cochlea were minimally affected. Cooling below 20 °C reduced or eliminated the firing of action potentials in frequency laminae at depths corresponding to characteristic frequencies up to ~8 kHz. Modulation of neural activity also occurred in the un-cooled IC with changes in single unit firing and LFPs. Components of LFPs signalling lemniscal afferent input to the IC showed little change in amplitude or latency with cooling, whereas the later components, which likely reflect inter- and intra-collicular processing, showed marked changes in form and amplitude. We conclude that the cryoloop is an effective method of selectively deactivating one IC in guinea pig, and demonstrate that auditory processing in the IC is strongly influenced by the other.

  12. Evaluation of Inferior Oblique Muscle Overaction Existence Time and Surgical Outcomes in Infantile Esotropia

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    Mehmet Ragıp Ekmen

    2013-12-01

    Full Text Available Purpose: Evaluation of inferior oblique muscle overaction (IOOA existence time and surgical outcomes in infantile esotropia. Material and Method: A total of 100 patients who underwent operation for infantile esotropia (IE were included in the study. Full ophthalmic assessment, including ocular motility, best-corrected visual acuity, cycloplegic refraction, any of alternant prism cover test or Hirschberg/Krimsky test, was performed. Results: Forty-nine patients (49% were male and (51% were female. The mean age at IE diagnosis was 23.2±18.6 months. The mean follow-up time was 43.7±18.0 months. The mean horizontal deviation - corrected and uncorrected - was 36.75±10.45 PD and 40.05±8.39 PD, respectively. We found that there was no statistically significant relationship between existence time of IOOA and the age at IE diagnosis (p: 0.486, p: 0.251. IOOA was detected in 69 patients. Inferior oblique (IO muscle weakening procedures were performed in 45 of 69 patients. In 45 patients who had undergone surgery for IOOA, 24 (53.3% had bilateral IO recession, 10 (22.2% had bilateral IO tenotomy, 8 (17.7% had unilateral IO tenotomy, 1(2.2% had unilateral myectomy, 1 (2.2% had bilateral myectomy, and 1 (2.2% had bilateral anteroposition. IOOA degrees after IO recession and tenotomy surgery were found to be significantly lower than the preoperative values (p=0.0586, p=0.7258. Discussion: There was no statistically significant relationship between the existence time of IOOA and the age of IE diagnosis. We concluded that IO tenotomy and IO recession surgical techniques are effective and safe procedures for cases which have IOOA associated with IE. (Turk J Ophthalmol 2013; 43: 419-23

  13. The value of prolactin in inferior petrosal sinus sampling with desmopressin stimulation in Cushing's disease.

    Science.gov (United States)

    Qiao, Xiaona; Ye, Hongying; Zhang, Xiaolong; Zhao, Weiwei; Zhang, Shuo; Lu, Bin; Wang, Xuanchun; Zhang, Zhaoyun; Wu, Xi; He, Min; Zhao, Xiaolong; Li, Shiqi; Zhou, Linuo; Yang, Yehong; Hu, Renming; Li, Yiming

    2015-03-01

    Prolactin may reduce false-negative results in diagnosing Cushing's disease (CD) during inferior petrosal sinus sampling (IPSS). Prolactin normalization could improve the accuracy of IPSS in predicting adenoma lateralization in CD. However, none of the previous studies had involved the use of desmopressin during IPSS. Our objective was to examine the utility of prolactin measurement during IPSS with desmopressin stimulation. We conducted a retrospective analysis of 40 patients (including 31 females) with ACTH-dependent Cushing's syndrome who underwent IPSS between 2010 and 2013. Thirty-eight CD patients were partitioned into true positive (n = 35) and false negative (n = 3). The proportion of improper IPSS venous sampling defined by corresponding IPS:P (inferior petrosal sinus to peripheral) prolactin ratio prolactin-normalized ACTH IPS:P ratio >0.8 cutoff could increase the sensitivity of IPSS to 38/38 (100 %). Among the 31 patients with histopathologically proven adenoma localization, correct prediction of adenoma lateralization was obtained in 14/31 (45 %) patients by a peak intersinus ACTH gradient of ≥1.4 in baseline and was not improved by desmopressin stimulation. Left-right intersinus gradients of unilateral prolactin-adjusted ACTH IPS:P ratios could increase the correct prediction of adenoma lateralization to 20/31 (65 %) in baseline and 24/31 (77 %) (P = 0.006) after desmopressin stimulation, respectively. Prolactin is helpful to adjust negative results of IPSS with desmopressin stimulation. It may improve the accuracy in predicting adenoma lateralization in CD as well.

  14. Efficacy of low level laser therapy on neurosensory recovery after injury to the inferior alveolar nerve

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    Gorur Ilker

    2006-02-01

    Full Text Available Abstract Background The most severe complication after the removal of mandibular third molars is injury to the inferior alveolar nerve or the lingual nerve. These complications are rather uncommon (0.4% to 8.4% and most of them are transient. However, some of them persist for longer than 6 months, which can leave various degrees of long-term permanent disability. While several methods such as pharmacologic therapy, microneurosurgery, autogenous and alloplastic grafting can be used for the treatment of long-standing sensory aberrations in the inferior alveolar nerve, there are few reports regarding low level laser treatment. This paper reports the effects of low level laser therapy in 4 patients with longstanding sensory nerve impairment following mandibular third molar surgery. Methods Four female patients had complaints of paresthesia and dysesthesia of the lip, chin and gingiva, and buccal regions. Each patient had undergone mandibular third molar surgery at least 1 year before. All patients were treated with low level laser therapy. Clinical neurosensory tests (the brush stroke directional discrimination test, 2-point discrimination test, and a subjective assessment of neurosensory function using a visual analog scale were used before and after treatment, and the responses were plotted over time. Results When the neurosensory assessment scores after treatment with LLL therapy were compared with the baseline values prior to treatment, there was a significant acceleration in the time course, as well as in the magnitude, of neurosensory return. The VAS analysis revealed progressive improvement over time. Conclusion Low level laser therapy seemed to be conducive to the reduction of long-standing sensory nerve impairment following third molar surgery. Further studies are worthwhile regarding the clinical application of this treatment modality.

  15. Ratio superior, ratio inferior y el agustinismo de Tomás de Aquino

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    Moya Cañas, Patricia

    2013-12-01

    Full Text Available This article discusses Aquinas’ reception of the Augustinian distinction between ratio inferior and superior. Though not a central aspect of Aquinas’ thought, it is a signifi cant pointer to the presence of Augustinian patterns of thought in a non-theological part of his work. After a general survey of the presence of this distinction in the opera omnia of Aquinas, his use of this topic in some specific instances is discussed: the distinction between contemplative and active life, the division of human faculties, and the moral problem of peevish delight.El artículo discute la recepción que hace Tomás de Aquino de la distinción agustiniana entre razón superior e inferior. Si bien no se trata de uno de los tópicos centrales de la doctrina tomasiana, es un elemento significativo a la hora de considerar dentro de la obra de Tomás la presencia de patrones agustinianos de pensamiento que no sean primordialmente teológicos. Tras discutir de modo general la presencia de esta distinción en la obra del aquinate, y los estudios previos sobre este binomio, se procede a discutir su uso por parte de Tomás de Aquino ante tres problemas específicos: la distinción entre géneros de vida, la división de las facultades humanas, y el problema moral de la delectación morosa.

  16. Distinct roles of left inferior frontal regions that explain individual differences in second language acquisition.

    Science.gov (United States)

    Sakai, Kuniyoshi L; Nauchi, Arihito; Tatsuno, Yoshinori; Hirano, Kazuyoshi; Muraishi, Yukimasa; Kimura, Masakazu; Bostwick, Mike; Yusa, Noriaki

    2009-08-01

    Second language (L2) acquisition is more susceptible to environmental and idiosyncratic factors than first language acquisition. Here, we used functional magnetic resonance imaging for L2 learners of different ages of first exposure (mean: 12.6 and 5.6 years) in a formal school environment, and compared the cortical activations involved in processing English sentences containing either syntactic or spelling errors, where the testing ages and task performances of both groups were matched. We found novel activation patterns in two regions of the left inferior frontal gyrus (IFG) that correlated differentially with the performances of the late and early learners. Specifically, activations of the dorsal and ventral triangular part (F3t) of the left IFG correlated positively with the accuracy of the syntactic task for the late learners, whereas activations of the left ventral F3t correlated negatively with the accuracy for the early learners. In contrast, other cortical regions exhibited differential correlation patterns with the reaction times (RTs) of the syntactic task. Namely, activations of the orbital part (F3O) of the left IFG, as well as those of the left angular gyrus, correlated positively with the RTs for the late learners, whereas those activations correlated negatively with the RTs for the early learners. Moreover, the task-selective activation of the left F3O was maintained for both the late and early learners. These results explain individual differences in L2 acquisition, such that the acquisition of linguistic knowledge in L2 is subserved by at least two distinct inferior frontal regions of the left F3t and F3O.

  17. Primary Intraventricular Brain Abscess Resulting in Isolated Dilation of the Inferior Horn and Unilateral Hydrocephalus

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    Joji Inamasu

    2015-07-01

    Full Text Available Primary intraventricular brain abscesses are rare, and there are no established treatment guidelines for this condition. We report a case in which isolated ventricular dilatation and unilateral hydrocephalus developed after seemingly successful conservative management and which required surgical diversion of the cerebrospinal fluid. A 59-year-old woman presented to our emergency department with high-grade fever and headache. Brain magnetic resonance imaging (MRI revealed abscesses in the bilateral posterior horn. Although surgical evacuation of the abscesses was considered, conservative management with antibiotics was selected because of the paucity of severe neurological deficits and the concern that an attempt to evacuate the intraventricular abscess might lead to inadvertent rupture of the abscess capsule and acute ventriculitis. Despite reduction in the abscess volume, the patient developed an altered mental status 4 weeks after admission. Follow-up MRI revealed isolated dilation of the left inferior horn, compressing the brainstem. Emergency fenestration of the dilated inferior horn was performed, and endoscopic observation revealed an encapsulated abscess with adhesion to the ventricular wall which was thought responsible for the ventricular dilation and unilateral hydrocephalus. Two weeks after the initial surgery, the unilateral hydrocephalus was treated by placement of a ventriculoperitoneal shunt. Eradication of the intraventricular brain abscesses without surgical evacuation may justify the conservative management of this patient. However, the possibility that earlier surgical evacuation might have prevented development of the isolated ventricular dilation cannot be denied. Additional clinical experience is required to determine which treatment (surgical vs. conservative is more appropriate in patients with primary intraventricular brain abscesses.

  18. Optimum level of inferior mesenteric artery ligation for the left-sided colorectal cancer

    Science.gov (United States)

    Guraya, Salman Y.

    2016-01-01

    Objectives: To compares the effectiveness and impact of high inferior mesenteric artery (IMA) versus low IMA ligation on 5-year survival, lymph node yield rates, and peri-operative morbidity and mortality. Methods: The databases of Educational Resources Information Centre (ERIC), the Web of Science, EBSCO and MEDLINE were searched using MeSH terms ‘colorectal cancer’, ‘inferior mesenteric artery’, ‘high ligation’, ‘low ligation’, ‘mesenteric lymph nodes’, ‘prognosis’, and ‘survival’. Only clinical studies were selected and review articles and meta-analysis were excluded. In cases of duplicate cohorts, only the latest article was included. Irrelevant articles and the articles on both right and left sided CRC were excluded. The finally selected studies were analysed for the defined end-point outcomes. Results: The published data has shown that high IMA ligation improves the yield of harvested lymph node that allows accurate tumor staging and a more reliable estimation of prognosis. High ligation was not found to be positively correlated with increased anastomotic leakage or impaired genito-urinary function. However, high ligation demands advanced surgical expertise and longer operating time. There was no significant difference in 5-year survival rates for both techniques. Some studies have reported fatal complications of high ligation such as proximal bowel necrosis. Conclusion: Although there is no consensus, this research signals the routine use of high ligation for left-sided CRC. However, the published fatal complications following high ligation and no significant difference in 5-year survival rates demand more studies to establishing a unified protocol. PMID:27381531

  19. Fluxo no ducto venoso e na veia cava inferior dos fetos em gestações isoimunizadas Assess flow velocity in the ductus venosus and inferior vena cava in fetuses in isoimmunized pregnancies

    Directory of Open Access Journals (Sweden)

    Eura Martins Lage

    2006-10-01

    Full Text Available OBJETIVO: Avaliar a velocidade de fluxo na veia cava inferior e no ducto venoso em fetos, nas gestações isoimunizadas. MÉTODOS: De junho de 1999 a junho de 2004, foram avaliados 61 fetos, entre 27 e 35 semanas, de gestantes portadoras de isoimunização por antígenos eritrocitários. Em todos os fetos foram avaliadas as velocidades de fluxo na veia cava inferior e no ducto venoso. Obteve-se amostra de sangue fetal para determinação dos valores da hemoglobina e calculou-se o déficit da concentração de hemoglobina. Esses fetos foram divididos em quatro grupos, de acordo com o déficit da concentração de hemoglobina: fetos não anêmicos, anêmicos leves, anêmicos moderados e anêmicos graves. Utilizou-se o teste Qui-quadrado para comparar os quatro grupos de fetos quanto à proporção da alteração da velocidade média de fluxo na veia cava inferior e no ducto venoso. RESULTADOS: A velocidade de fluxo na veia cava inferior estava alterada em 3,8% dos fetos não anêmicos, em 3,1% dos fetos com anemia leve, em 40% dos anêmicos moderados e em 76% dos fetos com anemia grave. Já a velocidade de fluxo no ducto venoso estava alterada em 7,7% dos fetos não anêmicos, em 3,1% dos fetos com anemia leve, em 32,5% dos anêmicos moderados e em 68% dos fetos com anemia grave. O valor p foi inferior a 0,001. CONCLUSÃO: Verificou-se aumento da freqüência de alteração da velocidade de fluxo na veia cava inferior e no ducto venoso à medida que a anemia se agravava.OBJECTIVE: Ductus venosus and inferior vena cava flow velocity was assessed in fetuses in isoimmunized pregnancies. METHODS: Examination of 61 fetuses aged 27 to 35 weeks from Rh-erythrocyte antigen isoimmunized women was carried out from June 1999 to June 2004. All fetuses were submitted to the examination of ductus venosus and inferior vena cava flow velocity. Blood samples were collected to determine hemoglobin values and hemoglobin concentration deficits. Accordingly, fetuses

  20. Prevalencia de várices en miembros inferiores en el personal del Hospital de Clínicas

    OpenAIRE

    ESPINÓLA,CARLA FABIOLA; BERNAL,MANUEL; AUCEJO,MARGARITA; VILLALBA,JUAN CARLOS

    2007-01-01

    Según estudios epidemiológicos, las várices de miembros inferiores tienen una elevada prevalencia en la población general¹, sobre todo en las profesiones que obligan a estar de pie por largos períodos de tiempo. Objetivos: Determinar la prevalencia de várices en miembros inferiores en el personal sanitario del Hospital de Clínicas y el porcentaje de la población estudiada que practica medidas profilácticas. Material y Método: Diseño prospectivo observacional de corte transversal, realizado en...

  1. Repair of Inferior Sternal Cleft Using Bilateral Sternal Bar Turnover Flaps in a Patient with Pentalogy of Cantrell

    Science.gov (United States)

    Yeow, Vincent Kok-Leng

    2014-01-01

    We report a case of sternal reconstruction using bilateral sternal bar turnover flaps in a 4-year-old boy with an inferior sternal cleft, as part of Cantrell's pentad. When the patient was 10 months old, he underwent sternal reconstruction using a resorbable poly-L-lactic-polyglycolic acid plate in the first stage when there was insufficient autogenous tissue to provide a reliable reconstruction. Bilateral sternal bar turnover was performed in the second stage at 4 years of age. This operative technique is described in this report. This novel technique provides a robust, dynamic, and reliable reconstruction for inferior sternal defects. PMID:24511499

  2. Alternative to the inferior alveolar nerve block anesthesia when placing mandibular dental implants posterior to the mental foramen.

    Science.gov (United States)

    Heller, A A; Shankland, W E

    2001-01-01

    Local anesthesia block of the inferior alveolar nerve is routinely taught throughout dental education. This commonly used technique eliminates all somatosensory perception of the mandible, mandibular teeth, floor of the mouth, ipsilateral tongue, and all but the lateral (buccal) gingivae. Generally, the dentist or surgeon desires these structures to be anesthetized. However, in the placement of mandibular implants, it may be useful for the patient to be able to sense when the inferior alveolar nerve is in danger of being damaged, possibly producing permanent paresthesia. In this article, the technique of mandibular infiltration prior to mandibular implant placement in the mandible is discussed.

  3. [Bilateral renal vein thrombosis and acute renal failure due to inferior vena cava filter thrombosis. Report of one case].

    Science.gov (United States)

    Vega, Jorge; Díaz, Rienzi

    2014-11-01

    Bilateral renal vein thrombosis is an unusual etiology of acute renal failure and usually is associated with nephrotic syndrome. We report a 77-year-old man, consulting in the emergency room for anuria that appeared 24 hours after a syncope. The patient was carrier of an inferior vena cava filter prophylactically installed 17 months earlier and was not receiving anticoagulation. Serum creatinine on admission was 5.45 mg/dl and blood urea nitrogen was 54 mg/dl. Computed tomography and Doppler ultrasonography showed an extensive thrombosis of inferior vena cava and both renal veins. Heparin therapy was started with a rapid recovery of renal function and diuresis.

  4. Morphometric study of distance between posterior inferior iliac spine and ischial spine of the human hip bone for sex determination

    OpenAIRE

    2014-01-01

    Background: Objective of current study was to study the distance between Posterior Inferior Iliac Spine and Ischial Spine (PIIS-IS) of human hip bone for determination of sex. Methods: The study comprised unpaired 149 adult human hip bones of known sex. The posterior inferior iliac spine and ischial spine were identified in all the hip bones and a vernier calliper was used to measure the distance between the PIIS-IS. Results: It was observed that the mean distance of PIIS-IS in males a...

  5. Superselective embolization of the inferior vesical artery for the treatment of intractable hematuria from pelvic malignancy: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jung; Jeon, Eui Yong [Hallym Univ. Sacred Heart Hospital/Hallym Univ. College of Medicine, Anyang, (Korea, Republic of); Choi, Sun Young [Ewha Womans Univ. Seoul (Korea, Republic of); Han, Kum Hyun [Inje Univ. Ilsan Paik Hospital/Inje Univ. College of Medicine, Goyang (Korea, Republic of)

    2012-05-15

    Intractable hematuria in from pelvic malignancy can be managed with conservative treatment in most patients. However, when treatment fails, surgical intervention may be required. Unfortunately, in most cases, the general condition of most patients is unfavorable for major surgery, with many patients having an inoperable status. We present two cases where intractable hematuria was successfully controlled by bilateral embolization of the inferior vesical artery with polyvinyl alcohol particles. Hematuria did not recur during the subsequent period and no complication was observed. Thus, bilateral embolization of the inferior vesical artery should be considered as an alternative method for the treatment of massive intractable hematuria caused by pelvic malignancy.

  6. Ventana ósea vestibular para la extracción de los terceros molares inferiores retenidos

    OpenAIRE

    Cima, Juan Ramón

    2013-01-01

    El objetivo principal de ésta investigación fue realizar un estudio comparativo entre las técnicas quirúrgicas convencionales o típicas (TQC), y la técnica quirúrgica propuesta para ésta tesis, que es la de la "Ventana Ósea Vestibular para la extracción de los terceros molares inferiores retenidos" (TQVOV). Teniendo en cuenta que la extracción de los terceros molares inferiores retenidos ha sido y es un problema todavía no resuelto en su totalidad por los cirujanos bucales, en lo qu...

  7. Combined Anomaly of the Right Hepatic Lobe Agenesis and Absence of the Inferior Vena Cava: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Hee Jung; Kim, Wan Tae; Kim, Mi Young; Cho, Yun Ku [Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2008-07-15

    The absence of the inferior vena cava is an uncommon congenital anomaly that has recently been identified as an important risk factor contributing to the development of deep venous thrombosis. Congenital agenesis of the right hepatic lobe is a rare anomaly which is found incidentally in radiologic examinations. We present a case of a congenital absence of the infrarenal inferior vena cava, combined with agenesis of the right hepatic lobe in a 62-year-old man presented with symptoms of deep venous thrombosis

  8. New approach of assessing hypovolemic shock class 1 during acute emergencies: Ultrasonographic inferior vena cava and abdominal aorta diameter ratio

    Science.gov (United States)

    Ahmad, Rashidi; Kunji, Mohamad Iqhbal; Hj Abd Kareem, Meera Mohaideen; Halim, Shamimi A.

    2013-09-01

    In a patient with hypovolemic shock class 1, the vital signs and biochemical properties are almost normal. The alteration of hemodynamic parameters and biochemical values occurs mainly in advanced hypovolemia state (neuroendocrine response). The availability of ultrasound machine at healthcare centers makes the measurement of vascular calibre feasible and possible. Inspiration and expiration inferior vena cava diameter changes predict hypovolemic shock class 1 but in acute emergencies this method is impractical. The purpose of this study is to develop a new approach in identifying hypovolemic shock at early phase by measuring the inferior vena cava and aorta diameter ratio using bedside ultrasound machine.

  9. Reconstrucción paleoambiental del magdaleniense inferior en la región francocantábrica

    OpenAIRE

    J. Furundarena García

    2005-01-01

    En artículos anteriores planteamos un ensayo del método de reconstrucción de paleoclimas en los que mostrábamos las claves del mismo. En este trabajo pretendemos mostrar los resultados del mismo aplicados al magdaleniense inferior en la región Francocantábrica

  10. Reconstrucción paleoambiental del magdaleniense inferior en la región francocantábrica

    Directory of Open Access Journals (Sweden)

    J. Furundarena García

    2005-01-01

    Full Text Available En artículos anteriores planteamos un ensayo del método de reconstrucción de paleoclimas en los que mostrábamos las claves del mismo. En este trabajo pretendemos mostrar los resultados del mismo aplicados al magdaleniense inferior en la región Francocantábrica

  11. Displaying inguinal lymph nodes before transplantation in a deep inferior epigastric perforator flap breast reconstruction using an innovative projection method

    NARCIS (Netherlands)

    Hummelink, S.L.; Schultze Kool, L.J.; Ulrich, D.J.

    2016-01-01

    INTRODUCTION: Lymphedema of the arm is a common postoperative complication as a result of breast cancer surgery. One of the surgical treatments comprises modification of a deep inferior epigastric perforator (DIEP) flap breast reconstruction to facilitate additional lymph node transplantation from t

  12. 从自卑情结看《远大前程》%Great Expectation interpreted with inferiority complex

    Institute of Scientific and Technical Information of China (English)

    王明娥

    2014-01-01

    分析指出,自卑情结是著名心理学家阿德勒个体心理学理论的一个重要概念。自卑是人类的正常情感,用适当的方式超越自卑也是社会进步的动力。《远大前程》中的三个主要人物皮普、郝薇仙和马格韦契都有不同程度的自卑情结,并且选择了不同的超越自卑方式。这些不当的超越自卑方式是人物悲剧命运的原因之一。%Inferiority complex is an important term in the individual psychology theory of Alfred Adler,the famous psychologist. Inferiority is the normal feeling of human being and to surpass inferiority in proper way is the motiva-tion of the advancement of the society. The three main characters in Great Expectation, Pip, Havisham, and Mag-witch,all have inferiority complex to some extent. They choose different ways to surpass it,which are inappropriate and are causes to their tragic fates.

  13. Bolsas palpebrales inferiores y blefaroplastia estética: investigación anatomo-quirúrgica

    Directory of Open Access Journals (Sweden)

    J.D. Giacomotti

    2015-03-01

    Full Text Available Abordamos el estudio de las bolsas adiposas palpebrales inferiores contemplando la importancia de dos ejes fundamentales como son, en la práctica, la blefaroplastia estética y el aspecto puramente anatómico. Sobre material formolizado de la región orbitaria y según técnica habitual, practicamos disecciones en cada una de las preparaciones anatómicas mediante las cuales fue posible estudiar, en la mitad inferior de la órbita, el comportamiento de la grasa y de las estructuras involucradas con ella permitiendo además incorporar la noción de la arquitectura del espacio retroseptal ántero-inferior y la de sus compartimentos o subdivisiones medial, central y lateral. Esta línea de investigación anatomo-quirúrgica condujo finalmente al preciso establecimiento de la ubicación y de las principales características de cada uno de los paquetes adiposos palpebrales inferiores.

  14. Does the inferior frontal sulcus play a functional role in deception? A neuronavigated theta-burst transcranial magnetic stimulation study

    NARCIS (Netherlands)

    B. Verschuere; T. Schuhmann; A.T. Sack

    2012-01-01

    By definition, lying involves withholding the truth. Response inhibition may therefore be the cognitive function at the heart of deception. Neuroimaging research has shown that the same brain region that is activated during response inhibition tasks, namely the inferior frontal region, is also activ

  15. A case of mental nerve paresthesia due to dynamic compression of alveolar inferior nerve along an elongated styloid process

    NARCIS (Netherlands)

    Gooris, P.J.J.; Zijlmans, J.C.M.; Bergsma, J.E.; Mensink, G.

    2014-01-01

    Spontaneous paresthesia of the mental nerve is considered an ominous clinical sign. Mental nerve paresthesia has also been referred to as numb chin syndrome. Several potentially different factors have been investigated for their role in interfering with the inferior alveolar nerve (IAN) and causing

  16. Differential roles for left inferior frontal and superior temporal cortex in multimodal integration of action and language

    NARCIS (Netherlands)

    Willems, R.M.; Özyürek, A.; Hagoort, P.

    2009-01-01

    Several studies indicate that both posterior superior temporal sulcus/middle temporal gyrus (pSTS/MTG) and left inferior frontal gyrus (LIFG) are involved in integrating information from different modalities. Here we investigated the respective roles of these two areas in integration of action and l

  17. Evaluation of inferior alveolar nerve regeneration by bifocal distraction osteogenesis with retrograde transportation of horseradish peroxidase in dogs.

    Directory of Open Access Journals (Sweden)

    Yosuke Shogen

    Full Text Available BACKGROUND: Bifocal distraction osteogenesis has been shown to be a reliable method for reconstructing segmental mandibular defects. However, there are few reports regarding the occurrence of inferior alveolar nerve regeneration during the process of distraction. Previously, we reported inferior alveolar nerve regeneration after distraction, and evaluated the regenerated nerve using histological and electrophysiological methods. In the present study, we investigated axons regenerated by bifocal distraction osteogenesis using retrograde transportation of horseradish peroxidase in the mandibles of dogs to determine their type and function. METHODS AND FINDINGS: Using a bifocal distraction osteogenesis method, we produced a 10-mm mandibular defect, including a nerve defect, in 11 dogs and distracted using a transport disk at a rate of 1 mm/day. The regenerated inferior alveolar nerve was evaluated by retrograde transportation of HRP in all dogs at 3 and 6 months after the first operation. At 3 and 6 months, HRP-labeled neurons were observed in the trigeminal ganglion. The number of HRP-labeled neurons in each section increased, while the cell body diameter of HRP-labeled neurons was reduced over time. CONCLUSIONS: We found that the inferior alveolar nerve after bifocal distraction osteogenesis successfully recovered until peripheral tissue began to function. Although our research is still at the stage of animal experiments, it is considered that it will be possible to apply this method in the future to humans who have the mandibular defects.

  18. Catheter-directed thrombolysis for double inferior vena cava with deep venous thrombosis: A case report and literature review.

    Science.gov (United States)

    Wang, Xiaodong; Chen, Zhengxin; Cai, Qianrong

    2014-08-01

    Double inferior vena cava (DIVC) with deep venous thrombosis (DVT) is rare, and there is only one reported case of DIVC with DVT treated by catheter-directed thrombolysis. We report a case of a 32-year-old man with an extensive venous clot involving the infrarenal segment of a double IVC who received filter implantation and catheter-directed thrombolysis.

  19. Impact of Coronary Collateral Circulation on In-Hospital Death in Patients with Inferior ST Elevation Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Baris Yaylak

    2015-01-01

    Full Text Available Objectives. Coronary collateral circulation (CCC may limit the size of right ventricular (RV infarcts but does not fully explain the relationship between CCC and clinical adverse events in patients with inferior STEMI. In this study, it was aimed to assess the relationship between preintervention angiographic evidence of CCC and clinical outcomes in patients with inferior STEMI who have undergone percutaneous coronary intervention. Methods. A total of 235 inferior STEMI patients who presented within the first 12 hours from the symptom onset were included. CCC to the right coronary artery (RCA before angioplasty were angiographically assessed, establishing two groups: 147 (63% patients without CCC and 88 (37% with CCC according to presence of CCC. Results. RV infarction, complete atrioventricular block, VT/VF, cardiogenic shock, and in-hospital death were noted less frequently in patients with CCC than in those without CCC. Absence of CCC to RCA was found to be the independent predictor for in-hospital death among them (odds ratio 4.0, 95% CI 1.8–12.6; p=0.03. Conclusion. Presence of angiographically detectable CCC was associated with better in-hospital outcomes including RV infarction, complete AV block, cardiogenic shock, and VT/VF in patients with inferior STEMI.

  20. Los Rumiantes (Artiodactyla, Mammalia del Mioceno inferior de La Encinilla (Colmenar Viejo, Madrid

    Directory of Open Access Journals (Sweden)

    Morales, J.

    2006-12-01

    Full Text Available This article is a preliminary study of the fossil ruminants found in the Early Miocene site of La Encinilla (Colmenar Viejo, Madrid. The morphological description of dentition and postcranial bones, along with the metrical and comparative study with material from localities of similar age in France and Spain has allowed us to confirm the presence of two Pecoran ruminants in La Encinilla: Andegameryx sp. and a larger species related to Teruelia Moyá-Solá, 1987. Although the identification in one of the cases should be confirmed with more material, the record in the Madrid Bassin would represent new information regarding the known biogeographical distribution of both taxa. The systematic position of Andegameryx and Teruelia is still under discussion, but both forms are clearly distinct from the Cervoidea ruminants found in Europe and the Iberian Peninsula at the same age, such as Amphitragulus, Oriomeryx, Bedenomeryx or Dremotherium.Este trabajo constituye un estudio preliminar de los restos de rumiantes fósiles hallados en el yacimiento del Mioceno inferior de La Encinilla (Colmenar Viejo, Madrid. La descripción morfológica de la dentición y del esqueleto postcraneal, así como el estudio métrico y comparativo con material procedente de localidades francesas y españolas de edad similar ha permitido constatar hasta el momento la presencia de dos formas de rumiantes Pecora en La Encinilla: Andegameryx sp. y un rumiante de mayor talla relacionado con Teruelia Moyá-Solá, 1987. Aunque la identificación en uno de los casos necesitaría confirmarse con más material, la presencia de estas dos formas en la Cuenca de Madrid ampliaría la distribución biogeográfica conocida para ambos taxones. La posición sistemática de Andegameryx y Teruelia permanece abierta a discusión, pero ambos géneros se diferencian de los Cervoidea del Mioceno inferior encontrados en Europa y la Península Ibérica, tales como Amphitragulus, Oriomeryx, Bedenomeryx

  1. Non-inferiority of retrospective data collection for assessing perioperative morbidity

    Science.gov (United States)

    Patel, Amour B.U.; Reyes, Anna

    2015-01-01

    Background. Postoperative morbidity has immediate and delayed consequences for surgical patients, including excess risk of premature death. Capturing these data objectively and routinely in large electronic databases using tools such as the Postoperative Morbidity Survey (POMS) would offer tremendous clinical and translational potential. However, POMS has thus far only utilised prospective data collection by research staff. We hypothesised that retrospective data collection from routinely collated hospital data from paper and electronic charts, medical and nursing notes was non-inferior to prospective data collection requiring research staff capturing POMS-defined morbidity in real-time. Methods. Morbidity was recorded by a trained investigator as defined by POMS prospectively on postoperative days 3 and 7. Separately, an independent investigator blinded to prospectively acquired data retrospectively assessed the same patients’ morbidity as defined by POMS criteria, using medical charts, nursing summaries and electronic data. Equivalence was accepted when the confidence limits for both modes of data collection fell completely inside the equivalence bounds, with the maximum equivalence difference (i.e., the largest value of the difference in sensitivities deemed to reach a conclusion of equivalence) set a priori at 0.2. Differences for confidence limits between retrospective and prospective data collection were based on Nam’s RMLE method. The relationship between morbidity on postoperative day 3 as recorded by each data collection method on time to become morbidity free and length of hospital stay was compared using the log-rank test. Results. POMS data from 85 patients undergoing elective or emergency surgery were analyzed. At postoperative day 3, POMS-defined morbidity was similar regardless of whether data were collected prospectively or retrospectively (95% CI [−0.13–0.013]; p < 0.001). Non-inferiority for sensitivity was observed for all other POMS

  2. Telephone Cognitive-Behavioral Therapy for Adolescents With Obsessive-Compulsive Disorder: A Randomized Controlled Non-inferiority Trial

    Science.gov (United States)

    Turner, Cynthia M.; Mataix-Cols, David; Lovell, Karina; Krebs, Georgina; Lang, Katie; Byford, Sarah; Heyman, Isobel

    2014-01-01

    Objective Many adolescents with obsessive-compulsive disorder (OCD) do not have access to evidence-based treatment. A randomized controlled non-inferiority trial was conducted in a specialist OCD clinic to evaluate the effectiveness of telephone cognitive-behavioral therapy (TCBT) for adolescents with OCD compared to standard clinic-based, face-to-face CBT. Method Seventy-two adolescents, aged 11 through 18 years with primary OCD, and their parents were randomized to receive specialist TCBT or CBT. The intervention provided differed only in the method of treatment delivery. All participants received up to 14 sessions of CBT, incorporating exposure with response prevention (E/RP), provided by experienced therapists. The primary outcome measure was the Children’s Yale–Brown Obsessive-Compulsive Scale (CY-BOCS). Blind assessor ratings were obtained at midtreatment, posttreatment, 3-month, 6-month, and 12-month follow-up. Results Intent-to-treat analyses indicated that TCBT was not inferior to face-to-face CBT at posttreatment, 3-month, and 6-month follow-up. At 12-month follow-up, there were no significant between-group differences on the CY-BOCS, but the confidence intervals exceeded the non-inferiority threshold. All secondary measures confirmed non-inferiority at all assessment points. Improvements made during treatment were maintained through to 12-month follow-up. Participants in each condition reported high levels of satisfaction with the intervention received. Conclusion TCBT is an effective treatment and is not inferior to standard clinic-based CBT, at least in the midterm. This approach provides a means of making a specialized treatment more accessible to many adolescents with OCD. Clinical trial registration information–Evaluation of telephone-administered cognitive-behaviour therapy (CBT) for young people with obsessive-compulsive disorder (OCD); http://www.controlled-trials.com; ISRCTN27070832. PMID:25457928

  3. 下鼻甲反转扩大下鼻道入路上颌窦手术%Extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach for maxillary lesions

    Institute of Scientific and Technical Information of China (English)

    马有祥; 丁秀勇; 田昊; 董宝成

    2014-01-01

    Objective To explore the feasibility of the extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach.Methods Eight patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach for maxillary sinus lesions.The indications,surgical management and outcomes of the surgery were presented.Results There were 2 cases of maxillary dentigerous cyst with oroantral fistula,2 cases of antrochoanal polyp,2 cases of maxillary sinus inverted papillomas,1 case of odontogenic maxillary sinusitis with oroantral fistula,and 1 case of maxillary sinus mucocele.All patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach without intraoperative complication,with good access to the lesions.Complete resection could be achieved through this approach,no postoperative complications occurred except one patient had a delayed wound healing of inferior turbinate,all patients were free of recurrence with the average postoperative follow-up of 7.8 months (range 4-12 months).Conclusion The extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach is recommended for some maxillary pathology owing to its good access to the lesions and complete resection.%目的 探讨下鼻甲反转扩大下鼻道入路上颌窦手术技术的可行性,初步评价其治疗效果,并就手术操作和适应证进行讨论.方法 2013年5月至2014年3月对首都医科大学附属北京友谊医院8例上颌窦病变患者在全身麻醉下施行鼻内镜下下鼻甲反转扩大下鼻道入路进行手术,术后观察随访其手术疗效.结果 8例上颌窦病变分别为上颌窦含牙囊肿伴上颌窦口腔瘘2例、上颌窦后鼻孔息肉2例、上颌窦内翻性乳头状瘤2例、牙源性上颌窦炎伴口腔瘘1例、上颌窦黏膜囊肿1例.手术均在鼻内镜下完成,无手术中并发症.通过下鼻甲反转扩大下鼻道入路上

  4. Acute iliofemoral venous thrombosis in patients with atresia of the inferior vena cava can be treated successfully with catheter-directed thrombolysis

    DEFF Research Database (Denmark)

    Broholm, Rikke; Jørgensen, Maja; Just, Sven;

    2011-01-01

    To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT).......To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT)....

  5. Distribution of GABAergic cells in the inferior colliculus that project to the thalamus

    Directory of Open Access Journals (Sweden)

    Jeffrey G Mellott

    2014-03-01

    Full Text Available A GABAergic component has been identified in the projection from the inferior colliculus (IC to the medial geniculate body (MG in cats and rats. We sought to determine if this GABAergic pathway exists in guinea pig, a species widely used in auditory research. The guinea pig IC contains GABAergic cells, but their relative abundance in the IC and their relative contributions to tectothalamic projections are unknown. We identified GABAergic cells with immunochemistry for glutamic acid decarboxylase (GAD and determined that ~21% of IC neurons are GABAergic. We then combined retrograde tracing with GAD immunohistochemistry to identify the GABAergic tectothalamic projection. Large injections of Fast Blue, red fluorescent beads or FluoroGold were deposited to include all subdivisions of the MG. The results demonstrate a GABAergic pathway from each IC subdivision to the ipsilateral MG. GABAergic cells constitute ~22% of this ipsilateral pathway. In addition, each subdivision of the IC had a GABAergic projection to the contralateral MG. Measured by number of tectothalamic cells, the contralateral projection is about 10% of the size of the ipsilateral projection. GABAergic cells constitute about 20% of the contralateral projection. In summary, the results demonstrate a tectothalamic projection in guinea pigs that originates in part from GABAergic cells that project ipsilaterally or contralaterally to the MG. The results show similarities to both rats and cats, and carry implications for the role of GABAergic tectothalamic projections vis-à-vis the presence (in cats or near absence (in rats and guinea pigs of GABAergic interneurons in the MG.

  6. P1-24: Neural Representation of Gloss in the Macaque Inferior Temporal Cortex

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    Akiko Nishio

    2012-10-01

    Full Text Available The variation of the appearance such as gloss provides one of the most important information for object recognition. However, little is known about the neural mechanisms related to the perception of gloss. We examined whether the neurons in the inferior temporal (IT cortex of the monkeys are coding gloss of objects. We made visual stimuli which have various surface reflectance properties, and tested responses of IT neurons to these stimuli while a monkey was performing a visual fixation task. We found that there exist neurons in the lower bank of the superior temporal sulcus that selectively responded to specific stimuli. The selectivity was largely maintained when the object shape or illumination condition was changed. In contrast, neural selectivity was lost when the pixels of objects were randomly rearranged. In the former manipulation of the stimuli, gloss perceptions were maintained, whereas in the latter manipulation, gloss perception was dramatically changed. These results indicate that these IT neurons selectively responded to gloss, not to the irrelevant local image features or average luminance or color. Next, to understand how the responses of gloss selective neurons are related to perceived gloss, responses of gloss selective neurons were mapped in perceptual gloss space in which glossiness changes uniformly. I found that responses of most gloss selective neurons can be explained by linear combinations of two parameters that are shown to be important for gloss perception. This result suggests that the responses of gloss selective neurons of IT cortex are closely related to gloss perception.

  7. The Inferior Vena Cava Diameter as a Marker of Dry Weight in Chronic Hemodialyzed Patients

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    We have previously reported that the diameter of the inferior vena cava(IVC) reflects the amount of body fluid in hemodialyzed (HD) patients. The present study was undertaken to depict the criteria of IVC diameters for determining dry weight (DW) in anuric HD patients. In healthy subjects, the maximal diameters during quiet expiration (IVCe) and the minimal diameters during quiet inspiration (IVCi) were (16.7±3.2) and (5.7±5.4)mm,respectively (mean±SD).The collapsibility index (CI,1-IVCi/IVCe), which inversely correlates with the central venous pressure,was 0.68±0.29. In anuric HD patients,the IVCe/CI values before and after HD were 14.9±3.2/0.68±0.24 and 8.2±2.3/0.94±0.09, respectively. IVCe decreased proportionally to the amount of ultrafiltration. In HD patients with hypervolemic pulmonary edema, the IVCe and CI values were 22.4±2.9 and 0.22±0.11, respectively. We proposed that IVCe/CI after HD is (8±3)mm/0.9 ± 0.1 as the markers of DW in anuric HD patients and that an IVCe value≥22mm together with a CI≤0.22 implies the warning level of body fluid retention.

  8. Sudden sensorineural hearing loss as prodromal symptom of anterior inferior cerebellar artery infarction.

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    Martines, Francesco; Dispenza, Francesco; Gagliardo, Cesare; Martines, Enrico; Bentivegna, Daniela

    2011-01-01

    Sudden sensorineural hearing loss is a clinical condition characterized by a sudden onset of unilateral or bilateral hearing loss. In recent years sudden deafness has been frequently described in association with anterior inferior cerebellar artery (AICA) infarction generally presenting along with other brainstem and cerebellar signs such as ataxia, dysmetria and peripheral facial palsy. The authors report a rare clinical case of a 53-year-old man who suddenly developed hearing loss and tinnitus without any brainstem or cerebellar signs. Computed tomography of his brain was normal, and the audiological results localized the lesion causing deafness to the inner ear. Surprisingly, magnetic resonance imaging showed an ischemic infarct in the right AICA territory. This case represents the fifth in the literature to date but it confirms that AICA occlusion can cause sudden deafness even without brainstem or cerebellar signs. Therefore, we recommend submitting the patient for neuroimaging, as an emergency, in order to exclude infarction of the AICA territory. By doing this, it may be possible to limit the extent of the lesion by commencing early therapy.

  9. Greater Left Inferior Frontal Activation for SVO than VOS during Sentence Comprehension in Kaqchikel

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    Koizumi, Masatoshi; Kim, Jungho

    2016-01-01

    Cortical activations during the processing of Kaqchikel transitive sentences with canonical and non-canonical word orders were investigated using functional magnetic resonance imaging. Kaqchikel is an endangered Mayan language spoken in Guatemala. The word order in this language is relatively flexible. We observed higher cortical activations in the left inferior frontal gyrus for sentences with the subject-verb-object (SVO) word order, as compared to sentences with the verb-object-subject (VOS) word order, suggesting that Kaqchikel sentences are easier to process when they have the VOS order than when they have the SVO order. This supports the traditional analysis of Mayan word order: the syntactically simplest word order of transitive sentences in Mayan languages, including Kaqchikel, is VOS. More importantly, the results revealed that the subject-before-object word order preference in sentence comprehension, previously observed in other languages, might not reflect a universal aspect of human languages. Rather, processing preference may be language-specific to some extent, reflecting syntactic differences in individual languages. PMID:27790165

  10. Age-related neurochemical changes in the rhesus macaque inferior colliculus.

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    James eEngle

    2014-04-01

    Full Text Available Age-related hearing loss (ARHL is marked by audiometric hearing deficits that propagate along the auditory pathway. Neurochemical changes as a function of aging have also been identified in neurons along the auditory pathway in both rodents and carnivores, however, very little is known about how these neurochemicals change in the non-human primate. To examine how these compensatory neurochemical changes relate to normal aging and audiometric sensitivity along the auditory pathway, we collected auditory brainstem responses (ABRs and brain specimens from seven rhesus monkeys spanning in age from 15 to 35 years old, and examined the relationship between click evoked ABR thresholds and the ABR evoked pure tone average and changes in the number of parvalbumin and NADPH-diaphorase positive cells in the auditory midbrain. We found that the number of parvalbumin positive cells in the central nucleus and the surrounding cortex regions of the inferior colliculus were strongly correlated with advancing age and ABR pure tone average. We also found that the numbers of NADPHd positive cells in these same regions were not associated with normal aging or changes in the ABR thresholds. These findings suggest that the auditory midbrain undergoes an up-regulation of parvalbumin expressing neurons with aging that is related to changes in the processing of frequencies across the audiometric range.

  11. Inferior Oblique Weakening and Abnormal Head Position: Controlled Myotomy versus Recession

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    R. Migliorini

    2016-01-01

    Full Text Available Purpose. Randomized controlled trial aimed at comparing surgical outcomes in a group of patients suffering from hyperfunction of the inferior oblique (IO muscle with abnormal head position (AHP. The surgical techniques being compared are Recession and (thread Controlled Myotomy. Materials and Methods. The group of 20 patients suffering from medium-high hyperfunction of the IO was assessed through an ophthalmological and orthoptic examination. 10 patients underwent traditional Recession (Group  A and 10 were treated with Controlled Myotomy (Group  B. Results. The average age was 19 years ± 10.7 SD. After 1 year, 20% of Group  A showed a small Vertical Deviation associated with a small AHP, while 80% had orthophoria and 40% of them had a small AHP. 80% of Group  B showed a small Vertical Deviation associated with an equally small AHP, while 20% had orthophoria with a full resolution of AHP. Conclusion. Based on the results obtained and the fewer intrasurgical risks involved, thread Controlled Myotomy proved to be a valid alternative to Recession. Furthermore, in case of Recession, over the long period a small residual AHP remained in the patients who had orthophoria, unlike Myotomy which led to a total resolution.

  12. Diode laser turbinate reduction in the treatment of symptomatic inferior turbinate hypertrophy.

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    Parida, Pradipta Kumar; Surianarayanan, Gopalakrishnan; Alexander, Arun; Saxena, Sunil Kumar; Santhosh, Krishnapriya

    2013-08-01

    To evaluate the efficacy of diode laser turbinate reduction procedure in treatment of symptomatic inferior turbinate hypertrophy (ITH) and to study the effect of it on mucociliary clearance of nose. This prospective study was carried out over 45 patients with symptomatic ITH refractory to medical management from July 2009 to March 2010 in Department of E.N.T, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, India. Each symptom (nasal obstruction, rhinorrhoea, sneezing, headache, hyposmia and snoring) was assessed by visual analogue scale (VAS). Mucociliary clearance was measured by saccharin transit time (STT). All patients underwent diode laser turbinate reduction (LTR) under local anesthesia. The patients were followed up at 1 week, 1, 3 and 6 months postoperatively. During each follow up visit, symptoms were reassessed by VAS score. Difference between preoperative and postoperative VAS score was statistically significant. All patients had significant symptomatic improvement which started from 1 week postoperatively and persisted throughout the follow up period. Prolongation of STT following diode laser turbinate reduction was significant. SST returned back to preoperative value by the end of 6 months. Crusting and pain were the main postoperative complaints. Diode laser turbinate reduction is safe, minimally invasive and effective in relieving the symptoms associated with ITH and can be performed on a day care basis under local anaesthesia. Longer follow up is required to assess the development of late complications and recurrence of symptoms after LTR.

  13. Recency Effects in the Inferior Parietal Lobe during Verbal Recognition Memory

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    Bradley Russell Buchsbaum

    2011-07-01

    Full Text Available The most recently encountered information is often most easily remembered in psychological tests of memory. Recent investigations of the neural basis of such recency effects have shown that activation in the lateral inferior parietal cortex (LIPC tracks the recency of a probe item when subjects make recognition memory judgments. A key question regarding recency effects in the LIPC is whether they fundamentally reflect the storage (and strength of information in memory, or whether such effects are a consequence of task difficulty or an upswing in resting state network activity. Using functional magnetic resonance imaging (fMRI we show that recency effects in the LIPC are independent of the difficulty of recognition memory decisions, that they are not a by-product of an increase in resting state network activity, and that they appear to dissociate from regions known to be involved in verbal working memory maintenance. We conclude with a discussion of two alternative explanations – the memory strength and expectancy hypotheses, respectively -- of the parietal lobe recency effect.

  14. Role of Colonial Subjects in Making Themselves Inferior in Chinua Achebe’s Things Fall Apart

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    Zahra Sadeghi

    2014-12-01

    Full Text Available Chinua Achebe in his novel Things Fall Apart gives us a unique picture of life in Africa before the arrival of Christianity and colonization and the era afterwards. He shows how African people lost their traditional culture and values, replacing them with foreign beliefs. In this article, the way black people lived before the arrival of white people, how they encountered and reacted to white colonizers, in addition to how they converted to Christianity and subsequently to White culture, as portrayed in this novel, will be analyzed. The purpose of this study is to trace the roots of this rapid pace of colonialism back to when colonial subjects lost their original culture to the new-coming people and to what extent those colonized people were affectively actualizing their inferiority and subordination to the white society. Frantz Fanon’s theories on the relation between language and culture or language and civilization, as well as his discussion of White notion of Blacks and Blacks’ conception of themselves are discussed and analyzed in Achebe’s masterpiece Things Fall Apart to prove that black people attempted to make up for their deep feeling of incompleteness by imitating white people and forming a white personality in a black statue as a result of their own conscious volition.

  15. The use of sensory action potential to evaluate inferior alveolar nerve damage after orthognathic surgery.

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    Calabria, Francesca; Sellek, Lucy; Gugole, Fabio; Trevisiol, Lorenzo; Trevisol, Lorenzo; Bertolasi, Laura; D'Agostino, Antonio

    2013-03-01

    To assess and monitor the common event of neurosensory disturbance to the inferior alveolar nerve (IAN) after bilateral sagittal split osteotomy, we used clinical sensory tests and neurophysiologic test sensory action potentials. The diagnostic value of these tests was evaluated by comparing them with the degree of nerve damage reported by patients. Fourteen patients undergoing bilateral sagittal split osteotomy were analyzed preoperatively and 2 years postoperatively. Patients were evaluated bilaterally for positive and negative symptoms: light touch sensation, paraesthesia, hyperesthesia, and dysaesthesia; a "sensation score" was then calculated for each patient. Patients were also asked if they would be willing to repeat the procedure knowing the sensation loss they had now. Next, the right and left IAN were evaluated using sensory action potential and correlated with the other results. Before surgery, the medium latency difference between left and right was lower compared with postsurgery, with all patients having some deficit. The reduction in medium amplitude of 67% after the intervention was statistically significant. The frequency of abnormal findings in the electrophysiologic tests indicating IAN injury correlated with subjective sensory alteration. All patients said that they would repeat the surgery. Electrophysiologic testing is recommended for the evaluation of nerve dysfunction and seems a sensitive method for accurately assessing postsurgical nerve conduction.

  16. fMRI adaptation reveals mirror neurons in human inferior parietal cortex.

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    Chong, Trevor T-J; Cunnington, Ross; Williams, Mark A; Kanwisher, Nancy; Mattingley, Jason B

    2008-10-28

    Mirror neurons, as originally described in the macaque, have two defining properties [1, 2]: They respond specifically to a particular action (e.g., bringing an object to the mouth), and they produce their action-specific responses independent of whether the monkey executes the action or passively observes a conspecific performing the same action. In humans, action observation and action execution engage a network of frontal, parietal, and temporal areas. However, it is unclear whether these responses reflect the activity of a single population that represents both observed and executed actions in a common neural code or the activity of distinct but overlapping populations of exclusively perceptual and motor neurons [3]. Here, we used fMRI adaptation to show that the right inferior parietal lobe (IPL) responds independently to specific actions regardless of whether they are observed or executed. Specifically, responses in the right IPL were attenuated when participants observed a recently executed action relative to one that had not previously been performed. This adaptation across action and perception demonstrates that the right IPL responds selectively to the motoric and perceptual representations of actions and is the first evidence for a neural response in humans that shows both defining properties of mirror neurons.

  17. Quantitative phosphoproteomic analyses of the inferior parietal lobule from three different pathological stages of Alzheimer's disease.

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    Triplett, Judy C; Swomley, Aaron M; Cai, Jian; Klein, Jon B; Butterfield, D Allan

    2015-01-01

    Alzheimer's disease (AD), the most common age-related neurodegenerative disorder, is clinically characterized by progressive neuronal loss resulting in loss of memory and dementia. AD is histopathologically characterized by the extensive distribution of senile plaques and neurofibrillary tangles, and synapse loss. Amnestic mild cognitive impairment (MCI) is generally accepted to be an early stage of AD. MCI subjects have pathology and symptoms that fall on the scale intermediately between 'normal' cognition with little or no pathology and AD. A rare number of individuals, who exhibit normal cognition on psychometric tests but whose brains show widespread postmortem AD pathology, are classified as 'asymptomatic' or 'preclinical' AD (PCAD). In this study, we evaluated changes in protein phosphorylation states in the inferior parietal lobule of subjects with AD, MCI, PCAD, and control brain using a 2-D PAGE proteomics approach in conjunction with Pro-Q Diamond phosphoprotein staining. Statistically significant changes in phosphorylation levels were found in 19 proteins involved in energy metabolism, neuronal plasticity, signal transduction, and oxidative stress response. Changes in the disease state phosphoproteome may provide insights into underlying mechanisms for the preservation of memory with expansive AD pathology in PCAD and the progressive memory loss in amnestic MCI that escalates to the dementia and the characteristic pathology of AD brain.

  18. Anatomical characterization of subcortical descending projections to the inferior colliculus in mouse.

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    Patel, Mili B; Sons, Stacy; Yudintsev, Georgiy; Lesicko, Alexandria M H; Yang, Luye; Taha, Gehad A; Pierce, Scott M; Llano, Daniel A

    2017-03-01

    Descending projections from the thalamus and related structures to the midbrain are evolutionarily highly conserved. However, the basic organization of this auditory thalamotectal pathway has not yet been characterized. The purpose of this study was to obtain a better understanding of the anatomical and neurochemical features of this pathway. Analysis of the distributions of retrogradely labeled cells after focal injections of retrograde tracer into the inferior colliculus (IC) of the mouse revealed that most of the subcortical descending projections originated in the brachium of the IC and the paralaminar portions of the auditory thalamus. In addition, the vast majority of thalamotectal cells were found to be negative for the calcium-binding proteins calbindin, parvalbumin, or calretinin. Using two different strains of GAD-GFP mice, as well as immunostaining for GABA, we found that a subset of neurons in the brachium of the IC is GABAergic, suggesting that part of this descending pathway is inhibitory. Finally, dual retrograde injections into the IC and amygdala plus corpus striatum as well into the IC and auditory cortex did not reveal any double labeling. These data suggest that the thalamocollicular pathway comprises a unique population of thalamic neurons that do not contain typical calcium-binding proteins and do not project to other paralaminar thalamic forebrain targets, and that a previously undescribed descending GABAergic pathway emanates from the brachium of the IC. J. Comp. Neurol. 525:885-900, 2017. © 2016 Wiley Periodicals, Inc.

  19. Reduced oligodendroglial density in the inferior parietal lobule and lack of insight in schizophrenia

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    Victor M. Vostrikov

    2013-06-01

    Full Text Available Background and Objectives: Alterations and deficits of oligodendrocytes reported in the grey and white matter in schizophrenia may contribute to neuronal disconnectivity. Prefrontal-parietal functional disconnections have been implicated in diverse clinical symptoms of schizophrenia, including poor insight. We studied the effects of schizophrenia diagnosis and insight on numerical density (Nv of oligodendrocytes in the inferior parietal lobule (IPL. Methods: Nissl-stained sections from the Stanley "Parietal Collection" from male schizophrenia subjects (n = 24 having poor, fair, or good insight and healthy matched controls (n = 24 were examined. The Nv of oligodendrocytes was estimated in layer 3 of BA 39 and BA 40 of the IPL and in white matter underlying layer 6 by optical dissector method. Results: In BA 39 we found a significant 15% decrease in the Nv of oligodendrocytes in layer 3 in the schizophrenia group. Nv of oligodendrocytes in the poor+fair insight subgroup was 20% lower compared to controls (pR only in the control group. There were no significant group differences in the Nv of oligodendrocytes in BA 40 or in the white matter underlying BA 39/40 areas. Conclusions: Lack of insight in schizophrenia may be associated with a deficit of oligodendroglia in the grey matter of IPL.

  20. Repetition Suppression in the Left Inferior Frontal Gyrus Predicts Tone Learning Performance.

    Science.gov (United States)

    Asaridou, Salomi S; Takashima, Atsuko; Dediu, Dan; Hagoort, Peter; McQueen, James M

    2016-06-01

    Do individuals differ in how efficiently they process non-native sounds? To what extent do these differences relate to individual variability in sound-learning aptitude? We addressed these questions by assessing the sound-learning abilities of Dutch native speakers as they were trained on non-native tone contrasts. We used fMRI repetition suppression to the non-native tones to measure participants' neuronal processing efficiency before and after training. Although all participants improved in tone identification with training, there was large individual variability in learning performance. A repetition suppression effect to tone was found in the bilateral inferior frontal gyri (IFGs) before training. No whole-brain effect was found after training; a region-of-interest analysis, however, showed that, after training, repetition suppression to tone in the left IFG correlated positively with learning. That is, individuals who were better in learning the non-native tones showed larger repetition suppression in this area. Crucially, this was true even before training. These findings add to existing evidence that the left IFG plays an important role in sound learning and indicate that individual differences in learning aptitude stem from differences in the neuronal efficiency with which non-native sounds are processed.

  1. Pathological internal mammary lymph nodes in secondary and tertiary deep inferior epigastric perforator flap breast reconstructions.

    Science.gov (United States)

    Hofer, Stefan O P; Rakhorst, Hinne A; Mureau, Marc A M; Moolenburgh, Sanne E; van Huizum, Martine A; van Geel, Albert N

    2005-12-01

    Use of internal mammary vessels during breast reconstruction provides information on part of the internal mammary chain lymph nodes (LNs). It was evaluated whether our current practice of screening should be changed to identify those delayed breast reconstruction patients with tumor-positive internal mammary nodes (IMNs) and whether breast reconstruction should be continued, in case suspicious IMNs were found intraoperatively. From February 2002 to December 2004, 81 patients had received 98 deep inferior epigastric perforator flaps for delayed breast reconstruction. Prospectively collected data for suspicious internal mammary LNs were evaluated. In 13 patients (16%) who had received a delayed breast reconstruction, macroscopically suspicious LNs were detected in the course of the internal mammary chain. Three patients (4%) had a pathologic diagnosis of malignancy, which was found to match their primary tumor. No relationship between positive internal mammary chain LNs and location of the primary tumor, TNM-stage, or previously administered adjuvant therapy was found. Suspicious internal mammary chain LNs found during recipient vessel dissection for breast reconstruction can have important consequences for treatment of malignant disease in individual patients. Presented data do not support changing the current perioperative approach of delayed breast reconstruction.

  2. Neural representation of ambiguous visual objects in the inferior temporal cortex.

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    Nazli Emadi

    Full Text Available Inferior temporal (IT cortex as the final stage of the ventral visual pathway is involved in visual object recognition. In our everyday life we need to recognize visual objects that are degraded by noise. Psychophysical studies have shown that the accuracy and speed of the object recognition decreases as the amount of visual noise increases. However, the neural representation of ambiguous visual objects and the underlying neural mechanisms of such changes in the behavior are not known. Here, by recording the neuronal spiking activity of macaque monkeys' IT we explored the relationship between stimulus ambiguity and the IT neural activity. We found smaller amplitude, later onset, earlier offset and shorter duration of the response as visual ambiguity increased. All of these modulations were gradual and correlated with the level of stimulus ambiguity. We found that while category selectivity of IT neurons decreased with noise, it was preserved for a large extent of visual ambiguity. This noise tolerance for category selectivity in IT was lost at 60% noise level. Interestingly, while the response of the IT neurons to visual stimuli at 60% noise level was significantly larger than their baseline activity and full (100% noise, it was not category selective anymore. The latter finding shows a neural representation that signals the presence of visual stimulus without signaling what it is. In general these findings, in the context of a drift diffusion model, explain the neural mechanisms of perceptual accuracy and speed changes in the process of recognizing ambiguous objects.

  3. Neural representation of ambiguous visual objects in the inferior temporal cortex.

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    Emadi, Nazli; Esteky, Hossein

    2013-01-01

    Inferior temporal (IT) cortex as the final stage of the ventral visual pathway is involved in visual object recognition. In our everyday life we need to recognize visual objects that are degraded by noise. Psychophysical studies have shown that the accuracy and speed of the object recognition decreases as the amount of visual noise increases. However, the neural representation of ambiguous visual objects and the underlying neural mechanisms of such changes in the behavior are not known. Here, by recording the neuronal spiking activity of macaque monkeys' IT we explored the relationship between stimulus ambiguity and the IT neural activity. We found smaller amplitude, later onset, earlier offset and shorter duration of the response as visual ambiguity increased. All of these modulations were gradual and correlated with the level of stimulus ambiguity. We found that while category selectivity of IT neurons decreased with noise, it was preserved for a large extent of visual ambiguity. This noise tolerance for category selectivity in IT was lost at 60% noise level. Interestingly, while the response of the IT neurons to visual stimuli at 60% noise level was significantly larger than their baseline activity and full (100%) noise, it was not category selective anymore. The latter finding shows a neural representation that signals the presence of visual stimulus without signaling what it is. In general these findings, in the context of a drift diffusion model, explain the neural mechanisms of perceptual accuracy and speed changes in the process of recognizing ambiguous objects.

  4. Changes in the response properties of inferior colliculus neurons relating to tinnitus

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    Joel I Berger

    2014-10-01

    Full Text Available Tinnitus is often identified in animal models by using the gap prepulse inhibition of acoustic startle (GPIAS. Impaired gap detection following acoustic over-exposure (AOE is thought to be caused by tinnitus ‘filling in’ the gap, thus reducing its salience. This presumably involves altered perception, and could conceivably be caused by changes at the level of the neocortex, i.e. cortical reorganization. Alternatively, reduced gap detection ability might reflect poorer temporal processing in the brainstem, caused by AOE; in which case, impaired gap detection would not be a reliable indicator of tinnitus. We tested the latter hypothesis by examining gap detection in inferior colliculus (IC neurons following AOE. Seven of nine unilaterally noise-exposed guinea pigs exhibited behavioural evidence of tinnitus. In these tinnitus animals, neural gap detection thresholds in the IC significantly increased in response to broadband noise stimuli, but not to pure tones or narrowband noise. In addition, when IC neurons were sub-divided according to temporal response profile (onset vs. sustained firing patterns, we found a significant increase in the proportion of onset-type responses after AOE. Importantly, however, gap detection thresholds were still considerably shorter than gap durations commonly used in objective behavioural tests for tinnitus. These data indicate that the neural changes observed in the IC are insufficient to explain deficits in behavioural gap detection that are commonly attributed to tinnitus. The subtle changes in IC neuron response profiles following AOE warrant further investigation.

  5. Human inferior colliculus activity relates to individual differences in spoken language learning.

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    Chandrasekaran, Bharath; Kraus, Nina; Wong, Patrick C M

    2012-03-01

    A challenge to learning words of a foreign language is encoding nonnative phonemes, a process typically attributed to cortical circuitry. Using multimodal imaging methods [functional magnetic resonance imaging-adaptation (fMRI-A) and auditory brain stem responses (ABR)], we examined the extent to which pretraining pitch encoding in the inferior colliculus (IC), a primary midbrain structure, related to individual variability in learning to successfully use nonnative pitch patterns to distinguish words in American English-speaking adults. fMRI-A indexed the efficiency of pitch representation localized to the IC, whereas ABR quantified midbrain pitch-related activity with millisecond precision. In line with neural "sharpening" models, we found that efficient IC pitch pattern representation (indexed by fMRI) related to superior neural representation of pitch patterns (indexed by ABR), and consequently more successful word learning following sound-to-meaning training. Our results establish a critical role for the IC in speech-sound representation, consistent with the established role for the IC in the representation of communication signals in other animal models.

  6. Vertical splitting of the mandibular body as an alternative to inferior alveolar nerve lateralization.

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    Rodriguez, J G; Eldibany, R M

    2013-09-01

    The aim of this study was to present and evaluate a modified technique to inferior alveolar nerve lateralization (IANL) that allows the placement of longer implants in the posterior mandibular region. One hundred and forty-three consecutive patients were enrolled in this study; these patients had between 1.8 and 8mm residual crestal height above the mandibular canal. Vertical splitting of the mandibular body was performed using piezoelectric surgery followed by bone expansion and insertion of special conical implants of 10 and/or 12mm in length. Two hundred and sixty-nine osteotomies were performed and 636 implants were inserted, with a survival rate of 99% at the end of 12 months. Immediately postoperative there was an alteration of sensation in the lip/chin area in 8.5% of cases; 4.1% regained full sensation within 10-14 days, 2.6% after 8 weeks, and 0.7% had persistent paresthesia that did not affect their daily activities. Progressively increasing pain and numbness was present in 1.1%; the implants were removed 6 months postoperatively. This is a relatively simple procedure that has no limitations in clinical situations with minimal bone height. It allows for greater implant stability, and the risk of neurological disturbance is minimal.

  7. Neural selectivity and representation of gloss in the monkey inferior temporal cortex.

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    Nishio, Akiko; Goda, Naokazu; Komatsu, Hidehiko

    2012-08-01

    When we view an object, its appearance depends in large part on specific surface reflectance properties; among these is surface gloss, which provides important information about the material composition of the object and the fine structure of its surface. To study how gloss is represented in the visual cortical areas related to object recognition, we examined the responses of neurons in the inferior temporal (IT) cortex of the macaque monkey to a set of object images exhibiting various combinations of specular reflection, diffuse reflection, and roughness, which are important physical parameters of surface gloss. We found that there are neurons in the lower bank of the superior temporal sulcus that selectively respond to specific gloss. This neuronal selectivity was largely maintained when the shape or illumination of the object was modified and perceived glossiness was unchanged. By contrast, neural responses were significantly altered when the pixels of the images were randomly rearranged, and perceived glossiness was dramatically changed. The stimulus preference of these neurons differed from cell to cell, and, as a population, they systematically represented a variety of surface glosses. We conclude that, within the visual cortex, there are mechanisms operating to integrate local image features and extract information about surface gloss and that this information is systematically represented in the IT cortex, an area playing an important role in object recognition.

  8. The impact of orientation filtering on face-selective neurons in monkey inferior temporal cortex.

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    Taubert, Jessica; Goffaux, Valerie; Van Belle, Goedele; Vanduffel, Wim; Vogels, Rufin

    2016-02-16

    Faces convey complex social signals to primates. These signals are tolerant of some image transformations (e.g. changes in size) but not others (e.g. picture-plane rotation). By filtering face stimuli for orientation content, studies of human behavior and brain responses have shown that face processing is tuned to selective orientation ranges. In the present study, for the first time, we recorded the responses of face-selective neurons in monkey inferior temporal (IT) cortex to intact and scrambled faces that were filtered to selectively preserve horizontal or vertical information. Guided by functional maps, we recorded neurons in the lateral middle patch (ML), the lateral anterior patch (AL), and an additional region located outside of the functionally defined face-patches (CONTROL). We found that neurons in ML preferred horizontal-passed faces over their vertical-passed counterparts. Neurons in AL, however, had a preference for vertical-passed faces, while neurons in CONTROL had no systematic preference. Importantly, orientation filtering did not modulate the firing rate of neurons to phase-scrambled face stimuli in any recording region. Together these results suggest that face-selective neurons found in the face-selective patches are differentially tuned to orientation content, with horizontal tuning in area ML and vertical tuning in area AL.

  9. Sinus bradycardia as a predictor of right coronary artery occlusion in patients with inferior myocardial infarction.

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    Serrano, C V; Bortolotto, L A; César, L A; Solimene, M C; Mansur, A P; Nicolau, J C; Ramires, J A

    1999-01-01

    Differentiation of right coronary artery (RCA) from left circumflex artery (LCxA) occlusion may be difficult since both can present an electrocardiographic pattern of inferior myocardial infarction (IMI). We studied 133 patients with IMI, 92 patients with RCA occlusion and 41 patients with LCxA occlusion. Risk factors such as previous MI, arterial hypertension, diabetes, smoking, and dislipemia, were similar for RCA and LCxA occlusions. Patients with RCA occlusion had a higher incidence of isolated IMI than patients with LCxA occlusion, 50% vs. 17%, respectively (P<0.001). Arterial hypotension was more prevalent (P<0.05) among patients with RCA (18%) rather than those with LCxA occlusion (2%). RCA occlusion presented an association with sinus bradycardia, an association not observed with LCxA occlusion (15% vs. 0%, respectively; P<0.01). Total atrioventricular block was only present among patients with RCA (18%). Proximal occlusions of the RCA presented lower heart rates (sinus bradycardia) than medial and distal occlusions (13% vs. 1% and 1%, respectively; P<0.0001 and P<0.001). Therefore, regarding patients with IMI: (1) sinus bradycardia is more frequent when the infarct-related artery is the RCA; (2) proximal occlusions of the right coronary predispose low heart rates; and (3) occlusion of the LCxA rarely induces sinus bradycardia.

  10. Left inferior-parietal lobe activity in perspective tasks: identity statements.

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    Arora, Aditi; Weiss, Benjamin; Schurz, Matthias; Aichhorn, Markus; Wieshofer, Rebecca C; Perner, Josef

    2015-01-01

    We investigate the theory that the left inferior parietal lobe (IPL) is closely associated with tracking potential differences of perspective. Developmental studies find that perspective tasks are mastered at around 4 years of age. Our first study, meta-analyses of brain imaging studies shows that perspective tasks specifically activate a region in the left IPL and precuneus. These tasks include processing of false belief, visual perspective, and episodic memory. We test the location specificity theory in our second study with an unusual and novel kind of perspective task: identity statements. According to Frege's classical logical analysis, identity statements require appreciation of modes of presentation (perspectives). We show that identity statements, e.g., "the tour guide is also the driver" activate the left IPL in contrast to a control statements, "the tour guide has an apprentice." This activation overlaps with the activations found in the meta-analysis. This finding is confirmed in a third study with different types of statements and different comparisons. All studies support the theory that the left IPL has as one of its overarching functions the tracking of perspective differences. We discuss how this function relates to the bottom-up attention function proposed for the bilateral IPL.

  11. Left Inferior-Parietal Lobe Activity in Perspective Tasks: Identity statements

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    Aditi eArora

    2015-06-01

    Full Text Available We investigate the theory that the left inferior parietal lobe (IPL is closely associated with tracking potential differences of perspective. Developmental studies find that perspective tasks are mastered at around four years of age. Our first study, meta-analyses of brain imaging studies shows that perspective tasks specifically activate a region in the left IPL and precuneus. These tasks include processing of false belief, visual perspective, and episodic memory. We test the location specificity theory in our second study with an unusual and novel kind of perspective task: identity statements. According to Frege’s classical logical analysis, identity statements require appreciation of modes of presentation (perspectives. We show that identity statements, e.g., the tour guide is also the driver activate the left IPL in contrast to a control statements, the tour guide has an apprentice. This activation overlaps with the activations found in the meta-analysis. This finding is confirmed in a third study with different types of statements and different comparisons. All studies support the theory that the left IPL has as one of its overarching functions the tracking of perspective differences. We discuss how this function relates to the bottom-up attention function proposed for the bilateral IPL.

  12. Dynamic Limb Bioimpedance and Inferior Vena Cava Ultrasound in Patients Undergoing Hemodialysis.

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    Tiba, Mohamad H; Belmont, Barry; Heung, Michael; Theyyunni, Nik; Huang, Robert D; Fung, Christopher M; Pennington, Amanda J; Cummings, Brandon C; Draucker, Gerard T; Shih, Albert J; Ward, Kevin R

    2016-01-01

    Assessment of volume status in critically ill patients poses a challenge to clinicians. Measuring changes in the inferior vena cava (IVC) diameter using ultrasound is becoming a standard tool to assess volume status. Ultrasound requires physicians with significant training and specialized expensive equipment. It would be of significant value to be able to obtain this measurement continuously without physician presence. We hypothesize that dynamic changes in limb's bioimpedance in response to respiration could be used to predict changes in IVC. Forty-six subjects were tested a hemodialysis session. Impedance was measured via electrodes placed on the arm. Simultaneously, the IVC diameter was assessed by ultrasound. Subjects were asked to breathe spontaneously and perform respiratory maneuvers using a respiratory training device. Impedance (dz) was determined and compared with change in IVC diameter (dIVC; r = 0.76, p < 0.0001). There was significant relationship between dz and dIVC (p< 0.0001). Receiver-operator curves for dz at thresholds of dIVC (20% to70%) demonstrated high predictive power with areas under the curves (0.87-0.99, p < 0.0001). This evaluation suggests that real-time dynamic changes in limb impedance are capable of tracking a wide range of dynamic dIVC. This technique might be a suitable surrogate for monitoring real-time changes in dIVC to assess intravascular volume status.

  13. Contribution of inferior temporal and posterior parietal activity to three-dimensional shape perception.

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    Verhoef, Bram-Ernst; Vogels, Rufin; Janssen, Peter

    2010-05-25

    One of the fundamental goals of neuroscience is to understand how perception arises from the activity of neurons in the brain. Stereopsis is a type of three-dimensional (3D) perception that relies on two slightly different projections of the world onto the retinas of the two eyes, i.e., binocular disparity. Neurons selective for curved surfaces defined by binocular disparity may contribute to the perception of an object's 3D structure. Such neurons have been observed in both the anterior lower bank of the superior temporal sulcus (TEs, part of the inferior temporal cortex [IT]) and the anterior intraparietal area (AIP). However, the specific contributions of IT and AIP to depth perception remain unknown. We simultaneously recorded multiunit activity in IT and AIP while monkeys discriminated between concave and convex 3D shapes. We observed a correlation between the neural activity and behavioral choice that arose early and during perceptual decision formation in IT but later and after perceptual decision formation in AIP. These results suggest a role for IT, but not AIP, in 3D shape discrimination. Furthermore, the results demonstrate that similar neuronal stimulus selectivities in two areas do not imply a similar function.

  14. Substance P-mediated membrane currents in voltage-clamped guinea pig inferior mesenteric ganglion cells.

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    Griffith, W H; Hills, J M; Brown, D A

    1988-01-01

    Responses to substance P (SP) and to hypogastric nerve stimulation were recorded from voltage-clamped guinea pig inferior mesenteric ganglion (IMG) neurons, and compared with those to muscarine. Muscarine produced a voltage-dependent inward current accompanied by a reduced input conductance and inhibition of IM a time- and voltage-dependent K+-current (Brown and Adams: Nature 283:673-676, 1980). SP also produced an inward current, accompanied by a fall in input conductance (20 out of 31 cells) or a rise in input conductance (7 out of 31 cells). The fall in input conductance was not accompanied by an inhibition of M-current (unlike frog ganglia: Adams et al.: British Journal of Pharmacology 79:330-333, 1983) or an inhibition of the inward rectifier current (unlike globus pallidus neurons: Stanfield et al.: Nature 315:498-501, 1985). Repetitive hypogastric nerve stimulation (10-20 Hz, 2-10 s) produced a slow inward postsynaptic current lasting 1-3 min, with decreases or increases of input conductance matching those produced by SP. The postsynaptic current did not show a consistent or reproducible change in amplitude on varying the holding potential between -90 and -25 mV. It is concluded that SP and hypogastric stimulation produce complex and variable changes in ionic conductance in IMG neurons.

  15. Stimulus-specific adaptation and deviance detection in the inferior colliculus

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    Yaneri eAguilar Ayala

    2013-01-01

    Full Text Available Deviancy detection in the continuous flow of sensory information into the central nervous system is of vital importance for animals. The task requires neuronal mechanisms that allow for an efficient representation of the environment by removing statistically redundant signals. Recently, the neuronal principles of auditory deviance detection have been approached by studying the phenomenon of stimulus-specific adaptation (SSA. SSA is a reduction in the responsiveness of a neuron to a common or repetitive sound while the neuron remains highly sensitive to rare sounds (Ulanovsky et al., 2003. This phenomenon could enhance the saliency of unexpected, deviant stimuli against a background of repetitive signals. SSA shares many similarities with the evoked potential known as the ‘mismatch negativity,’ and it has been linked to cognitive process such as auditory memory and scene analysis (Winkler et al., 2009 as well as to behavioral habituation (Netser et al., 2011. Neurons exhibiting SSA can be found at several levels of the auditory pathway, from the inferior colliculus (IC up to the auditory cortex (AC. In this review, we offer an account of the state-of-the art of SSA studies in the IC with the aim of contributing to the growing interest in the single-neuron electrophysiology of auditory deviance detection. The dependence of neuronal SSA on various stimulus features, e.g., probability of the deviant stimulus and repetition rate, and the roles of the AC and inhibition in shaping SSA at the level of the IC are addressed.

  16. Polygynous supercolonies of the acacia-ant Pseudomyrmex peperi, an inferior colony founder.

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    Kautz, S; Pauls, S U; Ballhorn, D J; Lumbsch, H T; Heil, M

    2009-12-01

    In ant-plant protection mutualisms, plants provide nesting space and nutrition to defending ants. Several plant-ants are polygynous. Possessing more than one queen per colony can reduce nestmate relatedness and consequently the inclusive fitness of workers. Here, we investigated the colony structure of the obligate acacia-ant Pseudomyrmex peperi, which competes for nesting space with several congeneric and sympatric species. Pseudomyrmex peperi had a lower colony founding success than its congeners and thus, appears to be competitively inferior during the early stages of colony development. Aggression assays showed that P. peperi establishes distinct, but highly polygynous supercolonies, which can inhabit large clusters of host trees. Analysing queens, workers, males and virgin queens from two supercolonies with eight polymorphic microsatellite markers revealed a maximum of three alleles per locus within a colony and, thus, high relatedness among nestmates. Colonies had probably been founded by one singly mated queen and supercolonies resulted from intranidal mating among colony-derived males and daughter queens. This strategy allows colonies to grow by budding and to occupy individual plant clusters for time spans that are longer than an individual queen's life. Ancestral states reconstruction indicated that polygyny represents the derived state within obligate acacia-ants. We suggest that the extreme polygyny of Pseudomyrmex peperi, which is achieved by intranidal mating and thereby maintains high nestmate relatedness, might play an important role for species coexistence in a dynamic and competitive habitat.

  17. Computational Simulations of Inferior Vena Cava (IVC) Filter Placement and Hemodynamics in Patient-Specific Geometries

    Science.gov (United States)

    Aycock, Kenneth; Sastry, Shankar; Kim, Jibum; Shontz, Suzanne; Campbell, Robert; Manning, Keefe; Lynch, Frank; Craven, Brent

    2013-11-01

    A computational methodology for simulating inferior vena cava (IVC) filter placement and IVC hemodynamics was developed and tested on two patient-specific IVC geometries: a left-sided IVC, and an IVC with a retroaortic left renal vein. Virtual IVC filter placement was performed with finite element analysis (FEA) using non-linear material models and contact modeling, yielding maximum vein displacements of approximately 10% of the IVC diameters. Blood flow was then simulated using computational fluid dynamics (CFD) with four cases for each patient IVC: 1) an IVC only, 2) an IVC with a placed filter, 3) an IVC with a placed filter and a model embolus, all at resting flow conditions, and 4) an IVC with a placed filter and a model embolus at exercise flow conditions. Significant hemodynamic differences were observed between the two patient IVCs, with the development of a right-sided jet (all cases) and a larger stagnation region (cases 3-4) in the left-sided IVC. These results support further investigation of the effects of IVC filter placement on a patient-specific basis.

  18. A STUDY OF NEURONAL PROFILE OF INFERIOR OLIVARY NUCLEAR COMPLEX IN FOETAL AND ADULT HUMAN MEDULLA

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    B.Narasinga Rao

    2013-09-01

    Full Text Available Abstract: Background: ION receives proprioceptive impulses from spino-olivary tract and conveys the fibers to the cerebellum through olivo-cerebellar tract. There is paucity of data in human olivary complex, hence the present study is done. Materials And Methods: 15 adult brains and 25 fetuses of different gestations were perfused with 10% formalin and processed for histological examination. Results: Rounded cells have been seen infiltrating the entire field. at 16 weeks of gestation. Segregation of neurons into principal, medial, and dorsal accessory olivary nuclei at 20 wks gestation. Discussion: Neuron differentiation into oval, round, multipolar types has begun at 40 wks gestation. Neurons in the olivary subdivisions are grouped in separate clusters as per Ramon y Cajal,1909; Scheibel and Scheibel, 1955, Bowman and King, 1973. Multipolar neurons dominated in adult inferior olivary nucleus. Conclusion:The greater development of neurons is a consequence of finer regulation of various movements of hands and finger associated with movement of head and eyes

  19. A new method in thoracoscopic inferior mediastinal lymph node biopsy: a case report

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    Sanlı Maruf

    2009-11-01

    Full Text Available Abstract Introduction We performed video-thoracoscopy with a video-mediastinoscope to conduct a mediastinal lymph node biopsy. Here, we discuss the various advantages of the method. Case presentation A 56-year-old Turkish Caucasian man had been complaining of dyspnea on exertion, hacking cough, fever and continuous sweating for one and a half months. Thoracic computed tomography revealed enlarged paratracheal and aorticopulmonary lymph nodes, the largest of which was 1 cm in diameter and reticulo-micronodular interstitial infiltration extending symmetrically to the pleural surfaces in both pulmonary perihilar areas. Computed tomography supported positron emission tomography showed increased fluorodeoxyglucose retention in lymph nodes in both hilar areas (10R and 10L (maximum standardized uptake values 5.6 and 5.7, and in the right lower paratracheal (4R (maximum standardized uptake value 4.1 and right para-esophageal (8 (maximum standardized uptake value 8.9 lymph nodes. Pathological examination of the right lymph node number 8 biopsy using the video-mediastinoscope revealed the presence of granulomatous inflammation. No problems were observed during the postoperative period. Conclusion The use of the video-mediastinoscope for inferior lymph node biopsy in thoracoscopy is an easy, safe and practical method, especially in patients with pleural adhesions.

  20. Tones inferior to eye movements in the EMDR treatment of PTSD.

    Science.gov (United States)

    van den Hout, Marcel A; Rijkeboer, Marleen M; Engelhard, Iris M; Klugkist, Irene; Hornsveld, Hellen; Toffolo, Marieke J B; Cath, Danielle C

    2012-05-01

    Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder (PTSD). During EMDR, patients make eye movements (EMs) while recalling traumatic memories, but recently therapists have replaced EMs by alternating beep tones. There are no outcome studies on the effects of tones. In an earlier analogue study, tones were inferior to EMs in the reduction of vividness of aversive memories. In a first EMDR session, 12 PTSD patients recalled trauma memories in three conditions: recall only, recall + tones, and recall + EMs. Three competing hypotheses were tested: 1) EMs are as effective as tones and better than recall only, 2) EMs are better than tones and tones are as effective as recall only, and 3) EMs are better than tones and tones are better than recall only. The order of conditions was balanced, each condition was delivered twice, and decline in memory vividness and emotionality served as outcome measures. The data strongly support hypothesis 2 and 3 over 1: EMs outperformed tones while it remained unclear if tones add to recall only. The findings add to earlier considerations and earlier analogue findings suggesting that EMs are superior to tones and that replacing the former by the latter was premature.

  1. Radiological assessment of the inferior alveolar artery course in human corpse mandibles

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    Bertl, Kristina [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Malmoe University, Department of Periodontology, Faculty of Odontology, Malmoe (Sweden); Hirtler, Lena [Medical University of Vienna, Center for Anatomy and Cell Biology, Department of Systematic Anatomy, Vienna (Austria); Dobsak, Toni [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Medical University of Vienna, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Vienna (Austria); Austrian Cluster for Tissue Regeneration, Vienna (Austria); Heimel, Patrick [Medical University of Vienna, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Vienna (Austria); Austrian Cluster for Tissue Regeneration, Vienna (Austria); Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna (Austria); Gahleitner, Andre [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Medical University of Vienna, Department of Diagnostic Radiology, Division of Osteoradiology, General Hospital, Vienna (Austria); Ulm, Christian [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Plenk, Hanns [Medical University of Vienna, Bone and Biomaterials Research, Institute for Histology and Embryology, Vienna (Austria)

    2015-04-01

    CT assessment of the entire course of the inferior alveolar artery (IAA) within the mandibular canal. After contrast medium injection (180 or 400 mg/ml iodine concentration) into the external carotid arteries of 15 fresh human cadaver heads, the main IAA's position in the canal (cranial, buccal, lingual or caudal) was assessed in dental CT images of partially edentulous mandibles. The course of the main IAA could be followed at both iodine concentrations. The higher concentration gave the expected better contrast, without creating artefacts, and improved visibility of smaller arteries, such as anastomotic sections, dental branches and the incisive branch. The main IAA changed its position in the canal more often than so far known (mean 4.3 times, SD 1.24, range 2-7), but with a similar bilateral course. A cranial position was most often detected (42 %), followed by lingual (36 %), caudal (16 %) and buccal (6 %). With this non-invasive radiologic method, the entire course of the main IAA in the mandibular canal could be followed simultaneously with other bone structures on both sides of human cadaver mandibles. This methodology allows one to amend existing anatomical and histological data, which are important for surgical interventions near the mandibular canal. (orig.)

  2. Conservative treatment of anterior inferior and superior avulsion fractures of spina iliaca in adolescent amateur footballer

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    Umut Hatay Gölge

    2015-06-01

    Full Text Available The anterior inferior iliac spine (AIIS and the anterior superior iliac spine (ASIS avulsion fracture is a rare injury of pelvis. It usually occurs during the sport activities especially in football while hitting the ball. It is commonly misdiagnosed so that a detailed history and physical examination have a great importance. We present two cases of AIIS and ASIS avulsion fracture. Both of the patients applied to outpatient clinics with hip pain and difficulty in walking. History revealed the complaints started after hitting the ball during the football match and hip movements were limited. The patients were fifteen and sixteen years and after physical examination and radiological evaluation, avulsion fracture of the AIIS and the ASIS were diagnosed. Patients were treated conservatively with non-steroidal anti-inflammatory drugs and limited weight bearing with crutches for a month. The patients were free of pain and had full range of hip movements after one month period. At the end of the second month patients returned to active sports. AIIS and ASIS avulsion fractures are more common in adolescent football players but clinicians sometimes fail to diagnose this rare injury. We emphasize the importance of the detailed history and clinical examination and direct radiography could be enough for the diagnosis.

  3. rTMS over bilateral inferior parietal cortex induces decrement of spatial sustained attention

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    Lee, Jeyeon; Ku, Jeonghun; Han, Kiwan; Park, Jinsick; Lee, Hyeongrae; Kim, Kyung Ran; Lee, Eun; Husain, Masud; Yoon, Kang Jun; Kim, In Young; Jang, Dong Pyo; Kim, Sun I.

    2013-01-01

    Sustained attention is an essential brain function that enables a subject to maintain attention level over the time of a task. In previous work, the right inferior parietal lobe (IPL) has been reported as one of the main brain regions related to sustained attention, however, the right lateralization of vigilance/sustained attention is unclear because information about the network for sustained attention is traditionally provided by neglect patients who typically have right brain damage. Here, we investigated sustained attention by applying a virtual lesion technique, transcranial magnetic stimulation (TMS), over the left and right superior parietal lobe (SPL) and IPL. We used two different types of visual sustained attention tasks: spatial (location based) and non-spatial (feature based). When the participants performed the spatial task, repetitive TMS (rTMS) over either the right or left IPL induced a significant decrement of sustained attention causing a progressive increment of errors and response time. In contrast, participants' performance was not changed by rTMS on the non-spatial task. Also, omission errors (true negative) gradually increased with time on right and left IPL rTMS conditions, while commission errors (false positive) were relatively stable. These findings suggest that the maintenance of attention, especially in tasks regarding spatial location, is not uniquely lateralized to the right IPL, but may also involve participation of the left IPL. PMID:23403477

  4. AN ACCESSORY/ABERRANT LEFT INFERIOR POLAR ARTERY AR ISING FROM THE AORTIC BIFURCATION

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    Sreekanth

    2013-04-01

    Full Text Available ABSTRACT: The frequently to rarely occurring wide range of va riations in the renal vasculature are considered critical issue that surgeons should have a thorough envision and appreciation of the condition. During the routine prosection hours for the preclinical MBBS students at Shadan Institute of Medical Sciences, Teaching Hospital and Research Centre, while dissecting a male cadaver revealed an interesting variation. The Main Renal Artery (MRA was arising from the aorta about 1.8 cm below the Superior Mesentric Arte ry (SMA extending laterally towards the hilum of the kidney. At about 1.5 cm below the orig in of the Inferior Mesenteric Artery (IMA from the antero lateral aspect of the Aortic Bifurca tion, an aberrant renal artery measuring 4.5 cm in length, was seen coursing upwards, backwards a nd laterally & made its portal of entry by penetrating into the medial border and extending on to the posterior surface by piercing the capsule just half cm. above its lower pole. The urete r and the gonadal vessels were superficial to it. A thorough knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal tra nsplantation, renal artery embolization, surgery for abdominal aortic aneurysm and conservat ive or radical renal surgery.

  5. Congenital agenesis of inferior vena cava: a rare cause of unprovoked deep venous thrombosis.

    Science.gov (United States)

    Parsa, Pouria; Lane, John S; Barleben, Andrew R; Owens, Erik L; Bandyk, Dennis

    2015-07-01

    Congenital anomalies of the inferior vena cava (IVC), although rare, are a risk factor for lower limb deep venous thrombosis (DVT). A 19-year-old male presented with a left flank and groin pain caused by iliofemoral venous thrombosis. Vascular imaging by computed tomography (CT) scanning and venography demonstrated agenesis of the IVC. Catheter-directed thrombolysis via a popliteal vein was attempted but did not alter the patency of the common femoral vein outflow collaterals into the retroperitoneal azygous venous system. The patient was anticoagulated using systemic heparin infusion and clinical symptoms resolved within 5 days. He was transitioned to oral Coumadin anticoagulation, and follow-up venous duplex testing demonstrated no infrainguinal DVT and phasic venous flow with respiration in the femoral vein indicating patent collateral veins. Anomalies of the IVC are present in 0.3-0.5% of otherwise healthy individuals. Agenesis of the IVC has an incidence of 0.0005-1% in the general population but is found in almost 5% of patients venous collaterals on noncontrast CT imaging. In young adults presenting with unprovoked lower limb DVT, the presence of an IVC anomaly should be considered and evaluated for by venous duplex testing and if necessary CT venography.

  6. Morphometric characteristics of neuropeptide Y immunoreactive neurons in cortex of human inferior parietal lobule.

    Science.gov (United States)

    Krivokuća, Dragan; Puskas, Laslo; Puskas, Nela; Erić, Mirela

    2010-03-01

    The aim of this study was to demonstrate and precisely define the morphology of neurons immunoreactive to neuropeptide Y (NPY) in cortex of human inferior parietal lobule (IPL). Five human brains were used for immunohistochemical investigation of the shape and laminar distribution of NPY neurons in serial section in the supramarginal and angular gyrus. Immunoreactivity to NPY was detected in all six layers of the cortex of human IPL. However a great number of NPY immunoreactive neurons were found in the white matter under the IPL cortex. The following types of NPY immunoreactive neurons were found: Cajal-Retzius, pyramidal, inverted pyramidal, "double bouquet" (bitufted), rare type 6, multipolar nonspinous, bipolar, voluminous "basket", and chandelier cells. These informations about morphometric characteristics of NPY immunoreactive neurons in cortical layers, together with morphometric data taken from brains having schizophrenia or Alzheimer's-type dementia may contribute to better understanding patogenesis of these neurological diseases. The finding of Cajal-Retzius neurons immunoreactive to NPY points to the need for further investigations because of great importance of these cells in neurogenesis and involvement in mentioned diseases instead of their rarity.

  7. 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

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    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

  8. Signaled two-way avoidance learning using electrical stimulation of the inferior colliculus as negative reinforcement: effects of visual and auditory cues as warning stimuli

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    A.C. Troncoso

    1998-03-01

    Full Text Available The inferior colliculus is a primary relay for the processing of auditory information in the brainstem. The inferior colliculus is also part of the so-called brain aversion system as animals learn to switch off the electrical stimulation of this structure. The purpose of the present study was to determine whether associative learning occurs between aversion induced by electrical stimulation of the inferior colliculus and visual and auditory warning stimuli. Rats implanted with electrodes into the central nucleus of the inferior colliculus were placed inside an open-field and thresholds for the escape response to electrical stimulation of the inferior colliculus were determined. The rats were then placed inside a shuttle-box and submitted to a two-way avoidance paradigm. Electrical stimulation of the inferior colliculus at the escape threshold (98.12 ± 6.15 (A, peak-to-peak was used as negative reinforcement and light or tone as the warning stimulus. Each session consisted of 50 trials and was divided into two segments of 25 trials in order to determine the learning rate of the animals during the sessions. The rats learned to avoid the inferior colliculus stimulation when light was used as the warning stimulus (13.25 ± 0.60 s and 8.63 ± 0.93 s for latencies and 12.5 ± 2.04 and 19.62 ± 1.65 for frequencies in the first and second halves of the sessions, respectively, P0.05 in both cases. Taken together, the present results suggest that rats learn to avoid the inferior colliculus stimulation when light is used as the warning stimulus. However, this learning process does not occur when the neutral stimulus used is an acoustic one. Electrical stimulation of the inferior colliculus may disturb the signal transmission of the stimulus to be conditioned from the inferior colliculus to higher brain structures such as amygdala

  9. 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

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    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

  10. 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

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    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

  11. Dynamic temporal signal processing in the inferior colliculus of echolocating bats

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    Jen, Philip H.-S.; Wu, Chung Hsin; Wang, Xin

    2012-01-01

    In nature, communication sounds among animal species including humans are typical complex sounds that occur in sequence and vary with time in several parameters including amplitude, frequency, duration as well as separation, and order of individual sounds. Among these multiple parameters, sound duration is a simple but important one that contributes to the distinct spectral and temporal attributes of individual biological sounds. Likewise, the separation of individual sounds is an important temporal attribute that determines an animal's ability in distinguishing individual sounds. Whereas duration selectivity of auditory neurons underlies an animal's ability in recognition of sound duration, the recovery cycle of auditory neurons determines a neuron's ability in responding to closely spaced sound pulses and therefore, it underlies the animal's ability in analyzing the order of individual sounds. Since the multiple parameters of naturally occurring communication sounds vary with time, the analysis of a specific sound parameter by an animal would be inevitably affected by other co-varying sound parameters. This is particularly obvious in insectivorous bats, which rely on analysis of returning echoes for prey capture when they systematically vary the multiple pulse parameters throughout a target approach sequence. In this review article, we present our studies of dynamic variation of duration selectivity and recovery cycle of neurons in the central nucleus of the inferior colliculus of the frequency-modulated bats to highlight the dynamic temporal signal processing of central auditory neurons. These studies use single pulses and three biologically relevant pulse-echo (P-E) pairs with varied duration, gap, and amplitude difference similar to that occurring during search, approach, and terminal phases of hunting by bats. These studies show that most collicular neurons respond maximally to a best tuned sound duration (BD). The sound duration to which these neurons are

  12. La fauna del pleistoceno inferior de la Sierra de Quibas (Abanilla, Murcia

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    Szyndlar, Z.

    1999-08-01

    de las serpientes, Elaphe cf. E. sealaris, apenas se hallan representadas en el registro fósil. Hay además varias especies de aves cuya aparición en Quibas supone la primera cita en el Pleistoceno inferior de la Península Ibérica. Entre los mamíferos posee una especial relevancia la presencia del cercopitécido Macaca sylvanus. La asociación de los taxones Arvieola deuealion, Castillomys rivas rivas, Eliomys intermedius, Equus altidens y Capra sp. aff. C. alba permite la correlación con Plines 1, Orce 3 y Venta Micena, entre otros. El yacimiento de Quibas puede situarse, por tanto, antes del final del Pleistoceno inferior, con una antigüedad entre 1.3 y 1 Ma. Por lo que se refiere a las condiciones paleoclimáticas, podemos inferir a partir de la asociación faunística un régimen xerófilo, muy semejante al actual en el área geográfica, aunque quizás con valores de humedad y temperatura algo superiores. El entorno de la cavidad kárstica estaba formado por roquedo calcáreo con áreas abiertas de matorral, pero en las proximidades se desarrollaron humedales y zonas arboladas, como así lo atestigua la presencia de aves y micromamíferos típicos de estos hábitats.

  13. Tratamiento de la isquemia crítica de miembros inferiores

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    Samir Jozami

    2010-01-01

    Full Text Available RESUMENIntroducciónLa isquemia crítica de miembros inferiores representa una manifestación extrema de laenfermedad vascular periférica crónica. La revascularización quirúrgica es el tratamientode elección para los pacientes con esta patología, ya que pese a ser un procedimiento invasivoreduce la tasa de amputación y de mortalidad. Sin embargo, tiene una tasa alta de complicaciones.Durante la última década, el perfeccionamiento y la introducción de nuevas tecnologíaspercutáneas han derivado en un crecimiento importante en la estrategia endovascular.Su baja morbilidad comparada con la de la alternativa quirúrgica ha llevado a un rápido yexplosivo incremento en su indicación.ObjetivoEvaluar los resultados clínicos en pacientes con lesiones críticas de miembros inferiorestratados de forma endovascular en un centro de alto volumen.Material y métodosDesde enero de 2005 hasta diciembre de 2008 se realizaron 60 procedimientos en 55 pacientes.ResultadosLa edad de los pacientes fue de 72,5 ± 10,6 años (rango 49-91; el 60,7% eran de sexomasculino, el 57% padecían diabetes y el 48,8%, enfermedad coronaria. El 50% de los pacientespresentaron dolor del miembro en reposo y el resto, lesiones tróficas menores en el41% y mayores en el 9%. Se trataron en total 74 lesiones: 14 aortoilíacas, 23 femoropoplíteas,28 infrapoplíteas y 9 bypass vasculares. En el seguimiento a 30 días, la tasa de reintervenciónde urgencia fue del 10,9%, la de amputación del 5,4%, la de muerte del 3,6% y la de eventoscardíacos mayores (muerte, infarto agudo de miocardio, accidente cerebrovascular,reintervención o amputación fue del 10,9%. Luego de 30 días, el seguimiento alejado (media727 ± 442 días arrojó las siguientes tasas: reintervención 11,7%, amputación 7,4%,infarto agudo de miocardio 2%, accidente cerebrovascular 2%, muerte 11,7% y eventos cardíacosmayores 27,4%. Las tasas de reintervención, amputación y eventos cardíacos mayoresdurante

  14. Correlações entre as estruturas dos membros inferiores Correlations between lower limb structures

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    Francis Trombini-Souza

    2009-09-01

    Full Text Available A literatura sugere que mudanças no ângulo Q podem alterar o arco plantar longitudinal e que um mau alinhamento do retropé poderia também modificar a postura do antepé. Contudo, não foram encontrados estudos que correlacionem quantitativamente, na postura ortostática bipodal, todos esses segmentos. Assim, o propósito deste estudo foi avaliar quantitativamente e verificar eventuais correlações entre o ângulo Q, arco plantar longitudinal, alinhamento frontal do tendão do calcâneo e antepé, na postura ortostática bipodal, por meio de fotogrametria. Foram avaliados 30 indivíduos jovens (60 membros inferiores de ambos os sexos, com idade entre 18 e 24 anos. Foi feita captura fotográfica digital no plano frontal anterior de joelho e antepé; no plano frontal posterior, do tendão do calcâneo; e da impressão plantar exposta no podoscópio. Os dados foram analisados estatisticamente e o nível de signficância fixado em 5%. Foram obtidas as seguintes correlações entre: ângulo Q X arco plantar, r=0,29 (p=0,021; ângulo Q X antepé, r=0,23 (p=0,092; ângulo Q X tendão do calcâneo, r=0,06 (p=0,627; arco plantar X antepé, r=0,09 (p=0,464; arco plantar X tendão do calcâneo, r=-0,05 (p=0,680; e antepé X tendão do calcâneo, r=-0,02 (p=0,857. A única correlação significativa encontrada, embora fraca, foi entre o ângulo Q e o arco plantar longitudinal medial, o que sugere cautela ao se inferirem correlações entre estruturas dos membros inferiores.Literature often reports that changes in the Q angle may alter the longitudinal plantar arch and that a misalignment of the rearfoot might also modify forefoot position. However, no studies could be found that quantitatively establish correlations between those lower limb segments in orthostatic bipedal posture. The goal of this study was to quantitatively assess possible correlations between the Q angle, longitudinal plantar arch, frontal forefoot and rearfoot alignment in bipedal

  15. Supplementary inferior phrenic artery embolization in the interventional treatment of hemoptysis

    Institute of Scientific and Technical Information of China (English)

    LIU Feng-yong; WANG Mao-qiang; FAN Qing-sheng; DUAN Feng; WANG Zhi-jun; SONG Peng

    2009-01-01

    Background Transcatheter bronchial artery embolization (BAE) is widely used for the treatment of hemoptysis and the immediate success rate is high, but there are still some hemorrhage recurrences. One of the common reasons for failure of BAE is collateral branches as blood supply. The inferior phrenic artery (IPA) is one of the most common collateral branches that is scarcely reported. Our purpose was to observe manifestations of IPA supplying to hemoptysis and evaluate the efficacy and safety of IPA embolization.Methods Angiography during interventional treatment of 178 hemoptysis patients in the past 7 years confirmed that IPA hemorrhage resulted in hemoptysis in 25 patients (26-67 years old) who had: lung cancer (11 patients), bronchiectasis (11 patients), chronic lung inflammation (2 patients), and pulmonary tuberculosis (1 patient). Among the 25 patients, 7 patients had twice interventional operations within one week and 6 patients still experienced intraoperative hemoptysis after conventional embolization of the bronchial artery, the internal thoracic artery, and the intercostal artery, then had the second interventional operation immediately. The total number of cases were 191. Selective embolization of the IPA was performed using polyvinyl alcohol microspheres, gelatin sponge particles, and microcoil. The safety and clinical significance of IPA embolization were evaluated. The Pearson χ2 test and Fisher's exact probability test were used in this study.Results Selective IPA angiography showed increased diameter of the IPA, disorganization of the branches, and varying degrees of angiogenesis. In 11 cases, contrast material was seen in vessels supplying the tumor and in the tumor. In 9 cases, contrast material had leaked into the area supplied by the IPA; in 8 cases, non-specific flake-like deposits of contrast material were seen; and in 14 cases, abnormal communication or shunt was visualized. Lesions were closely related to the pleura in 25 patients

  16. Excitatory and inhibitory projections in parallel pathways from the inferior colliculus to the auditory thalamus

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    Jeffrey Garrett Mellott

    2014-11-01

    Full Text Available Individual subdivisions of the medial geniculate body (MG receive a majority of their ascending inputs from 1 or 2 subdivisions of the inferior colliculus (IC. This establishes parallel pathways that provide a model for understanding auditory projections from the IC through the MG and on to auditory cortex. A striking discovery about the tectothalamic circuit was identification of a substantial GABAergic component. Whether GABAergic projections match the parallel pathway organization has not been examined. We asked whether the parallel pathway concept is reflected in guinea pig tectothalamic pathways and to what degree GABAergic cells contribute to each pathway. We deposited retrograde tracers into individual MG subdivisions (ventral, MGv; medial, MGm; dorsal, MGd; suprageniculate, MGsg to label tectothalamic cells and used immunochemistry to identify GABAergic cells. The MGv receives most of its IC input (~75% from the IC central nucleus (ICc; MGd and MGsg receive most of their input (~70% from IC dorsal cortex (ICd; and MGm receives substantial input from both ICc (~40% and IC lateral cortex (~40%. Each MG subdivision receives additional input (up to 32% from non-dominant IC subdivisions, suggesting cross-talk between the pathways. The proportion of GABAergic cells in each pathway depended on the MG subdivision. GABAergic cells formed ~20% of IC inputs to MGv or MGm, ~11% of inputs to MGd, and 4% of inputs to MGsg. Thus, non-GABAergic (i.e., glutamatergic cells are most numerous in each pathway with GABAergic cells contributing to different extents. Despite smaller numbers of GABAergic cells, their distributions across IC subdivisions mimicked the parallel pathways. Projections outside the dominant pathways suggest opportunities for excitatory and inhibitory crosstalk. The results demonstrate parallel tectothalamic pathways in guinea pigs and suggest numerous opportunities for excitatory and inhibitory interactions within and between pathways.

  17. Ionotropic glutamate receptor expression in preganglionic neurons of the rat inferior salivatory nucleus.

    Science.gov (United States)

    Kim, M; Chiego, D J; Bradley, R M

    2008-02-29

    Glutamate receptor (GluR) subunit composition of inferior salivatory nucleus (ISN) neurons was studied by immunohistochemical staining of retrogradely labeled neurons. Preganglionic ISN neurons innervating the von Ebner or parotid salivary glands were labeled by application of a fluorescent tracer to the lingual-tonsilar branch of the glossopharyngeal nerve or the otic ganglion respectively. We used polyclonal antibodies to glutamate receptor subunits NR1, NR2A, NR2B, (NMDA receptor subunits) GluR1, GluR2, GluR3, GluR4 (AMPA receptor subunits), and GluR5-7, KA2 (kainate receptor subunits) to determine their expression in ISN neurons. The distribution of the NMDA, AMPA and kainate receptor subunits in retrogradely labeled ISN neurons innervating the von Ebner and parotid glands was qualitatively similar. The percentage of retrogradley labeled ISN neurons innervating the parotid gland expressing the GluR subunits was always greater than those innervating the von Ebner gland. For both von Ebner and parotid ISN neurons, NR2A subunit staining had the highest expression and the lowest expression of GluR subunit staining was NR2B for von Ebner ISN neurons and GluR1 for parotid ISN neurons. The percentage of NR2B and GluR4 expressing ISN neurons was significantly different between the two glands. The percentage of ISN neurons that expressed GluR receptor subunits ranged widely indicating that the distribution of GluR subunit expression differs amongst the ISN neurons. While ISN preganglionic neurons express all the GluR subunits, differences in the percentage of ISN neurons expression between neurons innervating the von Ebner and parotid glands may relate to the different functional roles of these glands.

  18. Surgical management of renal cell carcinoma with inferior vena caval thrombus: A teaching hospital experience

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    Kulkarni Jagdeesh

    2007-01-01

    Full Text Available Purpose: To evaluate the outcome of patients of renal cell carcinoma (RCC with inferior vena caval (IVC thrombus treated by radical nephrectomy and IVC thrombectomy in terms of clinical and pathological factors and prognosis. Materials and Methods: Sixty-three consecutive patients of RCC with IVC thrombus who underwent radical nephrectomy with IVC thrombectomy between June 1993 and May 2003 were included in this retrospective analysis. Data was analyzed in terms of clinical factors, such as level of thrombus, and pathological factors, such as grade, local invasion and N status. Results: Tumor thrombus level was infrahepatic in 35 patients, retrohepatic in 20 and suprahepatic in 8, including 5 with right atrial thrombus. The immediate post-operative mortality was 3%, and the incidence of major post-operative complications was 34%, but most of them improved after conservative management except one who needed surgery for burst abdomen. The disease free survival (DFS was 48.5%, 50.6%, 66.6% and 40% for infrahepatic, retrohepatic, suprahepatic and intra-atrial tumors, respectively. Of the histological types, patients with clear cell tumors had the best prognosis; those with granular cell had the worst prognosis (DFS of 53.5% vs 33.3%, though statistically not significant. Grade-2 tumors had better prognosis than grade-4 tumors (DFS 66.6% vs 0%, P < 0.001. Sixty-eight percent of patients without perinephric fat invasion were free of disease as compared to 31% of those with perinephric fat invasion (P < 0.01. Further, N status showed DFS of 60.9% in patients with negative nodes and 30% in patients with positive nodes (P < 0.05. Conclusion: Though surgery for RCC with IVC thrombus has high morbidity, it can give good results in terms of prolonged DFS in expert hands. Regarding long-term survival, pathological factors, such as local stage and grade, are more important than clinical factors, such as level of thrombus.

  19. No Effects of Bilateral tDCS over Inferior Frontal Gyrus on Response Inhibition and Aggression.

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    Franziska Dambacher

    Full Text Available Response inhibition is defined as the capacity to adequately withdraw pre-planned responses. It has been shown that individuals with deficits in inhibiting pre-planned responses tend to display more aggressive behaviour. The prefrontal cortex is involved in both, response inhibition and aggression. While response inhibition is mostly associated with predominantly right prefrontal activity, the neural components underlying aggression seem to be left-lateralized. These differences in hemispheric dominance are conceptualized in cortical asymmetry theories on motivational direction, which assign avoidance motivation (relevant to inhibit responses to the right and approach motivation (relevant for aggressive actions to the left prefrontal cortex. The current study aimed to directly address the inverse relationship between response inhibition and aggression by assessing them within one experiment. Sixty-nine healthy participants underwent bilateral transcranial Direct Current Stimulation (tDCS to the inferior frontal cortex. In one group we induced right-hemispheric fronto-cortical dominance by means of a combined right prefrontal anodal and left prefrontal cathodal tDCS montage. In a second group we induced left-hemispheric fronto-cortical dominance by means of a combined left prefrontal anodal and right prefrontal cathodal tDCS montage. A control group received sham stimulation. Response inhibition was assessed with a go/no-go task (GNGT and aggression with the Taylor Aggression Paradigm (TAP. We revealed that participants with poorer performance in the GNGT displayed more aggression during the TAP. No effects of bilateral prefrontal tDCS on either response inhibition or aggression were observed. This is at odds with previous brain stimulation studies applying unilateral protocols. Our results failed to provide evidence in support of the prefrontal cortical asymmetry model in the domain of response inhibition and aggression. The absence of t

  20. Dissociated neurons and glial cells derived from rat inferior colliculi after digestion with papain.

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    Kaiser, Odett; Aliuos, Pooyan; Wissel, Kirsten; Lenarz, Thomas; Werner, Darja; Reuter, Günter; Kral, Andrej; Warnecke, Athanasia

    2013-01-01

    The formation of gliosis around implant electrodes for deep brain stimulation impairs electrode-tissue interaction. Unspecific growth of glial tissue around the electrodes can be hindered by altering physicochemical material properties. However, in vitro screening of neural tissue-material interaction requires an adequate cell culture system. No adequate model for cells dissociated from the inferior colliculus (IC) has been described and was thus the aim of this study. Therefore, IC were isolated from neonatal rats (P3_5) and a dissociated cell culture was established. In screening experiments using four dissociation methods (Neural Tissue Dissociation Kit [NTDK] T, NTDK P; NTDK PN, and a validated protocol for the dissociation of spiral ganglion neurons [SGN]), the optimal media, and seeding densities were identified. Thereafter, a dissociation protocol containing only the proteolytic enzymes of interest (trypsin or papain) was tested. For analysis, cells were fixed and immunolabeled using glial- and neuron-specific antibodies. Adhesion and survival of dissociated neurons and glial cells isolated from the IC were demonstrated in all experimental settings. Hence, preservation of type-specific cytoarchitecture with sufficient neuronal networks only occurred in cultures dissociated with NTDK P, NTDK PN, and fresh prepared papain solution. However, cultures obtained after dissociation with papain, seeded at a density of 2×10(4) cells/well and cultivated with Neuro Medium for 6 days reliably revealed the highest neuronal yield with excellent cytoarchitecture of neurons and glial cells. The herein described dissociated culture can be utilized as in vitro model to screen interactions between cells of the IC and surface modifications of the electrode.