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Sample records for base craneal anterior

  1. Ultrasonografía craneal neonatal

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    Carmen Gregoria Ustáriz Becerra

    2013-01-01

    Full Text Available La neuroecografía está posicionada en la práctica clínica, de acuerdo a la literatura consultada, como un procedimiento con una especificidad y efectividad que permite dar un reporte diagnóstico con seguridad. Esta técnica tiene como ventajas la exploración en tiempo real, el carácter atóxico e inocuo del procedimiento y el corto tiempo en el que se realiza, según la experticia del realizador. Como herramienta diagnóstica en recién nacidos pretérminos una de las principales indicaciones para la solicitud del procedimiento es poder hacer la identificación de las alteraciones visibles en la anatomía macroscópica, teniendo en cuenta las ventajas proporcionadas por la ventana acústica utilizada en el estudio sonográfico, las cuales dependen principalmente de la proximidad del transductor a la neuroanatomía que se desea explorar. [Ustáriz CG, Redondo LC, Avendaño LC, Noguera EC. Ultrasonografía craneal neonatal, revisión de tema. MedUNAB 2012; 15(3: 167-174].

  2. Abordaje subcraneal discusión y revisión histórica de la técnica quirúrgica Anterior subcranial approach: Discussion and historical review of the surgical technique

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    I. Zubillaga Rodríguez

    2009-02-01

    Full Text Available Introducción. La cirugía de la base craneal es en la actualidad una realidad que se ha ido consolidando en las últimas décadas. El vertiginoso avance tecnológico desarrollado ha actuado como motor en la evolución de las técnicas quirúrgicas que abordan dicha región anatómica. Su impulso definitivo se ha cimentado en el concepto básico de equipo multidisciplinario. Material y métodos. Se describe el abordaje subcraneal como alternativa a los tradicionales abordajes a la base craneal anterior. Discusión y revisión histórica de los distintos pasos claves en la realización del mismo. Discusión. La elección del abordaje más adecuado a la base craneal en cada caso es esencial para la obtención de resultados quirúrgicos globales satisfactorios. Inicialmente dependerá de la localización anatómica exacta de la lesión dentro de la base craneal y de su extensión tridimensional, así como de la naturaleza de la misma. El abordaje subcraneal representa un paso importante en el desarrollo de las técnicas quirúrgicas de la base craneal. Conclusiones. El abordaje subcraneal permite una amplia y óptima exposición de todos los planos de la fosa craneal anterior, desde el techo etmoidal anterior hasta el clivus-planum esfenoidale incluyendo los techos orbitarios. Este objetivo se logra sin retracción de los lóbulos frontales evitando de esta manera la morbimortalidad asociada que dicha maniobra conlleva. Favorece el manejo precoz preciso de patología oncológica con afectación intra-extradural y el tratamiento de fracturas tras impactos de alta energía con afectación de la fosa craneal anterior.Introduction. Skull base surgery is now a reality that has become consolidated over the last decades. The dizzyingly rapid technological advances that have taken place have served as a motor for the development of surgical techniques to approach this anatomic region. The foundation for the definitive push forward of this technique was

  3. Malformaciones craneales en larvas y juveniles de peces cultivados

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    Wilfrido Argüello-Guevara

    2014-11-01

    Full Text Available Las malformaciones óseas en peces cultivados representan un gran problema en acuicultura, no sólo por las pérdidas económicas que puede generar el mantenimiento de peces que no serán utilizados, sino también por las complicaciones a nivel fisiológico y morfológico que sufren los peces a lo largo de su ciclo de vida. Estas malformaciones pueden tener inicio desde los primeros estados de desarrollo y estar asociadas a una degeneración de las estructuras óseas con la edad, o a factores genéticos, nutricionales, ambientales, de manejo o una interacción entre éstas, haciéndose difícil la determinación de un solo agente causal. La presente revisión resume la información existente sobre la tipología, momento de aparición y posibles factores causales asociados a las malformaciones esqueléticas con particular énfasis en las malformaciones a nivel craneal.

  4. Paquimeningitis craneal hipertrófica idiopática.

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    Jairo Lizarazo

    2004-06-01

    Full Text Available La paquimeningitis craneal hipertrófica idiopática es un raro proceso inflamatorio crónico de etiología desconocida que produce engrosamiento de la duramadre y alteraciones neurológicas progresivas debido a la compresión de estructuras vecinas. Se presenta el caso de una mujer adulta con un cuadro clínico crónico de cefalea, fiebre, pérdida progresiva de la visión y neuropatía óptica bilateral. El diagnóstico se basó en la visualización de la duramadre engrosada en las neuroimágenes y en la exclusión de causas conocidas mediante estudios histopatológicos. La terapia con corticoesteroides mejoró la cefalea pero no el déficit visual. El diagnóstico y el seguimiento de esta entidad se han facilitado con la utilización de la resonancia magnética cerebral con medio de contraste. La biopsia de duramadre sigue siendo la regla de oro para el diagnóstico definitivo de la enfermedad. La terapia con esteroides produce mejoría en un buen número de pacientes; sin embargo, son frecuentes las recaídas por lo que es necesario el uso concomitante de otro inmunosupresor como la ciclofosfamida o la azatioprina. La mortalidad es baja, pero son comunes las secuelas neurológicas definitivas.

  5. Hidroxiapatita en defectos óseos craneales: Comunicación previa

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    Susana A Fernández Benítez

    1997-12-01

    Full Text Available Se exponen los resultados iniciales de un ensayo experimental y clínico, con gránulos de hidroxiapatita como implante en defectos óseos craneales aun radiológicos y microscópicos (BAAF el tiempo de los pasos de osificación craneal. Hubo crecimiento de fibroblasto en 7 días; en 2 meses y medio, crecimiento de osteoblastos y de hueso intramembranoso. En 3 meses la plastia presentaba consistencia ósea palpableThe initial results of an experimental and clinical assay using hydroxyapatite granules as implants in skull defects over 3 cm are exposed. An attempt is made to verify by clinical, radiological and microscopic examinations (BAAF the time of the cranial ossification steps. It was observed a growth of fibroblasts in 7 days, and of osteoblasts and intramembranous bone in 2 months and a half. 3 months later the plastic presented a palpable osteal consistency

  6. The anterior interhemispheric approach: a safe and effective approach to anterior skull base lesions.

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    Mielke, Dorothee; Mayfrank, Lothar; Psychogios, Marios Nikos; Rohde, Veit

    2014-04-01

    Many approaches to the anterior skull base have been reported. Frequently used are the pterional, the unilateral or bilateral frontobasal, the supraorbital and the frontolateral approach. Recently, endoscopic transnasal approaches have become more popular. The benefits of each approach has to be weighted against its complications and limitations. The aim of this study was to investigate if the anterior interhemispheric approach (AIA) could be a safe and effective alternative approach to tumorous and non-tumorous lesions of the anterior skull base. We screened the operative records of all patients with an anterior skull base lesion undergoing transcranial surgery. We have used the AIA in 61 patients. These were exclusively patients with either olfactory groove meningioma (OGM) (n = 43), ethmoidal dural arteriovenous fistula (dAVF) ( n = 6) or frontobasal fractures of the anterior midline with cerebrospinal fluid (CSF) leakage ( n = 12). Patient records were evaluated concerning accessibility of the lesion, realization of surgical aims (complete tumor removal, dAVF obliteration, closure of the dural tear), and approach related complications. The use of the AIA exclusively in OGMs, ethmoidal dAVFs and midline frontobasal fractures indicated that we considered lateralized frontobasal lesions not suitable to be treated successfully. If restricted to these three pathologies, the AIA is highly effective and safe. The surgical aim (complete tumor removal, complete dAVF occlusion, no rhinorrhea) was achieved in all patients. The complication rate was 11.5 % (wound infection (n = 2; 3.2 %), contusion of the genu of the corpus callosum, subdural hygroma, epileptic seizure, anosmia and asymptomatic bleed into the tumor cavity (n = 1 each). Only the contusion of the corpus callosum was directly related to the approach (1.6 %). Olfaction, if present before surgery, was preserved in all patients, except one (1.6 %). The AIA is an effective and a safe approach

  7. Glaucoma anterior chamber morphometry based on optical Scheimpflug images.

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    Alonso, Ruiz Simonato; Ambrósio Junior, Renato; Paranhos Junior, Augusto; Sakata, Lisandro Massanori; Ventura, Marcelo Palis

    2010-01-01

    To compare the performance of gonioscopy and noncontact morphometry with anterior chamber tomography (High Resolution Pentacam - HR) using optical Scheimpflug images in the evaluation of the anterior chamber angle (ACA). Transversal study. 112 eyes from 74 subjects evaluated at the Glaucoma Department, Fluminense Federal University, underwent gonioscopy and Pentacam HR. Using gonioscopy, the ACA was graded using the Shaffer Classification (SC) by a single experienced examiner masked to the Pentacam HR findings. Narrow angle was determined in eyes in which the posterior trabecular meshwork could not be seen in two or more quadrants on non-indentation gonioscopy (SC Grade 2 or less). Pentacam HR images of the nasal and temporal quadrants were evaluated by custom software to automatically obtain anterior chamber measurements, such as: anterior chamber angle (ACA), anterior chamber volume (ACV) and anterior chamber depth (ACD). Based on gonioscopy results, 74 (60.07%) eyes of patients classified as open-angle (SC 3 and 4) and 38 (33.93%) eyes of patients classified as narrow-angle (SC 1 and 2). Noncontact morphometry with Scheimpflug images revealed a mean ACA of 39.20 ± 5.31 degrees for open-angle and 21.18 ± 7.98 degrees for narrow-angle. The open-angle group showed significant greater ACV and ACD values when compared to narrow-angle group (ACV of 193 ± 36 mm³ vs. 90 ± 25 mm³, respectively, p<0.001; and ACD of 3,09 ± 0,42 mm vs. 1,55 ± 0,64 mm, respectively, p<0.0001.). In screening eyes with open-angle and narrow-angle with the Pentacam ACA of 20º (SC Grade 2) using the ROC curves, the analysis showed 52.6% of sensitivity and 100% of specificity. The Pentacam showed ability in detecting eyes at risk for angle closure analyzing ACV and ACD.

  8. Robotic Anterior and Midline Skull Base Surgery: Preclinical Investigations

    International Nuclear Information System (INIS)

    O'Malley, Bert W.; Weinstein, Gregory S.

    2007-01-01

    Purpose: To develop a minimally invasive surgical technique to access the midline and anterior skull base using the optical and technical advantages of robotic surgical instrumentation. Methods and Materials: Ten experimental procedures focusing on approaches to the nasopharynx, clivus, sphenoid, pituitary sella, and suprasellar regions were performed on one cadaver and one live mongrel dog. Both the cadaver and canine procedures were performed in an approved training facility using the da Vinci Surgical Robot. For the canine experiments, a transoral robotic surgery (TORS) approach was used, and for the cadaver a newly developed combined cervical-transoral robotic surgery (C-TORS) approach was investigated and compared with standard TORS. The ability to access and dissect tissues within the various areas of the midline and anterior skull base were evaluated, and techniques to enhance visualization and instrumentation were developed. Results: Standard TORS approaches did not provide adequate access to the midline and anterior skull base; however, the newly developed C-TORS approach was successful in providing the surgical access to these regions of the skull base. Conclusion: Robotic surgery is an exciting minimally invasive approach to the skull base that warrants continued preclinical investigation and development

  9. Fungal Infection of the Sinus and Anterior Skull Base

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    Morteza Javadi

    2008-11-01

    Full Text Available   Abstract   Background: Invasive fungal infection is an opportunistic infection caused commonly   by mucoraccae and aspergillus. It mostly occurs in patients with underlying disease.   Since it has a high mortality and morbidity rate, considering a treatment strategy seems   necessary.   Objective: Since there has not been a clear protocol for treating these patients, we decided   to establish a protocol for fungal infection of sinus and anterior skull base management.   Methods: This retrospective and descriptive case study series included 30 patients.   After confirming the pathogen, the authors came to a proper protocol for treatment which   is mentioned later.   Results: The site involvement included nose and orbital cavity (53.3%, anterior skull   base and brain in conjunction with sinonasal (36.6% and simple nasal cavity involvement   (10%. 86.6% of the patients had underlying diseases. 56.6% of patients had diabetes   as a single underlying disease, while 13.3% had both diabetes and renal failure in   combination. Acute lymphocytic leukemia was present in 6.6%, renal failure in 3.3%, lupus   in 3.3% and chronic lymphocytic leukemia in 3.3% of patients. Mortality rate was   40%. We categorized the patients into 3 groups: only sinonasal, sinonasal and orbit, and   associated anterior skull base and brain involvement.   Conclusion: Early diagnosis is an important factor in improving survival. Anterior   skull base and brain involvement has a very poor prognosis.  

  10. Sobre la identidad del fragmento craneal atribuido a Homo sp. en Venta Mlcena (Orce Granada

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    Moyá-Solá, S.

    1987-12-01

    Full Text Available The internal morphology of the cranial fragment attributed to Homo from Venta Micena (Granada is analysed. The presence of a coronal suture close to lambda does not permit its attribution to the genus Homo. The distace between the coronal suture and lambda (4 cm., the presence of tentorial procces and the digital impresions strongly suggesst its attribution to a juvenil specimen of Equus stenonis.Se analiza la morfología de la cara interna del fragmento craneal de Venta Micena atribuido inicialmente al género Homo. Se detecta la presencia de la sutura coronal a cuatro centímetros del punto lambda. Ello, conjuntamente a las fuertes impresiones digitales del endocraneo y la presencia de una cresta del proceso oseo tentoríal hacen imposible la adscripción de esta pieza al género Homo., atribuyendose a Equus stenonis.

  11. A checklist for endonasal transsphenoidal anterior skull base surgery.

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    Laws, Edward R; Wong, Judith M; Smith, Timothy R; de Los Reyes, Kenneth; Aglio, Linda S; Thorne, Alison J; Cote, David J; Esposito, Felice; Cappabianca, Paolo; Gawande, Atul

    2016-06-01

    OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and decrease complication rates. Although the authors' institution has instituted a general preoperative "time-out" designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for transnasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery uses a completely different conceptual approach, set-up, instrumentation, and operative procedure. Therefore, it can be associated with different types of complications as compared with open cranial surgery. The authors hypothesized that a detailed, procedure-specific, preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and maximize both teambuilding and operational efficiency. Thus, the object of this study was to develop such a checklist for endonasal transsphenoidal anterior skull base surgery. METHODS An expert panel was convened that consisted of all members of the typical surgical team for transsphenoidal endoscopic cases: neurosurgeons, anesthesiologists, circulating nurses, scrub technicians, surgical operations managers, and technical assistants. Beginning with a general checklist, procedure-specific items were added and categorized into 4 pauses: Anesthesia Pause, Surgical Pause, Equipment Pause, and Closure Pause. RESULTS The final endonasal transsphenoidal anterior skull base surgery checklist is composed of the following 4 pauses. The Anesthesia Pause consists of patient identification, diagnosis, pertinent laboratory studies, medications, surgical preparation, patient positioning, intravenous/arterial access, fluid management

  12. Osteomielitis tuberculosa de la bóveda craneal Tubercular osteomielitis of the skull

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    Isael Olazábal Armas

    2013-03-01

    Full Text Available Introducción: la osteomielitis tuberculosa del cráneo es una entidad rara y sólo ocurre en el 0,01 % de los pacientes con infección por Mycobacterium Tuberculosis, aunque esta frecuencia de presentación se incrementa notablemente en las personas portadoras de algún grado de inmunodeficiencia. El cuadro clínico suele ser de inicio insidioso y caracterizarse por la presencia de dolor local de intensidad progresiva. Objetivo: presentar un caso clínico poco frecuente con osteomielitis crónica de la bóveda craneal, secundaria a infección por Mycobacterium Tuberculoso. Presentación del caso: paciente de 5 años de edad con historia de dolor y aumento de volumen de la región interparietal del cráneo. Al examen físico se constató aumento de volumen con fluctuación de dicha región y defecto óseo irregular. Se realizó Rayos x de cráneo donde se pudo observar una lesión osteolítica de la bóveda craneal. Se practicó exéresis del hueso. En la recuperación post operatoria, se utilizaron durante las 2 primeras semanas la vancomicina y el ceftriaxone. La evolución clínica no fue satisfactoria, hasta que se obtuvo un cultivo positivo de Mycobacterium Tuberculoso, momento en que se comenzó tratamiento específico antituberculoso. El paciente evolucionó favorablemente después de cinco semanas del diagnóstico inicial. Conclusiones: la osteomielitis tuberculosa de la bóveda craneal aunque es poco frecuente puede verse, sobre todo, en países con una alta prevalencia de la enfermedad. Su diagnóstico y tratamiento oportuno pueden evitar complicaciones intracraneales.Background: tubercular osteomielitis of the skull is a rare entity that only occurs in the 0.01 % of patients infected by Mycobacterium Tuberculosis, although this frequency of presentation increases significantly in people who are carriers of some degree of immunodeficiency. The clinical picture is usually insidious at the onset of the disease and is characterized by the

  13. Colgajo prefabricado occipital para cobertura de exposición ósea craneal Prefabricated occipital flap to cover craneal bone exposition

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    B. Rivas León

    2010-03-01

    Full Text Available La exposición del cráneo tras un tratamiento quirúrgico oncológico agresivo es un desafió reconstructivo para el cirujano plástico; los defectos pueden variar en dimensiones y complejidad, desde pequeños defectos, que pueden ser cubiertos con injertos dérmicos o colgajos locales, a defectos más extensos que requerirán de un colgajo libre para su cobertura. Presentamos el caso de un varón de 39 años de edad que presentó un defecto biparietal posterior a radioterapia y resección por carcinoma. El defecto fue cubierto con un colgajo prefabricado axial, tomado del área antebraquial e implantado bajo la piel cabelluda occipital, para posteriormente ser llevado al sitio del defecto. El colgajo axial occipital evolucionó satisfactoriamente y logramos cubrir el defecto en su totalidad, sin complicaciones. En conclusión, el colgajo prefabricado occipital aporta suficiente piel cabelluda con patrón vascular axial para cubrir hueso craneal expuesto, cuando no hay una mejor opción cosmética.Cranial bone exposition after an aggressive oncological treatment is a challenge for plastic surgeon; defects can range in size and complexity, from small defects which can be covered only with skin graft or local flaps, to extensive defects that will require a free flap cover. We report a case of a 39 years-old man, who presented soft tissue defect of biparietal area following to radiotherapy and carcinoma resection. This defect was covered by prefabricated axial flap, which was harvest of forearm area and implanted under occipital hair skin and subsequently transported to the defect. The axial occipital flap healed uneventfully with a good outcome; we managed to cover the scalp defect completely without complications. As a conclusion, prefabricated occipital flap provides enough hair skin, with axial vascularity pattern to cover cranial bone exposed, when there is not a better cosmetical option.

  14. Apoplejía pituitaria con parálisis del III par craneal: Reporte de caso

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    Miguel Pinto Valdivia

    2011-10-01

    Full Text Available Se describe el caso de un varón de 65 años de edad, sin antecedentes patológicos de importancia, que acudió a emergencia del Hospital Nacional Cayetano Heredia por presentar cefalea intensa y ptosis palpebral izquierda. El examen físico mostró parálisis aislada del III par craneal izquierdo. Los análisis de laboratorio mostraron hiponatremia e hipopituitarismo y la resonancia magnética nuclear un adenoma pituitario con áreas de hemorragia e invasión de los senos cavernosos. El tratamiento incluyó glucocorticoides y descompresión quirúrgica transesfenoidal. La anatomía patológica confirmó el diagnóstico de infarto hemorrágico de un adenoma pituitario. El paciente fue dado de alta con terapia sustitutiva de levotiroxina y prednisona. La ptosis palpebral izquierda se recuperó en forma parcial. La apoplejía pituitaria es un síndrome clínico producido por un proceso expansivo dentro de la silla turca, secundario a hemorragia o infarto de un adenoma pituitario, que se caracteriza por cefalea, déficit visual, oftalmoplejía y alteración del nivel de conciencia. Este proceso expansivo puede comprimir los pares craneales en los senos cavernosos, produciendo diferentes grados de parálisis de los músculos oculomotores. La parálisis aislada del III par craneal es rara.(Rev Med Hered 2011;22:186-189.

  15. Importancia del estudio audiológico en los pacientes con trauma craneal Importance of the auditive study in patients with cranial trauma

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    Eulalia Alfonso Muñoz

    2005-03-01

    Full Text Available Se realizó un estudio de 50 pacientes con antecedentes de trauma craneal, atendidos en Consulta de Audiología del Hospital Militar “Dr. Carlos J. Finlay” en el período de enero de 2002 a diciembre de 2003. Los pacientes presentaban secuelas cocleo-vestibulares, y entre ellos predominó el sexo masculino (62,0 %, la edad de 16 a 30 años (52,0 % y las fracturas en la base del cráneo (según la naturaleza del trauma. A todos se les realizó un estudio audiológico detallado para determinar las lesiones que afectaron considerablemente su calidad de vidaA study of 50 patients with cranial trauma history that received attention at the Audiology Department of “Dr. Carlos J. Finlay” Military Hospital from January 2002 to December 2003, was conducted. The patients presented cochlear-vestibular sequelae. It was observed a predominance of males (62.0 %, of age 16-30 (52.0 % and of fractures in the base of cranium (according to the nature of the trauma. All of them underwent a detailed auditive test to determine the lesions considerably affecting their quality of life

  16. Visual outcome after fractionated stereotactic radiation therapy of benign anterior skull base tumors

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    Astradsson, Arnar; Wiencke, Anne Katrine; Munck af Rosenschold, Per

    2014-01-01

    To determine visual outcome including the occurrence of radiation induced optic neuropathy (RION) as well as tumor control after fractionated stereotactic radiation therapy (FSRT) of benign anterior skull base meningiomas or pituitary adenomas. Thirty-nine patients treated with FSRT for anterior...

  17. La osteopatía craneal no mejora el estado de salud de niños con parálisis cerebral.

    OpenAIRE

    Molina Arias, Manuel; González de Dios, Javier

    2011-01-01

    Este artículo pretende valorar el efecto del tratamiento con osteopatía craneal (OC) sobre la salud general, la función motora y la calidad de vida de niños con parálisis cerebral (PC), así como el efecto sobre la calidad de vida de sus cuidadores.

  18. Open Approaches to the Anterior Skull Base in Children: Review of the Literature.

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    Wasserzug, Oshri; DeRowe, Ari; Ringel, Barak; Fishman, Gadi; Fliss, Dan M

    2018-02-01

    Introduction  Skull base lesions in children and adolescents are rare, and comprise only 5.6% of all skull base surgery. Anterior skull base lesions dominate, averaging slightly more than 50% of the cases. Until recently, surgery of the anterior skull base was dominated by open procedures and endoscopic skull base surgery was reserved for benign pathologies. Endoscopic skull base surgery is gradually gaining popularity. In spite of that, open skull base surgery is still considered the "gold standard" for the treatment of anterior skull base lesions, and it is the preferred approach in selected cases. Objective  This article reviews current concepts and open approaches to the anterior skull base in children in the era of endoscopic surgery. Materials and Methods  Comprehensive literature review. Results  Extensive intracranial-intradural invasion, extensive orbital invasion, encasement of the optic nerve or the internal carotid artery, lateral supraorbital dural involvement and involvement of the anterior table of the frontal sinus or lateral portion of the frontal sinus precludes endoscopic surgery, and mandates open skull base surgery. The open approaches which are used most frequently for surgical resection of anterior skull base tumors are the transfacial/transmaxillary, subcranial, and subfrontal approaches. Reconstruction of anterior skull base defects is discussed in a separate article in this supplement. Discussion  Although endoscopic skull base surgery in children is gaining popularity in developed countries, in many cases open surgery is still required. In addition, in developing countries, which accounts for more than 80% of the world's population, limited access to expensive equipment precludes the use of endoscopic surgery. Several open surgical approaches are still employed to resect anterior skull base lesions in the pediatric population. With this large armamentarium of surgical approaches, tailoring the most suitable approach to a

  19. Subcranial approach in the surgical treatment of anterior skull base trauma.

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    Schaller, B

    2005-04-01

    Fractures of the anterior skull base, because of the region's anatomical relationships, are readily complicated by neurological damage to the brain or cranial nerves. This review highlights the use of a subcranial approach in the operative treatment of injuries of the anterior skull base and compares it to the more traditional neurosurgical transcranial approach. The extended anterior subcranial approach takes advantage of the specific features of injuries in this region and allows direct access to the central anterior cranial base in order to repair fractures, close CSF fistulae and relieve of optic nerve compression. It avoids extensive frontal lobe manipulation. The success of the approach in achieving the aims of surgery with low morbidity is reviewed.

  20. Contribution to speech development of the right anterior putamen revealed with multivariate tensor-based morphometry.

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    Vlasova, Roza; Yalin Wang; Dirks, Holly; Dean, Douglas; O'Muircheartaigh, Jonathan; Gonzalez, Sara; Binh Kien Nguyen; Nelson, Marvin D; Deoni, Sean; Lepore, Natasha

    2017-07-01

    In our previous study1, we suggested that the difference between tensor-based metrics in the anterior part of the right putamen between 21 and 18 months age groups associated with speech development during this ages. Here we used a correlational analysis between verbal scores and determinant of the Jacobian matrix to confirm our hypothesis. Significant correlations in anterior part of the right putamen between verbal scores and surface metric were revealed in the 18 and 21 age groups.

  1. Skull base tumours part I: Imaging technique, anatomy and anterior skull base tumours

    International Nuclear Information System (INIS)

    Borges, Alexandra

    2008-01-01

    Advances in cross-sectional imaging, surgical technique and adjuvant treatment have largely contributed to ameliorate the prognosis, lessen the morbidity and mortality of patients with skull base tumours and to the growing medical investment in the management of these patients. Because clinical assessment of the skull base is limited, cross-sectional imaging became indispensable in the diagnosis, treatment planning and follow-up of patients with suspected skull base pathology and the radiologist is increasingly responsible for the fate of these patients. This review will focus on the advances in imaging technique; contribution to patient's management and on the imaging features of the most common tumours affecting the anterior skull base. Emphasis is given to a systematic approach to skull base pathology based upon an anatomic division taking into account the major tissue constituents in each skull base compartment. The most relevant information that should be conveyed to surgeons and radiation oncologists involved in patient's management will be discussed

  2. Postnatal development of the anterior skull base and nasal septum: CT study

    International Nuclear Information System (INIS)

    Kim, Kwan Soo; Kim, Hyung Jin; Lee, Kyung Hee; Roh, Hong Gee; Lim, Myung Kwan

    2002-01-01

    To know the normal CT appearance of the anterior skull base and nasal septum after birth. Coronal CT scans with a helical mode were performed from the nasal bone to the sphenoid sinus in 99 children whose ages ranged from 27 days to 14 years. We investigated the CT appearance of the developing anterior skull base and nasal septum with particular attention to the anteroposterior length of the anterior skull base and the ossification patterns of the cribriform plate, perpendicular plate, crista galli, and vomer. The anteroposterior length of the anterior skull base statistically significantly increased with age. The cribriform plate showed partial or complete ossification in at least one segment at more than 3 months of age and in all three segments at more than 6 months of age. Ossification of the cribriform plate occurred earlier in the middle segment than in the anterior and posterior segments. It began exclusively in the region of the lateral mass of the ethmoid and proceeded medially toward the crista galli. Partial ossification of the perpendicular plate was noted as early as 9 months of age, and complete ossification as early as 13 months of age. All children at 18 months and older showed at least partial ossification of the perpendicular plate. Partial ossification of the crista galli was noted as early as 27 days of age, and complete ossification as early as 3 months of age. CT showed complete ossification of the crista galli in all but two children at 6 months and older. The superior aspect of the vomer exhibited a V- or Y-shape on all CT scans in 66%(65/99) of children at any age. It appeared as an undivided single lump anteriorly and a V or Y posteriorly in 34%(34/99). Knowledge of the normal developing patterns of ossification of the anterior skull base and nasal septum could help prevent errors in interpreting CT scans in this region, especially in infants and young children

  3. Chondroblastoma with secondary aneurysmal bone cyst in the anterior skull base

    Directory of Open Access Journals (Sweden)

    Ming Jie Wang, MD, PhD

    2016-06-01

    Full Text Available Chondroblastoma with secondary aneurysmal bone cyst (ABC, especially in the anterior skull base, is an extremely rare condition. A 5-year-old boy presented with a large space-occupying lesion in the anterior skull base along with a left sided-epistaxis, proptosis and decreased vision. Radical excision of the lesion was performed by an endoscopic transnasal and transethmoidal approach. The patient recovered without any recurrence during a follow-up period of up to 28 months. Here, we review this rare case and discuss the clinical presentation and surgical treatment.

  4. Recommended standardized terminology of the anterior female pelvis based on a structured medical literature review.

    Science.gov (United States)

    Jeppson, Peter C; Balgobin, Sunil; Washington, Blair B; Hill, Audra Jolyn; Lewicky-Gaupp, Christina; Wheeler, Thomas; Ridgeway, Beri; Mazloomdoost, Donna; Balk, Ethan M; Corton, Marlene M; DeLancey, John

    2018-07-01

    The use of imprecise and inaccurate terms leads to confusion amongst anatomists and medical professionals. We sought to create recommended standardized terminology to describe anatomic structures of the anterior female pelvis based on a structured review of published literature and selected text books. We searched MEDLINE from its inception until May 2, 2016, using 11 medical subject heading terms to identify studies reporting on anterior female pelvic anatomy; any study type published in English was accepted. Nine textbooks were also included. We screened 12,264 abstracts, identifying 200 eligible studies along with 13 textbook chapters from which we extracted all pertinent anatomic terms. In all, 67 unique structures in the anterior female pelvis were identified. A total of 59 of these have been previously recognized with accepted terms in Terminologia Anatomica, the international standard on anatomical terminology. We also identified and propose the adoption of 4 anatomic regional terms (lateral vaginal wall, pelvic sidewall, pelvic bones, and anterior compartment), and 2 structural terms not included in Terminologia Anatomica (vaginal sulcus and levator hiatus). In addition, we identified 2 controversial terms (pubourethral ligament and Grafenberg spot) that require additional research and consensus from the greater medical and scientific community prior to adoption or rejection of these terms. We propose standardized terminology that should be used when discussing anatomic structures in the anterior female pelvis to help improve communication among researchers, clinicians, and surgeons. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Skull base tumours part I: Imaging technique, anatomy and anterior skull base tumours

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Instituto Portugues de Oncologia Francisco Gentil, Centro de Lisboa, Servico de Radiologia, Rua Professor Lima Basto, 1093 Lisboa Codex (Portugal)], E-mail: borgesalexandra@clix.pt

    2008-06-15

    Advances in cross-sectional imaging, surgical technique and adjuvant treatment have largely contributed to ameliorate the prognosis, lessen the morbidity and mortality of patients with skull base tumours and to the growing medical investment in the management of these patients. Because clinical assessment of the skull base is limited, cross-sectional imaging became indispensable in the diagnosis, treatment planning and follow-up of patients with suspected skull base pathology and the radiologist is increasingly responsible for the fate of these patients. This review will focus on the advances in imaging technique; contribution to patient's management and on the imaging features of the most common tumours affecting the anterior skull base. Emphasis is given to a systematic approach to skull base pathology based upon an anatomic division taking into account the major tissue constituents in each skull base compartment. The most relevant information that should be conveyed to surgeons and radiation oncologists involved in patient's management will be discussed.

  6. Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note.

    Science.gov (United States)

    Dolci, Ricardo Landini Lutaif; Todeschini, Alexandre Bossi; Santos, Américo Rubens Leite Dos; Lazarini, Paulo Roberto

    2018-04-19

    One of the main concerns in endoscopic endonasal approaches to the skull base has been the high incidence and morbidity associated with cerebrospinal fluid leaks. The introduction and routine use of vascularized flaps allowed a marked decrease in this complication followed by a great expansion in the indications and techniques used in endoscopic endonasal approaches, extending to defects from huge tumours and previously inaccessible areas of the skull base. Describe the technique of performing endoscopic double flap multi-layered reconstruction of the anterior skull base without craniotomy. Step by step description of the endoscopic double flap technique (nasoseptal and pericranial vascularized flaps and fascia lata free graft) as used and illustrated in two patients with an olfactory groove meningioma who underwent an endoscopic approach. Both patients achieved a gross total resection: subsequent reconstruction of the anterior skull base was performed with the nasoseptal and pericranial flaps onlay and a fascia lata free graft inlay. Both patients showed an excellent recovery, no signs of cerebrospinal fluid leak, meningitis, flap necrosis, chronic meningeal or sinonasal inflammation or cerebral herniation having developed. This endoscopic double flap technique we have described is a viable, versatile and safe option for anterior skull base reconstructions, decreasing the incidence of complications in endoscopic endonasal approaches. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  7. Sinonasal outcomes following endoscopic anterior skull base surgery with nasoseptal flap reconstruction: a prospective study.

    Science.gov (United States)

    Hanson, M; Patel, P M; Betz, C; Olson, S; Panizza, B; Wallwork, B

    2015-07-01

    To assess nasal morbidity resulting from nasoseptal flap use in the repair of skull base defects in endoscopic anterior skull base surgery. Thirty-six patients awaiting endoscopic anterior skull base surgery were prospectively recruited. A nasoseptal flap was used for reconstruction in all cases. Patients were assessed pre-operatively and 90 days post-operatively via the Sino-Nasal Outcome Test 20 questionnaire and visual analogue scales for nasal obstruction, pain, secretions and smell; endoscopic examination findings and mucociliary clearance times were also recorded. Sino-Nasal Outcome Test 20 questionnaire data and visual analogue scale scores for pain, smell and secretions showed no significant differences between pre- and post-operative outcomes, with visual analogue scale scores for nasal obstruction actually showing a significant improvement (p = 0.0007). A significant deterioration for both flap and non-flap sides was demonstrated post-operatively on endoscopic examination (p = 0.002 and p = 0.02 respectively). Whilst elevation of a nasoseptal flap in endoscopic surgery of the anterior skull base engendered significant clinical deterioration on examination post-operatively, quality of life outcomes showed that no such deterioration was subjectively experienced by the patient. In fact, there was significant nasal airway improvement following nasoseptal flap reconstruction.

  8. A new slit lamp-based technique for anterior chamber angle estimation.

    Science.gov (United States)

    Gispets, Joan; Cardona, Genís; Tomàs, Núria; Fusté, Cèlia; Binns, Alison; Fortes, Miguel A

    2014-06-01

    To design and test a new noninvasive method for anterior chamber angle (ACA) estimation based on the slit lamp that is accessible to all eye-care professionals. A new technique (slit lamp anterior chamber estimation [SLACE]) that aims to overcome some of the limitations of the van Herick procedure was designed. The technique, which only requires a slit lamp, was applied to estimate the ACA of 50 participants (100 eyes) using two different slit lamp models, and results were compared with gonioscopy as the clinical standard. The Spearman nonparametric correlation between ACA values as determined by gonioscopy and SLACE were 0.81 (p gonioscopy (Spaeth classification). The SLACE technique, when compared with gonioscopy, displayed good accuracy in the detection of narrow angles, and it may be useful for eye-care clinicians without access to expensive alternative equipment or those who cannot perform gonioscopy because of legal constraints regarding the use of diagnostic drugs.

  9. Reconstrucción craneal con biomateriales: Revisión histórica y estado actual Cranial reconstruction with biomaterials: Historical revision and current state

    Directory of Open Access Journals (Sweden)

    I. Zubillaga Rodríguez

    2007-04-01

    Full Text Available La reconstrucción de defectos craneofaciales es todavía hoy día un proceso desafiante. Se define craneoplastia como la reparación de un defecto o deformidad craneal. La persistencia de traumatismos craneofaciales y procedimientos neuroquirúrgicos aporta un número importante de casos que permiten un fascinante progreso y desarrollo de nuevos materiales. El objetivo de este artículo es la revisión histórica de los distintos métodos reconstructivos craneales empleados, comentando sus ventajas e inconvenientes según el tamaño y forma del defecto a reparar. Se presentan casos clínicos recientes reconstruidos con diversos biomateriales.Craniofacial defect reconstruction is still a challenging procedure. A cranioplasty is the treatment of a cranial defect or a deformity. Cranial injuries and neurosurgical procedures provide an important group of cases that allow the development of new materials and fascinating progress. The aim of this article is a historic review of the different cranial reconstructive techniques used, describing advantages and drawbacks. The biomaterials applied in recent cases are presented.

  10. Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft

    Directory of Open Access Journals (Sweden)

    Seung Gee Kwon

    2012-07-01

    Full Text Available BackgroundCranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction.MethodsBetween April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability.ResultsThe mean follow-up period was 11.8 months and the mean operation time for reconstruction was 8.4±3.36 hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures.ConclusionsThe reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.

  11. Endoscopic Endonasal Anterior Skull Base Surgery: A Systematic Review of Complications During the Past 65 Years.

    Science.gov (United States)

    Borg, Anouk; Kirkman, Matthew A; Choi, David

    2016-11-01

    Endoscopic skull base surgery is becoming more popular as an approach to the anterior skull base for tumors and cerebrospinal fluid (CSF) fistulae. It offers the advantages of better cosmesis and improved quality of life after surgery. We reviewed the complication rates reported in the literature. A literature search was performed in the electronic database Ovid MEDLINE (1950 to August 25, 2015) with the search item "([Anterior] AND Skull base surgery) AND endoscopic." We identified 82 relevant studies that included 7460 cases. An average overall complication rate of 17.1% (range 0%-68.0%) and a mortality rate of 0.4% (0%-10.0%) were demonstrated in a total of 82 studies that included 7460 cases. The average CSF leak rate for all studies was 8.9% (0%-40.0%) with meningiomas and clival lesions having the greatest CSF leak rates. The most frequent benign pathology encountered was pituitary adenomas (n = 3720, 49.8% of all cases) and the most frequent malignant tumor was esthesioneuroblastoma (n = 120, 1.6% of all cases). Studies that included only CSF fistula repairs had a lower average total complication rate (12.9%) but a greater rate of meningitis compared with studies that reported mixed pathology (2.4% vs. 1.3%). A trend towards a lower total complication rate with increasing study size was observed. The endoscopic approach is an increasingly accepted technique for anterior skull base tumor surgery and is associated with acceptable complication rates. Increasing experience with this technique can decrease rates of complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Fournier?s gangrene - delayed pedicle flap based upon the anterior abdominal wall

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    Ania Sliwinski

    2014-06-01

    Full Text Available Introduction Fournier’s gangrene is a poly-microbial necrotizing fasciitis that involves the perineum and/or external genitalia. Urgent surgical debridement is well recognized as essential acute treatment yet unique challenges arise for plastic surgical reconstruction to obtain a complete functional recovery. This case describes a successful delayed pedicle flap repair based upon the anterior abdominal wall. Case description A 24 year old man was admitted to ICU ten days after elective circumcision with Fournier’s gangrene. He underwent a number of surgical debridements, and was referred for plastic surgical management. He had penile reconstruction using a random pattern abdominal flap, which was performed as a three stage procedure including flap vascular delay technique. Discussion Perineal and penile skin loss can be significant and is difficult to repair. Various techniques have been used to reconstruct lost tissue: skin grafts, transposition of the testes and spermatic cords to the thigh, flaps, and other types of pediculated myocutaneous flaps. Muscle flap reconstruction provides an environment that allows for complete regeneration of the urethral epithelium but is bulky and unsightly. Skin grafts contract and may produce painful and dysfunctional reconstructions. This novel technique produces a functional, and aesthetic reconstruction. Conclusion Penile skin recovery following Fournier’s gangrene recovery is problematic. This case demonstrates the functionality of a delayed flap repair using the anterior abdominal wall.

  13. Superior interhemispheric approach for midline meningioma from the anterior cranial base.

    Science.gov (United States)

    Lévêque, S; Derrey, S; Martinaud, O; Gérardin, E; Langlois, O; Fréger, P; Hannequin, D; Castel, H; Proust, F

    2011-07-01

    For suprasellar meningioma, the fronto-basal exposure is considered the standard approach. The superior interhemispheric (IH) approach is less described in the literature. To assess the surgical complications, functional outcome (visual, olfaction), morbidity and mortality rates and late recurrence, after resection by superior IH approach of midline skull base meningioma. Between 1998 and 2008, 52 consecutive patients with midline meningioma on the anterior portion of the skull base (mean age: 63.8 ± 13.1; sex ratio F/M: 3.7) were operated on via the superior IH approach. After a mean follow-up of 56.9 ± 32.9 months, an independent neurosurgeon proposed a prospective examination of functional outcome to each patient, as well as a visual and olfactory function assessment. Fifty-two patients were divided into a group with olfactory groove meningioma (n=34) and another with tuberculum sellae meningioma (n=18). The outcome was characterized by postoperative complications in 13 patients (25%), mortality rate in two (3.8%) and long-term morbidity at in 17 (37%) of 50 surviving patients. Based on multivariate analysis, no prognosis factor was significant as regards the favorable outcome. The mean postoperative KPS score (86.6 ± 9.4) was significantly improved. However, dysexecutive syndrome was observed in four patients (8%), hyposmia-anosmia in 34 (68%) and visual acuity deteriorated in one (2%). The superior IH approach could be considered a safe anteriorly orientated midline approach for removal OGM and TSM meningioma. Copyright © 2011. Published by Elsevier Masson SAS.

  14. Identification and prognostic value of anterior gradient protein 2 expression in breast cancer based on tissue microarray.

    Science.gov (United States)

    Guo, Jilong; Gong, Guohua; Zhang, Bin

    2017-07-01

    Breast cancer has attracted substantial attention as one of the major cancers causing death in women. It is crucial to find potential biomarkers of prognostic value in breast cancer. In this study, the expression pattern of anterior gradient protein 2 in breast cancer was identified based on the main molecular subgroups. Through analysis of 69 samples from the Gene Expression Omnibus database, we found that anterior gradient protein 2 expression was significantly higher in non-triple-negative breast cancer tissues compared with normal tissues and triple-negative breast cancer tissues (p gradient protein 2 expression pattern. Furthermore, we performed immunohistochemical analysis. The quantification results revealed that anterior gradient protein 2 is highly expressed in non-triple-negative breast cancer (grade 3 excluded) and grade 1 + 2 (triple-negative breast cancer excluded) tumours compared with normal tissues. Anterior gradient protein 2 was significantly highly expressed in non-triple-negative breast cancer (grade 3 excluded) and non-triple-negative breast cancer tissues compared with triple-negative breast cancer tissues (p gradient protein 2 was significantly highly expressed in grade 1 + 2 (triple-negative breast cancer excluded) and grade 1 + 2 tissues compared with grade 3 tissues (p gradient protein 2 expression was significantly associated with histologic type, histological grade, oestrogen status and progesterone status. Univariate analysis of clinicopathological variables showed that anterior gradient protein 2 expression, tumour size and lymph node status were significantly correlated with overall survival in patients with grade 1 and 2 tumours. Cox multivariate analysis revealed anterior gradient protein 2 as a putative independent indicator of unfavourable outcomes (p = 0.031). All these data clearly showed that anterior gradient protein 2 is highly expressed in breast cancer and can be regarded as a putative biomarker for

  15. Carotid-anterior cerebral artery anastomosis on MR angiography: a university hospital-based study

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Saito, Naoko; Okada, Yoshitaka; Inoue, Kaiji [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

    2012-01-15

    Rarely in the anterior circulation, an anastomosis of the carotid and anterior cerebral arteries occurs when an anomalous branch arises from the ophthalmic segment of the internal carotid artery and anastomoses with the A1-A2 junction of the anterior communicating artery. Right-side predominance is known. To our knowledge, the incidence of carotid-anterior cerebral artery anastomosis has not been reported, so we researched cases in our institution records to determine incidence and investigated characteristic features of the condition on magnetic resonance (MR) angiography. To isolate such cases, we retrospectively reviewed cranial MR angiographic images of 3,491 consecutive patients in our institution. We found three cases with carotid-anterior cerebral artery anastomosis (two men, one woman), representing an incidence of 0.086%. The anastomosis was on the right in all three cases. A normal A1 segment of the anterior cerebral artery (ACA) was present in two cases but could not be identified in the remaining case on MR angiographic images that included source images. Two of the three patients demonstrated associated arterial variations in their carotid systems. On MR angiography, we observed a 0.086% incidence of carotid-anterior cerebral artery anastomosis in our institution and reaffirmed the right-side predominance of this anomaly. We found a high frequency of other associated arterial variations in the carotid system. (orig.)

  16. [Simultaneous intrusion and retraction of the anterior teeth using a three-piece base arch].

    Science.gov (United States)

    Liu, D; Bai, D; Wang, C; Sun, W; Guo, J; Xi, R

    2000-06-01

    To evaluate the effects of the three-piece base arch on overbite correction of Class II malocclusion. 20 patients with high angle, flared incisors were treated using a three-piece base arch appliance. The intrusion force of four upper incisors was adjusted to approximately 50 g. The line of force action was 2 mm distally to the resistant center(RC) and the retraction force was 20 g, the right and left posterior segments were joined by a palatal bar. Cephalograms were taken before treatment (T1) and six months after treatment (T2). The upper molars moved mesially 0.60 +/- 0.35 mm and the distance of the vertical extrusion was 0.80 +/- 0.52 mm. The distances of the upper central incisor retraction and intrusion were -4.20 +/- 2.12 mm and 3.10 +/- 0.54 mm respectively. The RC of the central incisor retracted -4.12 +/- 1.96 mm and intruded 3.20 +/- 0.66 mm. The axial inclination of the upper incisor-palatal plane changed from 123.21 degrees +/- 4.26 degrees to 116.00 degrees +/- 3.96 degrees. The three-piece segmented approach can effectively intrude and retract the upper anterior teeth for flared incisors and deep overbite.

  17. Defining the implant treatment volume for patients with low risk prostate cancer: does the anterior base need to be treated?

    International Nuclear Information System (INIS)

    D'Amico, Anthony V.; Davis, Ann; Vargas, Sara O.; Renshaw, Andrew A.; Jiroutek, Michael; Richie, Jerome P.

    1999-01-01

    Purpose: An increased incidence of acute urinary retention has been reported after interstitial prostate radiation therapy when the anterior base of the prostate gland receives 100% of the prescription dose. The frequency of prostate cancer in this location as a function of the pre-treatment prostate specific antigen (PSA), biopsy Gleason score, and 1992 American Joint Commission on Cancer Staging (AJCC) was determined. Methods and Materials: One hundred four men treated at the Brigham and Women's Hospital with radical prostatectomy for clinically localized prostate cancer between 1995-1996 comprised the study population. Prostatectomy specimens were whole mounted and the location of each tumor foci enumerated. Results: Of 269 foci of prostate cancer found in 39 low-risk prostate cancer patients (PSA 1c,2a ), a single focus (0.37%) was noted in the anterior base. Conversely, 20/355 (5.6%) and 18/251 (7.2%) tumor foci were noted in the anterior base in 43 patients with intermediate risk and 24 patients with high-risk disease, respectively. Conclusions: A new definition of the treatment volume excluding the anterior base for low-risk prostate cancer patients may be justified

  18. Abordajes endoscópicos a la base de cráneo anterior

    Directory of Open Access Journals (Sweden)

    Gonzalo De Los Santos

    2016-07-01

    Full Text Available Los abordajes endoscópicos a la base de cráneo anterior se han desarrollado de forma muy importante en las últimas décadas y continúan extendiéndose paralelamente a la aparición de nuevo instrumental y equipo que facilitan su aplicación. Factores importantes que han contribuido a ello son la posibilidad de acceder de forma directa a zonas difíciles y la disminución de morbilidad que pueden aportar, manteniendo los resultados esperados. Pero también tienen desventajas y limitaciones pues requieren conocimiento anatómico y el uso de material específico en un campo quirúrgico limitado por el espacio, estructuras anatómicas vitales y la visión bidimensional. La correcta planificación quirúrgica y la selección de los pacientes son elementos fundamentales. Esto nos permitirá determinar si es posible este tipo de abordaje, conocer la localización de la lesión, la zona de entrada al cráneo y el corredor que deberemos utilizar para ello. Los abordajes endoscópicos, correctamente indicados y planificados son procedimientos seguros y efectivos.

  19. Accuracy and reproducibility of voxel based superimposition of cone beam computed tomography models on the anterior cranial base and the zygomatic arches.

    Science.gov (United States)

    Nada, Rania M; Maal, Thomas J J; Breuning, K Hero; Bergé, Stefaan J; Mostafa, Yehya A; Kuijpers-Jagtman, Anne Marie

    2011-02-09

    Superimposition of serial Cone Beam Computed Tomography (CBCT) scans has become a valuable tool for three dimensional (3D) assessment of treatment effects and stability. Voxel based image registration is a newly developed semi-automated technique for superimposition and comparison of two CBCT scans. The accuracy and reproducibility of CBCT superimposition on the anterior cranial base or the zygomatic arches using voxel based image registration was tested in this study. 16 pairs of 3D CBCT models were constructed from pre and post treatment CBCT scans of 16 adult dysgnathic patients. Each pair was registered on the anterior cranial base three times and on the left zygomatic arch twice. Following each superimposition, the mean absolute distances between the 2 models were calculated at 4 regions: anterior cranial base, forehead, left and right zygomatic arches. The mean distances between the models ranged from 0.2 to 0.37 mm (SD 0.08-0.16) for the anterior cranial base registration and from 0.2 to 0.45 mm (SD 0.09-0.27) for the zygomatic arch registration. The mean differences between the two registration zones ranged between 0.12 to 0.19 mm at the 4 regions. Voxel based image registration on both zones could be considered as an accurate and a reproducible method for CBCT superimposition. The left zygomatic arch could be used as a stable structure for the superimposition of smaller field of view CBCT scans where the anterior cranial base is not visible.

  20. Anterior loop of the inferior alveolar nerve: Averages and prevalence based on CT scans.

    Science.gov (United States)

    Juan, Del Valle Lovato; Grageda, Edgar; Gómez Crespo, Salvador

    2016-02-01

    The treatment of edentulous patients by using a complete implant-supported fixed prosthetic with distal extension has been widely studied; success is mainly dependent upon the placement of the distal implants. The location of the inferior alveolar nerve determines implant placement, but the length, prevalence, and symmetry between the left and right side of the anterior loop of the alveolar nerve are unknown. The purpose of this clinical study was to measure the anterior loop of the inferior alveolar nerve, which determines the placement of distal implants, in a group of 55 Mexican participants. The study expected to ascertain the average length, prevalence, and symmetry between left and right side and any sex differences. To differentiate the inferior alveolar nerve path, a new technique was applied using Hounsfield unit (HU) thresholds. The null hypothesis was that no significant differences would be found between the left and right sides or between men and women for the anterior loop of the inferior alveolar nerve. Fifty-five computed tomography (CT) scans were made (Somatom Sensation 16; Siemens Healthcare) and were visualized with InVesalius software. Anterior loop measurements were made on 3-dimensional surfaces. To determine statistical differences between the left and right side and between the sexes, the t test was used. The interclass correlation coefficient test was also applied to verify the reliability of the measurements. Ninety percent of participants showed the anterior loop of the inferior alveolar nerve. The length of the anterior loop ranged between 0 and 6.68 mm, with a mean of 2.19 mm. No significant differences were found between the left and right sides or between men and women. The mean length for the anterior loop in the sample was 2.19 mm. As the anterior loop length shows a high degree of variability, these findings suggest that a CT scan for each patient is recommended in order to visualize a safety zone before placing implants close to

  1. Performance-Based Outcomes After Anterior Cruciate Ligament Reconstruction in Professional Athletes Differ Between Sports.

    Science.gov (United States)

    Mai, Harry T; Chun, Danielle S; Schneider, Andrew D; Erickson, Brandon J; Freshman, Ryan D; Kester, Benjamin; Verma, Nikhil N; Hsu, Wellington K

    2017-08-01

    Excellent outcomes have been reported for anterior cruciate ligament (ACL) reconstruction (ACLR) in professional athletes in a number of different sports. However, no study has directly compared these outcomes between sports. To determine if differences in performance-based outcomes exist after ACLR between professional athletes of each sport. Cohort study; Level of evidence, 3. National Football League (NFL), National Basketball Association (NBA), National Hockey League (NHL), and Major League Baseball (MLB) athletes undergoing primary ACLR for an acute rupture were identified through an established protocol of injury reports and public archives. Sport-specific performance statistics were collected before and after surgery for each athlete. Return to play (RTP) was defined as a successful return to the active roster for at least 1 regular-season game after ACLR. Of 344 professional athletes who met the inclusion criteria, a total of 298 (86.6%) returned to play. NHL players had a significantly higher rate of RTP (95.8% vs 83.4%, respectively; P = .04) and a shorter recovery time (258 ± 110 days vs 367 ± 268 days, respectively; P NBA and NFL players showed decreased performance at season 1 after ACLR ( P ≤ .001). NFL players continued to have lower performance at seasons 2 and 3 ( P = .002), while NBA players recovered to baseline performance. The data indicate that NFL athletes fare the worst after ACLR with the lowest survival rate, shortest postoperative career length, and sustained decreases in performance. NHL athletes fare the best with the highest rates of RTP, highest survival rates, longest postoperative career lengths, and no significant changes in performance. The unique physical demand that each sport requires is likely one of the explanations for these differences in outcomes.

  2. Reconstruction of the anterior floor of the mouth with the inferiorly based nasolabial flap

    NARCIS (Netherlands)

    van Wijk, MP; Damen, A; Nauta, JM; Lichtendahl, DHE; Dhar, BK

    The results of reconstruction of the anterior floor of the mouth, using 105 nasolabial flaps in 79 patients were reviewed in a retrospective study. Of those flaps, 82% healed uneventfully; flap survival was 95%. Considerable flap loss occurred in 5%. Primary dehiscence was observed in 5% of all

  3. Anterior and posterior compartment 3D endovaginal ultrasound anatomy based on direct histologic comparison.

    Science.gov (United States)

    Shobeiri, S Abbas; White, Dena; Quiroz, Lieschen H; Nihira, Mikio A

    2012-08-01

    We used direct histologic comparison to validate the use of 3D endovaginal ultrasound (EVUS) as a novel and emerging technology for evaluating the structures found in the anterior and posterior pelvic floor compartments. A young nulliparous female pelvis specimen was dissected and histologic slides were prepared by making 8-Micron-thick sagittal cuts. The slides were stained with Mallory trichrome and arranged to form large sections encompassing each anterior and posterior sagittal plane. Healthy nulliparous women underwent 3D EVUS to obtain 3D cubes of the anterior and posterior compartments. Two investigators independently evaluated the anterior and posterior midsagittal structures. The investigators mutually viewed the images and calculated urethral and anal sphincter measurements. Thirty-one nulliparous women underwent 3D EVUS; 77% of the participants were Caucasian, with mean age 31.8 [standard deviation (SD) 5.8] and mean body mass index (BMI) of 28.5 (SD 7.9). The following mean (SD) measurements were obtained: urethral length 36 mm (± 5); striated urogenital sphincter area 0.6 cm(2) (± 0.16); longitudinal and circular smooth muscle area 1.1 cm(2) (± 0.4); urethral complex width 14 mm (± 2); urethral complex area 1.3 cm(2) (± 0.4); internal anal sphincter length 26 mm (± 4); internal anal sphincter thickness 3.2 mm (± 0.8); and rectovaginal septum length 31 mm (± 5). The agreement for visualization of structures was as follows: vesical trigone 96% (κ = 0.65), trigonal ring 94% (κ = 0.8), trigonal plate 84% (κ = 0.6); longitudinal and circular smooth muscle 100%; compressor urethra 97% (κ = 0.85); striated urogenital sphincter 97% (κ = 0.85); rectovaginal septum 100%; internal anal sphincter 100%; external anal sphincter subdivisions 100%. Three-dimensional EVUS can be used to visualize structures of the anterior and posterior compartments in nullipara.

  4. Sex-Based Differences in Knee Kinetics With Anterior Cruciate Ligament Strain on Cadaveric Impact Simulations

    Science.gov (United States)

    Schilaty, Nathan D.; Bates, Nathaniel A.; Nagelli, Christopher; Krych, Aaron J.; Hewett, Timothy E.

    2018-01-01

    Background: Females are at an increased risk of sustaining noncontact knee ligament injuries as compared with their male counterparts. The kinetics that load the anterior cruciate ligament (ACL) are still under dispute in the literature. Purpose/Hypothesis: The purpose of this study was to determine whether there are differences in knee kinetics between the sexes that lead to greater ACL strain in females when similar external loads are applied during a simulated drop vertical jump landing task. It was hypothesized that female limbs would demonstrate significant differences in knee abduction moment that predispose females to ACL injury when compared with males. Study Design: Controlled laboratory study. Methods: Motion analysis data of 67 athletes who performed a drop vertical jump were collected. The kinematic and kinetic data were used to categorize tertiles of relative risk, and these values were input into a cadaveric impact simulator to assess ligamentous loads during the simulated landing task. Uni- and multiaxial load cells and differential variable reluctance transducer strain sensors were utilized to collect kinetic data and maximum ACL strain for analysis. Conditions of external loads applied to the cadaveric limbs were systematically varied and randomized. Data were analyzed with 2-way repeated-measures analysis of variance and the Fisher exact test. Results: Five kinetic parameters were evaluated. Of the 5 kinetic variables, only knee abduction moment (KAM) demonstrated significant differences in females as compared with males (F 1,136 = 4.398, P = .038). When normalized to height and weight, this difference between males and females increased in significance (F 1,136 = 7.155, P = .008). Compared with males, females exhibited a 10.3-N·m increased knee abduction torque at 66 milliseconds postimpact and a 22.3-N·m increased abduction torque at 100 milliseconds postimpact. For loading condition, the condition of “maximum ACL strain” demonstrated a

  5. Informe sobre reptiles colombianos. III: investigaciones sobre la anatomía craneal; distribución geográfica y ecología de Crocodylus Intermedius (Graves en Colombia Informe sobre reptiles colombianos. III: investigaciones sobre la anatomía craneal; distribución geográfica y ecología de Crocodylus Intermedius (Graves en Colombia

    Directory of Open Access Journals (Sweden)

    Medem Fred

    1958-09-01

    hide-hunting Cr. intermedius was practically exterminated in large areas and became rather scarce even in remote regions. 1. Se presenta una investigación detallada sobre la anatomía craneal, distribución geográfica y ecología de Crocodylus intermedius en Colombia. 2. El material que forma la base para estos estudios, consiste en 16 cráneos y 54 huevos que contienen fetus, coleccionados en los ríos Guaviare, Ariari, Güejar y Cunimía en 1955-56 y 1956-57.     3. La descripción anatómica craneal fue hecha a base de cráneos de 25.4 centímetros a 70.7 centímetros de largo (tabla 2.                                   4. Se hicieron estudios detallados sobre el escamado, incluyendo el 4 de fetus (tabla 1. Existe una sola hilera de Occipitalia que contiene entre 2 y 6 escamas y dos de Cervicalia de las cuales la primera contiene 4 y la segunda 2 escamas. Los Dorsalia estan formados por 16 0 17 hileras transversales; el número de escamas en una de ellas es de 5 a 6. Hay 25 a 27½ hileras transversales de los Ventralia; el número de escamas en una hilera está entre 14 y 18. La cresta caudal doble contiene entre 17 y 19 segmentos, y la sencilla un número igual.                                             5. La coloración varía entre gris claro, verde y carmelita claro. Existen diferencias entre jóvenes y adultos.    ��                                                                    6. La distribución geográfica abarca los territorios entre el rio Arauca por el oriente y el río Duda por el occidente. En el Vaupés, Caquetá y Putumayo afluentes del Amazonas no existe C. intermedius (mapa. En el Orinoco (Venezuela se extiende hasta la región de San Fernando de Atabapo únicamente, pero no entra al Amazonas por el Casiquiare y el Rio Negro por razones aún desconocidas. 7. Los estudios sobre la ecolog

  6. Accuracy and reproducibility of voxel based superimposition of cone beam computed tomography models on the anterior cranial base and the zygomatic arches.

    Directory of Open Access Journals (Sweden)

    Rania M Nada

    Full Text Available Superimposition of serial Cone Beam Computed Tomography (CBCT scans has become a valuable tool for three dimensional (3D assessment of treatment effects and stability. Voxel based image registration is a newly developed semi-automated technique for superimposition and comparison of two CBCT scans. The accuracy and reproducibility of CBCT superimposition on the anterior cranial base or the zygomatic arches using voxel based image registration was tested in this study. 16 pairs of 3D CBCT models were constructed from pre and post treatment CBCT scans of 16 adult dysgnathic patients. Each pair was registered on the anterior cranial base three times and on the left zygomatic arch twice. Following each superimposition, the mean absolute distances between the 2 models were calculated at 4 regions: anterior cranial base, forehead, left and right zygomatic arches. The mean distances between the models ranged from 0.2 to 0.37 mm (SD 0.08-0.16 for the anterior cranial base registration and from 0.2 to 0.45 mm (SD 0.09-0.27 for the zygomatic arch registration. The mean differences between the two registration zones ranged between 0.12 to 0.19 mm at the 4 regions. Voxel based image registration on both zones could be considered as an accurate and a reproducible method for CBCT superimposition. The left zygomatic arch could be used as a stable structure for the superimposition of smaller field of view CBCT scans where the anterior cranial base is not visible.

  7. [Collateral score based on CT perfusion can predict the prognosis of patients with anterior circulation ischemic stroke after thrombectomy].

    Science.gov (United States)

    Wang, Qingsong; Zhang, Sheng; Zhang, Meixia; Chen, Zhicai; Lou, Min

    2017-07-25

    To evaluate the value of collateral score based on CT perfusion (CTP-CS) in predicting the clinical outcome of patients with anterior circulation ischemic stroke after thrombectomy. Clinical data of acute ischemic stroke patients with anterior artery occlusion undergoing endovascular treatment in the Second Affiliated Hospital, Zhejiang University School of Medicine during October 2013 and October 2016 were retrospectively reviewed. Collateral scores were assessed based on CTP and digital subtraction angiography (DSA) images, respectively. And DSA-CS or CTP-CS 3-4 was defined as good collateral vessels. Good clinical outcome was defined as a modified Rankin Scale (mRS) ≤ 2 at 3 months after stroke. The binary logistic regression model was used to analyze the correlation between the collateral score and clinical outcome, and the receiver operating characteristic (ROC) curve was used to analyze the value of DSA-CS and CTP-CS in predicting the clinical outcome. Among 40 patients, 33 (82.5%) acquired recanalization and 16 (40.0%) got good outcome. Compared with poor outcome group, the collateral score (all P collateral vessels were higher in good outcome group (all P collateral vessels were independent factor of good outcome (CTP-CS: OR =48.404, 95% CI :1.373-1706.585, P Collateral scores based on CTP and DSA had good consistency ( κ =0.697, P <0.01), and ROC curve showed that the predictive value of CTP-CS and DSA-CS were comparable (both AUC=0.726, 95% CI :0.559-0.893, P <0.05). CTP-CS can predict the clinical outcome of patients with anterior circulation ischemic stroke after thrombectomy.

  8. Features of Designing the Criterion-Based Rehabilitation Program for Patients after Arthroscopic Reconstruction of the Anterior Cruciate Ligament

    Directory of Open Access Journals (Sweden)

    I.V. Roy

    2016-04-01

    Full Text Available The article presents an innovative criterion-based rehabilitation program for patients, who underwent arthroscopic reconstruction of the anterior cruciate ligament. The features of the program are described, methodological foundations to perform permissible exercises are presented for each periods of the program, which correspond to a specific motor mode. The degree of preparedness of the patient is determined by the criterion of performance of the test exercises that will permit him to the loads of a new, higher level of trainings. The effectiveness of the developed program is confirmed clinically.

  9. Metodología para la manufactura de implantes craneales a partir de imágenes DICOM y tecnologías CAD/CAM/CNC Metodología para la manufactura de implantes craneales a partir de imágenes DICOM y tecnologías CAD/CAM/CNC

    Directory of Open Access Journals (Sweden)

    Iván López

    2005-12-01

    Full Text Available El presente artículo propone una metodología para el diseño y la fabricación de implantes craneales a partir de imágenes DICOM y tecnologías CAD/CAM/CNC. Esta metodología parte de las Tomografías Axiales Computarizadas (TAC de la cabeza del paciente, con las cuales se lleva a cabo la reconstrucción tridimensional del cráneo. Luego, en el sistema CAD se reconstruye el implante variando la técnica empleada dependiendo de la región del cráneo con defecto o trauma. Una vez obtenido el modelo, se diseña el montaje y se fabrica el implante con soporte en tecnología CAM/CNC.It’s proposed a methodology in order to design and manufacture cranial implants using DICOM and CAD/CAM/CNC technologies. This methodology begins when the designer makes a three-dimensional cranial reconstruction using the Axial Computer Tomographies (ACT of the patient’s cranium. Next, using a CAD system, the designer rebuilds the implant varying the used technique depending on the affected region. Finally, the designer builds the assembling and manufactures the implant.

  10. Preoperative MR imaging-based volume measurements of the hippocampal formation and anterior temporal lobe in epileptic patients

    International Nuclear Information System (INIS)

    Jack, C.R.; Sharbrough, F.W.; Twomey, C.; Zinsmeister, A.R.; Cascino, G.D.; Hirschorn, K.A.; Marsh, W.R.

    1989-01-01

    MR-based volume measurements of the anterior temporal lobe and hippocampal formation were performed in 36 patients who subsequently underwent surgery for medically refractory temporal lobe epilepsy. Seizure lateralization was based on standard clinical and electroencephalographic criteria. No surgical pathologic specimens contained structural lesions; epilepsy in these patients was therefore presumably due to mesial sclerosis. The right-minus-left hippocampal formation volume difference was greater than 0 in all 20 patients operated on the left side and less than 0 in all 16 patients operated on the right side. This difference completely separated the two surgical groups, while the same measurement in a group of 35 normal controls fell between the two surgical groups. Measurements of the anterior temporal to be showed a similar trend but incompletely separated controls, right- and left-sided epileptics. These results suggest that in a significant percentage of cases, MR-based volume measurements correctly identify the unilateral hippocampal atrophy that is known to occur in cases of mesial temporal sclerosis

  11. Evaluation of the cranial base in amnion rupture sequence involving the anterior neural tube: implications regarding recurrence risk.

    Science.gov (United States)

    Jones, Kenneth Lyons; Robinson, Luther K; Benirschke, Kurt

    2006-09-01

    Amniotic bands can cause disruption of the cranial end of the developing fetus, leading in some cases to a neural tube closure defect. Although recurrence for unaffected parents of an affected child with a defect in which the neural tube closed normally but was subsequently disrupted by amniotic bands is negligible; for a primary defect in closure of the neural tube to which amnion has subsequently adhered, recurrence risk is 1.7%. In that primary defects of neural tube closure are characterized by typical abnormalities of the base of the skull, evaluation of the cranial base in such fetuses provides an approach for making a distinction between these 2 mechanisms. This distinction has implications regarding recurrence risk. The skull base of 2 fetuses with amnion rupture sequence involving the cranial end of the neural tube were compared to that of 1 fetus with anencephaly as well as that of a structurally normal fetus. The skulls were cleaned, fixed in 10% formalin, recleaned, and then exposed to 10% KOH solution. After washing and recleaning, the skulls were exposed to hydrogen peroxide for bleaching and photography. Despite involvement of the anterior neural tube in both fetuses with amnion rupture sequence, in Case 3 the cranial base was normal while in Case 4 the cranial base was similar to that seen in anencephaly. This technique provides a method for determining the developmental pathogenesis of anterior neural tube defects in cases of amnion rupture sequence. As such, it provides information that can be used to counsel parents of affected children with respect to recurrence risk.

  12. Fractionated stereotactic radiosurgery for patients with skull base metastases from systemic cancer involving the anterior visual pathway

    International Nuclear Information System (INIS)

    Minniti, Giuseppe; Osti, Mattia Falchetto; Maurizi Enrici, Riccardo; Esposito, Vincenzo; Clarke, Enrico; Scaringi, Claudia; Bozzao, Alessandro; Falco, Teresa; De Sanctis, Vitaliana; Enrici, Maurizio Maurizi; Valeriani, Maurizio

    2014-01-01

    To analyze the tumor control, survival outcomes, and toxicity after stereotactic radiosurgery (SRS) for skull base metastases from systemic cancer involving the anterior visual pathway. We have analyzed 34 patients (23 females and 11 males, median age 59 years) who underwent multi-fraction SRS for a skull base metastasis compressing or in close proximity of optic nerves and chiasm. All metastases were treated with frameless LINAC-based multi-fraction SRS in 5 daily fractions of 5 Gy each. Local control, distant failure, and overall survival were estimated using the Kaplan-Meier method calculated from the time of SRS. Prognostic variables were assessed using log-rank and Cox regression analyses. At a median follow-up of 13 months (range, 2–36.5 months), twenty-five patients had died and 9 were alive. The 1-year and 2-year local control rates were 89% and 72%, and respective actuarial survival rates were 63% and 30%. Four patients recurred with a median time to progression of 12 months (range, 6–27 months), and 17 patients had new brain metastases at distant brain sites. The 1-year and 2-year distant failure rates were 50% and 77%, respectively. On multivariate analysis, a Karnofsky performance status (KPS) >70 and the absence of extracranial metastases were prognostic factors associated with lower distant failure rates and longer survival. After multi-fraction SRS, 15 (51%) out of 29 patients had a clinical improvement of their preexisting cranial deficits. No patients developed radiation-induced optic neuropathy during the follow-up. Multi-fraction SRS (5 x 5 Gy) is a safe treatment option associated with good local control and improved cranial nerve symptoms for patients with a skull base metastasis involving the anterior visual pathway

  13. Anterior and posterior ocular biometry in healthy Chinese subjects: data based on AS-OCT and SS-OCT.

    Directory of Open Access Journals (Sweden)

    Wenbin Huang

    Full Text Available To measure the anterior and posterior ocular biometric characteristics concurrently and to determine the relationship between the iris and choroid in healthy Chinese subjects.A total of 148 subjects (270 eyes were enrolled in this cross-section study. The anterior and posterior ocular biometric characteristics were measured simultaneously by anterior segment optical coherence tomography (AS-OCT and swept-source optical coherence tomography (SS-OCT.Compared with male eyes, female eyes had narrower anterior biometric parameters that presented with smaller anterior segment parameters [including anterior chamber depth (ACD, width (ACW, area (ACA, and volume (ACV; (all p<0.001], narrower anterior chamber angle parameters [including angle opening distance (AOD750, trabecular-iris space area (TISA750, and angle recess area (ARA; (all p<0.001], higher iris curvature (ICURV (p = 0.003, and larger lens vaults (LV (p = 0.019. These anterior ocular biometric parameters were correlated with increasing age (p<0.01. Iris thickness (IT750 and iris area (IAREA were associated with age, ACW, and pupil diameter (all p<0.05, while choroidal thickness (CT was associated with age, gender, and axial length (all p<0.05. Univariate regression analysis showed that greater CT was significantly associated with smaller IAREA (p = 0.026.Compared with male eyes, female eyes had narrower anterior biometric parameters that correlated with increasing age, which would be helpful in explaining the higher prevalence of angle closure rates in the female gender and in aging people. Increased CT might be associated with smaller iris area; however, this possibility needs to be investigated in future studies before this conclusion is made.

  14. Management of Anterior Skull Base Defect Depending on Its Size and Location

    Science.gov (United States)

    Bernal-Sprekelsen, Manuel; Rioja, Elena; Enseñat, Joaquim; Enriquez, Karla; Viscovich, Liza; Agredo-Lemos, Freddy Enrique; Alobid, Isam

    2014-01-01

    Introduction. We present our experience in the reconstruction of these leaks depending on their size and location. Material and Methods. Fifty-four patients who underwent advanced skull base surgery (large defects, >20 mm) and 62 patients with CSF leaks of different origin (small, 2–10 mm, and midsize, 11–20 mm, defects) were included in the retrospective study. Large defects were reconstructed with a nasoseptal pedicled flap positioned on fat and fascia lata. In small and midsized leaks. Fascia lata in an underlay position was used for its reconstruction covered with mucoperiosteum of either the middle or the inferior turbinate. Results. The most frequent etiology for small and midsized defects was spontaneous (48.4%), followed by trauma (24.2%), iatrogenic (5%). The success rate after the first surgical reconstruction was 91% and 98% in large skull base defects and small/midsized, respectively. Rescue surgery achieved 100%. Conclusions. Endoscopic surgery for any type of skull base defect is the gold standard. The size of the defects does not seem to play a significant role in the success rate. Fascia lata and mucoperiosteum of the turbinate allow a two-layer reconstruction of small and midsized defects. For larger skull base defects, a combination of fat, fascia lata, and nasoseptal pedicled flaps provides a successful reconstruction. PMID:24895567

  15. Role of targeted magnetic resonance imaging sequences in the surgical management of anterior skull base pathology.

    Science.gov (United States)

    Chawla, S; Bowman, J; Gandhi, M; Panizza, B

    2017-01-01

    The skull base is a highly complex anatomical region that provides passage for important nerves and vessels as they course into and out of the cranial cavity. Key to the management of pathology in this region is a thorough understanding of the anatomy, with its variations, and the relationship of various neurovascular structures to the pathology in question. Targeted high-resolution magnetic resonance imaging on high field strength magnets can enable the skull base surgeon to understand this intricate relationship and deal with the pathology from a position of relative advantage. With the help of case studies, this paper illustrates the application of specialised magnetic resonance techniques to study pathology of the orbital apex in particular. The fine anatomical detail provided gives surgeons the ability to design an endonasal endoscopic procedure appropriate to the anatomy of the pathology.

  16. Anterior mandibular apical base augmentation in the surgical orthodontic treatment of mandibular retrusion.

    Science.gov (United States)

    Brusati, R; Giannì, A B

    2005-12-01

    The authors describe a surgical technique alternative to traditional pre-surgical orthodontics in order to increase the apical base in mandibular retrusion (class II, division I). This subapical osteotomy, optimizing inferior incisal axis without dental extractions and a long orthodontic treatment, associated to genioplasty permits to obtain an ideal labio-dento-mental morphology. This procedure avoids in some cases the need of a mandibular advancement and, if necessary, it reduces his entity with obvious advantages.

  17. Clinical, biomechanical and morphological assessment of anterior cruciate ligament Kevlar®-based artificial prosthesis in rabbit model.

    Science.gov (United States)

    de la Garza-Castro, Santiago; González-Rivera, Carlos E; Vílchez-Cavazos, Félix; Morales-Avalos, Rodolfo; Barrera-Flores, Francisco J; Elizondo-Omaña, Rodrigo E; Soto-Dominguez, Adolfo; Acosta-Olivo, Carlos; Mendoza-Lemus, Oscar F

    2017-07-27

    The aim of this study was to evaluate the clinical, biomechanical and morphological characteristics of a Kevlar®-based prosthetic ligament as a synthetic graft of the anterior cruciate ligament (ACL) in an experimental animal model in rabbits. A total of 27 knees of rabbits randomly divided into 3 groups (control, ACL excision and ACL replacement with a Kevlar® prosthesis) were analyzed using clinical, biomechanical and morphological tests at 6, 12 and 18 weeks postprocedure. The mean displacement in mechanical testing was 0.73 ± 0.06 mm, 1.58 ± 0.19 mm and 0.94 ± 0.20 mm for the control, ACL excision and ACL replacement with synthetic prosthesis groups, respectively. The results showed an improvement in the stability of the knee with the use of the Kevlar® synthetic prosthesis in the biomechanical testing (p0.05), between the replacement group and the control group. The histological study revealed a good morphological adaptation of the synthetic material to the knee. This study proposes a new animal model for the placement and evaluation of Kevlar®-based synthetic ACL implants. The studied prosthesis showed promising behavior in the clinical and biomechanical tests and in the histological analysis. This study lays the foundation for further basic and clinical studies of artificial ACL prostheses using this material.

  18. Brain atrophy and neuropsychological outcome after treatment of ruptured anterior cerebral artery aneurysms: a voxel-based morphometric study

    International Nuclear Information System (INIS)

    Bendel, Paula; Koskenkorva, Paeivi; Vanninen, Ritva; Koivisto, Timo; Aeikiae, Marja; Niskanen, Eini; Koenoenen, Mervi; Haenninen, Tuomo

    2009-01-01

    Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) is frequently detected. Here, we describe the pattern of cerebral (gray matter) atrophy and its clinical relevance after treatment of aSAH caused by a ruptured anterior cerebral artery (ACA) aneurysm. Thirty-seven aSAH patients with ACA aneurysm (17 surgical, 20 endovascular treatment) and a good or moderate clinical outcome (Glasgow Outcome Scale V or IV) and 30 controls underwent brain MRI. Voxel-based morphometric analysis was applied to compare the patients and controls. Patients also underwent a detailed neuropsychological assessment. The comparisons between controls and either all patients (n=37) or the subgroup of surgically treated patients (n=17) revealed bilateral cortical atrophy in the frontal lobes, mainly in the basal areas. The brainstem, bilateral thalamic and hypothalamic areas, and ipsilateral caudate nucleus were also involved. Small areas of atrophy were detected in temporal lobes. The hippocampus and parahippocampal gyrus showed atrophy ipsilateral to the surgical approach. In the subgroup of endovascularly treated patients (n = 15), small areas of atrophy were detected in the bilateral orbitofrontal cortex and in the thalamic region. Twenty patients (54%) showed cognitive deficits in neuropsychological assessment. Group analysis after aSAH and treatment of the ruptured ACA aneurysm revealed gray matter atrophy, principally involving the frontobasal cortical areas and hippocampus ipsilateral to the surgical approach. Areas of reduced gray matter were more pronounced after surgical than endovascular treatment. Together with possible focal cortical infarctions and brain retraction deficits in individual patients, this finding may explain the neuropsychological disturbances commonly detected after treatment of ruptured ACA aneurysms. (orig.)

  19. Plasma metabonomics study of the patients with acute anterior uveitis based on ultra-performance liquid chromatography-mass spectrometry.

    Science.gov (United States)

    Guo, Junguo; Yan, Tingqin; Bi, Hongsheng; Xie, Xiaofeng; Wang, Xingrong; Guo, Dadong; Jiang, Haiqiang

    2014-06-01

    The identification of the biomarkers of patients with acute anterior uveitis (AAU) may allow for a less invasive and more accurate diagnosis, as well as serving as a predictor in AAU progression and treatment response. The aim of this study was to identify the potential biomarkers and the metabolic pathways from plasma in patients with AAU. Both plasma metabolic biomarkers and metabolic pathways in the AAU patients versus healthy volunteers were investigated using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) and a metabonomics approach. The principal component analysis (PCA) was used to separate AAU patients from healthy volunteers as well as to identify the different biomarkers between the two groups. Metabolic compounds were matched to the KEGG, METLIN, and HMDB databases, and metabolic pathways associated with AAU were identified. The PCA for UPLC-MS data shows that the metabolites in AAU patients were significantly different from those of healthy volunteers. Of the 4,396 total features detected by UPLC-MS, 102 features were significantly different between AAU patients and healthy volunteers according to the variable importance plot (VIP) values (greater than two) of partial least squares discriminate analysis (PLS-DA). Thirty-three metabolic compounds were identified and were considered as potential biomarkers. Meanwhile, ten metabolic pathways were found that were related to the AAU according to the identified biomarkers. These data suggest that metabolomics study can identify potential metabolites that differ between AAU patients and healthy volunteers. Based on the PCA, PLS-DA, several potential metabolic biomarkers and pathways in AAU patients were found and identified. In addition, the UPLC-MS technique combined with metabonomics could be a suitable systematic biology tool in research in clinical problems in ophthalmology, and can provide further insight into the pathophysiology of AAU.

  20. Risk factors associated with cognitions for late-onset depression based on anterior and posterior default mode sub-networks.

    Science.gov (United States)

    Liu, Rui; Yue, Yingying; Hou, Zhenghua; Yuan, Yonggui; Wang, Qiao

    2018-08-01

    Abnormal functional connectivity (FC) in the default mode network (DMN) plays an important role in late-onset depression (LOD) patients. In this study, the risk predictors of LOD based on anterior and posterior DMN are explored. A total of 27 LOD patients and 40 healthy controls (HC) underwent resting-state functional magnetic resonance imaging and cognitive assessments. Firstly, FCs within DMN sub-networks were determined by placing seeds in the ventral medial prefrontal cortex (vmPFC) and posterior cingulate cortex (PCC). Secondly, multivariable logistic regression was used to identify risk factors for LOD patients. Finally, correlation analysis was performed to investigate the relationship between risk factors and the cognitive value. Multivariable logistic regression showed that the FCs between the vmPFC and right middle temporal gyrus (MTG) (vmPFC-MTG_R), FCs between the vmPFC and left precuneus (PCu), and FCs between the PCC and left PCu (PCC-PCu_L) were the risk factors for LOD. Furthermore, FCs of the vmPFC-MTG_R and PCC-PCu_L correlated with processing speed (R = 0.35, P = 0.002; R = 0.32, P = 0.009), and FCs of the vmPFC-MTG_R correlated with semantic memory (R = 0.41, P = 0.001). The study was a cross-sectional study. The results may be potentially biased because of a small sample. In this study, we confirmed that LOD patients mainly present cognitive deficits in processing speed and semantic memory. Moreover, our findings further suggested that FCs within DMN sub-networks associated with cognitions were risk factors, which may be used for the prediction of LOD. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Brain atrophy and neuropsychological outcome after treatment of ruptured anterior cerebral artery aneurysms: a voxel-based morphometric study

    Energy Technology Data Exchange (ETDEWEB)

    Bendel, Paula; Koskenkorva, Paeivi; Vanninen, Ritva [Kuopio University Hospital and University of Kuopio, Department of Clinical Radiology, Kuopio (Finland); Koivisto, Timo; Aeikiae, Marja [Kuopio University Hospital and University of Kuopio, Department of Neurosurgery, Kuopio (Finland); Niskanen, Eini [Kuopio University Hospital and University of Kuopio, Department of Neurology, Kuopio (Finland); Kuopio University Hospital and University of Kuopio, Department of Physics, Kuopio (Finland); Koenoenen, Mervi [Kuopio University Hospital and University of Kuopio, Department of Clinical Radiology, Kuopio (Finland); Kuopio University Hospital and University of Kuopio, Department of Clinical Neurophysiology, Kuopio (Finland); Haenninen, Tuomo [Kuopio University Hospital and University of Kuopio, Department of Neurology, Kuopio (Finland)

    2009-11-15

    Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) is frequently detected. Here, we describe the pattern of cerebral (gray matter) atrophy and its clinical relevance after treatment of aSAH caused by a ruptured anterior cerebral artery (ACA) aneurysm. Thirty-seven aSAH patients with ACA aneurysm (17 surgical, 20 endovascular treatment) and a good or moderate clinical outcome (Glasgow Outcome Scale V or IV) and 30 controls underwent brain MRI. Voxel-based morphometric analysis was applied to compare the patients and controls. Patients also underwent a detailed neuropsychological assessment. The comparisons between controls and either all patients (n=37) or the subgroup of surgically treated patients (n=17) revealed bilateral cortical atrophy in the frontal lobes, mainly in the basal areas. The brainstem, bilateral thalamic and hypothalamic areas, and ipsilateral caudate nucleus were also involved. Small areas of atrophy were detected in temporal lobes. The hippocampus and parahippocampal gyrus showed atrophy ipsilateral to the surgical approach. In the subgroup of endovascularly treated patients (n = 15), small areas of atrophy were detected in the bilateral orbitofrontal cortex and in the thalamic region. Twenty patients (54%) showed cognitive deficits in neuropsychological assessment. Group analysis after aSAH and treatment of the ruptured ACA aneurysm revealed gray matter atrophy, principally involving the frontobasal cortical areas and hippocampus ipsilateral to the surgical approach. Areas of reduced gray matter were more pronounced after surgical than endovascular treatment. Together with possible focal cortical infarctions and brain retraction deficits in individual patients, this finding may explain the neuropsychological disturbances commonly detected after treatment of ruptured ACA aneurysms. (orig.)

  2. Anterior perineal hernia after anterior exenteration

    Directory of Open Access Journals (Sweden)

    Ka Wing Wong

    2017-10-01

    Full Text Available Perineal hernia is a rare complication of anterior exenteration. We reported this complication after an anterior exenteration for bladder cancer with bleeding complication requiring packing and second-look laparotomy. Perineal approach is a simple and effective method for repair of perineal hernia.

  3. A methodology based on the "anterior chamber of rabbit eyes" model for noninvasively determining the biocompatibility of biomaterials in an immune privileged site.

    Science.gov (United States)

    Lu, Pei-Lin; Lai, Jui-Yang; Tabata, Yasuhiko; Hsiue, Ging-Ho

    2008-07-01

    In this study, a novel methodology based on the anterior chamber of rabbit eyes model was developed to evaluate the in vivo biocompatibility of biomaterials in an immune privileged site. The 7-mm-diameter membrane implants made from either a biological tissue material (amniotic membrane, AM group) or a biomedical polymeric material (gelatin, GM group) were inserted in rabbit anterior chamber for 36 months and characterized by biomicroscopic examinations, intraocular pressure measurements, and corneal thickness measurements. The noninvasive ophthalmic parameters were scored to provide a quantitative grading system. In this animal model, both AM and GM implants were visible in an ocular immune privileged site during clinical observations. The implants of the AM group appeared as soft tissue patches and have undergone a slow dissolution process resulting in a partial reduction of their size. Additionally, the AM implants did not induce any foreign body reaction or change in ocular tissue response for the studied period. By contrast, in the GM groups, significant corneal edema, elevated intraocular pressure, and increased corneal thickness were noted in the early postoperative phase (within 3 days), but resolved rapidly with in vivo dissolution of the gelatin. The results from the ocular grading system showed that both implants had good long-term biocompatibility in an ocular immune privileged site for up to 3 years. It is concluded that the anterior chamber of rabbit eyes model is an efficient method for noninvasively determining the immune privileged tissue/biomaterial interactions. (c) 2007 Wiley Periodicals, Inc.

  4. Brown tumors of the anterior skull base as the initial manifestation of true normocalcemic primary hyperparathyroidism: report of three cases and review of the literature.

    Science.gov (United States)

    Khalatbari, Mahmoud Reza; Hamidi, Mehrdokht; Moharamzad, Yashar; Setayesh, Ali; Amirjamshidi, Abbas

    2013-01-01

    Brown tumor is a bone lesion secondary to hyperparathyroidism of various etiologies. Skeletal involvement in primary hyperparathyroidism secondary to parathyroid adenoma is very uncommon and brown tumor has become extremely a rare clinical entity. Hyperparathyroidism is usually associated with high levels of serum calcium. Brown tumor as the only and initial symptom of normocalcemic primary hyperparathyroidism is extremely rare. Moreover, involvement of the skull base and the orbit is exceedingly rare. The authors would report three cases of brown tumor of the anterior skull base that were associated with true normocalcemic primary hyperparathyroidism. Clinical manifestations, neuroimaging findings, pathological findings, diagnosis and treatment of the patients are discussed and the relevant literature is reviewed.

  5. The outcome of a surgical protocol based on ischemia overprotection in large and giant aneurysms of the anterior cerebral circulation.

    Science.gov (United States)

    Imai, Hideaki; Watanabe, Katsushige; Miyagishima, Takaaki; Yoshimoto, Yuhei; Kin, Taichi; Nakatomi, Hirofumi; Saito, Nobuhito

    2016-07-01

    Aiming to define the optimal treatment of large and giant aneurysms (LGAs) in the anterior circulation, we present our surgical protocol and patient outcome. A series of 42 patients with intracavernous LGAs (n = 16), paraclinoid (C2) LGAs (n = 17), and peripheral (middle cerebral artery-MCA or anterior cerebral artery-ACA) LGAs (n = 9) were treated after bypass under motor evoked potential (MEP) monitoring. Preoperatively, three categories of ischemic tolerance during internal carotid artery (ICA) occlusion were defined on conventional angiography: optimal, suboptimal, and insufficient collaterals. Accordingly, three types of bypass: low flow (LFB), middle flow (MFB) and high flow (HFB) were applied for the cases with optimal, suboptimal, and insufficient collaterals, respectively. Outcome was evaluated by the Glasgow Outcome Scale (GOS). All patients had excellent GOS score except one, who suffered a major ischemic stroke immediately after surgery for a paraclinoid lesion. Forty-one patients were followed up for 87.1 ± 40.1 months (range 13-144 months). Intracavernous LGAs were all treated by proximal occlusion with bypass surgery. Of paraclinoid LGA patients, 15 patients had direct clipping under suction decompression and other 2 patients with recurrent aneurysms had ICA (C2) proximal clipping with HFB. MEP monitoring guided for temporary clipping time and clip repositioning, observing significant MEP changes for up to 6 min duration. Of 9 peripheral LGAs patients 7 MCA LGAs had reconstructive clipping (n = 4) or trapping (n = 3) with bypass including LFB in 3 cases, MFB in 1 and HFB in 1. Two ACA LGAs had clipping (n = 1) or trapping (n = 1) with A3-A3 bypass. The applied protocol provided excellent results in intracavernous, paraclinoid, and peripheral thrombosed LGAs of the anterior circulation.

  6. Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus

    NARCIS (Netherlands)

    Melick, N. van; Cingel, R.E. van; Brooijmans, F.; Neeter, C.; Tienen, T. van; Hullegie, W.; Sanden, M.W. van der

    2016-01-01

    AIM: The Royal Dutch Society for Physical Therapy (KNGF) instructed a multidisciplinary group of Dutch anterior cruciate ligament (ACL) experts to develop an evidence statement for rehabilitation after ACL reconstruction. DESIGN: Clinical practice guideline underpinned by systematic review and

  7. Osteología craneal comparada de tres especies de lenguado del género Paralichthys (Pleuronectiformes, Paralichthyidae del Atlántico suroccidental Comparative cranial osteology of three species of the flatfish genus Paralichthys (Pleuronectiformes, Paralichthyidae from the southwestern Atlantic

    Directory of Open Access Journals (Sweden)

    JUAN M. DÍAZ DE ASTARLOA

    2005-09-01

    Full Text Available Se realiza un análisis osteológico comparativo del esqueleto craneal en Paralichthys isosceles, P. orbignyanus y P. patagonicus, tres especies de lenguados presentes en el Atlántico suroccidental. Se describen las características de los componentes óseos y se detallan las diferencias morfológicas y morfométricas encontradas, con el fin de aportar elementos diagnósticos para la identificación taxonómica de las tres especies de Paralichthys. Se utilizaron técnicas de desarticulación de esqueletos, tanto en ejemplares frescos congelados, como en especímenes conservados en líquidos fijadores. También fueron usadas técnicas de clareado y tinción diferencial para ejemplares de pequeño tamaño. Se observaron potenciales características diagnósticas para la discriminación de las especies en los huesos paretmoides derecho, lacrimal izquierdo, anguloarticular, mesopterigoides, los otolitos y el número de dientes del dentario. Se discuten las relaciones entre los huesos y se comparan sus características con las halladas en otras especies del género Paralichthys, en particular, y en otros Pleuronectiformes en generalAn osteological analysis of the cranial skeleton of the southwestern Atlantic flatfish species Paralichthys isosceles, P. orbignyanus and P. patagonicus was carried out based on comparative morphology and morphometrics of the bones. The objective was to provide osteological evidence of diagnostic value for a correct identification of the flatfish species. Methods for preparing disarticulated skeletons were used for both dissected fresh-frosen and alcohol-preserved specimens. Also methods of clearing and staining for bone and cartilage were applied for small fish specimens. Potentially diagnostic features were found to distinguish among species in the right parethmoid, left lachrymal, angulo-articular, mesopterygoid, the otoliths, and the number of dentary teeth. Relationships between bones are discussed and bone

  8. Cone Beam Computed Tomography-based Evaluation of the Anterior Teeth Position Changes obtained by Passive Self-ligating Brackets.

    Science.gov (United States)

    Rhoden, Fernando K; Maltagliati, Liliana Á; de Castro Ferreira Conti, Ana C; Almeida-Pedrin, Renata R; Filho, Leopoldino C; de Almeida Cardoso, Maurício

    2016-08-01

    The objective of this study was to evaluate the anterior teeth position changes obtained by passive self-ligating brackets using cone beam computed tomography (CBCT). Twenty patients with a mean age of 16.5 years, class I malocclusion, constricted maxillary arch, and teeth crowding above 5 mm were enrolled in this study, and treated by passive orthodontic self-ligating brackets. A sequence of stainless steel thermoset wire was implemented with ending wire of 0.019" × 0.025". The CBCT and dental casts were obtained prior to the installation of orthodontic appliances (T1), and 30 days after rectangular steel wire 0.019" × 0.025" installation (T2). The measurements in CBCT were performed with the Anatomage software, and the dental casts were evaluated with a digital caliper rule with an accuracy of 0.01 mm. The CBCT data demonstrated mean buccal inclination of the upper and lower central incisors ranging from 6.55° to 7.24° respectively. The upper and lower lateral incisors ranged from 4.90° to 8.72° respectively. The lower canines showed an average increase of 3.88° in the buccal inclination and 1.96 mm in the transverse intercuspal distance. The upper canines showed a negative inclination with mean average of -0.36°, and an average increase of 0.82 mm in the transverse distance, with negative correlation with the initial crowding. Treatment with passive self-ligating brackets without obtaining spaces increases buccal inclination of the upper and lower incisors with no correlation with the amount of initial teeth crowding. The intercanine distance tends to a small increase showing different inclinations between the arches. When taking into account the self-ligating brackets, the amount of initial dental crowding is not a limitation factor that could increase the buccal inclination of the anterior teeth.

  9. Traumatismo craneal por caída accidental en niños menores de dos años de edad. Mecanismos de producción, consecuencias y diagnóstico diferencial con las lesiones causadas por maltrato infantil.

    OpenAIRE

    Trenchs Sainz de la Maza, Victoria

    2008-01-01

    1. INTRODUCCIÓN:Muchos padres relatan una caída con traumatismo craneal (TCE) para justificar hematomas subdurales (HSD) y/o hemorragias retinianas (HR) debidas a maltrato. El diagnóstico diferencial entre TCE accidental e inflingido en ausencia de otras lesiones es difícil porque no hay estudios que determinen la prevalencia de HSD y/o HR en los traumatismos por caídas.2. HIPÓTESIS:- El mecanismo de producción y la altura de un caída condicionan las lesiones que aparecen en el niño.- El cono...

  10. Comparative analysis of the anterior and posterior length and deflection angle of the cranial base, in individuals with facial Pattern I, II and III

    Directory of Open Access Journals (Sweden)

    Guilherme Thiesen

    2013-02-01

    Full Text Available OBJECTIVE: This study evaluated the variations in the anterior cranial base (S-N, posterior cranial base (S-Ba and deflection of the cranial base (SNBa among three different facial patterns (Pattern I, II and III. METHOD: A sample of 60 lateral cephalometric radiographs of Brazilian Caucasian patients, both genders, between 8 and 17 years of age was selected. The sample was divided into 3 groups (Pattern I, II and III of 20 individuals each. The inclusion criteria for each group were the ANB angle, Wits appraisal and the facial profile angle (G'.Sn.Pg'. To compare the mean values obtained from (SNBa, S-N, S-Ba each group measures, the ANOVA test and Scheffé's Post-Hoc test were applied. RESULTS AND CONCLUSIONS: There was no statistically significant difference for the deflection angle of the cranial base among the different facial patterns (Patterns I, II and III. There was no significant difference for the measures of the anterior and posterior cranial base between the facial Patterns I and II. The mean values for S-Ba were lower in facial Pattern III with statistically significant difference. The mean values of S-N in the facial Pattern III were also reduced, but without showing statistically significant difference. This trend of lower values in the cranial base measurements would explain the maxillary deficiency and/or mandibular prognathism features that characterize the facial Pattern III.OBJETIVO: o presente estudo avaliou as variações da base craniana anterior (S-N, base craniana posterior (S-Ba, e ângulo de deflexão da base do crânio (SNBa entre três diferentes padrões faciais (Padrão I, II e III. MÉTODOS: selecionou-se uma amostra de 60 telerradiografias em norma lateral de pacientes brasileiros leucodermas, de ambos os sexos, com idades entre 8 anos e 17 anos. A amostra foi dividida em três grupos (Padrão I, II e III, sendo cada grupo constituído de 20 indivíduos. Os critérios de seleção dos indivíduos para cada grupo

  11. The Analysis of Plantar Pressure Data Based on Multimodel Method in Patients with Anterior Cruciate Ligament Deficiency during Walking

    Directory of Open Access Journals (Sweden)

    Xiaoli Li

    2016-01-01

    Full Text Available The movement information of the human body can be recorded in the plantar pressure data, and the analysis of plantar pressure data can be used to judge whether the human body motion function is normal or not. A two-meter footscan® system was used to collect the plantar pressure data, and the kinetic and dynamic gait characteristics were extracted. According to the different description of gait characteristics, a set of models was established according to various people to present the movement of lower limbs. By the introduction of algorithm in machine learning, the FCM clustering algorithm is used to cluster the sample set and create a set of models, and then the SVM algorithm was used to identify the new samples, so as to complete the normal and abnormal motion function identification. The multimodel presented in this paper was carried out into the analysis of the anterior cruciate ligament deficiency. This method demonstrated being effective and can provide auxiliary analysis for clinical diagnosis.

  12. IMU-based Real-time Pose Measurement system for Anterior Pelvic Plane in Total Hip Replacement Surgeries.

    Science.gov (United States)

    Zhe Cao; Shaojie Su; Hao Tang; Yixin Zhou; Zhihua Wang; Hong Chen

    2017-07-01

    With the aging of population, the number of Total Hip Replacement Surgeries (THR) increased year by year. In THR, inaccurate position of the implanted prosthesis may lead to the failure of the operation. In order to reduce the failure rate and acquire the real-time pose of Anterior Pelvic Plane (APP), we propose a measurement system in this paper. The measurement system includes two parts: Initial Pose Measurement Instrument (IPMI) and Real-time Pose Measurement Instrument (RPMI). IPMI is used to acquire the initial pose of the APP, and RPMI is used to estimate the real-time pose of the APP. Both are composed of an Inertial Measurement Unit (IMU) and magnetometer sensors. To estimate the attitude of the measurement system, the Extended Kalman Filter (EKF) is adopted in this paper. The real-time pose of the APP could be acquired together with the algorithm designed in the paper. The experiment results show that the Root Mean Square Error (RMSE) is within 1.6 degrees, which meets the requirement of THR operations.

  13. Pleomorphic rhabdomyosarcoma arising in the anterior mediastinum: A case report with cytological features of imprint and liquid-based cytology specimens.

    Science.gov (United States)

    Nishijima, Yoshimi; Hirato, Junko; Fukuda, Toshio

    2017-04-01

    We herein report the cytological features of a very rare case of pleomorphic rhabdomyosarcoma arising in the anterior mediastinum on imprint and liquid-based cytology (LBC) specimens. A 58-year-old man had an approximately 10-cm tumor in the anterior mediastinum as shown on computed tomography. Thymectomy with complete resection of the left lung was performed. The fresh cut surface of the tumor was used to prepare imprint and LBC specimens. The imprint specimens showed four types of tumor cells dispersed on a background of hemorrhage, necrosis, and mucus. On the other hand, only two types of tumor cells (spindle-shaped and spiderweb cells) were scattered or present in clusters in the LBC specimens. Immunocytologically, both of these cell types were positive for desmin and myoglobin, negative for pan-keratin and epithelial membrane antigen. Cytological and immunocytological features are useful for the correct diagnosis of pleomorphic rhabdomyosarcoma, and LBC specimens show clearer results than do imprint specimens. Diagn. Cytopathol. 2017;45:333-338. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. Trans-zygomatic middle cranial fossa approach to access lesions around the cavernous sinus and anterior parahippocampus: a minimally invasive skull base approach.

    Science.gov (United States)

    Melamed, Itay; Tubbs, R Shane; Payner, Troy D; Cohen-Gadol, Aaron A

    2009-08-01

    Exposure of the cavernous sinus or anterior parahippocampus often involves a wide exposure of the temporal lobe and mobilization of the temporalis muscle associated with temporal lobe retraction. The authors present a cadaveric study to illustrate the feasibility, advantages and landmarks necessary to perform a trans-zygomatic middle fossa approach to lesions around the cavernous sinus and anterior parahippocampus. The authors performed bilateral trans-zygomatic middle fossae exposures to reach the cavernous sinus and parahippocampus in five cadavers (10 sides). We assessed the morbidity associated with this procedure and compared the indications, advantages, and disadvantages of this method versus more extensive skull base approaches. A vertical linear incision along the middle portion of the zygomatic arch was extended one finger breadth inferior to the inferior edge of the zygomatic arch. Careful dissection inferior to the arch allowed preservation of facial nerve branches. A zygomatic osteotomy was followed via a linear incision through the temporalis muscle and exposure of the middle cranial fossa floor. A craniotomy along the inferolateral temporal bone and middle fossa floor allowed extradural dissection along the middle fossa floor and exposure of the cavernous sinus including all three divisions of the trigeminal nerve. Intradural inspection demonstrated adequate exposure of the parahippocampus. Exposure of the latter required minimal or no retraction of the temporal lobe. The trans-zygomatic middle fossa approach is a simplified skull base exposure using a linear incision, which may avoid the invasivity of more extensive skull base approaches while providing an adequate corridor for resection of cavernous sinus and parahippocampus lesions. The advantages of this approach include its efficiency, ease, minimalism, preservation of the temporalis muscle, and minimal retraction of the temporal lobe.

  15. Congenital anterior urethral diverticulum

    International Nuclear Information System (INIS)

    Jung, Hyun Sub; Chung, Young Sun; Suh, Chee Jang; Won, Jong Jin

    1985-01-01

    Two cases of congenital anterior urethral diverticular which have occurred in a 4 year old and one month old boy are presented. Etiology, diagnostic procedures, and its clinical results are briefly reviewed

  16. Involvement of the anterior cingulate cortex in time-based prospective memory task monitoring: An EEG analysis of brain sources using Independent Component and Measure Projection Analysis.

    Directory of Open Access Journals (Sweden)

    Gabriela Cruz

    Full Text Available Time-based prospective memory (PM, remembering to do something at a particular moment in the future, is considered to depend upon self-initiated strategic monitoring, involving a retrieval mode (sustained maintenance of the intention plus target checking (intermittent time checks. The present experiment was designed to explore what brain regions and brain activity are associated with these components of strategic monitoring in time-based PM tasks.24 participants were asked to reset a clock every four minutes, while performing a foreground ongoing word categorisation task. EEG activity was recorded and data were decomposed into source-resolved activity using Independent Component Analysis. Common brain regions across participants, associated with retrieval mode and target checking, were found using Measure Projection Analysis.Participants decreased their performance on the ongoing task when concurrently performed with the time-based PM task, reflecting an active retrieval mode that relied on withdrawal of limited resources from the ongoing task. Brain activity, with its source in or near the anterior cingulate cortex (ACC, showed changes associated with an active retrieval mode including greater negative ERP deflections, decreased theta synchronization, and increased alpha suppression for events locked to the ongoing task while maintaining a time-based intention. Activity in the ACC was also associated with time-checks and found consistently across participants; however, we did not find an association with time perception processing per se.The involvement of the ACC in both aspects of time-based PM monitoring may be related to different functions that have been attributed to it: strategic control of attention during the retrieval mode (distributing attentional resources between the ongoing task and the time-based task and anticipatory/decision making processing associated with clock-checks.

  17. Surgical versus conservative treatment for high-risk stress fractures of the lower leg (anterior tibial cortex, navicular and fifth metatarsal base): a systematic review

    NARCIS (Netherlands)

    Mallee, Wouter H.; Weel, Hanneke; van Dijk, C. Niek; van Tulder, Maurits W.; Kerkhoffs, Gino M.; Lin, Chung-Wei Christine

    2015-01-01

    To compare surgical and conservative treatment for high-risk stress fractures of the anterior tibial cortex, navicular and proximal fifth metatarsal. Systematic searches of CENTRAL, MEDLINE, EMBASE, CINAHL, SPORTDiscus and PEDro were performed to identify relevant prospective and retrospective

  18. Asymmetric activation of the anterior cerebral cortex in recipients of IRECA: Preliminary evidence for the energetic effects of an intention-based biofield treatment modality on human neurophysiology

    NARCIS (Netherlands)

    Pike, C.; Vernon, D.; Hald, L.A.

    2014-01-01

    Neurophysiologic studies of mindfulness link the health benefits of meditation to activation of the left-anterior cerebral cortex. The similarity and functional importance of intention and attentional stance in meditative and biofield therapeutic practices suggest that modulation of recipient

  19. Foraging Value, Risk Avoidance, and Multiple Control Signals: How the Anterior Cingulate Cortex Controls Value-based Decision-making.

    Science.gov (United States)

    Brown, Joshua W; Alexander, William H

    2017-10-01

    Recent work on the role of the ACC in cognition has focused on choice difficulty, action value, risk avoidance, conflict resolution, and the value of exerting control among other factors. A main underlying question is what are the output signals of ACC, and relatedly, what is their effect on downstream cognitive processes? Here we propose a model of how ACC influences cognitive processing in other brain regions that choose actions. The model builds on the earlier Predicted Response Outcome model and suggests that ACC learns to represent specifically the states in which the potential costs or risks of an action are high, on both short and long timescales. It then uses those cost signals as a basis to bias decisions to minimize losses while maximizing gains. The model simulates both proactive and reactive control signals and accounts for a variety of empirical findings regarding value-based decision-making.

  20. Osteointegration of a bisphenol-a-glycidyl-dimethacrylate composite and its use in anterior skull base defects: an experimental study in an experimental design model of cerebrospinal fluid leak.

    Science.gov (United States)

    Sanus, Galip Zihni; Kucukyuruk, Baris; Biceroglu, Huseyin; Isler, Cihan; Tanriverdi, Taner; Bas, Ahmet; Albayram, Sait; Kurkcu, Mehmet; Oz, Buge

    2014-07-01

    Promising clinical results were reported in watertight closure of anterior skull base defects (ASBDs) with bisphenol-a-glycidyl-dimethacrylate (bis-GMA)-based materials to prevent the cerebrospinal fluid leaks. However, interrelation of these materials with surrounding bones in histologic level, referred to as the osteointegration, has not been reported in the anterior skull base. In addition, an illustrative case with an ASBD that was repaired using a bis-GMA composite has been presented. Twenty New Zealand rabbits were divided into 4 groups: control and sham groups consisted of 2 and 6 rabbits, respectively. The "skull base defect" group (n = 6) underwent a unifrontal craniectomy and an iatrogenic ASBD followed by creating a dural defect to obtain a cerebrospinal fluid leak. Similar bony and dural defects were acquired in the "repair with bis-GMA based allograft" group (n = 6), but the bony defect was closed with bis-GMA-based allograft. All animals in the "skull base defect" group died in 3 weeks after surgery. There were no animal losses in the "repair with bis-GMA based allograft" group at the sixth month. Histologic evaluation revealed complete osteointegration of bis-GMA composite with surrounding bones. bis-GMA based allograft achieved a watertight repair of the ASBD. Histologic findings of this study showed that bis-GMA composite is a reliable material to be used in the closure of anterior skull base bony defects.

  1. Mechanisms and situations of anterior cruciate ligament injuries in professional male soccer players: a YouTube-based video analysis.

    Science.gov (United States)

    Grassi, Alberto; Smiley, Stephen Paul; Roberti di Sarsina, Tommaso; Signorelli, Cecilia; Marcheggiani Muccioli, Giulio Maria; Bondi, Alice; Romagnoli, Matteo; Agostini, Alessandra; Zaffagnini, Stefano

    2017-10-01

    Soccer is considered the most popular sport in the world concerning both audience and athlete participation, and the incidence of ACL injury in this sport is high. The understanding of injury situations and mechanisms could be useful as substratum for preventive actions. To conduct a video analysis evaluating the situations and mechanisms of ACL injury in a homogeneous population of professional male soccer players, through a search entirely performed on the YouTube.com Web site focusing on the most recent years. A video analysis was conducted obtaining videos of ACL injury in professional male soccer players from the Web site YouTube. Details regarding injured players, events and situations were obtained. The mechanism of injury was defined on the basis of the action, duel type, contact or non-contact injury, and on the hip, knee and foot position. Thirty-four videos were analyzed, mostly from the 2014-2015 season. Injuries occurred mostly in the first 9 min of the match (26%), in the penalty area (32%) or near the side-lines (44%), and in non-rainy conditions (97%). Non-contact injuries occurred in 44% of cases, while indirect injuries occurred in 65%, mostly during pressing, dribbling or tackling. The most recurrent mechanism was with an abducted and flexed hip, with knee at first degrees of flexion and under valgus stress. Through a YouTube-based video analysis, it was possible to delineate recurrent temporal, spatial and mechanical characteristics of ACL injury in male professional soccer players. Level IV, case series.

  2. Comparison of Anterior and Posterior Surgery for Degenerative Cervical Myelopathy: An MRI-Based Propensity-Score-Matched Analysis Using Data from the Prospective Multicenter AOSpine CSM North America and International Studies.

    Science.gov (United States)

    Kato, So; Nouri, Aria; Wu, Dongjin; Nori, Satoshi; Tetreault, Lindsay; Fehlings, Michael G

    2017-06-21

    Surgeons often choose between 2 different approaches (anterior and posterior) for surgical treatment of degenerative cervical myelopathy on the basis of imaging features of spinal cord compression, the number of levels affected, and the spinal alignment. However, there is a lack of consensus on which approach is preferable. The objective of the present study was to use magnetic resonance imaging (MRI)-based propensity-score-matched analysis to compare postoperative outcomes between the anterior and posterior surgical approaches for degenerative cervical myelopathy. A total of 757 patients were enrolled in 2 prospective multicenter AOSpine studies, which involved 26 international sites. Preoperative MRIs were reviewed to characterize the causes of the cord compression, including single-level disc disease, multilevel disc disease, ossification of the posterior longitudinal ligament, enlargement of the ligamentum flavum, vertebral subluxation/spondylolisthesis, congenital fusion, number of compressed levels, or kyphosis. The propensity to choose anterior decompression was calculated using demographic data, preoperative MRI findings, and the modified Japanese Orthopaedic Association (mJOA) scores in a logistic regression model. We then performed 1-to-1 matching of patients who had received anterior decompression with those who had the same propensity score but had received posterior decompression to compare 2-year postoperative outcomes and 30-day perioperative complication rates between the 2 groups after adjustment for background characteristics. A total of 435 cases were included in the propensity score calculation, and 1-to-1 matching resulted in 80 pairs of anterior and posterior surgical cases; 99% of these matched patients had multilevel compression. The anterior and posterior groups did not differ significantly in terms of the postoperative mJOA score (15.1 versus 15.3, p = 0.53), Neck Disability Index (20.5 versus 24.1, p = 0.44), or Short Form-36 (SF-36

  3. Multidisciplinary management of anterior diastemata

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  4. A Method of Accurate Bone Tunnel Placement for Anterior Cruciate Ligament Reconstruction Based on 3-Dimensional Printing Technology: A Cadaveric Study.

    Science.gov (United States)

    Ni, Jianlong; Li, Dichen; Mao, Mao; Dang, Xiaoqian; Wang, Kunzheng; He, Jiankang; Shi, Zhibin

    2018-02-01

    To explore a method of bone tunnel placement for anterior cruciate ligament (ACL) reconstruction based on 3-dimensional (3D) printing technology and to assess its accuracy. Twenty human cadaveric knees were scanned by thin-layer computed tomography (CT). To obtain data on bones used to establish a knee joint model by computer software, customized bone anchors were installed before CT. The reference point was determined at the femoral and tibial footprint areas of the ACL. The site and direction of the bone tunnels of the femur and tibia were designed and calibrated on the knee joint model according to the reference point. The resin template was designed and printed by 3D printing. Placement of the bone tunnels was accomplished by use of templates, and the cadaveric knees were scanned again to compare the concordance of the internal opening of the bone tunnels and reference points. The twenty 3D printing templates were designed and printed successfully. CT data analysis between the planned and actual drilled tunnel positions showed mean deviations of 0.57 mm (range, 0-1.5 mm; standard deviation, 0.42 mm) at the femur and 0.58 mm (range, 0-1.5 mm; standard deviation, 0.47 mm) at the tibia. The accuracy of bone tunnel placement for ACL reconstruction in cadaveric adult knees based on 3D printing technology is high. This method can improve the accuracy of bone tunnel placement for ACL reconstruction in clinical sports medicine. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Anterior Urethral Valves

    Directory of Open Access Journals (Sweden)

    Vidyadhar P. Mali

    2006-07-01

    Full Text Available We studied the clinical presentation and management of four patients with anterior urethral valves; a rare cause of urethral obstruction in male children. One patient presented antenatally with oligohydramnios, bilateral hydronephrosis and bladder thickening suggestive of an infravesical obstruction. Two other patients presented postnatally at 1 and 2 years of age, respectively, with poor stream of urine since birth. The fourth patient presented at 9 years with frequency and dysuria. Diagnosis was established on either micturating cystourethrogram (MCU (in 2 or on cystoscopy (in 2. All patients had cystoscopic ablation of the valves. One patient developed a postablation stricture that was resected with an end-to-end urethroplasty. He had an associated bilateral vesicoureteric junction (VUJ obstruction for which a bilateral ureteric reimplantation was done at the same time. On long-term follow-up, all patients demonstrated a good stream of urine. The renal function is normal. Patients are continent and free of urinary infections. Anterior urethral valves are rare obstructive lesions in male children. The degree of obstruction is variable, and so they may present with mild micturition difficulty or severe obstruction with hydroureteronephrosis and renal impairment. Hence, it is important to evaluate the anterior urethra in any male child with suspected infravesical obstruction. The diagnosis is established by MCU or cystoscopy and the treatment is always surgical, either a transurethral ablation or an open resection. The long-term prognosis is good.

  6. Perawatan Ortodontik Gigitan Terbuka Anterior

    Directory of Open Access Journals (Sweden)

    Yuniar Zen

    2014-06-01

    Full Text Available Perawatan gigitan terbuka anterior telah lama dianggap sebagai tantangan bagi ortodontis. Prevalensi gigitan terbuka anterior antara 3,5% hingga 11% terdapat pada berbagai usia dan kelompok etnis, serta ada sekitar 17% pasien ortodonti memiliki gigitan terbuka. Stabilitas hasil perawatan gigitan terbuka anterior sangat sulit, karena adanya kombinasi diskrepansi anteroposterior dengan gigitan terbuka skeletal sehingga dibutuhkan tingkat keterampilan diagnosis dan klinis yang tinggi. Etiologi gigitan terbuka anterior sangat kompleks karena dapat melibatkan skeletal, dental, dan faktor-faktor habitual. Eliminasi faktor etiologi merupakan hal yang penting dalam perawatan gigitan terbuka anterior. Berbagai cara perawatan untuk koreksi gigitan terbuka anterior diantaranya bedah ortognatik dan perawatan ortodontik kamuflase, seperti high-pull headgear, chincup, bite blocks, alatfungsional, pencabutan gigi, multi-loop edgewise archwires dan mini implan. Stabilitas hasil perawatan adalah kriteria yang paling penting dalam menentukan cara perawatan gigitan terbuka anterior. Orthodontic Treatment of Anterior Open Bite. An anterior open bite therapy has long been considered a challenge to orthodontist. The prevalence of anterior openbite range from 3,5 % to 11% among various age and ethnic groups and it has been shown that approximately 17% of orthodontic patients have open bite. Stability of treatment result of anterior open bite with well-maintained results is difficult, because the combination of anteroposteriorly discrepancy with skeletal open bite requires the highest degree of diagnostic and clinical skill. The etiology is complex, potentially involving skeletal, dental and habitual factors. The importance of an anterior open bite therapy is to eliminate the cause of the open bite. Various treatment modalities for the correction of an anterior open bite have been proposed, orthognatic surgery and orthodontic camouflage treatment such as high

  7. Surgical versus conservative treatment for high-risk stress fractures of the lower leg (anterior tibial cortex, navicular and fifth metatarsal base): a systematic review

    NARCIS (Netherlands)

    Mallee, W.H.; Weel, H.; van Dijk, C.N.; van Tulder, M.W.; Kerkhoffs, G.M.; Lin, C.W.C.

    2015-01-01

    Aim To compare surgical and conservative treatment for high-risk stress fractures of the anterior tibial cortex, navicular and proximal fifth metatarsal. Methods Systematic searches of CENTRAL, MEDLINE, EMBASE, CINAHL, SPORTDiscus and PEDro were performed to identify relevant prospective and

  8. Current approach in diagnosis and management of anterior uveitis

    OpenAIRE

    Agrawal, Rupesh V; Murthy, Somasheila; Sangwan, Virender; Biswas, Jyotirmay

    2010-01-01

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

  9. Anterior knee pain

    International Nuclear Information System (INIS)

    LLopis, Eva; Padron, Mario

    2007-01-01

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

  10. Anterior knee pain

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-04-15

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

  11. The anterior cingulate cortex

    Directory of Open Access Journals (Sweden)

    Pavlović D.M.

    2009-01-01

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

  12. Bioengineered anterior cruciate ligament

    Science.gov (United States)

    Martin, Ivan (Inventor); Altman, Gregory (Inventor); Kaplan, David (Inventor); Vunjak-Novakovic, Gordana (Inventor)

    2001-01-01

    The present invention provides a method for producing an anterior cruciate ligament ex vivo. The method comprises seeding pluripotent stem cells in a three dimensional matrix, anchoring the seeded matrix by attachment to two anchors, and culturing the cells within the matrix under conditions appropriate for cell growth and regeneration, while subjecting the matrix to one or more mechanical forces via movement of one or both of the attached anchors. Bone marrow stromal cells are preferably used as the pluripotent cells in the method. Suitable matrix materials are materials to which cells can adhere, such as a gel made from collagen type I. Suitable anchor materials are materials to which the matrix can attach, such as Goinopra coral and also demineralized bone. Optimally, the mechanical forces to which the matrix is subjected mimic mechanical stimuli experienced by an anterior cruciate ligament in vivo. This is accomplished by delivering the appropriate combination of tension, compression, torsion, and shear, to the matrix. The bioengineered ligament which is produced by this method is characterized by a cellular orientation and/or matrix crimp pattern in the direction of the applied mechanical forces, and also by the production of collagen type I, collagen type III, and fibronectin proteins along the axis of mechanical load produced by the mechanical forces. Optimally, the ligament produced has fiber bundles which are arranged into a helical organization. The method for producing an anterior cruciate ligament can be adapted to produce a wide range of tissue types ex vivo by adapting the anchor size and attachment sites to reflect the size of the specific type of tissue to be produced, and also adapting the specific combination of forces applied, to mimic the mechanical stimuli experienced in vivo by the specific type of tissue to be produced. The methods of the present invention can be further modified to incorporate other stimuli experienced in vivo by the

  13. [Anterior guidance in complete dentures].

    Science.gov (United States)

    Dubreuil, J; Trevelo, A

    1990-01-01

    Although the anterior guidance in complete dentures is not really a guide, the arrangement of the anterior maxillary and mandibular prosthetic teeth, defines a propulsive line called the virtual anterior guidance, a part from the cinematic criterias. The influence of this guide on cuspal movement is superior, in all mandibular points, to the influence of the condylar pathway. If this line is not respected, the practitioner may have to do excessive grindings during occlusal adjustments.

  14. Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

    DEFF Research Database (Denmark)

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

    2014-01-01

    OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN...

  15. anomalous left anterior cerebral artery with hypoplastic right anterior ...

    African Journals Online (AJOL)

    2018-02-28

    Feb 28, 2018 ... We report an extremely rare anomalous variation of left anterior cerebral artery arising from the ... paraclinoid internal carotid artery and right ... Studies on the arteries of the brain: II-The anterior cerebral artery: Some anatomic ...

  16. Accuracy and reproducibility of voxel based superimposition of cone beam computed tomography models on the anterior cranial base and the zygomatic arches

    NARCIS (Netherlands)

    Nada, R.M.; Maal, T.J.J.; Breuning, K.H.; Berge, S.J.; Mostafa, Y.A.; Kuijpers-Jagtman, A.M.

    2011-01-01

    Superimposition of serial Cone Beam Computed Tomography (CBCT) scans has become a valuable tool for three dimensional (3D) assessment of treatment effects and stability. Voxel based image registration is a newly developed semi-automated technique for superimposition and comparison of two CBCT scans.

  17. Nonnecrotizing anterior scleritis mimicking orbital inflammatory disease

    Directory of Open Access Journals (Sweden)

    Lynch MC

    2013-08-01

    Full Text Available Michelle Chen Lynch,1 Andrew B Mick21Optometry Clinic, Ocala West Veterans Affairs Specialty Clinic, Ocala, FL, USA; 2Eye Clinic, San Francisco VA Medical Center, San Francisco, CA, USABackground: Anterior scleritis is an uncommon form of ocular inflammation, often associated with coexisting autoimmune disease. With early recognition and aggressive systemic therapy, prognosis for resolution is good. The diagnosis of underlying autoimmune disease involves a multidisciplinary approach.Case report: A 42-year-old African American female presented to the Eye Clinic at the San Francisco Veteran Affairs Medical Center, with a tremendously painful left eye, worse on eye movement, with marked injection of conjunctiva. There was mild swelling of the upper eyelid. Visual acuity was unaffected, but there was a mild red cap desaturation. The posterior segment was unremarkable. The initial differential diagnoses included anterior scleritis and orbital inflammatory disease. Oral steroid treatment was initiated with rapid resolution over a few days. Orbital imaging was unremarkable, and extensive laboratory work-up was positive only for antinuclear antibodies. The patient was diagnosed with idiopathic diffuse, nonnecrotizing anterior scleritis and has been followed for over 5 years without recurrence. The rheumatology clinic monitors the patient closely, as suspicion remains for potential arthralgias including human leukocyte antigen-B27-associated arthritis, lupus-associated arthritis, seronegative rheumatoid arthritis, recurrent juvenile idiopathic arthritis, and scleroderma, based on her constitutional symptoms and clinical presentation, along with a positive anti-nuclear antibody lab result.Conclusion: Untreated anterior scleritis can progress to formation of cataracts, glaucoma, uveitis, corneal melting, and posterior segment disease with significant risk of vision loss. Patients with anterior scleritis must be aggressively treated with systemic anti

  18. Anterior cervical fusion: the role of anterior plating.

    Science.gov (United States)

    Daffner, Scott D; Wang, Jeffrey C

    2009-01-01

    Treatment of cervical pathology requires a clear understanding of the biomechanical benefits and limitations of cervical plates, their indications, and their associated complications. The use of anterior cervical plates has evolved significantly since their early application in cervical trauma. They have become widely used for anterior cervical decompression and fusion for cervical spondylosis. Plate design has undergone significant refinement and innovation, from the initial unlocked plates requiring bicortical purchase to the latest rotationally and translationally semiconstrained dynamic plates. Excellent clinical results have been reported for single-level anterior cervical decompression and fusion with or without plate fixation; however, the addition of an anterior cervical plate clearly leads to earlier fusion and better clinical results in longer fusions. Longer fusions should ideally consist of corpectomies and strut grafting because the decreased number of fusion surfaces tends to lead to higher fusion rates. Although anterior plate fixation leads to higher fusion rates in fusions of three or more levels, the associated pseudarthrosis rate is still high. The use of dynamic plates, through increased load sharing across the graft and decreased stress shielding, may improve fusion rates, particularly in long fusions. Nevertheless, adjuvant posterior fixation is recommended for fusions of more than three vertebral levels. Anterior plate fixation may be of particular benefit in the management of traumatic injuries, in revision settings, and in the treatment of smokers. Complications unique to plate fixation include hardware breakage and migration as well as ossification of the adjacent disk levels.

  19. Radiographic study on the anterior portion of the neck of the condylar process. Aged-related developmental changes based on Hellman's dental stage

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Hiroshi; Yamato, Rieko; Tada, Miwako [Meikai Univ., Sakado, Saitama (Japan). School of Dentistry] [and others

    2003-02-01

    The condylar process is directly and indirectly influenced by the masticatory muscles and the temporomandibular joint, which functions to regulate jaw movement. Age-related changes in the condylar process were found in both external and internal structures. Observation of X-ray profiles afforded identification of areas of interest in the anterior portion of the neck of condylar process. This portion anatomically includes the pterygoid fovea; moreover, the process serves as a terminal for the lateral pterygoid muscle. Rather than directly analyzing bone structure, we made distinct measurements in regions of interest by X-ray image analysis. Subsequently, changes in occlusion during each developmental stage were evaluated. In addition, bone mineral density measurements were performed. Greater growth was recognized in the long axis of the condylar process in comparison to the short axis. The long axis indicated a 2.7-fold increase in ODL (length along the major axis) from the IA period to the VA period; additionally, the total absolute length increased by 3.1-fold. The short axis demonstrated a 2.3-fold increase in ODS (length along the minor axis) from the IA period to the VA period; furthermore, the total average length revealed a 1.9-fold increase. Bone mineral density was highest in the anterior portion (region of interest) and was higher in the posterior portion (cortical bone); than in the middle portion (central bone). Among these 3 areas, density differences became larger as the developmental stage of occlusion progressed. Detailed measurements in the region of interest demonstrated significant increases from the IIC period to the IIIA (B) period, and distinct peak times of increases were observed in bone mineral density: the center bone structure, as well as the posterior cortical bone, showed significant increases between the IIIC period and the IVA period. The anterior border displayed to constant increase with an exception for the period between stages

  20. Anterior ankle arthroscopy, distraction or dorsiflexion?

    OpenAIRE

    de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.

    2010-01-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, where...

  1. Anterior Knee Pain (Chondromalacia Patellae).

    Science.gov (United States)

    Garrick, James G.

    1989-01-01

    This article presents a pragmatic approach to the definition, diagnosis, and management of anterior knee pain. Symptoms and treatment are described. Emphasis is on active involvement of the patient in the rehabilitation exercise program. (IAH)

  2. Anterior approach for knee arthrography

    International Nuclear Information System (INIS)

    Zurlo, J.V.; Towers, J.D.; Golla, S.

    2001-01-01

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

  3. Hoffa's fat pad injuries and their relationship with anterior cruciate ligament tears: new observations based on MR imaging in patients and MR imaging and anatomic correlation in cadavers

    International Nuclear Information System (INIS)

    Abreu, Marcelo R.; Chung, Christine B.; Trudell, Debra; Resnick, Donald

    2008-01-01

    To determine the normal anatomic relationships of Hoffa's fat pad with the anterior cruciate ligament (ACL) and with the frequency of Hoffa's fat pad abnormalities in ACL-deficient knees. Retrospective clinical study on patients and observational anatomic study on cadavers. The study was approved by the Institutional Review Board. MR imaging studies of the knees of 100 patients (21-48 years old) with or without arthroscopically proven tears of the ACL, performed at a single institution, were reviewed by two readers for abnormalities of Hoffa's fat pad. Ten cadaveric knee specimens were studied with MR imaging and Faxitron radiographs, and by inspection of sections and histology. Alterations in Hoffa's fat pad on MR imaging were present in 64% (32/50) of patients with torn ACLs, and in 24% (12/50) of patients without a tear of the ACL (P < 0.05). Hoffa's fat pad inserted into the intercondylar notch in 50% (5/10) of cadaveric specimens, four in conjunction with the ligamentum mucosum and in one in an isolated fashion. Histological study demonstrated the composition of the ligamentum mucosum and Hoffa's fat pad and their course and insertion sites in the intercondylar notch. Abnormalities of Hoffa's fat pad, such as focal and diffuse edema, tears, scars and synovial proliferation, are more common in knees with torn ACLs than in knees with intact ACLs. (orig.)

  4. Anterior ankle arthroscopy, distraction or dorsiflexion?

    NARCIS (Netherlands)

    de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.

    2010-01-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly

  5. Anterior ethmoid anatomy facilitates dacryocystorhinostomy.

    Science.gov (United States)

    Blaylock, W K; Moore, C A; Linberg, J V

    1990-12-01

    The ethmoid air cell labyrinth lies adjacent to the medial orbital wall, extending even beyond the sutures of the ethmoid bone. Its anatomic relationship to the lacrimal sac fossa is important in lacrimal surgery. We evaluated computed tomographic scans of 190 orbits with normal ethmoid anatomy to define the anatomic relationship of anterior ethmoid air cells to the lacrimal sac fossa. In 93% of the orbits, the cells extended anterior to the posterior lacrimal crest, with 40% entering the frontal process of the maxilla. This anatomic relationship may be used to facilitate the osteotomy during dacryocystorhinostomy. During a 10-year period (310 cases), one of us routinely entered the anterior ethmoid air cells to initiate the osteotomy during dacryocystorhinostomy. This technique has helped to avoid lacerations of the nasal mucosa.

  6. Clinic-based assessment of weight-bearing asymmetry during squatting in people with anterior cruciate ligament reconstruction using Nintendo Wii Balance Boards.

    Science.gov (United States)

    Clark, Ross A; Howells, Brooke; Feller, Julian; Whitehead, Tim; Webster, Kate E

    2014-06-01

    To use low-cost Nintendo Wii Balance Boards (NWBB) to assess weight-bearing asymmetry (WBA) in people who have undergone anterior cruciate ligament reconstruction (ACLR), and to compare their results with a matched control group. Quantitative clinical study using a cross-sectional design. Orthopedic clinic of a private hospital. ACLR participants (n=41; mean age ± SD, 26.0 ± 9.8 y; current Cincinnati sports activity level, 75.3 ± 19.8) performed testing in conjunction with their routine 6- or 12-month clinical follow-up, and a control group (n=41) was matched for age, height, body mass, and physical activity level. Participants performed double-limb squats while standing on 2 NWBBs, 1 under each foot. The WBA variables mean mass difference as a percentage of body mass, time favoring a single limb by >5% body mass, absolute symmetry index, and symmetry index relative to the operated or matched control limb were derived. Mann-Whitney U tests were performed to assess between-group differences. Significant (P<.05) increases in asymmetry in the ACLR group were found for all outcome measures except symmetry index relative to the operated limb. People who have undergone ACLR are likely to possess WBA during squats, and this can be assessed using low-cost NWBBs in a clinical setting. Interestingly, the observed asymmetry was not specific to the surgical limb. Future research is needed to assess the relationship between WBA early in the rehabilitation process and long-term outcomes. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Unilateral anterior ischemic optic neuropathy

    DEFF Research Database (Denmark)

    Herbst, Kristina; Sander, Birgit; Lund-Andersen, Henrik

    2013-01-01

    of this study was to investigate the ipRGC mediated pupil response in patients with a unilateral non-arteritic anterior ischemic optic neuropathy (NAION). Consensual pupil responses during and after exposure to continuous 20 s blue (470 nm) or red (660 nm) light of high intensity (300 cd/m(2)) were recorded...

  8. Válvula de uretra anterior Anterior urethral valves

    Directory of Open Access Journals (Sweden)

    Silvio Tucci Jr.

    2003-02-01

    Full Text Available Objetivo: apresentar os aspectos clínicos, diagnósticos e terapêuticos de pacientes portadores de válvula da uretra anterior. Descrição: em dois neonatos, o diagnóstico presuntivo de patologia obstrutiva do trato urinário foi sugerido pela ultra-sonografia realizada no período pré-natal, confirmando-se o diagnóstico de válvula de uretra anterior pela avaliação pós-natal. Os pacientes foram submetidos a tratamento cirúrgico paliativo, com vesicostomia temporária e, posteriormente, definitivo, pela fulguração endoscópica das válvulas. Ambos evoluíram com função renal normal. Comentários: a válvula da uretra anterior é anomalia rara que deve ser considerada em meninos com quadro radiológico pré-natal sugestivo de obstrução infravesical, secundariamente à hipótese mais comum de válvula da uretra posterior. Ressaltamos a utilização da vesicostomia como derivação urinária temporária nestes casos, prevenindo potenciais complicações pela manipulação da uretra do recém-nascido.Objective: to discuss clinical signs, diagnostic tools and therapeutics of anterior urethral valves, an obstructive anomaly of the urinary system in males. Description: signs of urinary tract obstruction were identified on pre-natal ultrasound in two male fetuses and the diagnosis of anterior urethral valves was made through post-natal evaluation. As an initial treatment, vesicostomy was performed in both patients. Later, the valves were fulgurated using an endoscopic procedure. During the follow-up period both patients presented normal renal function. Comments: anterior urethral valves are a rare form of urethral anomaly that must be ruled out in boys with pre-natal ultrasound indicating infravesical obstruction. Vesicostomy used as an initial treatment rather than transurethral fulguration may prevent potential complications that can occur due to the small size of the neonatal urethra.

  9. Microneurosurgical management of anterior choroid artery aneurysms.

    Science.gov (United States)

    Lehecka, Martin; Dashti, Reza; Laakso, Aki; van Popta, Jouke S; Romani, Rossana; Navratil, Ondrej; Kivipelto, Leena; Kivisaari, Riku; Foroughi, Mansoor; Kokuzawa, Jouji; Lehto, Hanna; Niemelä, Mika; Rinne, Jaakko; Ronkainen, Antti; Koivisto, Timo; Jääskelainen, Juha E; Hernesniemi, Juha

    2010-05-01

    Anterior choroid artery aneurysms (AChAAs) constitute 2%-5% of all intracranial aneurysms. They are usually small, thin walled with one or several arteries originating at their base, and often associated with multiple aneurysms. In this article, we review the practical microsurgical anatomy, the preoperative imaging, surgical planning, and the microneurosurgical steps in the dissection and the clipping of AChAAs. This review, and the whole series on intracranial aneurysms (IAs), are mainly based on the personal microneurosurgical experience of the senior author (J.H.) in two Finnish centers (Helsinki and Kuopio) that serve, without patient selection, the catchment area in Southern and Eastern Finland. These two centers have treated more than 10,000 patients with IAs since 1951. In the Kuopio Cerebral Aneurysm Database of 3005 patients with 4253 IAs, 831 patients (28%) had altogether 980 internal carotid artery (ICA) aneurysms, of whom 95 patients had 99 (2%) AChAAs. Ruptured AChAAs, found in 39 patients (41%), with median size of 6 mm (range = 2-19 mm), were associated with intracerebral hematoma (ICH) in only 1 (3%) patient. Multiple aneurysms were seen in 58 (61%) patients. The main difficulty in microneurosurgical management of AChAAs is to preserve flow in the anterior choroid artery originating at the base and often attached to the aneurysm dome. This necessitates perfect surgical strategy based on preoperative knowledge of 3 dimensional angioarchitecture and proper orientation during the microsurgical dissection. Copyright © 2010 Elsevier Inc. All rights reserved.

  10. Conservative treatment of excessive anterior pelvic tilt

    DEFF Research Database (Denmark)

    Brekke, Anders Falk

    of Clinical Research, University of Southern Denmark, Denmark 3Department of Physiotherapy, University College Zealand, Denmark 4Center for Evidence-Based Medicine, Odense University Hospital, Denmark Correspondence Anders Falk Brekke E-mail: afbrekke@health.sdu.dk Mob: +45 7248 2626 Add: Sdr. Boulevard 29......Conservative treatment of excessive anterior pelvic tilt: A systematic review Anders Falk Brekke1,2,3, Søren Overgaard1,2, Asbjørn Hróbjartsson4, Anders Holsgaard-Larsen1,2 1Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital 2Department...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-15

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

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

    International Nuclear Information System (INIS)

    Petrover, David; Schweitzer, Mark E.; Laredo, J.D.

    2007-01-01

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

  13. Epidermoid cyst in Anterior, Middle

    Directory of Open Access Journals (Sweden)

    Kankane Vivek Kumar

    2016-09-01

    Full Text Available Epidermoid cysts are benign slow growing more often extra-axial tumors that insinuate between brain structures, we present the clinical, imaging, and pathological findings in 35 years old female patients with atypical epidermoid cysts which was situated anterior, middle & posterior cranial fossa. NCCT head revealed hypodense lesion over right temporal and perisylvian region with extension in prepontine cistern with mass effect & midline shift and MRI findings revealed a non-enhancing heterogeneous signal intensity cystic lesion in right frontal & temporal region extending into prepontine cistern with restricted diffusion. Patient was detoriated in night of same day of admission, emergency Fronto-temporal craniotomy with anterior peterousectomy and subtotal resection was done. The histological examination confirms the epidermoid cyst. The timing of ectodermal tissue sequestration during fetal development may account for the occurrence of atypical epidermoid cysts.

  14. Anterior ankle arthroscopy, distraction or dorsiflexion?

    Science.gov (United States)

    de Leeuw, Peter A J; Golanó, Pau; Clavero, Joan A; van Dijk, C Niek

    2010-05-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7-1.5) and 0.7 cm (range 0.5-0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy.

  15. Anterior spinal cord syndrome of unknown etiology

    OpenAIRE

    Klakeel, Merrine; Thompson, Justin; Srinivasan, Rajashree; McDonald, Frank

    2015-01-01

    A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. We present the cases of two 13-year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome.

  16. Anterior fixation of the axis.

    Science.gov (United States)

    Traynelis, Vincent C; Fontes, Ricardo B V

    2010-09-01

    Although anterior fixation of the axis is not commonly performed, plate fixation of C2 is an important technique for treating select upper cervical traumatic injuries and is also useful in the surgical management of spondylosis. To report the technique and outcomes of C2 anterior plate fixation for a series of patients in which the majority presented with symptomatic degenerative spondylosis. Forty-six consecutive patients underwent single or multilevel fusions over a 7-year period; 30 of these had advanced degenerative disease manifested by myelopathy or deformity. Exposure was achieved with rostral extension of the standard anterior cervical exposure via careful soft tissue dissection, mobilization of the superior thyroid artery, and the use of a table-mounted retractor. It was not necessary to remove the submandibular gland, section the digastric muscle, or make additional skin incisions. Screws were placed an average of 4.6 mm (+/- 2.3 mm) from the inferior C2 endplate with a mean sagittal trajectory of 15.7 degrees (+/- 7.6 degrees). Short- and long-term procedure-related mortality was 4.4%, and perioperative morbidity was 8.9%. Patients remained intubated an average of 2.5 days following surgery. Dysphagia was initially reported by 15.2% of patients but resolved by the 8th postoperative week in all patients. Arthrodesis was achieved in all patients available for long-term follow-up. Multilevel fusions were not associated with longer hospitalization or morbidity. Anterior plate fixation of the axis for degenerative disease can be accomplished with acceptable morbidity employing an extension of the standard anterolateral route.

  17. 38 CFR 3.379 - Anterior poliomyelitis.

    Science.gov (United States)

    2010-07-01

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

  18. Fenestration of the anterior cerebral artery

    International Nuclear Information System (INIS)

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

    1981-01-01

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

  19. Anterior Temporal Lobe Morphometry Predicts Categorization Ability.

    Science.gov (United States)

    Garcin, Béatrice; Urbanski, Marika; Thiebaut de Schotten, Michel; Levy, Richard; Volle, Emmanuelle

    2018-01-01

    Categorization is the mental operation by which the brain classifies objects and events. It is classically assessed using semantic and non-semantic matching or sorting tasks. These tasks show a high variability in performance across healthy controls and the cerebral bases supporting this variability remain unknown. In this study we performed a voxel-based morphometry study to explore the relationships between semantic and shape categorization tasks and brain morphometric differences in 50 controls. We found significant correlation between categorization performance and the volume of the gray matter in the right anterior middle and inferior temporal gyri. Semantic categorization tasks were associated with more rostral temporal regions than shape categorization tasks. A significant relationship was also shown between white matter volume in the right temporal lobe and performance in the semantic tasks. Tractography revealed that this white matter region involved several projection and association fibers, including the arcuate fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, and inferior longitudinal fasciculus. These results suggest that categorization abilities are supported by the anterior portion of the right temporal lobe and its interaction with other areas.

  20. Anterior Temporal Lobe Morphometry Predicts Categorization Ability

    Directory of Open Access Journals (Sweden)

    Béatrice Garcin

    2018-02-01

    Full Text Available Categorization is the mental operation by which the brain classifies objects and events. It is classically assessed using semantic and non-semantic matching or sorting tasks. These tasks show a high variability in performance across healthy controls and the cerebral bases supporting this variability remain unknown. In this study we performed a voxel-based morphometry study to explore the relationships between semantic and shape categorization tasks and brain morphometric differences in 50 controls. We found significant correlation between categorization performance and the volume of the gray matter in the right anterior middle and inferior temporal gyri. Semantic categorization tasks were associated with more rostral temporal regions than shape categorization tasks. A significant relationship was also shown between white matter volume in the right temporal lobe and performance in the semantic tasks. Tractography revealed that this white matter region involved several projection and association fibers, including the arcuate fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, and inferior longitudinal fasciculus. These results suggest that categorization abilities are supported by the anterior portion of the right temporal lobe and its interaction with other areas.

  1. Surgical management of anterior chamber epithelial cysts.

    Science.gov (United States)

    Haller, Julia A; Stark, Walter J; Azab, Amr; Thomsen, Robert W; Gottsch, John D

    2003-03-01

    To review management strategies for treatment of anterior chamber epithelial cysts. Retrospective review of consecutive interventional case series. Charts of patients treated for epithelial ingrowth over a 10-year period by a single surgeon were reviewed. Cases of anterior chamber epithelial cysts were identified and recorded, including details of ocular history, preoperative and postoperative acuity, intraocular pressure (IOP), and ocular examination, type of surgical intervention, and details of further procedures performed. Seven eyes with epithelial cysts were identified. Patient age ranged from 1.5 to 53 years at presentation. Four patients were children. In four eyes, cysts were secondary to trauma, one case was presumably congenital, one case developed after corneal perforation in an eye with Terrien's marginal degeneration, and one case developed after penetrating keratoplasty (PK). Three eyes were treated with vitrectomy, en bloc resection of the cyst and associated tissue, fluid-air exchange and cryotherapy. The last four eyes were treated with a new conservative strategy of cyst aspiration (three cases) or local excision (one keratin "pearl" cyst), and endolaser photocoagulation of the collapsed cyst wall/base. All epithelial tissue was successfully eradicated by clinical criteria; one case required repeat excision (follow-up, 9 to 78 months, mean 45). Two eyes required later surgery for elevated IOP, two for cataract extraction and one for repeat PK. Final visual acuity ranged from 20/20 to hand motions, depending on associated ocular damage. Best-corrected visual results were obtained in the more conservatively managed eyes. Anterior chamber epithelial cysts can be managed conservatively in selected cases with good results. This strategy may be particularly useful in children's eyes, where preservation of the lens, iris, and other structures may facilitate amblyopia management. Copyright 2003 by Elsevier Science Inc.

  2. Gnathostomiasis of the anterior chamber

    Directory of Open Access Journals (Sweden)

    Barua P

    2007-01-01

    Full Text Available Ocular involvement with Gnathostoma spinigerum occurs years after the initial infection that is acquired by ingestion of poorly cooked, pickled seafood or water contaminated with third stage larvae. Here we report a case of gnathostomiasis of the left eye of a 32-year-old lady hailing from Meghalaya, India. Her vision had deteriorated to hand movement. Slit lamp examination revealed a live, actively motile worm in the anterior chamber, which was extracted by supra temporal limbal incision and visual acuity was restored.

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

    International Nuclear Information System (INIS)

    AbouZeid, Amr Abdelhamid; Mohammad, Shaimaa Abdelsattar; Khairy, Khaled Talaat

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-15

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

  5. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

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

  6. Operation for recurrent cystocele with anterior colporrhaphy or non-absorbable mesh: patient reported outcomes

    DEFF Research Database (Denmark)

    Nüssler, Emil Karl; Greisen, Susanne; Kesmodel, Ulrik Schiøler

    2013-01-01

    Abstract INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare patient reported outcomes and complications after repair of recurrent anterior vaginal wall prolapse in routine health care settings using standard anterior colporrhaphy or non-absorbable mesh. METHODS: The study is based...... on prospective data from the Swedish National Register for Gynaecological Surgery. 286 women were operated on for recurrent anterior vaginal wall prolapse in 2008-2010; 157 women had an anterior colporrhaphy and 129 were operated on with a non-absorbable mesh. Pre-, and perioperative data were collected from...... (0.6 %) in the anterior colporrhaphy group (p = 0.58). The infection rate was higher after mesh (8.5 %) than after anterior colporrhaphy (2.5 %; OR 3.19 ; 1.07-14.25). CONCLUSION: Implantation of synthetic mesh during operation for recurrent cystocele more than doubled the cure rate, whereas...

  7. Anterior celiac plexus block for interventional biliary procedures

    International Nuclear Information System (INIS)

    Benenati, J.F.; Widlus, D.M.; Venbrux, A.C.; Lynch-Nyhan, A.; Osterman, F.A.; Taylor, D.R.; Tewes, P.A.; Cassidy, F.P.

    1989-01-01

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

  8. Sinonasal metallic foreign body penetration of the anterior cranial fossa

    Directory of Open Access Journals (Sweden)

    Madeleine B. Samuelson

    2017-03-01

    Conclusion: Intracranial metallic foreign bodies may have significant potential morbidity. Recent advances in endonasal techniques for anterior skull base access may enhance outcomes through reduced morbidity and mortality, improved speed and precision, shorter hospital stays, and lower post-operative pain [1,2,4]. Technical nuances of these approaches and medical decision-making in the context of various neurosurgical considerations are discussed.

  9. Imaging findings of anterior hip dislocations

    Energy Technology Data Exchange (ETDEWEB)

    Pfeifer, Kyle [Mallinckrodt Institute of Radiology, Department of Radiology, St. Louis, MO (United States); Leslie, Michael [Yale School of Medicine, Department of Orthopedics and Rehabilitation, New Haven, CT (United States); Menn, Kirsten; Haims, Andrew [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States)

    2017-06-15

    Anterior hip dislocations are rare orthopedic emergencies resulting from high-energy trauma and have unique imaging characteristics on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Imaging findings on CT and MRI allow for the prompt recognition and classification of anterior hip dislocations, which guides patient management and reduces complications. The purpose of this article is to review imaging findings of anterior hip dislocations, specifically focusing on CT and MRI. (orig.)

  10. Herniation of the anterior lens capsule

    Directory of Open Access Journals (Sweden)

    Pereira Nolette

    2007-01-01

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

  11. Toxic Anterior Segment Syndrome (TASS

    Directory of Open Access Journals (Sweden)

    Özlem Öner

    2011-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Su-Na Lee

    2014-01-01

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

  13. Anterior capsular rupture following blunt ocular injury

    Science.gov (United States)

    Gremida, Anas; Kassem, Iris; Traish, Aisha

    2011-01-01

    Summary A 10-year-old boy suffered a large, oblique anterior capsular tear following blunt injury to his right eye. The boy was followed daily for hyphema resolution and progressive traumatic cataract formation. After the hyphema had resolved, the lens was removed using an anterior approach and an intraocular lens was placed with excellent visual outcome. PMID:23362402

  14. Totally thrombosed giant anterior communicating artery aneurysm

    Directory of Open Access Journals (Sweden)

    V R Roopesh Kumar

    2015-01-01

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

  15. National trends in anterior cervical fusion procedures.

    Science.gov (United States)

    Marawar, Satyajit; Girardi, Federico P; Sama, Andrew A; Ma, Yan; Gaber-Baylis, Licia K; Besculides, Melanie C; Memtsoudis, Stavros G

    2010-07-01

    Population-based database analysis. To analyze trends in patient- and healthcare-system-related characteristics, utilization and outcomes associated with anterior cervical spine fusions. Anterior cervical decompression and spine fusion (ACDF) is one of the most commonly performed surgical procedures of the spine. However, few data analyzing trends in patient- and healthcare-system-related characteristics, utilization and outcomes exist. Data from 1990 to 2004 collected in the National Hospital Discharge Survey were accessed. ACDF procedures were identified. Five-year periods of interest (POI) were created for temporal analysis and changes in the prevalence and utilization of this procedure as well as in patient- and healthcare-system-related variables were examined. The changes in the occurrence of procedure-related complications were evaluated. An estimated total of 771,932 discharges after ACDF were identified. Temporally, an almost 8-fold increase in total prevalence was accompanied by a similar increase in utilization (23/100.000 civilians/POI to 157/100.000/civilians/POI). The highest increase in utilization was observed in those > or =65 years (28-fold). Average age increased from 47.2 years to 50.5 years over time. Length of hospital stay decreased from 5.17 days to 2.38 days. Overall procedure-related complication rates decreased from 4.6% to 3.03%. The prevalence of hypertension, diabetes mellitus, hypercholesterolemia, obesity, pulmonary, and coronary artery increased over time among patients undergoing ACDF. Despite limitations inherent to secondary analysis of large databases, we identified a number of significant changes in the utilization, demographics, and outcomes associated with ACDF, which can be used to assess the effect of changes in medical care, direct health care resources, and future research. The effect of the increased prevalence of comorbidities on medical practice remains to be evaluated. Further studies are necessary to evaluate causal

  16. The anterior hypothalamus in cluster headache.

    Science.gov (United States)

    Arkink, Enrico B; Schmitz, Nicole; Schoonman, Guus G; van Vliet, Jorine A; Haan, Joost; van Buchem, Mark A; Ferrari, Michel D; Kruit, Mark C

    2017-10-01

    Objective To evaluate the presence, localization, and specificity of structural hypothalamic and whole brain changes in cluster headache and chronic paroxysmal hemicrania (CPH). Methods We compared T1-weighted magnetic resonance images of subjects with cluster headache (episodic n = 24; chronic n = 23; probable n = 14), CPH ( n = 9), migraine (with aura n = 14; without aura n = 19), and no headache ( n = 48). We applied whole brain voxel-based morphometry (VBM) using two complementary methods to analyze structural changes in the hypothalamus: region-of-interest analyses in whole brain VBM, and manual segmentation of the hypothalamus to calculate volumes. We used both conservative VBM thresholds, correcting for multiple comparisons, and less conservative thresholds for exploratory purposes. Results Using region-of-interest VBM analyses mirrored to the headache side, we found enlargement ( p cluster headache compared to controls, and in all participants with episodic or chronic cluster headache taken together compared to migraineurs. After manual segmentation, hypothalamic volume (mean±SD) was larger ( p cluster headache compared to controls (1.72 ± 0.15 ml) and migraineurs (1.68 ± 0.19 ml). Similar but non-significant trends were observed for participants with probable cluster headache (1.82 ± 0.19 ml; p = 0.07) and CPH (1.79 ± 0.20 ml; p = 0.15). Increased hypothalamic volume was primarily explained by bilateral enlargement of the anterior hypothalamus. Exploratory whole brain VBM analyses showed widespread changes in pain-modulating areas in all subjects with headache. Interpretation The anterior hypothalamus is enlarged in episodic and chronic cluster headache and possibly also in probable cluster headache or CPH, but not in migraine.

  17. Atraumatic Anterior Dislocation of the Hip Joint

    Directory of Open Access Journals (Sweden)

    Tadahiko Ohtsuru

    2015-01-01

    Full Text Available Dislocation of the hip joint in adults is usually caused by high-energy trauma such as road traffic accidents or falls from heights. Posterior dislocation is observed in most cases. However, atraumatic anterior dislocation of the hip joint is extremely rare. We present a case of atraumatic anterior dislocation of the hip joint that was induced by an activity of daily living. The possible causes of this dislocation were anterior capsule insufficiency due to developmental dysplasia of the hip, posterior pelvic tilt following thoracolumbar kyphosis due to vertebral fracture, and acetabular anterior coverage changes by postural factor. Acetabular anterior coverage changes in the sagittal plane were measured using a tomosynthesis imaging system. This system was useful for elucidation of the dislocation mechanism in the present case.

  18. Long anterior zonules and pigment dispersion.

    Science.gov (United States)

    Moroi, Sayoko E; Lark, Kurt K; Sieving, Paul A; Nouri-Mahdavi, Kouros; Schlötzer-Schrehardt, Ursula; Katz, Gregory J; Ritch, Robert

    2003-12-01

    To describe pigment dispersion associated with long anterior zonules. Multicenter observational case series. Fifteen patients, seven of whom were treated for glaucoma or ocular hypertension, were identified with long anterior zonules and pigment dispersion. Transmission electron microscopy was performed on one anterior capsule specimen. All patients had anterior zonules that inserted centrally on the lens capsule. Signs of pigment dispersion included corneal endothelial pigmentation, loss of the pupillary ruff, and variable trabecular meshwork pigmentation. Ultrasound biomicroscopy verified the lack of posterior iris insertion and concavity. There was no exfoliation material. Transmission electron microscopy showed zonular lamellae with adherent pigment granules, and no exfoliation material. Long anterior zonules inserted onto the central lens capsule may cause mechanical disruption of the pigment epithelium at the pupillary ruff and central iris leading to pigment dispersion.

  19. Anterior capsulotomy using the CO2 laser

    Science.gov (United States)

    Barak, Adiel; Ma-Naim, Tova; Rosner, Mordechai; Eyal, Ophir; Belkin, Michael

    1998-06-01

    Continuous circular capsulorhexis (CCC) is the preferred technique for removal of the anterior capsule during cataract surgery due to this technique assuring accurate centration of the intraocular lens. During modern cataract surgery, especially with small or foldable intra ocular lenses, centration of the lens is obligatory. Radial tears at the margin of an anterior capsulotomy may be associated with the exit of at least one loop of an intraocular lens out of the capsular bag ('pea pod' effect) and its subsequent decentration. The anterior capsule is more likely to ream intact if the continuous circular capsulorhexis (CCC) technique is used. Although manual capsulorhexis is an ideal anterior capsulectomy technique for adults, many ophthalmologists are still uncomfortable with it and find it difficult to perform, especially in complicated cases such as these done behind small pupil, cataract extraction in children and pseudoexfoliation syndrome. We have developed a technique using a CO2 laser system for safe anterior capsulotomy and tested it in animal eyes.

  20. Landmarks for Identifying the Suprascapular Foramen Anteriorly: Application to Anterior Neurotization and Decompressive Procedures.

    Science.gov (United States)

    Manouvakhova, Olga V; Macchi, Veronica; Fries, Fabian N; Loukas, Marios; De Caro, Raffaele; Oskouian, Rod J; Spinner, Robert J; Tubbs, R Shane

    2018-02-01

    Additional landmarks for identifying the suprascapular nerve at its entrance into the suprascapular foramen from an anterior approach would be useful to the surgeon. To identify landmarks for the identification of this hidden site within an anterior approach. In 8 adult cadavers (16 sides), lines were used to connect the superior angle of the scapula, the acromion, and the coracoid process tip thus creating an anatomic triangle. The suprascapular nerve's entrance into the suprascapular foramen was documented regarding its position within this anatomical triangle. Depths from the skin surface and specifically from the medial-most point of the clavicular attachment of the trapezius to the suprascapular nerve's entrance into the suprascapular foramen were measured using calipers and a ruler. The clavicle was then fractured and retracted superiorly to verify the position of the nerve's entrance into the suprascapular foramen. From the trapezius, the nerve's entrance into the foramen was 3 to 4.2 cm deep (mean, 3.5 cm). The mean distance from the tip of the corocoid process to the suprascapular foramen was 3.8 cm. The angle best used to approach the suprascapular foramen from the surface was 15° to 20°. Based on our study, an anterior suprascapular approach to the suprascapular nerve as it enters the suprascapular foramen can identify the most medial fibers of the trapezius attachment onto the clavicle and insert a finger at an angle of 15° to 20° laterally and advanced to an average depth of 3.5 cm. Copyright © 2017 by the Congress of Neurological Surgeons

  1. New Treatments for Nonarteritic Anterior Ischemic Optic Neuropathy.

    Science.gov (United States)

    Foroozan, Rod

    2017-02-01

    Despite increasing knowledge about the risk factors and clinical findings of nonarteritic anterior ischemic optic neuropathy (NAION), the treatment of this optic neuropathy has remained limited and without clear evidence-based benefit. Historical treatments of NAION are reviewed, beginning with the Ischemic Optic Neuropathy Decompression Trial. More recent treatments are placed within the historical context and illustrate the need for evidence-based therapy for ischemic optic neuropathy. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. [Anterior lumbar interbody fusion. Indications, technique, advantages and disadvantages].

    Science.gov (United States)

    Richter, M; Weidenfeld, M; Uckmann, F P

    2015-02-01

    Anterior lumbar interbody fusion (ALIF) for lumbar interbody fusion from L2 to the sacrum has been an established technique for decades. The advantages and disadvantages of ALIF compared to posterior interbody fusion techniques are discussed. The operative technique is described in detail. Complications and avoidance strategies are discussed. This article is based on a selective literature search using PubMed and the experience of the authors in this medical field. The advantages of ALIF compared to posterior fusion techniques are the free approach to the anterior disc space without opening of the spinal canal or the neural foramina. This gives the possibility of an extensive anterior release and placement of the largest possible cages without the risk of neural structure damage. The disadvantages of ALIF are the additional anterior approach and the related complications. The most frequent complication is due to damage of vessels. The rate of complications is significantly increased in revision surgery. The ALIF technique meaningfully expands the repertoire of the spinal surgeon especially for the treatment of non-union after interbody fusion, in patients with epidural scar tissue at the index level and spinal infections. Advantages and disadvantages should be considered when evaluating the indications for ALIF.

  3. Relative Frequencies of Arteritic and Nonarteritic Anterior Ischemic Optic Neuropathy in an Arab Population.

    Science.gov (United States)

    Gruener, Anna M; Chang, Jessica R; Bosley, Thomas M; Al-Sadah, Zakeya M; Kum, Clarissa; McCulley, Timothy J

    2017-12-01

    To evaluate the relative frequencies of arteritic and nonarteritic anterior ischemic optic neuropathy (AION) in an Arab population and to compare and contrast these findings with known epidemiological data from Caucasian populations. A retrospective review of the medical records of all patients diagnosed with AION at the King Khaled Eye Specialist Hospital (KKESH) in Riyadh, Saudi Arabia, between 1997 and 2012. Of 171 patients with AION, 4 had biopsy-proven giant-cell arteritis (GCA). The relative frequencies of arteritic anterior ischemic optic neuropathy (AAION) and nonarteritic anterior ischemic optic neuropathy (NAION) in this Arab cohort were 2.3% and 97.7%, respectively. The relative frequencies of arteritic anterior ischemic optic neuropathy and nonarteritic anterior ischemic optic neuropathy differ between Arab and North American clinic-based populations, with giant-cell arteritis-related ischemia being much less frequent in Saudi Arabia.

  4. Role of the right dorsal anterior insula in the urge to tic in Tourette syndrome.

    Science.gov (United States)

    Tinaz, Sule; Malone, Patrick; Hallett, Mark; Horovitz, Silvina G

    2015-08-01

    The mid-posterior part of the insula is involved in processing bodily sensations and urges and is activated during tic generation in Tourette syndrome. The dorsal anterior part of the insula, however, integrates sensory and emotional information with cognitive valuation and is implicated in interoception. The right dorsal anterior insula also participates in urge suppression in healthy subjects. This study examined the role of the right dorsal anterior insula in the urge to tic in Tourette syndrome. Resting-state functional magnetic resonance imaging was performed in 13 adult Tourette patients and 13 matched controls. The role of the right dorsal anterior insula within the urge-tic network was investigated using graph theory-based neural network analysis. The functional connectivity of the right dorsal anterior insula was also correlated with urge and tic severity. Even though the patients did not exhibit any overt tics, the right dorsal anterior insula demonstrated higher connectivity, especially with the frontostriatal nodes of the urge-tic network in patients compared with controls. The functional connectivity between the right dorsal anterior insula and bilateral supplementary motor area also correlated positively with urge severity in patients. These results suggest that the right dorsal anterior insula is part of the urge-tic network and could influence the urge- and tic-related cortico-striato-thalamic regions even during rest in Tourette syndrome. It might be responsible for heightened awareness of bodily sensations generating premonitory urges in Tourette syndrome. © 2015 International Parkinson and Movement Disorder Society.

  5. MR imaging of the anatomy of the anterior horn of the medial meniscus.

    Science.gov (United States)

    De Coninck, Tineke; Vanrietvelde, Frederik; Seynaeve, Patrick; Verdonk, Peter; Verstraete, Koenraad

    2017-04-01

    Background In cadaveric and arthroscopic studies different insertion locations of the anterior horn of the medial meniscus (AHMM) have been described. Purpose To investigate if the different insertion locations of the AHMM, as described in cadaveric studies, can be determined on magnetic resonance imaging (MRI). Material and Methods MR images of 100 patients without meniscal tears on MRI were retrospectively evaluated. Two observers classified the AHMM insertion based on its position relative to the anterior tibial edge and the medial tibial spine. The association between AHMM insertion and tibial plateau slope, meniscal radial displacement, and anterior intermeniscal ligament (AIL) presence was investigated. Results The AHMM inserted posterior to the anterior tibial edge in 93 knees and anterior to the tibial edge in seven knees (= type III). Of the 93 knees with AHMM insertion posterior to the anterior tibial edge, 63 inserted lateral to the medial tibial spine (= type I) and 30 medial (= type II). The AHMMs inserting anterior to the tibial edge had a significantly ( P  0.05). A strong inter- and intra-observer agreement was observed. Conclusion Three different bony insertion locations of the AHMM, as described in cadaveric studies, could be identified on MRI. All AHMMs inserting anterior to the tibial edge displayed an AIL. Whether there is a clinical correlation with these insertion patterns remains unclear.

  6. Avaliação pré-operatória visando ao uso do halo craniano no tratamento de deformidades rígidas da coluna vertebral Evaluación pre-operatoria del uso del halo craneal en lo tratamiento de las deformidades rígidas de la columna vertebral Preoperative evaluation for the use of cranial halo traction in the spine treatment of rigid deformities

    Directory of Open Access Journals (Sweden)

    Lucas Sasdelli Soares de Oliveira

    2010-12-01

    Full Text Available OBJETIVO: avaliar a eficácia e a segurança do uso do halo craniano gravitacional como técnica de tratamento de deformidades rígidas da coluna vertebral e rever complicações associadas ao seu tratamento. MÉTODOS: análise retrospectiva de dez pacientes com deformidades rígidas da coluna vertebral: cifose, escoliose, cifoescoliose e hiperlordose cervical. O critério para inclusão dos pacientes foi o uso do halo craniano gravitacional em um período pré-operatório e interoperatório em deformidades rígidas da coluna vertebral. Foram avaliados os prontuários dos pacientes e suas mensurações radiográficas foram feitas em um período pré-operatório, após instalação do halo craniano gravitacional, e no período pós-operatório. As variáveis estudadas foram idade, sexo, valor angular da curva principal, valor angular da curva secundária, valor angular da curva sagital maior, protocolo de tração e tipo de procedimento utilizado. RESULTADOS: em relação ao plano frontal, avaliou-se, no período pré-operatório, a média angular de 89,9º, decrescendo para 65º após a instalação do halo e 56,9º no pós-operatório. Analisando o plano sagital, observou-se no período pré-operatório o valor angular de 77,7º, decrescendo para 55,4º, com o uso do halo-colete, e 46,5º no pós-operatório tardio. CONCLUSÃO: pode-se concluir que o uso da tração halo craniana é um método eficaz no auxílio da correção das deformidades rígidas da coluna vertebral, visto que se conseguiu uma correção significativa das deformidades do período pré-operatório para os períodos pós-instalação do halo e pós-operatório, sem se observar lesão neurológica ou outra grave complicação.OBJETIVO: evaluar, retrospectivamente, la eficacia y la seguridad del uso del halo craneal gravitacional como técnica de tratamiento de deformidades rígidas de la columna vertebral, y rever complicaciones asociadas a su tratamiento. MÉTODOS: ha sido

  7. Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment

    NARCIS (Netherlands)

    Notten, K. J. B.; Essers, B. A.; Weemhoff, M.; Rutten, A. G. H.; Donners, J. J. A. E.; van Gestel, I.; Kruitwagen, R. F. M. P.; Roovers, J. P. W. R.; Dirksen, C. D.

    2015-01-01

    We investigated patients' preferences for anterior colporrhaphy or mesh surgery as surgical correction of anterior vaginal wall prolapse. Labelled discrete choice experiment. Three Dutch teaching hospitals. Women with anterior vaginal wall prolapse Pelvic Organ Prolapse Quantification stage 2 or

  8. MRI of tibialis anterior tendon rupture

    International Nuclear Information System (INIS)

    Gallo, Robert A.; DeMeo, Patrick J.; Kolman, Brett H.; Daffner, Richard H.; Sciulli, Robert L.; Roberts, Catherine C.

    2004-01-01

    Ruptures of the tibialis anterior tendon are rare. We present the clinical histories and MRI findings of three recent male patients with tibialis anterior tendon rupture aged 58-67 years, all of whom presented with pain over the dorsum of the ankle. Two of the three patients presented with complete rupture showing discontinuity of the tendon, thickening of the retracted portion of the tendon, and excess fluid in the tendon sheath. One patient demonstrated a partial tear showing an attenuated tendon with increased surrounding fluid. Although rupture of the tibialis anterior tendon is a rarely reported entity, MRI is a useful modality in the definitive detection and characterization of tibialis anterior tendon ruptures. (orig.)

  9. Anterior pseudoarthrectomy for symptomatic Bertolotti's syndrome.

    Science.gov (United States)

    Malham, Gregory M; Limb, Rebecca J; Claydon, Matthew H; Brazenor, Graeme A

    2013-12-01

    Painful L5/S1 pseudoarthrosis has been previously managed with posterior excision and/or lumbar fusion. To our knowledge, the anterior approach for L5/S1 pseudoarthrectomy in the treatment of Bertolotti's syndrome has not been described. We present two patients with severe symptomatic L5/S1 pseudoarthroses that were successfully excised via an anterior retroperitoneal approach with 2 year clinical and radiological follow-up. The literature regarding surgical treatments for Bertolotti's syndrome is reviewed. The technique for an anterior retroperitoneal approach is described. This approach has been safe and effective in providing long term symptomatic relief to our two patients. Further studies comparing the outcomes of anterior versus posterior pseudoarthrectomy will guide the management of this condition. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Is antibiotic prophylaxis in nasal packing for anterior epistaxis needed?

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    Francisco Pérez

    2016-03-01

    Full Text Available La epistaxis es un problema extremadamente común que en ocasiones requiere de taponamiento anterior. Usualmente se indican antibióticos de forma concomitante para la prevención de complicaciones infecciosas, aunque el rol de esta medida es controvertido. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos una revisión sistemática que incluye tres estudios primarios, ninguno de ellos controlado y aleatorizado. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que no está claro si los antibióticos profilácticos disminuyen las complicaciones infecciosas en pacientes con taponamiento nasal por epistaxis anterior porque la certeza de la evidencia es muy baja.

  11. What role for the anterior cingulate in analogical reasoning?

    Science.gov (United States)

    O'Boyle, Michael W

    2010-06-01

    Abstract While prefrontal and frontal cortex of the brain are well documented to mediate many executive functions, including creativity, flexibility, and adaptability, the anterior cingulate cortex (ACC) is known to be involved in error detection and conflict resolution, and is crucial to reward-based learning. A case is made for the notion that any neural model of analogical reasoning must incorporate the critical (and specialized) contributions of the ACC.

  12. Tratamiento de la mordida cruzada anterior con plano inclinado anterior. Efecto sobre los arcos dentales

    OpenAIRE

    Carolina Rodríguez Manjarrés; Jesús Alberto Hernández Silva

    2017-01-01

    Objetivo: Evaluar los cambios dimensionales de los arcos dentales primarios tratados con plano inclinado anterior como método de corrección de la mordida cruzada anterior. Métodos: Se trataron 10 pacientes con edades entre 3 y 5 años afectados con mordida cruzada anterior completa, se colocó un plano inclinado anterior elaborado en acrílico, que estuvo en posición en promedio 8.5 semanas. Se obtuvieron modelos de estudio en 3 momentos T0: antes del tratamiento; T1: 6 meses después de iniciado...

  13. Morphometric Analysis of Bone Resection in Anterior Petrosectomies.

    Science.gov (United States)

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

    2016-06-01

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

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

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    Firoozeh Abtahi

    2016-06-01

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

  15. Aphasia following anterior cerebral artery occlusion

    International Nuclear Information System (INIS)

    Shimosaka, Shinichi; Waga, Shiro; Kojima, Tadashi; Shimizu, Takeo; Morikawa, Atsunori

    1982-01-01

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

  16. Innervation of the Anterior Sacroiliac Joint.

    Science.gov (United States)

    Cox, Marcus; Ng, Garrett; Mashriqi, Faizullah; Iwanaga, Joe; Alonso, Fernando; Tubbs, Kevin; Loukas, Marios; Oskouian, Rod J; Tubbs, R Shane

    2017-11-01

    Sacroiliac joint pain can be disabling and recalcitrant to medical therapy. The innervation of this joint is poorly understood, especially its anterior aspect. Therefore, the present cadaveric study was performed to better elucidate this anatomy. Twenty-four cadaveric sides underwent dissection of the anterior sacroiliac joint, with special attention given to any branches from regional nerves to this joint. No femoral, obturator, or lumbosacral trunk branches destined to the anterior sacroiliac joint were identified in the 24 sides. In 20 sides, one or two small branches (less than 0.5 mm in diameter) were found to arise from the L4 ventral ramus (10%), the L5 ventral ramus (80%), or simultaneously from both the L4 and L5 ventral rami (10%). The length of the branches ranged from 5 to 31 mm (mean, 14 mm). All these branches arose from the posterior part of the nerves and traveled to the anterior surface of the sacroiliac joint. No statistical significance was found between sides or sexes. An improved knowledge of the innervation of the anterior sacroiliac joint might decrease suffering in patients with chronic sacroiliac joint pain. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Factors associated with anterior open bite in children with developmental disabilities.

    Science.gov (United States)

    de Castilho, Lia Silva; Abreu, Mauro Henrique Nogueira Guimarães; Pires E Souza, Luiz Gustavo de Almeida; Romualdo, Leiliane Teresinha de Almeida; Souza E Silva, Maria Elisa; Resende, Vera Lúcia Silva

    2018-01-01

    To investigate factors associated with anterior open bite in individuals aged from 2 to 33 years with developmental disabilities. This is a cross-sectional study. A total of 271 dental records were examined. The anterior open bite analyzed was determined based on clinic exam. These variables were also analyzed: gender, age, education level of mother, International Code of Diseases (ICD), mouth breathing, use of anticonvulsant drugs, hyperkinesis, pacifier use, thumb sucking, seizure, and involuntary movements. For the purposes of analysis, the individuals were categorized as being with and without anterior open bite. Variables with a p-value of open bite than nasal breathers. Pacifier users are more likely to have an anterior open bite (3.32-fold, 95% CI: 1.62-6.77). Individuals with reported involuntary movements had a 2.66-fold (95% CI: 1.26-5.63) greater chance of exhibiting anterior open bite. Users of anticonvulsants drugs had a 3.05 (95% CI: 1.57-5.92) greater chance of showing anterior open bite. Involuntary movements, mouth breathing, using anticonvulsant drugs, and using pacifier are factors associated with anterior open bite in patients with developmental disabilities. © 2017 Special Care Dentistry Association and Wiley Periodicals, Inc.

  18. Effect of the Mitral Valve's Anterior Leaflet on Axisymmetry of Transmitral Vortex Ring.

    Science.gov (United States)

    Falahatpisheh, Ahmad; Pahlevan, Niema M; Kheradvar, Arash

    2015-10-01

    The shape and formation of transmitral vortex ring are shown to be associated with diastolic function of the left ventricle (LV). Transmitral vortex ring is a flow feature that is observed to be non-axisymmetric in a healthy heart and its inherent asymmetry in the LV assists in efficient ejection of the blood during systole. This study is a first step towards understanding the effects of the mitral valve's anterior leaflet on transmitral flow. We experimentally study a single-leaflet model of the mitral valve to investigate the effect of the anterior leaflet on the axisymmetry of the generated vortex ring based on the three-dimensional data acquired using defocusing digital particle image velocimetry. Vortex rings form downstream of a D-shaped orifice in presence or absence of the anterior leaflet in various physiological stroke ratios. The results of the statistical analysis indicate that the formed vortex ring downstream of a D-shaped orifice is markedly non-axisymmetric, and presence of the anterior leaflet improves the ring's axisymmetry. This study suggests that the improvement of axisymmetry in presence of the anterior leaflet might be due to coupled dynamic interaction between rolling-up of the shear layer at the edges of the D-shaped orifice and the borders of the anterior leaflet. This interaction can reduce the non-uniformity in vorticity generation, which results in more axisymmetric behavior compared to the D-shaped orifice without the anterior leaflet.

  19. ANTERIOR KNEE PAIN AND LOWER EXTREMITY FUNCTIONS IN INDIAN ADOLESCENT POPULATION

    Directory of Open Access Journals (Sweden)

    Riddhi Shroff

    2016-01-01

    Full Text Available Background & Purpose - Anterior knee pain is one of the most common musculoskeletal complain seen in Indian adolescent population with high incidence among those who are active in sports and recreation. The purpose of this study was to investigate the age of onset of anterior knee pain, to find its effect on sports participation and also to find the activities which are maximally affected due to anterior knee pain in Indian population. Method- A questionnaire based survey was conducted among 50 subjects using three outcome measures namely self made demographic questionnaire, anterior knee pain scale and lower extremity functional scale. Result- Maximally affected activities are running, jumping & squatting and maximally affected functions are squatting, running on uneven ground, making sharp turns while running and hopping with increase incidence of anterior knee pain among those who participate daily in sports. Conclusion- The study concluded, that in adolescent age group of 11-17 years, anterior knee pain is more prevalent in adolescent girls with the age of onset being around 13 years for girls & 14.5 years in boys and it also showed moderate positive correlation between anterior knee pain and lower extremity functions.

  20. URETHROPLASTY FOR COMPLICATED ANTERIOR URETHRAL STRICTURES.

    Science.gov (United States)

    Aoki, Katsuya; Hori, Shunta; Morizawa, Yosuke; Nakai, Yasushi; Miyake, Makito; Anai, Satoshi; Torimoto, Kazumasa; Yoneda, Tatsuo; Tanaka, Nobumichi; Yoshida, Katsunori; Fujimoto, Kiyohide

    2016-01-01

    (Objectives) To compare efficacy and outcome of urethroplasty for complicated anterior urethral strictures. (Methods) Twelve patients, included 3 boys, with anterior urethral stricture underwent urethroplasty after the failure of either urethral dilatation or internal urethrotomy. We evaluated pre- and post-operative Q max and surgical outcome. (Results) Four patients were treated with end-to-end anastomosis, included a case of bulbar urethral elongation simultaneously, one patient was treated with augmented anastomotic urethroplasty, three patients were treated with onlay urethroplasty with prepucial flap, one patient was treated with tubed urethroplasty with prepucial flap (Ducket procedure) and three patients were treated with onlay urethroplasty with buccal mucosal graft. Postoperative Qmax improved in all patients without major complications and recurrence during follow-up periods ranging from 17 to 102 months (mean 55 months). (Conclusions) Urethroplasty is an effective therapeutic procedure for complicated anterior urethral stricture.

  1. Anterior cruciate ligament tears: MRI versus arthroscopy

    International Nuclear Information System (INIS)

    Tosch, U.; Felix, R.; Schauwecker, W.; Dreithaler, B.

    1992-01-01

    Because of suspected rupture of the anterior cruciate ligament sixteen acute traumatised patients were investigated by MR and arthroscopy. The MR diagnosis of a lesion of the anterior cruciate ligament proved to be correct by arthroscopy in fifteen of sixteen cases. Diagnostic criteria for lesions of the anterior cruciate ligament were: increased signal intensity in T 1 - and T 2 weighted images, increased volume and discontinuity of ligamentous structures. Additional MR findings of meniscal tears were correct in three of four cases laterally and in four of four cases medially. Femoral cartilage lesions were correctly identified by MR in three cases. MR normal findings proved to be correct by arthroscopy in another five cases. (orig.) [de

  2. Morphometric Study of the Anterior Thalamoperforating Arteries

    Science.gov (United States)

    Kim, Sung-Ho; Yeo, Dong-Kyu; Shim, Jae-Joon; Yoon, Seok-Mann; Chang, Jae-Chil

    2015-01-01

    Objective To evaluate the morphometry of the anterior thalamoperforating arteries (ATPA). Methods A microanatomical study was performed in 79 specimens from 42 formalin-fixed adult cadaver brains. The origins of the ATPAs were divided into anterior, middle, and posterior segments according to the crowding pattern. The morphometry of the ATPAs, including the premammillary artery (PMA), were examined under a surgical microscope. Results The anterior and middle segments of the ATPAs arose at mean intervals of 1.75±1.62 mm and 5.86±2.05 mm from the internal carotid artery (ICA), and the interval between these segments was a mean of 3.17±1.64 mm. The posterior segment arose at a mean interval of 2.43±1.46 mm from the posterior cerebral artery (PCA), and the interval between the middle and posterior segments was a mean of 3.45±1.39 mm. The mean numbers of perforators were 2.66±1.19, 3.03±1.84, and 1.67±0.98 in the anterior, middle, and posterior segments, respectively. The PMA originated from the middle segment in 66% of cases. A perforator-free zone was located >2 mm from the ICA in 30.4% and >2 mm from the PCA in 67.1% of cases. Conclusion Most perforators arose from the anterior and middle segments, within the anterior two-thirds of the posterior communicating artery (PCoA). The safest perforator-free zone was located closest to the PCA. These anatomical findings may be helpful to verify safety when treating lesions around the PCoA and in the interpeduncular fossa. PMID:26113962

  3. Inferior Oblique Overaction: Anterior Transposition Versus Myectomy.

    Science.gov (United States)

    Rajavi, Zhale; Feizi, Mohadeseh; Behradfar, Narges; Yaseri, Mehdi; Sayanjali, Shima; Motevaseli, Tahmine; Sabbaghi, Hamideh; Faghihi, Mohammad

    2017-07-01

    To compare the efficacy of inferior oblique myectomy and anterior transposition for correcting inferior oblique overaction (IOOA). This retrospective study was conducted on 56 patients with IOOA who had either myectomy or anterior transposition of the inferior oblique muscle from 2010 to 2015. The authors compared preoperative and postoperative inferior oblique muscle function grading (-4 to +4) as the main outcome measure and vertical and horizontal deviation, dissociated vertical deviation (DVD), and A- and V-pattern between the two surgical groups as secondary outcomes. A total of 99 eyes of 56 patients with a mean age of 5.9 ± 6.5 years were included (47 eyes in the myectomy group and 52 eyes in the anterior transposition group). There were no differences in preoperative best corrected visual acuity, amblyopia, spherical equivalent, and primary versus secondary IOOA between the two groups. Both surgical procedures were effective in reducing IOOA and satisfactory results were similar between the two groups: 61.7% and 67.3% in the myectomy and anterior transposition groups, respectively (P = .56). After adjustment for the preoperative DVD, there was no statistically significant difference between the two groups postoperatively. The preoperative hypertropia was 6 to 14 and 6 to 18 prism diopters (PD) in the myectomy and anterior transposition groups, respectively. After surgery, no patient had a vertical deviation greater than 5 PD. Both the inferior oblique myectomy and anterior transposition procedures are effective in reducing IOOA with similar satisfactory results. DVD and hypertropia were also corrected similarly by these two surgical procedures. [J Pediatr Ophthalmol Strabismus. 2017;54(4):232-237.]. Copyright 2017, SLACK Incorporated.

  4. Reflex muscle contraction in anterior shoulder instability.

    Science.gov (United States)

    Wallace, D A; Beard, D J; Gill, R H; Eng, B; Carr, A J

    1997-01-01

    Reduced proprioception may contribute to recurrent anterior shoulder instability. Twelve patients with unilateral shoulder instability were investigated for evidence of deficient proprioception with an activated pneumatic cylinder and surface electromyography electrodes; the contralateral normal shoulder was used as a control. The latency between onset of movement and the detection of muscle contraction was used as an index of proprioception. No significant difference in muscle contraction latency was detected between the stable and unstable shoulders, suggesting that there was no significant defect in muscular reflex activity. This study does not support the use proprioception-enhancing physiotherapy in the treatment of posttraumatic anterior shoulder instability.

  5. Roentgenographic findings following anterior cervical fusion

    Energy Technology Data Exchange (ETDEWEB)

    Gore, D R; Gardner, G M; Sepic, S B; Murray, M P

    1986-10-01

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

  6. Clinical decisions for anterior restorations: the concept of restorative volume.

    Science.gov (United States)

    Cardoso, Jorge André; Almeida, Paulo Júlio; Fischer, Alex; Phaxay, Somano Luang

    2012-12-01

    The choice of the most appropriate restoration for anterior teeth is often a difficult decision. Numerous clinical and technical factors play an important role in selecting the treatment option that best suits the patient and the restorative team. Experienced clinicians have developed decision processes that are often more complex than may seem. Less experienced professionals may find difficulties making treatment decisions because of the widely varied restorative materials available and often numerous similar products offered by different manufacturers. The authors reviewed available evidence and integrated their clinical experience to select relevant factors that could provide a logical and practical guideline for restorative decisions in anterior teeth. The presented concept of restorative volume is based on structural, optical, and periodontal factors. Each of these factors will influence the short- and long-term behavior of restorations in terms of esthetics, biology, and function. Despite the marked evolution of esthetic restorative techniques and materials, significant limitations still exist, which should be addressed by researchers. The presented guidelines must be regarded as a mere orientation for risk analysis. A comprehensive individual approach should always be the core of restorative esthetic treatments. The complex decision process for anterior esthetic restorations can be clarified by a systematized examination of structural, optical, and periodontal factors. The basis for the proposed thought process is the concept of restorative volume that is a contemporary interpretation of restoration categories and their application. © 2012 Wiley Periodicals, Inc.

  7. Endoscopic Anatomy of the Tensor Fold and Anterior Attic.

    Science.gov (United States)

    Li, Bin; Doan, Phi; Gruhl, Robert R; Rubini, Alessia; Marchioni, Daniele; Fina, Manuela

    2018-02-01

    Objectives The objectives of the study were to (1) study the anatomical variations of the tensor fold and its anatomic relation with transverse crest, supratubal recess, and anterior epitympanic space and (2) explore the most appropriate endoscopic surgical approach to each type of the tensor fold variants. Study Design Cadaver dissection study. Setting Temporal bone dissection laboratory. Subjects and Methods Twenty-eight human temporal bones (26 preserved and 2 fresh) were dissected through an endoscopic transcanal approach between September 2016 and June 2017. The anatomical variations of the tensor fold, transverse crest, supratubal recess, and anterior epitympanic space were studied before and after removing ossicles. Results Three different tensor fold orientations were observed: vertical (type A, 11/28, 39.3%) with attachment to the transverse crest, oblique (type B, 13/28, 46.4%) with attachment to the anterior tegmen tympani, and horizontal (type C, 4/28, 14.3%) with attachment to the tensor tympani canal. The tensor fold was a complete membrane in 20 of 28 (71.4%) specimens, preventing direct ventilation between the supratubal recess and anterior epitympanic space. We identified 3 surgical endoscopic approaches, which allowed visualization of the tensor fold without removing the ossicles. Conclusions The orientation of the tensor fold is the determining structure that dictates the conformation and limits of the epitympanic space. We propose a classification of the tensor fold based on 3 anatomical variants. We also describe 3 different minimally invasive endoscopic approaches to identify the orientation of the tensor fold while maintaining ossicular chain continuity.

  8. Anterior tibial stress fractures treated with anterior tension band plating in high-performance athletes.

    Science.gov (United States)

    Cruz, Alexandre Santa; de Hollanda, João Paris Buarque; Duarte, Aires; Hungria Neto, José Soares

    2013-06-01

    The non-surgical treatment of anterior tibial cortex stress fractures requires long periods of abstention from sports activities and often results in non-union. Many different surgical techniques have already been previously described to treat these fractures, but there is no consensus on the best treatment. We describe the outcome of treatment using anterior tibial tension band plating in three high-performance athletes (4 legs) with anterior tibial cortex stress fractures. Tibial osteosynthesis with a 3.5-mm locking compression plate in the anterolateral aspect of the tibia was performed in all patients diagnosed with anterior tibial stress fracture after September 2010 at Santa Casa Hospital. All of the fractures were consolidated within a period of 3 months after surgery, allowing for an early return to pre-injury levels of competitive sports activity. There were no infection, non-union, malunion or anterior knee pain complications. Anterior tibial tension band plating leads to prompt fracture consolidation and is a good alternative for the treatment of anterior tibial cortex stress fractures. Bone grafts were shown to be unnecessary.

  9. Combination nivolumab- and cabiralizumab-associated acute bilateral anterior and posterior scleritis and anterior uveitis

    Directory of Open Access Journals (Sweden)

    John A. Gonzales

    2018-06-01

    Full Text Available Purpose: To report on a case of uveitis and scleritis resulting as an immune-mediated side effect of cancer immunotherapy with nivolumab and cabiralizumab. Observations: Bilateral anterior nongranulomatous anterior uveitis and bilateral diffuse anterior and posterior scleritis occurred following the use of combination cancer immunotherapy. The uveitis and scleritis resolved following temporary discontinuation of nivolumab and cabiralizumab as well as systemic prednisone. Conclusions and importance: Ophthalmologists should be aware of the possibility of acute ocular inflammation developing with cancer immunotherapy. Systemic corticosteroids play a first-line role in managing such immune-mediated side effects. Keywords: Uveitis, Scleritis, Cancer immunotherapy, Side effects, Nivolumab, Cabiralizumab

  10. Novel Insights into Anterior Cruciate Ligament Injury

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan)

    2011-01-01

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

  11. Optical coherence tomography in anterior segment imaging

    Science.gov (United States)

    Kalev-Landoy, Maya; Day, Alexander C.; Cordeiro, M. Francesca; Migdal, Clive

    2008-01-01

    Purpose To evaluate the ability of optical coherence tomography (OCT), designed primarily to image the posterior segment, to visualize the anterior chamber angle (ACA) in patients with different angle configurations. Methods In a prospective observational study, the anterior segments of 26 eyes of 26 patients were imaged using the Zeiss Stratus OCT, model 3000. Imaging of the anterior segment was achieved by adjusting the focusing control on the Stratus OCT. A total of 16 patients had abnormal angle configurations including narrow or closed angles and plateau irides, and 10 had normal angle configurations as determined by prior full ophthalmic examination, including slit-lamp biomicroscopy and gonioscopy. Results In all cases, OCT provided high-resolution information regarding iris configuration. The ACA itself was clearly visualized in patients with narrow or closed angles, but not in patients with open angles. Conclusions Stratus OCT offers a non-contact, convenient and rapid method of assessing the configuration of the anterior chamber. Despite its limitations, it may be of help during the routine clinical assessment and treatment of patients with glaucoma, particularly when gonioscopy is not possible or difficult to interpret. PMID:17355288

  12. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

    Frobell, Richard B; Roos, Harald P; Roos, Ewa M

    2013-01-01

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

  13. Post caesarean section anterior abdominal wall endometriosis ...

    African Journals Online (AJOL)

    Abdominal wall endometriosis is a likely sequelae of caesarean section as viable endometrial tissue are deposited in the peritoneal cavity or anterior abdominal wall. One such case to sensitize clinicians of this rare presentation of the disease is presented. The patient was a 48 year old woman who presented with a lesion ...

  14. [Capsular retensioning in anterior unidirectional glenohumeral instability].

    Science.gov (United States)

    Benítez Pozos, Leonel; Martínez Molina, Oscar; Castañeda Landa, Ezequiel

    2007-01-01

    To present the experience of the Orthopedics Service PEMEX South Central Hospital in the management of anterior unidirectional shoulder instability with an arthroscopic technique consisting of capsular retensioning either combined with other anatomical repair procedures or alone. Thirty-one patients with anterior unidirectional shoulder instability operated-on between January 1999 and December 2005 were included. Fourteen patients underwent capsular retensioning and radiofrequency, and in 17 patients, capsular retensioning was combined with suture anchors. Patients with a history of relapsing glenohumeral dislocations and subluxations, with anterior instability with or without associated Bankart lesions were selected; all of them were young. The results were assessed considering basically the occurrence of instability during the postoperative follow-up. No cases of recurring instability occurred. Two cases had neuroma and one experienced irritation of the suture site. Six patients had residual limitation of combined lateral rotation and abduction movements, of a mean of 10 degrees compared with the healthy contralateral side. The most frequent incident was the leak of solutions to the soft tissues. Capsular retensioning, whether combined or not with other anatomical repair techniques, has proven to result in a highly satisfactory rate of glenohumeral stabilization in cases of anterior unidirectional instabilities. The arthroscopic approach offers the well-known advantages of causing less damage to the soft tissues, and a shorter time to starting rehabilitation therapy and exercises.

  15. Tunnel widening in anterior cruciate ligament reconstruction

    DEFF Research Database (Denmark)

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

    1999-01-01

    We report a prospective series evaluating the incidence and degree of tunnel widening in a well-matched series of patients receiving a hamstring or patella tendon graft for anterior cruciate ligament (ACL) deficiency. We correlated tunnel widening with clinical factors, knee scores, KT-1000 and i...

  16. Anterior interbody fusion for cervical osteomyelitis

    Science.gov (United States)

    Bartal, A. D.; Schiffer, J.; Heilbronn, Y. D.; Yahel, M.

    1972-01-01

    Interbody fusion for stabilization of the cervical spine after osteomyelitic destruction of the body of C5 vertebra is reported in a patient with quadriplegia and sphincter disturbances secondary to an epidural abscess. The successful union of the bone graft along with complete neurological recovery after anterior decompression and evacuation of the epidural mass seem to justify the procedure. Images PMID:4554587

  17. Anterior process fractures of the calcaneus

    International Nuclear Information System (INIS)

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

    1985-01-01

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

  18. Anterior Segment Ischemia after Strabismus Surger

    Directory of Open Access Journals (Sweden)

    Emine Seyhan Göçmen

    2017-01-01

    Full Text Available A 46-year-old male patient was referred to our clinic with complaints of diplopia and esotropia in his right eye that developed after a car accident. The patient had right esotropia in primary position and abduction of the right eye was totally limited. Primary deviation was over 40 prism diopters at near and distance. The patient was diagnosed with sixth nerve palsy and 18 months after trauma, he underwent right medial rectus muscle recession. Ten months after the first operation, full-thickness tendon transposition of the superior and inferior rectus muscles (with Foster suture was performed. On the first postoperative day, slit-lamp examination revealed corneal edema, 3+ cells in the anterior chamber and an irregular pupil. According to these findings, the diagnosis was anterior segment ischemia. Treatment with 0.1/5 mL topical dexamethasone drops (16 times/day, cyclopentolate hydrochloride drops (3 times/day and 20 mg oral fluocortolone (3 times/day was initiated. After 1 week of treatment, corneal edema regressed and the anterior chamber was clean. Topical and systemic steroid treatment was gradually discontinued. At postoperative 1 month, the patient was orthophoric and there were no pathologic symptoms besides the irregular pupil. Anterior segment ischemia is one of the most serious complications of strabismus surgery. Despite the fact that in most cases the only remaining sequel is an irregular pupil, serious circulation deficits could lead to phthisis bulbi. Clinical properties of anterior segment ischemia should be well recognized and in especially risky cases, preventative measures should be taken.

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

    Directory of Open Access Journals (Sweden)

    Miesje K. Purwanegara

    2015-09-01

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

  20. Anterior mediastinal masses in the Framingham Heart Study: Prevalence and CT image characteristics

    International Nuclear Information System (INIS)

    Araki, Tetsuro; Nishino, Mizuki; Gao, Wei; Dupuis, Josée; Washko, George R.; Hunninghake, Gary M.; Murakami, Takamichi; O’Connor, George T.; Hatabu, Hiroto

    2015-01-01

    To investigate the prevalence and CT image characteristics of anterior mediastinal masses in a population-based cohort and their association with the demographics of the participants. Chest CT scans of 2571 Framingham Heart Study participants (mean age 58.9 years, 51% female) were evaluated by two board-certified radiologists with expertise in thoracic imaging for the presence of anterior mediastinal masses, their shape, contour, location, invasion of adjacent structures, fat content, and calcification. For participants with anterior mediastinal masses, a previous cardiac CT scan was reviewed for interval size change of the masses, when available. The demographics of the participants were studied for any association with the presence of anterior mediastinal masses. Of 2571, 23 participants (0.9%, 95% CI: 0.6–1.3) had anterior mediastinal masses on CT. The most common CT characteristics were oval shape, lobular contour, and midline location, showing soft tissue density (median 32.1 HU). Fat content was detected in a few cases (9%, 2/23). Six out of eight masses with available prior cardiac CT scans demonstrated an interval growth over a median period of 6.5 years. No risk factors for anterior mediastinal masses were detected among participants’ demographics, including age, sex, BMI, and cigarette smoking. The prevalence of anterior mediastinal masses is 0.9% in the Framingham Heart Study. Those masses may increase in size when observed over 5–7 years. Investigation of clinical significance in incidentally found anterior mediastinal masses with a longer period of follow-up would be necessary

  1. Anterior sagittal transanorectal approach to the posterior urethra in the pediatric age group.

    Science.gov (United States)

    Rossi, F; De Castro, R; Ceccarelli, P L; Dòmini, R

    1998-09-01

    Surgical access to the posterior urethra is often difficult and several surgical solutions have been proposed. We suggest an anterior sagittal transanorectal approach based on splitting the anterior rectal wall only. This alternative technique provides excellent exposure to the retrourethral region, permitting simple and safe surgery. Between 1994 and 1996 we performed surgery via the anterior sagittal transanorectal approach in 8 patients with a mean age of 9.06 years. Patients included 1 girl with a posttraumatic urethrovaginal fistula, 3 with intersex disorders (2 with mixed gonadal dysgenesis raised as boys and 1 with male dysgenetic pseudohermaphroditism with an enlarged urtricle) and 4 boys (1 with penile agenesis raised as girl, 2 with urethral duplication and 1 with prostatic rhabdomyosarcoma). The patient was placed in a knee-chest position. A midline sagittal incision was made through the anterior anorectal wall only and deepened through the perineal body to expose the posterior urethra and retrovesical space. After the pathological condition was corrected the anterior rectal wall and perineal body were reconstructed. The operation was completed with protective colostomy. In our final patient with prostatic rhabdomyosarcoma the anterior sagittal transanorectal approach was used without colostomy. Anorectal manometry was done 6 months postoperatively. All patients were completely continent of stool and urine. Convalescence was unremarkable in all cases. Postoperative manometry in 7 patients revealed no differences from preoperative measurements. This procedure should be considered a useful alternative to other techniques for various congenital and acquired pelvic disorders.

  2. Preliminary results of anterior lumbar interbody fusion, anterior column realignment for the treatment of sagittal malalignment.

    Science.gov (United States)

    Hosseini, Pooria; Mundis, Gregory M; Eastlack, Robert K; Bagheri, Ramin; Vargas, Enrique; Tran, Stacie; Akbarnia, Behrooz A

    2017-12-01

    OBJECTIVE Sagittal malalignment decreases patients' quality of life and may require surgical correction to achieve realignment goals. High-risk posterior-based osteotomy techniques are the current standard treatment for addressing sagittal malalignment. More recently, anterior lumbar interbody fusion, anterior column realignment (ALIF ACR) has been introduced as an alternative for correction of sagittal deformity. The objective of this paper was to report clinical and radiographic results for patients treated using the ALIF-ACR technique. METHODS A retrospective study of 39 patients treated with ALIF ACR was performed. Patient demographics, operative details, radiographic parameters, neurological assessments, outcome measures, and preoperative, postoperative, and mean 1-year follow-up complications were studied. RESULTS The patient population comprised 39 patients (27 females and 12 males) with a mean follow-up of 13.3 ± 4.7 months, mean age of 66.1 ± 11.6 years, and mean body mass index of 27.3 ± 6.2 kg/m 2 . The mean number of ALIF levels treated was 1.5 ± 0.5. Thirty-three (84.6%) of 39 patients underwent posterior spinal fixation and 33 (84.6%) of 39 underwent posterior column osteotomy, of which 20 (60.6%) of 33 procedures were performed at the level of the ALIF ACR. Pelvic tilt, sacral slope, and pelvic incidence were not statistically significantly different between the preoperative and postoperative periods and between the preoperative and 1-year follow-up periods (except for PT between the preoperative and 1-year follow-up, p = 0.018). Sagittal vertical axis, T-1 spinopelvic inclination, lumbar lordosis, pelvic incidence-lumbar lordosis mismatch, intradiscal angle, and motion segment angle all improved from the preoperative to postoperative period and the preoperative to 1-year follow-up (p < 0.05). The changes in motion segment angle and intradiscal angle achieved in the ALIF-ACR group without osteotomy compared with the ALIF-ACR group with osteotomy

  3. Fiber-reinforced Composite for Chairside Replacement of Anterior ...

    African Journals Online (AJOL)

    Fiber-reinforced Composite for Chairside Replacement of Anterior Teeth: A Case Report. ... investigation will be required to provide additional information on the survival of directly-bonded anterior fixed prosthesis made with FRC systems.

  4. Hoffa's fat pad injuries and their relationship with anterior cruciate ligament tears: new observations based on MR imaging in patients and MR imaging and anatomic correlation in cadavers

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, Marcelo R. [University of California San Diego, VA Health Care System, San Diego, CA (United States); Chung, Christine B.; Trudell, Debra; Resnick, Donald [University of California San Diego, VA Health Care System, San Diego, CA (United States); Hospital Mae de Deus, Porto Alegre, RS (Brazil)

    2008-04-15

    To determine the normal anatomic relationships of Hoffa's fat pad with the anterior cruciate ligament (ACL) and with the frequency of Hoffa's fat pad abnormalities in ACL-deficient knees. Retrospective clinical study on patients and observational anatomic study on cadavers. The study was approved by the Institutional Review Board. MR imaging studies of the knees of 100 patients (21-48 years old) with or without arthroscopically proven tears of the ACL, performed at a single institution, were reviewed by two readers for abnormalities of Hoffa's fat pad. Ten cadaveric knee specimens were studied with MR imaging and Faxitron radiographs, and by inspection of sections and histology. Alterations in Hoffa's fat pad on MR imaging were present in 64% (32/50) of patients with torn ACLs, and in 24% (12/50) of patients without a tear of the ACL (P < 0.05). Hoffa's fat pad inserted into the intercondylar notch in 50% (5/10) of cadaveric specimens, four in conjunction with the ligamentum mucosum and in one in an isolated fashion. Histological study demonstrated the composition of the ligamentum mucosum and Hoffa's fat pad and their course and insertion sites in the intercondylar notch. Abnormalities of Hoffa's fat pad, such as focal and diffuse edema, tears, scars and synovial proliferation, are more common in knees with torn ACLs than in knees with intact ACLs. (orig.)

  5. Displaced fracture through the anterior atlantal synchondrosis

    International Nuclear Information System (INIS)

    Thakar, Chrishan; Allibone, James; Harish, Srinivasan; Saifuddin, Asif

    2005-01-01

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

  6. A brief review on anterior urethral strictures

    Directory of Open Access Journals (Sweden)

    Li Cheng

    2018-04-01

    Full Text Available The treatment of urethral strictures remains a challenging field in urology even though there are a variety of procedures to treat it at present, as no one approach is superior over another. This paper reviewed the surgical options for the management of different sites and types of anterior urethral stricture, providing a brief discussion of the controversies regarding this issue and suggesting possible future advancements. Among the existing procedures, simple dilation and direct vision internal urethrotomy are more commonly used for short urethral strictures ( <1 cm, soft and no previous intervention. Currently, urethroplasty using buccal mucosa or penile skin is the most widely adopted clinical techniques and have proved successful. Nonetheless, complications such as donor site morbidity remain problem. Tissue engineering techniques are considered as a promising solution for urethral reconstruction, but require further investigation, as does stem cell therapy. Keywords: Anterior urethral strictures, Urethral reconstruction, Tissue engineering, Urethral strictures

  7. Bypass grafting to the anterior tibial artery.

    Science.gov (United States)

    Armour, R H

    1976-01-01

    Four patients with severe ischaemia of a leg due to atherosclerotic occlusion of the tibial and peroneal arteries had reversed long saphenous vein grafts to the patent lower part of the anterior tibial artery. Two of these grafts continue to function 19 and 24 months after operation respectively. One graft failed on the fifth postoperative day and another occluded 4 months after operation. The literature on femorotibial grafting has been reviewed. The early failure rate of distal grafting is higher than in the case of femoropopliteal bypass, but a number of otherwise doomed limbs can be salvaged. Contrary to widely held views, grafting to the anterior tibial artery appears to give results comparable to those obtained when the lower anastomosis is made to the posterior tibial artery.

  8. Displaced fracture through the anterior atlantal synchondrosis

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-09-01

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

  9. Cataract Surgery in Anterior Megalophthalmos: A Review

    Science.gov (United States)

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

    2015-01-01

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

  10. Epiphyseal osteochondroma of the anterior cruciate ligament.

    Science.gov (United States)

    Chekofsky, K M; Scott, W N; Fielding, J W

    1979-01-01

    An 8-year-old Black boy complained of pain, swelling, and a decreased range of motion in the knee. One arthrotomy operation was reported to show a normal knee joint. Six months later, a second arthrotomy demonstrated an osteochondroma growing from the epiphysis into the anterior cruciate ligament. Epiphyseal osteochondroma should be added to the working differential diagnosis on children with effusion and decrease of knee motion.

  11. Anterior rectal duplication: a diagnostic challenge.

    Science.gov (United States)

    Amjadi, K; Poenaru, D; Soboleski, D; Hurlbut, D; Kamal, I

    2000-04-01

    The authors present an anterior rectal cyst in a 14-month-old girl. This rare variant of rectal duplications presented with recurrent urinary infections. The diagnosis was challenging in view of the multiple differential diagnoses to be considered. Magnetic resonance imaging appeared to be the most accurate preoperative investigation. The cyst was removed uneventfully by partial excision and mucosal ablation. An awareness of this variant can lead to early diagnosis and curative resection.

  12. Anterior colorectal duplication presenting as rectal prolapse.

    Science.gov (United States)

    Ramirez-Resendiz, Amador; Asz, Jose; Medina-Vega, F Antonio; Ortega-Salgado, J Arturo

    2007-09-01

    Duplications of the gastrointestinal (GI) tract are rare. Only 5% of them are rectal and there are very few reports of rectal prolapse (RP) caused by a duplication. An 11 month-old female presented with a RP caused by a blind-ended anterior tubular colorectal duplication. The duplication was successfully opened and connected to the normal rectum without complications. Although infrequent, a rectal duplication should be considered in the differential diagnosis of RP.

  13. Arthroscopic Findings in Anterior Shoulder Instability

    OpenAIRE

    Hantes, Michael; Raoulis, Vasilios

    2017-01-01

    Background: In the last years, basic research and arthroscopic surgery, have improved our understanding of shoulder anatomy and pathology. It is a fact that arthroscopic treatment of shoulder instability has evolved considerably over the past decades. The aim of this paper is to present the variety of pathologies that should be identified and treated during shoulder arthroscopy when dealing with anterior shoulder instability cases. Methods: A review of the current literature regarding arthros...

  14. Anterior Tibial Artery Pseudoaneurysm: Case Report

    Directory of Open Access Journals (Sweden)

    Funda Tor

    2012-06-01

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

  15. Unilateral Anterior Epistaxis Electrocautery versus Chemical Cautery

    International Nuclear Information System (INIS)

    Umar, A. S.; Rahat, Z. M.; Hussain, S. S.; Khan, M. Z.; Fareed, G.

    2013-01-01

    Objective: To evaluate and compare the two methods, electrocautery versus chemical cautery, for controlling unilateral anterior epistaxis and to identify the complications. Design: Randomized control trial. Place and Duration: This study was conducted in ENT Department PNS Shifa Hospital Karachi from August 2009 to June 2011. Patients and Methods: Ninety two cases with unilateral anterior epistaxis were divided using random number trials into two groups i.e. group A and group B containing 46 cases each. In group A electrocautery and in group B chemical cautery with 50% silver nitrate was done and the results were compared. Results: In this study 92 cases were divided randomly into two groups i.e. group A and group B containing 46 cases in each group. In group A 44 (95.6%) out of 46 cases were treated successfully with a single visit as an outpatient by electrocautery, the patients were called for follow up on the fifth day and then fortnightly for three months after the procedure, only 2 (4.3%) cases reported in first five days with mild recurrence of bleeding. In group B 42 (91.3%) cases out of 46 cases were treated successfully in a single visit and recurrence of bleeding occured in 4 (8.7%) cases who required a second visit during the first five days. There were no major complications found in either group except few complaints of post cauterization pain and mucosal inflammation observed slightly more in group B patients. Conclusion: Electrocautery and chemical cautery with 50% silver nitrate both are equally effective procedures to control anterior epistaxis if the bleeding point is visible and small. Both procedures are reliable and there are no major complications. Occasionally if the bleeding point in the anterior nasal septum is large then electrocautery may be a preferred option. (author)

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

    Directory of Open Access Journals (Sweden)

    Arlindo Alfredo Silveira D’Ávila

    2006-06-01

    Full Text Available A substância perfurada anterior constitui referencial na base do encéfalo. Localizada acima da bifurcação subaracnóidea da artéria carótida interna em sua porção basal e junto à artéria comunicante anterior na face inter-hemisférica, é transfixada por ramos perfurantes dirigidos aos núcleos telencefálicos corticais, cápsula interna e parte do tálamo. Por injeção intravascular de gelatina carminada, resina de Batson e látex, analisamos 50 hemisférios cerebrais humanos adultos de ambos os sexos, sob o microscópio cirúrgico. Objetivamos contribuir para a determinação da origem, número e topografia dos ramos destinados a essa região, seu curso, anastomoses e territórios de penetração. Propusemo-nos também a analisar a contribuição da artéria comunicante anterior à substância perfurada anterior. Foram encontradas variações anatômicas, incluindo anastomoses, envolvendo principalmente a artéria cerebral média e a artéria coróidea anterior. Estes conhecimentos são de interesse clínico-cirúrgico em razão da freqüência de patologias vasculares e tumorais a ela relacionadas.The anterior perforated substance (APS is a landmark in the basal forebrain. It has a basal face located above the carotid bifurcation in the subarachnoid space, and an interhemispheric one. It is the site of passage of the arteries to the caudate nucleus, putamen, internal capsule, adjacent areas of the globus pallidus and thalamus. Fifty hemispheres from twenty-five adult cadavers were obtained. The arteries were perfused with colored latex, Batson’s resin and gelatin colored with carmine. Using a surgical microscope we have determined the origin, local and number of origin from the parent vessel. The sites of penetration in the mediolateral and anteroposterior direction were also recorded. The anterior communicating artery contribution to the basal APS was reviewed. Significant vascular variations and anastomoses were encountered

  17. CT evaluation of the anterior epitympanic recess

    International Nuclear Information System (INIS)

    Yamasoba, Tatsuya; Kikuchi, Shigeru; Takeuchi, Naonobu; Harada, Takehiko; Nomura, Yasuya

    1991-01-01

    The structures of the anterior epitympanic recess and its surrounding tissues were examined among non-inflammatory ear, chronic otitis media with central perforation and cholesteatoma, using axial scans of high resolution computed tomography. The length and width of the recess, as well as the number of the slices where the cog was determined, had no significant differences among them. Thus, the bony structure of the recess was considered to be seldom influenced by inflammatory processes. In the non-inflammatory ear, the degree of pneumatization around the recess was similar to that of the petrous apex cells and lower than that of the mastoid cells. In the chronic otitis media with central perforation and cholesteatoma, the pneumatization of the whole temporal bones was suppressed and the tendency was also found that the cells around the recess were less pneumatized than the mastoid cells. When cholesteatoma invaded into the anterior epitympanic recess, the destruction of the bony protrusion of the lateral wall between the recess and the epitympanum was recognized, as well as the disappearance of the cog. The bony protrusion was considered to be an inferior extention of the cog toward the anterior tympanic spine. (author)

  18. Anterior cruciate ligament ganglion: case report

    Directory of Open Access Journals (Sweden)

    André Pedrinelli

    Full Text Available CONTEXT: A ganglion is a cystic formation close to joints or tendinous sheaths, frequently found in the wrist, foot or knee. Intra-articular ganglia of the knee are rare, and most of them are located in the anterior cruciate ligament. The clinical picture for these ganglia comprises pain and movement restrictions in the knee, causing significant impairment to the patient. Symptoms are non-specific, and anterior cruciate ligament ganglia are usually diagnosed through magnetic resonance imaging or arthroscopy. Not all ganglia diagnosed through magnetic resonance imaging need to undergo surgical treatment: only those that cause clinical signs and symptoms do. Surgical results are considered good or excellent in the vast majority of cases. CASE REPORT: A 29-year-old male presented with pain in the left knee during a marathon race. Physical examination revealed limitation in the maximum range of knee extension and pain in the posterior aspect of the left knee. Radiographs of the left knee were normal, but magnetic resonance imaging revealed a multi-lobed cystic structure adjacent to the anterior cruciate ligament, which resembled a ganglion cyst. The mass was removed through arthroscopy, and pathological examination revealed a synovial cyst. Patient recovery was excellent, and he resumed his usual training routine five months later.

  19. Traumatic Anterior Cerebral Artery Pseudoaneurysmal Epistaxis.

    Science.gov (United States)

    Liu, Qing Lin; Xue, Hao; Qi, Chang Jing; Zhao, Peng; Wang, Dong Hai; Li, Gang

    2017-04-01

    Pseudoaneurysmal epistaxis is a rare but emergent condition. We report a case of traumatic anterior cerebral artery pseudoaneurysmal epistaxis and review the published literature. A 49-year-old man sustained severe head trauma. He was diagnosed with multiple skull bone fractures, left subdural hematoma, subarachnoid hemorrhage, pneumocephalus, and right frontal hematoma. Subdural hematoma evacuation was done at a local hospital. In the following months, he experienced repeated epistaxis that required nasal packing to stop the bleeding. Digital subtraction angiography showed an anterior cerebral artery pseudoaneurysm protruding into the posterior ethmoid sinus. Embolization of the aneurysm was performed with microcoils, and the parent artery was occluded by thrombosis. The patient presented 1 month later with another epistaxis episode. Digital subtraction angiography showed recanalization of the parent artery and recurrence of the aneurysm. The parent artery was occluded for the second time with coils and Onyx embolic agent. Pseudoaneurysmal epistaxis is rare, and this is the first report of an anterior cerebral artery pseudoaneurysm that manifested with epistaxis. Endovascular intervention has become the first choice of treatment for this disease. The high recurrence rate is the main disadvantage of endovascular intervention. Aneurysm trapping with bypass surgery is another treatment option. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Anterior Face Height Values in a Nigerian Population | Folaranmi ...

    African Journals Online (AJOL)

    ... Anterior Upper Face Height 47.7 (4) mm, Anterior Total Face Height (ATFH) 108.5 (5) mm, ratio of ALFH to ATFH ALFH: ATFH 56 (4)%. Conclusion: This study provides anterior face height measurements, which will be of great significance in evaluating facial proportions andesthetics in orthodontics, orthognathic surgery, ...

  1. Spatial relationship between intrahepatic artery and portal vein based on the fusion image of CT-arterial portography (CTAP) and CT-angiography (CTA): New classification for hepatic artery at hepatic hilum and the segmentation of right anterior section of the liver

    International Nuclear Information System (INIS)

    Ibukuro, Kenji; Takeguchi, Takaya; Fukuda, Hozumi; Abe, Shoko; Tobe, Kimiko; Tanaka, Rei; Tagawa, Kazumi

    2012-01-01

    Purpose: To clarify the variations of the intrahepatic artery and portal vein and to verify the proper segmentation for the right anterior section of the liver. Materials and methods: CT during arterial portography and CT angiography were performed on 64-slice multi detector row CT in 147 patients. All images were transferred to a workstation for analysis using multi-image-fusion mode. We investigated the spatial relationship between hepatic artery and portal vein in the right hemiliver and the segmentation of the right anterior hepatic artery and portal vein. Results: The spatial anatomy of right hepatic arteries and portal vein was (1) anterior and posterior hepatic artery run superior and inferior to anterior portal vein, respectively (47.6%), (2) one anterior hepatic artery runs superior to and another one runs inferior to anterior portal vein (15%), (3) anterior and posterior hepatic arteries run superior to anterior portal vein (11.6%), (4) anterior and posterior hepatic arteries run inferior to anterior portal vein (7.5%), and (5) one posterior hepatic artery runs superior to and another one runs inferior to anterior portal vein (6.8%). The combined anatomy of right anterior artery and portal vein with regard to segmentation was classified as (1) dorso-ventral (26.5%), (2) dorso-ventral and inferior (10.9%), (3) multiple (18.4%), and (4) superior and inferior segments (1.4%). Conclusion: There are various types of spatial anatomy of intrahepatic artery and portal vein. The hepatic arteries as well as portal veins of right anterior section of the liver could be divided into dorsal and ventral, not superior and inferior.

  2. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture

    OpenAIRE

    Fukui, Shinji; Aoki, Katsuya; Kaneko, Yoshiteru; Samma, Shoji; Fujimoto, Kiyohide

    2014-01-01

    A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed...

  3. Capsulorhexis contraction after cataract surgery: Comparison of sharp anterior edge and modified anterior edge acrylic intraocular lenses

    DEFF Research Database (Denmark)

    Corydon, C.; Lindholt, M.; Knudsen, E.B.

    2007-01-01

    eyes) were included in a prospective randomized study. All had phacoemulsification followed by implantation of an IOL with a modified anterior edge (38 eyes) or a sharp anterior edge (46 eyes). One day (baseline) and 3 months postoperatively, the area of the anterior capsule opening was measured using...... retroillumination photographs. RESULTS: There was a significant reduction in the area of the anterior capsule opening from 1 day to 3 months postoperatively in both groups (Psharp...

  4. Measurement of bone mineral density in the tunnel regions for anterior cruciate ligament reconstruction by dual-energy X-ray absorptiometry, computed tomography scan, and the immersion technique based on Archimedes' principle.

    Science.gov (United States)

    Tie, Kai; Wang, Hua; Wang, Xin; Chen, Liaobin

    2012-10-01

    To determine, for anterior cruciate ligament (ACL) reconstruction, whether the bone mineral density (BMD) of the femoral tunnel was higher than that of the tibial tunnel, to provide objective evidence for choosing the appropriate diameter of interference screws. Two groups were enrolled. One group comprised 30 normal volunteers, and the other comprised 9 patients with ACL rupture. Dual-energy X-ray absorptiometry was used to measure the BMD of the femoral and tibial tunnel regions of the volunteers' right knees by choosing a circular area covering the screw fixation region. The knees were also scanned by spiral computed tomography (CT), and the 3-dimensional reconstruction technique was used to determine the circular sections passing through the longitudinal axis of the femoral and tibial tunnels. Grayscale CT values of the cross-sectional area were measured. Cylindrical cancellous bone blocks were removed from the femoral and tibial tunnels during the ACL reconstruction for the patients. The volumetric BMD of the bone blocks was measured using a standardized immersion technique according to Archimedes' principle. As measured by dual-energy X-ray absorptiometry, the BMD of the femoral and tibial tunnel regions was 1.162 ± 0.034 g/cm(2) and 0.814 ± 0.038 g/cm(2), respectively (P difference in both femoral and tibial tunnel regions. For ACL reconstruction, the BMD of the femoral tunnel is higher than that of the tibial tunnel. This implies that a proportionally larger-diameter interference screw should be used for fixation in the proximal tibia than that used for fixation in the distal femur. Level IV, therapeutic case series. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Placement of implant bridge anterior maxilla post autograft (Serial case

    Directory of Open Access Journals (Sweden)

    Rifaat Nurrahma

    2016-06-01

    Full Text Available An advanced technology with implants based has now been developed in recent years.Implant with the bridge superstructure method is employed after variety of considerations where it is expected to meet its function, aesthetics, and comfortability.The alveolar bone existed is one reason for the process of adding bone (bonegraft.This case report proposes to determine the successful insertion of a superstructure anterior implant bridge post autograft.Two female patients were asked to use dental implant anterior with bridge system.The first case, the autograft application is made for a 20-year-old woman with edentulous teeth 11, 21, 22. One year later it was then inserted in the area of dental implant fixture 11 and 22. After 9 months, the healing abutments and the superstructure were inserted too.2 weeks after, the abutments of bridge and crowns of teeth 11, 21 and 22 with a pontic in the teeth 21 had been inserted. The second case, a 46-year-old woman with edentulous 11,12,21,22.They want to change the denture because they did not feel comfortable with the removable denture acrylic.Fixture placement was done a year after autograft.Insertion of healing abutments and the superstructure printing can be done after 6 months.A month later implant abutments and crowns could be inserted.Labial fullness is corrected; an implant-retained in the region of 12 and 21, 12, and 22 used the pontic.Prosthodontic rehabilitation with a fixed denture using the implant bridge after autograft anterior maxilla is an alternative fixed denture placement with satisfactory results, aesthetic correction and comfortably.

  6. Recurrent instability after revision anterior shoulder stabilization surgery.

    Science.gov (United States)

    Friedman, Lisa Genevra Mandeville; Griesser, Michael J; Miniaci, Anthony A; Jones, Morgan H

    2014-03-01

    The purpose of this study was to perform a systematic review of the literature to compare outcomes of revision anterior stabilization surgeries based on technique. This study also sought to compare the impact of bone defects on outcomes. A systematic review of the electronic databases PubMed, Cochrane Central Register of Controlled Trials, and Scopus was performed in July 2012 and March 2013. Of 345 articles identified in the search, 17 studies with Level I to IV Evidence satisfied the inclusion criteria and were analyzed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Recurrent instability was defined as redislocation, resubluxation, or a positive apprehensive test after revision surgery. Procedures were categorized as arthroscopic Bankart repair, open Bankart repair, Bristow-Latarjet procedure, and other open procedures. In total, 388 shoulders were studied. Male patients comprised 74.1% of patients, 66.7% of cases involved the dominant shoulder, the mean age was 28.2 years, and the mean follow-up period was 44.2 months. The surgical procedures classified as "other open procedures" had the highest rate of recurrent instability (42.7%), followed by arthroscopic Bankart repair (14.7%), the Bristow-Latarjet procedure (14.3%), and open Bankart repair (5.5%). Inconsistent reporting of bone defects precluded drawing significant conclusions. A number of different procedures are used to address recurrent instability after a primary operation for anterior shoulder instability has failed. There is significant variability in the rate of recurrent instability after revision anterior shoulder stabilization surgery. Level IV, systematic review of Level I to IV studies. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Harry Laksono

    2013-03-01

    Full Text Available Background: Local muscle soreness is the most common temporomandibular disorders complaint of patients seeking treatment in the dental clinics. The emergency treatment that can be done in the clinics to manage this disorder is by making anterior bite splint. Anterior bite splint is usually made of acrylic, but currently there is a soft putty impression material that can also be used for making anterior bite splint. The effectiveness of soft putty anterior bite splint in local muscle soreness treatment still has not clear. Purpose: To determine the effectiveness of the soft putty impression material as a material used for making anterior bite splint in the treatment of local muscle soreness. Case: Six patients was reported five female patients aged 20-40 years old and one male patient aged 37 years old with local muscle soreness. Four female patients with a “click” sound on TMJ. Case management: Make differential diagnosis with screening history (anamnesis, clinical examination consists of extra oral examination such as muscle and temporomandibular joint palpation, measure the mandibular movement, end-feel, load test, intra oral examination and radiographic evaluation. Record the results and make the diagnosis. Make a soft putty anterior bite splint, adjusted and inserted in the maxillary anterior teeth. Record the results based on signs and symptoms. Conclusion: It can be concluded that anterior bite splint made of soft putty impression material is effective for treatment the local muscle soreness.Latar belakang: Salah satu tipe temporomandibular disorders yang paling sering dijumpai di klinik dokter gigi adalah local muscle soreness. Perawatan yang dapat dengan segera dilakukan di klinik untuk mengelola gangguan tersebut adalah dengan pembuatan anterior bite splint. Biasanya anterior bite splint terbuat dari akrilik, namun saat ini telah ada bahan cetak soft putty yang memungkinkan untuk dipakai sebagai bahan pembuatan anterior bite splint

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-01

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

  9. Anterior lumbar fusion with titanium threaded and mesh interbody cages.

    Science.gov (United States)

    Rauzzino, M J; Shaffrey, C I; Nockels, R P; Wiggins, G C; Rock, J; Wagner, J

    1999-12-15

    The authors report their experience with 42 patients in whom anterior lumbar fusion was performed using titanium cages as a versatile adjunct to treat a wide variety of spinal deformity and pathological conditions. These conditions included congenital, degenerative, iatrogenic, infectious, traumatic, and malignant disorders of the thoracolumbar spine. Fusion rates and complications are compared with data previously reported in the literature. Between July 1996 and July 1999 the senior authors (C.I.S., R.P.N., and M.J.R.) treated 42 patients by means of a transabdominal extraperitoneal (13 cases) or an anterolateral extraperitoneal approach (29 cases), 51 vertebral levels were fused using titanium cages packed with autologous bone. All vertebrectomies (27 cases) were reconstructed using a Miami Moss titanium mesh cage and Kaneda instrumentation. Interbody fusion (15 cases) was performed with either the BAK titanium threaded interbody cage (in 13 patients) or a Miami Moss titanium mesh cage (in two patients). The average follow-up period was 14.3 months. Seventeen patients had sustained a thoracolumbar burst fracture, 12 patients presented with degenerative spinal disorders, six with metastatic tumor, four with spinal deformity (one congenital and three iatrogenic), and three patients presented with spinal infections. In five patients anterior lumbar interbody fusion (ALIF) was supplemented with posterior segmental fixation at the time of the initial procedure. Of the 51 vertebral levels treated, solid arthrodesis was achieved in 49, a 96% fusion rate. One case of pseudarthrosis occurred in the group treated with BAK cages; the diagnosis was made based on the patient's continued mechanical back pain after undergoing L4-5 ALIF. The patient was treated with supplemental posterior fixation, and successful fusion occurred uneventfully with resolution of her back pain. In the group in which vertebrectomy was performed there was one case of fusion failure in a patient with

  10. An anterior signaling center patterns and sizes the anterior neuroectoderm of the sea urchin embryo.

    Science.gov (United States)

    Range, Ryan C; Wei, Zheng

    2016-05-01

    Anterior signaling centers help specify and pattern the early anterior neuroectoderm (ANE) in many deuterostomes. In sea urchin the ANE is restricted to the anterior of the late blastula stage embryo, where it forms a simple neural territory comprising several types of neurons as well as the apical tuft. Here, we show that during early development, the sea urchin ANE territory separates into inner and outer regulatory domains that express the cardinal ANE transcriptional regulators FoxQ2 and Six3, respectively. FoxQ2 drives this patterning process, which is required to eliminate six3 expression from the inner domain and activate the expression of Dkk3 and sFRP1/5, two secreted Wnt modulators. Dkk3 and low expression levels of sFRP1/5 act additively to potentiate the Wnt/JNK signaling pathway governing the positioning of the ANE territory around the anterior pole, whereas high expression levels of sFRP1/5 antagonize Wnt/JNK signaling. sFRP1/5 and Dkk3 levels are rigidly maintained via autorepressive and cross-repressive interactions with Wnt signaling components and additional ANE transcription factors. Together, these data support a model in which FoxQ2 initiates an anterior patterning center that implements correct size and positions of ANE structures. Comparisons of functional and expression studies in sea urchin, hemichordate and chordate embryos reveal striking similarities among deuterostome ANE regulatory networks and the molecular mechanism that positions and defines ANE borders. These data strongly support the idea that the sea urchin embryo uses an ancient anterior patterning system that was present in the common ambulacrarian/chordate ancestor. © 2016. Published by The Company of Biologists Ltd.

  11. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture.

    Science.gov (United States)

    Fukui, Shinji; Aoki, Katsuya; Kaneko, Yoshiteru; Samma, Shoji; Fujimoto, Kiyohide

    2014-05-01

    A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed when he was 5 years. After excision of the scarred portions of the urethra, the defect of the urethra was 20 mm. Transperineal bulbar urethral mobilization was performed, and a single-stage end-to-end anterior urethroplasty without tension could be performed simultaneously.

  12. Post Operative Voiding Efficacy after Anterior Colporrhaphy

    Directory of Open Access Journals (Sweden)

    Behnoosh Miladpoor

    2010-02-01

    Full Text Available The aim of this study was to determine the most effective and suitable time to remove the urinary catheter (Foley after anterior and posterior colporrhaphy surgery. Patients who experience anterior Colporrhaphy operation for genuine stress incontinency or pelvic organ prolapsed will have post operative voiding dysfunction. These patients need postoperative drainage. One of the methods preferred for this purpose is to apply Foley Catheter, but there is no particular regimen available for the exact time of catheter removal in these patients. We have tried to find out the best time to remove Foley catheter after which the repeated Foley catheter is not required or minimized. One hundred and eighty nine patients who have been undergone Colporrhaphy have been selected randomly and divided into three groups' as 1, 2 and 4 days of catheter removal. The number of patients in each group was 62, 63 and 64 respectively. In all three groups, before removing urinary catheter, it was clamped every 4 hrs, for 3 times. After removing of Foley, the patients were guided for urination; the voiding and residual volume was measured. In the patients with an increase of residual volume, the  repeated Foley requirement was increased. However,  5.6 % of the patients with residual volume of ≤ 33 percent and 23.9% of the patients with residual volume between 33 to 68 percent, and finally  64.8% of the patients with residual volume of ≥ 68% had repeated Foley insertion. When considering the number of days, 85, 65 and 35.7 percent of the patients needed repeated Foley after 1, 2, and 4 days of catheter removal respectively. Interestingly, in the third group ( 4 days of the catheter removal with residual volume of ≤ 33% the repeated Foley requirement was nil, with no increase risk of urinary infection. We suggest that the best time to remove the urinary Foley catheter after anterior and posterior Colporrhaphy is the day four.

  13. Toxic anterior-segment syndrome (TASS

    Directory of Open Access Journals (Sweden)

    Cetinkaya S

    2014-10-01

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

  14. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

    Frobell, Richard B; Roos, Harald P; Roos, Ewa M

    2015-01-01

    STUDY QUESTION: In young active adults with an acute anterior cruciate ligament (ACL) rupture, do patient reported or radiographic outcomes after five years differ between those treated with rehabilitation plus early ACL reconstruction and those treated with rehabilitation and optional delayed AC...... AND WHAT THIS PAPER ADDS: The relative efficacy of surgical reconstruction and rehabilitation for short and long term outcomes of ACL rupture is debated. Clinicians and young active adult patients should consider rehabilitation as a primary treatment option following an acute ACL tear....

  15. Superior labrum anterior-to-posterior tear.

    Science.gov (United States)

    Sum, Jonathan C; Omid, Reza

    2012-12-01

    The patient was a 25-year-old male college student with a chief complaint of right shoulder pain. The patient was initially diagnosed with bicipital tendinitis by his physician and had been treated for 4 weeks by a physical therapist. However, his symptoms did not improve and he was unable to return to his preinjury activity levels, so he sought the services of another physical therapist for a second opinion. Due to concern for a labrum tear, the physical therapist referred the patient to an orthopaedic surgeon. Magnetic resonance arthrography revealed findings consistent with a superior labrum anterior-to-posterior tear.

  16. Outcomes in Anterior Cruciate Ligament Reconstruction Surgery

    Directory of Open Access Journals (Sweden)

    Roman Mihai

    2016-11-01

    Full Text Available Improving the outcomes in reconstructive surgery of the anterior cruciate ligament (ACL requires a rigorous and permanent assessment of specific parameters. Therefore, we can increase the degree of reproducibility of the procedure and identify particular aspects in order to achieve an adequate and individualized therapeutic approach for each case. In order to accomplish this goal, the use of complex means (scores of quantifying results is required. That includes objective means of verifying the parameters in knee surgery, and a subjective evaluation of the patient in order to compare the results.

  17. Genetic disorders of the anterior pituitary gland.

    Science.gov (United States)

    Teller, W M

    1985-01-01

    This survey deals with disorders caused by genetically disturbed function of the anterior pituitary gland. Genetic Dwarfism may be caused by isolated growth hormone deficiency (IGHD) or panpituitary diseases, such as congenital absence of the pituitary or familial panhypopituitarism. Genetic disturbances of isolated pituitary hormone secretion without dwarfism may occur as isolated gonadotropin deficiency (IGD), isolated luteinizing hormone deficiency ("fertile eunuch"), Kallmann syndrome (olfactogenital dysplasia), isolated thyrotropin deficiency (ITD) and isolated corticotropin deficiency (ICD). Pituitary dysfunction may also be associated with other genetic disease entities.

  18. [Anterior shoulder instabilities: about 73 cases].

    Science.gov (United States)

    Jamal, Louaste; Bousbaa, Hicham; Cherrad, Taoufik; Wahidi, Mohammed; Amhajji, Larbi; Rachid, Khalid

    2016-01-01

    Between 2005 and 2014, 73 patients (77 shoulders) underwent Latarjet procedure for anterior shoulder instability. This retrospective study aims to evaluate the clinical and radiographic results of this surgical technique. Surgical intervention was performed to treat 69 cases with recurrent dislocation, 5 cases with recurrent painful subluxation and 3 cases with painful shoulder. All patients underwent radiographic evaluation before surgery and during the most recent medical control. According to Rowe score, 73 (94.8%) of 77 shoulders got a good or excellent result. In the longest follow-up, 74 shoulders were free from glenohumeral arthrosis.

  19. The Effects of Specialization and Sex on Anterior Y-Balance Performance in High School Athletes.

    Science.gov (United States)

    Miller, Madeline M; Trapp, Jessica L; Post, Eric G; Trigsted, Stephanie M; McGuine, Timothy A; Brooks, M Alison; Bell, David R

    Sport specialization and movement asymmetry have been separately discussed as potential risk factors for lower extremity injury. Early specialization may lead to the development of movement asymmetries that can predispose an athlete to injury, but this has not been thoroughly examined. Athletes rated as specialized would exhibit greater between-limb anterior reach asymmetry and decreased anterior reach distance on the Y-balance test (YBT) as compared with nonspecialized high school athletes, and these differences would not be dependent on sex. Cross-sectional study. Level 3. Two hundred ninety-five athletes (117 male, 178 female; mean age, 15.6 ± 1.2 years) from 2 local high schools participating in basketball, soccer, volleyball, and tennis responded to a questionnaire regarding sport specialization status and performed trials of the YBT during preseason testing. Specialization was categorized according to 3 previously utilized specialization classification methods (single/multisport, 3-point scale, and 6-point scale), and interactions between specialization and sex with Y-balance performance were calculated using 2-way analyses of variance. Single-sport male athletes displayed greater anterior reach asymmetry than other interaction groups. A consistent main effect was observed for sex, with men displaying greater anterior asymmetry and decreased anterior reach distance than women. However, the interaction effects of specialization and sex on anterior Y-balance performance varied based on the classification method used. Single-sport male athletes displayed greater anterior reach asymmetry on the YBT than multisport and female athletes. Specialization classification method is important because the 6- and 3-point scales may not accurately identify balance abnormalities. Male athletes performed worse than female athletes on both of the Y-balance tasks. Clinicians should be aware that single-sport male athletes may display deficits in dynamic balance, potentially

  20. Extradural anterior clinoidectomy: Technical nuances from a learner's perspective

    Science.gov (United States)

    Mishra, Shashwat; Leão, Baltazar; Rosito, Diego Mendez

    2017-01-01

    Background: Extradural removal of the anterior clinoid process (ACP) is a crucial step in the proper surgical exposure of various pathologies in and around the central skull base. Since the pioneering description by Dolenc, the technique of extradural clinoidectomy has undergone several refinements in the light of improved understanding of microsurgical anatomy and maturation of neurosurgical techniques. Mastery of the surgical nuances involved in performing this surgical exercise will allow the young neurosurgeon to execute this step without undue reluctance and trepidation. Objective: This paper is an attempt to describe in detail, from a learner's viewpoint, the sequence of maneuvers involved in extradural removal of the ACP. Materials and Methods: The standard pterional approach and extradural anterior clinoidectomy was performed on four sides of two formalin fixed and latex injected cadaver heads. Important steps were photographed through the surgical microscope. Conclusion: An accurate understanding of the microsurgical anatomy of this region and the surgical nuances relevant to extradural clinoidectomy helps simplify the complexity of this surgical step. PMID:28484528

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-01-15

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

  2. Anterior Temporal Lobe Tracks the Formation of Prejudice.

    Science.gov (United States)

    Spiers, Hugo J; Love, Bradley C; Le Pelley, Mike E; Gibb, Charlotte E; Murphy, Robin A

    2017-03-01

    Despite advances in understanding the brain structures involved in the expression of stereotypes and prejudice, little is known about the brain structures involved in their acquisition. Here, we combined fMRI, a task involving learning the valence of different social groups, and modeling of the learning process involved in the development of biases in thinking about social groups that support prejudice. Participants read descriptions of valenced behaviors performed by members of novel social groups, with majority groups being more frequently encountered during learning than minority groups. A model-based fMRI analysis revealed that the anterior temporal lobe tracked the trial-by-trial changes in the valence associated with each group encountered in the task. Descriptions of behavior by group members that deviated from the group average (i.e., prediction errors) were associated with activity in the left lateral PFC, dorsomedial PFC, and lateral anterior temporal cortex. Minority social groups were associated with slower acquisition rates and more activity in the ventral striatum and ACC/dorsomedial PFC compared with majority groups. These findings provide new insights into the brain regions that (a) support the acquisition of prejudice and (b) detect situations in which an individual's behavior deviates from the prejudicial attitude held toward their group.

  3. Bony Reconstruction of the Anterior Glenoid Rim.

    Science.gov (United States)

    Willemot, Laurent B; Elhassan, Bassem T; Verborgt, Olivier

    2018-04-13

    Recurrent anterior shoulder instability is associated with glenohumeral bone loss. Glenoid deficiency compromises the concavity-compression mechanism. Medial Hill-Sachs lesions can result in an off-track humeral position. Anterior glenoid reconstruction or augmentation prevents recurrence by addressing the pathomechanics. In Bristow and Latarjet procedures, the coracoid process is harvested for conjoint tendon transfer, capsular reinforcement, and glenoid rim restoration. Complications and the nonanatomic nature of the procedure have spurred research on graft sources. The iliac crest is preferred for autogenous structural grafts. Tricortical, bicortical, and J-bone grafts have shown promising results despite the historical association of Eden-Hybinette procedures with early degenerative joint disease. Allogeneic osteochondral grafts may minimize the risk of arthropathy and donor site morbidity. Tibial plafond and glenoid allografts more closely match the native glenoid geometry and restore the articular chondral environment, compared with conventional grafts. Graft availability, cost, risk of disease transmission, and low chondrocyte viability have slowed the acceptance of osteochondral allografts.

  4. MRI of anterior cruciate ligament autografts

    International Nuclear Information System (INIS)

    Ogi, Shigeyuki; Ariizumi, Mitsuko; Yamagishi, Tsuneo; Agata, Toshihiko; Tada, Shinpei; Fukuda, Kunihiko

    2000-01-01

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

  5. Approach-avoidance activation without anterior asymmetry

    Directory of Open Access Journals (Sweden)

    Andero eUusberg

    2014-03-01

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

  6. Anterior eye protection with orbital neoplasia

    International Nuclear Information System (INIS)

    Hancock, S.L.

    1986-01-01

    The administration of adequate doses of radiation to tumors involving the orbit and surrounding facial structures and sinuses is often complicated by the need to protect the sensitive ocular components, the lens and cornea. A technique has been devised that uses four photon beam fields and an optional electron field to treat the contents of both orbits and adjacent sinuses with effective, reproducible protection of cornea and lens. Essential features include: alignment of the corneal surfaces with the central plane of rotation of the treatment machine, use of a narrow eye block across the entire beam to shield a strip equal to the width of the cornea, positioned symmetrically across the central plane of rotation, fine alignment of the eye block with both corneal surfaces by altering pedestal angle, treatment with paired, wedged, anterior oblique fields to encompass desired orbital and sinus volumes with additional blocking placed as needed, and complementary, lateral strip fields using collimators set to eye block thickness to equalize dose in the posterior orbit shielded by the strip eye block. A similar anterior electron beam strip field may be added to boost the medial orbit and ethmoid regions covered by the eye block. Bite block head immobilization and easy, direct daily visualization of block position assures eye protection for each treatment and provides substantial reduction in dose to the cornea, lens and iris. Additional blocking may be incorporated to provide partial lacrimal and parotid sparing

  7. Penghentian Karies Gigi Sulung Anterior (Laporan Penelitian

    Directory of Open Access Journals (Sweden)

    Titi Pratiwi Indra Yoga

    2015-10-01

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

  8. Anterior vitrectomy and partial capsulectomy via anterior approach to treat chronic postoperative endophthalmitis

    Directory of Open Access Journals (Sweden)

    Mete Güler

    2013-02-01

    Full Text Available AIM:To describe the results of vitrectomy and partial capsulectomy via anterior approach surgical technique in treatment of chronic postoperative endophthalmitis (CPE.METHODS:Clinical records of 9 patients treated for CPE between 2006 and 2010 were reviewed retrospectively. All of these patients were treated with vitrectomy and partial capsulectomy via anterior approach.RESULTS:Six of 9 patients were male. The average patients’ age was (60±8.1 years. The average period between cataract extraction and onset of signs and symptoms was (3.6±1.3 weeks. The average presenting visual acuity was 0.3±0.1 and the average final post operative visual acuity was 0.7±0.2. The mean follow-up period was (28.1±8.9 weeks. In all patients, the inflammation subsided after surgery.CONCLUSION:Our results suggest that anterior vitrectomy and partial capsulectomy via anterior approach may be considered as potentially useful and relatively less invasive technique to treat CPE.

  9. Immediate postoperative anterior knee stability: double- versus triple-bundle anterior cruciate ligament reconstructions.

    Science.gov (United States)

    Mae, Tatsuo; Shino, Konsei; Matsumoto, Norinao; Yoneda, Kenji; Yoshikawa, Hideki; Nakata, Ken

    2013-02-01

    The purpose of this study was to compare the triple-bundle (TB) anterior cruciate ligament (ACL) reconstruction with the double-bundle (DB) ACL reconstruction in immediate postoperative anterior knee stability. This study involved 133 patients who had undergone the anatomic ACL reconstruction with autogenous hamstring tendon unilaterally. Then 83 patients (mean age, 28.8 years) underwent the DB between November 2004 and December 2005, and 50 patients (mean age, 29.6 years) underwent the TB ACL reconstruction between January and December 2006. The 2 femoral tunnels were created in the ideal ACL attachment area, whereas 2 tibial tunnels for the DB and 3 tunnels for the TB were created in the ACL footprint. The 2 doubled tendon grafts were fixed with EndoButton-CL (Smith & Nephew Endoscopy, Andover, MA) on the femur. The grafts were fixed to the tibia using a Double Spike Plate and a screw under the total initial tension of 20 N at 20° of flexion, after meticulous in situ pretensioning using a tensioning boot. Then immediate postoperative anterior knee laxity in response to 89 N of anterior load was measured by one experienced examiner (T.M.) with the KT-2000 Knee Arthrometer (MEDmedtric, San Diego, CA) under general anesthesia at 30° of knee flexion with muscle relaxants. The measured anterior laxity was 3.4 ± 1.2 mm in the DB and 2.5 ± 0.7 mm in the TB ACL reconstruction, a statistically significant difference. The side-to-side difference of the laxity was -3.2 ± 1.6 mm in the DB and -4.2 ± 2.0 mm in the TB, again a significant difference. TB ACL reconstruction resulted in better immediate postoperative anterior knee stability than DB ACL reconstruction under 89 N of anterior tibial load (P = .031). Level III, therapeutic retrospective comparative study. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  10. Hyper-responsivity to losses in the anterior insula during economic choice scales with depression severity.

    Science.gov (United States)

    Engelmann, J B; Berns, G S; Dunlop, B W

    2017-12-01

    Commonly observed distortions in decision-making among patients with major depressive disorder (MDD) may emerge from impaired reward processing and cognitive biases toward negative events. There is substantial theoretical support for the hypothesis that MDD patients overweight potential losses compared with gains, though the neurobiological underpinnings of this bias are uncertain. Twenty-one unmedicated patients with MDD were compared with 25 healthy controls (HC) using functional magnetic resonance imaging (fMRI) together with an economic decision-making task over mixed lotteries involving probabilistic gains and losses. Region-of-interest analyses evaluated neural signatures of gain and loss coding within a core network of brain areas known to be involved in valuation (anterior insula, caudate nucleus, ventromedial prefrontal cortex). Usable fMRI data were available for 19 MDD and 23 HC subjects. Anterior insula signal showed negative coding of losses (gain > loss) in HC subjects consistent with previous findings, whereas MDD subjects demonstrated significant reversals in these associations (loss > gain). Moreover, depression severity further enhanced the positive coding of losses in anterior insula, ventromedial prefrontal cortex, and caudate nucleus. The hyper-responsivity to losses displayed by the anterior insula of MDD patients was paralleled by a reduced influence of gain, but not loss, stake size on choice latencies. Patients with MDD demonstrate a significant shift from negative to positive coding of losses in the anterior insula, revealing the importance of this structure in value-based decision-making in the context of emotional disturbances.

  11. Endoscopic transnasal resection of anterior cranial fossa meningiomas.

    Science.gov (United States)

    de Divitiis, Enrico; Esposito, Felice; Cappabianca, Paolo; Cavallo, Luigi M; de Divitiis, Oreste; Esposito, Isabella

    2008-01-01

    The extended transnasal approach, a recent surgical advancements for the ventral skull base, allows excellent midline access to and visibility of the anterior cranial fossa, which was previously thought to be approachable only via a transcranial route. The extended transnasal approach allows early decompression of the optic canals, obviates the need for brain retraction, and reduces neurovascular manipulation. Between 2004 and 2007, 11 consecutive patients underwent transnasal resection of anterior cranial fossa meningiomas--4 olfactory groove (OGM) and 7 tuberculum sellae (TSM) meningiomas. Age at surgery, sex, symptoms, and imaging studies were reviewed. Tumor size and tumor extension were estimated, and the anteroposterior, vertical, and horizontal diameters were measred on MR images. Medical records, surgical complications, and outcomes of the patients were collected. A gross-total removal of the lesion was achieved in 10 patients (91%), and in 1 patient with a TSM only a near-total (> 90%) resection was possible. Four patients with preoperative visual function defect had a complete recovery, whereas 3 patients experienced a transient worsening of vision, fully recovered within few days. In 3 patients (2 with TSMs and 1 with an OGM), a postoperative CSF leak occurred, requiring a endoscopic surgery for skull base defect repair. Another patient (a case involving a TSM) developed transient diabetes insipidus. The operative time ranged from 6 to 10 hours in the OGM group and from 4.5 to 9 hours in the TSM group. The mean duration of the hospital stay was 13.5 and 10 days in the OGM and TSM groups, respectively. Six patients (3 with OGMs and 3 with TSMs) required a blood transfusion. Surgery-related death occurred in 1 patient with TSM, in whom the tumor was successfully removed. The technique offers a minimally invasive route to the midline anterior skull base, allowing the surgeon to avoid using brain retraction and reducing manipulation of the large vessels and

  12. The Anterior SMAS Approach for Facelifting and for Buccal Fat Pad Removal.

    Science.gov (United States)

    Paul, Malcolm D

    2017-10-01

    Having performed numerous varieties of SMAS advancement including: plication, resection, flap elevation with variable anterior deep dissection, the author has developed a direct approach to the mobile anterior SMAS which allows correction of midface descent, modest elevation of the modiolus, jawline correction, and, where indicated, direct access for buccal fat pad resection. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  13. The Use of All-Ceramic Resin-Bonded Bridges in the Anterior Aesthetic Zone.

    Science.gov (United States)

    Shah, Rupal; Laverty, Dominic P

    2017-03-01

    For several years, all-ceramic resin-bonded bridges (RBBs) have been considered an aesthetic treatment option for the replacement of missing teeth in the anterior region. With continued developments in technology, various different ceramic materials have been used to fabricate all-ceramic RBBs including zirconia, glass-reinforced, alumina-based ceramics, and lithium disilicate glass ceramics. The aim of this article is to provide an overview of all-ceramic RBBs, the advantages and disadvantages associated with these prostheses, as well as to demonstrate their application in replacing missing anterior teeth. Clinical relevance: To present the current literature and clinical application of all-ceramic resin-bonded bridges for replacing missing anterior teeth.

  14. Navigation-aided visualization of lumbosacral nerves for anterior sacroiliac plate fixation: a case report.

    Science.gov (United States)

    Takao, Masaki; Nishii, Takashi; Sakai, Takashi; Sugano, Nobuhiko

    2014-06-01

    Anterior sacroiliac joint plate fixation for unstable pelvic ring fractures avoids soft tissue problems in the buttocks; however, the lumbosacral nerves lie in close proximity to the sacroiliac joint and may be injured during the procedure. A 49 year-old woman with a type C pelvic ring fracture was treated with an anterior sacroiliac plate using a computed tomography (CT)-three-dimensional (3D)-fluoroscopy matching navigation system, which visualized the lumbosacral nerves as well as the iliac and sacral bones. We used a flat panel detector 3D C-arm, which made it possible to superimpose our preoperative CT-based plan on the intra-operative 3D-fluoroscopic images. No postoperative complications were noted. Intra-operative lumbosacral nerve visualization using computer navigation was useful to recognize the 'at-risk' area for nerve injury during anterior sacroiliac plate fixation. Copyright © 2013 John Wiley & Sons, Ltd.

  15. Preoperative Prediction of the Necessity for Anterior Clinoidectomy During Microsurgical Clipping of Ruptured Posterior Communicating Artery Aneurysms.

    Science.gov (United States)

    Kamide, Tomoya; Burkhardt, Jan-Karl; Tabani, Halima; Safaee, Michael M; Lawton, Michael T

    2018-01-01

    Although most posterior communicating artery (PCoA) aneurysms can be clipped easily with excellent results, some require anterior clinoidectomy for safe and complete clipping. To review our microsurgical series of ruptured PCoA aneurysms and identify the preoperative predictors for anterior clinoidectomy during microsurgical clipping for PCoA aneurysms. Results from microsurgical clipping of 104 patients with ruptured PCoA aneurysms were reviewed retrospectively. Distances and angles were obtained from computed tomographic angiography and compared between the anterior and nonanterior clinoidectomy groups. Anterior clinoidectomy was required in 19 of the 104 cases (18%). None developed surgical complications due to anterior clinoid process (ACP) resection, including postoperative visual deficit. Univariate and multivariate analyses revealed that the distances from the ACP tip to the aneurysmal proximal neck and from the ACP line to the aneurysmal proximal neck were statistically significant predictive factors for the need of anterior clinoidectomy. Based on a receiver operating characteristic analysis, the distances from the ACP tip to the aneurysmal proximal neck PCoA aneurysm surgery, the distances from the ACP tip to the aneurysmal proximal neck and from the ACP line to the aneurysmal proximal neck were both found to be useful predictors of whether anterior clinoidectomy was required. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Invisalign® treatment in the anterior region: were the predicted tooth movements achieved?

    Science.gov (United States)

    Krieger, Elena; Seiferth, Jörg; Marinello, Ivana; Jung, Britta A; Wriedt, Susanne; Jacobs, Collin; Wehrbein, Heinrich

    2012-09-01

    Based on our previous pilot study, the objective of this extended study was to compare (a) casts to their corresponding digital ClinCheck® models at baseline and (b) the tooth movement achieved at the end of aligner therapy (Invisalign®) to the predicted movement in the anterior region. Pre- and post-treatment casts as well as initial and final ClinChecks® models of 50 patients (15-63 years of age) were analyzed. All patients were treated with Invisalign® (Align Technology, Santa Clara, CA, USA). Evaluated parameters were: upper/lower anterior arch length and intercanine distance, overjet, overbite, dental midline shift, and the irregularity index according to Little. The comparison achieved/predicted tooth movement was tested for equivalence [adjusted 98.57% confidence interval (- 1.00; + 1.00)]. Before treatment the anterior crowding, according to Little, was on average 5.39 mm (minimum 1.50 mm, maximum 14.50 mm) in the upper dentition and 5.96 mm (minimum 2.00 mm, maximum 11.50 mm) in the lower dentition. After treatment the values were reduced to 1.57 mm (minimum 0 mm, maximum 4.5 mm) in the maxilla and 0.82 mm (minimum 0 mm, maximum 2.50 mm) in the mandible. We found slight deviations between pretreatment casts and initialClinCheck® ranging on average from -0.08 mm (SD ± 0.29) for the overjet and up to -0.28 mm (SD ± 0.46) for the upper anterior arch length. The difference between achieved/predicted tooth movements ranged on average from 0.01 mm (SD ± 0.48) for the lower anterior arch length, up to 0.7 mm (SD ± 0.87) for the overbite. All parameters were significantly equivalent except for the overbite (-1.02; -0.39). Performed with aligners (Invisalign®), the resolvement of the partly severe anterior crowding was successfully accomplished. Resolving lower anterior crowding by protrusion of the anterior teeth (i.e., enlargement of the anterior arch length) seems well predictable. The initial ClinCheck® models provided high accuracy compared to the

  17. Management of anterior teeth damage caused by complex caries through aesthetic endorestoration

    Directory of Open Access Journals (Sweden)

    Nanik Zubaidah

    2011-03-01

    Full Text Available Background: Dental caries is a microbiological disease that result in localized dissolution and destruction of the calcified tissue. It is multifactorial, therefore prevention must be based on a multifactorial approach. The damage of anterior teeth due to complex caries, for certain person may interfere their performance and decrease their self confidence aesthetically. Restoration of tooth form and function, especially on anterior teeth is highly valuable. Purpose: To present a case of maxillary anterior teeth with complex caries, through endorestoration treatment for recovering its original function and aesthetic. Case: The 21 years old male patient with complex carries on maxillary anterior teeth number 12, 11, 21, 22 and 23. The patient felt bad about his performance and affect his self confidence. The patient visited the clinic to repair his teeth and to get its form and function aesthetically. Case management: The endorestoration treatment was performed for carious teeth through pulpectomy followed by insertion of post retention and porcelain fused to metal crowns. Conclusion: Anterior teeth with severed complex caries can be managed through endorestoration treatment to recover its performance and function aesthetically.Latar belakang: Dental karies adalah penyakit infeksi yang berakibat kerusakan jaringan kalsifikasi dan bersifat multifactorial. Oleh karena itu pencegahan dilakukan dengan pendekatan multifactorial. Kerusakan gigi anterior karena karies kompleks untuk orang-orang tertentu mungkin berdampak pada penampilan dan penurunan kepercayaan diri karena factor estetik. Perbaikan gigi anterior dari berbagai kerusakan baik dalam hal bentuk maupun fungsinya sangat besar nilainya. Tujuan: Untuk menunjukkan kasus gigi anterior rahang atas karena karies kompleks melalui perawatan endorestorasi untuk mengembalikan fungsi gigi asli dan estetik. Kasus: Laki-laki usia 21 tahun dengan karies kompleks pada gigi anterior rahang atas 12, 11, 21

  18. Strategies for revision surgery after primary double-bundle anterior cruciate ligament (ACL) reconstruction

    NARCIS (Netherlands)

    Hofbauer, Marcus; Muller, Bart; Murawski, Christopher D.; Baraga, Michael; van Eck, Carola Franziska; Fu, Freddie H.

    2013-01-01

    The purpose of this article was to discuss pre- and intra-operative considerations as well as surgical strategies for different femoral and tibial tunnel scenarios in revision surgery following primary double-bundle anterior cruciate ligament (ACL) reconstruction. Based on the current literature of

  19. Is it possible to differentiate between Takotsubo cardiomyopathy and acute anterior ST-elevation myocardial infarction?

    DEFF Research Database (Denmark)

    Vervaat, Fabienne E; Christensen, Thomas E; Smeijers, Loes

    2015-01-01

    . The latter group was divided into the following subgroups: 46 patients with proximal, 47 with mid and 10 with distal LAD occlusion. Three ST-segment based ECG features were investigated: (1) Existing criterion for differentiating anterior STEMI from TC: ST-segment depression >0.5mm in lead aVR...

  20. Postural stability in subjects with anterior cruciate ligament injury

    OpenAIRE

    Kolář, Miroslav

    2011-01-01

    6 Abstract Title: Postural stability in subjects with anterior cruciate ligament injury. Objectives: The aim of this thesis was to find out if the postural stability is differed in subjects with anterior cruciate ligament injury and in the control group after the "4 steps - one leg stance" test had been performed. Methods: This study compared a group with anterior cruciate ligament injury and a control group on the basis of the "4 steps - one leg stance" test. Methods of comparison and analys...

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

    Directory of Open Access Journals (Sweden)

    Egemen Kucuk

    2014-04-01

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

  2. A small absorbable stent for treatment of anterior glottic web.

    Science.gov (United States)

    Bhongmakapat, Thongchai; Kantapasuantara, Kanjalak; Praneevatakul, Phurich

    2012-03-01

    A new one-stage approach for treatment of selected anterior glottic web has been successful. This case report illustrates its simplicity in microlaryngoscopy with complete lysis of the anterior glottic web by CO(2) laser. Then a small neck horizontal incision is made at the level of anterior commissure to gain exposure to thyroid cartilage. Absorbable suture is passed through the midline of thyroid cartilage below and above the anterior commissure. A knot is tied over thyroid ala. The suture acts as a tiny stent to prevent recurrence of the web. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  3. Winging of scapula due to serratus anterior tear

    Directory of Open Access Journals (Sweden)

    Varun Singh Kumar

    2014-10-01

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

  4. Anterior corneal profile with variable asphericity.

    Science.gov (United States)

    Rosales, Marco A; Juárez-Aubry, Montserrat; López-Olazagasti, Estela; Ibarra, Jorge; Tepichín, Eduardo

    2009-12-10

    We present a corneal profile in which the eccentricity, e(Q=-e(2)), has a nonlinear continuous variation from the center outwards. This nonlinear variation is intended to fit and reproduce our current experimental data in which the anterior corneal surface of the human eye exhibits different values of e at different diameters. According to our clinical data, the variation is similar to an exponential decay. We propose a linear combination of two exponential functions to describe the variation of e. We then calculate the corneal sagittal height by substituting e in the first-order aspherical surface equation to obtain the corneal profile. This corneal profile will be used as a reference to analyze the resultant profiles of the customized corneal ablation in refractive surgery.

  5. RETAINED STONE PIECE IN ANTERIOR CHAMBER

    Directory of Open Access Journals (Sweden)

    ZvornicaninJasmin, Nadarevic-VodencarevicAmra

    2015-04-01

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

  6. Concrescent triplets involving primary anterior teeth

    Directory of Open Access Journals (Sweden)

    Urvashi Sharma

    2013-01-01

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

  7. Foreign Body Embedded in Anterior Chamber Angle

    Directory of Open Access Journals (Sweden)

    Shmuel Graffi

    2012-01-01

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

  8. Coherent concepts are computed in the anterior temporal lobes.

    Science.gov (United States)

    Lambon Ralph, Matthew A; Sage, Karen; Jones, Roy W; Mayberry, Emily J

    2010-02-09

    In his Philosophical Investigations, Wittgenstein famously noted that the formation of semantic representations requires more than a simple combination of verbal and nonverbal features to generate conceptually based similarities and differences. Classical and contemporary neuroscience has tended to focus upon how different neocortical regions contribute to conceptualization through the summation of modality-specific information. The additional yet critical step of computing coherent concepts has received little attention. Some computational models of semantic memory are able to generate such concepts by the addition of modality-invariant information coded in a multidimensional semantic space. By studying patients with semantic dementia, we demonstrate that this aspect of semantic memory becomes compromised following atrophy of the anterior temporal lobes and, as a result, the patients become increasingly influenced by superficial rather than conceptual similarities.

  9. Anterior open bite treatment with magnets.

    Science.gov (United States)

    Kiliaridis, S; Egermark, I; Thilander, B

    1990-11-01

    The aim of this study was to examine the effects of repelling magnets on the treatment of anterior open bite and compare them with the effects of acrylic posterior bite-blocks. Twenty patients, aged 9-16 years with skeletal anterior open bite, were randomly divided into two groups. In one group the patients wore posterior repelling magnet splints and in the other they wore acrylic posterior bite-blocks of the same thickness as the magnet splints. The patients were instructed to use their appliance as much as possible (the minimum accepted being 18 hours daily) during a 6-month period. Dental casts, intra-oral photos, and lateral cephalograms were taken before and after treatment, and the patients were also examined regularly to identify the development of any craniomandibular disorders. In the first group, the dental and skeletal vertical relation responded quickly to the magnet treatment. The open bite was generally closed in just under 4 months, especially in patients in early mixed dentition. Spacing in the labial segments decreased in some cases, while slight crowding was induced in others. Transverse problems, i.e. unilateral cross-bite, sometimes followed by scissor-bite on the opposite side, was observed in those patients who were in the early mixed dentition and had used the magnets intensively. The patients who wore acrylic posterior bite-blocks also showed improvement in the dental and skeletal vertical relationships, especially during the first months. This was followed by a 'plateau' period. No transverse problems were found in these patients.

  10. Anterior Visceral Endoderm SMAD4 Signaling Specifies Anterior Embryonic Patterning and Head Induction in Mice

    Science.gov (United States)

    Li, Cuiling; Li, Yi-Ping; Fu, Xin-Yuan; Deng, Chu-Xia

    2010-01-01

    SMAD4 serves as a common mediator for signaling of TGF-β superfamily. Previous studies illustrated that SMAD4-null mice die at embryonic day 6.5 (E6.5) due to failure of mesoderm induction and extraembryonic defects; however, functions of SMAD4 in each germ layer remain elusive. To investigate this, we disrupted SMAD4 in the visceral endoderm and epiblast, respectively, using a Cre-loxP mediated approach. We showed that mutant embryos lack of SMAD4 in the visceral endoderm (Smad4Co/Co;TTR-Cre) died at E7.5-E9.5 without head-fold and anterior embryonic structures. We demonstrated that TGF-β regulates expression of several genes, such as Hex1, Cer1, and Lim1, in the anterior visceral endoderm (AVE), and the failure of anterior embryonic development in Smad4Co/Co;TTR-Cre embryos is accompanied by diminished expression of these genes. Consistent with this finding, SMAD4-deficient embryoid bodies showed impaired responsiveness to TGF-β-induced gene expression and morphological changes. On the other hand, embryos carrying Cre-loxP mediated disruption of SMAD4 in the epiblasts exhibited relatively normal mesoderm and head-fold induction although they all displayed profound patterning defects in the later stages of gastrulation. Cumulatively, our data indicate that SMAD4 signaling in the epiblasts is dispensable for mesoderm induction although it remains critical for head patterning, which is significantly different from SMAD4 signaling in the AVE, where it specifies anterior embryonic patterning and head induction. PMID:20941375

  11. Inner Synovial Membrane Footprint of the Anterior Elbow Capsule: An Arthroscopic Boundary

    Directory of Open Access Journals (Sweden)

    Srinath Kamineni

    2015-01-01

    Full Text Available Introduction. The purpose of this study is to describe the inner synovial membrane (SM of the anterior elbow capsule, both qualitatively and quantitatively. Materials and Methods. Twenty-two cadaveric human elbows were dissected and the distal humerus and SM attachments were digitized using a digitizer. The transepicondylar line (TEL was used as the primary descriptor of various landmarks. The distance between the medial epicondyle and medial SM edge, SM apex overlying the coronoid fossa, the central SM nadir, and the apex of the SM insertion overlying the radial fossa and distance from the lateral epicondyle to lateral SM edge along the TEL were measured and further analyzed. Gender and side-to-side statistical comparisons were calculated. Results. The mean age of the subjects was 80.4 years, with six male and five female cadavers. The SM had a distinctive double arched attachment overlying the radial and coronoid fossae. No gender-based or side-to-side quantitative differences were noted. In 18 out of 22 specimens (81.8%, an infolding extension of the SM was observed overlying the medial aspect of the trochlea. The SM did not coincide with the outer fibrous attachment in any specimen. Conclusion. The humeral footprint of the synovial membrane of the anterior elbow capsule is more complex and not as capacious as commonly understood from the current literature. The synovial membrane nadir between the two anterior fossae may help to explain and hence preempt technical difficulties, a reduction in working arthroscopic volume in inflammatory and posttraumatic pathologies. This knowledge should allow the surgeon to approach this aspect of the anterior elbow compartment space with the confidence that detachment of this synovial attachment, to create working space, does not equate to breaching the capsule. Alternatively, stripping the synovial attachment from the anterior humerus does not constitute an anterior capsular release.

  12. Perineal anterior dislocation of the hip with avulsion fracture of ...

    African Journals Online (AJOL)

    Traumatic anterior dislocation of the hip is rare even in children. Very uncommon also is the perineal variant of the inferior type of anterior dislocation with concomitant avulsion fracture of the greater trochanter. We report such a case highlighting the peculiarity of its management. No similar case of triumvirate injury of the hip ...

  13. Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

    OpenAIRE

    van Eijk, F.

    2009-01-01

    This thesis describes the long-term results of reconstruction of the anterior cruciate ligament with an allograft. Due to the poor results found, further studies were performed to investigate alternative strategies for reconstruction of the anterior cruciate ligament in the field of tissue engineering.

  14. Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

    NARCIS (Netherlands)

    van Eijk, F.

    2009-01-01

    This thesis describes the long-term results of reconstruction of the anterior cruciate ligament with an allograft. Due to the poor results found, further studies were performed to investigate alternative strategies for reconstruction of the anterior cruciate ligament in the field of tissue

  15. Superior dislocation hip with anterior column acetabular fracture ...

    African Journals Online (AJOL)

    Superior variety of anterior dislocation of the hip is a rare injury. Its occurrence with acetabular fractures has been documented infrequently. We report a case of superior dislocation of the hip with anterior column acetabular fracture. Open reduction of the hip and internal fixation of the fracture was carried out using a twin ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-09-15

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

  17. Causes and consequences of anterior pharyngeal pouch after total laryngectomy.

    Science.gov (United States)

    Anderson, S; Hogan, D; Panizza, B

    2014-07-01

    To assess the frequency of anterior pharyngeal pouch formation after total laryngectomy, and to discuss the causes and consequences of anterior pharyngeal pouch formation. A prospective, observational study of 43 patients undergoing total laryngectomy. Data collected included laryngeal defect closure type, tumour staging and demographic information. A barium swallow was performed on day 7-14 after surgery to assess for anterior pharyngeal pouch formation and fistula formation. The incidence of anterior pharyngeal pouch formation was 47 per cent. Patients who did not have an anterior pharyngeal pouch on swallow imaging assessment were less likely to develop a pharyngo-cutaneous fistula. There was no statistically significant association between laryngeal defect closure type and anterior pharyngeal pouch formation. The anterior pharyngeal pouch is a dynamic phenomenon best investigated with a fluoroscopic swallow imaging study. Its causes are multi-factorial. Absence of an anterior pharyngeal pouch appears to confer protection against pharyngo-cutaneous fistula formation, hastening commencement of adjuvant therapy and an oral diet.

  18. Direct composite restoration of permanent anterior teeth uncomplicated crown fractures

    Directory of Open Access Journals (Sweden)

    Ashley Evans Nicholas

    2018-01-01

    Full Text Available An uncomplicated crown fracture is a fracture that involves only the tooth enamel or the dentin and tooth enamel without any damage or exposure to the pulp. Crown fracture of the anterior teeth usually caused by traumatic forces such as falls, accidents, violence, or sports activities. Traumatic injuries of the oral region frequently involve the anterior teeth, especially maxillary incisors due to the anatomic factors which may affect the functional and aesthetical values of the teeth. The objective of this literature study was to know more about uncomplicated crown fracture of the anterior teeth and its restoration. This research was a literature study performed by researching, highlighting various interesting facts and compiling the relevant published journals. The most common and ideal direct restoration of the anterior teeth was the composite resin restoration. The anterior teeth restoration was considered to be a complex and challenging case to solves due to the fact that besides reconstructing the tooth and regaining the function, the aesthetical aspect was also becoming the main objectives. The permanent anterior teeth uncomplicated crown fracture was the most common case of tooth fractures which was mainly caused by traumatic injuries such as falls, accidents, excessive forces, violence, and also sports activities. Dental injuries of the anterior teeth also affected the aesthetical properties and the function of the tooth. Composite resin restoration was able to performed directly on the permanent anterior teeth uncomplicated crown fracture.

  19. Endothelial cell density after deep anterior lamellar keratoplasty (Melles technique)

    NARCIS (Netherlands)

    van Dooren, Bart T. H.; Mulder, Paul G. H.; Nieuwendaal, Carla P.; Beekhuis, W. Houdijn; Melles, Gerrit R. J.

    2004-01-01

    To measure the recipient endothelial cell loss after the Melles technique for deep anterior lamellar keratoplasty. In 21 eyes of 21 patients, a deep anterior lamellar keratoplasty procedure was performed. Before surgery and at 6, 12, and 24 months after surgery, specular microscopy was performed to

  20. Endothelial cell density after deep anterior lamellar keratoplasty (Melles technique)

    NARCIS (Netherlands)

    Van Dooren, BTH; Mulder, PGH; Nieuwendaal, CP; Beekhuis, WH; Melles, GRJ

    PURPOSE: To measure the recipient endothelial cell loss after the Melles technique for deep anterior lamellar keratoplasty. METHODS: In 21 eyes of 21 patients, a deep anterior lamellar keratoplasty procedure was performed. Before surgery and at 6, 12, and 24 months after surgery, specular microscopy

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

    International Nuclear Information System (INIS)

    Moon, W.-J.; Porto, L.; Lanfermann, H.; Zanella, F.E.; Weis, R.

    2002-01-01

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

  2. Factors predicting dysphagia after anterior cervical surgery

    Science.gov (United States)

    Wang, Tao; Ma, Lei; Yang, Da-Long; Wang, Hui; Bai, Zhi-Long; Zhang, Li-Jun; Ding, Wen-Yuan

    2017-01-01

    Abstract A multicenter retrospective study. The purpose of this study was to explore risk factors of dysphagia after anterior cervical surgery and factors affecting rehabilitation of dysphagia 2 years after surgery. Patients who underwent anterior cervical surgery at 3 centers from January 2010 to January 2013 were included. The possible factors included 3 aspects: demographic variables—age, sex, body mass index (BMI): hypertension, diabetes, heart disease, smoking, alcohol use, diagnose (cervical spondylotic myelopathy or ossification of posterior longitudinal ligament), preoperative visual analogue scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA), surgical-related variables—surgical option (ACDF, ACCF, ACCDF, or Zero profile), operation time, blood loss, operative level, superior fusion segment, incision length, angle of C2 to C7, height of C2 to C7, cervical circumference, cervical circumference/height of C2 to C7. The results of our study indicated that the rate of dysphagia at 0, 3, 6, 12, and 24 months after surgery was 20%, 5.4%, 2.4%, 1.1%, and 0.4%, respectively. Our results showed that age (58.8 years old), BMI (27.3 kg/m2), course of disease (11.6 months), operation time (103.2 min), blood loss (151.6 mL), incision length (9.1 cm), cervical circumference (46.8 cm), angle of C2 to C7 (15.3°), cervical circumference/height of C2 to C7 (4.8), preoperative VAS (7.5), and ODI (0.6) in dysphagia group were significantly higher than those (52.0, 24.6, 8.6, 88.2, 121.6, 8.6, 42.3, 12.6, 3.7, 5.6, and 0.4, respectively) in nondysphagia group; however, height of C2 to C7 (9.9 vs 11.7 cm) and preoperative JOA (8.3 vs 10.7) had opposite trend between 2 groups. We could also infer that female, smoking, diabetes, ossification of posterior longitudinal ligament, ACCDF, multilevel surgery, and superior fusion segment including C2 to C3 or C6 to C7 were the risk factors for dysphagia after surgery immediately. However

  3. Toxic Anterior Segment Syndrome Related to Viscoelastic Substance

    Directory of Open Access Journals (Sweden)

    Ayşe Gül Altıntaş

    2014-10-01

    Full Text Available Objectives: To evaluate the etiologic factors of toxic anterior segment syndrome (TASS outbreak after uneventful cataract surgery, to discuss the treatment plan, and to assess the response to medical therapy. Materials and Methods: Clinical features in twenty-two eyes of 22 patients who had TASS outbreak after uneventful cataract surgery were evaluated. Visual acuity (VA, intraocular pressure (IOP measurements, biomicroscopic and B-mode ultrasound evaluations were performed. To establish the differential diagnosis from infectious endophthalmitis, cultures were taken from different subjects such as surgical equipment, solutions, medical devices. All patients were treated as having endophthalmitis until the culture results were obtained. Results: Based on the negative culture results, absence of any symptoms of TASS in other patients who underwent different intraocular surgeries rather than cataract surgery in the same day and same surgical condition in which VES was not used, and the fact that postoperative inflammation occurred only in eyes in which the new VES made of rooster comb was used, we assume that the recently used VES is most likely responsible for the TASS outbreak. As soon as another VES was replaced with the suspected one, no other cases with TASS occurred. Conclusion: Even though the chemical compositions of VES are in physiological limits for viability to the anterior segment tissue, the suboptimal or inappropriate storage conditions may cause loss of the original chemical integrity which can be the reason of TASS. Close monitoring of each patient, early diagnosis, and correct treatment can prevent its complications. (Turk J Ophthalmol 2014; 44: 341-6

  4. Patients’ general satisfaction with the appearance of anterior maxillary teeth

    Directory of Open Access Journals (Sweden)

    Lajnert Vlatka

    2017-01-01

    Full Text Available Background/Aim. Dental appearance plays an important role in practically all personal social interactions. The main factors that define the dental appearance are tooth colour, shape and position, quality of restoration, and the general position of the teeth in arch, especially in the anterior region. The aim of this study was to evaluate the impact of dental status (tooth shape, fracture, dental and prosthetic restorations and presence of plaque on patient''s satisfaction with the dental appearance, controlling for the age and gender. Methods. A total of 700 Caucasian subjects (439 women aged 18–86 (median 45 years participated in the cross-sectional study. Study included clinical examination and self-administrated questionnaire based on selfperceived aesthetics and satisfaction with the appearance of their maxillary anterior teeth. Results. A regression analysis demonstrated that presence of dental plaque, tooth fracture, composite fillings and crowns had significant independent contribution and were negative predictors of satisfaction with teeth appearance. Participants with presence of plaque on upper teeth (p < 0.001, fractures (p = 0.005, composite fillings (p < 0.001 and crowns (p = 0.032 were less satisfied than those without it. Model explains 12% or variance of general satisfaction with the appearance of maxillary frontal teeth (p < 0.001 and the major contributors are composite fillings (5.3% and plaque (3.2%. Tooth shape, age and gender were not significant predictors of satisfaction. Conclusion. Satisfaction with the teeth appearance is under the influence of many factors with significant negative influence of presence of dental plaque, fractures, composite restorations, and crowns.

  5. The relationship between anterior pelvic tilt and gait, balance in patient with chronic stroke.

    Science.gov (United States)

    Kim, Myoung-Kwon; Kim, Seong-Gil; Shin, Young-Jun; Choi, Eun-Hong; Choe, Yu-Won

    2018-01-01

    [Purpose] The aim of this study is to find out the association between anterior pelvic tilt and gait and balance in chronic stroke. [Subjects and Methods] Fourteen chronic stroke patients were included in this study. A palpation meter was employed to measure the anterior inclination of the pelvis. A GAITRite system automates measuring temporal and spatial gait parameters. A 10-Meter Walk test was used to measure gait speed. The Timed Up and Go test was used to measure the dynamic balance ability and gait ability of the participants. A BioRescue was used to assess balance by measuring the moving distance and area of the center of pressure. [Results] There were significant negative correlations between pelvic anterior tilt and velocity, step length, and stride. There were significant positive correlations between velocity and cadence, step length, and stride length. There were significant negative correlations between velocity and cycle time, H-H base, TUG, and 10MWT. There was significant negative correlation between cadence and cycle time and H-H base. [Conclusion] This study showed a negative correlation between pelvic anterior tilt and gait function including gait speed and step length.

  6. Anterior glenoid rim fracture: the value of helical CT with threedimensional reconstruction and electronic humeral disarticulation

    Directory of Open Access Journals (Sweden)

    Heverton César de Oliveira

    2003-06-01

    Full Text Available Objectives: To show a new three-dimensional reconstructiontechnique based on helical computed tomography images withelectronic humeral disarticulation in anterior glenoid rim fractures,correlating the anatomic specimen with simulation of an anteriorglenoid rim fracture, as well as evaluating the extension of thefracture, the bone fragment position and distance in relation to theglenoid cavity in six patients. Methods: One scapula and onehumerus with no signs of fracture or congenital malformationswere placed in anatomical position using an adhesive tape aftersimulating an anterior glenoid rim fracture made by an osteotome.Helical CT imaging was acquired and three-dimensionalreconstructions were made based on these images, with andwithout electronic humeral disarticulation. The bone fragment waslocated, measured and its position in relation to the glenoid cavitywas assessed. Six patients with anterior glenoid rim fracture weresubmitted to CT of the shoulder using the same parameters asthose applied to the anatomic specimen. Results: In the anatomicspecimen and in all six patients the bone fragment was clearlydemonstrated; bone fragment measurements in the anatomicspecimen and in three-dimensional reconstructions wereequivalent. The fragment was better demonstrated in the imagestaken with electronic humeral disarticulation, particularly in thefrontal view of the glenoid cavity as observed in all six patients.Conclusion: We concluded that our experiment with the anatomicspecimen and the study of six patients allow us to state that thistechnique is safe and accurate to demonstrate the extension, sizeand location of the bone fragment in anterior glenoid rim fractures,and it provides essential elements for therapeutic planning.

  7. Anterior segment sparing to reduce charged particle radiotherapy complications in uveal melanoma

    International Nuclear Information System (INIS)

    Daftari, Inder K.; Char, Devron H.; Verhey, Lynn J.; Castro, Joseph R.; Petti, Paula L.; Meecham, William J.; Kroll, Stewart; Blakely, Eleanor A.

    1997-01-01

    helium-ion irradiation is correlated to the amount of lens, anterior chamber in the treatment field, tumor height, proximity to the fovea, history of diabetes, and the development of vitreous hemorrhage. Although the influence of the higher LET deposition of helium-ions is unclear, this study suggests that by reducing the dose to the anterior segment of the eye may reduce the NVG complications. Based on this retrospective analysis of LBNL patients, we have implemented techniques to reduce the amount of the anterior segment receiving a high dose in our new series of patients treated with protons using the cyclotron at the UC Davis Crocker Nuclear Laboratory (CNL)

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

    NARCIS (Netherlands)

    Borens, Olivier; Sen, Milan K.; Huang, Russel C.; Richmond, Jeffrey; Kloen, Peter; Jupiter, Jesse B.; Helfet, David L.

    2006-01-01

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

  9. Radiographic localization of unerupted mandibular anterior teeth.

    Science.gov (United States)

    Jacobs, S G

    2000-10-01

    The parallax method and the use of 2 radiographs taken at right angles to each other are the 2 methods generally used to accurately localize teeth. For the parallax method, the combination of a rotational panoramic radiograph with an occlusal radiograph is recommended. This combination involves a vertical x-ray tube shift. Three case reports are presented that illustrate: (1) how this combination can accurately localize unerupted mandibular anterior teeth, (2) how a deceptive appearance of the labiolingual position of the unerupted tooth can be produced in an occlusal radiograph, (3) how increasing the vertical angle of the tube for the occlusal radiograph makes the tube shift easier to discern, (4) why occlusal radiographs are preferable to periapical radiographs for tube shifts, and (5) how localization can also be carried out with 2 radiographs at right angles to each other, one of which is an occlusal radiograph taken with the x-ray tube directed along the long axis of the reference tooth.

  10. Exercise Rehabilitation after Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Keun Ok An

    2017-06-01

    Full Text Available OBJECTIVES Exercise rehabilitation after anterior cruciate ligament (ACL reconstruction has changed dramatically in recent years. In this review, we discuss recent changes in exercise programs related to ACL rehabilitation. METHODS We conducted a literature review of recently published articles related exercise programs after ACL reconstruction. RESULTS The accelerated rehabilitation program, which allows patients to achieve full extension ofthe knee early in the postoperative period, is now a widely practiced rehabilitation program. A prospective study of rehabilitation programs after ACL reconstruction showed that early joint exercises do not interfere with the healing of grafts. Instead, they alleviate pain, thereby reducing the negative impact. Moreover, according to several biomechanical studies, open kinetic chain exercises are potentially disadvantageous to knee stability. There is no evidence that early weight bearing results in weakening of graft distraction or internal fixation compared with delayed weight bearing. CONCLUSIONS In conclusion, prevention of ACL injuries and rehabilitative exercise training can help to achieve optimal exercise performance while avoiding the risk of sports-related injury.

  11. Evaluation of anterior chamber angle under dark and light conditions in angle closure glaucoma: An anterior segment OCT study.

    Science.gov (United States)

    Masoodi, Habibeh; Jafarzadehpur, Ebrahim; Esmaeili, Alireza; Abolbashari, Fereshteh; Ahmadi Hosseini, Seyed Mahdi

    2014-08-01

    To evaluate changes of nasal and temporal anterior chamber angle (ACA) in subjects with angle closure glaucoma using Spectralis AS-OCT (SAS-OCT) under dark and light conditions. Based on dark-room gonioscopy, 24 subjects with open angles and 86 with narrow angles participated in this study. The nasal and temporal angle opening distance at 500 μm anterior to the scleral spur (AOD500), nasal and temporal ACA were measured using SAS-OCT in light and dark conditions. In 2 groups, ACA and AOD500 in nasal and temporal quadrants were significantly greater in light compared to dark (all with p=0.000). The AOD500 and ACA were significantly higher in nasal than temporal in measured conditions for 2 groups except the ACA and AOD500 of normal group measured in light. The difference between nasal and temporal in dark (29.07 ± 65.71 μm for AOD500 and 5.7 ± 4.07° for ACA) was greater than light (24.86 ± 79.85 μm for AOD500 and 2.09 ± 7.21° for ACA) condition. But the difference was only significant for ACA (p=0.000). The correlation analysis showed a negative correlation between AOD500 and pupil diameter in temporal and nasal quadrants (both with p=0.000). While temporal AOD500 difference correlated with spherical equivalent, temporal and asal gonioscopy, nasal AOD correlated with IOP, temporal and nasal gonioscopy. Clinically important changes in ACA structure could be detected with SAS-OCT in nasal and temporal quadrants under different illumination intensity. The results could help in improvement of examination condition for better and more accurate assessment of individuals with angle closure glaucoma. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Ramon Coral Ghanem

    2004-08-01

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

  13. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture

    Directory of Open Access Journals (Sweden)

    Shinji Fukui

    2014-05-01

    Full Text Available A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed when he was 5 years. After excision of the scarred portions of the urethra, the defect of the urethra was 20 mm. Transperineal bulbar urethral mobilization was performed, and a single-stage end-to-end anterior urethroplasty without tension could be performed simultaneously.

  14. Clinical results of a new strategy (modified CHIVA) for surgical treatment of anterior accessory great saphenous varicose veins.

    Science.gov (United States)

    Maldonado-Fernández, Nicolás; Linares-Palomino, Jose Patricio; López-Espada, Cristina; Martínez-Gámez, Francisco Javier; Ros-Díe, Eduardo

    2016-03-01

    Traditionally, anterior accessory great saphenous vein insufficiency was managed by crossectomy and resection of varicose veins. The aim of this paper is to show the safety and efficacy of a new therapeutic strategy for anterior accessory great saphenous varicose veins. This non-randomised prospective study included 65 patients with varicose veins from the anterior accessory great saphenous vein. The novelty of the technique is to avoid the great saphenous vein crossectomy and perform just flebectomy of the visible veins. Venous duplex studies were performed preoperatively, a month and a year postoperatively. The clinical assessment was done by the Fligelstone scale. The baseline CEAP clinical classification was: 58% C2, 26% C3 and 15% C4-6. The new strategy was applied to all cases. 3 haematomas, 7 cases of asymptomatic partial anterior saphenous thrombosis. Reduction of the initial average diameter was from 6.4 mm anterior saphenous to 3.4 mm by one year (p <0.001). At twelve months a forward flow is maintained in 82% of cases. Recurrence of varicose veins was 8%. All patients improved their clinical status based on the Fligelstone scale. Cases with saphenous diameter bigger than 7.5 mm and obesity were identified as predictors of worse clinical and hemodynamic outcome. This modified surgical strategy for anterior saphenous varicose veins results in better clinical outcomes at one year postoperatively. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Gonioscopy and ultrasound biomicroscopy in the detection of angle closure in patients with shallow anterior chamber.

    Science.gov (United States)

    Cui, Shan-shan; Zou, Yan-hong; Li, Qian; Li, Li-na; Zhang, Ning; Liu, Xi-pu

    2014-12-01

    To assess the agreement between gonioscopy and ultrasound biomicroscopy (UBM) in detecting angle closure in Chinese patients with shallow anterior chamber. An observational comparative study of the two different examination methods was conducted. Patients with normal intraocular pressure and temporal peripheral anterior chamber depth less than a quarter of corneal thickness based on slit lamp examination were included in this study from December 2007 to May 2009 in the outpatient clinic of First Hospital of Tsinghua University. Gonioscopy was performed with a Goldman goniolens in dark room first and followed by full beam light and indentation. If the filtering trabecular meshwork was invisible or any peripheral anterior synechia was found, that quadrant of the angle was considered closed. UBM was first undertaken in a darkened room then repeated with normal room lighting. If iridotrabecular apposition was showed, that quadrant of the angle was considered closed. The status of angle closure of each quadrant with different methods was recorded. 85 eyes of 46 patients were included in this study. The agreement between gonioscopy and UBM was poor (Κgonioscopy and UBM was hardly affected by age or sex, while in dark condition, eyes with deeper anterior chamber (P=0.005) or plateau iris configuration tended to produce different results (P=0.075) in the 2 methods. Gonioscopy and UBM are both indispensable methods for detecting angle closure, neither can completely replace the other.

  16. Failed anterior cruciate ligament reconstruction: analysis of factors leading to instability after primary surgery.

    Science.gov (United States)

    Ma, Yong; Ao, Ying-Fang; Yu, Jia-Kuo; Dai, Ling-Hui; Shao, Zhen-Xing

    2013-01-01

    Revision anterior cruciate ligament (ACL) surgery can be expected to become more common as the number of primary reconstruction keeps increasing. This study aims to investigate the factors causing instability after primary ACL reconstruction, which may provide an essential scientific base to prevent surgical failure. One hundred and ten revision ACL surgeries were performed at our institute between November 2001 and July 2012. There were 74 men and 36 women, and the mean age at the time of revision was 27.6 years (range 16 - 56 years). The factors leading to instability after primary ACL reconstruction were retrospectively reviewed. Fifty-one knees failed because of bone tunnel malposition, with too anterior femoral tunnels (20 knees), posterior wall blowout (1 knee), vertical femoral tunnels (7 knees), too posterior tibial tunnels (12 knees), and too anterior tibial tunnels (10 knees). There was another knee performed with open surgery, where the femoral tunnel was drilled through the medial condyle and the tibial tunnel was too anterior. Five knees were found with malposition of the fixation. One knee with allograft was suspected of rejection and a second surgery had been made to take out the graft. Three knees met recurrent instability after postoperative infection. The other factors included traumatic (48 knees) and unidentified (12 knees). Technical errors were the main factors leading to instability after primary ACL reconstructions, while attention should also be paid to the risk factors of re-injury and failure of graft incorporation.

  17. Dysphonia and dysphagia after anterior cervical decompression.

    Science.gov (United States)

    Tervonen, Hanna; Niemelä, Mika; Lauri, Eija-Riitta; Back, Leif; Juvas, Anja; Räsänen, Pirjo; Roine, Risto P; Sintonen, Harri; Salmi, Tapani; Vilkman, S Erkki; Aaltonen, Leena-Maija

    2007-08-01

    In this paper, the authors investigate the effects of anterior cervical decompression (ACD) on swallowing and vocal function. The study comprised 114 patients who underwent ACD. The early group (50 patients) was examined immediately pre- and postoperatively, and the late group (64 patients) was examined at only 3 to 9 months postoperatively. Fifty age- and sex-matched patients from the Department of Otorhinolaryngology-Head and Neck Surgery who had not been intubated in the previous 5 years were used as a control group. All patients in the early and control groups were examined by a laryngologist; patients in the late group were examined by a laryngologist and a neurosurgeon. Videolaryngostroboscopy was performed in all members of the patient and control groups, and the function of the ninth through 12th cranial nerves were clinically evaluated. Data were collected concerning swallowing, voice quality, surgery results, and health-related quality of life. Patients with persistent dysphonia were referred for phoniatric evaluation and laryngeal electromyography (EMG). Those with persistent dysphagia underwent transoral endoscopic evaluation of swallowing function and videofluorography. Sixty percent of patients in the early group reported dysphonia and 69% reported dysphagia at the immediate postoperative visit. Unilateral vocal fold paresis occurred in 12%. The prevalence of both dysphonia and dysphagia decreased in both groups 3 to 9 months postoperatively. All six patients with vocal fold paresis in the early group recovered, and in the late group there were two cases of vocal fold paresis. The results of laryngeal EMG were abnormal in 14 of 16 patients with persistent dysphonia. Neither intraoperative factors nor age or sex had any effect on the occurrence of dysphonia, dysphagia, or vocal fold paresis. Most patients were satisfied with the surgical outcome. Dysphonia, dysphagia, and vocal fold paresis are common but usually transient complications of ACD

  18. STRATIFICATION TECHNIQUE IN MAXILLARY ANTERIOR INCISORS RESTORATION

    Directory of Open Access Journals (Sweden)

    Janet Kirilova

    2014-08-01

    Full Text Available Background: Because of their main characteristics: transparency, opalescence and color density, the tooth structures are extremely difficult to restore by means of completely inconspicuous restorations of the natural tooth tissue characteristics. The aim is to show successful aesthetic restoration of III Class dental lesions in upper incisors by means of high quality composites. Materials and method: A female patient visited the clinic being not satisfied with the esthetics of her front teeth. The intraoral examination showed previous restorations and carious lesions in 12, 11, 21, 22. After defining the tooth color a silicone key was made. The treatment was performed under anesthesia, the existing restorations were removed and the carious lesions in teeth 11, 12, 21, 22 were treated with restorations using Vanini edge preparation. The teeth were restored by means of stratification technique. After etching and rinsing, bonding was applied for 20 sec. and then polymerized. After fixing the silicone key enamel shade was applied and then dentine shades UD2, UD3, UD4 of 0.5mm thickness each. The polymerization was done layer by layer. Applied were 10 to 15 layers in total. The composite material was preheated in oven up to 55. Teeth 21 and 22 are restored with Enamel Plus HRi (Micerium. Results and Discussion: Excellent aesthetics is achieved with composite material. They have enamel and dentine shades and allow high quality aesthetics. The polishing is excellent in Enamel Plus HRi (Micerium which is typical for this type of composite. The result of the carious lesion treatment in this patient is real improvement of the dental appearance of her anterior incisors. Conclusion: Materials show excellent aesthetic results due to their characteristics and the stratification technique used.

  19. Anterior Commissure-posterior commissure revisited

    International Nuclear Information System (INIS)

    Choi, Sang Han; Chi, Je Geun; Kim, Young Bo; Cho, Zang Hee

    2013-01-01

    The anterior commissure (AC) and posterior commissure (PC) are the two distinct anatomic structures in the brain which are difficult to observe in detail with conventional MRI, such as a 1.5T MRI system. However, recent advances in ultra-high resolution MRI have enabled us to examine the AC and PC directly. The objective of the present study is to standardize the shape and size of the AC and PC using a 7.0T MRI and to propose a new brain reference line. Thirty-four, 21 males and 13 females, healthy volunteers were enrolled in this study. After determining the center of each AC and PC, we defined the connection of these centers as the central intercommissural line (CIL). We compared the known extra- and intra-cerebral reference lines with the CIL to determine the difference in the angles. Additionally, we obtained horizontal line from flat ground line of look front human. The difference in angle of the CIL and the tangential intercommissural line (TIL) from the horizontal line was 8.7 ± 5.1 (11 ± 4.8) and 17.4 ± 5.2 (19.8 ± 4.8) degrees in males and females, respectively. The difference in angle between the CIL and canthomeatal line was 10.1 in both male and female, and there was no difference between both sexes. Likewise, there was no significant difference in angle between the CIL and TIL between both sexes (8.3 +/- 1.1 in male and 8.8 +/- 0.7 in female). In this study, we have used 7.0T MRI to define the AC and PC quantitatively and in a more robust manner. We have showed that the CIL is a reproducible reference line and serves as a standard for the axial images of the human brain.

  20. Orbicularis oris musculomucosal flap for anterior palatal fistula

    Directory of Open Access Journals (Sweden)

    Tiwari V

    2006-01-01

    Full Text Available Anterior palatal fistulae or residual anterior clefts are a frequent problem following palatoplasty. Various techniques have been used to repair such fistulae, each having its own advantages and disadvantages. We have successfully used orbicularis oris musculomucosal flap to close anterior fistula and residual clefts in 25 patients. This study shows the superiority of this flap over other techniques because of its reliable blood supply, easy elevation and transfer to fistula site and finally because it is a single-stage procedure.

  1. Fibrinous anterior uveitis following laser in situ keratomileusis

    Directory of Open Access Journals (Sweden)

    Parmar Pragya

    2009-01-01

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

  2. Multi drug resistant tuberculosis presenting as anterior mediastinal mass

    Directory of Open Access Journals (Sweden)

    Parmarth Chandane

    2016-01-01

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

  3. Management of anterior dental crossbite with removable appliances

    Directory of Open Access Journals (Sweden)

    Ayca Tuba Ulusoy

    2013-01-01

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

  4. Basic principles of aggressive rehabilitation after anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Dubljanin-Raspopović Emilija

    2005-01-01

    Full Text Available Rehabilitation after ACL (anterior cruciate ligament reconstruction has drastically changed over the last decade, with the adoption of a more aggressive approach, right from the first day after surgery. Progress in the effectiveness of rehabilitation is based on improvements in operative techniques, as well as on the encouraging results of histological studies regarding graft healing. Despite a huge amount of research papers on this topic, a rehabilitation golden standard still has not been established, due to the complexity of this problem. In this review, we point out the basic principles of rehabilitation after arthroscopically assisted ACL reconstruction based on actual practices, as well as the importance of specific procedures for the prevention of complications during the postoperative period. The importance of range-of-motion exercises, early weight bearing, an appropriate gait scheme, patella mobilisation, pain and oedema control, as well as stretching and balance exercises is explained. The functional advantages of closed kinetic chain exercises, as well as their influence on the graft are also described, in comparison to open kinetic chain exercises. The fundamentals of returning to sports are revealed and the specific aspects of rehabilitation regarding graft choice are pointed out. While waiting for new clinical investigations, which are expected to enable the establishment of a rehabilitation golden standard, the outlined principles should be followed. The complexity of this injury requires treatment in highly specialised institutions.

  5. Dynamic restraint capacity of the hamstring muscles has important functional implications after anterior cruciate ligament injury and anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Bryant, Adam L; Creaby, Mark W; Newton, Robert U; Steele, Julie R

    2008-12-01

    The purpose of this study was to investigate the relation between knee functionality of anterior cruciate ligament deficient (ACLD) and anterior cruciate ligament reconstruction (ACLR) patients and hamstring antagonist torque generated during resisted knee extension. Cross-sectional. Laboratory based. Male ACLD subjects (n=10) (18-35 y) and 27 matched males who had undergone ACLR (14 patella tendon [PT] grafts and 13 combined semitendinosus/gracilis tendon grafts). Not applicable. Knee functionality was rated (0- to 100-point scale) by using the Cincinnati Knee Rating System. Using electromyography data from the semitendinosus (ST) and biceps femoris muscles, we created a mathematical model to estimate the opposing torque generated by the hamstrings during isokinetic knee extension in 10 degrees intervals from 80 degrees to 10 degrees knee flexion. Pearson product-moment correlations revealed that more functional ACLD subjects generated significantly (Phamstring antagonist torque throughout knee extension. In contrast, more functional PT subjects produced significantly lower hamstring antagonist torque at 80 degrees to 70 degrees knee flexion, whereas no significant associations were found between hamstring antagonist torque and knee functionality for the ST/gracilis tendon subjects. An increased hamstring antagonist torque generated by the more functional ACLD subjects, reflective of increased hamstring contractile force, is thought to represent a protective mechanism to compensate for mechanical instability. The restoration of anterior knee stability through ACLR negates the need for augmented hamstring antagonist torque.

  6. Correlation between cervical lordosis and adjacent segment pathology after anterior cervical spinal surgery.

    Science.gov (United States)

    Lee, Soo Eon; Jahng, Tae-Ahn; Kim, Hyun Jib

    2015-12-01

    To evaluate the incidence and risk factors for adjacent segment pathology (ASP) after anterior cervical spinal surgery. Fourteen patients (12 male, mean age 47.1 years) who underwent single-level cervical disk arthroplasty (CDA group) and 28 case-matched patients (24 male, mean age 53.6 years) who underwent single-level anterior cervical discectomy and fusion (ACDF group) were included. Presence of radiologic ASP (RASP) was based on observed changes in anterior osteophytes, disks, and calcification of the anterior longitudinal ligament on lateral radiographs. The mean follow-up period was 43.4 months in the CDA group and 44.6 months in the ACDF group. At final follow-up, ASP was observed in 5 (35.7%) CDA patients and 16 (57.1%) ACDF patients (p = 0.272). The interval between surgery and ASP development was 33.8 months in the CDA group and 16.3 months in the ACDF group (p = 0.046). The ASP risk factor analysis indicated postoperative cervical angle at C3-7 being more lordotic in non-ASP patients in both groups. Restoration of lordosis occurred in the CDA group regardless of the presence of ASP, but heterotopic ossification development was associated with the presence of ASP in the CDA group. And the CDA group had significantly greater clinical improvements than those in the ACDF group when ASP was present. In both CDA and ACDF patients, RASP developed, but CDA was associated with a delay in ASP development. A good clinical outcome was expected in CDA group, even when ASP developed. Restoration of cervical lordosis was an important factor in anterior cervical spine surgery.

  7. Surgical treatment of pelvic organ prolapse: a historical review with emphasis on the anterior compartment.

    Science.gov (United States)

    Lensen, E J M; Withagen, M I J; Kluivers, K B; Milani, A L; Vierhout, M E

    2013-10-01

    The objective of this work was to collect and summarize a detailed historical review of the surgical treatment of pelvic organ prolapse (POP) in which we specifically focused on the anterior compartment. A literature search in English, Dutch, and German was carried out using the keywords pelvic organ prolapse, anterior colporrhaphy, cystocele, and interposition operations in several databases (e.g., PubMed and HathiTrust Digital Library). Other relevant journal and textbook articles were found by retrieving references cited in previous articles and textbooks. Probably the first explanation of the treatment of POP dates from 1500 B.C. The Egyptians gave a description to "falling of the womb" in the Kahun Papyrus. More than a millennium later, Euryphon, a contemporary of Hippocrates (400 B.C.) described some interesting therapeutic options, from succussion (turning a women upside down for several minutes) to irrigating the displaced uterus with wine. A wide range of techniques has been attempted to repair the prolapsing anterior vaginal wall. By 1866, Sim had already performed a series of operations very similar to a modern anterior repair. The first reviews about the abdominal approach to correcting a cystocele were in 1890. The first description of using mesh to cystoceles was the use of tantalum mesh in 1955. In 1970, the first report of collagen mesh in urogynecology was described. Nowadays, robot-assisted surgery and cell-based tissue engineering are the latest interventions. Many surgeons have tried to find the ideal surgical therapy for anterior compartment prolapse, but to date, this has not been achieved.

  8. Cytological organization of the alpha component of the anterior olfactory nucleus and olfactory limbus

    Directory of Open Access Journals (Sweden)

    Jorge A Larriva-Sahd

    2012-06-01

    Full Text Available This study describes the microscopic organization of a wedge-shaped area at the intersection of the main and accessory olfactory bulbs, or olfactory limbus , and an additional component of the anterior olfactory nucleus or alpha accessory olfactory bulb that lies underneath of the accessory olfactory bulb. The olfactory limbus consists of a modified bulbar cortex bounded anteriorly by the main olfactory bulb and posteriorly by the accessory olfactory bulb. In Nissl-stained specimens the olfactory limbus differs from the main olfactory bulb by a progressive, antero-posterior decrease in thickness or absence of the external plexiform, mitral/tufted cell, and granule cell layers. On cytoarchitectual grounds the olfactory limbus is divided from rostral to caudal into three distinct components: a stripe of glomerular-free cortex or preolfactory area, a second or necklace glomerular area, and a wedge-shaped or interstitial area crowned by the so-called modified glomeruli that appear to belong to the anterior accessory olfactory bulb. The strategic location and interactions with the main and accessory olfactory bulbs, together with the previously noted functional and connectional evidence, suggest that the olfactory limbus may be related to both sensory modalities. The alpha component of the anterior olfactory nucleus, a slender cellular cluster (i.e., 650 x 150 µm paralleling the base of the accessory olfactory bulb, contains two neuron types: a pyramidal-like neuron and an interneuron. Dendrites of pyramidal-like cells organize into a single bundle that ascends avoiding the accessory olfactory bulb to resolve in a trigone bounded by the edge of the olfactory limbus, the accessory olfactory bulb and the dorsal part of the anterior olfactory nucleus. Utrastructurally, the neuropil of the alpha component contains three types of synaptic terminals; one of them immunoreactive to the enzyme glutamate decarboxylase, isoform 67.

  9. Passage of an Anterior Odontoid Screw through Gastrointestinal Tract.

    Science.gov (United States)

    Leitner, L; Brückmann, C I; Gilg, M M; Bratschitsch, G; Sadoghi, P; Leithner, A; Radl, R

    2017-01-01

    Purpose . Anterior screw fixation has become a popular surgical treatment method for instable odontoid fractures. Screw loosening and migration are a rare, severe complication following anterior odontoid fixation, which can lead to esophagus perforation and requires revision operation. Methods . We report a case of screw loosening and migration after anterior odontoid fixation, which perforated the esophagus and was excreted without complications in a 78-year-old male patient. Results . A ventral dislocated anterior screw perforated through the esophagus after eight years after implantation and was excreted through the gastrointestinal (GI) tract. At a 6-month follow-up after the event the patient was asymptomatic. Conclusion . Extrusion via the GI tract is not safe enough to be considered as a treatment option for loosened screws. Some improvements could be implemented to prevent such an incident. Furthermore, this case is a fine example that recent preoperative imaging is mandatory before revision surgery for screw loosening.

  10. Passage of an Anterior Odontoid Screw through Gastrointestinal Tract

    Directory of Open Access Journals (Sweden)

    L. Leitner

    2017-01-01

    Full Text Available Purpose. Anterior screw fixation has become a popular surgical treatment method for instable odontoid fractures. Screw loosening and migration are a rare, severe complication following anterior odontoid fixation, which can lead to esophagus perforation and requires revision operation. Methods. We report a case of screw loosening and migration after anterior odontoid fixation, which perforated the esophagus and was excreted without complications in a 78-year-old male patient. Results. A ventral dislocated anterior screw perforated through the esophagus after eight years after implantation and was excreted through the gastrointestinal (GI tract. At a 6-month follow-up after the event the patient was asymptomatic. Conclusion. Extrusion via the GI tract is not safe enough to be considered as a treatment option for loosened screws. Some improvements could be implemented to prevent such an incident. Furthermore, this case is a fine example that recent preoperative imaging is mandatory before revision surgery for screw loosening.

  11. Prosthodontic Rehabilitation of Patient with Anterior Hyper Function Syndrome

    Directory of Open Access Journals (Sweden)

    Vesna Korunoska-Stevkovska

    2017-12-01

    CONCLUSION: Anterior hyperfunction syndrome with its high incidence is a disease with the need of interdisciplinary therapy approach. Fast diagnosis, thorough clinical examination using all available diagnostic tools, and choosing the right treatment is very challenging.

  12. Laparoscopic repair of paraesophageal hernia with anterior gastropexy

    DEFF Research Database (Denmark)

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

    2015-01-01

    despite significant dysphagia rates. We present our multicenter prospective data on laparoscopic PEH repairs using a modified Boerema anterior gastropexy without fundoplication. METHODS: We prospectively followed patients after modified Boerema PEH repair at three institutions. Patient demographics...

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

    Science.gov (United States)

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

    2008-02-01

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

  14. Anterior vaginal wall repair (surgical treatment of urinary incontinence) - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100110.htm Anterior vaginal wall repair (surgical treatment of urinary incontinence) - series— ... to slide 4 out of 4 Overview The vaginal opening lies just below the urethral opening, and ...

  15. Memory-guided attention in the anterior thalamus.

    Science.gov (United States)

    Leszczyński, Marcin; Staudigl, Tobias

    2016-07-01

    The anterior thalamus is densely connected with both the hippocampus and the prefrontal cortex. It is known to play a role in learning and episodic memory. Given its connectivity profile with the prefrontal cortex, it may also be expected to contribute to executive functions. Recent studies in both rodents and humans add to our understanding of anterior thalamic function, suggesting that it is a key region for allocating attention. We discuss the convergence between studies in rodents and humans, both of which imply that the anterior thalamus may play a key role in memory-guided attention. We suggest that efficient allocation of attention to memory representations requires interaction between the memory-related hippocampal and the attention related fronto-parietal networks. We further propose that the anterior thalamus is a hub that connects and modulates both systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-11-01

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

  17. ARTHROSCOPIC TREATMENT OF ANTERIOR IMPINGEMENT IN THE ANKLE

    Directory of Open Access Journals (Sweden)

    Martin Mikek

    2004-12-01

    Full Text Available Background. Anterior soft tissue impingement is a common cause of chronic pain in the ankle. The preferred method of operative treatment is an arthroscopic excision of hypertrophic fibrous and synovial tissue in the anterior part of the ankle joint.Methods. We present the results of arthroscopic treatment of anterior ankle impingement in group of 14 patients.Results. Subjective improvement after the procedure was observed in all patients and 13 of them (93% were without any symptoms after the operation. One patient reported of intermittent pain, especially when walking on uneven grounds.Conclusions. We conclude that arthroscopic excision of hypertrophic synovial tissue in the anterior part of the ankle which causes the symptoms of impingement is a minimally invasive procedure that is both safe and reliable. When used for appropriate indications, an improvement can be expected in over 90% of patients.

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

    International Nuclear Information System (INIS)

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

    1988-01-01

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

  19. work in miners following anterior cruciate ligament reconstruction

    African Journals Online (AJOL)

    Return to work in miners following anterior cruciate ligament reconstruction. ... Patients were evaluated in terms of range of motion (ROM) values; Lysholm, Cincinati and ... pain inside the knee were the most significant reason which affected ...

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

    NARCIS (Netherlands)

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

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Challenges and outcomes of management of anterior abdominal ...

    African Journals Online (AJOL)

    Challenges and outcomes of management of anterior abdominal wall defects in a Nigerian tertiary hospital. ... African Journal of Paediatric Surgery ... Postoperative complication rate was 32.1% and overall mortality was 30.4%, with the ...

  3. Anterior ischemic optic neuropathy in patients undergoing hemodialysis

    NARCIS (Netherlands)

    DoorenbosBot, ACC; Geerlings, W; Houtman, IA

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

  4. Application and experience of anterior vitrectomy in phacoemulsification

    Directory of Open Access Journals (Sweden)

    Xiao-Bo Zeng

    2016-02-01

    Full Text Available AIM: To observe and discuss the clinical application and effect of anterior vitrectomy in phacoemulsification for the treatment of vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection.METHODS:Retrospective analysis of 28 cases(35 eyeswith cataract in whom vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification and intraocular lens implantation and anterior vitrectomy were performed was conducted. RESULTS:Anterior vitrectomy for timely and accurate treatment for vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification was satisfied. CONCLUSION: Anterior vitrectomy has good curative effect for vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification and is effective with less severe complications.

  5. A conservative approach for restoring anterior guidance: a case report.

    Science.gov (United States)

    Pontons-Melo, Juan Carlos; Pizzatto, Eduardo; Furuse, Adilson Yoshio; Mondelli, José

    2012-06-01

    One of the most common dental problems in today's clinics is tooth wear, specifically when related to bruxism. In such cases, the esthetics of anterior teeth may be compromised when excessive wear to the incisal surfaces occurs. Anterior tooth wear resulting from parafunctional bruxism can be conservatively treated with the use of direct resin composite restorations. This restorative approach has the advantages of presenting good predictability, load resistance, acceptable longevity, preservation of healthy dental tissues, and lower cost when compared with indirect restorations. The use of resin composites to solve esthetic problems, however, requires skill and practice. Thus, the present article demonstrates a conservative approach for restoring the esthetics and function of worn anterior teeth with the aid of direct resin composite restorations and selective occlusal adjustment. A conservative approach to restore anterior teeth with excessive wear is possible with direct resin composites. © 2011 Wiley Periodicals, Inc.

  6. A censervative programme for treatment of anterior knee pain in ...

    African Journals Online (AJOL)

    week conservative rehabilitation programme in addressing anterior knee pain in adolescents. Design. Subjects were randomly allocated to a control group (N=12) and an experimental group (N=18). The experimental group was subjected to a ...

  7. Anterior vaginal prolapse repair: A randomised trial of traditional ...

    African Journals Online (AJOL)

    Women with symptomatic anterior vaginal prolapse ≥POPQ stage II were included. Those with concomitant stress urinary ... ation, erosion, bleeding and discharge, pain and dyspareunia.[9] The .... which is similar to reports in other studies.

  8. Acute anterior uveitis following intravitreal bevacizumab but not subsequent ranibizumab

    Directory of Open Access Journals (Sweden)

    Antonopoulos C

    2011-11-01

    Full Text Available Christina Antonopoulos1, Maxwell Stem2, Grant M Comer21Department of Ophthalmology, Boston University, Boston, MA, USA; 2WK Kellogg Eye Center, Department of Ophthalmology, University of Michigan, Ann Arbor, MI, USAPurpose: Previous reports have identified noninfectious uveitis as a potential sequela following both intravitreal bevacizumab and ranibizumab injections. We present two unique cases of acute anterior uveitis following intravitreal bevacizumab that did not occur with subsequent ranibizumab injections.Methods: Case report.Conclusion: These cases may reflect differences in the etiology of anterior uveitis following intravitreal bevacizumab and ranibizumab. Given these differences, it may be reasonable to offer ranibizumab to patients who have experienced presumed bevacizumab-induced anterior uveitis.Keywords: adverse effect, age-related macular degeneration, anterior uveitis, bevacizumab, ranibizumab, uveitis

  9. Pigment dispersion syndrome masquerading as acute anterior uveitis.

    Science.gov (United States)

    Gonzalez-Gonzalez, Luis Alonso; Rodríguez-García, Alejandro; Foster, C Stephen

    2011-06-01

    Signs and symptoms of pigment dispersion may be confused with those of acute anterior uveitis. This case series is intended to aid the ophthalmologist in the clinical differentiation between these two disorders. The authors present a series of 6 patients with pigment dispersion who were initially diagnosed as having acute anterior uveitis and treated with anti-inflammatory medication, including corticosteroids. The patients were referred for a second opinion due to poor or no response to therapy and were found to have pigment dispersion instead of uveitis. Symptoms of pigment dispersion may consist of blurred vision, redness, ocular pain, and photophobia, all of which are also symptoms of acute anterior uveitis. These symptoms, plus the fact that pigment floating in the aqueous humor can be mistaken for inflammation, make diagnosis challenging. Moreover, the possible co-existence of true anterior uveitis and pigment dispersion makes the diagnosis and treatment more difficult.

  10. Automatic anterior chamber angle assessment for HD-OCT images.

    Science.gov (United States)

    Tian, Jing; Marziliano, Pina; Baskaran, Mani; Wong, Hong-Tym; Aung, Tin

    2011-11-01

    Angle-closure glaucoma is a major blinding eye disease and could be detected by measuring the anterior chamber angle in the human eyes. High-definition OCT (Cirrus HD-OCT) is an emerging noninvasive, high-speed, and high-resolution imaging modality for the anterior segment of the eye. Here, we propose a novel algorithm which automatically detects a new landmark, Schwalbe's line, and measures the anterior chamber angle in the HD-OCT images. The distortion caused by refraction is corrected by dewarping the HD-OCT images, and three biometric measurements are defined to quantitatively assess the anterior chamber angle. The proposed algorithm was tested on 40 HD-OCT images of the eye and provided accurate measurements in about 1 second.

  11. Asteroid hyalosis removal during phacoemulsification: an anterior approach

    Directory of Open Access Journals (Sweden)

    Mohamed Anbar

    2017-01-01

    Removal of AH by means of anterior vitrectomy during phacoemulsification through a posterior capsulorhexis is safe and effective and enables the surgeon to treat undiagnosed missed retinal lesions that were not obvious preoperatively.

  12. Giant primary synovial sarcoma of the anterior mediastinum: A case ...

    African Journals Online (AJOL)

    2015-06-11

    Jun 11, 2015 ... We present a case of primary monophasic synovial sarcoma of the anterior ... Here, we report a case of ... fatigue and anorexia, but no weight loss. ..... Primary intrathoracic synovial sarcoma: A clinicopathologic study of. 40 t (X ...

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

    LENUS (Irish Health Repository)

    Walker, Cameron

    2009-12-01

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

  14. Incipient nonarteritic anterior ischemic optic neuropathy.

    Science.gov (United States)

    Hayreh, Sohan Singh; Zimmerman, M Bridget

    2007-09-01

    To describe the clinical entity of incipient nonarteritic anterior ischemic optic neuropathy (NAION). Cohort study. Fifty-four patients (60 eyes) seen in our clinic from 1973 through 2000. At their first visit to our clinic, all patients gave a detailed ophthalmic and medical history and underwent a comprehensive ophthalmic evaluation, color fundus photography, and fluorescein fundus angiography. At each follow-up visit (of 49 patients [55 eyes]), the same ophthalmic evaluation was performed, except for fluorescein fundus angiography. Clinical features of incipient NAION. Mean age (+/- standard deviation) of the patients was 58.7+/-15.9 years. Median follow-up time was 6.3 years (interquartile range [IQR], 2.1-8.5). At initial visit, all had optic disc edema (ODE) without any visual loss attributable to NAION. In 55%, the fellow eye had classic NAION; in 25%, incipient progressed to classic NAION (after a median time of 5.8 weeks [IQR, 3.2-10.1]); and in 20%, classic NAION developed after resolution of the first episode of incipient NAION. Patients with incipient, compared with classic, NAION had a greater prevalence of diabetes mellitus (Pheart disease (P = 0.046). Patients who progressed to classic NAION versus those who did not were significantly younger (P = 0.025), and their visual acuity worsened in 31% and 0%, respectively, and remained stable in 62% and 98%, respectively; in the eyes with progression, central (in 31%) and peripheral (in 77%) visual fields worsened compared with only 1 eye and 2 eyes, respectively, that did not (P = 0.01 and Pversus 9.6 weeks (IQR, 6.0-17.7) in those who did not progress. The results show that incipient NAION is a distinct clinical entity, with asymptomatic ODE and no visual loss attributable to NAION. When a patient seeks treatment with asymptomatic ODE, incipient NAION must be borne in mind as a strong possibility in those who have had classic NAION in the fellow eye, in diabetics of all ages, and in those with high risk

  15. [Microsurgical anatomy importance of A1-anterior communicating artery complex].

    Science.gov (United States)

    Monroy-Sosa, Alejandro; Pérez-Cruz, Julio César; Reyes-Soto, Gervith; Delgado-Hernández, Carlos; Macías-Duvignau, Mario Alberto; Delgado-Reyes, Luis

    2013-01-01

    The anterior cerebral artery originates from the bifurcation of the internal carotid artery lateral to the optic chiasm, then joins with its contralateral counterpart via the anterior communicating artery. A1-anterior communicating artery complex is the most frequent anatomical variants and is the major site of aneurysms between 30 to 37%. Know the anatomy microsurgical, variants anatomical and importance of complex precommunicating segment-artery anterior communicating in surgery neurological of the pathology vascular, mainly aneurysms, in Mexican population. The study was performed in 30 brains injected. Microanatomy was studied (length and diameter) of A1-anterior communicating artery complex and its variants. 60 segments A1, the average length of left side was 11.35 mm and 11.84 mm was right. The average diameter of left was 1.67 mm and the right was 1.64 mm. The average number of perforators on the left side was 7.9 and the right side was 7.5. Anterior communicating artery was found in 29 brains of the optic chiasm, its course depended on the length of the A1 segment. The average length of the segment was 2.84 mm, the average diameter was 1.41 mm and the average number of perforators was 3.27. A1-anterior communicating artery complex variants were found in 18 (60%) and the presence of two blister-like aneurysms. It is necessary to understand the A1-anterior communicating artery complex microanatomy of its variants to have a three-dimensional vision during aneurysm surgery.

  16. Does concomitant anterior fundoplication promote dysphagia after laparoscopic Heller myotomy?

    Science.gov (United States)

    Tapper, Donovan; Morton, Connor; Kraemer, Emily; Villadolid, Desiree; Ross, Sharona B; Cowgill, Sarah M; Rosemurgy, Alexander S

    2008-07-01

    Concerns for gastroesophageal reflux after laparoscopic Heller myotomy for achalasia justify considerations of concomitant anterior fundoplication. This study was undertaken to determine if concomitant anterior fundoplication reduces symptoms of reflux after myotomy without promoting dysphagia. From 1992 to 2004, 182 patients underwent laparoscopic Heller myotomy without fundoplication. After a prospective randomized trial justified its concomitant application, anterior fundoplication was undertaken with laparoscopic Heller myotomy in 171 patients from 2004 to 2007. All patients have been prospectively followed. Pre and postoperatively, patients scored the frequency and severity of symptoms of achalasia (including dysphagia, choking, vomiting, regurgitation, chest pain, and heartburn) using a Likert Scale (0 = never/not bothersome to 10 = always/very bothersome). Before myotomy, symptoms of achalasia were frequent and severe for all patients. After myotomy, the frequency and severity of all symptoms of achalasia significantly decreased for all patients (P Heller myotomy alone, concomitant anterior fundoplication led to significantly less frequent and severe heartburn after myotomy (P Heller myotomy reduces the frequency and severity of symptoms of achalasia. Concomitant anterior fundoplication decreases the frequency and severity of heartburn and dysphagia after laparoscopic Heller myotomy. Concomitant anterior fundoplication promotes salutary relief in the frequency and severity of symptoms after myotomy and is warranted.

  17. Transanal stent in anterior resection does not prevent anastomotic leakage

    DEFF Research Database (Denmark)

    Bülow, Steffen; Bulut, O; Christensen, Ib Jarle

    2006-01-01

    OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS AND METH....... On this basis it was decided to discontinue the study prematurely for ethical reasons. CONCLUSION: Decompression of the anastomosis with a transanal stent does not reduce the risk of anastomotic leakage after anterior resection.......OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS...... AND METHODS: Randomized open trial of 194 patients operated in 11 hospitals during September 2000 to September 2003 with anterior resection for a mobile rectal tumour, 115 men and 79 women, median age 68 years (range 37-90 years). The surgeon decided upon the use of a protective ileostomy, and after...

  18. Compensatory orthodontic treatment of skeletal Class III malocclusion with anterior crossbite

    OpenAIRE

    José Valladares Neto

    2014-01-01

    INTRODUCTION: This case report describes the orthodontic treatment of an adult patient with skeletal Class III malocclusion and anterior crossbite. A short cranial base led to difficulties in establishing a cephalometric diagnosis. The patient's main complaint comprised esthetics of his smile and difficulties in mastication. METHODS: The patient did not have the maxillary first premolars and refused orthognathic surgery. Therefore, the treatment chosen was orthodontic camouflage and extr...

  19. Resultados del tratamiento quirúrgico de los aneurismas del complejo cerebral anterior-arteria comunicante anterior

    Directory of Open Access Journals (Sweden)

    Armando Alemán Rivera

    2001-06-01

    Full Text Available Se realiza un estudio de 30 pacientes con aneurismas localizados en el complejo de la arteria cerebral anterior-arteria comunicante anterior (ACoA, operados en el Servicio de Neurocirugía del Hospital Universitario "Arnaldo Milián Castro", durante un período de 7 años. Se analizan variables tales como edad, sexo, estado neurológico preoperatorio, momento quirúrgico, complicaciones y estado al egreso. La mortalidad general fue del 10 %The authors carried out a study in 30 patients with aneurysms located in the anterior communicating artery-anterior cerebral complex (ACA-ACC, that were operated on at the Neurosurgery Service of "Arnaldo Milián Castro" Teaching Hospital, during a period of 7 years. Variables such as age, sex, preoperative neurologic state, surgical moment, complications and status on discharge were analyzed. General mortality was 10 %

  20. Impact of Isometric Contraction of Anterior Cervical Muscles on Cervical Lordosis.

    Science.gov (United States)

    Fedorchuk, Curtis A; McCoy, Matthew; Lightstone, Douglas F; Bak, David A; Moser, Jacque; Kubricht, Brett; Packer, John; Walton, Dustin; Binongo, Jose

    2016-09-01

    This study investigates the impact of isometric contraction of anterior cervical muscles on cervical lordosis. 29 volunteers were randomly assigned to an anterior head translation (n=15) or anterior head flexion (n=14) group. Resting neutral lateral cervical x-rays were compared to x-rays of sustained isometric contraction of the anterior cervical muscles producing anterior head translation or anterior head flexion. Paired sample t-tests indicate no significant difference between pre and post anterior head translation or anterior head flexion. Analysis of variance suggests that gender and peak force were not associated with change in cervical lordosis. Chamberlain's to atlas plane line angle difference was significantly associated with cervical lordosis difference during anterior head translation (p=0.01). This study shows no evidence that hypertonicity, as seen in muscle spasms, of the muscles responsible for anterior head translation and anterior head flexion have a significant impact on cervical lordosis.

  1. Synthesis and characterization of polycaprolactone for anterior cruciate ligament regeneration

    International Nuclear Information System (INIS)

    Gurlek, Ayse Cansu; Sevinc, Burcu; Bayrak, Ece; Erisken, Cevat

    2017-01-01

    Anterior cruciate ligament (ACL) is the most frequently torn ligament in the knee, and complete healing is unlikely due to lack of vascularization. Current approaches for the treatment of ACL injuries include surgical interventions and grafting, however recent reports show that surgeries have 94% recurrency, and that repaired tissues are biomechanically inferior to the native tissue. These necessitate the need for new strategies for scar-free repair/regeneration of ACL injuries. Polycaprolactone (PCL) is a biodegradable and biocompatible synthetic polymer, which has been widely used in the connective tissue repair/regeneration attempts. Here, we report on the synthesis of PCL via ring opening polymerization using ε-caprolactone as the monomer, and ammonium heptamolybdate as a catalyst. The synthesized PCL was characterized using Fourier Transform Infrared Spectroscopy (FTIR) and Nuclear Magnetic Resonance (NMR) spectroscopy. It was then processed using electrospinning to form nanofiber-based scaffolds. These scaffolds were characterized in terms of surface as well as mechanical properties, and compared to the properties of commercially available PCL, and of native ACL tissue harvested from sheep. In addition, scaffolds fabricated with synthesized PCL were evaluated regarding their cell attachment capacity using human bone marrow mesenchymal stem cells (hBMSCs). Our findings demonstrated that the synthesized PCL is similar to its commercially available counterpart in terms of surface morphology and mechanical properties. In addition, fibrous scaffolds generated with electrospinning showed weaker mechanical properties visa vis native ACL tissue in terms of ultimate stress, and elastic modulus. Also, the synthesized PCL can accommodate cell attachment when tested with hBMSCs. Putting together, these observations reveal that the PCL synthesized in this study could be a good candidate as a biomaterial for ligament repair or regeneration. - Highlights: • Synthesis of

  2. Synthesis and characterization of polycaprolactone for anterior cruciate ligament regeneration

    Energy Technology Data Exchange (ETDEWEB)

    Gurlek, Ayse Cansu; Sevinc, Burcu; Bayrak, Ece; Erisken, Cevat, E-mail: cerisken@etu.edu.tr

    2017-02-01

    Anterior cruciate ligament (ACL) is the most frequently torn ligament in the knee, and complete healing is unlikely due to lack of vascularization. Current approaches for the treatment of ACL injuries include surgical interventions and grafting, however recent reports show that surgeries have 94% recurrency, and that repaired tissues are biomechanically inferior to the native tissue. These necessitate the need for new strategies for scar-free repair/regeneration of ACL injuries. Polycaprolactone (PCL) is a biodegradable and biocompatible synthetic polymer, which has been widely used in the connective tissue repair/regeneration attempts. Here, we report on the synthesis of PCL via ring opening polymerization using ε-caprolactone as the monomer, and ammonium heptamolybdate as a catalyst. The synthesized PCL was characterized using Fourier Transform Infrared Spectroscopy (FTIR) and Nuclear Magnetic Resonance (NMR) spectroscopy. It was then processed using electrospinning to form nanofiber-based scaffolds. These scaffolds were characterized in terms of surface as well as mechanical properties, and compared to the properties of commercially available PCL, and of native ACL tissue harvested from sheep. In addition, scaffolds fabricated with synthesized PCL were evaluated regarding their cell attachment capacity using human bone marrow mesenchymal stem cells (hBMSCs). Our findings demonstrated that the synthesized PCL is similar to its commercially available counterpart in terms of surface morphology and mechanical properties. In addition, fibrous scaffolds generated with electrospinning showed weaker mechanical properties visa vis native ACL tissue in terms of ultimate stress, and elastic modulus. Also, the synthesized PCL can accommodate cell attachment when tested with hBMSCs. Putting together, these observations reveal that the PCL synthesized in this study could be a good candidate as a biomaterial for ligament repair or regeneration. - Highlights: • Synthesis of

  3. Simulation of Anterior Cruciate Ligament Reconstruction in a Dry Model.

    Science.gov (United States)

    Dwyer, Tim; Slade Shantz, Jesse; Chahal, Jaskarndip; Wasserstein, David; Schachar, Rachel; Kulasegaram, K Mahan; Theodoropoulos, John; Greben, Rachel; Ogilvie-Harris, Darrell

    2015-12-01

    As the demand increases for demonstration of competence in surgical skill, the need for validated assessment tools also increases. The purpose of this study was to validate a dry knee model for the assessment of performance of anterior cruciate ligament reconstruction (ACLR). The hypothesis was that the combination of a checklist and a previously validated global rating scale would be a valid and reliable means of assessing ACLR when performed by residents in a dry model. Controlled laboratory study. All residents, sports medicine staff, and fellows were invited to perform a hamstring ACLR using anteromedial drilling and Endobutton fixation on a dry model of an anterior cruciate ligament. Previous exposure to knee arthroscopy and ACLR was recorded. A detailed surgical manuscript and technique video were sent to all participants before the study. Residents were evaluated by staff surgeons with task-specific checklists created by use of a modified Delphi procedure and the Arthroscopic Surgical Skill Evaluation Tool (ASSET). Each procedure (hand movements and arthroscopic video) was recorded and scored by a fellow blinded to the year of training of each participant. A total of 29 residents, 5 fellows, and 6 staff surgeons (40 participants total) performed an ACLR on the dry model. The internal reliability (Cronbach alpha) of the test when using the total ASSET score was very high (>0.9). One-way analysis of variance for the total ASSET score and the total checklist score demonstrated a difference between participants based on year of training (P .05). A good correlation was seen between the total ASSET score and prior exposure to knee arthroscopy (0.73) and ACLR (0.65). The interrater reliability (intraclass correlation coefficient) between the examiner ratings and the blinded assessor ratings for the total ASSET score was very high (>0.8). The results of this study provide evidence that the performance of an ACLR in a dry model is a reliable method of assessing a

  4. Kainate-induced network activity in the anterior cingulate cortex.

    Science.gov (United States)

    Shinozaki, R; Hojo, Y; Mukai, H; Hashizume, M; Murakoshi, T

    2016-06-14

    Anterior cingulate cortex (ACC) plays a pivotal role in higher order processing of cognition, attention and emotion. The network oscillation is considered an essential means for integration of these CNS functions. The oscillation power and coherence among related areas are often dis-regulated in several psychiatric and pathological conditions with a hemispheric asymmetric manner. Here we describe the network-based activity of field potentials recorded from the superficial layer of the mouse ACC in vitro using submerged type recordings. A short activation by kainic acid administration to the preparation induced populational activities ranging over several frequency bands including theta (3-8Hz), alpha (8-12Hz), beta (13-30Hz), low gamma (30-50Hz) and high gamma (50-80Hz). These responses were repeatable and totally abolished by tetrodotoxin, and greatly diminished by inhibitors of ionotropic and metabotropic glutamate receptors, GABAA receptor or gap-junctions. These observations suggest that the kainate-induced network activity can be a useful model of the network oscillation in the ACC circuit. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  5. Mucoid degeneration of the anterior cruciate ligament: Management and outcome

    Directory of Open Access Journals (Sweden)

    Vivek Pandey

    2014-01-01

    Full Text Available Background: Mucoid degeneration (MD is a rare pathological affection of the anterior cruciate ligament (ACL. Mucinous material within the substance of ACL produces pain and limited motion in the knee. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. Materials and Methods: During a period of 3 years, 11 patients were included based upon the clinical suspicion, magnetic resonance imaging (MRI findings, arthroscopic features and histopathologic confirmation of MD of ACL. Result: Six patients were male and five were female with median age of 40 years (range 21-59 years. All patients complained of knee pain with median duration of 5 months (range 1-24 months. All patients had painful deep flexion with 63.6% (N = 7 reporting trivial trauma before the onset of symptoms. MRI revealed MD of ACL in all with associated cyst in three patients. Partial debridement of ACL was done in ten and complete in one patient. None of them required notchplasty. Histopathology confirmed the diagnosis in all of them. At the mean followup of 13.81 months (range 6-28 months, all patients regained complete flexion and none complained of instability. Conclusion: Prior knowledge of condition with high index of suspicion and careful interpretation of MRI can establish the diagnosis preoperatively. It responds well to partial debridement of ACL and mucinous material without development of instability.

  6. [Anterior rectal duplication in adult patient: a case report].

    Science.gov (United States)

    Rodríguez-Cabrera, J; Villanueva-Sáenz, E; Bolaños-Badillo, L E

    2009-01-01

    To report a case of rectal duplication in the adult and make a literature review. The intestinal duplications are injuries of congenital origin that can exist from the base of the tongue to the anal verge, being the most frequent site at level of terminal ileum (22%) and at the rectal level in 5% To date approximately exist 80 reports in world-wide Literature generally in the pediatric population being little frequent in the adult age. Its presentation could be tubular or cystic. The recommended treatment is the surgical resection generally in block with coloanal anastomosis. A case review of rectal duplication in the adult and the conducted treatment. The case of a patient appears with diagnose of rectal duplication with tubular type,whose main symptom was constipation and fecal impactation. In the exploration was detect double rectal lumen (anterior and posterior) that it above initiates by of the anorectal ring with fibrous ulcer of fibrinoid aspect of 3 approx cm of length x 1 cm wide, at level of the septum that separates both rectal lumina. The rectal duplication is a rare pathology in the adult nevertheless is due to suspect before the existence of alterations in the mechanics of the defecation, rectal prolapse and rectal bleeding,the election treatment is a protectomy with colonic pouch in "J" and coloanal anastomosis.

  7. Partial tearing of the anterior cruciate ligament: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Eduardo Frois Temponi

    2015-02-01

    Full Text Available Partial tears of the anterior cruciate ligament (ACL are common and represent 10-27% of the total. The main reasons for attending to cases of non-torn bundles are biomechanical, vascular and proprioceptive. Continued presence of the bundle also serves as protection during the healing process. There is controversy regarding the definition of these injuries, which is based on anatomy, clinical examination, translation measurements, imaging examinations and arthroscopy. The way in which it is treated will depend on the existing laxity and instability. Conservative treatment is optional for cases without instability, with a focus on motor rehabilitation. Surgical treatment is a challenge, since it requires correct positioning of the bone tunnels and conservation of the remnants of the torn bundle. The pivot shift test under anesthesia, the magnetic resonance findings, the previous level and type of sports activity and the arthroscopic appearance and mechanical properties of the remnants will aid the orthopedist in the decision-making process between conservative treatment, surgical treatment with strengthening of the native ACL (selective reconstruction and classical (anatomical reconstruction.

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

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, W.T. [Dept. of Radiology, Univ. of Texas Health Science Center, San Antonio, TX (United States); McMahan, C.A. [Dept. of Pathology, Univ. of Texas Health Science Center, San Antonio, TX (United States); Lasher, J.C. [Dept. of Radiology, Univ. of Texas Health Science Center, San Antonio, TX (United States); Blumhardt, M.R. [Dept. of Pathology, Univ. of Texas Health Science Center, San Antonio, TX (United States); Schwartz, J.G. [Dept. of Pathology, Univ. of Texas Health Science Center, San Antonio, TX (United States)

    1995-02-01

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

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

    International Nuclear Information System (INIS)

    Tirman, P.F.J.; Steinbach, L.S.; Feller, J.F.; Stauffer, A.E.

    1996-01-01

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

  10. [Anterior Superior and Anterior Interior Iliac Spine Fractures. Comparison of the Results of Conservative and Surgical Treatment].

    Science.gov (United States)

    Stančák, A; Kautzner, J; Havlas, V

    2016-01-01

    Avulsion fractures of the anterior superior iliac spine (ASIS) and anterior inferior iliac spine (AIIS) are rare injuries to the skeleton in children. They are most frequent in adolescent athletes, such as sprinters and long-distance runners, and football players. The authors present a group of patients treated at their department and compare the results of procedures used to manage different pelvic avulsion fractures. Between 2005 and 2012, 38 patients (31 boys and seven girls) with an average age of 15.1 years (range, 4-17 years) were treated. Fourteen patients with minimally displaced fractures were treated conservatively, 24 patients with fractures displaced more than 1 cm underwent surgery. All patients had a standard rehabilitation protocol. Post-operative assessments included: the range of motion in the hip; X-ray at 6 weeks, 3 months and 1 year; duration of bed rest; return to previous activities; occurrence of complications (heterotopic ossification, infection, etc). All patients returned to the pre-injury level of sports activities. Recovery was faster and early rehabilitation was better tolerated in patients treated surgically (p = 0.03), particularly in those with AIIS avulsion fractures. Ambulation with partial weight bearing was possible on average at 7.2 days (range, 2-10 days) in surgically treated patients and at 24.1 days (18-27 days) in conservatively treated patients; the difference was statistically significant (p = 0.02). The range of motion markedly improved in surgically treated patients as early as at 6 weeks while, in conservatively treated patients, the comparable outcome was achieved at 3 months of follow-up (p = 0.02). The time necessary for radiographic evidence of fragment union as well as full recovery was comparable in both patient groups. No deep wound infection was recorded; minor heterotopic ossification was detected in five patients, but no further treatment during follow-up was required. Indications for surgical treatment are

  11. A neuromuscular exercise programme versus standard care for patients with traumatic anterior shoulder instability

    DEFF Research Database (Denmark)

    Eshoj, Henrik; Rasmussen, Sten; Frich, Lars Henrik

    2017-01-01

    BACKGROUND: Anterior shoulder dislocation is a common injury and may have considerable impact on shoulder-related quality of life (QoL). If not warranted for initial stabilising surgery, patients are mostly left with little to no post-traumatic rehabilitation. This may be due to lack of evidence......-based exercise programmes. In similar, high-impact injuries (e.g. anterior cruciate ligament tears in the knee) neuromuscular exercise has shown large success in improving physical function and QoL. Thus, the objective of this trial is to compare a nonoperative neuromuscular exercise shoulder programme...... dislocations due to at least one traumatic event will be randomised to 12 weeks of either a standardised, individualised or physiotherapist-supervised neuromuscular shoulder exercise programme or standard care (self-managed shoulder exercise programme). Patients will be stratified according to injury status...

  12. SPHENOID SINUS (SS ANTERIOR MEDIAL TEMPORAL LOBE ENCEPHALOCELE (AMTLE WITH SPONTANEOUS CSF RHINORRHOEA : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Laveena

    2015-09-01

    Full Text Available Cranial encephaloceles are the herniation of intracranial meninges and brain tissue through a defect in the cranium or skull base. These are rare conditions with an incidence of approximately 1 in 35,000 people, and are more common in the anterior cranial fossa than those in the middle one . 1,2 Temporal lobe herniation through a mid dle fossa defect into the lateral recess of the Sphenoid Sinus is even rarer than its medial representation. Intrasphenoidal encephaloceles are extremely rare findings 3 . Spontaneous, or primary, CSF fistula is a separate entity with no underlying cause of the CSF leak. Spontaneous CSF leaks are usually associated with a co - existing encephalocele of variable size 4 . We present a case of spontaneous CSF rhinorrhoea in a sphenoid sinus Anterior Medial Temporal lobe encephalocele herniating through a clinically silent lateral Craniopharyngeal canal.

  13. Cervical vertebral column morphology and head posture in preorthodontic patients with anterior open bite

    DEFF Research Database (Denmark)

    Kim, Phong; Sarauw, Martin Toft; Sonnesen, Liselotte

    2014-01-01

    INTRODUCTION: Cervical vertebral column morphology and head posture were examined and related to craniofacial morphology in preorthodontic children and adolescents with anterior open bite. METHODS: One hundred eleven patients (ages, 6-18 years) with an anterior open bite of more than 0 mm were...... posture were made on profile radiographs. RESULTS: Deviations in the cervical vertebral column morphology occurred in 23.7% of the subjects in the skeletal open-bite group and in 19.2% in the dentoalveolar open-bite group, but the difference was not significant. Head posture was significantly more...... extended in the skeletal open-bite group compared with the dentoalveolar open-bite group (craniovertical angle [Mx/VER], P posture was associated with craniofacial morphology: extended posture was associated with a large cranial base angle...

  14. An outcomes analysis of anterior epistaxis management in the emergency department.

    Science.gov (United States)

    Newton, E; Lasso, A; Petrcich, W; Kilty, S J

    2016-04-11

    Many treatment options exist for the management of anterior epistaxis. However, little is known about treatment outcomes. The objective was to identify the currently utilised methods of management and outcomes for patients with anterior epistaxis presenting to the emergency department (ED) at a Canadian tertiary care center. A retrospective review of ED visits from January 2012-May 2014 for adult patients with a diagnosis of anterior epistaxis was performed. Patient demographic data, comorbidities, and treatment methods were documented. The effectiveness of different treatment modalities was determined. Three hundred fifty-three primary anterior epistaxis cases were included. Mean patient age was 70 years and 49% of patients were female. Comorbidities included hypertension (56%), diabetes (19%), CAD (28%), and atrial fibrillation (27%). A large proportion of the cohort (61%) was on at least one anticoagulant or antiplatelet therapy. The most common utilised treatment modalities were silver nitrate cauterization, Merocel®, petroleum gauze packing, nasal clip and 15% were simply observed. Initial treatment success was achieved in 74% of cases. Of patients receiving specific treatment modalities, silver nitrate cauterization had the highest success rate at 80%. 26% of patients returned to the ED for recurrence of epistaxis with highest rates occurring in the nasal clip (59%), Merocel® (26%), and petroleum gauze packing (42%) groups. The differences in recurrence rate among the different treatment modalities observed may be due to true differences in effectiveness or differences in treatment selection by the ED physicians based on severity of epistaxis. Cauterization with silver nitrate, however, offers the added benefit of no need for follow up. Further study is needed to elucidate the most efficacious treatment modality based on epistaxis severity.

  15. Anterior Cortical Development During Adolescence in Bipolar Disorder.

    Science.gov (United States)

    Najt, Pablo; Wang, Fei; Spencer, Linda; Johnston, Jennifer A Y; Cox Lippard, Elizabeth T; Pittman, Brian P; Lacadie, Cheryl; Staib, Lawrence H; Papademetris, Xenophon; Blumberg, Hilary P

    2016-02-15

    Increasing evidence supports a neurodevelopmental model for bipolar disorder (BD), with adolescence as a critical period in its development. Developmental abnormalities of anterior paralimbic and heteromodal frontal cortices, key structures in emotional regulation processes and central in BD, are implicated. However, few longitudinal studies have been conducted, limiting understanding of trajectory alterations in BD. In this study, we performed longitudinal neuroimaging of adolescents with and without BD and assessed volume changes over time, including changes in tissue overall and within gray and white matter. Larger decreases over time in anterior cortical volumes in the adolescents with BD were hypothesized. Gray matter decreases and white matter increases are typically observed during adolescence in anterior cortices. It was hypothesized that volume decreases over time in BD would reflect alterations in those processes, showing larger gray matter contraction and decreased white matter expansion. Two high-resolution magnetic resonance imaging scans were obtained approximately 2 years apart for 35 adolescents with bipolar I disorder (BDI) and 37 healthy adolescents. Differences over time between groups were investigated for volume overall and specifically for gray and white matter. Relative to healthy adolescents, adolescents with BDI showed greater volume contraction over time in a region including insula and orbitofrontal, rostral, and dorsolateral prefrontal cortices (p adolescence in BDI in anterior cortices, including altered developmental trajectories of anterior gray and white matter. Published by Elsevier Inc.

  16. Psychological Aspects of Recovery Following Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Christino, Melissa A; Fantry, Amanda J; Vopat, Bryan G

    2015-08-01

    Recovery following anterior cruciate ligament reconstruction is an arduous process that requires a significant mental and physical commitment to rehabilitation. Orthopaedic research in recent years has focused on optimizing anterior cruciate ligament surgical techniques; however, despite stable anterior cruciate ligament reconstructions, many athletes still never achieve their preinjury ability or even return to sport. Psychological factors associated with patient perceptions and functional outcomes following anterior cruciate ligament reconstruction are important to acknowledge and understand. Issues related to emotional disturbance, motivation, self-esteem, locus of control, and self-efficacy can have profound effects on patients' compliance, athletic identity, and readiness to return to sport. The psychological aspects of recovery play a critical role in functional outcomes, and a better understanding of these concepts is essential to optimize the treatment of patients undergoing anterior cruciate ligament reconstruction, particularly those who plan to return to sport. Identifying at-risk patients, encouraging a multidisciplinary approach to patient care, and providing early referral to a sports psychologist may improve patient outcomes and increase return-to-play rates among athletes. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

  17. Phase image characterization of ventricular contraction in left anterior hemiblock

    International Nuclear Information System (INIS)

    Ono, Akifumi; Mizuno, Haruyoshi; Tahara, Yorio; Ishikawa, Kyozo

    1991-01-01

    We investigated whether or not left anterior hemiblock is present in patients with left axis deviation using first-harmonic Fourier analysis of gated blood-pool images. Gated blood-pool images were taken in 50 patients without contraction abnormality. They included 14 normal subjects, 8 patients with right bundle branch block (RBBB), 20 with left axis deviation (LAD) and 8 with both RBBB and LAD (RBBB+LAD). ECG gated blood-pool scans were acquired in the anterior and 'best septal' left anterior oblique projections. First, the phase images were displayed cinematically as a continuous-loop movie. Next, for quantitative analysis of the phase image, the whole left ventricular and left ventricular high lateral regions of interest were drawn. The 'regional phase shift' (RPS) was then defined as {RPS=A-a} where 'A' is the mean value of the whole left ventricular phase angles and 'a' is that of phase angles in the high lateral region. The left ventricular phase changes and the RPSs in the RBBB and LAD groups were similar to those in the normal group. In the RBBB+LAD group, the latest phase changes occurred in the high anterolateral region. The RPSs of this group were significantly lower than those in the other 3 groups (p<0.01). These data suggest that left anterior hemiblock might coexist with RBBB in patients with RBBB+LAD, whereas left anterior hemiblock might not exist in the majority of patients with LAD alone. (author)

  18. Diffuse Anterior Retinoblastoma with Sarcoidosis-Like Nodule

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    Koji Kitazawa

    2015-12-01

    Full Text Available Background: Retinoblastomas account for 4% of malignancies in children, 1-2% of which are diffuse infiltrating retinoblastomas. Diffuse anterior retinoblastoma is rare and does not involve the retina. Here, we report on a diffuse anterior retinoblastoma with large sarcoidosis-like nodules on the iris that were responsive to anti-inflammatory therapy. Case: We present a 6-year-old girl who had anterior uveitis with white nodules on the iris and posterior surface of the cornea in her right eye. The nodules initially responded well to anti-inflammatory treatment. However, anterior segment optical coherence tomography (AS-OCT showed that the nodules gradually grew, shrinking the iris. We then collected the aqueous humor for diagnosis. A biopsy revealed clusters of small cells with a high nuclear-to-cytoplasm ratio with partial rosette formation. Therefore, we diagnosed diffuse anterior retinoblastoma without retinal involvement and performed enucleation of the right eye. The histopathology demonstrated undifferentiated cells similar to those seen on the biopsy, and tumor cells invaded the iris stroma, posterior surface of the cornea, ciliary body, and sclera. After the enucleation, she underwent chemotherapy and remains alive. Conclusion: A differential diagnosis of retinoblastoma should be considered when white nodules refractory to anti-inflammatory therapy occur in the eye, even in the absence of obvious retinal masses. AS-OCT findings are useful in assessing retinoblastoma.

  19. Evaluation of the anterior chamber angle in pseudoexfoliation syndrome.

    Science.gov (United States)

    Iwanejko, Małgorzata; Turno-Kręcicka, Anna; Tomczyk-Socha, Martyna; Kaczorowski, Kamil; Grzybowski, Andrzej; Misiuk-Hojło, Marta

    2017-08-01

    Pseudoexfoliation syndrome (PEX) is the most frequently identifiable cause of secondary open-angle glaucoma, known as pseudoexfoliation glaucoma. The exact pathophysiology and etiology of PEX and associated glaucoma remains obscure. The purpose of this study was to determine the differences in the morphology of the anterior chamber angle in people with pseudoexfoliation syndrome and pseudoexfoliation glaucoma compared to a control group. We also evaluated the correlation between intraocular pressure (IOP) and pigmentation of the angle with the amount of exfoliated material in the anterior segment. The study group was composed of 155 eyes from 103 patients aged between 43 and 86 years. Each patient underwent a complete ophthalmological examination. Some difference was found in intraocular pressure between the PEX group and the control group and between the pseudoexfoliation glaucoma group and the control group, but no significant difference was found between the 2 study groups. There was a significant difference in the incidence of some degree of pigmentation in the anterior chamber angle and no difference in the widths of the angle between each group. A significant positive relationship was observed between intraocular pressure and the degree of pigmentation of the anterior chamber angle in both the PEX group and the pseudoexfoliation glaucoma group. The results of this study indicate that the amount of pigmentation and exfoliation material in the anterior segment significantly correlates with the level of IOP and possibly with the degree of trabecular dysfunction. It seems that for clear identification of PEX and pseudoexfoliation glaucoma factors, clinical assessment appears to be insufficient.

  20. Experience with titanium cages in anterior cervical discectomy and fusion

    International Nuclear Information System (INIS)

    Junaid, M.; Afsheen, A.; Bukhari, S.S.; Rashid, M.U.; Kalsoom, A.

    2016-01-01

    Background: Anterior cervical discectomy is a common procedure for treating patients for cervical disc prolapse. This study was conducted to study the surgical outcome and demographic characteristics of patients who were treated for anterior cervical disc prolapse. Methods: Study was conducted in the combined military hospital (CMH) Peshawar. Study interval was 3 years from 1st September, 2011 to 31st August, 2014. Total number of patients were 84. Males were 54 (64.28 percentage) and females were 30 (35.71 percentage). All the patients had undergone the procedure of anterior cervical discectomy and fusion with titanium cages (ACDF). All the patients had plain MRI cervical spine done for diagnosis of anterior cervical disc prolapse. Results: Total 84 patients were operated. In the patients who complained of brachialgia, 100 percentage improvement was seen after the operation. Three (3.5 percentage) of the patients, who presented with axial neck pain, continued to complain of pain and 2 (2.5 percentage) of the patients complained of pain at the donor site after the operation. One of the patient had dural tear which resulted in subcutaneous cerebrospinal fluid (CSF) accumulation and was treated conservatively with repeated aspiration. Fusion rate was 100 percentage with titanium cages used for fusion after anterior cervical discectomy. No complications were noted after the surgery at 1 year of interval. Conclusion: Results with titanium cages are expectedly good. Symptoms resolved and fusion rate was 100 percentage at 1 year follow up. (author)

  1. Anterior Overgrowth in Primary Curves, Compensatory Curves and Junctional Segments in Adolescent Idiopathic Scoliosis.

    Science.gov (United States)

    Schlösser, Tom P C; van Stralen, Marijn; Chu, Winnie C W; Lam, Tsz-Ping; Ng, Bobby K W; Vincken, Koen L; Cheng, Jack C Y; Castelein, René M

    2016-01-01

    Although much attention has been given to the global three-dimensional aspect of adolescent idiopathic scoliosis (AIS), the accurate three-dimensional morphology of the primary and compensatory curves, as well as the intervening junctional segments, in the scoliotic spine has not been described before. A unique series of 77 AIS patients with high-resolution CT scans of the spine, acquired for surgical planning purposes, were included and compared to 22 healthy controls. Non-idiopathic curves were excluded. Endplate segmentation and local longitudinal axis in endplate plane enabled semi-automatic geometric analysis of the complete three-dimensional morphology of the spine, taking inter-vertebral rotation, intra-vertebral torsion and coronal and sagittal tilt into account. Intraclass correlation coefficients for interobserver reliability were 0.98-1.00. Coronal deviation, axial rotation and the exact length discrepancies in the reconstructed sagittal plane, as defined per vertebra and disc, were analyzed for each primary and compensatory curve as well as for the junctional segments in-between. The anterior-posterior difference of spinal length, based on "true" anterior and posterior points on endplates, was +3.8% for thoracic and +9.4% for (thoraco)lumbar curves, while the junctional segments were almost straight. This differed significantly from control group thoracic kyphosis (-4.1%; P<0.001) and lumbar lordosis (+7.8%; P<0.001). For all primary as well as compensatory curves, we observed linear correlations between the coronal Cobb angle, axial rotation and the anterior-posterior length difference (r≥0.729 for thoracic curves; r≥0.485 for (thoraco)lumbar curves). Excess anterior length of the spine in AIS has been described as a generalized growth disturbance, causing relative anterior spinal overgrowth. This study is the first to demonstrate that this anterior overgrowth is not a generalized phenomenon. It is confined to the primary as well as the

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

    Directory of Open Access Journals (Sweden)

    Antonio Egydio de Carvalho Junior

    2010-01-01

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

  3. Evisceración en estafiloma escleral anterior gigante Evisceration of the giant anterior scleral staphyloma

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    Irene Rojas Rondón

    2010-01-01

    Full Text Available La evisceración es la técnica quirúrgica seleccionada para el tratamiento de muchas afecciones oculares graves como: endoftalmitis, ojo ciego doloroso por trauma crónico, glaucoma absoluto, desprendimiento de retina crónico, uveítis crónica, pthisis bulbi, buftalmos y por razones estéticas. Paciente de 21 años de edad que acude a consulta solicitando mejoría de su apariencia facial. Al examen ocular encontramos aumento de volumen localizado en toda la zona superior del globo ocular desde hora 9 hasta hora 3 del ojo derecho, donde se observaba adelgazamiento escleral con extensas zonas de coroides expuesta, leucoma corneal que ocupaba eje visual y exotropia 30° x Hirshberg, como secuela de trauma ocular. El diagnóstico fue estafiloma escleral anterior en el ojo derecho con riesgo de perforación escleral. La evisceración fue el proceder quirúrgico de elección en este tipo de afección, se colocó implante orbitario, sin complicaciones. Inmediatamente después de la cirugía se coloca conformador en la cavidad y luego de un mes se coloca prótesis ocular. De esta forma se logra mejorar el componente estético así como una adecuada rehabilitación y por ello la calidad de vida de nuestro paciente.Evisceration is the surgical technique selected for the treatment of many serious ocular illnesses such as endophthalmitis, painful blind eye due to chronic trauma, absolute glaucoma, chronic retinal detachment, chronic uveitis, pthisis bulbi, buphthalmos and for aesthetic reasons. A 21 years-old patient went to the doctor's office to request some assistance to improve her facial look. On ocular exam, increased volume located in the upper area of the eyeball from hour 9 to hour 3 of the right eye was observed; also scleral thinning with extensive areas of exposed choroid, corneal leukoma occupying the visual axis and 30° exotropia x Hirshberg, as ocular trauma sequel. The diagnosis was anterior scleral staphyloma with risk of scleral

  4. Relation between anterior displacement of the temporomandibular joint disc and size of the condyle

    International Nuclear Information System (INIS)

    Ohgushi, Masatoshi; Kubota, Hisashi; Yamaguchi, Kouichi; Shibata, Takanori

    1996-01-01

    To elucidate the cause of anterior displacement of the disc, we evaluated the relation between anterior displacement and the size of the condyle from MR images in 301 patients (602 TMJs) with clinical diagnosis of internal derangement. We found that the size of condyles with anterior displacement of the disc was significantly smaller than that of condyles without anterior displacement. This result suggests that small condyles may give rise to anterior displacement of the disc. (author)

  5. Evaluation of the research diagnostic criteria for temporomandibular disorders for the recognition of an anterior disc displacement with reduction

    NARCIS (Netherlands)

    Naeije, M.; Kalaykova, S.; Visscher, C.M.; Lobbezoo, F.

    2009-01-01

    The aim of this Focus Article is to review critically the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for the recognition of an anterior disc displacement with reduction (ADDR) in the temporomandibular joint (TMJ). This evaluation is based upon the experience gained

  6. Resting state functional connectivity of the anterior cingulate cortex in veterans with and without post-traumatic stress disorder

    NARCIS (Netherlands)

    Kennis, Mitzy; Rademaker, Arthur R.; van Rooij, Sanne J H; Kahn, René S.; Geuze, Elbert

    2015-01-01

    Post-traumatic stress disorder (PTSD) is an anxiety disorder that is associated with structural and functional alterations in several brain areas, including the anterior cingulate cortex (ACC). Here, we examine resting state functional connectivity of ACC subdivisions in PTSD, using a seed-based

  7. Sonourethrography in the evaluation of anterior urethral strictures

    International Nuclear Information System (INIS)

    Kim, Jong Chul; Kwag, Jin Geun

    1994-01-01

    To determine the reliability of sonourethrography (SUG) in the evaluation of male anterior urethral strictures. Both SUG with retrograde saline infusion and retrograde urethrography (RUG) were performed in 5 young normal volunteers and 20 patients with symptoms of impaired urine flow. Those findings were compared with urethroscopic and operative findings in all patients. SUG was more accurate in the evaluation of the stricture length and degree than RUG in 7 patients with anterior urethral strictures, when compared with their subsequent open urethroplasty findings. Only SUG could classify the degree of spongiofibrosis surrounding the strictures in 15 patients. So, SUG was diagnostically as efficacious as or, superior to, RUG in all 20 patients. SUG can be used as one of complementary and reliable tools for diagnosis, evaluation and follow-up of anterior urethral strictures

  8. Complex aesthetic treatment on anterior maxillary teeth with malposition

    Directory of Open Access Journals (Sweden)

    Febriastuti Febriastuti

    2008-12-01

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

  9. Imaging assessment of anterior knee pain and patellar maltracking

    International Nuclear Information System (INIS)

    McNally, E.G.

    2001-01-01

    Anterior knee pain is a common complaint in the orthopaedic clinic. The differential diagnosis is wide and the principal goal of initial assessment is to detect remediable causes. The majority of patients do not have a specific disease and increasingly interest has focused on the role of patello-femoro-tibial morphology and of patellar maltracking in the aetiology of anterior knee pain. Classification in this group of patients is poor and there is no uniform agreement on which patient groups benefit from treatment and which treatment is best. Much of the literature involves relatively small numbers of patients, is poorly controlled and there is little agreement on outcome measures [1, 2]. The purpose of this review is to outline the current status of the imaging assessment of recalcitrant anterior knee pain with particular reference to patellar maltracking. (orig.)

  10. Refraction and eye anterior segment parameters in schizophrenic patients

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    Tongabay Cumurcu

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Wen-xiang YUE

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Strajnić Ljiljana

    2013-01-01

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

  13. A chondrosarcoma in the anterior mediastinum mimicking a thymoma

    International Nuclear Information System (INIS)

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

    2015-01-01

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

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

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    Karpagam S

    2005-01-01

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

  15. Efficacy and complications of radiotherapy of anterior visual pathway tumors

    International Nuclear Information System (INIS)

    Capo, H.; Kupersmith, M.J.

    1991-01-01

    A progressive disturbance in visual acuity or visual field, along with an unexplained optic nerve atrophy, suggests the possibility of a tumor. Tumors that frequently affect the anterior visual pathway include primary optic nerve sheath meningiomas, intracranial meningiomas, optic gliomas, pituitary tumors, and craniopharyngiomas. The location of these tumors sometimes prohibits a complete surgical excision that might jeopardize the visual system. Radiation therapy, however, can be beneficial in these cases. This article reviews the indications for radiotherapy of tumors that involve the anterior visual pathway, along with the possible complications. Cases that present the effect of radiation therapy and radiation damage are presented.131 references

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

    International Nuclear Information System (INIS)

    Williams, G.A.; Hatchell, D.L.; Collier, B.D.; Knobel, J.

    1984-01-01

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

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

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    S Ahmad

    2015-03-01

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

  18. Anterior stromal puncture in the treatment of bullous keratopathy

    OpenAIRE

    Gomes, José Alvaro Pereira; Haraguchi, Daniel Keizo de Medeiros; Zambrano, Delbis Uzcátegui; Villavicencio, Luis Izquierdo; Cunha, Marcelo C.; Freitas, Denise de

    2000-01-01

    Objetivo: Avaliar o efeito terapêutico das punções do estroma anterior corneal em pacientes com ceratopatia bolhosa (CB). Métodos:Vinte e cinco pacientes com CB sintomáticos, com baixa visão, com e sem indicação de transplante de córnea, foram avaliados antes, uma, 4 e 12 semanas após punções estromais anteriores realizadas com agulha #25 à lâmpada de fenda. Em cada visita, os pacientes foram questionados sobre intensidade da dor, fotofobia, sensação de corpo estranho, além de serem submetido...

  19. Anterior mediastinal paraganglioma: A case for preoperative embolization

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    Shakir Murtaza

    2012-07-01

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

  20. Mucoepidermoid carcinoma of the anterior maxilla: A rare entity

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    Smitha Kullaje

    2014-01-01

    Full Text Available Mucoepidermoid carcinoma is the second most common salivary gland tumor primarily involving major salivary glands and intraoral minor salivary glands. Although rare, it can occur in the jaw bones, but it is very rare in the maxillary anterior region. Here, we present a case of mucoepidermoid carcinoma occurring in maxillary anterior region in a 33-year-old male patient presented as painless swelling clinically appearing similar to a periapical or nasopalatine cyst. The final diagnosis of this lesion was made after microscopic examination of biopsy specimen.

  1. Usurering af osteosyntesemateriale gennem øsofagus efter anterior cervikalkirurgi

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  2. Esthetic smile rehabilitation of anterior teeth by treatment with biomimetic restorative materials: a case report

    Directory of Open Access Journals (Sweden)

    Gouveia TH

    2017-05-01

    Full Text Available Thayla Hellen Nunes Gouveia, Jéssica Dias Theobaldo, Waldemir Francisco Vieira-Junior, Débora Alves Nunes Leite Lima, Flávio Henrique Baggio Aguiar Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Campinas, SP, Brazil Background: In daily clinical practice, esthetics of anterior teeth is a common presenting complaint of patients.Objective: This case report discusses the management of asymmetric smile associated with unsatisfactory extensive composite restorations and describes a clinical protocol using the direct composite resin for smile enhancement to restore the dental harmony of anterior teeth.Methods: The treatment planning was based on a diagnostic wax-up and cosmetic mock-up. After clinical and patient approvals were obtained, the patient was subjected to direct and indirect restorative treatment.Conclusion: Nanocomposites are an effective alternative for anterior teeth restorations. Additionally, good planning enables satisfactory esthetic results, leading to the correction of an inappropriate axial inclination of incisors. Keywords: composite, adhesive, smile, esthetic, restoration

  3. Segmentation and Quantification for Angle-Closure Glaucoma Assessment in Anterior Segment OCT.

    Science.gov (United States)

    Fu, Huazhu; Xu, Yanwu; Lin, Stephen; Zhang, Xiaoqin; Wong, Damon Wing Kee; Liu, Jiang; Frangi, Alejandro F; Baskaran, Mani; Aung, Tin

    2017-09-01

    Angle-closure glaucoma is a major cause of irreversible visual impairment and can be identified by measuring the anterior chamber angle (ACA) of the eye. The ACA can be viewed clearly through anterior segment optical coherence tomography (AS-OCT), but the imaging characteristics and the shapes and locations of major ocular structures can vary significantly among different AS-OCT modalities, thus complicating image analysis. To address this problem, we propose a data-driven approach for automatic AS-OCT structure segmentation, measurement, and screening. Our technique first estimates initial markers in the eye through label transfer from a hand-labeled exemplar data set, whose images are collected over different patients and AS-OCT modalities. These initial markers are then refined by using a graph-based smoothing method that is guided by AS-OCT structural information. These markers facilitate segmentation of major clinical structures, which are used to recover standard clinical parameters. These parameters can be used not only to support clinicians in making anatomical assessments, but also to serve as features for detecting anterior angle closure in automatic glaucoma screening algorithms. Experiments on Visante AS-OCT and Cirrus high-definition-OCT data sets demonstrate the effectiveness of our approach.

  4. Nonarteritic anterior ischemic optic neuropathy associated with interferon and ribavirin in a patient with hepatitis C.

    Science.gov (United States)

    Sharif, Walid; Sheikh, Khayam; De Silva, Ian; Elsherbiny, Samer

    2017-04-01

    To report a case of a temporal artery biopsy negative anterior ischemic optic neuropathy associated with a recently completed course of pegylated interferon 2 α with ribavirin for chronic hepatitis C. Despite the early presentation with symptoms and prompt treatment with systemic intravenous steroids the patient experienced deterioration of their optic neuropathy over the following few days. Although nonarteritic anterior ischemic optic neuropathy is a common disorder with known risk factors, the timing of onset of symptoms in our patient was suggestive of a possible etiology related to treatment with ribavirin and interferon 2 α, as found in the previously reported cases. There have been a few reported cases of the association between the use of interferon/ribavirin for treatment of chronic hepatitis with nonarteritic anterior ischemic optic neuropathy. In these cases stopping the drug caused some improvement of symptoms or halting the progression of optic neuropathy. Having reviewed the literature on previous cases, we postulate that there may be a dose related reaction to explain the delay and deterioration of vision in some cases despite stopping the drugs. We also advise that any person who is started on this treatment for chronic hepatitis are appropriately counselled as to the potential optic nerve side effect of the drug, based on the evidence reported in the literature.

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

    Science.gov (United States)

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

    2015-08-01

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

  6. Anterior and posterior erp rhyming effects in 3- to 5-year-old children

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    Annika Andersson

    2018-04-01

    Full Text Available During early literacy skills development, rhyming is an important indicator of the phonological precursors required for reading. To determine if neural signatures of rhyming are apparent in early childhood, we recorded event-related potentials (ERPs from 3- to 5-year-old, preliterate children (N = 62 in an auditory prime-target nonword rhyming paradigm (e.g., bly-gry, blane-vox. Overall, nonrhyming targets elicited a larger negativity (N450 than rhyming targets over posterior regions. In contrast, rhyming targets elicited a larger negativity than nonrhyming targets over fronto-lateral sites. The amplitude of the two rhyming effects was correlated, such that a larger posterior effect occurred with a smaller anterior effect. To determine whether these neural signatures of rhyming related to phonological awareness, we divided the children into two groups based on phonological awareness scores while controlling for age and socioeconomic status. The posterior rhyming effect was stronger and more widely distributed in the group with better phonological awareness, whereas differences between groups for the anterior effect were small and not significant. This pattern of results suggests that the rhyme processes indexed by the anterior effect are developmental precursors to those indexed by the posterior effect. Overall, these findings demonstrate early establishment of distributed neurocognitive networks for rhyme processing. Keywords: Rhyming effect, Event-related potentials, Phonological awareness, Preschoolers, Nonword processing

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

    Directory of Open Access Journals (Sweden)

    Jiu-hong MA

    2016-10-01

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

  8. Structural whole-brain covariance of the anterior and posterior hippocampus: Associations with age and memory.

    Science.gov (United States)

    Nordin, Kristin; Persson, Jonas; Stening, Eva; Herlitz, Agneta; Larsson, Elna-Marie; Söderlund, Hedvig

    2018-02-01

    The hippocampus (HC) interacts with distributed brain regions to support memory and shows significant volume reductions in aging, but little is known about age effects on hippocampal whole-brain structural covariance. It is also unclear whether the anterior and posterior HC show similar or distinct patterns of whole-brain covariance and to what extent these are related to memory functions organized along the hippocampal longitudinal axis. Using the multivariate approach partial least squares, we assessed structural whole-brain covariance of the HC in addition to regional volume, in young, middle-aged and older adults (n = 221), and assessed associations with episodic and spatial memory. Based on findings of sex differences in both memory and brain aging, we further considered sex as a potential modulating factor of age effects. There were two main covariance patterns: one capturing common anterior and posterior covariance, and one differentiating the two regions by capturing anterior-specific covariance only. These patterns were differentially related to associative memory while unrelated to measures of single-item memory and spatial memory. Although patterns were qualitatively comparable across age groups, participants' expression of both patterns decreased with age, independently of sex. The results suggest that the organization of hippocampal structural whole-brain covariance remains stable across age, but that the integrity of these networks decreases as the brain undergoes age-related alterations. © 2017 Wiley Periodicals, Inc.

  9. Three-Dimensional Reconstruction of Post-Traumatic Deficient Anterior Maxilla.

    Science.gov (United States)

    Rachmiel, Adi; Shilo, Dekel; Aizenbud, Dror; Pen, Mark; Rachmiel, Dana; Emodi, Omri

    2017-12-01

    Maxillary retrognathism appears in 14.3% of patients exhibiting malocclusion after trauma treatment. This report describes the application of alveolar distraction osteogenesis (ADO) for treating the severely deficient anterior maxilla after trauma injuries in the vertical and anteroposterior planes. This is a retrospective study of patients exhibiting severe vertical and anteroposterior maxillary bone deficiency after trauma injuries and treated by ADO as a first stage with additional Le Fort I advancement when required. Predictor variables included ADO for alveolar augmentation and Le Fort I advancement for anteroposterior discrepancy after ADO. Outcome variables included dental implant failure and anteroposterior maxillary relations. Twelve patients with severe atrophic anterior maxilla secondary to trauma injuries were included and treated using ADO. In accordance to the size of the horizontal deficiency, 1 or 2 distractors were used. Vertical alveolar distraction was performed and the transported segments were elongated at a rate of 0.5 mm/day to a mean total of 13.9 mm (12 to 15 mm). In 4 of 12 cases, there was a severe anteroposterior discrepancy larger than 8 mm that could not be fully corrected using an anterior inclination during the vertical elongation. Therefore, a second stage of conventional Le Fort I advancement was performed. Thirty-eight dental implants were inserted, with a survival rate of 97.37% (median follow-up, 6.2 yr). This report describes treatment of the deficient anterior maxilla after trauma injuries in the vertical and anteroposterior planes, including implant-based dental rehabilitation. The main advantages include simultaneous bone and mucosa augmentation, no donor site morbidity, considerably higher vertical augmentation compared with other methods, and minimal relapse. Using an additional Le Fort I advancement in severe cases permits a useful method for proper repositioning of the maxilla, thus resulting in superior

  10. Brain-derived neurotrophic factor signaling and subgenual anterior cingulate cortex dysfunction in major depressive disorder.

    Science.gov (United States)

    Tripp, Adam; Oh, Hyunjung; Guilloux, Jean-Philippe; Martinowich, Keri; Lewis, David A; Sibille, Etienne

    2012-11-01

    The subgenual anterior cingulate cortex is implicated in the pathology and treatment response of major depressive disorder. Low levels of brain-derived neurotrophic factor (BDNF) and reduced markers for GABA function, including in the amygdala, are reported in major depression, but their contribution to subgenual anterior cingulate cortex dysfunction is not known. Using polymerase chain reaction, we first assessed the degree to which BDNF controls mRNA expression (defined as BDNF dependency) of 15 genes relating to GABA and neuropeptide functions in the cingulate cortex of mice with reduced BDNF function (BDNF-heterozygous [Bdnf(+/-)] mice and BDNF exon-IV knockout [Bdnf(KIV)] mice). Gene expression was then quantified in the subgenual anterior cingulate cortex of 51 postmortem subjects with major depressive disorder and comparison subjects (total subjects, N=102; 49% were women) and compared with previous amygdala results. Based on the results in Bdnf(+/-) and Bdnf(KIV) mice, genes were sorted into high, intermediate, and no BDNF dependency sets. In postmortem human subjects with major depression, BDNF receptor (TRKB) expression, but not BDNF, was reduced. Postmortem depressed subjects exhibited down-regulation in genes with high and intermediate BDNF dependency, including markers of dendritic targeting interneurons (SST, NPY, and CORT) and a GABA synthesizing enzyme (GAD2). Changes extended to BDNF-independent genes (PVALB and GAD1). Changes were greater in men (potentially because of low baseline expression in women), displayed notable differences from prior amygdala results, and were not explained by demographic or clinical factors other than sex. These parallel human/mouse analyses provide direct (low TRKB) and indirect (low expression of BDNF-dependent genes) evidence in support of decreased BDNF signaling in the subgenual anterior cingulate cortex in individuals with major depressive disorder, implicate dendritic targeting GABA neurons and GABA synthesis

  11. Arthroscopic repair of acute traumatic anterior shoulder dislocation in young athletes.

    Science.gov (United States)

    Larrain, M V; Botto, G J; Montenegro, H J; Mauas, D M

    2001-04-01

    To compare the results of arthroscopic repair in acute anterior shoulder traumatic dislocation with those of nonoperative treatment. A prospective nonrandomized study was performed. Between August 1989 and April 1997, 46 patients were seen after a first episode of traumatic anterior shoulder dislocation. The average age was 21 years (range, 17 to 27 years). Most dislocations were in rugby players (36 patients). There were 18 patients treated by nonoperative methods and 28 patients treated by acute arthroscopic repair; 22 patients using transglenoid suture and 6 patients with bone anchor suture fixation. Of the patients treated nonoperatively, 94.5% suffered a redislocation between 4 and 18 months (average, 6 months). In the operative group, 96% of the patients (27) obtained excellent results according to the Rowe scale. Only 1 patient suffered a redislocation 1 year after surgery. Three different types of lesions were found during surgery: group I, capsular tear with no labrum lesion (4%); group II, capsular tear with partial labrum detachment (32%); and group III, capsular tear and full anterior labrum detachment (64%). The average follow-up was 67.4 months (range, 28 to 120). There were no surgical complications. The operative group obtained 96% excellent results, but the nonoperative group only obtained 5.5% excellent results, according to the Rowe scale. The nonoperative group showed a high incidence of redislocation (94.5%) compared with the operative group (4%). Based on the findings of this study, we recommend using an arthroscopic evaluation and repair after an initial anterior traumatic shoulder dislocation in young athletes.

  12. MR imaging of subscapularis tendon injury in the setting of anterior shoulder dislocation

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    Gyftopoulos, Soterios; Carpenter, Elizabeth; Kazam, Jonathan; Babb, James; Bencardino, Jenny [NYU Hospital for Joint Diseases, New York, NY (United States)

    2012-11-15

    To evaluate the degree and location patterns of subscapularis tendon injury in patients with prior anterior shoulder dislocation (ASD). Forty-five consecutive MR shoulder examinations in patients with a history of ASD and 20 consecutive MR examinations in patients without prior dislocation were reviewed. Two readers assessed for the presence and location of tendinosis and tearing in the subscapularis tendon, which was divided into three segments: superior, middle, and inferior. The readers also documented the presence of anterior labral tears, osseous Bankart defects and Hill-Sachs lesions. Fisher's exact tests were performed to analyze the different types of pathology and their locations. Subscapularis tendinosis, and partial thickness and full thickness tears were more common in patients with a history of ASD. Tendinosis was found in 60-64.4% of the dislocation patients compared with 40% of the non-dislocation group. When stratified by location, the middle and inferior thirds were the most commonly affected with statistical significance (p < 0.05) found in tearing of the inferior third. Anterior labral tears, osseous Bankart defects, and Hill-Sachs lesions were more common in the dislocation group with statistically significant associations with tendinosis in the middle and inferior thirds and tearing of the middle third (p < 0.05). Our study suggests an association between middle and inferior subscapularis tendon pathology and prior anterior shoulder dislocation. Based on our results, careful MR assessment of the subscapularis tendon by the radiologist is indicated in the setting of ASD as injury of this structure can be symptomatic and may be amenable to treatment. (orig.)

  13. MR imaging of subscapularis tendon injury in the setting of anterior shoulder dislocation

    International Nuclear Information System (INIS)

    Gyftopoulos, Soterios; Carpenter, Elizabeth; Kazam, Jonathan; Babb, James; Bencardino, Jenny

    2012-01-01

    To evaluate the degree and location patterns of subscapularis tendon injury in patients with prior anterior shoulder dislocation (ASD). Forty-five consecutive MR shoulder examinations in patients with a history of ASD and 20 consecutive MR examinations in patients without prior dislocation were reviewed. Two readers assessed for the presence and location of tendinosis and tearing in the subscapularis tendon, which was divided into three segments: superior, middle, and inferior. The readers also documented the presence of anterior labral tears, osseous Bankart defects and Hill-Sachs lesions. Fisher's exact tests were performed to analyze the different types of pathology and their locations. Subscapularis tendinosis, and partial thickness and full thickness tears were more common in patients with a history of ASD. Tendinosis was found in 60-64.4% of the dislocation patients compared with 40% of the non-dislocation group. When stratified by location, the middle and inferior thirds were the most commonly affected with statistical significance (p < 0.05) found in tearing of the inferior third. Anterior labral tears, osseous Bankart defects, and Hill-Sachs lesions were more common in the dislocation group with statistically significant associations with tendinosis in the middle and inferior thirds and tearing of the middle third (p < 0.05). Our study suggests an association between middle and inferior subscapularis tendon pathology and prior anterior shoulder dislocation. Based on our results, careful MR assessment of the subscapularis tendon by the radiologist is indicated in the setting of ASD as injury of this structure can be symptomatic and may be amenable to treatment. (orig.)

  14. Meningiomas of the Anterior Clinoid Process: Is It Wise to Drill Out the Optic Canal?

    Science.gov (United States)

    Sughrue, Michael; Kane, Ari; Rutkowski, Martin J; Berger, Mitchel S

    2015-01-01

    Introduction: Meningiomas of the anterior clinoid process are uncommon tumors, acknowledged by most experienced surgeons to be among the most challenging meningiomas to completely remove. In this article, we summarize our institutional experience removing these uncommon and challenging skull base meningiomas. Methods: We analyzed the clinical outcomes of patients undergoing surgical removal of anterior at our institution over an 18-year period. We characterized the radiographic appearance of these tumors and related tumor features to symptoms and ability to obtain a gross total resection. We also analyzed visual outcomes in these patients, focusing on visual outcomes with and without optic canal unroofing. Results: We identified 29 patients with anterior clinoid meningiomas who underwent surgical resection at our institution between 1991 and 2007. The median length of follow-up was 7.5 years (range: 2.0 to 18.6 years). Similar to others, we found gross total resection was seldom safely achievable in these patients. Despite this, only 1/20 of patients undergoing subtotal resection without immediate postoperative radiosurgery experienced tumor progression. The optic canal was unroofed in 18/29 patients in this series, while in 11/29 patients it was not. Notably, all five patients experiencing visual improvement underwent optic canal unroofing, while three of four patients experiencing visual worsening did not. Conclusions:  These data provide some evidence suggesting that unroofing the optic canal in anterior clinoid meningiomas might improve visual outcomes in these patients. PMID:26487997

  15. Automated analysis of angle closure from anterior chamber angle images.

    Science.gov (United States)

    Baskaran, Mani; Cheng, Jun; Perera, Shamira A; Tun, Tin A; Liu, Jiang; Aung, Tin

    2014-10-21

    To evaluate a novel software capable of automatically grading angle closure on EyeCam angle images in comparison with manual grading of images, with gonioscopy as the reference standard. In this hospital-based, prospective study, subjects underwent gonioscopy by a single observer, and EyeCam imaging by a different operator. The anterior chamber angle in a quadrant was classified as closed if the posterior trabecular meshwork could not be seen. An eye was classified as having angle closure if there were two or more quadrants of closure. Automated grading of the angle images was performed using customized software. Agreement between the methods was ascertained by κ statistic and comparison of area under receiver operating characteristic curves (AUC). One hundred forty subjects (140 eyes) were included, most of whom were Chinese (102/140, 72.9%) and women (72/140, 51.5%). Angle closure was detected in 61 eyes (43.6%) with gonioscopy in comparison with 59 eyes (42.1%, P = 0.73) using manual grading, and 67 eyes (47.9%, P = 0.24) with automated grading of EyeCam images. The agreement for angle closure diagnosis between gonioscopy and both manual (κ = 0.88; 95% confidence interval [CI), 0.81-0.96) and automated grading of EyeCam images was good (κ = 0.74; 95% CI, 0.63-0.85). The AUC for detecting eyes with gonioscopic angle closure was comparable for manual and automated grading (AUC 0.974 vs. 0.954, P = 0.31) of EyeCam images. Customized software for automated grading of EyeCam angle images was found to have good agreement with gonioscopy. Human observation of the EyeCam images may still be needed to avoid gross misclassification, especially in eyes with extensive angle closure. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  16. The effectiveness of Pilates for partial anterior cruciate ligament injury.

    Science.gov (United States)

    Çelik, Derya; Turkel, Nilgun

    2017-08-01

    This study explored the effects of Pilates on the muscle strength, function, and instability of patients with partial anterior cruciate ligament (ACL) injuries in situations in which a non-surgical treatment option is preferred. Fifty participants 20-45 years of age who were diagnosed with isolated ACL injuries were included in the study. The participants were randomly assigned to either the Pilates exercise group (n = 24) or the control group (n = 26). The subjects in the Pilates exercise group performed basic mat exercises that focused on the muscle strength and flexibility of the lower limbs and core muscles during each class session, which met three times per week for 12 weeks. The control group did not receive any treatment or home exercise programme. All patients were evaluated using the Lysholm Knee Scale, the Cincinnati Knee Rating System, and isokinetic quadriceps and hamstring strength. Patient satisfaction regarding improvement in knee stability was assessed using the Global Rating of Change scale. The Pilates group experienced significant improvement over the control group as measured by the difference in quadriceps strength at 12 weeks (p = 0.03). Both groups showed some clinical change over time, but the Pilates group improved for all outcome measurements at the 12-week follow-up, and the control group only improved for functional outcomes. Patient satisfaction with the level of knee stability based on the Global Rating of Change scale was higher in the Pilates group than in the control group. Although both groups exhibited improvements in knee strength and functional outcomes, the results suggest that Pilates is a superior management approach over a control treatment for increasing quadriceps strength in participants with partial ACL injury. Pilates may provide clinicians a novel option when choosing a treatment for a partial ACL injury. Further study is needed to determine whether certain subgroups of individuals might achieve an added

  17. Insuficiência tricúspide pós trauma associada a agnesia de músculo papilar anterior Post-traumatic tricuspid insufficiency associated with agenesis of the anterior papillary muscle

    Directory of Open Access Journals (Sweden)

    Ronaldo Ducceschi FONTES

    2000-09-01

    Full Text Available Relatamos o caso de paciente do sexo masculino com 36 anos de idade com sinais e sintomas de insuficiência cardíaca direita. A história revelou trauma torácico há aproximadamente cinco anos. Submetido a operação para tratamento de insuficiência tricúspide, notou-se ausência do músculo papilar anterior da valva tricúspide, fenda na cúspide anterior e dilatação do anel tricuspídeo. Foi realizada sutura da fenda localizada na cúspide anterior e feita sua sustentação utilizando-se tira de pericárdio bovino fixada na face atrial e base do músculo papilar posterior. A operação foi completada com anuloplastia de Revuelta. O paciente obteve nítida melhora dos sintomas no pós-operatório imediato, mantendo-se em classe funcional I (NYHA, após 22 meses de evolução.Tricuspid regurgitation arising from chest trauma five years earlier was successfully corrected by valve reconstruction in a 36 year-old man. During correction a fissure of the anterior leaflet, absence of the anterior papillary muscle, chordae tendineae and tricuspid annulus dilatation were found. Tricuspid valvuloplasty was feasible using an anchored suture of the anterior leaflet fissure, artificial bovine chordae, pericardium implantation and Revuelta ring annuloplasty. There were no complications and no early or late mortality. At 22 months follow-up tricuspid valve function has remained with mild regurgitation. The patient is in good clinical condition.

  18. [The "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for anterior decompression at upper cervical spine].

    Science.gov (United States)

    Wu, Xiang-Yang; Zhang, Zhe; Wu, Jian; Lü, Jun; Gu, Xiao-Hui

    2009-11-01

    To investigate the "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for the exposure and decompression and instrumentation of the upper cervical spine. From Jan. 2000 to July 2008, 5 patients with upper cervical spinal injuries were treated by surgical operation included 4 males and 1 female with and average age of 35 years old ranging from 16 to 68 years. There were 2 cases of Hangman's fractures (type II ), 2 of C2.3 intervertebral disc displacement and 1 of C2 vertebral body tuberculosis. All patients underwent the upper cervical anterior retropharyngeal approach through the "window" between the hypoglossal nerve and the superior laryngeal nerve and pharynx and carotid artery. Two patients of Hangman's fractures underwent the C2,3 intervertebral disc discectomy, bone graft fusion and internal fixation. Two patients of C2,3 intervertebral disc displacement underwent the C2,3 intervertebral disc discectomy, decompression bone graft fusion and internal fixation. One patient of C2 vertebral body tuberculosis was dissected and resected and the focus and the cavity was filled by bone autografting. C1 anterior arch to C3 anterior vertebral body were successful exposed. Lesion resection or decompression and fusion were successful in all patients. All patients were followed-up for from 5 to 26 months (means 13.5 months). There was no important vascular and nerve injury and no wound infection. Neutral symptoms was improved and all patient got successful fusion. The "window" surgical exposure surgical technique of the upper cervical anterior retropharyngeal approach is a favorable strategy. This approach strategy can be performed with full exposure for C1-C3 anterior anatomical structure, and can get minimally invasive surgery results and few and far between wound complication, that is safe if corresponding experience is achieved.

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

    Science.gov (United States)

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

    2016-04-01

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

  20. Sphincter-saving extrasphincteric rectal dissection and proximal segmental sphincteric excision techniques by using combined abdominal and transvaginal anterior perineal access in female patients who have lower rectal cancer (Transvaginal low anterior rectal resection

    Directory of Open Access Journals (Sweden)

    Ali Naki Yücesoy

    2017-10-01

    Full Text Available Background: Combined abdominal and transvaginal anterior perineal approaches have been used as an alternative surgical method for the surgical treatment of the lower rectal cancer. The main aim of this paper is to describe the surgical stages of the combined abdominal and transvaginal approaches performed for lower rectal cancer, especially in transvaginal anterior perineal stage. Method: We have performed sphincter-saving surgical operations by using transvaginal anterior perineal access by combining with the abdominal access in four female patients who had lower rectal cancer. Results: Sphincter-saving extrasphincteric dissection and proximal segmental sphincteric excision techniques were performed in four female patients operated with combined abdominal and transvaginal anterior perineal approach. All patients were found to have continence. Postoperatively, one patient was converted to abdominoperineal rectal amputation due to the detected distal resection margin positivity. Conclusion: Transvaginal anterior perineal access provides the extrasphincteric rectal dissection possibility in the ischioanal fossa. Therefore, the combined abdominal and transvaginal anterior perineal approaches have been based on the different anatomical and surgical features when compared to intersphincteric dissection technique which is the most common used surgical procedure in lower rectal cancer surgery. Resumo: Introdução: Uma combinação de abordagens abdominal e perineal anterior transvaginal tem sido empregada como método cirúrgico alternativo para o tratamento cirúrgico do câncer de reto baixo. O principal objetivo do presente artigo é a descrição dos estágios cirúrgicos das abordagens abdominal e transvaginal combinadas realizadas para câncer de reto baixo, especialmente no estágio perineal anterior transvaginal. Método: Realizamos operações cirúrgicas com preservação de esfíncter com o uso do acesso perineal anterior transvaginal, em

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

    Sufficient area in the interforaminal region is required for dental implant placement, and the anterior loop of the mandibular canal is located within the limits of this area. The aim of this study was to evaluate the prevalence and extent of the anterior loop in a Brazilian sample population using cone-beam computed tomography (CBCT). CBCT images from 250 patients (500 hemimandibles) obtained for various clinical indications were randomly selected and evaluated to determine the presence and length of the anterior loop. The length of the anterior loop was then compared based on gender, age, and the side of the mandible. The data were analyzed using the Pearson chi-square test and linear regression analysis. An anterior loop was identified in 41.6% of the cases, and its length ranged from 0.25 mm to 4.00 mm (mean, 1.1±0.8 mm). The loop had a greater mean length and was significantly more prevalent in males (p=0.014). No significant differences were found between the right and left sides regarding length (p=0.696) or prevalence (p=0.650). In this study, a high prevalence of the anterior loop of the mandibular canal was found, and although its length varied greatly, in most cases it was less than 1 mm long. Although this is a prevalent anatomical variation, safety limits for the placement of implants in this region cannot be established before an accurate evaluation using imaging techniques in order to identify and preserve the neurovascular bundles.

  2. Visual Internal Urethrotomy in the Management of Anterior Urethral ...

    African Journals Online (AJOL)

    Objective: Urethral stricture disease is common in our environment. The aim of this study is to report our experience with visual internal urethrotomy (VIU) in the management of this disease. Patients and Methods: Seventy male patients with a mean age of 30.6 years were treated for anterior urethral stricture by VIU at the Jos ...

  3. [A case of double monster--duplicitas anterior with diprosopia].

    Science.gov (United States)

    Meyer, R

    1983-01-01

    Report on a delivery of a double monster, duplicitas anterior with diprosopia. The course of delivery is compared with literature. The exclusion of malformations in early pregnancy is possible and necessary. Perinatal mortality can be reduced by abortion in time. The psychic burden of women concerned needs a special regard.

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

    Science.gov (United States)

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

    2014-03-01

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

  5. Anterior Cingulate Cortex in Schema Assimilation and Expression

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Aldona J. Spiegel, MD

    2013-11-01

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

  7. current concepts in the management of anterior urethral strictures

    African Journals Online (AJOL)

    iam

    such as calculi, urethral hair and stent encrustation which may be useful in ... and 7 o'clock to the prostatic urethra, 3 and 9 o'clock ... anterior urethra the use of stents is limited to but ... take such as radiotherapy, peripheral vascular disease.

  8. Bacteriology of the Anterior Genitalia of the Domestic House Cat ...

    African Journals Online (AJOL)

    The bacteriology of the anterior genitalia of the domestic house cat was determined using vaginal swabs collected from sixty apparently healthy female domestic cats (20 kittens, 20 pregnant and 20 non-pregnant adults). The swabs were streaked on blood agar, Mac Conkey agar and eosin methylene blue agar plates ...

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

    Science.gov (United States)

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

    2015-05-01

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

  10. Ocular Adnexal and Anterior Segment Manifestations of HIV/AIDS ...

    African Journals Online (AJOL)

    Background: Benue State has the highest rate of sero-prevalence to human immuno virus (HIV) infections among the ten hyper-endemic states in Nigeria. This study evaluates the pattern of ocular adnexal and anterior segment manifestations in HIV/AIDS patients attending the HIV clinic at the NAF Hospital in Makurdi, ...

  11. Quadriceps Strength and Anterior Knee Pain following Tibia ...

    African Journals Online (AJOL)

    2017-07-17

    Jul 17, 2017 ... prior history of knee pain, but had unilateral tibiofibular fracture, who had internal fixation with ... It may take several months for healing and subsequent .... time after surgery and those with anterior knee pain may never get ...

  12. Genetic studies in congenital anterior midline cervical cleft

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sugahara M

    2013-05-01

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

  14. Quadriceps strength and anterior knee pain following tibia ...

    African Journals Online (AJOL)

    The tension generated on extension of the knee against a resistance using tensiometer was measured in Newton. The ranges of motion of the knees were documented, as well as Lysholm score which measures activities and document the presence and limitation caused by anterior knee pain. Results: A total of 36 patients ...

  15. Modified protrusion arch for anterior crossbite correction - a case report.

    Science.gov (United States)

    Roy, Abhishek Singha; Singh, Gulshan Kr; Tandon, Pradeep; Chaudhary, Ramsukh

    2013-01-01

    Borderline and mild skeletal Class III relationships in adult patients are usually treated by orthodontic camouflage. Reasonably rood results have been achieved with nonsurgical teatment of anterior crossbite. Class III malocclusion may be associated with mandibular prognathism, maxillary retrognathism, or both. Class III maxillary retrognathism generally involves anterior crossbite, which must be opened if upper labial brackets are to be bonded. If multiple teeth are in crossbite, after opening the bite usual step is to ligate forward or advancement arch made of 0.018" or 0.020" stainless steel or NiTi wire main arch that must be kept separated 2 mm from the slot ofupper incisor braces. Two stops or omegas are made 1 mm mesial to the tubes of the molar bands that will impede main arch from slipping,and in this manner the arch will push the anterior teeth forward Here we have fabricated a modified multiple loop protrusion arch to correct an anterior crossbite with severe crowding that was not amenable to correct by advancement arches.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  17. The concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction

    NARCIS (Netherlands)

    Hofbauer, M.; Muller, B. [=Bart; Murawski, C. D.; van Eck, C. F.; Fu, F. H.

    2014-01-01

    To describe the concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction. The PubMed/Medline database was searched using keywords pertaining to ACL reconstruction. Relevant articles were reviewed in order to summarize important concepts of individualized surgery in ACL

  18. Management of anterior urethral strictures with buccal mucosa: Our ...

    African Journals Online (AJOL)

    Abdelwahab Elkassaby

    2016-03-02

    Mar 2, 2016 ... face of the cheeks from the line of contact of the opposing lips anteriorly to the line of ... as catheterization and endoscopic procedures, but it decreases with ... But with detailed history, most of these patients are found to have tolerated ..... central tendon of the perineum, the bulbo-spongiosum muscle and.

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

    Directory of Open Access Journals (Sweden)

    Leonardo Provetti Cunha

    2014-04-01

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

  20. Giant primary synovial sarcoma of the anterior mediastinum: A case ...

    African Journals Online (AJOL)

    Primary synovial sarcoma is a very rare tumor of the mediastinum, which is unreported in the entire subcontinent of West Africa, and presents daunting challenges from diagnosis to management with lack of standard management strategies. We present a case of primary monophasic synovial sarcoma of the anterior ...

  1. Anastomotic leakage after anterior resection for rectal cancer

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    On the basis of the literature about anastomotic leakage after anterior resection for rectal cancer a review is presented of the frequency, potential risk factors and consequences of leakage. The risk factors are evaluated according to the level of scientific evidence of the individual background...

  2. Porcine skin collagen implants for anterior vaginal wall prolapse

    DEFF Research Database (Denmark)

    Hviid, Ulla; Hviid, Thomas; Rudnicki, Peter Martin

    2010-01-01

    INTRODUCTION AND HYPOTHESIS: The effect of a Pelvicol graft compared with a conventional anterior vaginal repair was evaluated in this randomised controlled study. METHODS: Only patients with a stage II or higher (Ba >or= -1) defect were included. RESULTS: Thirty-one patients were allocated to a ...

  3. Spindle neurons of the human anterior cingulate cortex

    Science.gov (United States)

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

    1995-01-01

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

  4. Histomorphological features of atherosclerosis in the left anterior ...

    African Journals Online (AJOL)

    The pattern of coronary artery atherosclerosis is valuable in informing mitigation strategies for coronary heart disease. Histomorphological data on this disease among Africans living in Sub Saharan Africa are, however, scarce. The left anterior descending is one of the most commonly afflicted arteries. This study, therefore ...

  5. Traumatic injuries to the anterior teeth of Nigerian urban public ...

    African Journals Online (AJOL)

    Falls (78.4%) and luxation/enamel fracture (31.9%) accounted for the majority of the injuries. Upper jaw (86.6%) and upper central incisors (75.5%) suffered traumatic anterior injuries most often. Conclusion: Within the limitations of the study, traumatic dental injuries were fairly common and it is suggested that preventive ...

  6. Anterior palatal island advancement flap for bone graft coverage ...

    African Journals Online (AJOL)

    ... Palatal Island Advancement Flap was effective in bone graft coverage in premaxillary edentulous area. Conclusion: It can be used as an aid for bone graft coverage of premaxillary edentulous ridge, where the need for mucosa is small in width but long in length. Keywords: Anterior maxilla, bone graft, dental implant, ...

  7. Brachial plexus injury in anterior dislocation of shoulder -case report ...

    African Journals Online (AJOL)

    Brachial plexus injury in anterior dislocation of shoulder -case report and literature review. D Dhar. Abstract. No Abstract. Nigerian Journal of Orthopaedics and Trauma Vol. 6 () 2007: pp. 37-38. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  8. Pericardial effusion presenting as an anterior mediastinal mass

    International Nuclear Information System (INIS)

    Schlesinger, A.E.; Fernbach, S.K.; Northwestern Univ., Chicago, IL

    1986-01-01

    The authors present a case of pericardial effusion in a patient with previous cardiac surgery. Because the pericardium is opened and not reclosed during surgery, fluid can extend superior to the normal upper reflections of the pericardium and simulate an anterior mediastinal mass. (orig.)

  9. ANTERIOR SUPERIOR DISLOCATION OF THE HIP JOINT: A ...

    African Journals Online (AJOL)

    Owing to the ligamentous and muscle forces around the hip, it is only rarely ... operating table, the femoral head was exposed via an anterior approach and found just below the sartorius muscle. The ligamentum teres was found avulsed, and the iliopubic .... of the socket tearing the iliofemoral ligament in the process, or ...

  10. Anastomoselaekage efter lav anterior resektion for cancer recti

    DEFF Research Database (Denmark)

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

    1997-01-01

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

  11. Anterior Weqatal in the Hebrew Bible and the Qumran Documents

    DEFF Research Database (Denmark)

    Siegismund, Kasper

    2017-01-01

    weqatal in Qumran are examined. In the larger, relatively non-fragmentary texts, scholars examining the verbal system of Qumran Hebrew have noticed an almost complete absence of this form. This contribution draws the attention to the use of anterior weqatal in other, more fragmentary texts, evaluating...... of Qumran Hebrew as a deliberately archaizing literary language are tentatively proposed....

  12. Hypospadiac Duplication of Anterior Urethra-a Rare Congenital Anomaly.

    Science.gov (United States)

    Goyal, Bhawana; Gupta, Suresh; Goyal, Parag

    2017-02-01

    Duplication of the urethra is a complex and rarely seen congenital anomaly with three anatomic variants: epispadiac (dorsal), hypospadiac (ventral), and Y-type. We report here a case of hypospadiac duplication of anterior urethra with dorsal blind ending urethra in a 9-year-old boy who presented with complaint of passing urine from the ventral aspect of penis.

  13. Anterior Colporrhaphy Technique and Approach Choices: Turkey Evaluation

    Directory of Open Access Journals (Sweden)

    Serdar Aydın

    2016-09-01

    Full Text Available Aim: To evaluate the diversity in techniques and approaches for anterior colporrhaphy among operators in Turkey. Methods: A survey evaluating the preoperative examination, technique of anterior colporrhaphy, operation choice and postoperative care was presented to surgeons. We contacted via directly, mail or telephone. We used 28 item questionnaire. Results: Majority (87.9% was composed of young gynecologists. Urologists composed of the 9.5% of the study population. The rate of paravaginal defect evaluation was 75.9% and mostly by inspection the presence of vaginal rugae. The use of transperineal 3D pelvic floor ultrasonography was low (5.7%. The evaluation of levator ani muscle defect was 46.6%. The usage of the transperineal 3D ultrasonography for levator ani muscle defect was 19 percent of operators. There were diversity in use of hydrodissection, fascial plication, excision of vaginal mucosa and suture choice. Usage of mesh for anterior colporrhaphy was limited (17.8% and mostly in recurrent cases (12.2%. Paravaginal defect repair rate was 31.9%. The urinary catheter was generally removed one or two day after operation. Vaginal pack usually removed 24 hours after. Conclusion: Several techniques and approaches for anterior vaginal wall repair among operators in Turkey. The variety of techniques suggested that there is no consensus on best surgical technique.

  14. Extrinsic stretching narrowing and anterior indentation of the rectosigmoid junction

    International Nuclear Information System (INIS)

    Schulman, A.; Fataar, S.

    1979-01-01

    Thirty-five cases of extrinsic narrowing or anterior indentation of the rectosigmoid junction (RSJ) have been studied. The RSJ lies directly behind the pouch of Douglas which is a favoured site for peritoneal metastasis, abscess and endometriosis. Any space-occupying lesion of sufficient size at this site will indent the anterior aspects of the RSJ. Causes include distension or tumour of the ileum or sigmoid colon, gross ascites (when the patient is erect), and tumours below the pelvic peritonium, such as gynaecological neoplasm and internal iliac artery aneurysm. When a desmoplastic metastasis in the pouch of Douglas infiltrates the outer layers of the RSJ, the fibrosis produces an eccentric shortening on its anterior aspect, which in turn causes a pleating of the mucosa with the folds radiating towards the shortened area. This is also seen with primary pelvic carcinomas directly adherent to the rectum, endometriosis with repeated bleeding and increasing eccentric, submucosal fibrosis, and chronic abscess in the pouch of Douglas. Not all extrinsic narrowing of the RSJ are pathological. One case of anterior indentation followed operation for rectal prolapse. Ten additional cases showed narrowing due to a technical artefact air-distended colon rising into the upper abdomen to cause stretching at the RSJ. As with ascites, this narrowing due to 'high-rise sigmoid' disappeared when the patients became recumbent and the colonic air redistributed. (author)

  15. Passive Anterior Tibial Subluxation in the Setting of Anterior Cruciate Ligament Injuries: A Comparative Analysis of Ligament-Deficient States.

    Science.gov (United States)

    McDonald, Lucas S; van der List, Jelle P; Jones, Kristofer J; Zuiderbaan, Hendrik A; Nguyen, Joseph T; Potter, Hollis G; Pearle, Andrew D

    2017-06-01

    Static anterior tibial subluxation after an anterior cruciate ligament (ACL) injury highlights the abnormal relationship between the tibia and femur in patients with ACL insufficiency, although causal factors including injuries to secondary stabilizers or the time from injury to reconstruction have not been examined. To determine static relationships between the tibia and femur in patients with various states of ACL deficiency and to identify factors associated with anterior tibial subluxation. Cross-sectional study; Level of evidence, 3. Patients treated for ACL injuries were identified from an institutional registry and assigned to 1 of 4 cohorts: intact ACL, acute ACL disruption, chronic ACL disruption, and failed ACL reconstruction (ACLR). Anterior tibial subluxation of the medial and lateral compartments relative to the femoral condyles were measured on magnetic resonance imaging (MRI), and an MRI evaluation for meniscal tears, chondral defects, and injuries to the anterolateral ligament (ALL) was performed. One hundred eighty-six ACL-insufficient knees met inclusion criteria, with 26 patients without an ACL injury utilized as a control group. In the lateral compartment, the mean anterior tibial subluxation measured 0.78 mm for the control group (n = 26), 2.81 mm for the acute ACL injury group (n = 74), 3.64 mm for the chronic ACL injury group (n = 40), and 4.91 mm for the failed ACLR group (n = 72). In the failed ACLR group, 37.5% of patients demonstrated lateral compartment anterior subluxation ≥6 mm, and 11.1% of this group had anterior subluxation of the lateral compartment ≥10 mm. Multivariate regression revealed that the presence of both medial and lateral chondral defects was associated with a mean 1.09-mm increase in subluxation of the medial compartment ( P = .013). The combination of medial and lateral meniscal tears was an independent predictor of increased lateral tibia subluxation by 1.611 mm ( P = .0022). Additionally, across all knee states

  16. Pembuatan Cantilever Bridge Anterior Rahang Atas sebagai Koreksi Estetik

    Directory of Open Access Journals (Sweden)

    Yusrina Sumartati

    2012-12-01

    Full Text Available Latar belakang. Kehilangan gigi anterior rahang atas mengakibatkan gangguan fungsi fonetik dan estetik. Gangguan fungsi estetik menyebabkan pasie menjadi rendah diri. Kondisi ini dapat diatasi oleh dokter gigi, salah satunya dengan pembuatan cantilever bridge. Tujuan. Penulisan ini yaitu untuk memberi informasi bahwa pada kasus kehilangan gigi-gigi anterior rahang atas dengan space yang telah menyempit dan malposisi gigi dapat dibuatkan protesa berupa gigi tiruan cekat dengan desain cantilever bridge. Kasus dan perawatan. Laporan kasus ini membahas tentang pasien perempuan umur 39 tahun yang datang ke Rumah Sakit Gigi dan Mulut Prof. Soedomo, dengan keluhan merasa kurang percaya diri karena gigi depan rahang atas hilang sejak 5 tahun yang lalu akibat kecelakaan. Gigi-gigi anterior rahang atas yang masih ada mengalami malposisi akibat pemakaian gigi tiruan sebagian lepasan yang tidak baik. Perawatan yang dilakukan adalah dengan pembuatan cantilever bridge pada gigi 11, 12, 13 dan 21, 22, 23. Kesimpulan. Gangguan fungsi estetik pada gigi anterior rahang atas dapat diatasi dengan pembuatan cantilever bridge.   Background. Maxillary anteriortooth loss resulting in impaired function of phonetic and aesthetic. Impaired function of aesthetic cause patients to become self conscious. This condition can be treated by a dentist, one with a cantilever bridge. Purpose. To inform that in case of missing anterior teeth of the upper jaw with a space that has been narrowed, and malposition of teeth can be made prosthesis denture fixed bridge with a cantilever design. Case and treatment. This case report discusses the 39 years old female patient who came to he Dental Hospital Prof. Soedomo, with complaints of feeling less confident due to the maxillary front teeth missing since 5 years ago due to an accident. Anterior teeth of the upper jaw are still experiencing malposition due to the use of removable partial dentures are not good. The treatment is done is by

  17. Osteología craneal del género Philodryas (Serpentes: Colubridae

    Directory of Open Access Journals (Sweden)

    Lobo, Fernando

    1994-01-01

    Full Text Available We studied the skulls of eleven species of Philodryas. The skull of Philodryas patagoniensis is described, and some characters that show interspecific variation are recognized. These characters are used for phylogenetic inferences. We obtained three trees using Hennig86. The pair of sister species wich is presented in the three cladograms is P. mattogrossensis - P. varius: in only ene tree: P. buroni - P. burmeisteri.

  18. Anterior transposition of the radial nerve--a cadaveric study.

    Science.gov (United States)

    Yakkanti, Madhusudhan R; Roberts, Craig S; Murphy, Joshua; Acland, Robert D

    2008-01-01

    The radial nerve is at risk during the posterior plating of the humerus. The purpose of this anatomic study was to assess the extent of radial nerve dissection required for anterior transposition through the fracture site (transfracture anterior transposition). A cadaver study was conducted approaching the humerus by a posterior midline incision. The extent of dissection of the nerve necessary for plate fixation of the humerus fracture was measured. An osteotomy was created to model a humeral shaft fracture at the spiral groove (OTA classification 12-A2, 12-A3). The radial nerve was then transposed anterior to the humeral shaft through the fracture site. The additional dissection of the radial nerve and the extent of release of soft tissue from the humerus shaft to achieve the transposition were measured. Plating required a dissection of the radial nerve 1.78 cm proximal and 2.13 cm distal to the spiral groove. Transfracture anterior transposition of the radial nerve required an average dissection of 2.24 cm proximal and 2.68 cm distal to the spiral groove. The lateral intermuscular septum had to be released for 2.21 cm on the distal fragment to maintain laxity of the transposed nerve. Transfracture anterior transposition of the radial nerve before plating is feasible with dissection proximal and distal to the spiral groove and elevation of the lateral intermuscular septum. Potential clinical advantages of this technique include enhanced fracture site visualization, application of broader plates, and protection of the radial nerve during the internal fixation.

  19. Histologic Anatomy of the Anterior Vagina and Urethra.

    Science.gov (United States)

    Mazloomdoost, Donna; Westermann, Lauren B; Mutema, George; Crisp, Catrina C; Kleeman, Steven D; Pauls, Rachel N

    Vaginal and urethral histology is important to understanding the pathophysiology of the pelvic floor. En bloc removal of 4 female cadaveric pelvises was performed, with 18 to 25 serial sections obtained from each. The vaginal and urethral lengths were divided into distal and proximal sections; urethra was divided into anterior and posterior segments as well. Innervation and vasculature were qualified as small and large and quantified per high-power field. The mean vaginal length was 7.45 cm, and the mean urethral length was 3.38 cm. A distinct vaginal fibromuscular layer was noted, without evidence of a dense sheet of continuous collagen. An epithelial, lamina propria, and muscular layer surrounded the urethral lumen. Adipose and loose fibroconnective tissue separated the urethra from the anterior vagina in 41% of slides. Nerves and vasculature were concentrated in the lamina propria. More small nerves and vessels were grossly seen compared with larger counterparts in both the vagina and urethra. No significant differences in layer thickness, innervation, or vasculature were observed along the vaginal length. The posterior urethra had greater innervation than did the anterior (P = 0.012). The distal posterior urethra had more large vessels than did the proximal posterior urethra (P = 0.03). No other differences were noted in urethral sections. A vaginal fibromuscular layer was confirmed, refuting a true fascia. Innervation and vasculature were quantitatively the same along the anterior vagina. However, the posterior urethra had greater innervation than did anterior and is most innervated proximally. Nerve and vascular histology may relate to pelvic floor disorder etiology.

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

    Directory of Open Access Journals (Sweden)

    Eha Djulaeha

    2009-12-01

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

  1. Diagnóstico e tratamento do lenticone anterior

    Directory of Open Access Journals (Sweden)

    Ana Luiza Biancardi

    2011-08-01

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

  2. Anterior Lens Capsule and Iris Thicknesses in Pseudoexfoliation Syndrome.

    Science.gov (United States)

    Batur, Muhammed; Seven, Erbil; Tekin, Serek; Yasar, Tekin

    2017-11-01

    The aim of this study was to evaluate anatomic properties of the lens capsule and iris by anterior segment optical coherence tomography (AS-OCT) in patients with pseudoexfoliation (PEX). This prospective study included 62 eyes of 62 patients with PEX syndrome and 43 eyes of 43 age- and gender-matched controls. All subjects underwent full ophthalmologic examinations including AS-OCT. Pupillary diameter, midperipheral stromal iris thickness, central and temporal lens capsule thicknesses, and peripheral pseudoexfoliation material thickness on the anterior lens capsule surface were measured and recorded. Mean age was 66.8 ± 9.3 years in the PEX group and 65.5 ± 8.9 years in the control group (p = 0.44). The PEX group consisted of 62 patients: 38 men (61.3%) and 24 women (38.7%); the control group included 43 subjects: 25 men (58.1%) and 18 women (41.9%). Pupillary diameter after pharmacologic mydriasis was 21% smaller in the PEX group than controls. Mean midperipheral iris thickness was 36 ± 7.2 μm (7.8%) thinner in the PEX group than that of control group (p = 0.047). The central anterior capsule was a mean of 3.40 ± 0.51 μm (18%) thicker in the PEX group compared to the control group (p = 0.0001). The temporal anterior lens capsule was a mean of 0.17 ± 0.15 μm thicker in the PEX group compared to the control group (p = 0.81). With high-resolution OCT imaging, it has become possible to evaluate the anterior lens capsule without histologic examination and demonstrate that it is thicker than normal in PEX patients.

  3. Lower gray matter density and functional connectivity in the anterior insula in smokers compared with never smokers.

    Science.gov (United States)

    Stoeckel, Luke E; Chai, Xiaoqian J; Zhang, Jiahe; Whitfield-Gabrieli, Susan; Evins, A Eden

    2016-07-01

    Although nicotine addiction is characterized by both structural and functional abnormalities in brain networks involved in salience and cognitive control, few studies have integrated these data to understand how these abnormalities may support addiction. This study aimed to (1) evaluate gray matter density and functional connectivity of the anterior insula in cigarette smokers and never smokers and (2) characterize how differences in these measures were related to smoking behavior. We compared structural magnetic resonance imaging (MRI) (gray matter density via voxel-based morphometry) and seed-based functional connectivity MRI data in 16 minimally deprived smokers and 16 matched never smokers. Compared with controls, smokers had lower gray matter density in left anterior insula extending into inferior frontal and temporal cortex. Gray matter density in this region was inversely correlated with cigarettes smoked per day. Smokers exhibited negative functional connectivity (anti-correlation) between the anterior insula and regions involved in cognitive control (left lPFC) and semantic processing/emotion regulation (lateral temporal cortex), whereas controls exhibited positive connectivity between these regions. There were differences in the anterior insula, a central region in the brain's salience network, when comparing both volumetric and functional connectivity data between cigarette smokers and never smokers. Volumetric data, but not the functional connectivity data, were also associated with an aspect of smoking behavior (daily cigarettes smoked). © 2015 Society for the Study of Addiction.

  4. Lower grey matter density and functional connectivity in the anterior insula in smokers compared to never-smokers

    Science.gov (United States)

    Stoeckel, Luke E.; Chai, Xiaoqian J.; Zhang, Jiahe; Whitfield-Gabrieli, Susan; Evins, A. Eden

    2015-01-01

    Rationale While nicotine addiction is characterized by both structural and functional abnormalities in brain networks involved in salience and cognitive control, few studies have integrated these data to understand how these abnormalities may support addiction. Objectives (1) To evaluate grey matter density and functional connectivity of the anterior insula in cigarette smokers and never-smokers and (2) characterize how differences in these measures related to smoking behavior. Methods We compared structural MRI (grey matter density via voxel-based morphometry) and seed-based functional connectivity MRI data in 16 minimally deprived smokers and 16 matched never-smokers. Results Compared to controls, smokers had lower grey matter density in left anterior insula extending into inferior frontal and temporal cortex. Grey matter density in this region was inversely correlated with cigarettes smoked per day. Smokers exhibited negative functional connectivity (anti-correlation) between the anterior insula and regions involved in cognitive control (left lateral prefrontal cortex) and semantic processing / emotion regulation (lateral temporal cortex), whereas controls exhibited positive connectivity between these regions. Conclusions There were differences in the anterior insula, a central region in the brain’s salience network, when comparing both volumetric and functional connectivity data between cigarette smokers and never smokers. Volumetric data, but not the functional connectivity data, was also associated with an aspect of smoking behavior (daily cigarettes smoked). PMID:25990865

  5. Korean standard of postero-anterior cephalography

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    Ahn, Hyung Kyu [College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1974-11-15

    The author conducted an experiment using P-A Cephalography of 242 male and female subjects of ages ranging 2-6, 7- 15, and adult group. By means of Nakago's method of measurement, the standard value of Korean was obtained. The results were as follows; 1. In the group of an age, the male value was slightly greater than female value. 2. In each age group the difference between the right and left widths could be recognizable, however, it was not much great. 3. In each group, regardless of sex, the growth relation was clearly distinguishable at PO, ARI, ARE, MG, AG, and CAW. 4. When the standard value of adult Korean was compared with that of Japanese, that of Japanese was great with respect to the width of maxillary portion and that of Korean was great with respect to the width of mandibular portion. 5. Maximum head width of white man was almost similar to that of Korean, however, maxillary alveolar base width of white man was considerably small or the dental arch was narrow.

  6. Evaluation of the anterior chamber angle in glaucoma: a report by the american academy of ophthalmology.

    Science.gov (United States)

    Smith, Scott D; Singh, Kuldev; Lin, Shan C; Chen, Philip P; Chen, Teresa C; Francis, Brian A; Jampel, Henry D

    2013-10-01

    To assess the published literature pertaining to the association between anterior segment imaging and gonioscopy and to determine whether such imaging aids in the diagnosis of primary angle closure (PAC). Literature searches of the PubMed and Cochrane Library databases were last conducted on July 6, 2011. The searches yielded 371 unique citations. Members of the Ophthalmic Technology Assessment Committee Glaucoma Panel reviewed the titles and abstracts of these articles and selected 134 of possible clinical significance for further review. The panel reviewed the full text of these articles and identified 79 studies meeting the inclusion criteria, for which the panel methodologist assigned a level of evidence based on a standardized grading scheme adopted by the American Academy of Ophthalmology. Three, 70, and 6 studies were rated as providing level I, II, and III evidence, respectively. Quantitative and qualitative parameters defined from ultrasound biomicroscopy (UBM), anterior segment optical coherence tomography (OCT), Scheimpflug photography, and the scanning peripheral anterior chamber depth analyzer (SPAC) demonstrate a strong association with the results of gonioscopy. There is substantial variability in the type of information obtained from each imaging method. Imaging of structures posterior to the iris is possible only with UBM. Direct imaging of the anterior chamber angle (ACA) is possible using UBM and OCT. The ability to acquire OCT images in a completely dark environment allows greater sensitivity in detecting eyes with appositional angle closure. Noncontact imaging using OCT, Scheimpflug photography, or SPAC makes these methods more attractive for large-scale PAC screening than contact imaging using UBM. Although there is evidence suggesting that anterior segment imaging provides useful information in the evaluation of PAC, none of these imaging methods provides sufficient information about the ACA anatomy to be considered a substitute for

  7. Knee Kinematics During Noncontact Anterior Cruciate Ligament Injury as Determined From Bone Bruise Location.

    Science.gov (United States)

    Kim, Sophia Y; Spritzer, Charles E; Utturkar, Gangadhar M; Toth, Alison P; Garrett, William E; DeFrate, Louis E

    2015-10-01

    The motions causing noncontact anterior cruciate ligament (ACL) injury remain unclear. Tibiofemoral bone bruises are believed to be the result of joint impact near the time of ACL rupture. The locations and frequencies of these bone bruises have been reported, but there are limited data quantifying knee position and orientation near the time of injury based on these contusions. Knee position and orientation near the time of noncontact ACL injury include extension and anterior tibial translation. Descriptive laboratory study. Magnetic resonance images of 8 subjects with noncontact ACL injuries were acquired within 1 month of injury and were subsequently analyzed. All subjects exhibited bruises on both the femur and tibia in both medial and lateral compartments. The outer margins of bone and the bone bruise surfaces were outlined on each image to create a 3-dimensional model of each subject's knee in its position during magnetic resonance imaging (MRI position). Numerical optimization was used to maximize overlap of the bone bruises on the femur and tibia and to predict the position of injury. Flexion angle, valgus orientation, internal tibial rotation, and anterior tibial translation were measured in both the MRI position and the predicted position of injury. Differences in kinematics between the MRI position, which served as an unloaded reference, and the predicted position of injury were compared by use of paired t tests. Flexion angle was near full extension in both the MRI position and the predicted position of injury (8° vs 12°; P = .2). Statistically significant increases in valgus orientation (5°; P = .003), internal tibial rotation (15°; P = .003), and anterior tibial translation (22 mm; P injury relative to the MRI position. These results suggest that for the bone bruise pattern studied, landing on an extended knee is a high risk for ACL injury. Extension was accompanied by increased anterior tibial translation (22 mm), internal tibial rotation (15

  8. A Newly Defined Area of the Mouse Anterior Hypothalamus Involved in Septohypothalamic Circuit: Perifornical Area of the Anterior Hypothalamus, PeFAH.

    Science.gov (United States)

    Horii-Hayashi, Noriko; Nishi, Mayumi

    2018-02-27

    Although the hypothalamus is classified into more than 10 compartments, it still contains uncharacterized areas. In this study, we identified a new triangular-shaped area between the paraventricular hypothalamic nucleus (PVN) and the fornix area in the mouse anterior hypothalamus, which is enriched in chondroitin sulfate proteoglycans (CSPGs). We designated this region as the perifornical area of the anterior hypothalamus (PeFAH) based on its anatomical location. As evidenced by Nissl staining, the PeFAH was distinguishable as an area of relatively low density. Immunohistochemical and DNA microarray analyses indicated that PeFAH contains sparsely distributed calretinin-positive neurons and densely clustered enkephalin-positive neurons. Furthermore, the PeFAH was shown to have bidirectional neural connections with the lateral septum. Indeed, we confirmed enkephalinergic projections from PeFAH neurons to the lateral septum, and inversely, calbindin-positive lateral septum neurons as afferents to the PeFAH. Finally, c-Fos expression analysis revealed that the activity of certain PeFAH neuronal populations tended to be increased by psychological stressors, but not that of enkephalinergic neurons. We proposed PeFAH as a new region in the AH.

  9. Tratamiento ortodóncico-quirúrgico de una adaquia anterior Orthodontic-surgical treatment of anterior open bite

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    Anselmo López Rodríguez

    2004-08-01

    Full Text Available En la práctica y desarrollo de la cirugía ortognática en el Hospital Universitario "Comandante Manuel Fajardo" a lo largo de los años, la morbilidad de diferentes anomalías del desarrollo maxilo-mandibulares ha mostrado que la adaquia o mordida abierta anterior es bastante frecuente. Desde tempranas edades se detectan y son tratadas por el especialista en Ortodoncia. El cerrar una adaquia en ocasiones se torna difícil y es cuando el análisis del paciente debe realizarse en el grupo multidisciplianrio integrado por cirujanos maxilofaciales, ortodoncistas y protesistas. Se han detectado diferentes causas que pueden producir una adaquia y en su mayor parte son hábitos nocivos que perduran en el paciente; por ejemplo, la interferencia con el centro de crecimiento condilar, la succión del pulgar, la deglución atípica o lengua protractil, la respiración bucal, entre otras. Este trabajo está encaminado en mostrar los diferentes tratamientos que en la actualidad se emplean para reducir una mordida abierta anterior y presenta el caso de una niña de 14 años de edad portadora de una adaquia de más de 18 mm.In the context of orthognathic surgery practice and development at "Comandante Manuel Fajardo" university hospital, morbidity from several anomalies in the maxillomandibular growth has shown that anterior open bite is pretty common. Such anomalies are detected and treated by the orthodontist at early childhood. To close an anterior open bite is difficult sometimes and requires the analysis of the patient by a multidisciplinary group made up of maxillofacial surgeons, orthodontists and denture specialists. A number of causes may be the origin of anterior open bite, mainly harmful habits that persist in the patient such as interference with the condylar growth center, dummy sucking, atypical deglutition or proctatile tongue, mouth breathing, among others. This paper is aimed at showing different therapies that presently reduce anterior open

  10. Cornea and anterior eye assessment with placido-disc keratoscopy, slit scanning evaluation topography and scheimpflug imaging tomography.

    Science.gov (United States)

    Martin, Raul

    2018-03-01

    Current corneal assessment technologies make the process of corneal evaluation extremely fast and simple and several devices and technologies allow to explore and to manage patients. The purpose of this special issue is to present and also to update in the evaluation of cornea and ocular surface and this second part, reviews a description of the corneal topography and tomography techniques, providing updated information of the clinical recommendations of these techniques in eye care practice. Placido-based topographers started an exciting anterior corneal surface analysis that allows the development of current corneal tomographers that provide a full three-dimensional reconstruction of the cornea including elevation, curvature, and pachymetry data of anterior and posterior corneal surfaces. Although, there is not an accepted reference standard technology for corneal topography description and it is not possible to determine which device produces the most accurate topographic measurements, placido-based topographers are a valuable technology to be used in primary eye care and corneal tomograhers expanding the possibilities to explore cornea and anterior eye facilitating diagnosis and follow-up in several situations, raising patient follow-up, and improving the knowledge regarding to the corneal anatomy. Main disadvantages of placido-based topographers include the absence of information about the posterior corneal surface and limited corneal surface coverage without data from the para-central and/or peripheral corneal surface. However, corneal tomographers show repeatable anterior and posterior corneal surfaces measurements, providing full corneal thickness data improving cornea, and anterior surface assessment. However, differences between devices suggest that they are not interchangeable in clinical practice.

  11. Assessment of the anterior loop of mental nerve in an Iranian population using cone beam computed tomography scan

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    Mitra Karbasi Kheir

    2017-01-01

    Conclusion: Great care is required when placing implants in proximity to mental foramen to avoid anterior loop injury. Because of the variations of anterior loop length in each patient, a fixed distance anterior to the mental foramen is not safe, and the anterior loop length should be determined for each individual. The use of CBCT provides accurate measurements of the length of anterior loop.

  12. Mechanisms for noncontact anterior cruciate ligament injuries: knee joint kinematics in 10 injury situations from female team handball and basketball.

    Science.gov (United States)

    Koga, Hideyuki; Nakamae, Atsuo; Shima, Yosuke; Iwasa, Junji; Myklebust, Grethe; Engebretsen, Lars; Bahr, Roald; Krosshaug, Tron

    2010-11-01

    The mechanism for noncontact anterior cruciate ligament injury is still a matter of controversy. Video analysis of injury tapes is the only method available to extract biomechanical information from actual anterior cruciate ligament injury cases. This article describes 3-dimensional knee joint kinematics in anterior cruciate ligament injury situations using a model-based image-matching technique. Case series; Level of evidence, 4. Ten anterior cruciate ligament injury video sequences from women's handball and basketball were analyzed using the model-based image-matching method. The mean knee flexion angle among the 10 cases was 23° (range, 11°-30°) at initial contact (IC) and had increased by 24° (95% confidence interval [CI], 19°-29°) within the following 40 milliseconds. The mean valgus angle was neutral (range, -2° to 3°) at IC, but had increased by 12° (95% CI, 10°-13°) 40 milliseconds later. The knee was externally rotated 5° (range, -5° to 12°) at IC, but rotated internally by 8° (95% CI, 2°-14°) during the first 40 milliseconds, followed by external rotation of 17° (95% CI, 13°-22°). The mean peak vertical ground-reaction force was 3.2 times body weight (95% CI, 2.7-3.7), and occurred at 40 milliseconds after IC (range, 0-83). Based on when the sudden changes in joint angular motion and the peak vertical ground-reaction force occurred, it is likely that the anterior cruciate ligament injury occurred approximately 40 milliseconds after IC. The kinematic patterns were surprisingly consistent among the 10 cases. All players had immediate valgus motion within 40 milliseconds after IC. Moreover, the tibia rotated internally during the first 40 milliseconds and then external rotation was observed, possibly after the anterior cruciate ligament had torn. These results suggest that valgus loading is a contributing factor in the anterior cruciate ligament injury mechanism and that internal tibial rotation is coupled with valgus motion. Prevention

  13. FIXED OR REMOVABLE APPLIANCE FOR EARLY ORTHODONTIC TREATMENT OF FUNCTIONAL ANTERIOR CROSSBITE.

    Science.gov (United States)

    Wiedel, Anna-Paulina

    2015-01-01

    Anterior crossbite with functional shift also called pseudo Class III is a malocclusion in which the incisal edges of one or more maxillary incisors occlude with the incisal edges of the mandibular incisors in centric relationship: the mandible and mandibular incisors are then guided anteriorly in central occlusion resulting in an anterior crossbite. Early correction, at the mixed dentition stage, is recommended, in order to avoid a compromising dentofacial condition which could result in the development of a true Class III malocclusion and temporomandibular symptoms. Various treatment options are available. The method of choice for orthodontic correction of this condition should not only be clinically effective, with long-term stability, but also cost-effective and have high patient acceptance, i.e. minimal perceived pain and discomfort. At the mixed dentition stage, the condition may be treated by fixed (FA) or removable appliance (RA). To date there is insufficient evidence to determine the preferred method. The overall aim of this thesis was therefore to compare and evaluate the use of FA and RA for correcting anterior crossbite with functional shift in the mixed dentition, with special reference to clinical effectiveness, stability, cost-effectiveness and patient perceptions. Evidence-based, randomized controlled trial (RCT) methodology was used, in order to generate a high level of evidence. The thesis is based on the following studies: The material comprised 64 patients, consecutively recruited from the Department of Orthodontics, Faculty of Odontology, Malmö University, Sweden and from one Public Dental Health Service Clinic in Malmö, Skane County Council, Sweden. The patients were no syndrome and no cleft patients. The following inclusion criteria were applied: early to late mixed dentition, anterior crossbite affecting one or more incisors with functional shift, moderate space deficiency in the maxilla, no inherent skeletal Class III discrepancy, ANB

  14. Ipsilateral open anterior hip dislocation and open posterior elbow dislocation in an adult

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    Kumar Sunil

    2014-02-01

    Full Text Available 【Abstract】Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.

  15. Complete Obstruction of Endotracheal Tube in an Infant with a Retropharyngeal and Anterior Mediastinal Abscess

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    Dennis B. Thapa

    2017-01-01

    Full Text Available Intraoperative ventilatory failure is not an uncommon complication; however, acute endotracheal obstruction by a foreign body or blood clot can be difficult to quickly discriminate from other causes. Once the diagnosis is made, quick action is needed to restore ventilation. The ultimate solution is to exchange the endotracheal tube; however, there can be other ways of resolving this in situations where reintubation would be difficult or unsafe. This case report discusses such an event in an infant with multiple airway challenges including a retropharyngeal and anterior mediastinal abscess. We have also formulated a pathway based on various case reports involving complete ETT obstruction.

  16. Complete Obstruction of Endotracheal Tube in an Infant with a Retropharyngeal and Anterior Mediastinal Abscess.

    Science.gov (United States)

    Thapa, Dennis B; Greene, Nathaniel H; Udani, Andrea G

    2017-01-01

    Intraoperative ventilatory failure is not an uncommon complication; however, acute endotracheal obstruction by a foreign body or blood clot can be difficult to quickly discriminate from other causes. Once the diagnosis is made, quick action is needed to restore ventilation. The ultimate solution is to exchange the endotracheal tube; however, there can be other ways of resolving this in situations where reintubation would be difficult or unsafe. This case report discusses such an event in an infant with multiple airway challenges including a retropharyngeal and anterior mediastinal abscess. We have also formulated a pathway based on various case reports involving complete ETT obstruction.

  17. Three-dimensional kinematic and kinetic gait deviations in individuals with chronic anterior cruciate ligament deficient knee: A systematic review and meta-analysis.

    Science.gov (United States)

    Ismail, Shiek Abdullah; Button, Kate; Simic, Milena; Van Deursen, Robert; Pappas, Evangelos

    2016-06-01

    Altered joint motion that occurs in people with an anterior cruciate ligament deficient knee is proposed to play a role in the initiation of knee osteoarthritis, however, the exact mechanism is poorly understood. Although several studies have investigated gait deviations in individuals with chronic anterior cruciate ligament deficient knee in the frontal and transverse planes, no systematic review has summarized the kinematic and kinetic deviations in these two planes. We searched five electronic databases from inception to 14th October 2013, with key words related to anterior cruciate ligament, biomechanics and gait, and limited to human studies only. Two independent reviewers assessed eligibility based on predetermined inclusion/exclusion criteria and methodological quality was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology statement checklist. We identified 16 studies, totaling 183 subjects with anterior cruciate ligament deficient knee and 211 healthy subjects. Due to the variability in reported outcomes, we could only perform meta-analysis for 13 sagittal plane outcomes. The only significant finding from our meta-analysis showed that individuals with anterior cruciate ligament deficient knee demonstrated a significantly greater external hip flexor angular impulse compared to control (P=0.03). No consensus about what constitutes a typical walking pattern in individuals with anterior cruciate ligament deficient knee can be made, nor can conclusions be derived to explain if gait deviations in the frontal and transverse plane contributed to the development of the knee osteoarthritis among this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

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

    2017-04-01

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

  19. Diffusion tensor imaging of the anterior cruciate ligament graft.

    Science.gov (United States)

    Van Dyck, Pieter; Froeling, Martijn; De Smet, Eline; Pullens, Pim; Torfs, Michaël; Verdonk, Peter; Sijbers, Jan; Parizel, Paul M; Jeurissen, Ben

    2017-11-01

    A great need exists for objective biomarkers to assess graft healing following ACL reconstruction to guide the time of return to sports. The purpose of this study was to evaluate the feasibility and reliability of diffusion tensor imaging (DTI) to delineate the anterior cruciate ligament (ACL) graft and to investigate its diffusion properties using a clinical 3T scanner. DTI of the knee (b = 0, 400, and 800 s/mm 2 , 10 diffusion directions, repeated 16 times for a total of 336 diffusion-weighted volumes) was performed at 3T in 17 patients between 3 and 7 months (mean, 4 months) following ACL reconstruction. Tractography was performed by two independent observers to delineate the ACL graft. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were calculated within the graft. Interrater reliability was assessed using the intraclass correlation coefficient (ICC) and the scan-rescan reproducibility was evaluated based on the percentage coefficient of variance (%CV) across 20 repetition bootknife samples. In all subjects, tractography of the ACL graft was feasible. Quantitative evaluation of the diffusion properties of the ACL graft yielded the following mean ± SD values: FA = 0.23 ± 0.04; MD = 1.30 ± 0.11 × 10 -3 mm 2 /s; AD = 1.61 ± 0.12 × 10 -3 mm 2 /s, and RD = 1.15 ± 0.11 × 10 -3 mm 2 /s. Interrater reliability for the DTI parameters was excellent (ICC = 0.91-0.98). Mean %CVs for FA, MD, AD, and RD were 4.6%, 3.5%, 3.7%, and 4.4%, respectively. We demonstrated the feasibility and reliability of DTI for the visualization and quantitative evaluation of the ACL graft at 3T. 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1423-1432. © 2017 International Society for Magnetic Resonance in Medicine.

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

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    Jalalian E.

    2007-07-01

    Full Text Available Background and Aim: Considering flexural strength of fiber-reinforced composites (FRC and also the role of conservative cavities in protecting sound tissue of abutments, the aim of this study was to evaluate the fracture resistance of these bridges by handmade samples in vitro.Materials and Methods: In this experimental in vitro study, 44 sound newly extracted teeth were used to make 22 fixed inlay bridges including 11 three unit anterior upper inlay bridges substituting clinical model of upper central and 11 three unit posterior lower inlay bridges substituting clinical model of lower first molar. Specimens were prepared with FRC and mounted with artificial PDL in acryl. Cases were exposed to final load by using Universal Testing Machine (Instron 1195 with the speed of 1 mm/min. Statistical analysis was performed by Kolmogorov- Smirnov, independent sample T and Kaplan-Meier tests with p<0.05 as the level of significance.Results: Based on the statistical tests, the 95% confidence interval of mean was 450-562 N in anterior and  1473- 1761 N in posterior area. Fracture strength was high in the studied groups. Fractures in both groups occurred on composite facing, and the framework remained intact. The highest percentage of fracture in posterior teeth was in the middle of pontic towards the distal connector and in the anterior teeth in the lateral connector, between central pontic and lateral abutment. Using the independent sample T  test a significant statistical difference was observed between two groups (P<0.001. The fracture resistance of anterior samples was lower than the posterior ones.Conclusion: Based on the results of this study regarding the high fracture resistance in both areas FRC inlay bridges could be recommended for upper anterior and lower posterior teeth in clinical dentistry certainly more studies are needed to ascertain this treatment option.

  1. Influence of Bundle Diameter and Attachment Point on Kinematic Behavior in Double Bundle Anterior Cruciate Ligament Reconstruction Using Computational Model

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    Oh Soo Kwon

    2014-01-01

    Full Text Available A protocol to choose the graft diameter attachment point of each bundle has not yet been determined since they are usually dependent on a surgeon’s preference. Therefore, the influence of bundle diameters and attachment points on the kinematics of the knee joint needs to be quantitatively analyzed. A three-dimensional knee model was reconstructed with computed tomography images of a 26-year-old man. Based on the model, models of double bundle anterior cruciate ligament (ACL reconstruction were developed. The anterior tibial translations for the anterior drawer test and the internal tibial rotation for the pivot shift test were investigated according to variation of bundle diameters and attachment points. For the model in this study, the knee kinematics after the double bundle ACL reconstruction were dependent on the attachment point and not much influenced by the bundle diameter although larger sized anterior-medial bundles provided increased stability in the knee joint. Therefore, in the clinical setting, the bundle attachment point needs to be considered prior to the bundle diameter, and the current selection method of graft diameters for both bundles appears justified.

  2. Anterior Chamber-Associated Immune Deviation (ACAID: An Acute Response to Ocular Insult Protects from Future Immune-Mediated Damage?

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    Robert E. Cone

    2009-01-01

    Full Text Available The “immune privilege” that inhibits immune defense mechanisms that could lead to damage to sensitive ocular tissue is based on the expression of immunosuppressive factors on ocular tissue and in ocular fluids. In addition to this environmental protection, the injection of antigen into the anterior chamber or infection in the anterior chamber induces a systemic suppression of potentially damaging cell-mediated and humoral responses to the antigen. Here we discuss evidence that suggests that Anterior Chamber-Associated Immune Deviation (ACAID a is initiated by an ocular response to moderate inflammation that leads to a systemic immunoregulatory response. Injection into the anterior chamber induces a rise in TNF-α and MCP-1 in aqueous humor and an infiltration of circulating F4/80 + monocytes that home to the iris. The induction of ACAID is dependent on this infiltration of circulating monocytes that eventually emigrate to the thymus and spleen where they induce regulatory T cells that inhibit the inductive or effector phases of a cell-mediated immune response. ACAID therefore protects the eye from the collateral damage of an immune response to infection by suppressing a future potentially damaging response to infection.

  3. Differential Resting-State Connectivity Patterns of the Right Anterior and Posterior Dorsolateral Prefrontal Cortices (DLPFC in Schizophrenia

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    Natalia Chechko

    2018-05-01

    Full Text Available In schizophrenia (SCZ, dysfunction of the dorsolateral prefrontal cortex (DLPFC has been linked to the deficits in executive functions and attention. It has been suggested that, instead of considering the right DLPFC as a cohesive functional entity, it can be divided into two parts (anterior and posterior based on its whole-brain connectivity patterns. Given these two subregions' differential association with cognitive processes, we investigated the functional connectivity (FC profile of both subregions through resting-state data to determine whether they are differentially affected in SCZ. Resting-state magnetic resonance imaging (MRI scans were obtained from 120 patients and 172 healthy controls (HC at 6 different MRI sites. The results showed differential FC patterns for the anterior and posterior parts of the right executive control-related DLPFC in SCZ with the parietal, the temporal and the cerebellar regions, along with a convergent reduction of connectivity with the striatum and the occipital cortex. An increased psychopathology level was linked to a higher difference in posterior vs. anterior FC for the left IFG/anterior insula, regions involved in higher-order cognitive processes. In sum, the current analysis demonstrated that even between two neighboring clusters connectivity could be differentially disrupted in SCZ. Lacking the necessary anatomical specificity, such notions may in fact be detrimental to a proper understanding of SCZ pathophysiology.

  4. Anterior Segmental Distraction Osteogenesis in the Hypoplastic Cleft Maxilla

    Science.gov (United States)

    Rao (Janardhan), Sruthi; Kotrashetti, S. M.; Lingaraj, J. B.; Pinto, P. X.; Keluskar, K. M.; Jain, Siddharth; Sone, Piyush; Rao, Santhosh

    2013-01-01

    Orthognathic surgery and distraction osteogenesis play a prime role in the correction of maxillary hypoplasia in patients with cleft lip and palate (CLP). Advancement of the anterior maxilla alone without interfering with the velopharyngeal sphincter may be advantageous in cleft patients, who more commonly have speech deficits and dental crowding. We present a case series of anterior maxillary segmental distraction for maxillary hypoplasia in 5 CLP patients with a one-year follow-up. A custom-made tooth-borne distraction device with a hyrax screw positioned anteroposteriorly was used. The evaluation comprised of hard and soft tissue analysis and speech assessment. A stable occlusion with positive overjet and correction of dental-crowding without extraction was achieved at one year post-distraction. Facial profile and lip support improved. There was no deterioration in speech. PMID:23984033

  5. Nongranulomatous anterior uveitis in a patient with Usher syndrome.

    Science.gov (United States)

    Alzuhairy, Sultan Abdulaziz S; Alfawaz, Abdullah

    2013-10-01

    A 34-year-old female with Usher syndrome, but no family history of similar illness, presented with complaints of vision reduction, redness, and photophobia. Biomicroscopic examination showed mildly injected conjunctivae bilateral, small, round keratic precipitates; bilateral +2 cells with no flare reaction in the anterior chamber; and bilateral posterior subcapsular cataracts. No associated posterior synechiae, angle neovascularization, or iris changes were detected; normal intraocular pressures were obtained. Fundus examination demonstrated waxy pallor of both optic nerves, marked vasoconstriction in retinal vessels, and retinal bone spicule pigment formation, with a normal macula. Electroretinography confirmed the diagnosis of retinitis pigmentosa, optical coherent tomography was normal and otolaryngology consultation was conducted. To our knowledge, an association between Usher syndrome and bilateral nongranulomatous anterior uveitis has not been previously reported, and our purpose is to report this association.

  6. Prokaryotic adenylate cyclase toxin stimulates anterior pituitary cells in culture

    International Nuclear Information System (INIS)

    Cronin, M.J.; Evans, W.S.; Rogol, A.D.; Weiss, A.A.; Thorner, M.O.; Orth, D.N.; Nicholson, W.E.; Yasumoto, T.; Hewlett, E.L.

    1986-01-01

    Bordetella pertussis synthesis a variety of virulence factors including a calmodulin-dependent adenylate cyclase (AC) toxin. Treatment of anterior pituitary cells with this AC toxin resulted in an increase in cellular cAMP levels that was associated with accelerated exocytosis of growth hormone (GH), prolactin, adrenocorticotropic hormone (ACTH), and luteinizing hormone (LH). The kinetics of release of these hormones, however, were markedly different; GH and prolactin were rapidly released, while LH and ACTH secretion was more gradually elevated. Neither dopamine agonists nor somatostatin changes the ability of AC toxin to generate cAMP (up to 2 h). Low concentrations of AC toxin amplified the secretory response to hypophysiotrophic hormones. The authors conclude that bacterial AC toxin can rapidly elevate cAMP levels in anterior pituitary cells and that it is the response that explains the subsequent acceleration of hormone release

  7. BILATERAL SIMULTANEOUS ANTERIOR AND POSTERIOR LENTICONUS WITHOUT SYSTEMIC SIGNS

    Directory of Open Access Journals (Sweden)

    Hima Bindu

    2015-02-01

    Full Text Available A 21 year male came for eye checkup with a refractive error OD - 12.00 sph, - 2.25 @ 160° cyl and OS - 15.00 sph, - 2.50 @ 5°cyl and was referred to department of refractive surgery for opinion His BCVA in OD 6 / 18, OS 6/ 24. Slit lamp examination under dilation with phenylephrine plus tropic amide revealed the abnormal contour of the anterior and posterior lens capsule. Rest of the findings were normal with clear cornea, Von Herricks grade 3 deep anterior chamber, open angles in Gonioscopy. Retro illumination showed the typical’ oil droplet configuration’ in the lens. Retinal examination with the 90 D lens was otherwise normal except of the peculiar ‘OMEGA' shaped curving of the slit beam over the retina which occurred due the difference in the refractive power of the lens in the axial and paraxial zones of the lens

  8. What are patient goals after an anterior colporrhaphy operation?

    DEFF Research Database (Denmark)

    Kousgaard, Sabrina J; Bjørk, Jonna; Glavind, Karin

    2017-01-01

    OBJECTIVES: The aim of this study was to describe patient-reported goals after an anterior colporrhaphy operation for anterior vaginal wall prolapse, the fulfilment of goals, and the correlation with subjective patient-reported outcomes. STUDY DESIGN: A prospective study involving 100 women....... Preoperatively, patients completed three modified questions from the International Consultation on Incontinence Questionnaire - Vaginal Symptoms (ICIQ-VS) named ICIQ-VS short form (ICIQ-VS SF) and stated three goals for the operation. A telephone interview was performed 3 months postoperatively. RESULTS......: A Visual Analogue Scale (VAS) score from one to 10 estimated the extent to which goals were achieved. Goals were divided into eight groups: 1: mechanical symptoms (bulging), 2: voiding symptoms, 3: quality of life (physical), 4: quality of life (emotional), 5: avoidance of urinary tract infection, 6: cure...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-03-01

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

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

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  11. [Fractographic analysis of clinically failed anterior all ceramic crowns].

    Science.gov (United States)

    DU, Qian; Zhou, Min-bo; Zhang, Xin-ping; Zhao, Ke

    2012-04-01

    To identify the site of crack initiation and propagation path of clinically failed all ceramic crowns by fractographic analysis. Three clinically failed anterior IPS Empress II crowns and two anterior In-Ceram alumina crowns were retrieved. Fracture surfaces were examined using both optical stereo and scanning electron microscopy. Fractographic theory and fracture mechanics principles were applied to disclose the damage characteristics and fracture mode. All the crowns failed by cohesive failure within the veneer on the labial surface. Critical crack originated at the incisal contact area and propagated gingivally. Porosity was found within the veneer because of slurry preparation and the sintering of veneer powder. Cohesive failure within the veneer is the main failure mode of all ceramic crown. Veneer becomes vulnerable when flaws are present. To reduce the chances of chipping, multi-point occlusal contacts are recommended, and layering and sintering technique of veneering layer should also be improved.

  12. Case of prostate cancer with anterior localization multiparametric MRI study

    International Nuclear Information System (INIS)

    Georgiev, A.

    2016-01-01

    Prostate cancer most often originates from acinar epithelium. Most of the clinically palpable carcinomas are located predominantly in the rear/dorzo-lateraI zones of the gland, but the tumors in the transition zone anatomical may spread to the periphery. The detection of a neoplastic process in the front parts of the gland is rare and poses difficulties in diagnosis. We present a rare case of anterior location of prostate carcinoma with invasion of bladder, blood vessels and seminal vesicles. At present, diagnosis of prostate cancer in most men is demonstrated by elevated serum levels of prostate-specific antigen (PSA), or positive rectal examination or ultrasonography. Multi parametric MR study is a promising method for detecting prostate cancer. When used in conjunction with PSA values and rectal examination, MRI is increasingly accepted as a standard for the diagnosis and characterization of prostate carcinoma. Key words; Prostate Cancer. Anterior Localization. Multi Parametric MRI

  13. Transanal stent in anterior resection does not prevent anastomotic leakage

    DEFF Research Database (Denmark)

    Bülow, Steffen; Bulut, O; Christensen, Ib Jarle

    2006-01-01

    OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS...... completion of the operation the patients were randomized in two groups with and without a transanal stent. RESULTS: A clinically significant leakage was diagnosed in 25 patients (13%). No significant difference was found 17 of 98 patients with a stent and 8 of 96 without (P = 0.09), or in 9 of 44 ileostomy...... patients with a stent and in 3 of 45 without (P = 0.07). Several leaks over a short time led to an interim analysis after inclusion of 194 of 448 planned patients. The analysis showed no significant protective effect of the stent, and more leakages in the stent group, although not statistically significant...

  14. Complications and Management of Deep Anterior Lamellar Keratoplasty

    Directory of Open Access Journals (Sweden)

    Banu Torun Acar

    2014-10-01

    Full Text Available Objectives: To report the intraoperative and postoperative follow-up complications and management of these in deep anterior lamellar keratoplasty (DALK surgery. Materials and Methods: Two hundred eighty-four eyes of 252 patients followed up in our cornea clinic who underwent DALK using Anwar’s big-bubble technique with healthy Descemet’s membrane and endothelium were included in this study. Intraoperative and postoperative complications as well as the management and treatment of these complications were evaluated. Results: Big bubble was created in 220 (77.5% eyes of 284 eyes, and lamellar dissection was performed in 64 (22.5% eyes. Perforation occurred during trephination in 4 eyes, and the procedure was accomplished by penetrating keratoplasty (PK. Intraoperative microperforation occurred in 44 eyes. Perforation enlarged in 4 eyes and PK was performed. Operation was continued in 40 eyes with air injection into the anterior chamber. In postopertive follow-up period, double anterior chamber (DAC occurred in 32 of 40 eyes. DAC spontaneously regressed in 8 eyes, and air was given into the anterior chamber with a second surgical intervention in 24 eyes. DAC improved in 20 eyes. Four eyes underwent PK. Fungal keratitis evolved at the interface in one eye, because of no healing during the follow-up period, this eye underwent PK under antifungal therapy. Eyes with interface haze and Descemet’s membrane folds were followed. Conclusion: DALK is a difficult technique with a steep learning curve. In addition to the complications seen in PK, specific complications can occur in lamellar surgery. (Turk J Ophthalmol 2014; 44: 337-40

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

    Directory of Open Access Journals (Sweden)

    Choudhari Nikhil

    2010-01-01

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

  16. Decoding Pedophilia: Increased Anterior Insula Response to Infant Animal Pictures

    Directory of Open Access Journals (Sweden)

    Jorge Ponseti

    2018-01-01

    Full Text Available Previous research found increased brain responses of men with sexual interest in children (i.e., pedophiles not only to pictures of naked children but also to pictures of child faces. This opens the possibly that pedophilia is linked (in addition to or instead of an aberrant sexual system to an over-active nurturing system. To test this hypothesis we exposed pedophiles and healthy controls to pictures of infant and adult animals during functional magnetic resonance imaging of the brain. By using pictures of infant animals (instead of human infants, we aimed to elicit nurturing processing without triggering sexual processing. We hypothesized that elevated brain responses to nurturing stimuli will be found – in addition to other brain areas – in the anterior insula of pedophiles because this area was repeatedly found to be activated when adults see pictures of babies. Behavioral ratings confirmed that pictures of infant or adult animals were not perceived as sexually arousing neither by the pedophilic participants nor by the heathy controls. Statistical analysis was applied to the whole brain as well as to the anterior insula as region of interest. Only in pedophiles did infants relative to adult animals increase brain activity in the anterior insula, supplementary motor cortex, and dorsolateral prefrontal areas. Within-group analysis revealed an increased brain response to infant animals in the left anterior insular cortex of the pedophilic participants. Currently, pedophilia is considered the consequence of disturbed sexual or executive brain processing, but details are far from known. The present findings raise the question whether there is also an over-responsive nurturing system in pedophilia.

  17. Decoding Pedophilia: Increased Anterior Insula Response to Infant Animal Pictures.

    Science.gov (United States)

    Ponseti, Jorge; Bruhn, Daniel; Nolting, Julia; Gerwinn, Hannah; Pohl, Alexander; Stirn, Aglaja; Granert, Oliver; Laufs, Helmut; Deuschl, Günther; Wolff, Stephan; Jansen, Olav; Siebner, Hartwig; Briken, Peer; Mohnke, Sebastian; Amelung, Till; Kneer, Jonas; Schiffer, Boris; Walter, Henrik; Kruger, Tillmann H C

    2017-01-01

    Previous research found increased brain responses of men with sexual interest in children (i.e., pedophiles) not only to pictures of naked children but also to pictures of child faces. This opens the possibly that pedophilia is linked (in addition to or instead of an aberrant sexual system) to an over-active nurturing system. To test this hypothesis we exposed pedophiles and healthy controls to pictures of infant and adult animals during functional magnetic resonance imaging of the brain. By using pictures of infant animals (instead of human infants), we aimed to elicit nurturing processing without triggering sexual processing. We hypothesized that elevated brain responses to nurturing stimuli will be found - in addition to other brain areas - in the anterior insula of pedophiles because this area was repeatedly found to be activated when adults see pictures of babies. Behavioral ratings confirmed that pictures of infant or adult animals were not perceived as sexually arousing neither by the pedophilic participants nor by the heathy controls. Statistical analysis was applied to the whole brain as well as to the anterior insula as region of interest. Only in pedophiles did infants relative to adult animals increase brain activity in the anterior insula, supplementary motor cortex, and dorsolateral prefrontal areas. Within-group analysis revealed an increased brain response to infant animals in the left anterior insular cortex of the pedophilic participants. Currently, pedophilia is considered the consequence of disturbed sexual or executive brain processing, but details are far from known. The present findings raise the question whether there is also an over-responsive nurturing system in pedophilia.

  18. Microimplant in Lingual Tori to Correct Anterior Crossbite in Adult

    Directory of Open Access Journals (Sweden)

    Deepak Rai

    2012-01-01

    Full Text Available Anterior crossbites are difficult to correct in adults. A case where microimplants were placed in the lingual tori of an adult patient along with a lingual appliance is reported. The use of the esthetic lingual appliance along with the stable anchorage provided by the microimplants, aids in decreasing the duration of treatment as well as making the same more acceptable to the patient.

  19. Nongranulomatous anterior uveitis in a patient with Usher syndrome

    OpenAIRE

    Alzuhairy, Sultan Abdulaziz S.; Alfawaz, Abdullah

    2013-01-01

    A 34-year-old female with Usher syndrome, but no family history of similar illness, presented with complaints of vision reduction, redness, and photophobia. Biomicroscopic examination showed mildly injected conjunctivae bilateral, small, round keratic precipitates; bilateral +2 cells with no flare reaction in the anterior chamber; and bilateral posterior subcapsular cataracts. No associated posterior synechiae, angle neovascularization, or iris changes were detected; normal intraocular pressu...

  20. [Collaboration from periodontics in the aesthetic restoration of anterior teeth].

    Science.gov (United States)

    Qintao, Wang; Yumei, Zhang

    2017-10-01

    Anterior teeth are the main zones that reflect oral aesthetics. The histological structure, outside appearance, relative ratios, and other characteristics of tissues must be understood to obtain relatively ideal and natural restoration effects. A collaboration of different disciplines must be implemented to obtain harmonious and stable restoration outcomes that help the majority appreciate beauty. This article aims to discuss the role of periodontics in this collaboration and introduce several common techniques.

  1. ACTH radioimmunocytochemistry (RICH) on rat anterior pituitary cells

    International Nuclear Information System (INIS)

    Rappay, G.; Karteszi, M.; Makara, G.B.

    1979-01-01

    Radioimmunocytochemistry (RICH) was applied to detect corticotrophs in adult rat pituitaries and 8-day-old anterior pituitary monolayers by incubating sections and cultures with 125 I-ACTH-anti ACTH immune complexes. After incubations autoradiography was made. In comparison, 'conventional' immunostaining was carried out on adjacent sections and parallel cultures. It has been established that RICH is suitable for detection of corticotrophs. (orig.) [de

  2. Safety and resource utilization of anterior cervical discectomy and fusion

    OpenAIRE

    Yu-Tung Feng; Shiuh-Lin Hwang; Chih-Lung Lin; I-Chen Lee; King-Teh Lee

    2012-01-01

    Degenerative cervical spondylosis (DCS) is part of the aging process and is the most common reason for degenerative changes with the spinal column. Anterior cervical discectomy and fusion (ACDF) is a major option for operative management of DCS in our institution. This retrospective study investigated the frequency of postoperative complications and resource utilization in 145 patients who underwent ACDF procedures from January 2009 to December 2011. Patients with degenerative changes that in...

  3. Early Results of Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction

    OpenAIRE

    Demet Pepele

    2014-01-01

    Aim: The goal in anterior cruciate ligament reconstruction (ACLR) is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our ...

  4. Anterior capsulotomy with an ultrashort-pulse laser.

    Science.gov (United States)

    Tackman, Ramon Naranjo; Kuri, Jorge Villar; Nichamin, Louis D Skip; Edwards, Keith

    2011-05-01

    To assess the precision of laser anterior capsulotomy compared with that of manual continuous curvilinear capsulorhexis (CCC). Asociación Para Evitar La Ceguera en México IAP, Hospital Dr. Luis Sánchez Bulnes, Mexico City, Mexico. Nonrandomized single-center clinical trial. In patients presenting for cataract surgery, the LensAR Laser System was used to create a laser anterior capsulotomy of the surgeon's desired size. Capsule buttons were retrieved and measured and then compared with buttons retrieved from eyes having a manually torn CCC. Deviation from the intended diameter and the regularity of shape were assessed. When removing the capsule buttons at the start of surgery, the surgeon rated the ease of removal on a scale of 1 to 10 (1 = required manual capsulorhexis around the whole diameter; 10 = button free floating or required no manual detachment from remaining capsule during removal). The mean deviation from the intended diameter was 0.16 mm ± 0.17 (SD) for laser anterior capsulotomy and 0.42 ± 0.54 mm for CCC (P=.03). The mean absolute deviation from the intended diameter was 0.20 ± 0.12 mm and 0.49 ± 0.47 mm, respectively (P=.003). The mean of the average squared residuals was 0.01 ± 0.03 and 0.02 ± 0.04, respectively (P=.09). The median rating of the ease of removal was 9 (range 5 to 10). Laser anterior capsulotomy created a more precise capsule opening than CCC, and the buttons created by the laser procedure were easy to remove at the beginning of cataract surgery. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  5. Nonarteritic anterior ischemic optic neuropathy: cause, effect, and management.

    Science.gov (United States)

    Berry, Shauna; Lin, Weijie V; Sadaka, Ama; Lee, Andrew G

    2017-01-01

    Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common form of ischemic optic neuropathy and the second most common optic neuropathy. Patients are generally over the age of 50 years with vasculopathic risk factors (eg, diabetes mellitus, hypertension, and obstructive sleep apnea). The exact mechanism of NAION is not fully understood. In addition, several treatment options have been proposed. This article summarizes the current literature on the diagnosis, treatment, and management of NAION.

  6. Plurihormonal cells of normal anterior pituitary: Facts and conclusions

    OpenAIRE

    Mitrofanova, Lubov B.; Konovalov, Petr V.; Krylova, Julia S.; Polyakova, Victoria O.; Kvetnoy, Igor M.

    2017-01-01

    Introduction plurihormonality of pituitary adenomas is an ability of adenoma cells to produce more than one hormone. After the immunohistochemical analysis had become a routine part of the morphological study, a great number of adenomas appeared to be multihormonal in actual practice. We hypothesize that the same cells of a normal pituitary gland releases several hormones simultaneously. Objective To analyse a possible co-expression of hormones by the cells of the normal anterior pituitary of...

  7. Acute anterior uveitis as the initial presentation of alkaptonuria.

    Science.gov (United States)

    John, S S; Padhan, P; Mathews, J V; David, S

    2009-01-01

    Alkaptonuria is a rare autosomal recessive metabolic disorder that may present with multi-system involvement such as ochronotic arthropathy, renal, urethral and prostatic calculi, cardiac valvular lesions and pigmentation of the skin, sclera, cartilage and other connective tissues. An association of the disease with uveitis has never been reported. We report the first case of alkaptonuria with ochronotic arthropathy presenting with recurrent acute anterior uveitis as the initial manifestation. The possible common link with the HLA-B27 gene is discussed.

  8. Linguatula serrata in the anterior chamber of the eye

    Directory of Open Access Journals (Sweden)

    Muna Bhende

    2014-01-01

    Full Text Available We report a case of intraocular Linguatula in healthy young female who presented with a history of trivial trauma, dislocated lens, inflammation and secondary glaucoma. A mobile worm was seen in the anterior chamber. Pars plana lensectomy and vitrectomy was planned to remove both the cataractous lens and the parasite during which the worm disappeared from view but was later recovered from the cassette fluid. It was identified as the nymphal form of Linguatula serrata (tongue worm.

  9. THE MINIMALLY INVASIVE METHODS OF TREATMENT OF ANTERIOR URETHRA STRICTURES

    Directory of Open Access Journals (Sweden)

    V. L. Medvedev

    2017-01-01

    Full Text Available This review is to evaluate literature concerning different methods of treatment of anterior urethra strictures: internal optical urethrotomy (OIU, laser urethrotomy, urethra stenting, urethra dilatation, OIU in combination with selfdilatation, OIU combined with chemicals injection. Evaluation of expedience, advisability and reasonableness of the chosen methods and techniques. Hereby presented statistical assessment of longtime postoperative data, low efficiency researches analysis. This research is compiled using Medline, PubMed and Embase databases.

  10. Invisible Cost Effective Mechanics for Anterior Space Closure.

    Science.gov (United States)

    Jumle, Aatish Vinod; Bagrecha, Saurabh; Gharat, Ninad; Misal, Abhijit; Toshniwal, N G

    2015-01-01

    The shifting paradigm towards invisible orthodontic treatment and also awareness in patients has allured their focus towards the most esthetic treatment approach. Also the lingual treatment is proved successful and is very well accepted by the patients. The problem that persist is its high expenses, which is not affordable by all patients. This article is a effort to treat a simple Class I malocclusion with anterior spacing using a simple, esthetic, Cost effective approach with acceptable results when esthetics plays a priority role.

  11. A functional dissociation of conflict processing within anterior cingulate cortex

    OpenAIRE

    Chobok Kim; James Kroger; Jeounghoon Kim

    2008-01-01

    Goal-directed behavior requires cognitive control to regulate neural processing when conflict is encountered. The dorsal anterior cingulate cortex (dACC) has been associated with detecting response conflict during conflict tasks. However, recent findings have indicated not only that two distinct subregions of dACC are involved in conflict processing but also that the conflict occurs at both perceptual and response levels. We clarified a functional dissociation of the caudal dACC (cdACC) and t...

  12. Indirect veneer treatment of anterior maxillary teeth with enamel hypoplasia

    OpenAIRE

    Juniarti, Devi Eka

    2010-01-01

    Background: Nowadays, aesthetic rehabilitation becomes a necessity. It is affected by patient’s background, especially career, social and economic status. The aesthetic abnormality of anterior teeth i.e discoloration, malposition and malformation can affect patient’s appearance, especially during smile. These dental abnormalities, as a result, can decrease patient’s performance. Dental malformation, for instance, can be caused by developmental tooth defect, such as enamel hypoplasia. Enamel h...

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

    Directory of Open Access Journals (Sweden)

    Numa Mercier

    2011-01-01

    Full Text Available Anterior shoulder instability is a common problem. The Latarjet procedure has been advocated as an option for the treatment of anteroinferior shoulder instability. The purpose of this paper is to explain our surgical procedure titled “Mini-open Latarjet Procedure.” We detailed patient positioning, skin incision, subscapularis approach, and coracoid fixation. Then, we reviewed the literature to evaluate the clinical outcomes of this procedure.

  14. Nonarteritic anterior ischemic optic neuropathy: cause, effect, and management

    Directory of Open Access Journals (Sweden)

    Berry S

    2017-09-01

    Full Text Available Shauna Berry,1 Weijie V Lin,2 Ama Sadaka,1 Andrew G Lee1–7 1Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA; 2Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA; 3Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch (UTMB, Galveston, TX, USA; 4Department of Ophthalmology, 5Department of Neurology, 6Department of Neurosurgery, Weill Cornell Medicine, Houston, TX, USA; 7Department of Ophthalmology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: Nonarteritic anterior ischemic optic neuropathy (NAION is the most common form of ischemic optic neuropathy and the second most common optic neuropathy. Patients are generally over the age of 50 years with vasculopathic risk factors (eg, diabetes mellitus, hypertension, and obstructive sleep apnea. The exact mechanism of NAION is not fully understood. In addition, several treatment options have been proposed. This article summarizes the current literature on the diagnosis, treatment, and management of NAION. Keywords: anterior ischemic optic neuropathy, nonarteritic anterior ischemic optic neuropathy, ischemic optic neuropathy

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

    Directory of Open Access Journals (Sweden)

    El Saghir Nagi S

    2005-12-01

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

  16. Diagnosis and treatment of anterior uveitis: optometric management

    Directory of Open Access Journals (Sweden)

    Harthan JS

    2016-03-01

    Full Text Available Jennifer S Harthan,1 Dominick L Opitz,2 Stephanie R Fromstein,1 Christina E Morettin3 1Cornea Center for Clinical Experience, 2Ophthalmology Services and Practice Development, 3Urgent Eye Care Service, Illinois College of Optometry, Chicago, IL, USA Abstract: Anterior uveitis encompasses inflammation of the iris and/or ciliary body and is one of the most common types of ocular inflammation that primary eye care practitioners will encounter. Anterior uveitis may be caused by a variety of etiologies, including infectious, noninfectious, and masquerade diseases. The short-term and long-term treatment of uveitis should include the evaluation of location, duration, pathology, and laterality, in addition to presenting signs and symptoms of the disease. A complete review of systems, thorough examination, and laboratory testing, may assist the practitioner in narrowing the list of possible causes for the uveitis. This is imperative as once a list of diagnoses has been made, a targeted approach to treatment can be pursued. Keywords: anterior uveitis, iritis, inflammation

  17. Hong's grading for evaluating anterior chamber angle width.

    Science.gov (United States)

    Kim, Seok Hwan; Kang, Ja Heon; Park, Ki Ho; Hong, Chul

    2012-11-01

    To compare Hong's grading method with anterior segment optical coherence tomography (AS-OCT), gonioscopy, and the dark-room prone-position test (DRPT) for evaluating anterior chamber width. The anterior chamber angle was graded using Hong's grading method, and Hong's angle width was calculated from the arctangent of Hong's grades. The correlation between Hong's angle width and AS-OCT parameters was analyzed. The area under the receiver operating characteristic curve (AUC) for Hong's grading method when discriminating between narrow and open angles as determined by gonioscopy was calculated. Correlation analysis was performed between Hong's angle width and intraocular pressure (IOP) changes determined by DRPT. A total of 60 subjects were enrolled. Of these subjects, 53.5 % had a narrow angle. Hong's angle width correlated significantly with the AS-OCT parameters (r = 0.562-0.719, P < 0.01). A Bland-Altman plot showed relatively good agreement between Hong's angle width and the angle width obtained by AS-OCT. The ability of Hong's grading method to discriminate between open and narrow angles was good (AUC = 0.868, 95 % CI 0.756-0.942). A significant linear correlation was found between Hong's angle width and IOP change determined by DRPT (r = -0.761, P < 0.01). Hong's grading method is useful for detecting narrow angles. Hong's grading correlated well with AS-OCT parameters and DRPT.

  18. Activation of anterior insula during self-reflection.

    Directory of Open Access Journals (Sweden)

    Gemma Modinos

    Full Text Available BACKGROUND: Functional neuroimaging studies have suggested activation of midline frontoparietal brain regions to be at the core of self-related processes. However, although some studies reported involvement of the insula, little attention has been paid to this region as forming part of the "self"-network. METHODOLOGY/PRINCIPAL FINDINGS: Using functional magnetic resonance imaging (fMRI, we aimed at replicating and extending previous studies by scanning subjects whilst reflecting upon their own personal qualities as compared to those of an acquaintance. A third condition with statements about general knowledge was used to control for attention, semantic processing and decision making processes. The results showed a significant effect of task in brain activity, consistent with previous findings, by which both person conditions recruited a common set of medial prefrontal and posterior regions, yet significant differences between self and other were found in the medial prefrontal cortex (MPFC and the anterior cingulate cortex (ACC. Notably, significant neural activation in the left anterior insula was observed as uniquely associated with self-reflection. CONCLUSIONS/SIGNIFICANCE: The results provide further evidence for the specific recruitment of anterior MPFC and ACC regions for self-related processing, and highlight a role for the insula in self-reflection. As the insula is closely connected with ascending internal body signals, this may indicate that the accumulation of changes in affective states that might be implied in self-processing may contribute to our sense of self.

  19. Activation of anterior insula during self-reflection.

    Science.gov (United States)

    Modinos, Gemma; Ormel, Johan; Aleman, André

    2009-01-01

    Functional neuroimaging studies have suggested activation of midline frontoparietal brain regions to be at the core of self-related processes. However, although some studies reported involvement of the insula, little attention has been paid to this region as forming part of the "self"-network. Using functional magnetic resonance imaging (fMRI), we aimed at replicating and extending previous studies by scanning subjects whilst reflecting upon their own personal qualities as compared to those of an acquaintance. A third condition with statements about general knowledge was used to control for attention, semantic processing and decision making processes. The results showed a significant effect of task in brain activity, consistent with previous findings, by which both person conditions recruited a common set of medial prefrontal and posterior regions, yet significant differences between self and other were found in the medial prefrontal cortex (MPFC) and the anterior cingulate cortex (ACC). Notably, significant neural activation in the left anterior insula was observed as uniquely associated with self-reflection. The results provide further evidence for the specific recruitment of anterior MPFC and ACC regions for self-related processing, and highlight a role for the insula in self-reflection. As the insula is closely connected with ascending internal body signals, this may indicate that the accumulation of changes in affective states that might be implied in self-processing may contribute to our sense of self.

  20. Encephalitozoon cuniculi causes focal anterior cataract and uveitis in dogs.

    Science.gov (United States)

    Nell, B; Csokai, J; Fuchs-Baumgartinger, A; Maaß, G

    2015-01-01

    Three mongrel dogs, aged 10 months (case 1), 14 months (case 2) and 7.5 years (case 3), were presented because of ophthalmologic disorders of 4 months, 6 months and 7 years duration, respectively. All three dogs were offspring of stray dogs from Hungary and Serbia and had positive serum antibody titres against Encephalitozoon (E.) cuniculi. The two young dogs showed unilateral, the older dog bilateral chronic anterior uveitis with posterior synechia and focal anterior cortical cataract. The fundi that could be evaluated developed focal tapetal hyporeflective lesions in the course of the disease. Dogs 1 and 2 underwent removal of the lens via phacoemulsification. PCR of the lens material was positive for E. cuniculi strains IV and II, respectively. In dog 2 findings suggestive of microsporidia were detected underneath the anterior lens capsule by immunohistochemical staining. In all cases medical treatment consisted of systemic fenbendazole, prednisolone, and topical anti-inflammatory drugs, and additional brinzolamid/timolol for dog 3. For the time being all cases (follow up 23 months, 6 months and 3 months, respectively) are still on topical anti-inflammatory therapy. It is concluded that E. cuniculi infections can cause cataract and chorioretinal lesions in dogs.

  1. Effects of primary selective laser trabeculoplasty on anterior segment parameters

    Science.gov (United States)

    Guven Yilmaz, Suzan; Palamar, Melis; Yusifov, Emil; Ates, Halil; Egrilmez, Sait; Yagci, Ayse

    2015-01-01

    AIM To investigate the effects of selective laser trabeculoplasty (SLT) on the main numerical parameters of anterior segment with Pentacam rotating Scheimpflug camera in patients with ocular hypertension (OHT) and primary open angle glaucoma (POAG). METHODS Pentacam measurements of 45 eyes of 25 (15 females and 10 males) patients (12 with OHT, 13 with POAG) before and after SLT were obtained. Measurements were taken before and 1 and 3mo after SLT. Pentacam parameters were compared between OHT and POAG patients, and age groups (60y and older, and younger than 60y). RESULTS The mean age of the patients was 57.8±13.9 (range 20-77y). Twelve patients (48%) were younger than 60y, while 13 patients (52%) were 60y and older. Measurements of pre-SLT and post-SLT 1mo were significantly different for the parameters of central corneal thickness (CCT) and anterior chamber volume (ACV) (P0.05). CONCLUSION SLT leads to significant increase in CCT and decrease in ACV at the 1st month of the procedure. Effects of SLT on these anterior segment parameters, especially for CCT that interferes IOP measurement, should be considered to ensure accurate clinical interpretation. PMID:26558208

  2. Hemodynamics Modeling and Simulation of Anterior Communicating Artery Aneurysms

    Directory of Open Access Journals (Sweden)

    Jianjun Li

    2014-07-01

    Full Text Available It is a general agreement that hemodynamics plays very important role in the initiation, growth, and rupture of cerebral aneurysms and hemodynamics in the anterior communicating artery aneurysms is considered the most complex in all cerebral aneurysms and it is difficult to find some reasonable relationship between the hemodynamics parameters and the rupture risk. In this paper, the 3D geometries of four anterior communicating artery aneurysms were generated from the CTA data and the computational models with bilateral feeding arteries for the four aneurysms were constructed. The blood flow was simulated by computational fluid dynamics software and the hemodynamics parameters such as velocity, wall shear stress, and oscillatory shear index were calculated. The following results were observed: one of the four models only needs the left feeding artery; the max normalized wall shear stress locates at the aneurysmal neck of the largest aneurysm; the max oscillatory shear index locates at the aneurysmal sac of the largest aneurysm. The conclusion was drawn that the anterior communicating artery aneurysm has higher rupture risk from the hemodynamics viewpoint if the max wall shear stress locates at the neck and the max oscillatory shear index locates at the dome.

  3. Hypertrophic anterior cervical osteophytes causing dysphagia and airway obstruction.

    Science.gov (United States)

    Lin, Harrison W; Quesnel, Alicia M; Holman, Allison S; Curry, William T; Rho, Michael B

    2009-10-01

    Hyperostosis of anterior cervical vertebral osteophytes can produce otolaryngological symptoms ranging from mild dysphagia, dysphonia, and foreign body sensation to severe food impaction and stridulous dyspnea. Airway compromise necessitating a tracheostomy is very rare. We discuss the case of an elderly man who presented with progressive dysphagia and a large hypopharyngeal mass as his initial manifestations of hypertrophic anterior cervical osteophytes. After a biopsy of the mass, the patient went into airway distress due to bilateral vocal fold fixation by the enlarging mass and consequently required a surgical airway. A combined team approach to the removal of the osteophytes successfully resolved his symptoms. The clinical, diagnostic, radiologic, and therapeutic principles involved in this case are presented and discussed. The recognition of hypertrophic osteophytes as a potential cause of common otolaryngological symptoms in the elderly population is paramount, as these symptoms can rapidly progress and lead to life-threatening airway obstruction. Medical and surgical interventions can be employed for the treatment of hypertrophic anterior cervical osteophytes, and they often result in favorable outcomes.

  4. Is biologic width of anterior and posterior teeth similar?

    Directory of Open Access Journals (Sweden)

    Amir Alireza Rasouli Ghahroudi

    2014-09-01

    Full Text Available The biologic width (BW includes attached epithelial cells and connective tissue attachment complex being very important in the periodontal health during prosthetic treatments as invading this zone can cause bone resorption and gingival recession. The present study investigated biologic width values in the normal periodontium in anterior and posterior teeth. 30 patients that referred from restorative department to periodontics department of Tehran University of medical sciences who need crown lengthening procedure on their teeth with no history of orthodontic, prosthodontic and periodontal treatment were randomly enrolled in this cross-sectional trial. Sulcus depths (SD as well as the distance between free gingival margin and the bone crest (FB of anterior and posterior teeth were measured by UNC-15 probe and compared. periodontium thickness was also assessed. The data were subjected to Student t test. Mean BW in the 43 anterior and 47 posterior teeth was measured and not significantly different (1.4651±0.39 mm vs. 1.6312±0.49 mm was observed; however, BW was significantly more in the teeth with thick periodontium compared to those with thin periodontium (1.703±0.5 vs. 1.408±0.35; P=0.002. BW not only is different in individuals but also could be dissimilar in different teeth and should be calculated independently prior to restorative treatments.

  5. Anterior-posterior regionalized gene expression in the Ciona notochord.

    Science.gov (United States)

    Reeves, Wendy; Thayer, Rachel; Veeman, Michael

    2014-04-01

    In the simple ascidian chordate Ciona, the signaling pathways and gene regulatory networks giving rise to initial notochord induction are largely understood and the mechanisms of notochord morphogenesis are being systematically elucidated. The notochord has generally been thought of as a non-compartmentalized or regionalized organ that is not finely patterned at the level of gene expression. Quantitative imaging methods have recently shown, however, that notochord cell size, shape, and behavior vary consistently along the anterior-posterior (AP) axis. Here we screen candidate genes by whole mount in situ hybridization for potential AP asymmetry. We identify 4 genes that show non-uniform expression in the notochord. Ezrin/radixin/moesin (ERM) is expressed more strongly in the secondary notochord lineage than the primary. CTGF is expressed stochastically in a subset of notochord cells. A novel calmodulin-like gene (BCamL) is expressed more strongly at both the anterior and posterior tips of the notochord. A TGF-β ortholog is expressed in a gradient from posterior to anterior. The asymmetries in ERM, BCamL, and TGF-β expression are evident even before the notochord cells have intercalated into a single-file column. We conclude that the Ciona notochord is not a homogeneous tissue but instead shows distinct patterns of regionalized gene expression. Copyright © 2013 Wiley Periodicals, Inc.

  6. [Compressive anterior thoracoplasty (modified Abramson's repair) for pectus carinatum repair].

    Science.gov (United States)

    Álvarez Muñoz, V; Prado Valle, M A; López López, A J; Martínez Suárez, M A; Oviedo Gutiérrez, M; Montalvo Ávalos, C; Fernández García, L

    2014-04-15

    For anterior protruding chest wall deformities treatment, mainly pectus carinatum, pediatric surgeons have been managing either orthotic methods or open surgical repairs. Anterior compressive thoracoplasty (Abramson's technique) has widened the therapeutic options. We describe herein a modification of this technique in the first reported Europen series. From 2010 to 2012, a total of five patients (four male and one female) underwent a modified Abramson's technique to correct pectus carinatum or combined protrusion of the chest at our center. We report the operative technique used for these reconstructions. In all five cases, the operation was completed uneventfully and with excellent results either for the surgical team or the patients. Mean operative time was 190 minutes and hospitalization lasted for three to six days, at the time of analgesic drugs withdrawal. We consider the anterior compresive thorocoplasty (modified Abramson's technique) a safe and feasible method to correct protruding chest deformities, particularly in those patients with stiff chest or lack of compliance, in order to avoid the agressive open procedures.

  7. Reduced anterior internal capsule white matter integrity in primary insomnia.

    Science.gov (United States)

    Spiegelhalder, Kai; Regen, Wolfram; Prem, Martin; Baglioni, Chiara; Nissen, Christoph; Feige, Bernd; Schnell, Susanne; Kiselev, Valerij G; Hennig, Jürgen; Riemann, Dieter

    2014-07-01

    Chronic insomnia is one of the most prevalent central nervous system diseases, however, its neurobiology is poorly understood. Up to now, nothing is known about the integrity of white matter tracts in insomnia patients. In this study, diffusion tensor imaging (DTI) was used in a well-characterized sample of primary insomnia (PI) patients and good sleeper controls to fill this void. Voxelwise between-group comparisons of fractional anisotropy (FA) were performed in 24 PI patients (10 males; 14 females; 42.7 ± 14.5 years) and 35 healthy good sleepers (15 males; 20 females; 40.1 ± 9.1 years) with age and sex as covariates. PI patients showed reduced FA values within the right anterior internal capsule and a trend for reduced FA values in the left anterior internal capsule. The results suggest that insomnia is associated with a reduced integrity of white matter tracts in the anterior internal capsule indicating that disturbed fronto-subcortical connectivity may be a cause or consequence of the disorder.

  8. Age-related motor unit remodeling in the Tibialis Anterior.

    Science.gov (United States)

    Siddiqi, Ariba; Kumar, Dinesh; Arjunan, Sridhar

    2015-01-01

    Limited studies exist on the use of surface electromyogram (EMG) signal features to detect age-related motor unit remodeling in the Tibialis Anterior. Motor unit remodeling leads to declined muscle strength and force steadiness during submaximal contractions which are factors for risk of falls in the elderly. This study investigated the remodeling phenomena in the Tibialis Anterior using sample entropy and higher order statistics. Eighteen young (26.1 ± 2.9 years) and twelve elderly (68.7 ± 9.0 years) participants performed isometric dorsiflexion of the ankle at 20% maximal voluntary contraction (MVC) and their Tibialis Anterior (TA) EMG was recorded. Sample entropy, Gaussianity and Linearity Test statistics were calculated from the recorded EMG for each MVC. Shapiro-Wilk test was used to determine normality, and either a two-tail student t-test or Wilcoxon rank sum test was performed to determine significant difference in the EMG features between the young and old cohorts. Results show age-related motor unit remodeling to be depicted by decreased sample entropy (p <; 0.1), increased non-Gaussianity (p <; 0.05) and lesser degree of linearity in the elderly. This is due to the increased sparsity of the MUAPs as a result of the denervation-reinnervation process, and the decrease in total number of motor units.

  9. Stability of anterior open-bite treatment with occlusal adjustment.

    Science.gov (United States)

    Janson, Guilherme; Crepaldi, Marcus Vinicius; Freitas, Karina Maria Salvatore; de Freitas, Marcos Roberto; Janson, Waldyr

    2010-07-01

    In this study, we aimed to evaluate the long-term stability of anterior open-bite treatment with occlusal adjustment and the dentinal sensitivity caused by this procedure in the long term. The sample comprised 17 open-bite patients who experienced relapse of the negative vertical overbite after orthodontic treatment and were retreated with occlusal adjustment. The cephalometric changes were evaluated on lateral cephalograms obtained before and after the occlusal adjustment and in the long term (mean, 3.4 years after occlusal adjustment). Dentinal sensitivity was also evaluated before the occlusal adjustment, and 1.35 months, 4.61 months, and 3.4 years later. The cephalometric statuses between the 3 evaluations were compared with analysis of variance (ANOVA) and Tukey tests. The percentages of clinically significant relapse were calculated. To compare dentinal sensitivity at the several stages, nonparametric Friedman and Wilcoxon tests were performed. Statistically significant relapse of anterior open bite occurred in 33.3% of the patients. Those who had the procedure before 21 years of age were most likely to experience relapse. Dentinal sensitivity remained within the normal range in the long term. Despite the statistically significant relapse of anterior open bite, clinically significant stability was found in 66.7% of the patients. Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  10. Anterior cervical decompression and fusion with caspar plate fixation

    International Nuclear Information System (INIS)

    Rehman, L.; Akbar, H.; Das, G.; Hashim, A.S.M.

    2013-01-01

    Objective: To evaluate the role of anterior cervical decompression and fixation with Caspar plating in cervical spine injury on neurological outcome. Study Design: A case series. Place and Duration of Study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2008 to March 2011. Methodology: Thirty patients admitted with cervical spine injuries were inducted in the study. All cases were evaluated for their clinical features, level of injury and degree of neurological injury was assessed using Frankel grading. Pre and postoperative record with X-rays and MRI were maintained. Cervical traction was applied to patients with sub-luxation. All patients underwent anterior cervical decompression, fusion and Caspar plate fixation. The follow-up period was 6 months with clinical and radiological assessment. Results: Among 30 patients, 24 (80%) were males and 6 (20%) were females. Age ranged from 15 to 55 years. Causes of injury were road traffic accident (n = 20), fall (n = 8) and assault (n = 2). Commonest mode of injury was road traffic accident (66.6%). Postoperative follow-up showed that pain and neurological deficit were improved in 21 patients. There was no improvement in 7 patients, one patient deteriorated and one expired. All patients developed pain at donor site. Conclusion: Anterior decompression, fusion and fixation with Caspar plate is an effective method with good neurological and radiological outcome. However, it is associated with pain at donor site. (author)

  11. Three-dimensional bone kinematics in an anterior laxity test of the ankle joint

    NARCIS (Netherlands)

    Kerkhoffs, G.; Blankevoort, L.; Kingma, I.; van Dijk, C.N.

    2007-01-01

    Questions addressed in this in-vitro study are (1) what are the actual three-dimensional kinematics of talus and calcaneus during an anterior drawer test as performed with the quasi-static anterior ankle tester (QAAT) (2) does laxity measurement with the QAAT represent the true anterior translation

  12. Prevalence and factors associated with anterior open bite in 2 to 5 ...

    African Journals Online (AJOL)

    Prevalence and factors associated with anterior open bite in 2 to 5 year old children in Benin city, Nigeria. ... Background: Anterior open bite is said to exist when there is an actual vertical gap between the upper and lower incisors with the teeth in centric occlusion. This could occur in the anterior or posterior region, and may ...

  13. Germ Cell Tumor Located in the Midline of the Anterior Neck

    OpenAIRE

    Tatyana PIRDOPSKA; Ivan TERZIEV; Sv. HRISTOVA; W. MLADENOVSKY; R. PETKOV

    2011-01-01

    Primary germ cell tumors involving midline of the anterior neck are extremely rare. Here we report a 68-year-old male who was operated due to a mass lesion in the anterior neck with infiltration of the isthmus of the thyroid gland. Histopathological examination revealed a germ cell tumor with extragonadal localization in the anterior neck infiltrating the isthmus of the thyroid gland.

  14. Y BALANCE TEST™ ANTERIOR REACH SYMMETRY AT THREE MONTHS IS RELATED TO SINGLE LEG FUNCTIONAL PERFORMANCE AT TIME OF RETURN TO SPORTS FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION.

    Science.gov (United States)

    Garrison, J Craig; Bothwell, James M; Wolf, Gina; Aryal, Subhash; Thigpen, Charles A

    2015-10-01

    Restoration of symmetrical strength, balance, and power following anterior cruciate ligament reconstruction (ACL-R) are thought to be important factors for successful return to sports. Little information is available regarding early rehabilitation outcomes and achieving suggested limb indices of 90% on functional performance measures at the time of return to sports (RTS). To examine the relationship between symmetry of the anterior reach of the Y Balance Test™ at 12 weeks and functional performance measures at time of return to sports after anterior cruciate ligament (ACL) reconstruction. Retrospective Cohort. Forty subjects (mean ± SD age, 17.2 ± 3.8 years) who were in the process of rehabilitation following ACL reconstruction. Each subject volunteered and was enrolled in the study during physical therapy following ACL-R. Participants averaged two visits per week in physical therapy until the time of testing for RTS. The Y Balance Test™ was assessed at 12 weeks. Participants completed a battery of tests at RTS (6.4 ± 1.1 months) including triple hop distance (THD), single hop distance (SHD), isometric knee extension strength (KE), and the Vail Sport Test™. Side to side difference was calculated for the Y Balance Test™ anterior reach and limb symmetry indices (LSI) were computed for THD, SHD, and KE. Multiple regression models were used to study the relationship between variables at 12 weeks and RTS while controlling for age, gender, type of graft, and pain score. In addition, subjects were dichotomized based on a side-to-side Y Balance anterior reach difference into high risk (>4 cm) or low risk (≤4 cm) categories. A receiver operating characteristic (ROC) curve was used to identify individuals at 12 weeks who do not achieve 90% limb symmetry indices at time of RTS testing. . A statistically significant association was seen between Y Balance ANT at 12 weeks and SHD at RTS (β = -1.46, p = 0.0005, R(2) = 0.395), THD at RTS

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

    Directory of Open Access Journals (Sweden)

    Herdi Eko Pranjoto

    2005-09-01

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

  16. Prevalence and Length of the Anterior Loop of the Inferior Alveolar Nerve in Iranians.

    Science.gov (United States)

    Moghddam, Maryam Rastegar; Davoudmanesh, Zeinab; Azizi, Nasim; Rakhshan, Vahid; Shariati, Mahsa

    2017-10-01

    The anterior loop of the inferior alveolar nerve is a sensitive anatomical feature that should be taken into account during installation of dental implants anterior to the mental foramen. This study was conducted to explore the controversy regarding prevalence and length. A total of 452 mandible quadrants of 234 patients (age: 50.1 ± 13.3 years, 113 males, 121 females) were studied using cone-beam computerized tomography. After reconstructing axial, frontal, and sagittal slices, the region between the most anterior point on the mental foramen and the most anterior part of the mandibular nerve was inspected for signs of anterior loop presence. If positive, the length of the anterior loop was measured in mm as the distance between the anterior border of mental foramen and the anterior border of the loop. Prevalence and length of the anterior loop were compared statistically between sexes and age groups. The anterior loop was observed in 106 quadrants (23.5% of 451 quadrants) of 95 patients (40.6% of 234 patients), of whom 11 had bilateral anterior loops. Prevalences were similar in males (41%) and females (39%, chi-square P =.791). The mean anterior loop length was 2.77 ± 1.56 mm (95% CI: 2.5-3.1 mm), without significant sex (regression beta = -0.159, P = .134) or age (beta = -0.059, P = .578) differences. The anterior loop might exist in about 40% of patients, regardless of their gender. The mean safe anterior distance from the anterior loop is about 3 mm + (2.5-3.1 mm) = 5.5-6.1 mm, regardless of age.

  17. Worse patient-reported outcome after lateral approach than after anterior and posterolateral approach in primary hip arthroplasty

    Science.gov (United States)

    Havelin, Leif I; Furnes, Ove; Baste, Valborg; Nordsletten, Lars; Hovik, Oystein; Dimmen, Sigbjorn

    2014-01-01

    Background The surgical approach in total hip arthroplasty (THA) is often based on surgeon preference and local traditions. The anterior muscle-sparing approach has recently gained popularity in Europe. We tested the hypothesis that patient satisfaction, pain, function, and health-related quality of life (HRQoL) after THA is not related to the surgical approach. Patients 1,476 patients identified through the Norwegian Arthroplasty Register were sent questionnaires 1–3 years after undergoing THA in the period from January 2008 to June 2010. Patient-reported outcome measures (PROMs) included the hip disability osteoarthritis outcome score (HOOS), the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), health-related quality of life (EQ-5D-3L), visual analog scales (VAS) addressing pain and satisfaction, and questions about complications. 1,273 patients completed the questionnaires and were included in the analysis. Results Adjusted HOOS scores for pain, other symptoms, activities of daily living (ADL), sport/recreation, and quality of life were significantly worse (p < 0.001 to p = 0.03) for the lateral approach than for the anterior approach and the posterolateral approach (mean differences: 3.2–5.0). These results were related to more patient-reported limping with the lateral approach than with the anterior and posterolateral approaches (25% vs. 12% and 13%, respectively; p < 0.001). Interpretation Patients operated with the lateral approach reported worse outcomes 1–3 years after THA surgery. Self-reported limping occurred twice as often in patients who underwent THA with a lateral approach than in those who underwent THA with an anterior or posterolateral approach. There were no significant differences in patient-reported outcomes after THA between those who underwent THA with a posterolateral approach and those who underwent THA with an anterior approach. PMID:24954494

  18. Sonography of the anterior oblique ligament of the trapeziometacarpal joint: a study of cadavers and asymptomatic volunteers.

    Science.gov (United States)

    Chiavaras, Mary M; Harish, Srinivasan; Oomen, Glen; Popowich, Terry; Wainman, Bruce; Bain, James R

    2010-12-01

    The purpose of this study was to evaluate the ability of ultrasound to identify and characterize the anterior oblique ligament of the thumb in cadavers and asymptomatic volunteers. The anterior oblique ligaments of four cadaveric hands were imaged with a high-resolution transducer. The ligaments were then injected with 0.1% methylene blue using ultrasound guidance. To confirm identification of the ligament, the base of the thumb was immediately dissected, revealing the exact location of the dye. The bilateral ligaments in 40 asymptomatic adult volunteers were imaged. Surgical dissection confirmed injection of methylene blue into all cadaveric ligaments. The proximal attachment of the anterior oblique ligament was well defined in all the hands, and the distal attachment was well defined in 94% of the hands. The mean thickness of the anterior oblique ligament at the metacarpal attachment (0.7 mm), midportion (0.98 mm), and trapezial attachment (0.65 mm) did not differ significantly with respect to sex, right and left side, or hand dominance and was weakly correlated with weight, height, body mass index, and age. The length of the ligament was statistically significantly different between the dominant (10.6 mm) and nondominant (9.6 mm) hands. The volar metacarpal translation with palmar abduction stress did not differ significantly between the dominant (0.7 mm) and nondominant (0.8 mm) hands. There was no association between the degree of translation and the biologic characteristics (weight, height, body mass index, and age). High-resolution ultrasound can be used to identify and measure the thickness of the anterior oblique ligament. Dynamic ultrasound imaging can depict volar translation of the metacarpal, which may facilitate diagnosis of ligamentous injury.

  19. Anatomical Footprint of the Tibialis Anterior Tendon: Surgical Implications for Foot and Ankle Reconstructions

    Directory of Open Access Journals (Sweden)

    Madeleine Willegger

    2017-01-01

    Full Text Available This study aimed to analyze precisely the dimensions, shapes, and variations of the insertional footprints of the tibialis anterior tendon (TAT at the medial cuneiform (MC and first metatarsal (MT1 base. Forty-one formalin-fixed human cadaveric specimens were dissected. After preparation of the TAT footprint, standardized photographs were made and the following parameters were evaluated: the footprint length, width, area of insertion, dorsoplantar location, shape, and additional tendon slips. Twenty feet (48.8% showed an equal insertion at the MC and MT1, another 20 feet (48.8% had a wide insertion at the MC and a narrow insertion at the MT1, and 1 foot (2.4% demonstrated a narrow insertion at the MC and a wide insertion at the MT1. Additional tendon slips inserting at the metatarsal shaft were found in two feet (4.8%. Regarding the dorsoplantar orientation, the footprints were located medial in 29 feet (70.7% and medioplantar in 12 feet (29.3%. The most common shape at the MT1 base was the crescent type (75.6% and the oval type at the MC (58.5%. The present study provided more detailed data on the dimensions and morphologic types of the tibialis anterior tendon footprint. The established anatomical data may allow for a safer surgical preparation and a more anatomical reconstruction.

  20. Laparoscopic anterior gastropexy for chronic recurrent gastric volvulus: a case report

    Directory of Open Access Journals (Sweden)

    Morelli Umberto

    2008-07-01

    Full Text Available Abstract Introduction Gastric volvulus is an uncommon clinical entity, first described by Berti in 1866. It is a rotation of all or part of the stomach through more than 180°. This rotation can occur on the longitudinal (organo-axial or transverse (mesentero-axial axis. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report the case of a patient with chronic intermittent gastric volvulus who underwent a successful laparoscopic treatment. Case presentation A 34-year-old woman presented with multiple episodes of recurrent upper abdominal pain associated with retching and vomiting, treated unsuccessfully with intramuscular metoclopramide. Endoscopic examination of the upper digestive tract showed a suspected rotation of the stomach, and a chronic recurrent gastric volvulus was revealed by barium meal. The patient was operated on successfully, with an anterior laparoscopic gastropexy performed as the first surgical approach. Conclusion Experience with laparoscopic anterior gastropexy is limited only to a few described cases. Our patient was clinically and radiologically followed-up for 2 years with no evidence of recurrence, either radiological or symptomatic. Based on this result, laparoscopic gastropexy can be seen and considered as an initial 'gold standard' for the treatment of gastric volvulus.