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Sample records for bilateral anterior ischemic

  1. Bilateral Simultaneous Nonarteritic Anterior Ischemic Optic Neuropathy after Ingestion of Sildenafil for Erectile Dysfunction

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    Anna Tarantini; Alessandra Faraoni; Francesca Menchini; Paolo Lanzetta

    2012-01-01

    Purpose. To describe a patient who developed bilateral, simultaneous nonarteritic anterior ischemic optic neuropathy (NAION) after ingestion of Sildenafil citrate (Viagra) for erectile dysfunction. Methods. Observational case report. Results. A 60-year-old diabetic man noted sudden decrease of vision in both eyes 16 hours after his third consecutive 50 mg daily Sildenafil ingestion. A diagnosis of bilateral NAION was made and he was treated for three days with methylprednisolone 1 g/d intrave...

  2. Bilateral simultaneous nonarteritic anterior ischemic optic neuropathy in a patient with alcoholic liver disease

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    Shikha Talwar Bassi

    2014-01-01

    Full Text Available A 53-year-old man with a history of alcoholism since 10 years admitted for jaundice elsewhere developed bilateral simultaneous decrease in vision in both the eyes 4 days after admission. His best-corrected visual acuity was 20/20 in both eyes. Visual field evaluation revealed an inferior altitudinal defect in both the eyes. Optic disc appearance, visual fields, and optical coherence tomography of discs were suggestive of nonarteritic anterior ischemic optic neuropathy (NAION in both the eyes. Liver function tests revealed elevated serum bilirubin and hepatic enzymes. He was negative for hepatitis B virus (HBV and hepatitis C virus (HCV infection. Abdominal ultrasound revealed no focal hepatic lesion, and carotid doppler revealed no arteriosclerosis. A diagnosis of bilateral ischemic optic neuropathy associated with alcoholic hepatitis was made. Bilateral simultaneous NAION has been previously reported in perioperative visual loss, HCV infection, and interferon treatment. This is the first case report of bilateral simultaneous NAION in alcoholic hepatitis in the absence of associated infective viral hepatitis. We explore the pathophysiology of ischemic optic neuropathy in liver disease. An early intervention to correct the risk factors leading to NAION may help in preventing this vision-threatening complication in patients with chronic liver disease.

  3. Bilateral Simultaneous Nonarteritic Anterior Ischemic Optic Neuropathy after Ingestion of Sildenafil for Erectile Dysfunction

    Science.gov (United States)

    Tarantini, Anna; Faraoni, Alessandra; Menchini, Francesca; Lanzetta, Paolo

    2012-01-01

    Purpose. To describe a patient who developed bilateral, simultaneous nonarteritic anterior ischemic optic neuropathy (NAION) after ingestion of Sildenafil citrate (Viagra) for erectile dysfunction. Methods. Observational case report. Results. A 60-year-old diabetic man noted sudden decrease of vision in both eyes 16 hours after his third consecutive 50 mg daily Sildenafil ingestion. A diagnosis of bilateral NAION was made and he was treated for three days with methylprednisolone 1 g/d intravenously, followed by oral prednisone 75 mg/d. Final visual acuity was 20/50 right eye (OD) and 20/20 left eye (OS). He had preexisting diabetes. Conclusion. This is the first reported case of simultaneous bilateral NAION occurred in a diabetic patient early after Sildenafil intake. Patients with predisposing conditions such as diabetes have to be warned against the use of PDE inhibitors. PMID:22481954

  4. Unilateral Acute Anterior Ischemic Optic Neuropathy in a Patient with an Already Established Diagnosis of Bilateral Optic Disc Drusen

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    Ziya Ayhan; Aylin Yaman; Meltem Söylev Bajin; Osman Saatci, A

    2015-01-01

    Optic disc drusen (ODD) are calcific deposits that form in the optic nerve head secondary to abnormalities in axonal metabolism and degeneration. Anterior ischemic optic neuropathy, central retinal artery, and vein occlusion are among the rare vascular complications of disc drusen. We reported the clinical course of a 51-year-old patient with a unilateral acute nonarteritic anterior ischemic optic neuropathy (NAION) who received the diagnosis of bilateral optic disc drusen five years earlier ...

  5. Bilateral anterior shoulder dislocation

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

    2013-01-01

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

  6. Anterior ischemic optic neuropathy in patients undergoing hemodialysis

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    DoorenbosBot, ACC; Geerlings, W; Houtman, IA

    1996-01-01

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

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

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    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

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

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    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.)

  9. Erlotinib-related bilateral anterior uveitis

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

    2011-01-01

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

  10. Bilateral anterior uveitis secondary to erlotinib

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

    2010-01-01

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

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

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

    2013-01-01

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

  12. Diffusion MR Imaging of Postoperative Bilateral Acute Ischemic Optic Neuropathy

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    Kannan, Anusha; Srinivasan, Sivasubramanian [Khoo Teck Puat Hospital, Singapore (Singapore)

    2012-09-15

    We read with great interest, the case report on ischemic optic neuropathy (1). We would like to add a few points concerning the blood supply of the optic nerve and the correlation with the development of post-operative ischemic neuropathy. Actually, the perioperative or post-operative vision loss (postoperative ischemic neuropathy) is most likely due to ischemic optic neuropathy. Ischemic optic neuropathy (2) is classified as an anterior ischemic optic neuropathy (AION) and posterior ischemic optic neuropathy (PION). This classification is based on the fact that blood supply (2) to the anterior segment of the optic nerve (part of the optic nerve in the scleral canal and the optic disc) is supplied by short posterior ciliary vessels or anastamotic ring branches around the optic nerve. The posterior part of the optic canal is relatively less perfused, and is supplied by ophthalmic artery and central fibres are perfused by a central retinal artery. So, in the post-operative period, the posterior part of the optic nerve is more vulnerable for ischemia, especially, after major surgeries (3), one of the theories being hypotension or anaemia (2) and resultant decreased perfusion. The onset of PION is slower than the anterior ischemic optic neuropathy. AION on the other hand, is usually spontaneous (idiopathic) or due to arteritis, and is usually sudden in its onset. The reported case is most likely a case of PION. The role of imaging, especially the diffusion weighted magnetic resonance imaging, is very important because the ophthalmoscopic findings in early stages of PION is normal, and it may delay the diagnosis. On the other hand, edema of the disc is usually seen in the early stages of AION.

  13. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

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    Patil, Mallanagouda N

    2013-01-01

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

  14. Association of Cryptogenic Organizing Pneumonia in Bilateral Anterior Uveitis

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    Kaori Fujimoto

    2014-11-01

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

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

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    Yashavantha Kumar C

    2013-01-01

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

  16. Association of Cryptogenic Organizing Pneumonia in Bilateral Anterior Uveitis

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    Fujimoto, Kaori; Hiraoka, Miki; Inatomi, Shuichiro; Ohguro, Hiroshi

    2014-01-01

    Two female patients with histories of cancer who showed cryptogenic organizing pneumonia (COP) complications and bilateral anterior uveitis with hypopyon were examined. Both patients had suffered from COP and received intermitted systemic corticosteroid administration (SCA). The first patient, a 65-year-old woman with a history of breast cancer, showed bilateral uveitis with hypopyon. The topical corticosteroid treatment was ineffective. After SCA for the treatment of COP was started, the hyp...

  17. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

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    Mallanagouda N Patil

    2013-04-01

    Full Text Available Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand. He complained of pain and difficulty in moving both the shoulders. On clinical examination, patient’s both upper limbs were abducted and externally rotated. Bilaterally shoulder contour was lost with flattening. Other classical signs of shoulder dislocation viz, Bryants test, Callway sign, Hamilton’s ruler test were positive. Diagnosis was confirmed on X rays. Both shoulders were reduced in emergency operation theater under general anaesthesia by Kocher’s method and were immobilised in sling. Conclusion: Though bilateral shoulder dislocations are commonly posterior, usually either secondary to convulsions or electric shock, anterior dislocation has to be kept in mind , especially in post traumatic injuries. This bilateral dislocation also presents with practical problems immobilization and day to day care of patients. Keywords: Simultaneous, bilateral, shoulder dislocation, traumatic.

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

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

    2014-09-01

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

  19. Simultaneous bilateral ganglion cysts of the anterior cruciate ligaments.

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    Demircay, Emre; Ofluoglu, Demet; Ozel, Omer; Oztop, Pinar

    2015-04-01

    Intra-articular ganglion cysts of the anterior cruciate ligament (ACL) are rare, and bilateral ganglion cysts are even rarer. These cysts may cause intermittent or chronic nonspecific knee discomfort. Although three cases of bilateral ganglion cysts have been reported in the literature, the knees were not simultaneously affected in those cases. Herein, we report the case of a 56-year-old woman who presented with simultaneous bilateral ganglion cysts of the ACL that were symptomatic. She was successfully treated with arthroscopic resection and debridement. We also present a brief review of the literature, highlighting the aetiology, diagnosis and management of ganglion cysts of the ACL. To the best of our knowledge, this is the first report of simultaneous bilateral intra-articular ganglion cysts of the ACL. PMID:25917477

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

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    Luís Pires Silva

    2011-01-01

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

  1. Intravitreal Bevacizumab in Nonarteritic Anterior Ischemic Optic Neuropathy

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    Ebadollah Heidari

    2014-01-01

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

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

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

    2013-01-01

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

  3. Bilateral anterior shoulder fracture-dislocation : A case report and a review of the literature

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    Dinopoulos, H. T.; Giannoudis, P. V.; Smith, R. M.; Matthews, S.J.

    1999-01-01

     We report an unusual case of bilateral anterior shoulder dislocation following trauma. Previously reported cases were either of bilateral dislocations or bilateral fracture dislocations. In our case the patient suffered bilateral anterior dislocation with a three part fracture dislocation on the right. A review of the literature is presented.

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

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    Bakbak B

    2013-03-01

    Full Text Available Berker Bakbak, Banu Turgut Ozturk, Sansal Gedik, Bengu Ekinci Koktekir, Saban Gonul Selcuk University Medical Faculty, Department of Ophthalmology, Konya, Turkey Abstract: A 56-year-old man noted a sudden decrease of vision in his right eye 4 hours after intramuscular triamcinolone acetonide (TA injection. A diagnosis of unilateral nonarteritic anterior ischemic optic neuropathy (NAION was made, and the patient was counseled to discontinue using TA. Examination for possible risk factors revealed controlled hypertension. Final visual acuity was finger counting at 1 m, and the optic disc was pale in his right eye. This is the first reported case of unilateral NAION that has occurred in a patient after intramuscular corticosteroid injection. Although a cause-and-effect relationship is difficult to prove, the short duration between the TA injection and the NAION is noteworthy. The history of corticosteroid injection should be questioned in cases with predisposing conditions such as hypertension. Keywords: ischemic optic neuropathy, corticosteroids, optic disc edema

  5. Bilateral Anterior Shoulder Dislocation with Symmetrical Greater Tuberosity Fracture following Seizure

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    Suryavanshi, Ashish; Mittal, Amber; Dongre, Snehal; Kashyap, Neeti

    2012-01-01

    Introduction: Majority of bilateral shoulder dislocations are posterior. Simultaneous bilateral anterior shoulder dislocations and bilateral anterior fracture-dislocations are rare and mostly of traumatic origin. We present a rare case of bilateral anterior shoulder dislocation with symmetrical greater tuberosity fracture following an episode of seizure with an unusual injury mechanism which was treated conservatively. Case Report: A 45 year old office worker presented to the Casualty of our ...

  6. Concurrent cases of bilateral anterior shoulder dislocation: our observations in three cases

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    Orhan Akinci; Yavuz Akalin; Ali Otuzbir; Alpaslan Oztürk

    2016-01-01

    Bilateral anterior shoulder dislocations are  rarely seen and usually occur due to the same mechanism arising from traumatic injuries. In here, we discussed three cases of traumatic bilateral anterior shoulder dislocation , one had an additional patella fracture, and the other one had bilateral tuberculum majus fracture. All of the patients were female and our first case that presented here was 65-year-old and given a closed reduction for isolated bilateral anterior shoulder dislocation that ...

  7. Intravitreal Bevacizumab in Nonarteritic Anterior Ischemic Optic Neuropathy

    OpenAIRE

    Ebadollah Heidari; Mohammad Reza Niyousha; Reza Heidari; Babak Rahimi-Aradabili; Farzad Hami Adl; Nooshin Bazzazi

    2014-01-01

    Purpose: To evaluate the effect of intravitreal injection of Bevacizumab on improving visual function in patients with Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION). Methods: In a prospective interventional case series, 11 eyes with vision loss due to (NAION) in less than 15 days of attack were studied. Visual acuity, perimetry and optic nerve head changes were evaluated 1 week post-intravitreal injection of 1.25mg/0.1 mL Bevacizumab. Results: 5 of patients had improved visual acui...

  8. Progressive bilateral anterior sacral meningoceles in Marfan syndrome

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    Scheck, R.J. [Dept. of Radiology, Univ. Muenchen (Germany); Schramm, T. [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany); Gloning, K.P. [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany); Vogl, T. [Dept. of Radiology, Univ. Muenchen (Germany); Ostermayer, E. [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany)

    1995-08-01

    Anterior sacral meningoceles (ASM) in Marfan syndrome are rare. They may cause constipation, urinary frequency, dysmenorrhoea, and low back pain or numbness. This report describes bilateral ASM at the level of S1, S2 and S3 in a woman with Marfan syndrome who was admitted to the gynaecology department for evaluation of left lower abdominal pain. The magnetic resonance appearance of the meningoceles is discussed and compared with findings from transvaginal ultrasound and CT. As MRI offers excellent delineation of spinal and pelvic structures, it is the most useful technique available in establishing the diagnosis and planning the treatment of ASM. (orig.)

  9. Progressive bilateral anterior sacral meningoceles in Marfan syndrome

    International Nuclear Information System (INIS)

    Anterior sacral meningoceles (ASM) in Marfan syndrome are rare. They may cause constipation, urinary frequency, dysmenorrhoea, and low back pain or numbness. This report describes bilateral ASM at the level of S1, S2 and S3 in a woman with Marfan syndrome who was admitted to the gynaecology department for evaluation of left lower abdominal pain. The magnetic resonance appearance of the meningoceles is discussed and compared with findings from transvaginal ultrasound and CT. As MRI offers excellent delineation of spinal and pelvic structures, it is the most useful technique available in establishing the diagnosis and planning the treatment of ASM. (orig.)

  10. Simultaneous Bilateral Anterior Shoulder Dislocation Occurred During Sleepwalking

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    fevzi yilmaz

    2013-10-01

    A 17-years-old male presented to our emergency department with a complaint of bilateral shoulder pain and motion restriction. His past medical history was unremarkable for epilepsy or major trauma. His family members said that he was a sleepwalker since he was 5 or 6 years old and sometimes he was going to another place from his bed and when they saw him there were abrasions especially on his face and extremities. It was learned that he left the drugs given by the doctors for his complaint after using a short time. On his physical examination in the emergency department he appeared to be good, he was concious, cooperative and oriented to person, time and place. His vital signs and neurological examination were normal. His extremity examination revealed that his arms were slightly in abduction and external rotation. There was epaulet sign bilateral on his shoulders and his peripheral neurological examination was otherwise normal. The radiological evaluation revealed bilateral subchorocoidal anterior dislocation without signs of fracture (Figure 1.

  11. A Case of Neglected Bilateral Anterior Shoulder Dislocation: A Rare Entity with Unusual Mechanism of Injury

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    Raghuram Choulapalle; Ramu Chokkarapu; Ravi Kanth Kolluri; Sreedhar Reddy Anne; Shanmuga Raju Perumal; Pavan Kumar Avadhanam; Ramesh Bheemanathuni

    2015-01-01

    Bilateral shoulder dislocations are rare, and if they occurred, posterior type of dislocations is common. Bilateral anterior shoulder dislocations are very rare and occur due to trauma with unique mechanism of injury. We report a case of unreduced simultaneous bilateral anterior dislocations of shoulder without associated fractures in a forty-year-old man following a unique mechanism of injury; both hands of the patient were pulled from either side. To the best of our knowledge, this unusual ...

  12. Bilateral Anterior Fracture-Dislocation of Shoulder Joint- A rare case with Delayed Presentation

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    Sunku, Nithin; Kalaiah, Kiran; Marulasidappa, G.; Gopinath, P

    2012-01-01

    Introduction: The shoulder is the most frequently dislocated joint. Bilateral glenohumeral dislocations are rare and almost always posterior. Bilateral anterior fracture dislocations of humeral neck in a patient with seizure are extremely rare. We report one such case of delayed presentation of bilateral anterior fracture dislocation of shoulder after an epileptic attack. Case Report: We describe a rare case of 30 year old gentleman who presented with first episode of seizure following alcoho...

  13. Anterior ischemic optic neuropathy in association with optic nervehead drusen

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    Bharathi Megur

    2014-01-01

    Full Text Available Optic nerve head drusen (ONHD are incidental ophthalmologic finding in the optic nerve. Patients with ONHD are often asymptomatic, but sometimes present with transient visual obscuration′s (TVO, the reported incidence of which is 8.6%. Optic nerve head drusen are of two types: Superficial; visible and deep. The deep-buried drusen mimic papilledema. Because of the varied presentation deep-buried drusen pose a diagnostic challenge to the ophthalmologists. In young patients, they are mistaken for papilledema as it is clinically difficult to detect a buried drusen in the optic nerve head, but are seen on the surface with aging as the retinal nerve fiber layer thins out. They are observed as pale yellow lesions more often located towards the poles. Clinical examination aided with diagnostic tests like computed tomography (CT orbits and ultrasound B scan can help establish the diagnosis. Herein, we report a rare case of optic nerve head drusen in a young lady, who presented with loss of vision and clinical evaluation and investigations suggested ONHD with anterior ischemic optic neuropathy.

  14. Radial optic neurotomy as a treatment for anterior ischemic optic neuropathy secondary to optic disc drusen

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    Pinxten, I; Stalmans, P

    2014-01-01

    Importance: Radial optic neurotomy (RON) was first described by Opremcak as a treatment for patients with central retinal vein occlusion (CRVO). The most common cause of visual loss in patients with optic disc drusen is nonarteritic anterior ischemic optic neuropathy (NAION). The pathogenesis of nonarteritic anterior ischemic optic neuropathy associated with optic disc drusen is assumed to be similar to the compartment-like syndrome described by Opremcak in the case of central retinal vein o...

  15. Radial optic neurotomy as a treatment for anterior ischemic optic neuropathy secondary to optic disc drusen

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    Pinxten, Isabel; Stalmans, Peter

    2014-01-01

    [english] Importance: Radial optic neurotomy (RON) was first described by Opremcak as a treatment for patients with central retinal vein occlusion (CRVO). The most common cause of visual loss in patients with optic disc drusen is nonarteritic anterior ischemic optic neuropathy (NAION). The pathogenesis of nonarteritic anterior ischemic optic neuropathy associated with optic disc drusen is assumed to be similar to the compartment-like syndrome described by Opremcak in the case of central retin...

  16. BILATERAL ANTERIOR DISLOCATION OF SHOULDER WITH GREATER TUBEROSITY FRACTURE DUE TO HYPONATREMIA : A RARE PRESENTATION

    Directory of Open Access Journals (Sweden)

    Sivananda

    2015-01-01

    Full Text Available We here report a rare presentation of bilateral anterior dislocation of shoulder with associated fracture of greater tuberosity in a 38 year old male due to minor trauma which he sustained secondary to hyponatremia induced irritability. There was no associ ated rotator cuff tear which is often associated with BADS which makes this presentation unique. Unilateral dislocation of shoulder is a common condition which is frequently encountered in emergency trauma department. Anterior dislocation is more common th an posterior dislocation. However, simultaneous bilateral shoulder dislocations are usually posterior. Bilateral anterior dislocations with fractures of the greater tuberosity are even rarer and are usually associated with trauma or seizures

  17. Bilateral anterior ischaemic optic neuropathy associated with optic disc drusen and systemic hypotension.

    OpenAIRE

    C. Michaelson; Behrens, M; Odel, J

    1989-01-01

    We report a case of bilateral anterior ischaemic optic neuropathy in a 23-year-old woman which was probably attributable to optic disc drusen and systemic hypotension related to peritoneal dialysis for renal failure.

  18. Simultaneous bilateral anterior shoulder dislocation: report of two cases and review of the literature

    OpenAIRE

    Tripathy Sujit Kumar; Sen Ramesh Kumar; Aggarwal Sameer; Dhatt Sarvdeep Singh; Tahasildar Naveen

    2012-01-01

    【Abstract】Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective grou...

  19. A Case of Neglected Bilateral Anterior Shoulder Dislocation: A Rare Entity with Unusual Mechanism of Injury

    Directory of Open Access Journals (Sweden)

    Raghuram Choulapalle

    2015-01-01

    Full Text Available Bilateral shoulder dislocations are rare, and if they occurred, posterior type of dislocations is common. Bilateral anterior shoulder dislocations are very rare and occur due to trauma with unique mechanism of injury. We report a case of unreduced simultaneous bilateral anterior dislocations of shoulder without associated fractures in a forty-year-old man following a unique mechanism of injury; both hands of the patient were pulled from either side. To the best of our knowledge, this unusual mechanism of injury has not been reported in the literature.

  20. Chloroquine-induced bilateral anterior shoulder dislocation: a unique aetiology for a rare clinical problem.

    Science.gov (United States)

    Martin, Alexander Nicholas; Tsekes, Dimitris; White, William James; Rossouw, Dan

    2016-01-01

    Bilateral anterior shoulder dislocation is a rare clinical entity with few case reports and limited series published in the literature. Bilateral shoulder dislocations are rare and of them, most are posterior. We present a highly unusual case of bilateral, atraumatic, anterior shoulder dislocation with concomitant comminuted greater tuberosity fracture on the right side, secondary to seizure, in a patient without known epilepsy, induced by oral chloroquine medication. We demonstrate the treatment approach that led to a satisfactory clinical outcome, evidenced by radiological union, clinical assessment and Patient Reported Outcome Measure data, following non-operative management of both shoulders. The unusual mechanism for anterior shoulder dislocation, the asymmetric dislocation pattern and peculiar precipitant for the causative seizure all provide interesting learning points from this case. PMID:27005796

  1. Simultaneous bilateral anterior shoulder dislocation: report of two cases and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Sujit Kumar Tripathy; Ramesh Kumar Sen; Sameer Aggarwal; Sarvdeep Singh Dhatt; Naveen Tahasildar

    2011-01-01

    Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had satisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment.An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature.

  2. Simultaneous bilateral anterior shoulder dislocation: report of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Tripathy Sujit Kumar

    2012-02-01

    Full Text Available 【Abstract】Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had sa-tisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment. An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature. Key words: Shoulder dislocation; Epilepsy; Accidents, traffic

  3. Bilateral Anterior Opercular Syndrome With Partial Kluver-Bucy Syndrome in a Stroke Patient: A Case Report.

    Science.gov (United States)

    Cho, Ah-Ra; Lim, Young-Ho; Chung, Sae-Hoon; Choi, Eun-Hi; Lim, Jong Youb

    2016-06-01

    Bilateral anterior opercular syndrome and partial Kluver-Bucy syndrome are associated with bilateral middle cerebral artery lesions. The combination of these two syndromes has only been reported in a child with limbic encephalitis. In this case, a 44-year-old woman with bilateral middle cerebral artery infarction, which occurred 2 years prior, could walk independently. However, she showed automatic-voluntary dissociation and anarthria with preserved writing skills. She also presented hypersexuality, hypermetamorphosis, and memory disturbances. Here, we report a case of an adult stroke patient who suffered from bilateral anterior opercular syndrome accompanied by partial Kluver-Bucy syndrome. PMID:27446793

  4. BILATERAL ANTERIOR DISLOCATION OF SHOULDER WITH GREATER TUBEROSITY FRACTURE DUE TO HYPONATREMIA : A RARE PRESENTATION

    OpenAIRE

    Sivananda; Sudheer; Varun Kumar; Mani Kumar

    2015-01-01

    We here report a rare presentation of bilateral anterior dislocation of shoulder with associated fracture of greater tuberosity in a 38 year old male due to minor trauma which he sustained secondary to hyponatremia induced irritability. There was no associ ated rotator cuff tear which is often associated with BADS which makes this presentation unique. Unilateral dislocation of shoulder is a common condition which is frequently encountered in emergency trauma department. Ante...

  5. Surgical Treatment of a Rare Isolated Bilateral Agenesis of Anterior and Posterior Cruciate Ligaments

    Directory of Open Access Journals (Sweden)

    G. Cerulli

    2014-01-01

    Full Text Available The isolated bilateral agenesis of both cruciate ligaments is a rare congenital disorder. A 17-year-old male came to our attention due to an alteration in gait pattern, pain, and tendency to walk on the forefoot with his knee flexed. The patient did not recall previous injuries. Upon physical examination anterior and posterior chronic instability were observed. Radiographic examination of both knees showed hypoplasia of the tibial eminence, a hypoplastic lateral femoral condyle, and a narrow intercondylar notch. MRI brought to light a bilateral agenesis of both posterior cruciate ligaments. Arthroscopic evaluation confirmed bilateral isolated agenesis of both cruciate ligaments. We recommended a rehabilitation program to prepare the patient for the arthroscopic construction of both cruciate ligaments.

  6. Bilateral Simultaneous Anterior Cruciate Ligament Injury: A Case Report and National Survey of Orthopedic Surgeon Management Preference

    OpenAIRE

    Ehsan Saadat; Emily J. Curry; Xinning Li; Matzkin, Elizabeth G.

    2014-01-01

    Unilateral anterior cruciate ligament (ACL) tear is a common injury seen by sports medicine orthopedic surgeons. However, a bilateral simultaneous ACL injury is extremely rare and has been reported only three times in the literature. We present a young female skier with simultaneous bilateral ACL tears that were managed with staged ACL reconstruction. We then conducted a nationwide survey (United States) to determine the prevalence of simultaneous bilateral ACL tear and preferred management s...

  7. Neuropatia óptica isquêmica anterior e poliarterite nodosa: relato de caso Anterior ischemic optic neuropathy and polyarteritis nodosa: case report

    OpenAIRE

    Christie Michelle Graf; Thelma Larocca Skare; Carlos Augusto Moreira

    2006-01-01

    Descreve-se uma paciente com diagnóstico de poliarterite nodosa, em tratamento com citostáticos e corticosteróides que desenvolveu neuropatia óptica isquêmica anterior, uma manifestação considerada bastante rara para esta doença.We describe a patient with polyarteritis nodosa being treated with cytostatics and corticosteroids who developed an anterior ischemic optic neuropathy, a rare manifestation of this pathology.

  8. Neuropatia óptica isquêmica anterior e poliarterite nodosa: relato de caso Anterior ischemic optic neuropathy and polyarteritis nodosa: case report

    Directory of Open Access Journals (Sweden)

    Christie Michelle Graf

    2006-02-01

    Full Text Available Descreve-se uma paciente com diagnóstico de poliarterite nodosa, em tratamento com citostáticos e corticosteróides que desenvolveu neuropatia óptica isquêmica anterior, uma manifestação considerada bastante rara para esta doença.We describe a patient with polyarteritis nodosa being treated with cytostatics and corticosteroids who developed an anterior ischemic optic neuropathy, a rare manifestation of this pathology.

  9. Thrombolysis in anterior versus posterior circulation strokes: timing of recanalization, ischemic tolerance, and other differences.

    Science.gov (United States)

    Pagola, Jorge; Ribo, Marc; Alvarez-Sabin, José; Rubiera, Marta; Santamarina, Estevo; Maisterra, Olga; Delgado-Mederos, Raquel; Ortega, Gemma; Quintana, Manuel; Molina, Carlos A

    2011-04-01

    Previous studies have suggested a greater ischemic tolerance in posterior circulation as compared to anterior cerebral circulation. We aimed to investigate whether a differential response exists between anterior and posterior circulation strokes. Two hundred and four middle cerebral artery (MCA) patients and 28 basilar artery occlusion (BAO) patients treated with intravenous recombinant tissue plasminogen activator were included. Transcranial Doppler assessed recanalization at different time points. Patients were divided in three groups: total time of ischemia (TTI)24 hours. We calculated the percentage of recovery (admission National Institutes of Health Stroke Scale [NIHSS]- discharge NIHSS/admission NIHSS)×100. Mean time to treatment was longer in BAO patients (P=.031). Early recanalization was more frequent among MCA occlusions (41% vs 29%; P=.039); the rate of persisting occlusion at 24 hours was similar (P=.933). Clinical recovery according to TTI was similar in each group: 24 hours: BAO -44%/MCA 11% (P=.23). For each hour of ischemia MCA patients worsened 1.78% (P=.035) and BAO 1.76% (P=.421). MCA occlusions compared to BAO were independently associated with hemorrhagic transformation (OR: 8.2; P=.043). Our data do not support the theory of increased ischemic tolerance in posterior circulation. Despite longer time-to-treatment, BAO were more resistant to hemorrhagic transformations. PMID:20040010

  10. Bilateral spontaneous anterior dislocation of intraocular lens with the capsular bag in a patient with pseudoexfoliation

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    Harsha Bhattacharjee

    2015-01-01

    Full Text Available We report a rare case of bilateral spontaneous anterior partial in-the-bag intraocular lens (IOL dislocation in a 75-year-old man with pseudoexfoliation (PXF. He underwent uneventful phacoemulsification in both eyes with in-the-bag IOL implantation 9 years back. In the right eye, single piece poly (methyl methacrylate (PMMA IOL (+19 D and in the left eye, single piece acrylic foldable IOL (+19 D were implanted. An attempt at pharmacological IOL repositioning was unsuccessful. The dislocated IOLs were explanted and exchanged with scleral suture fixated PMMA IOLs. Vision improved to 20/30 in both eyes following surgery, without any associated ocular morbidity. We believe that zonular weakness secondary to PXF, capsular contraction, and myopia together were the predisposing factors for partial anterior dislocation of IOLs and IOL exchange with scleral suture fixation of IOL is a safe and effective treatment option.

  11. Delayed surgical treatment for a traumatic bilateral cervical facet joint dislocation using a posterior-anterior approach: a case report

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    Shimada Takashi

    2013-01-01

    Full Text Available Abstract Introduction There have been few reports of patients with bilateral cervical facet dislocations that remain untreated for eight weeks or more. We report the case of a 76-year-old man with an old bilateral cervical facet joint dislocation fracture that was treated by posterior-anterior reduction and fixation. Case presentation A 76-year-old Asian man was involved in a road traffic accident. He presented with neck pain and arm pain on his right side, but motor weakness and paralysis were not observed. He was treated conservatively; however, instability and spondylolisthesis at the C5 to C6 joint increased eight weeks after the injury. We performed a posterior-anterior reduction and fixation. After surgery, bony union was achieved, and his neck pain and arm pain disappeared. Conclusion We recommend reduction and fixation surgery if a patient has an old bilateral facet joint dislocation fracture in the cervical spine.

  12. Bilateral Common Carotid Artery Occlusion in Spontaneously Hypertensive Rats: A Feasible Animal Model for Ocular Ischemic Syndrome.

    Science.gov (United States)

    Wang, Yacong; Fan, Yuhua; Zhang, Lihong; Wang, Yi-Xiang J; Qi, Wei; Liang, Willmann; Wang, Chunmei; T W Yew, David; Ye, Cunxi; Sha, Ou

    2016-06-01

    The purpose of this study was to investigate the feasibility of inducing ocular ischemic syndrome in spontaneously hypertensive rats. Hypertensive and normotensive Wistar-Kyoto rats had bilateral occlusion or sham surgery. They were divided into 4 groups: (1) hypertensive-ischemia, (2) hypertensive-sham, (3) normotensive-ischemia, and (4) normotensive-sham. Four months after the operation, the global changes of the eye and pupillary light reflex were assessed. Then each rat was perfused, and randomly one of the bulbuses oculi was prepared as retinal flat mounts for investigation of vascular changes. The opposite eyeball was prepared as a paraffin section for observation of the linear density of retinal ganglion cells and for thickness measurement. One hypertensive-ischemia rat had a cataract in one eye and another rat in the same group had bulbus oculi collapse in one eye. The light reflex disappeared in 13.33% of hypertensive-ischemia rats, and the rest of the hypertensive-ischemia rats and normotensive-ischemia rats had slow reflex. Compared with the respective controls, the peripheral retinal vascular network in hypertensive-ischemia and normotensive-ischemia rats was sparse; linear density of the retinal ganglion cells was significantly reduced; and the retinal thickness was reduced. Compared with normotensive-ischemia rats, the hypertensive-ischemia rats demonstrated more severe changes. After bilateral common carotic artery occlusion, the eyes of hypertensive rats developed various pathological changes similar to those of ocular ischemic syndrome. In conclusion, an animal model for ocular ischemic syndrome can be created by bilateral common carotid artery occlusion in spontaneously hypertensive rats. Anat Rec, 299:806-814, 2016. © 2016 Wiley Periodicals, Inc. PMID:26917224

  13. Impending anterior ischemic optic neuropathy with elements of retinal vein occlusion in a patient on interferon for polycythemia vera

    OpenAIRE

    Rue KS; Hirsch LK; Sadun AA

    2012-01-01

    Kelly S Rue, Louis K Hirsch, Alfredo A SadunDepartment of Neuro-Ophthalmology, Doheny Eye Institute and Keck School of Medicine, University of Southern California, Los Angeles, CA, USAAbstract: We describe the course and likely pathophysiology of impending anterior ischemic optic neuropathy (AION) and retinal vein occlusion in a 56-year-old man with polycythemia vera managed with interferon alpha for 2 years. Our patient presented with decreased vision, scintillating scotomata, and floaters. ...

  14. The Association between Diabetes Mellitus and Nonarteritic Anterior Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis

    OpenAIRE

    CHEN Ting; Song, Delu; Shan, Guangliang; Wang, Ke; Wang, Yiwei; Ma, Jin; Zhong, Yong

    2013-01-01

    Background The association of diabetes mellitus (DM) with nonarteritic anterior ischemic optic neuropathy (NAION) has been inconclusive. Purpose To determine whether DM is associated with an increased risk of NAION. Methods A comprehensive literature search was performed for published studies reporting both DM and NAION based on PubMed and EMBASE. After reviewing characteristics of all the included studies systematically, meta-analytical method was employed to calculate the pooled odds ratio ...

  15. Arteritic anterior ischemic optic neuropathy associated with chronic myelomonocytic leukemia (CMML: A case report

    Directory of Open Access Journals (Sweden)

    Miriam García Fernández

    2015-02-01

    Full Text Available Introduction: Ocular involvement in patients with CMML is rarely reported, owing in part to the fact that the severe illness faced by many of these patients limits the feasibility of ocular examinations. Nevertheless, post-mortem examination of the eyes of patients without ophthalmological symptoms and diagnosis of CMML, has revealed ocular infiltration of atypical cells. Case report: A 72-year-old man presented with two days of left-sided blurring of vision and an episode of transient visual obscuration associated to periorbitary pain. A relative afferent pupillary defect was present in the LE. Fundus examination revealed optic disc swelling in LE. The erythrocyte sedimentation rate (ESR was 120 mm (1st hour and C-reactive protein was 7.8. Complementary examinations yielded normal findings. A presumptive diagnosis of arteritic anterior ischemic optic neuropathy (AAION was made. Treatment with endovenous bolus of methylprednisolone, followed by slow-tapering of oral steroids, was started, without improvement. Temporal artery biopsy confirmed the diagnosis. Conclusions: To our knowledge, this is the second case in peer-reviewed literature reporting the association between AAION and CMML. A possible explanation is the fact that small vessel vasculitis, of unclear pathogenesis so far, complicates approximately 10% of CMML and presents as cutaneous vasculitis and lupus-like syndromes. Therefore, this may be in relation with the vasculitis of the short posterior ciliary arteries which happens in cases of AAION.

  16. Analysis of Fundus Photography and Fluorescein Angiography in Nonarteritic Anterior Ischemic Optic Neuropathy and Optic Neuritis

    Science.gov (United States)

    Kim, Min Kyung

    2016-01-01

    Purpose We evaluated fundus and fluorescein angiography (FAG) findings and characteristics that can help distinguish nonarteritic anterior ischemic optic neuropathy (NAION) from optic neuritis (ON). Methods Twenty-three NAION patients and 17 ON with disc swelling patients were enrolled in this study. We performed fundus photography and FAG. The disc-swelling pattern, hyperemia grade, presence of splinter hemorrhages, cotton-wool spots, artery/vein ratio and degree of focal telangiectasia were investigated. The FAG findings for each patient were compared with respect to the following features: the pattern of disc leakage in the early phase, arteriovenous (artery/vein) transit time (second), and the presence and pattern of the filling delay. Results Cotton-wool spots, focal telangiectasia, and venous congestion were more common in the affected eyes of NAION patients. Upon FAG, 76.5% of the patients in the ON group exhibited normal choroidal circulation. However, 56.5% of patients in the NAION group demonstrated abnormal filling defects, such as peripapillary, generalized, or watershed zone filling delays. Conclusions Fundus findings, including cotton-wool spots, focal telangiectasia, and venous congestion in the affected eye, may be clues that can be used to diagnose NAION. In addition, choroidal insufficiencies on FAG could be also helpful in differentiating NAION from ON. PMID:27478356

  17. Central Corneal Thickness Measurements in Nonarteritic Anterior Ischemic Optic Neuropathy Patients: A Controlled Study

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    Haneen Jabaly-Habib

    2014-01-01

    Full Text Available Purpose. To measure central corneal thickness (CCT in patients with history of nonarteritic anterior ischemic optic neuropathy (NAION. Patients and Methods. Patients older than 40 years with a history of NAION (group 1 were prospectively evaluated including full eye examination and central corneal thickness (CCT pachymetry. Patients with a history of intraocular surgery, corneal disease, glaucoma, and contact lens wear were excluded. Measurements were also performed in a gender and age matched control group (group 2. Results. Thirty-one eyes of 31 NAION patients in group 1 were included and 30 eyes of 30 participants in group 2. There were 15 men in group 1 and 9 in group 2 P=0.141, and mean age of the patients was 59±10 years in group 1 versus 61±11 years in group 2 P=0.708. Mean CCT was 539±30 microns in group 1 and 550±33 microns in group 2 P=0.155. Conclusion. Patients with NAION have no special characteristic of CCT in contrast to the crowded optic disc known to be a significant anatomic risk factor for NAION. More studies should be carried out to investigate CCT and other structure related elements in NAION patients.

  18. Traumatic bilateral testicular dislocation associated with an anterior posterior compression fracture of the pelvis: a case report.

    Science.gov (United States)

    Smith, Christopher S; Rosenbaum, Corey S; Harris, A Michael

    2012-01-01

    Traumatic dislocation of a single testicle is an exceedingly rare event and bilateral dislocation is even less common. Traumatic testicular dislocation occurs by the mechanism of direct pressure exerted on the scrotum. Motorcycle collisions are the most frequent causative mechanism, usually related to deceleration straddle injuries. Since traumatic testicular dislocation is associated with other severe injuries, it is usually a late finding, leading to delayed diagnosis and treatment. This report describes a rare case of a patient involved in a motorcycle crash who sustained bilateral testicular dislocation associated with an anterior posterior compression pelvic fracture. To date, there are no reported cases involving management of bilateral testicular dislocation discovered during open reduction and internal fixation of the pelvis. Because the orthopaedic traumatologist may be the first to assess patients with pelvic fracture requiring surgery, the authors feel it is important to raise awareness of this injury. PMID:23199946

  19. Thallium-201 evidence that anterior ST segment depression during early acute inferior myocardial infarction reflects septal or posterolateral ischemic injury

    International Nuclear Information System (INIS)

    The pathogenesis of anterior (ANT) ST segment depression (ST decreasing) during acute inferior myocardial infarction (IMI) remains controversial. To evaluate the role of septal (S) or posterolateral (PL) ischemic injury (IS), resting thallium-201 (T1-201) scintigrams closely timed to ECG findings (mean 21+-21 minutes) were evaluated in 49 consecutive pts during the first 5 hrs of a first acute IMI. ANT ST decreasing (any lead V1-V4) of ≥ 1.0 mm was considered significant. All 49 pts had inferior T1-201 defects. In all 38 pts with ANT ST decreasing, there was T1-201 evidence of PL and/or S IS. In 9 of 11 pts without ANT ST decreasing, IS was confined to the inferior wall. The magnitude of inferior lead ST segment elevation correlated well with ST decreasing in leads 1 and AVL (r=0.88) and poorly with ST decreasing in anterior leads (r=0.32, supporting the concept that in acute IMI, ST decreasing in 1 and AVL is a reciprocal electrical phenomenon, but that ANT ST decreasing has a different pathogenesis. Thus the authors conclude that anterior ST depression in acute inferior myocardial infarction is associated with additional septal and/or posterolateral ischemic injury and does not reflect a benign reciprocal electrical phenomenon

  20. Diode Laser 810 Nm as a Potential Treatment to Improve Visual Function in Nonarteritic Anterior Ischemic Optic Neuropathy (NAION

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Heidari

    2011-01-01

    Full Text Available Nonarteritic anterior ischemic optic neuropathy (NAION is one of the most widespread visually disabling diseases in the middle-aged and elderly population. The optic nerve damage appears to result from a perfusion insufficiency in the short posterior ciliary arteries leading to infarction of the retrolaminar portion of the optic disc. Induced Heat shock protein (Hsp is known to have neuroprotective effects against ischemic injury of the central nervous system in mammals. Transpupillary thermotherapy (TTT application to the optic nerve head induces Hsp70 expression. We hypothesize that Transpupillary thermotherapy (TTT could be a novel method for improving and preserving the function of the optic nerve fibers in the eye with NAION. An 810-nm diode laser beam is focused to the center of the optic nerve head to induce Hsp. Controlled prospective and randomized clinical trial is necessary to confirm conclusively the effectiveness of this method.

  1. Bulectomia bilateral por cirurgia torácica vídeo-assistida uniportal combinada com acesso contralateral ao mediastino anterior Bilateral bullectomy through uniportal video-assisted thoracoscopic surgery combined with contralateral access to the anterior mediastinum

    Directory of Open Access Journals (Sweden)

    Nan Song

    2013-02-01

    Full Text Available OBJETIVO: A cirurgia torácica vídeo-assistida (CTVA tem sido uma intervenção de escolha para o tratamento de pneumotórax espontâneo (PS com bolha pulmonar. Nosso objetivo foi apresentar uma abordagem de CTVA uniportal unilateral para bulectomia bilateral e avaliar sua eficácia terapêutica. MÉTODOS: Entre maio de 2011 e janeiro de 2012, cinco pacientes foram submetidos a bulectomia bilateral por essa abordagem. Todos apresentavam PS bilateral. A TCAR pré-operatória mostrou que todos os pacientes tinham bolhas bilaterais no pulmão apical. As indicações cirúrgicas, os procedimentos de operação e os desfechos foram revisados. RESULTADOS: Todos os pacientes foram submetidos com sucesso a essa abordagem para bulectomia bilateral, sem complicações intraoperatórias. A mediana de tempo para a retirada do dreno torácico foi de 4,2 dias, e a mediana do tempo de hospitalização no pós-operatório foi de 5,2 dias. A mediana de seguimento pós-operatório foi de 11,2 meses. Um paciente teve recidiva de PE do lado esquerdo três semanas após a cirurgia e foi submetido a abrasão pleural. CONCLUSÕES: A bulectomia bilateral utilizando CTVA uniportal combinada com acesso contralateral ao mediastino anterior é tecnicamente confiável e promove desfechos favoráveis para pacientes com PS que desenvolvem bolhas bilaterais no pulmão apical. Entretanto, para a realização desse procedimento cirúrgico, são necessários cirurgiões com experiência em CTVA, instrumentos toracoscópicos longos, entre outras exigências.OBJECTIVE: Video-assisted thoracoscopic surgery (VATS has been a surgical intervention of choice for the treatment of spontaneous pneumothorax (SP with lung bulla. Our objective was to introduce a uniportal VATS approach for simultaneous bilateral bullectomy and to evaluate its therapeutic efficacy. METHODS: Between May of 2011 and January of 2012, five patients underwent bilateral bullectomy conducted using this approach. All

  2. Rehabilitation of a Completely Edentulous Patient with Nonreducible Bilateral Anterior Dislocation of the Temporomandibular Joint: A Prosthodontic Challenge-Clinical Report.

    Science.gov (United States)

    Momani, Moath; Abdallah, Mohamed-Nur; Al-Sebaie, Derar; Tamimi, Faleh

    2016-07-01

    Nonreduced bilateral anterior dislocation of the temporomandibular joint (TMJ) is an extremely rare condition, and its prosthodontic rehabilitation is a clinical challenge, especially in patients who refuse to or cannot undergo surgery. There are no previous clinical reports of successful or standardized prosthetic rehabilitation approaches for patients with this condition. This clinical report describes the successful prosthodontic management of an edentulous patient with nonreduced bilateral anterior dislocation of the TMJ. PMID:26216338

  3. Bilateral simultaneous anterior cruciate ligament injury: a case report and national survey of orthopedic surgeon management preference

    Directory of Open Access Journals (Sweden)

    Ehsan Saadat

    2014-12-01

    Full Text Available Unilateral anterior cruciate ligament (ACL tear is a common injury seen by sports medicine orthopedic surgeons. However, a bilateral simultaneous ACL injury is extremely rare and has been reported only three times in the literature. We present a young female skier with simultaneous bilateral ACL tears that were managed with staged ACL reconstruction. We then conducted a nationwide survey (United States to determine the prevalence of simultaneous bilateral ACL tear and preferred management strategies by sports medicine orthopedic surgeons. Sports medicine fellowship directors were contacted and asked to send an 8-item survey to colleagues (sports medicine fellowship trained surgeons asking about overall number of ACL reconstructions performed, number of bilateral simultaneous ACL injuries seen and optimal management strategies of such an injury. Out of 43 responses, only 22 (51.2% surgeons had seen a bilateral simultaneous ACL injury. Of these, 16 (76.2% preferred staged reconstruction. Graft choice was mixed between autograft and allograft, but a large majority preferred either patellar tendon autograft (58% or hamstring autograft (41% were the most common choice. Staged reconstruction is the treatment of choice by surgeons surveyed in our study.

  4. Risk of Nonarteritic Anterior Ischemic Optic Neuropathy Following End-Stage Renal Disease.

    Science.gov (United States)

    Chang, Yuh-Shin; Weng, Shih-Feng; Chang, Chun; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Wang, Jiu-Yao; Jan, Ren-Long

    2016-03-01

    To investigate the risk of nonarteritic anterior ischemic optic neuropathy (NAION) following end-stage renal disease (ESRD).A retrospective, nationwide, matched cohort study.ESRD patients identified by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 585.The study cohort included 93,804 ESRD patients registered with the Taiwan National Health Insurance Research Database between January 2000 and December 2009. An age- and sex-matched control group comprised 93,804 patients (case:control = 1:1) selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected from the index date until December 2011. The incidence and risk of NAION were compared between the ESRD and control groups. The adjusted hazard ratio (HR) for NAION after adjustment for potential confounders was obtained by a Cox proportional hazard regression analysis. A Kaplan-Meier analysis was used to calculate the cumulative incidence rate of NAION.The incidence of NAION following ESRD.In total, 133 ESRD patients (0.14%) and 51 controls (0.05%) had NAION (P leading to a significantly elevated risk of NAION in the ESRD patients compared with the controls (incidence rate ratio = 3.14, 95% confidence interval [CI] = 2.11-4.67). After adjustment for potential confounders including diabetes mellitus, hypertension, hypotension, hyperlipidemia, and 2-way interaction terms between any 2 factors, ESRD patients were 3.12 times more likely to develop NAION than non-ESRD patients in the full cohort (adjusted HR = 3.12, 95% CI = 2.10-4.64). Additionally, patients with hypertension and hyperlipidemia showed higher incidence rates of NAION in the ESRD group compared with the controls: 2.31 (95% CI = 1.40-3.82) for hypertension and 2.72 (95% CI = 1.14-6.50) for hyperlipidemia.ESRD increased the risk of NAION, which is an interdisciplinary emergency. Close collaboration between nephrologists and

  5. Dissecting Aneurysms of Bilateral Anterior Cerebral Artery Complicated by Subarachnoid Hemorrhage After Cerebral Infarction: A Case Report

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    Akihiro Kurosu

    2008-01-01

    Full Text Available Introduction: Intracranial dissecting aneurysms have been increased due to recent advancements in diagnostic imaging. However there have been little article with subarachnoid hemorrhage and cerebral infarction occurring almost at the same time. We performed the surgical treatment and obtained good result.Case presentation: A 47-year-old male presented to our hospital with chief complaints of sudden headache and mild paralysis of the left lower extremity. Brain imaging at admission revealed cerebral infarction in the right frontal lobe and subarachnoid hemorrhage in the frontal convexy and anterior interhemispheric fissure. The left and right internal carotid angiography showed a bulging cerebral aneurysm at the left A1–A2 junction and stenosis and arterial dissections in the peripheral of the bilateral anterior cerebral artery. Wrapping was performed for the dissecting aneurysm of the left anterior cerebral artery. For the right anterior cerebral artery, trapping was performed at the A2 segment without vascular anastomosis. The patient’s postoperative course was uneventful.Conclusion: A consensus has not been reached on the treatment for intracranial dissecting aneurysms. Proximal trapping without vascular reconstruction was performed for the right anterior cerebral artery without vascular anastomosis to prevent rebleeding. However no symptoms of neurological deficiency were observed. Proximal trapping of dissecting aneurysm seems to be a good option when patient’s functional and life prognosis are taken into account in case that vascular reconstruction will be anticipated difficulty.

  6. Combined Effect of Bilateral Ovariectomy and Anterior Cruciate Ligament Transection With Medial Meniscectomy on the Development of Osteoarthritis Model

    Science.gov (United States)

    2016-01-01

    Objective To investigate the combined effect of bilateral ovariectomy (OVX) and anterior cruciate ligament transection (ACLT) with medial meniscectomy (MM) on the development of osteoarthritis (OA). Methods Twenty female 15-week-old Sprague-Dawley rats were used. Five rats in each group underwent bilateral OVX (OVX group), bilateral ACLT with MM (ACLT with MM group), bilateral OVX plus ACLT with MM (OVX plus ACLT with MM group), and sham surgery (SHAM group). All the rats were subjected to treadmill running for 4 weeks. The behavioral evaluation for induction of OA used the number of rears method, and this was conducted at 1, 2, and 4 weeks post-surgery. Bone mineral density (BMD) was calculated with micro-computerized tomography images and the modified Mankin's scoring was used for the histological changes. Results The number of rears in the OVX plus ACLT with MM group decreased gradually and more rapidly in the ACLT with MM group. Histologically, the OVX plus ACLT with MM group had a significantly higher modified Mankin's score than the OVX group (p=0.008) and the SHAM group (p=0.008). BMDs of the OVX plus ACLT with MM group were significantly lower than the SHAM group (p=0.002), and the ACLT with MM group (p=0.003). Conclusion We found that bilateral OVX plus ACLT with MM induced definite OA change in terms of histology and BMD compared to bilateral OVX and ACLT with MM alone. Therefore, OVX and ACLT with MM was an appropriate degenerative OA rat model. PMID:27606264

  7. Computed tomography perfusion imaging may predict cognitive impairment in patients with first-time anterior circulation transient ischemic attack.

    Science.gov (United States)

    Wang, Jun; Li, Yunming; Zheng, Bo; Wang, Jian; Wang, Zhiqiang; Duan, Dan; Li, Yuxia; Wang, Qingsong

    2016-04-01

    To determine whether computed tomography perfusion imaging (CTPI)-derived parameters are associated with vascular cognitive impairment (VCI) in patients with transient ischemic attack (TIA). Patients with first-time anterior circulation TIA (diagnosed within 24 h of onset) and normal cognition, treated between August 2009 and August 2014 at the Department of Neurology of Chengdu Military General Hospital, China, were analyzed retrospectively. Patients underwent whole-brain CTPI within 1 week of TIA to detect cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) in the ischemic region. Based on cognitive function assessment 4 weeks after TIA, using the Montreal cognitive assessment (MoCA) and mini mental state examination, the patients were divided into control and VCI groups. CTPI parameters and other clinical data were compared between groups, and Spearman's correlation analysis used to identify associations between cognitive scores and CTPI parameters in the VCI group. 50 patients (25 per group; aged 55-72 years) were included. Patient age, gender, smoking status, alcohol consumption, educational level, time from TIA onset to admission, time from TIA onset to CTPI, and prevalence of hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation and hyperhomocysteinemia did not differ between groups. Both groups showed TTP and MTT prolongation, CBF reduction, but no change in CBV in the ischemic region; these changes were significantly larger in the VCI group (P < 0.05). MTT correlated negatively with MoCA score (r = -0.51, P = 0.009). CTPI could facilitate early diagnosis of VCI in patients with anterior circulation TIA. PMID:26721459

  8. Establishing an experimental model of photodynamic induced anterior ischemic optic neuropathy

    Institute of Scientific and Technical Information of China (English)

    Runsheng Wang; Xiaodi Wang; Peilin Lü; Jianwei Bai; Jianzhou Wang; Xiaoqin Lei; Xiaoliang Zhou; Hongfen Sun; Aizhu Pan

    2006-01-01

    BACKGROUND: Scholars have supposed to establish animal models of optic neuropathy by pressing and partially amputating optic nerve, increasing intraocular pressure and injecting vasoconstrictor, etc., but the models are greatly different from anterior ischemia optic neuropathy. Therefore, a more ideal method is needed to establish animal model of anterior ischemic optic neuropathy (AION).OBJECTIVE: To establish AION models in rats, observe the functional changes of fundus, fundus fluorescein angiography (FFA), optical coherence tomography (OCT), flash visual evoked potential (F-VEP), and histopathologically confirm its reliability.DESIGN: A randomized control trial.SETTINGS: Department of Ophthalmology, Xi'an Fourth Hospital; Xi'an Institute of Ocular Fundus Diseases.MATERIALS: The experiments were carried out in the research room of Xi'an Institute of Ocular Fundus Diseases from February 2005 to May 2006. Thirty healthy male SD rats of 4-5 weeks old, weighing 140-160 g,were provided by the animal experimental center of the Fourth Military Medical University of Chinese PLA [SCXK (Military)2002-005], and those without eye disease examined by slit lamp and direct ophthalmoscope after mydriasis were enrolled. The conditions for feeding mice without special pathogen were strictly followed.The rats were randomly divided into blank control group (n =5), laser group (n =5), hematoporphyrin derivative (HPD) group and AION group (n =15), each group was numbered randomly. For each rat, the right eye was taken as the experimental eye, and the left one as the control one.METHODS: In the AION group, the rats were injected with HPD (10 mg/kg) via caudal vein, and then the optic discs were exposed to krypton red (647 nm, 80 mV) for 120 s, and the rats were in avoidance of light for 2 weeks postoperatively. Rats in the laser group were only exposed to krypton red (647 nm, 80 mV) for 120 s, and in avoidance of light for 2 weeks postoperatively; Those in the HPD group were only

  9. Bilateral spontaneous crystalline lens dislocation to the anterior chamber: A case report

    OpenAIRE

    Jovanović Miloš

    2013-01-01

    Introduction. There are various reasons for the lens dislocation. Spontaneous dislocation of a clear lens is extremely rare, especially its dislocation to the anterior chamber. Case Outline. The author presents a case of spontaneous clear lens dislocation to the anterior chamber in both eyes in a patient without the history of any trauma. Dislocation occurred spontaneously, first in the left eye, along with a sudden decrease of vision. The ophthalmologist f...

  10. Bilateral Carotid and Vertebral Rete Mirabile Presenting with a Prominent Anterior Spinal Artery Mimicking a Spinal Dural AV Fistula at MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Young; Cha, Sang Hoon [Chungbuk National University College of Medicine, Iksan (Korea, Republic of)

    2011-11-15

    Bilateral carotid and vertebral rete mirabile (CVRM) is a very rare condition. We report a new case of CVRM initially detected by magnetic resonance imaging (MRI) of the cervical spine. MRI demonstrated tortuous vascular signal voids limited to the anterior cerebrospinal fluid space mimicking spinal dural arteriovenous fistula. A diagnosis of CVRM was confirmed on the basis of angiographic findings of rete formation associated with bilateral aplasia of the cavernous internal carotid and vertebral arteries without abnormal arteriovenous connection.

  11. Bilateral Carotid and Vertebral Rete Mirabile Presenting with a Prominent Anterior Spinal Artery Mimicking a Spinal Dural AV Fistula at MRI

    International Nuclear Information System (INIS)

    Bilateral carotid and vertebral rete mirabile (CVRM) is a very rare condition. We report a new case of CVRM initially detected by magnetic resonance imaging (MRI) of the cervical spine. MRI demonstrated tortuous vascular signal voids limited to the anterior cerebrospinal fluid space mimicking spinal dural arteriovenous fistula. A diagnosis of CVRM was confirmed on the basis of angiographic findings of rete formation associated with bilateral aplasia of the cavernous internal carotid and vertebral arteries without abnormal arteriovenous connection.

  12. Comparison of the Deep Optic Nerve Head Structure between Normal-Tension Glaucoma and Nonarteritic Anterior Ischemic Optic Neuropathy

    Science.gov (United States)

    Kim, Tae-Woo; Hwang, Jeong-Min

    2016-01-01

    Purpose To compare the deep optic nerve head (ONH) structure between normal-tension glaucoma (NTG) and nonarteritic anterior ischemic optic neuropathy (NAION) and also in healthy subjects as a control using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT). Methods This prospective cross-sectional study included 21 NAION patients who had been diagnosed as NAION at least 6 months prior to study entry, and 42 NTG patients and 42 healthy controls who were matched with NAION patients in terms of age, intraocular pressure (IOP), and optic disc area. The retinal nerve fiber layer (RNFL) thickness in the affected sector was also matched between NAION and NTG patients. The ONH was imaged using SD-OCT with the EDI technique. The anterior lamina cribrosa surface depth (LCD) and average prelaminar tissue (PT) thickness were measured in a sector of interest in each eye and compared among the three groups. Results In the sector-matched comparison, LCD was largest in NTG patients, followed by NAION patients, while PT was thinner in NTG patients than in NAION patients (all P < 0.001). NAION patients had a comparable LCD and a thinner PT relative to normal controls (P = 0.170 and < 0.001, respectively). Conclusion The deep ONH configuration is strikingly different between NTG and NAION. The differing features provide comparative insight into the pathophysiology of the two diseases, and may be useful for differential diagnosis. PMID:27035660

  13. Should steroids be offered to patients with nonarteritic anterior ischemic optic neuropathy (NAION)?

    OpenAIRE

    Lee, Andrew G.; Biousse, Valérie

    2010-01-01

    The treatment of nonarteritic anterior optic neuropathy remains very limited and disappointing. Recent publications have suggested that oral steroids as well as intravitreal injections of steroids might be helpful to accelerate resolution of disc edema and improve visual outcome. However, the use of steroids to treat acute NAION remains largely debated.

  14. Case report 549: Case 1: Ischemic necrosis femoral heads with pathological fracture right femur. Case 2: Ischemic necrosis femoral heads with fracture bilaterally

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    McGlade, C.T.; Bassett, L.W.; Mirra, J.; Gold, R.H. (California Univ., Los Angeles (USA). Dept. of Radiological Sciences)

    1989-07-01

    Two cases have been presented in which ischemic necrosis was the cause of pathologic fractures of the femoral necks. Because these patients had primary malignancies that frequently seed in bone, metastatic disease was suspected to be responsible for the pathologic fractures. However, a history of use of corticosteroids and the absence of other skeletal lesions were the clues to the correct diagnosis in both cases. In Case 1, a patient with unilateral femoral head fracture, an MRI examination revealed ischemic necrosis in the asymptomatic contralateral hip. Currently, MRI and SPECT scanning are the most sensitive imaging methods for the diagnosis of ischemic necrosis. Ischemic necrosis should be considered in the differential diagnosis of pathological fracture of the femoral head when a patient has a history of predisposition for osteonecrosis. (orig.).

  15. Case report 549: Case 1: Ischemic necrosis femoral heads with pathological fracture right femur. Case 2: Ischemic necrosis femoral heads with fracture bilaterally

    International Nuclear Information System (INIS)

    Two cases have been presented in which ischemic necrosis was the cause of pathologic fractures of the femoral necks. Because these patients had primary malignancies that frequently seed in bone, metastatic disease was suspected to be responsible for the pathologic fractures. However, a history of use of corticosteroids and the absence of other skeletal lesions were the clues to the correct diagnosis in both cases. In Case 1, a patient with unilateral femoral head fracture, an MRI examination revealed ischemic necrosis in the asymptomatic contralateral hip. Currently, MRI and SPECT scanning are the most sensitive imaging methods for the diagnosis of ischemic necrosis. Ischemic necrosis should be considered in the differential diagnosis of pathological fracture of the femoral head when a patient has a history of predisposition for osteonecrosis. (orig.)

  16. Anterior urethral valve, a rare cause of bilateral vesicoureteral reflux in a two year old boy: A case report and a review of the literature

    Directory of Open Access Journals (Sweden)

    Amit Sharma

    2016-04-01

    Full Text Available Anterior urethral valve (AUV is a rare cause of obstructive uropathy in children. These are much rarer than posterior urethral valves. We report a case of a child with AUV and high grade bilateral vesicoureteric reflux. He was managed by transurethral laser ablation. The left sided reflux resolved after ablation. The right sided reflux persisted. The child is awaiting ureteric reimplantation.

  17. Impending anterior ischemic optic neuropathy with elements of retinal vein occlusion in a patient on interferon for polycythemia vera

    Directory of Open Access Journals (Sweden)

    Rue KS

    2012-10-01

    Full Text Available Kelly S Rue, Louis K Hirsch, Alfredo A SadunDepartment of Neuro-Ophthalmology, Doheny Eye Institute and Keck School of Medicine, University of Southern California, Los Angeles, CA, USAAbstract: We describe the course and likely pathophysiology of impending anterior ischemic optic neuropathy (AION and retinal vein occlusion in a 56-year-old man with polycythemia vera managed with interferon alpha for 2 years. Our patient presented with decreased vision, scintillating scotomata, and floaters. Fundus examination findings and results of a fluorescein angiogram led to the diagnosis of impending AION and retinal vein occlusion. Considering that both polycythemia vera and interferon have possible influences on vascular occlusion and optic disc edema, we stopped interferon treatment and immediately attempted to treat the polycythemia vera empirically with pentoxifylline and any interferon-associated inflammation with prednisone. Our patient experienced complete resolution of fundus abnormalities and return of normal vision within 3 weeks, which may be attributed to our successful treatment of both etiologies. Thus, further study is warranted to elucidate the treatment of both polycythemia vera and interferon-induced impending AION.Keywords: optic disc edema, interferon alpha, vascular occlusion, Roth spot, autoantibody, pentoxifylline

  18. Dynamic Single-Leg Postural Control Is Impaired Bilaterally Following Anterior Cruciate Ligament Reconstruction: Implications for Reinjury Risk.

    Science.gov (United States)

    Culvenor, Adam G; Alexander, Bryce C; Clark, Ross A; Collins, Natalie J; Ageberg, Eva; Morris, Hayden G; Whitehead, Timothy S; Crossley, Kay M

    2016-05-01

    Study Design Cross-sectional, controlled laboratory study. Background Postural control following anterior cruciate ligament reconstruction (ACLR) primarily has been investigated during static single-leg balance tasks. Little is known about dynamic postural control deficits post-ACLR. Objectives To compare dynamic postural control (bilaterally) in individuals who have undergone ACLR and in healthy controls, and to evaluate the relationship between dynamic postural control and self-reported and objective function. Methods Ninety-seven participants (66 male; median age, 28 years) 12 months post-ACLR and 48 healthy controls (20 male; median age, 30 years) underwent balance assessment using a Nintendo Wii Balance Board during a single-leg squat. Center-of-pressure (CoP) path velocity, as well as CoP amplitude and standard deviation, in both mediolateral (ML) and anteroposterior (AP) directions were recorded. Self-reported function was assessed with the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), while hop for distance was used to evaluate functional status. Results Compared to healthy controls, the ACLR group had greater mean CoP path velocity (16% higher, P = .004), ML range (23%, P<.001), ML SD (28%, P<.001), AP range (14%, P = .009), and AP SD (15%, P = .013), indicating worse dynamic balance post-ACLR. Dynamic balance performance was similar between the ACLR limb and the uninjured contralateral limb. The AP SD was weakly associated with hop performance (β = -.2, P = .046); no balance measures were associated with IKDC score. Conclusion Individuals who have undergone ACLR demonstrate impaired dynamic balance bilaterally when performing a single-leg squat, which may have implications for physical function and future injury risk. Routine dynamic balance assessment may help identify patients who could benefit from targeted neuromuscular training programs to improve objective function and potentially lower reinjury risk. J Orthop

  19. Decreases in electrocardiographic R-wave amplitude and QT interval predict myocardial ischemic infarction in Rhesus monkeys with left anterior descending artery ligation.

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    Xiaorong Sun

    Full Text Available Clinical studies have demonstrated the predictive values of changes in electrocardiographic (ECG parameters for the preexisting myocardial ischemic infarction. However, a simple and early predictor for the subsequent development of myocardial infarction during the ischemic phase is of significant value for the identification of ischemic patients at high risk. The present study was undertaken by using non-human primate model of myocardial ischemic infarction to fulfill this gap. Twenty male Rhesus monkeys at age of 2-3 years old were subjected to left anterior descending artery ligation. This ligation was performed at varying position along the artery so that it produced varying sizes of myocardial infarction at the late stage. The ECG recording was undertaken before the surgical procedure, at 2 h after the ligation, and 8 weeks after the surgery for each animal. The correlation of the changes in the ECG waves in the early or the late stage with the myocardial infarction size was analyzed. The R wave depression and the QT shortening in the early ischemic stage were found to have an inverse correlation with the myocardial infarction size. At the late stage, the R wave depression, the QT prolongation, the QRS score, and the ST segment elevation were all closely correlated with the developed infarction size. The poor R wave progression was identified at both the early ischemic and the late infarction stages. Therefore, the present study using non-human primate model of myocardial ischemic infarction identified the decreases in the R wave and the QT interval as early predictors of myocardial infarction. Validation of these parameters in clinical studies would greatly help identifying patients with myocardial ischemia at high risk for the subsequent development of myocardial infarction.

  20. Bilateral macular thickening in mild unilateral anterior uveitis: is HLA-B27 involved?

    Directory of Open Access Journals (Sweden)

    Wexler Alexandra

    2012-07-01

    Full Text Available Abstract Background Macular thickening (MT without clinically recognized macular edema has been described in anterior uveitis (AU. Although fellow-eyes of patients have been used as controls in several studies, little is known about macular thickness in these eyes. We studied the rate and extent of MT in both AU-affected and quiescent fellow-eyes of phakic AU patients with good visual acuity (VA. We also assessed macular thickness related to HLA-B27 presence and to recurrence, since these issues have been almost unexplored by previous optical coherence tomography (OCT studies. Methods Patients with AU were prospectively included and macular thickness was measured with OCT initially and on follow up. Macular thickness in patients’ affected eyes (n = 30 as well as in their quiet fellow-eyes (n = 28 was compared with eyes of age- and gender matched controls. Inter-ocular differences in macular thickness between AU affected eyes and their fellow-eyes were assessed in patients (n = 28, also in a subgroup with visual acuity ≥ 0.8 (n = 23 by one-sample Student’s t-tests. Inter-ocular differences were also assessed related to HLA-B27 presence and related to the status of current AU episode (initial or relapse. Results Subclinical MT is present in both quiet fellow-eyes and AU-affected eyes of patients. MT was found in most cases of AU, even in phakic eyes with good VA. There was a larger increase in macular thickness in HLA-B27-positive than in HLA-B27-negative patients. No differences in macular thickness were found between patients with their first AU episode and patients with recurrent episodes. Conclusions MT probably reflects systemic immune-mediated response to the inflammatory disorder in AU, and it is possible that HLA-B27-related factors are involved in the pathogenesis of AU. These observations are in line with and extend the current understanding of the mechanisms behind MT in AU.

  1. Repetitive Diving in Trained Rats Still Increases Fos Production in Brainstem Neurons after Bilateral Sectioning of the Anterior Ethmoidal Nerve

    Science.gov (United States)

    McCulloch, Paul F.; Warren, Erik A.; DiNovo, Karyn M.

    2016-01-01

    This research was designed to investigate the role of the anterior ethmoidal nerve (AEN) during repetitive trained diving in rats, with specific attention to activation of afferent and efferent brainstem nuclei that are part of this reflexive response. The AEN innervates the nose and nasal passages and is thought to be an important component of the afferent limb of the diving response. Male Sprague-Dawley rats (N = 24) were trained to swim and dive through a 5 m underwater maze. Some rats (N = 12) had bilateral sectioning of the AEN, others a Sham surgery (N = 12). Twelve rats (6 AEN cut and 6 Sham) had 24 post-surgical dive trials over 2 h to activate brainstem neurons to produce Fos, a neuronal activation marker. Remaining rats were non-diving controls. Diving animals had significantly more Fos-positive neurons than non-diving animals in the caudal pressor area, ventral medullary dorsal horn, ventral paratrigeminal nucleus, nucleus tractus solitarius, rostral ventrolateral medulla, Raphe nuclei, A5, Locus Coeruleus, and Kölliker-Fuse area. There were no significant differences in brainstem Fos labeling in rats diving with and without intact AENs. Thus, the AENs are not required for initiation of the diving response. Other nerve(s) that innervate the nose and nasal passages, and/or suprabulbar activation of brainstem neurons, may be responsible for the pattern of neuronal activation observed during repetitive trained diving in rats. These results help define the central neuronal circuitry of the mammalian diving response. PMID:27148082

  2. Intravitreal Injection of a Rho-Kinase Inhibitor (Fasudil) for Recent-Onset Nonarteritic Anterior Ischemic Optic Neuropathy.

    Science.gov (United States)

    Sanjari, Nasrin; Pakravan, Mohammad; Nourinia, Ramin; Esfandiari, Hamed; Hafezi-Moghadam, Ali; Zandi, Souska; Nakao, Shintaro; Shah-Heidari, Mohamamad-Hassan; Jamali, Arsia; Yaseri, Mehdi; Ahmadieh, Hamid

    2016-06-01

    This study evaluated the effects of intravitreal injection of fasudil (IVF), a Rho-kinase inhibitor, in cases of recent-onset nonarteritic anterior ischemic optic neuropathy (NAION). In this interventional case series, 13 eyes of 13 patients diagnosed with NAION within 14 days of onset were included. The affected eyes received a 0.025 mg/0.05 mL IVF. Functional and structural outcomes were assessed 1 and 3 months following treatment. Best corrected visual acuity (BCVA) was the main outcome measured, with mean deviation (MD) index of the VF test and peripapillary retinal nerve fiber layer thickness as secondary measures. There was a statistically significant improvement in the patients' BCVA 1 and 3 months following IVF; BCVA improved from 1.69 ± 0.55 logMAR at baseline to 0.98 ± 0.47 and 0.93 ± 0.51 logMAR at 1 and 3 months, respectively (P = .004). The change in BCVA was not significant between month 1 and month 3 (P = .22). Peripapillary retinal nerve fiber layer thickness decreased from 173.5 ± 29.28 µm in the baseline evaluation to 85.8 ± 8.8 µm at 1 month, and 62.9 ± 5.97 µm at 3 months (P = .003). MD values changed from 24.60 ± 3.80 to 21.0 ± 6.10 and 20.5 ± 6.50 at 1 and 3 months, respectively (P = .007 and .005, respectively). This pilot study suggests that IVF may be an effective treatment for patients with recent-onset NAION. Larger studies are required to establish the therapeutic role of fasudil for NAION. PMID:26444290

  3. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: first reported case and review of literature

    OpenAIRE

    Manoharan, Gopikanthan; Singh, Rohit; Ahmed, Bessam; Kathuria, Vinod

    2014-01-01

    The anatomy of the shoulder joint comprises a relatively large humeral head with a shallow glenoid cavity allowing a remarkable range of motion at the expense of inherent instability. Despite anterior shoulder dislocations being the most common type encountered, bilateral dislocations are rare and almost always posterior. The aetiology is usually direct or indirect trauma related to sports, seizures, electric shock or electroconvulsive therapy. We present the first reported case of atraumatic...

  4. Repetitive Diving in Trained Rats Still Increases Fos Production in Brainstem Neurons after Bilateral Sectioning of the Anterior Ethmoidal Nerve

    Directory of Open Access Journals (Sweden)

    Paul F Mcculloch

    2016-04-01

    Full Text Available This research was designed to investigate the role of the anterior ethmoidal nerve (AEN during repetitive trained diving in rats, with specific attention to activation of afferent and efferent brainstem nuclei that are part of this reflexive response. The AEN innervates the nose and nasal passages and is thought to be an important component of the afferent limb of the diving response. Male Sprague-Dawley rats (N=24 were trained to swim and dive through a 5 m underwater maze. Some rats (N=12 had bilateral sectioning of the AEN, others a Sham surgery (N=12. Twelve rats (6 AEN cut and 6 Sham had 24 post-surgical dive trials over 2 hrs to activate brainstem neurons to produce Fos, a neuronal activation marker. Remaining rats were non-diving controls. Diving animals had significantly more Fos-positive neurons than non-diving animals in the caudal pressor area, ventral medullary dorsal horn, ventral paratrigeminal nucleus, nucleus tractus solitarius, rostral ventrolateral medulla, Raphe nuclei, A5, Locus Coeruleus, and Kölliker-Fuse area. There were no significant differences in brainstem Fos labeling in rats diving with and without intact AENs. Thus the AENs are not required for initiation of the diving response. Other nerve(s that innervate the nose and nasal passages, and/or suprabulbar activation of brainstem neurons, may be responsible for the pattern of neuronal activation observed during repetitive trained diving in rats. These results help define the central neuronal circuitry of the mammalian diving response.

  5. A novel computed method to reconstruct the bilateral digital interarticular channel of atlas and its use on the anterior upper cervical screw fixation

    Science.gov (United States)

    Wu, Ai-Min; Wang, Wenhai; Xu, Hui; Lin, Zhong-Ke; Yang, Xin-Dong; Wang, Xiang-Yang; Xu, Hua-Zi

    2016-01-01

    Purpose. To investigate a novel computed method to reconstruct the bilateral digital interarticular channel of atlas and its potential use on the anterior upper cervical screw fixation. Methods. We have used the reverse engineering software (image-processing software and computer-aided design software) to create the approximate and optimal digital interarticular channel of atlas for 60 participants. Angles of channels, diameters of inscribed circles, long and short axes of ellipses were measured and recorded, and gender-specific analysis was also performed. Results. The channels provided sufficient space for one or two screws, and the parameters of channels are described. While the channels of females were smaller than that of males, no significant difference of angles between males and females were observed. Conclusion. Our study demonstrates the radiological features of approximate digital interarticular channels, optimal digital interarticular channels of atlas, and provides the reference trajectory of anterior transarticular screws and anterior occiput-to-axis screws. Additionally, we provide a protocol that can help make a pre-operative plan for accurate placement of anterior transarticular screws and anterior occiput-to-axis screws. PMID:26925345

  6. Estenosis isquémica tardía tras resección anterior de recto Late ischemic stricture following anterior rectal resection

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    J. Zuloaga

    2008-01-01

    Full Text Available Existe una incidencia no despreciable de lesiones de colon de origen isquémico tras resecciones anteriores bajas por cáncer. Presentamos un caso de estenosis isquémica de colon, no relacionada con radioterapia, a los 5 años de la cirugía. Se discute la dificultad del diagnóstico diferencial con recidiva tumoral, así como el importante papel que desempeña la endoscopia en el abordaje de estos pacientes.A considerable incidence of colonic strictures after oncologic low anterior resections has been reported. The present paper describes a colonic stricture 5 years after the surgery, and not related to radiotherapy, that required a challenging differential diagnosis with local recurrence of rectal cancer. The role of endoscopy in the management of this condition is discussed.

  7. Acute Ischemic Stroke Involving Both Anterior and Posterior Circulation Treated by Endovascular Revascularization for Acute Basilar Artery Occlusion via Persistent Primitive Trigeminal Artery

    Science.gov (United States)

    Fujita, Atsushi; Hosoda, Kohkichi; Kohmura, Eiji

    2016-01-01

    We report a case of acute ischemic stroke involving both the anterior and posterior circulation associated with a persistent primitive trigeminal artery (PPTA), treated by endovascular revascularization for acute basilar artery (BA) occlusion via the PPTA. An otherwise healthy 67-year-old man experienced sudden loss of consciousness and quadriplegia. Magnetic resonance imaging showed an extensive acute infarction in the right cerebral hemisphere, and magnetic resonance angiography showed occlusion of the right middle cerebral artery (MCA) and BA. Because the volume of infarction in the territory of the right MCA was extensive, we judged the use of intravenous tissue plasminogen activator to be contraindicated. Cerebral angiography revealed hypoplasia of both vertebral arteries and the presence of a PPTA from the right internal carotid artery. A microcatheter was introduced into the BA via the PPTA and revascularization was successfully performed using a Merci Retriever with adjuvant low-dose intraarterial urokinase. After treatment, his consciousness level and right motor weakness improved. Although persistent carotid-vertebrobasilar anastomoses such as a PPTA are relatively rare vascular anomalies, if the persistent primitive artery is present, it can be an access route for mechanical thrombectomy for acute ischemic stroke. PMID:27446523

  8. Acute Ischemic Stroke Involving Both Anterior and Posterior Circulation Treated by Endovascular Revascularization for Acute Basilar Artery Occlusion via Persistent Primitive Trigeminal Artery.

    Science.gov (United States)

    Imahori, Taichiro; Fujita, Atsushi; Hosoda, Kohkichi; Kohmura, Eiji

    2016-07-01

    We report a case of acute ischemic stroke involving both the anterior and posterior circulation associated with a persistent primitive trigeminal artery (PPTA), treated by endovascular revascularization for acute basilar artery (BA) occlusion via the PPTA. An otherwise healthy 67-year-old man experienced sudden loss of consciousness and quadriplegia. Magnetic resonance imaging showed an extensive acute infarction in the right cerebral hemisphere, and magnetic resonance angiography showed occlusion of the right middle cerebral artery (MCA) and BA. Because the volume of infarction in the territory of the right MCA was extensive, we judged the use of intravenous tissue plasminogen activator to be contraindicated. Cerebral angiography revealed hypoplasia of both vertebral arteries and the presence of a PPTA from the right internal carotid artery. A microcatheter was introduced into the BA via the PPTA and revascularization was successfully performed using a Merci Retriever with adjuvant low-dose intraarterial urokinase. After treatment, his consciousness level and right motor weakness improved. Although persistent carotid-vertebrobasilar anastomoses such as a PPTA are relatively rare vascular anomalies, if the persistent primitive artery is present, it can be an access route for mechanical thrombectomy for acute ischemic stroke. PMID:27446523

  9. Bilateral congenital absence of anterior cruciate ligaments associated with the scoliosis and hip dysplasia: a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    HU Jun; DU Shi-xin; HUANG Zhong-lian; XIA Xue

    2010-01-01

    @@ Congenital absence of the cruciate ligaments is an extremely rare condition with a prevalence of 0.017 per 1000 live births.~1 Niebauer and King~2 first reported this disease in 1960, and after that, similar cases have been reported. These cases are usually associated with other deformities of the knee joint, such as the joint dislocation, absence of the tibial intercondylar eminence, deformity of the meniscus, dysplasia of the distal femur, etc.~3 However, its association with multiple congenital abnormalities in other areas of the body has been rarely reported. Here, we report a patient with congenital deficiency of bilateral anterior cruciate ligaments associated with scoliosis and hip dysplasia, together with the result of four years follow-up along with a literature review.

  10. Bilateral ocular abnormalities in a wild stranded harp seal (Phoca groenlandica) suggestive of anterior segment dysgenesis and persistent hyperplastic primary vitreous.

    Science.gov (United States)

    Erlacher-Reid, Claire; Colitz, Carmen M H; Abrams, Ken; Smith, Ainsley; Tuttle, Allison D

    2011-06-01

    A male yearling harp seal (Phoca groenlandica) stranded and was brought to Mystic Aquarium & Institute for Exploration's Seal Rescue and Rehabilitation Center. The seal presented with a bilateral pendular vertical nystagmus, negative menace response, and a positive palpebral response. Ophthalmological examination by slit lamp biomicroscopy revealed perilimbal corneal edema, excessive iridal surface structures, pupils that appeared to be shaped improperly (dyscoria), and suspected cataracts. Attempts to dilate the pupils with both dark-lighted conditions and repeated dosages of 10% phenylephrine and 1% atropine ophthalmic solution in each eye (OU) were unsuccessful. Ocular ultrasonography findings suggested bilateral cataracts with flattened anterior-posterior (A-P) diameter and possible persistent hyperplastic primary vitreous. It is possible that these structural congenital abnormalities could produce further ocular complications for this seal including uveitis, secondary glaucoma, retinal detachment, and/or vitreal hemorrhage in the future. This case demonstrates the importance of a thorough ophthalmological examination in stranded wild animals, especially if their symptoms appear neurological. PMID:22946409

  11. Decreases in Electrocardiographic R-Wave Amplitude and QT Interval Predict Myocardial Ischemic Infarction in Rhesus Monkeys with Left Anterior Descending Artery Ligation

    OpenAIRE

    Xiaorong Sun; Jindan Cai; Xin Fan; Pengfei Han; Yuping Xie; Jianmin Chen; Ying Xiao; Y James Kang

    2013-01-01

    Clinical studies have demonstrated the predictive values of changes in electrocardiographic (ECG) parameters for the preexisting myocardial ischemic infarction. However, a simple and early predictor for the subsequent development of myocardial infarction during the ischemic phase is of significant value for the identification of ischemic patients at high risk. The present study was undertaken by using non-human primate model of myocardial ischemic infarction to fulfill this gap. Twenty male R...

  12. 双侧内囊前肢毁损术治疗难治性焦虑症%Bilateral anterior internal capsulotomy for refractory anxiety disorders

    Institute of Scientific and Technical Information of China (English)

    孙发发; 潘宜新; 曹春燕; 李永超; 林国珍; 孙伯民; 占世坤

    2015-01-01

    Objective To study the clinical effect of bilateral anterior internal capsulotomy on patients with refractory anxiety disorders.Methods Twenty-one patients with anxiety disorders,failed to pharmacological and cognitive behavior therapies for 5 years and admitted to our hospital from November 2009 to January 2012,were chosen; they received MRI-guided stereotactic bilateral anterior capsulotomy.The coordinates of the lesion target were determined under high resolution MRI directly and confirmed by intra-operative impedance test and high frequency stimulation.The lesions were received radiofrequency at 80 ℃ for 60 seconds.Pre-and post-operative mini-mental state examination (MMSE),self-rating anxiety scale (SAS),Hamilton depression rating scale (HAMD) and Hamilton anxiety rating scale (HAMA) were performed by the same psychiatrists.Results In the 21 patients,8 had anxiety-free,10 had significant improvement,and 3 had no significant improvement.No serious surgery-related complications were noted.Nine patients had mild cognitive deficit and transient dysmnesia only at 1-2 weeks after operation.Personality changes,such as lack of motivation,apathy and indolence,appeared in 4 patients.Psychiatric evaluations demonstrated significant decrease of SAS,HAMD and HAMA scores after operation as compared with those before operation (P<0.05).However,the difference of MMSE scores between pre-and post-operation was not statistically significant (P>0.05).Conclusion MRI guided stereotactic bilateral capsulotomy is precise,safe and much an effective treatment for refractory anxiety disorders,whcih is promising to alleviate the symptoms of anxiety and depression,as well as improving the quality of life.%目的 分析立体定向下双侧内囊前肢毁损术治疗难治性焦虑症的临床疗效. 方法 收集上海交通大学附属瑞金医院功能神经外科自2009年11月至2012年1月收治的21例难治性焦虑症患者临床资料,所有患者均在MRI计算机工作

  13. Cerebral blood flow and metabolic patterns as predictors of response to bilateral anterior capsulotomy for obsessive-compulsive disorder: a retrospective study

    International Nuclear Information System (INIS)

    Aims: Earlier Single Photon Emission Tomography (SPECT) and Positron Emission Tomography (PET) studies of patients with Obsessive-Compulsive Disorder (OCD) have demonstrated abnormal regional Cerebral Blood Flow (rCBF) and Cerebral Glucose Metabolic (rCGlM) pattern in the orbitofrontal-basal ganglia-thalamo-cortical circuits (OBgThC). OCD is characterized by intrusive, repetitive thoughts and/or behaviors that cause marked distress. In case of a severe, and medically and/or psycho therapeutically intractable disease surgical therapy remains the only possible solution. The purpose of this study was to evaluate rCBF and rCGlM patterns as potential predictors of treatment response to bilateral anterior capsulotomy. We performed rCBF SPECT and rCGlM PET studies in 5 patients with severe, intractable OCD before and after (3, 6 and 12 months) surgical therapy. Methods: The assessment included neurological, psychiatrical examination, CT, MRI, and neuropsychological evaluation. 99mTc-HMPAO-SPECT and 18F-FDG-PET studies were carried out with a standard technique for each patient. The data were analyzed visually and by a special region of interests (ROIs) program. The rCBF SPECT and glucose metabolic PET results were compared to clinical and neuropsychological findings. Results: The SPECT and PET measurements showed significant (p<0.05) rCBF and metabolic abnormalities in caudate nuclei, thalamus, singular and orbitofrontal cortex. There was a marked, but individually variable rCBF and rCGlM pattern before and after surgery. Additionally, the preoperative and postoperative rCBF and rCGlM data proved to be concordant with clinical and neuropsychological findings. Conclusion: Both SPECT and PET (before and after surgery) proved to be concordant with clinical and neuropsychological findings. However, rCGlM PET measurements had a higher sensitivity. Patients with higher preoperative rCBF and rCGlM rates of OBgThC circuits were associated with a better postoperative outcome. RCBF

  14. Bilateral Primary Intraocular Lymphoma

    OpenAIRE

    Mehrdad Karimi; Masoud Soheilian; Mozhgan Rezaei Kanavi

    2011-01-01

    Purpose: To report a case of bilateral primary intraocular lymphoma. Case report: A 33-year-old man presented with bilateral blurred vision since two years ago. Examination revealed large keratic precipitates, anterior chamber reaction, posterior subcapsular cataracts, and vitreous infiltration. After a short trial of topical and periocular steroids, diagnostic 25-gauge pars plana vitrectomy was performed and cytologic evaluation of the aspirate confirmed a diagnosis of intraocular lympho...

  15. 前部缺血性视神经病变并发视网膜分支动脉阻塞1例%A case of branch retinal artery obstruction complicated after anterior ischemic optic neuropathy

    Institute of Scientific and Technical Information of China (English)

    Ungsoo Samuel Kim; Hyoung-Seok Kim; Young Ju Lew

    2011-01-01

    AIM: To report a case of branch retinal artery obstruction (BRAO) complicated after anterior ischemic optic neuropathy (AION).METHODS: A 42-year-old woman who complained of visual disturbance was performed ophthalmological examinations such as fundus photography, fluorescent angiography (FAG) and visual field test. RESULTS: At first visit, disc swelling was noted and arterial circulation was intact, however, 1 week after onset, the inferior branch retinal artery began to shrink and the flame hemorrhage intensified. Sixteen months later, the optic disc evidenced an atrophic change; additionally, a ghost vessel in the inferior branch retinal artery was found.CONCLUSION: We report a case of complications of BRAO arising after AION which caused the mechanical compression on the arterial circulation.%目的:报告1例前部缺血性视神经病变(anterior ischemic optic neuropathy,AION)并发视网膜分支动脉阻塞(branch retinal artery obstruction,BRAO).方法:患者,女,42岁,因视力障碍进行如下眼科检查:眼底照相、荧光血管造影(fluorescent angiography,FAG)和视野测试.结果:第一次就诊时,患者视盘肿胀,动脉循环完整,发病1wk后,视网膜下支动脉开始萎缩并火焰状出血加剧.16mo后,视盘呈萎缩性改变,此外,发现视网膜下分支动脉血管影一条.结论:AION并发BRAO可造成动脉循环的机械性压迫.

  16. [Bilateral caudate head infarcts].

    Science.gov (United States)

    Kuriyama, N; Yamamoto, Y; Akiguchi, I; Oiwa, K; Nakajima, K

    1997-11-01

    We reported a 67-year-old woman with bilateral caudate head infarcts. She developed sudden mutism followed by abulia. She was admitted to our hospital 2 months after ictus for further examination. She showed prominent abulia and was inactive, slow and apathetic. Spontaneous activity and speech, immediate response to queries, spontaneous word recall and attention and persistence to complex programs were disturbed. Apparent motor disturbance, gait disturbance, motor aphasia, apraxia and remote memory disturbance were not identified. She seemed to be depressed but not sad. Brain CT and MRI revealed bilateral caudate head hemorrhagic infarcts including bilateral anterior internal capsules, in which the left lesion was more extensive than right one and involved the part of the left putamen. These infarct locations were thought to be supplied by the area around the medial striate artery including Heubner's arteries and the A1 perforator. Digital subtraction angiography showed asymptomatic right internal carotid artery occlusion. She bad had hypertension, diabetes mellitus and atrial fibrillation and also had a left atrium with a large diameter. The infarcts were thought to be caused by cardioembolic occlusion to the distal portion of the left internal carotid artery. Although some variations of vasculature at the anterior communicating artery might contribute to bilateral medial striate artery infarcts, we could not demonstrate such abnormalities by angiography. Bilateral caudate head infarcts involving the anterior internal capsule may cause prominent abulia. The patient did not improve by drug and rehabilitation therapy and died suddenly a year after discharge. PMID:9503974

  17. Ischemic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Ischemic stroke is the most common type. It is usually ... are at risk for having a more serious stroke. Symptoms of stroke are Sudden numbness or weakness ...

  18. Ischemic Stroke

    Science.gov (United States)

    ... can help you. Learn more What Is Stroke? Hemorrhagic Stroke Ischemic Stroke What is TIA? Stroke Facts Recognizing ... Stroke Survey Faces of Stroke What is stroke? Hemorrhagic stroke Ischemic stroke What is TIA? Stroke facts I ...

  19. Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients

    Directory of Open Access Journals (Sweden)

    Felipe Torres Pacheco

    2015-05-01

    Full Text Available Objective The potential of computed tomography angiography (CTA was assessed for early determination of stroke subtypes in a Brazilian cohort of patients with stroke. Method From July 2011 to July 2013, we selected patients with suspected hyperacute stroke (< 6 hours. Intracranial and cervical arteries were scrutinized on CTA and their imaging features were correlated with concurrent subtype of stroke. Results Stroke was documented in 50/106 selected patients (47.2% based on both clinical grounds and imaging follow-up (stroke group, with statistically significant arterial stenosis and vulnerable plaques on CTA. Intracranial large artery disease was demonstrated in 34% of patients in the stroke group. Partial territorial infarct prevailed (86% while artery-to-artery embolization was the most common stroke mechanism (52%. Conclusion Multidetector CTA was useful for the etiologic work-up of hyperacute ischemic stroke and facilitated the knowledge about the topographic pattern of brain infarct in accordance with its causative mechanism.

  20. Bilateral Primary Intraocular Lymphoma

    Directory of Open Access Journals (Sweden)

    Mehrdad Karimi

    2011-01-01

    Full Text Available Purpose: To report a case of bilateral primary intraocular lymphoma. Case report: A 33-year-old man presented with bilateral blurred vision since two years ago. Examination revealed large keratic precipitates, anterior chamber reaction, posterior subcapsular cataracts, and vitreous infiltration. After a short trial of topical and periocular steroids, diagnostic 25-gauge pars plana vitrectomy was performed and cytologic evaluation of the aspirate confirmed a diagnosis of intraocular lymphoma. The patient was subsequently managed with intravitreal methotrexate in both eyes and responded favorably. Central nervous system workup for lymphoma was negative. Conclusion: Primary intraocular lymphoma should be considered in young adults suffering from chronic recalcitrant panuveitis.

  1. Bilateral intraocular dirofilariasis

    Directory of Open Access Journals (Sweden)

    Viney Gupta

    2014-01-01

    Full Text Available Ocular dirofilariasis mostly presents as a subconjunctival or eyelid lesion. [1] Intraocular dirofilarial infestation is rare. [2],[3] We report a case of a young woman who was accidentally detected to have a live motile worm in the anterior segment in one eye and a cystic lesion on the optic disc in the other eye. To our knowledge, bilateral intraocular dirofilariasis has never been reported.

  2. Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Eleni Dokoutsidou

    2009-05-01

    Full Text Available Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etiology, can be classified into two major categories, ischemic and hemorrhagic. 20% of stroke are of hemorrhagic type, whereas 80% are of ischemic type. Although, ischemic stroke is the most common type, its’ etiology differs. Ischemic stroke is categorized in thrombotic, embolic, lacunar, unknown etiology, transient and due to systematic low blood pressure. In the literature is cited that risk factors for stroke are classified in non-modifiable and modifiable. Non-modifiable risk factors are age, gender, ethnicity and heredity. The most important modifiable risk factors for stroke are high blood pressure and atrial fibrillation. Other modifiable risk factors include high blood cholesterol levels, diabetes mellitus, cigarette smoking (active and passive, carotid artery stenosis, heavy alcohol consumption, drug abuse, lack of physical activity, obesity and unhealthy diet.Conclusions: As it is supported by published evidence, ischemic stroke is of higher incidence compared to hemorrhagic stroke. Risk factor modification remains as the principal aspect of care for ischemic stroke prevention.

  3. Ischemic Stroke

    OpenAIRE

    Eleni Dokoutsidou; Konstantina Antoniou

    2009-01-01

    Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etio...

  4. Transient central diabetes insipidus following ischemic stroke

    Directory of Open Access Journals (Sweden)

    Muthukrishnan Jayaraman

    2013-01-01

    Full Text Available Central Diabetes Insipidus (CDI following ischemic infarction of the brain has been described as a rare presentation. Posterior pituitary ischemia has also been postulated as a possible cause of idiopathic CDI. We encountered a young male with bilateral extensive ischemic infarction sustained at high altitude, who had transient polyuria due to central diabetes insipidus, requiring desmopressin therapy. DI completely resolved during the course of his neurological recovery.

  5. Transient central diabetes insipidus following ischemic stroke

    OpenAIRE

    Muthukrishnan Jayaraman; Sandeep Kumar; Ahmad, F. M. H.

    2013-01-01

    Central Diabetes Insipidus (CDI) following ischemic infarction of the brain has been described as a rare presentation. Posterior pituitary ischemia has also been postulated as a possible cause of idiopathic CDI. We encountered a young male with bilateral extensive ischemic infarction sustained at high altitude, who had transient polyuria due to central diabetes insipidus, requiring desmopressin therapy. DI completely resolved during the course of his neurological recovery.

  6. Transient central diabetes insipidus following ischemic stroke.

    Science.gov (United States)

    Jayaraman, Muthukrishnan; Kumar, Sandeep; Ahmad, F M H

    2013-10-01

    Central Diabetes Insipidus (CDI) following ischemic infarction of the brain has been described as a rare presentation. Posterior pituitary ischemia has also been postulated as a possible cause of idiopathic CDI. We encountered a young male with bilateral extensive ischemic infarction sustained at high altitude, who had transient polyuria due to central diabetes insipidus, requiring desmopressin therapy. DI completely resolved during the course of his neurological recovery. PMID:24251140

  7. Avaliação metabólica das lesões de isquemia e reperfusão cerebrais após oclusão bilateral das artérias carótidas comuns: estudo experimental em ratos Metabolic evaluation of ischemic and reperfusion brain injury following bilateral occlusion of common carotid arteries: an experimental study in rats

    Directory of Open Access Journals (Sweden)

    Luiz Roberto Franklin Muniz

    2004-10-01

    Full Text Available OBJETIVO: Caracterizar as alterações no metabolismo energético após isquemia/reperfusão cerebral através de um modelo experimental de isquemia global reversível por simples oclusão das artérias carótidas comuns (ACCs em ratos da linhagem Wistar. MÉTODOS: Quarenta e oito ratos Wistar machos foram distribuídos aleatoriamente em dois grupos (C - Controle; T - Teste e cada um deles redistribuídos em quatro tempos de estudos. Após oclusão bilateral das ACCs por 30min, permitiu-se reperfusão aos animais do grupo T nos tempos 0, 5, 10 e 15min. Foram coletadas amostras de tecido cerebral e sangue arterial sistêmico e quantificados os metabólitos D-glicose (GLI, piruvato (PRV, lactato (LCT e adenosina trifosfato (ATP. RESULTADOS: Observou-se aumento nos níveis sangüíneos de GLI e PRV de, respectivamente, 85,00% (pPURPOSE: To describe alterations on the energy metabolism after cerebral ischemia/reperfusion, through an experimental model of reversible global ischemia, by simple occlusion of common carotid arteries (CCAs in rats of Wistar lineage. METHODS: Forty-eight male Wistar rats were randomly distributed on two groups (C - Control; T - Test and further redistributed into four times sets of study. After bilateral occlusion of CCAs for 30min, the animals of group T were allowed reperfusion for 0, 5, 10 and 15min. Samples of cerebral tissue and systemic arterial blood were collected and the metabolites D-glucose (GLI, pyruvate (PRV, lactate (LCT and adenosine triphosphate (ATP quantified. RESULTS: Increases of GLI and PRV blood values of, respectively, 85,00% (p<0,05 and 51,72% (p<0,01 were observed at 5min of reperfusion, which reflect a systemic response to the cerebral ischemia. The brain's LCT remained stable despite a reduction of 52,66% (p<0,05 in its blood concentration at 15min of reperfusion. The cerebral concentrations of ATP decreased 85,40% (p<0,05 after ischemia, followed by an augmentation of 3.033,40% (p<0,05 at 5min

  8. Study of diffusion tensor imaging in subcortical ischemic vascular cognitive impairment

    Directory of Open Access Journals (Sweden)

    Hui-ying GUO

    2014-04-01

    Full Text Available Objective Using diffusion tensor imaging (DTI to explore the microstructure changes of white matter in subcortical ischemic vascular cognitive impairment (SIVCI and its correlation with cognitive function.  Methods Forty-nine patients with subcortical ischemic cerebrovascular diseases were collected. By using Clinical Dementia Rating Scale (CDR, they were classified into 10 cases of vascular dementia (VaD group, 20 cases of vascular cognitive impairment-no dementia (VCIND group and 19 cases of normal cognitive function (control group. Conventional MRI and DTI were performed in all cases. Based on the DTI data, voxel-based analysis was used to assess the whole brain region. Correlation analysis was applied to illustrate the relationship between DTI parameters and cognitive scale in VaD patients.  Results Compared with the control group, fractional anisotropy (FA values of patients in VaD group decreased in medial prefrontal cortex, anterior cingulate cortex, corpus callosum stem, bilateral parietal lobes, right temporal lobe and bilateral orbitofrontal lobes (P = 0.000, for all, and FA values of patients in VCIND group decreased in right inferior frontal gyrus, right hippocampus and bilateral precuneus (P = 0.000, for all. Compared with VCIND group, FA values of patients in VaD group decreased in medial prefrontal cortex, anterior cingulate, corpus callosum, bilateral parietal lobes and right temporal lobe (P = 0.000, for all. Compared with the control group, mean diffusivity (MD values in VaD group increased in medial prefrontal cortex, corpus callosum, bilateral parietal lobes, bilateral temporal lobes and anterior cingulate (P = 0.000, for all, while in VCIND group increased in bilateral precuneus and right hippocampus (P = 0.000, for all. Compared with VCIND group, MD values in VaD group increased in right medial prefrontal cortex, anterior cingulate cortex, corpus callosum stem, bilateral parietal lobes and bilateral temporal lobes (P = 0

  9. 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.

  10. Cervicoplastia anterior Anterior cervicoplasty

    Directory of Open Access Journals (Sweden)

    Lucas Gomes Patrocínio

    2004-10-01

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

  11. Travoprost Induced Granulomatous Anterior Uveitis

    OpenAIRE

    Patrick Chiam

    2011-01-01

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

  12. Bilateral dacryoadenitis

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    Charlotte Derr

    2012-01-01

    Full Text Available Acute dacryoadenitis is an uncommon condition that involves inflammation of the lacrimal gland. In rare instances, dacryoadenitis may be bilateral. A delay in proper treatment of an otherwise simple case of dacryoadenitis may lead to significant soft tissue morbidity such as cellulitis, lacrimal gland abscess, or orbital abscess. We report the case of a 24-year-old male who presented to the emergency department with acute bilateral dacryoadenitis. The patient′s symptoms did not respond to oral antibiotics and he subsequently required admission for intravenous antibiotics. During his hospitalization the patient had diagnostic testing to try to determine the etiology for his symptoms. The unique aspects of managing a case of bilateral dacryoadenitis as well as treatment recommendations are discussed in this case report.

  13. Persimmon leaf flavonoid promotes brain ischemic tolerance**

    Institute of Scientific and Technical Information of China (English)

    Mingsan Miao; Xuexia Zhang; Ming Bai; Linan Wang

    2013-01-01

    Persimmon leaf flavonoid has been shown to enhance brain ischemic tolerance in mice, but its mechanism of action remains unclear. The bilateral common carotid arteries were occluded using a micro clip to block blood flow for 10 minutes. After 10 minutes of ischemic preconditioning, 200, 100, and 50 mg/kg persimmon leaf flavonoid or 20 mg/kg ginaton was intragastrical y administered per day for 5 days. At 1 hour after the final administration, ischemia/reperfusion models were estab-lished by blocking the middle cerebral artery for 2 hours. At 24 hours after model establishment, compared with cerebral ischemic rats without ischemic preconditioning or drug intervention, plasma endothelin, thrombomodulin and von Wil ebrand factor levels significantly decreased and intercel-lular adhesion molecule-1 expression markedly reduced in brain tissue from rats with ischemic pre-conditioning. Simultaneously, brain tissue injury reduced. Ischemic preconditioning combined with drug exposure noticeably improved the effects of the above-mentioned indices, and the effects of 200 mg/kg persimmon leaf flavonoid were similar to 20 mg/kg ginaton treatment. These results indicate that ischemic preconditioning produces tolerance to recurrent severe cerebral ischemia. However, persimmon leaf flavonoid can elevate ischemic tolerance by reducing inflammatory reactions and vascular endothelial injury. High-dose persimmon leaf flavonoid showed an identical effect to ginaton.

  14. Bilateral panuveitis associated with Whipple disease – case report

    OpenAIRE

    Lisboa, Maria; Domingues, Isabel; Pamplona, Jaime; Barata, Pedro; Morgado, Joana; Brotas, Vítor

    2014-01-01

    [english] Purpose: To describe a clinical case and literature review of Whipple disease.Methods: A 65-year-old male with bilateral decreased visual acuity for 3 weeks as well as bilateral hypoacusia, vertigo, disequilibrium, headache and decreased strength in the right upper limb for 4 months. The clinical work-up revealed a bilateral panuveitis and an ischemic cerebellar stroke.Result: The diagnosis of Whipple disease was confirmed by histopathological analysis of adenopathy. The patient was...

  15. Treatment of pediatric moyamoya disease by simultaneous bilateral dual EDASs

    International Nuclear Information System (INIS)

    Treatment of moyamoya disease should be considered, especially in children in whom the disease develops rapidly and causes mental retardation. To address these concerns, we have been treating these patients with simultaneous bilateral dual encephaloduro-arterio-synangiosis (EDAS). The patients were 12 children and one adult. Ten of the children developed symptoms under 6 years of age. Their initial symptoms were transient ischemic attack (TIA) in 7, convulsions in 2, hemiparesis secondary to infarction and hemorrhage in 2, TIA and convulsion in 1, and headache in 1. All patients had diagnosis made by the cerebral angiography. All of them underwent EDAS using anterior and posterior branches of superficial temporal artery simultaneously and bilaterally. In this procedure, it is important to dissect both branches more than 10 cm. The mean operation time was 8 hours 25 minutes. Postoperatively, two patients developed hemiparesis secondary to cerebral infarction; both, however, recovered with the aid of rehabilitation. TIAs decreased immediately after surgery and disappeared in a couple of years except in one case. Convulsions ceased immediately. One patient with pre-op TIA developed convulsions 2 years after surgery. Headaches decreased in frequency. One developed cerebral infarction after surgery and mental status deteriorated, but the others maintained stable mental condition post-operatively. Post-operative angiographies were performed 3 and 9 months after surgery. Most patients attained excellent revascularization in the frontal to parietal regions except for three cases. Two of them finally showed good anastomosis 2 and 8 years later. One remained poor because the patient still had early stage of moyamoya disease. It may be postulated that the use of simultaneous bilateral dual EDAS prevents the rapid progression of and the development of mental problems seen in child moyamoya disease. (author)

  16. 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.)

  17. Diagnosis and management of bilateral nasolabial cysts

    OpenAIRE

    Rajkumar Parwani; Simran Parwani; Sangeeta Wanjari

    2013-01-01

    Nasolabial cysts are painless, submucosal, non-odontogenic jaw cysts presenting as soft tissue swellings in the maxillary anterior mucolabial fold lateral to midline, leading to elevation of nasal ala. Present case documents bilateral nasolabial cysts in a 69-year-old Asian female patient. In the present case, extraoral swelling of maxillary lip and elevation of nasal ala was observed on right side of the face. Intraorally, soft and fluctuant bilateral cysts were observed. Straw-colored fluid...

  18. Ischemic Postconditioning Alleviates Neuronal Injury Caused by Relief of Carotid Stenosis in a Rat Model of Cerebral Hypoperfusion

    OpenAIRE

    Pengfei Ge; Yinan Luo; Boyu Wang; Tianfei Luo; Li Qi; Chunsheng Feng

    2012-01-01

    The effects of early relief of heavy bilateral carotid stenosis and ischemic postconditioning on hippocampus CA1 neurons are still unclear. In this study, we used a rat model to imitate severe bilateral carotid stenosis in humans. The rats were divided into sham group, carotid stenosis group, stenosis relief group and ischemic postconditioning group. Ischemic postconditioning consisted of three cycles of 30 s ischemia and 30 s reperfusion. The cerebral blood flow was measured with a laser Dop...

  19. Anterior ischemic optic neuropathy: a comparison of the optic disc area of patients with the arteritic and non-arteritic forms of the disease and that of normal controls Neuropatia óptica isquêmica anterior: estudo comparativo da área do disco óptico de pacientes com as formas arterítica e não-arterítica da doença e de controles normais

    Directory of Open Access Journals (Sweden)

    Mário Luiz Ribeiro Monteiro

    2006-12-01

    Full Text Available PURPOSE: To evaluate the optic disc area of patients with non-arteritic anterior ischemic optic neuropathy (NA-AION and arteritic anterior ischemic optic neuropathy (A-AION and compare the results between each other and with those from controls in order to verify the existence and the magnitude of anatomical factors predisposing to the development of anterior ischemic optic neuropathy. METHODS: This is a case-controlled study of the optic disc area of 24 consecutive patients affected with NA-AION, 13 patients with A-AION and 24 consecutive healthy normals, sex- and age-matched with the patients with the NA-AION group. Measurements of optic disc area were performed for each studied group using disc photographs projected, measured and corrected for the refractive error and the keratometric readings, according to Littmann's method in each studied group. The results were compared using variance analysis. RESULTS: The mean areas and standard deviations of the optic discs from patients with NA-AION, A-AION and normals were respectively 1.99 ± 0.35 mm², 2.29 ± 0.39 mm² and 2.49 ± 0.53 mm². The statistical analysis revealed that the mean areas of the optic disc of patients with NA-AION were significantly different from those of normal controls. No statistical difference was found between A-AION and normal controls. CONCLUSION: NA-AION occurs predominantly in small discs while the arteritic form of the disease shows no such preference. Factors related to optic disc structure play a role in the pathophysiology of NA-AION. The occurrence of AION in large optic optic discs should raise the suspicion of temporal arteritis. On the other hand, small optic disc areas do not rule out that vasculitis.OBJETIVO: Calcular a área do disco óptico de pacientes com neuropatia óptica isquêmica anterior não arterítica (NOIA-NA e com neuropatia óptica isquêmica anterior por arterite temporal (NOIA-A comparando os resultados entre si e com o grupos controle

  20. Anterior capsule tear after laser iridotomy complicating phacoemulsification

    OpenAIRE

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

    2011-01-01

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

  1. Bilateral agreements

    International Nuclear Information System (INIS)

    Ten bilateral agreements are presented. These are: 1) Co-operation agreement relating to the peaceful uses of nuclear energy between Argentina and EURATOM (1996); 2) Agreement on co-operation in the peaceful uses of nuclear energy between Argentina and Greece (1997); 3) Implementing arrangement for technical exchange and co-operation in the area of peaceful uses of nuclear energy between Argentina and the United States (1997); 4) Agreement concerning co-operation in nuclear science and technology between Australia and Indonesia (1997); 5) Implementation of the 1985 Agreement for co-operation concerning the peaceful uses of nuclear energy between the People's Republic of China and the United States (1998); 6) Protocol of co-operation between France and Lithuania (1997); 7) Agreement on co-operation in energy research, science and technology, and development between Germany and the United States (1998); 8) Agreement on early notification of a nuclear accident and exchange of information on nuclear facilities between Greece and Romania (1997); 9) Agreement on early notification of nuclear accidents and co-operation in the field of nuclear safety between Hungary and the Ukraine (1997); 10) Agreement in the field of radioactive waste management between Switzerland and the United States (1997). (K.A.)

  2. Travoprost Induced Granulomatous Anterior Uveitis

    Science.gov (United States)

    Chiam, Patrick

    2011-01-01

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

  3. Anterior tarsaltunnelsyndrom

    DEFF Research Database (Denmark)

    Miliam, Palle B; Basse, Peter N

    2009-01-01

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

  4. Protective effects of remote ischemic preconditioning in rat hindlimb on ischemia-reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Ying Zhang; Xiangrong Liu; Feng Yan; Lianqiu Min; Xunming Ji; Yumin Luo

    2012-01-01

    Three cycles of remote ischemic pre-conditioning induced by temporarily occluding the bilateral femoral arteries (10 minutes) prior to 10 minutes of reperfusion were given once a day for 3 days before the animal received middle artery occlusion and reperfusion surgery. The results showed that brain infarct volume was significantly reduced after remote ischemic pre-conditioning. Scores in the forelimb placing test and the postural reflex test were significantly lower in rats having undergone remote ischemic pre-conditioning compared with those who did not receive remote ischemic pre-conditioning. Thus, neurological function was better in rats having undergone remote ischemic pre-conditioning compared with those who did not receive remote ischemic pre-conditioning. These results indicate that remote ischemic pre-conditioning in rat hindlimb exerts protective effects in ischemia-reperfusion injury.

  5. Ketone bodies metabolism during ischemic and reperfusion brain injuries following bilateral occlusion of common carotid arteries in rats Metabolismo dos corpos cetônicos durante as lesões de isquemia e reperfusão cerebrais após oclusão bilateral das artérias carótidas comuns em ratos

    Directory of Open Access Journals (Sweden)

    Mário Henrique Girão Faria

    2007-04-01

    Full Text Available PURPOSE: To evaluate the in vivo alterations on ketone bodies metabolism after cerebral ischemia/reperfusion through an experimental model of brain ischemia induced by simple occlusion of common carotid arteries (CCAs in Wistar rats. METHODS: Forty-eight male Wistar rats were randomly distributed on two groups (S - Sham; T - Test and further redistributed into four times sets of study. After bilateral occlusion of CCAs for 30min, the animals of group T were allowed reperfusion for 0, 5, 10 and 15min. Samples of cerebral tissue and systemic arterial blood were collected and the metabolites acetoacetate (ACT and beta-hydroxybutyrate (BHB were determined. RESULTS: Cerebral ACT and BHB levels increased significantly in Group T after 30min of carotid occlusion (time 0. The highest brain ketone bodies (ACT+BHB concentration was verified at 5min of reperfusion, decreasing after 10min of recirculation. Systemic ketone bodies levels increased similarly between test and sham groups. Group S demonstrated a significant increase in cerebral and systemic ACT and BHB concentrations mainly after 40-45min of study. CONCLUSIONS: The partial transient acute global brain ischemia induced by the bilateral carotid occlusion in Wistar rats triggered ketogenesis probably due to a central stimulation of catecholamine secretion. There was an increased cerebral uptake of ketone bodies following brain ischemia, reaffirming these metabolites as alternative energy substrates under conditions of cerebral metabolic stress as well as its potential role on neuroprotection. The greatest changes in ketone bodies metabolism were verified at initial minutes of recirculation as a result of the reperfusion injury phenomenon.OBJETIVO: Avaliar as alterações in vivo no metabolismo dos corpos cetônicos após isquemia/reperfusão cerebral através de um modelo experimental de isquemia cerebral induzido pela simples oclusão das artérias carótidas comuns (CCAs em ratos Wistar. M

  6. The tole of ischemic preconditioning in acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Ristić Anđelka

    2005-01-01

    Full Text Available Introduction Ischemic preconditioning is a phenomenon in which brief episodes of ischemia and reperfusion increase myocardial tolerance and substantially reduce the infarction size. Case report Two patients with acute left anterior descending artery occlusion received fibrinolytic therapy within 6 hours of symptom onset, but nevertheless developed myocardial infarctions of different size. The first patient, without a history of preinfarction angina, developed a large anterior infarction, because there was no time for ischemic preconditioning or development of coronary collateral vessels. The second patient, with a 4-day history of preinfarction angina, had a more favorable outcome-he developed apical necrosis, with greater myocardial viability in the infarct-related area. Conclusion The beneficial effects of angina occurring 24-48h before infarction are resulting from ischemic preconditioning, which reduces cardiac mortality, infarct size and occurrence of life-threatening ventricular arrhythmias. .

  7. Chronic Bilateral Tibial Stress Fractures with Valgus Treated with Bilateral Intramedullary Nailing: A Case Report

    Directory of Open Access Journals (Sweden)

    Steven K Dailey

    2014-01-01

    Full Text Available Introduction: Stress fractures are overuse injuries most commonly seen in athletes, military recruits, and individuals with endocrine abnormalities. It has been demonstrated that chronic cases of anterior tibial stress fractures refractory to conservative management respond well to intramedullary nailing. To our knowledge, only one report has been published concerning patients with bilateral tibial stress fractures treated with bilateral intramedullary nailing. All patients in the series were high-level athletes. We present the case of a non-athletic patient with chronic bilateral tibial stress fractures and associated deformity successfully treated with bilateral intramedullary nails. Case Report: A 23-year-old Caucasian female full-time student presented with chronic bilateral shin pain for approximately five years. She had failed an extensive regimen of conservative management. She was diagnosed with chronic bilateral tibial stress fractures based on history, physical examination, and radiologic findings. She subsequently underwent sequential intramedullary nailing of her tibiae. Both tibiae were in valgus alignment; however, this did not preclude nail placement. The nails deformed upon insertion into the sclerotic canals to conform to the deformation. Post operatively the tibiae united and patient was relieved of her symptoms. Conclusion: Bilateral intramedullary nailing of chronic bilateral tibial stress fractures should be considered as a treatment option for all patients, not just high-level athletes, who fail a trial of conservative management. Additionally, mild to moderate tibial malalignment does not necessarily preclude tibial nailing as the smaller nails placed in sclerotic canals will likely deform on insertion and conform to the canal. Keywords: Bilateral intramedullary nailing, bilateral tibial stress fractures, valgus

  8. Evolving Treatments for Acute Ischemic Stroke.

    Science.gov (United States)

    Zerna, Charlotte; Hegedus, Janka; Hill, Michael D

    2016-04-29

    The purpose of this article is to review advances in stroke treatment in the hyperacute period. With recent evolutions of technology in the fields of imaging, thrombectomy devices, and emergency room workflow management, as well as improvement in statistical methods and study design, there have been ground breaking changes in the treatment of acute ischemic stroke. We describe how stroke presents as a clinical syndrome and how imaging as the most important biomarker will help differentiate between stroke subtypes and treatment eligibility. The evolution of hyperacute treatment has led to the current standard of care: intravenous thrombolysis with tissue-type plasminogen activator and endovascular treatment for proximal vessel occlusion in the anterior cerebral circulation. All patients with acute ischemic stroke are in need of hyperacute secondary prevention because the risk of recurrence is highest closest to the index event. The dominant themes of modern stroke care are the use of neurovascular imaging and speed of diagnosis and treatment. PMID:27126651

  9. Bilateral lateral periodontal cyst

    OpenAIRE

    Govil, Somya; Gupta, Vishesh; Misra, Neeta; Misra, Pradyumna

    2013-01-01

    The bilateral lateral periodontal cyst is a rare nasological entity, which despite clinical and radiological presentation is being diagnosed by histological characteristics. It is asymptomatic in nature and is observed in routine radiography. The aim and objective of this article is to present a rare case of bilateral lateral periodontal cyst in a 14-year-old child. The clinical and radiographical findings, along with its management have been discussed. Enucleation of bilateral cyst without e...

  10. Bilateral optic nerve infarction in rhino-cerebral mucormycosis: A rare magnetic resonance imaging finding

    OpenAIRE

    Mandeep Singh Ghuman; Shabdeep Kaur; Samarjit Kaur Bhandal; Archana Ahluwalia; Kavita Saggar

    2015-01-01

    Mucormycosis is an emerging disease in diabetes and immunocompromised patients. Rhino-orbito-cerebral mucormycosis is one of the common forms of the disease. Mucormycosis leading to ischemic optic neuropathy is a rare complication. The role of magnetic resonance imaging (MRI) in the diagnosis of ischemic optic neuropathy is limited and uncommonly reported. We report an unusual case of mucormycosis in which MRI revealed bilateral optic nerve infarction, in addition to perineural extension of t...

  11. Transient Ischemic Attack

    Medline Plus

    Full Text Available ... TIA , or transient ischemic attack, is a "mini stroke" that occurs when a blood clot blocks an ... a short time. The only difference between a stroke and TIA is that with TIA the blockage ...

  12. Bilateral Congenital Diaphragmatic Hernia

    OpenAIRE

    Dhua, Anjan K; Aggarwal, Satish K; NB Mathur; GR Sethi

    2012-01-01

    Bilateral congenital diaphragmatic hernia (CDH) is a rare birth defect, with a poor prognosis. We describe a case of bilateral CDH discovered while repairing the right sided CDH. Diaphragmatic defect was repaired and a silo was applied on the abdominal wound to avoid abdominal compartment syndrome. The patient however died postoperatively due to severe pulmonary hypertension.

  13. Acute ischemic cerebral attack

    OpenAIRE

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  14. Nonarteritic ischemic optic neuropathy developed after capsular block syndrome

    Directory of Open Access Journals (Sweden)

    Volkan Hurmeric

    2014-01-01

    Full Text Available A 65-year-old man developed capsular block syndrome in the early postoperative period, following phacoemulsification surgery. After neodymium-doped yttrium aluminum garnet (Nd:YAG laser anterior capsulotomy, the intraocular pressure remained elevated for 4 days despite antiglaucomatous medication. On the postoperative fifth day, nonarteritic ischemic optic neuropathy was diagnosed. To the best of our knowledge, this is the first report of a case with nonarteritic ischemic optic neuropathy associated with early postoperative capsular block syndrome after phacoemulsification surgery.

  15. Carbon monoxide poisoning: Bilateral lesions in the thalamus on MR imaging of the brain

    International Nuclear Information System (INIS)

    Magnetic Resonance (MR) Imaging of the brain in a child with carbon monoxide poisoning revealed bilateral diffuse high signal in the centrum semiovale and the previously unreported finding of bilateral high intensity lesions the anterior thalami. This case illustrates a previously unrecognized effect of carbon monoxide poisoning and demonstrates the superiority of MR imaging over computed tomography in cases of carbon monoxide poisoning. (orig.)

  16. Pregnancy following bilateral salpingectomy

    DEFF Research Database (Denmark)

    Oturai, Annette Bang

    2008-01-01

    This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy was...... unwanted, and the woman decided to terminate the pregnancy. She was offered diagnostic examination to localise a potential fistula, but she declined. In a MEDLINE search of English literature this is only the second case of spontaneous pregnancy following bilateral salpingectomy Udgivelsesdato: 2008/4/21...

  17. Phacoemulsification in anterior megalophthalmos.

    Science.gov (United States)

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

    2006-07-01

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

  18. 非动脉炎性前部缺血性视神经病变24h动态血压的初步分析%Preliminary analysis on 24-hour ambulatory blood pressure monitoring of 19 patients with non-arteritic anterior ischemic optic neuropathy

    Institute of Scientific and Technical Information of China (English)

    梅晓白; 范坷; 魏世辉

    2012-01-01

    OBJECTIVE To conduct the preliminary analysis of the characteristics of 24-hour ambulatory blood pressure monitoring (ABPM) of the 19 patients with non-arteritic anterior ischemic optic neuropathy (NAION).METHODS Chose 19 cases of NA10N group and normal control group respectively, and recorded its 24-hour systolic, diastolic and mean arterial pressure, then portrayed the curve and analyzed the morning blood pressure surge (MBPS). RESULTS The daytime systolic blood pressure of 19 cases with NAION was lower than the normal group(P<0.01); The diastolic blood pressure of the day and the night was higher than the normal group(P<0.01); The blood pressure curves concluded seven non-dippers and eleven reverse-dippers. MBPS values were measured (MBPS==35 mmHg, 3cases; 10 mmHg =MBPS<35 mmHg, llcases; 0=MBPS<10 mmHg, 2cases, MBPS<0, 3cases). CONCLUSIONS NAION patients with low systolic blood pressure in the daytime, high diastolic blood pressure in the day and the night, reverse-dippers and non-dippers of the blood pressure curve, low morning blood pressure surge were all the possible risk factors damaging target organ, and further researches are needed.%目的 初步分析非动脉炎性前部缺血性视神经病变(non-arteritic anterior ischaemic optic neuropathy,NAION)患者的24h动态血压(ambulatory blood pressure monitoring,ABPM)特点.方法 选取NAION患者19例作为病例组,同期健康体检者19例作为正常对照组,分别记录其24h的收缩压、舒张压和平均动脉压,描绘其动态曲线并分类,分析血压晨峰情况.结果 19例NAION患者日间收缩压低于正常对照组(P<0.01),昼夜的舒张压均高于正常组(P<0.01);血压变化曲线中有7例为非勺型,其余均为反勺型;血压晨峰(morning blood pressure surge,MBPS)值>35mmHg者3例,≥10mmHg~<35mmHg者11例,≥0mmHg~<10mmHg者2例,<0mmHg者3例.结论 NAION患者的日间低收缩压、昼夜高舒张压、反勺型和非勺型血压曲线、低血

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

    Science.gov (United States)

    Okamoto, Kensho; Hamada, Eri; Okuda, Bungo

    2004-01-01

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

  20. Bilateral panuveitis associated with Whipple disease – case report

    Directory of Open Access Journals (Sweden)

    Lisboa, Maria

    2014-01-01

    Full Text Available [english] Purpose: To describe a clinical case and literature review of Whipple disease.Methods: A 65-year-old male with bilateral decreased visual acuity for 3 weeks as well as bilateral hypoacusia, vertigo, disequilibrium, headache and decreased strength in the right upper limb for 4 months. The clinical work-up revealed a bilateral panuveitis and an ischemic cerebellar stroke.Result: The diagnosis of Whipple disease was confirmed by histopathological analysis of adenopathy. The patient was treated with cortico-antibiotic therapy with significant clinical improvement.Conclusion: Although rare, Whipple disease is potentially fatal if left untreated, it must be always be taken into consideration before any panuveitis of an unknown cause, even in the absence of gastrointestinal symptoms.

  1. Bilateral acute depigmentation of the iris (BADI: first reported case in Brazil

    Directory of Open Access Journals (Sweden)

    Heloisa Andrade Maestrini

    2013-02-01

    Full Text Available Bilateral acute depigmentation of the iris (BADI is a recently described entity characterized by acute onset of pigment dispersion in the anterior chamber, depigmentation of the iris, and heavy pigment deposition in the anterior chamber angle. Involvement is always bilateral, simultaneous, and symmetrical. We report the case of a 61-year-old man who presented with bilateral ocular pain, red eyes, and severe photophobia. Examination revealed a dense Krukenberg spindle, heavy pigment dispersion in the anterior chamber, extensive transillumination iris defects, and a heavy pigment deposition in the trabecular meshwork bilaterally. Intraocular pressure increased to 48 mmHg in both eyes. The patient received topical steroids, maximum hypotensive treatment and oral valacyclovir. Intraocular pressure gradually decreased throughout the second and third months, and medications were gradually tapered. The time to complete resolution of pigment dispersion was 18 weeks. Visual acuity and visual fields remained normal, but the photophobia was permanent.

  2. Ischemic strokes and migraine

    International Nuclear Information System (INIS)

    Lasting neurological deficits, though most infrequent, do occur in migrainous subjects and are well documented by clinical angiographic computed tomographic (CT scan) and even pathological studies. However the mechanism of cerebral ischemia in migraine remains widely unknown and the precise role of migraine in the pathogenesis of ischemic strokes is still debated. (orig./MG)

  3. Bilateral popliteal arterial dissection.

    Science.gov (United States)

    Chen, Po-Liang; Ko, Shih-Yu; Tan, Ken-Hing

    2012-01-01

    A clinical feature of bilateral popliteal arterial dissection without involving the descending aorta, bilateral iliac, as well as femoral arteries has never been reported in the past literature. We report a 56-year-old man with hypertension and coronary artery disease who presented to our emergency department with complaints of bilateral knee pain after long-distance walking. Physical examination was notable for elevated blood pressure, but there was no palpable pulsation over dorsalis pedis arteries on his feet. Laboratory evaluation revealed a d-dimer level of 35.2 mg/L (FEU) on the day of the test and 1.2 mg/L one and a half months ago (normal level, <0.55). These findings were suggestive of a recent-onset peripheral arterial occlusive disorder. Computed tomography of the aorta showed bilateral popliteal arterial dissection with arterial intimal flap. Abdominal aorta, bilateral iliac, and femoral arteries remained intact with only arteriosclerotic change. Minimally invasive endovascular stent grafting was then performed. The patient had an uneventful recovery. PMID:21106320

  4. Escleritis posterior bilateral Bilateral posterior scleritis

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    A. Zurutuza

    2011-08-01

    Full Text Available La escleritis posterior es un proceso inflamatorio de la parte posterior de la esclera. Su prevalencia es muy baja y el diagnóstico puede resultar complicado por la ausencia de signos oculares externos. Es más frecuente en mujeres. Cuando aparece en pacientes jóvenes no suele tener otras patologías asociadas, pero en mayores de 55 años hasta un tercio de los casos tienen relación con alguna enfermedad sistémica, sobre todo la artritis reumatoide. El diagnóstico de esta patología puede requerir un abordaje multidisciplinar y la colaboración de oftalmólogos con neurólogos, internistas o reumatólogos. En este artículo se describe un caso de escleritis posterior bilateral idiopática.Posterior scleritis is an inflammatory process of the posterior part of the sclera. Its prevalence is very low and its diagnosis can be complicated due to the absence of external ocular signs. It is more frequent in women. In young patients it does not usually have other associated pathologies, but in those over 55 years nearly one-third of the cases have a relation with some systemic disease, above all rheumatoid arthritis. The diagnosis of this pathology can require a multidisciplinary approach and the collaboration of ophthalmologists with neurologists, internists or rheumatologists. This article describes a case of idiopathic bilateral posterior scleritis.

  5. Bilateral panophthalmitis in dengue fever

    Directory of Open Access Journals (Sweden)

    Sangeetha Sriram

    2015-01-01

    Full Text Available We report the case of a 25-year-old male patient who presented with bilateral panophthalmitis as the initial ocular manifestation of dengue fever. The diagnosis was a little confusing as he initially presented with features suggestive of retrobulbar hemorrhage secondary to his very low platelet count, which is a common feature of dengue fever. Ophthalmic complications are usually seen in young adults who often present at the nadir of thrombocytopenia. Ocular findings may include anterior uveitis, vitritis, retinal hemorrhages, retinal vascular sheathing, yellow subretinal dots, retinal pigment epithelium (RPE mottling, foveolitis that is clinically seen as a round subretinal yellowish lesion at the fovea, retinochoroiditis, choroidal effusion, optic disc swelling, optic neuritis, neuroretinitis, and oculomotor nerve palsy. [1] There is only one reported case of unilateral endogenous panophthalmitis due to dengue fever. Hence, clinicians and ophthalmologists have to be aware of this vision-threatening complication of dengue for early recognition and prompt treatment to save the vision of these young patients and prevent morbidity.

  6. Bilaterally Incarcerated Morgagni Hernia

    Directory of Open Access Journals (Sweden)

    Zuhal Demirhan Yananli

    2013-06-01

    Full Text Available Morgagni hernia is a rare congenital diaphragmatic hernia. It is seen rarely bilaterally. Patients are usually asymptomatic. Therefore, diagnosis may be delayed until adulthood. Significant morbidity can occur in case complications arise and diagnosis is delayed. The patient, a 74 year-old female, presented in this article, was admitted to the emergency department with abdominal pain, vomiting, and shortness of breath. The plain abdominal radiograph of the patient revealed bowel obstruction and suspicious appearence in favor of the diaphragmatic hernia on both sides of the sternum. Computed tomography revealed bilaterally incarcerated Morgagni hernia with strangulated omentum in the right side of the sternum and a part of colon in the left side of sternum. Incarcerated organs were withdrawn to peritoneal cavity and defects of hernia were sutured primarily on laparatomy. Because bilateral incarcerated Morgagni hernia can be seen rarely, this case was reported.

  7. Efficacy of bilateral pallidotomy.

    Science.gov (United States)

    Kim, R; Alterman, R; Kelly, P J; Fazzini, E; Eidelberg, D; Beric, A; Sterio, D

    1997-03-15

    Unilateral pallidotomy is a safe and effective treatment for medically refractory bradykinetic Parkinson's disease, especially in those patients with levodopa-induced dyskinesia and severe on-off fluctuations. The efficacy of bilateral pallidotomy is less certain. The authors completed 11 of 12 attempted bilateral pallidotomies among 150 patients undergoing pallidotomy at New York University. In all but one patient, the pallidotomies were separated by at least 9 months. Patients were selected for bilateral pallidotomy if they exhibited bilateral rigidity, bradykinesia, or levodopa-induced dyskinesia prior to treatment or if they exhibited disease progression contralateral to their previously treated side. The Unified Parkinson's Disease Rating Scale (UPDRS) and timed upper-extremity tasks of the Core Assessment Protocol for Intracerebral Transplantation (CAPIT) were administered to all 12 patients in the "off" state (12 hours without receiving medications) preoperatively and again at 6 and 12 months after each procedure. The median UPDRS and contralateral CAPIT scores improved 60% following the initial procedure (p = 0.008, Wilcoxon rank sums test). The second pallidotomy generated only an additional 10% improvement in the UPDRS and CAPIT scores ipsilateral to the original procedure (p = 0.05). Worsened speech was observed in two cases. In the 12th case, total speech arrest was noted during test stimulation. Speech returned within minutes after stimulation was halted. Lesioning was not performed. These results indicate that bilateral pallidotomy has a narrow therapeutic window. Motor improvement ipsilateral to the first lesion leaves little room for further improvement from the second lesion and the risk of speech deficit is greatly enhanced. Chronic pallidal stimulation contralateral to a previously successful pallidotomy may prove to be a safer alternative for the subset of patients who require bilateral procedures. PMID:15096015

  8. A RARE CASE OF BILATERAL MICROSPHEREPHAKIA

    Directory of Open Access Journals (Sweden)

    Pandu

    2015-05-01

    Full Text Available Microspherophakia is rare bilateral congenital anamoly of the crystalline lens. The condition may be isolated , familial or it may be associated with systemic affections like Marfan's syndrome , Weil - Marchesani syndrome , hyperlysinemia and congenital rubella. Microspherophakia results in lenticular myopia , lens dislocation , usually inferiorly and inverse glaucoma. We present a case in a 8 year old child who presented with bilateral microspherophakia and anterior dislocation of lens of right eye. visual acuity in right eye was counting fingers close to face and i n left eye 6/60.IOP with perkins applanation tonometer was 30mmHg in right eye 22mmHg in left eye , cornea was hazy due to edema , anterior chamber was shallow in both eye patient was managed with emergency lens extraction of right eye and secondary ACIOL im plantation. Left eye was managed by laser peripheral iridotomy. IOP was within normal limits postoperatively in both eyes without any antiglaucoma medications. Postoperatively best corrected visual acuity in right was 6/18 and 6/9 in left eye.

  9. Bilateral neck paragangliomas.

    Science.gov (United States)

    Mumoli, N; Cei, M; Pauletti, M; Ferrito, G; Scazzeri, F

    2009-10-01

    Paragangliomas of the head and neck are rare neoplasms presented as cervical mass, generally bilateral, that arise from chemoreceptors located at the carotid bifurcation (carotid body tumors), along the vagus nerve (vagal paragangliomas), and in the jugular fossa and tympanic cavity (jugulotympanic paragangliomas). They are typically asymptomatic at the beginning, highly vascular, slow-growing and compressing the surrounding anatomic structures. Only radical surgery is the curative treatment for paragangliomas. We present a case of a 62- year-old woman with a diagnosis of bilateral neck paragangliomas where surgical removal was judged burdened by excessive risk because of the size of the tumor. PMID:19622673

  10. BILATERAL IMMATURE OVARIAN TERATOMA

    OpenAIRE

    Vinay; Aditya Pratap; Chetan; Ramesh; Rajlaxmi Jaysing

    2014-01-01

    : Immature teratoma (IMT) is tumor composed of tissues from ectoderm, mesoderm and endoderm and is considered the second most common germ cell tumor. IMT account for 10-20% of all ovarian neoplasias in women less than 20 years of age, with peak incidence between 15 and 19 years old. IMT rarely occurs during menopause. We herein reporting a rare case in a 3 years old girl with bilateral immature ovarian teratoma which is very rare in bilateralism of tumor as well as the fac...

  11. BILATERAL IMMATURE OVARIAN TERATOMA

    Directory of Open Access Journals (Sweden)

    Vinay

    2014-10-01

    Full Text Available : Immature teratoma (IMT is tumor composed of tissues from ectoderm, mesoderm and endoderm and is considered the second most common germ cell tumor. IMT account for 10-20% of all ovarian neoplasias in women less than 20 years of age, with peak incidence between 15 and 19 years old. IMT rarely occurs during menopause. We herein reporting a rare case in a 3 years old girl with bilateral immature ovarian teratoma which is very rare in bilateralism of tumor as well as the fact that the patient age is below the average for the occurrence of these tumors.

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

    Directory of Open Access Journals (Sweden)

    Jacob A Udell

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

  13. EFFECT OF DESTRUCTION OF NTS AND PVN ON NEIGUAN (PC 6)ELECTROACUPUNCTURE-INDUCED IMPROVEMENT OF ISCHEMIC MYOCARDIAL CELLULAR MEMBRANE POTENTIALS IN RABBITS

    Institute of Scientific and Technical Information of China (English)

    CHEN Ze-bin; WANG Shu-ju; WANG Ya-wen; WU Xu-ping; WANG Hua

    2005-01-01

    Objective:To observe the influence of electrolytic destruction of nucleus solitary tract (NTS) and hypothalamic paraventricular nucleus (PVN) on the effect of electroacupuncture (EA) in improving ischemic myocardia cellular transmembrane action potential (TMAP). Methods: 38 Japanese breed big-ear white rabbits (anesthetized with 20% Urethane, 4mL/kg) were randomly divided into acute myocardial ischemia (AMI) group (n=8), PVN destruction group (n=12) and PVN+NTS destruction group (n=18). AMI model was established by occlusion of the descending anterior branch (DAB) of the coronary artery. TMAP of myocytes was recorded by using a glass microelectrode which was fixed to a suspending spring silver wire. Bilateral "Neiguan"(PC 6) in all the 3 groups were punctured and stimulated electrically by using parameters of continuous waves, frequency ECG-ST elevated significantly while APA lowered, APD50 and APD90 shortened of 7 Hz, intensity of 6 mA and duration of 30 minutes. Results: After AMI,clearly in comparison with those of pre-AMI in the 3 groups. Compared with AMI group, ECG-ST values of PVN destruction group and PVN+NTS destruction group were significantly higher (P<0.05~0.01), while APA, APD50 and APD90 all significantly lower in all the recording time courses(P<0.05). The facts displayed that electrolytic destruction of PVN and PVN+NTS could produce ischemic myocardial injury and reduce the protective effect of EA on ischemic myocardial cells. Comparison between PVN destruction and PVN+NTS groups showed that all the 4 indexes of the later group were evidently worse than those of the former group (P<0.05), suggesting after destruction of these two nuclei, the effect of EA was worsened further. Conclusion: Electrolytic destruction of PVN and NTS weakens the protective effect of EA on ischemic myocardial cells, both NTS and PVN take part in the effect of EA of "Neiguan"(PC 6) Point in improving ischemic myocardium.

  14. Bilateral caudate infarct--a case report.

    Science.gov (United States)

    Lim, J K; Yap, K B

    1999-07-01

    Caudate strokes comprise only a small proportion of all subtypes of strokes. Bilateral caudate infarcts are even rarer and only a few cases have been reported in the literature. We report an 86-year-old woman with bilateral caudate infarcts. She had no past medical history of note. She presented with headache for several days and drowsiness on day of admission. Clinical examination revealed abulia, inability to comprehend or verbalize (acute mutism), right-sided neglect and right-sided hemiparesis. Computed tomographic (CT) scan brain revealed decreased attenuation in both heads of both caudate nuclei with extension across the anterior limb of both internal capsules to involve the lentiform nuclei. Echocardiography showed aortic valve sclerosis, mild mitral and aortic regurgitation and normal left ventricular function. Carotid ultrasound revealed mild stenosis of proximal right internal carotid and left distal common carotid and adjacent proximal internal carotid arteries. She showed initial improvement in the first week, but subsequently had a progressive downward course despite rehabilitation and died 44 days after her stroke. A patient with bilateral caudate infarcts is likely to have poor prognosis for rehabilitation and survival. PMID:10561773

  15. Diagnosis and management of bilateral nasolabial cysts

    Directory of Open Access Journals (Sweden)

    Rajkumar Parwani

    2013-01-01

    Full Text Available Nasolabial cysts are painless, submucosal, non-odontogenic jaw cysts presenting as soft tissue swellings in the maxillary anterior mucolabial fold lateral to midline, leading to elevation of nasal ala. Present case documents bilateral nasolabial cysts in a 69-year-old Asian female patient. In the present case, extraoral swelling of maxillary lip and elevation of nasal ala was observed on right side of the face. Intraorally, soft and fluctuant bilateral cysts were observed. Straw-colored fluid was aspirated from the right cyst. Radiographically, erosion of bone in a "cupping" fashion was observed in the region of left cyst. The cysts were enucleated using intraoral approach. Histopathology of the right-sided cyst revealed a cystic cavity lined by stratified squamous cells along with a few mucosal cells. At few places, stratified squamous and pseudostratified columnar epithelia with many cilia and goblet cells were also evident. Capsule was loosely arranged with fibrous tissue and chronic inflammatory infiltrate. Left-sided cystic specimen showed two or more layered stratified squamous lining epithelium with thin capsule. Diagnosis of bilateral nasolabial/nasoalveolar cysts was confirmed.

  16. Bilateral akillesseneruptur hos nyretransplanterede

    DEFF Research Database (Denmark)

    Skovgaard, D; Feldt-Rasmussen, B F; Nimb, L;

    1996-01-01

    Increased incidence of tendinitis and tendon ruptures is reported in recipients of a kidney transplant. Two cases of bilateral achilles tendon rupture after minimal trauma are described. Tendon ruptures are more frequent in individuals with kidney disease in dialysis or after transplantation comp...

  17. Bilateral endogenous fungal endophthalmitis

    OpenAIRE

    Michal, Wilczynski; Olena, Wilczynska; Wojciech, Omulecki

    2013-01-01

    Endogenous endophthalmitis is a rare and severe intraocular infection which can be vision-threatening. We describe a case of bilateral fungal endogenous endophthalmitis in a 64-year-old male which was successfully treated with systemic administration of fluconazole followed by pars plana vitrectomy with an intravitreous injection of amphotericin B.

  18. Bilateral chronic subdural hematoma

    DEFF Research Database (Denmark)

    Andersen-Ranberg, Nina Christine; Poulsen, Frantz Rom; Bergholt, Bo;

    2016-01-01

    ) surgery. The overall retreatment rate was 21.6% (57 of 264 patients). Cases treated with unilateral surgery had twice the risk of retreatment compared with cases undergoing bilateral surgery (28.7% vs 14.1%, respectively, p = 0.002). In accordance with previous studies, the data also showed that a...

  19. Bilateral lunate intraosseous ganglia

    International Nuclear Information System (INIS)

    An intraosseous ganglion is a relatively uncommon, benign, cyst-like lesion that occurs in young and middle-aged adults. Most commonly seen adjacent to the hip, ankle, knee, or wrist, they are histologically identical to their soft tissue counterparts. A review of the literature revealed only two previously reported examples of bilateral symmetrical ganglia of the lunate bones. (orig.)

  20. Bilateral meandering pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Thupili, Chakradhar R.; Udayasankar, Unni [Pediatric Imaging, Imaging Institute Cleveland Clinic, Cleveland, OH (United States); Renapurkar, Rahul [Imaging Institute Cleveland Clinic, Thoracic Imaging, L10, Cleveland, OH (United States)

    2015-06-15

    Meandering pulmonary veins is a rare clinical entity that can be mistaken for more complex congenital syndromes such as hypogenetic lung syndrome. We report imaging findings in a rare incidentally detected case of bilateral meandering pulmonary veins. We briefly discuss the role of imaging in diagnosing this condition, with particular emphasis on contrast-enhanced CT. (orig.)

  1. Complement sequestration in ischemic baboon myocardium

    International Nuclear Information System (INIS)

    Complement-mediated myocardial tissue injury following ischemia has proposed. In the present study, sequestration of radiolabeled human C5 was estimated in baboon myocardial tissue samples obtained 24 hr following ligation of the left anterior descending coronary artery (n=5 baboons). 125I-C5 and 131I-albumin were intravenously administered 24 hr prior to the ligation procedure; 99T-albumin was injected just prior to sacrifice and used to estimate tissue blood volume. Alternating myocardial tissue samples were evaluated for creatine kinase (CK) content after homogenization or for histology after fixation in neutral buffered formalin. 99Tc, 125I, and 131I were determined in all samples. Both C5 and albumin were sequestered in formalin-fixed tissues. No 131I-albumin was retained in any pellet following homogenization whereas, 125I-C5 was present in tissue pellets obtained from ischemic regions. 125I-C5 bound to myocardium was correlated to the extent of the tissue injury, i.e., as myocardial CK decreased, 125I-C5 sequestration increased. Thus, C5 accumulates in ischemic myocardium, and, in contrast to albumin which is present as a consequence of tissue edema following tissue injury, appears to be tissue-bound

  2. Ischemic Posterior Circulation Stroke: A Review of Anatomy, Clinical Presentations, Diagnosis and Current Management

    Directory of Open Access Journals (Sweden)

    Amre eNouh

    2014-04-01

    Full Text Available Posterior circulation (PC strokes represent approximately 20% of all ischemic strokes. In contrast to the anterior circulation (AC several differences in presenting symptoms, clinical evaluation, diagnostic testing and management strategy exist which may present a challenge to the treating physician. This review will discuss the anatomical, etiological and clinical classification of PC strokes, identify diagnostic pitfalls and overview current therapeutic regimens.

  3. Cervical facet joint kinematics during bilateral facet dislocation

    OpenAIRE

    Panjabi, Manohar M.; Simpson, Andrew K.; Ivancic, Paul C.; Pearson, Adam M.; Tominaga, Yasuhiro; Yue, James J.

    2007-01-01

    Previous biomechanical models of cervical bilateral facet dislocation (BFD) are limited to quasi-static loading or manual ligament transection. The goal of the present study was to determine the facet joint kinematics during high-speed BFD. Dislocation was simulated using ten cervical functional spinal units with muscle force replication by frontal impact of the lower vertebra, tilted posteriorly by 42.5°. Average peak rotations and anterior sliding (displacement of upper articulating facet s...

  4. A case of bilateral posterior scleritis with serous detachment

    OpenAIRE

    Murat Aslankurt; Adnan Aksoy; Lokman Aslan; İbrahim Yaşar; Harun Gizir

    2012-01-01

    Seventeen years old male patient was admitted to theclinic with complaints of pain in the right eye, reductionof vision, painful eye movements and headache for 10days. Visual acuity was found Snellen 0.2 on the right eyeand 1.0 on the left eye. Anterior segment examinationwas normal. Fundus examination revealed bilateral chorioretinalfold on the papillo-macular bundle and serousmacular detachment on the right eye. Fundus angiography(FA) revealed late macular hyperfluorescence due toleakage. E...

  5. Bilateral ocular osseous choristomas

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Jeung Hee; Yoon, Dae Young; Choi, Chul Soon; Yoon, Eun Joo; Park, Sang Joon; Seo, Young Lan [Hallym University, Department of Radiology, Kangdong Sacred Heart Hospital, Seoul (Korea); Kim, Byoung Jin [Hallym University, Department of Ophthalmology, Kangdong Sacred Heart Hospital, Seoul (Korea)

    2005-11-01

    Choristoma is a benign tumour defined as normal tissue in an ectopic location. Osseous choristoma, one subtype of this entity, occurring within the orbit has rarely been reported in the world literature. We report a 6-year-old girl with bilateral ocular osseous choristomas who presented with palpable nodules protruding from both upper lids. The radiological and clinical findings are described and previous reports are reviewed. (orig.)

  6. Bilateral Integrative Medicine, Obviously

    OpenAIRE

    Shapiro, Simon J.; Stumpf, Steven H.

    2006-01-01

    Unstated and unacknowledged bias has a profound impact on the nature and implementation of integrative education models. Integrative education is the process of training conventional biomedical and traditional Chinese medicine practitioners in each tradition such that patient care may be effectively coordinated. A bilateral education model ensures that students in each tradition are cross-taught by experts from the ‘other’ tradition, imparting knowledge and values in unison. Acculturation is ...

  7. Bilateral lunate intraosseous ganglia

    Energy Technology Data Exchange (ETDEWEB)

    Pablos, J.M. [Department of Radiology, Hospital San Juan de Dios, Seville (Spain); Valdes, J.C. [Department of Radiology, Cemedi, Seville (Spain); Gavilan, F. [Department of Pathology, Hospital Universitario Virgen del Rocio, Seville (Spain)

    1998-12-01

    An intraosseous ganglion is a relatively uncommon, benign, cyst-like lesion that occurs in young and middle-aged adults. Most commonly seen adjacent to the hip, ankle, knee, or wrist, they are histologically identical to their soft tissue counterparts. A review of the literature revealed only two previously reported examples of bilateral symmetrical ganglia of the lunate bones. (orig.) With 3 figs., 10 refs.

  8. Compressive Bilateral Filtering.

    Science.gov (United States)

    Sugimoto, Kenjiro; Kamata, Sei-Ichiro

    2015-11-01

    This paper presents an efficient constant-time bilateral filter that produces a near-optimal performance tradeoff between approximate accuracy and computational complexity without any complicated parameter adjustment, called a compressive bilateral filter (CBLF). The constant-time means that the computational complexity is independent of its filter window size. Although many existing constant-time bilateral filters have been proposed step-by-step to pursue a more efficient performance tradeoff, they have less focused on the optimal tradeoff for their own frameworks. It is important to discuss this question, because it can reveal whether or not a constant-time algorithm still has plenty room for improvements of performance tradeoff. This paper tackles the question from a viewpoint of compressibility and highlights the fact that state-of-the-art algorithms have not yet touched the optimal tradeoff. The CBLF achieves a near-optimal performance tradeoff by two key ideas: 1) an approximate Gaussian range kernel through Fourier analysis and 2) a period length optimization. Experiments demonstrate that the CBLF significantly outperforms state-of-the-art algorithms in terms of approximate accuracy, computational complexity, and usability. PMID:26068315

  9. Acute vertebrobasilar ischemic stroke due to electric injury.

    Science.gov (United States)

    Singh Jain, Rajendra; Kumar, Sunil; Suresh, Desai Tushar; Agarwal, Rakesh

    2015-07-01

    Electrical injuries are most commonly due to household accidents.Various factors determine the severity of electric injury, including type of current, amperage, voltage, tissue resistance, pathway of current,and duration of contact with the body. Various types of neurologic damage due to electrical injury have been described in literature. It may manifest as peripheral nerve injury, spinal cord damage, seizures, cerebellarataxia, hypoxic encephalopathy, and intracerebral hemorrhage. Acute ischemic stroke is an infrequent complication of electrical injury. Herein,we report a case of middle-aged man, who accidentally sustained high voltage electrical injury followed by acute vertebrobasilar ischemic stroke. Magnetic resonance imaging of the brain showed acute infarctin bilateral cerebellar and medial occipital regions. Computed tomographic angiogram of the brain and neck vessels was normal. Possibly,in our patient, the mechanism could be related to direct vascular injury due to electric current. PMID:25684743

  10. Coronary bypass using bilateral internal mammary arteries in an achondroplast.

    Science.gov (United States)

    Alassal, Mohamed Abdulwahab; Youssef, Mostafa; Koudieh, Mohammed

    2015-01-01

    Coronary bypass grafting for ischemic heart disease in achondroplastic dwarfs is very rare. Shortage of veins and inadequate vein quality may cause difficulties during surgery. Only 2 cases of coronary bypass surgery in an achondroplastic dwarf, in which the left internal mammary artery and vein grafts were used, have been reported. We describe the case of a 55-year-old male achondroplastic dwarf who had triple-vessel coronary disease and underwent successful coronary bypass surgery using one saphenous vein graft and bilateral internal mammary artery grafts. The anatomic and surgical challenges in achondroplasia are highlighted. PMID:24887865

  11. Etiologic Classification in Ischemic Stroke

    OpenAIRE

    Hakan Ay

    2011-01-01

    Ischemic stroke is an etiologically heterogenous disorder. Classification of ischemic stroke etiology into categories with discrete phenotypic, therapeutic, and prognostic features is indispensible to generate consistent information from stroke research. In addition, a functional classification of stroke etiology is critical to ensure unity among physicians and comparability among studies. There are two major approaches to etiologic classification in stroke. Phenotypic systems define subtypes...

  12. Simultaneous Bilateral Carotid Stenting for Symptomatic Bilateral High-Grade Carotid Stenosis: A Retrospective Clinical Investigation

    Science.gov (United States)

    Ye, Ziming; Liu, Ying; Deng, Xiao; Chen, Xiangren; Lin, Cuiting; Tang, Yanyan; Su, Ying; Fang, Lanji; Wu, Yuan; Qin, Chao

    2016-01-01

    Background This retrospective clinical investigation aimed to evaluate the short-term effectiveness and safety of SBCAS for symptomatic bilateral high-grade CS. Material/Methods From 2009 to 2014, 145 patients were recruited. Among them, 70 underwent SBCAS, and other 75 patients underwent SAMM and served as controls. The immediate postprocedural complications and postprocedural neurological evaluation, as well as restenosis at 6-month and 1-year follow-ups in the SBCAS group are reported. Additionally, baseline risk factors for ischemic stroke, adverse effects of drugs, and outcomes at 30-day, 6-month, and 1-year follow-ups were compared between the 2 groups. Results Our data did not reveal significant differences between the 2 groups in baseline risk factors for ischemic stroke. In the SBCAS group, both HPS (5.7%) and HD (40%) occurred, but they were not very severe, and no patients had postprocedural neurological deficit. Moreover, restenosis only occurred in 3 patients at 3 stent placement sites (4.3%) at 1-year follow-up. Adverse effects of drugs did not occur in SBCAS group, but adverse effects of Bayer aspirin and Lipitor occurred in 4 patients (5.4%) and 18 patients (24.3%), respectively, at 6-month follow-up in the control group. Furthermore, there were significant differences in outcomes between the 2 groups at 30-day, 6-month, and 1-year follow-ups, in that NIHSS, CS ratio, and incidence of endpoint events, as well as 1-year cumulative probability of endpoint events, were all lower in the SBCAS group than in the control group (p<0.05). Conclusions Compared to SAMM, we found that SBCAS was more effective and safer for symptomatic bilateral high-grade CS. PMID:27542158

  13. Bilateral inflammatory cysts of the jaw: report of an unusual case

    OpenAIRE

    Holla, Vidya A.; Chatra, Laxmikanth; Shenai, Prashanth; Rao, Prasanna Kumar; Veena, KM; Prabhu, Rachana Vishnudas

    2012-01-01

    Radicular cyst is the most common odontogenic cyst occurring in the jaws. The cyst is commonly found in relation to the maxillary anterior teeth in the third and fifth decade of life. Although multiple radicular cysts are not uncommon in the jaws, bilaterally symmetrical representation of these cysts is rare. Radiographs prior to extraction help in diagnosis of these cysts and thereby prevent further morbidities. We report a case of 16-year-old male patient who presented bilateral radicular c...

  14. Simultaneous bilateral distal biceps tendon ruptures repaired using an endobutton technique: a case report

    OpenAIRE

    DaCambra, Mark P; Walker, Richard EA; Hildebrand, Kevin A.

    2013-01-01

    Introduction The simultaneous rupture of both distal biceps tendons is a rare clinical entity that is difficult to treat and can have poor outcomes. A variety of treatment and rehabilitation options exist and have been reported for single sided and staged bilateral repairs, but none have described an approach for acute bilateral ruptures. Repairing distal biceps tendon ruptures using a single anterior incision and a cortical suspensory button technique has become increasingly popular in recen...

  15. Unilateral and Bilateral Expression of a Quantitative Trait: Asymmetry and Symmetry in Coronal Craniosynostosis

    OpenAIRE

    Heuzé, Yann; Martínez-Abadías, Neus; STELLA, JENNIFER M.; Senders, Craig W.; Simeon A Boyadjiev; Lo, Lun-Jou; Richtsmeier, Joan T.

    2012-01-01

    Bilateral symmetry in vertebrates is imperfect and mild asymmetries are found in normal growth and development. However, abnormal development is often characterized by strong asymmetries. Coronal craniosynostosis, defined here as consisting of premature suture closure and a characteristic skull shape, is a complex trait. The premature fusion of the coronal suture can occur unilaterally associated with skull asymmetry (anterior plagiocephaly) or bilaterally associated with a symmetric but brac...

  16. Wnt3a gradient converts radial to bilateral feather symmetry via topological arrangement of epithelia

    OpenAIRE

    Yue, Zhicao; Jiang, Ting-Xin; Widelitz, Randall Bruce; Chuong, Cheng-Ming

    2006-01-01

    The evolution of bilaterally symmetric feathers is a fundamental process leading toward flight. One major unsolved mystery is how the feathers of a single bird can form radially symmetric downy feathers and bilaterally symmetric flight feathers. In developing downy feather follicles, barb ridges are organized parallel to the long axis of the feather follicle. In developing flight-feather follicles, the barb ridges are organized helically toward the anterior region, leading to the fusion and c...

  17. Acute Ischemic Lesions Associated with Impairments in Expression and Recognition of Affective Prosody

    Directory of Open Access Journals (Sweden)

    Amy Elizabeth Wright

    2015-04-01

    had deficits in both expression and recognition of affective prosody. The two patients with selective deficits in expressive prosody had right frontal lesions. Patients with selective deficits in receptive prosody had posterior temporal (n=3, caudate (n=2, or thalamic (n=1 lesions. DISCUSSION: A double dissociation between impaired modulation of expressive prosody (with normal recognition of affective prosody in some cases and impaired recognition of affective prosody (with intact expressive prosody in other cases after acute stroke provides evidence that there are at least some distinct mechanisms underlying expression and recognition of prosody that can be selectively impaired. (see also Ross & Monnot, 2008; Bowers, Bauer, & Heilman, 1993. Patients with impaired expression and recognition of affective prosody had lesions mostly involving right anterior temporal pole, and this area was statistically associated with severity of their expressive deficit. This region may be critical for a component common to expression and recognition of prosody, such as the semantic representation of the emotion to be conveyed. The anterior temporal poles (bilaterally have been proposed as a “semantic hub” in object meaning (Pobric, Jefferies, & Ralph, 2010, and have been proposed as a critical for understanding social concepts (Zahn et al., 2009. It would not be surprising if they have a role in representing the meaning of emotions.

  18. Ocular perfusion pressure and hemodynamics analysis in non-arteritic anterior ischemic optic neuropathy and idiopathic optic neuritis%非炎性前部缺血性视神经病变和特发性视神经炎眼灌注压与眼部血流动力学研究

    Institute of Scientific and Technical Information of China (English)

    王欣玲; 李雪姣; 阎启昌

    2014-01-01

    Objective To compare the Ocular perfusion pressure (OPP) and ocular hemodynamics of patients with non-arteritic anterior ischemic optic neuropathy (NAION) and idiopathic optic neuritis (ION),and analyze their relationship with fixation features.Methods It was a retrospective case study.Data were collected in patients with NAION and ION who were treated in Department of Ophthalmology,the Fourth Affiliated Hospital,China Medical University from March 2011 to May 2013.OPP and ocular hemodynamics were analyzed,as well as the ages,gender,and systemic diseases after these patients were divided as the central fixation group and the extra-central fixation one on the basis of ocular fixation features.The reason making the differences were thought over.Results There were 21 NAION cases (21 eyes,14 for central fixation and 7 for extra-central fixation) and 21 ION ones (21 eyes,8 for central fixation and 13 for extra-central fixation).The peak systolic velocity (PSV) of posterior ciliary artery (PCA) and central retinal artery (CRA) were significantly decreased in the NAION group comparing with the ION group in central fixation eyes (t =12.49,P =0.00; t =14.25,P =0.00).In the extra-central fixation eyes,the sitting mean artery pressure (MAP) of brachial artery and OPP were significantly increased in the NAION group,and the PSV of PCA and CRA were significantly decreased in the NAION group (t =6.41,P =0.02; t =5.66,P =0.03; t =8.47,P =0.01; t =11.32,P =0.00).However,the PSV of PCA and CRA were significantly decreased in the NAION group when the fixation features were excluded from the classification criteria and all kinds of vision was regarded totally as central fixation vision (t =5.81,P =0.02; t =9.20,P =0.00).Conclusions The fixation features of NAION and ION eyes can be classified as central fixation and extra-central fixation.The comparisons of OPP and ocular hemodynamics should be classified according to the fixation features.%目的 比较非炎性前部缺血性视神

  19. Asymptomatic ischemic cerebral lesions

    International Nuclear Information System (INIS)

    For the purpose of studying the incidence, pathomorphology and etiology of asymptomatic ischemic cerebral lesions, we carried out a brain MRI study on 65 patients with diabetes mellitus accompanied with hypertension who are thought to belong to a high risk group of ischemic cerebrovascular diseases. Excluding the abnormality of tendon reflex due to diabetic neuropathy, sixty percent of the total patients had some mild neurological signs and symptoms, most of them was discrepancy in tendon reflex. The percentage of the patients in whom MRI disclosed some abnormalities was as high as 70%, they were lacunar stroke, multiple lacunar state, cortical infarct, and patchy high signal lesions visible only in the T2 weighted image. Lacunes or these patchy high signal lesions (considered to be the dilatation of the perivascular space or true lacunes) tended to be found along the border zone or the terminal zone. These results indicate that asymptomatic patients in whom MRI discloses the abnormalities should be considered as candidates for the future onset of multi-infarct. (author)

  20. Bilateral Testicular Epidermoid Cysts

    OpenAIRE

    Norman Loberant; Shweta Bhatt; Edward Messing; Dogra, Vikram S.

    2011-01-01

    Testicular epidermoid cysts are the most common benign tumors of the testes, but account for only 1-2% of all testicular tumors. In a young man presenting with a testicular mass, a high index of suspicion must be maintained for the malignant testicular germ cell tumor, which is 50-times more common than testicular epidermoid cyst. Bilateral testicular epidermoid cysts are a very rare condition, with only a few reports in the literature. It is extremely important in this condition to make a co...

  1. Ischemic Retinopathy and Neovascular Proliferation Secondary to Severe Head Injury

    Directory of Open Access Journals (Sweden)

    Muge Coban-Karatas

    2014-01-01

    Full Text Available We report a case with severe head trauma and perforating globe injury in one eye and ischemic retinopathy and neovascular proliferation in the other eye. A 37-year-old male was brought to the emergency department after a motor vehicle accident with severe maxillofacial trauma. Ophthalmic examination revealed hematoma of the left eyelids as well as traumatic rupture and disorganization of the left globe. On the right eye, anterior segment and fundoscopic examination were normal. Primary globe repair was performed. At postoperative one-month visit, the right eye revealed no pathology of the optic disc and macula but severe neovascularization in the temporal peripheral retina. The patient was diagnosed as ischemic retinopathy and neovascular proliferation due to head trauma.

  2. Anterior Cruciate Ligament (ACL) Injuries

    Science.gov (United States)

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

  3. Bilateral matrix-exponential distributions

    DEFF Research Database (Denmark)

    Bladt, Mogens; Esparza, Luz Judith R; Nielsen, Bo Friis

    2012-01-01

    In this article we define the classes of bilateral and multivariate bilateral matrix-exponential distributions. These distributions have support on the entire real space and have rational moment-generating functions. These distributions extend the class of bilateral phasetype distributions of [1......] and the class of multivariate matrix-exponential distributions of [9]. We prove a characterization theorem stating that a random variable has a bilateral multivariate distribution if and only if all linear combinations of the coordinates have a univariate bilateral matrix-exponential distribution. As...... an application we demonstrate that certain multivariate disions, which are governed by the underlying Markov jump process generating a phasetype distribution, have a bilateral matrix-exponential distribution at the time of absorption, see also [4]....

  4. Achondroplasia Associated with Bilateral Keratoconus

    OpenAIRE

    Samar A. Al-Swailem; Al Bin Ali, Ghada Y.; Al Katan, Hind M.; Al Mahmood, Ammar M.

    2012-01-01

    We report a rare case of bilateral keratoconus in association with achondroplasia. A 26-year-old male, with a known case of achondroplasia, complained of bilateral gradual deterioration in vision for the past few years. Slit lamp biomicroscopy showed bilateral central corneal protrusion and stromal thinning at the apex consistent with keratoconus. a trial of hard contact lens fitting failed to improve VA in the left eye (LE). Right eye (RE) improved to 20/25. The patient underwent penetrating...

  5. Bilateral persistent trigeminal artery variants diagnosed by MR angiography.

    Science.gov (United States)

    Uchino, Akira

    2011-12-01

    A persistent trigeminal artery (PTA) is the most common anastomosis between the carotid and vertebrobasilar system. A PTA variant (PTAV) is a rare anomaly in which the cerebellar artery arises from the internal carotid artery (ICA) without connection with the basilar artery (BA). I present what I believe is the first report of bilateral PTAVs diagnosed using magnetic resonance (MR) angiography and briefly discuss the embryology of this rare anomaly. An 81-year-old woman with small infarctions underwent cerebral MR imaging and MR angiography with a 1.5-tesla imager for the evaluation of brain lesions. An MR angiography was obtained using the standard noncontrast three-dimensional time-of-flight technique. The MR angiographic demonstration of bilateral anterior inferior cerebellar arteries arising from the precavernous segment of the ICA without anastomosis to the BA indicated bilateral PTAVs. This is the first report of bilateral PTAVs diagnosed by MR angiography. The literature review indicates that an estimated prevalence of bilateral PTAVs is about 0.0012%. PMID:21544587

  6. Bilateral inferior petrosal sinus sampling using vasopressin

    Directory of Open Access Journals (Sweden)

    Narendra Kotwal

    2016-01-01

    Full Text Available Context: Anatomical localization of pituitary adenoma can be challenging in adrenocorticotropic hormone (ACTH-dependent Cushing's syndrome, and bilateral inferior petrosal sinus sampling (BIPSS is considered gold standard in this regard. Stimulation using corticotrophin-releasing hormone (CRH improves the sensitivity of BIPSS, however, same is not easily available in India. Therefore, we undertook this study of BIPPS using vasopressin as agent for stimulation owing to its ability to stimulate V3 receptors present on corticotrophs. Aims: To study the tumor localization and lateralization in difficult to localize cases of ACTH-dependent Cushing's syndrome by bilateral inferior petrosal sinus sampling using vasopressin for corticotroph stimulation. Settings and Design: Prospective observational study. Subjects and Methods: Six patients (5 females meeting inclusion criteria underwent BIPSS using vasopressin for stimulation. Results: All six patients had nonsuppressible overnight and low dose dexamethasone suppression test with elevated plasma ACTH levels suggestive of ACTH-dependent Cushing's syndrome. High dose dexamethasone suppression test showed suppressible cortisol in two cases, and microadenoma was seen in two patients on magnetic resonance imaging pituitary. Contrast enhanced computed tomography of the abdomen showed left adrenal hyperplasia in one case and anterior mediastinal mass with bilateral adrenal hyperplasia another. Using BIPSS four patients were classified as having Cushing's disease that was confirmed histopathologically following surgery. Of the remaining two, one had primary pigmented nodular adrenocortical disease, and another had thymic carcinoid with ectopic ACTH production as the cause of Cushing's syndrome. No serious adverse events were noted. Conclusions: Vasopressin may be used instead of CRH and desmopressin for stimulation in BIPSS.

  7. [Cerebrolysin for acute ischemic stroke].

    Science.gov (United States)

    iganshina, L E; Abakumova, T R

    2013-01-01

    The review discusses existing evidence of benefits and risks of cerebrolysin--a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue with proposed neuroprotective and neurotrophic properties, for acute ischemic stroke. The review presents results of systematic search and analysis of randomised clinical trials comparing cerebrolysin with placebo in patients with acute ischemic stroke. Only one trial was selected as meeting quality criteria. No difference in death and adverse events between cerebrolysin and placebo was established. The authors conclude about insufficiency of evidence to evaluate the effect of cerebrolysin on survival and dependency in people with acute ischemic stroke. PMID:23805635

  8. A case of simultaneous bilateral spontaneous pneumothorax after the Nuss procedure.

    Science.gov (United States)

    Matsuoka, Shunichiro; Miyazawa, Masahisa; Kashimoto, Kentaro; Kobayashi, Hiroaki; Mitsui, Fumihiko; Tsunoda, Hajime; Kunitomo, Kazuyoshi; Chisuwa, Hisanao; Haba, Yoshiaki

    2016-06-01

    We present a case of simultaneous bilateral spontaneous pneumothorax caused by a pleuro-pleural communication formed from Nuss procedure for pectus excavatum. A 17-year-old man with a history of Nuss operation complained chest pain and dyspnea. A chest roentgenogram demonstrated a tiny bilateral pneumothorax and two metallic bars inserted at the Nuss procedure. Computed tomography revealed furthermore a bulla in the apex of the left lung. The bilateral pneumothorax critically deteriorated after 4 days from onset and urgent bilateral chest drainages were performed. Nevertheless the drainages the full expansion of both lungs was not obtained and air leakage only from left side was continued. A video-assisted left bullectomy was performed 9 days after the tube insertion. The two bars penetrating anterior mediastinal pleura were thought to be a cause of the simultaneous bilateral spontaneous pneumothorax. PMID:25352312

  9. Anterior cervical plating

    Directory of Open Access Journals (Sweden)

    Gonugunta V

    2005-01-01

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

  10. Anterior knee pain

    Science.gov (United States)

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

  11. Anterior knee pain

    Science.gov (United States)

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

  12. Ophthalmoscopic image characteristics and relation with vision and course of disease in nonarteritic anterior ischemic optic neuropathy%非动脉炎性前部缺血性视神经病变患者眼底影像检查特征及其与视力、病程转归的关系

    Institute of Scientific and Technical Information of China (English)

    韩梅; 陈松; 王兰惠; 解士勇; 时冀川

    2010-01-01

    视网膜神经纤维层平均厚度、视盘颞侧视网膜神经纤维层厚度呈显著负相关关系(r=-0.394,-0.424,-0.412,-0.464;P<0.05).结论 NAION患者FFA特征为早期视盘充盈迟缓,晚期视盘呈强荧光渗漏;OCT特征为随病程发展,视网膜神经上皮层增厚,神经纤维层变薄.视盘形态及视网膜神经纤维层变化的OCT检查与视野检查结果一致;患者视力与神经上皮层厚度的OCT检查结果呈负相关关系.%Objective To observe the characteristics of fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) in nonarteritic anterior ischemic optic neuropathy (NAION),and investigate its relation with visual acuity and course of disease. Methods The clinical data of 47 patients (47 eyes) with NAION were retrospectively analyzed. All the patiens had undergone visual acuity, fundus and visual field examination ,meanwhile FFA and OCT were carried out at first visit. FFA and visual field were carried out by routine. OCT was carried out by line and circle shape scanning in macula and optic disc.Thirty-five NAION patients were checked with OCT at half, one, two, three and six month after onset in respectively. Take the healthy fellow eyes of 36 NAION patiens as control group. The FFA, visual field, OCT characteristics and relation with visual acuity and course disease were comparatively analyzed. Results FFA showed that all the eyes appear as delayed filling of the optic disc in early stage and hyperfluorescence leakage of the optic disc in late stage,besides hyperfluorescence presented to macular area in 24 eyes. OCT showed that optic papilla swelling and physiological depression narrow or nearly disappearance, neuroepithelial layer thickening or neuroepithelial layer eminence and subretinal fluidity area opaca between optic disc and macula. There were 14 eyes with normal physiological depression and 22 eyes with small physiological depression or non- physiological depression in control group. Half

  13. Bilateral Antepartum Mastitis

    Directory of Open Access Journals (Sweden)

    Peyman Alibeigi

    2010-12-01

    Full Text Available Antepartum mastitis is a rare condition, whereas postpartum orlactation mastitis is a common problem. This report introducesa case of complicated bilateral antepartum mastitis, which wastreated successfully by drain insertion and antibiotic therapy.The patient was a 23-year-old woman in the 23rd week of herfirst pregnancy. Her chief complaint was progressive swelling,redness and radicular pain in both breasts, which had beenstarted gradually from the 18th week of pregnancy. The patientwas admitted to hospital, and received oral and intravenous antibioticsempirically, which was not effective. The patient wastreated by drainage and oral antibiotic therapy. Based on theapproaches employed and the outcomes achieved it is suggestedthat early surgical insertion in the presence of fluid collection inantepartum mastitis will shorten hospitalization and course ofintravenous antibiotic therapy.Iran J Med Sci 2010; 35(4: 327-330.

  14. Idiopathic Bilateral Bloody Tearing

    Directory of Open Access Journals (Sweden)

    Emrullah Beyazyıldız

    2015-01-01

    Full Text Available Bloody tear is a rare and distinct clinic phenomenon. We report a case presenting with the complaint of recurrent episodes of bilateral bloody tearing. A 16-year-old girl presented to our clinic with complaint of bloody tearing in both eyes for 3 months. Bloody tearing was not associated with her menses. A blood-stained discharge from the punctum was not observed during the compression of both nasolacrimal ducts. Nasolacrimal passage was not obstructed. Imaging studies such as dacryocystography and gradient-echo magnetic resonance imaging (MRI of nasolacrimal canal were normal. Intranasal endoscopic evaluation was normal. We collected samples from bloody tears two times and pathological examination was performed. Pathological analysis showed lots of squamous cells and no endometrial cells; dysplastic cells were found. Further evaluations for underlying causes were unremarkable. No abnormalities were found in ophthalmologic, radiologic, and pathologic investigations. This condition is likely a rare abnormality and the least recognized aetiology for the idiopathic phenomenon.

  15. Isolated bilateral ectopic microspherophakia

    Directory of Open Access Journals (Sweden)

    André Omgbwa Eballe

    2010-02-01

    Full Text Available André Omgbwa Eballe1, Godefroy Koki2, Emilienne Epée2, Didier Owono2, Lucienne Bella Asumpta2, Côme Ebana Mvogo21Faculty of Medicine and Pharmaceuticals Sciences, University of Douala Cameroon; 2Faculty of Medicine and Biomedical Sciences, University of Yaoundé CameroonSummary: An eight-year-old school girl presented to us with a bilateral ectopic microspherophakia. She was surgically managed in the ophthalmology unit of the Gynaeco-Obstetric and Pediatric Hospital of Yaoundé in Cameroon. The postoperative follow up was uneventful, and the patient returned to school with a best corrected visual acuity of 4/10 in both eyes to the great satisfaction of her parents.Keywords: ectopic, microspherophakia, surgery

  16. Echocardiographic Findings And Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Natalya Gamletovna Dadamyants

    2011-10-01

    Full Text Available In order to study cardiac pathology in different subtypes of ischemic stroke we examined 165 stroke patients. The 1st group included 90 (54.5% patients with hemodynamic stroke, the 2nd one - 75 (45.5% patients with cardioembolic stroke. Control group consisted of 45 individuals without cerebrovascular diseases. Cardiac pathologies with the prevalence of various types of ischemic heart disease were observed in all groups. The parameters of left ventricular stroke volume and ejection fraction were lower in patients with hemodynamic stroke than in other groups, but were within normal limits. Potential sources of cardiogenic embolism were found in all groups: in the 1st group at 74.4%, in the 2nd one at 100%. Thus, most patients with ischemic stroke have different heart defects related to the subtypes of ischemic stroke. 

  17. RANOLAZINE IN ISCHEMIC HEART DISEASE

    OpenAIRE

    V. P. Lupanov

    2015-01-01

    Study results of a new anti-anginal drug (an inhibitor of sodium channels — ranolazine) are presented. Indications, contraindications, major clinical trials of the drug in patients with ischemic heart disease are considered.

  18. RANOLAZINE IN ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    V. P. Lupanov

    2015-12-01

    Full Text Available Study results of a new anti-anginal drug (an inhibitor of sodium channels — ranolazine are presented. Indications, contraindications, major clinical trials of the drug in patients with ischemic heart disease are considered.

  19. 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

  20. Silicosis with bilateral spontaneous pneumothorax

    OpenAIRE

    Fotedar Sanjay; Chaudhary Dhruva; Singhla Vikas; Narang Rajat

    2010-01-01

    Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax. The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

  1. Silicosis with bilateral spontaneous pneumothorax

    Directory of Open Access Journals (Sweden)

    Fotedar Sanjay

    2010-01-01

    Full Text Available Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax.The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

  2. Bilateral, independent juvenile nasopharyngeal angiofibroma

    DEFF Research Database (Denmark)

    Mørkenborg, Marie-Louise; Frendø, M; Stavngaard, T;

    2015-01-01

    BACKGROUND: Juvenile nasopharyngeal angiofibroma is a benign, vascular tumour that primarily occurs in adolescent males. Despite its benign nature, aggressive growth patterns can cause potential life-threatening complications. Juvenile nasopharyngeal angiofibroma is normally unilateral, originati...... with bilateral symptoms. Our management, including successful pre-operative planning, enabled one-step total removal of both tumours and rapid patient recovery....... from the sphenopalatine artery, but bilateral symptoms can occur if a large tumour extends to the contralateral side of the nasopharynx. This paper presents the first reported case of true bilateral extensive juvenile nasopharyngeal angiofibroma involving clinically challenging pre-surgical planning...... bilateral embolisation. Radical removal performed as one-step, computer-assisted functional endoscopic sinus surgery was performed. The follow-up period was uncomplicated. CONCLUSION: This case illustrates the importance of suspecting bilateral juvenile nasopharyngeal angiofibroma in patients presenting...

  3. Bilateral Acute Angle-Closure Glaucoma Induced By Escitalopram

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    Dilbade Yıldız Ekinci

    2014-10-01

    Full Text Available Escitalopram is an antidepressant of the selective serotonin reuptake inhibitor(SSRI class. In this manuscript, we report the case of a female patient who developed bilateral acute angle-closure glaucoma induced by escitalopram. A 46-year-old female patient was admitted to our ophthalmology clinic with complaints of severe pain around the both eyes, headache, nausea, and vomiting for two days. In her past medical history, she was using escitalopram for depression for two years. Visual acuity was at hand movement level in both eyes. Anterior segment examination showed bilateral diffuse conjunctival hyperemia, corneal edema, shallow anterior chamber, and fixed dilated pupils. Intraocular pressure was 47 mmHg in the right and 68 mmHg in the left eye. The diagnosis was acute angle-closure glaucoma, and the escitalopram medication was discontinued. She was treated with topical and systemic antiglaucomatous medication. After the cornea become clear, bilateral peripheral laser iridotomy was done. In the following year, she did not begin escitalopram medication again and no other acute angle-closure attack was seen. (Turk J Ophthalmol 2014; 44:396-9

  4. Fifty-eight cases of ocular ischemic diseases caused by carotid artery stenosis

    Institute of Scientific and Technical Information of China (English)

    LUO Rong-jiang; LIU Shao-rui; LI Xiao-min; ZHUO Ye-hong; TIAN Zhen

    2010-01-01

    Background The blood supply to the eye comes from the retinal central vascular system of the ophthalmic artery and the ciliary vascular system. The ophthalmic artery stems from the ipsilateral internal carotid artery. If occlusion or stenosis occurs in the carotid artery, the blood perfusion to the ophthalmic artery becomes insufficient, leading to signs and symptoms of anterior and posterior ocular ischemia. The objective of this study was to evaluate the clinical characteristics and risk factors of ocular ischemic diseases caused by carotid artery stenosis.Methods This study was a retrospective review of 145 patients with carotid artery stenosis. Fifty-eight patients who had symptoms of ocular ischemic disease caused by carotid artery stenosis formed group A and the other 87 patients who only had carotid artery stenosis formed group B. We analyzed the causes and course of disease, and relative risk factors,by comparing the two groups.Results The degree of carotid artery stenosis in group A was higher than that in group B. And group A had a greater decrease of ophthalmic artery flow. Male, hypertension, hyperlipidemia, and smoking were significantly related to carotid artery stenosis. Amaurosis fugax was the most common ocular symptom in group A. The ocular ischemic diseases mainly included ischemic optic neuropathy, central/branch retinal artery occlusion, ophthalmoplegia externa, and ocular ischemic syndrome.Conclusions Carotid artery stenosis correlates with ocular ischemic diseases. Ophthalmologists must observe for ocular symptoms, which were the onset symptoms in some patients.

  5. Radon inhalation protects against transient global cerebral ischemic injury in gerbils.

    Science.gov (United States)

    Kataoka, Takahiro; Etani, Reo; Takata, Yuji; Nishiyama, Yuichi; Kawabe, Atsushi; Kumashiro, Masayuki; Taguchi, Takehito; Yamaoka, Kiyonori

    2014-10-01

    Although brain disorders are not the main indication for radon therapy, our previous study suggested that radon inhalation therapy might mitigate brain disorders. In this study, we assessed whether radon inhalation protects against transient global cerebral ischemic injury in gerbils. Gerbils were treated with inhaled radon at a concentration of 2,000 Bq/m(3) for 24 h. After radon inhalation, transient global cerebral ischemia was induced by bilateral occlusion of the common carotid artery. Results showed that transient global cerebral ischemia induced neuronal damage in hippocampal CA1, and the number of damaged neurons was significantly increased compared with control. However, radon treatment inhibited ischemic damage. Superoxide dismutase (SOD) activity in the radon-treated gerbil brain was significantly higher than that in sham-operated gerbils. These findings suggested that radon inhalation activates antioxidative function, especially SOD, thereby inhibiting transient global cerebral ischemic injury in gerbils. PMID:24792782

  6. Correction of transverse maxillary deficiency and anterior open bite in an adult Class III skeletal patient

    Directory of Open Access Journals (Sweden)

    Prerna Hoogan Teja

    2016-01-01

    Full Text Available Transverse maxillary deficiency may be associated with sagittal or vertical problems of the maxilla or mandible. It may contribute to unilateral or bilateral posterior crossbite, anterior dental crowding, and unesthetic black buccal corridors on smiling. An adequate transverse dimension is important for stable and proper functional occlusion. Surgically, assisted rapid palatal expansion has been the treatment of choice to resolve posterior crossbite in skeletally mature patients. The following case report presents an adult Class III skeletal patient with an anterior open bite and bilateral posterior crossbite which was treated by surgically assisted rapid maxillary expansion with satisfactory outcomes.

  7. Acute ischemic cerebral attack

    Directory of Open Access Journals (Sweden)

    Franco-Garcia Samir

    2010-12-01

    Full Text Available The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violent death in the world and the first of disability. Many risk factors favor the presentation of these events and some of them are susceptible of modification and therfore are objetives of primary prevention just as the control of diabetes, hypertension and the practice of healthy habits of life. The advances in the knowledge of the physiopatology, had taken to sustantial change in the nomenclature and management of ischemic ACS. Within these changes it was substituted the term cerebrovascular accident fo acute stroke, making emphasis in the key rol of a timely management with goals of time similiar to the acute coronary syndrome. It was redefined the time of acute ischemic attack to a one hour. Once stablished the cerebrovascular attack the semiology of symtoms with frecuency will led us make a topographic diagnosis of the in injury that joined to the cerebral TAC will allow us to exclude an hemorragic event and to start the treatment. In the management of these patients its essential the coordination of the differents teams of work, from the early recognition of symtoms on the part of patients andthe family, the rapid activation and response of emergency systems and the gearing of health care institutions. Are pillars of treatment: the abcde of reanimatiion, to avoid the hiperpirexis, the seizures, the hipoglicemy, the hiperglicemy, to achieve the thrombolysis in the first three hours of the begining of symtoms, to use antiplatelets, antithrombotic profilaxis

  8. Anatomy and radiology of the anterior inferior cerebellar artery

    International Nuclear Information System (INIS)

    This study describes the variations of the Anterior Inferior Cerebellar Artery (AICA) and identifies its types of appearance in normal angiograms as well as in angiograms of patients suffering from posterior fossa tumours or from ischemic lesions in the vertebro-basilar territory. For this purpose a study of 20 normal specimens was undertaken. Four main types of the AICA are distinguished. One hundred normal vertebral angiograms, made between 1976 and 1982 in the Valeriuskliniek and the Academisch Ziekenhuis der Vrije Univesiteit are reviewed. The AICA's are classified in the same way as in the anatomical study. The same classification was used in the analysis of 41 vertebral angiograms of patients with posterior fossa tumours and nine angiograms of patients with ischemic disturbances in the posterior cranial fossa. (Auth.)

  9. Acute silicosis with bilateral pneumothorax.

    Science.gov (United States)

    Srivastava, G N; Prasad, Rajniti; Meena, Manoj; Hussain, Moosa

    2014-01-01

    We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of acute silicosis as bilateral pneumothorax. PMID:24862410

  10. Distribution territories and causative mechanisms of ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Rovira, A.; Grive, E.; Alvarez-Sabin, J. [Unidad de Resonancia Magnetica, Hospital Vall d' Hebron, Barcelona (Spain)

    2005-03-01

    Ischemic stroke prognosis, risk of recurrence, clinical assessment, and treatment decisions are influenced by stroke subtype (anatomic distribution and causative mechanism of infarction). Stroke subtype diagnosis is better achieved in the early phase of acute ischemia with the use of multimodal MR imaging. The pattern of brain lesions as shown by brain MR imaging can be classified according to a modified Oxfordshire method, based on the anatomic distribution of the infarcts into six groups: (1) total anterior circulation infarcts, (2) partial anterior circulation infarcts, (3) posterior circulation infarcts, (4) watershed infarcts, (5) centrum ovale infarcts, and (6) lacunar infarcts. The subtype of stroke according to its causative mechanism is based on the TOAST method, which classifies stroke into five major etiologic groups: (1) large-vessel atherosclerotic disease, (2) small-vessel atherosclerotic disease, (3) cardioembolic source, (4) other determined etiologies, and (5) undetermined or multiple possible etiologies. The different MR imaging patterns of acute ischemic brain lesions visualized using diffusion-weighted imaging and the pattern of vessel involvement demonstrated with MR angiography are essential factors that can suggest the most likely causative mechanism of infarction. This information may have an impact on decisions regarding therapy and the performance of additional diagnostic tests. (orig.)

  11. Anterior Cervical Osteophytes Causing Dysphagia and Dyspnea: An Uncommon Entity Revisited

    OpenAIRE

    Giger, Roland; Dulguerov, Pavel; Payer, Michael

    2007-01-01

    Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis (DISH). We present the case of an 83-year-old patient with progressive dysphagia and acute dyspnea, necessitating emergency tracheotomy. Voluminous anterior cervical osteophytes extending from C3 to C7 and narrowing the pharyngoesophageal segment by external compression and bilateral vocal fold immobility were diagnosed radiologically and by fiberoptic laryngoscop...

  12. Surgical Management of Anterior Lenticonus in a Patient with Alport´s Syndrome

    OpenAIRE

    Can, Çiğdem Ülkü; İlhan, Bayazıt; Sibel POLAT

    2008-01-01

    Background: To discuss ophthalmic features and management of a patient with Alport´s syndrome and anterior lenticonus. Materials and Methods: A 22-year-old female patient with Alport´s syndrome who, in another center, had undergone laser in situ keratomileusis (LASIK) because of high myopia was determined to have bilateral anterior lenticonus. We treated the other eye by phacoemulsification and intraocular lens (IOL) implantation. Results: Lens extraction and IOL implantation gave satisfact...

  13. Congenital anterior urethral diverticulum.

    Science.gov (United States)

    Singh, Sanjeet Kumar; Ansari, Ms

    2014-09-01

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

  14. Hepatopancreatic arterial ring: bilateral symmetric typology in human celiaco-mesenteric arterial system.

    Directory of Open Access Journals (Sweden)

    Kosaka M

    2002-10-01

    Full Text Available The celiac and mesenteric arterial system including the left gastric, splenic, common hepatic, and superior mesenteric arteries shows various types of origins, courses, ramifications and anastomoses. In order to explain the various expressions of this system, we have proposed a typological model, in which celiacomesenteric arteries develop as paired or bilaterally symmetrical primordial vessels originated from the anterior aspect of the aorta, and these vessels anastomose each other with longitudinal and horizontal pathways. Here, we report 3 unusual cases characterized by arterial rings, formed by the left gastric, left accessory hepatic, proper hepatic, anterior pancreaticoduodenal, and dorsal pancreatic arteries. The dorsal pancreatic and anterior pancreaticoduodenal arteries are located to the right and left of the embryonic pancreas developing in the dorsal mesentery, respectively. Such hepatopancreatic arterial rings simultaneously containing right and left elements can only be explained using our typological model, in which the concept of paired arteries or bilateral symmetry is introduced.

  15. Hepatopancreatic arterial ring: bilateral symmetric typology in human celiaco-mesenteric arterial system.

    Science.gov (United States)

    Kosaka, Motohiro; Horiuchi, Kanji; Nishida, Keiichiro; Taguchi, Takehito; Murakami, Takuro; Ohtsuka, Aiji

    2002-10-01

    The celiac and mesenteric arterial system including the left gastric, splenic, common hepatic, and superior mesenteric arteries shows various types of origins, courses, ramifications and anastomoses. In order to explain the various expressions of this system, we have proposed a typological model, in which celiacomesenteric arteries develop as paired or bilaterally symmetrical primordial vessels originated from the anterior aspect of the aorta, and these vessels anastomose each other with longitudinal and horizontal pathways. Here, we report 3 unusual cases characterized by arterial rings, formed by the left gastric, left accessory hepatic, proper hepatic, anterior pancreaticoduodenal, and dorsal pancreatic arteries. The dorsal pancreatic and anterior pancreaticoduodenal arteries are located to the right and left of the embryonic pancreas developing in the dorsal mesentery, respectively. Such hepatopancreatic arterial rings simultaneously containing right and left elements can only be explained using our typological model, in which the concept of paired arteries or bilateral symmetry is introduced. PMID:12530508

  16. İki taraflı anterior omuz çıkığı: Olgu sunumu ve literatür taraması

    OpenAIRE

    Ozan, F; Altay, T; Koyuncu, Ş; Çeliker, H

    2014-01-01

    Dislocation is more often encountered due to multilateral mobility of the shoulder joint, its anatomic characteristics, and its being more exposed to traumas. Shoulder dislocations are often anterior and unilateral; though rare, bilateral shoulder dislocations are also encountered. Such dislocations are mostly posterior. A simultaneous bilateral anterior shoulder dislocation is extremely rare. In the current study, we present the case of a 55-year-old female patient, with a simultaneous bilat...

  17. Bilateral support programmes

    International Nuclear Information System (INIS)

    In the Russian Federation, serious consideration is being given to the safety of nuclear facilities and to security of nuclear material. One important factor in ensuring security of nuclear material and facilities is physical protection. The Ministry of Atomic Energy of the Russian Federation is making great efforts to improve physical protection of nuclear facilities. Some of the measures which are being implemented to improve physical protection are being carried out in the framework of international co-operation in this field. To date, the Russian Federation has established bilateral co-operation with the United States of America, Germany, Belgium, France and Finland, and has studied and taken account of the experience of foreign countries in the field of physical protection and nuclear material accounting and control. At present, over 20 enterprises of the Ministry of Atomic Energy of the Russian Federation representing all the main branches of the nuclear activities of the Ministry are involved in international co-operation on physical protection and nuclear material accounting and control. The main branches of this co-operation are as follows: Scientific and technical co-operation; production of a conceptual design to improve physical protection systems directly at nuclear risk facilities; swift improvement of physical protection (without developing design documentation for the nuclear risk facility as a whole); reinforcement of physical protection during the transport of nuclear material; and training of staff at nuclear risk facilities. During this work, many facilities were equipped with modern physical protection and with nuclear material accounting and control equipment. The Ministry of Atomic Energy of the Russian Federation is pleased with the results of this international co-operation and feels that it should continue. (author)

  18. Bilateral internal laryngoceles mimicking asthma.

    Science.gov (United States)

    Aksoy, Elif A; Elsürer, Cağdaş; Serin, Gediz M; Unal, O Faruk

    2013-05-01

    Laryngocele is an air-filled, abnormal dilation of the laryngeal saccule that extends upward within the false vocal fold, in communication with the laryngeal lumen. A case of 43-year-old male with bilateral internal laryngoceles, who has been treated as asthma for 4 years, is presented. The patient had dyspnea, cough, and excessive phlegm for a month and a late onset stridor. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Although the incidence of internal laryngocele is rare, it should be remembered in the differential diagnosis of upper airway problems and diagnostic flexible nasopharnygolaryngoscopy is routinely indicated for airway evaluation in at-risk patients. PMID:24174956

  19. Bilateral internal laryngoceles mimicking asthma

    Directory of Open Access Journals (Sweden)

    Elif A Aksoy

    2013-01-01

    Full Text Available Laryngocele is an air-filled, abnormal dilation of the laryngeal saccule that extends upward within the false vocal fold, in communication with the laryngeal lumen. A case of 43-year-old male with bilateral internal laryngoceles, who has been treated as asthma for 4 years, is presented. The patient had dyspnea, cough, and excessive phlegm for a month and a late onset stridor. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Although the incidence of internal laryngocele is rare, it should be remembered in the differential diagnosis of upper airway problems and diagnostic flexible nasopharnygolaryngoscopy is routinely indicated for airway evaluation in at-risk patients.

  20. Transient Ischemic Attack (Beyond the Basics)

    Science.gov (United States)

    ... and diagnosis (Beyond the Basics)" and "Patient information: Hemorrhagic stroke treatment (Beyond the Basics)" and "Patient information: Ischemic ... symptoms and diagnosis (Beyond the Basics) Patient information: Hemorrhagic stroke treatment (Beyond the Basics) Patient information: Ischemic stroke ...

  1. STATINS IN PREVENTION OF ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    A. V. Susekov

    2015-09-01

    Full Text Available The evidence base of statin therapy in primary and secondary prevention of ischemic stroke is surveyed. Results of classical trails with statins in ischemic stroke prevention as well as results of meta-analyses are discussed.

  2. Statins in prevention of ischemic stroke

    OpenAIRE

    A.V. Susekov; A. B. Blohin; Z. G. Luginova; E. J. Soloveva; N. V. Maltseva; O.E. Tarasova; V.V. Kuharchuk

    2013-01-01

    The evidence base of statin therapy in primary and secondary prevention of ischemic stroke is surveyed. Results of classical trails with statins in ischemic stroke prevention as well as results of meta-analyses are discussed.

  3. Anterior vaginal wall repair

    Science.gov (United States)

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

  4. [Toxic anterior segment syndrome].

    Science.gov (United States)

    Cornut, P-L; Chiquet, C

    2011-01-01

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

  5. Bilateral Polydactyly in a foal

    OpenAIRE

    Carstanjen, Bianca; Abitbol, Marie; Desbois, Christophe

    2007-01-01

    The following case report describes the diagnosis and surgery of bilateral polydactyly of unknown origin in a colt. A 7-month-old Berber colt was referred for cosmetic and curative excision of supernumerary digits. Radiographic examination revealed bilateral polydactyly and well-developed first carpal bones. Surgery consisted of an osteotomy of both second metacarpal bones combined with an amputation of the supernumerary digits. The follow-up at 18 months after surgery revealed a sound horse ...

  6. Bilateral Symmetrical Parietal Extradural Hematoma

    OpenAIRE

    Agrawal, Amit

    2011-01-01

    The occurrence of bilateral extradural hematomas (EDH) is an uncommon consequence of craniocerebral trauma, and acute symmetrical bilateral epidural hematomas are extremely rare. We discuss the technique adopted by us for the management of this rare entity. A 55-year-old patient presented with history of fall of branch of tree on her head. She had loss of consciousness since then and had multiple episodes of vomiting. Examination of the scalp was suggestive of diffuse subgaleal hematoma. Her ...

  7. Bilateral cleft lip nasal deformity

    OpenAIRE

    Singh Arun; Nandini R.

    2009-01-01

    Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the li...

  8. Bilateral persistent primitive trigeminal arteries associated with trigeminal neuralgia.

    Science.gov (United States)

    Son, B; Yang, S; Sung, J; Lee, S

    2013-03-01

    Persistent carotid-vertebrobasilar anastomoses (PCVBA) include the primitive trigeminal artery (PTA), the primitive otic artery (POA), the primitive hypoglossal artery and proatlantal arteries (ProAs). The PTA is the most commonly seen of these accounting for approximately 80-85% of PCVBAs. The PTA which connects the internal carotid artery (ICA) to the basilar artery (BA) may occasionally connect to the superior or posterior inferior cerebellar arteries without interposition to the BA. It is then referred to as a persistent trigeminal artery variant (PTAV), an anomalous carotid-cerebellar anastomosis. Bilateral occurrence of PTA is extremely rare. During vertebral artery (VA) development the anterior radicular artery of segment C1 from the proatlantal artery of Padget evolves into the intradural component of the VA (V4 segment) plus a short extradural segment (distal V3 segment). Agenesis of a single anterior radicular artery of ProA results in the absence of one distal VA associated with an unremarkable contralateral VA and the BA. Absence or hypoplasia of the terminal portion of one VA is a commonly observed anatomic variant. However, absence of the terminal portions of both VAs is exceptional. A rare case of bilateral PTAs is presented with unilateral PTA and a contralateral PTAV causing trigeminal neuralgia. Furthermore, the bilateral PTAs were associated with the absence of the proximal portion of the BA in addition to the bilateral lack of a distal VA. This finding comes as a logical consequence of the developmental anatomy of the vertebrobasilar junction and is consistent with the assumed congenital nature of the anatomic variant. PMID:22113402

  9. MRI in ischemic heart disease

    International Nuclear Information System (INIS)

    Full text: The role of magnetic resonance imaging in the evaluation of ischemic heart disease has increased over the last years. Cardiac MRI is the only imaging modality that provides 'one stop shop' assessment. Information about ventricular function, myocardial ischemia and myocardial viability can be obtained in a single cardiac MRI session. Additionally, Cardiac MRI has become a gold standard method in evaluation of myocardial viability and in assessment of ventricular mass and function. As a result, cardiac MRI enable radiologist to comprehensively assess ischemic heart disease. The aim of this presentation is to provide the reader a state-of-the art on how the newest cardiac MRI techniques can be used to study ischemic heart disease patients.

  10. MR imaging of ischemic penumbra

    International Nuclear Information System (INIS)

    Cerebral ischemic stroke is one of the most fatal diseases despite current advances in medical science. Recent demonstration of efficacy using intravenous and intra-arterial thrombolysis demands therapeutic intervention tailored to the physiologic state of the individual tissue and stratification of patients according to the potential risks for therapies. In such an era, the role of the neuroimaging becomes increasingly important to evaluate the extent and location of tissues at risk of infarction (ischemic penumbra), to distinguish it from unsalvageable infarcted tissues or doomed hemorrhagic parenchyma. In this review, we present briefly the current role and limitation of computed tomography and conventional magnetic resonance imaging (MRI). We also present the possible applications of advanced MR techniques, such as diffusion and perfusion imaging, concentrating on the delineation or detection of ischemic penumbra

  11. MR imaging of ischemic penumbra

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Osamu E-mail: abediag-tky@umin.ac.jp; Aoki, Shigeki; Shirouzu, Ichiro; Kunimatsu, Akira; Hayashi, Naoto; Masumoto, Tomohiko; Mori, Harushi; Yamada, Haruyasu; Watanabe, Makoto; Masutani, Yoshitaka; Ohtomo, Kuni

    2003-04-01

    Cerebral ischemic stroke is one of the most fatal diseases despite current advances in medical science. Recent demonstration of efficacy using intravenous and intra-arterial thrombolysis demands therapeutic intervention tailored to the physiologic state of the individual tissue and stratification of patients according to the potential risks for therapies. In such an era, the role of the neuroimaging becomes increasingly important to evaluate the extent and location of tissues at risk of infarction (ischemic penumbra), to distinguish it from unsalvageable infarcted tissues or doomed hemorrhagic parenchyma. In this review, we present briefly the current role and limitation of computed tomography and conventional magnetic resonance imaging (MRI). We also present the possible applications of advanced MR techniques, such as diffusion and perfusion imaging, concentrating on the delineation or detection of ischemic penumbra.

  12. An unusual case report of bilateral mandibular radicular cysts

    Directory of Open Access Journals (Sweden)

    Niyanta S Joshi

    2011-01-01

    Full Text Available A radicular cyst is one of the most common odontogenic cysts of anterior maxilla, not commonly seen in adolescence. Here, we present a rare, atypical case, of bilateral radicular cysts of the mandibular posterior region in a 13-year-old girl. The patient management comprised surgical enucleation of cystic sac under general anesthesia followed by rehabilitation of the same area. The purpose of this article is to lay emphasis on the pedodontist′s role in early diagnosis and treatment of such lesions.

  13. A case of bilateral posterior scleritis with serous detachment

    OpenAIRE

    Aslankurt, Murat; Aksoy, Adnan; Aslan, Lokman; Yaşar, İbrahim; Gizir, Harun

    2012-01-01

    Seventeen years old male patient was admitted to the clinic with complaints of pain in the right eye, reduction of vision, painful eye movements and headache for 10 days. Visual acuity was found Snellen 0.2 on the right eye and 1.0 on the left eye. Anterior segment examination was normal. Fundus examination revealed bilateral chorioretinal fold on the papillo-macular bundle and serous macular detachment on the right eye. Fundus angiography (FA) revealed late macular hyperfluorescence due to l...

  14. Simultaneous Bilateral Ophthalmic Artery Chemosurgery for Bilateral Retinoblastoma (Tandem Therapy)

    Science.gov (United States)

    Abramson, David H.; Marr, Brian P.; Francis, Jasmine H.; Dunkel, Ira J.; Fabius, Armida W. M.; Brodie, Scott E.; Mondesire-Crump, Ijah; Gobin, Y. Pierre

    2016-01-01

    Objective Report on the 7-year experience with bilateral ophthalmic artery chemosurgery (OAC-Tandem therapy) for bilateral retinoblastoma. Design Retrospective, single institution study. Subjects 120 eyes of 60 children with bilateral retinoblastoma treated since March 2008. Methods Retrospective review of all children treated at Memorial Sloan Kettering with bilateral ophthalmic artery chemosurgery (Melphalan, Carboplatin, Topotecan, Methotrexate) delivered in the same initial session to both naïve and previously treated eyes. Main Outcome Measures Ocular survival, metastatic disease, patient survival from metastases, second cancers, systemic adverse effects, need for transfusion of blood products, electroretinogram before and after treatment. Results 116 eyes were salvaged (4 eyes were enucleated: 3 because of progressive disease, 1 family choice). Kaplan Meier ocular survival was 99.2% at one year, 96.9% at 2 and 3 years and 94.9% for years 4 through 7. There were no cases of metastatic disease or metastatic deaths with a mean follow-up of 3.01 years. Two children developed second cancers (both pineoblastoma) and one of them died. Transfusion of blood products was required in 3 cases (4 transfusions), 1.9%. Two children developed fever/neutropenia requiring hospitalization (0.95%). ERGs were improved in 21.6% and unchanged after treatment in 52.5% of cases (increase or decrease of less than 25μV). Conclusions Bilateral ophthalmic artery chemosurgery is a safe and effective technique for managing bilateral retinoblastoma-even when eyes are advanced bilaterally, and if both eyes have progressed after systemic chemotherapy. Ocular survival was excellent (94.9% at 8 years), there were no cases of of metastatic disease and no deaths from metastatic disease, but children remain at risk for second cancers. In 21.6% of cases ERG function improved. Despite using chemotherapy in both eyes in the same session, systemic toxicity was low. PMID:27258771

  15. Salvia miltiorrhiza and ischemic diseases

    Institute of Scientific and Technical Information of China (English)

    Xin-Yan JI; Benny K-H TAN; Yi-Zhun ZHU

    2000-01-01

    The demonstration of beneficial effects of salvia miltiorrhiza (DanShen) on ischemic diseases has revolutionized the management of angina pectoris, myocardial infarction (MI) or stroke in Chinese society. Experimental studies have shown that DanShen dilated coronary arteries, increased coronary blood flow, and scavenged free radicals in ischemic diseases, so that it reduced the cellular damage from ischemia and improved heart functions. Clinical trials also indicated that DanShen was an effective medicine for angina pectoris, MI, and stroke. This review will focus on DanShen's effects in angina pectoris, MI and stroke.

  16. Anterior cruciate ligament (ACL) injury

    Science.gov (United States)

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

  17. Bilateral internal carotid artery dissection associated with prior syphilis: a case report and review of the literature.

    Science.gov (United States)

    Marangi, Antonio; Moretto, Giuseppe; Cappellari, Manuel; Micheletti, Nicola; Tomelleri, Giampaolo; Bovi, Paolo

    2016-01-01

    Bilateral internal carotid artery dissection is a rare entity, and its presentation may include cerebral ischemia. We describe the case of a 69-year-old man with ischemic stroke and radiological evidence of intimal flap of both internal carotid arteries suggestive for dissection. During the hospitalization, our patient was found positive for a previous syphilis infection. We conducted a review of the literature, with evidence of a few cases of ischemic stroke presumably related to a prior syphilis. The absence of major cardiovascular risk factors in our patient leads us to believe that an etiopathogenetic link may exist between these two conditions. PMID:27354805

  18. Ischemic glans penis after circumcision

    Institute of Scientific and Technical Information of China (English)

    Yuan-ShengTzeng; Shou-HungTang; EnMeng; Teng-FuLin; Guang-HuanSun

    2004-01-01

    A 33-year-old male receiving dorsal penile nerve block (DPNB) for circumcision exhibited a postoperative ischemic change over the glans penis. The event occurred nearly 24 hours after the procedure. The patient was treated with intravenous pentoxifyllin and hyperbaric oxygenation. Total reverse of the ischemia was observed. The complications associated with circumcision and DPNB were reviewed and discussed.

  19. Let's Talk about Ischemic Stroke

    Science.gov (United States)

    ... Tools & Resources Stroke More Let's Talk About Ischemic Stroke Updated:Dec 9,2015 The majority of strokes occur when blood vessels to the brain become ... cuts off blood flow to brain cells. A stroke caused by lack of blood reaching part of ...

  20. Diabetes and ischemic heart disease

    DEFF Research Database (Denmark)

    Bergmann, Natasha; Ballegaard, Søren; Holmager, Pernille;

    2014-01-01

    The aim of this study was to test i) whether patients having diabetes and ischemic heart disease (IHD), i.e., patients suffering from two chronic diseases, demonstrate a higher degree of chronic stress when compared with patients suffering from IHD alone, and ii) whether suffering from the two...

  1. Ischemic strokes and oral contraception

    International Nuclear Information System (INIS)

    The authors describe the epidemiology and the physiopathological aspects of ischemic strokes in patients with history of oestroprogestogen use. They then study their main radiological correlates: arterial infarcts at CT scan and angiographic non-specific lesions which can be included in the extremely wide framework of arteritis, much more rarely venous thrombophlebitis. (orig.)

  2. Ischemic strokes and oral contraception

    International Nuclear Information System (INIS)

    The authors describe the epidemiology and the physiopathological aspects of ischemic strokes in patients with a history of oestroprogestogen use. They then study their main radiological correlates: arterial infarcts at CT scan and angiographic non-specific lesions which can be included in the extremely wide framework of arteritis and, much more rarely, venous thrombophlebitis

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

    Science.gov (United States)

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

    1998-10-01

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

  4. Anterior Cruciate Ligament Injury

    OpenAIRE

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

    2015-01-01

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

  5. Paralisia facial bilateral Bilateral facial paralysis: a case report

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1976-03-01

    Full Text Available É apresentado um caso de diplegia facial surgida após meningite meningocócica e infecção por herpes simples. Depois de discutir as diversas condições que o fenômeno pode apresentar-se, o autor inclina-se por uma etiologia herpética.A case of bilateral facial paralysis following meningococcal meningitis and herpes simplex infection is reported. The author discusses the differential diagnosis of bilateral facial nerve paralysis which includes several diseases and syndromes and concludes by herpetic aetiology.

  6. Bilateral spontaneous hemotympanum: Case report

    Directory of Open Access Journals (Sweden)

    Economou Nicolas C

    2006-10-01

    Full Text Available Abstract Background The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. Case presentation A 72-year-old male presented with acute deterioration of hearing. In the patient's medical history aortic valve replacement 1 year before presentation was reported. Since then he had been administered regularly coumarinic anticoagulants, with INR levels maintained between 3.4 and 4.0. Otoscopy revealed the presence of bilateral hemotympanum. The audiogram showed symmetrical moderately severe mixed hearing loss bilaterally, with the conductive component predominating. Tympanograms were flat bilaterally with absent acoustic reflexes. A computerized tomography scan showed the presence of fluid in the mastoid and middle ear bilaterally. Treatment was conservative and consisted of a 10-day course of antibiotics, anticongestants and temporary interruption of the anticoagulant therapy. After 3 weeks, normal tympanic membranes were found and hearing had returned to previous levels. Conclusion Anticoagulant intake should be included in the differential diagnosis of hemotympanum, because its detection and appropriate treatment may lead to resolution of the disorder.

  7. Evaluation of the shape symmetry of bilateral normal corneas in a Chinese population.

    Directory of Open Access Journals (Sweden)

    Fangjun Bao

    Full Text Available PURPOSE: To investigate the bilateral symmetry of the global corneal topography in normal corneas with a wide range of curvature, astigmatism and thickness values. DESIGN: Cross-Sectional Study. METHODS: Topography images were recorded for the anterior and posterior surfaces of 342 participants using a Pentacam. Elevation data were fitted to a general quadratic model that considered both translational and rotational displacements. Comparisons between fellow corneas of estimates of corneal shape parameters (elevation, radius in two main directions, Rx and Ry, and corresponding shape factors, Qx and Qy and corneal position parameters (translational displacements: x0, y0 and z0, and rotational displacements: α, β and γ were statistically analyzed. RESULTS: The general quadratic model provided average RMS of fit errors with the topography data of 1.7±0.6 µm and 5.7±1.3 µm in anterior and posterior corneal surfaces. The comparisons showed highly significant bilateral correlations with the differences between fellow corneas in Rx, Ry, Qx and Qy of anterior and posterior surfaces remaining insignificantly different from zero. Bilateral differences in elevation measurements at randomly-selected points in both corneal central and peripheral areas indicated strong mirror symmetry between fellow corneas. The mean geometric center (x0, y0, z0 of both right and left corneas was located on the temporal side and inferior-temporal side of the apex in anterior and posterior topography map, respectively. Rotational displacement angle α along X axis had similar distributions in bilateral corneas, while rotation angle β along Y axis showed both eyes tilting towards the nasal side. Further, rotation angle γ along Z axis, which is related to corneal astigmatism, showed clear mirror symmetry. CONCLUSIONS: Analysis of corneal topography demonstrated strong and statistically-significant mirror symmetry between bilateral corneas. This characteristic could help

  8. Concomitant bilateral testicular epidermoid cysts

    International Nuclear Information System (INIS)

    Epidermoid cyst of the testis is a rare benign germ tumor, comprising 1-2% of all resected benign testicular masses. Approximately 300 cases have been reported to date. Unilateral involvement has often been reported in the English literature. However, bilateral occurrence is very rare and to the best of our knowledge, there only 3 previous reports of bilateral testicular epidermoid cysts. The fact that they are completely benign makes them amenable to treatment by local excision, thereby saving patient from orchidectomy. Recognition of their characteristic ulatrsonographic features is very important to avoid unnecessary intervention. We present here, a case of bilateral epidermoid cyst in which characteristic ultrasound (US) findings allowed testis-sparing enucleation instead of radical orchiectomy. (author)

  9. Sequential bilateral retinal artery occlusion

    OpenAIRE

    Padrón-Pérez N; Aronés JR; Muñoz S; Arias-Barquet L; Arruga J

    2014-01-01

    Noel Padrón-Pérez,1 Janny Rosario Aronés,2 Silvia Muñoz,1 Luis Arias-Barquet,1 Jorge Arruga1,31Department of Ophthalmology, Hospital Universitari de Bellvitge, 2Hospital de l'Esperança – Parc de Salut Mar, 3Institut Català de Retina, Barcelona, SpainAbstract: An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic...

  10. Acute silicosis with bilateral pneumothorax

    OpenAIRE

    Srivastava, G. N.; Prasad, Rajniti; Meena, Manoj; Hussain, Moosa

    2014-01-01

    We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of...

  11. Bilateral inflammatory cysts of the jaw: report of an unusual case

    International Nuclear Information System (INIS)

    Radicular cyst is the most common odontogenic cyst occurring in the jaws. The cyst is commonly found in relation to the maxillary anterior teeth in the third and fifth decade of life. Although multiple radicular cysts are not uncommon in the jaws, bilaterally symmetrical representation of these cysts is rare. Radiographs prior to extraction help in diagnosis of these cysts and thereby prevent further morbidities. We report a case of 16-year-old male patient who presented bilateral radicular cysts symmetrically in the mandible.

  12. A case of severe congenital kyphoscoliosis secondary to multiple bilateral thoracic pedicle aplasia

    Energy Technology Data Exchange (ETDEWEB)

    Geoffray, Anne; Leloutre, Beatrice; Albertario, Marco; Bechard-Sevette, Nancy [Fondation Lenval Children' s Hospital, Department of Pediatric Imaging, Nice (France); Clement, Jean-Luc [Fondation Lenval Children' s Hospital, Department of Orthopedic and Spine Surgery, Nice (France)

    2008-07-15

    A 9-month-old boy with congenital kyphoscoliosis secondary to multiple bilateral thoracic pedicle aplasias is presented. This anomaly has rarely been described in the literature. Plain films showed absence of thoracic pedicles bilaterally from T2 to T9, which was better demonstrated on CT multiplanar and 3-D reformatted images. There were no neurological symptoms even though the deformity progressed rapidly. Congenital kyphosis or kyphoscoliosis is often related to spinal anomalies that are located on the anterior aspect of the vertebrae. However, posterior anomalies may also be responsible and should be recognized before neurological complications occur. (orig.)

  13. Bilateral inflammatory cysts of the jaw: report of an unusual case

    Energy Technology Data Exchange (ETDEWEB)

    Holla, Vidya A.; Chatra, Laxmikanth; Shenai, Prashanth; Rao, Prasanna Kumar; Veena, KM; Prabhu, Rachana Vishnudas [Yenepoya Dental College, Yenepoya University, Mangalore (India)

    2012-06-15

    Radicular cyst is the most common odontogenic cyst occurring in the jaws. The cyst is commonly found in relation to the maxillary anterior teeth in the third and fifth decade of life. Although multiple radicular cysts are not uncommon in the jaws, bilaterally symmetrical representation of these cysts is rare. Radiographs prior to extraction help in diagnosis of these cysts and thereby prevent further morbidities. We report a case of 16-year-old male patient who presented bilateral radicular cysts symmetrically in the mandible.

  14. Anterior knee pain

    International Nuclear Information System (INIS)

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

  15. 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.

  16. A bilateral frontoparietal network underlies visuospatial analogical reasoning.

    Science.gov (United States)

    Watson, Christine E; Chatterjee, Anjan

    2012-02-01

    Our ability to reason by analogy facilitates problem solving and allows us to communicate ideas efficiently. In this study, we examined the neural correlates of analogical reasoning and, more specifically, the contribution of rostrolateral prefrontal cortex (RLPFC) to reasoning. This area of the brain has been hypothesized to integrate relational information, as in analogy, or the outcomes of subgoals, as in multi-tasking and complex problem solving. Using fMRI, we compared visuospatial analogical reasoning to a control task that was as complex and difficult as the analogies and required the coordination of subgoals but not the integration of relations. We found that analogical reasoning more strongly activated bilateral RLPFC, suggesting that anterior prefrontal cortex is preferentially recruited by the integration of relational knowledge. Consistent with the need for inhibition during analogy, bilateral, and particularly right, inferior frontal gyri were also more active during analogy. Finally, greater activity in bilateral inferior parietal cortex during the analogy task is consistent with recent evidence for the neural basis of spatial relation knowledge. Together, these findings indicate that a network of frontoparietal areas underlies analogical reasoning; we also suggest that hemispheric differences may emerge depending on the visuospatial or verbal/semantic nature of the analogies. PMID:21982934

  17. Bilateral posterior cerebral artery infarction

    OpenAIRE

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA

  18. Primary synchronous bilateral breast cancer

    Directory of Open Access Journals (Sweden)

    R Krishnappa

    2014-01-01

    Full Text Available Background: Primary synchronous bilateral breast cancer (PSBBC is a rare clinical entity. The reported incidence ranges between 0.3% and 12%. There are several controversial issues regarding PSBBC pertaining to the diagnostic criteria, nomenclature, and management policies. Materials and Methods: Fourteen cases of PSBBC treated between 2001 to 2010 at our institute were retrospectively analysed in regards to demographic data, management and follow up. Results: PSBBC constituted 0.19% of total breast cancer patients at our institute. Age ranged from 28 to 78 years. PSBBC were detected by clinical examination in eight cases and by mammography in six cases. Twelve patients underwent bilateral modified radical mastectomy, one had unilateral mastectomy on one side and breast conservation on the other side and one patient has bilateral breast conservation. Majority of patients belonged to stage 2 and stage 3. All patients were found to have invasive ductal carcinoma. Five cases were ER/PR positive and 8 patients were triple hormone receptor negative. Eight patients received unilateral and six received bilateral adjuvant radiotherapy. Nine patients received adjuvant chemotherapy. 5 patients received adjuvant hormonal therapy. Median follow up of patients was 15.4 months. Conclusion: PSBBC is a rare event warranting awareness and screening of the contralateral breast in patients with unilateral breast cancer. These patients require individualized treatment planning based on the tumor factors of the index lesion. Further multi institutional prospective studies are needed for adequate understanding of management of PSBBC.

  19. Ischemic stroke and incomplete infarction

    DEFF Research Database (Denmark)

    Garcia, Javier; Lassen, N A; Weiller, C;

    1996-01-01

    The concept of selective vulnerability or selective loss o f individual neurons, with survival of glial and vascular elements as one of the consequences of a systemic ischemic-hypoxic insult (eg, transient cardiac arrest or severe hypotension), has been recognized for decades. In contrast, select......, selective neuronal death as one of the lesions that may develop in the brain after occluding an intracranial artery is an idea not readily acknowledged in the current medical literature dealing with human stroke....

  20. Perinatal Hypoxic-Ischemic Encephalopathy

    OpenAIRE

    Ming-Chi Lai; San-Nan Yang

    2010-01-01

    Perinatal hypoxic-ischemic encephalopathy (HIE) is an important cause of brain injury in the newborn and can result in long-term devastating consequences. Perinatal hypoxia is a vital cause of long-term neurologic complications varying from mild behavioural deficits to severe seizure, mental retardation, and/or cerebral palsy in the newborn. In the mammalian developing brain, ongoing research into pathophysiological mechanism of neuronal injury and therapeutic strategy after perinatal hypoxia...

  1. Denervation in Femoral Artery-Ligated Hindlimbs Diminishes Ischemic Recovery Primarily via Impaired Arteriogenesis

    Science.gov (United States)

    Qin, Yuansen; Liu, Ruiming; Wang, Huijin; Zhou, Yu; Wang, Shenming; Hu, Zuojun

    2016-01-01

    Aims Multiple factors regulate arteriogenesis. Peripheral nerves play a crucial role in vascular remodeling, but the function of peripheral nerves during arteriogenesis is obscure. Our study investigated the contribution of denervation to arteriogenesis during post-ischemic recovery from hindlimb femoral artery ligation. Methods and Results Sprague-Dawley rats were randomly allocated into four groups of normal control (NC), hindlimb ischemia (HI), hindlimb ischemia with denervation (HID) and hindlimb simple denervation (HD). Hindlimb ischemic recovery was assessed by clinical assessment and tibialis anterior muscle remodeling on day 28 post-surgery. Blood flow was determined by laser Doppler imaging on day 0, 3, 7, 14 and 28 post-surgery. Collateral number of hindlimb was observed by angiography and gracilis muscles were tested by immunostaining on day 7 and 28 post-surgery. Angiogenesis was accessed by counting CD31 positive capillaries in tibialis anterior muscles on day 28 post-surgery. Group HID showed impaired ischemic recovery compared with the other 3 groups and impaired blood flow recovery compared with group HI on day 28 post-surgery. The collateral number and capillary density of group HID were lower than group HI. The collateral diameter of both group HID and group HI significantly increased compared with group NC. However, the lumen diameter was much narrower and the vessel wall was much thicker in group HID than group HI. We also demonstrated that the thickened neointima of collaterals in group HID comprised of smooth muscle cells and endothelial cells. Conclusions Denervation of the ligated femoral artery in the hindlimb impairs ischemic recovery via impaired perfusion. The possible mechanisms of impaired perfusion are lower collateral number, lower capillary density and most likely narrower lumen, which damage ischemic recovery. This study illustrates the crucial role of peripheral nerves in arteriogenesis using a model combined ischemia with

  2. Multidisciplinary management of anterior diastemata

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  3. Infectious mononucleosis presenting as bilateral acute dacryocystitis.

    OpenAIRE

    Atkinson, P L; Ansons, A M; Patterson, A.

    1990-01-01

    A case of infectious mononucleosis presenting as bilateral acute dacryocystitis in a 7-year-old girl is reported. Acute dacryocystitis is uncommon in this age group, and an underlying systemic illness should be suspected particularly when it is bilateral.

  4. Bilateral Vascular Variations at the Renal Hilum: A Case Report

    Directory of Open Access Journals (Sweden)

    Naveen Kumar

    2012-01-01

    Full Text Available Imaging technology with its advancement in the field of urology is the boon for the patients who require minimally invasive approaches for various kidney disorders. These approaches require a precise knowledge of the normal and variant anatomy of vascular structures at the hilum of the kidney in terms of their pattern of arrangement and division. The present paper describes a bilateral anomalous arrangement of the structures at the renal hilum as well as their peculiar branching pattern which is of clinical and surgical relevance. Multiple branching of the renal vessels was observed in both kidneys due to which the hila were congested. The right renal artery immediately after its origin divided into 2 branches. The upper branch represented an aberrant artery whereas the lower branch gave 5 divisions. The left renal artery also divided into 2 branches much before the hilum as anterior and posterior divisions. The anterior branch took an arched course and gave 6 branches. The posterior branch gave 3 terminal branches before entering the renal substance. In addition to anomalous hilar structures, normal architecture of both kidneys was altered and the hilum of the left kidney was found on its anterior surface.

  5. Bilateral ovarian tumour in a young girl

    OpenAIRE

    2013-01-01

    Bilateral ovarian tumour in a girl presents the dilemma of conservative versus aggressive approach towards these tumours. When faced with suspicious tumour and complete replacement of the ovaries bilaterally, bilateral oophorectomy is a viable option, though the certain possibility of infertility and lifelong hormonal supplementation is unavoidable. We report a case of bilateral ovarian masses in a young girl, which on histopathological examination showed mature teratoma with aggregates of pr...

  6. Laparoscopic Adrenalectomy for Bilateral Metachronous Aldosteronomas

    OpenAIRE

    Rizek, Philippe; Gorecki, Piotr; Lindenmayer, Aristid; Moktan, Sabita

    2011-01-01

    Introduction: Primary aldosteronism affects 5% to 13% of patients with hypertension. Idiopathic bilateral hyperplasia (IHA) and unilateral aldosterone-producing adenoma (APA) are the most common types of primary aldosteronism. Bilateral APA is a very rare entity with only a few reports in the literature. We present the case of a patient with metachronous bilateral APA treated with metachronous bilateral total and near total adrenalectomy. Case Report: A 66-year-old female was evaluated for hy...

  7. Tratamiento conservador en pacientes con retinoblastoma bilateral

    OpenAIRE

    Juan C. Suárez; Mabel C. Ospina; Sandra A. Arias; González, María E

    2008-01-01

    OBJETIVO: comparar el tratamiento convencional del retinoblastoma bilateral, usado hasta hace algunos años, consistente en radioterapia o enucleación bilateral, con el tratamiento conservador actual que incluye termoterapia transpupilar (TTT) o TTT/quimioterapia al menos en un ojo, en niños con diagnóstico de retinoblastoma bilateral. DISEÑO: estudio retrospectivo descriptivo. MUESTRA: 20 pacientes con diagnóstico de retinoblastoma bilateral que consultaron al Hospital Universitario San Vicen...

  8. Bilateral thoracic outlet syndrome: An uncommon presentation of a rare condition in children

    Directory of Open Access Journals (Sweden)

    Arif Khan

    2012-01-01

    Full Text Available We report an adolescent girl who had left-sided neurogenic thoracic outlet syndrome (TOS due to impingement of the scalenus anterior muscle with bilateral changes on nerve conduction studies and responded well to surgical decompression. A 13-year-old Caucasian girl presented with intermittent pain, swelling, erythema, tingling and numbness of the palmar aspect of her left hand. Nerve conduction studies revealed bilateral ulnar sensory and motor conduction abnormalities, suggesting early compressive neuropathy in the asymptomatic arm as well. She underwent surgical exploration when it was noted that the scalenus anterior itself was impinging on the brachial plexus. She had a good clinical response to scalenectomy. The diagnosis of neurogenic TOS remains difficult as no single test has been accepted as a gold standard. But, once diagnosed using clinical symptoms, nerve conduction studies, electromyography and radiological investigations, it is a treatable condition with good prognosis.

  9. Simultaneous and staged bilateral total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik;

    2013-01-01

    Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

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

    Science.gov (United States)

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

    2016-09-01

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

  11. Music perception and cognition following bilateral lesions of auditory cortex.

    Science.gov (United States)

    Tramo, M J; Bharucha, J J; Musiek, F E

    1990-01-01

    We present experimental and anatomical data from a case study of impaired auditory perception following bilateral hemispheric strokes. To consider the cortical representation of sensory, perceptual, and cognitive functions mediating tonal information processing in music, pure tone sensation thresholds, spectral intonation judgments, and the associative priming of spectral intonation judgments by harmonic context were examined, and lesion localization was analyzed quantitatively using straight-line two-dimensional maps of the cortical surface reconstructed from magnetic resonance images. Despite normal pure tone sensation thresholds at 250-8000 Hz, the perception of tonal spectra was severely impaired, such that harmonic structures (major triads) were almost uniformly judged to sound dissonant; yet, the associative priming of spectral intonation judgments by harmonic context was preserved, indicating that cognitive representations of tonal hierarchies in music remained intact and accessible. Brainprints demonstrated complete bilateral lesions of the transverse gyri of Heschl and partial lesions of the right and left superior temporal gyri involving 98 and 20% of their surface areas, respectively. In the right hemisphere, there was partial sparing of the planum temporale, temporoparietal junction, and inferior parietal cortex. In the left hemisphere, all of the superior temporal region anterior to the transverse gyrus and parts of the planum temporale, temporoparietal junction, inferior parietal cortex, and insula were spared. These observations suggest that (1) sensory, perceptual, and cognitive functions mediating tonal information processing in music are neurologically dissociable; (2) complete bilateral lesions of primary auditory cortex combined with partial bilateral lesions of auditory association cortex chronically impair tonal consonance perception; (3) cognitive functions that hierarchically structure pitch information and generate harmonic expectancies

  12. Ischemic Postconditioning Alleviates Neuronal Injury Caused by Relief of Carotid Stenosis in a Rat Model of Cerebral Hypoperfusion

    Directory of Open Access Journals (Sweden)

    Pengfei Ge

    2012-10-01

    Full Text Available The effects of early relief of heavy bilateral carotid stenosis and ischemic postconditioning on hippocampus CA1 neurons are still unclear. In this study, we used a rat model to imitate severe bilateral carotid stenosis in humans. The rats were divided into sham group, carotid stenosis group, stenosis relief group and ischemic postconditioning group. Ischemic postconditioning consisted of three cycles of 30 s ischemia and 30 s reperfusion. The cerebral blood flow was measured with a laser Doppler flowmeter. Neuronal death in the CA1 region was observed by hematoxylin-eosin staining, and the number of live neurons was assessed by cell counting under a light microscope. The levels of oxidative products MDA and 8-iso-PGF2α, inflammatory factors IL-1β and TNF-α, and the activities of anti-oxidative enzymes SOD and CAT were assayed by specific enzyme-linked immunosorbent assay (ELISA kits, respectively. We found that relief of carotid stenosis and ischemic postconditioning could increase cerebral blood flow. When stenosis was relieved, the percentage of live neurons was 66.6% ± 6.2% on day 3 and 62.3% ± 9.8% on day 27, which was significantly higher than 55.5% ± 4.8% in stenosis group. Ischemic postconditioning markedly improved the live neurons to 92.5% ± 6.7% on day 3 and 88.6% ± 9.1% on day 27. Further study showed that, neuronal death caused by relief of stenosis is associated with increased oxidative stress and enhanced inflammatory response, and the protection of ischemic postconditioning is related to inhibition of oxidative stress and suppression of inflammatory response.

  13. Anterior cruciate ligament reconstruction

    International Nuclear Information System (INIS)

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

  14. Anterior hip pain.

    Science.gov (United States)

    O'Kane, J W

    1999-10-15

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

  15. Use of bilateral groin flaps in the closure of defects of the perineum: A case report

    OpenAIRE

    Balakrishnan, Chenicheri; Klein, Justin D; Vashi, Christopher

    2006-01-01

    Reconstruction of perineal and groin defects is a challenging problem. Commonly used methods of reconstruction include skin grafts and local flaps. The groin flap is a vascularized axial flap based on the superficial circumflex iliac artery arising from the femoral artery just below the inguinal ligament. Due to the location, the donor defect can usually be closed primarily, leaving an acceptable scar. The use of bilateral groin flaps for coverage of defects of the anterior perineum following...

  16. Coronary bilateral ostial enlargement using the saphenous vein in a patient with syphilitic aortitis

    Directory of Open Access Journals (Sweden)

    Croti Ulisses A.

    2000-01-01

    Full Text Available A patient with tertiary syphilis presenting with bilateral coronary ostial lesions and aortic regurgitation underwent surgical reconstruction of the coronary ostia by the anterior approach with autogenous saphenous vein grafting and substitution of the aortic valve with a bovine bioprosthesis. The procedure was easily performed and had good outcomes both early and late. The rarity of the association of a lesion in both coronary ostia with aortic regurgitation in syphilis and the surgical technique employed are discussed.

  17. Bilateral spontaneous dislocation of posterior chamber intraocular lens in a patient with gyrate atrophy

    Directory of Open Access Journals (Sweden)

    Michael Kinori

    2012-01-01

    Full Text Available We report a patient with gyrate atrophy, a rare metabolic disease, who had bilateral late spontaneous posterior dislocation of in-the-bag posterior chamber intraocular lens (PCIOL. He underwent pars plana vitrectomy, PCIOL retrieval and anterior chamber intraocular lens implantation in both eyes. This report may imply that patients with gyrate atrophy are at risk for spontaneous dislocation of intraocular lenses.

  18. Bilateral posterior cerebral artery infarction.

    Science.gov (United States)

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA infarction, no aetiological cause was identified. Unlike the transient nature of symptoms in some cases following unilateral infarction, his deficits persisted on 2-month follow-up. PMID:22798298

  19. China's Bilateral Currency Swap Lines

    OpenAIRE

    Zhitao, Lin; Wenjie, Zhan; Cheung, Yin-Wong

    2016-01-01

    We study the determinants of China’s bilateral local currency swap lines that were established since the recent global finance crisis. It is found that economic factors, political considerations, and institutional characteristics including trade intensity, economic size, strategic partnership, free trade agreement, corruption, and stability affect the decision of signing a swap line agreement. Once a swap line agreement decision is made, the size of the swap line is then mainly affected by tr...

  20. Bilateral monopolies and location choice

    OpenAIRE

    Brekke, Kurt R.; Straume, Odd Rune

    2002-01-01

    We analyse how equilibrium locations in location-price games à la Hotelling are affected when firms acquire inputs through bilateral monopoly relations with suppliers. Assuming a duopoly downstream market, we consider the case of two independent input suppliers bargaining with both downstream firms. We find that the presence of input suppliers changes the locational incentives of downstream firms in several ways, compared with the case of exogenous production costs. Bargaining induces downstr...

  1. Bilateral Molariform Mandibular Second Premolars

    OpenAIRE

    Sonu Acharya; Pradip Kumar Mandal; Chiranjit Ghosh

    2015-01-01

    Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side ...

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

    Science.gov (United States)

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

    2014-03-01

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

  3. Adenosine Preconditioning versus Ischemic Preconditioning in Patients undergoing Off-Pump Coronary Artery Bypass (OPCAB

    Directory of Open Access Journals (Sweden)

    SeyedKhalil Forouzannia

    2015-10-01

    Full Text Available Background: During off-pump coronary artery bypass (OPCAB, the heart is subjected to ischemic and reperfusion injury. Preconditioning is a mechanism that permits the heart to tolerate myocardial ischemia. The aim of this study was to compare the effects of Adenosine preconditioning with ischemic preconditioning on the global ejection fraction (EF in patients undergoing OPCAB.Methods: In this single-blind, randomized controlled trial, sixty patients undergoing OPCAB were allocated into three equally-numbered groups through simple randomization: Adenosine group, ischemic group, and control group. The patients in the Adenosine group received an infusion of Adenosine. In the ischemic group, ischemic preconditioning was induced by the temporary occlusion of the left anterior descending coronary artery twice for a 2-minute period, followed by 3-minute reperfusion before bypass grafting of the first coronary vessel. The control group received an intravenous infusion of 0.9% saline. Blood samples at different times were sent for the measurement of creatine kinase isoenzyme MB (CK-MB and cardiac troponin I (cTnI. We also recorded electrocardiographic indices and clinical parameters, including postoperative use of inotropic drugs and preoperative and postoperative EF.Results: History of myocardial infarction, hyperlipidemia, diabetes mellitus, kidney disease, preoperative arrhythmias, and utilization of postoperative inotrope was the same between the three groups. The incidence of postoperative arrhythmias was not significant between the three groups. Also, there were no significant differences in preoperative and postoperative EF and the serum levels of enzymes (cTnI and CK-MB between the groups.Conclusion: Based on the findings of this study, there was no significant difference in the postoperative EF between the groups. Although the incidence of arrhythmias was higher in the ischemic preconditioning group than in the other groups, the difference

  4. Galvanic vestibular stimulation may improve anterior bending posture in Parkinson's disease.

    Science.gov (United States)

    Okada, Yohei; Kita, Yorihiro; Nakamura, Junji; Kataoka, Hiroshi; Kiriyama, Takao; Ueno, Satoshi; Hiyamizu, Makoto; Morioka, Shu; Shomoto, Koji

    2015-05-01

    This study investigated the effects of binaural monopolar galvanic vestibular stimulation (GVS), which likely stimulates the bilateral vestibular system, on the anterior bending angle in patients with Parkinson's disease (PD) with anterior bending posture in a single-blind, randomized sham-controlled crossover trial. The seven PD patients completed two types of stimulation (binaural monopolar GVS and sham stimulation) applied in a random order 1 week apart. We measured each patient's anterior bending angles while he or she stood with eyes open and eyes closed before/after the stimulations. The anterior bending angles in both the eyes-open and the eyes-closed conditions were significantly reduced after the GVS. The amount of change in the eyes-closed condition post-GVS was significantly larger than that by sham stimulation. The amount of change in anterior bending angles in the GVS condition was not significantly correlated with Unified Parkinson's Disease Rating Scale motor score, disease duration, the duration of the postural deformities, and the anterior bending angles before the GVS. Binaural monopolar GVS might improve anterior bending posture in PD patients, irrespective of the duration and the severity of disease and postural deformities. Binaural monopolar GVS might be a novel treatment strategy to improve anterior bending posture in PD. PMID:25793635

  5. Anterior Approach Total Hip Replacement

    Medline Plus

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

  6. MRI and diffusion tensor imaging in assessing correlation of activation of cortical motor function and manifestations of corticospinal tract with muscle strength in patients with ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    Ziqian Chen; Hui Xiao; Biyun Zhang; Gennian Qian; Ping Ni; Xizhang Yang

    2006-01-01

    brain was observed. ② The DTI image was processed with the dTV.Ⅱ.R1 software part of the anisotropic image and color anisotropic image were shown,and the three-dimensional white matter image of bilateral corticospinal tracts of the patients were reconstructed. ③ The muscle strength of the affected hand of the stroke patients was judged with the Brunnstorm standard.MAIN OUTCOME MEASURES:The manifestations of MRI,DTI and corticospinal tracts of the 9 stroke patients were mainly observed.RESULTS: All the 9 stroke patients and 9 healthy subjects were involved in the analysis of results. ① Results of MRI examination: The handed exercise of the healthy subjects mainly activated contralateral sensorimotor cortex, posterior parietal cortex and bilateral supplementary motor areas. For the exercise of ipsilateral hand of 7 stroke patients, contralateral sensorimotor cortex was weakly activated, but ipsilateral posterial parietal cortex was obviously activated, and the activation of cerebrum was observed in 3 of them. For the other two patients, bilateral sensorimotor cortexes were activated during the exercise of ipsilateral hand, and the ipsilateral activated area was greater than the controlateral one.The exercise of contralateral hand activated contralateral sensorimotor cortex, posterior parietal cortex and contralateral supplementary motor area, and no obvious ipsilateral activated area was observed. ② Results of DTI examination: The anisotropic values of the infarcted area were obviously lower than those of the contralateral part (t=4.570, P < 0.01). The anisotropic value of the infarcted area were obviously was obviously correlated with bilateral muscle strength (t=0.888,P < 0.05). ③ Results of the examination for corticospinal tracts: The reconstruction of bilateral corticospinal tracts, contralateral anatomic form were generally identical with those of normal subjects, the consistency of each continuous form from anterior central gyrus downward to

  7. Glucose metabolism in ischemic myocardium

    International Nuclear Information System (INIS)

    We determined the myocardial metabolic rate for glucose (MMRGlc) in the ischemic or infarcted myocardium using 18-F-fluorodeoxyglucose (18-FDG) with positron emission tomography (PET), and studied energy metabolism in the ischemic myocardium. In some cases, we compared glucose metabolism images by 18-FDG with myocardial blood flow images using 15-oxygen water. Two normal subjects, seven patients with myocardial infarction and four patients with angina pectoris were studied. Coronary angiography was performed within two weeks before or after the PET study to detect ischemic areas. PET studies were performed for patients who did not eat for 5 to 6 hours after breakfast. Cannulation was performed in the pedal artery to measure free fatty acid, blood sugar, and insulin. After recording the transmission scan for subsequent correction of photon attenuation, blood pool images were recorded for two min. after the inhalation of carbon monoxide (oxygen-15) which labeled the red blood cells in vivo. After 20 min., oxygen-15 water (15 to 20 mCi) was injected for dynamic scans, and flow images were obtained. Thirty min. after this procedure, 18-FDG (5 to 6 mCi) was injected, and 60 min later, a static scan was performed and glucose metabolism images were obtained. Arterial blood sampling for the time activity curve of the tracer was performed at the same time. According to the method of Phelps et al, MMRGlc was calculated in each of the region of interest (ROI) which was located in the left ventricular wall. MMRGlc obtained from each ROI was 0 to 17 mg/100 ml/min. In normal subjects MMRGlc was 0.4 to 7.3 mg/100 ml/min. In patients with myocardial infarction, it ranged from 3 to 5 mg/100 ml/min in the infarcted lesion. In patients with angina pectoris and subendocardial infarction, MMRGlc was 7 to 17 mg/100 ml/min in the ischemic lesion. In this lesion, myocardial blood flow was relatively low by oxygen-15 imagings (so-called mismatch). (J.P.N.)

  8. Sex Hormones and Ischemic Stroke

    DEFF Research Database (Denmark)

    Holmegard, Haya N; Nordestgaard, Børge G; Jensen, Gorm B;

    2016-01-01

    = 4615) and women (n = 4724) with measurements of endogenous sex hormones during the 1981-1983 examination of the Copenhagen City Heart Study, Denmark, were followed for up to 29 years for incident IS, with no loss to follow-up. Mediation analyses assessed whether risk of IS was mediated through......CONTEXT AND OBJECTIVE: Whether endogenous sex hormones are associated with ischemic stroke (IS) is unclear. We tested the hypothesis that extreme concentrations of endogenous sex hormones are associated with risk of IS in the general population. DESIGN, SETTING, AND PARTICIPANTS: Adult men (n...

  9. Elevated Troponin Level with Negative Outcome Was Found in Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Buse Hasırcı

    2013-01-01

    Full Text Available Background. Troponin increment is a highly sensitive and specific marker of myocardial necrosis. The reason of high troponin levels in acute stroke is not clear. The aim of this study was to identify the relationships between cardiac troponin-I (cTnI level and stroke. Methods. This study recruited 868 patients who were admitted to Istanbul Medeniyet University due to acute ischemic stroke, and the diagnosis was confirmed by diffusion magnetic resonance imaging. The patients with the causes increasing troponin level were excluded from the study. A total of 239 patients were finally included in the study. Clinics were evaluated by the modified Rankin Scale (mRS and the National Institutes of Health Stroke Scale (NIHSS. Results. Serum level of troponin was higher in ischemic stroke patients with anterior circulation involvement in comparison to posterior involvement or hemorrhagic stroke (. Higher troponin levels related to increased stroke scale scores at discharge in ischemic stroke (. The level of cTnI was correlated with stroke scale scores at both admission and discharge in posterior stroke patients (. Conclusion. cTnI is a highly specific and sensitive marker of myocardial damage, and its elevation was associated with more severe neurological deficits in acute ischemic stroke.

  10. Unilateral and bilateral internal carotid artery stenosis or occlusion: a study of the secondary collateral circulation

    International Nuclear Information System (INIS)

    Objective: It's a study of the collateral circulation secondary to unilateral and bilateral internal carotid artery (ICA) severe stenosis or occlusion using digital subtract angiography (DSA) and magnetic resonance angiography (MRA). Methods: Ninty-five patients with ICA stenosis or occlusion were diagnosed by DSA or MRA. Forty-four patients were assessed by DSA, and fifty-one patients were evaluated by MRA, who were divided into two groups of the unilateral and bilateral involvement. DSA, MRA findings were analyzed, by which the patterns of the collateral circulation were comparatively studied. Results: The presence rate of anterior communicating artery (AcoA) in the unilateral group on DSA and MRA was significantly higher than that in the bilateral group (P0.05). On DSA, the presence rate of ophthalmic artery (OphA) in the unilateral and bilateral groups had no significant difference between the two groups. The augmentation rate of the OphA in the bilateral group was significantly higher than that in the unilateral group (P<0.05). The presence rate of leptomeningeal anastomosis in the bilateral group was significantly higher than that in the unilateral group on DSA and MRA (P<0.01). Conclusion: In patients with the unilateral and bilateral ICA stenosis or occlusion, the collateral circulation formats in different patterns. The major collateral pathways secondary to the unilateral ICA stenosis or occlusion are AcoA and ispilateral PCoA, while to the bilateral ICA stenosis or' occlusion are PCoA, OPhA, and leptomeningeal anastomosis. (authors)

  11. Bilateral symmetrical basal ganglia and thalamic lesions in children: an update (2015)

    Energy Technology Data Exchange (ETDEWEB)

    Zuccoli, Giulio [Children' s Hospital of Pittsburgh of UPMC, Section of Neuroradiology, Pittsburgh, PA (United States); Yannes, Michael Paul [University of Pittsburgh School of Medicine, Department of Radiology, Pittsburgh, PA (United States); Nardone, Raffaele [Paracelsus Medical University, Department of Neurology, Christian Doppler Klinik, Salzburg (Austria); Bailey, Ariel [West Virginia University, Department of Radiology, Morgantown, WV (United States); Goldstein, Amy [Children' s Hospital of Pittsburgh of UPMC, Department of Neurology, Section of Metabolic Disorders and Neurogenetics, Pittsburgh, PA (United States)

    2015-10-15

    In children, many inherited or acquired neurological disorders may cause bilateral symmetrical signal intensity alterations in the basal ganglia and thalami. A literature review was aimed at assisting neuroradiologists, neurologists, infectious diseases specialists, and pediatricians to provide further understanding into the clinical and neuroimaging features in pediatric patients presenting with bilateral symmetrical basal ganglia and thalamic lesions on magnetic resonance imaging (MRI). We discuss hypoxic-ischemic, toxic, infectious, immune-mediated, mitochondrial, metabolic, and neurodegenerative disorders affecting the basal ganglia and thalami. Recognition and correct evaluation of basal ganglia abnormalities, together with a proper neurological examination and laboratory findings, may enable the identification of each of these clinical entities and lead to earlier diagnosis. (orig.)

  12. Bilateral symmetrical basal ganglia and thalamic lesions in children: an update (2015)

    International Nuclear Information System (INIS)

    In children, many inherited or acquired neurological disorders may cause bilateral symmetrical signal intensity alterations in the basal ganglia and thalami. A literature review was aimed at assisting neuroradiologists, neurologists, infectious diseases specialists, and pediatricians to provide further understanding into the clinical and neuroimaging features in pediatric patients presenting with bilateral symmetrical basal ganglia and thalamic lesions on magnetic resonance imaging (MRI). We discuss hypoxic-ischemic, toxic, infectious, immune-mediated, mitochondrial, metabolic, and neurodegenerative disorders affecting the basal ganglia and thalami. Recognition and correct evaluation of basal ganglia abnormalities, together with a proper neurological examination and laboratory findings, may enable the identification of each of these clinical entities and lead to earlier diagnosis. (orig.)

  13. Computerized tomography of five cases with global cerebral ischemic-anoxia

    International Nuclear Information System (INIS)

    Among eight cases with global cerebral ischemic-anoxia which were monitored with a serial computerized tomography (CT) scan, five had characteristic CT findings. It was revealed by the CT scan that, after diffuse brain swelling which had occurred immediately or a week after injury, remarkable brain atrophy appeared in two cases; these cases remained in the persistent vegetative state. In three other cases which were resuscitated one hour or more after injury, the CT scan showed symmetric low-density areas of the bilateral basal ganglia, and their prognoses were very poor: two died, while one remained in a near-brain-death state. (author)

  14. Swallowing disorders after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Gabriela Camargo Remesso

    2011-10-01

    Full Text Available OBJECTIVE: To investigate occurrences of swallowing disorders after ischemic stroke. METHOD: This was a retrospective study on 596 medical files. The inclusion criterion was that the patients needed to have been hospitalized with a diagnosis of ischemic stroke; the exclusion criteria were the presence of associated cardiac problems and hospital stay already more than 14 days. RESULTS: 50.5% were men and 49.5% women; mean age 65.3 years (SD=±11.7 (p<0.001. Among the risk factors, 79.4% had hypertension, 36.7% had diabetes (p<0.001 and 42.7% were smokers. 13.3% of the patients died. Swallowing disorders occurred in 19.6%, among whom 91.5% had mild difficulty and 8.5% had severe difficulty. 87.1% had spontaneous recovery after a mean of 2.4 months. A lesion in the brainstem region occurred in 6.8% (p<0.001. CONCLUSION: Swallowing disorders occurred in almost 20% of the population and most of the difficulty in swallowing found was mild. The predictors for swallowing disorders were older age, diabetes mellitus and lesions in the brainstem region.

  15. Chinese Ischemic Stroke Subclassification (CISS

    Directory of Open Access Journals (Sweden)

    ShanGAO

    2011-02-01

    Full Text Available Accurate classification of stroke has significant impact on patient care and conduction of stroke clinical trials. The current systems such as TOAST, SSS-TOAST, Korean TOAST and A-S-C-O have limitations. With the advent of new imaging technology, there is a need to have a more accurate stroke subclassification system. Chinese Ischemic Stroke Subclassification (CISS system is a new two step system aims at the etiology and then underlying mechanism of a stroke. The first step classifies stroke into five categories: large artery atherosclerosis (LAA, including atherosclerosis of aortic arch and intra-/extracranial large arteries, cardiogenic stroke (CS, penetrating artery disease (PAD, other etiology (OE and undetermined etiology (UE. The second step is to further classify the underlying mechanism of ischemic stroke from the intracranial and extracranial large artery atherosclerosis into the parent artery (plaque or thrombosis occluding penetrating artery, artery-to-artery embolism, hypoperfusion/impaired emboli clearance and multiple mechanisms. Although clinical validation of CISS is being planned, CISS is an innovative system that offers much more detailed information on the pathophysiology of a stroke.

  16. Morbidity predictors in ischemic stroke

    Directory of Open Access Journals (Sweden)

    Panicker J

    2003-01-01

    Full Text Available Background: Although ischemic CVA is one of the leading causes for death and disability, parameters for predicting long-term outcome in such patients have not been clearly delineated, especially in the Indian context. Methods: A prospective hospital-based study of 105 patients of ischemic stroke, focal neurological deficits and functional score was assessed and the C-reactive protein level (CRP was measured. A follow-up was done at 5 days and at 6 months and outcome variable was the functional status at 6 months using Barthel Index of Activities of Daily Living. Accordingly, patients were grouped into 3 - Barthel Index < 41: Severely disabled, Barthel Index 41-60: Moderately disabled and Barthel Index > 60: Mildly disabled. Results: At admission, if upper limb power was less than Medical Research Council (MRC grade 4, or aphasia was present or CRP assay was positive, then at 6 months, these patients most likely belonged to the severely disabled group. If upper limb or lower limb power was greater than MRC grade 3 or there was no aphasia or conjugate gaze deviation or CRP assay was negative, these patients most likely belonged to the mildly disabled group at 6 months. Follow-up rate was 86%. Conclusion: Patients can be stratified according to the predicted prognosis. The treatment and rehabilitation can be properly planned and strictly adhered to in patients predicted to have worse prognosis.

  17. Bilateral ECT induces bilateral increases in regional cortical thickness.

    Science.gov (United States)

    van Eijndhoven, P; Mulders, P; Kwekkeboom, L; van Oostrom, I; van Beek, M; Janzing, J; Schene, A; Tendolkar, I

    2016-01-01

    Electroconvulsive therapy (ECT) is the most effective treatment for patients suffering from severe or treatment-resistant major depressive disorder (MDD). Unfortunately its underlying neurobiological mechanisms are still unclear. One line of evidence indicates that the seizures produced by ECT induce or stimulate neuroplasticity effects. Although these seizures also affect the cortex, the effect of ECT on cortical thickness is not investigated until now. We acquired structural magnetic resonance imaging data in 19 treatment-resistant MDD patients before and after a bilateral ECT course, and 16 healthy controls at 2 time points, and compared changes in cortical thickness between the groups. Our results reveal that ECT induces significant, bilateral increases in cortical thickness, including the temporal pole, inferior and middle temporal cortex and the insula. The pattern of increased cortical thickness was predominant in regions that are associated with seizure onset in ECT. Post hoc analyses showed that the increase in thickness of the insular cortex was larger in responders than in non-responders, which may point to a specific relationship of this region with treatment effects of ECT. PMID:27552587

  18. Bilateral cleft lip nasal deformity

    Directory of Open Access Journals (Sweden)

    Singh Arun

    2009-01-01

    Full Text Available Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it′s management both at the time of cleft lip repair

  19. BILATERAL OVARIAN MASS COMPLICATING PREGNANCY

    OpenAIRE

    Arjumand; Triveni

    2015-01-01

    A 22 years old patient with 9 months of Amenorrhoea with a abdominal swelling was admitted to our institution with an Ultrasonography report of Bilateral ovarian mass (14.3x5.9cm in left ovary) and (9.5x7cm in right ovary) with internal vascularity with septations along with single live intrauterine fetus. She delivered by elective caesarean section in V/O breech presenta tion. Left side ovarian cystectomy done Right side ovarian puncture done. Histopathology showed left sid...

  20. Immediate Sequential Bilateral Cataract Surgery

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper

    2015-01-01

    performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery......-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were...

  1. Bilateral molariform mandibular second premolars.

    Science.gov (United States)

    Acharya, Sonu; Kumar Mandal, Pradip; Ghosh, Chiranjit

    2015-01-01

    Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side and erupted macrodontic premolar on the other side and their distinct morphological appearance, characterized by large, multitubercular, and molariform crowns and tapering, single roots. PMID:25685564

  2. Bilateral internuclear ophthalmoplegia as first manifestation of extra pontine myelinolysis

    Directory of Open Access Journals (Sweden)

    Tushar Kanti Bandyopadhyay, Rudrajit Paul, Amit K Das, Rathindranath Sarkar

    2014-07-01

    Full Text Available Extrapontine myelinolysis (EPM is a rare clinical entity affecting anterior basal ganglia. This is one of the osmotic demyelination syndromes. It occurs due to rapid correction of hyponatremia and also rarely occurs in alcoholics. It generally presents with extrapyramidal symptoms. We here report a case of EPM in a 13 year old boy presenting with bilateral internuclear ophthalmoplegia and ptosis. The patient also had generalised weakness, but no psychiatric symptoms. The patient slowly recovered over six months. EPM can affect any age group, although the elderly are more likely to be affected due to frequent electrolyte abnormalities. Ocular movement disorders or brainstem signs are rarely reported in EPM. When present, it can create diagnostic confusion with multiple sclerosis. We believe this is the first report of this entity from India. The relevant literature regarding brainstem manifestations in myelinolysis syndromes is also discussed, along with the radiological findings.

  3. Atypical presentation of popliteal artery entrapment syndrome: involvement of the anterior tibial artery.

    Science.gov (United States)

    Bou, Steven; Day, Carly

    2014-11-01

    Popliteal artery entrapment syndrome (PAES) is a rare condition that should be suspected in a young patient with exertional lower extremity pain. We report the case of an 18-year-old female volleyball player with bilateral exertional lower extremity pain who had been previously diagnosed with tendinitis and periostitis. Diagnostic studies showed entrapment of the left popliteal artery and the left anterior tibial artery. To our knowledge, there has only been 1 previous report of anterior tibial artery involvement in PAES. PMID:24880061

  4. BILATERAL OVARIAN MASS COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Arjumand

    2015-06-01

    Full Text Available A 22 years old patient with 9 months of Amenorrhoea with a abdominal swelling was admitted to our institution with an Ultrasonography report of Bilateral ovarian mass (14.3x5.9cm in left ovary and (9.5x7cm in right ovary with internal vascularity with septations along with single live intrauterine fetus. She delivered by elective caesarean section in V/O breech presenta tion. Left side ovarian cystectomy done Right side ovarian puncture done. Histopathology showed left side – Mucinous cystadenoma. Right Side – Follicular cyst. Mucinous cystadenomas are benign epithelial ovarian tumors which tend to be unilateral, bilateral a nd multilocular with smooth surface and contain mucinous fluid, 75% of all mucinous tumors are benign, while 10% are borderline and 15% are invasive carcinomas. Benign mucinous tumors are most common in the third to fifth decades of life and may be 20 - 30 c ms in size. The incidence of ovarian cysts during pregnancy is less than 5% and most of them are benign in nature. G i ant cysts found in less than 1% of the cases of ovarian cysts with pregnancy.

  5. [Simultaneous bilateral pneumothorax. Case report].

    Science.gov (United States)

    Paolini, A; Caminiti, F; Tosato, F; Ruggieri, M; Paolini, G; Carnevale, L; Corsini, F; Marano, S; Monsellato, I

    2001-04-01

    A case report of a 44 year-old white man admitted to the surgical unit for a bilateral simultaneous pneumothorax is presented. The pneumothorax occurred on day one after a surgical operation for discal hernia; in the past the patient already presented a right spontaneous pneumothorax at 32 years of age and a left pneumothorax at 37 years of age, both treated with a pleural drainage. A thoracic drain was bilaterally positioned with a good result only in the right side. The persistence of the left pneumothorax induced the authors to perform a postero-lateral thoracotomy bullae excision and pleurectomy with a good postoperative course. After a few months a new right pneumothorax occurred and the patient was treated with a right postero-lateral thoracotomy, bullae resection and pleurectomy. On the basis of the case reported, the authors consider the different opportunities in the treatment of spontaneous pneumothorax in relation to the present knowledges and technologies. Surgical procedure is to be preferred in case of persistence of pneumothorax despite a pleural drain and in case of pneumothorax in high risk subjects. Even if thoracoscopy seems to give better results regarding postoperative pain, it is not always possible with such a method to perform a careful pleurectomy neither to obtain it in all cases (above all in secondary pneumothorax). Every case must then be carefully studied to choose the best treatment at present available. PMID:11353349

  6. Immune mechanisms in cerebral ischemic tolerance

    Directory of Open Access Journals (Sweden)

    LidiaGarcia-Bonilla

    2014-03-01

    Full Text Available Stressor-induced tolerance is a central mechanism in the response of bacteria, plants, and animals to potentially harmful environmental challenges. This response is characterized by immediate changes in cellular metabolism and by the delayed transcriptional activation or inhibition of genetic programs that are not generally stressor specific (cross-tolerance. These programs are aimed at countering the deleterious effects of the stressor. While induction of this response (preconditioning can be established at the cellular level, activation of systemic networks is essential for the protection to occur throughout the organs of the body. This is best signified by the phenomenon of remote ischemic preconditioning, whereby application of ischemic stress to one tissue or organ induces ischemic tolerance in remote organs through humoral, cellular and neural signaling. The immune system is an essential component in cerebral ischemic tolerance acting simultaneously both as mediator and target. This dichotomy is based on the fact that activation of inflammatory pathways is necessary to establish ischemic tolerance and that ischemic tolerance can be, in part, attributed to a subdued immune activation after index ischemia. Here we describe the components of the immune system required for induction of ischemic tolerance and review the mechanisms by which a reprogrammed immune response contributes to the neuroprotection observed after preconditioning. Learning how local and systemic immune factors participate in endogenous neuroprotection could lead to the development of new stroke therapies.

  7. 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.

  8. Anterior Approach Total Hip Replacement

    Medline Plus

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

  9. Anterior Approach Total Hip Replacement

    Medline Plus

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

  10. Anterior Approach Total Hip Replacement

    Medline Plus

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

  11. Anterior approach for knee arthrography

    International Nuclear Information System (INIS)

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

  12. Update on anterior ankle impingement

    OpenAIRE

    Vaseenon, Tanawat; Amendola, Annunziato

    2012-01-01

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

  13. Multiresolution Bilateral Filtering for Image Denoising

    OpenAIRE

    Zhang, Ming; Gunturk, Bahadir K.

    2008-01-01

    The bilateral filter is a nonlinear filter that does spatial averaging without smoothing edges; it has shown to be an effective image denoising technique. An important issue with the application of the bilateral filter is the selection of the filter parameters, which affect the results significantly. There are two main contributions of this paper. The first contribution is an empirical study of the optimal bilateral filter parameter selection in image denoising applications. The second contri...

  14. Anterior chamber depth during hemodialysis

    Directory of Open Access Journals (Sweden)

    Gracitelli CPB

    2013-08-01

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

  15. Bilateral assessment of knee muscle relationships in healthy adults

    Directory of Open Access Journals (Sweden)

    Gislaine Regina Santos dos Santos

    2014-09-01

    Full Text Available Asymmetric performance of flexor and extensor muscles of the knee may be a risk factor for knee injuries, especially the anterior cruciate ligament. Additionally, asymmetries in power and work may have correlations with fatigue and performance during functional tasks. Among untrained individuals, such asymmetries may be of potential interest for training prescription. Here, we investigated the bilateral performance of knee flexors and extensors muscle groups of untrained individuals. We quantified the torque-angle and torque-velocity relationships, as well as work, power and asymmetry indexes in 20 untrained male (25 ± 4 years old; height 1.74 ± 0.05 m; body mass 76 ± 9 kg. No significant asymmetry was observed for torque-angle and torque-velocity relationships, work and power output for knee flexor and extensor muscle groups (p < .05. Our results suggest that untrained male present symmetry in the knee flexion and extension bilateral performance. Changes in this behavior due to physical training must be monitored.

  16. Leiomyosarcoma of the distal femur in a patient with a history of bilateral retinoblastoma: a case report and review of the literature

    International Nuclear Information System (INIS)

    We report a case of primary leiomyosarcoma of the distal femoral shaft arising in a patient who had undergone bilateral orbital enucleation for bilateral retinoblastoma several years previously. Radiography demonstrated an osteolytic, expansive lesion with cortical destruction anteriorly in the distal femoral shaft, and these findings were confirmed on CT. MR imaging revealed an expansive intramedullary lesion with cortical breakthrough and soft tissue extension. The occurrence of a second malignancy in patients with a history of bilateral retinoblastoma is well documented. Many different histological types have been described, with osteosarcoma and leiomyosarcoma occurring with the greatest frequency. (orig.)

  17. Quantitative Measurement of Physical Activity in Acute Ischemic Stroke and Transient Ischemic Attack

    DEFF Research Database (Denmark)

    Strømmen, Anna Maria; Christensen, Thomas; Jensen, Kai

    2014-01-01

    BACKGROUND AND PURPOSE: The purpose of this study was to quantitatively measure and describe the amount and pattern of physical activity in patients within the first week after acute ischemic stroke and transient ischemic attack using accelerometers. METHODS: A total of 100 patients with acute...... ischemic stroke or transient ischemic attack admitted to our acute stroke unit wore Actical accelerometers attached to both wrists and ankles and the hip for ≤7 days. Patients were included within 72 hours of symptom onset. Accelerometer output was measured in activity counts (AC). Patients were tested...... feasibility of using accelerometers to quantitatively and continuously measure physical activity simultaneously from all 4 extremities and the hip in patients with acute ischemic stroke and transient ischemic attack. Our study provides quantitative evidence of physical inactivity in patients with acute...

  18. Bilateral ovarian tumour in a young girl

    Directory of Open Access Journals (Sweden)

    Krishna Kumar Govindarajan

    2013-01-01

    Full Text Available Bilateral ovarian tumour in a girl presents the dilemma of conservative versus aggressive approach towards these tumours. When faced with suspicious tumour and complete replacement of the ovaries bilaterally, bilateral oophorectomy is a viable option, though the certain possibility of infertility and lifelong hormonal supplementation is unavoidable. We report a case of bilateral ovarian masses in a young girl, which on histopathological examination showed mature teratoma with aggregates of proliferating capillary and cavernous sized vessels in the tumour wall. Such associations are rare and must be differentiated from a vascular neoplasm.

  19. Bilateral Clavicle Fracture in two Newborn Infants

    Directory of Open Access Journals (Sweden)

    Ali Kanik

    2011-12-01

    Full Text Available Background: The fracture of clavicle is the most frequently observed bone fracture as birth trauma and it is usually unilateral. It is seen following shoulder dystocia deliveries or breech presentation of macrosomic newborns.Case Presentation: We report two macrosomic newborns with bilateral clavicle fracture and brachial plexus palsy due to birth trauma. Chest X-rays confirmed bilateral fracture of clavicles. Both patients were recovered without any sequel.Conclusion: Bilateral clavicular fracture should be considered in any neonate with bilateral absent Moro reflexes.

  20. Bilateral Clavicle Fracture in Two Newborn Infants

    Directory of Open Access Journals (Sweden)

    Esra Arun Ozer

    2011-12-01

    Full Text Available Background: The fracture of clavicle is the most frequently observed bone fracture as birth trauma and it is usually unilateral. It is seen following shoulder dystocia deliveries or breech presentation of macrosomic newborns.Case Presentation: We report two macrosomic newborns with bilateral clavicle fracture and brachial plexus palsy due to birth trauma. Chest X-rays confirmed bilateral fracture of clavicles. Both patients were recovered without any sequel.Conclusion: Bilateral clavicular fracture should be considered in any neonate with bilateral absent Moro reflexes.

  1. Subcutaneous Venous Port Implantation in Patients with Bilateral Breast Surgery

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the long-term follow-up results of subcutaneous venous ports implanted in patients with bilateral mastectomies. We retrospectively reviewed the hospital charts and the electronic database of 17 patients with bilateral mastectomies whom had venous port implantation in our interventional radiology suit. A total of 17 ports were implanted to the paramedian (n = 3) and anterolateral (standard; n = 12) chest wall, on the trapezius muscle (n = 1), and to the antecubital fossa (n = 1). The mean age was 48.29 years (range: 35-60 years). The mean time interval from time of surgery to port implantation was 34 months (range: 1-84 months). The mean follow-up time was 15 months (range: 7-39 months). Follow-up parameters and classification of the complications was defined according to the SIR guidelines. No procedure-related complication occurred. A single case of mild late infection was noted and the infection rate was 0.19/1000 catheter days. Infusion chemotherapy administration was still going on in eight patients. Two patients died during the follow-up and four patients were lost after 6 months. Port removal was performed in three patients at follow-up because of the end of treatment. One trapezius port and one paramedian port weres among the removed ports without any problem. Although we have a limited number of patients, port placement to the anterior chest wall, either paramedian or anterolateral, on the trapezius muscle or to the antecubital fossa depending on the extent of the bilateral breast surgeries that can be performed with low complication rates by a careful patient and anatomical location selection by involving the patients in the decision-making process. We believe that patient education and knowledge of possible complications have high importance in follow-up

  2. Acupuncture at Waiguan (TE5) influences activation/deactivation of functional brain areas in ischemic stroke patients and healthy people A functional MRI study

    Institute of Scientific and Technical Information of China (English)

    Junqi Chen; Yong Huang; Xinsheng Lai; Chunzhi Tang; Junjun Yang; Hua Chen; Tongjun Zeng; Junxian Wu; Shanshan Qu

    2013-01-01

    In the present study, 10 patients with ischemic stroke in the left hemisphere and six healthy controls were subjected to acupuncture at right Waiguan (TE5). In ischemic stroke subjects, functional MRI showed enhanced activation in Broadmann areas 5, 6, 7, 18, 19, 24, 32, the hypothalamic inferior lobe, the mamillary body, and the ventral posterolateral nucleus of the left hemisphere, and Broadmann areas 4, 6, 7, 18, 19 and 32 of the right hemisphere, but attenuated activation of Broadmann area 13, the hypothalamic inferior lobe, the posterior lobe of the tonsil of cerebellum, and the culmen of the anterior lobe of hypophysis, in the left hemisphere and Broadmann area 13 in the right hemisphere. In ischemic stroke subjects, a number of deactivated brain areas were enhanced, including Broadmann areas 6, 11, 20, 22, 37, and 47, the culmen of the anterior lobe of hypophysis, alae lingulae cerebella, and the posterior lobe of the tonsil of cerebellum of the left hemisphere, and Broadmann areas 8, 37, 45 and 47, the culmen of the anterior lobe of hypophysis, pars tuberalis adenohypophyseos, inferior border of lentiform nucleus, lateral globus pallidus, inferior temporal gyrus, and the parahippocampal gyrus of the right hemisphere. These subjects also exhibited attenuation of a number of deactivated brain areas, including Broadmann area 7. These data suggest that acupuncture at Waiguan specifically alters brain function in regions associated with sensation, vision, and motion in ischemic stroke patients. By contrast, in normal individuals, acupuncture at Waiguan generally activates brain areas associated with insomnia and other functions.

  3. Percutaneous Implantation of A Parachute Device For Treatment of Ischemic Heart Failure

    Energy Technology Data Exchange (ETDEWEB)

    Cilingiroglu, Mehmet, E-mail: mcilingiroglu@yahoo.com; Rollefson, William A.; Mego, David

    2013-07-15

    Congestive heart failure (CHF) secondary to ischemic cardiomyopathy is associated with significant morbidity and mortality despite currently available medical therapy. The Parachute{sup TM} device is a novel left ventricular partitioning device that is delivered percutaneously in the left ventricle (LV) in patients with anteroapical regional wall motion abnormalities, dilated LV and systolic dysfunction after anterior myocardial infarction with favorable clinical and LV hemodynamic improvements post-implantation. Here, we do review the current literature and present a case of the Parachute device implantation.

  4. Pre-ischemic exercise alleviates oxidative damage following ischemic stroke in rats

    OpenAIRE

    Feng, Rui; Zhang, Min; Wang, Xiao; Li, Wen-bin; REN, SHI-QING; Feng ZHANG

    2014-01-01

    Physical exercise has been proved to be neuroprotective in clinical trials and animal experiments. However, the exact mechanism underlying this neuroprotective effect remains unclear. The aim of the present study was to explore whether pre-ischemic treadmill training could act as a form of ischemic preconditioning in a rat following ischemic stroke by reducing oxidative damage. Fifty-four rats were randomly divided into three groups (n=18 per group): Sham surgery, middle cerebral artery occlu...

  5. A Case Report of Bilateral Mirror Clubfeet and Bilateral Hand Polydactyly

    OpenAIRE

    Nguyen, Mai P; Lawler, Ericka A.; Morcuende, Jose A.

    2014-01-01

    We report a rare case of a patient with bilateral mirror clubfeet and bilateral hand polydactyly. The patient presented to our orthopaedic clinic with bilateral mirror clubfeet, each with eight toes, and bilateral hands with six fingers and a hypoplastic thumb. The pattern does not fit any described syndrome such as Martin or Laurin-Sandrow syndrome. Treatments by an orthopaedic pediatric surgeon and an orthopaedic pediatric hand surgeon are described. The patient achieved excellent functiona...

  6. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation

    OpenAIRE

    Rajendra Nehete; Anita Nehete; Sandeep Singla; Harshad Adhav

    2012-01-01

    In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally s...

  7. Bilateral metachronous breast cancer with bilateral recurrences: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Hyun; Sohn, Yu Mee [Dept. of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Kim, Eun Kyung [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-05-15

    The incidence of bilateral breast cancer has been reported to range from 0.4% to 14%, and it increases gradually as a result of improved early detection capabilities and longer survival times. We report a rare case where the bilateral breast cancers occurred as a metachronous bilateral breast cancer with bilateral recurrences, detected by mammography, and the rapid growth of tumor that manifested as microcalcification and skin thickening within 3 months.

  8. Laser Peripheral Iridotomy with Iridoplasty in Primary Angle Closure Suspect: Anterior Chamber Analysis by Pentacam

    OpenAIRE

    Lee, Jong Rak; Choi, Jin Young; Kim, Yeon-Deok; Choi, Jaewan

    2011-01-01

    Purpose To compare conventional laser peripheral iridotomy (LPI) and LPI combined with laser peripheral iridoplasty in eyes with primary angle closure suspect (PACS) by assessment of anterior chamber dimensional changes using a Pentacam. Methods Forty-eight eyes of 24 subjects with bilateral PACS were recruited consecutively. Each eye was randomly allocated to treatment with conventional LPI, argon LPI only, or LPI plus iridoplasty, which consisted of simultaneous argon LPI and peripheral iri...

  9. Correction of transverse maxillary deficiency and anterior open bite in an adult Class III skeletal patient

    OpenAIRE

    Prerna Hoogan Teja; Samarjit Singh Teja; Nayak, Rabindra S; Abhijit Bagade; Manu Rashmi Sharma

    2016-01-01

    Transverse maxillary deficiency may be associated with sagittal or vertical problems of the maxilla or mandible. It may contribute to unilateral or bilateral posterior crossbite, anterior dental crowding, and unesthetic black buccal corridors on smiling. An adequate transverse dimension is important for stable and proper functional occlusion. Surgically, assisted rapid palatal expansion has been the treatment of choice to resolve posterior crossbite in skeletally mature patients. The followin...

  10. Anterior spinal cord syndrome after initiation of treatment with atenolol.

    Science.gov (United States)

    Schneider, Gregory S

    2010-06-01

    Anterior spinal cord syndrome is a rare condition with a variety of precipitating factors. Patients typically complain of weakness or paralysis of the extremities, often accompanied by pain, but frequently without a history of trauma. A 48-year-old man presented to the emergency department complaining of neck pain and inability to move his legs in the absence of trauma. Several hours prior he had seen his private physician and was given a dose of atenolol for elevated blood pressure. He had not previously been on medications for hypertension. His neurological examination revealed bilateral paralysis of the lower extremities. In the upper extremities he had weakness and sensory loss at the level of C6. Rectal tone was decreased and without sensation. Cervical and thoracic spine magnetic resonance imaging showed spondylotic disc disease, with disc herniation at C6-7 causing severe spinal canal stenosis. Despite i.v. methylprednisolone, pressors, and a prolonged intensive care unit course, the patient was discharged 5 weeks later with continued neurological deficits. Anterior spinal cord syndrome results from compression of the anterior spinal artery and often occurs in the absence of traumatic injury. The recognition, management, and prognosis of this condition are discussed. PMID:18597977

  11. Anatomic variations of anterior cerebral artery cortical branches.

    Science.gov (United States)

    Stefani, M A; Schneider, F L; Marrone, A C; Severino, A G; Jackowski, A P; Wallace, M C

    2000-01-01

    The anterior cerebral artery (ACA) is a major vessel responsible for the blood supply to the interhemispheric region. The ACA segment after the anterior communicating artery (AComA) origin is called the distal ACA and has central and cortical branches. The cortical branches are distributed in the different regions of the orbital and medial part of the brain. The objects of this study are the anatomical variations found in the distal ACA. In 76 hemispheres the ACA distal branches were injected with latex and dissected under microscope magnification. Vessel diameters and distances between vessel origins and anterior communicating artery were recorded and analyzed. Microsurgical dissection was carried out to demonstrate anatomic variations of these vessels. Average diameter of ACA at origin was 2.61 +/- 0.34 mm and average diameter of cortical branches diameter ranged from 0.79 +/- 0.27 mm to 1.84 +/- 0.3 mm. Distances between vessel origin and AComA ranged from 7.68 +/- 3.91 mm (orbitofrontal) to 112.6 +/- 11.63 mm (inferior internal parietal). This study found anatomical variations: a single (azygos) ACA was present in one case and three in three cases. Crossing branches of the distal ACA to the contralateral hemisphere were present in 26% of the cases. In some cases a single ACA may supply the posterior hemispheric region through crossing branches. This calls attention to potential bilateral brain infarcts due to a single unilateral ACA occlusion. PMID:10873213

  12. Bilateral Auricular Milia en Plaque

    Directory of Open Access Journals (Sweden)

    Savaş

    2011-12-01

    Full Text Available Milia en plaque (MEP is an extremely rare form of milia that is characterized by a number of milia-like cysts on an erythematous base and histologically exhibits features of keratin cysts. The etiology is not exactly known. MEP is generally seen among middle-aged women and especially on the head and neck region. Many of the diagnosed cases are localized in the retroauricular region, eyelids and the nose region. To date, no case of MEP in the auricula has been reported in the literature. In this article, we present the case of a 71-year-old female patient clinically and histologically diagnosed with bilateral auricular milia en plaque (in the external ear canal in the light of current literature. (Turk­derm 2011; 45: 216-8

  13. Protein S and ischemic brain disease

    Directory of Open Access Journals (Sweden)

    Raičević Ranko

    2003-01-01

    Full Text Available Ischemic brain disease (IBD represents clinical entity participating with almost 80% in all vascular brain diseases. Ethiopatogenesis and pathophysiology of the ischemic brain disease are apparently most complex in human medicine. In addition to the significant progression in understanding of ethiopatogenesis and pathophysiology of the ischemic brain disease, we are currently aware of the fact that in one third of these patients the source - the disorder or the disease of crucial importance for this sequence of events in the opposing direction cannot be diagnosed with certainty. This case report presents a 32-year-old patient with the verified ischemic lesion of brain parenchyma, in whom the lowered concentrations of protein S were registered by comprehensive clinical and biochemical examinations. The lower concentrations of protein S are a significant co-factor of anticoagulant system, in the absence of other significant diseases, disorders or abnormalities which could ethiopatogenetically be significant for IBD.

  14. Cerebral Ischemic Events with Sickle Cell Anemia

    OpenAIRE

    J Gordon Millichap

    2013-01-01

    Researchers at Cincinnati Children's Hospital and several additional centers in the US and UK studied the incidence of acute silent cerebral ischemic events (ASCIEs) in MRIs of children with asymptomatic sickle cell anemia (SCA).

  15. 25-Hydroxyvitamin D and symptomatic ischemic stroke

    DEFF Research Database (Denmark)

    Brøndum-Jacobsen, Peter; Nordestgaard, Børge G; Schnohr, Peter;

    2013-01-01

    OBJECTIVE: We tested the hypothesis that low plasma concentrations of 25-hydroxyvitamin D are associated with increased risk of symptomatic ischemic stroke in the general population. METHODS: We measured plasma 25-hydroxyvitamin D in 10,170 individuals from the general population, the Copenhagen...... City Heart Study. During 21 years of follow-up, 1,256 and 164 persons developed ischemic and hemorrhagic stroke, respectively. In a meta-analysis of ischemic stroke, we included 10 studies, 58,384 participants, and 2,644 events. RESULTS: Stepwise decreasing plasma 25-hydroxyvitamin D concentrations...... were associated with stepwise increasing risk of ischemic stroke both as a function of seasonally adjusted percentile categories and as a function of clinical categories of 25-hydroxyvitamin D (p for trend ≤ 2 × 10(-3) ). In a Cox regression model comparing individuals with plasma 25-hydroxyvitamin D...

  16. Molecular Mechanisms of Renal Ischemic Conditioning Strategies.

    Science.gov (United States)

    Kierulf-Lassen, Casper; Nieuwenhuijs-Moeke, Gertrude J; Krogstrup, Nicoline V; Oltean, Mihai; Jespersen, Bente; Dor, Frank J M F

    2015-01-01

    Ischemia-reperfusion injury is the leading cause of acute kidney injury in a variety of clinical settings such as renal transplantation and hypovolemic and/or septic shock. Strategies to reduce ischemia-reperfusion injury are obviously clinically relevant. Ischemic conditioning is an inherent part of the renal defense mechanism against ischemia and can be triggered by short periods of intermittent ischemia and reperfusion. Understanding the signaling transduction pathways of renal ischemic conditioning can promote further clinical translation and pharmacological advancements in this era. This review summarizes research on the molecular mechanisms underlying both local and remote ischemic pre-, per- and postconditioning of the kidney. The different types of conditioning strategies in the kidney recruit similar powerful pro-survival mechanisms. Likewise, renal ischemic conditioning mobilizes many of the same protective signaling pathways as in other organs, but differences are recognized. PMID:26330099

  17. Early Arterial Ischemic Stroke in Premature Infants

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-05-01

    Full Text Available Presentation, clinical course, and outcomes for 23 premature children with arterial ischemic stroke before 44 weeks gestational age are reported from Riley Hospital for Children, Indianapolis, IN.

  18. Sequential bilateral retinal artery occlusion

    Directory of Open Access Journals (Sweden)

    Padrón-Pérez N

    2014-04-01

    Full Text Available Noel Padrón-Pérez,1 Janny Rosario Aronés,2 Silvia Muñoz,1 Luis Arias-Barquet,1 Jorge Arruga1,31Department of Ophthalmology, Hospital Universitari de Bellvitge, 2Hospital de l'Esperança – Parc de Salut Mar, 3Institut Català de Retina, Barcelona, SpainAbstract: An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic embolic event. Initially, she presented a superior branch retinal artery occlusion in her right eye followed by a central retinal artery occlusion with cilioretinal artery sparing in her left eye. Some conservative maneuvers performed did not improve visual acuity in the left eye. Supra-aortic Doppler ultrasonography revealed mild right internal carotid artery stenosis and moderate left internal carotid artery stenosis with a small, smooth, and homogeneous plaque. The transthoracic echocardiography showed a severe calcification of the mitral valve with a mild-moderate rim of stenosis. Central retinal artery occlusion and branch retinal artery occlusion are characterized by painless monocular loss of vision. Clinical approach and management attempt to treat the acute event, find the source of the vascular occlusion, and prevent further vascular events from occurring. Giant cell arteritis is a potentially treatable cause of central retinal artery occlusion and should be excluded in every single patient over 50 years old.Keywords: loss of vision, branch retinal artery occlusion, central retinal artery occlusion, Hollenhorst plaque

  19. Human Pericytes for Ischemic Heart Repair

    OpenAIRE

    2013-01-01

    Human microvascular pericytes (CD146+/34−/45−/56−) contain multipotent precursors and repair/regenerate defective tissues, notably skeletal muscle. However, their ability to repair the ischemic heart remains unknown. We investigated the therapeutic potential of human pericytes, purified from skeletal muscle, for treating ischemic heart disease and mediating associated repair mechanisms in mice. Echocardiography revealed that pericyte transplantation attenuated left ventricular dilatation and ...

  20. Insular Ischemic Stroke: Clinical Presentation and Outcome

    OpenAIRE

    Lemieux, F.; Lanthier, S.; Chevrier, M.-C.; de Gioia, L.; I. Rouleau; Cereda, C.; Nguyen, D.K.

    2012-01-01

    Background The insula is a small but complex structure located in the depth of the sylvian fissure, covered by the frontal, parietal and temporal operculum. Ischemic strokes limited to the insula are rare and have not been well studied. Our objective is to better define the clinical presentation and outcome of insular ischemic strokes (IIS). Methods We reviewed the institutional prospective, consecutive stroke database from two centers to identify patients with IIS seen between 2008 and 2010....

  1. Angiotensin II Removes Kidney Resistance Conferred by Ischemic Preconditioning

    Directory of Open Access Journals (Sweden)

    Hee-Seong Jang

    2014-01-01

    Full Text Available Ischemic preconditioning (IPC by ischemia/reperfusion (I/R renders resistance to the kidney. Strong IPC triggers kidney fibrosis, which is involved in angiotensin II (AngII and its type 1 receptor (AT1R signaling. Here, we investigated the role of AngII/AT1R signal pathway in the resistance of IPC kidneys to subsequent I/R injury. IPC of kidneys was generated by 30 minutes of bilateral renal ischemia and 8 days of reperfusion. Sham-operation was performed to generate control (non-IPC mice. To examine the roles of AngII and AT1R in IPC kidneys to subsequent I/R, IPC kidneys were subjected to either 30 minutes of bilateral kidney ischemia or sham-operation following treatment with AngII, losartan (AT1R blocker, or AngII plus losartan. IPC kidneys showed fibrotic changes, decreased AngII, and increased AT1R expression. I/R dramatically increased plasma creatinine concentrations in non-IPC mice, but not in IPC mice. AngII treatment in IPC mice resulted in enhanced morphological damage, oxidative stress, and inflammatory responses, with functional impairment, whereas losartan treatment reversed these effects. However, AngII treatment in non-IPC mice did not change I/R-induced injury. AngII abolished the resistance of IPC kidneys to subsequent I/R via the enhancement of oxidative stress and inflammatory responses, suggesting that the AngII/AT1R signaling pathway is associated with outcome in injury-experienced kidney.

  2. Bilateral failure of adduction following orbital decompression.

    OpenAIRE

    Kinsella, F; Kyle, P.; Stansfield, A

    1990-01-01

    We report a case of bilateral complete failure of adduction following bilateral translid antralethmoidal orbital decompression. We believe the probable mechanism is neuropraxia (temporary dysfunction) of the third cranial nerves' supply to the medial recti, owing to these nerves' occupying an anatomically abnormal position. Partial recovery of adduction occurred over the ensuing six months.

  3. Bilateral breast involvement in acute myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Hakeem A, Mandakini BT, Asif K, Firdaus, Shagufta RC

    2013-04-01

    Full Text Available Breast involvement by leukemic infiltration is usually bilateral, but may be unilateral. Clinically patients can present with either single or multiple masses, or with diffuse breast engorgement, with or without nodularity. The affected patients are predominantly young adults. We present a case of an adolescent girl with acute myeloid leukemia having bilateral breast infiltration by leukemic cells.

  4. BILATERAL OVARIAN TORSION: A CASE REPORT

    OpenAIRE

    Manohar; Gopalakrishna; Kavyashree; Kala; Karthik

    2014-01-01

    : Bilateral ovarian torsion is a rare event with only a few cases reported in literature in women using ovarian stimulation drugs and in pre-menarchal age group with synchronous and asynchronous ovarian tumors. We hereby present a case of bilateral ovarian torsion in a 16 year old girl who presented as an acute pain abdomen and was diagnosed intra operatively.

  5. Marfan's syndrome presenting as bilateral spontaneous pneumothorax.

    OpenAIRE

    Gawkrodger, D J

    1981-01-01

    A case of bilateral spontaneous pneumothorax in a 14-year-old girl with previously undiagnosed Marfan's syndrome is described. The pulmonary abnormalities of Marfan's syndrome are not commonly encountered and bilateral pneumothorax is itself a rare event which, in most instances, has been reported following invasive procedures.

  6. Acral osteolysis in bilateral compartment syndrome

    Directory of Open Access Journals (Sweden)

    Iram Saeed

    2008-08-01

    Full Text Available Carpal tunnel syndrome is a common neurological condition with rare yet potentially serious cutaneous and skeletal complications. We present a case of mutilating/ulcerating bilateral carpal tunnel syndrome in a 63 year old female. Radiographs showed symmetrical acral osteolysis in the index and middle fingers distal phalanges bilaterally. Carpal tunnel decompressions provided symptomatic relief.

  7. Bilateral spontaneous adrenal haemorrhage complicating acute pancreatitis

    International Nuclear Information System (INIS)

    Bilateral adrenal haemorrhage is an event that mandates prompt diagnosis and treatment to prevent primary adrenocortical insufficiency and potential death. Presentation can be non-specific and incidentally diagnosed with imaging alone, primarily CT. We present a case of acute pancreatitis with spontaneous bilateral adrenal haemorrhage and briefly discuss imaging and treatment implications

  8. Simultaneous and spontaneous bilateral quadriceps tendons rupture.

    Science.gov (United States)

    Celik, Evrim Coşkun; Ozbaydar, Mehmet; Ofluoglu, Demet; Demircay, Emre

    2012-07-01

    Simultaneous and spontaneous bilateral quadriceps tendon rupture is an uncommon injury that is usually seen in association with multiple medical conditions and some medications. We report a case of simultaneous and spontaneous bilateral quadriceps tendon rupture that may be related to the long-term use of a statin. PMID:22561379

  9. Bilateral microperc in a severe kyphoscoliosis

    Science.gov (United States)

    Dağgülli, Mansur; Penbegül, Necmettin; Dede, Onur; Utanğaç, Mehmet Mazhar

    2016-01-01

    Percutaneous nephrolithotomy is the standard modality for large renal calculi in normal and abnormal renal anatomic situations. This case report describes a 57-year-old male patient who presented with bilateral kidney stones and severe kyphoscoliosis. He had successfully been treated with a bilateral microperc technique. PMID:27011881

  10. Secondary polycythaemia associated with bilateral renal lymphocoeles.

    OpenAIRE

    Burton, I E; Sambrook, P.; McWilliam, L J

    1994-01-01

    A patient with a 15 year history of secondary polycythaemia due to renal erythropoietin hypersecretion is presented. Subsequent spontaneous development of bilateral renal lymphocoeles, which contained high erythropoietin levels, was shown by computerized tomography. The lymphocoeles were successfully treated by bilateral peritoneal marsupialization. No cause for the persistent polycythaemia or lymphocoeles was found at laparotomy or on renal biopsy.

  11. Factors of Transient Ischemic Dilation on Gated Myocardial Perfusion Imaging

    International Nuclear Information System (INIS)

    That transient ischemic dilation (TID) of the left ventricle on SPECT myocardial perfusion imaging (MPI) is the marker of severe and extensive coronary artery disease (CAD). But other clinic factors influencing TID is less certain. The object of this study was to investigate that of the factors,as left ventricle hypertrophy (LVH) and diabetes (DM). MPI 87 patients who undertaken coronary angiography and transthoracic echocardiography within 1 month of stress electrocardiography-gated MPI were retrospectively analyzed. TID was assessed quantitatively using a soft program.A ratio cutoff of ≥1.22 was to represent TID. Summed stress score and summed different score (ischemia score) were determined using 20-segment 5-point scoring system to quantify myocardial ischemia. LVH was defined as a left ventricular wall thickness of >11 mm on M-mode echocardiography. Severe CAD was defined as severe stenosis (≥90%) of either the left anterior descending artery or both the right coronary and lateral circumflex arteries. All of the 87 patients, 13 of them had TID, 9 of them TID had LVH, and 10 of the TID had severe CAD. A high percentage had DM (84%). Severe CAD,diabetes and LVH were independent predictors of TID, the effect of LVH on the incidence of TID was additive increasing the incidence from without LVH 10% to with LVH 55% (P<0.01). Likewise, with severe CAD, the incidence of TID rose from in patient without diabetes 4% to in those with diabetes 86% (P<0.01). Transient ischemic dilation of the left ventricle on Gated SPECT myocardial perfusion imaging is associated with the severe CAD, but this association is modified by LVH and DM. (authors)

  12. Tragic result of traditional Chinese medicine manipulation: an unusual case report of bilateral anterior shoulder dislocations

    OpenAIRE

    Chen, Chiu-Liang; Chiu, Shin-Lin; Chu, Chiao-Lee; Lan, Shou-Jen

    2015-01-01

    Background In Taiwan, there is a good universal healthcare system to the patients; however, the majority of Taiwanese seek the complementary and alternative medicine when they are injured or ill. The traditional Chinese medicine, which is a branch of complementary alternative medicine, is prevalent in Taiwan. Without proper sequence of maneuvers, either traditional Chinese medicine or conventional medicine might cause unexpected complications. We report a case of 76-year-old woman who was man...

  13. The Guided Bilateral Filter: When the Joint/Cross Bilateral Filter Becomes Robust

    OpenAIRE

    Caraffa, Laurent; Tarel, Jean Philippe; Charbonnier, Pierre

    2015-01-01

    The bilateral filter and its variants such as the Joint/Cross bilateral filter are well known edge-preserving image smoothing tools used in many applications. The reason of this success is its simple definition and the possibility of many adaptations. The bilateral filter is known to be related to robust estimation. This link is lost by the ad hoc introduction of the guide image in the Joint/Cross bilateral filter. We here propose a new way to derive the Joint/Cross bilateral filter as a part...

  14. Application of multiple intraoperative monitoring techniques in microsurgery for anterior communicating aneurysms

    Directory of Open Access Journals (Sweden)

    NI Wei

    2012-02-01

    Full Text Available Objective To evaluate the efficacy of combined multiple intraoperative monitoring techniques including transcranial Doppler (TCD, indocyanine green angiography (ICGA and neuroelectrophysiological monitoring consisting of somatosensory evoked potential (SEP and motor evoked potential (MEP in the surgical management of anterior communicating aneurysm. Methods Clinical data were analyzed for the 23 patients who underwent microsurgery for anterior communicating aneurysms with assistance of combined multiple intraoperative monitoring techniques. Twenty-three patients [12 males, 11 females; mean age 52 (range 44-63 years] underwent aneurysm clipping via modified pterional approach. Total vein anaesthesia was used for all patients. Propofol, fentanyl and scoline were administrated before intubation. Remifentanil and propofol were used throughout the procedure. Internal carotid artery and A1 segment of anterior cerebral artery were exposed successively. The parent artery, perforating artery and aneurysm were carefully recognized after the A1 segment was temporarily occluded. The temporary clip was removed after the aneurysm being clipped. Neuroelectrophysiological monitoring, ICGA and TCD were applied for intraoperative monitoring. Results All of the 23 aneurysms were successfully clipped. MEP changes were seen in 6 patients during the temporary occlusion of A1 segment, which directed neurosurgeon to pause for its recovery. TCD and ICGA detected A2 segment or anterior communicating artery stenosis in 2 patients and residual aneurysm in 1 patient during clipping procedure, which directed neurosurgeons to readjust aneurysmal clips. Postoperative transient hemiparalysis were observed in 1 patient with modified Rankin Scale level 1 at discharge. No hemorrhagic or ischemic events were observed in other 22 patients with modified Rankin Scale level 0 at discharge. Conclusion Combined multiple intraoperative monitoring techniques may provide important

  15. A case of bilateral visual loss after spinal cord surgery.

    Science.gov (United States)

    Shifa, Jemal; Abebe, Worknehe; Bekele, Negussie; Habte, Dereje

    2016-01-01

    Visual loss is a rare but potentially devastating postoperative complication of prone spinal surgery with a reported incidence of 0.017 to 0.1 percent. We present a case of post-operative bilateral visual loss in a patient who had a laminectomy in prone position under general anesthesia. A 17-year-old male patient with large syringomyelia extending from C2 - T2 level had a surgical procedure done under general anesthesia (GA) in prone position that lasted four hours. After the surgical procedure, the patient presented to the Ophthalmology Clinic of Princess Marina Hospital, with a complaint of visual loss of the right eye followed by left, of one week duration. The patient never had a visual impairment in the past. Physical examination, fundal examination and CT scan revealed no primary cause for the visual loss. In this patient the absence of any finding in the optic disc and the retina and the normal CT scan, suggests that the most likely diagnosis is posterior ischemic optic neuropathy. The patient was treated with prednisolone tablet daily and showed mild improvement in vision. PMID:27279946

  16. Syncope in Patient with Bilateral Severe Internal Carotid Arteries Stenosis/Near Occlusion: A Case Report and Literature Review

    Science.gov (United States)

    Miran, Muhammad Shah; Suri, M. Fareed K.; Qureshi, Mushtaq H.; Ahmad, Aamir; Suri, Mariam K.; Basreen, Rabia; Qureshi, Adnan I.

    2016-01-01

    Background Syncope is commonly worked up for carotid stenosis, but only rarely attributed to it. Considering paucity of such cases in literature, we report a case and discuss the pathophysiology. Design/methods We report a patient with high-grade bilateral severe internal carotid artery (ICA) stenosis who presented with syncopal episodes in the absence of stroke, orthostatic hypotension, significant cardiovascular disease, or vasovagal etiology. We reviewed all literature pertaining to syncope secondary to carotid stenosis and other cerebrovascular disease. Results A 67-year-old man presented with two brief syncopal episodes. History and physical examination was not suggestive of seizure or vasovagal syncope. Other workup was negative for any stroke or syncope secondary to cardiac or vasovagal etiology. Magnetic resonance angiography (MRA) revealed bilateral ICA severe stenosis. This was confirmed by transfemoral carotid vessels angiography. Internal carotid angioplasty and stenting was performed on one side. After this, the patient remained asymptomatic. After one month, carotid endarterectomy (CEA) of contralateral side was performed. Patient remained symptom free after that. On review of literature, we identified only 12 cases of syncope attributable to carotid stenosis and reviewed 24 cases attributable to other cerebrovascular disease. Conclusion Syncope secondary to carotid stenosis, especially in the absence of any focal ischemic events is rare. It can only be expected in those patients who have bilateral hemodynamically significant carotid disease, which is unlikely in the absence of any focal ischemic events. PMID:27403223

  17. Evaluation of regenerative capacity after kidney ischemic/reperfustion injury using 99mTc-DMSA

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, W. J.; Kim, J. W.; Park, K. M.; Lee, S. W.; Ahn, B. C.; Lee, J. T.; Yoo, J. S. [Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2007-07-01

    Acute renal failure can be caused by a reduced renal blood flow induced because of ischemic injury. The damaged kidney can be completely restored in structure and function. {sup 99m}Tc-DMSA binds to cortical tubules in kidney and its uptake has been suggested to indicate function of cortical mass. Herein, the generative capacity of kidney after bilateral or unilateral ischemia/reperfusion (I/R) injury was evaluated non-invasively by scintigraphic imaging. Three different animal models were used. One or both kidneys of mice were subjected ischemic for 30 min for unilateral or bilateral I/R model, respectively. In third model, one kidney was excised and the other kidney was subjected ischemic for 30 min to give nephrectomy model. At 1 hr, 1 d, 3 d, 1 w, 2 w, 3 w after reperfusion, {sup 99m}Tc-DMSA (27.7 MBq) was injected via tail vein. After 3 hr, the mice were scanned for 30 min with pinhole equipped gamma camera. The ratio of ROI counts of kidney to total counts was calculated. In unilateral I/R mouse, the {sup 99m}Tc-DMSA uptake of injured kidney was decreased continuously up to 3 w (13.9 to 7.7%), while uptake in normal kidney is slowly increased. In case of nephrectomy model, {sup 99m}Tc-DMSA uptake of injured kidney was rapidly restored within 1 w after I/R operation (8.5 to 30%). Bilateral model showed reduced {sup 99m}Tc-DMSA uptake at 1 d, but total uptake in both I/R kidney was also increase up to 30% after 1 w and the uptake was maintained up to 3 w. In unilateral model, the {sup 99m}Tc-DMSA uptake of injured kidney kept decreasing up to 3 w while normal kidney showed increased {sup 99m}Tc-DMSA uptake. The restoration of I/R kidney was not observed within 3 w. However, in case of animal models which have only I/R kidneys such as bilateral and nephrectomy models, the {sup 99m}Tc-DMSA uptake was restored within 1 w and the excised kidney size was also normal in contrast to much smaller I/R kidney of unilateral model.

  18. Evaluation of regenerative capacity after kidney ischemic/reperfustion injury using 99mTc-DMSA

    International Nuclear Information System (INIS)

    Acute renal failure can be caused by a reduced renal blood flow induced because of ischemic injury. The damaged kidney can be completely restored in structure and function. 99mTc-DMSA binds to cortical tubules in kidney and its uptake has been suggested to indicate function of cortical mass. Herein, the generative capacity of kidney after bilateral or unilateral ischemia/reperfusion (I/R) injury was evaluated non-invasively by scintigraphic imaging. Three different animal models were used. One or both kidneys of mice were subjected ischemic for 30 min for unilateral or bilateral I/R model, respectively. In third model, one kidney was excised and the other kidney was subjected ischemic for 30 min to give nephrectomy model. At 1 hr, 1 d, 3 d, 1 w, 2 w, 3 w after reperfusion, 99mTc-DMSA (27.7 MBq) was injected via tail vein. After 3 hr, the mice were scanned for 30 min with pinhole equipped gamma camera. The ratio of ROI counts of kidney to total counts was calculated. In unilateral I/R mouse, the 99mTc-DMSA uptake of injured kidney was decreased continuously up to 3 w (13.9 to 7.7%), while uptake in normal kidney is slowly increased. In case of nephrectomy model, 99mTc-DMSA uptake of injured kidney was rapidly restored within 1 w after I/R operation (8.5 to 30%). Bilateral model showed reduced 99mTc-DMSA uptake at 1 d, but total uptake in both I/R kidney was also increase up to 30% after 1 w and the uptake was maintained up to 3 w. In unilateral model, the 99mTc-DMSA uptake of injured kidney kept decreasing up to 3 w while normal kidney showed increased 99mTc-DMSA uptake. The restoration of I/R kidney was not observed within 3 w. However, in case of animal models which have only I/R kidneys such as bilateral and nephrectomy models, the 99mTc-DMSA uptake was restored within 1 w and the excised kidney size was also normal in contrast to much smaller I/R kidney of unilateral model

  19. Behavioral effects and neural changes induced by continuous and not continuous treadmill training, post bilateral cerebral ischemia in gerbils.

    Science.gov (United States)

    Kitabatake, Takae Tamy; Marini, Luana de Castro; Gonçalves, Renata Batagini; Bertolino, Guilherme; de Souza, Hugo Celso Dutra; de Araujo, João Eduardo

    2015-09-15

    This study aims to investigate the effects of treadmill training and the possible influences of the start, regularity, and duration after experimental ischemic stroke. We performed bilateral occlusion of both the carotid arteries for 5 min in Mongolian gerbils. The training groups were: continuous training for 5 consecutive days or not continuous training for 3 non-consecutive days. The groups remained in the treadmill for 15 min, and the training started 12 or 24h after the stroke. In the activity cage (AC), behaviors of crossing and distance traveled were registered. The forced motor behavior was analyzed by a Rota Rod test. After the experiments, the brains were perfused, and coronal sections of the striatum, motor cortex M1, and CA1 area of the hippocampus were cut and stained with hematoxylin and eosin. Behavioral and morphological data analysis was performed by an ANOVA and MANCOVA. Results showed an increased density of neurons in the CA1 area of the hippocampus, motor cortex M1, and the striatum in ischemic training groups compared to the not training ischemic groups. Animals subjected to continuous training that started 24h after ischemia showed a satisfactory behavior in the AC and a higher number of striatal neurons when compared to ischemic animals. The animals in the not continuous training started 12h after the stroke showed an unsatisfactory performance in the AC and Rota Rod. These findings suggest that early training and not continuous training are inadequate for motor behavior improvement after stroke. PMID:25975174

  20. Imaging of ischemic heart disease

    International Nuclear Information System (INIS)

    Despite advances in the understanding and treatment of ischemic cardiomyopathy, characterized by extensive coronary artery disease and left ventricular (LV) dysfunction, the prognosis remains poor with only a 50-60% 5-year survival rate. The composition of atherosclerotic lesions is currently regarded as being more important than the degree of stenosis in determining acute events. If imaging techniques could distinguish vulnerable from stable plaques, then high-risk patient subgroups could be identified. Another important concept is that LV dysfunction may be the result of either scarring due to necrosis or to the presence of myocardial hibernation, in which there is sufficient blood flow to sustain viable myocytes, but insufficient to maintain systolic contraction. This concept of myocardial viability is critical for making optimal clinical management decisions. This review describes how noninvasive imaging methods can be used to distinguish regions of irreversibly injured myocardium from viable but hibernating segments. Technical advances in CT and MR have made imaging of the beating heart possible. Considerable clinical progress has already been made and further cardiac applications are expected. Radiologists therefore have new opportunities for involvement in cardiac imaging but must recognize the political implications as well as the diagnostic potential of these modalities not only for the heart, but also for the whole vascular system. This review focuses on imaging myocardial injury. It compares state-of-the-art CT and MR with more established yet contemporary echocardiography and nuclear scintigraphy. (orig.)

  1. Anterior cervical osteophytes causing dysphagia and dyspnea: an uncommon entity revisited.

    Science.gov (United States)

    Giger, Roland; Dulguerov, Pavel; Payer, Michael

    2006-10-01

    Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis (DISH). We present the case of an 83-year-old patient with progressive dysphagia and acute dyspnea, necessitating emergency tracheotomy. Voluminous anterior cervical osteophytes extending from C3 to C7 and narrowing the pharyngoesophageal segment by external compression and bilateral vocal fold immobility were diagnosed radiologically and by fiberoptic laryngoscopy. Surgical removal of all osteophytes led to the resolution of symptoms. Dyspnea with or without dysphagia caused by hypertrophic anterior cervical osteophytes is an uncommon entity. The exhaustive diagnostic workup proposed in the literature could be simplified by using fiberoptic laryngoscopy and dynamic videofluoroscopy. The causes, treatment, and outcome are discussed. PMID:17216390

  2. Effects of ischemic preconditioning on short-duration cycling performance.

    Science.gov (United States)

    Cruz, Rogério Santos de Oliveira; de Aguiar, Rafael Alves; Turnes, Tiago; Salvador, Amadeo Félix; Caputo, Fabrizio

    2016-08-01

    It has been demonstrated that ischemic preconditioning (IPC) improves endurance performance. However, the potential benefits during anaerobic events and the mechanism(s) underlying these benefits remain unclear. Fifteen recreational cyclists were assessed to evaluate the effects of IPC of the upper thighs on anaerobic performance, skeletal muscle activation, and metabolic responses during a 60-s sprint performance. After an incremental test and a familiarization visit, subjects were randomly submitted in visits 3 and 4 to a performance protocol preceded by intermittent bilateral cuff inflation (4 × (5 min of blood flow restriction + 5 min reperfusion)) at either 220 mm Hg (IPC) or 20 mm Hg (control). To increase data reliability, each intervention was replicated, which was also in a random manner. In addition to the mean power output, the pulmonary oxygen uptake, blood lactate kinetics, and quadriceps electromyograms (EMGs) were analyzed during performance and throughout 45 min of passive recovery. After IPC, performance was improved by 2.1% compared with control (95% confidence intervals of 0.8% to 3.3%, P = 0.001), followed by increases in (i) the accumulated oxygen deficit, (ii) the amplitude of blood lactate kinetics, (iii) the total amount of oxygen consumed during recovery, and (iv) the overall EMG amplitude (P exercise performance. PMID:27404398

  3. Study of retinal vessel oxygen saturation in ischemic and non-ischemic branch retinal vein occlusion

    Science.gov (United States)

    Lin, Lei-Lei; Dong, Yan-Min; Zong, Yao; Zheng, Qi-Shan; Fu, Yue; Yuan, Yong-Guang; Huang, Xia; Qian, Garrett; Gao, Qian-Ying

    2016-01-01

    AIM To explore how oxygen saturation in retinal blood vessels is altered in ischemic and non-ischemic branch retinal vein occlusion (BRVO). METHODS Fifty BRVO eyes were divided into ischemic (n=26) and non-ischemic (n=24) groups, based on fundus fluorescein angiography. Healthy individuals (n=52 and n=48, respectively) were also recruited as controls for the two groups. The mean oxygen saturations of the occluded vessels and central vessels were measured by oximetry in the BRVO and control groups. RESULTS In the ischemic BRVO group, the occluded arterioles oxygen saturation (SaO2-A, 106.0%±14.3%), instead of the occluded venule oxygen saturation (SaO2-V, 60.8%±9.4%), showed increases when compared with those in the same quadrant vessels (SaO2-A, 86.1%±16.5%) in the contralateral eyes (P<0.05). The oxygen saturations of the central vessels showed similar trends with those of the occluded vessels. In the non-ischemic BRVO group, the occluded and central SaO2-V and SaO2-A showed no significant changes. In both the ischemic and non-ischemic BRVOs, the central SaO2-A was significantly increased when compared to healthy individuals. CONCLUSION Obvious changes in the occluded and central SaO2-A were found in the ischemic BRVO group, indicating that disorders of oxygen metabolism in the arterioles may participate in the pathogenesis of ischemic BRVO. PMID:26949618

  4. Bilateral symmetry across Aphrodite Terra

    International Nuclear Information System (INIS)

    There are three main highland areas on Venus: Beta Regio, Ishtar Terra and Aphrodite Terra. The latter is least known and the least mapped, yet existing analyses of Aphrodite Terra based on available Pioneer-Venus orbiter data suggest that it may be the site of extensive rifting. Some of the highest resolution (30 km) PV data (SAR) included most of the western half of Aphrodite Terra. Recent analysis of the SAR data together with Arecibo range-doppler topographic profiling (10 X 100 km horizontal and 10 m vertical resolution) across parts of Aphrodite, further characterized the nature of possible tectonic processes in the equatorial highlands. The existence of distinct topographic and radar morphologic linear discontinuities across the nearly east-west strike of Aphrodite Terra is indicated. Another prominent set of linear features is distinctly parallel to and orthogonal to the ground tracks of the PV spacecraft and are not included because of the possibility that they are artifacts. Study of the northwest trending cross-strike discontinuities (CSD's) and the nature of topographic and morphologic features along their strike suggest the presence of bilateral topographic and morphologic symmetry about the long axis of Aphrodite Terra

  5. Stent-assisted mechanical recanalization for the treatment of acute ischemic stroke

    International Nuclear Information System (INIS)

    Objective: to evaluate the safety and efficacy of stent-assisted mechanical recanalization technique in treating acute ischemic stroke. Methods: Stent-assisted mechanical recanalization procedure was carried out in 12 patients with acute ischemic stroke. The lesions were located at the anterior circulation in 10 cases and at posterior circulation in 2 cases. The clinical data were retrospectively analyzed. The technical success rate, the vascular recanalization, the occurrence of symptomatic intracranial hemorrhage, the clinical improvement and mortality were observed and evaluated. Results: The stent was successfully deployed in 11 patients (92%). After the treatment, different degrees of vascular recanalization were obtained in all patients. The complete (TIMI 3), partial (TIMI 2) and minor (TIMI 1) recanalization rate was 58.3% (7/12), 25% (3/12) and 8.3% (1/12), respectively. Postoperative symptomatic intracranial hemorrhage occurred in one patient (8.3%). Stroke-related death occurred in one patient (8.3%) and eight patients had their modified Rankin Score ≤ 2. Conclusion: For the treatment of acute ischemic stroke, stent-assisted mechanical recanalization technique is clinically feasible and safe with high vascular recanalization rate although further studies with larger sample to clarify its clinical usefulness are still needed. (authors)

  6. Mechanical thrombectomy with snare in patients with acute ischemic stroke

    International Nuclear Information System (INIS)

    We evaluated the efficacy and safety of thrombus extraction using a microsnare in patients with acute ischemic stroke (AIS). This was a prospective, observational, cohort study in which consecutive patients with AIS (<6 hours of ischemia for anterior circulation and <24 hours for posterior circulation) who had been previously excluded from intravenous tissue plasminogen activator (tPA) thrombolysis were included and followed-up for 3 months. Mechanical embolectomy with a microsnare of 2-4 mm was undertaken as the first treatment. Low-dose intraarterial thrombolysis or angioplasty was used if needed. TIMI grade and modified Rankin stroke scale (mRSS) score were used to evaluate vessel recanalization and clinical efficacy, respectively. Nine patients (mean age 55 years, range 17-69 years) were included. Their basal mean NIHSS score was 16 (range 12-24). In seven out of the nine patients (77.8%) the clot was removed, giving a TIMI grade of 3 in four patients and TIMI grade 2 in three patients. Occlusion sites were: middle cerebral artery (four), basilar artery (two) and anterior cerebral artery plus middle cerebral artery (one). The mean time for recanalization from the start of the procedure was 50 min (range 50-75 min). At 3 months, the mRSS score was 0 in two patients and 3-4 in three patients (two patients died). According to our results, the microsnare is a safe procedure for mechanical thrombectomy with a good recanalization rate. Further studies are required to determine the role of the microsnare in the treatment of AIS. (orig.)

  7. Anterior Approach Total Hip Replacement

    Medline Plus

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

  8. Anterior Approach Total Hip Replacement

    Medline Plus

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

  9. Anterior Approach Total Hip Replacement

    Medline Plus

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

  10. Bilateral Petit’s Triangle Hernia

    Directory of Open Access Journals (Sweden)

    Sanjay Kumar Bhasin, Arshad Bashir Khan, Sanjay Sharma

    2006-07-01

    Full Text Available Lumbar traingle hernia that occurs through lumbar triangles is very rare type of hernia. Only about 300 cases havebeen reported till date. Bilateral Petit’s triangle hernia find further rarity and the case under reference is probably thefirst ever reported case of Primary bilateral Petit’s triangle hernia. The present case is of a 46 years old married,multigravida female who presented with 1 year duration of LBA and subsequently notice of swelling both sides oflow back. FNAC revealed lipoma and on exploration it turned out to be rarest extra peritoneal bilateral Petit’s trianglehernia, fat as contents.

  11. Bilateral facial palsy associated with leptospirosis

    Directory of Open Access Journals (Sweden)

    Andressa Alves da Silva

    2009-08-01

    Full Text Available Leptospirosis is a zoonosis of worldwide occurrence caused by the spirochete Leptospira interrogans. It is an acute feverish disease with a broad clinical spectrum and follows a characteristic biphasic course. Bilateral facial palsy is a rare clinical condition and the differential diagnosis of its causes is extensive. The objective of this exploratory study, presented as a case report, is to describe the occurrence of bilateral facial palsy as an unusual manifestation of leptospirosis. This suggestion should not be overlooked when analyzing the causes for bilateral facial palsy, and should be considered with other possible differential diagnoses, some of which are potentially fatal.

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

    Directory of Open Access Journals (Sweden)

    Shridhar N

    2014-11-01

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

  13. Imaging features of bilateral breast plasmacytoma as unusual initial presentation of multiple myeloma: case report and literature review

    International Nuclear Information System (INIS)

    Breast plasmacytoma (BP) is an extremely rare extramedullary manifestation of multiple myeloma (MM). We report the imaging findings of an unusual case in which BP was the initial presentation of MM. A 53-year-old woman with no contributory medical history underwent chest computed tomography to evaluate intermittent nocturnal anterior chest pain, and bilateral multiple breast masses were found. Following an ultrasound-guided core needle biopsy, these lesions were confirmed to be BP

  14. Small vessel hematocrit in ischemic myocardium

    International Nuclear Information System (INIS)

    As blood enters the microvasculature of normally perfused myocardium, there is a progressive decrease in small vessel hematocrit (SV Hct) due to RBC streaming in smaller branching vessels and the Fahraeus-Lindqvist effect. We hypothesized that if the coronary collateral circulation was composed of very small vessels branching from large parent vessels, plasma streaming would result in a further decrease of SV Hct in ischemic myocardium. Six open chest anesthetized dogs were studied. Plasma was labelled with 59FeCl siderophilin and RBC's with 99mTc to estimate SV Hct from myocardial biopsies. The LAD was occluded and cannulated for measurement of retrograde flow (arising presumably from proximal collaterals). The ischemic region was identified using the microsphere shadow technique. Collateral flow after LAD occlusion was 30 +- 12 ml/min 100g (x +- SE). Systemic Hct was 40 +- 1%. The Hct of blood from retrograde flow was 39 +- 1% (p = NS). Activity of 59FeCl and 99mTc in known quantities of blood were compared to myocardial biopsies to estimate SV Hct. Ischemic SV Hct was 23 +- 2% and non-ischemic SV Hct was 21 +- 1% (p = NS). We conclude that the size and branching pattern of coronary collaterals is such that plasma streaming in collaterals does not result in an additional decrease in SV Hct in ischemic myocardium

  15. Anterior transarticular screw fixation for atlantoaxial arthrodesis: A report of two cases

    OpenAIRE

    Carrier, C. S.; A A Sama; Girardi, F. P.; Lebl, D. R.

    2013-01-01

    The sequelae of atlantoaxial instability (AAI) range from axial neck pain to life-threatening neurologic injury. Instrumentation and fusion of the C1-2 joint is often indicated in the setting of clinical or biomechanical instability. This is the first clinical report of anterior Smith-Robinson C1-2 transarticular screw (TAS) fixation for AAI. The first patient presented with ischemic brain tissue secondary to post-traumatic C1-2 segment instability from a MVC 7 years prior to presentation. Th...

  16. Rehabilitation of a bilateral maxillectomy patient with a free fibula osteocutaneous flap.

    Science.gov (United States)

    Mukohyama, H; Haraguchi, M; Sumita, Y I; Iida, H; Hata, Y; Kishimoto, S; Taniguchi, H

    2005-07-01

    Rehabilitation of patients who have undergone bilateral maxillectomy is difficult because of extensive loss of bone and soft tissue. In this clinical report, prosthodontic rehabilitation of oral function in a bilateral maxillecitomy patient combined with a new fibular osteocutaneous flap, which was designed to have two oronasal slits for the retention of an obturator prosthesis, was described. A 58-year-old man with a maxillary alveolar carcinoma underwent bilateral maxillectomy. The defect was reconstructed using a vascularized fibular bone wrapped circumferentially with a peroneal flap, which was fixed with miniplates between the right malar prominence and cut edge of the left zygoma remaining two slits anterior and posterior to the graft. Two and half weeks after the surgery, a delayed surgical obturator was delivered and an obturator prosthesis was delivered 6 weeks after the surgery. This obturator prosthesis could be extended into the slits to engage the tissue undercuts, and was stable during use. Mastication, deglutition, articulation and the mid-facial profile of the patient were rehabilitated. After installation of the obturator prosthesis, relining of the prosthesis base was carried out alongside the healing process of the graft, and adjustment of occlusions and high-pressure spots was carried out. No clinical disorders were observed either in the grafted tissue or the obturator prosthesis with a 3-year prognosis. Newly designing a fibular osteocutaneous flap combined with tissue-borne obturator prosthesis is one successful approach to the restoration of oral function, and increases the patient's quality of life after bilateral maxillectomy. PMID:15975135

  17. Unusual bilateral origins of the deep artery of thigh and associated variations

    Directory of Open Access Journals (Sweden)

    Shankar N

    2009-08-01

    Full Text Available During routine dissection of a middle aged male cadaver, an unusual origin of the deep artery of thigh was observed bilaterally. It arose from the femoral artery less than 1 cm distal to the inguinal ligament. On both sides, its diameter was greater than that of the femoral artery. An unusually distal origin of the lateral circumflex femoral artery was observed bilaterally. An unnamed branch from the deep artery of thigh on the left side was seen coursing superolaterally towards the anterior superior iliac spine. The deep external pudendal artery arose from the medial circumflex femoral artery on either side. On the right side, the femoral nerve emerged in the femoral triangle by piercing the iliacus muscle. As the deep artery of thigh is often used in vascular reconstructive procedures and is frequently visualized by various radiological imaging techniques, anatomical variations of itself as well as its branches have significant clinical implications.

  18. Anterior Uveitis as an Initial Manifestation of Polymyalgia Rheumatica

    Directory of Open Access Journals (Sweden)

    Hiromasa Tsuda

    2011-01-01

    Full Text Available A 74-year-old woman without contributory medical history presented with acute iridocyclitis in the right eye. Although the iridocyclitis disappeared within two weeks under topical steroid, she complained of acute progressing bilateral shoulder pain and morning stiffness of upper extremities. She was diagnosed as having polymyalgia rheumatica (PMR, and iridocyclitis was considered as its related manifestation. PMR and giant cell arteritis (GCA are closely related conditions and frequently occur together. GCA with uveitis has been rarely noted. However, ocular symptoms in PMR have not been previously mentioned. This is a first reported case of PMR presented with uveitis, without a complication of GCA. This anterior uveitis might be caused by ischemia of the posterior ciliary arteries and their branches.

  19. Caffeine prevents protection in two human models of ischemic preconditioning.

    NARCIS (Netherlands)

    Riksen, N.P.; Zhou, Z.; Oyen, W.J.G.; Jaspers, R.A.; Ramakers, B.P.; Brouwer, R.M.H.J.; Boerman, O.C.; Steinmetz, N.; Smits, P.; Rongen, G.A.

    2006-01-01

    OBJECTIVES: We studied whether caffeine impairs protection by ischemic preconditioning (IP) in humans. BACKGROUND: Ischemic preconditioning is critically dependent on adenosine receptor stimulation. We hypothesize that the adenosine receptor antagonist caffeine blocks the protective effect of IP. ME

  20. Pre-ischemic exercise alleviates oxidative damage following ischemic stroke in rats.

    Science.gov (United States)

    Feng, Rui; Zhang, Min; Wang, Xiao; Li, Wen-Bin; Ren, Shi-Qing; Zhang, Feng

    2014-10-01

    Physical exercise has been proved to be neuroprotective in clinical trials and animal experiments. However, the exact mechanism underlying this neuroprotective effect remains unclear. The aim of the present study was to explore whether pre-ischemic treadmill training could act as a form of ischemic preconditioning in a rat following ischemic stroke by reducing oxidative damage. Fifty-four rats were randomly divided into three groups (n=18 per group): Sham surgery, middle cerebral artery occlusion (MCAO) without exercise and MCAO with exercise. Subsequent to treadmill training, ischemic stroke was induced by occluding the MCA for 1.5 h, followed by reperfusion. Six rats in each group were evaluated for neurological deficits and then sacrificed by decapitation to calculate the infarct volume. The remaining rats in each group were sacrificed to detect the level of superoxide dismutase (SOD) activity (n=6) and malondialdehyde (MDA) concentration (n=6). The results indicated that pre-ischemic exercise training reduced brain infarct volume and neurological deficits, increased SOD activity and decreased the concentration of MDA following ischemic stroke. In conclusion, treadmill exercise training prior to MCAO/reperfusion increased the antioxidant ability and decreased the oxidative damage in the brain subsequent to ischemic stroke. PMID:25187848

  1. FLOWING BILATERAL FILTER: DEFINITION AND IMPLEMENTATIONS

    Directory of Open Access Journals (Sweden)

    Maxime Moreaud

    2015-06-01

    Full Text Available The bilateral filter plays a key role in image processing applications due to its intuitive parameterization and its high quality filter result, smoothing homogeneous regions while preserving the edges of the objects. Considering the image as a topological relief, seeing pixel intensities as peaks and valleys, we introduce a way to control the tonal weighting coefficients, the flowing bilateral filter, reducing "halo" artifacts typically produced by the regular bilateral filter around a large peak surrounded by two valleys of lower values. In this paper we propose to investigate exact and approximated versions of CPU and parallel GPU (Graphical Processing Unit based implementations of the regular and flowing bilateral filter using the NVidia CUDA API. Fast implementations of these filters are important for the processing of large 3D volumes up to several GB acquired by x-ray or electron tomography.

  2. THE EUROPEAN UNION’S BILATERAL APPROACH

    Directory of Open Access Journals (Sweden)

    Ludmila BORTA

    2014-12-01

    Full Text Available The EU is a world economic power and a major trading partner for most countries. All the time, this region has been interested and has acted towards a free and fair trade. The decrease and even the elimination of tariff and non-tariff barriers in the world trade are among the main objectives of the EU strategy for international trade. At the moment, the elusive outcome of the WTO Doha Round has led to the proliferation of bilateral trade agreements worldwide. Although the EU remains committed to further development of the multilateral trading system, however, the EU still has appealed also to the development of bilateral trade relations. The aim of this paper is to illustrate the current bilateral dimension of the common commercial policy of the EU. In conclusion, to describe this bilateral approach of the EU we are using one word, namely “diversity”.

  3. An unusual cause of bilateral diaphragmatic paralysis.

    OpenAIRE

    Pandit, A; Kalra, S.; Woodcock, A

    1992-01-01

    In a patient who had a sudden onset of bilateral diaphragmatic paralysis after forceful neck manipulation complete, though gradual, recovery in lung function and transdiaphragmatic pressures was seen over three years. This is a previously unrecognised risk of neck osteopathy.

  4. Spectroscopic Monitoring of Kidney Tissue Ischemic Injury

    Energy Technology Data Exchange (ETDEWEB)

    Demos, S G; Fitzgerald, J T; Michalopoulou, A P; Troppmann, C

    2004-03-11

    Noninvasive evaluation of tissue viability of donor kidneys used for transplantation is an issue that current technology is not able to address. In this work, we explore optical spectroscopy for its potential to assess the degree of ischemic damage in kidney tissue. We hypothesized that ischemic damage to kidney tissue will give rise to changes in its optical properties which in turn may be used to asses the degree of tissue injury. The experimental results demonstrate that the autofluorescence intensity of the injured kidney is decreasing as a function of time exposed to ischemic injury. Changes were also observed in the NIR light scattering intensities most probably arising from changes due to injury and death of the tissue.

  5. Lumbar discal cyst causing bilateral radiculopathy

    OpenAIRE

    Hyung-Jun, Kwak; Dae-Yong, Kim; Tae-Ho, Kim; Ho-Sang, Park; Jae-Sung, Kim; Jae-Won, Jang; Jung-Kil, Lee; Pawl, Ron; Nancy E Epstein; Bydon, Ali

    2011-01-01

    Background: Discal cyst is a rare lesion that can result in clinical symptoms typical of disc herniation manifesting as a unilateral single nerve root lesion. To the best of the authors’ knowledge, this is the first reported case of discal cyst resulting in bilateral radiculopathy. Case Description: A 48-year-old female presented with bilateral sciatica and neurogenic claudication for 3 months. Magnetic resonance imaging revealed an extradural cystic lesion compressing the ventral aspect of t...

  6. Accounting Relations in Bilateral Value Added Trade

    OpenAIRE

    Robert Stehrer

    2013-01-01

    Abstract The increasing international fragmentation of production has triggered the development of a number of widely used indicators accounting for value added flows in the world economy. This paper generalises these measures by simultaneously considering the import side and focusing on bilateral gross and value added trade flows. It discusses how these indicators relate to each other, the role of double counting in bilateral value added trade, and aggregation issues in global value added flows...

  7. Bilateral Hypertrophic Olivary Degeneration in Wilson Disease

    OpenAIRE

    Otto, Josephin; Guenther, Peter; Hoffmann, Karl-Titus

    2013-01-01

    Hypertrophic olivary degeneration resulting from lesions of the dento-rubro-olivary pathway, also called Guillain-Mollaret-triangle, has been described previously in a number of cases. Reports about bilateral hypertrophic olivary degeneration of the inferior olivary nuclei are very limited, and the magnetic resonance imaging findings of hypertrophic olivary degeneration in Wilson disease have not yet been described to the best of our knowledge. Herein, we present the first report of bilateral...

  8. Bilateral synchronous plasmacytoma of the testis.

    Science.gov (United States)

    Narayanan, Geetha; Joseph, Rona; Soman, Lali V

    2016-04-01

    Extramedullary plasmacytoma (EMP) is usually seen in the head and neck regions and in the upper respiratory, gastrointestinal, and central nervous systems. Testis is a rare site for EMP, and bilateral synchronous testicular plasmacytoma occurring as an isolated event at initial presentation has been reported only once previously. We present herein the second such report in a 70-year-old man who underwent bilateral orchidectomy. PMID:27034568

  9. Superpixel Convolutional Networks using Bilateral Inceptions

    OpenAIRE

    Gadde, Raghudeep; Jampani, Varun; Kiefel, Martin; Gehler, Peter V.

    2015-01-01

    In this paper we propose a CNN architecture for image segmentation. We introduce a new "bilateral inception" layer that is used on top of a convolutional architecture. The bilateral inception performs a filtering between superpixels in an image. This addresses two problems that arise with CNN segmentation architectures. First, this layer propagates information between (super) pixels while respecting image edges, thus using the structured information of the problem for improved results. Second...

  10. Bilateral lipoma arborescens associated with early osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Al-Ismail, Khalid; Torreggiani, William C.; Keogh, Ciaran; Munk, Peter L. [Department of Radiology, Vancouver General Hospital, 855 West 12th Avenue, Vancouver, BC, Canada V5Z 1M9 (Canada); Al-Sheikh, Fahad [Department of Radiology, Riyadh Military Hospital (Saudi Arabia)

    2002-11-01

    Lipoma arborescens is a rare disease that has generally been considered to be unilateral. We report a case of bilateral disease in a patient with associated marked premature osteoarthritis of the knees. We postulate a possible association between these two conditions and explain a possible underlying mechanism. We suggest that lipoma arborescens be considered as a rare underlying cause of young patients with bilateral premature osteoarthritis, and recommend MRI as the definitive imaging modality. (orig.)

  11. Complementarity between Bilateral Trade and Financial Integration

    OpenAIRE

    Shin, Kwanho; Yang, Doo Yong

    2006-01-01

    This paper explores the complementarities between bilateral trade in goods and financial assets. By utilizing a gravity model specification with an extended dataset in terms of time span and asset classification as well as alternative instrumental variables, we confirm the existence of positive evidence for complementarities. We find that common factors such as bilateral distance and other economic size variables that determine both cross-border trade and financial flows contribute to complem...

  12. Response of SII cortex to ipsilateral, contralateral and bilateral flutter stimulation in the cat

    Directory of Open Access Journals (Sweden)

    Favorov Oleg

    2005-02-01

    Full Text Available Abstract Background A distinctive property of SII is that it is the first cortical stage of the somatosensory projection pathway that integrates information arising from both sides of the body. However, there is very little known about how inputs across the body mid-line are processed within SII. Results Optical intrinsic signal imaging was used to evaluate the response of primary somatosensory cortex (SI and SII in the same hemisphere to 25 Hz sinusoidal vertical skin displacement stimulation ("skin flutter" applied contralaterally, ipsilaterally, and bilaterally to the central pads of the forepaws. A localized increase in absorbance in both SI and SII was evoked by both contralateral and bilateral flutter stimulation. Ipsilateral flutter stimulation evoked a localized increase in absorbance in SII, but not in SI. The SII region that responded with an increase in absorbance to ipsilateral stimulation was posterior to the region in which absorbance increased maximally in response to stimulation of the contralateral central pad. Additionally, in the posterior SII region that responded maximally to ipsilateral stimulation of the central pad, bilateral central pad stimulation approximated a linear summation of the SII responses to independent stimulation of the contralateral and ipsilateral central pads. Conversely, in anterior SII (the region that responded maximally to contralateral stimulation, bilateral stimulation was consistently less than the response evoked from the contralateral central pad. Conclusions The results indicate that two regions located at neighboring, but distinctly different A-P levels of the anterior ectosylvian gyrus process input from opposite sides of the body midline in very different ways. The results suggest that the SII cortex, in the cat, can be subdivided into at least two functionally distinct regions and that these functionally distinct regions demonstrate a laterality preference within SII.

  13. Bilateral temporomandibular joint dislocation in a 29-year-old man: a case report

    Directory of Open Access Journals (Sweden)

    Thangarajah Tanujan

    2010-08-01

    Full Text Available Abstract Introduction A dislocation of the temporomandibular joint represents three percent of all reported dislocated joints. The treatment entails reduction of the deformity and this can often be achieved in a ward setting. Case presentation We present the case of a 29-year-old Caucasian man with a non-traumatic bilateral anterior temporomandibular joint dislocation. Following several unsuccessful attempts, due to both inadequate patient analgesia and sedation, joint reduction had to be performed in theatre with the patient under general anesthesia. Conclusion This case highlights the importance of providing the patient with adequate analgesia and sedation when attempting the reduction of temporomandibular joint dislocations.

  14. MODERN VIEWS ON BILATERAL BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Ye. A. Fesik

    2014-01-01

    Full Text Available Presented modern literature data on the features of the pathogenesis, course, clinical and morphological expression and tumor characteristics, parameters and nodal metastasis of hematogenous bilateral breast cancer. Highlight the results of domestic and foreign studies in recent years to determine the prognostic factors and recurrence of synchronous and metachronous bilateral breast cancer. It was revealed that the frequency of bilateral breast tumor lesions varies widely, ranging from 0.1 to 20%, with metachronous tumors recorded significantly higher (69.6% than the synchronous (22.7%. The probability of occurrence of metachronous breast cancer is higher in women with a family history, as well as if they have a gene mutation BRCA-1. Found that the most common histological type of breast tumor with bilateral lesions is invasive ductal. However, the incidence of invasive lobular cancer and non-invasive lobular cancer is slightly higher among synchronous bilateral cancer compared with unilateral disease. Studies have shown that in a double-sided synchronous breast cancer tumor, as a rule, has a lower degree of differentiation, and the higher the expression level of estrogen receptors and progesterone receptors. Relevance of the issue because the identification of patterns in the study of lymphatic and hematogenous features bilateral metastasis of mammary tumors provides a basis for speculation about the differences in the progression of neoplastic disease in these groups and is a cause for further detailed research in this area to identify and evaluate the prognosis and also the choice of tactics of such patients.

  15. Bilateral Keratectasia 34 Years after Corneal Transplant

    Directory of Open Access Journals (Sweden)

    Xavier Valldeperas

    2010-07-01

    Full Text Available We report the clinical findings of a patient with severe bilateral keratectasia 34 years after a penetrating keratoplasty (PK in both eyes. An otherwise healthy 67-year-old man complained of deterioration of the eyesight in both eyes over the last 6 months. The patient was diagnosed with bilateral keratoconus at the age of 32 years, and he underwent a bilateral PK. At presentation, visual acuity was 20/200 in the right eye and light perception in the left eye. A Pentacam pachymetric map revealed a central pachymetry of 720 µm in the right eye and of 710 µm in the left eye, as well as an average paracentral pachymetry of 436 and 270 µm in the 9-mm zone in the right and the left eye, respectively. Corneal topography revealed bilateral irregular and asymmetric bowing with generalized steepening and high corneal power. We describe a case of bilateral keratectasia 34 years after PK in a patient who was originally diagnosed with bilateral keratoconus.

  16. Analysis of acute ischemic stroke presenting classic lacunar syndrome. A study by diffusion-weighted MRI

    International Nuclear Information System (INIS)

    We retrospectively assessed the pathophysiological features of acute ischemic stroke presenting ''classic'' lacunar syndrome by using diffusion-weighted imaging (DWI). Subjects were 16 patients who were admitted to our hospital within 24 hours of stroke onset and underwent DWI examination on admission. These were divided into three categorical groups; pure motor hemiplegia (PMH) in 8, sensorimotor stroke (SMS) in 7, and dysarthria-clumsy hand syndrome (DCHS) in 1. The fresh responsible lesions were identified by DWI in the perforating territory in 7 patients with PMH and 7 with SMS. Four (one had two possible response lesions; pons and corona radiata) and five patients in the respective groups were diagnosed as lacunar infarction on admission (the largest dimension of the lesion measuring smaller than 15 mm). On the contralateral side to the neurological symptoms, DWI revealed high intensities in cortex, subcortical white matter, and anterior and posterior border zones in the remaining one patient with PMH and in the precentral arterial region in one with DCHS. They were diagnosed as atherothrombotic infarction resulting from the occlusion of the internal carotid artery and cerebral embolism due to atrial fibrillation, respectively. Three patients with PMH showed progressive deterioration after admission and follow-up DWI study in an acute stage revealed enlargement of heir ischemic lesions. The present study suggests that DWI is a useful imaging technique for diagnosis of clinical categories and observation for pathophsiological alteration in the acute ischemic stroke patients with ''classic'' lacunar syndrome. Our results also indicate a necessity to be aware that various types of fresh ischemic lesions other than a single lacune might possibly be developing in cases with this syndrome. (author)

  17. Delayed Ischemic Stroke after Flow Diversion of Large Posterior Communicating Artery Aneurysm.

    Science.gov (United States)

    Kim, Si On; Chung, Yeon Gu; Won, Yu Sam; Rho, Myung Ho

    2016-03-01

    For securing large, giant, and wide-neck aneurysms, conventional coil embolization has substantial limitations, such as incomplete occlusion, recanalization, and a high recurrence rate. To overcome these limitations, a novel paradigm was suggested and, as a result, flow-diverting device was developed. The flow-diverting device is an innovative and effective technique to allow securing of large, giant, and wide-neck aneurysms. In numerous studies, the flow-diverting device has shown better outcomes than coil embolization. However, the flow-diverting device has also some risks, including rupture of aneurysm, intracerebral hemorrhage, and ischemic stroke. In addition, with more experience, unexpected complications are also reported.5)7) In the present case, we experienced a delayed ischemic stroke at 27 days after endovascular treatment. The patient had multiple aneurysms and, among them, we treated a large posterior communicating artery aneurysm using Pipeline™ Embolization Device. The patient was tolerable for 25 days, but then suddenly presented intermittent right hemiparesis. In the initial diffusion magnetic resonance imaging (MRI), there was no acute lesion; however, in the follow-up MRI, an acute ischemic stroke was found in the territory of anterior choroidal artery which was covered by Pipeline Embolization Device. We suspect that neo-intimal overgrowth or a tiny thrombus have led to this delayed complication. Through our case, we learned that the neurosurgeon should be aware of the possibility of delayed ischemic stroke after flow diversion, as well as, long-term close observation and follow-up angiography are necessary even in the event of no acute complications. PMID:27114962

  18. Analysis of acute ischemic stroke presenting classic lacunar syndrome. A study by diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Terai, Satoshi; Ota, Kazuki; Tamaki, Kinya [Hakujyuji Hospital, Fukuoka (Japan)

    2002-03-01

    We retrospectively assessed the pathophysiological features of acute ischemic stroke presenting ''classic'' lacunar syndrome by using diffusion-weighted imaging (DWI). Subjects were 16 patients who were admitted to our hospital within 24 hours of stroke onset and underwent DWI examination on admission. These were divided into three categorical groups; pure motor hemiplegia (PMH) in 8, sensorimotor stroke (SMS) in 7, and dysarthria-clumsy hand syndrome (DCHS) in 1. The fresh responsible lesions were identified by DWI in the perforating territory in 7 patients with PMH and 7 with SMS. Four (one had two possible response lesions; pons and corona radiata) and five patients in the respective groups were diagnosed as lacunar infarction on admission (the largest dimension of the lesion measuring smaller than 15 mm). On the contralateral side to the neurological symptoms, DWI revealed high intensities in cortex, subcortical white matter, and anterior and posterior border zones in the remaining one patient with PMH and in the precentral arterial region in one with DCHS. They were diagnosed as atherothrombotic infarction resulting from the occlusion of the internal carotid artery and cerebral embolism due to atrial fibrillation, respectively. Three patients with PMH showed progressive deterioration after admission and follow-up DWI study in an acute stage revealed enlargement of heir ischemic lesions. The present study suggests that DWI is a useful imaging technique for diagnosis of clinical categories and observation for pathophsiological alteration in the acute ischemic stroke patients with ''classic'' lacunar syndrome. Our results also indicate a necessity to be aware that various types of fresh ischemic lesions other than a single lacune might possibly be developing in cases with this syndrome. (author)

  19. A Case Report of Bilateral Mirror Clubfeet and Bilateral Hand Polydactyly

    Science.gov (United States)

    Nguyen, Mai P; Lawler, Ericka A; Morcuende, Jose A

    2014-01-01

    We report a rare case of a patient with bilateral mirror clubfeet and bilateral hand polydactyly. The patient presented to our orthopaedic clinic with bilateral mirror clubfeet, each with eight toes, and bilateral hands with six fingers and a hypoplastic thumb. The pattern does not fit any described syndrome such as Martin or Laurin-Sandrow syndrome. Treatments by an orthopaedic pediatric surgeon and an orthopaedic pediatric hand surgeon are described. The patient achieved excellent functional and cosmetic outcomes at four year follow-up. PMID:25328478

  20. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation

    Directory of Open Access Journals (Sweden)

    Rajendra Nehete

    2012-01-01

    Full Text Available In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally symmetric and aesthetically superior to the osteoplastic reconstruction. The technical details are discussed, and the long term functional and aesthetic results are presented.

  1. Computer Aided Detection of Ischemic Stroke Using Verilog HDL

    OpenAIRE

    P. Arivalagan*1; K. Adalarasu2

    2014-01-01

    Computed tomography (CT) images are widely used in the diagnosis of ischemic stroke because of its faster acquisition and compatibility with most life support devices. In present work we proposal advance techniques to automated detection of ischemic stroke using verilog code and image feature characteristics, which separate the ischemic stroke region from healthy tissues in computed tomography images.

  2. Sonographic and Endoscopic Findings in Cocaine-Induced Ischemic Colitis

    DEFF Research Database (Denmark)

    Leth, Thomas; Wilkens, Rune; Bonderup, Ole Kristian

    2015-01-01

    Cocaine-induced ischemic colitis is a recognized entity. The diagnosis is based on clinical and endoscopic findings. However, diagnostic imaging is helpful in the evaluation of abdominal symptoms and prior studies have suggested specific sonographic findings in ischemic colitis. We report...... sonographic and endoscopic images along with abdominal computed tomography in a case of cocaine-induced ischemic colitis....

  3. Neonatal ischemic brain injury: what every radiologist needs to know

    International Nuclear Information System (INIS)

    We present a pictorial review of neonatal ischemic brain injury and look at its pathophysiology, imaging features and differential diagnoses from a radiologist's perspective. The concept of perinatal stroke is defined and its distinction from hypoxic-ischemic injury is emphasized. A brief review of recent imaging advances is included and a diagnostic approach to neonatal ischemic brain injury is suggested. (orig.)

  4. 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...

  5. Significance of ultrasound evaluation of carotid atherosclerotic plaque for diagnosing ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    stenosis degree of subjects who had plaque was measured. Blood flow parameters were recorded, and stenosis degree and plaque area were calculated. Blood flow volume of bilateral carotid artery and VA was separately measured with ultrasound equipment software,and brain blood flow volume was calculated.MAIN OUTCOME MEASURES: Atherosclerotic degree and blood flow volume of patients of two groups.RESULTS: Sixty patients with ischemic cerebrovascular disease and twenty subjects who received health examination participated in the final analysis. ①The IMT thickness, total plaque score, and total plaque area of patient group was significantly superior to that of control group, respectively( t=5.216 - 10.158, P < 0.05 ).② There were significant differences in the stenosis degree of CCA, ICA and VA between patient group and control group (t=6.720 - 12.816, P < 0.05 ) . ③ The blood flow volume of CCA, ICA, VA and brain of patient group was significantly lower than that of control group, respectively (t=2.872 - 10.860, P < 0.05).CONCLUSION: Ischemic cerebrovascular disease patients have different degrees of changes in atherosclerosis and arterial blood flow.

  6. Pediatric anterior cruciate ligament reconstruction

    OpenAIRE

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

    2011-01-01

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

  7. Anterior impingement syndrome in dancers

    OpenAIRE

    O’Kane, John William; Kadel, Nancy

    2007-01-01

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

  8. Targeted Anterior Gland Focal Therapy-a Novel Treatment Option for a Better Defined Disease.

    Science.gov (United States)

    Tay, Kae Jack; Villers, Arnauld; Polascik, Thomas J

    2016-10-01

    The goal of focal therapy is to achieve long-term oncological control by eradicating only the clinically significant focus/foci of cancer within the prostate, while preserving erectile function and continence. Anterior prostate cancers may have a PZ or TZ origin and share commonalities in location and biology. While anterior prostate cancers previously constituted a diagnostic blind spot in the prostate and were often not detected or discovered late, with the rapid dissemination of advanced imaging and biopsy techniques, they can now be identified at an earlier, organ-confined stage due to MR imaging and targeted biopsies. Due to their anterior location, they represent a therapeutic target that allows for thorough ablation of the cancer focus/foci with an adequate margin while remaining far from the neurovascular bundles bilaterally. However, the TZ origin cancers are mostly anterior to the distal urethra close to the apex and the striated sphincter. Men having early stage anterior cancers may represent good candidates to achieve a balance between oncological control and functional preservation with focal therapy. Thus, this class of tumor based on location, along with the proposed treatment, represents a novel form of targeted image-guided therapy. PMID:27502428

  9. Rehabilitation Outcomes: Ischemic versus Hemorrhagic Strokes

    Directory of Open Access Journals (Sweden)

    Robert Perna

    2015-01-01

    Full Text Available Background. Ischemic and hemorrhagic strokes have different pathophysiologies and possibly different long-term cerebral and functional implications. Hemorrhagic strokes expose the brain to irritating effects of blood and ischemic strokes reflect localized or diffuse cerebral vascular pathology. Methods. Participants were individuals who suffered either an ischemic (n=172 or hemorrhagic stroke (n=112 within the past six months and were involved in a postacute neurorehabilitation program. Participants completed three months of postacute neurorehabilitation and the Mayo Portland Adaptability Inventory-4 (MPAI-4 at admission and discharge. Admission MPAI-4 scores and level of functioning were comparable. Results. Group ANOVA comparisons show no significant group differences at admission or discharge or difference in change scores. Both groups showed considerably reduced levels of productivity/employment after discharge as compared to preinjury levels. Conclusions. Though the pathophysiology of these types of strokes is different, both ultimately result in ischemic injuries, possibly accounting for lack of findings of differences between groups. In the present study, participants in both groups experienced similar functional levels across all three MPAI-4 domains both at admission and discharge. Limitations of this study include a highly educated sample and few outcome measures.

  10. An overview of antithrombotics in ischemic stroke.

    Science.gov (United States)

    Schweickert, Patricia A; Gaughen, John R; Kreitel, Elizabeth M; Shephard, Timothy J; Solenski, Nina J; Jensen, Mary E

    2016-06-19

    The use of antithrombotic medications is an important component of ischemic stroke treatment and prevention. This article reviews the evidence for best practices for antithrombotic use in stroke with focused discussion on the specific agents used to treat and prevent stroke. PMID:27153001

  11. Hyperglycemia Increases Susceptibility to Ischemic Necrosis

    Directory of Open Access Journals (Sweden)

    D. Lévigne

    2013-01-01

    Full Text Available Diabetic patients are at risk for spontaneous foot ulcers, chronic wounds, infections, and tissue necrosis. Current theories suggest that the development and progression of diabetic foot ulcers are mainly caused by arteriosclerosis and peripheral neuropathy. Tissue necrosis plays a primordial role in the progression of diabetic foot ulcers but the underlying mechanisms are poorly understood. The aim of the present study was to investigate the effects of hyperglycemia per se on the susceptibility of ischemic tissue to necrosis, using a critical ischemic hind limb animal model. We inflicted the same degree of ischemia in both euglycemic and streptozotocin-induced hyperglycemic rats by resecting the external iliac, the femoral, and the saphenous arteries. Postoperative laser Doppler flowmetry of the ischemic feet showed the same degree of reduction in skin perfusion in both hyperglycemic and euglycemic animals. Nevertheless, we found a significantly higher rate of limb necrosis in hyperglycemic rats compared to euglycemic rats (71% versus 29%, resp.. In this study, we revealed that hyperglycemia per se increases the susceptibility to limb necrosis in ischemic conditions. Our results may help to better understand the physiopathology of progressive diabetic wounds and underline the importance of strict glycemic control in patients with critical limb ischemia.

  12. Cerebral Ischemic Preconditioning: the Road So Far….

    Science.gov (United States)

    Thushara Vijayakumar, N; Sangwan, Amit; Sharma, Bhargy; Majid, Arshad; Rajanikant, G K

    2016-05-01

    Cerebral preconditioning constitutes the brain's adaptation to lethal ischemia when first exposed to mild doses of a subtoxic stressor. The phenomenon of preconditioning has been largely studied in the heart, and data from in vivo and in vitro models from past 2-3 decades have provided sufficient evidence that similar machinery exists in the brain as well. Since preconditioning results in a transient protective phenotype labeled as ischemic tolerance, it can open many doors in the medical warfare against stroke, a debilitating cerebrovascular disorder that kills or cripples thousands of people worldwide every year. Preconditioning can be induced by a variety of stimuli from hypoxia to pharmacological anesthetics, and each, in turn, induces tolerance by activating a multitude of proteins, enzymes, receptors, transcription factors, and other biomolecules eventually leading to genomic reprogramming. The intracellular signaling pathways and molecular cascades behind preconditioning are extensively being investigated, and several first-rate papers have come out in the last few years centered on the topic of cerebral ischemic tolerance. However, translating the experimental knowledge into the clinical scaffold still evades practicality and faces several challenges. Of the various preconditioning strategies, remote ischemic preconditioning and pharmacological preconditioning appears to be more clinically relevant for the management of ischemic stroke. In this review, we discuss current developments in the field of cerebral preconditioning and then examine the potential of various preconditioning agents to confer neuroprotection in the brain. PMID:26081149

  13. Magnetic resonance imaging in acute ischemic stroke

    International Nuclear Information System (INIS)

    This paper summarizes current MRI technology used in the diagnosis of acute cerebral infarction and discusses tasks for further improvement of MRI technology. First, the principles and methods of MRI imaging are described in terms of 1) diffusion-weighted imaging (DWI) and ADC maps, 2) perfusion imaging, 3) the fluid-attenuated inversion recovery (FLAIR) method, and 4) MR angiography (MRA). Then, the actual use of MRI in the early phase of ischemic cerebrovascular disorders is discussed focusing on general MRI procedures, cases in which an ischemic lesion dose not yield a high signal with DWI in the acute phase, and chronological changes in DWI signal strength and ADC. Third, chronological changes in acute cerebrovascular disorder in an animal model of local cerebral ischemia are summarized in terms of expansion of reduced ADC areas and ischemic penumbras in the acute phase of cerebral ischemia. Finally, chronological changes in acute ischemic disorders in patients with cerebrovascular disorders are assessed by reviewing the development of reduced ADC and expansion of DWI lesions. Whether MRI can identify cerebral tissues that can be rescued by the reperfusion method by examining the mismatchs between perfusion images and DWI, relative CBV, and ADC is also discussed. (K.H.)

  14. Remnant cholesterol and ischemic heart disease

    DEFF Research Database (Denmark)

    Varbo, Anette; Nordestgaard, Børge G

    2014-01-01

    PURPOSE OF REVIEW: To review recent advances in the field of remnant cholesterol as a contributor to the development of ischemic heart disease (IHD). RECENT FINDINGS: Epidemiologic, mechanistic, and genetic studies all support a role for elevated remnant cholesterol (=cholesterol in triglyceride...

  15. The neuroprotective mechanism of brain ischemic preconditioning

    Institute of Scientific and Technical Information of China (English)

    Xiao-qian LIU; Rui SHENG; Zheng-hong QIN

    2009-01-01

    Brain ischemia is one of the most common causes of death and the leading cause of adult disability in the world. Brain ischemic pre- conditioning (BIP) refers to a transient, sublethal ischemia which results in tolerance to later, otherwise lethal, cerebral ischemia. Many attempts have been made to understand the molecular and cellular mechanisms underlying the neuroprotection offered by ischemic preconditioning. Many studies have shown that neuroprotective mechanisms may involve a series of molecular regulatory pathways including activation of the N-methyI-D-aspartate (NMDA) and adenosine receptors; activation of intracellular signaling pathways such as mitogen activated protein kinases (MAPK) and other protein kinases; upregulation of Bcl-2 and heat shock proteins (HSPs); and activation of the ubiquitin-proteasome pathway and the autophagic-lysosomal pathway. A better understanding of the processes that lead to cell death after stroke as well as of the endogenous neuroprotective mechanisms by which BIP protects against brain ischemic insults could help to develop new therapeutic strategies for this devastating neurological disease. The purpose of the present review is to summarize the neuroprotective mechanisms of BIP and to discuss the possibility of mimicking ischemic preconditioning as a new strategy for preventive treatment of ischemia.

  16. Ischemic Stroke during Pregnancy and Puerperium

    Directory of Open Access Journals (Sweden)

    Elisabetta Del Zotto

    2011-01-01

    Full Text Available Ischemic stroke during pregnancy and puerperium represents a rare occurrence but it could be a serious and stressful event for mothers, infants, and also families. Whenever it does occur, many concerns arise about the safety of the mother and the fetus in relation to common diagnostic tests and therapies leading to a more conservative approach. The physiological adaptations in the cardiovascular system and in the coagulability that accompany the pregnant state, which are more significant around delivery and in the postpartum period, likely contribute to increasing the risk of an ischemic stroke. Most of the causes of an ischemic stroke in the young may also occur in pregnant patients. Despite this, there are specific conditions related to pregnancy which may be considered when assessing this particular group of patients such as pre-eclampsia-eclampsia, choriocarcinoma, peripartum cardiomiopathy, amniotic fluid embolization, and postpartum cerebral angiopathy. This article will consider several questions related to pregnancy-associated ischemic stroke, dwelling on epidemiological and specific etiological aspects, diagnostic issue concerning the use of neuroimaging, and the related potential risks to the embryo and fetus. Therapeutic issues surrounding the use of anticoagulant and antiplatelets agents will be discussed along with the few available reports regarding the use of thrombolytic therapy during pregnancy.

  17. Quality of Life and Economic Outcomes with Surgical Ventricular Reconstruction in Ischemic Heart Failure: Results From the Surgical Treatment for Ischemic Heart Failure Trial

    Science.gov (United States)

    Mark, Daniel B.; M.P.H; Knight, J. David; Velazquez, Eric J.; Howlett, Jonathan G.; Spertus, John A.; Djokovic, Ljubomir T.; Harding, Tina M.; Rankin, Gena R.; R.D.; Drew, Laura A.; Szygula-Jurkiewicz, Bozena; Adlbrecht, Christopher; Anstrom, Kevin J.

    2009-01-01

    Background Surgical ventricular reconstruction (SVR) is used in conjunction with coronary artery bypass graft surgery (CABG) to improve left ventricular function and clinical outcomes in selected patients with ischemic heart failure. The impact of SVR on quality of life and medical costs is unknown. Methods We compared CABG plus SVR with CABG alone in 1000 patients with ischemic heart failure, a large anterior wall scar, and a left ventricular ejection fraction ≤ 0.35. In 991 (99% of eligible), we collected a battery of quality of life (QOL) instruments. The principal, pre-specified QOL measure was the Kansas City Cardiomyopathy Questionnaire (KCCQ), which evaluates the effects of heart failure symptoms on QOL using a scale from 0 to 100 with higher scores indicating better QOL. Structured QOL interviews were conducted at baseline, 4, 12, 24, and 36 months post randomization and were ≥ 92% complete. Cost data were collected on 196 of 200 (98%) patients enrolled in the United States. Results Heart-failure-related QOL outcomes did not differ between the two treatment strategies out to 3 years (median KCCQ scores for CABG alone and CABG plus SVR, respectively: baseline 53 versus 54, p=0.53; 3 years 85 versus 84, p=0.89). There were no treatment-related differences in other QOL measures. In the US patients, total index hospitalization costs averaged over $14,500 higher for CABG plus SVR (P=0.004) due primarily to 4.2 extra post-operative high-intensity care days in the hospital. Conclusions Addition of SVR to CABG in patients with ischemic heart failure did not improve quality of life but significantly increased health care costs. PMID:19376309

  18. Bilateral ovarian cystic teratomata mimicking bilateral pure ovarian hemangiomata: case report.

    Science.gov (United States)

    Feuerstein, I M; Aronson, B L; McCarthy, E F

    1984-01-01

    This report describes a case of bilateral, benign cystic ovarian teratomata which were composed predominantly of cavernous hemangiomatous elements. The right-sided lesion, in particular, mimicked a pure ovarian hemangioma. The clinical presentation, bilaterality of the lesions, the sizes of the hemangiomata, and the subsequent hemangioma of the leg are all of interest in this very rare lesion. PMID:6511164

  19. Acute Anterior Uveitis and Spondyloarthritis: More Than Meets the Eye.

    Science.gov (United States)

    Khan, Muhammad A; Haroon, Muhammad; Rosenbaum, James T

    2015-09-01

    Ankylosing spondylitis (AS) and related forms of spondyloarthritis (SpA) are associated with some extra-articular features, and the most common symptomatic association is with acute anterior uveitis (AAU). Thus, approximately 40 % of patients with AS will experience a sudden onset of a unilateral anterior uveitis sometime during the course of their disease. Patients with AAU, especially those who are HLA-B27 positive, should be questioned about inflammatory low back pain and also evaluated for other clinical features of SpA. Since a prolonged delay in diagnosis is common among SpA patients and occurrence of AAU may be the reason for their first interaction with medical care, occurrence of AAU presents a unique opportunity for identifying such undiagnosed SpA patients. Therefore, a novel evidence-based algorithm called Dublin Uveitis Evaluation Tool (DUET) has been proposed to guide ophthalmologists and primary care physicians to refer appropriate AAU patients to rheumatologists. In a large two-phase study, approximately 40 % of patients presenting with idiopathic AAU were noted to have undiagnosed SpA, and DUET algorithm was noted to have excellent sensitivity (96 %) and specificity (97 %). It has a positive likelihood ratio (LR) 41.5 and negative LR 0.03. In most instances, the eye inflammation responds well to corticosteroid and mydriatic eye drops and without the need for additional therapy. Use of oral corticosteroids is reserved for patients, especially with associated chronic inflammatory bowel disease or psoriatic arthritis presenting with bilateral, chronic, anterior, and/or intermediate uveitis, and this treatment is rarely needed for more than a couple of weeks. A very small percentage may be more refractory to such treatment and require potential novel therapies, including the use of tumor necrosis factor blockers. PMID:26233598

  20. Novel spatula and dissector for safer deep anterior lamellar keratoplasty

    Directory of Open Access Journals (Sweden)

    Gustavo ,2,3 Bonfadini

    2014-10-01

    Full Text Available Objective: We describe a novel spatula and dissector to facilitate the big-bubble technique in deep anterior lamellar keratoplasty (DALK. Methods: A 29-year-old man who was diagnosed with bilateral keratoconus underwent deep anterior lamellar keratoplasty (DALK. After 350μm partial thickness incision of the recipient cornea, the Bonfadini dissector was inserted at the deepest point in the peripheral incision and could be advanced to the center of the cornea safely because of its "semi-sharp" tip. After achieving the big-bubble (BB separation of Descemet membrane (DM from the overlying stroma, the anterior stromal disc was removed. Viscoelastic material was placed on the stromal bed to prevent uncontrolled collapse and perforation of DM during the paracentesis blade incision into the BB. We could detect the safe opening of the BB using the Bonfadini dissector by the leakage of air bubbles into the viscoelastic material. After injecting viscoelastic material into the BB space, we inserted the Bonfadini spatula into the bigbubble safely because of its curved profile and blunt edges. The groove along the length of the Bonfadini spatula enables safe and efficient incision or the residual stromal tissue using the pointed end of a sharp blade while protecting the underlying DM. After removal of posterior stroma, the donor button was sutured with 16 interrupted 10-0 nylon sutures. Results: This technique and the use of the Bonfadini spatula and dissector facilitate exposure of Descemet membrane. Conclusion: The smooth Bonfadini DALK spatula and dissector facilitate safe and efficient completion of DALK surgery.

  1. Bilateral electric energy contracts: return and risk

    Energy Technology Data Exchange (ETDEWEB)

    Gunn, Laura K.; Silva, Elisa B.; Correia, Paulo B. [State University of Campinas (UNICAMP), SP (Brazil). College of Mechanical Engineering

    2009-07-01

    In Brazil electricity is traded through three segments: the spot market that balances offer and demand, with prices calculated by a cost-based computational model; the regulated market , where prices are settled in public auctions, and the free market for bilateral contracts. As spot and regulated market prices are public information, a seller is able to calculate his opportunity price to trade a bilateral contract in the free market by using the non-arbitrage principle. Thus, the seller searches the price of a bilateral contract in the free market that balances his/her revenues with the value expected in case it were negotiated in the regulated and the spot market. Besides the expected revenue, the seller may also consider the CVaR to measure the risk of her/his bilateral contract in the free market. So this paper develops a binomial lattice approach to price bilateral contracts in the free market, considering the seller's opportunity of negotiations in both regulated and spot markets, and measuring the contract risk directly. (author)

  2. Cerebrospinal fluid may mediate CNS ischemic injury

    Directory of Open Access Journals (Sweden)

    Soriano Sulpicio G

    2005-09-01

    Full Text Available Abstract Background The central nervous system (CNS is extremely vulnerable to ischemic injury. The details underlying this susceptibility are not completely understood. Since the CNS is surrounded by cerebrospinal fluid (CSF that contains a low concentration of plasma protein, we examined the effect of changing the CSF in the evolution of CNS injury during ischemic insult. Methods Lumbar spinal cord ischemia was induced in rabbits by cross-clamping the descending abdominal aorta for 1 h, 2 h or 3 h followed by 7 d of reperfusion. Prior to ischemia, rabbits were subjected to the following procedures; 1 CSF depletion, 2 CSF replenishment at 0 mmHg intracranial pressure (ICP, and 3 replacement of CSF with 8% albumin- or 1% gelatin-modified artificial CSF, respectively. Motor function of the hind limbs and histopathological changes of the spinal cord were scored. Post-ischemic microcirculation of the spinal cord was visualized by fluorescein isothiocyanate (FITC albumin. Results The severity of histopathological damage paralleled the neurological deficit scores. Paraplegia and associated histopathological changes were accompanied by a clear post-ischemic deficit in blood perfusion. Spinal cord ischemia for 1 h resulted in permanent paraplegia in the control group. Depletion of the CSF significantly prevented paraplegia. CSF replenishment with the ICP reduced to 0 mmHg, did not prevent paraplegia. Replacement of CSF with albumin- or gelatin-modified artificial CSF prevented paraplegia in rabbits even when the ICP was maintained at 10–15 mmHg. Conclusion We conclude that the presence of normal CSF may contribute to the vulnerability of the spinal cord to ischemic injury. Depletion of the CSF or replacement of the CSF with an albumin- or gelatin-modified artificial CSF can be neuroprotective.

  3. A reversible bilateral renal artery stenosis in association with antiphospholipid syndrome.

    Science.gov (United States)

    Remondino, G I; Mysler, E; Pissano, M N; Furattini, M C; Basta, M C; Presas, J L; Allievi, A

    2000-01-01

    We describe a 26-year-old white female with a history of Raynaud phenomenon, erythema nodosum, polyarthralgias, migraine, vertigo, seizures, transient ischemic attacks, one fetal loss, and false positive VDRL, who developed milk hypertension without overt lupus nephritis. She had positive antinuclear antibodies (ANA) and double-stranded deoxyribonucleic acid (dsDNA) antibodies. The lupus anticoagulant test (LAC) and cardiolipins antibodies (aCL) were positive. She was diagnosed as having a Systemic Lupus Erythematosus-like illness (SLE-like) with 'secondary' antiphospholipid syndrome (APS). Renal spiral computed tomography (CT) with intravenous (IV) contrast showed bilateral renal artery stenosis. Anticoagulation with acenocumarol was started. She became normotensive without antihypertensive drugs five months later. A follow-up renal spiral CT showed complete recanalization of both renal arteries, making thrombosis the more likely culprit pathology in the stenosis. After two years follow up the patient is normotensive. She remains on acenocumarol. PMID:10713649

  4. Anterior capsulotomy improves persistent developmental stuttering with a psychiatric disorder: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Zhang SZ

    2014-04-01

    Full Text Available Shizhen Zhang,* Peng Li,* Zhujun Zhang, Wei WangDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China *These authors contributed equally to this workAbstract: Stuttering is characterized by disrupted fluency of verbal expression, and occurs mostly in children. Persistent developmental stuttering (PDS may occur in adults. Reports of the surgical management of PDS are limited. Here we present the case of a 28-year-old man who had had PDS since the age of 7 years, was diagnosed with depression and anxiety disorder at the age of 24 years, and had physical concomitants. He underwent a bilateral anterior capsulotomy 4 years after the diagnosis. Over one year of follow-up, his physical concomitants resolved, and significant improvements in his psychiatric disorders and PDS were observed. To the best of our knowledge, this is the first report of simultaneous improvement in a patient's PDS and psychiatric disorder after a bilateral anterior capsulotomy.Keywords: persistent developmental stuttering, psychiatric disorders, anterior capsulotomy

  5. Differential proteomics of the synovial membrane between bilateral and unilateral knee osteoarthritis in surgery‑induced rabbit models.

    Science.gov (United States)

    Liu, Weilin; He, Jian; Lin, Ruhui; Liang, Jie; Luo, Qinglu

    2016-09-01

    The present study investigated the differential proteomics of synovial membranes between bilateral and unilateral anterior cruciate ligament transection (ACLT) in rabbits with knee osteoarthritis (KOA), in order to elucidate the pathological biomarkers of different degrees of KOA. A total of 6 New Zealand rabbits were randomly divided into groups A and B (three rabbits per group). The two groups were subjected to bilateral and unilateral ACLT, respectively. A total of 6 weeks following surgery, proteins were extracted from the knee joint synovial membranes of KOA rabbits and were separated by two‑dimensional polyacrylamide gel electrophoresis. The differentially expressed proteins in the OA synovial membranes were selected for further analysis by linear ion trap‑Fourier transform ion cyclotron resonance mass spectrometry. Ten protein spots were identified to be different between the synovial membranes of the bilateral and unilateral KOA rabbits. Protein disulfide‑isomerase and creatine kinase M‑type were identified in the unilateral KOA rabbit synovial membranes. Serum albumin (three spots), lumican, α‑2‑HS‑glycoprotein and three uncharacterized proteins were identified in the synovial membranes of the bilateral KOA rabbits. The differential proteomic expression demonstrated the different biomarkers associated with bilateral and unilateral KOA, and indicated that spontaneous and secondary KOA require diverse methods of treatment; thus the underlying mechanism of KOA requires further investigation. PMID:27430254

  6. Connectivity pattern differences bilaterally in the cerebellum posterior lobe in healthy subjects after normal sleep and sleep deprivation: a resting-state functional MRI study

    Directory of Open Access Journals (Sweden)

    Liu XM

    2015-05-01

    Full Text Available Xuming Liu,1 Zhihan Yan,2 Tingyu Wang,1 Xiaokai Yang,1 Feng Feng,3 Luping Fan,1 Jian Jiang4 1Department of Radiology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, 2Department of Radiology, The 2nd Affiliated Hospital of Wenzhou Medical University, Wenzhou, 3Peking Union Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 4Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China Objective: The aim of this study was to use functional magnetic resonance imaging (fMRI technique to explore the resting-state functional connectivity (rsFC differences of the bilaterial cerebellum posterior lobe (CPL after normal sleep (NS and after sleep deprivation (SD. Methods: A total of 16 healthy subjects (eight males, eight females underwent an fMRI scan twice at random: once following NS and the other following 24 hours’ SD, with an interval of 1 month between the two scans. The fMRI scanning included resting state and acupuncture stimulation. The special activated regions located during the acupuncture stimulation were selected as regions of interest for rsFC analysis. Results: Bilateral CPLs were positively activated by acupuncture stimulation. In the NS group, the left CPL showed rsFC with the bilateral CPL, bilateral frontal lobe (BFL, left precuneus and right inferior parietal lobule, while the right CPL showed rsFC with the bilateral temporal lobe, right cerebellum anterior lobe, right CPL, left frontal lobe, left anterior cingulate, right posterior cingulate, and bilateral inferior parietal lobule. In the SD group, the left CPL showed rsFC with the left posterior cingulate gyrus bilateral CPL, left precuneus, left precentral gyrus, BFL, and the left parietal lobe, while the right CPL showed rsFC with bilateral cerebellum anterior lobe, bilateral CPL, left frontal lobe and left temporal lobe. Compared with the NS group, the

  7. Prognosis of synchronous bilateral breast cancer

    DEFF Research Database (Denmark)

    Holm, Marianne; Tjønneland, Anne; Balslev, Eva;

    2014-01-01

    Currently, no consistent evidence-based guidelines for the management of synchronous bilateral breast cancer (SBBC) exist and it is uncertain how presenting with SBBC affects patients' prognosis. We conducted a review of studies analyzing the association between SBBC and prognosis. The studies that...... reported adjusted effect measures were included in meta-analyses of effect of bilaterality on breast cancer mortality. From 57 initially identified records 17 studies from 11 different countries including 8,050 SBBC patients were included. The quality of the studies varied but was generally low with small...... sample sizes, and lack of consistent, detailed histo-pathological information. When doing meta-analysis on the subgroup of studies that provided adjusted effect estimates on breast cancer mortality (nine studies including 3,631 SBBC cases), we found that bilaterality in itself had a negative impact on...

  8. Langerhans Cell Histiocytosis in Bilateral Mastoid Cavity

    Directory of Open Access Journals (Sweden)

    Kazım Bozdemir

    2013-01-01

    Full Text Available A 39-year-old male was admitted to our clinic with symptoms of headache, dizziness, nausea, otalgia, otorrhea, tinnitus, and hearing loss in both ears for 3 weeks. Physical examination revealed edema in the tympanic membrane and external ear canal, and pain by palpation in the mastoid area bilaterally. There was no nystagmus, and the rest of the physical examination was otherwise normal. Temporal bone high resolution computed tomography (CT showed a lesion causing erosion in the mastoid cortex, tegmen tympani, ossicles, and in the bone covering the sigmoid sinus bilaterally. There was also erosion in the superior semicircular canal and petrous bone on the left side. Cortical mastoidectomy was performed under general anesthesia. Histopathologic examination of the tissue revealed Langerhans cell histiocytosis (LCH. In this paper a case with LCH, presenting with bilateral mastoid involvement which has been rarely reported in the literature, is discussed with the existing literature.

  9. Bilateral Supernumerary Kidney: A Very Rare Presentation

    International Nuclear Information System (INIS)

    To our knowledge, bilateral supernumerary kidney is a very rare renal abnormality and there are five cases presented in the literature. It is difficult to diagnose supernumerary kidney and clinicians have not detected most cases preoperatively. Laboratory and imaging studies were acquired and carefully examined. The normal laboratory tests were found. Emergency ultrasonography was performed and they revealed no signs of parenchymal abnormality in both kidneys. Serial imaging study including enhanced computed tomography (CT) was performed. An imaging study identified bilateral supernumerary kidney with expanded collecting systems. On each side, significant rotation anomaly was found. In addition, there were two different renal arteries originating from the aorta. This report presents radiological determinations of supernumerary kidney bilaterally in a young man. We think that CT commonly appears to be enough for the diagnosis of supernumerary kidneys

  10. Danish Exports and Danish Bilateral Aid

    DEFF Research Database (Denmark)

    Hansen, Henrik; Rand, John

    was much higher in the 1980s compared to in particular the most recent decade. This may be related to factors such as untying of aid in the same period. The econometric analysis has two important limitations. First of all, the model can only give information about marginal changes in aid. As a...... trade policies. The main result of the study is that Danish bilateral aid has a positive and statistically significant impact on Danish exports to the recipient countries. Bilateral development assistance may affect exports through several channels. Three of the main channels are direct aid tying......; increasing recipient income where higher income leads to higher imports, and decreased trade costs, say due to improved information about cultural and administrative customs and practices. Thus, as for preferential trade arrangements, bilateral aid has two potential economic effects; trade creation working...

  11. Absence of scalenus anterior muscle.

    OpenAIRE

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

    2003-01-01

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

  12. Lesiones del ligamento cruzado anterior

    OpenAIRE

    Alejandro Álvarez López; Yenima García Lorenzo

    2015-01-01

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

  13. Bilateral subepidermal calcified nodules of the eyelid

    OpenAIRE

    Malki, Salem Al; Al-Faky, Yasser H.; Al-Rikabi, Ammar C

    2010-01-01

    A subepidermal calcified nodule (SCN) is an uncommon benign lesion, which usually develops in early childhood and is typically solitary. A rare form of this lesion has been reported in the eyelid. We report here a case of a 12-year-old girl with bilateral nodules of the right upper eyelid and a left lower eyelid simulating epidermal cyst. The histopathologic examination of the excised nodule confirmed the diagnosis. To our knowledge, this may be the first bilateral case of eyelid SCN reported...

  14. Congenital bilateral perisylvian syndrome with hydrocephalus

    Directory of Open Access Journals (Sweden)

    Salih Hattapoğlu

    2012-12-01

    Full Text Available Congenital bilateral perisylvian syndrome (CBPS, whichis seen by indications of mental retardasyon, epilepsi,speech disorder and pseudobulbar palsy, is a diseasewhich comes up with genetic and non-genetic reasons.Revealing characteristic indications (like polymicrogyriawith MR imaging and clinic indications contributes makingdiagnosis. In present paper, we aimed to present 18month girl case report who diagnosed as CBPS with hydrocephaliindication. J Clin Exp Invest 2012; 3(4: 552-554Key words: Epilepsy, congenital bilateral perisylviansyndrome, polymicrogyria, hydrocephalus, pseudobulbarpalsy

  15. Bilateral hydronephrosis caused by vaginal prolapse

    Directory of Open Access Journals (Sweden)

    Begliomini Helio

    2003-01-01

    Full Text Available INTRODUCTION: Even though it is uncommon, uterine prolapse can cause compression of ureters and bilateral hydronephrosis, predisposing to arterial hypertension and renal failure. Hydronephrosis consequent to cystocele and to vaginal prolapse is even rarer. CASE REPORT: This paper reports on a 59 year-old patient, Caucasian, obese and hysterectomized who presented complete vaginal prolapse with bilateral hydronephrosis and slight alteration in serum urea and creatinine. Patient underwent correction of vaginal prolapse by endoscopic suspension technique with improvement of hydronephrosis and normalization of renal function. This work emphasizes the rarity of such case and the requirement of surgical approach.

  16. Bilateral Petit’s Triangle Hernia

    OpenAIRE

    Sanjay Kumar Bhasin, Arshad Bashir Khan, Sanjay Sharma

    2006-01-01

    Lumbar traingle hernia that occurs through lumbar triangles is very rare type of hernia. Only about 300 cases havebeen reported till date. Bilateral Petit’s triangle hernia find further rarity and the case under reference is probably thefirst ever reported case of Primary bilateral Petit’s triangle hernia. The present case is of a 46 years old married,multigravida female who presented with 1 year duration of LBA and subsequently notice of swelling both sides oflow back. FNAC revealed lipoma a...

  17. Bilateral hypertrophic olivary degeneration in Wilson disease

    Energy Technology Data Exchange (ETDEWEB)

    Otto, Josephin; Guenther, Pete; Hoffmann, Karl Titus [Leipzig University Hospital, Leipzig (Greece)

    2013-04-15

    Hypertrophic olivary degeneration resulting from lesions of the dento-rubro-olivary pathway, also called Guillain-Mollaret-triangle, has been described previously in a number of cases. Reports about bilateral hypertrophic olivary degeneration of the inferior olivary nuclei are very limited, and the magnetic resonance imaging findings of hypertrophic olivary degeneration in Wilson disease have not yet been described to the best of our knowledge. Herein, we present the first report of bilateral hypertrophic olivary degeneration diagnosed by magnetic resonance imaging in a patient suffering from Wilson disease.

  18. Bilateral Diabetic Papillopathy and Metabolic Control

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Lund-Andersen, Henrik; Sander, Birgit; Hvidt-Nielsen, Ditte; Larsen, Michael

    2010-01-01

    -six patients with type 1 diabetes. METHODS: Review of clinical, photographic, and clinical chemistry records from a large diabetology and ophthalmology unit between 2001 and 2008. MAIN OUTCOME MEASURES: Simultaneous, bilateral diabetic papillopathy. RESULTS: The mean follow-up was 4.9 years. During 10 020...... patient-years of observation, bilateral diabetic papillopathy developed in 5 patients. During the year preceding this incident, all 5 patients had experienced a decrease in glycosylated hemoglobin A(1c) (HbA(1C)) at a maximum rate of -2.5 (mean) percentage points per quarter year, which was significantly...

  19. Comparing the Effect of Interavitreal Bevacizumab in Visual Acuity of Ischemic and Non-Ischemic Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Farzaneh Ghasemzadeh

    2013-02-01

    Full Text Available Background: The paper tries to examine the effect of avastin on visual acuity in patients with Ischemic and non-ischemic diabetic macular edema which was estimated convenient, inexpensive, safe, and quick in contrast to laser or deep vitrectomy. Materials and Methods: In this clinical trial study, patients with clinically significant macular edema (CSMA were subjected to fluorescein angiography (FA and people whose foveal avascular zones (FAZ were over 1000 µm were defined as ischemic diabetic macular edema. Patients were divided into two ischemic and non-ischemic groups. The best corrected visual acuity (BCVA and the central macular thickness (CMT in all eyes were measured and recorded by optical coherence tomography (OCT. All patients received 3 vitreous injections of bevacizumab (avastin at 1-month intervals. One month after the third injection, BCVA and CMT were measured again and patient’s information was compared before and after the injection. Results: Out of 87 eyes (66 patients, 23 eyes (26.4% belonged to ischemic group and 64 eyes (73.6% belonged to non-ischemic group. In ischemic group, BCVA improved from 0.653 ±0.309 LogMAR to 0.404 ±0.255 LogMAR (p=0.001, while no significant change was seen in non-ischemic group (from 0.881 ±0.332 to 0.879 ±0.378. In ischemic group, CMT was increased from 362.9±34.66 to 278.76 ± 45.57 and in non-ischemic group it was enhanced from 353.47 ±67.61 to 239.87±55.44 (p=0.001.Conclusion: In spite of the great impact of vitreous injection of avastin in reducing the central macular thickness in both ischemic and non-ischemic groups and sensible improvement of patients’ visibility, the visibility itself was not improved considerably in ischemic group.

  20. 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.

  1. Dolor anterior de la rodilla

    Directory of Open Access Journals (Sweden)

    Alejandro Álvarez López

    2010-01-01

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

  2. Positioning of anterior teeth in removable dentures

    Directory of Open Access Journals (Sweden)

    Strajnić Ljiljana

    2002-01-01

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

  3. Pharyngocutaneous fistula after anterior cervical spine surgery

    OpenAIRE

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

    2009-01-01

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

  4. Effect of electroacupuncture on synaptic transmission in dentate gyrus of the hippocampus in cerebral ischemic injured rats

    Institute of Scientific and Technical Information of China (English)

    Haibo Yu; Zhuoxin Yang; Ling Wang; Min Pi; Jiawei Zhang

    2006-01-01

    BACKGROUND: Some studies suggest that the long-term potentiation (LTP) of synaptic transmission may be the basis for the neural synaptic plasticity of hippocampus, but can be evoked by various factors including electroacupuncture.OBJECTIVE: To observe the effect of electroacupuncture on the activities of basic synaptic transmission in dentate gyrus of hippocampus and the changes of high frequency stimulation (HFS) induced activity of synaptic transmission in cerebral ischemic injured rats.DESIGN: A randomized control trial.SETTING: Shenzhen Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Traditional Chinese Medicine.MATERIALS: Sixty healthy male Wistar rats, weighing 150-250 g, were provided by the Experimental Animal Center of Guangzhou University of Traditional Chinese Medicine. The experiment began after adaptation of environment for 1 week under standard experimental environment. The main experimental instruments included the programming electrical acupuncture apparatus (PCEA, product of the Institute of Acupuncture and Meridians, Anhui College of Traditional Chinese Medicine) and multichannel physiologic recorder (RM-86, Nihon Konden).METHODS: The experiment was carried out in Guangzhou University of Traditional Chinese Medicine between July 2003 and July 2004. ① Embedding of brain electrodes: In reference of the Pellegrino's rat brain atlas, the bipolar electrode stimulator was embedded into the perforant path (PP) anterior to the entorhinal area with location coordinates of AP 7.5 mm, L 4.2 mm and H 3.0 mm, that is, 7.5 mm posterior to the anterior fontanelle, 4.2 mm laterally on the right side and 3.0 mm under the subcortex. The subcortex recorder electrode coordinates are AP 3.8 mm, L 2.5 mm and H 3.5 mm, located in the granular cell layer of the unilateral dentate gyrus (DG) of hippocampus, at the site of which an opening with the diameter of 1.5 mm was drilled for the purpose of embedding of the stimulating and recording

  5. Bilateral atraumatic tibial tubercle avulsion fractures: case report and review of the literature.

    Science.gov (United States)

    Khoriati, Al-Achraf; Guo, Shigong; Thakrar, Raj; Deol, Rupinderbir S; Shah, Khalil Y

    2015-04-01

    An avulsion fracture of the tibial tubercle is an uncommon injury, comprising less than 1% of all physeal injuries. The occurrence of such injuries bilaterally is even rarer. We report a case of bilateral atraumatic tibial tubercle avulsion fractures and its presentation, mechanism of injury, surgical management, post-operative rehabilitation and implications for clinical practice. A 17-year-old healthy male presented to the emergency department with severe pain on the anterior aspect of both knees and was unable to walk, having been brought in by ambulance after hearing a crack whilst jogging. On examination, there was significant swelling of both knees which were held in extension. On both sides there was a prominent deformity on the region of the tibial tubercle with a palpable gap, although no open skin wound. He was unable to actively move either knee joint. No neurovascular deficit was present. Plain radiographs revealed bilateral tibial tubercle avulsion fractures. Gentle manipulation was performed in the emergency department to the fragments in order to remove the tension from the skin. The fragments were reduced and fixed surgically with 4mm cannulated screws in an anterior to posterior direction. Both limbs were placed in temporary casts in 20 degrees of flexion. Postoperatively, the patient was kept non-weight bearing for four weeks then placed into a range of motion brace and movement commenced. Full weight bearing was permitted at the one month stage and he was advised to avoid any sporting activity until the 8 week stage and contact sports until the 10 week stage. Full movement of both joints was regained and the patient returned to full sporting activity in the absence of symptoms. This case emphasises the need for a high degree of vigilance when faced with such a presentation and a low threshold for further investigation and surgical intervention. PMID:25638599

  6. Bilateral atypical optic neuritis associated with tuberculosis in an immunocompromised patient

    Institute of Scientific and Technical Information of China (English)

    Juanarita Jaafar; Wan Hazabbah Wan Hitam; Raja Azmi Mohd Noor

    2012-01-01

    A 27 year-old lady, presented with sudden loss of vision in the right eye for a week. It was followed by poor vision in the left eye after 3 days. It involved the whole entire visual field and was associated with pain on eye movement. She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago. She was started on anti-TB since then but defaulted highly active anti-retroviral therapy (HAART). On examination, her visual acuity was no perception of light in the right eye and 6/120 (pinhole 3/60) in the left eye. Anterior segment in both eyes was unremarkable. Funduscopy showed bilateral optic disc swelling with presence of multiple foci of choroiditis in the peripheral retina. The vitreous and retinal vessels were normal. Chest radiography was normal. CT scan of orbit and brain revealed bilateral enhancement of the optic nerve sheath that suggest the diagnosis of bilateral atypical optic neuritis. This patient was managed with infectious disease team. She was started on HAART and anti-TB treatment was continued. She completed anti-TB treatment after 9 months without any serious side effects. During follow up the visual acuity in both eyes was not improved. However, funduscopy showed resolving of disc swelling and choroiditis following treatment.

  7. Ischemic stroke: carotid and vertebral artery disease.

    Science.gov (United States)

    Vilela, P; Goulão, A

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. PMID:15657789

  8. Ischemic stroke: carotid and vertebral artery disease

    International Nuclear Information System (INIS)

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  9. Genetics of ischemic stroke: Indian perspective

    Directory of Open Access Journals (Sweden)

    Subhash Kaul

    2012-01-01

    Full Text Available A stroke is still a major cause of long-term disability and the third largest killer in the world after heart attack and cancer. Inherited genetic variation has been shown to play a role in its pathogenesis and therefore, there is a need to identify the culprit genetic variants. They may provide novel targets for preventive therapeutics. The most intensively investigated candidate gene is PDE4D. There are several positive replication studies of PDE4D gene with stroke. The genetic contribution to ischemic stroke risk in India has not been explored adequately. Reports on few candidate genes are available but we are still lagging behind in this aspect. Most of the reports are from Andhra Pradesh, a province in south India and a few parts of north India. PDE4D has been identified as a predisposition gene for ischemic stroke in Southern as well as the Northern population of India.

  10. Ischemic stroke: carotid and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  11. Bilateral Pulmonary Cyst in a Child

    OpenAIRE

    Ravinder K Gupta, Ritu Gupta

    2008-01-01

    A four year old male child presented with history of cough for last six months. Chest skiagram and CTscan of mediastinum revealed bilateral pulmonary hydatid cyst. Serology did authenticate diagnosis. Thechild was prescribed albendazole for 6 months and was advised to come for follow up. The case ofbilateral pulmonary hydatid cyst is being presentated because of rarity.

  12. Bilateral Odontogenic Keratocyst of the Mandible

    OpenAIRE

    Ram, Hari; Mohammad, Shadab; Husain, Nuzhat; Gupta, Shalini; Kumar, Ajay

    2011-01-01

    Odontogenic keratocyst (OKC) is a cyst of dental origin with an aggressive clinical behavior, having high recurrence rate. Multiple cysts are associated with bifid-rib basal cell nevus syndrome (Gorlin syndrome). We present a case of bilateral odontogenic keratocyst in a cleft lip patient.

  13. Bilateral Pulmonary Cyst in a Child

    Directory of Open Access Journals (Sweden)

    Ravinder K Gupta, Ritu Gupta

    2008-04-01

    Full Text Available A four year old male child presented with history of cough for last six months. Chest skiagram and CTscan of mediastinum revealed bilateral pulmonary hydatid cyst. Serology did authenticate diagnosis. Thechild was prescribed albendazole for 6 months and was advised to come for follow up. The case ofbilateral pulmonary hydatid cyst is being presentated because of rarity.

  14. Synchronous bilateral breast cancer in a male

    OpenAIRE

    Rubio Hernández, María Caridad; Díaz Prado, Yenia Ivet; Pérez, Suanly Rodríguez; Díaz, Ronald Rodríguez; Aleaga, Zaili Gutiérrez

    2013-01-01

    Male breast cancer, which represents only 1% of all breast cancers, is occasionally associated with a family history of breast cancer. Sporadic male breast cancers presenting with another primary breast cancer are extremely rare. In this article, we report on a 70-year-old male patient with bilateral multifocal and synchronous breast cancer and without a family history of breast cancer.

  15. Problems in severe bilateral urinary tract anomalies

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens

    1989-01-01

    Management of children with severe infravesical or bilateral ureterovesical obstruction with or without reflux is difficult. Our experience over 10 years includes 29 such children, 19 of whom presented in the first 3 months of life. At the time of diagnosis, 13 had severe disturbance of renal...

  16. A Bilateral Traumatic Hip Obturator Dislocation

    Science.gov (United States)

    Karaarslan, Ahmet Adnan; Acar, Nihat; Karci, Tolga; Sesli, Erhan

    2016-01-01

    A case of a bilateral simultaneous traumatic obturator dislocation of both hip joints in an 18-year-old young man following a traffic accident is presented. We reduced the dislocated femoral heads immediately under general anesthesia followed by passive and active exercises and early full-weight bearing mobilization. After 5 years, the result was excellent. PMID:26977327

  17. Fast and Provably Accurate Bilateral Filtering.

    Science.gov (United States)

    Chaudhury, Kunal N; Dabhade, Swapnil D

    2016-06-01

    The bilateral filter is a non-linear filter that uses a range filter along with a spatial filter to perform edge-preserving smoothing of images. A direct computation of the bilateral filter requires O(S) operations per pixel, where S is the size of the support of the spatial filter. In this paper, we present a fast and provably accurate algorithm for approximating the bilateral filter when the range kernel is Gaussian. In particular, for box and Gaussian spatial filters, the proposed algorithm can cut down the complexity to O(1) per pixel for any arbitrary S . The algorithm has a simple implementation involving N+1 spatial filterings, where N is the approximation order. We give a detailed analysis of the filtering accuracy that can be achieved by the proposed approximation in relation to the target bilateral filter. This allows us to estimate the order N required to obtain a given accuracy. We also present comprehensive numerical results to demonstrate that the proposed algorithm is competitive with the state-of-the-art methods in terms of speed and accuracy. PMID:27093722

  18. Bilateral segmental neurofibromatosis diagnosed during pregnancy.

    Science.gov (United States)

    Maldonado Cid, P; Sendagorta Cudós, E; Noguera Morel, L; Beato Merino, M J

    2011-01-01

    Bilateral segmental neurofibromatosis is a rare subtype of neurofibromatosis type 1 defined by lesions affecting a single segment of the body and crossing the midline, with no systemic involvement. We present a case diagnosed during pregnancy because of the characteristic increase in size of the lesions during this period. PMID:21635828

  19. Bilateral synchronous rupture of the quadriceps tendon.

    LENUS (Irish Health Repository)

    Ellanti, P

    2012-09-01

    Bilateral simultaneous rupture of the quadriceps tendon is a rare entity. They are often associated with degenerative changes of the tendons and predisposing conditions such as diabetes or excessive steroid use. They most commonly tend to occur in patients of 40 years of age or older.

  20. Occipital seizures presenting with bilateral visual loss

    OpenAIRE

    Hadjikoutis S; Sawhney I

    2003-01-01

    Transient visual loss may occur with occipital seizures as an ictal or post-ictal phenomenon. Its duration varies from less than one minute to days, or can be permanent. We describe a 61-year-old man presenting with headache, vomiting and bilateral visual loss. EEG revealed persistent spike discharge in the occipital lobes suggesting occipital seizures. His vision improved with carbamazepine.

  1. A RARE CASE OF BILATERAL MICROSPHEREPHAKIA

    OpenAIRE

    Pandu; Arunkumar B.; Sujatha; Srinivas; Muthukumaran

    2015-01-01

    Microspherophakia is rare bilateral congenital anamoly of the crystalline lens. The condition may be isolated , familial or it may be associated with systemic affections like Marfan's syndrome , Weil - Marchesani syndrome , hyperlysinemia and congenital rubella. Microspherophakia results in lenticular myopia , lens dislocation , usually inferiorly and inverse glaucoma. We present a case in a 8 year old child who presented with bil...

  2. Amnesia due to bilateral hippocampal glioblastoma

    International Nuclear Information System (INIS)

    The authors report a unique case of glioblastoma which caused permanent amnesia. Magnetic resonance imaging showed the lesion to be limited to the hippocampal formation bilaterally. Although glioblastoma extends frequently into fiber pathways and expands into the opposite cerebral hemisphere, making a 'butterfly' lesion, it is unusual for it to invade the limbic system selectively to this extent. (orig.)

  3. Simulations of bilateral energy markets using MATLAB

    International Nuclear Information System (INIS)

    This paper presents simulation results of energy bilateral markets using MATLAB/SIMULINK. The algorithm for congestion management and transmission pricing is implemented by means of DC load flow. The simulation results show how elasticity of market participants to transmission usage charges can affect the overall network usage and its cost. (Author)

  4. Bilateral median nerve palsy in a cyclist.

    OpenAIRE

    Braithwaite, I J

    1992-01-01

    Cyclists are prone to a number of sport-related musculoskeletal injuries, mainly of the lower limb. Nerve compression injuries are relatively rare, though in the hand ulnar nerve compression is well described. We describe a case of bilateral median nerve compression caused by cycling.

  5. Bilateral eyelid edema : Cutis laxa or blepharochalasis?

    NARCIS (Netherlands)

    Braakenburg, A; Nicolai, JPA

    2000-01-01

    A 59-year-old woman with massive bilateral edema of the upper and lower eyelids is presented. The edema occurred suddenly and without provocation. No cause could be identified despite a multitude of examinations. Initially the patient was diagnosed as having blepharochalasis, but later skin biopsy s

  6. Spontan bilateral ekstrauterin graviditet efter kejsersnit

    DEFF Research Database (Denmark)

    Petersen, Jesper Friis; Ekelund, Charlotte; Settnes, Annette

    2015-01-01

    We describe a rare case of bilateral tubal pregnancy following natural conception in a woman with no other known risk factor than two former caesarean sections. Intraabdominal adhesions following the caesarean sections complicated the salpingectomy thus diminishing certainty of a healthy...

  7. Bilateral breast cancer : mammographic and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Kyung; Oh, Ki Keun; Jun, Hwang Yoon; Lee, Byung Chan; Lee, Kyong Sik; Lee, Yong Hee [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-06-01

    To evaluate the mammographic and clinical features of bilateral breast cancer. We retrospectively reviewed clinical records(n=23) and mammograms (n=15) of 23 patients with bilateral breast cancer. Patients' age, location of the tumor and pathologic staging were determined from clinical records. Mammographic features were classified as spiculated mass, nonspiculated mass, mass with microcalcification, microcalcification only, asymmetric density, and normal. Of the 23 cases of bilateral breast cancer, 8(34.8%) were synchronous and 15(65.2%) were metachronous. Age at diagnosis of cancer in the first breast was between 27 and 59(mean 43) years ; there was no statistically significant difference in mean age between patients with synchronous and metachronous cancer. The mean interval between the diagnosis of each lesion of the metachronous pairs was 9.1 years. In 11 of 23 cases(48%), tumors were locaated in the same quadrant, and in the other 12 cases(52%), they were in different quadrant. At mammography, five of 15 metachronous cancers(33%) were similar in appearance and 10 pairs(67%) were different. In 4 of 23 cases(17%), cancer in the first breast was at stage 0 and stage 1, and in 13 of 23(57%), cancer in the second breast was at this same stage. In bilateral breast cancer, the two breasts frequently show different mammographic features. Cancer of the second breast was at an early stage; this suggest that regular examination and mammography are important and can allow early detection of contralateral breast cancer.

  8. 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.

  9. Transient ischemic attack after Mesobuthus gibbosus envenomation

    OpenAIRE

    Golcuk, Yalcin; Ozsarac, Murat; Bilge, Adnan; Golcuk, Burcu; Cinar, Bilge Piri; Hayran, Mustafa

    2014-01-01

    Endometriosis Mesobuthus gibbosus is a medically important venomous scorpion in western of Turkey which causes significant morbidity. Envenoming of this species scorpion results with varying degrees of local symptoms and clinically important systemic effects. This case describes an authenticated first case of transient ischemic attack in a 68 year-old-woman following envenoming by M. gibbosus in Turkey.Keywords: Scorpion, Envenomation, Emergency department

  10. ENDOTHELIAL DYSFUNCTION IN ISCHEMIC HEART DISEASE

    OpenAIRE

    N. E. Zakirova; R. G. Oganov; A. N. Zakirova; M. P. Plotnikova; G. M. Salakhova

    2016-01-01

    Aim. To assess the role of endothelial vasodilating, vasoconstrictive and adhesive dysfunction in the development of angina pectoris (AP) in patients with ischemic heart disease (IHD).Material and methods. 83 patients with IHD were included in the study. 30 patients had AP of functional class (FC)-II, 27 patients - FC-III and 26 patients - FC-IV. The control group consisted of 25 healthy persons. Bicycle ergometry, daily ECG monitoring and echocardiography were used for verification of IHD. E...

  11. Inflammatory responses in hypoxic ischemic encephalopathy

    OpenAIRE

    Liu, Fudong; McCullough, Louise D.

    2013-01-01

    Inflammation plays a critical role in mediating brain injury induced by neonatal hypoxic ischemic encephalopathy (HIE). The mechanisms underlying inflammatory responses to ischemia may be shared by neonatal and adult brains; however, HIE exhibits a unique inflammation phenotype that results from the immaturity of the neonatal immune system. This review will discuss the current knowledge concerning systemic and local inflammatory responses in the acute and subacute stages of HIE. The key compo...

  12. Endothelial progenitor cells in acute ischemic stroke

    Science.gov (United States)

    Martí-Fàbregas, Joan; Crespo, Javier; Delgado-Mederos, Raquel; Martínez-Ramírez, Sergi; Peña, Esther; Marín, Rebeca; Dinia, Lavinia; Jiménez-Xarrié, Elena; Fernández-Arcos, Ana; Pérez-Pérez, Jesús; Querol, Luis; Suárez-Calvet, Marc; Badimon, Lina

    2013-01-01

    Objectives The levels of circulating endothelial progenitor cells (EPCs) in ischemic stroke have not been studied extensively and reported results are inconsistent. We aimed to investigate the time course, the prognostic relevance, and the variables associated with EPC counts in patients with ischemic stroke at different time points. Material and methods We studied prospectively 146 consecutive patients with ischemic stroke within the first 48 h from the onset of symptoms (baseline). We evaluated demographic data, classical vascular risk factors, treatment with thrombolysis and statins, stroke etiology, National Institute of Health and Stroke Scale score and outcome (favorable when Rankin scale score 0–2). Blood samples were collected at baseline, at day 7 after stroke (n = 121) and at 3 months (n = 92). The EPC were measured by flow cytometry. Results We included 146 patients with a mean age of 70.8 ± 12.2 years. The circulating EPC levels were higher on day 7 than at baseline or at 3 months (P = 0.045). Pretreatment with statins (odds ratio [OR] 3.11, P = 0.008) and stroke etiology (P = 0.032) were predictive of EPC counts in the baseline sample. EPC counts were not associated with stroke severity or functional outcome in all the patients. However, using multivariate analyses, a better functional outcome was found in patients with higher EPC counts in large-artery atherosclerosis and small-vessel disease etiologic subtypes. Conclusions After acute ischemic stroke, circulating EPC counts peaked at day 7. Pretreatment with statins increased the levels of EPC. In patients with large-artery atherosclerosis and small-vessel disease subtypes, higher counts were related to better outcome at 3 months. PMID:24363968

  13. Ischemic Colitis in an Endurance Runner

    Directory of Open Access Journals (Sweden)

    Chase Grames

    2012-01-01

    Full Text Available A 20-year-old female running the Marine Corps Marathon developed diarrhea at mile 12. After finishing the race she noted that she was covered in bloody stool. A local emergency department suspected ischemic colitis. After discharge, her primary care physician instructed her to discontinue the use of all nonsteroidal anti-inflammatory drugs. Her symptoms resolved and she returned to running without any complications. This paper describes the pathophysiology, diagnostic approach, and management options.

  14. Resilience in Patients with Ischemic Heart Disease

    OpenAIRE

    Conceição Maria Martins de Lemos; David William Moraes; Lucia Campos Pellanda

    2016-01-01

    Background: Resilience is a psychosocial factor associated with clinical outcomes in chronic diseases. The relationship between this protective factor and certain diseases, such heart diseases, is still under-explored. Objective: The present study sought to investigate the frequency of resilience in individuals with ischemic heart disease. Method: This was a cross-sectional study with 133 patients of both genders, aged between 35 and 65 years, treated at Rio Grande do Sul Cardiology Institu...

  15. Recent Advances in Childhood Arterial Ischemic Stroke

    OpenAIRE

    Fox, Christine K.; Fullerton, Heather J.

    2010-01-01

    Although many underlying diseases have been reported in the setting of childhood arterial ischemic stroke, emerging research demonstrates that non-atherosclerotic intracerebral arteriopathies in otherwise healthy children are prevalent. Minor infections may play a role in arteriopathies that have no other apparent underlying cause. Although stroke in childhood differs in many aspects from adult stroke, few systematic studies specific to pediatrics are available to inform stroke management. Tr...

  16. Data considerations in ischemic stroke trials

    OpenAIRE

    Liebeskind, David S.; Feldmann, Edward

    2014-01-01

    Data drive the analyses of any ischemic stroke trial, culminating in the main results and potential next steps. The distinct purpose of a given trial, advancing a novel treatment or examining routine clinical practice, determines the nature of essential data elements. Information gathering for an effective trial depends on ample data, adequate infrastructure, and properly planned statistical analyses. This review highlights the fact that successful future trials will require appropriate exper...

  17. Gene Therapy For Ischemic Heart Disease

    OpenAIRE

    Lavu, Madhav; Gundewar, Susheel; Lefer, David J.

    2010-01-01

    Current pharmacologic therapy for ischemic heart disease suffers multiple limitations such as compliance issues and side effects of medications. Revascularization procedures often end with need for repeat procedures. Patients remain symptomatic despite maximal medical therapy. Gene therapy offers an attractive alternative to current pharmacologic therapies and may be beneficial in refractory disease. Gene therapy with isoforms of growth factors such as VEGF, FGF and HGF induces angiogenesis, ...

  18. Ischemic Stroke during Pregnancy and Puerperium

    OpenAIRE

    Del Zotto, Elisabetta; Giossi, Alessia; Volonghi, Irene; Costa, Paolo; Padovani, Alessandro; Pezzini, Alessandro

    2011-01-01

    Ischemic stroke during pregnancy and puerperium represents a rare occurrence but it could be a serious and stressful event for mothers, infants, and also families. Whenever it does occur, many concerns arise about the safety of the mother and the fetus in relation to common diagnostic tests and therapies leading to a more conservative approach. The physiological adaptations in the cardiovascular system and in the coagulability that accompany the pregnant state, which are more significant arou...

  19. Perawatan Gigitan Terbalik Anterior Dengan Menggunakan Inclined Plane

    OpenAIRE

    Siregar, Wilda A.

    2008-01-01

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

  20. Curcumin protects against ischemic spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Jinhua Zhang; Hao Wei; Meimei Lin; Chunmei Chen; Chunhua Wang; Maobai Liu

    2013-01-01

    Inducible nitric oxide synthase and N-methyl-D-aspartate receptors have been shown to participate in nerve cellinjury during spinal cord ischemia. This study observed a protective effect of curcumin on ischemic spinal cord injury. Models of spinal cord ischemia were established by ligating the lumbar artery from the left renal artery to the bifurcation of the abdominal aorta. At 24 hours after model establishment, the rats were intraperitoneal y injected with curcumin. Reverse transcrip-tion-polymerase chain reaction and immunohistochemical results demonstrated that after spinal cord ischemia, inducible nitric oxide synthase and N-methyl-D-aspartate receptor mRNA and protein expression significantly increased. However, curcumin significantly decreased inducible nitric oxide synthase and N-methyl-D-aspartate receptor mRNA and protein expression in the ischemic spinal cord. Tarlov scale results showed that curcumin significantly improved motor function of the rat hind limb after spinal cord ischemia. The results demonstrate that curcumin exerts a neuroprotective ef-fect against ischemic spinal cord injury by decreasing inducible nitric oxide synthase and N-methyl-D-aspartate receptor expression.

  1. Hypercholesterolemia in patients of ischemic stroke

    International Nuclear Information System (INIS)

    Background: Stroke is a common neurological disease that results in significant mortality and morbidity globally. Several risk factors have been identified for stroke among which hyperlipidaemia is one of the modifiable risk factors. Recent clinical trials have shown a reduction in ischemic stroke for patients taking lipid lowering medications. Therefore, the aim of this study was to find out the frequency of hypercholesterolemia in patients of ischemic stroke in Hazara region. Method: This cross sectional study was carried out in the Medical Department of Ayub Teaching Hospital, Abbottabad. Ninety patients of stroke confirmed as ischemic by CT scan brain were enrolled in the study after informed consent. The frequency of hypercholesterolemia in patients was recorded. Results: There were 55 (61.1 percentage) males. The mean age of patients was 64.4±11.5 years. The mean serum cholesterol in all patients was 4.16±1.1 mmol/l. The mean serum cholesterol of male patients was 4.3±1.2 mmol/l and 4.0±10.9 mmol/l in the case of females. Conclusions: Hypercholesterolemia could not be established as a major risk factor for stroke in our setup through this study that allude to the fact that other risk factors might be contributing more to the incidence of cerebrovascular accident in our population. (author)

  2. Ischemic Retinal Vasculitis and Its Management

    Directory of Open Access Journals (Sweden)

    Lazha Talat

    2014-01-01

    Full Text Available Ischemic retinal vasculitis is an inflammation of retinal blood vessels associated with vascular occlusion and subsequent retinal hypoperfusion. It can cause visual loss secondary to macular ischemia, macular edema, and neovascularization leading to vitreous hemorrhage, fibrovascular proliferation, and tractional retinal detachment. Ischemic retinal vasculitis can be idiopathic or secondary to systemic disease such as in Behçet’s disease, sarcoidosis, tuberculosis, multiple sclerosis, and systemic lupus erythematosus. Corticosteroids with or without immunosuppressive medication are the mainstay treatment in retinal vasculitis together with laser photocoagulation of retinal ischemic areas. Intravitreal injections of bevacizumab are used to treat neovascularization secondary to systemic lupus erythematosus but should be timed with retinal laser photocoagulation to prevent further progression of retinal ischemia. Antitumor necrosis factor agents have shown promising results in controlling refractory retinal vasculitis excluding multiple sclerosis. Interferon has been useful to control inflammation and induce neovascular regression in retinal vasculitis secondary to Behçet’s disease and multiple sclerosis. The long term effect of these management strategies in preventing the progression of retinal ischemia and preserving vision is not well understood and needs to be further studied.

  3. Ischemic preconditioning—an unfulfilled promise

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Timothy M. [Ashford & St. Peter' s Hospitals NHS Foundation Trust, Guildford Road, Surrey, KT16 0PZ (United Kingdom); Waksman, Ron [Washington Hospital Centre, 110 Irving Street, Washington, DC 20010 (United States); De Silva, Kalpa; Jacques, Adam [Ashford & St. Peter' s Hospitals NHS Foundation Trust, Guildford Road, Surrey, KT16 0PZ (United Kingdom); Mahmoudi, Michael, E-mail: m.mahmoudi@surrey.ac.uk [Ashford & St. Peter' s Hospitals NHS Foundation Trust, Guildford Road, Surrey, KT16 0PZ (United Kingdom); University of Surrey, 13AY04, Surrey, GU2 7XH (United Kingdom)

    2015-03-15

    Myocardial reperfusion injury has been identified as a key determinant of myocardial infarct size in patients undergoing percutaneous or surgical interventions. Although the molecular mechanisms underpinning reperfusion injury have been elucidated, attempts at translating this understanding into clinical benefit for patients undergoing cardiac interventions have produced mixed results. Ischemic conditioning has been applied before, during, or after an ischemic insult to the myocardium and has taken the form of local induction of ischemia or ischemia of distant tissues. Clinical studies have confirmed the safety of differing conditioning techniques, but the benefit of such techniques in reducing hard clinical event rates has produced mixed results. The aim of this article is to review the role of ischemic conditioning in patients undergoing percutaneous and surgical coronary revascularization. - Highlights: • There are a multitude of techniques for conditioning. • Conditioning has been utilized in percutaneous coronary intervention and cardiac surgery. • There is a lack of consistency in the techniques utilized and outcomes that have been measured. • The results of studies to date lack a consistency in the benefits of conditioning.

  4. TOWARD THE QUESTION OF ISCHEMIC MYOCARDIAL DYSFUNCTION

    Directory of Open Access Journals (Sweden)

    V. V. Kalyuzhin

    2015-12-01

    Full Text Available The authors of the review have analyzed papers published on the problem of ischemic myocardial dysfunction. They begin with a definition of the term “ischemia” (derived from two Greek words: ischō, meaning to hold back, and haima, meaning blood - a condition at which the arterial blood flow is insufficient to provide enough oxygen to prevent intracellular respiration from shifting from the aerobic to the anaerobic form. The poor rate of ATP generation from this process causes a decrease in cellular ATP, a concomitant rise in ADP, and ultimately, to depression inotropic (systolic and lusitropic (diastolic function of the affected segments of the myocardium. But with such simplicity of basic concepts, the consequences of ischemia so diverse. Influence of an ischemia on myocardial function so unequally at different patients, which is almost impossible to find two identical cases (as in the case of fingerprints. It depends on the infinite variety of lesions of coronary arteries, reperfusion (time and completeness of restoration of blood flow and reactions of a myocardium which, apparently, has considerable flexibility in its response. Ischemic myocardial dysfunction includes a number of discrete states, such as acute left ventricular failure in angina, acute myocardial infarction, ischemic cardiomyopathy, stunning, hibernation, pre- and postconditioning. There are widely differing underlying pathophysiologic states. The possibility exists that several of these states can coexist.

  5. Ischemic preconditioning—an unfulfilled promise

    International Nuclear Information System (INIS)

    Myocardial reperfusion injury has been identified as a key determinant of myocardial infarct size in patients undergoing percutaneous or surgical interventions. Although the molecular mechanisms underpinning reperfusion injury have been elucidated, attempts at translating this understanding into clinical benefit for patients undergoing cardiac interventions have produced mixed results. Ischemic conditioning has been applied before, during, or after an ischemic insult to the myocardium and has taken the form of local induction of ischemia or ischemia of distant tissues. Clinical studies have confirmed the safety of differing conditioning techniques, but the benefit of such techniques in reducing hard clinical event rates has produced mixed results. The aim of this article is to review the role of ischemic conditioning in patients undergoing percutaneous and surgical coronary revascularization. - Highlights: • There are a multitude of techniques for conditioning. • Conditioning has been utilized in percutaneous coronary intervention and cardiac surgery. • There is a lack of consistency in the techniques utilized and outcomes that have been measured. • The results of studies to date lack a consistency in the benefits of conditioning

  6. Obstructive sleep apnea in ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Aliye Tosun

    2008-01-01

    Full Text Available OBJECTIVE: To investigate the prevalence of obstructive sleep apnea in patients with ischemic stroke and to evaluate the effectiveness of nasal continuous positive airway pressure treatment. METHODS: Overnight polysomnography was performed by a computerized system in 19 subjects with ischemic stroke. Patients with an apnea-hypopnea index > 5 were considered to have obstructive sleep apnea. The appropriate level of continuous positive airway pressure for each patient was determined during an all-night continuous positive airway pressure determination study. Attended continuous positive airway pressure titration was performed with a continuous positive airway pressure auto-titrating device. RESULTS: Obstructive sleep apnea prevalence among patients with ischemic stroke was 73.7%. The minimum SaO2 was significantly lower, and the percent of total sleep time in the wake stage and stage 1 sleep was significantly longer in patients with obstructive sleep apnea. In two patients with severe obstructive sleep apnea, we observed a decrease in the apnea-hypopnea index, an increase in mean wake time, mean SaO2, and minimum SaO2, and alterations in sleep structures with continuous positive airway pressure treatment. CONCLUSION: As the diagnosis and treatment of obstructive sleep apnea is of particular importance in secondary stroke prevention, we suggest that the clinical assessment of obstructive sleep apnea be part of the evaluation of stroke patients in rehabilitation units, and early treatment should be started.

  7. Scintigraphy of incidentally discovered bilateral adrenal masses

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the patterns of iodine-131 6β-iodomethylnorcholesterol (NP-59) imaging and the correlation with CT-guided adrenal biopsy and follow-up in patients with bilateral adrenal masses. To this end we investigated a consecutive sample of 29 euadrenal patients with bilateral adrenal masses discovered on CT for reasons other than suspected adrenal disease. Adrenal scintigraphy was performed using 1 mCi of NP-59 injected i.v., with gamma camera imaging 5-7 d later. In 13 of the 29 patients bilateral adrenal masses were the result of metastatic involvement from lung carcinoma (5), lymphoma (3), adrenocarcinoma of the colon (3), squamous cell carcinoma of the larynx (1), and anaplastic carcinoma of unknown primary (1). Among these cases the NP-59 scan demonstrated either bilaterally absent tracer accumulation (8, all with bilateral metastases) or marked asymmetry of adrenocortical NP-59 uptake (5). Biopsy of the adrenal demonstrating the least NP-59 uptake documented malignant involvement of that gland in five of five patients. In two patients an adenoma was found simultaneously in one adrenal with a contralateral malignant adrenal mass. In each of these cases, the adenoma demonstrated the greatest NP-59 uptake. In 16 patients diagnosis of adenoma was made on the basis of CT-guided adrenal biopsy of the gland with the greatest NP-59 uptake of the pair (n=4), or adrenalectomy (n=2), or absence of change in the size of the adrenal mass on follow-up CT scanning performed 6 months to 3 years later (n=10). (orig./MG)

  8. Nasal airway and septal variation in unilateral and bilateral cleft lip and palate.

    Science.gov (United States)

    Starbuck, John M; Friel, Michael T; Ghoneima, Ahmed; Flores, Roberto L; Tholpady, Sunil; Kula, Katherine

    2014-10-01

    Cleft lip and palate (CLP) affects the dentoalveolar and nasolabial facial regions. Internal and external nasal dysmorphology may persist in individuals born with CLP despite surgical interventions. 7-18 year old individuals born with unilateral and bilateral CLP (n = 50) were retrospectively assessed using cone beam computed tomography. Anterior, middle, and posterior nasal airway volumes were measured on each facial side. Septal deviation was measured at the anterior and posterior nasal spine, and the midpoint between these two locations. Data were evaluated using principal components analysis (PCA), multivariate analysis of variance (MANOVA), and post-hoc ANOVA tests. PCA results show partial separation in high dimensional space along PC1 (48.5% variance) based on age groups and partial separation along PC2 (29.8% variance) based on CLP type and septal deviation patterns. MANOVA results indicate that age (P = 0.007) and CLP type (P ≤ 0.001) significantly affect nasal airway volume and septal deviation. ANOVA results indicate that anterior nasal volume is significantly affected by age (P ≤ 0.001), whereas septal deviation patterns are significantly affected by CLP type (P ≤ 0.001). Age and CLP type affect nasal airway volume and septal deviation patterns. Nasal airway volumes tend to be reduced on the clefted sides of the face relative to non-clefted sides of the face. Nasal airway volumes tend to strongly increase with age, whereas septal deviation values tend to increase only slightly with age. These results suggest that functional nasal breathing may be impaired in individuals born with the unilateral and bilateral CLP deformity. PMID:24976342

  9. Pure word deafness with auditory object agnosia after bilateral lesion of the superior temporal sulcus.

    Science.gov (United States)

    Gutschalk, Alexander; Uppenkamp, Stefan; Riedel, Bernhard; Bartsch, Andreas; Brandt, Tobias; Vogt-Schaden, Marlies

    2015-12-01

    Based on results from functional imaging, cortex along the superior temporal sulcus (STS) has been suggested to subserve phoneme and pre-lexical speech perception. For vowel classification, both superior temporal plane (STP) and STS areas have been suggested relevant. Lesion of bilateral STS may conversely be expected to cause pure word deafness and possibly also impaired vowel classification. Here we studied a patient with bilateral STS lesions caused by ischemic strokes and relatively intact medial STPs to characterize the behavioral consequences of STS loss. The patient showed severe deficits in auditory speech perception, whereas his speech production was fluent and communication by written speech was grossly intact. Auditory-evoked fields in the STP were within normal limits on both sides, suggesting that major parts of the auditory cortex were functionally intact. Further studies showed that the patient had normal hearing thresholds and only mild disability in tests for telencephalic hearing disorder. Prominent deficits were discovered in an auditory-object classification task, where the patient performed four standard deviations below the control group. In marked contrast, performance in a vowel-classification task was intact. Auditory evoked fields showed enhanced responses for vowels compared to matched non-vowels within normal limits. Our results are consistent with the notion that cortex along STS is important for auditory speech perception, although it does not appear to be entirely speech specific. Formant analysis and single vowel classification, however, appear to be already implemented in auditory cortex on the STP. PMID:26343343

  10. Robotically assisted multivessel minimally invasive direct coronary artery bypass grafting with the use of bilateral internal thoracic arteries.

    Science.gov (United States)

    Nishida, Satoru; Yasuda, Tamotsu; Watanabe, Go; Kikuchi, Yujiro; Shintani, Yoshiko; Ito, Shigeki; Tabata, Shigeki; Kawachi, Kenji

    2007-09-01

    This case report presents the robotically assisted multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB) technique using the bilateral internal thoracic arteries. A 54-year-old man with multivessel coronary artery disease was considered eligible for a robotically assisted myocardial revascularization. The bilateral internal thoracic arteries were harvested completely in a totally skeletonized fashion through three 1-2-cm-long incisions on the left thoracic wall. A small left anterior thoracotomy was then performed. The left internal thoracic artery was anastomosed to the left anterior descending coronary artery, and the composite radial artery graft from the right internal thoracic artery was sequentially anastomosed to the first diagonal branch, the obtuse marginal branch, and the distal right coronary artery on the beating heart without cardiopulmonary bypass. The harvesting time of the grafts was 66 min, and the total operative time was 5 h 58 min. Postoperative angiography revealed that all grafts were widely patent. The postoperative course was uneventful, and the patient was discharged 10 days after the operation. Robotically assisted MIDCAB using the bilateral thoracic arteries is a safe and effective means of myocardial revascularization for patients with multivesssel disease. PMID:17721036

  11. Laparoscopic total extraperitoneal repair of preoperatively diagnosed bilateral obturator and incidental bilateral femoral herniae.

    Science.gov (United States)

    Malik, Muhammad Usman; Connelly, Tara M; Hamid, Mustafa; Pretorius, Frederik

    2016-01-01

    Obturator hernia (OH), a rare type of hernia, is associated with high morbidity and mortality. Diagnosis is often delayed as clinical symptoms are typically non-specific. OH is frequently associated with other occult inguinopelvic herniae. Early diagnosis is vital to decrease morbidity and mortality. We report the case of a 75-year-old woman who presented to the surgical outpatients' department with non-specific bilateral groin pain radiating to the thighs. CT of the pelvis demonstrated bilateral OH with no radiological evidence of bowel obstruction. Semiurgent elective laparoscopic total extraperitoneal mesh repair was performed. Intraoperative findings confirmed bilateral obturator herniae as well as incidental bilateral femoral herniae. This case highlights the need for a high index of suspicion for such concomitant hernias that, in the presence of OH, may only be identified intraoperatively. PMID:27113790

  12. Bilateral Facial Paralysis Caused by Bilateral Temporal Bone Fracture: A Case Report and a Literature Review

    Directory of Open Access Journals (Sweden)

    Sultan Şevik Eliçora

    2015-01-01

    Full Text Available Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis.

  13. Impaired mitochondrial function in chronically ischemic human heart

    DEFF Research Database (Denmark)

    Stride, Nis Ottesen; Larsen, Steen; Hey-Mogensen, Martin;

    2013-01-01

    Chronic ischemic heart disease is associated with myocardial hypoperfusion. The resulting hypoxia potentially inflicts damage upon the mitochondria, leading to a compromised energetic state. Furthermore, ischemic damage may cause excessive production of reactive oxygen species (ROS), producing...... mitochondrial damage, hereby reinforcing a vicious circle. Ischemic preconditioning has been proven protective in acute ischemia, but the subject of chronic ischemic preconditioning has not been explored in humans. We hypothesized that mitochondrial respiratory capacity would be diminished in chronic ischemic...... regions of human myocardium but that these mitochondria would be more resistant to ex vivo ischemia and, second, that ROS generation would be higher in ischemic myocardium. The aim of this study was to test mitochondrial respiratory capacity during hyperoxia and hypoxia, to investigate ROS production, and...

  14. The anterior loop of the inferior alveolar nerve. A radiographic study of panoramic radiographs and review of the literature.

    Directory of Open Access Journals (Sweden)

    Konstantinos VLASTOS

    2014-04-01

    Full Text Available The inferior alveolar nerve sometimes extends anteriorly beyond the mental foramen and runs outward, upward and backward before it reaches the mental foramen, creating what is known as the anterior loop. Placement of dental implants in this area, has a high risk of injury to the inferior alveolar nerve. Aim: This study seeks to investigate the visualization of the anterior loop on panoramic radiographs. Material and methods: 100 panoramic radiographs were analysed in terms of loop visualization. Results: Anterior loop was observed in 34% of the radiographs. Its prevalence was higher in males (70.5% and in patients between 40-60 years old (47%. In most cases the loop was located bilaterally (64.7%, while the interforaminal area was mostly edentulous (64.7%. The loop length ranged between 0.5-8 mm, with an average length of 4.37mm. Conclusions: An analysis of the findings shows that implants should be placed at least 5-8mm anteriorly to the mental foramen. According to a review of the literature, computed tomography is more accurate than panoramic radiography in identifying the anterior loop.

  15. Imaging, Intervention, and Workflow in Acute Ischemic Stroke: The Calgary Approach.

    Science.gov (United States)

    Zerna, C; Assis, Z; d'Esterre, C D; Menon, B K; Goyal, M

    2016-06-01

    Five recently published clinical trials showed dramatically higher rates of favorable functional outcome and a satisfying safety profile of endovascular treatment compared with the previous standard of care in acute ischemic stroke with proximal anterior circulation artery occlusion. Eligibility criteria within these trials varied by age, stroke severity, imaging, treatment-time window, and endovascular treatment devices. This focused review provides an overview of the trial results and explores the heterogeneity in imaging techniques, workflow, and endovascular techniques used in these trials and the consequent impact on practice. Using evidence from these trials and following a case from start to finish, this review recommends strategies that will help the appropriate patient undergo a fast, focused clinical evaluation, imaging, and intervention. PMID:26659339

  16. Absence of scalenus anterior muscle.

    Directory of Open Access Journals (Sweden)

    Murakami S

    2003-06-01

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

  17. 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

  18. Neonatal ischemic brain injury: what every radiologist needs to know

    Energy Technology Data Exchange (ETDEWEB)

    Badve, Chaitra A.; Khanna, Paritosh C.; Ishak, Gisele E. [Seattle Children' s Hospital, University of Washington Medical Center, Department of Radiology, Seattle, WA (United States)

    2012-05-15

    We present a pictorial review of neonatal ischemic brain injury and look at its pathophysiology, imaging features and differential diagnoses from a radiologist's perspective. The concept of perinatal stroke is defined and its distinction from hypoxic-ischemic injury is emphasized. A brief review of recent imaging advances is included and a diagnostic approach to neonatal ischemic brain injury is suggested. (orig.)

  19. A Simplified Technique for Producing an Ischemic Wound Model

    OpenAIRE

    Chien, Sufan; Wilhelmi, Bradon J.

    2012-01-01

    One major obstacle in current diabetic wound research is a lack of an ischemic wound model that can be safely used in diabetic animals. Drugs that work well in non-ischemic wounds may not work in human diabetic wounds because vasculopathy is one major factor that hinders healing of these wounds. We published an article in 2007 describing a rabbit ear ischemic wound model created by a minimally invasive surgical technique. Since then, we have further simplified the procedure for easier operati...

  20. Ischemic stroke susceptibility gene in a Northern Han Chinese population

    OpenAIRE

    Wang, Haiping; Shi, Shujuan; Yan, Wenjing; Song, Yan; Zhan, Jingjing; Zhang, Chen; Wang, Haiji

    2013-01-01

    Interleukin-18 gene promoter polymorphisms are potential risk factors for ischemic cerebrovascular disease, and the –607C allele may increase ischemic stroke risk in the Han Chinese population. In the present study, we recruited 291 patients with ischemic cerebrovascular disease from the Affiliated Hospital of Qingdao University Medical College, China, and 226 healthy controls. Both patients and controls were from the Han population in northern China. Immunoresonance scattering assays detecte...