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Sample records for bilateral stapes footplate

  1. Relapsing polychondritis associated with bilateral stapes footplate fixation: a case report

    Directory of Open Access Journals (Sweden)

    Takwoingi Yohanna M

    2009-09-01

    Full Text Available Abstract Introduction Relapsing polychondritis is a rare multisystem autoimmune disease of uncertain etiology characterized by recurrent episodes of inflammation and progressive destruction of cartilaginous tissues. Its respiratory, cardiovascular, renal and neurological complications are life-threatening, and it is thus important to recognize the disease and its complications early. Relapsing polychondritis may follow a slowly evolving or rapidly progressive course. Case presentation The case of a 39-years-old Caucasian woman with a three-year history of recurrent bilateral chondritis of the auricles, nasal chondritis, seronegative polyarthritis and dermatitis is reported. She had an associated bilateral stapedial fixation and one side was successfully operated on. She also had a large septal perforation involving both the cartilaginous and bony parts. The patient first presented with severe cutaneous inflammation when she was only one month old, and so this is an illustrative case of relapsing polychondritis that slowly evolved over many years. Conclusions Relapsing polychondritis is still a relatively uncommon condition, which explains why there is often a delayed diagnosis of the disease. It is usually difficult to examine tympanic membranes in cases of relapsing polychondritis, and, therefore stapes fixation should also be suspected when there is an associated conductive hearing loss.

  2. Lunar drill footplate and casing

    Science.gov (United States)

    Maassen, Erik C.; Hendrix, Thomas H.; Morrison, Eddie W.; Phillips, Rodrick B.; Le, Vu Quang; Works, Bruce A.

    1989-01-01

    To prevent hole collapse during lunar drilling operations, a casing has been devised of a graphite reinforced polyimide composite which will be able to withstand the lunar environment. Additionally, this casing will be inserted into the ground in segments two meters long which will penetrate the regolith simultaneously with the auger. The vertical action of the mobile platform will provide a downward force to the casing string through a special adaptor, giving the casing the needed impetus to sink the anticipated depth of ten meters. Casing segments will be connected with a simple snap arrangement. Excess casing will be cut off by a cylindrical cutting tool which will also transport the excess casing away from the hole. A footplate will be incorporated to grasp the auger rod string during rod segment additions or removals. The footplate grasping mechanism will consist of a set of vice-like arms, one end of each bearing threaded to a common power screw. The power screw will be threaded such that one end's thread pitch opposes that of the other end. The weight of the auger and rod string will be transmitted through the arms to the power screw and absorbed by a set of three ball bearing assemblies. The power screw will be driven by a one-half horsepower brushless motor actuated by radio control. The footplate will rest on four short legs and be anchored with pins that are an integral part of each leg.

  3. Stapes surgery: a National Survey of British Otologists.

    Science.gov (United States)

    Lancer, Hannah; Manickavasagam, Jaiganesh; Zaman, Azreena; Lancer, Jack

    2016-02-01

    To investigate individual stapes surgery practice in the UK, a retrospective study was conducted by postal questionnaire to all 'assumed' stapes-performing otologists. 225 questionnaires were sent out to practicing otologists in the UK. 184 replies (81.8 %) indicated that 134 (72.9 %) otologists perform stapes surgery [stapedectomy (8.2 %), stapedotomy (91.0 %) or other (0.8 %)]. The '6-10 stapes operation per year' category is the most common, with most using general anaesthetic (GA) (78.3 %). Unilateral surgery is advised in 89.6 %, and 96.3 % perform second-side surgery, with all advising the option of a hearing aid prior to surgery. The majority (88.1 %) would fit the prosthesis after removing the stapes, with the top three prostheses being Causse, Smart and Teflon (as described by respondents). 42.5 % always use a vein graft or fat to cover the fenestration, 9.3 % use a laser and 48.5 % carry out the surgery as a day case. For an overhanging facial nerve (less than 50 % of the footplate obscured), the majority stated that it would depend whether they would abandon surgery. 25.4 % have encountered a 'gusher' and 83.6 % would recommend revision surgery. 82.8 % have a registrar present when carrying out stapes operations, but 69.4 % only offer training to trainees with an otological interest. In the UK, stapedotomy is the preferred technique. Most prefer the Causse prosthesis, general anaesthesia and an inpatient stay. Hearing aids are advised prior to surgery. Day-case and inpatient practice is about equal. 'Gushers' are encountered rarely. Revision surgery is advised if a conductive loss returns. Flying is recommended from 6 weeks. Most otologists are willing to teach trainees with an otological interest. PMID:25711736

  4. Biocompatibility of Nitinol Stapes Prosthesis

    OpenAIRE

    Röösli, C; P. Schmid; Huber, A. M.

    2011-01-01

    OBJECTIVE: Use of the SMart piston, a nitinol-based, self-crimping prosthesis in stapes surgery may allow improved functional results because of better sound transmission properties at the incus-prosthesis interface because of the elimination of manual crimping. Possible disadvantages include thermal damage or strangulation of the incus and its mucoperiosteum or nickel intolerance. The goal of this study was to morphologically assess the fixation of this prosthesis to the incus, investigate t...

  5. Teflon Implants Versus Titanium Implants in Stapes Surgery.

    Science.gov (United States)

    Bansal, Mohan

    2016-03-01

    Otosclerosis is the most common cause of bilateral gradually progressive conductive hearing loss with normal tympanic membrane and Eustachian tube. Otosclerosis surgical treatment is one of the most gratifying operations in Otorhinolaryngology. It is not only the surgical techniques but also the prosthesis which are evolving in the attempt of providing best hearing results. Teflon piston is the most commonly employed prosthesis in stapes surgery. Titanium pistons are relatively the new development in the evolution of stapes prosthesis. The aim of this review article is to know and compare the surgical technicalities and postoperative outcomes including hearing improvement after the use of Teflon and titanium stapes piston. The adverse reactions occurred during follow-up were taken into consideration. The data in this article are supported by a Medline search. The use of both the prosthesis gave good results in cases of otosclerosis. The placement of titanium soft clip design was found easier than the earlier àWengen design of clip piston. PMID:27066403

  6. Bilateral Schwartze Sign, Decision-Making for Surgery

    Directory of Open Access Journals (Sweden)

    Morteza Nourollahian

    2013-10-01

    Full Text Available Otosclerosis is an otic capsule disorder that leads to progressive conductive and/or sensorineural hearing loss due to stapes footplate fixation and cochlear bone involvement. The disorder is bilateral in 70% of patients and it usually starts between the third and fifth decade. One of its characteristic clinical findings is Schwartze sign which refers to a reddish discoloration over the promontory seen beyond the intact tympanic membrane. Schwartze sign, also known as Flemingo's flush sign or Rising sun sign is believed to be associated with otospongiosis which is the active phase of the disease. The prevalence of Schwartze sign is estimated to be 10%. The prevalence of bilateral sign has not been reported, but it is presumed to be too low. Herein, we introduce a patient with bilateral positive Schwartze sign. A twenty two year old woman with bilateral hearing loss came to our clinic. She also complained from non pulsating tinnitus in both ears since one year ago. On physical examination, bilateral schwartze sign with an intact tympanic membrane was noted (Fig.1.  The audiometric evaluation showed a conductive hearing loss with speech reception threshold of 50 dB and 30 dB for the right and left ear respectively. Sodium fluoride 8mg every 8 hours was prescribed for three months. She noticed partial improvement during the treatment and on her otoscopic exam, the Schwartze sign was reduced. Then stapedotomy was scheduled for the right ear (the worse ear in regard to     the hearing & tinnitus. The surgery went uneventful and she proved to be much better afterwards. Her right ear tinnistus has gone completely and the speech reception threshold has changed from 45 dB preoperatively to 10 dB postoperatively. It seems that the surgery remains a therapeutic option, when the active phase of the disease is stabilized even following a short course of pharmacologic therapy.

  7. TEFLON VS TITANIUM PROSTHESES IN STAPES SURGERY

    OpenAIRE

    Rajesh Vishwakarma; Simple Patadia; Pratibha Goswami; Kalpesh Patel; Dipesh Darji

    2014-01-01

    BACKGROUND: Otosclerosis is one of the most leading causes of conductive hearing loss with intact tympanic membrane in adults. Stapes prostheses have seen many changes in its shape, design and material. Both Teflon and Titanium prostheses used in this study having different method of application are reviewed in detail. OBJECTIVE: To compare the outcomes of use of Teflon and Titanium prostheses in stapedotomy surgery in patients with conductive hearing loss. STUDY DESIGN: Prospective ...

  8. Congenital stapes malformation: Rare conductive hearing loss in a patient with Waardenburg syndrome.

    Science.gov (United States)

    Melzer, Jonathan M; Eliason, Michael; Conley, George S

    2016-04-01

    Waardenburg syndrome is a known autosomal dominant cause of congenital hearing loss. It is characterized by a distinctive phenotypic appearance and often involves sensorineural hearing loss. Temporal bone abnormalities and inner ear dysmorphisms have been described in association with the disease. However, middle ear abnormalities as causes of conductive hearing loss are not typically seen in Waardenburg syndrome. We discuss a case of an 8-year-old female who meets diagnostic criteria for Waardenburg syndrome type 3 and who presented with a bilateral conductive hearing loss associated with congenital stapes fixation. We discuss management strategy in this previously unreported phenotype. PMID:26152551

  9. TEFLON VS TITANIUM PROSTHESES IN STAPES SURGERY

    Directory of Open Access Journals (Sweden)

    Rajesh Vishwakarma

    2014-04-01

    Full Text Available BACKGROUND: Otosclerosis is one of the most leading causes of conductive hearing loss with intact tympanic membrane in adults. Stapes prostheses have seen many changes in its shape, design and material. Both Teflon and Titanium prostheses used in this study having different method of application are reviewed in detail. OBJECTIVE: To compare the outcomes of use of Teflon and Titanium prostheses in stapedotomy surgery in patients with conductive hearing loss. STUDY DESIGN: Prospective study SETTING: Tertiary referral centre METHODS: A prospective study of 50 patients of otosclerosis, who underwent stapedotomy at B.J.Medical College, Civil Hospital, Ahmedabad, with Teflon/Titanium prostheses, from June 2009-February 2012 was done. Follow up was done for a minimum period of 6 months. Revision cases were excluded. A comparison of prostheses was concluded by differences in AB (Air Bone Gap. RESULT: Postoperative ABG of 20db or less was seen in 96% in both groups. The mean postoperative ABGap was 8.2 dB and 11.5 dB for Teflon and Titanium group respectively. There was no statistically significance difference noted in ABGap between Teflon and Titanium pistons at 95% confidence limit at P<0.05. There was significant improvement of AC thresholds at each frequency except for above 4 kHz, in postoperative period. CONCLUSION: Both prostheses provide equal benefit to patients and there is no statistically significant difference between the uses of Teflon/Titanium prostheses. Long term results are still to be analyzed.

  10. X-linked deafness with stapes gusher in females

    International Nuclear Information System (INIS)

    A 22-year-old woman presented with severe mixed hearing loss and a flow of cerebrospinal fluid in the middle ear during stapes surgery (stapes gusher). HRCT of the temporal bones showed characteristic abnormalities of the inner ear (bulbous dilatation of the lateral portion of the internal acoustic meatus with incomplete separation from the cochlea, and widening of the first part of the facial nerve canal) described in X-linked progressive mixed deafness with stapes gusher. The evaluation of the patient's family revealed a sister with the same clinical history and identical HRCT findings, and 11 normal male relatives. This is the first report with typical findings of this entity that affects only female members of a family, suggesting another type of inheritance

  11. X-linked deafness with stapes gusher in females

    Energy Technology Data Exchange (ETDEWEB)

    Papadaki, E. [Department of Radiology, Faculty of Medicine, University Hospital of Heraklion, Medical School of Crete, 71110 Stavrakia, Heraklion, Crete (Greece); Prassopoulos, P. [Department of Radiology, Faculty of Medicine, University Hospital of Heraklion, Medical School of Crete, 71110 Stavrakia, Heraklion, Crete (Greece); Bizakis, J. [Department of Otolaryngology, University Hospital of Heraklion, Medical School of Crete, 71110 Stavrakia, Heraklion, Crete (Greece); Karampekios, S. [Department of Radiology, Faculty of Medicine, University Hospital of Heraklion, Medical School of Crete, 71110 Stavrakia, Heraklion, Crete (Greece); Papadakis, H. [Department of Otolaryngology, University Hospital of Heraklion, Medical School of Crete, 71110 Stavrakia, Heraklion, Crete (Greece); Gourtsoyiannis, N. [Department of Radiology, Faculty of Medicine, University Hospital of Heraklion, Medical School of Crete, 71110 Stavrakia, Heraklion, Crete (Greece)

    1998-11-01

    A 22-year-old woman presented with severe mixed hearing loss and a flow of cerebrospinal fluid in the middle ear during stapes surgery (stapes gusher). HRCT of the temporal bones showed characteristic abnormalities of the inner ear (bulbous dilatation of the lateral portion of the internal acoustic meatus with incomplete separation from the cochlea, and widening of the first part of the facial nerve canal) described in X-linked progressive mixed deafness with stapes gusher. The evaluation of the patient's family revealed a sister with the same clinical history and identical HRCT findings, and 11 normal male relatives. This is the first report with typical findings of this entity that affects only female members of a family, suggesting another type of inheritance.

  12. No Evidence of Measles Virus in Stapes Samples from Patients with Otosclerosis

    OpenAIRE

    Grayeli, Alexis Bozorg; Palmer, Pierre; Tran Ba Huy, Patrice; Soudant, Jacques; Sterkers, Olivier; Lebon, Pierre; Ferrary, Evelyne

    2000-01-01

    Otosclerosis is a localized bone dystrophy of unknown etiology mainly involving the stapes. The hypothesis of a persistent infection by the measles virus was based on the inconstant detection of the virus by various methods, including reverse transcription-PCR (RT-PCR) of patients' stapes samples. The aim of this work was to investigate the presence of the measles virus in stapedial otosclerosis foci by different sensitive methods. Pathologic stapes samples were obtained from 35 patients suff...

  13. An experimental study for qualitatively diagnosing stapes lesions by helical 3-dimensional CT

    Energy Technology Data Exchange (ETDEWEB)

    Kawaue, Akifumi; Kuki, Kiyonori; Yamanaka, Noboru [Wakayama Medical Univ., Wakayama (Japan); Nishimura, Michihiko

    2001-08-01

    To evaluate qualitative diagnosis of stapes lesions by 3-dimensional computed tomography (3D-CT) combined with superselective image processing (3D-SS) of stapes, we studied helical 3D-CT on a phantom model of the temporal bone. Two stapes models were used-1 made from the bone filler, Celatite, consistent in bone density but changing in cross sectional area, and the other made from an apacerum rod used in quantitative computed tomography (QCT), consistent in cross sectional area but changing in bone density. These stapes models were put into a skull phantom and analyzed by helical 3D-CT. The influence of the tympanic cavity conditions on CT images of stapes was evaluated by filling the phantom model with Vaseline following 3D selective reconstruction. In all stapes models, lowering the lower CT window width threshold resulted in an enlarged cross-sectional area of the model. The higher the bone density, the lower the increase in cross-sectional area in the image. The stapes model with lower density had greater influence on the imaging by tympanic cavity conditions and was likely to be misdiagnosed as showing higher bone density. Based on the experimental study, 3D-SS by helical 3D-CT appears to be a useful measure for qualitatively diagnosing stapes lesions. (author)

  14. Incus and stapes necrosis associated with diabetes mellitus.

    Science.gov (United States)

    Tüz, M; Doğru, H; Yasan, H; Döner, F; Yariktaş, M

    2006-07-01

    Chronic otitis media is often associated with ossicular defects, the most frequent being necrosis of the long process of incus. Except for infection and cholesteatoma; trauma and local pressure by chorda tympani are uncommon causes leading to incus erosion. In the literature, no case of incus necrosis has been reported associated with type II diabetes mellitus (DM). A patient is presented in this report with incus and stapes suprastructure necrosis and associated type II DM who was admitted to the out-patient clinic with complaints of conductive hearing loss. PMID:16834796

  15. Mesenchymal cells engulf and clear apoptotic footplate cells in macrophageless PU.1 null mouse embryos.

    Science.gov (United States)

    Wood, W; Turmaine, M; Weber, R; Camp, V; Maki, R A; McKercher, S R; Martin, P

    2000-12-01

    Apoptosis is one of the key tools used by an embryo to regulate cell numbers and sculpt body shape. Although massive numbers of cells die during development, they are so rapidly phagocytosed that very few corpses are ever seen in most embryonic tissues. In this paper, we focus on the catastrophic cell death that occurs as the developing footplate is remodelled to transform webbed regions into free interdigital spaces. In the wild-type embryo, these dead cells are rapidly engulfed and cleared by macrophages. We show that in a macrophageless mouse embryo, null for the haemopoetic-lineage-specific transcription factor, PU.1, the task of phagocytosis is taken over by 'stand-in' mesenchymal neighbours in a clear example of cell redundancy. However, it takes three times as many of these mesenchymal phagocytes to complete the task and, at each stage of the clearance process - in the recognition of apoptotic debris, its engulfment and finally its digestion - they appear to be less efficient than macrophages. A molecular explanation for this may be that several of the engulfment genes expressed by macrophages, including the ABC1 transporter (believed to be part of the phagocytic machinery conserved from Caenorhabditis elegans to mouse), are not upregulated by these 'stand-in' phagocytes. PMID:11076747

  16. The Stapes of Gomphodont Cynodonts: Insights into the Middle Ear Structure of Non-Mammaliaform Cynodonts.

    Science.gov (United States)

    Gaetano, Leandro C; Abdala, Fernando

    2015-01-01

    The stapes is known in several non-mammaliaform cynodonts, although it has only been cursorily studied. Here we thoroughly analyze the stapedial anatomy of several basal cynodonts in a phylogenetic framework. Our study shows that the stapedial anatomy is more variable than previously thought. The morphological variation of the stapes led to the recognition of 11 phylogenetic characters that were included in a total evidence data matrix centered in the analysis of gomphodont cynodonts. Stapes morphology does not provide evidence to suggest a direct connection between the stapes and a postquadrate tympanic membrane (if present) and the hypothesis of a dorsal process as the site of attachment of a small ligament or the stapedial muscle is supported. The re-evaluation of the theories concerning the position of the tympanic membrane in non-mammaliaform cynodonts allowed us to conclude that the hypothetical postquadrate tympanic membrane associated with the squamosal sulcus is at best relictual and most likely non-functional (not connected with the stapes). The sound waves were most likely transmitted to the stapes from a postdentary tympanic membrane through the quadrate. Our analysis results in a better understanding of the auditory system in basal cynodonts and its evolution, highlighting the variability of the stapedial anatomy. PMID:26176619

  17. Transverse Fracture of the Stapes Anterior Crus Caused by the Blast Pressure from a Land Mine Explosion

    OpenAIRE

    Hong, Seok Min; Lee, Jun Ho; Park, Chan Hum; Kim, Hyung-Jong

    2014-01-01

    Stapes fractures without other ossicle problems are rare and ossicle problems due to explosion pressure are also rare. We describe a very rare case of stapes anterior crural fracture resulting from a land mine explosion. As this case suggests, a close examination of the ossicles is necessary during an exploration tympanotomy.

  18. Ossiculoplasty with a cartilage-connecting hydroxyapatite prosthesis for tympanosclerotic stapes fixation.

    Science.gov (United States)

    Kawano, Hirokazu; Matsuda, Keiji; Nakanishi, Haruka; Toyama, Katsuhiro; Nagai, Noriaki; Tono, Tetsuya

    2010-06-01

    Many cases of tympanosclerotic stapes fixation are accompanied by fixation or erosion of malleus and/or incus. This status of the ossicular chain is one of the reasons that ossiculoplasty for tympanosclerotic stapes fixation is more difficult than that for otosclerosis. We conducted a retrospective review of seven patients who were operated on for tympanosclerotic stapes fixation between 2002 and 2006. All of the patients had abnormal conditions of the malleus and/or incus and underwent stapedectomy and total ossiculoplasty with hydroxyapatite prosthesis (Apaceram T-7 type), which has a planar-like head portion that contacts a piece of cartilage. Postoperative hearing results were assessed in all seven patients after at least 1 year. The postoperative air-bone gap (ABG) was closed within 10 dB in two of seven patients, and was less than 20 dB in six of seven patients. The mean postoperative ABG was closed within 10 dB at 1 and 2 kHz and less than 20 dB at low frequencies (0.25 and 0.5 Hz). There was almost no hearing improvement at high frequencies (4 and 8 kHz). There were no patients with postoperative sensorineural hearing loss. The present study shows that stapedectomy and total ossiculoplasty with cartilage-connecting hydroxyapatite prosthesis is effective and safe for stapes fixation accompanied by fixation or erosion of the malleus and/or incus. PMID:19902232

  19. Stapes malformations: the contribute of the endoscopy for diagnosis and surgery.

    Science.gov (United States)

    Marchioni, Daniele; Soloperto, Davide; Villari, Domenico; Tatti, Maria Fatima; Colleselli, Elena; Genovese, Elisabetta; Presutti, Livio

    2016-07-01

    The aim of this study is to investigate the contribute of the endoscopic exclusive transcanalar approach for the management of stapes malformations. A retrospective chart review was made at our tertiary referral centers. 17 patients with stapes malformations underwent surgery with endoscopic exclusive transcanal approach. A complete audiological and radiological assessment before and after surgery was performed. 12/17 (70 %) underwent a surgical endoscopic correction, In case of fixed platina underwent five endoscopic stapedotomy and one endoscopic stapedectomy were performed. In case of mobile platina five endoscopic ossiculoplasties with partial ossiculoplasty replacement prosthesis were performed, 3 with autologous remodeling incus and 2 with malleus head remodeling. In 1 case, only an endoscopic stapes mobilization was made. In 5/17 (30 %), due to difficult anatomical findings an endoscopic explorative tympanotomy was finally performed. The mean preoperative air conduction (AC), bone conduction (BC) and air-bone gap (ABG) were, respectively, 60.7, 26.3 and 34.4 dB. The mean postoperative AC, BC and ABG were, respectively, 33.8, 26.5 and 7.3 dB, with a mean improvement of the ABG of 27.1 dB. Discharge from hospital was on the first post-surgery day. No relevant postoperative complications were noted. The median follow-up was 3.6 years (range 1-6). The endoscopic approach results very adequate for the diagnosis and treatment of stapes malformations, checking variations of the ossicles conformation and functioning and performing safe surgery, under direct control of middle ear structures. PMID:26253427

  20. Flat panel CT following stapes prosthesis insertion: an experimental and clinical study

    International Nuclear Information System (INIS)

    Anatomical information of the middle and inner ear is becoming increasingly important in post-operative evaluation especially after stapesplasty with unsuccessful improvement of the air-bone gap (ABG). So far computed tomography (CT) has been the first choice for detection of reasons for recurrent hearing loss. CT has the disadvantage of metal-induced artefacts after insertion of middle ear implants and of a relatively high irradiation dose. Flat panel CT (fpCT) was performed in three temporal bone specimen after experimental insertion of different stapes prostheses, aiming to validate the accuracy of fpCT of the middle and inner ear. Additionally, 28 consecutive patients, supplied with different stapes prostheses underwent post-operative fpCT to compare the pre- and post-operative hearing results with the determined prosthesis position in the middle and inner ear. In all cases, fpCT showed a statistically significant correlation between hearing improvement and prosthesis position. This technique provided detailed post-operative information of the implant position in patients and temporal bone specimen. The new imaging technique of fpCT allows the immediate and almost artefact-free evaluation of surgical results following stapesplasty. Further benefits are a lower irradiation dose and higher isovolumetric resolution compared with standard CT. (orig.)

  1. Flat panel CT following stapes prosthesis insertion: an experimental and clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Zaoui, K. [University-Hospital Heidelberg, Ludwig-Karls-University Heidelberg, Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg (Germany); Kromeier, J. [St.-Josefs-Hospital, RkK, Department of Radiology, Freiburg (Germany); Neudert, M.; Zahnert, T. [University-Hospital Dresden, Technical-University Dresden, Department of Otorhinolaryngology, Head and Neck Surgery, Dresden (Germany); Boedeker, C.C.; Laszig, R.; Offergeld, C. [University-Hospital Freiburg, Albert-Ludwigs-University Freiburg, Department of Otorhinolaryngology, Head and Neck Surgery, Freiburg (Germany)

    2012-04-15

    Anatomical information of the middle and inner ear is becoming increasingly important in post-operative evaluation especially after stapesplasty with unsuccessful improvement of the air-bone gap (ABG). So far computed tomography (CT) has been the first choice for detection of reasons for recurrent hearing loss. CT has the disadvantage of metal-induced artefacts after insertion of middle ear implants and of a relatively high irradiation dose. Flat panel CT (fpCT) was performed in three temporal bone specimen after experimental insertion of different stapes prostheses, aiming to validate the accuracy of fpCT of the middle and inner ear. Additionally, 28 consecutive patients, supplied with different stapes prostheses underwent post-operative fpCT to compare the pre- and post-operative hearing results with the determined prosthesis position in the middle and inner ear. In all cases, fpCT showed a statistically significant correlation between hearing improvement and prosthesis position. This technique provided detailed post-operative information of the implant position in patients and temporal bone specimen. The new imaging technique of fpCT allows the immediate and almost artefact-free evaluation of surgical results following stapesplasty. Further benefits are a lower irradiation dose and higher isovolumetric resolution compared with standard CT. (orig.)

  2. Bilateral dacryoadenitis

    Directory of Open Access Journals (Sweden)

    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.

  3. Ossiculoplasty in Missing Malleus and Stapes Patients : Experimental and Preliminary Clinical Results With a New Malleus Replacement Prosthesis With the Otology-Neurotology Database

    NARCIS (Netherlands)

    Vincent, Robert; Bittermann, Arnold J. N.; Wenzel, Gentiana; Oates, John; Sperling, Neil; Lenarz, Thomas; Grolman, Wilko

    2013-01-01

    Objective: To present the preliminary results of new malleus replacement prosthesis combined with a total ossicular prosthesis in middle ear reconstruction in patients missing the malleus and stapes. Study Design: Prospective experimental and nonrandomized clinical study. Setting: Tertiary referral

  4. Experimental study on heat transmission to the vestibule during CO2 laser use in revision stapes surgery.

    Science.gov (United States)

    Szymański, M; Morshed, K; Mills, R

    2007-01-01

    We studied the transmission of heat to the vestibule during revision stapes surgery with a piston in situ, using a CO2 laser, in an in vitro model. A type K thermocouple was placed around the medial end of stainless steel and fluoroplastic wire pistons in a 'vestibule' filled with saline. The effect of laser hits on fluoroplastic wire and stainless steel stapes prostheses was investigated. The effect of introducing a vein graft to seal the stapedotomy was also examined. Greater temperature rises occurred with stainless steel than with fluoroplastic wire pistons. The addition of the vein graft reduced heat transmission. Application of the CO2 laser to fluoroplastic wire pistons, using the power settings suggested by the manufacturer, is not likely to damage the inner-ear structures. Application of 6 W laser energy to stainless steel pistons can potentially disturb the inner-ear function. PMID:17076928

  5. [Surgery for tympanosclerotic stapes fixation accompanied by malleus fixation at the anterior malleus: report of 2 cases].

    Science.gov (United States)

    Kawano, Hirokazu; Ohhashi, Mitsuru; Nakajima, Munehiro; Tsuboi, Yasuhiro; Komune, Shizuo

    2004-11-01

    Most tympanosclerotic stapes fixation involves fixation or erosion of the malleus and/or incus. This status of the ossicular chain is one reason that ossiculoplasty for tympanosclerotic stapes fixation is more difficult than that for otosclerosis. In some cases, the malleus is fixed only at the anterior, while the incus is intact. In such cases, anterior spinotomy can recover mobilization of the malleus, then a prosthesis can be used for the long process of the incus during ossiculoplasty. We conducted stapedectomy with anterior spinotomy on 3 ears in 2 patients. Over 15 dB of hearing was regained in all 3 ears 6 months after surgery. No significant sensorineural hearing loss was seen in any ear. To adapt this surgical procedure, it is necessary to evaluate preoperative CT findings and the status of the ossicular chain during surgery. PMID:15624507

  6. 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.)

  7. Bilateral anterior shoulder dislocation

    OpenAIRE

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

    2013-01-01

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

  8. 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...

  9. 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.

  10. 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...

  11. Revision stapes surgery for lysis of the long process of the incus: comparing hydroxyapatite bone cement versus malleovestibulopexy and total ossicular replacement prosthesis.

    Science.gov (United States)

    Pitiot, Vincent; Hermann, Ruben; Tringali, Stéphane; Dubreuil, Christian; Truy, Eric

    2016-09-01

    The objective of the study was to report audiological results in revision stapes surgery, comparing hydroxyapatite (HAP) bone cement, malleovestibular (MV) prosthesis, and total ossicular replacement prosthesis (TORP). The study is a retrospective case review conducted in a tertiary referral center. Patients treated for revision stapes surgery from 2010 to 2014, where a lysis of the long process of the incus (LPI) was observed with the use of HAP bone cement, MV prosthesis, or a TORP were included in the study. The main outcomes measured were pre- and postoperative bone conduction (BC) and air conduction (AC) pure-tone averages (PTA) (0.5, 1, 2, 3 kHz), including high frequencies BC (HFBC) (1, 2, 3, 4 kHz) and air-bone gap (ABG). 107 revision stapes surgery were performed in 96 ears. Main cause of failure was LPI lysis in 38 cases (39.6 %). 31 patients were analyzed: HAP bone cement was used in 11 patients (Group I), MV prosthesis in ten patients (Group II), and TORP in ten patients (Group III). The mean post-operative ABG was 10.7 dB (±7.4) (p = 0.003), 10.7 dB (±8.8) (p = 0.001), and 16.9 dB (±9.8) (p = 0.001), respectively. There were no significant differences between groups. In Group I, the mean change in HFBC revealed an improvement of 5.6 dB (±7.9) (p = 0.03), while in Group III there was a significant deterioration of the thresholds of 5.8 dB (±7.6) (p = 0.04). There were no cases of post-operative anacusis. In revision stapes surgery when LPI is eroded, we recommend to perform a cement ossiculoplasty for stabilizing a standard Teflon piston when LPI is still usable, the LPI lengthening with cement being not recommended. When LPI is too eroded, we prefer performing a malleovestibulopexy, and reserve TORP for cases with a bad anatomical presentation. PMID:26690574

  12. 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...

  13. [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

  14. 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

  15. Escleritis posterior bilateral Bilateral posterior scleritis

    Directory of Open Access Journals (Sweden)

    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.

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. 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...

  1. 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.

  2. 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...

  3. 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.

  4. 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...

  5. 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.)

  6. 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.)

  7. 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.

  8. 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.)

  9. 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 ...

  10. 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.

  11. 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

  12. Effects in laser-assisted stapedotomy

    NARCIS (Netherlands)

    Kamalski, D.M.A.

    2014-01-01

    In patients with otosclerosis, the stapes fixates in the oval window, resulting in a conductive hearing loss. A stapedotomy can be performed to restore hearing. During this surgery a small hole is created in the footplate of the stapes, by a micropick instrument or laser. Making a fenestration is no

  13. 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...

  14. 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]....

  15. 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...

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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...

  2. Gait rehabilitation machines based on programmable footplates

    Directory of Open Access Journals (Sweden)

    Bernhardt Rolf

    2007-02-01

    Full Text Available Abstract Background Gait restoration is an integral part of rehabilitation of brain lesioned patients. Modern concepts favour a task-specific repetitive approach, i.e. who wants to regain walking has to walk, while tone-inhibiting and gait preparatory manoeuvres had dominated therapy before. Following the first mobilization out of the bed, the wheelchair-bound patient should have the possibility to practise complex gait cycles as soon as possible. Steps in this direction were treadmill training with partial body weight support and most recently gait machines enabling the repetitive training of even surface gait and even of stair climbing. Results With treadmill training harness-secured and partially relieved wheelchair-mobilised patients could practise up to 1000 steps per session for the first time. Controlled trials in stroke and SCI patients, however, failed to show a superior result when compared to walking exercise on the floor. Most likely explanation was the effort for the therapists, e.g. manually setting the paretic limbs during the swing phase resulting in a too little gait intensity. The next steps were gait machines, either consisting of a powered exoskeleton and a treadmill (Lokomat, AutoAmbulator or an electromechanical solution with the harness secured patient placed on movable foot plates (Gait Trainer GT I. For the latter, a large multi-centre trial with 155 non-ambulatory stroke patients (DEGAS revealed a superior gait ability and competence in basic activities of living in the experimental group. The HapticWalker continued the end effector concept of movable foot plates, now fully programmable and equipped with 6 DOF force sensors. This device for the first time enables training of arbitrary walking situations, hence not only the simulation of floor walking but also for example of stair climbing and perturbations. Conclusion Locomotor therapy is a fascinating new tool in rehabilitation, which is in line with modern principles of motor relearning promoting a task-specific repetitive approach. Sophisticated technical developments and positive randomized controlled trials form the basis of a growing acceptance worldwide to the benefits or our patients.

  3. 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

  4. 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)

  5. 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

  6. 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.

  7. 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 ...

  8. 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 ...

  9. 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...

  10. 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

  11. 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.

  12. 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.

  13. 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)

  14. 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...

  15. 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...

  16. 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

  17. 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.

  18. 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.

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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

  4. 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...

  5. 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...

  6. 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 ...

  7. 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

  8. 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

  9. 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...

  10. 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...

  11. 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

  12. 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.

  13. [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

  14. 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...

  15. 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.

  16. 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.

  17. 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.

  18. 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...

  19. 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...

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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.

  12. 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...

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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”.

  19. 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.

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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

  5. 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...

  6. 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.)

  7. 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...

  8. 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.

  9. 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.

  10. Simulations and Measurements of Human Middle Ear Vibrations Using Multi-Body Systems and Laser-Doppler Vibrometry with the Floating Mass Transducer

    Directory of Open Access Journals (Sweden)

    Tobias Strenger

    2013-10-01

    Full Text Available The transfer characteristic of the human middle ear with an applied middle ear implant (floating mass transducer is examined computationally with a Multi-body System approach and compared with experimental results. For this purpose, the geometry of the middle ear was reconstructed from μ-computer tomography slice data and prepared for a Multi-body System simulation. The transfer function of the floating mass transducer, which is the ratio of the input voltage and the generated force, is derived based on a physical context. The numerical results obtained with the Multi-body System approach are compared with experimental results by Laser Doppler measurements of the stapes footplate velocities of five different specimens. Although slightly differing anatomical structures were used for the calculation and the measurement, a high correspondence with respect to the course of stapes footplate displacement along the frequency was found. Notably, a notch at frequencies just below 1 kHz occurred. Additionally, phase courses of stapes footplate displacements were determined computationally if possible and compared with experimental results. The examinations were undertaken to quantify stapes footplate displacements in the clinical practice of middle ear implants and, also, to develop fitting strategies on a physical basis for hearing impaired patients aided with middle ear implants.

  11. 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

  12. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-09-15

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

  14. 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

  15. 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)

  16. 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

  17. 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...

  18. 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.

  19. 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

  20. 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...

  1. 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...

  2. 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

  3. 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.

  4. 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...

  5. 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.

  6. 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...

  7. Cirurgia do estapédio na residência: experiência do Hospital de Clínicas/UFPR Stapes surgery in residency: the ufpr clinical hospital experience

    Directory of Open Access Journals (Sweden)

    Adriano Ulisses Caldart

    2007-10-01

    Full Text Available A cirurgia do estapédio permanece como tratamento consagrado para a otosclerose. Recentes publicações têm demonstrado que o sucesso cirúrgico nas cirurgias realizadas por médicos residentes tem diminuído e que os resultados audiológicos tem sido piores que os obtidos por cirurgiões experientes. OBJETIVOS: Avaliar a experiência do serviço de otorrinolaringologia do Hospital de Clínicas/UFPR na realização de cirurgias do estapédio no programa de residência médica. MATERIAL E MÉTODO: Estudo retrospectivo de 114 cirurgias do estapédio realizadas nos últimos 9 anos, em 96 pacientes. Os resultados audiométricos foram analisados conforme orientação do Committee on Hearing and Equilibrium e através do Amsterdam Hearing Evaluation Plots, considerando a melhora do gap pós-operatório e de limiares da via aérea. RESULTADOS: Foram incluídos 96 pacientes, na maioria adultos, do sexo feminino (67,7% e caucasianos (93,7%. Em 50,9% dos casos foi realizada estapedectomia, sendo a grande maioria sob anestesia local e sedação (96,5% e utilizando principalmente a prótese de Teflon (37,7%. A taxa de sucesso cirúrgico foi de 50,88%, com 11,4% de complicações. CONCLUSÃO: Os ganhos de audição pós-operatórios considerados como sucesso cirúrgico foram inferiores aos publicados na literatura por cirurgiões experientes.Surgery of the stapedius remains the established treatment for otosclerosis. Recent publications have showed that success in surgeries done by residents have decreased and hearing results are worse than those obtained by experienced otologic surgeons. AIM: To evaluate the experience of the otorhinolaryngology unit, Parana University, relative to stapes surgery done in the residency training program. MATERIAL AND METHOD: A retrospective study of 114 stapes surgeries done in the past 9 years in 96 patients. Audiometric results were analysed according to the Commitee on Hearing and Equilibrium guidelines and the Amsterdam

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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...

  13. 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

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. 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...

  19. 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.)

  20. 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)

  1. 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.

  2. 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

  3. 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...

  4. 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.

  5. 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)

  6. 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

  7. 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.

  8. A review of bilateral training for upper extremity hemiparesis.

    Science.gov (United States)

    Stoykov, Mary Ellen; Corcos, Daniel M

    2009-01-01

    Upper extremity hemiparesis is the most common post-stroke disability. Longitudinal studies have indicated that 30-66% of stroke survivors do not have full arm function 6 months post-stroke. The current gold standard for treatment of mild post-stroke upper limb impairment is constraint-induced therapy but, because of the inclusion criteria, alternative treatments are needed which target more impaired subjects. Bilateral arm training has been investigated as a potential rehabilitation intervention. Bilateral arm training encompasses a number of methods including: (1) bilateral isokinematic training; (2) mirror therapy using bilateral training; (3) device-driven bilateral training; and (4) bilateral motor priming. Neural mechanisms mediating bilateral training are first reviewed. The key bilateral training studies that have demonstrated evidence of efficacy will then be discussed. Finally, conclusions are drawn concerning clinical implications based on the reviewed literature. PMID:19517519

  9. Bilateral spontaneous pneumothorax with pulmonary metastases of synovial sarcoma

    International Nuclear Information System (INIS)

    The association of bilateral spontaneous pneumothorax with pulmonary tumor is uncommon and with pulmonary metastases is rare. The clinical and radiological features of bilateral spontaneous pneumothorax from a synovial sarcoma in a 14 years old boy are described. (author)

  10. Bilateral cerebellar activation in unilaterally challenged essential tremor

    Directory of Open Access Journals (Sweden)

    Marja Broersma

    2016-01-01

    Conclusions: Our results expand on previous findings of bilateral cerebellar involvement in ET. We have identified specific areas in the bilateral somatomotor regions of the cerebellum: lobules V, VI and VIII.

  11. Hardware Implementation of a Bilateral Subtraction Filter

    Science.gov (United States)

    Huertas, Andres; Watson, Robert; Villalpando, Carlos; Goldberg, Steven

    2009-01-01

    A bilateral subtraction filter has been implemented as a hardware module in the form of a field-programmable gate array (FPGA). In general, a bilateral subtraction filter is a key subsystem of a high-quality stereoscopic machine vision system that utilizes images that are large and/or dense. Bilateral subtraction filters have been implemented in software on general-purpose computers, but the processing speeds attainable in this way even on computers containing the fastest processors are insufficient for real-time applications. The present FPGA bilateral subtraction filter is intended to accelerate processing to real-time speed and to be a prototype of a link in a stereoscopic-machine- vision processing chain, now under development, that would process large and/or dense images in real time and would be implemented in an FPGA. In terms that are necessarily oversimplified for the sake of brevity, a bilateral subtraction filter is a smoothing, edge-preserving filter for suppressing low-frequency noise. The filter operation amounts to replacing the value for each pixel with a weighted average of the values of that pixel and the neighboring pixels in a predefined neighborhood or window (e.g., a 9 9 window). The filter weights depend partly on pixel values and partly on the window size. The present FPGA implementation of a bilateral subtraction filter utilizes a 9 9 window. This implementation was designed to take advantage of the ability to do many of the component computations in parallel pipelines to enable processing of image data at the rate at which they are generated. The filter can be considered to be divided into the following parts (see figure): a) An image pixel pipeline with a 9 9- pixel window generator, b) An array of processing elements; c) An adder tree; d) A smoothing-and-delaying unit; and e) A subtraction unit. After each 9 9 window is created, the affected pixel data are fed to the processing elements. Each processing element is fed the pixel value for

  12. Bilateral Thoracic Ganglion Cyst : A Rare Case Report

    OpenAIRE

    Kazanci, Burak; Tehli, Ozkan; Türkoglu, Erhan; Guclu, Bulent

    2013-01-01

    Ganglion cysts usually arise from the tissues around the facet joints. It is usually associated with degenerative cahanges in facet joints. Bilateral thoracic ganglion cysts are very rare and there is no previous case that located in bilateral intervertebral foramen compressing the L1 nerve root associated with severe radiculopathy. We report a 53 years old woman who presented with bilateral groin pain and severe numbness. Magnetic resonance imaging revealed bilateral cystic mass in the inter...

  13. Acute bilateral isolated foot drop: Report of two cases

    OpenAIRE

    Kertmen, H.; Gürer, B.; Yimaz, E. R.; Sekerci, Z.

    2015-01-01

    Foot drop is defined as the weakness of the foot and ankle dorsiflexion. Acute unilateral foot drop is a well-documented entity, whereas bilateral foot drop is rarely documented. Slowly progressing bilateral foot drop may occur with various metabolic causes, parasagittal intracranial pathologies, and cauda equina syndrome. Acute onset of bilateral foot drop due to disc herniation is extremely rare. Here we present two cases of acute bilateral foot drop due to disc herniation. The first patien...

  14. Tratamiento conservador en pacientes con retinoblastoma bilateral

    Directory of Open Access Journals (Sweden)

    Juan C. Suárez

    2008-11-01

    Full Text Available 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 Vicente de Paúl, de Medellín, Colombia, entre 1997 y 2007. MÉTODO: se hizo enucleación del ojo con el tumor de mayor tamaño. En el otro ojo se hizo tratamiento con TTT, con el láser diodo (810 nm, spot amplio, solo o combinado con otras terapias. RESULTADOS: se dividió a los pacientes en dos grupos: 16 pacientes (32 ojos en el grupo 1 tratados conservadoramente y 4 pacientes (8 ojos en el grupo 2 con tratamiento convencional. El rango de edad fue de 1-72 meses en el grupo 1 y de 1-12 meses en el grupo 2. El tiempo de seguimiento fue de 7-67 meses para el grupo 1 y de 13-73 meses para el grupo 2. En el grupo 1 se hizo enucleación de 16 ojos (50%, radioterapia externa de uno (3,1%, quimioterapia más termoterapia de 5 (15,6% y quimioterapia más termoterapia más crioterapia de 10 (31,3%. En todos los pacientes se logró preservar al menos un ojo. En el grupo 2, se enuclearon 7 ojos (87,5% y se hizo radioterapia externa más enucleación en un paciente (12.5%. Además, todos los pacientes recibieron quimioterapia. CONCLUSIÓN: la terapia conservadora actual consistente en tratamiento local (termoterapia, crioterapia o braquiterapia y quimiorreducción permite preservar al menos un ojo y en algunos casos de los dos, muchas veces con buena agudeza visual, en niños con retinoblastoma bilateral; se evitan así la enucleación bilateral y la radioterapia externa usada en el tratamiento convencional con todos sus efectos secundarios. La enucleación contin

  15. Cryptogenic organising pneumonia presenting with bilateral hilar and mediastinal lymphadenopathy

    OpenAIRE

    Kahraman, Hasan; Tokur, Mahmut; Hamide SAYAR; Inci, Mehmet Fatih

    2013-01-01

    Cryptogenic organising pneumonia is not considered in the differential diagnosis of bilateral hilar and mediastinal lymphadenopathy. We submitted a patient presenting with bilateral hilar and mediastinal lymphadenopathy. We suspected diagnosis of sarcoidosis, but the patient was diagnosed as cryptogenic organising pneumonia with the histological result. This is the second case report of cryptogenic organising pneumonia presenting with bilateral hilar and mediastinal lymphadenopathy.

  16. Nocturnal seizure and simultaneous bilateral shoulder fracture-dislocation.

    Science.gov (United States)

    Sahbudin, Ilfita; Filer, Andrew

    2016-01-01

    An otherwise fit and well 27-year-old man presented with acute onset unexplained bilateral shoulder pain, and was found to have bilateral shoulder fractures and dislocations on imaging. Although features were atypical, a nocturnal seizure causing the bilateral shoulder fractures was suspected and EEG showed features compatible with epilepsy. PMID:26838296

  17. HORSE SHOE KIDNEY WITH BILATERAL STAGHORN CALCULUS: A RARE PRESENTATION

    OpenAIRE

    Khalid,; Mahendra; Sangeeta; Vijoy; Ahsan; Vijayanand,

    2014-01-01

    Horseshoe kidney (HSK) is the most common renal anomalies. Bilateral staghorn calculi in HSK are rare and management is challenging. Anatomic consideration is important in choosing treatment modality. We report a case of bilateral staghorn calculus and its management. We report a case of bilateral staghorn calculus due to its rarity and challenge associated with its management.

  18. HORSE SHOE KIDNEY WITH BILATERAL STAGHORN CALCULUS: A RARE PRESENTATION

    Directory of Open Access Journals (Sweden)

    Khalid

    2014-05-01

    Full Text Available Horseshoe kidney (HSK is the most common renal anomalies. Bilateral staghorn calculi in HSK are rare and management is challenging. Anatomic consideration is important in choosing treatment modality. We report a case of bilateral staghorn calculus and its management. We report a case of bilateral staghorn calculus due to its rarity and challenge associated with its management.

  19. Preoperative diagnosis and surgical strategy in congenital auditory ossicular malformation of 26 ears

    International Nuclear Information System (INIS)

    We retrospectively analyzed 26 ears of 21 subjects having auditory ossicular malformation and who had undergone auditory reconstruction between April 2004 and December 2010 at our clinic. We checked preoperative condition, pathological classification, surgical procedure, and hearing improvement. We could predict pathological conditions precisely from preoperative computed tomography (CT), including incudostapedial disconnection (9/12, 75%) and malleus and/or incus fixation (7/12, 58%), which tended to be present in external ear malformation, and stapes footplate fixation (0/12, 0%). We could not, however, predict complex malformation (0/8, 0%). Overall success was 90% (18/20) in the 20 ears observed for at least 1 year. In the 2 ears without improved hearing, the first had congenital cholesteatoma and no stapes superstructure, was treated with type IV tympanoplasty. The second had malleus, incus, and stapes fixation and discontinuity between the incus and stapes, and was treated with type III tympanoplasty and stapes mobilization. Preoperative diagnosis is difficult in mixed congenital auditory ossicular malformation, especially stapes footplate fixation, possibly requiring unexpected procedures, with a poor hearing outcome. Preoperative status must thus be evaluated precisely using hearing, tympanometry, acoustic reflex test, and CT. Temporal bone CT and external ear findings are useful in diagnosing middle-ear malformation. Subjects' informed consent should also be obtained due to the possible need for changing procedure based on findings during surgery. (author)

  20. 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

    OBJECTIVE: The pathogenesis of diabetic papillopathy largely is unknown, but case reports suggest that it may follow rapidly improved metabolic control. The present study was designed to investigate this hypothesis. DESIGN: Retrospective case-control study. PARTICIPANTS: Two thousand sixty......-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...

  1. Simultaneous bilateral patellar tendon rupture without

    Directory of Open Access Journals (Sweden)

    LU Hua-ding

    2012-04-01

    Full Text Available 【Abstract】There is a dearth of case reports de-scribing simultaneous bilateral patellar tendon ruptures in the medical literature. These ruptures are often associated with systemic disorders such as lupus erythematosus or chronic steroid use. The author describes a case of a 24-year-old man who sustained traumatic bilateral patellar ten-don ruptures without any history of systemic disease or steroidal medication. We repaired and reattached the rup-tured tendons to the patella and augmented our procedure with allogeneic tendon followed by wire loop reinforcement. One year after operation, the patient regained a satisfactory range of motion of both knees with good quadriceps strength and no extensor lag. The recurrent microtrauma from a history of intense sports activity and a high body mass index may have played an important role in this trauma event. Key words: Patella; Patellar ligament; Rupture; Ten-don injuries; Knee

  2. Bilateral Nocardia Keratitis after Photorefractive Keratectomy

    Directory of Open Access Journals (Sweden)

    Amir Faramarzi

    2012-01-01

    Full Text Available Purpose: To report the clinical, confocal scan, and histopathologic features of Nocardia keratitis in a patient who developed bilateral infection following photorefractive keratectomy (PRK. Case Report: A 23-year-old woman underwent bilateral PRK for low myopia. On postoperative day 3, dense central stromal infiltrates were noticed in both eyes. Empirical antibiotic therapy was initiated which was converted into specific therapy after a definite diagnosis was made based on clinical features and confirmed by confocal scan and histopathologic findings. Clinical and confocal scan features were consistent with the diagnosis of Nocardia keratitis, and topical 2% amikacin eye drops were started. Because of poor response to medical therapy, lamellar keratectomy was performed in both eyes which shortened the treatment course. Histopathologic examination reconfirmed the initial diagnosis. Conclusion: Familiarity with clinical and confocal scan features facilitates early diagnosis of Nocardia keratitis leading to proper management and hence a rapid therapeutic response.

  3. Bilateral Nocardia Keratitis after Photorefractive Keratectomy

    Science.gov (United States)

    Faramarzi, Amir; Feizi, Sepehr; Javadi, Mohammad-Ali; Rezaei Kanavi, Mozhgan; Yazdizadeh, Forouzan; Moein, Hamid-Reza

    2012-01-01

    Purpose To report the clinical, confocal scan, and histopathologic features of nocardia keratitis in a patient who developed bilateral infection following photorefractive keratectomy (PRK). Case Report A 23-year-old woman underwent bilateral PRK for low myopia. On postoperative day 3, dense central stromal infiltrates were noticed in both eyes. Empirical antibiotic therapy was initiated which was converted into specific therapy after a definite diagnosis was made based on clinical features and confirmed by confocal scan and histopathologic findings. Clinical and confocal scan features were consistent with the diagnosis of Nocardia keratitis, and topical 2% amikacin eye drops were started. Because of poor response to medical therapy, lamellar keratectomy was performed in both eyes which shortened the treatment course. Histopathologic examination reconfirmed the initial diagnosis. Conclusion Familiarity with clinical and confocal scan features facilitates early diagnosis of Nocardia keratitis leading to proper management and hence a rapid therapeutic response. PMID:23275825

  4. Bilateral Pial siderosis and hearing loss

    International Nuclear Information System (INIS)

    Seven adult patients with bilateral progressive hearing loss (six male, one female; aged 40-74 years) were studied with a high-field strength (1.5-T) magnetic resonance (MR) system after previous negative workup with either air contrast or intravenous contrast medium-enhanced computed tomography (CT). In all instances, the patients showed extensive evidence of pial siderosis outlining the posterior fossa subarachnoid space. The siderosis was manifested (on long repetition time images) as an increasing susceptibility effect (hypointensity) with a prolongation of echo time. The results of this study indicate that a negative CT examination is inadequate in patients with bilateral hearing loss and that when evidence of siderosis is found on MR images, an etiology for prior subarachnoid hemorrhage must be pursued

  5. Bilateral breast cancer after cured Hodgkin's disease

    International Nuclear Information System (INIS)

    Three patients developed bilateral breast cancer at 10 to 24 years after mantle irradiation for locally or systemically advanced Hodgkin's disease (HD). Four of the six cancers in the three patients were detected only by mammography. Pathologically, five of the cancers were intraductal carcinomas (four with an invasive component) with one being a lobular carcinoma. Five of the six lesions were Stage I pathologically without evidence of axillary nodal involvement. It is recommended that female patients with Hodgkin's disease who have received mantle irradiation as part of the therapy for their Hodgkin's disease and who are observed for 10 or more years after completion of mantle irradiation be considered at risk for the development of breast cancer. Such patients should be monitored appropriately by routine bilateral mammograms to increase the early detection of early stage lesions

  6. A rare case of bilateral aspergillus endophthalmitis

    Science.gov (United States)

    Gupta, Saurabh; Loudill, Cameron; Tammara, Anita; Chow, Robert T.

    2015-01-01

    Aspergillus endophthalmitis is a devastating inflammatory condition of the intraocular cavities that may result in irreparable loss of vision and rapid destruction of the eye. Almost all cases in the literature have shown an identified source causing aspergillus endophthalmitis as a result of direct extension of disease. We present a rare case of bilateral aspergillus endophthalmitis. A 72-year-old woman with a history of diabetes mellitus, congenital Hirschsprung disease, and recent culture-positive candida pyelonephritis with hydronephrosis status post-surgical stent placement presented with difficulty opening her eyes. She complained of decreased vision (20/200) with pain and redness in both eyes – right worse then left. Examination demonstrated multiple white fungal balls in both retinas consistent with bilateral fungal endophthalmitis. Bilateral vitreous taps for cultures and staining were performed. Patient was given intravitreal injections of amphotericin B, vancomycin, ceftazidime, and started on oral fluconazole. Patient was scheduled for vitrectomy to decrease organism burden and to remove loculated areas of infection that would not respond to systemic antifungal agents. Four weeks after initial presentation, the fungal cultures revealed mold growth consistent with aspergillus. Patient was subsequently started on voriconazole and fluconazole was discontinued due to poor efficacy against aspergillus. Further workup was conducted to evaluate for the source of infection and seeding. Transthoracic cardiogram was unremarkable for any vegetation or valvular abnormalities. MRI of the orbits and sinuses did not reveal any mass lesions or bony destruction. CT of the chest was unremarkable for infection. Aspergillus endophthalmitis may occur because of one of these several mechanisms: hematogenous dissemination, direct inoculation by trauma, and contamination during surgery. Our patient's cause of bilateral endophthalmitis was through an unknown iatrogenic seed

  7. Bilateral Parotid Swelling in Polycystic Ovarian Syndrome.

    Science.gov (United States)

    Yakubov, Yakov; Mandel, Louis

    2016-05-01

    Polycystic ovarian syndrome (PCOS) is recognized by the presence of polycystic ovaries, irregular menstruation, and increased androgen levels. Many patients have insulin resistance or impaired glucose tolerance and an associated development of type 2 diabetes mellitus. A patient with PCOS is presented whose cosmetic concerns centered on the prolonged existence of substantial bilateral parotid swelling. The pathophysiology, diagnosis, and therapy of sialosis are discussed. PMID:26657398

  8. Frequency and causes of bilateral ocular trauma

    International Nuclear Information System (INIS)

    To determine the frequency and causes of bilateral ocular trauma. All patients coming to the hospital with bilateral eye trauma and requiring admission were recruited into the study. The details of patients demographics, risk factors, ocular examination, treatment offered and final visual acuity were noted and described as frequency and percentages. Out of a total of 1551 patients of hospitalized ocular trauma, 46 (2.9%, 92 eyes) had bilateral ocular trauma. The majority (54.3%) were due to landmine blast injuries followed by dynamite blast in 10.8%, coalmine blast and firearm injury in 6.5% each. Pressure cooker explosion and road traffic accident was the cause in 4.3% each. Gas cylinder and automobile battery explosion, alkali and acid burn, assault and incidental trauma occurred in 2.1%. Sixty three percent were between 16 and 40 years of age. Males were affected in 93.4%. Corneal and / or scleral repair was done in 58.6%, conjunctival and or corneal foreign body removal in 26% and extracapular cataract extraction with intraocular lens implantation in 16.3%. The visual acuity was in the range of 6/60 and perception of light in 54.3%, while in 21.7%, there was no perception of light at the time of admission. Due to severity of injury, the final visual acuity was poor and only 28.2% regained vision between 6/18 and 6/60. In this series, landmine, dynamite and coalmine blasts were the major causes of bilateral ocular trauma. Victims were usually young males. Due to severity of ocular trauma, majority had poor visual outcome. (author)

  9. BILATERAL LUXATIO ERECTA, A CASE REPORT

    OpenAIRE

    Acosta, César Augusto Xavier; da Silva Resch, Elemar; Rodrigues, Rafael

    2015-01-01

    Inferior shoulder dislocation (luxactio erecta) is a rare lesion affecting approximately 0.5% of dislocations of this joint. The vast majority of these cases occur unilaterally. In September 2004, a 43 year old man was brought to the emergency room of the University Hospital of Santa Maria (HUSM) complaining of bilateral shoulder pain and inability to lower the arms, as a result of a fall with the arms abducted, while carrying out work activities. After physical examination and radiological e...

  10. Erlotinib-related bilateral anterior uveitis

    OpenAIRE

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

    2011-01-01

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

  11. Bilateral Globus Pallidus Ischemia: Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Hizir Akdemir

    2014-03-01

    Karbonmonoksit zehirlenmesi ile iliskili serebral lezyonlar BT ve MRG ile tespit edilebilir. Karbonmonoksit zehirlenmesi sonrasi serebral korteks, derin beyaz cevher, bazal gangliyonlar ve hipokampal bölgede lezyonlar ortaya çikabilir. Radyolojik bulgularin ortaya çikisi farkli zamanlarda olabilir. Karbonmonoksit zehirlenmelerinde en sik beyaz cevher degisiklikleri görülür. Siklikla derin beyaz cevher ve sentrum semiovale düzeyinde bilateral diffüz radyolojik etkilenim saptanir.

  12. Bilateral Filter Evaluation Based on Exponential Kernels

    OpenAIRE

    Al Ismaeil, Kassem; Aouada, Djamila; Mirbach, Bruno; Ottersten, Björn

    2012-01-01

    The well-known bilateral filter is used to smooth noisy images while keeping their edges. This filter is commonly used with Gaussian kernel functions without real justification. The choice of the kernel functions has a major effect on the filter behavior. We propose to use exponential kernels with L1 distances instead of Gaussian ones. We derive Stein's Unbiased Risk Estimate to find the optimal parameters of the new filter and compare its performance with the conventional one. We show that t...

  13. Marfan Syndrome Presenting with Bilateral Retinal Detachment

    OpenAIRE

    Subrata Chakrabarti; Koushik Pan

    2014-01-01

    Marfan syndrome is an autosomal dominant systemic disorder of the connective tissue. Marfan syndrome affects most organs and tissues, especially the skeleton, lungs, eyes, heart, and the large blood vessels. Eye involvement may be in the form of retinal detachment which is a potentially dangerous manifestation for its sight threatening nature .We report a case where a 17 year old male developed sudden blindness due to spontaneous bilateral retinal detachment. Examination revealed features...

  14. A rare case of bilateral aspergillus endophthalmitis.

    Science.gov (United States)

    Gupta, Saurabh; Loudill, Cameron; Tammara, Anita; Chow, Robert T

    2015-01-01

    Aspergillus endophthalmitis is a devastating inflammatory condition of the intraocular cavities that may result in irreparable loss of vision and rapid destruction of the eye. Almost all cases in the literature have shown an identified source causing aspergillus endophthalmitis as a result of direct extension of disease. We present a rare case of bilateral aspergillus endophthalmitis. A 72-year-old woman with a history of diabetes mellitus, congenital Hirschsprung disease, and recent culture-positive candida pyelonephritis with hydronephrosis status post-surgical stent placement presented with difficulty opening her eyes. She complained of decreased vision (20/200) with pain and redness in both eyes - right worse then left. Examination demonstrated multiple white fungal balls in both retinas consistent with bilateral fungal endophthalmitis. Bilateral vitreous taps for cultures and staining were performed. Patient was given intravitreal injections of amphotericin B, vancomycin, ceftazidime, and started on oral fluconazole. Patient was scheduled for vitrectomy to decrease organism burden and to remove loculated areas of infection that would not respond to systemic antifungal agents. Four weeks after initial presentation, the fungal cultures revealed mold growth consistent with aspergillus. Patient was subsequently started on voriconazole and fluconazole was discontinued due to poor efficacy against aspergillus. Further workup was conducted to evaluate for the source of infection and seeding. Transthoracic cardiogram was unremarkable for any vegetation or valvular abnormalities. MRI of the orbits and sinuses did not reveal any mass lesions or bony destruction. CT of the chest was unremarkable for infection. Aspergillus endophthalmitis may occur because of one of these several mechanisms: hematogenous dissemination, direct inoculation by trauma, and contamination during surgery. Our patient's cause of bilateral endophthalmitis was through an unknown iatrogenic seed

  15. Expectation Damages and Bilateral Cooperative Investments

    OpenAIRE

    Göller, Daniel

    2012-01-01

    We examine the efficiency of the standard breach remedy expectation damages in a setting of bilateral cooperative investment by a buyer and a seller. Contracts may specify a required quality level and an upper bound to the cost of production. We find that it is optimal to write an augmented Cadillac contract that sets one threshold such that it cannot be met with positive probability together with an extreme price. Then, one of the parties becomes a residual claimant of the trade relationship...

  16. Bilateral anterior uveitis secondary to erlotinib

    OpenAIRE

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

    2010-01-01

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

  17. A rare case of bilateral aspergillus endophthalmitis

    Directory of Open Access Journals (Sweden)

    Saurabh Gupta

    2015-12-01

    Full Text Available Aspergillus endophthalmitis is a devastating inflammatory condition of the intraocular cavities that may result in irreparable loss of vision and rapid destruction of the eye. Almost all cases in the literature have shown an identified source causing aspergillus endophthalmitis as a result of direct extension of disease. We present a rare case of bilateral aspergillus endophthalmitis. A 72-year-old woman with a history of diabetes mellitus, congenital Hirschsprung disease, and recent culture-positive candida pyelonephritis with hydronephrosis status post-surgical stent placement presented with difficulty opening her eyes. She complained of decreased vision (20/200 with pain and redness in both eyes – right worse then left. Examination demonstrated multiple white fungal balls in both retinas consistent with bilateral fungal endophthalmitis. Bilateral vitreous taps for cultures and staining were performed. Patient was given intravitreal injections of amphotericin B, vancomycin, ceftazidime, and started on oral fluconazole. Patient was scheduled for vitrectomy to decrease organism burden and to remove loculated areas of infection that would not respond to systemic antifungal agents. Four weeks after initial presentation, the fungal cultures revealed mold growth consistent with aspergillus. Patient was subsequently started on voriconazole and fluconazole was discontinued due to poor efficacy against aspergillus. Further workup was conducted to evaluate for the source of infection and seeding. Transthoracic cardiogram was unremarkable for any vegetation or valvular abnormalities. MRI of the orbits and sinuses did not reveal any mass lesions or bony destruction. CT of the chest was unremarkable for infection. Aspergillus endophthalmitis may occur because of one of these several mechanisms: hematogenous dissemination, direct inoculation by trauma, and contamination during surgery. Our patient's cause of bilateral endophthalmitis was through an

  18. Characteristics of immigrants and bilateral trade

    OpenAIRE

    José Vicente Blanes-Cristóbal

    2008-01-01

    This paper tests the impact of immigration on bilateral trade using Spanish data from 1995 to 2003. It also explores some possible mechanisms behind this link. It uses a gravity equation for trade augmented with an immigrant’s stock variable and a set of control variables. The immigrants variable enters the estimated equation in different ways depending on immigrant relevant characteristics both individual and non individualspecific. Results show that there is a positive link between immigrat...

  19. Methanol intoxication with bilateral basal ganglia infarct

    International Nuclear Information System (INIS)

    Methanol is a toxic agent that affects the central nervous system, especially the optic nerves and basal ganglia. Symmetrical hypodense lesions in the basal ganglia, which can be demonstrated by CT or MRI, is accepted as the most characteristic radiological feature of the disease. A case of a patient with bilateral putaminal hypodense infarcts due tomethanol intoxication is presented. Copyright (2001) Blackwell Science Pty Ltd

  20. Bilateral Ossiculoplasty in 1 Case of Achondroplasia

    OpenAIRE

    Jung, Jongyoon; Yang, Chulwon; Lee, Sunkyu; Choi, June

    2013-01-01

    Achondroplasia is the most common skeletal dysplasia and it combines various complications with normal longevity. Hearing disturbance due to otitis media or an ossicular anomaly is one of the most common complications. Conductive hearing loss is suggested as the most common form of hearing loss. Temporal bone and middle ear structures are distorted in achondroplasia because of rotational change of the skull base. Authors experienced a case of an achondroplastic patient with bilateral hearing ...

  1. Psychosocial Outcomes after Bilateral Hand Transplantation

    OpenAIRE

    Singh, Mansher; Oser, Megan; Zinser, Jennifer; Sisk, Geoffroy; Carty, Matthew J; Sampson, Christian; Pribaz, Julian J.; Pomahac, Bohdan; Talbot, Simon G

    2015-01-01

    Background: Since the first successful hand transplantation in 1998, there have been multiple reports about surgical technique, transplant survival, and immunosuppression. However, very limited published data exist on psychosocial outcomes following hand transplantation. Methods: We report psychosocial outcomes in a patient with bilateral hand transplants at the midforearm level with serial follow-ups over 3.5 years. Different metrics used to study psychosocial outcomes included the following...

  2. Surgical treatment of patients with bilateral cataracts

    Directory of Open Access Journals (Sweden)

    I.E. Ioshin

    2013-02-01

    Full Text Available ABSTRACT The Determination of the tactics for surgical cataract treatment in the fellow eye in patients with bilateral cataracts did not received any unambiguous solution till now and the periods of operation performance are interpreted differently. The authors analyzed the results of treatment in 486 patients with bilateral cataracts. The authors identified a possible favorable interval between first and second operations in case of bilateral cataract, which was based on the clinical, functional and immunological parameters. Phacoemulsifications with peri-operative antibiotic prophylaxis were carried out not later than 4 days after the operation on the first eye, if there were no complications intra-operatively and in post-operative period in the first eye. Recommended time of surgery in the fellow eye in 114 patients of the main group allowed to reveal high functional results (0.7-1.0 in 90.4% in the first eye and in 85.1% of cases in the fellow eye, that promoted the restoration of binocular functions in 98 % of cases after surgery in the shortest possible time. In all patients of the main group the clear vision at different distances were achieved after surgery with bilateral implantation of multifocal IOLs in both eyes in the maximum shortest time. Selected dates of cataract surgery in both eyes taking into account the general and associated ocular pathology allows to reduce the emotional cost, time and organizational problems in preparation for the operation, adding the benefits of quality of early rehabilitation after surgery in both eyes.

  3. Bilateral Pregnancy Luteoma: A Case Report

    OpenAIRE

    Annu Nanda; Uday A. Gokhale; G Rajasekharan Pillai

    2014-01-01

    Pregnancy luteoma is a non-neoplastic lesion of the ovary occurring during pregnancy and is usually discovered incidentally at the time of a cesarean section or during postpartum tubal ligation. An accurate diagnosis is important for the mother and the fetus as it can be confused with ovarian malignancy leading to unnecessary surgery. We report a case of a pregnant female who was discovered to have bilateral enlarged ovaries at the time of emergency cesarean section.

  4. Bilateral exposures and systemic solvency risk

    OpenAIRE

    Gouriéroux, Christian; Héam, Jean-Cyprien; Monfort, Alain

    2012-01-01

    By introducing a structure of the balance sheets of the banks, which takes into account their bilateral exposures in terms of stocks or lendings, we get a structural model for default analysis. This model allows us to distinguish the exogenous and endogenous default dependence. We prove the existence and uniqueness of the liquidation equilibrium, we study the consequences of exogenous shocks on the banking system and we measure contagion phenomena. This approach is illustrated by an applicati...

  5. China-Pakistan Strengthen Bilateral Custom Cooperation

    Institute of Scientific and Technical Information of China (English)

    Guo Yan

    2008-01-01

    @@ Mr.Abdullah Yusuf,Secretary General/Chairman,Central Board Of Revenue of Pakistan,arrived Shenzhen on April 22 to meet with Mr.Sheng Guangzu,the Chinese Minister for Customs Administration for discussing the bilateral customs issues.During his two-day visit,China's Foreign Trade Magazine interviewed to Mr.Abdullah Yusuf in Beijing,he gave the high evaluation on this visit and China's great development in the recent years.

  6. Bilateral femoral head dysplasia and osteochondritis

    International Nuclear Information System (INIS)

    Multiple epiphyseal dysplasia tarda (MEDT) and spondylo-epiphyseal dysplasisa tarda (SEDT) are genetically transmitted conditions affecting the hips, which may resemble bilateral Legg-Perthes disease (LPD). Misdiagnoses are not uncommon, with serious implications for treatment, prognosis and genetic counseling. An epidemiologic study of MEDT and SEDT in a well-defined population of 453 921 persons in Denmark was performed. A population prevalence of 0.7 per 100 000 inhabitants with SEDT and 4.0 per 100 000 inhabitants with MEDT was found. Distinguishing features between MEDT, SEDT and bilateral LPD based on radiologic findings in the hips, other joints, and spine were ascertained. Bilateral LPD is always asymmetric, exhibits patches of increased density in the epiphyses and often metaphyseal cyst-like changes. No spinal lesion or affection of other joints is present, and the acetabula are normal. In MEDT and SEDT the capital femoral epiphyses are symmetrically flattened, fragmented and uniformly slightly sclerotic. Generalised platyspondyly is a constant finding in SEDT. (orig.)

  7. Multilateral, regional and bilateral energy trade governance

    Energy Technology Data Exchange (ETDEWEB)

    Leal-Arcas, Rafael; Grasso, Costantino; Rios, Juan Alemany (Queen Mary Univ. of London (United Kingdom))

    2014-12-01

    The current international energy trade governance system is fragmented and multi-layered. Streamlining it for greater legal cohesiveness and international political and economic cooperation would promote global energy security. The current article explores three levels of energy trade governance: multilateral, regional and bilateral. Most energy-rich countries are part of the multilateral trading system, which is institutionalized by the World Trade Organization (WTO). The article analyzes the multilateral energy trade governance system by focusing on the WTO and energy transportation issues. Regionally, the article focuses on five major regional agreements and their energy-related aspects and examines the various causes that explain the proliferation of regional trade agreements, their compatibility with WTO law, and then provides several examples of regional energy trade governance throughout the world. When it comes to bilateral energy trade governance, this article only addresses the European Union’s (EU) bilateral energy trade relations. The article explores ways in which gaps could be filled and overlaps eliminated whilst remaining true to the high-level normative framework, concentrating on those measures that would enhance EU energy security.

  8. Medical Image Denoising Using Bilateral Filter

    Directory of Open Access Journals (Sweden)

    Devanand Bhonsle

    2012-07-01

    Full Text Available Medical image processing is used for the diagnosis of diseases by the physicians or radiologists. Noise is introduced to the medical images due to various factors in medical imaging. Noise corrupts the medical images and the quality of the images degrades. This degradation includes suppression of edges, structural details, blurring boundaries etc. To diagnose diseases edge and details preservation are very important. Medical image denoising can help the physicians to diagnose the diseases. Medical images include MRI, CT scan, x-ray images, ultrasound images etc. In this paper we implemented bilateral filtering for medical image denoising. Its formulation & implementation are easy but the performance of bilateral filter depends upon its parameter. Therefore for obtaining the optimum result parameter must be estimated. We have applied bilateral filtering on medical images which are corrupted by additive white Gaussian noise with different values of variances. It is a nonlinear and local technique that preserves the features while smoothing the images. It removes the additive white Gaussian noise effectively but its performance is poor in removing salt and pepper noise.

  9. 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

  10. High Performance, Three-Dimensional Bilateral Filtering

    Energy Technology Data Exchange (ETDEWEB)

    Bethel, E. Wes

    2008-06-05

    Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

  11. Bilateral femoral neck fractures following pelvic irradiation

    International Nuclear Information System (INIS)

    Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was found out, but thickness of the internal membrane and thrombogenesis were not recognized. Treatment should be performed according to degree of displacement of fractures. In this case, artificial joint replacement surgery was performed to the side of fracture of this time, because this case was bilateral femoral neck fractures and the patient had received artificial head replacement surgery in the other side of fracture formerly. (Tsunoda, M.)

  12. Bilateral spontaneous rupture of 'hale' kidneys

    International Nuclear Information System (INIS)

    A rare case of spontaneous bilateral rupture of the kidneys, occurring consecutively over a one-year period in a young male patient with 'hale' kidneys until then, is described. The patient's past history and thorough examination performed do not justify to assign the case under the heading of some of the etiological factors as the underlying cause of spontaneous kidney rupture. The literature survey on spontaneous bilateral non-tumor ruptures of kidneys shows that over a 20-year period, only 3 cases of bilateral spontaneous ruptures have been reported. It is pointed out that panarteritis nodosa followed by hemorrhagic fever with renal syndrome is the commonest underlying cause of such ruptures. Clinically spontaneous ruptures become manifest with emergency condition presenting severe renal colic, impaired to serious general condition, often with acute abdomen and hemodynamic breakdown, and no past history evidence of renal disease or injury. In the initial phase diagnosing is not always easy; it is usually made on the ground of physical examination and the full range of imaging studies used in urological practice and during operative treatment. Emphasis is laid on the fact that the imaging methods are not invariably sufficient to identify the exact etiological factor giving rise to such a severe condition, but nevertheless these methods have an essential practical bearing on diagnosing a rupture. (authors)

  13. 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.

  14. High Performance, Three-Dimensional Bilateral Filtering

    International Nuclear Information System (INIS)

    Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

  15. A case misdiagnosed as bilateral abducens palsy

    International Nuclear Information System (INIS)

    A 66-year-old male was admitted to our neurosurgical floor because of double vision and gait disturbance. Neurological examinations revealed bilateral 6th nerve palsy with both eyes pointing toward the midline. Initially, using a tentative diagnosis of intracranial mass lesions, especially localized at the base of the skull, computerized tomography of the head, cerebral angiography, orbital venography, and metrizamide CT cisternography were performed; the findings were normal. An orbital CT scan showed an enlargement of the bilateral medial rectus muscles, and the thyroid functions of T3 and T4 and the T3 uptake were all elevated, which was compatible with the diagnosis of Graves' disease. The limitations of both eyeballs were considered to be due not to the 6th nerve palsy, but to the hypertrophy of the bilateral medial rectus muscles. We neurosurgeons should recall Graves' disease as well as intracranial lesions, cerebrovascular disease, and post-traumatic sequelae when examining a patient who presents limitations of external ocular movement. (author)

  16. Resultados da cirurgia para otospongiose com dois tipos de prótese em procedimentos realizados por residentes Results of stapes surgery for otosclerosis with two kinds of prothesis in residency training

    Directory of Open Access Journals (Sweden)

    Celso Dall'Igna

    2008-12-01

    Full Text Available A cirurgia do estapédio é um dos tratamentos indicados para a melhora da surdez condutiva secundária à otospongiose. O procedimento requer habilidade e experiência do cirurgião e faz parte do treinamento durante a residência médica. OBJETIVOS: Avaliar qual tipo de prótese (teflon ou mista de metal e aço apresenta melhores os resultados auditivos em cirurgias realizadas por residentes e a incidência de complicações. MATERIAL E MÉTODOS: Foram avaliadas retrospectivamente 189 intervenções cirúrgicas que tiveram participação ativa de residentes, comparando-se os dois tipos de prótese utilizados. Os resultados audiométricos foram analisados conforme orientação do Committee on Hearing and Equilibrium e segundo o Amsterdam Hearing Evaluation Plots. RESULTADOS: O gap aéreo-ósseo diminuiu em média 21,90 dB (pStapes surgery is one of the approaches indicated to treat conductive hearing loss secondary to otosclerosis. The procedures requires skill and experience from the surgeon and is part of medical residency training. AIMS: To assess which type of prosthesis (Teflon or metal/steel presents the best results in surgeries performed by residents and the incidence of complications. MATERIALS AND METHODS: we retrospectively assessed 189 interventions that counted on the active participation of resident physicians, and we compared the two types of prosthesis used. Audiometric results were analyzed following the guidelines from the Committee on Hearing and Equilibrium and also according to the Amsterdam Hearing Evaluation Plots. RESULTS: Bone-air gap reduced in an average value of 21.90 dB (p<0.05 after the surgery in the group that received the Teflon prosthesis and 21.37 dB (p<0.05 in the group that received the mixed prosthesis, and gain in SRI was of 22.33 and 26.10 dB (p<0.05, and the air-bone gap was below 20 dB in 80.6% and 85.04%, respectively. CONCLUSIONS: We did not see differences in the audiometry and in the incidence of

  17. FEATURES OF BILATERAL BREAST CANCER NODAL METASTASIS

    Directory of Open Access Journals (Sweden)

    Ye. A. Fesik

    2014-01-01

    Full Text Available This article focuses on issues related to the identification and investigation of the lymph node metastases with bilateral breast cancer. The presence of metastases in the lymph nodes determines the stage of the disease, and introducing a form of tumor progression, characterizes the course and prognosis for the future in a specific patient. Thus, the identification of possible morphological and immunohistochemical characteristics of the tumor tissue and their comparison with the frequency and severity of regional lymph nodes would help to solve the problem of the identification of prognostic factors and markers associated with the risk of nodal metastasis in bilateral breast cancer. This work is relevant due to the fact that the literature on this issue to date are treated ambiguously, and answers to many questions, unfortunately, no.The authors performed a morphological study of the tumor tissue from 600 patients suffering from unilateral and bilateral breast cancer. To avoid false results were studied only cases corresponding to the histological type of invasive carcinoma of non-specific type. The study found that a greater number and a greater percentage of the affected lymph node metastases were observed in patients with bilaterally synchronous tumors. The patients of this group of metastatic lymph nodes was detected more frequently in the presence of infiltrative component of three or more types of structures with the presence of these discrete groups of tumor cells, and the observed maximum degree of inflammatory infiltration of the tumor stroma. In the group of patients with unilateral breast cancer nodal metastasis often detects when triple negative molecular genetic type of the lesion, with large amounts of tumor site, in the presence of infiltrative component of three or more types of structures with the obligatory presence of these microalveolar structures and discretely spaced groups of tumor cells and the highest severity of

  18. Iatrogenic “buffalo chest” bilateral pneumothoraces following unilateral transbronchial lung biopsies in a bilateral lung transplant recipient

    Directory of Open Access Journals (Sweden)

    Leith Sawalha

    2015-01-01

    Full Text Available We present a 54 year old male patient who had a bilateral lung transplant sixteen years ago for Alpha-1 Antitrypsin Deficiency-related emphysema. He was referred for flexible bronchoscopy with transbronchial biopsies to evaluate new mild exertional dyspnea and worsening of his FEV1. Eight transbronchial biopsies were done from the right middle lobe and the right lower lobe. Post procedure he developed bilateral pneumothoces that required emergent bilateral pleural ‘pigtail’ catheters. To our knowledge, this is the first reported case of bilateral pneumothoraces that developed after a unilateral procedure in a bilateral lung transplant recipient relatively late after the transplant.

  19. Ceratite bilateral por Acanthamoeba: relato de caso Bilateral Acanthamoeba keratitis: case report

    Directory of Open Access Journals (Sweden)

    Wilson Nahmatallah Obeid

    2003-12-01

    Full Text Available A ceratite por Acanthamoeba é uma infecção ocular grave que, apesar dos recentes progressos no diagnóstico e tratamento, ainda provoca prolongada morbidade e perda da acuidade visual. Relatamos um caso de ceratite bilateral por Acanthamoeba em usuário de lentes de contato, que é o primeiro caso descrito na literatura brasileira.Acanthamoeba keratitis is a severe ocular infection which even with recent progress in diagnosis and treatment still causes long morbidity and loss of visual acuity. We describe a case of bilateral Acanthamoeba keratitis in a user of contact lenses, which is the first case discussed in Brazilian literature.

  20. 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.

  1. Primary Amenorrhea with Bilateral Endometriotic Cysts

    International Nuclear Information System (INIS)

    Primary amenorrhea is a common problem. Diagnosis is usually by going through systematic approach of history, examination and investigations. This case had bilateral large endometriotic cysts in the adnexal region. Uterus was normal sized with well-formed endometrium. She underwent laparotomy followed by drainage of endometriotic cysts, stripping and reconstruction of ovaries was performed. Patient was given a trial of combined oral contraceptive pills for two consecutive cycles to observe withdrawal bleeding, but it failed. Till now we are unable to find out such case in literature. Exact case of primary amenorrhea could not be found. (author)

  2. Bilateral lipoma arborescens of the subdeltoid bursa

    International Nuclear Information System (INIS)

    Lipoma arborescens is a rare cause of chronic monoarticular arthritis. It is most commonly seen in the knees, but only a few cases involving other joints, especially the subdeltoid bursa, have been described. To our knowledge, this is the first reported case of lipoma arborescens involving bilateral subdeltoid bursae. Although it is associated with joint effusion, synovial cysts and erosions, the presence of reactive bone formation has not been reported. Magnetic resonance imaging is a very effective method for the diagnosis of this rare condition because of its ability to do tissue characterization

  3. Bilateral pulmonary sequestration: a case report

    International Nuclear Information System (INIS)

    A 21-year-old woman presented with productive cough and hemoptysis. Chest radiograph shows a large thin-walled cystic lesion with an air-fluid level in medial portion of the left lower lung zone and opacity in paravertebral area of the right lower lung zone. Chest CT scan shows a thin-walled cavitary lesion in the posterior basal segment of left lower lobe with an air-fluid level. Area of consolidation containing air-filled cysts was also observed in medial aspect of right lower lobe. Selective angiogram obtained from aberrant artery arising from descending abdominal aorta showed two main branches of the artery supplying bilateral pulmonary lesions

  4. Familial extensive idiopathic bilateral pleural fibrosis.

    Science.gov (United States)

    Azoulay, E; Paugam, B; Heymann, M F; Kambouchner, M; Haloun, A; Valeyre, D; Battesti, J P; Tazi, A

    1999-10-01

    The authors report three sisters with bilateral isolated apical pleural fibrosis of unknown origin, which did not respond to empirical antituberculosis therapy and oral corticosteroids. The disease evolved in an unrelenting fashion producing pleural fibrosis at the lung bases and leading to the death of two sisters and to lung transplantation in the other one. There was no history of other familial disease or consanguinity. The particular features of these cases and the differences from other reports of apparently cryptogenic pleural fibrosis are outlined. PMID:10573252

  5. Bilateral Supernumerary Breast. A Case Report

    Directory of Open Access Journals (Sweden)

    Martha Yudey Rodríguez Pino

    2014-04-01

    Full Text Available Incidence of polymastia in the general population ranges from 0.4 to 6%. Accessory breasts are often considered a purely cosmetic problem; however various benign and malignant alterations may occur in these structures, as in any other breast tissue. A case of a patient who developed a painless mass in both axillary regions during pregnancy is presented. Her family physician interpreted it as lymphadenopathy. During the immediate puerperium, a greater enlargement in the axillary regions and pain, evident on physical examination, were found. Hence, a mammography and ultrasound were performed. Bilateral supernumerary breast and duct ectasia of the left breast were diagnosed.

  6. Bilateral Kimura's disease of the eyelids.

    OpenAIRE

    Kennedy, S.M.; Pitts, J F; Lee, W. R.; Gibbons, D C

    1992-01-01

    A case of Kimura's disease affecting the eyelids bilaterally is reported in a 5-year-old boy of Afro-Caribbean extraction who has been followed for 12 years with repeat biopsies. He initially presented at 5 years of age with swelling of the left upper eyelid, left cervical lymphadenopathy, and eosinophilia. One year later he developed swelling of the right upper eyelid. There has been no change in the clinical appearance over the next 12 years. Repeated biopsies of the eyelids showed a diffus...

  7. Bilateral internuclear ophthalmoplegia following mild head injury.

    Science.gov (United States)

    Muthukumar, N; Veerarajkumar, N; Madeswaran, K

    2001-05-01

    A 7-year-old child presented with bilateral internuclear ophthalmoplegia (INO) following a trivial head injury. CT was normal. MRI revealed a pontine lesion. Two months after the injury the patient was neurologically normal. INO following head injury is rare. Rarer still is INO following mild head injury. To date, only four cases of INO had been reported following mild head injury; the present case is the fifth and the first in which the lesion was documented using MRI. The relevant literature is reviewed. PMID:11417420

  8. Bilateral akillesseneruptur efter behandling med ciprofloxacin

    DEFF Research Database (Denmark)

    Attarzadeh, Amir Pasha; Ryge, Camilla

    2013-01-01

    We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment with...... ciprofloxacin 500 mg twice daily and long-term treatment with prednisolon 10 mg once daily. This rare side effect caused by concurrent treatment with steroids and ciprofloxacin should be kept in mind. Any signs of tendinitis following this treatment should arouse the physicians' suspicion towards ciprofloxacin....

  9. Bilateral sequential Propionibacterium acnes exogenous endophthalmitis.

    Science.gov (United States)

    Saffra, Norman; Moriarty, Emily; Milman, Tatyana

    2016-12-01

    A 68-year-old man underwent uncomplicated sequential cataract extractions performed more than a year apart. He presented 6 months after the second surgery with persistent intraocular inflammation in both eyes. Cultures from both eyes grew Propionibacterium acnes and he responded well to treatment. Suspicion for delayed-onset post-operative endophthalmitis must remain high in uveitis cases that fail to resolve with anti-inflammatory treatments. The authors believe this is the first reported case of bilateral sequential P. acnes exogenous endophthalmitis. PMID:27220771

  10. A case of bilateral aldosterone-producing adenomas differentiated by segmental adrenal venous sampling for bilateral adrenal sparing surgery.

    Science.gov (United States)

    Morimoto, R; Satani, N; Iwakura, Y; Ono, Y; Kudo, M; Nezu, M; Omata, K; Tezuka, Y; Seiji, K; Ota, H; Kawasaki, Y; Ishidoya, S; Nakamura, Y; Arai, Y; Takase, K; Sasano, H; Ito, S; Satoh, F

    2016-06-01

    Primary aldosteronism due to unilateral aldosterone-producing adenoma (APA) is a surgically curable form of hypertension. Bilateral APA can also be surgically curable in theory but few successful cases can be found in the literature. It has been reported that even using successful adrenal venous sampling (AVS) via bilateral adrenal central veins, it is extremely difficult to differentiate bilateral APA from bilateral idiopathic hyperaldosteronism (IHA) harbouring computed tomography (CT)-detectable bilateral adrenocortical nodules. We report a case of bilateral APA diagnosed by segmental AVS (S-AVS) and blood sampling via intra-adrenal first-degree tributary veins to localize the sites of intra-adrenal hormone production. A 36-year-old man with marked long-standing hypertension was referred to us with a clinical diagnosis of bilateral APA. He had typical clinical and laboratory profiles of marked hypertension, hypokalaemia, elevated plasma aldosterone concentration (PAC) of 45.1 ng dl(-1) and aldosterone renin activity ratio of 90.2 (ng dl(-1) per ng ml(-1 )h(-1)), which was still high after 50 mg-captopril loading. CT revealed bilateral adrenocortical tumours of 10 and 12 mm in diameter on the right and left sides, respectively. S-AVS confirmed excess aldosterone secretion from a tumour segment vein and suppressed secretion from a non-tumour segment vein bilaterally, leading to the diagnosis of bilateral APA. The patient underwent simultaneous bilateral sparing adrenalectomy. Histopathological analysis of the resected adrenals together with decreased blood pressure and PAC of 5.2 ng dl(-1) confirmed the removal of bilateral APA. S-AVS was reliable to differentiate bilateral APA from IHA by direct evaluation of intra-adrenal hormone production. PMID:26538381

  11. Bilateral based robust load frequency control

    International Nuclear Information System (INIS)

    Load frequency control (Lc) has been one of the major subjects in electric power system design/operation and is becoming much more significant today in accordance with increasing size and the changing structure and complexity of interconnected power systems. In practice, power systems use simple proportional-integral (PI) controllers for frequency regulation and load tracking. However, since the PI controller parameters are usually tuned based on classical or trial and error approaches, they are incapable of obtaining good dynamical performance for a wide range of operating conditions and various load changes scenarios in a restructured power system. This paper addresses a new decentralized robust Lc design in a deregulated power system under a bilateral based policy scheme. In each control area, the effect of bilateral contracts is taken into account as a set of new input signals in a modified traditional dynamical model. The Lc problem is formulated as a multi-objective control problem via a mixed H2/H∞ control technique. In order to design a robust PI controller, the control problem is reduced to a static output feedback control synthesis, and then, it is solved using a developed iterative linear matrix inequalities algorithm to get a robust performance index close to a specified optimal one. The proposed method is applied to a 3 control area power system with possible contract scenarios and a wide range of load changes. The results of the proposed multi-objective PI controllers are compared with H2/H∞ dynamic controllers

  12. Bilateral high division of sciatic nerve

    Directory of Open Access Journals (Sweden)

    K. Shwetha

    2014-08-01

    Full Text Available Sciatic nerve is the thickest nerve in the body formed by the sacral plexus from L4 to S3 in the lesser pelvis. It emerges through the greater sciatic foramen below the piriformis and enter the gluteal region. Then the nerve passes on the back of the thigh and at the level of superior angle of popliteal fossa it terminates by dividing into tibial and common peroneal nerve. The knowledge of anatomical variations in the division of nerve is important for various surgical and anaesthetic procedures. During routine dissection in the department of anatomy, Mysore Medical College and Research Institute, Mysore, a rare bilateral high division of sciatic nerve was observed in a female cadaver aged about 40 years. In the present case there was bilateral high division of sciatic nerve. The nerve was seen dividing into two branches before it emerges through the greater sciatic foramen. The tibial nerve was entering the gluteal region below the piriformis muscle and common peroneal nerve was entering by piercing the piriformis. The knowledge of this variation is important as the nerve may get compressed with surrounding anatomical structures resulting in non discogenic sciatica. The awareness of variations is important for surgeons during various procedures like fracture, posterior dislocation of hip joint and hip joint replacement. The anatomical variations are important during deep intramuscular injections in gluteal region and also for anaesthetists during sciatic nerve block. [Int J Res Med Sci 2014; 2(4.000: 1785-1787

  13. 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.

  14. Unusual Bilateral Rim Fracture in Femoroacetabular Impingement

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    Claudio Rafols

    2015-01-01

    Full Text Available This is a report of one case of bilateral acetabular rim fracture in association with femoroacetabular impingement (FAI, which was treated with a hip arthroscopic procedure, performing a partial resection, a labral reinsertion, and a subsequential internal fixation with cannulated screws. Up to date, there are in the literature only two reports of rim fracture and “os acetabuli” in association with FAI. In the case we present, the pincer and cam resection were performed without complications; the technique used was published previously. With this technique the head of the screw lays hidden by the reattached labrum. We removed partially the fractured rim fragment and the internal fixation of the remaining portion was achieved with a screw. In the event of a complete resection of the fragment, it would have ended with a LCE angle of 18° and a high probability of hip instability. We believe that this bilateral case helps establish the efficacy and reproducibility of the technique described by Larson.

  15. Bilateral tension pneumothorax following equipment improvisation.

    Science.gov (United States)

    Zambricki, Christine; Schmidt, Carol; Vos, Karen

    2014-02-01

    This case report describes an unexpected event that took place as a result of using improvised equipment. The patient, a 16-year-old female undergoing complex oral surgery, suffered bilateral pneumothorax following the improper use of an airway support device. During the immediate postoperative period with the patient still intubated, oxygen tubing was attached to a right angle elbow connector with the port closed and 10 L/minute oxygen flow was administered to the patient in a manner that did not allow the patient to exhale. Within seconds, pneumothorax was apparent as the patient's vital signs deteriorated, visible swelling was noted in the shoulders and neck, and there was an absence of breath sounds on auscultation. This case study has application beyond the immediate discussion of bilateral pneumothorax, serving as a caution about the unintended consequences of equipment improvisation. In addition to highlighting the hazards of providing patient care with a non-standard device, this study also provides a powerful example of the human factors that can contribute to medical errors in the healthcare setting. PMID:24654348

  16. Bilateral acute retinal necrosis after herpetic meningitis

    Directory of Open Access Journals (Sweden)

    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  17. Bilateral Single-Session Retrograde Intrarenal Surgery for the Treatment of Bilateral Renal Stones

    Directory of Open Access Journals (Sweden)

    Gokhan Atis

    2013-06-01

    Full Text Available Purpose The aim of the study was to evaluate the efficacy and safety of bilateral single-session retrograde intrarenal surgery in the treatment of bilateral renal stones. Materials and Methods From December 2008 to February 2012, 42 patients who had undergone bilateral single-session retrograde intrarenal surgery (RIRS and laser lithotripsy were included in the study. The procedures were performed in the lithotomy position on an endoscopy table under general anesthesia, beginning on the side in which the stone size was smaller. Plain abdominal radiography, intravenous urograms (IVU, renal ultrasonography (USG and / or non-contrast tomography (CT scans were conducted for all patients. The success rate was defined as patients who were stone-free or only had residual fragment less than 4 mm. Results A total of 42 patients (28 male, 14 female with a mean age 39.2 ± 14.2 were included in the present study. The mean stone size was 24.09 ± 6.37 mm with a mean operative time of 51.08 ± 15.22 minutes. The stone-free rates (SFR were 92.8% and 97.6% after the first and second procedures, respectively. The average hospital stay was 1.37 ± 0.72 days. In two patients (4.7%, minor complications (Clavien I or II were observed, whereas no major complications (Clavien III-V or blood transfusions were noted in the studied group. Conclusions Bilateral single-session RIRS and laser lithotripsy can be performed safely and effectively with a high success rate and low complication rate in patients with bilateral renal stones.

  18. Simultaneous bilateral spontaneous pneumothorax with congenital pleuro-pleural communication

    OpenAIRE

    HATA, YOSHINOBU; Suzuki, Takashi; Yokoi, Masahide; Yoshida, Shuji; Takeyama, Teruaki; Nakazaki, Haruhiro; Goto, Hidenori; Sato, Fumitomo; Takagi, Keigo; Otsuka, Hajime

    2013-01-01

    A single pleural space can lead to serious simultaneous bilateral pneumothorax in cases of congenital or acquired pleuro-pleural communication. Here we report a 35-year-old man with bilateral pneumothorax. Chest computed tomography scans revealed a small air space between the esophagus and aorta, suggesting pleuro-pleural communication. Bilateral thoracoscopic bullectomy was performed. Repeated inspection revealed a 2-cm-long pleural window between the aorta and esophagus, which was closed wi...

  19. Bilateral Foot Pain in a Collegiate Distance Runner

    OpenAIRE

    Denegar, Craig R.; Siple, Bonnie J.

    1996-01-01

    A 19-year-old, white female, college freshman cross-country runner presented to the athletic training center complaining of bilateral plantar foot pain 1 week into the cross-country season. She had been treated for bilateral plantar fasciitis twice in the previous 3 years, and initial evaluation suggested a recurrence. A failure to respond to treatment led us to suspect other causes. Subsequent diagnostic imaging (bone scan, CT scan) revealed bilateral navicular stress fractures. Navicular st...

  20. Bilateral leukocoria in a patient with homozygous protein C deficiency

    International Nuclear Information System (INIS)

    We describe a bilateral leukocoria and neonatal purpura fulminans in a male infant, born at full term after an unremarkable pregnancy to a healthy consanguineous married couple. Multiple hemorrhagic skin bullae were found at birth on various parts of the body with bilateral leukocoria, organized vitreous hemorrhage, retinal detachment, and intracranial hemorrhage with undetectable levels of protein C activity. We report a clinical case of homozygous protein-C deficiency with severe purpura fulminans and bilateral leukocoria. (author)

  1. Bilateral fat necrosis of the breast: report of a case.

    OpenAIRE

    Sonobe,Hiroshi; SATO, Yasuo; Suzuki,Yoshihide; Hayashi, Kazuhiko; Kawabata, Kenji

    1980-01-01

    A rare case of bilateral fat necrosis of the breast is reported. The patient was a 50-year-old unmarried woman having no history of trauma, disease or surgery of the breast. In the bilateral breasts, ill-defined, firm masses with skin retraction were noted. Bilateral breast cancer was diagnosed clinically. However, both lesions showed histologically chronic granulomatous inflammation with foci of fatty necrosis, infiltration of lymphocytes, plasma cells, lipid containing foamy cells, foreign ...

  2. Unilateral versus Bilateral Instrumentation in Spinal Surgery: A Systematic Review

    OpenAIRE

    Molinari, Robert W.; Saleh, Ahmed; Molinari, Robert; Hermsmeyer, Jeff; Dettori, Joseph R.

    2015-01-01

    Study Design Systematic review. Clinical Questions (1) What is the comparative efficacy of unilateral instrumentation compared with bilateral instrumentation in spine surgery? (2) What is the safety of unilateral instrumentation compared with bilateral instrumentation in spine surgery? Methods Electronic databases and reference lists of key articles were searched up to September 30, 2014, to identify studies reporting the comparative efficacy and safety of unilateral versus bilateral instrume...

  3. Successful Reconstruction of Asymptomatic Bilateral External Carotid Artery Aneurysms.

    Science.gov (United States)

    Loja, Melissa N; Pevec, William C

    2016-04-01

    True aneurysms of the external carotid artery (ECA) are extremely rare with an unknown incidence and natural history. We present the successful operative management of an asymptomatic 65-year-old man found to have bilateral internal carotid artery stenosis and bilateral ECA aneurysms. His bilateral carotid arteries were reconstructed with bifurcated interposition grafts in a staged fashion. The patient recovered without sequelae and continues to be asymptomatic 1 year after reconstruction. We present the operative management of this rare case. PMID:26802292

  4. Complete bilateral horizontal gaze paralysis disclosing multiple sclerosis

    OpenAIRE

    MILEA, D; Napolitano, M.; Dechy, H; Le Hoang, P.; Delattre, J.; Pierrot-Deseillig..., C

    2001-01-01

    Two women presented with bilateral internuclear ophthalmoplegia evolving in a few days to complete bilateral horizontal gaze paralysis. Convergence and vertical eye movements were normal. Cerebral MRI showed a few small white matter lesions in the lateral ventricle regions, and, at the brainstem level, a single, small, bilateral lesion affecting the posterior part of the medial pontine tegmentum and responsible for the clinical syndrome. The condition gradually improved in b...

  5. 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...

  6. Bilateral inverted and impacted maxillary third molars: a case report

    OpenAIRE

    Abu-Mostafa, Nedal; Barakat, Ali; Al Turkmani, Tareq; Al Yousef, Abdulaziz

    2015-01-01

    Bilateral inverted third molar impaction is an extremely rare condition. We reported the case of a 50-year-old female patient with bilateral inverted and impacted maxillary third molars. Both were asymptomatic and pathology free clinically and radiographically. Surgical extraction of these inverted third molars with inaccessible positions requires an aggressive bone removal on the tuberosity bilaterally. Moreover, it contains a high risk of displacement of the inverted third molar into the ma...

  7. Bilateral pneumothoraces complicating reduction mammoplasty: a case report

    OpenAIRE

    Mavridis, Stylianos; Gnauk, Hans Georg; Schumacher, Martina; Wagner, Roland

    2013-01-01

    Background Bilateral pneumothoraces after cosmetic breast surgery are rare and sporadically reported in the literature. Case presentation A 65-year-old female patient developed bilateral pneumothoraces after bilateral breast reduction surgery. Emergent chest tube thoracostomy was performed on both sides. The chest drains were removed on the fourth day (left side) and sixth day (right side), and the patient was discharged after 7 days of hospitalization without any further complications. Concl...

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

    OpenAIRE

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

    2013-01-01

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

  9. Bilateral angiosarcoma of breast in a young lady

    Directory of Open Access Journals (Sweden)

    Sanjoy Roy

    2011-01-01

    Full Text Available We report a young lady with bilateral angiosarcoma of breast because of its rarity. A 29 year old unmarried female presented with bilateral breast lump. She underwent bilateral mastectomy with axillary dissection histopathology of which showed low grade angiosarcoma of left breast and high grade angiosarcoma of right breast. CT Thorax revealed right hilar and right mediastenal lymph nodes. She was treated with radiotherapy and chemotherapy postoperatively.

  10. Bilateral cystic neuroblastoma: imaging features and differential diagnoses

    International Nuclear Information System (INIS)

    Neuroblastoma is one of the most common malignant tumors of childhood, with 40 % arising in the adrenal glands. Bilateral adrenal involvement from synchronous development or metastatic spread of the tumor is seen in less than 10 % of children with neuroblastoma [1[. Neuroblastoma rarely presents as a cystic suprarenal mass that is difficult to differentiate from adrenal hemorrhage, extralobar sequestration, or dilated upper-pole renal calyces. To our knowledge, bilateral cystic neuroblastoma has not been previously reported. We present a case of bilateral cystic adrenal neuroblastoma to demonstrate the imaging features of this unusual entity, and to expand the differential diagnosis of bilateral cystic suprarenal masses in an infant. (orig.). With 2 figs

  11. Bilateral pulmonary emboli after bilateral mastectomy in a 15-year-old boy with hypogonadism: A case report

    OpenAIRE

    Piggott, JR; Yazdani, Arjang

    2010-01-01

    Pulmonary emboli are rare, yet serious, complications of body contouring surgery. When they occur, they more often follow as complications of long, invasive procedures in adults. The present report details a case of bilateral pulmonary emboli in an obese 15-year-old boy with hypogonadism undergoing bilateral mastectomy for gynecomastia. The diagnosis of bilateral pulmonary emboli was made on the basis of clinical presentation and positive ventilation/perfusion scan. The patient responded well...

  12. [Unilateral to bilateral pleurisy: Pleural tuberculosis?].

    Science.gov (United States)

    Ben Ameur, S; Smaoui, S; Kamoun, F; Chabchoub, I; Kamoun, T; Messaadi, F; Aloulou, H; Hachicha, M

    2016-04-01

    Pleural tuberculosis is the first or second most common form of extrapulmonary tuberculosis as well as the main cause of pleural effusion in many countries. It is rare in young infants and is more common in children over 10 years of age. We report the case of a 19-month-old girl admitted for prolonged fever with unilateral pleural effusion. The mother reported a history of lymph node tuberculosis 6 years previously. Intravenous antibiotics with cefotaxime and vancomycin were started. Thoracocentesis yielded a serosanguinous exudate fluid with a lymphocyte predominance. The tuberculin skin test and PCR GeneXpert(©) on pleural fluid were negative. The initial outcome was favorable, but the chest X-rays 10 days after discharge showed bilateral pleural effusion. Pleural biopsy was proposed but the culture of pleural fluid was positive for Mycobacterium tuberculosis. The child was put under standard treatment for tuberculosis. The outcome was favorable. PMID:26922570

  13. Rare case of bilateral carotic chemodectoma

    International Nuclear Information System (INIS)

    Glomus tumor (chemodectomy, paraganglion) is a rarely occurring tumor built of paraganglia, most often located in the common carotid artery division. This slowly increasing tumor develops mostly between the ages of 45 and 50, and more or less evenly in male and female patients. This article describes the characteristics of tumors such as chemodectomy, diagnostic methods, and procedures for medical treatment. The article describes a case of tumor in the common carotid artery bifurcation diagnosed as chemodectomy with a very rare bilateral locus. The tumor was accidentally discovered during ultrasonography, and confirmed in computer tomography examination. The first examination should be ultrasonography, complemented with color Doppler. A standard angiographic examination should be performed in the case of planned surgery, with one-time-only embolization of tumor vascularization. Computer tomography examination in the angio-CT option with RT3D reconstruction is an adequate method of imaging a tumour such as chemodectomy. (author)

  14. Computed tomography findings in bilateral perinephric lymphangiomatosis

    Directory of Open Access Journals (Sweden)

    Hakeem Aijaz

    2010-01-01

    Full Text Available Perinephric lymphangioma is rare disorder that may be confused with various forms of renal cystic diseases and urinomas. In this disorder a developmental malformation results in failure of developing lymphatic tissue to establish normal communication with the rest of lymphatic system. Once there is restricted drainage of lymphatic fluid the lymphatic channels dilate to form cystic masses that may be unilocular or multilocular and may be seen unilaterally or bilaterally .This condition presents with various signs and symptoms or can be just an incidental finding which in presence of misleading clinical history may be confused with other diseases. CT scan with delayed cuts and USG guided aspiration with biochemical analysis of fluid will help us in arriving to final diagnosis.

  15. Patient with bilateral breast enlargement and hypospadias.

    Science.gov (United States)

    Ali, A A; Ahmed, T; Rashid, M M

    2009-01-01

    A 20 year old man was admitted in the surgical unit of Dhaka Medical College Hospital on August 2007 presented with Hypospadias & underdeveloped penis from childhood, gradual enlargement of both breasts for the last 10 years, absence of axillary and pubic hair from puberty & painful swelling of both testes for the last 3 years. The patient was regarded as a female upto the age of 10 years. He has got no voice change since puberty. On examination he had average body built, there was bilateral gynaecomastia, hypospadias, rudimentary penis & absence of pubic and axillary hair. His testosterone level, serum prolactin level, serum progesterone level, serum estradiol level was done. Cytology on buccal smear done and ultrasonography revealed no ovary and uterus. Ultimately patient was diagnosed as a case of androgen insensitivity syndrome (AIS). The case is reported for clinical awareness & to share our experience. PMID:19182761

  16. Bilateral Trade Flows and Income Distribution Similarity

    Science.gov (United States)

    2016-01-01

    Current models of bilateral trade neglect the effects of income distribution. This paper addresses the issue by accounting for non-homothetic consumer preferences and hence investigating the role of income distribution in the context of the gravity model of trade. A theoretically justified gravity model is estimated for disaggregated trade data (Dollar volume is used as dependent variable) using a sample of 104 exporters and 108 importers for 1980–2003 to achieve two main goals. We define and calculate new measures of income distribution similarity and empirically confirm that greater similarity of income distribution between countries implies more trade. Using distribution-based measures as a proxy for demand similarities in gravity models, we find consistent and robust support for the hypothesis that countries with more similar income-distributions trade more with each other. The hypothesis is also confirmed at disaggregated level for differentiated product categories. PMID:27137462

  17. Bilaterally Microstructured Thin Polydimethylsiloxane Film Production

    DEFF Research Database (Denmark)

    Vudayagiri, Sindhu; Yu, Liyun; Hassouneh, Suzan Sager;

    2015-01-01

    Thin PDMS films with complex microstructures are used in the manufacturing of dielectric electro active polymer (DEAP) actuators, sensors and generators, to protect the metal electrode from large strains and to assure controlled actuation. The current manufacturing process at Danfoss Polypower A...... with the existing manufacturing process. In employing the new technique, films with microstructures on both surfaces are successfully made with two different liquid silicone rubber (LSR) formulations: 1) pure XLR630 and 2) XLR630 with titanium dioxide (TiO2). The LSR films (∼70 μm) are cast on a....../S produces films with a one-sided microstructured surface only. It would be advantageous to produce a film with both surfaces microstructured, as this increases the film’s performance efficiency. The new technique introduced herein produces bilaterally microstructured film by combining an embossing method...

  18. Bilateral Scapulohumeral Ankylosis after Prolonged Mechanical Ventilation.

    Science.gov (United States)

    van Lotten, Manon L; Schreinemakers, J Rieneke; van Noort, Arthur; Rademakers, Maarten V

    2016-09-01

    This case demonstrates a rarely reported bilateral scapulohumeral bony ankylosis. A young woman developed extensive heterotopic ossifications (HOs) in both shoulder joints after being mechanically ventilated for several months at the intensive care unit in a comatose status. She presented with a severe movement restriction of both shoulder joints. Surgical resection of the bony bridges was performed in 2 separate sessions with a significant improvement of shoulder function afterwards. No postoperative complications, pain, or recurrence of HOs were noted at 1-year follow-up. Mechanical ventilation, immobilization, neuromuscular blockage, and prolonged sedation are known risk factors for the development of HOs in the shoulder joints. Relatively early surgical resection of the HOs can be performed safely in contrary to earlier belief. Afterwards, nonsteroidal anti-inflammatory drugs and/or radiation therapy can be possible treatment modalities to prevent recurrence of HOs. PMID:27583120

  19. Marfan Syndrome Presenting with Bilateral Retinal Detachment

    Directory of Open Access Journals (Sweden)

    Subrata Chakrabarti

    2014-02-01

    Full Text Available Marfan syndrome is an autosomal dominant systemic disorder of the connective tissue. Marfan syndrome affects most organs and tissues, especially the skeleton, lungs, eyes, heart, and the large blood vessels. Eye involvement may be in the form of retinal detachment which is a potentially dangerous manifestation for its sight threatening nature .We report a case where a 17 year old male developed sudden blindness due to spontaneous bilateral retinal detachment. Examination revealed features of Marfan syndrome and was stamped as a case of Marfan syndrome by Ghent criteria . The point to stress upon is that a young male developing spontaneous retinal detachment, a diagnosis of underlying Marfan syndrome should be kept in mind if appropriate clinical stigmata are present. [Natl J Med Res 2014; 4(1.000: 104-105

  20. Fetal goiter and bilateral ovarian cysts

    DEFF Research Database (Denmark)

    Lassen, Pernille; Sundberg, Karin; Juul, Anders; Skibsted, Lillian

    2008-01-01

    A unique case of fetal goiter accompanied by bilateral ovarian cysts in a mother treated with methimazole for Graves'disease is reported. The abnormal findings were detected by ultrasound at 31 weeks of gestation. Umbilical fetal blood sampling revealed elevated serum TSH, normal concentrations of...... each injection and followed by a gradual reduction of fetal goiter as well as the left ovarian cyst. The right cyst ruptured spontaneously. At 36 weeks + 4 days, the patient underwent elective caesarean section and gave birth to a female, weighing 2,880 g with 1- and 5-min Apgar scores of 10. The...... thyroid gland appeared normal in size, and cord blood TSH and free T 4 were both within normal limits. At ultrasound control6 days later, the right ovarian cyst was not visible, while the left cyst was still present. Thus, our report supports previous findings that fetal goiter can be treated successfully...

  1. Fetal goiter and bilateral ovarian cysts

    DEFF Research Database (Denmark)

    Lassen, Pernille; Sundberg, Karin; Juul, Anders; Skibsted, Lillian

    2008-01-01

    A unique case of fetal goiter accompanied by bilateral ovarian cysts in a mother treated with methimazole for Graves'disease is reported. The abnormal findings were detected by ultrasound at 31 weeks of gestation. Umbilical fetal blood sampling revealed elevated serum TSH, normal concentrations of...... each injection and followed by a gradual reduction of fetal goiter as well as the left ovarian cyst. The right cyst ruptured spontaneously. At 36 weeks + 4 days, the patient underwent elective caesarean section and gave birth to a female, weighing 2,880 g with 1- and 5-min Apgar scores of 10. The...... thyroid gland appeared normal in size, and cord blood TSH and free T 4 were both within normal limits. At ultrasound control 6 days later, the right ovarian cyst was not visible, while the left cyst was still present. Thus, our report supports previous findings that fetal goiter can be treated...

  2. Bilateral Trade Flows and Income Distribution Similarity.

    Science.gov (United States)

    Martínez-Zarzoso, Inmaculada; Vollmer, Sebastian

    2016-01-01

    Current models of bilateral trade neglect the effects of income distribution. This paper addresses the issue by accounting for non-homothetic consumer preferences and hence investigating the role of income distribution in the context of the gravity model of trade. A theoretically justified gravity model is estimated for disaggregated trade data (Dollar volume is used as dependent variable) using a sample of 104 exporters and 108 importers for 1980-2003 to achieve two main goals. We define and calculate new measures of income distribution similarity and empirically confirm that greater similarity of income distribution between countries implies more trade. Using distribution-based measures as a proxy for demand similarities in gravity models, we find consistent and robust support for the hypothesis that countries with more similar income-distributions trade more with each other. The hypothesis is also confirmed at disaggregated level for differentiated product categories. PMID:27137462

  3. Intensity modulated radiotherapy (IMRT) in bilateral retinoblastoma

    International Nuclear Information System (INIS)

    External beam radiotherapy (EBRT) for retinoblastoma has traditionally been done with conventional radiotherapy techniques which resulted high doses to the surrounding normal tissues. A 20 month-old girl with group D bilateral retinoblastoma underwent intensity modulated radiotherapy (IMRT) to both eyes after failing chemoreduction and focal therapies including cryotherapy and transpupillary thermotherapy. In this report, we discuss the use of IMRT as a method for reducing doses to adjacent normal tissues while delivering therapeutic doses to the tumour tissues compared with 3-dimensional conformal radiotherapy (3DCRT). At one year follow-up, the patient remained free of any obvious radiation complications. Image guided IMRT provides better dose distribution than 3DCRT in retinoblastoma eyes, delivering the therapeutic dose to the tumours and minimizing adjacent tissue damage

  4. Bilateral type emphysematous pyelonephritis: imaging evaluation

    International Nuclear Information System (INIS)

    Emphysematous pyelonephritis (EPN) is a serious infectious disease that occurs more frequently in diabetic patients. Radiological studies are indispensable for distinguishing between the two types since each is associated with a markedly different prognosis. We present a case of bilateral EPN diagnosed as type I on the basis of computed tomography findings, differentiating it from type II EPN, taking into account the prognostic value of this distinction. Type I EPN is characterized by the destruction of the renal parenchyma, a mottled or linear gas pattern and the absence of renal and perirenal fluid collection. Type II EPN is characterized by a loculated or bubbly gas pattern, the existence of fluid collection and less marked renal destruction. Type I is more aggressive and is associated with high rate of mortality. (Author) 7 refs

  5. Bilateral mandibular fracture related to osteoradionecrosis.

    Science.gov (United States)

    Goyal, Shikha; Mohanti, Bidhu Kalyan

    2015-01-01

    Mandible is the most frequently affected bone during head and neck irradiation. Late changes in the mandible may manifest in the form of reduced bone density, dental caries, loss of spongiosa trabeculations, delayed healing following dental extraction, pathologic fractures, osteoradionecrosis, trismus, growth defects in children or second malignancies. Pathologic fractures of mandibular bone are rare and may be spontaneous or traumatic (following dental extraction). We report the case of a 55-year lady, who had undergone surgery and adjuvant radiotherapy for carcinoma oral tongue T2N0M0 on a cobalt-60 unit and was disease-free. After a follow-up of 8 years post-irradiation, she presented with sudden onset oral pain and inability to open mouth. Pantomogram showed fracture at the junction of body and ramus of the mandible bilaterally. PMID:26097342

  6. BILATERAL STEROID INDUCED GLAUCOMA IN VERNAL KERATOCONJUNCTIVITIS

    Directory of Open Access Journals (Sweden)

    Bangal Surekha V, Bankar Mahima S, Bhandari Akshay J, Kalkote Prasad R

    2015-01-01

    Full Text Available Vernal Keratoconjunctivits (VKC is a bilateral recurrent allergic interstitial conjunctival inflammation with a periodic seasonal incidence and of self limiting nature, mainly affecting the younger population. Patients of VKC on steroid therapy are at higher risk of developing steroid induced glaucoma. Raised intraocular pressure due to steroids typically occurs within few weeks of starting steroid therapy and comes back to normal on immediate stoppage of steroids. A case of steroid induced glaucoma in a 30 years old female with vernal keratoconjunctivitis. She was on topical steroids for 3-4 years. She was incompliant with the instructions to stop steroids. She eventually developed steroid induced glaucoma and glaucomatous optic neuropathy with tunnel vision.

  7. Bilateral stony lung: pulmonary alveolar microlithiasis.

    Science.gov (United States)

    Chandra, Subhash; Mohan, Anant; Guleria, Randeep; Das, Prasenjit; Sarkar, Chitra

    2009-01-01

    A 40-year-old male paddy field worker was referred for exertional shortness of breath and non-productive cough for 4 years. He had been treated for pulmonary tuberculosis twice. Chest radiograph showed extensive bilateral nodular opacities ("sandstorm-like") in the middle and lower lobe. Pulmonary function tests revealed a restrictive ventilatory defect. High resolution CT showed widespread nodular infiltration with "crazy paving" appearance and interrupted black pleura sign. This was confirmed as pulmonary alveolar microlithiasis (PAM) by trans-bronchial lung biopsy, which showed normal respiratory lining epithelium with dilated alveolar spaces containing many calcific bodies, some of which showed concentric calcification. The possibilities of silicosis (due to exposure to husk) and tuberculosis, both of which can mimic PAM clinically and radiologically, made this case a diagnostic challenge. PMID:21686505

  8. Bilateral foveal retinoschisis accompanying unilateral peripheral retinoschisis

    Directory of Open Access Journals (Sweden)

    Nilufer Kocak

    2014-01-01

    Full Text Available X-linked juvenile retinoschisis is a rare hereditary retinal disease characterized by a tangential splitting of the neurosensory retina which may cause early-onset visual impairment. Existence of the retinal neurosensory layer splitting on cross-sectional images of optical coherance tomography (OCT and the absence of leakage on fluorescein angiography (FA help confirming the diagnosis. Such diagnostic tests are also helpful in determining the management of the disease. However, most of the retinoschisis cavities remain stable and rarely extend to the posterior pole, many authors suggest laser prophylaxis to avoid the potential risk of retinal detachment due to holes in the outer retinal layer. Herein, we report a case with bilateral foveal retinoschisis accompanying unilateral peripheral retinoschisis who was evaluated with detailed ophthalmologic examination. Visual acuity, fundoscopy, OCT, and FA remained stable in the second year of follow-up after prophylactic argon laser treatment.

  9. Bilateral adrenal histoplasmosis in an immunocompetent man Histoplasmose adrenal bilateral em um homem imunocompetente

    Directory of Open Access Journals (Sweden)

    Carlos Frederico Lopes Benevides

    2007-04-01

    Full Text Available Histoplasmosis is a fungal disease that is endemic in Brazil. It may present as chronic pulmonary infection or in disseminated form. Disseminated histoplasmosis frequently affects the adrenal gland; however, unilateral involvement in immunosuppressed patients is the usual presentation. We report a case of an elderly immunocompetent male with history of weight loss, fever and bilateral adrenal mass who was successfully treated with itraconazole.Histoplasmose é uma doença fúngica endêmica no Brasil que pode se apresentar como infecção pulmonar crônica ou na forma disseminada. A histoplasmose disseminada freqüentemente acomete a glândula adrenal; entretanto, ocorre mais em pacientes imunossuprimidos e de forma unilateral. Relatamos um caso de um homem idoso imunocompetente com história de perda de peso, febre e massa adrenal bilateral que foi tratada com itraconazol, com sucesso.

  10. Simultaneous bilateral shoulder and bilateral central acetabular fracture dislocation: What to do?

    Institute of Scientific and Technical Information of China (English)

    Hardik Sheth; Abhijeet Ashok Salunke; Ramesh Panchal; Jimmy Chokshi; G.I.Nambi; Saranjeet Singh; Amit Patel

    2016-01-01

    Musculoskeletal injuries following seizures have a high morbidity and mortality.These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations.We report a case of 72 years old male with simultaneous bilateral central acetabular fracture dislocation and bilateral posterior shoulder fracture dislocation secondary to an epileptic seizure.Present study highlights the significance of clinical suspicion and clinico-radiological evaluation for diagnosis of a rare injury following episode of seizures.Simultaneous fracture dislocation of all four limbs treated with a holistic approach can lead to a good functional recovery.Surgical management with open reduction and internal fixation is preferred and replacement arthroplasty should be reserved for cases with implant failure and elderly patients.

  11. Paresia diafragmática bilateral idiopática Idiopathic bilateral diaphragmatic paresis

    Directory of Open Access Journals (Sweden)

    Mônica Corso Pereira

    2006-10-01

    Full Text Available Relata-se o caso de um paciente com dispnéia intensa ao se deitar, em que foram excluídas doenças pulmonares, neuromusculares ou cardíacas, cuja investigação revelou paresia diafragmática bilateral. Um sinal chave para o diagnóstico foi a evidência de respiração paradoxal com o doente em decúbito supino. Havia piora da oxigenação e da capacidade vital forçada com a mudança da posição ortostática para supina. A fluoroscopia ortostática foi normal. A pressão inspiratória máxima estava muito reduzida. A estimulação elétrica transcutânea do diafragma foi normal, e a eletroestimulação do nervo frênico mostrou ausência de resposta, permitindo o diagnóstico de paresia bilateral do diafragma.We report the case of a patient with severe dyspnea upon reclining. Lung disease, neuromuscular disorders and heart disease were ruled out. However, during the course of the investigation, bilateral diaphragmatic paresis was discovered. A key sign leading to the diagnosis was evidence of paradoxical respiration in the dorsal decubitus position. When the patient was moved from the orthostatic position to the dorsal decubitus position, oxygenation and forced vital capacity worsened. The orthostatic fluoroscopy was normal. Maximal inspiratory pressure was severely reduced. The responses to transcutaneous electric stimulation of the diaphragm were normal. However, electric stimulation of the phrenic nerve produced no response, leading to the diagnosis of bilateral diaphragmatic paresis.

  12. Bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei

    DEFF Research Database (Denmark)

    Kaldau, Niels Christian; Brorson, Stig; Jensen, Poul Einar;

    2012-01-01

    We present a case of bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei, and review the literature on Candida osteomyelitis.......We present a case of bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei, and review the literature on Candida osteomyelitis....

  13. Bilateral retinal cyst accompanying with renal and thyroidal multiorgan cyst

    OpenAIRE

    Amber Şenel; Rıfat Rasier; Alper Şengül; Erdal Yüzbaşıoğlu; Özgür Artunay; Halil Bahçecioğlu

    2011-01-01

    Although retinal cysts are commonly seen in von Hippel Lindau syndrome, bilateral retinal cysts can occasionally appear unrelated to this syndrome. Retinal cysts can be confused with retinal tumours and infectious diseases of retina. In this report we represent a patient demonstrating bilateral retinal cyst accompanying with renal and thyroidal multiorgan cysts without Von-Hippel Lindau syndrome.

  14. Bilateral Occipital Condyle Fracture: Report of Two Cases

    OpenAIRE

    Schrödel, Markus H.; Kestlmeier, Ralph; Trappe, Anna E.

    2002-01-01

    Occipital condyle fractures are a rare finding in trauma victims. Bilateral fractures are even more unusual and have typically been reported in autopsy studies. We treated two patients with bilateral occipital condyle fractures who had only minor symptoms. Anderson and Montesano's classification,1 possible cranial nerve palsies, diagnosis, and treatment of this rare fracture are discussed.

  15. Ultrasound Diagnosis of Bilateral Quadriceps Tendon Rupture After Statin Use

    Science.gov (United States)

    Nesselroade, Ryan D.; Nickels, Leslie Connor

    2010-01-01

    Simultaneous bilateral quadriceps tendon rupture is a rare injury. We report the case of bilateral quadriceps tendon rupture sustained with minimal force while refereeing a football game. The injury was suspected to be associated with statin use as the patient had no other identifiable risk factors. The diagnosis was confirmed using bedside ultrasound. PMID:21079697

  16. Unilateral Breast Reconstruction Using Bilateral Inferior Gluteal Artery Perforator Flaps

    Directory of Open Access Journals (Sweden)

    Toshihiko Satake, MD

    2015-03-01

    Conclusions: Use of bilateral IGAP flaps for breast reconstruction helps to avoid asymmetry of the inferior buttock volume and shape. Bilateral flaps provide sufficient tissue volume and allow for reconstruction of a breast comparable to the unaffected side. In patients with moderate-to-high projection breast whose abdominal tissue cannot be used for reconstruction, IGAP flaps may be a suitable alternative.

  17. Bilateral ganglion cyst of the common peroneal nerve

    International Nuclear Information System (INIS)

    Ganglion cysts of the common peroneal nerve are rarely described in the literature and a bilateral lesion has not been previously reported. We present a case of a 41-year-old man with a bilateral cyst of the common peroneal nerve diagnosed with ultrasound and magnetic resonance imaging. (orig.)

  18. Bilateral ganglion cyst of the common peroneal nerve

    Energy Technology Data Exchange (ETDEWEB)

    Pedrazzini, Massimo; Cusmano, Ferdinando; Armaroli, Sara; Pavone, Paolo [Institute of Radiology, University of Parma, Viale Gramsci 14, 43100 Parma (Italy); Pogliacomi, Francesco; Rinaldi, Elio [Institute of Clinical Orthopedics and Traumatology, University of Parma, Viale Gramsci 14, 43100 Parma (Italy)

    2002-11-01

    Ganglion cysts of the common peroneal nerve are rarely described in the literature and a bilateral lesion has not been previously reported. We present a case of a 41-year-old man with a bilateral cyst of the common peroneal nerve diagnosed with ultrasound and magnetic resonance imaging. (orig.)

  19. Bilateral symmetric autosomal dominant sector chorioretinopathy with late maculopathy

    DEFF Research Database (Denmark)

    Fledelius, Hans C; Rosenberg, Thomas

    2012-01-01

    To describe the long-term course of bilateral symmetric autosomal dominant sector chorioretinopathy in a 79-year-old man who was diagnosed at age 31.......To describe the long-term course of bilateral symmetric autosomal dominant sector chorioretinopathy in a 79-year-old man who was diagnosed at age 31....

  20. Hansen′s disease with bilateral tarsal disorganisation

    OpenAIRE

    Nair Pradeep; Vijayadharan M; Yogirajan K; Suprakasan S; Rajasree P

    1999-01-01

    A 37-year old male patient with Hansen′s disease midborderline spectrum, presented with bilateral pedal edema. X-ray examination of the feet showed disorganisation and disintegration of the tarsal bones. Bilateral tarsal disorganisation which can develop in Hansen′s disease is usually not recognised by the clinician.

  1. Bilateral Very Late Onset Cystoid Macular Edema after Uncomplicated Phacoemulsification

    International Nuclear Information System (INIS)

    We describe the occurrence of a very rare type of bilateral pseudophakic cystoids macular edema 16 years after uncomplicated phacoemulsification with posterior chamber intraocular lens implantation in a 55 year old patient. To our knowledge this is the first case report of a bilateral very late onset cystoids macular edema following uncomplicated phacomulsification with posterior intraocular lens implantation. (author)

  2. Effects of Bilateralism and the MFN Clause on International Trade

    DEFF Research Database (Denmark)

    Lampe, Markus

    2009-01-01

    This study contributes to a revised picture of nineteenth-century bilateralism. Employing a new disaggregated data set, it argues that bilateral treaties did not implement general free trade, but instead reduced tariffs unevenly through commodity-specific preferences, especially favoring manufact......This study contributes to a revised picture of nineteenth-century bilateralism. Employing a new disaggregated data set, it argues that bilateral treaties did not implement general free trade, but instead reduced tariffs unevenly through commodity-specific preferences, especially favoring...... manufactured goods. Gravity model estimates show that specific liberalizations increased exports of corresponding items, but not overall trade. Exporters from countries whose governments used bilateralism strategically to bring down partner tariffs benefitted most. Hence, the network in form and outcome is...... more properly identified with reciprocal liberalization practiced by the French than with British free-trade ideology....

  3. MRI features of bilateral parotid haemangiomas of infancy

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, Savvas; Jadwat, Saaleeha [Institute of Child Health, University of Cape Town, Klipfontein Road, Rondebosch, 7700, Cape Town (South Africa); McHugh, Kieran; Linward, Jane [Department of Radiology, Great Ormond Street Hospital for Children, London, WC1N 3JH (United Kingdom)

    2003-04-01

    The aim of this article is to report the MRI features of bilateral parotid haemangiomas of infancy and highlight the diagnostic and prognostic value of MRI especially with regard to those lesions that may cause respiratory compromise. Retrospective review of MRI scans in six infants with bilateral parotid haemangiomas. The bilateral haemangiomas were symmetrical in all but one patient. On T1-weighted images the masses were isointense to muscle and on T2 they were hyperintense with numerous small vessels giving a septated appearance. There was vivid enhancement with gadolinium in all cases. In three patients, deep bilateral extensions were demonstrated involving the parapharyngeal spaces resulting in respiratory compromise which required tracheostomy. Bilateral parotid haemangiomas are rare, but when present may have deep extensions, which can result in respiratory compromise requiring tracheostomy. (orig.)

  4. Comparative gait initiation kinematics between simulated unilateral and bilateral ankle hypomobility: Does bilateral constraint improve speed performance?

    Science.gov (United States)

    Delafontaine, A; Honeine, J-L; Do, M-C; Gagey, O; Chong, R K

    2015-08-31

    Improvement of motor performance in unilateral upper limb motor disability has been shown when utilizing inter-limb coupling strategies during physical rehabilitation. This suggests that 'default' bilateral central motor commands are facilitated. Here, we tested whether this bilateral motor control principle may be generalized to the lower limbs during gait initiation, which involves alternate bilateral actions. Disability was simulated by strapping to produce ankle hypomobility. Healthy adult subjects initiated gait at a self-paced speed with no ankle constraint (control), or with the stance, swing or bilateral ankles strapped. The duration of the anticipatory postural adjustments lengthened and the center of mass instantaneous progression velocity at foot-off decreased when the ankle was strapped. During the step execution phase, progression velocity at foot-contact was higher when both ankles were strapped compared to unilateral strapping of the stance ankle. These findings suggest that bilateral central motor commands are favored during walking tasks. Indeed, unilateral constraint of the stance ankle should compel the central nervous system to adapt specific commands to the constraint and normal sides whereas the 'default' bilateral motor commands would be utilized when both ankles are strapped leading to better kinematics performance. Bilateral in-phase upper limb coordination and bilateral alternating lower limb locomotor movements may share similar control mechanisms. PMID:26197055

  5. Synchronous Bilateral Solid Papillary Carcinomas of the Breast

    Directory of Open Access Journals (Sweden)

    Noriko Yoshimura

    2013-01-01

    Full Text Available We herein report a case of synchronous bilateral solid papillary carcinoma of the breast. A 73-year-old female had a mass that was detected in the right breast on mammography. An ultrasound examination revealed one intracystic tumor in the right breast and two tumors in the left breast. A fine-needle aspiration biopsy of these three tumors was performed, which revealed a diagnosis of malignancy. A magnetic resonance imaging examination of the breasts showed diffuse small nodules surrounding these tumors bilaterally. Bilateral partial mastectomy and a sentinel lymph node biopsy were performed. Lymph node metastasis was detected in the right axilla, and additional lymph node dissection was performed. The pathological diagnosis was synchronous bilateral breast cancer, invasive ductal carcinoma NOS of the right breast, mucinous carcinomas of the left breast, and bilateral SPCs. A wide range of surgical margins were positive for SPCs, and additional bilateral total mastectomy was then performed. To the best of our knowledge, little is known about synchronous bilateral SPCs. Our case indicates that some SPCs can be widely scattered and make up a variety of invasive carcinomas. It is difficult to make a correct preoperative evaluation in such cases.

  6. Rehabilitation for bilateral amputation of fingers

    Science.gov (United States)

    Stapanian, Martin A.; Stapanian, Adrienne M.P.; Staley, Keith E.

    2010-01-01

    We describe reconstructive surgeries, therapy, prostheses, and adaptations for a patient who experienced bilateral amputation of all five fingers of both hands through the proximal phalanges in January 1992. The patient made considerable progress in the use of his hands in the 10 mo after amputation, including nearly a 120% increase in the active range of flexion of metacarpophalangeal joints. In late 1992 and early 1993, the patient had "on-top plasty" surgeries, in which the index finger remnants were transferred onto the thumb stumps, performed on both hands. The increased web space and functional pinch resulting from these procedures made many tasks much easier. The patient and occupational therapists set challenging goals at all times. Moreover, the patient was actively involved in the design and fabrication of all prostheses and adaptations or he developed them himself. Although he was discharged from occupational therapy in 1997, the patient continues to actively find new solutions for prehension and grip strength 18 yr after amputation.

  7. BILATERAL OSSIFIED STYLOHYOID COMPLEX: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sarada Devi S

    2015-11-01

    Full Text Available : Mineralisation of all components of stylohyoid complex or chain, a 2nd branchial arch derivative is frequently reported. But bilateral occurrence of continuous bands of ossified tissue involving stylohyoid complex, are less commonly encountered. An adult skull specimen presented abnormally long osseous bands extending from base of skull in place of styloid process. On left side a band of 6.5cm long x1cm wide and 0.3cm in thickness, and on right side an irregularly rounded elongated structure of 7.5cm length were noticed. Lower end of the left process was fused to hyoid bone. Either abnormally long styloid process or this type of ossified stylohyoid complex may be a causative factor for severe pharyngeal pain, dysphagia, may be a cause for occasional swelling in submandibular region or may be associated with Eagle syndrome. Due to its close proximity to tonsillar bed, if elongated it may be felt during tonsillectomy in tonsillar fossa. In this backdrop reports of this type may be of interest to clinicians.

  8. Haptic Manipulation of Deformable Objects in Hybrid Bilateral Teleoperation System

    Directory of Open Access Journals (Sweden)

    Juan Manuel Ibarra-Zannatha

    2007-01-01

    Full Text Available The aim of this work is the integration of a virtual environment containing a deformable object, manipulated by an open kinematical chain virtual slave robot, to a bilateral teleoperation scheme based on a real haptic device. The virtual environment of this hybrid bilateral teleoperation system combines collision detection algorithms, dynamical, kinematical and geometrical models with a position–position and/or force–position bilateral control algorithm, to produce on the operator side the reflected forces corresponding to the virtual mechanical interactions, through a haptic device. Contact teleoperation task over the virtual environment with a flexible object is implemented and analysed.

  9. Pycnodysostosis associated with bilateral congenital pseudarthrosis of the clavicle.

    Science.gov (United States)

    Karakurt, Lokman; Yilmaz, Erhan; Belhan, Oktay; Serin, Erhan

    2003-04-01

    We report the case of a 22-year-old woman with pycnodysostosis associated with bilateral congenital pseudarthrosis of the clavicle. The patient was first seen at the age of 19 years and had no symptoms during the 3-year follow-up period. The diagnosis of pycnodysostosis was made by typical clinical and radiological findings. Bilateral painless mid-clavicular mass and plain radiograms confirmed the diagnosis of bilateral congenital pseudarthrosis of the clavicle. Surgery was not performed for pseudarthrosis of the clavicles, just observation was preferred. PMID:12721693

  10. Bilateral Tibial Tubercle Sleeve Fractures in a Skeletally Immature Patient

    Directory of Open Access Journals (Sweden)

    Rasesh R. Desai

    2013-01-01

    Full Text Available Tibial tubercle sleeve fracture is a rare injury. In concept, it is similar to the patellar sleeve fracture in a skeletally immature patient. We describe a unique case of simultaneous bilateral tibial tubercle sleeve fractures in a 12-year-old boy. Radiographs and MRI confirmed the injury. The patient underwent open surgical repair of bilateral sleeve fractures with suture anchor fixation. At the final followup, 3 years after his initial injury, the patient demonstrated full knee function bilaterally without radiographic evidence of growth disturbances.

  11. Geleophysic dysplasia associated with bilateral angle closure glaucoma

    Directory of Open Access Journals (Sweden)

    Murat Sinan Saricaoglu

    2013-01-01

    Full Text Available In this case report, we present occurrence of bilateral angle closure glaucoma in a 9-year-old girl with geleophysic dysplasia. Bilateral YAG laser iridotomy was applied, but intraocular pressure (IOP remained at high levels, necessitating bilateral trabeculectomy with mitomycin C. On her follow-up examinations for 3 years, IOP remained in the mid-20s with no need for further intervention or antiglaucoma medication. There are few reports describing the ocular findings of geleophysic dysplasia in literature. To our knowledge, this is the first case report describing an application of glaucoma surgery and its results at geleophysic dysplasia.

  12. Reduced 123I Ioflupane Binding in Bilateral Diabetic Chorea

    Science.gov (United States)

    Sato, Kenichiro; Hida, Ayumi; Kameyama, Masashi; Morooka, Miyako; Takeuchi, Sousuke

    2016-01-01

    Abstract We report a 64-year-old man with diabetic chorea whom we investigated with dopamine transporter SPECT, 18F FDG PET, 99mTc ethylcysteinate dimer (ECD) SPECT, and 123I metaiodobenzylguanidine (MIBG) scintigraphy. Dopamine transporter SPECT revealed reduced 123I ioflupane binding in the bilateral striatum. 18F FDG PET showed metabolic dysfunction in the bilateral striatum, as shown in earlier studies. 99mTc ECD SPECT revealed reduced brain perfusion in the bilateral caudate nucleus and putamen. 123I MIBG scintigraphy revealed no cardiac sympathetic nerve dysfunction. Our case suggests a possible nigrostriatal presynaptic dopaminergic involvement in diabetic chorea. PMID:26975011

  13. Bilateral Ota nevus in a 15 years old patient

    Directory of Open Access Journals (Sweden)

    Savaş Öztürk

    2013-12-01

    Full Text Available Nevus of Ota is a dermal melanocytosis, clinically localizedon skin that is innervated by the first and secondbranches of the trigeminal nerve. It occurs almost entirelyin Asian people. The clinical manifestations are usuallyunilateral; only 5% of cases are bilateral. In this article,due to rarity of the case, a 15-year-old patient, who was diagnosedwith bilateral ota nevus, without having any dermatologicalcomplaints other than cosmetic appearenceand stains in her eyes and around was presented.Key words: Bilateral ota nevus, child, melanocytosis

  14. A 72-year-old patient with bilateral Maisonneuve fractures

    Directory of Open Access Journals (Sweden)

    Thomas Dienstknecht

    2012-07-01

    Full Text Available Maisonneuve fractures result from a disruption of the medial ankle structures and a proximal fibular fracture. Patient complaints can be misleading and there is a significant rate of delayed diagnosed injuries. We present a case of bilateral Maisonneuve fractures after a fall due to a syncopal collapse. A precise clinical examination led to this rare diagnosis. The injuries were treated with syndesmotic screw fixation, removal of hardware followed after 6 weeks. The patient was asymptomatic at threemonths follow up. Patients with bilateral injuries undergoing standard surgical treatment can gain full recovery, but high suspicion in clinical examination is needed to detect this uncommon bilateral injury.

  15. Spheniodal mucocele causing bilateral optic neuropathy and ophthalmoplegia

    Directory of Open Access Journals (Sweden)

    Ambika Selvakumar

    2014-01-01

    Full Text Available Sphenoid sinus mucocele comprises only 2% of all paranasal sinus mucoceles. In literature, there is a case report on sphenoidal mucocele causing bilateral optic neuropathy, with unilateral partial recovery and cranial nerve palsy, but we did not come across any literature with bilateral optic neuropathy and ophthalmoplegia together caused by spheno-ethmoidal mucocele. We present such a rare case of spheno-ethmoidal mucocele causing bilateral optic neuropathy and unilateral sixth nerve palsy who had postsurgery, unilateral good vision recovery, and complete resolution of sixth nerve palsy.

  16. BILATERAL ANOMALOUS MUSCLE IN THE POPLITEAL FOSSA & ITS CLINICAL SIGNIFICANCE

    Directory of Open Access Journals (Sweden)

    Sowmya S

    2014-10-01

    Full Text Available Muscle variation may occur due to genetic or developmental causes. Some variations may compromise the vascular, muscular or nervous system in the region. Bilateral muscle variation in popliteal fossa is very rare. In present study an instance of bilateral muscle variation in popliteal fossa, arising from different muscles like gastrocnemius and from biceps femoris is recorded. There is no report of such variations. These observations are rare of its kind because of bilateral asymmetrical presence and difference in the origins in different legs. This is the first report as for the literatures available. Clinical and functional importance of such variation is discussed with the morphological aspects of this anomalous muscle.

  17. Luxatio erecta bilateral: um relato de caso Bilateral luxatio erecta, a case report

    OpenAIRE

    César Augusto Xavier Acosta; Elemar da Silva Resch; Rafael Rodrigues

    2012-01-01

    O deslocamento inferior do ombro (luxatio erecta) é uma lesão rara, acometendo aproximadamente 0,5% dos deslocamentos dessa articulação. A grande maioria desses casos ocorre unilateralmente. Em setembro de 2004, um homem de 43 anos chegou ao pronto-socorro do Hospital Universitário de Santa Maria (HUSM) com queixa de dor bilateral no ombro e incapacidade de abaixar os braços, em consequência de uma queda com os braços abduzidos, enquanto desempenhava sua atividade laboral. Após o exame físico...

  18. Point Climat no. 11 'Japan's Bilateral Offset Crediting Mechanism: A Bilateral Solution to a Global Issue?'

    International Nuclear Information System (INIS)

    Among the publications of CDC Climat Research, 'Climate Briefs' presents, in a few pages, hot topics in climate change policy. This issue addresses the following points: In order to achieve its long-term emission reduction target following the Fukushima incident, Japan would rely more heavily on international offsetting activities. Concurrent to vigorous proposals to reform the CDM, Japan is also promoting an offset crediting scheme through bilateral agreements with developing countries as a post-2012 market mechanism. Despite potential benefits, issues relating to the accounting rules, environmental integrity and implications to carbon markets warrant further consideration prior to international recognition

  19. Bilateral Tarsal Tunnel Syndrome Due To Bilateral Lipoma: A Case Report

    Directory of Open Access Journals (Sweden)

    C. Eren CANSÜ, İstemi YÜCEL, Kutay ÖZTURAN

    2010-11-01

    Full Text Available Tarsal tunnel syndrome is an entrapment neuropathy of posterior tibial nerve under the flexorretinaculum. Patients generally present with paresthesias on the plantar side of foot and fingersand in the distal kruris.The causes of tarsal tunnel syndrome are space occupying lesions within or around the tunnelwhich exert pressure to the nerve, ankle deformities, systemic illnesses, trauma or lesions ofthe nerve itself.In this study a case of tarsal tunnel syndrome due to bilateral lipoma which was treated surgicallyis presented.

  20. Luxatio erecta bilateral: um relato de caso Bilateral luxatio erecta, a case report

    Directory of Open Access Journals (Sweden)

    César Augusto Xavier Acosta

    2012-02-01

    Full Text Available O deslocamento inferior do ombro (luxatio erecta é uma lesão rara, acometendo aproximadamente 0,5% dos deslocamentos dessa articulação. A grande maioria desses casos ocorre unilateralmente. Em setembro de 2004, um homem de 43 anos chegou ao pronto-socorro do Hospital Universitário de Santa Maria (HUSM com queixa de dor bilateral no ombro e incapacidade de abaixar os braços, em consequência de uma queda com os braços abduzidos, enquanto desempenhava sua atividade laboral. Após o exame físico e radiológico constatou- se que o indivíduo apresentava uma luxação inferior bilateral dos ombros. O paciente foi então encaminhado ao bloco cirúrgico onde foi realizada redução incruenta das luxações sob anestesia através da técnica de tração e contra-tração. No dia seguinte recebeu alta com imobilização tipo Velpeau mantendo os ombros totalmente aduzidos e rotados internamente, com orientação de manter a imobilização por três semanas. Foi orientado também a realizar fisioterapia.Inferior shoulder dislocation (luxactio erecta is a rare lesion affecting approximately 0.5% of dislocations of this joint. The vast majority of these cases occur unilaterally. In September 2004, a 43 year old man was brought to the emergency room of the University Hospital of Santa Maria (HUSM complaining of bilateral shoulder pain and inability to lower the arms, as a result of a fall with the arms abducted, while carrying out work activities. After physical examination and radiological exams, it was found that the patient had a bilateral inferior shoulder dislocation. He was referred to the surgical ward and after intravenous sedation, both shoulders were reduced by closed reduction using the traction-countertraction maneuver. The patient was discharged the day after the reduction. Both arms were immobilized with a velpeau sling in total adduction and intrarotation, with instructions to maintain immobilization for three weeks. The patient was

  1. CT-guided once-through bilateral percutaneous needle puncturing sclerotic therapy for bilateral multiple renal cysts: preliminary results

    International Nuclear Information System (INIS)

    Objective: To evaluate CT-guided once-through bilateral percutaneous needle puncturing, aspiration and injection of sclerotic agents (ethanol) in treating bilateral multiple renal cysts. Methods: CT-guided once-through bilateral percutaneous needle puncturing sclerotic therapy was performed in 19 patients with bilateral multiple renal cysts. First, under CT guidance the puncture points and puncture routs were decided, then, puncturing, aspiration, rinsing and ethanol injection of the cysts were taken place by turn. The clinical results were analyzed. Results: bilateral percutaneous needle puncturing sclerotic therapy was successfully completed in all 19 cases. The whole procedure was well tolerated by all patients. The mean operative time was 23 minutes with a range of 20-35 minutes. No severe complications occurred. Conclusion: With proficient manipulation, CT-guided bilateral percutaneous needle puncturing sclerotic therapy for bilateral multiple renal cysts can be smoothly carried out. The technique can reduced the number of sclerotherapy times, cut down the medical expenses and, therefore, get twofold results with half the effort. (authors)

  2. Australia and China: A Joint Report on the Bilateral Relationship

    Institute of Scientific and Technical Information of China (English)

    Liu Junhong; Guo Chunmei; Richard Rigby; Sang Ye

    2012-01-01

    After China and Australia established diplomatic ties in 1972, bilateral relations developed rapidly. People-to-people links, politicalexchanges and trade and economic cooperation played an increasingly larger part in the foreign policies of the two countries. In the post global financial crisis era, bilateral relations have remained positive and played an imPortant role in ensuring the stability and prosperity of the Pacific region. There have been several unavoidable misunderstandings and even disagreements between the two countries, which has influenced mutual trust and policies. This article will aim to analyze the history and current situation of the Sino-Australian relationship in an objective and comprehensive way; to look ahead to future bilateral relations, and make policy recommendations for the further development of bilateral ties to increase mutual understanding and promote a more positive future for Sino-Australian relations.

  3. Delayed-onset bilateral abducens paresis after head trauma

    Directory of Open Access Journals (Sweden)

    Pravin Salunke

    2012-01-01

    Full Text Available Bilateral sixth nerve paresis following closed head injury, though rare, is a known entity. However, delayed-onset post-traumatic bilateral abducens paresis is extremely rare. We present two cases. The first patient had onset of bilateral abducens paresis 2 weeks after closed head injury and the second patient after 3 days. The cause in the former was detected to be chronic subdural hematoma and in the latter is speculated to be edema/ischemia due to injury to soft tissue structures housing these nerves. The delayed onset of bilateral abducens paresis following head injury may vary according to the cause. There may be another mechanism of injury apart from direct trauma. Though rare, it needs to be evaluated and may have a treatable cause like elevated intracranial pressure.

  4. Surgical Management of Bilateral Limbal Stem Cell Deficiency.

    Science.gov (United States)

    Vazirani, Jayesh; Mariappan, Indumathi; Ramamurthy, Shreyas; Fatima, Saba; Basu, Sayan; Sangwan, Virender S

    2016-07-01

    Limbal stem cell deficiency (LSCD) is now established as a distinct entity with a spectrum of clinical manifestations. Bilateral LSCD presents a unique set of challenges to the clinician dealing with ocular surface disease, due to the underlying causes, clinical presentation, and adnexal status, as well as lack of a source of autologous limbal stem cells. Various surgical modalities have been described to achieve visual rehabilitation in patients with bilateral LSCD. These can primarily be divided into cell-based therapies and implantation of keratoprostheses. In this review, the surgical options for management of bilateral LSCD, including autologous and allogeneic cell-based therapies and different types of keratoprostheses are described and classified. The indications, prerequisites, technique, results and complications of each modality are discussed. Based on the status of the ocular surface, an algorithm for choosing appropriate surgical management for vision restoration in bilateral LSCD has been proposed. PMID:27151421

  5. Spontaneous Unruptured Bilateral Tubal Pregnancy: A Case Report

    Directory of Open Access Journals (Sweden)

    Nayereh Ghomian

    2015-11-01

    Full Text Available Bilateral spontaneous tubal ectopic pregnancy is the rarest form of extra uterine pregnancy. The diagnosis is usually made intraoperatively and levels of serum BHCG and ultrasound has not been useful in the diagnosis of bilateral tubal ectopic pregnancy. A 33-year-old woman with 8 weeks amenorrhea and sever lower abdominal pain was admitted. A transvaginal pelvic ultrasound revealed left adnexal mass and massive fluid collection in the pelvis and abdomen. The serum BHCG was 5,700 mIU/ml and in laparotomy bilateral unruptured tubal pregnancy was noted. Left salpingectomy and right salpingostomy were performed. The diagnosis of bilateral spontaneous tubal ectopic pregnancy is usually made intraoperatively. Both tubes at the time of surgery should be closely examined in order to prevent maternal morbidity and mortality.

  6. Pneumomediastinum, simultaneous bilateral spontaneous pneumothorax and subcutaneous emphysema following burn

    Directory of Open Access Journals (Sweden)

    Dixit Ramakant

    2006-01-01

    Full Text Available Simultaneous bilateral spontaneous pneumothorax and pneumomediastinum with subcutaneous emphysema following burn is unreported in the literature. We de-scribe such case in an 18-year-old male patient with possible mechanism of such presentation.

  7. Riesz's and Bessel's Operators in Bilateral Grand Lebesgue Spaces

    CERN Document Server

    Ostrovsky, E; Sirota, L

    2009-01-01

    In this paper we obtain the non - asymptotic estimations for Riesz's and Bessel's potential integral operators in the so - called Bilateral Grand Lebesgue Spaces. We also give examples to show the sharpness of these inequalities.

  8. Bilateral SMAS rhytidectomy in parotid recurrent pleomorphic adenoma

    OpenAIRE

    A. Baj; BELTRAMINI, G.A.; Demarchi, M; V.A. Combi; A. Giannì

    2011-01-01

    SUMMARY A case is presented of a young female with parotid recurrent pleomorphic adenoma and skin infiltration treated with subtotal parotidectomy combined with a bilateral superficial muscular aponeurotic system rhytidectomy.

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

    Science.gov (United States)

    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

  10. Bilateral Efforts in Seizing Opportunities for Better Relations

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    @@ General improvement of the Japan-ROK relations started after the end of the Cold War. Although the Japanese wrongdoings over the history-related issues have caused fluctuations in the bilateral relations, no substantial damage has occurred.

  11. Neonatal bilateral diaphragmatic paralysis caused by brain stem haemorrhage.

    OpenAIRE

    Blazer, S; Hemli, J A; Sujov, P O; Braun, J

    1989-01-01

    We describe a neonate with severe bilateral diaphragmatic paralysis caused by haemorrhage in the lower brain stem. To our knowledge this association has not been previously reported in the English medical literature.

  12. Synchronous bilateral male breast cancer: a case report.

    Science.gov (United States)

    Sun, Woo-Young; Lee, Ki-Hyeong; Lee, Ho-Chang; Ryu, Dong-Hee; Park, Jin-Woo; Yun, Hyo-Young; Song, Young-Jin

    2012-06-01

    Synchronous bilateral breast cancer is extremely rare in men and has not, up to date, been reported in Korea. A 54-year-old man presented with a palpable mass in the right breast. The right nipple was retracted and bilateral axillary accessory breasts and nipples were present. On physical examination, a 2 cm-sized mass was palpated directly under the right nipple, and, with squeezing, bloody discharge developed in a single duct of the left nipple. There was no palpable mass in the left breast, and axillary lymph nodes were not palpable. Physical examination of external genitalia revealed a unilateral undescended testis on the left side. Synchronous bilateral breast cancer was diagnosed using mammography, ultrasonography, and core-needle biopsy. Histopathological examination revealed invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast. Bilateral total mastectomy, sentinel lymph node biopsy, and excision of accessory breasts in the axilla were performed. PMID:22807945

  13. Bilateral hematoma of sternocleidomastoid muscles. A case presentation.

    Directory of Open Access Journals (Sweden)

    Zoe Quintero Delgado

    2005-08-01

    Full Text Available Presentation of the case of an infant with bilateral congenital torticollis which development was followed by ultrasound. Homeopathy and physiotherapy were used for its treatment. This is an infrequent disease scarcely reported in medical literature.

  14. Bilateral Teleoperation in Cartesian Space with Time-Varying Delay

    Directory of Open Access Journals (Sweden)

    Zhang Chen

    2012-10-01

    Full Text Available The bilateral control of a teleoperator in Cartesian space with time‐varying delay is studied in this paper. Compared with the traditional joint‐space teleoperation mode, bilateral control in Cartesian space has advantages when dealing with the kinematically dissimilar (KDS teleoperation systems. A Cartesian space‐based PD‐like bilateral controller with dissipation factors is designed. Considering the fact that attitude errors derived by rotation matrix cannot be directly used for PD control, a quaternion‐based approach is adopted to calculate the attitude errors in Cartesian space. In order to overcome the instability brought about by communication delay, local damping components are employed at both ends of the teleoperator system. The variation of time delay may generate extra energy and influence the stability of the system, thus dissipation factors are introduced into the controller. The stability of the proposed bilateral controller is proved and the simulations show the effectiveness of the approach.

  15. A case of bilateral primary fallopian tube carcinoma

    Directory of Open Access Journals (Sweden)

    Manisha Sahu

    2014-09-01

    Full Text Available A 60 years old postmenopausal woman was presented with complaints of intermittent watery discharge from vagina, and of cramping pain at the lower abdomen. On pelvic examination, blood tinged watery discharge was seen coming out of os. But, ultrasonography revealed bilateral adenexal masses and pyometra. The serum CA-125 level in blood was raised. Cervical smear showed inflammatory changes, but endometrial histopathology was negative for malignant cells. Suspecting ovarian malignancy, laparotomy was done that revealed the bilateral tubal growth with normal ovaries; the right adenexal mass was of the size (6.8×4.8 cm while, the left adenexal mass was the size of (4.2×2.6 cm. Histopathology study revealed bilateral serous cyst adenocarcinoma of fallopian tubes. The case of bilateral primary fallopian tube carcinoma was presented here for its rarity.

  16. Bilateral same day phacoemulsification: 220 cases retrospectively reviewed

    OpenAIRE

    Johansson, B A; Lundh, B L

    2003-01-01

    Background/aims: The relative frequency, basic patient data, results, and complications of planned same day bilateral phacoemulsification were studied from April 1999 to May 2001 at the Department of Ophthalmology, Linköping University Hospital, Sweden.

  17. Mielolipoma adrenal bilateral em um cão Bilateral adrenal myelolipoma in a dog

    Directory of Open Access Journals (Sweden)

    Silvia de Araújo França

    2008-08-01

    Full Text Available O presente relato descreve um caso de mielolipoma adrenal bilateral em uma cadela Poodle de 13 anos de idade. O cão morreu por peritonite séptica aguda, decorrente de ulceração e perfuração intestinal por corpo estranho linear. O neoplasma foi achado incidentalmente durante a necropsia. Macroscopicamente, as adrenais estavam redondas e com volume e aumentados. Ao corte elas eram friáveis, vermelho-amarronzadas, intercaladas por áreas branco-amareladas levemente proeminentes. Histologicamente, extensas áreas do parênquima continham adipócitos bem diferenciados, células hematopoéticas e macrófagos com hemossiderina, achados característicos de mielolipoma adrenal.A case of bilateral adrenal myelolipoma in a 13-year-old female Poodle is reported. Acute septic peritonitis due to intestinal ulceration and perforation caused by a linear foreign body was the cause of death. The adrenal neoplasm was an incidental necropsy finding. The adrenal glands were grossly rounded, enlarged and friable, and had red-brownish parenchyma interwoven by slightly prominent white-yellowish foci. Histologically, the findings of differentiated adipocytes in large areas of the parenchyma, in association to hematopoietic cells and macrophages with hemosiderin were consistent with the diagnosis of adrenal myelolipoma.

  18. An Investigation of Bilateral Symmetry During Manual Wheelchair Propulsion

    OpenAIRE

    Soltau, Shelby L.; Slowik, Jonathan S.; Requejo, Philip S.; Mulroy, Sara J; Neptune, Richard R.

    2015-01-01

    Studies of manual wheelchair propulsion often assume bilateral symmetry to simplify data collection, processing, and analysis. However, the validity of this assumption is unclear. Most investigations of wheelchair propulsion symmetry have been limited by a relatively small sample size and a focus on a single propulsion condition (e.g., level propulsion at self-selected speed). The purpose of this study was to evaluate bilateral symmetry during manual wheelchair propulsion in a large group of ...

  19. Prolapsed bilateral ureteroceles leading to intermittent outflow obstruction.

    LENUS (Irish Health Repository)

    Stunell, H

    2012-02-01

    A ureterocele refers to a cystic dilatation of the distal ureter. It may be unilateral or bilateral and may be associated with a duplex system in some cases. We present an unusual case where a young patient was found to have large bilateral ureteroceles which prolapsed into the urethra, causing intermittent incontinence and obstruction. We discuss the case and review the literature concerning this rare anomaly.

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

    Directory of Open Access Journals (Sweden)

    Yashavantha Kumar C

    2013-01-01

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

  1. An unusual triad: Bilateral dilated odontoma, hypodontia and peg laterals

    Directory of Open Access Journals (Sweden)

    Alphy Alphonsa Sebastian

    2013-01-01

    The aim of this case report is to present a rare case of bilateral dilated odontoma affecting a microdontic permanent lateral incisor in a 30 year old female patient with hypodontia and peglateral teeth with its clinical, radiological and histological features, which has yet been not reported. Bilateral presence of dilated odontoma is not a common occurrence, although a single tooth involvement in each case has been reported in the literature.

  2. Bilateral thecoma presenting as premenopausal hirsutism: Laproscopic removal

    Directory of Open Access Journals (Sweden)

    S Ramkumar

    2013-01-01

    Full Text Available Hyperandrogenism is a common disorder among women in the reproductive age group. One of the rare causes for androgen excess is sex cord- stromal tumors of the ovary. These are usually unilateral. Here we report case of a 48 year old woman who presented with hyperandrogenism due to bilateral ovarian thecoma. Androgen levels normalized following resection of the tumor. This, to the best of our knowledge, is the first case of bilateral thecoma presenting as hirsutism in a premenopausal woman.

  3. Bilateral thecoma presenting as premenopausal hirsutism: Laproscopic removal

    OpenAIRE

    Ramkumar, S; V P Jyotsna; Mallick, S.; Garima Kachhawa; Kandasamy, D; A Kriplani; Ammini, A.C.

    2013-01-01

    Hyperandrogenism is a common disorder among women in the reproductive age group. One of the rare causes for androgen excess is sex cord- stromal tumors of the ovary. These are usually unilateral. Here we report case of a 48 year old woman who presented with hyperandrogenism due to bilateral ovarian thecoma. Androgen levels normalized following resection of the tumor. This, to the best of our knowledge, is the first case of bilateral thecoma presenting as hirsutism in a premenopausal woman.

  4. Presentation of a Rare Case of Bilateral Lumbar Synovial Cysts

    OpenAIRE

    Konstantinos Violaris; Maria Karakyriou

    2012-01-01

    Purpose: To report a quite rare case of bilateral symptomatic synovial cysts of the lumbar spine. Surgical resection is usually the cure for this condition. Methods: A 65 year old female patient came to our department, complaining for severe lumbar and sciatic pain. MRI and CT were used to diagnose bilateral synovial cysts. Because of the intensity of symptoms, she was subjected to surgery. Laminectomy and cyst resection were performed. Results: The patient showed complete resolution of pain ...

  5. Bilateral keratocystic odontogenic tumor: A report of two cases

    OpenAIRE

    Srivatsan, K. S.; Kumar, Vikas; Mahendra, Ashish; Singh, Preeti

    2014-01-01

    The designation “keratocyst” was used to describe any jaw cyst in which keratin was formed to a large extent. A rare incidence of bilateral mandibular cysts (odontogenic keratocysts) was related to third molar teeth. Herein, we report two cases of bilateral keratocystic odontogenic tumor in a 22-year-old male and 15-year-old female, which was diagnosed by a series of investigations and treated appropriately.

  6. Reversible tobramycin-induced bilateral high-frequency vestibular toxicity.

    Science.gov (United States)

    Walsh, R M; Bath, A P; Bance, M L

    2000-01-01

    We report an unusual case of tobramycin-induced bilateral high-frequency vestibular toxicity with subsequent clinical and objective evidence of functional recovery. In those patients with a clinical presentation suggestive of aminoglycoside-induced bilateral vestibular toxicity (ataxia and oscillopsia) and normal low-frequency (ENG-caloric) responses, high-frequency rotation chair testing should be performed to exclude a high-frequency vestibular deficit. PMID:10810261

  7. Stage 4S Bilateral Adrenal Neuroblastoma in a Newborn

    Directory of Open Access Journals (Sweden)

    Rahul Gupta

    2014-02-01

    Full Text Available Stage 4S bilateral adrenal neuroblastoma presenting in the neonatal period is extremely rare. A 1-day-old male with 4S bilateral adrenal neuroblastoma complicated by marked hepatomegaly managed by chemotherapy is being reported. The provisional diagnosis of neuroblastoma was made in the fetal life during the last trimester of pregnancy. Cardiomyopathy due to doxorubicin cytotoxicity developed over ensuing years, which is being treated.

  8. Fast and Accurate Bilateral Filtering using Gauss-Polynomial Decomposition

    OpenAIRE

    Chaudhury, Kunal N.

    2015-01-01

    The bilateral filter is a versatile non-linear filter that has found diverse applications in image processing, computer vision, computer graphics, and computational photography. A widely-used form of the filter is the Gaussian bilateral filter in which both the spatial and range kernels are Gaussian. A direct implementation of this filter requires $O(\\sigma^2)$ operations per pixel, where $\\sigma$ is the standard deviation of the spatial Gaussian. In this paper, we propose an accurate approxi...

  9. Cooled Radiofrequency Ablation for Bilateral Greater Occipital Neuralgia

    OpenAIRE

    Tiffany Vu; Akhil Chhatre

    2014-01-01

    This report describes a case of bilateral greater occipital neuralgia treated with cooled radiofrequency ablation. The case is considered in relation to a review of greater occipital neuralgia, continuous thermal and pulsed radiofrequency ablation, and current medical literature on cooled radiofrequency ablation. In this case, a 35-year-old female with a 2.5-year history of chronic suboccipital bilateral headaches, described as constant, burning, and pulsating pain that started at the subocci...

  10. Amyad's hernia while reparing the bilateral inguinal hernia

    Directory of Open Access Journals (Sweden)

    Arif Aslaner

    2015-01-01

    Full Text Available Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  11. Bilateral diffuse uveal melanocytic proliferation: a management dilemma

    OpenAIRE

    Alrashidi, Salah; Aziz, Ayman A; Krema, Hatem

    2014-01-01

    A female patient suffered from gradual decline of vision for few months. She presented with bilateral multiple pigmented choroidal tumours, associated with overlying retinal changes. The clinical presentation suggested bilateral diffuse uveal melanocytic proliferation (BDUMP) syndrome, which is a paraneoplastic disease, although there was no evidence of any concurrent malignancy. The periodic systemic surveillance that was undertaken for the following 4 years failed to reveal any occult cance...

  12. Misdiagnosis of bilateral tubal pregnancy: a case report

    OpenAIRE

    Li, Weifeng; Wang, Gang; Lin, Tiecheng; Sun, Wenwen

    2014-01-01

    Introduction The incidence of bilateral tubal pregnancy is rising due to the increase of pelvic inflammatory disease and assisted reproductive techniques. Because the clinical manifestations of bilateral tubal pregnancy are not specific, we often ignore inspection of the other fallopian tube when focusing on the lesions, which may cause misdiagnosis. Case presentation A 33-year-old Chinese woman presented with vaginal bleeding after menopause and with an abnormality found by transvaginal ultr...

  13. Association of Cryptogenic Organizing Pneumonia in Bilateral Anterior Uveitis

    OpenAIRE

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

    2014-01-01

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

  14. Bilateral adrenal hemorrhage and primary antiphospholipid antibody syndrome

    International Nuclear Information System (INIS)

    Bilateral adrenal hemorrhage is an uncommon entity that is difficult to diagnose given the ambiquity of the clinical signs. Computerized tomography plays a major role in the diagnosis, disclosing enlarged adrenal glands presenting the hyperdense aspect that characterizes this disorders. We present a case of bilateral adrenal hemoorrhage in a patient diagnosed as having primary antiphospholipid antibody syndrome, which is a less common cause of adrenal hemorrhage than those classically reported, such as anticoagulant therapy, sepsis, shock and abdominal injury. (Author) 8 refs

  15. Ultrasound Diagnosis of Bilateral Quadriceps Tendon Rupture After Statin Use

    Directory of Open Access Journals (Sweden)

    Nesselroade, Ryan D

    2010-09-01

    Full Text Available Simultaneous bilateral quadriceps tendon rupture is a rare injury. We report the case of bilateral quadriceps tendon rupture sustained with minimal force while refereeing a football game. The injury was suspected to be associated with statin use as the patient had no other identifiable risk factors.The diagnosis was confirmed using bedside ultrasound. [West J Emerg Med. 2010; 11(4:306-309.

  16. Bilateral practice improves dominant leg performance in long jump.

    Science.gov (United States)

    Focke, Anne; Spancken, Sina; Stockinger, Christian; Thürer, Benjamin; Stein, Thorsten

    2016-10-01

    Benefits of bilateral practice both for the non-dominant and for the dominant body side have been shown in several studies. Thereby, most of the studies included movement tasks of the upper extremity or investigated sports games in which the ability of acting bilaterally is an essential basis for success and, thus, a bilateral practice is reasonable anyway. Individual unilaterally performed sports including movement tasks of the lower extremity are rarely investigated. Therefore, the aim of our study was to test if contralateral transfer due to bilateral practice can be found in an unilaterally performed sport including the lower extremity. We trained and tested 61 adolescent athletes in long jump to compare the jumping performance of the dominant leg after a 12-week practice period between two groups: a bilateral practice group that practiced specific long jump exercises with both the dominant and non-dominant leg and an unilateral practice group that practiced specific long jump exercises only with the dominant leg. Results showed a superior effect of bilateral practice compared to unilateral practice regarding the jumping performance of the dominant leg. The performance increase at post-test and retention-test for the dominant limb was significantly higher for the bilateral practice group (pre-to-post: 5.2%, pre-to-retention: 7.4%) compared to the unilateral practice group (pre-to-post: 3.4%, pre-to-retention: 4.5%). Thus, bilateral practice should be established in the early practice programmes of track and field athletes to improve the performance of the dominant take-off leg. PMID:26864045

  17. Localisation with bilateral hearing aids: without is better than with

    OpenAIRE

    Van den Bogaert, Tim; Moonen, Marc; Wouters, Jan

    2004-01-01

    By using two ears normal hearing people are able to localize sounds correctly in the horizontal plane, and are able to understand speech better in noisy scenario’s where noise and target are spatially separated. Although a lot of studies have been done on normal hearing and hearing impaired persons, little research has been done on directional hearing in bilateral hearing aid users. A person with bilateral hearing aids is wearing two independent digital signal processors with microphones ...

  18. Bilateral intramuscular pseudotumor in a body-builder.

    OpenAIRE

    Ardies, L; Beule, T.; Degroote, T; Vanhoenacker, F M; Vanhoenacker, P K

    2012-01-01

    A 29-year-old bodybuilder presented with a bilateral palpable and painful soft tissue mass in the deltoid region. CT scan showed a bilateral intramuscular mass within the deltoid muscle with intralesional fat (not shown). For further differentiation and exclusion of a fat-containing sarcomatous lesion, MRI of both shoulders was performed. Axial T1-weighted images (WI) of the right shoulder showed a heterogeneous mass lesion containing multiple fatty components (Fig. A, arrows). Axial T1-WI of...

  19. Bilateral FTAs in South Asia: Recasting the Regionalism Debate

    OpenAIRE

    Dushni Weerakoon

    2009-01-01

    The slow pace of progress of the South Asian regional trade integration process under SAARC has prompted many countries to seek bilateral agreements. Sri Lanka is a casein point with bilateral agreements with both India and Pakistan. While the former is acknowledged to have yielded positive results, the latter hasremained of limited interest. Given that India remains the single most important trading partner for almost all other South Asian countries, regionalism in South Asia essentially ent...

  20. Bilateral Central Vein Occlusion in a Case of Diaphragmatic Eventration

    OpenAIRE

    STER, Anda-Maria; Stan, Cristina; GHERVAN, Mihaela

    2014-01-01

    Central Retinal Vein Occlusion (CRVO) is a severe retinal pathology, which causes visual impairment usually after the age of 40. Mostly unilateral, less than 10% of cases are bilateral. Affected young adults (under the age of 40), usually exhibit a hidden, underlying systemic disease. Thorough testing has to be done in order to spot the pathogenic agent. We present the case of a 25 years old woman with bilateral CRVO caused by Diaphragmatic Eventration and Chronic Respiratory Failure.

  1. Bilateral central vein occlusion in a case of diaphragmatic eventration.

    Science.gov (United States)

    Ster, Anda-Maria; Stan, Cristina; Ghervan, Mihaela

    2014-09-01

    Central Retinal Vein Occlusion (CRVO) is a severe retinal pathology, which causes visual impairment usually after the age of 40. Mostly unilateral, less than 10% of cases are bilateral. Affected young adults (under the age of 40), usually exhibit a hidden, underlying systemic disease. Thorough testing has to be done in order to spot the pathogenic agent. We present the case of a 25 years old woman with bilateral CRVO caused by Diaphragmatic Eventration and Chronic Respiratory Failure. PMID:25705293

  2. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    OpenAIRE

    Patil, Mallanagouda N

    2013-01-01

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

  3. Bilateral fracture dislocation of the shoulder (Presentation of a Case)

    OpenAIRE

    Kuzgun, Unal; Baskir, Orhan; Temelli, Yener; Yazicioglu, Onder; Temocin, Bahattin O.; Kokino, Misel

    2004-01-01

    The largest portion of the dislocations encountered in the adults comprises shoulder dislocations and 2.16% of these dislocations constitute posterior dislocations. It is possible to detect that a dislocation develops secondary to convulsions due to immediate loss of consciousness in the history of most of the posterior dislocations of the shoulder. Approximately 20 cases have been so far reported in literature regurding bilateral dislocations of the shoulder. Bilateral dislocation associated...

  4. Amyad's hernia while reparing the bilateral inguinal hernia

    OpenAIRE

    Arif Aslaner; Tuğrul Çakır; Umut Rıza Gündüz; Burhan Mayir; Nurullah Bülbüller

    2015-01-01

    Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  5. Bilateral compared with unilateral sacral nerve stimulation for faecal incontinence

    DEFF Research Database (Denmark)

    Duelund-Jakobsen, J; Buntzen, S; Lundby, L;

    2015-01-01

    % improvement were eligible. Twenty-seven patients who accepted to enter the trial were bilaterally implanted with two permanent leads and pacemakers. Patients were randomized into three periods of four weeks stimulation including unilateral right, unilateral left and bilateral. Symptoms scores and bowel habit...... incontinence is not superior to standard unilateral stimulation in the short term. Equal functional results can be obtained regardless the side of implantation. This article is protected by copyright. All rights reserved....

  6. Cardiovascular disease risk in adults with spastic bilateral cerebral palsy

    OpenAIRE

    Slot, Wilma; Roebroeck, Marij; Nieuwenhuijsen, Channah; Bergen, Michael; Stam, Henk; Burdorf, Alex; Berg-Emons, Rita

    2013-01-01

    textabstractObjective: To explore: (i) cardiovascular disease risk factors and the 10-year clustered risk of a fatal cardiovascular event in adults with spastic bilateral cerebral palsy; and (ii) relationships between the 10-year risk and body fat, aerobic fitness and physical activity. Design: Cross-sectional study. Subjects: Forty-three adults with spastic bilateral cerebral palsy without severe cognitive impairment (mean age 36.6 years (standard deviation 6); 27 men). Methods: Biological a...

  7. Bilateral Traumatic Globe Luxation with Optic Nerve Transection

    Directory of Open Access Journals (Sweden)

    Levent Tok

    2014-12-01

    Full Text Available Purpose: The purpose of this study was to document clinical findings and management of a patient with bilateral globe luxation and optic nerve transection. Materials and Methods: A 25-year-old female patient was admitted to the emergency department with bilateral traumatic globe luxation following a motor vehicle accident. Results: Visual acuity testing showed no light perception. The right pupil was dilated and bilaterally did not react to light. The globes were bilaterally intact. A computed tomography scan revealed Le Fort type II fractures, bilateral optic nerve transection and disruption of all extraocular muscles. The globes of the patient were bilaterally reduced into the orbit. However, the patient developed phthisis bulbi in the right eye at month 3. Conclusion: Globe luxation presents a dramatic clinical picture, and may lead to the development of severe complications due to the concomitance of complete optic nerve dissection and multiple traumas. Even if the luxated globe is repositioned into the orbit, there is still an increased risk of the development of phthisis due to ischemia.

  8. Sense of smell in patients with bilateral nasal polyposis

    Directory of Open Access Journals (Sweden)

    Savović Slobodan N.

    2004-01-01

    Full Text Available Introduction Sense of smell is susceptible to various changes, both in physiological and in numerous pathological conditions. Of quantitative disorders of smell, hyposmia and anosmia are quite common, whereas of qualitative disorders parosmia is most frequent. The aim of this paper was to examine impact of bilateral nasal polyposis on olfactory function. Material and methods The research was carried out at the Nose, Ear and Throat Clinic in Novi Sad. It included 80 examinees, 40 (20 male, 20 female with bilateral nasal polyposis, while 40 examinees belonged to the control group (20 male, 20 female without symptoms of nasal polyposes. Fortunato-Niccolini olfactometer was used for this examination. Results and discussion In patients with bilateral nasal polyposis the average perception threshold values for examined odors were 15.50 ccm of odorous air, while in the control group they were 10,20 ccm of odorous air. The average identification threshold values for examined odors in patients with bilateral nasal polyposis were 18.80 ccm of odorous air, while in the control group they were 13.55 ccm of scented air. T-test showed that values of both tresholds were statistically significantly higher (p< 0,01 in patients with bilateral nasal polyposis in relation to the control group. Conclusion Olfactory deficit in patients with bilateral nasal polyposis is explained by difficult or impossible passage of odors into the olfactory region.

  9. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Mallanagouda N Patil

    2013-04-01

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

  10. Neuralgia do trigêmeo bilateral: relato de caso Neuralgia del trigémino bilateral: relato de caso Bilateral trigeminal neuralgia: case report

    OpenAIRE

    Caio Marcio Barros de Oliveira; Luis Gustavo Baaklini; Adriana Machado Issy; Rioko Kimiko Sakata

    2009-01-01

    JUSTIFICATIVA E OBJETIVOS: A neuralgia do nervo trigêmeo é uma condição intensamente dolorosa, caracterizada por surtos de dor lancinante e súbita, tipo choque, com duração de poucos segundos a dois minutos e geralmente unilateral. Sua incidência anual é de cerca de 4,3 em 100.000 na população geral, tendo manifestação bilateral em apenas 3% desses casos. O objetivo deste artigo foi descrever um caso raro de neuralgia do trigêmeo primário bilateral. RELATO DO CASO: Paciente de 61 anos, maranh...

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

    OpenAIRE

    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.

  12. Bilateral naso labial cyst: report of two cases; Cisto nasolabial bilateral: relato de dois casos

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Rodrigo de; Haetinger, Rainer Guilherme [Hospital Beneficencia Portuguesa de Sao Paulo, SP (Brazil). Med Imagem; Sales, Marcelo Augusto Oliveira [Universidade Federal da Paraiba (UFPB), Joao Pessoa, PB (Brazil). Hospital Universitario Lauro Wanderley; Fonseca, Luciana Cardoso [Pontificia Universidade Catolica de Belo Horizonte, MG (Brazil). Faculdade de Odontologia; Cavalcanti, Marcelo Gusmao Paraiso [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Estomatologia]. E-mail: mgpcaval@usp.br

    2007-07-01

    The nasolabial cyst is defined as nonodontogenic soft tissue lesion, rare and with occurrence in sagittal plane, between midline and nasal cartilage. Because its soft tissue composition, there is no radiographic presentation in conventional radiographic examination, being indicated evaluation through computed tomography and magnetic resonance imaging. In the present study, two cases are discussed, being one in white female subject, 72-year-old, and other in a black male subject, 24-year-old. The authors discuss about relevant aspects related to differential diagnosis through computed tomography and magnetic resonance imaging, as well as atypical features founded in one of the cases, like bilateral occurrence with different signal intensity in magnetic resonance imaging and determinant factors for differential diagnosis of soft tissues pathologies of maxillofacial complex, as fissure cysts with central occurrence (sagittal cysts), as dermoid cysts, palatine and nasopalatine and lateral fissure cysts. (author)

  13. Paresia diafragmática bilateral idiopática Idiopathic bilateral diaphragmatic paresis

    OpenAIRE

    Mônica Corso Pereira; Rodrigo Frange Miziara Mussi; Reinaldo Alexandre de Carvalho Massucio; Ana Maria Camino; Aristóteles de Souza Barbeiro; Wander de Oliveira Villalba; Ilma Aparecida Paschoal

    2006-01-01

    Relata-se o caso de um paciente com dispnéia intensa ao se deitar, em que foram excluídas doenças pulmonares, neuromusculares ou cardíacas, cuja investigação revelou paresia diafragmática bilateral. Um sinal chave para o diagnóstico foi a evidência de respiração paradoxal com o doente em decúbito supino. Havia piora da oxigenação e da capacidade vital forçada com a mudança da posição ortostática para supina. A fluoroscopia ortostática foi normal. A pressão inspiratória máxima estava muito red...

  14. Bilateral type emphysematous pyelonephritis: imaging evaluation; Pielonefritis enfisematosa bilateral tipo I. Evaluacion por la imagen

    Energy Technology Data Exchange (ETDEWEB)

    Salvador Cueto-Alvarez, L.; Piriz-Campos, E.; Ruiz-Garcia, T.; Roldan-Lora, F. [Hospital Universitario Virgen Macarena. Sevilla (Spain)

    2000-07-01

    Emphysematous pyelonephritis (EPN) is a serious infectious disease that occurs more frequently in diabetic patients. Radiological studies are indispensable for distinguishing between the two types since each is associated with a markedly different prognosis. We present a case of bilateral EPN diagnosed as type I on the basis of computed tomography findings, differentiating it from type II EPN, taking into account the prognostic value of this distinction. Type I EPN is characterized by the destruction of the renal parenchyma, a mottled or linear gas pattern and the absence of renal and perirenal fluid collection. Type II EPN is characterized by a loculated or bubbly gas pattern, the existence of fluid collection and less marked renal destruction. Type I is more aggressive and is associated with high rate of mortality. (Author) 7 refs.

  15. An unusual case of sub-condylar bilateral fracture and bilateral post-traumatic temporomandibular ankylosis.

    Science.gov (United States)

    Matteini, C; Belli, E

    2001-01-01

    A case of bilateral sub-condylar fracture with wide stump dislocation associated with a central facial trauma, fracture-intrusion of the rhino-orbital-maxillary complex and a parasymphyseal mandibular fracture, is reported. After surgery and inter-maxillary fixation an unusual temporo-mandibular ankylosis developed. Maximum mouth opening, lateral and protrusive movements were severely limited. Surgical treatment of ankylosis was requested and performed. The originality of this case lies in the atypical lateral dislocation of condylar neck fractured stumps to the zygomatic arches and in the later appearance of ankylosis between the glenoid fossa, zygomatic arch, condylar neck stump, and the condylar process displaced anteromedially. The ankylosed blocks were resected, displaced condyles were also removed due to the strong adhesion with the ankylotic tissue and the lack of any anatomical continuity or connection with the glenoid fossa. Functional therapy allowed the resolution of the functional limitation. PMID:11723434

  16. 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

  17. US findings of bilateral primary breast cancer: Retrospective study

    International Nuclear Information System (INIS)

    Background: For women with breast cancer, the contralateral breast is at high risk. The bilateral cancers may be synchronous or metachronous. If the bilateral breast cancers have similar ultrasonography (US) appearances, the US findings of the first breast cancer (index cancer) might lead to early detection of the contralateral cancer. The purpose of this study was to identify the US characteristics of bilateral breast cancer and to determine whether bilateral breast cancers have similar US appearances and whether the US findings for one breast cancer might be predictive of the contralateral breast cancer. Methods: We retrospectively reviewed the US manifestations of 58 patients with surgically proven bilateral primary breast cancer and compared the contralateral cancer with the index cancer by evaluation the margin, shape, inside echoes, posterior attenuation, calcification and color flow signals of 58 lesion pairs to investigate whether the bilateral breast cancers have similar US appearances. Results: Bilateral primary breast cancers were more located in upper outer quadrant, frequently spiculation, taller than wide shape, with irregular margin, heterogeneous internal echo and acoustic shadowing, containing microcalcification and abundant color flow signals. The most common US appearances were taller than wide shape (75.0%, 87/116), irregular margins (79.3%, 92/116) and heterogeneous internal echo (86.2%, 100/116). Of the total 58 lesion pairs, 18 (31.0%) pairs had similar US characteristics, whereas 40 (69.0%) pairs had different US characteristics. Conclusions: US signs of the index cancer do not indicate the most likely appearance of the second cancer in the contralateral breast. Evaluation of the contralateral cancer should be performed without regard for the US findings for the index cancer

  18. Bilateral adrenal masses: a single-centre experience

    Science.gov (United States)

    Bandgar, Tushar; Khare, Shruti; Jadhav, Swati; Lila, Anurag; Goroshi, Manjunath; Kasaliwal, Rajeev; Khadilkar, Kranti; Shah, Nalini S

    2016-01-01

    Background Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenal masses are limited. Aims To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses. Methods Retrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India (2002–2015). Results The most common aetiology was pheochromocytoma (40%), followed by tuberculosis (27.1%), primary adrenal lymphoma (PAL) (10%), metastases (5.7%), non-functioning adenomas (4.3%), primary bilateral macronodular adrenal hyperplasia (4.3%), and others (8.6%). Age at presentation was less in patients with pheochromocytoma (33 years) and tuberculosis (41 years) compared with PAL (48 years) and metastases (61 years) (PAI) (95%). The presenting symptoms for PAL were AI (57%) and abdominal pain (43%), whereas all cases of metastasis had abdominal pain. Mean size of adrenal masses was the largest in lymphoma (5.5cm) followed by pheochromocytoma (4.8cm), metastasis (4cm) and tuberculosis (2.1cm) (P<0.001). Biochemically, most patients with pheochromocytoma (92.8%) had catecholamine excess. Hypocortisolism was common in tuberculosis (100%) and PAL (71.4%) and absent with metastases (P<0.001). Conclusion In evaluation of bilateral adrenal masses, age at presentation, presenting symptoms, lesion size, and biochemical features are helpful in delineating varied underlying aetiologies. PMID:27037294

  19. Bilateral optic nerve sheath meningiomas in a patient with neurofibromatosis type 2.

    OpenAIRE

    Cunliffe, I A; Moffat, D A; Hardy, D G; Moore, A T

    1992-01-01

    A 34-year-old woman who presented with hearing loss and tinnitus was found to have reduced vision bilaterally. Computed tomography scan revealed bilateral acoustic neuromas and bilateral optic nerve sheath meningiomas. The presence of bilateral acoustic neuromas fulfils the criteria for the diagnosis of central neurofibromatosis (neurofibromatosis type 2). Although this is the first report of bilateral optic nerve sheath meningioma in neurofibromatosis type 2, meningiomas are commoner in this...

  20. 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

  1. Successful management of bilateral patellar tendon rupture in a dog.

    Science.gov (United States)

    Shipov, A; Shahar, R; Joseph, R; Milgram, J

    2008-01-01

    A seven-year-old, 41 kg, intact, cross breed dog, was presented with a history of bilateral hind limb lameness after falling from a height of 1 m. Clinical and radiographic findings were consistent with bilateral patellar tendon rupture. Surgical repair was performed bilaterally. The tendons were sutured primarily, and an internal splint of nylon leader was added. Good apposition of the severed tendon ends had been achieved intraoperatively; however, post operative radiographs showed supra-trochlear displacement of both patellae. The casts used to immobilize the stifle joints slipped distally and three days post operatively the tendon repair had broken down, bilaterally. Revision surgery was undertaken and the tendons were re-sutured. Nylon leader was placed through holes that had been drilled in the patellae and tibiae. The stifle joints were immobilized with type I external skeletal fixators (ESFs). Both freeform polymethylmethacrylate (PMMA) connecting bars were found to be broken at the level of the stifle joints two days later, without any disruption of the primary tendon repair. Each connecting bar was replaced with two connecting bars of PMMA reinforced with 3 mm steel wire. The dog was fully weight-bearing with a reduced range of motion in flexion immediately after removal of the ESFs at six weeks and was still sound 18 months post-operatively. Primary tendon repair in combination with adequate immobilization allowed for an excellent outcome in a complicated bilateral pathology. PMID:18545725

  2. Association of Cryptogenic Organizing Pneumonia in Bilateral Anterior Uveitis

    Directory of Open Access Journals (Sweden)

    Kaori Fujimoto

    2014-11-01

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

  3. Bilateral Ramsay Hunt syndrome in a diabetic patient

    Directory of Open Access Journals (Sweden)

    Goyal Amit

    2004-12-01

    Full Text Available Abstract Background Herpes zoster oticus accounts for about 10% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. Bilateral herpes zoster oticus can sometime occur in immunocompromised patients, though incidence is very rare. Case presentation Diabetic male, 57 year old presented to us with bilateral facial palsy due to herpes zoster oticus. Patient was having bilateral mild to moderate sensorineural hearing loss. Patient was treated with appropriate metabolic control, anti-inflammatory drugs and intravenous acyclovir. Due to uncontrolled diabetes, glucocorticoids were not used in this patient. Significant improvement in hearing status and facial nerve functions were seen in this patient. Conclusions Herpes zoster causes severe infections in diabetic patients and can be a cause of bilateral facial palsy and bilateral Ramsay Hunt syndrome. Herpes zoster in diabetic patients should be treated with appropriate metabolic control, NSAIDS and intravenous acyclovir, which we feel should be started at the earliest. Glucocorticoids should be avoided in diabetic patients.

  4. Empirical Analysis of Xinjiang's Bilateral Trade: Gravity Model Approach

    Institute of Scientific and Technical Information of China (English)

    CHEN Xuegang; YANG Zhaoping; LIU Xuling

    2008-01-01

    Based on the basic trade gravity model and Xinjiang's practical situation, new explanatory variables (GDP,GDPpc and SCO) are introduced to build an extended trade gravity model fitting for Xinjiang's bilateral trade. Fromthe empirical analysis of this model, it is proposed that those three variables affect the Xinjiang's bilateral trade posi-tively. Whereas, geographic distance is found to be a significant factor influencing Xinjiang's bilateral trade negatively.Then, by the extended trade gravity model, this article analyzes the present trade situation between Xinjiang and itsmain trade partners quantitatively in 2004. The results indicate that Xinjiang cooperates with its most trade partnerssuccessfully in terms of present economic scale and developing revel. Xinjiang has established successfully trade part-nership with Central Asia, Central Europe and Eastern Europe, Western Europe, East Asia and South Asia. However,the foreign trade development with West Asia is much slower. Finally, some suggestions on developing Xinjiang's for-eign trade are put forward.

  5. Bilateral Synchronous Ectopic Ethmoid Sinus Olfactory Neuroblastoma: A Case Report.

    Science.gov (United States)

    Leon-Soriano, Elena; Alfonso, Carolina; Yebenes, Laura; Garcia-Polo, Julio; Lassaletta, Luis; Gavilan, Javier

    2016-01-01

    BACKGROUND Olfactory neuroblastoma (ONB), also known as esthesioneuroblastoma, is a rare malignant head and neck cancer thought to originate from the olfactory epithelium. It typically invades contiguous structures at presentation. We report a very rare case of multifocal and ectopic ONB. CASE REPORT A 41-year-old man presented with left nasal obstruction and occasional left epistaxis associated with headache. Endoscopic examination of the nasal cavities and computed tomography suggested bilateral polypoid masses. Histopathological diagnosis after endoscopic resection established bilateral olfactory neuroblastoma of the ethmoid sinuses. The patient received postoperative radiotherapy. He remains free of disease 4 years after treatment. CONCLUSIONS To the best of our knowledge this is the second documented case of multifocal ectopic olfactory neuroblastoma. Clinicians should consider ONB in the differential diagnosis of bilateral synchronous nasal and paranasal masses to avoid delayed diagnosis. Endoscopic resection of ONB could be an option in selected cases. PMID:27097989

  6. Adenocarcinoma of the ethmoid following radiotherapy for bilateral retinoblastoma

    International Nuclear Information System (INIS)

    Adenocarcinoma of the ethmoid sinus is rare, representing only 4 to 8% of malignancies of the paranasal sinuses. An extraordinary case of papillary adenocarcinoma of the ethmoid sinus arising 30 years following high-dose radiotherapy for bilateral retinoblastoma is presented. Second fatal mesenchymal and epithelial primaries have been described in 8.5% of patients with bilateral retinoblastomas previously treated with radiotherapy; however, papillary adenocarcinoma arising within the paranasal sinuses has not been reported. Aggressive treatment including partial maxillectomy, radical pansinusectomy, radical neck dissection followed by regional radiotherapy and systemic chemotherapy failed to prevent the development of fatal hepatic metastases. The high incidence of second fatal primary neoplasms in patients with bilateral retinoblastomas receiving radiation suggests an innate susceptibility that may add to the risk of radiotherapy

  7. Bilateral fat necrosis of the breast: report of a case.

    Directory of Open Access Journals (Sweden)

    Sonobe,Hiroshi

    1980-11-01

    Full Text Available A rare case of bilateral fat necrosis of the breast is reported. The patient was a 50-year-old unmarried woman having no history of trauma, disease or surgery of the breast. In the bilateral breasts, ill-defined, firm masses with skin retraction were noted. Bilateral breast cancer was diagnosed clinically. However, both lesions showed histologically chronic granulomatous inflammation with foci of fatty necrosis, infiltration of lymphocytes, plasma cells, lipid containing foamy cells, foreign body giant cells engurfing choresterol-crystals, and calcification. "Paraffinoma" was thus suspected, but there was no history of cosmetic mammoplasty and histochemical studies failed to demonstrate saturated lipid indicating paraffin or other mineral oils

  8. Bilateral macular injury from a green laser pointer

    Directory of Open Access Journals (Sweden)

    Dirani A

    2013-10-01

    Full Text Available Ali Dirani,1,2 Elias Chelala,2 Ali Fadlallah,1,2 Rafic Antonios,1 George Cherfan11Beirut Eye Specialist Hospital, 2Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon Abstract: We report the case of a 13-year-old boy who had a bilateral macular injury after playing with a green laser pointer for a duration of 1 minute. Clinical examination revealed a decrease in visual acuity and macular injury in both eyes, and imaging investigations revealed a bilateral macular lesion due to exposure to the laser pointer. At 3 months' follow up, visual function had improved but remained partially impaired. This case emphasizes the importance of cautious and appropriate use of laser pointer devices because of the potential vision-threatening hazards induced by mishandling of these devices. Keywords: green laser pointer, bilateral, macular injury

  9. Repair of bilateral cleft lip and its variants

    Directory of Open Access Journals (Sweden)

    Mulliken John

    2009-10-01

    Full Text Available The surgeon who lifts a scalpel to repair a bilateral cleft lip and nasal deformity is accountable for: 1 precise craftsmanship based on three-dimensional features and four-dimensional changes; 2 periodic assessment throughout the child′s growth; and 3 technical modifications during primary closure based on knowledge gained from long-term follow-up evaluation. These children should not have to endure the stares prompted by nasolabial stigmata that result from outdated concepts and technical misadventures. The principles for repair of bilateral complete cleft lip have evolved to such a level that the child′s appearance should be equivalent to, or surpass, that of a unilateral complete cleft lip. These same principles also apply to the repair of the variants of bilateral cleft lip, although strategies and execution differ slightly.

  10. Introduction of a Case of Bilateral Pheochromocytoma Tumor

    Directory of Open Access Journals (Sweden)

    M Zare

    2009-01-01

    Full Text Available Summary: Pheochromocytoma is an adrenal tumor characterized by symptoms of hypertension, headache, increased sweating, and tachycardia .In one third of patients, the tumor is discovered incidentally during radiological evaluation of the abdomen. In this article a case of bilateral pheochromocytoma is reported. The patient, a twelve years old boy, referred with complaints of headache, flushing, palpitation and blurring of vision. He had a blood pressure of 200/120 mmHg and after investigation, coarctation of aorta was excluded. On abdominal ultrasound, bilateral adrenal mass was diagnosed, followed by serial measurements of urinary vanillyl mandellic acid (VMA which was found to be elevated. Meta- Iodio benzyl glunidin (MIBG scan showed increased uptake in both adrenals. Patient underwent laparotomy and bilateral adrenalectomy with the diagnosis of pheochromocytoma. Pathologic report confirmed the diagnosis

  11. CETA - BILATERAL TRADE AGREEMENT BETWEEN THE EU AND CANADA

    Directory of Open Access Journals (Sweden)

    Ludmila Borta

    2014-04-01

    Full Text Available The international trade for wide world countries in the means more growth, more jobs and access on more products at competitive prices. The European Union is a major economy and an important trading partner for many countries and regions in the world. To stimulate growth and to create jobs in the Union, this economy has concluded multilateral trade agreement (under the World Trade Organisation and a number of bilateral (preferential trade agreements. The aim of this paper is to present an example of fully elimination of tariffs and tariff lines under a bilateral trade agreement. In this case, we have analysed Comprehensive Economic and Trade Agreement (CETA negotiated by the European Union and Canada. For both sides of Atlantic, the CETA is supposed to bring the solution for today's issues concerning the important trading aspects and, also, to facilitate the EU-Canada bilateral trade by creating competition.

  12. 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.

  13. Constipation following bilateral of internal iliac artery aneurysms

    Directory of Open Access Journals (Sweden)

    S Morita

    2012-09-01

    Full Text Available A 72-year-old man presented with constipation. He was hypertensive and suffered from chronic constipation. On arrival, the patient was fully conscious, and his vital signs were stable. He requested an enema because this treatment had proved effective in the past. On physical examination, a hard palpable mass was detected in the lower abdomen. Computed tomography was performed with contrast media. It revealed an abdominal aortic aneurysm (AAA and bilateral internal iliac artery aneurysms (IIAAs; the latter obstructing the sigmoid colon. We believe that this obstruction was the cause of constipation. The patient underwent Y-graft replacement for the treatment of the AAA and bilateral IIAAs. The surgery was successful, and constipation has not recurred since. As constipation is the most common digestive disorder in the general population, all physicians should be aware that chronic constipation can be caused by bilateral IIAAs.

  14. International bilateral and multilateral arrangements in energy technologies

    International Nuclear Information System (INIS)

    This document, the second report in the series, outlines current DOE international commitments under bilateral and multilateral arrangements, as of January 1, 1978. Included are bilateral agreements for cooperation in the civil uses of atomic energy with countries and international organizations, bilateral and multilateral technical exchanges in all energy technology areas, and multilateral agreements under the auspices of the International Energy Agency (IEA). In addition to outlining the terms, scope, and status of these agreements, this document describes DOE's participation in the work of the major international energy organizations. IEA, the International Atomic Energy Agency (IAEA), and the Nuclear Energy Agency (NEA). Future reports will update the status of ongoing cooperative projects and provide information on new energy R and D activities

  15. Bilateral diffuse tumorous pseudoangiomatous stromal hyperplasia: a case of bilateral mastectomy in a 29-year-old woman.

    Science.gov (United States)

    Dai, Hongyan; Connor, Carol; Cui, Wei; Gatewood, Jason; Fan, Fang

    2014-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast lesion commonly encountered as an incidental microscopic finding. However, it can also manifest as a mass-forming lesion (tumorous PASH) capable of recurrence after surgical excision. Most of the previously reported cases of tumorous PASH present as a single dominant mass. Here we reported a rare case of diffuse tumorous PASH involving bilateral breasts clinically mimicking malignancy. A 29-year-old African-American female presented with a one-year history of bilateral breast enlargement and asymmetry. Physical examination revealed multiple palpable nodules in bilateral breasts. Imaging studies demonstrated innumerable homogeneously enhancing masses throughout both breasts, greater on the left, with multiple cysts and edema. Biopsy of the breast nodules demonstrated histopathological changes consistent with PASH. Due to the extent of the lesions and progressive clinical symptoms, decision was made to perform bilateral mastectomy. Macroscopic examination of the bilateral mastectomy specimens revealed markedly enlarged breasts with marked edema and numerous well-defined firm nodules. Microscopic evaluation of the nodules confirmed the diagnosis of PASH. No evidence of malignancy was identified. Recognition of this rare form of PASH is essential for the proper clinical management. PMID:25544925

  16. Unusual Anatomic Variations Associated With Bilateral Ulnar Artery Hypoplasia.

    Science.gov (United States)

    Ro, Hyung-Suk; Roh, Si-Gyun; Shin, Jin Yong; Lee, Nae-Ho; Yang, Kyung-Moo

    2016-05-01

    Variations and anomalies of upper extremities have been commonly reported in routine dissection, clinical practices, and cadaver studies. Despite ongoing research on arterial variations of upper extremities, the absence of bilateral ulnar artery is extremely rare with only 3 patients reported. As the authors are presenting a successfully treated patient, initially prepped for radial forearm osteocutaneous free flap for treatment on oromandibular defect after a wide resection of head and neck cancer lesion, being confirmed to have bilateral ulnar artery hypoplasia and due to this, the patient had to change her surgical plan to fibular osteocutaneous free flap. PMID:27100648

  17. Bilateral macular injury from a green laser pointer

    OpenAIRE

    Fadlallah, Ali

    2013-01-01

    Ali Dirani,1,2 Elias Chelala,2 Ali Fadlallah,1,2 Rafic Antonios,1 George Cherfan11Beirut Eye Specialist Hospital, 2Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon Abstract: We report the case of a 13-year-old boy who had a bilateral macular injury after playing with a green laser pointer for a duration of 1 minute. Clinical examination revealed a decrease in visual acuity and macular injury in both eyes, and imaging investigations revealed a bilateral macular lesion due to expo...

  18. Bilateral macular injury from a green laser pointer.

    Science.gov (United States)

    Dirani, Ali; Chelala, Elias; Fadlallah, Ali; Antonios, Rafic; Cherfan, George

    2013-01-01

    We report the case of a 13-year-old boy who had a bilateral macular injury after playing with a green laser pointer for a duration of 1 minute. Clinical examination revealed a decrease in visual acuity and macular injury in both eyes, and imaging investigations revealed a bilateral macular lesion due to exposure to the laser pointer. At 3 months' follow up, visual function had improved but remained partially impaired. This case emphasizes the importance of cautious and appropriate use of laser pointer devices because of the potential vision-threatening hazards induced by mishandling of these devices. PMID:24204114

  19. Bilateral macular injury from a green laser pointer

    OpenAIRE

    Dirani A; Chelala E; Fadlallah A; Antonios R; Cherfan G

    2013-01-01

    Ali Dirani,1,2 Elias Chelala,2 Ali Fadlallah,1,2 Rafic Antonios,1 George Cherfan11Beirut Eye Specialist Hospital, 2Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon Abstract: We report the case of a 13-year-old boy who had a bilateral macular injury after playing with a green laser pointer for a duration of 1 minute. Clinical examination revealed a decrease in visual acuity and macular injury in both eyes, and imaging investigations revealed a bilateral macular lesion due to expos...

  20. Bilateral transaction bargaining between independent utilities under incomplete information

    International Nuclear Information System (INIS)

    A new approach to designing bilateral power transaction bargaining models between two independent utilities in a deregulated electricity market is proposed. In the paper it is assumed that each utility (a seller or a buyer) knows its own operating costs but does not know those of its opponent. The bilateral power transaction problem is then considered as non-cooperative bargaining under incomplete information. Each participant develops its own bargaining strategy based on estimates of the opponent's operating costs and bargaining strategy. Two bargaining models are developed and examples are employed for demonstration. (Author)

  1. A rare entity in adults: Bilateral Hutch diverticulum with calculi.

    Science.gov (United States)

    Telli, Onur; Guclu, Adil Gucal; Haciyev, Perviz; Burgu, Berk; Gogus, Cagatay

    2015-01-01

    Congenital bladder diverticulum (CBD) is a very uncommon entity in adults. CBD could be unilateral or bilateral and is caused by a congenital weakness in the bladder musculature. CBD is differentiated from the paraureteral or Hutch type of diverticula. A 42-year-old male presented with bilateral Hutch diverticulum and multiple diverticulum calculus on intravenous pyelography. Cystoscopy revealed bladder diverticulum just medial to the left ureteral orifice with multiple calculi; the patient successfully underwent endoscopic laser cystolithotripsy with resolution of his urinary tract infection. To the best of our knowledge, this is the first case report presenting stone formation of CBD in an adult. PMID:26029313

  2. Bilateral giant femoropopliteal artery aneurysms: a case report

    Directory of Open Access Journals (Sweden)

    Perdikides Theodossios P

    2008-04-01

    Full Text Available Abstract Introduction Popliteal artery aneurysms are the most common peripheral arterial aneurysms, and are frequently bilateral. Acute limb ischemia, rupture and compression phenomena can complicate these aneurysms when the diameter exceeds 2 cm. Case Presentation We report an 82-year-old male patient with two giant femoropopliteal aneurysms, 10.5 and 8.5 cm diameters, managed in our institution. Both aneurysms were resected and a polytetrafluoroethylene (PTFE femoropopliteal interposition graft was placed successfully. Management and literature review are discussed. Conclusion We believe this is the first report in the medical literature of bilateral giant femoropopliteal aneurysms.

  3. Links between the Philippines and Spain: migration and bilateral relations

    Directory of Open Access Journals (Sweden)

    Rogelia Pe-Pua

    2005-01-01

    Full Text Available This paper analyses the implications which Spanish policy regarding foreign workers has on the living and working conditions of the Filipino community in Spain. The author pays special attention to bilateral relations between the Philippines and Spain in issues suchas Spanish investment in the Philippines, the trade balance between the two countries and labour relations. In conclusion the article considers the necessity of reaching a bilateral labour agreement which would be beneficial to both countries and which at the same time would improve the working conditions and the integration of Philippine nationals living in Spain.

  4. Abnormalities of the bilateral basal ganglia and thalami - diagnostic possibilities

    International Nuclear Information System (INIS)

    Several diseases may cause non specific MRT abnormalities of the bilateral basal ganglia and thalami. As such, diagnosis of the underlying etiology may be difficult to achieve at imaging. In one clinical case are presented the diagnostic possibilities based on clinical date (previous history, clinical symptoms and evolution) and imaging data (type of signal abnormalities, location of lesions and associated abnormalities). The main categories of diseases causing MRT abnormalities of the bilateral basal ganglia and thalami in adult are: toxic, metabolic, vascular, infectious, inflammatory diseases and tumors.

  5. Follow-up of vestibular function in bilateral vestibulopathy

    OpenAIRE

    Zingler, Vera C.; Weintz, E.; Jahn, Klaus; Mike, A; Huppert, Doreen; Rettinger, Nicole; BRANDT, THOMAS; Strupp, Michael

    2008-01-01

    Objective: Bilateral vestibulopathy (BV) leads to a bilateral deficit of the vestibulo-ocular reflex and has various aetiologies. The main goal of this study was to determine the frequency and degree of recovery or worsening of vestibular function over time.Methods: 82 patients (59 males, 23 females; mean age at the time of diagnosis 56.3 (SD 17.6) years) were re-examined 51 (36) months after the first examination. All patients underwent a standardised neuro-ophthalmological and neuro-otologi...

  6. Hypertension associated with massive, bilateral, posture-dependent renal dysfunction

    International Nuclear Information System (INIS)

    Hippurate function scintiscans were obtained in prone and standing positions in a group of 76 patients with concurrent hypertension and nephroptosis. Twelve of these patients had massive, bilateral disturbance of intrarenal hippurate transport in the standing position; hippurate transport was normal in the prone position. This pattern was present in only three of 120 normotensive patients with nephroptosis. To investigate the importance of nephroptosis, 87 other hypertensive patients were examined. Eighteen of these patients demonstrated posture-dependent tubular dysfunction, but only four had nephroptosis. The results suggest a direct relationship between bilateral posture-dependent tubular dysfunction and hypertension

  7. Modeling microstructure of incudostapedial joint and the effect on cochlear input

    Science.gov (United States)

    Gan, Rong Z.; Wang, Xuelin

    2015-12-01

    The incudostapedial joint (ISJ) connects the incus to stapes in human ear and plays an important role for sound transmission from the tympanic membrane (TM) to cochlea. ISJ is a synovial joint composed of articular cartilage on the lenticular process and stapes head with the synovial fluid between them. However, there is no study on how the synovial ISJ affects the middle ear and cochlear functions. Recently, we have developed a 3-dimensinal finite element (FE) model of synovial ISJ and connected the model to our comprehensive FE model of the human ear. The motions of TM, stapes footplate, and basilar membrane and the pressures in scala vestibule and scala tympani were derived over frequencies and compared with experimental measurements. Results show that the synovial ISJ affects sound transmission into cochlea and the frequency-dependent viscoelastic behavior of ISJ provides protection for cochlea from high intensity sound.

  8. Bilateral malignant teratoma of the mediastinum: case report; Teratome malin bilateral du mediastin: a propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Ousehal, A.; Skalli, A.; Kadiri, R.; Nejjar, M.; Belaabidia, B. [Centre Hospitalier Universitaire Ibn Rochd, Casablanca (Morocco)

    2001-02-01

    The authors report a case of bilateral malignant teratoma of the mediastinum in a 40 year old female presenting with chest pain. Two separate bilateral soft tissue masses were noted in the mediastinum at imaging. On the right side, the mass was heterogeneous with large calcification and infiltration of the pericardium. On the left side, the mass was well defined heterogeneous and without evidence of local invasion. The analysis of samples obtained by US guided puncture biopsy and surgical specimen of the two masses confirmed the diagnosis of pluri-cellular malignant teratoma. Mediastinal malignant teratomas represent 1 to 5% of all mediastinal tumors. To our knowledge, no case of synchronous bilateral mediastinal teratoma has never been reported. (authors)

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

    Directory of Open Access Journals (Sweden)

    Luís Pires Silva

    2011-01-01

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

  10. Bilateral optic neuritis in a boy - More than the eyes.

    Science.gov (United States)

    Loh, M A; Alex Khoo, P C; Chong, M F

    2016-04-01

    Neuromyelitis optica (NMO) is a rare disorder in children with variable presentation. We report a 7-year-old boy who presented with bilateral retrobulbar optic neuritis and responded very well to treatment. He was also positive for aquaporin 4 (AQP4) antibodies, which is part of an emerging endophenotype within autoimmune neurological disorders in childhood. PMID:27326949

  11. Security cost allocation under combined bilateral-pool market dispatch

    International Nuclear Information System (INIS)

    Most electricity markets around the world are a combination of bilateral and pool markets, such as NordPool and NYPOOL. In these models, market participants bid into the pool and also make bilateral contracts with each other. This paper addressed the issue of congestion management and security cost allocation in a power pool market model. The basic idea of security cost allocation is to divide the incurred security cost due to congestion relief into pool and bilateral market based on their flow contribution to the congested line. A newly proposed security cost allocation strategy of the combined bilateral-pool market was also presented along with case studies using IEEE-14 bus system that tested the proposed method. Using the proposed method, it was shown that security costs are allocated to market participants at different prices which reflect the load contribution to the security problem. This solves the problem of the uniform security cost allocation in a pure pool market system having uniform pricing, and provides a proper security signal to market participants. 11 refs., 3 tabs., 4 figs

  12. Bilateral Endobronchial Seeding After Spontaneous Rupture of Pulmonary Hydatid Cyst

    OpenAIRE

    Berkant Özpolat; Çağrı Şenyücel

    2011-01-01

      A 10-year-old boy presented with  sudden unset cough and watery sputum. Chest CT demonstrated a  ruptured left sided pulmonary hydatid cyst with bilateral alveolar consolidation areas.  Albendazole theraphy was started. Cystotomy and capitonnage was performed and he was discharged uneventfully.

  13. Bilateral Endobronchial Seeding After Spontaneous Rupture of Pulmonary Hydatid Cyst

    Directory of Open Access Journals (Sweden)

    Berkant Ozpolat

    2011-09-01

    A 10-year-old boy presented with  sudden unset cough and watery sputum. Chest CT demonstrated a  ruptured left sided pulmonary hydatid cyst with bilateral alveolar consolidation areas.  Albendazole theraphy was started. Cystotomy and capitonnage was performed and he was discharged uneventfully.

  14. A Penalization Method for the Elliptic Bilateral Obstacle Problem

    OpenAIRE

    Murea, Cornel,; Tiba, Dan

    2014-01-01

    In this paper we propose a new algorithm for the wellknown elliptic bilateral obstacle problem. Our approach enters the category of fixed domain methods and solves just linear elliptic equations at each iteration. The approximating coincidence set is explicitly computed. In the numerical examples, the algorithm has a fast convergence.

  15. Amnesia due to bilateral hippocampal glioblastoma. MRI finding

    Energy Technology Data Exchange (ETDEWEB)

    Shimauchi, M.; Wakisaka, S.; Kinoshita, K. (Miyazaki Medical Coll., Kiyotake (Japan). Dept. of Neurosurgery)

    1989-11-01

    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.).

  16. Pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema complicating acute silicosis

    OpenAIRE

    Ramakant Dixit; Manoj Meena; Patil, Chetan B

    2015-01-01

    A case of acute silicosis complicating as spontaneous pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema is described in a 35-year-old male engaged in stone crusher unit. Diagnosis was established on clinical and radiological assessment and supported by occupational history of the patient. This case is unique one as all these 3 complications at the same time are very uncommon in acute silicosis.

  17. Tuberous sclerosis with bilateral renal angiomyolipoma and wunderlich's syndrome

    International Nuclear Information System (INIS)

    This case describes a 47-year-old female with tuberous sclerosis associated with bilateral giant renal angiomyolipomas. She underwent an initial renal angioembolization in August 2006. After four months, she required emergency nephrectomy due to spontaneous hemorrhage from the angiomyolipoma (Wunderlich's syndrome). Life threatening Wunderlich's syndrome requires emergency nephrectomy, however, renal preservation can be achieved by elective nephron sparing surgery. (author)

  18. Bilateral flexor tendon contracture following onychectomy in 2 cats.

    Science.gov (United States)

    Cooper, Maureen A; Laverty, Peter H; Soiderer, Emily E

    2005-03-01

    Two cats presented with bilateral flexor tendon contracture following onychectomy. This previously unreported complication proved to be painful and debilitating. Deep digital flexor tenectomy successfully resolved the problem. Twelve months after surgery, the first cat remains free of complications. The second cat recovered full limb function, but died of unrelated causes. PMID:15884646

  19. Bilateral flexor tendon contracture following onychectomy in 2 cats

    OpenAIRE

    Cooper, Maureen A; Laverty, Peter H.; Soiderer, Emily E.

    2005-01-01

    Two cats presented with bilateral flexor tendon contracture following onychectomy. This previously unreported complication proved to be painful and debilitating. Deep digital flexor tenectomy successfully resolved the problem. Twelve months after surgery, the first cat remains free of complications. The second cat recovered full limb function, but died of unrelated causes.

  20. Late Bilateral Renal Metastasis of Choriocarcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    M. Tahmasebi

    2008-01-01

    Full Text Available Introduction: Late bilateral renal metastasis of chori-ocarcinoma is a rare condition. Herein we report a case of late renal metastasis of choriocarcinoma."nCase Presentation: A 28 years old woman presented with gross hematuria since three months ago. A mo-bile palpable mass in her right flank was detected. She was not pregnant but had a history of abortion at six weeks of gestation in seven years age. Her gyneco-logic examination was normal. She had severe anemia (Hb=7.2, elevated ESR (52 with normal renal and liver function testes. Ultrasonography showed bilat-eral large kidney masses by solid-cystic components, with predominant solid parts. Bilateral lobulated het-erogeneous renal masses were found at non-enhancing axial CT-Scan, with notable enhancement of solid parts after administration of contrast agent. Angiography revealed bilateral hypovascular renal masses. Right radical nephrectomy performed for the patient and pathology reported choriocarcinoma of kidney. Finally, she was referred for chemotherapy of contralateral renal mass, but she delayed that for three months. She died following a seizure attack and cardiopulmonary arrest without response to prompt cardio-pulmonary resuscitation. Autopsy not permit-ted by relevants. "nConclusion: Late metastases of choriocarcinoma may appear in kidney or brain after a long time following the primary source of malignancy, when the primary lesion has disappeared.

  1. Metachronous lung cancer that presented as bilateral synchronous lung cancer

    OpenAIRE

    Kocaturk, Celalettin Ibrahim; Cansever, Levent; Kanmaz, Dilek Zehra; Bedirhan, Mehmet Ali

    2013-01-01

    Every patient undergoing curative treatment for primary lung cancer is a candidate for metachronous lung cancer, with a reported risk of 5% per year. The majority of cases are stage I patients. Patients who undergo resection for lung cancer should be followed regularly. A metachronous lung cancer that develops as bilateral synchronous lung cancer is very rare.

  2. Bilateral multiple pulmonary tuberculous nodules mimicking metastatic disease

    International Nuclear Information System (INIS)

    We present CT findings of a young woman who has bilateral pulmonary nodules mimicking metastases. Clinical presentation with active multiple pulmonary macronodules without cavitation responsive to treatment is an atypical manifestation of pulmonary tuberculosis. We reviewed the causes of multiple pulmonary nodules, role of radiological findings in differential diagnosis and parenchymal manifestations of pulmonary tuberculosis in this report

  3. Scrub typhus with bilateral pneumonitis: a case report

    OpenAIRE

    P. Venkata Krishna; Shaik Moulali; Shaik Ahmed

    2014-01-01

    Scrub typhus caused by Orientia tsutsugamushi is an uncommon cause of pneumonitis. We report a case of scrub typhus presenting with bilateral pneumonitis, left ventricular dysfunction and eschar. The present case reiterates the importance of careful physical examination in the early diagnosis of scrub typhus as aetiological cause.

  4. Scrub typhus with bilateral pneumonitis: a case report

    Directory of Open Access Journals (Sweden)

    P. Venkata Krishna

    2014-04-01

    Full Text Available Scrub typhus caused by Orientia tsutsugamushi is an uncommon cause of pneumonitis. We report a case of scrub typhus presenting with bilateral pneumonitis, left ventricular dysfunction and eschar. The present case reiterates the importance of careful physical examination in the early diagnosis of scrub typhus as aetiological cause.

  5. Security cost allocation under combined bilateral-pool market dispatch

    Energy Technology Data Exchange (ETDEWEB)

    Abdullah, M.P.; Hassan, M.Y.; Hussin, F. [Technological Univ. of Malaysia (Malaysia). Dept. of Power Engineering

    2008-07-01

    Most electricity markets around the world are a combination of bilateral and pool markets, such as NordPool and NYPOOL. In these models, market participants bid into the pool and also make bilateral contracts with each other. This paper addressed the issue of congestion management and security cost allocation in a power pool market model. The basic idea of security cost allocation is to divide the incurred security cost due to congestion relief into pool and bilateral market based on their flow contribution to the congested line. A newly proposed security cost allocation strategy of the combined bilateral-pool market was also presented along with case studies using IEEE-14 bus system that tested the proposed method. Using the proposed method, it was shown that security costs are allocated to market participants at different prices which reflect the load contribution to the security problem. This solves the problem of the uniform security cost allocation in a pure pool market system having uniform pricing, and provides a proper security signal to market participants. 11 refs., 3 tabs., 4 figs.

  6. Bilateral oligopoly in pollution permit markets - experimental evidence

    Science.gov (United States)

    We experimentally investigate behavior in a bilateral oligopoly using a supply function equilibria model (Klemper and Meyer 1989; Hendricks and McAfee 2010; Malueg and Yates 2009). We focus on the role that market size and the degree of firm heterogeneity have on the market equilibrium. Our results ...

  7. Bilateral diaphragmatic palsy after congenital heart surgery: management options.

    Science.gov (United States)

    Bhaskar, Pradeep; Lone, Reyaz A; Sallehuddin, Ahmad; John, Jiju; Bhat, Akhlaque N; Rahmath, Muhammed R K

    2016-06-01

    Diaphragmatic paralysis following phrenic nerve injury is a major complication following congenital cardiac surgery. In contrast to unilateral paralysis, patients with bilateral diaphragmatic paralysis present a higher risk group, require different management methods, and have poorer prognosis. We retrospectively analysed seven patients who had bilateral diaphragmatic paralysis following congenital heart surgery during the period from July, 2006 to July, 2014. Considerations were given to the time to diagnosis of diaphragm paralysis, total ventilator days, interval after plication, and lengths of ICU and hospital stays. The incidence of bilateral diaphragmatic paralysis was 0.68% with a median age of 2 months (0.6-12 months). There was one neonate and six infants with a median weight of 4 kg (3-7 kg); five patients underwent unilateral plication of the paradoxical diaphragm following recovery of the other side, whereas the remaining two patients who did not demonstrate a paradoxical movement were successfully weaned from the ventilator following recovery of function in one of the diaphragms. The median ventilation time for the whole group was 48 days (20-90 days). The median length of ICU stay was 46 days (24-110 days), and the median length of hospital stay was 50 days (30-116 days). None of the patients required tracheostomy for respiratory support and there were no mortalities, although all the patients except one developed ventilator-associated pneumonia. The outcome of different management options for bilateral diaphragmatic paralysis following surgery for CHD is discussed. PMID:26345716

  8. BILGO: Bilateral greedy optimization for large scale semidefinite programming

    KAUST Repository

    Hao, Zhifeng

    2013-10-03

    Many machine learning tasks (e.g. metric and manifold learning problems) can be formulated as convex semidefinite programs. To enable the application of these tasks on a large-scale, scalability and computational efficiency are considered as desirable properties for a practical semidefinite programming algorithm. In this paper, we theoretically analyze a new bilateral greedy optimization (denoted BILGO) strategy in solving general semidefinite programs on large-scale datasets. As compared to existing methods, BILGO employs a bilateral search strategy during each optimization iteration. In such an iteration, the current semidefinite matrix solution is updated as a bilateral linear combination of the previous solution and a suitable rank-1 matrix, which can be efficiently computed from the leading eigenvector of the descent direction at this iteration. By optimizing for the coefficients of the bilateral combination, BILGO reduces the cost function in every iteration until the KKT conditions are fully satisfied, thus, it tends to converge to a global optimum. In fact, we prove that BILGO converges to the global optimal solution at a rate of O(1/k), where k is the iteration counter. The algorithm thus successfully combines the efficiency of conventional rank-1 update algorithms and the effectiveness of gradient descent. Moreover, BILGO can be easily extended to handle low rank constraints. To validate the effectiveness and efficiency of BILGO, we apply it to two important machine learning tasks, namely Mahalanobis metric learning and maximum variance unfolding. Extensive experimental results clearly demonstrate that BILGO can solve large-scale semidefinite programs efficiently.

  9. Spanish Bilateral Initiatives for Education in Latin America

    Science.gov (United States)

    Cortina, Regina; Sanchez, Maria Teresa

    2007-01-01

    The research presented in this article concerns la Agencia Espanola de Cooperacion Internacional (Spanish Agency for International Cooperation--AECI) and its growing presence in Latin America since the late 1990s. The aim is to evaluate the transformative potential that bilateral funding can have on educational reform in the region. The article…

  10. Muscle Activity during Unilateral Vs. Bilateral Battle Rope Exercises

    DEFF Research Database (Denmark)

    Calatayud, J.; Martin, F.; Colado, J. C.;

    2015-01-01

    Calatayud, J, Martin, F, Colado, JC, Benitez, JC, Jakobsen, MD, and Andersen, LL. Muscle activity during unilateral vs. bilateral battle rope exercises. J Strength Cond Res 29(10): 2854-2859, 2015High training intensity is important for efficient strength gains. Although battle rope training is m...

  11. Early morbidity after simultaneous and staged bilateral total knee arthroplasty

    DEFF Research Database (Denmark)

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

    2015-01-01

    PURPOSE: The aim of this nationwide study was to investigate the early morbidity after bilateral simultaneous and staged total knee arthroplasty (TKA) in order to clarify potential benefits of a well-established fast-track regime. METHODS: The Danish National Patient Registry was searched for all...

  12. Groin hernia subtypes are associated in patients with bilateral hernias

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Andresen, Kristoffer; Pommergaard, Hans-Christian; Rosenberg, Jacob

    2015-01-01

    repair (89.9% males) were registered, and of those were 12,041 persons operated bilaterally (94.9% males). Females and males operated for a unilaterally direct inguinal hernia (DIH) had increased Hazard Ratios (HR) of 3.85 (CI 95% 2.14-6.19) and 4.46 (CI 95% 2.57-7.88) of being contralaterally operated...

  13. Bilateral spontaneous rupture of flexor digitorum profundus tendons.

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    Spontaneous tendon rupture is an unusual condition usually associated with underlying disease processes such as rheumatoid arthritis, chronic renal failure or bony abnormalities of the hand. We report a case of spontaneous, non-concurrent bilateral rupture of flexor profundus tendons in an otherwise healthy individual. Treatment was successful and consisted of a two-stage reconstruction of the ruptured tendon.

  14. Recurrence of recipient Langerhans' cell histiocytosis following bilateral lung transplantation

    OpenAIRE

    Habib, S.; Congleton, J; Carr, D; Partridge, J; Corrin, B.; Geddes, D; Banner, N.; Yacoub, M; Burke, M.

    1998-01-01

    Langerhans' cell histiocytosis may cause irreversible respiratory failure due to progressive destruction of lung parenchyma and widespread cystic change. Transplantation offers a therapeutic option. A case is described of recurrence of Langerhans' cell histiocytosis which was associated with deterioration in lung function four years following bilateral lung transplantation. Patients transplanted for Langerhans' cell histiocytosis should be followed up with this complication in min...

  15. Radiotherapy for Langerhans Cell Histiocytosis of Bilateral Eyelids.

    Science.gov (United States)

    Leveson, James; Bourque, Jean-Marc; Lukovic, Jelena; Dar, A Rashid

    2016-01-01

    Langerhans cell histiocytosis (LCH) is a rare disorder with numerous clinicopathological variants with differing clinical courses, treatment methods, and prognoses. We report one patient with atypical LCH of the bilateral lower eyelids and subsequent successful treatment with local radiation therapy. PMID:27004151

  16. Bilateral multiligament injury of knee caused by entangled dupatta

    OpenAIRE

    Shrinand V Vaidya; Mathesul, Ambarish A; Panghate, Atul N; Roshan Wade; Sonawane, Dhiraj V

    2012-01-01

    We report a rare case of bilateral multiligament knee injury in an 18-year-old female employed in garment industry. Patient was wearing salwar kameez and dupatta while operating an electric laundry machine. In this case we discuss a peculiar mechanism of injury caused due to wearing dupatta near working site and suggest simple preventive measures.

  17. Bilateral nekrose af caput femoris efter brug af arbejdssele

    DEFF Research Database (Denmark)

    Husted, Henrik; Nielsen, Reno E Tilgreen; Linnet, Jan A Rørgaard

    2002-01-01

    The case of a 42-year old man, who developed bilateral necrosis of the femoral head from traumatic causes is described. He hung in stirrups, working 4-6 hours a day decorating for three weeks, during which he complained of numbness, fatigue and radiating pain in both legs. X-rays and a bone scan ...

  18. Bilateral chondrolysis of the hip following liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Chechik, Ofir; Dekel, Samuel [Tel Aviv Sourasky Medical Center, Department of Orthopedic Surgery ' B' , Tel Aviv (Israel)]|[Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel)

    2009-03-15

    A 32-year-old woman with bilateral hip chondrolysis diagnosed 2 years following allogeneic liver transplantation is described. Severe osteoarthritis was demonstrated on physical examination, serial radiographs and magnetic resonance imaging. Only four cases of chondrolysis in solid organ recipients have been described in the literature. (orig.)

  19. Bilateral chondrolysis of the hip following liver transplantation

    International Nuclear Information System (INIS)

    A 32-year-old woman with bilateral hip chondrolysis diagnosed 2 years following allogeneic liver transplantation is described. Severe osteoarthritis was demonstrated on physical examination, serial radiographs and magnetic resonance imaging. Only four cases of chondrolysis in solid organ recipients have been described in the literature. (orig.)

  20. Market Power in Bilateral Oligopoly Markets with Nonexpendable Infrastructure

    NARCIS (Netherlands)

    Funaki, Y.; Houba, H.E.D.; Motchenkova, E.

    2012-01-01

    Abstract: We consider price-fee competition in bilateral oligopolies with perfectly-divisible goods, non-expandable infrastructures, concentrated agents on both sides, and constant marginal costs. We define and characterize stable market outcomes. Buyers exclusively trade with the supplier with whom

  1. Proksimal bilateral humerusfraktur med posterior luksation af caput

    DEFF Research Database (Denmark)

    Kristensen, W; Osther, P

    1990-01-01

    Seizures as the cause of skeletal fractures are well recognized. The commonest is fracture of the humerus. Bilateral fractures are rare and extremely rare in combination with posterior dislocation of the shoulder joint. Two cases of this condition with very unusual etiology are described here. The...

  2. Bilateral coronary ostial stenosis secondary to syphilitic aortitis.

    Science.gov (United States)

    Cheng, Zhaoping; Zhao, Shihua; Bi, Wanli; Wang, Ximing

    2014-01-01

    Cardiovascular syphilis is associated with the tertiary stage of syphilis infection; it involves the ascending aorta and can cause aortic aneurysm, aortic regurgitation, and coronary ostial stenosis. We report here a case in which bilateral coronary ostial stenosis and aortic regurgitation due to syphilitic aortitis was diagnosed; coronary artery bypass graft was then performed. PMID:25151925

  3. Reversible bilateral ureteric obstruction due to a pancreatic pseudocyst.

    OpenAIRE

    Gibson, G E; Tiernan, E; Cronin, C. C.; Ferriss, J B

    1993-01-01

    An unusual case of bilateral ureteric obstruction and hydronephrosis due to pancreatic pseudocyst formation, after an episode of acute pancreatitis is reported. All abnormalities resolved with conservative management. Possible reasons for such ureteric obstruction include periureteric fat necrosis by pancreatic enzymes and compression by the inflammatory mass.

  4. Bilateral exophthalmos in a Holstein cow with lymphosarcoma

    OpenAIRE

    Malatestinic, Andrea

    2003-01-01

    A 4-year-old Holstein cow presented with severe bilateral exophthalmos. A complete blood cell count revealed late stage lymphoma; the agar gel immunodiffusion test for enzootic bovine leukosis was positive. The cow was euthanized 1 wk after presentation. Necropsy revealed generalized lymphadenopathy and tumors in most organs. Final diagnosis was lymphosarcoma.

  5. Reduced Misinformation Effects Following Saccadic Bilateral Eye Movements

    Science.gov (United States)

    Parker, Andrew; Buckley, Sharon; Dagnall, Neil

    2009-01-01

    The effects of saccadic bilateral (horizontal) eye movements on memory for a visual event narrative were investigated. In the study phase, participants were exposed to a set of pictures accompanied by a verbal commentary describing the events depicted in the pictures. Next, the participants were asked either misleading or control questions about…

  6. Age-Related Differences in Bilateral Asymmetry in Cycling Performance

    Science.gov (United States)

    Liu, Ting; Jensen, Jody L.

    2012-01-01

    Bilateral asymmetry, a form of limb laterality in the context of moving two limbs, emerges in childhood. Children and adults show lateral preference in tasks that involve the upper and lower limbs. The importance of research in limb laterality is the insight it could provide about lateralized functions of the cerebral hemispheres. Analyzing…

  7. Bilateral breast cancer, synchronous and metachronous; differences and outcome

    NARCIS (Netherlands)

    Jobsen, J.J.; Palen, van der J.; Ong, F.; Riemersma, S.; Struikmans, H.

    2015-01-01

    The aims of this study were twofold: to analyze the incidence of patients having synchronous or metachronous bilateral invasive breast cancer (SBBC and MBBC) and to assess the characteristics and outcome compared to those having unilateral breast cancer (UBC). The used data were obtained from our pr

  8. Rapidly Growing Bilateral Pseudoangiomatous Stromal Hyperplasia of the Breast

    International Nuclear Information System (INIS)

    A tumoral pseudoangiomatous stromal hyperplasia (PASH) that causes huge breast enlargement is very rare. Only two cases of huge tumoral PASHs have been reported in the English medical literature. We report here on a surgically confirmed case of bilateral huge tumoral PASH in a 47-year-old woman, and we present the imaging and histopathology findings. We also review the relevant medical literature

  9. Rapidly Growing Bilateral Pseudoangiomatous Stromal Hyperplasia of the Breast

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Eun Mi; Whang, In Yong; Chang, Eun Deok [Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of)

    2010-06-15

    A tumoral pseudoangiomatous stromal hyperplasia (PASH) that causes huge breast enlargement is very rare. Only two cases of huge tumoral PASHs have been reported in the English medical literature. We report here on a surgically confirmed case of bilateral huge tumoral PASH in a 47-year-old woman, and we present the imaging and histopathology findings. We also review the relevant medical literature.

  10. Meningococcal meningitis presenting with bilateral deafness and ataxia.

    OpenAIRE

    Sandyk, R.; Brennan, M J

    1984-01-01

    A 50-year-old man presented with bilateral deafness and ataxia of sudden onset and without constitutional symptoms or signs of meningeal irritation. He was subsequently proved to have meningococcal meningitis, and the deafness and ataxia resolved following appropriate antibiotic therapy.

  11. Bilateral adaptive deep brain stimulation is effective in Parkinson's disease

    Science.gov (United States)

    Little, Simon; Beudel, Martijn; Zrinzo, Ludvic; Foltynie, Thomas; Limousin, Patricia; Hariz, Marwan; Neal, Spencer; Cheeran, Binith; Cagnan, Hayriye; Gratwicke, James; Aziz, Tipu Z; Pogosyan, Alex; Brown, Peter

    2016-01-01

    Introduction & objectives Adaptive deep brain stimulation (aDBS) uses feedback from brain signals to guide stimulation. A recent acute trial of unilateral aDBS showed that aDBS can lead to substantial improvements in contralateral hemibody Unified Parkinson’s Disease Rating Scale (UPDRS) motor scores and may be superior to conventional continuous DBS in Parkinson’s disease (PD). We test whether potential benefits are retained with bilateral aDBS and in the face of concurrent medication. Methods We applied bilateral aDBS in 4 patients with PD undergoing DBS of the subthalamic nucleus. aDBS was delivered bilaterally with independent triggering of stimulation according to the amplitude of β activity at the corresponding electrode. Mean stimulation voltage was 3.0±0.1 volts. Motor assessments consisted of double-blinded video-taped motor UPDRS scores that included both limb and axial features. Results UPDRS scores were 43% (p=0.04; Cohen’s d=1.62) better with aDBS than without stimulation. Motor improvement with aDBS occurred despite an average time on stimulation (ToS) of only 45%. Levodopa was well tolerated during aDBS and led to further reductions in ToS. Conclusion Bilateral aDBS can improve both axial and limb symptoms and can track the need for stimulation across drug states. PMID:26424898

  12. EVOLUTION OF SYNCHRONOUS BILATERAL BREAST CARCINOMA IN A YOUNG PATIENT.

    Science.gov (United States)

    Manea, Elena; Munteanu, Anca

    2016-01-01

    Bilateral breast cancer incidence is appreciated to be between 0.3 to 12% and is determined either by a hereditary load associated with chromosomal instability under the effect of environmental factors, or by the evolution in a particular hormonal context which gives biological aggressiveness. We present the case of a patient, aged 38 years, clinically, imagistic and bioptic diagnosed with left axillary lymph node metastases of breast carcinoma NST invasive G3, IHC-RE = 60%, RP = 30%, HER2neu = 2 +, Ki67 = 20%, in August 2013. Patient followed neoadjuvant chemotherapy treatment during September-October 2013. In December 2013 she was clinically and imaging diagnosed with bilateral breast cancer, for which surgical intervention was done which consisted of bilateral radical Madden mastectomy with bilateral axillary lymphadenectomy. BAP-invasive carcinoma NST: left breast-pT2mN3a G2, right breast--pT3mN3a G2, IHC-RE = 90%, RP =70% HER2neu = 2 +, Ki67 = 50%. During the period of January-March 2014, the patient followed adjuvant chemotherapy and Herceptin. Bilateral breast ultrasound assessment in April 2014 revealed: left axilla--liquid blade 29 / 6mm; right axilla--oval ganglion 9/5 mm. Abdominal and pelvic ultrasound: empty uterine cavity, bosselated contour; at left ovary level multiple cystic formations. During the period of May-June 2014, adjuvant radiation therapy and ovarian irradiationwas administered to the patient. Subsequently hormone therapy was initiated. Following CHT / ovarian irradiation patient continues to experience intermittent uterine bleeding, which is why a total hysterectomy with bilateral ovariectomy was done, and BAP: cervical, endometrialand left ovary with tumor multifocal infiltration with histopathological aspect of invasive breast carcinoma NST. Periodic imaging evaluations do not reveal local or distant recurrence. The particularity of this case is synchronous bilateral breast cancer diagnosis in a young patient complicated in its

  13. Retinoblastoma bilateral de aparecimento tardio: relato de caso Late presentation of bilateral retinoblastoma: case report

    Directory of Open Access Journals (Sweden)

    Maria Cecília Santos Cavalcanti Melo

    2008-06-01

    Full Text Available É relatado um caso de retinoblastoma de aparecimento tardio, com características pouco freqüentes, com o objetivo de melhorar o controle da afecção. Em 1993, SJMMF, nove meses, masculino, leucodermo, apresentou tumor na retina esquerda. O paciente tinha história familiar de retinoblastoma. A enucleação foi realizada, comprovando-se retinoblastoma. Os exames para estadiamento sistêmico foram normais. O olho direito evoluiu normal por dez anos. Em exame de rotina, foram constatadas três lesões de retinoblastoma na retina nasal. Foi feita termoterapia transpupilar, com laser de diodo de 810 nm. Após 30 dias, as lesões regrediram. Após 60 dias houve recidiva na borda da lesão, onde foi realizada crioterapia transescleral, com regressão do tumor por seis meses. Durante o controle, observaram-se condensações próximas à lesão tumoral atrófica (sementes vítreas. Foi feito braquiterapia com Iodo125, havendo desaparecimento das mesmas após 30 dias. Novas sementes surgiram três meses pós-braquiterapia, depositadas na superfície retiniana, sendo tratadas com crioterapia transescleral e termoterapia transpupilar, havendo regressão. O paciente evoluiu com nova semente vítrea após seis meses, a qual, após depositar-se na superfície da retina, foi tratada com termoterapia transpupilar. Está em seguimento há 38 meses desde o aparecimento do tumor bilateral, mantendo acuidade visual de 20/20 e exames clínicos normais. Considera-se importante este caso pela pouca freqüência de aparecimento da doença nesta idade. Julga-se necessário o alerta para os casos de retinoblastoma já considerados curados.A case of retinoblastoma with uncommon features is reported, aiming at improving follow-up. In 1993, SJMMF, 9-month-old white boy, presented a squint in the left eye. A retinal tumor was detected. The patient had a family history of retinoblastoma. Enucleation was performed and retinoblastoma was proved. The patient underwent

  14. Bilateral adrenalectomy for Cushing's syndrome: Pros and cons

    Directory of Open Access Journals (Sweden)

    O P Prajapati

    2015-01-01

    Full Text Available Aim: To assess the outcome of patients undergoing bilateral adrenalectomy for Cushing's syndrome (CS. Methods: All patients who underwent bilateral adrenalectomy for CS at the Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences hospital between 1991 and 2013 were included. Medical records were reviewed to obtain patient characteristics and follow-up data. Results: Twenty-seven patients were studied. Mean age was 28.74 ± 12.95 years (range 9–60, male:female ratio was 1.7:1. About half that is, 48.19% were of Cushing's disease (failed trans-sphenoidal surgery [TSS], 37.04% were of ectopic CS (ECS, and 14.81% were of CS due to bilateral adrenal pathology. Median follow-up period was 80.5 months. Before surgery, 74.1% patients had body mass index > which after surgery declined to <25 in 75% of them. Hypertension was present in 85.2% and after surgery resolved in 40%. Diabetes mellitus was present in 44.4% and after surgery resolved in 33% of them. Hirsutism and proximal muscle weakness were present in 55.6% and 70.4% patients, respectively, and after surgery improved markedly in all patients. Adrenal crisis developed in 36.3% and Nelson's syndrome in 41.7% patients during follow-up. Three patients died in perioperative period while three succumbed to the disease during follow-up. Two patients developed recurrence of endogenous cortisol production during the follow-up period. Conclusions: Bilateral adrenalectomy is a valid treatment option for palliating severe symptoms in Pituitary Cushing's with failed TSS and unlocalized ECS but the procedure is curative for CS due to bilateral adrenal disease. Overall morbidity and mortality is higher than other endocrine operations. Co-morbidities tend to be more severe and are a risk factor for mortality during the time patient survives.

  15. Localization ability with bimodal hearing aids and bilateral cochlear implants

    Science.gov (United States)

    Seeber, Bernhard U.; Baumann, Uwe; Fastl, Hugo

    2004-09-01

    After successful cochlear implantation in one ear, some patients continue to use a hearing aid at the contralateral ear. They report an improved reception of speech, especially in noise, as well as a better perception of music when the hearing aid and cochlear implant are used in this bimodal combination. Some individuals in this bimodal patient group also report the impression of an improved localization ability. Similar experiences are reported by the group of bilateral cochlear implantees. In this study, a survey of 11 bimodally and 4 bilaterally equipped cochlear implant users was carried out to assess localization ability. Individuals in the bimodal implant group were all provided with the same type of hearing aid in the opposite ear, and subjects in the bilateral implant group used cochlear implants of the same manufacturer on each ear. Subjects adjusted the spot of a computer-controlled laser-pointer to the perceived direction of sound incidence in the frontal horizontal plane by rotating a trackball. Two subjects of the bimodal group who had substantial residual hearing showed localization ability in the bimodal configuration, whereas using each single device only the subject with better residual hearing was able to discriminate the side of sound origin. Five other subjects with more pronounced hearing loss displayed an ability for side discrimination through the use of bimodal aids, while four of them were already able to discriminate the side with a single device. Of the bilateral cochlear implant group one subject showed localization accuracy close to that of normal hearing subjects. This subject was also able to discriminate the side of sound origin using the first implanted device alone. The other three bilaterally equipped subjects showed limited localization ability using both devices. Among them one subject demonstrated a side-discrimination ability using only the first implanted device.

  16. Amputee Mobility Predictor-Bilateral: A performance-based measure of mobility for people with bilateral lower-limb loss

    Directory of Open Access Journals (Sweden)

    Michele A. Raya, PhD, PT, SCS, ATC

    2013-10-01

    Full Text Available The Amputee Mobility Predictor (AMP is an outcome measure designed to assess mobility and functional capabilities for people with unilateral lower-limb amputation. No comparable measure exists for those with bilateral lower-limb amputation (BLLA. The purpose of this study was to examine the utility of the AMP-Bilateral (AMP-B to measure the ability to perform functional tasks related to participation in advanced skill activities in those with BLLA and to determine whether AMP-B scores correlated with 6-minute walk test (6MWT performance. Twenty-six male servicemembers (SMs completed the study: 12 with bilateral transtibial amputation (BTTA, 7 with bilateral transfemoral amputation (BTFA, and 7 with combination transtibial and transfemoral amputation (TTA/TFA. Significant differences existed between the AMP-B scores (p < 0.001, AMP scores (p < 0.001, and 6MWT distance (p < 0.05 for SMs with BTTA and TTA/TFA and SMs with BTTA and BTFA but not between those with BTFA and TTA/TFA. Scoring of five AMP items was modified because they necessitate at least one intact knee joint to generate the necessary torque requirements to perform the activity without upper-limb assistance. Minor modifications in scoring of the AMP do not alter total score and allow clinicians to determine the mobility and functional capabilities of SMs with BTFA and TFA/TTA.

  17. Bilateral Ovarian Dermoid Cyst with Bladder Involvement and Hematuria: A Case Report and Literature Review

    OpenAIRE

    Mohammad Mehdi Hosseini; Shahrokh Jahanbini; Sara Pakbaz; Shahryar Zeighami

    2014-01-01

    Bilateral ovarian dermoid tumor with invasion to surrounding organ is a rare entity. We report the case of a 63-year-old woman with prolonged dysuria and hematuria who had bilateral ovarian dermoid cysts with urinary bladder involvement.

  18. Multicentre prospective evaluation of implant-assisted mandibular bilateral distal extension removable partial dentures: patient satisfaction

    NARCIS (Netherlands)

    D. Wismeijer; A. Tawse-Smith; A.G.T. Payne

    2013-01-01

    Objective To compare the levels of patient satisfaction with either conventional mandibular bilateral distal extension partial dentures or those assisted by bilateral distal implants. Materials and methods Forty-eight participants who were dissatisfied with their existing conventional mandibular dis

  19. Bilateral superficial peroneal nerve entrapment secondary to anorexia nervosa: a case report

    OpenAIRE

    Doğramacı Yunus; Kalacı Aydıner; Sevinç Teoman; Yanat Ahmet

    2008-01-01

    Abstract We report a case of severe weight loss secondary to anorexia nervosa causing bilateral superficial peroneal nerve entrapment in a young female patient who was treated successfully by bilateral surgical decompression.

  20. Effect of unilateral and simultaneous bilateral cochlear implantation on tinnitus : A randomized controlled trial

    NARCIS (Netherlands)

    van Zon, Alice; Smulders, Yvette E; Ramakers, Geerte G J; Stegeman, Inge; Smit, Adriana L; Van Zanten, Gijsbert A; Stokroos, Robert J; Hendrice, Nadia; Free, Rolien H; Maat, Bert; Frijns, Johan H M; Mylanus, Emmanuel A M; Huinck, Wendy J; Topsakal, Vedat; Tange, Rinze A; Grolman, Wilko

    2015-01-01

    OBJECTIVES/HYPOTHESIS: To determine the effect of cochlear implantation on tinnitus perception in patients with severe bilateral postlingual sensorineural hearing loss and to demonstrate possible differences between unilateral and bilateral cochlear implantation. STUDY DESIGN: Prospective study. MET

  1. Salvage Gamma Knife Radiosurgery after failed management of bilateral trigeminal neuralgia

    OpenAIRE

    Raval, Ami B.; Jennifer Salluzzo; Tomas Dvorak; Lori Lyn Price; Mignano, John E.; Wu, Julian K.

    2014-01-01

    Background: The incidence of bilateral trigeminal neuralgia (TN) is 1-6% of total number of TN cases. Gamma Knife Radiosurgery (GKRS) is effective in treating unilateral TN; however, outcomes of bilateral TN treated by GKRS have not been well evaluated. The purpose of this study is to evaluate the long-term GKRS outcomes of bilateral TN at our institution and compare with our published treatment outcomes of unilateral TN. Methods: Between 2000 and 2006, eight patients with bilateral TN we...

  2. Horizontal localization with bilateral hearing aids: without is better than with

    OpenAIRE

    Van den Bogaert, Tim; Klasen, Thomas; Moonen, Marc; Van Deun, Lieselot; Wouters, Jan

    2006-01-01

    This paper studies the effect of bilateral hearing aids on directional hearing in the frontal horizontal plane. Localization tests evaluated bilateral hearing aid users using different stimuli and different noise scenarios. Normal hearing subjects were used as a reference. The main research questions raised in this paper are: (i) How do bilateral hearing aid users perform on a localization task, relative to normal hearing subjects? (ii) Do bilateral hearing aids preserve localization cues, an...

  3. Locked bilateral posterior fracture-dislocation of the shoulder in an epileptic patient: case report

    OpenAIRE

    CAUTERO, ENRICO; GERVASI, ENRICO

    2014-01-01

    Bilateral posterior dislocation of the shoulder, often secondary to seizures, is uncommon, while bilateral posterior fracture-dislocations is rarer still: 0.6 cases among a population of 100,000 people per year. The scientific literature contains very few published reports of cases of bilateral posterior fracture-dislocation of the shoulder, a condition that tends to be sustained by epileptic patients during seizures. The authors presented a case of bilateral posterior fracture-dislocation of...

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

    OpenAIRE

    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 ...

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

    OpenAIRE

    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 ...

  6. Multiple and bilateral benign cystic teratomas of ovary with broad ligament leiomyoma: a case report

    OpenAIRE

    Choukimath S.M; Ramalingappa C.A

    2012-01-01

    Background: Benign cystic teratoma is the most common tumor of ovary. Though bilateralism is seen in 10-15% of the cases, bilateral and multiple benign cystic teratomas are rare and very few cases have been reported in the literature. Aim: We present a case of bilateral and multiple benign cystic teratomas with a broad ligament leiomyoma. Case findings: A 38 –year- old female presented with lower abdominal pain of 5 months duration. Ultrasonography of abdomen showed bilateral multiple adnexal...

  7. Anaesthetic Considerations in A Child with Bilateral Hydatid Cysts of Lung

    OpenAIRE

    Harsimran Singh; Harjinder Kohli; Anju Grewal; Sushil Budhiraja

    2008-01-01

    Bilateral hydatid cyst of lung in a child is a challenge to anaesthesiologist. The benefits of one lung versus two lung ventilation is still a question. A 9-yr-old male child presented with respiratory distress. The chest X-ray showed the presence of two cysts bilaterally in the lung fields. A possibility of bilateral hydatid cyst in lung was considered. The child was taken up for emergency single stage bilateral thoracotomy under general anaesthesia. Two lung ventilation technique was used. ...

  8. Long-term functional outcome of bilateral spontaneous and simultaneous Achilles tendon ruptures.

    LENUS (Irish Health Repository)

    Ellanti, Prasad

    2012-10-01

    Bilateral simultaneous ruptures are rare comprising less than 1% of all Achilles tendon ruptures. Risk factors for bilateral ruptures include chronic diseases and medications such as corticosteroids and fluoroquinolones. There is little in the literature on the long-term functional outcome of bilateral Achilles tendon ruptures. This article present a series of 3 cases of simultaneous and spontaneous bilateral Achilles tendon ruptures with a minimum of 5-year follow up suggesting a good functional outcome.

  9. The Origin, Evolution and Development of Bilateral Symmetry in Multicellular Organisms

    OpenAIRE

    Werner, Eric

    2012-01-01

    A computational theory and model of the ontogeny and development of bilateral symmetry in multicellular organisms is presented. Understanding the origin and evolution of bilateral organisms requires an understanding of how bilateral symmetry develops, starting from a single cell. Bilateral symmetric growth of a multicellular organism from a single starter cell is explained as resulting from the opposite handedness and orientation along one axis in two daughter founder cells that are in equiva...

  10. A comparative outcome analysis of bilateral versus unilateral endoscopic extraperitoneal inguinal hernioplastics

    OpenAIRE

    Patil, NG; Lau, H.; Yuen, WK

    2003-01-01

    Background: Bilateral inguinal hernia is an accepted indication for endoscopic totally extraperitoneal inguinal hernioplasty (TEP), but few studies have proved that the outcomes of bilateral TEP are as good as those of unilateral TEP. The objective of the present study was to compare the clinical outcomes of patients who underwent unilateral TEP with those of patients who underwent bilateral TEP. Patients and Methods: From June 1999 to May 2002, 103 patients underwent simultaneous bilateral T...

  11. Bilateral ureteropelvic disruption following blunt abdominal trauma: Case report

    Directory of Open Access Journals (Sweden)

    Kikuchi Hiroko

    2011-07-01

    Full Text Available Abstract Background Ureteral injury occurs in less than 1% of blunt abdominal trauma cases, partly because the ureters are relatively well protected in the retroperitoneum. Bilateral ureteral injury is extremely rare, with only 10 previously reported cases. Diagnosis may be delayed if ureteric injury is not suspected, and delay of 36 hours or longer has been observed in more than 50% of patients with ureteric injury following abdominal trauma, leading to increased morbidity. Case presentation A 29-year-old man was involved in a highway motor vehicle collision and was ejected from the front passenger seat even though wearing a seatbelt. He was in a preshock state at the scene of the accident. An intravenous line and left thoracic drain were inserted, and he was transported to our hospital by helicopter. Whole-body, contrast-enhanced computed tomography (CT scan showed left diaphragmatic disruption, splenic injury, and a grade I injury to the left kidney with a retroperitoneal haematoma. He underwent emergency laparotomy. The left diaphragmatic and splenic injuries were repaired. Although a retroperitoneal haematoma was observed, his renal injury was treated conservatively because the haematoma was not expanding. In the intensive care unit, the patient's haemodynamic state was stable, but there was no urinary output for 9 hours after surgery. Anuresis prompted a review of the abdominal x-ray which had been performed after the contrast-enhanced CT. Leakage of contrast material from the ureteropelvic junctions was detected, and review of the repeat CT scan revealed contrast retention in the perirenal retroperitoneum bilaterally. He underwent cystoscopy and bilateral retrograde pyelography, which showed bilateral complete ureteral disruption, preventing placement of ureteral stents. Diagnostic laparotomy revealed complete disruption of the ureteropelvic junctions bilaterally. Double-J ureteral stents were placed bilaterally and ureteropelvic

  12. Post appendectomy acalculus bilateral ureteric obstruction: A rare entity in children

    Directory of Open Access Journals (Sweden)

    Vipul Gupta

    2013-01-01

    Full Text Available Bilateral acalculus ureteric obstruction is described as rare sequelae of acute appendicitis in two paediatric patients aged 6 and 11 years presented with features of anuria. Imaging and endoscopic evaluation confirmed bilateral ureteric obstruction secondary to bladder wall oedema as an inflammatory reaction to appendix. Both cases recovered following bilateral ureteric stenting and are doing well.

  13. Double Trouble: A Rare Case of Bilateral Upper Pole Ureteropelvic Junction Obstruction

    Directory of Open Access Journals (Sweden)

    Craig A. Peters

    2014-09-01

    Full Text Available A 16-year-old girl presented with bilateral back pain caused by bilateral upper pole ureteropelvic junction obstructions; an extremely rare phenomenon. Bilateral robotically assisted upper pole pyeloplasties were preformed at the same setting with an excellent clinical response. Although rare, upper pole ureteropelvic junction obstruction is a defined entity that urologists should be aware of.

  14. 15 CFR 40.3 - Cooperation with bilateral technical assistance programs of the United States.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Cooperation with bilateral technical... PARTICIPANTS IN CENSUS PROCEDURES AND GENERAL STATISTICS § 40.3 Cooperation with bilateral technical assistance... cooperation with the bilateral technical assistance programs of the United States Government....

  15. Pascal Pyramids, Pascal Hyper-Pyramids and a Bilateral Multinomial Theorem

    OpenAIRE

    Horn, Martin Erik

    2003-01-01

    Part I: The two-dimensional Pascal Triangle will be generalized into a three-dimensional Pascal Pyramid and four-, five- or whatsoever-dimensional hyper-pyramids. Part II: The Bilateral Binomial Theorem will be generalised into a Bilateral Trinomial Theorem resp. a Bilateral Multinomial Theorem.

  16. CT findings of bilateral congenital absence of the long process of the incus

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, A. [Kasaoka Daiichi Hospital, Department of Neurosurgery, Okayama (Japan); Okayama (Japan); Miyashima, H. [Kasaoka Daiichi Hospital, Department of Pediatrics, Okayama (Japan); Kobashi, T. (Kasaoka Daiichi Hospital, Department of Radiology, Okayama, japan); Take, K. [Take Otolaryngolgy Hospital, Department of Otolaryngology, Okayama (Japan)

    2004-10-01

    Bilateral conductive deafness due to congenital absence of the long process of the incus (CALPI) is rare. The authors present the case of a patient with bilateral CALPI. To the best of our knowledge, this is the first reported case preoperatively diagnosed as bilateral CALPI by computed tomography. Multislice computed tomography is very useful for the diagnosis of minute abnormalities of the ossicles. (orig.)

  17. An unusual triad: Bilateral dilated odontoma, hypodontia and peg laterals.

    Science.gov (United States)

    Sebastian, Alphy Alphonsa; Ahsan, Auswaf; George, Ahkin John; Aby, John

    2013-09-01

    The dilated odontoma is an infrequent developmental alteration that appears in any area of the dental arches and can affect deciduous, permanent and supernumerary tooth. Dens invaginatus is a developmental anomaly resulting from invagination of a portion of crown forming within the enamel organ during odontogenesis. The most extreme form of dens invaginatus is known as dilated odontoma. The aim of this case report is to present a rare case of bilateral dilated odontoma affecting a microdontic permanent lateral incisor in a 30 year old female patient with hypodontia and peglateral teeth with its clinical, radiological and histological features, which has yet been not reported. Bilateral presence of dilated odontoma is not a common occurrence, although a single tooth involvement in each case has been reported in the literature. PMID:24348628

  18. Oncogenic osteomalacia presenting as bilateral stress fractures of the tibia

    International Nuclear Information System (INIS)

    We report on a patient with bilateral stress fractures of the tibia who subsequently showed classic biochemical features of oncogenic osteomalacia. Conventional radiographs were normal. MR imaging revealed symmetric, bilateral, band-like low-signal lesions perpendicular to the medial cortex of the tibiae and corresponding to the only lesions subsequently seen on the bone scan. A maxillary sinus lesion was subsequently detected and surgically removed resulting in prompt alleviation of symptoms and normalization of hypophosphatemia and low 1,25-(OH)2 vitamin D3. The lesion was pathologically diagnosed as a hemangiopericytoma-like tumor. Patients with oncogenic osteomalacia may present with stress fractures limited to the tibia, as seen in athletes. The clue to the real diagnosis lies in paying close attention to the serum phosphate levels, especially in patients suffering generalized symptoms of weakness and not given to unusual physical activity. (orig.)

  19. Anesthetic management of a child undergoing bilateral laparoscopic adrenalectomy

    Directory of Open Access Journals (Sweden)

    Mediha Turktan

    2016-03-01

    Full Text Available Pheochromocytoma is a rare catecholamine secreting neuroendocrine tumor in children. It is usually localized unilaterally in adults but often bilaterally in children. The symptoms are variable related to the level of secreted catecholamine. The most common symptoms are hypertension, tachycardia and headache. Beta blockers, alcohol consumption, injection of contrast substance and surgical procedures may lead to attacks. The most effective treatment is surgical resection. In recent years, laparoscopic surgery has been more preferred. Anesthetic management is very important in this cases. Especially, sudden hemodynamic changes may be observed during laparoscopic adrenalectomy. In our case, the control of hemodynamic changes with esmolol and norepinephrine infusion were discussed during bilaterally laparoscopic adrenalectomy in a 14-year old child with pheochromocytoma. [Cukurova Med J 2016; 41(1.000: 171-174

  20. A Case of Spontaneously Resolved Bilateral Primary Spontaneous Pneumothorax

    Directory of Open Access Journals (Sweden)

    Hasan Kahraman

    2014-03-01

    Full Text Available A condition of intrapleural air-space accumulation in individuals without any history of trauma or lung disease is called as primary spontaneous pneumothorax (PSP. Sixteen-years-old male patient admitted with complains of chest pain and dyspnea beginning 3 day ago. On physical examination, severity of breath sounds decreased on right side. Chest radiograph was taken and right-sided pneumothorax was detected and tube thoracostomy was inserted. Two months ago the patient referred to a doctor with similar complaints and physical examination and chest radiograph were reported as normal. The radiograph was retrospectively examined and bilateral PSP was detected. We presented the case duo to spontaneous recovery of bilateral PSP is seen very rarely and so contributes data to the literature. In patients admitted to the clinic with chest pain and shortness of breath, pneumothorax should be considered at differential diagnosis.

  1. Bilaterally impacted mandibular supernumerary premolars associated with unusual clinical complications

    Directory of Open Access Journals (Sweden)

    Zameer Pasha

    2013-01-01

    Full Text Available Supernumerary teeth are extra teeth in comparison to the normal dentition. Their prevalence varies between 0.1% and 3.8%. Supernumeraries are more common in permanent dentition and its incidence is higher in maxillary incisor region, followed by maxillary third molar and mandibular molar, premolar, canine, and lateral incisor. The prevalence of supernumerary premolars is between 0.075-0.26%, and they may occur in single or multiple numbers Bilateral occurrence is uncommon and large percentage of supernumerary premolars remains impacted, unerupted, and usually asymptomatic; radiograph plays an important role in diagnosis of these. The present paper reports a case of bilaterally impacted completely developed supernumerary premolars associated with common clinical complication in unusual manner along with taurodontism of the upper and lower molars.

  2. [Simultaneous bilateral cataract surgery--advantages and disadvantages].

    Science.gov (United States)

    Obuchowska, Iwona; Mariak, Zofia

    2006-01-01

    During the past decade, advances in techniques and technology led to major changes in cataract surgical practice patterns. In this progression towards ever faster eye rehabilitation after surgery, simultaneous bilateral cataract surgery (SBCS) may be the next and ultimate step. It is not routinely performed: however, there are certain situations in which SBCS might be beneficial to the patients. It has been considered a good option in patients who have significant cataract in both eyes and are not good candidates for having anesthesia and surgery twice. The question is, if the benefits by bilateral surgery justify the risk of simultaneous complications, in particular endophthalmitis. In this perspective we present the clinical, social and economic advantages and disadvantages of such surgical procedures. PMID:17290841

  3. Bilateral patellar tendon rupture associated with statin use.

    Science.gov (United States)

    Kearns, Marie C; Singh, Vinay K

    2016-01-01

    Patellar tendon rupture is an uncommon clinical presentation, which generally affects the under 40s who are active in sport. Bilateral rupture of both tendons is much rarer. It occurs most frequently in patients with predisposing factors such as corticosteroid use or systemic diseases. The authors present the case of a 56-year-old male on long-term statin therapy who sustained this injury following a fall on ice. He had no known risk factors for tendon rupture. Surgical treatment involved tendon repair using Krakow suture via bony tunnels in the patella. Statins have previously been associated with tendon ruptures at other sites but there have been no published cases of bilateral patellar tendon rupture linked to statin use. We review the literature regarding the association between statins and tendon rupture. PMID:27165749

  4. Thrombolytic therapy in bilateral embolism of renal arteries branches

    Directory of Open Access Journals (Sweden)

    Cassini Marcelo F.

    2003-01-01

    Full Text Available Bilateral renal artery embolism is rare, but it is a significant cause of arterial hypertension and renal failure, and most often is associated with cardiac arrhythmias. We report a case of bilateral renal artery embolism with a satisfactory outcome following use of thrombolytic therapy. A 42 year-old Caucasian man presented a sudden complaint of intense abdominal pain, in mesogastrium and left flank with dorsal irradiation, 3 days after electrical cardioversion due to cardiac arrhythmia. Laboratory tests revealed slight leukocytosis, hematuria, and creatinine of 1.8 mg/dL. Chest radiography was normal and computerized tomography showed an area of massive ischemia in left kidney, and focal ischemia in right kidney and spleen. The patient was then submitted to systemic venous therapy with 1.5 million units of streptokinase, with an excellent outcome.

  5. BILATERAL CLEIDOHYOIDEUS ACCESSORIUS MUSCLE-A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Naveen Kumar

    2013-01-01

    Full Text Available ABSTRACT: Accessory muscles are rare anatomical variants whic h may have clinical implications. Variations of the muscles in the infrahyoid region assume clinical significance during diagnostic procedures and surgical operati ons in the region of neck. An unusual muscle “Cleidohyoideus accessorius” was found in th e infra hyoid region bilaterally during routine dissection of neck region in an adult male cadaver. On both the sides muscle had its origin from the superior surface of the middle one third of the clavicle. The muscle coursing upward, lateral to the sternohyoid, was ins erted into the hyoid bone. The other infra hyoid muscles including omohyoid were intact and in their typical form. The accessory muscle received its nerve supply from ansa cervicalis. Here we report a variation of rare occurrence, a case of bilateral accessory muscle “Cleid ohyoideus accessorius”, its embryological and clinical considerations are being reviewed here

  6. Bilateral orbital bone infarction in sickle-cell disease.

    Science.gov (United States)

    Ghafouri, Roya H; Lee, Irene; Freitag, Suzanne K; Pira, Tony N

    2011-01-01

    This is a case of a 2-year-old boy with sickle cell disease who presented with bilateral eyelid swelling, limited extraocular motility, and lateral subperiosteal fluid collection associated with bilateral lateral orbital wall infarctions on MRI. The patient was managed medically with intravenous fluids, analgesics, broad-spectrum antibiotics, systemic steroids, and clinically improved. Patients with sickle cell disease are susceptible to infarction of the orbital bones during vaso-occlusive crises. Orbital wall infarction can lead to acute proptosis and restricted extraocular motility. Orbital wall infarction should be considered in sickle cell patients with orbital diseases so that appropriate treatment can be instituted promptly to prevent the serious sequelae of orbital compression syndrome. PMID:20577135

  7. A Case with Bilateral Periventricular Nodular Heterotopia Diagnosed as Depression

    Directory of Open Access Journals (Sweden)

    Melek Kandemir

    2010-06-01

    Full Text Available Periventricular nodular heterotopia is a form of neuronal migration abnormality. Periventricular nodular heterotopia can easily be recognized by cranial magnetic resonance imaging. The most common clinical appearance is epileptic seizures. In some cases, symptoms are accompanied with psychiatric complaints. In this article, we report a 33-year-old female with complaints of left-sided paresthesia induced by emotional stress. She had been followed at an outpatient psychiatry clinic for about 10 years with the diagnosis of somatization disorder. Her electroencephalography recordings -awake as well as during sleep- were found to be normal. The cranial magnetic resonance imaging showed bilateral periventricular nodular heterotopia. Her seizures were controlled with carbamazepine treatment. Partial epileptic seizures might also be observed, even though the cerebral heterotopic lesions are bilateral. When a history is obtained from a patient with somatoform complaints, it should be kept in mind that these symptoms might be seizures, and the patient should be questioned accordingly.

  8. Eye muscle proprioception is represented bilaterally in the sensorimotor cortex

    DEFF Research Database (Denmark)

    Balslev, Daniela; Albert, Neil B; Miall, Chris

    2011-01-01

    the proprioceptive representation for the left and the right eye separately. Data were acquired while passive eye movement was used to stimulate EOM proprioceptors in the absence of a motor command. We also controlled for the tactile stimulation of the eyelid by removing from the analysis voxels activated by eyelid...... touch alone. For either eye, the brain area commonly activated by passive and active eye movement was located bilaterally in the somatosensory area extending into the motor and premotor cytoarchitectonic areas. We suggest this is where EOM proprioception is processed. The bilateral representation......The cortical representation of eye position is still uncertain. In the monkey a proprioceptive representation of the extraocular muscles (EOM) of an eye were recently found within the contralateral central sulcus. In humans, we have previously shown a change in the perceived position of the right...

  9. Metachronous bilateral testicular germ cell tumors: Report of two cases

    Directory of Open Access Journals (Sweden)

    James Francis

    2009-01-01

    Full Text Available Metachronous bilateral testicular germ cell tumors is a rare known problem. However, no report of metachronus bilateralism was identified in the PubMed database published from India so far, where testicular cancer is relatively rare. We report the cases of two gentlemen. One had stage 1 nonseminomatous germ cell tumor (NSGCT at the age of 32 in 1990 and developed marker relapse on surveillance and had chemotherapy using cisplatin and etoposide for four cycles. He developed contralateral seminoma in the testis 13 years later. Another patient had left orchidectomy in 2003 for NSGCT, had adjuvant BEP for two cycles, and developed a contralateral testicular tumor 5 years later, which was also seminoma. As more patients with germ cell tumors are cured with chemotherapy, long-term problems become important. Contralateral testicular tumor is one of them. As it can be very late, many years of continued follow-up examination and patients′ awareness are necessary.

  10. Predicting stretcher carriage: Investigating variations in bilateral carry tests.

    Science.gov (United States)

    Beck, Ben; Middleton, Kane J; Carstairs, Greg L; Billing, Daniel C; Caldwell, Joanne N

    2016-07-01

    Carrying a casualty on a stretcher is a critical task within military and emergency service occupations. This study evaluated the impact of manipulating carry speed and the object type in bilateral carries on the ability to predict performance and reflect the physical and physiological requirements of a unilateral stretcher carry. We demonstrated that three task-related predictive tests; a jerry can carry performed at 4.5 km h(-1)or 5.0 km h(-1) and a kettle-bell carry performed at 5.0 km h(-1) were strongly predictive of the physical and physiological demands of an individual participating as part of a four-person stretcher carry team. Therefore, bilateral predictive assessments have the utility for predicting the suitability of employees to effectively and safely conduct a four-person unilateral stretcher carry. PMID:26995042

  11. Bilateral dystonia in type 1 diabetes: a case report

    Directory of Open Access Journals (Sweden)

    Yasuhara Akihiro

    2008-11-01

    Full Text Available Abstract Introduction Diabetic hemichorea-hemiballismus is a rare complication of type 2 diabetes. Here, we report a case with type 1 diabetes, with hemichorea and bilateral dystonia manifested as hyperglycemia-induced involuntary movement. Case presentation A 62-year-old Japanese women with body weight loss of 30 kg during the past year developed symptoms of thirst, polydipsia and polyuria. She also presented with hemichorea and bilateral dystonia for 5 days and extremely high plasma glucose (774 mg/dl, hemoglobin A1c (21.2% and glycated albumin (100% with ketosis. Based on the presence of glutamic acid decarboxylase antibodies (18,000 U/ml; normal Conclusion Hyperglycemia-induced involuntary movement is one of the manifestations of dystonia and hemichorea-hemiballism.

  12. Bilateral primary adrenal lymphoma presenting with adrenal insufficiency

    DEFF Research Database (Denmark)

    Holm, Jakob; Breum, Leif; Stenfeldt, Katrine; Friberg Hitz, Mette

    2012-01-01

    surgery was performed. A new computerized tomography scan showed rapid progression of disease with further enlargement of the adrenal masses and both pulmonary and hepatic metastasis. Needle biopsy was performed but the patient refused further treatment and died before a diagnosis was obtained. The...... immuneohistochemical diagnosis was large B-cell lymphoma. This case should remind clinicians that PAL may be a cause of bilateral adrenal incidentaloma especially if the patient presents with adrenal insufficiency....

  13. Bilateral paramedian thalamic artery infarcts: report of eight cases.

    OpenAIRE

    Gentilini, M.; De Renzi, E; Crisi, G

    1987-01-01

    Eight consecutive patients with CT scan evidence of a bilateral infarct in the territory of the paramedian thalamic artery are reported. In seven cases the infarct also extended to the territory of the polar artery. The main symptoms were: disorder of vigilance which cleared in a few days, and hypersomnolence which lasted longer and in two patients was still present a year later; amnesia, detectable clinically in four patients and only with tests in two patients, which persisted in one patien...

  14. Bilateral fusion of permanent mandibular incisors: A case report

    OpenAIRE

    Saxena A.; Pandey R; Kamboj M

    2008-01-01

    This case report showing a classical presentation of bilateral fusion of permanent mandibular incisors in a child patient for dental attention. Fusion defined as the merger of two adjacent tooth germs producing one tooth. These teeth may be fused by enamel, dentin, or both. The fused crown is broader than non fused adjacent teeth and thus resembles gemination. However, tooth counting reveals decreased numbers. Fused teeth are rare in the permanent dentition. The incisors are reported to be fu...

  15. An unusual triad: Bilateral dilated odontoma, hypodontia and peg laterals

    OpenAIRE

    Alphy Alphonsa Sebastian; Auswaf Ahsan; Ahkin John George; John Aby

    2013-01-01

    The dilated odontoma is an infrequent developmental alteration that appears in any area of the dental arches and can affect deciduous, permanent and supernumerary tooth. Dens invaginatus is a developmental anomaly resulting from invagination of a portion of crown forming within the enamel organ during odontogenesis. The most extreme form of dens invaginatus is known as dilated odontoma. The aim of this case report is to present a rare case of bilateral dilated odontoma affecting a microdon...

  16. Follicular Thyroid Carcinoma Presenting as Bilateral Cheek Masses

    OpenAIRE

    KIM Dong-Wook; Hah, J. Hun; An, Soo-Youn; Chang, Hak; Kim, Kwang Hyun

    2011-01-01

    Mandibular metastasis of thyroid carcinoma is extremely rare. We present the case of a 46-year-old woman who had bilateral huge cheek masses that had grown rapidly over several years. Intra-oral mucosal tissue biopsy and imaging work-up including computed tomography scan and magnetic resonance imaging were performed and the initial diagnosis was presumed to be central giant cell granuloma. Incidentally detected thyroid lesions were studied with ultra-sonography guided fine needle aspiration a...

  17. Right sided hemispatial neglect and bilateral cerebral lesions.

    OpenAIRE

    Weintraub, S.; Daffner, K R; Ahern, G L; Price, B H; Mesulam, M M

    1996-01-01

    This study compared the frequency with which unilateral and bilateral cerebral disease gives rise to right sided visual hemispatial inattention. A retrospective survey identified brain injured patients for whom target omissions on visual target cancellation tasks significantly exceeded control values. Subjects consisted of 40 right handed patients referred for clinical evaluation or research study of hemispatial inattention. Right sided visual hemispatial inattention occurred with greater fre...

  18. BILATERAL NASOLABIAL CYST: A RARE CAUSE OF NASAL OBSTRUCTION

    OpenAIRE

    Samir

    2015-01-01

    Nasolabial cyst is rare, nonodontogenic, soft tissue, and developmental cyst. It is located inferior to the nasal ala. It is frequently asymptomatic, we report a rare case of bilateral nasolabial cysts causing nasal obstruction. This case report provides review of current knowledge adout pathogenesis, symptoms, imaging modalities, histopathology, treatment options and prognosis of nasolabial cyst. A 30 years old woman presented with swelling below the nose around the upper lip...

  19. Bilateral thalamic infarction with psychiatric symptoms: case report

    OpenAIRE

    Betül Tekin Güveli; Ahmet Nalbant; Metin Dedei Daryan; Batuhan Kara; Cengiz Dayan; Dilek Ataklı

    2016-01-01

    Introduction: Thalamus is a mass of gray matter, which plays a role in the transmission of sensory and motor information to the primary sensory and motor centers of the cerebral cortex, cerebellum and basal ganglia. Vascular lesions of thalamus may occur in different syndromes depending on the affected nuclei. In this report, a case with acute evolving personality and behavior changes and detected bilateral thalamic infarction will be presented. Case: A 40-year-old male patient was brought to...

  20. Systemic Weber-Christian disease with reversible bilateral ureteric obstruction.

    OpenAIRE

    Brawn, L. A.; Ramsay, L E; Shortland, J R; Williams, J.L.

    1989-01-01

    It has been proposed that idiopathic retroperitoneal fibrosis may be a consequence of 'healed' retroperitoneal lesions of systemic Weber-Christian disease. However ureteric obstruction which is the hallmark of idiopathic retroperitoneal fibrosis, has not been described in systemic Weber-Christian disease. We report a patient with systemic Weber-Christian disease who, during a relapse, developed bilateral ureteric obstruction which resolved when the Weber-Christian disease remitted. The radiol...

  1. 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

  2. Pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema complicating acute silicosis.

    Science.gov (United States)

    Dixit, Ramakant; Meena, Manoj; Patil, Chetan B

    2015-01-01

    A case of acute silicosis complicating as spontaneous pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema is described in a 35-year-old male engaged in stone crusher unit. Diagnosis was established on clinical and radiological assessment and supported by occupational history of the patient. This case is unique one as all these 3 complications at the same time are very uncommon in acute silicosis. PMID:26190738

  3. Pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema complicating acute silicosis

    Directory of Open Access Journals (Sweden)

    Ramakant Dixit

    2015-06-01

    Full Text Available A case of acute silicosis complicating as spontaneous pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema is described in a 35-year-old male engaged in stone crusher unit. Diagnosis was established on clinical and radiological assessment and supported by occupational history of the patient. This case is unique one as all these 3 complications at the same time are very uncommon in acute silicosis.

  4. DELAYED BILATERAL HYDROTHORAX AFTER CENTRAL VENOUS CATHERIZATION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Arpana

    2014-09-01

    Full Text Available : Central venous catheterization is a common procedure in anesthetic management of patients undergoing major surgery or care of critically ill patients. Delayed complication such as hydrothorax, hydromediastinum or cardiac tamponade is extremely rare with a few case reports. We report a case of bilateral hydrothorax due to migration of the tip of the central venous catheter from within the vein into the mediastinum following subclavian vein catheterization.

  5. Effects of Unilateral and Bilateral Epididymectomy on Testes of Rats

    Directory of Open Access Journals (Sweden)

    Ayfer Aktaş

    2007-01-01

    Full Text Available It is generally agreed that the testis is under endocrine control from the pituitary, and is influenced by physiological and paracrine factors within the organ.The aim of this study is to analyze the effect of unilateral and bilateral epididectomy on the testicular tissue growth of rats.Twenty- one male old Sprague-Dawley rats (28 days old were used in the study. Rats were assigned into 3 equal groups. The first group was the control group, while unilateral and bilateral epididectomy was performed on the second and third groups, respectively. Twenty-one days after the epididectomy, testicular tissues from each group were taken and fixed in Bouin solution. Paraffin sections were stained with Haematoxylin and Eosin, Vangiesson, PAS-Hemalun and examined by light microscopy.Disorganization of the germinal epithelium, desquamation, degeneration and edema in interstitial tissue was seen in the testicular cross sections of the unilateral group. Arrest in spermatozoon stage in some tubules and presence of eosinophylic stained multinucler bodies were recognizable. In the bilateral group, degeneration and atrophic status in the seminiferous tubules of the bilateral group was observed preciesly, and occasional interstitial edema and perforations in the basal lamina were recognizable. In addition, vasodilatation, arrest in spermatozoa stage and multinucleated bodies in some of the seminiferous tubules lumen were observed in some testicular cross sections of this group.As a result, epididectomy causes degeneration in the germinal epithelium and hypoplasia in Leydig cells.It is concluded that epididectomy causes degeneration in the germinal epithelium, interruption of spermatogenesis, and a notable decrease in the number of Leydig cells.

  6. Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients

    OpenAIRE

    Tien-En Huang; Hsi-Kung Kuo; Sue-Ann Lin; Po-Chiung Fang; Pei-Chang Wu; Yi-Hao Chen; Yung-Jen Chen

    2007-01-01

    Background: The aim of this study was to evaluate the indications, safety, benefits, disadvantagesand advantages, and the visual outcomes for simultaneous bilateralcataract surgery (SBCS) under general anesthesia.Methods: This retrospective case review pertained to a period spanning from June1998 through June 2005 inclusively, and comprised of 27 consecutivepatients (54 eyes) that underwent simultaneous bilateral cataract surgeryunder general anesthesia at the Kaohsiung Chang Gung Memorial Ho...

  7. Asymmetric traumatic bilateral dislocation of hip. Case report

    Directory of Open Access Journals (Sweden)

    Pedro Gonzalo González González

    2009-05-01

    Full Text Available A male (26 years suffered an asymmetric bilateral dislocation of hip as a result of a car accident. The patient was treated with closed reduction and bone traction for six weeks. We present this report since the reviewed literature only include six cases with this kind of lesion and because this is a medical emergency resulting from high impact trauma, being the aseptic osteonecrosis the most significant and serious complication.

  8. Fear and panic in humans with bilateral amygdala damage

    OpenAIRE

    Feinstein, Justin S.; Buzza, Colin; Hurlemann, Rene; Follmer, Robin L.; Dahdaleh, Nader S.; Coryell, William H.; Welsh, Michael J.; Tranel, Daniel; Wemmie, John A.

    2013-01-01

    Decades of research have highlighted the amygdala’s influential role in fear. Surprisingly, we found that inhalation of 35% CO2 evoked not only fear, but also panic attacks, in three rare patients with bilateral amygdala damage. These results indicate that the amygdala is not required for fear and panic, and make an important distinction between fear triggered by external threats from the environment versus fear triggered internally by CO2.

  9. Refractory headaches treated with bilateral occipital and temporal region stimulation

    OpenAIRE

    Zach KJ; Trentman TL; Zimmerman RS; DW, Dodick

    2014-01-01

    Kelly J Zach,1 Terrence L Trentman,1 Richard S Zimmerman,2 David W Dodick31Department of Anesthesiology, 2Department of Neurosurgery, 3Department of Neurology, Mayo Clinic in Arizona, Phoenix, AZ, USAObjectives: To describe use of bilateral temporal and occipital stimulator leads for a refractory headache disorder.Materials and methods: A 31-year-old female had a 10-year history of chronic, severe occipital and temporal region headaches. The patient underwent permanent implant of an occipital...

  10. Bilateral variant of sciatic nerve exhibiting intra-pelvic division

    OpenAIRE

    Rejeena P Raj, Kunjumon PC, More Anju B

    2014-01-01

    Context (background): In case of high division of the sciatic nerve in the pelvis its, common peroneal component may pierce the Piriformis muscle. This anatomical variant can explain many clinical findings. Aims: Its objective is to report a case of high division of the sciatic nerve in order to contribute towards better anatomical understanding of the gluteal region. Methods and Material: Routine undergraduate dissection of a male cadaver revealed bilateral variation in sciatic nerve. Result...

  11. New Developments in India–Myanmar Bilateral Relations?

    OpenAIRE

    Pierre Gottschlich; Department of Political Science at the University of Rostock

    2015-01-01

    The article deals with bilateral relations between India and Myanmar. It argues that the current transformation processes offer a unique opportunity for a major readjustment of India’s foreign policy towards Myanmar. In taking on India’s perspective, it assesses the history, current state of and prospects for the relationship between New Delhi and Naypyidaw in six policy areas: democratization and stability; security in India’s Northeast region and illegal migration; trade and infrastructure;...

  12. Carpal ligamentous laxity with bilateral perilunate dislocation in Marfan syndrome

    International Nuclear Information System (INIS)

    A case of persistent bilateral perilunate dislocation unrelated to trauma in a patient with Marfan syndrome is discussed. This finding is believed to be a manifestation of the generalized ligamentous laxity occurring in this disorder. Radiographs of eight additional Marfan syndrome patients failed to demonstrate similar carpal instability. Because some carpal derangements are dynamic events, stress views or wrist fluoroscopy may be necessary to demonstrate unsuspected carpal instability in Marfan patients. (orig.)

  13. Carpal ligamentous laxity with bilateral perilunate dislocation in Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Pennes, D.R.; Braunstein, E.M.; Shirazi, K.K.

    1985-01-01

    A case of persistent bilateral perilunate dislocation unrelated to trauma in a patient with Marfan syndrome is discussed. This finding is believed to be a manifestation of the generalized ligamentous laxity occurring in this disorder. Radiographs of eight additional Marfan syndrome patients failed to demonstrate similar carpal instability. Because some carpal derangements are dynamic events, stress views or wrist fluoroscopy may be necessary to demonstrate unsuspected carpal instability in Marfan patients.

  14. Acute bilateral ureteral obstruction secondary to guaifenesin toxicity.

    Science.gov (United States)

    Cockerill, Patrick A; de Cógáin, Mitra R; Krambeck, Amy E

    2013-10-01

    Several medications or their metabolites have been associated with urolithiasis, although overall they remain an infrequent cause of urolithiasis. Guaifenesin stones were originally reported as complexed with ephedrine, and subsequent reports have demonstrated pure guaifenesin stones, occurring after long term abuse. We report a case of a 23-year-old male who ingested a large, one time dose of guaifenesin, resulting in acute bilateral ureteral obstruction, which, to our knowledge, is the first such reported case in the literature. PMID:24128843

  15. Bilateral facial palsy as a manifestation of Japanese encephalitis

    OpenAIRE

    Verma, Rajesh; Praharaj, Heramba Narayan

    2012-01-01

    Japanese encephalitis is a cause of substantial morbidity and mortality, prevalent mainly in South East nations. It is caused by group B arbovirus and transmitted with bite of infected culex mosquitoes. The clinical features described are: headache, vomiting, altered sensorium, convulsions and both hypokinetic and hyperkinetic movement disorders. In this submission, we described a 68-year-old man suffering from Japanese encephalitis, who presented with bilateral facial palsy with encephalitic...

  16. Spontaneous Bilateral Tubal Gestation: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Marwah Sheeba

    2016-01-01

    Full Text Available Here a case is presented where the woman after a positive pregnancy test underwent medical abortion for unwanted pregnancy without ultrasound confirmation of intrauterine pregnancy. On persistence of symptoms, a second opinion was procured, when examination and a transvaginal ultrasound scan revealed ruptured unilateral tubal ectopic pregnancy. However upon subsequent laparotomy (considering deteriorating hemodynamic status of the patient, intraoperatively it turned out to be a bilateral tubal ectopic gestation.

  17. 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...

  18. Do Bilateral Tax Treaties Promote Foreign Direct Investment?

    OpenAIRE

    Blonigen, Bruce A.; Davies, Ronald B.

    2002-01-01

    We explore the impact of bilateral tax treaties on foreign direct investment using data from OECD countries over the period 1982-1992. We find that recent treaty formation does not promote new investment, contrary to the common expectation. For certain specifications we find that treaty formation may actually reduce investment as predicted by arguments suggesting treaties are intended to reduce tax evasion rather than promote foreign investment.

  19. Acoustic Neurinoma With Bilateral Audio Logical Complication; a Case Report

    OpenAIRE

    Saeed Farahani

    1998-01-01

    Many of the CP angle tumors are acoustic neuroma, vestibular schowanoma or 8th nerve tumor. This kind of tumor is benign histologically. Big size ones can cause neurological symptoms such as cerebellar imbalance, edema and cranial nerves dysfunction. Acoustic neuroma is mostly unilateral and audio logical findings manifest a unilateral hearing loss. Although big size tumors can lead to bilateral audio logical symptoms which can affect the findings of hearing assessment. Here, a 31 year-old pa...

  20. A rare case of bilateral optic nerve sheath meningioma

    Directory of Open Access Journals (Sweden)

    Somen Misra

    2014-01-01

    Full Text Available A 60-year-old female presented with gradual, painless, progressive diminution of vision, and progressive proptosis of left eye since 7 years. Ophthalmological examination revealed mild proptosis and total optic atrophy in the left eye. Magnetic resonance imaging (MRI and computed tomography (CT brain with orbit showed bilateral optic nerve sheath meningioma (ONSM involving the intracranial, intracanalicular, intraorbital part of the optic nerve extending up to optic chiasma and left cavernous sinus.