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Sample records for canal syndrome due

  1. Síndrome do canal de Guyon causada por cisto sinovial Guyon's canal syndrome due to a synovial cyst

    Directory of Open Access Journals (Sweden)

    Evandro Silva Ruas

    2010-01-01

    Full Text Available Apresentamos um caso de síndrome do canal de Guyon por um cisto sinovial no punho esquerdo de uma paciente do sexo feminino, de 48 anos. A paciente apresentava dor e parestesia na topografia do nervo ulnar, diminuição da força muscular e deformidade na mão esquerda. A eletroneuromiografia evidenciava compressão do nervo ulnar no nível do punho. Realizada a ressecção do cisto e descompressão do nervo no canal de Guyon. Após a cirurgia a paciente apresentou melhora da dor e da parestesia, além de aumento do trofismo muscular e correção da deformidade.The authors present a case of Guyon's canal syndrome due to a synovial cyst within the left wrist of a 48-year-old female patient. The patient reported pain and paresthesia in the topography of the ulnar nerve, loss of muscular strength and left hand deformity. Electromyography showed a compression of the ulnar nerve at the wrist level. Surgical decompression at the Guyon canal with resection of the cyst was performed. After surgery, the patient presented with improvement of pain and paresthesia, as well as an increase in muscular trophism and correction of the deformity.

  2. Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report

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    Zeeshan, Muhammad; Ahmed, Farhan; Kanwal, Darakhshan; Khalid, Qazi Saad Bin; Ahmed, Muhammad Nadeem

    2009-01-01

    The Guyon's canal syndrome is a well known clinical entity and may have significant impact on patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous in...

  3. Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report.

    Science.gov (United States)

    Zeeshan, Muhammad; Ahmed, Farhan; Kanwal, Darakhshan; Khalid, Qazi Saad Bin; Ahmed, Muhammad Nadeem

    2009-01-01

    The Guyon's canal syndrome is a well known clinical entity and may have significant impact on patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous injury and subsequently these were confirmed on surgery.Although it is a rare syndrome, early diagnosis and treatment prevents permanent neurological deficits and improve patient's quality of life. PMID:20076781

  4. Tullio phenomenon in superior semicircular canal dehiscence syndrome.

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    Basura, Gregory J; Cronin, Scott J; Heidenreich, Katherine D

    2014-03-18

    Tullio phenomenon refers to eye movements induced by sound.(1) This unusual examination finding may be seen in superior semicircular canal dehiscence (SSCD) syndrome.(2) This disorder is due to absent bone over the superior semicircular canal (figure). Patients complain of dizziness triggered by loud sound, aural fullness, autophony, and pulsatile tinnitus. When Tullio phenomenon exists in SSCD syndrome, the patient develops a mixed vertical-torsional nystagmus in which the slow phase rotates up and away from the affected ear (video on the Neurology® Web site at Neurology.org). This pattern of nystagmus aligns in the plane of the dehiscent semicircular canal and is due to excitation of its afferent nerves.

  5. Absent posterior semicircular canal: HRCT feature of Waardenburg syndrome

    OpenAIRE

    Sandeep M Mahajan; Manish Pithwa; Apeksha Chavan; Deepti Pimple

    2012-01-01

    Absence of posterior semicircular canal is a rare condition, having been reported with only a few syndromes such as Waardenburg syndrome (WS), Alagellie, CHARGE, and Goldenhaar syndromes. We report a 12- year old male with bilateral absent posterior semicircular canals. These phenotypic characteristics of the patient favored the diagnosis of WS. WS is a rare autosomal dominant condition characterized by sensorineural hearing loss, in conjunction with pigmentary abnormalities and defects of th...

  6. A Guyon's canal ganglion presenting as occupational overuse syndrome: A case report.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2008-01-01

    Occupational overuse syndrome (OOS) can present as Guyon\\'s canal syndrome in computer keyboard users. We report a case of Guyon\\'s canal syndrome caused by a ganglion in a computer user that was misdiagnosed as OOS.

  7. Absent posterior semicircular canal: HRCT feature of Waardenburg syndrome

    Directory of Open Access Journals (Sweden)

    Sandeep M Mahajan

    2012-01-01

    Full Text Available Absence of posterior semicircular canal is a rare condition, having been reported with only a few syndromes such as Waardenburg syndrome (WS, Alagellie, CHARGE, and Goldenhaar syndromes. We report a 12- year old male with bilateral absent posterior semicircular canals. These phenotypic characteristics of the patient favored the diagnosis of WS. WS is a rare autosomal dominant condition characterized by sensorineural hearing loss, in conjunction with pigmentary abnormalities and defects of the neural crest-derived tissues. The case is presented for its rarity and for its high resolution computed tomography (HRCT temporal bone findings so as to reach a precise diagnosis.

  8. Partial absence of the posterior semicircular canal in Alagille syndrome: CT findings

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    Koch, Bernadette; Egelhoff, John; Benton, Corning [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati (United States); Goold, Amy [Tripler Army Medical Center, Family Practice, Honolulu, HI (United States)

    2006-09-15

    We report a case of bilateral partial absence of the posterior semicircular canals (with normal lateral semicircular canals) imaged with CT in a patient with Alagille syndrome. Similar histologic findings have been reported in the pathology literature. This association has been previously reported only for Waardenburg syndrome in the imaging literature. We review the imaging findings and embryology of the semicircular canals, and suggest that this abnormality is specific to patients with Alagille or Waardenburg syndrome. (orig.)

  9. Arcuate eminence: Is it due to semicircular canal?

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    Manvikar Purushottam Rao

    2012-01-01

    Full Text Available Background: Arcuate eminence (AE is an arc-like elevation seen on the anterior surface of petrous part of temporal bone in the middle cranial fossa (MCF. It has been believed and conventionally taught that AE is a protrusion caused because of the superior semicircular canal (SSC present in the petrous bone. AE is an useful anatomical landmark in the MCF during surgical approaches to acoustic neuroma through suprapetrosal approach. However, the relevance of relation to AE and SSC has been questioned in recent times. Presence of AE of various shapes and dimensions supports this view. Aim: To study and to establish the relation between shape of AE and inferior surface of cerebral hemispheres. Classify various types and subtypes in case of variation in shape based on its appearance. AE could be a negative impression of either gyrus or a sulcus. Material and Methods: The study was conducted in two parts. In the first part, the shape of AE and the impression on cerebral surface were correlated while removing brain from cranial cavity in 8 cadavers (16 wet temporal bones. In second part of the study, 100 dry temporal bones were examined. Relevant photographs were taken. A total of 116 temporal bones were studied. AE was classified as linear, globular, generalized swelling, and flat based on the appearance. Results and Conclusion: 10 AE of 16 wet temporal bones were linear type and did correspond with a sulcus, whilein 1 cadaver no relation was seen. In dry bones, maximum linear variety was seen. There was no relation to shape of AE and cerebral surface in two cadavers. Diversity in shapes, (linear type 47% and correlation with sulci on cerebral surface contests the earlier understanding that AE is due to SSC. Thickness of bone over SSC was not measured in this study. Having seen so many shapes of AE in this study, authors are of the opinion that there is a need to revisit this bony landmark in MCF and rethink if it can be used as a guide in middle

  10. Atrioventricular canal defect and associated genetic disorders: new insights into polydactyly syndromes

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    M. Cristina Digilio

    2011-07-01

    Full Text Available Atrioventricular canal defect (AVCD is a common congenital heart defect (CHD, representing 7.4% of all cardiac malformations, considered secondary to an extracellular matrix anomaly. The AVCD is associated with extracardiac defects in about 75% of the cases. In this review we analyzed different syndromic AVCDs, in particular those associated with polydactyly disorders, which show remarkable genotype-phenotype correlations. Chromo - some imbalances more frequently associated with AVCD include Down syndrome, deletion 8p23 and deletion 3p25, while mendelian disorders include Noonan syndrome and related RASopathies, several polydactyly syndromes, CHARGE and 3C (cranio-cerebello-cardiac syndrome. The complete form of AVCD is prevalent in patients with chromosomal imbalances. Additional cardiac defects are found in patients affected by chromosomal imbalances different from Down syndrome. Left-sided obstructive lesions are prevalently found in patients with RASopathies. Patients with deletion 8p23 often display AVCD with tetralogy of Fallot or with pulmonary valve stenosis. Tetralogy of Fallot is the only additional cardiac defect found in patients with Down syndrome and AVCD. On the other hand, the association of AVCD and tetralogy of Fallot is also quite characteristic of CHARGE and 3C syndromes. Heterotaxia defects, including common atrium and anomalous pulmonary venous return, occur in patients with AVCD associated with polydactyly syndromes (Ellis-van Creveld, short rib polydactyly, oral-facial-digital, Bardet-Biedl, and Smith-Lemli-Opitz syndromes. The initial clinical evidence of anatomic similarities between AVCD and heterotaxia in polydactyly syndromes was corroborated and explained by experimental studies in transgenic mice. These investigations have suggested the involvement of the Sonic Hedgehog pathway in syndromes with postaxial polydactyly and heterotaxia, and ciliary dysfunction was detected as pathomechanism for these disorders

  11. Utility of cVEMPs in bilateral superior canal dehiscence syndrome

    NARCIS (Netherlands)

    Niesten, Marlien E. F.; McKenna, Michael J.; Herrmann, Barbara S.; Grolman, Wilko; Lee, Daniel J.

    2013-01-01

    Objectives/Hypothesis: To determine the utility of cervical vestibular evoked myogenic potential (cVEMP) thresholds in the surgical management of bilateral superior canal dehiscence syndrome (SCDS). Study design: Retrospective review. Methods: We identified patients who underwent surgical treatment

  12. Lower lip numbness due to the mandibular canal narrowing after dental reimplantation: A case report

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    Shamloo, Nafiseh; Safi, Yaser; Fathpour, Kamyar; Yaghmaei, Masood; Bahemmat, Nika

    2015-01-01

    Mandibular canal is the most important anatomical landmark in the body of mandible which always must be considered for implant surgery in posterior mandibular region. Damage to vessels and inferior alveolar nerve that passes through the mandibular canal can cause problems such as hemorrhage and neurosensory disturbances. Damage to the mandibular canal can occur during implant surgery. Depending on the severity of injuries, it would result in temporary or permanent neurosensory disturbances. We have reported a case that mandibular canal narrowing occurred following implant surgery and resulted in anesthetic and hypoesthetic areas in the lower lip. Patient had a history of implant surgery in the region of teeth numbered 30 and numbered 31. The inserted implant failed after 6 years, and reimplantation was done in this area, but due to lower lip numbness in the right side, the second implant was removed, and another implant was inserted in the region of the tooth numbered 32. After 2 years, right lower lip numbness was reported again by the patient. Cone beam computed tomography images showed canal narrowing in the region of the tooth numbered 31 where the second implant was inserted. It seems that the main cause for anesthesia and hypoesthesia in this patient is canal narrowing due to damage during implant replacement and removal. PMID:26288630

  13. Lower lip numbness due to the mandibular canal narrowing after dental reimplantation: A case report

    Directory of Open Access Journals (Sweden)

    Nafiseh Shamloo

    2015-01-01

    Full Text Available Mandibular canal is the most important anatomical landmark in the body of mandible which always must be considered for implant surgery in posterior mandibular region. Damage to vessels and inferior alveolar nerve that passes through the mandibular canal can cause problems such as hemorrhage and neurosensory disturbances. Damage to the mandibular canal can occur during implant surgery. Depending on the severity of injuries, it would result in temporary or permanent neurosensory disturbances. We have reported a case that mandibular canal narrowing occurred following implant surgery and resulted in anesthetic and hypoesthetic areas in the lower lip. Patient had a history of implant surgery in the region of teeth numbered 30 and numbered 31. The inserted implant failed after 6 years, and reimplantation was done in this area, but due to lower lip numbness in the right side, the second implant was removed, and another implant was inserted in the region of the tooth numbered 32. After 2 years, right lower lip numbness was reported again by the patient. Cone beam computed tomography images showed canal narrowing in the region of the tooth numbered 31 where the second implant was inserted. It seems that the main cause for anesthesia and hypoesthesia in this patient is canal narrowing due to damage during implant replacement and removal.

  14. Orocardiodigital syndrome: an oral-facial-digital type II variant associated with atrioventricular canal.

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    Digilio, M C; Marino, B; Giannotti, A; Dallapiccola, B

    1996-01-01

    We report on a patient with a constellation of anomalies including hamartomas of the tongue, polysyndactyly, and atrioventricular canal. A similar association has been previously described by Orstavik et al in two sibs. The clinical spectrum of the oralfacial-digital syndrome (OFDS) type II includes all these features. In particular, congenital heart defect, mainly atrioventricular canal, has been described in a few cases. It has been previously suggested that these latter patients may be affected by a variant of OFDS type II. We propose to distinguish this orocardiodigital variant and point out the association of the syndrome with atrioventricular canal. Images PMID:8733055

  15. A Guyon's canal ganglion presenting as occupational overuse syndrome: A case report

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    Hennessy Michael J

    2008-02-01

    Full Text Available Abstract Background Occupational overuse syndrome (OOS can present as Guyon's canal syndrome in computer keyboard users. We report a case of Guyon's canal syndrome caused by a ganglion in a computer user that was misdiagnosed as OOS. Case presentation A 54-year-old female secretary was referred with a six-month history of right little finger weakness and difficulty with adduction. Prior to her referral, she was diagnosed by her general practitioner and physiotherapist with a right ulnar nerve neuropraxia at the level of the Guyon's canal. This was thought to be secondary to computer keyboard use and direct pressure exerted on a wrist support. There was obvious atrophy of the hypothenar eminence and the first dorsal interosseous muscle. Both Froment's and Wartenberg's signs were positive. A nerve conduction study revealed that both the abductor digiti minimi and the first dorsal interosseus muscles showed prolonged motor latency. Ulnar conduction across the right elbow was normal. Ulnar sensory amplitude across the right wrist to the fifth digit was reduced while the dorsal cutaneous nerve response was normal. Magnetic resonance imaging of the right wrist showed a ganglion in Guyon's canal. Decompression of the Guyon's canal was performed and histological examination confirmed a ganglion. The patient's symptoms and signs resolved completely at four-month follow-up. Conclusion Clinical history, occupational history and examination alone could potentially lead to misdiagnosis of OOS when a computer user presents with these symptoms and we recommend that nerve conduction or imaging studies be performed.

  16. A case of anal canal cancer which developed fournier's syndrome after chemoradiotherapy

    International Nuclear Information System (INIS)

    Fournier's syndrome is an acute necrotizing fasciitis of the perineum which progresses rapidly, resulting in poor prognosis if not treated appropriately at an early stage. Here we report a case of anal canal cancer which developed Fournier's syndrome after chemoradiotherapy (CRT). A 79-year-old man with anal canal cancer received a double-barrel sigmoid colostomy followed by concurrent CRT (50.4 Gy) with S-1 (100 mg/body). Although the patient was discharged after CRT, he developed a fever at 10 days after discharge and visited our hospital complaining of pain in the anal region. He was hospitalized with a diagnosis of Fournier's syndrome. Extensive drainage, administration of antibiotics, additional drainage and continuous irrigation of the affected region improved the symptoms of Fournier's syndrome. Multiple liver metastases were found on a CT scan at 3 months after onset of Fournier's syndrome, and the patient was transferred to another hospital for systemic chemotherapy. There have been no reports on the onset of Fournier's syndrome after CRT for rectal cancer with anal canal involvement; we report this case with a review of the literature. (author)

  17. [Secondary nephrotic syndrome due to cardiovascular disease].

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    Hirayama, Tomoya; Takahashi, Fumihiko; Kikuchi, Kenjiro

    2004-10-01

    Cardiovascular diseases ralely evoke nephrotic syndrome. Especially hypertensive renal disease (nephroscrelosis) and renovascular hypertension occasionally may lead to nephrotic syndrome. We reported a case of nephrotic syndrome with renovascular hypertension successfully treated with candesartan. In eldery patients cardiovascular diseases are appeared. It is very important for clinicians to detect the mechanism of nephrotic syndrome caused by cardiovascular diseases. PMID:15500142

  18. Cushing syndrome due to adrenal tumor

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    Adrenal tumor - Cushing syndrome ... Cushing syndrome is a disorder that occurs when your body has a higher than normal level of the ... or cancerous (malignant). Noncancerous tumors that can cause ... Adrenal adenomas Micronodular hyperplasia Cancerous tumors that ...

  19. Cushing's syndrome due to ectopic ACTH secretion.

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    Cieszyński, Łukasz; Berendt-Obołończyk, Monika; Szulc, Michał; Sworczak, Krzysztof

    2016-01-01

    Cushing's syndrome (CS) is defined as a constellation of clinical signs and symptoms occurring due to hypercortisolism. Cortisol excess may be endogenous or exogenous. The most common cause of CS is glucocorticoid therapy with supraphysiological (higher than in the case of substitution) doses used in various diseases (e.g. autoimmune). One possible CS cause is ectopic (extra-pituitary) ACTH secretion (EAS) by benign or malignant tumours. Since its first description in 1963, EAS aetiology has changed, i.e. as well as small cell lung cancer (SCLC), higher incidence in other malignancies has been reported. Ectopic ACTH secretion symptoms are usually similar to hypercortisolism symptoms due to other causes. A clinical suspicion of CS requires laboratory investigations. There is no single and specific laboratory test for making a CS diagnosis, and therefore multiple dynamic tests should be ordered. A combination of multiple laboratory noninvasive and invasive tests gives 100% sensitivity and 98% specificity for EAS diagnosis. If the EAS is caused by localised malignancy, surgery is the optimal treatment choice. Radical tumour excision may be performed in 40% of patients, and 80% of them are cured of the disease. The authors present an interesting clinical case of EAS, which is always a huge diagnostic challenge for clinicians. (Endokrynol Pol 2016; 67 (4): 458-464). PMID:27387249

  20. Sudden hearing loss due to internal auditory canal metastasis of Her2-positive gastric cancer: A case report

    OpenAIRE

    Kim, Chang-Hee; Shin, Jung Eun; Roh, Hong Gee; LEE, JONG SIK; Yoon, So Young

    2014-01-01

    Internal auditory canal (IAC) metastasis due to leptomeningeal carcinomatosis (LMC) from gastric cancer (GC) has rarely been reported. Early manifestation of symptoms, such as hearing loss, vertigo and facial paralysis, in cases of IAC metastasis due to LMC may facilitate the early detection of brain metastasis. To the best of our knowledge, the present study is the first to report IAC metastasis due to LMC in human epidermal growth factor receptor 2 (Her2)-positive GC. This study reports a c...

  1. Sudden Death Due to Undiagnosed Wilkie Syndrome.

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    Baber, Yeliena Fay; OʼDonnell, Chris

    2016-06-01

    A 56-year-old transgender woman with mitochondrial encephalomyopathy, lactic acidosis, and strokelike episodes syndrome and diabetes presented to hospital with headaches and experiencing with malnutrition. She was agitated and refused medical and physical assistance. Soon after admission, she started to vomit and developed abdominal pain, becoming rapidly unresponsive on the ward after attending the radiology department, and was pronounced deceased. Autopsy revealed a cachectic transgender woman with a grossly distended stomach and proximal duodenum containing 2 L of liquid. The postmortem computed tomography scan showed compression of the duodenum by the superior mesenteric artery, diagnostic of Wilkie syndrome. Superior mesenteric artery syndrome, or Wilkie syndrome, was first described in 1861 by Von Rokitansky. It is an uncommon but well-recognized clinical entity characterized by compression of the third, or transverse, portion of the duodenum between the aorta and the superior mesenteric artery. This results in chronic, intermittent, or acute complete or partial duodenal obstruction. It is a well-recognized complication of anorexia. PMID:26963629

  2. Widening of the spinal canal and dural ectasia in Marfan's syndrome: assessment by CT

    International Nuclear Information System (INIS)

    We describe a method for diagnosing dural ectasia (DE) and spinal canal widening (SCW) using CT. We examined 23 patients with Marfan's syndrome (MFS), 17 with Ehlers-Danlos syndrome (EDS) and 29 normal subjects, using six axial slices at the level of the L1-S1 pedicles. Transverse diameters of the vertebral bodies, spinal canal and dural sac were measured and indices were defined to differentiate patients with DE and SCW from normal. Statistical significance was assessed using Student's t -test, χ 2-test and Pearson's correlation coefficient. DE and SCW occurred in 69.6 % and 60.9 % of cases of MFS and in 23.5 % and 35.3 % of EDS respectively. In MFS, prevalence was significantly higher than in the control group. DE was significantly more frequent in MFS than in EDS. A strong correlation existed between DE and SCW in MFS and the control group, but not in EDS. Our system enables quantitative assessment of SCW and DE. The latter is particularly important in subjects suspected of having MFS, in whom it is a common and characteristic sign. (orig.)

  3. Lethal neuroleptic malignant syndrome due to amisulpride.

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    Musshoff, Frank; Doberentz, Elke; Madea, Burkhard

    2013-06-01

    A 42-year old-man was found lying in his bed having seizures. Later he became unconscious and hypotonic developing mydriasis as well as rigidity. The body core temperature (rectal temperature) was above 42 °C. Blood pH was decreased during treatment, and his general condition deteriorated. The patient developed gasping respiration, ventricular fibrillation, and died. During autopsy and histological investigation cerebral and pulmonary edema were noted together with general congestion of the internal organs. Further observations included contraction bands of myocytes, a contracted spleen, fibrosis of the liver, and gall stones. Toxicological analyses of peripheral blood revealed the following results: amisulpride 4.65 mg/l, biperiden 0.12 mg/l, imipramine 0.33 mg/l, and desipramine 0.68 mg/l. An amisulpride-induced neuroleptic malignant syndrome was therefore diagnosed as the patho-physiological mechanism leading to death.

  4. CT in low back and sciatic pain due to lumbar canal osseous changes

    International Nuclear Information System (INIS)

    In a consecutive series of 600 patients scanned by CT for various spinal diseases, those with low back and sciatic pain without disc herniation were selected for study. The causes proved to be joint facet degeneration (32 cases), stenosis of the neural foramina (13 cases), stenosis of the spinal canal (13 cases), lateral recess stenosis (6 cases) and spondylolisthesis (6 cases). The predominance of joint fact pathology as the underlying cause of low back and sciatic pain in the absence of disc herniation is confirmed. CT scanning of the soft tissues as well as of the skeletal structures is crucial to the aetiological diagnosis of the condition under study and hence to the proper planning of treatment. (orig.)

  5. CT in low back and sciatic pain due to lumbar canal osseous changes

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    Rosa, M.; Capellini, C.; Canevari, M.A.; Prosetti, D.; Schiavoni, S.

    1986-05-01

    In a consecutive series of 600 patients scanned by CT for various spinal diseases, those with low back and sciatic pain without disc herniation were selected for study. The causes proved to be joint facet degeneration (32 cases), stenosis of the neural foramina (13 cases), stenosis of the spinal canal (13 cases), lateral recess stenosis (6 cases) and spondylolisthesis (6 cases). The predominance of joint fact pathology as the underlying cause of low back and sciatic pain in the absence of disc herniation is confirmed. CT scanning of the soft tissues as well as of the skeletal structures is crucial to the aetiological diagnosis of the condition under study and hence to the proper planning of treatment.

  6. A Case with Repeated Recurrent Acute Coronary Syndrome due to Pseudoephedrine Use: Kounis Syndrome

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    Metin Çeliker

    2014-01-01

    Full Text Available Allergic reaction-associated acute coronary syndrome picture is defined as Kounis syndrome. Although drug use is the most common cause of allergic reaction, foods and environmental factors may also play a role in the etiology. Herein, a case with acute coronary syndrome that developed two times at 8-month interval due to pseudoephedrine use for upper respiratory tract infection is presented.

  7. The Management of Persistent Pain From a Branch of the Trifid Mandibular Canal due to Implant Impingement.

    Science.gov (United States)

    Aljunid, Sharifah; AlSiweedi, Saif; Nambiar, Phrabhakaran; Chai, Wen-Lin; Ngeow, Wei-Cheong

    2016-08-01

    The mandibular canal is a conduit that allows the inferior alveolar neurovascular bundle to transverse the mandible to supply the dentition, jawbone, and soft tissue around the lower lip. It is now acknowledged that the mandibular canal is not a single canal but an anatomical structure with multiple branches and variations. Iatrogenic injury to branches of the mandibular canal that carry a neurovascular bundle has been reported to cause injury to the main canal as severe as if the main canal itself is traumatized. These injuries include bleeding, neurosensory disturbance, or the formation of traumatic neuroma, and so far, they have involved cases with the bifid mandibular canal. This current report presents a case of neurosensory disturbance that resulted from the impingement of a branch of a trifid mandibular canal during implant insertion. Its management included analgesics, reexamination, and reinserting a shorter implant. PMID:27078072

  8. Anton's syndrome due to cerebrovascular disease: a case report

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    Maddula Mohana

    2009-09-01

    Full Text Available Abstract Introduction Anton's syndrome describes the condition in which patients deny their blindness despite objective evidence of visual loss, and moreover confabulate to support their stance. It is a rare extension of cortical blindness in which, in addition to the injury to the occipital cortex, other cortical centres are also affected, with patients typically behaving as if they were sighted. Case presentation We present a case report of an 83-year-old white woman with cortical blindness as a result of bilateral occipital lobe infarcts. Despite her obvious blindness, illustrated by her walking into objects, the patient expressed denial of visual loss and demonstrated confabulation in her accounts of her surroundings, consistent with a diagnosis of Anton's syndrome. Conclusions A suspicion of cortical blindness and Anton's syndrome should be considered in patients with atypical visual loss and evidence of occipital lobe injury. Cerebrovascular disease is the most common cause of Anton's syndrome, as in our patient. However, any condition that may result in cortical blindness can potentially lead to Anton's syndrome. Recovery of visual function will depend on the underlying aetiology, with cases due to occipital lobe infarction after cerebrovascular events being less likely to result in complete recovery. Management in these circumstances should accordingly focus on secondary prevention and rehabilitation.

  9. T2-signal of ulnar nerve branches at the wrist in guyon's canal syndrome.

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    Jennifer Kollmer

    Full Text Available OBJECTIVE: To evaluate T2-signal of high-resolution MRI in distal ulnar nerve branches at the wrist as diagnostic sign of guyon's-canal-syndrome (GCS. MATERIALS AND METHODS: 11 GCS patients confirmed by clinical/electrophysiological findings, and 20 wrists from 11 asymptomatic volunteers were prospectively included to undergo the following protocol: axial T2-weighted-fat-suppressed and T1-weighted-turbo-spin-echo-sequences (3T-MR-scanner, Magnetom/Verio/Siemens. Patients were examined in prone position with the arm extended and wrist placed in an 8-channel surface-array-coil. Nerve T2-signal was evaluated as contrast-to-noise-ratios (CNR from proximal-to-distal in ulnar nerve trunk, its superficial/sensory and deep/motor branch. Distal motor-nerve-conduction (distal-motor-latency (dml to first dorsal-interosseus (IOD I and abductor digiti minimi muscles was correlated with T2-signal. Approval by the institutional review-board and written informed consent was given by all participants. RESULTS: In GCS, mean nerve T2-signal was strongly increased within the deep/motor branch (11.7±4.8 vs.controls:-5.3±2.4;p = 0.001 but clearly less and not significantly increased in ulnar nerve trunk (6.8±6.4vs.-7.4±2.5;p = 0.07 and superficial/sensory branch (-2.1±4.9vs.-9.7±2.9;p = 0.08. Median nerve T2-signal did not differ between patients and controls (-9.8±2.5vs.-6.7±4.2;p = 0.45. T2-signal of deep/motor branch correlated strongly with motor-conduction-velocity to IOD I in non-linear fashion (R(2 = -0.8;p<0.001. ROC-analysis revealed increased nerve T2-signal of the deep/motor branch to be a sign of excellent diagnostic performance (area-under-the-curve 0.94, 95% CI: 0.85-1.00; specificity 90%, sensitivity 89.5%. CONCLUSIONS: Nerve T2-signal increase of distal ulnar nerve branches and in particular of the deep/motor branch is highly accurate for the diagnostic determination of GCS. Furthermore, for the first time it was found in nerve entrapment

  10. Widening of the spinal canal and dural ectasia in Marfan's syndrome: assessment by CT

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    Villeirs, G.M.; Verstraete, K.L.; Kunnen, M.F. [Dept. of Radiology, Univ. Hospital, Gent (Belgium); Tongerloo, A.J. van; Paepe, A.M. de [Dept. of Medical Genetics, Univ. Hospital, Gent (Belgium)

    1999-11-01

    We describe a method for diagnosing dural ectasia (DE) and spinal canal widening (SCW) using CT. We examined 23 patients with Marfan's syndrome (MFS), 17 with Ehlers-Danlos syndrome (EDS) and 29 normal subjects, using six axial slices at the level of the L1-S1 pedicles. Transverse diameters of the vertebral bodies, spinal canal and dural sac were measured and indices were defined to differentiate patients with DE and SCW from normal. Statistical significance was assessed using Student's t -test, {chi} {sup 2}-test and Pearson's correlation coefficient. DE and SCW occurred in 69.6 % and 60.9 % of cases of MFS and in 23.5 % and 35.3 % of EDS respectively. In MFS, prevalence was significantly higher than in the control group. DE was significantly more frequent in MFS than in EDS. A strong correlation existed between DE and SCW in MFS and the control group, but not in EDS. Our system enables quantitative assessment of SCW and DE. The latter is particularly important in subjects suspected of having MFS, in whom it is a common and characteristic sign. (orig.)

  11. Hyperimmunoglobulin E syndrome with persistent vertebral osteomyelitis due to methicillin-resistant Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    San S. Wong

    2014-01-01

    Full Text Available We report a case of vertebral osteomyelitis due to methicillin-resistant Staphylococcus aureus (MRSA with a slowly progressive, relatively asymptomatic course in a young woman with suspected hyperimmunoglobulin E syndrome (Job's syndrome.

  12. Turner syndrome with spinal hemorrhage due to vascular malformation.

    Science.gov (United States)

    Yu, Min Kyung; Jung, Mo Kyung; Kim, Ki Eun; Kwon, Ah Reum; Chae, Hyun Wook; Kim, Duk Hee; Kim, Ho-Seong

    2015-12-01

    Turner syndrome (TS) is a relatively common chromosomal disorder and is associated with a range of comorbidities involving the cardiovascular system. Vascular abnormalities, in particular, are a common finding in cases of TS. However, dissection involving the vertebral arteries is rare. Here, we report the case of a 9-year-old girl with TS who had been treated with growth hormone replacement therapy for the past 3 years. She presented with weakness of both lower legs, and was ultimately diagnosed with spinal hemorrhage due to vascular malformation. We treated her with intravenous high dose dexamethasone (0.6 mg/kg) and she could walk without assistance after 6 days of treatment. In conclusion, when a patient with TS shows sudden weakness of the lower limbs, we should consider the possibility of spinal vessel rupture and try to take spine magnetic resonance imaging as soon as possible. We suggest a direction how to make a proper diagnosis and management of sudden vertebral artery hemorrhage in patients with TS.

  13. Turner syndrome with spinal hemorrhage due to vascular malformation.

    Science.gov (United States)

    Yu, Min Kyung; Jung, Mo Kyung; Kim, Ki Eun; Kwon, Ah Reum; Chae, Hyun Wook; Kim, Duk Hee; Kim, Ho-Seong

    2015-12-01

    Turner syndrome (TS) is a relatively common chromosomal disorder and is associated with a range of comorbidities involving the cardiovascular system. Vascular abnormalities, in particular, are a common finding in cases of TS. However, dissection involving the vertebral arteries is rare. Here, we report the case of a 9-year-old girl with TS who had been treated with growth hormone replacement therapy for the past 3 years. She presented with weakness of both lower legs, and was ultimately diagnosed with spinal hemorrhage due to vascular malformation. We treated her with intravenous high dose dexamethasone (0.6 mg/kg) and she could walk without assistance after 6 days of treatment. In conclusion, when a patient with TS shows sudden weakness of the lower limbs, we should consider the possibility of spinal vessel rupture and try to take spine magnetic resonance imaging as soon as possible. We suggest a direction how to make a proper diagnosis and management of sudden vertebral artery hemorrhage in patients with TS. PMID:26817012

  14. Turner syndrome with spinal hemorrhage due to vascular malformation

    Science.gov (United States)

    Yu, Min Kyung; Jung, Mo Kyung; Kim, Ki Eun; Kwon, Ah Reum; Kim, Duk Hee; Kim, Ho-Seong

    2015-01-01

    Turner syndrome (TS) is a relatively common chromosomal disorder and is associated with a range of comorbidities involving the cardiovascular system. Vascular abnormalities, in particular, are a common finding in cases of TS. However, dissection involving the vertebral arteries is rare. Here, we report the case of a 9-year-old girl with TS who had been treated with growth hormone replacement therapy for the past 3 years. She presented with weakness of both lower legs, and was ultimately diagnosed with spinal hemorrhage due to vascular malformation. We treated her with intravenous high dose dexamethasone (0.6 mg/kg) and she could walk without assistance after 6 days of treatment. In conclusion, when a patient with TS shows sudden weakness of the lower limbs, we should consider the possibility of spinal vessel rupture and try to take spine magnetic resonance imaging as soon as possible. We suggest a direction how to make a proper diagnosis and management of sudden vertebral artery hemorrhage in patients with TS. PMID:26817012

  15. Cyclical Cushing's syndrome due to an atypical thymic carcinoid

    NARCIS (Netherlands)

    Meinardi, [No Value; van den Berg, G; Wolffenbuttel, BHR; Kema, IP; Dullaart, RPF

    2006-01-01

    A 43-year-old man presented with fluctuating symptoms of weight gain, shortness of breath, pretibial oedema, associated with anxiety and memory disturbances. Laboratory investigation revealed an adrenocorticotropin (ACTH)-dependent cyclical Cushing's syndrome characterised by remarkable variations i

  16. Burning mouth syndrome due to herpes simplex virus type 1.

    Science.gov (United States)

    Nagel, Maria A; Choe, Alexander; Traktinskiy, Igor; Gilden, Don

    2015-01-01

    Burning mouth syndrome is characterised by chronic orofacial burning pain. No dental or medical cause has been found. We present a case of burning mouth syndrome of 6 months duration in a healthy 65-year-old woman, which was associated with high copy numbers of herpes simplex virus type 1 (HSV-1) DNA in the saliva. Her pain resolved completely after antiviral treatment with a corresponding absence of salivary HSV-1 DNA 4 weeks and 6 months later. PMID:25833911

  17. Ortner Syndrome due to Concomitant Mitral Stenosis and Bronchiectasis

    OpenAIRE

    Islam, AKM Monwarul; Zaman, Shahana; Doza, Fatema

    2012-01-01

    Ortner syndrome or cardiovocal syndrome is a rare condition characterized by hoarseness of voice associated with cardiovascular pathology. Compression of the left recurrent laryngeal nerve by the pulmonary artery or left atrium is usually responsible. Recurrent aspiration pneumonia may cause significant morbidity and mortality. Early recognition and treatment along with removal of the underlying cause, if possible, may change an otherwise poor prognosis of the condition. The case presented he...

  18. Placenta accreta: adherent placenta due to Asherman syndrome

    DEFF Research Database (Denmark)

    Engelbrechtsen, Line; Langhoff-Roos, Jens; Kjer, Jens Jørgen;

    2015-01-01

    It is important to be aware of the risk of abnormally invasive placenta in patients with a history of Asherman syndrome and uterine scarring. A prenatal diagnosis by ultrasonography is useful when planning of mode of delivery.......It is important to be aware of the risk of abnormally invasive placenta in patients with a history of Asherman syndrome and uterine scarring. A prenatal diagnosis by ultrasonography is useful when planning of mode of delivery....

  19. RRH: envenoming syndrome due to 200 stings from Africanized honeybees

    Directory of Open Access Journals (Sweden)

    Guilherme Almeida Rosa da Silva

    2013-02-01

    Full Text Available Envenoming syndrome from Africanized bee stings is a toxic syndrome caused by the inoculation of large amounts of venom from multiple bee stings, generally more than five hundred. The incidence of severe toxicity from Africanized bee stings is rare but deadly. This report reveals that because of the small volume of distribution, having fewer stings does not exempt a patient from experiencing an unfavorable outcome, particularly in children, elderly people or underweight people.

  20. Abnormal location of umbilical venous catheter due to Scimitar syndrome

    International Nuclear Information System (INIS)

    Scimitar syndrome is a rare congenital anomaly where the right pulmonary veins return to the inferior vena cava (IVC) just below the diaphragm. On chest X-ray (CXR), an IVC catheter will be in a bizarre location outside the heart if it inadvertently passes into the scimitar vein rather than into the right atrium

  1. Adaptive behavioural syndromes due to strategic niche specialization

    Directory of Open Access Journals (Sweden)

    Bergmüller Ralph

    2007-10-01

    Full Text Available Abstract Background Behavioural syndromes, i.e. consistent individual differences in behaviours that are correlated across different functional contexts, are a challenge to evolutionary reasoning because individuals should adapt their behaviour to the requirements of each situation. Behavioural syndromes are often interpreted as a result of constraints resulting in limited plasticity and inflexible behaviour. Alternatively, they may be adaptive if correlated ecological or social challenges functionally integrate apparently independent behaviours. To test the latter hypothesis we repeatedly tested helpers in the cooperative breeder Neolamprologus pulcher for exploration and two types of helping behaviour. In case of adaptive behavioural syndromes we predicted a positive relationship between exploration and aggressive helping (territory defence and a negative relationship between these behaviours and non-aggressive helping (territory maintenance. Results As expected, helpers engaging more in territory defence were consistently more explorative and engaged less in territory maintenance, the latter only when dominant breeders were present. Contrary to our prediction, there was no negative relationship between exploration and territory maintenance. Conclusion Our results suggest that the three behaviours we measured are part of behavioural syndromes. These may be adaptive, in that they reflect strategic specialization of helpers into one of two different life history strategies, namely (a to stay and help in the home territory in order to inherit the breeding position or (b to disperse early in order to breed independently.

  2. [Bilateral diaphragmatic paralysis due to Parsonage-Turner syndrome].

    Science.gov (United States)

    Tissier-Ducamp, D; Martinez, S; Alagha, K; Charpin, D; Chanez, P; Palot, A

    2015-09-01

    We report the case of a 49-years-old patient who presented to the accident and emergency department with sudden onset dyspnea associated with acute shoulder pain. He was breathless at rest with supine hypoxemia. He had an amyotrophic left shoulder with localized paresis of the shoulder. Both hemi-diaphragms were elevated on chest X-rays. Pulmonary function tests showed a restrictive pattern and both phrenic nerve conduction velocities were decreased. At night, alveolar hypoventilation was evidenced by elevated mean capnography (PtcCO2: 57mmHg). Neuralgic amyotrophy, Parsonage-Turner syndrome was the final diagnosis. This syndrome is a brachial plexus neuritis with a predilection for the suprascapular and axillary nerves. Phrenic nerve involvement is rare but where present can be the most prominent clinical feature as in our case report.

  3. [Bilateral diaphragmatic paralysis due to Parsonage-Turner syndrome].

    Science.gov (United States)

    Tissier-Ducamp, D; Martinez, S; Alagha, K; Charpin, D; Chanez, P; Palot, A

    2015-09-01

    We report the case of a 49-years-old patient who presented to the accident and emergency department with sudden onset dyspnea associated with acute shoulder pain. He was breathless at rest with supine hypoxemia. He had an amyotrophic left shoulder with localized paresis of the shoulder. Both hemi-diaphragms were elevated on chest X-rays. Pulmonary function tests showed a restrictive pattern and both phrenic nerve conduction velocities were decreased. At night, alveolar hypoventilation was evidenced by elevated mean capnography (PtcCO2: 57mmHg). Neuralgic amyotrophy, Parsonage-Turner syndrome was the final diagnosis. This syndrome is a brachial plexus neuritis with a predilection for the suprascapular and axillary nerves. Phrenic nerve involvement is rare but where present can be the most prominent clinical feature as in our case report. PMID:25534571

  4. Postpartum spontaneous colonic perforation due to antiphospholipid syndrome

    OpenAIRE

    Ahmed, Kamran; Darakhshan, Amir; Au, Eleanor; Khamashta, Munther A; Katsoulis, Iraklis E

    2009-01-01

    The antiphospholipid syndrome (APS) is a multi-systemic disease being characterized by the presence of antiphospholipid antibodies that involves both arterial and venous systems resulting in arterial or venous thrombosis, fetal loss, thrombocytopenia, leg ulcers, livedo reticularis, chorea, and migraine. We document a previously unreported case of a 37-year-old female in whom APS was first manifested by infarction and cecal perforation following cesarean section. At laparotomy the underlying ...

  5. Naxos disease: Cardiocutaneous syndrome due to cell adhesion defect

    OpenAIRE

    Protonotarios Nikos; Tsatsopoulou Adalena

    2006-01-01

    Abstract Naxos disease is a recessively inherited condition with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) and a cutaneous phenotype, characterised by peculiar woolly hair and palmoplantar keratoderma. The disease was first described in families originating from the Greek island of Naxos. Moreover, affected families have been identified in other Aegean islands, Turkey, Israel and Saudi Arabia. A syndrome with the same cutaneous phenotype and predominantly left ventric...

  6. Hypercalcemic encephalopathy due to milk alkali syndrome and injection teriparatide

    Directory of Open Access Journals (Sweden)

    Sandeep Kharb

    2012-01-01

    Full Text Available An 82-year-old male, a known case of severe osteoporosis with vertebral fracture and prostatic carcinoma, was treated with gonadotropin releasing hormone analogue, calcium carbonate, cholecalciferol sachet and injection teriparatide. His diet consisted of milk and curd. He developed altered behavior and generalized weakness, and on investigation, hypercalcemia, hypokalemia, and metabolic alkalosis with low parathyroid hormone levels were detected. Injection teriparatide was stopped and he was managed with forced saline diuresis and injection zoledronic acid. He was diagnosed as a case of milk alkali syndrome in whom teriparatide and prolonged immobilization played a permissive role in the development of hypercalcemic encephalopathy.

  7. Naxos disease: Cardiocutaneous syndrome due to cell adhesion defect

    Directory of Open Access Journals (Sweden)

    Protonotarios Nikos

    2006-03-01

    Full Text Available Abstract Naxos disease is a recessively inherited condition with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C and a cutaneous phenotype, characterised by peculiar woolly hair and palmoplantar keratoderma. The disease was first described in families originating from the Greek island of Naxos. Moreover, affected families have been identified in other Aegean islands, Turkey, Israel and Saudi Arabia. A syndrome with the same cutaneous phenotype and predominantly left ventricular involvement has been described in families from India and Ecuador (Carvajal syndrome. Woolly hair appears from birth, palmoplantar keratoderma develop during the first year of life and cardiomyopathy is clinically manifested by adolescence with 100% penetrance. Patients present with syncope, sustained ventricular tachycardia or sudden death. Symptoms of right heart failure appear during the end stages of the disease. In the Carvajal variant the cardiomyopathy is clinically manifested during childhood leading more frequently to heart failure. Mutations in the genes encoding the desmosomal proteins plakoglobin and desmoplakin have been identified as the cause of Naxos disease. Defects in the linking sites of these proteins can interrupt the contiguous chain of cell adhesion, particularly under conditions of increased mechanical stress or stretch, leading to cell death, progressive loss of myocardium and fibro-fatty replacement. Implantation of an automatic cardioverter defibrillator is indicated for prevention of sudden cardiac death. Antiarrhythmic drugs are used for preventing recurrences of episodes of sustained ventricular tachycardia and classical pharmacological treatment for congestive heart failure, while heart transplantation is considered at the end stages.

  8. Further patient with Angelman syndrome due to paternal disomy of chromosome 15 and a milder phenotype

    Energy Technology Data Exchange (ETDEWEB)

    Gillessen-Kaesbach, G.; Passarge, E.; Horsthemke, B. [Institut fuer Humangenetik, Essen (Germany)

    1995-04-10

    This {open_quotes}Letter to the Editor{close_quotes} decribes a patient with Angelman syndrome due to paternal uniparental disomy of chromosome 15 and a milder phenotype compared to Angelman syndrome patients with a 15q deletion. 10 refs., 1 fig.

  9. Dysenteric syndrome due to Balantidium coli: a case report.

    Science.gov (United States)

    Bellanger, Anne-Pauline; Scherer, Emeline; Cazorla, Arnault; Grenouillet, Frederic

    2013-04-01

    A 28-year-old man was hospitalized for a dysenteric syndrome that had developed during the previous days. Physical examination revealed abdominal pains, fever, vomiting and more than ten liquid stools per day. Fresh stool examination showed numerous mobile ciliated trophozoites of Balantidium coli. The patient reported having been on a hike the previous weekend during which he had drunk water through a hydration pouch bladder. Complete resolution was observed after intravenous rehydration and ten days of oral treatment with metronidazole (Flagyl®). Balantidium coli is the largest ciliate protozoan able to infect humans. This parasite is common in pigs and has a worldwide distribution. Human infections, a rare event in industrialised countries, are usually acquired by ingestion of food or water contaminated by mammal faeces. Human B. coli infections are easily treated but may be severe and even fatal if neglected. PMID:23686128

  10. A case of Stevens-Johnson syndrome due to rifampicin

    Directory of Open Access Journals (Sweden)

    Vandana A. Badar

    2014-02-01

    Full Text Available A 25 year old female known case of category II pulmonary Tuberculosis was on anti-coch’s treatment in the FDC of rifampicin, isoniazid, pyrazinamide, ethambutol and Streptomycin. Fifteen days after the commencement of Cat II anti TB treatment she developed diffuse erythematous rash on face, trunk and both extremities which turned into blisters. There were ulcers on oral and genital cavity. A diagnosis of Stevens Johnson’s syndrome was made. The patient had a history of cat I pulmonary TB and treated for 8 months and at the end of 8th month she was sputum smear negative. Four months later she had a relapse of sputum smear positive for pulmonary TB. She responded to the stoppage of drugs and oral/inj. Corticosteroids, antihistaminics and antibiotics. [Int J Basic Clin Pharmacol 2014; 3(1.000: 239-241

  11. 无顶冠状静脉窦综合征合并房室通道的临床分析%Clinical analysis of unroofed coronary sinus syndrome with atrioventricular canal defect

    Institute of Scientific and Technical Information of China (English)

    张旌; 黄志雄; 孙寒松; 罗新锦; 许建屏

    2009-01-01

    reconstructed the intraatrial baffle or the intracardiac tunnel to drain LSVC to right atrium. The other 9 patients with simple unroofed coronary sinus were repaired with other procedures. The associated cardiac lesions were corrected concomitantly. Results Death occurred in 1 patient with complex congenital cardiac disease due to pulmonary infection. In the 14 early survivors, who had been followed up from 4 months to 3 years, there was no death and severe complications. Conclusious When associated with apatial or complete atrioventricular canal defect, LSVC and a common atrium, unroofed coronary sinus syndrome should be considered as a possible additional finding. Repair according to the type of unroofed coronary sinus syndrome is effective.

  12. On biogeochemistry and water quality of river canals in Northern France subject to daily sediment resuspension due to intense boating activities

    International Nuclear Information System (INIS)

    In Northern France, channelized rivers facilitate greatly the waterway transport that should still increase in the coming years to replace as much as possible the road traffic, considered as a heavier source of pollution. These rivers are now subjected to the good potential status objectives required by the Water Framework Directive. The impact of the recurrent resuspension by the current boat traffic of polluted sediments (due to strong historical pollution) on the water quality is the main concern of this work. Our study reveals that the navigation seems to play a limited role on the enrichment of the water columns by dissolved metals and phosphorus, as well as on the oxygenation of surface waters. Conversely, the cycling of the phytoplankton over the year appears to partly control the physico-chemical and chemical evolutions of the overlying waters. - Highlights: • In river canals boating results in the daily resuspension of polluted sediments. • Chemical indexes indicate that metals should be well trapped in the sediments. • Polluted sediments in Cd and Pb may only slightly enrich the river waters. • Daily boating activity results in the scavenging of dissolved phosphorus. • Phytoplanktonic biomass and seasonal effects partly control the water quality. - Polluted sediments resuspension in river canals by daily boat traffic seems to play a limited role on the enrichment of the water columns by dissolved metals and phosphorus

  13. Postpartum spontaneous colonic perforation due to antiphospholipid syndrome

    Institute of Scientific and Technical Information of China (English)

    Kamran Ahmed; Amir Darakhshan; Eleanor Au; Munther A Khamashta; Iraklis E Katsoulis

    2009-01-01

    The antiphospholipid syndrome (APS) is a multi-systemic disease being characterized by the presence of antiphospholipid antibodies that involves both arterial and venous systems resulting in arterial or venous thrombosis, fetal loss, thrombocytopenia, leg ulcers, livedo reticularis, chorea,and migraine. We document a previously unreported case of a 37-year-old female in whom APS was first manifested by infarction and cecal perforation following cesarean section. At laparotomy the underlying cause of colonic perforation was not clear and after resection of the affected bowel an ileo-colostomy was performed. The diagnosis of APS was established during post-operative hospital stay and the patient was commenced on warfarin.Eventually, she made a full recovery and had her stoma reversed after 4 mo. Pregnancy poses an increased risk of complications in women with APS and requires a more aggressive approach to the obstetric care. This should include full anticoagulation in the puerperium and frequent doppler ultrasound monitoring of uterine and umbilical arteries to detect complications such as preeclampsia and placental insufficiency.

  14. Pulmonary hypertension due to acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    S.A. Ñamendys-Silva

    2014-10-01

    Full Text Available Our aims were to describe the prevalence of pulmonary hypertension in patients with acute respiratory distress syndrome (ARDS, to characterize their hemodynamic cardiopulmonary profiles, and to correlate these parameters with outcome. All consecutive patients over 16 years of age who were in the intensive care unit with a diagnosis of ARDS and an in situ pulmonary artery catheter for hemodynamic monitoring were studied. Pulmonary hypertension was diagnosed when the mean pulmonary artery pressure was >25 mmHg at rest with a pulmonary artery occlusion pressure or left atrial pressure <15 mmHg. During the study period, 30 of 402 critically ill patients (7.46% who were admitted to the ICU fulfilled the criteria for ARDS. Of the 30 patients with ARDS, 14 met the criteria for pulmonary hypertension, a prevalence of 46.6% (95% CI; 28-66%. The most common cause of ARDS was pneumonia (56.3%. The overall mortality was 36.6% and was similar in patients with and without pulmonary hypertension. Differences in patients' hemodynamic profiles were influenced by the presence of pulmonary hypertension. The levels of positive end-expiratory pressure and peak pressure were higher in patients with pulmonary hypertension, and the PaCO2 was higher in those who died. The level of airway pressure seemed to influence the onset of pulmonary hypertension. Survival was determined by the severity of organ failure at admission to the intensive care unit.

  15. Gluteal compartment syndrome due to prolonged immobilization after alcohol intoxication: a case report.

    Science.gov (United States)

    Iizuka, Shinichi; Miura, Naoyuki; Fukushima, Tomokazu; Seki, Tomoko; Sugimoto, Katuhiko; Inokuchi, Sadaki

    2011-07-01

    Gluteal compartment syndrome is a relatively rare condition that mostly result from atraumatic causes such as prolonged immobilization due to drug abuse or alcoholic intoxication and incorrect positioning during surgical procedures rather than traumatic causes. Early diagnosis is difficult and sometimes delayed or overlooked because of poor physical signs resulting from altered mental status and inappropriate diagnosis by clinicians. It has been reported that more than half of the cases of gluteal compartment syndrome are associated with crush syndrome and sciatic nerve palsy. Early diagnosis and immediate fasciotomy are necessary to improve the functional prognosis. Here, we report the case of a patient with gluteal compartment syndrome caused by prolonged immobilization after acute alcoholic intoxication. After disease onset, the patient developed complications of crush syndrome and sciatic nerve palsy, but immediate fasciotomy improved his condition. PMID:21769768

  16. Painful tic convulsif syndrome due to vertebrobasilar dolichoectasia

    Directory of Open Access Journals (Sweden)

    Puneet Mittal

    2011-01-01

    Full Text Available Combined clinical presentation of hemifacial spasm and ipsilateral trigeminal neuralgia is also known as painful tic convulsif (PTC. It is a rare condition and the most common cause is vascular compression. Vertebrobasilar dolichoectasia (VBD is characterized by dilated and tortuous vertebral and basilar arteries. VBD is an uncommon and rarely reported cause of PTC. Magnetic resonance imaging (MRI, due to its inherent excellent contrast resolution, is an excellent modality for demonstrating the nerve compression by dilated and tortuous vessels seen in this condition. For this purpose, 3D MRI sequences are especially useful like constructive interference in steady state (CISS and MR angiography. Both of these have been reported to be helpful in the diagnosis of this condition. We report a case of PTC in which we were able to document facial and trigeminal nerve compression by VBD on MRI, using CISS and time-of-flight MR angiography.

  17. Handwriting changes due to aging and Parkinson's syndrome.

    Science.gov (United States)

    Walton, J

    1997-08-22

    Wills signed by elderly people are often contested on the grounds the the signature is different from their earlier specimen signatures. Neurological disease, which can affect handwriting, is very common and progressive amongst elderly people. Handwriting change due to old age and neurological disease is poorly understood. To better understand this subject, we carried out a large methodical study based on almost 200 handwriting specimens of Parkinson patients and age-matched controls. Interestingly, our findings indicate that some of the handwriting changes which occur in these populations tend to resemble forgery indicia although upon close inspection they are distinguishable from them. Thus, document examiners are urged to exercise caution in assessing purported forgeries on wills and other documents signed of written during older age or a writer suffering from neurological disease. PMID:9291592

  18. Superior Vena Cava Syndrome due to Thrombosis: A Rare Paraneoplastic Presentation of Bronchogenic Carcinoma

    Directory of Open Access Journals (Sweden)

    Avradip Santra

    2016-07-01

    Full Text Available Superior vena cava (SVC syndrome is not an uncommon occurrence in patients with malignancy and it is often described as a medical emergency. In majority of the cases, SVC syndrome occurs due to mechanical obstruction of the SVC by extraluminal compression with primary intrathoracic malignancies. However, intraluminal obstruction due to thrombosis can also produce symptoms and signs of SVC syndrome. Clot-related SVC obstruction is mostly associated with indwelling central venous catheter and pacemaker leads, although such thrombosis can occur spontaneously in a background of a hypercoagulable state, e.g., malignancy. Here, an unusual case of sudden onset SVC syndrome has been reported, which on initial radiologic evaluation was found to have a lung nodule without any significant mediastinal mass or adenopathy compressing SVC. Subsequent investigation with Doppler ultrasonography of the neck showed thrombosis in the right internal jugular, right subclavian and right brachiocephalic vein, which was responsible for SVC syndrome. Histopathological evaluation of lung nodule confirmed presence of an adenocarcinoma. Therefore, venous thromboembolism as a paraneoplastic syndrome should be kept in mind while evaluating a case of SVC obstruction in a cancer patient. Management of the underlying disease is of prime importance in such cases and anticoagulation is the mainstay of therapy. Ability to identify paraneoplastic syndrome may have a significant effect on clinical outcome, ranging from early diagnosis to improved quality of life of the patient.

  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. Scalloping at the lumbosacral canal

    International Nuclear Information System (INIS)

    Scalloping is an indentation of the dorsal side of the vertebral body (anterior wall of the lumbosacral or sacral canal) which typically involves several adjacent lumbal vertebral body segments and the anterior wall of the canalis sacralis. Occurrence without underlying disease is rare; it occurs most frequently with chondrodystrophy, neurofibromatosis, Morquio's syndrome, Hurler's syndrome, acromegaly, Ehlers-Danlos syndrome, Marfan's syndrome, cysts, tumors and in peridural lipomas. (orig.)

  1. Scalloping at the lumbosacral canal

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, R.

    1987-07-01

    Scalloping is an indentation of the dorsal side of the vertebral body (anterior wall of the lumbosacral or sacral canal) which typically involves several adjacent lumbal vertebral body segments and the anterior wall of the canalis sacralis. Occurrence without underlying disease is rare; it occurs most frequently with chondrodystrophy, neurofibromatosis, Morquio's syndrome, Hurler's syndrome, acromegaly, Ehlers-Danlos syndrome, Marfan's syndrome, cysts, tumors and in peridural lipomas.

  2. RPGR-containing protein complexes in syndromic and non-syndromic retinal degeneration due to ciliary dysfunction

    Indian Academy of Sciences (India)

    Carlos A. Murga-Zamalloa; Anand Swaroop; Hemant Khanna

    2009-12-01

    Dysfunction of primary cilia due to mutations in cilia-centrosomal proteins is associated with pleiotropic disorders. The primary (or sensory) cilium of photoreceptors mediates polarized trafficking of proteins for efficient phototransduction. Retinitis pigmentosa GTPase regulator (RPGR) is a cilia-centrosomal protein mutated in >70% of X-linked RP cases and 10%–20% of simplex RP males. Accumulating evidence indicates that RPGR may facilitate the orchestration of multiple ciliary protein complexes. Disruption of these complexes due to mutations in component proteins is an underlying cause of associated photoreceptor degeneration. Here, we highlight the recent developments in understanding the mechanism of cilia-dependent photoreceptor degeneration due to mutations in RPGR and RPGR-interacting proteins in severe genetic diseases, including retinitis pigmentosa, Leber congenital amaurosis (LCA), Joubert syndrome, and Senior–Loken syndrome, and explore the physiological relevance of photoreceptor ciliary protein complexes.

  3. Pseudo-acute myocardial infarction due to transient apical ventricular dysfunction syndrome (Takotsubo syndrome)

    OpenAIRE

    Maciel, Bruno Araújo; Cidrão, Alan Alves de Lima; Sousa, Ítalo Bruno dos Santos; Ferreira, José Adailson da Silva; Messias Neto, Valdevino Pedro

    2013-01-01

    Takotsubo syndrome is characterized by predominantly medial-apical transient left ventricular dysfunction, which is typically triggered by physical or emotional stress. The present article reports the case of a 61-year-old female patient presenting with dizziness, excessive sweating, and sudden state of ill feeling following an episode involving intense emotional stress. The physical examination and electrocardiogram were normal upon admission, but the troponin I and creatine kinase-MB concen...

  4. Cushing Syndrome in a 6-Month-Old Infant due to Adrenocortical Tumor

    Directory of Open Access Journals (Sweden)

    Volmar KeithE

    2009-09-01

    Full Text Available Cushing syndrome is rare in infancy and usually due to an adrenocortical tumor (ACT. We report an infant with Cushing syndrome due to adrenocortical carcinoma. The patient presented at six months of age with a three-month history of growth failure, rapid weight gain, acne, and irritability. Physical examination showed obesity, hypertension, and Cushingoid features. Biochemical evaluation showed very high serum cortisol, mildly elevated testosterone, and suppressed ACTH. Abdominal MRI revealed a heterogeneous right adrenal mass extending into the inferior vena cava. Evaluation for metastases was negative. The tumor was removed surgically en bloc. Pathologic examination demonstrated low mitotic rate, but capsular and vascular invasion. She received no adjuvant therapy. Her linear growth has improved and Cushingoid features resolved. Hormonal markers and quarterly PET scans have been negative for recurrence 24 months postoperatively. In conclusion, adrenocortical neoplasms in children are rare, but should be considered in the differential diagnosis of Cushing syndrome.

  5. Cushing Syndrome in a 6-Month-Old Infant due to Adrenocortical Tumor

    Directory of Open Access Journals (Sweden)

    Keith E. Volmar

    2009-01-01

    Full Text Available Cushing syndrome is rare in infancy and usually due to an adrenocortical tumor (ACT. We report an infant with Cushing syndrome due to adrenocortical carcinoma. The patient presented at six months of age with a three-month history of growth failure, rapid weight gain, acne, and irritability. Physical examination showed obesity, hypertension, and Cushingoid features. Biochemical evaluation showed very high serum cortisol, mildly elevated testosterone, and suppressed ACTH. Abdominal MRI revealed a heterogeneous right adrenal mass extending into the inferior vena cava. Evaluation for metastases was negative. The tumor was removed surgically en bloc. Pathologic examination demonstrated low mitotic rate, but capsular and vascular invasion. She received no adjuvant therapy. Her linear growth has improved and Cushingoid features resolved. Hormonal markers and quarterly PET scans have been negative for recurrence 24 months postoperatively. In conclusion, adrenocortical neoplasms in children are rare, but should be considered in the differential diagnosis of Cushing syndrome.

  6. Guillain-Barré Syndrome due to CMV Reactivation after Cardiac Transplantation

    Directory of Open Access Journals (Sweden)

    Christina Maria Steger

    2012-01-01

    Full Text Available A 40-year-old male patient suffered from end-stage heart failure due to ischemic cardiomyopathy and received orthotopiccardiac transplantation in June 2005. The instantaneous postoperative course was uneventful, but, seven months later, he suffered from paralysis in the lower extremities finally resulting in quadriplegia and was admitted to hospital. After laboratory testings the diagnosis of a Guillain-Barré syndrome due to cytomegalovirus reactivation was confirmed.

  7. Exérese do segmento vertical do canalículo lacrimal na síndrome do olho seco: estudo preliminar Removal of the vertical portion of the lacrimal canaliculus in dry eye syndrome

    Directory of Open Access Journals (Sweden)

    Eliana Forno

    2005-04-01

    Full Text Available OBJETIVO: Avaliar a eficácia e possíveis complicações da remoção do segmento vertical do canalículo lacrimal, em pacientes com síndrome do olho seco grave. MÉTODOS: Seis canalículos de quatro pacientes, 3 dos quais tinham o diagnóstico de olho seco associado à síndrome de Sjögren primária e o quarto, ceratoconjuntivite sicca por remoção completa de glândula lacrimal, foram submetidos a exérese do segmento vertical do canalículo lacrimal. Os critérios de inclusão foram: sinais e sintomas de olho seco que não melhoraram com tratamento clínico, Schirmer menor que 5 mm, rosa bengala corando córnea e conjuntiva e casos de recanalização após eletrocauterização dos pontos. Os pontos lacrimais foram avaliados por exame biomicroscópico após 7, 15, 30, 90 e 180 dias da cirurgia. RESULTADOS: No período de seguimento, nenhum canalículo sofreu recanalização. Em cinco olhos, houve diminuição da ceratite ponteada difusa e dos filamentos corneanos e melhora nos valores do teste de Schirmer e rosa bengala. No olho submetido à remoção completa da glândula lacrimal, a córnea ainda apresentava ceratite ponteada difusa, mesmo após dois meses de cirurgia. Não houve alterações da margem palpebral. CONCLUSÃO: Esta técnica, além de mostrar-se efetiva e simples para oclusão permanente do canalículo lacrimal, não cursou com complicações observadas em outros procedimentos.PURPOSE: To demonstrate the efficacy and possible complications of a surgical technique that includes the removal of the vertical portion of the lacrimal canaliculus in patients with dry eye syndrome. METHODS: A study was performed on six canaliculi of six eyes (four patients. Three patients had dry eye, associated with primary Sjögren syndrome. One of the four patients developed keratoconjuntivitis sicca due to lacrimal gland removal. The criteria included: patients with symptoms of dry eye that did not improve even with the continuous use of

  8. Fulminant intracranial hypertension due to cryptococcal meningitis in a child with nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Leena Nagotkar

    2011-01-01

    Full Text Available Cryptococcus neoformans has a worldwide distribution. Meningoencephalitis is the most common manifestation of cryptococcosis. The outcome of a patient with cryptococcal infection depends on the immune status of the host. Patients with nephrotic syndrome are particularly susceptible to cryptococcal infection not only due to innate changes in their immune system but also because of the immunosuppressive agents used in the treatment. We report an 8-year-old boy with nephrotic syndrome, who developed cryptococcal meningitis and died of fulminant intracranial hypertension.

  9. canal24

    Data.gov (United States)

    California Department of Resources — Canal system center lines in the Central Valley of California and adjacent areas captured from 1:24,000-scale USGS topographic maps. Updates and modifications made...

  10. Focal dermal hypoplasia due to a novel mutation in a boy with Klinefelter syndrome.

    Science.gov (United States)

    Alkindi, Said; Battin, Malcolm; Aftimos, Salim; Purvis, Diana

    2013-01-01

    A boy was born with multiple anomalies, including right hemifacial microsomia, eye abnormalities, syndactyly, right hand ectrodactyly, hypoplastic nails, omphalocele, bladder exstrophy, renal dilatation, and splayed symphysis pubis. The skin was also abnormal, with atrophic skin plaques and areas of telangiectasia along the lines of Blaschko. The karyotype was 47,XXY (Klinefelter syndrome). He was found to have a heterozygous mutation in the PORCN gene. He exhibited the classical features of focal dermal hypoplasia. Fewer than 15% of reported cases are male when it is thought to be due to postzygotic mutation and thus mosaic. This is the first reported boy to have heterozygous mutation for Goltz syndrome who survived due to the extra X chromosome. PMID:23131169

  11. Severe drug hypersensitivity syndrome due to sulphasalazine in patient with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    W. Grassi

    2011-06-01

    Full Text Available Drug Hypersensitivity Syndrome, also known as Drug Rash with Eosinophilia and Systemic Symptoms is a severe adverse reaction characterized by clinical manifestations including fever, skin eruption, lymphoadenopathy, associated with eosinophilia, leukocytosis and multiple visceral involvement, with 10% of mortality due to development of multiple organ failure. This reaction usually occurs between two and six-eight weeks after the beginning of the treatment and may not resolve with interruption of the suspected drug. Sulfonamides, anticonvulsant, allopurinol are the most frequently involved molecules, but recently cases have been described also with gabapentin and strontium ranelate. In the present report we describe a case of a patient with rheumatoid arthritis who presented severe drug hypersensitivity syndrome, with liver and kidney involvement due to sulphasalazine.

  12. Feasibility and limitations of endoscopy in Guyon's canal

    OpenAIRE

    Noszczyk, Bartłomiej H.; Zdybek, Piotr

    2014-01-01

    Introduction This retrospective report summarizes observations from eight operations where the endoscopically assisted approach was used to explore Guyon's canal syndromes of idiopathic aetiology. Aim To evaluate the feasibility and limitations of endoscopic Guyon's canal release performed from a distal forearm incision. Material and methods Eight charts and video records of eight ulnar tunnel syndrome patients presenting concomitant idiopathic Guyon's canal syndromes were retrospectively rev...

  13. Multiple organ dysfunction syndrome due to massive wasp stings:an autopsy case report

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ling; TANG Yi; LIU Fang; SHI Yu-ying; CAO Yu; XU Huan; FU Ping

    2012-01-01

    We reported a case of multiple organ dysfunction syndrome (MODS) following about 300 wasp stings.The diagnosis was based on autopsy findings of acute pulmonary edema,acute kidney injury,hepatic and cardiac dysfunction,and cerebral edema.MODS is a life-threatening complication,and should be considered a possibility after multiple wasp stings.Our autopsy helped to establish the cause of unexpected death due to wasp stings and to elucidate a possible mechanism of MODS.

  14. Heart failure due to ‘stress cardiomyopathy’: a severe manifestation of the opioid withdrawal syndrome

    OpenAIRE

    Spadotto, Veronica; Zorzi, Alessandro; ElMaghawry, Mohamed; Meggiolaro, Marco; Pittoni, Giovanni Maria

    2013-01-01

    Takotsubo cardiomyopathy (TTC) is a transient left ventricular (LV) dysfunction due to akinesia of the LV mid-apical segments (‘apical ballooning’) in the absence of critical coronary stenoses which can be complicated in the acute phase by heart failure, mitral regurgitation, life-threatening ventricular arrhythmias, or apical LV thrombosis. The syndrome is typically precipitated by intense emotional or physical stress; however, other causes of sympathetic overstimulation including administra...

  15. Surgical management of Guyon's canal syndrome, an ulnar nerve entrapment at the wrist: report of two cases Síndrome de compressão do nervo ulnar a nível do punho (síndrome do canal de Guyon: relato de dois casos

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Aguiar

    2001-03-01

    Full Text Available Guyon's canal syndrome, an ulnar nerve entrapment at the wrist, is a well-recognized entity. The most common causes that involve the ulnar nerve at the wrist are compression from a ganglion, occupational traumatic neuritis, a musculotendinous arch and disease of the ulnar artery. We describe two cases of Guyon's canal syndrome and discuss the anatomy, aetiology, clinical features, anatomical classification, diagnostic criteria and treatment. It is emphasized that the knowledge of both the surgical technique and anatomy is very important for a satisfactory surgical result.A síndrome do canal de Guyon, um encarceramento do nervo ulnar a nível do punho, é bem conhecida. Ela é causada por neurite ocupacional traumática, doenças e traumas do arco músculo-tendíneo e doença de artéria ulnar. Descrevemos dois casos de síndrome do canal de Guyon e discutimos os aspectos anatômicos e etiológicos, suas características clínicas, classificação anatômica e critérios de diagnóstico, bem como fazemos uma análise crítica do tratamento imposto. Enfatizamos também que, para obter um resultado cirúrgico satisfatório, é importante conhecer bem tanto as técnicas cirúrgicas como sua anatomia.

  16. Clinical experience of Pseudo-Meigs' Syndrome due to colon cancer

    Institute of Scientific and Technical Information of China (English)

    HiromichiMaeda; TakehrioOkabayashi; KazuhiroHanazaki; MichiyaKobayashi

    2011-01-01

    We report a rare case of Pseudo-Meigs' Syndrome caused by ovarian metastasis from sigmoid colon cancer, which was accompanied by peritoneal dissemination. A 58-year-old female patient presented with massive right pleural effusion, ascites and a huge pelvic mass. Under the diagnosis of an advanced ovarian tumor, bilateral oophorectomy was performed and sigmoidectomy was also carried out after intraoperative diagnosis of peritoneal dissemination involving the sigmoid colon. How- ever, immunohistochemical staining revealed that the ovarian lesions were metastasis from the primary advanced colon cancer. Postoperatively, ascites and pleural effusion subsided, and the diagnosis of Pseudo-Meigs' Syndrome due to a metastatic ovarian tumor from colon cancer was determined. The patient is now undergoing a regimen of chemotherapy for colon cancer without recurrence of ascites or hydrothorax 10 mo after the surgery. Pseudo-Meigs' Syndrome due to a metastaticovarian tumor from colon cancer is rare but clinically important because long-term alleviation of symptoms can be achieved by surgical resection. This case report suggests that selected patients, even with peritoneal dissemination, may obtain palliation from surgical resection of metastatic ovarian tumors.

  17. Role of anti-thrombotic therapy for recurrent pregnancy loss due to anti-phospholipid syndrome

    International Nuclear Information System (INIS)

    Background: Recurrent pregnancy loss is a major health problem effecting 1 to 2% of women of reproductive age. Its causes range from chromosomal abnormalities to endocrinological factors and thrombophilia related factors. Treating thrombophilia s especially anti phospholipid syndrome with low dose aspirin and low molecular weight heparin improves foetal outcome. This study will add local data to already existing knowledge. Method: Sixty selected patients from gynaecology OPD of Aero Hospital with clinical and/or serological findings of anti phospholipid syndrome from February 2009 to January 2011 were given aspirin 75 mg once daily and enoxaparine 40 mg subcutaneously once daily from 6 - 8 weeks to 35 and 37 weeks respectively. Results : Ninety-three percent of patients achieved live birth. Out of these 75% patients delivered at term and 18% had preterm delivered. Four (7%) had early pregnancy loss and only one had early neonatal death due to extreme prematurity. None of patients experienced any major hemorrhagic complications . Conclusion: Use of low dose aspirin and low molecular weight heparin is safe in pregnancy and improve foetal outcome in patients with recurrent pregnancy loss due to anti phospholipids syndrome. (author)

  18. Compartment syndrome developed due to the plaster cast :Three cases report

    Directory of Open Access Journals (Sweden)

    Pinar Doruk

    2013-08-01

    Full Text Available Compartment syndrome can occur as a result of the complication of the plaster cast applications ,which are frequently used for fracture stabilization. This syndrome occurs due to increased compartment volume or shrinking of compartment area because of edema, hemorrage or high pressure of tissues. All of these mechanisms causes arteriolar compression, resulting nerve and muscle ischemia. Intensive and continuous pain is common and limits the motions of the patient and increases with passive stretching of the involved muscles. Swelling of limb, change in skin color, peripheral vasculatory failure symptoms such as pallor,weak arterial pulsation and as a result of peripheral nerve damage, sensorimotor deficit can also be observed. Clinical evaluation, measure of pressure within the compartment, and electroneuromyography (ENMG can be used for the diagnosis. In addition to treatment of to the treatment of etiology and pain, further treatment options such as fasciotomy, physiotherapy modalities, tendon transfers, can be performed. In this case report, we will discuss three patients with nerve lesions as a result of the compartment syndrome that developed due to the plaster casting of bone fractures. [Cukurova Med J 2013; 38(4.000: 774-778

  19. Hunt综合征伴眩晕患者的半规管损伤频率特征%Frequency characteristics of the semicircular canals lesion in Hunt syndrome with vertigo

    Institute of Scientific and Technical Information of China (English)

    李姗姗; 陈太生; 董红; 林鹏; 温超; 程岩; 赵晖

    2012-01-01

    vestibular function tests,including caloric test ( CT),head shaking test (HST) and vHIT.The parameters of the unilateral weakness (UW),head shaking nystagmus (HSN) and video head impulse test gain (vHIT-G)were observed.The correlations and characteristics of the results of the three tests in Hunt syndrome with vertigo deal were analyzed with SPSS 16.0 software.Results The vaules of vHIT-G of the six groups semicircular canal in the control group were normal distribution without statistical significance ( F =0.005,P < 0.01 ),two sides anterior,horizontal and posterior semicircular canals vHIT-G average ( (x) ± s) were(16.80 ±9.80)%,(16.57 ± 10.30)%,(16.52 ± 11.12)% respectively; in the study group the separately vHIT-G of the three canals of the affected side were (46.96 ± 34.54) %,(75.35 ± 35.29 ) %and (41.65 ± 32.87)%,in which statistical significance comparing with the control group was detected( all P < 0.01 ); the positive one of the three tests vHIT,HSN and CT were 23 cases (88.46%),22 cases (84.61%)and 24 cases(92.31% ),bilateral exact propability x2 test all the P >0.05;there were Positive correlation between UW and the vHIT-G of lateral semicircular canal (r =0.692,P < 0.01 ).Conclusions The vestibular lesion of Hunt syndrome with vertigo is almost complete or multiple-frequency,which is characterized by the reduced or even aborted nerve conduction.Therefore,vHIT can be ultimately used for the screening test evaluating due to the vestibular function in Hunt syndrome with vertigo.

  20. Love canal questions

    Science.gov (United States)

    Bell, Peter M.

    The Environmental Protection Agency (EPA) conducted a 3-month monitoring study of the Love Canal area near Niagara Falls, N.Y., after the federal government pronounced that a potential health risk existed due to chemical waste dumps. In 1982 the Department of Health and Human Services (HHS) decided that the area was habitable, subject to implementation of effective safeguards against leakage from the canal and to cleaning up of the contaminants. Now, the Congressional Office of Technology Assessment (OTA) has announced that, with the information available, it is not possible to demonstrate with certainty that unsafe levels do not exist within the so-called “emergency declaration area” (EDA).

  1. Multiple osteoblastomas in a child with Cushing syndrome due to bilateral adrenal micronodular hyperplasias

    Science.gov (United States)

    Yu, Hyeoh Won; Cho, Won Im; Choi, Keun Hee; Yun, Sumi; Cho, Hwan Seong; Shin, Choong Ho; Yang, Sei Won

    2016-01-01

    Adrenocorticotropin-independent adrenal hyperplasias are rare diseases, which are classified into macronodular (>1 cm) and micronodular (≤1 cm) hyperplasia. Micronodular adrenal hyperplasia is subdivided into primary pigmented adrenocortical disease and a limited or nonpigmented form 'micronodular adrenocortical disease (MAD)', although considerable morphological and genetic overlap is observed between the 2 groups. We present an unusual case of a 44-month-old girl who was diagnosed with Cushing syndrome due to MAD. She had presented with spotty pigmentation on her oral mucosa, lips and conjunctivae and was diagnosed with multiple bone tumors in her femur, pelvis and skull base at the age of 8 years. Her bone tumor biopsies were compatible with osteoblastoma. This case highlights the importance of verifying the clinicopathologic correlation in Cushing syndrome and careful follow-up and screening for associated diseases. PMID:27104180

  2. Acute respiratory failure due to refeeding syndrome and hypophosphatemia induced by hypocaloric enteral nutrition.

    Science.gov (United States)

    Patel, Utpal; Sriram, Krishnan

    2009-03-01

    We report a case of acute respiratory failure due to refeeding syndrome caused by hypocaloric enteral tube feeds. A 60-y-old obese man, with a diagnosis of esophageal carcinoma with local metastases, underwent feeding jejunostomy tube insertion. Enteral tube feeding was initiated at small volumes providing 4.4 kcal x kg(-1) x d(-1) and gradually increased over 48 h to 29 kcal x kg(-1) x d(-1) (based on adjusted body weight). The patient then developed acute respiratory distress requiring intubation and ventilatory support. Serum phosphorus (P) level was extremely low at 4 d to adequately correct the electrolyte derangements. Successful liberation from mechanical ventilation was then possible. In chronically malnourished patients undergoing nutritional support, even hypocaloric feeding should be considered a risk factor for developing refeeding syndrome leading to severe and acute electrolyte fluid-balance and metabolic abnormalities.

  3. Carcinoid syndrome, acromegaly, and hypoglycemia due to an insulin-secreting neuroendocrine tumor of the liver.

    Science.gov (United States)

    Furrer, J; Hättenschwiler, A; Komminoth, P; Pfammatter, T; Wiesli, P

    2001-05-01

    We report a patient with a hepatic neuroendocrine tumor showing an extraordinary change of the tumor's humoral manifestations from a clinically documented extrapituitary acromegaly and a typical carcinoid syndrome toward a hyperinsulinemic hypoglycemia syndrome. At the primary manifestation of the tumor, an increased serum level of insulin-like growth factor I due to overproduction of GHRH and an increased urinary excretion of 5-hydroxyindoleacetic acid were found. The clinical manifestation of the GHRH excess was an arthralgia, which resolved completely after operative tumor debulking and normalization of insulin-like growth factor I and GHRH serum levels. The secretion of serotonin from the tumor resulted in a typical carcinoid syndrome including right-sided valvular heart disease. On the later course of the disease, the humoral manifestations of the tumor were supplemented by the secretion of insulin, leading to recurrent severe hyperinsulinemic hypoglycemia. The hepatic origin of hyperinsulinism was demonstrated by selective arterial calcium stimulation. Moreover, tumor cells revealed insulin and C-peptide immunoreactivity in the immunohistochemical analysis. The patient died 8 yr after the initial diagnosis of the tumor, and a carefully performed autopsy procedure confirmed the absence of any extrahepatic tumor manifestation.

  4. Novel SCN5A mutation associated with idiopathic ventricular fibrillation due to subclinical Brugada syndrome

    Directory of Open Access Journals (Sweden)

    Juan Jiménez-Jáimez

    2011-12-01

    Full Text Available Idiopathic ventricular fibrillation can be caused by subclinical channelopathies such as Brugada syndrome. Our objective is to study the clinical behaviour of a new SCN5A mutation found in a woman with idiopathic ventricular fibrillation. A 53-year-old woman presented with multiple episodes of ventricular fibrillation, a structurally normal heart and normal baseline electrocardiogram. Genetic testing included KCNQ1, KCNH2, SCN5A, KCNE1, KCNE2 and KCNJ2 and identified a mutation in SCN5A (D1816fs/g98747-98748insT. We studied 15 immediate family members by means of electrocardiogram, echocardiogram, flecainide challenge test and genetic study. Eight subjects had the mutation. The flecainide challenge test was positive for Brugada syndrome in two subjects in the case group and none in the control group. The PR and QRS intervals on the baseline electrocardiogram were longer in the case group. The left atrial volume indexed to body surface was higher in the case group, likely due to the fact that two patients with the mutation had atrial fibrillation and none had it in the control group. The D1816fs/g98747-98748insT mutation in SCN5A may be associated with idiopathic ventricular fibrillation and Brugada syndrome with a broad phenotypic spectrum and incomplete penetrance. Genetic testing may be useful to identify the etiology of idiopathic ventricular fibrillation in patients with a negative thorough clinical evaluation.

  5. Drug-induced hypersensitivity syndrome due to anticonvulsants in a two-year-old boy.

    Science.gov (United States)

    Criado, Paulo Ricardo; Criado, Roberta F J; Vasconcellos, Cidia; Pegas, Jose Roberto P; Cera, Patrícia Calil

    2004-12-01

    Drug-induced hypersensitivity syndrome (DIHS) usually refers to severe cutaneous drug eruption associated with systemic involvement and potentially fatal outcome. We report a 2-year-old Caucasian boy who developed DIHS due to phenytoin and phenobarbital and who showed extensive internal organ involvement. We are alerting that failure to recognize this drug eruption and discontinue the culprit drug may result in increased severity, greater extent of internal organ involvement, and fatal outcome. The recent research about the influence of human herpesvirus 6 co-infection on the pathogenesis of DIHS is also discussed by the authors in this paper. PMID:15801266

  6. Controle postural na síndrome de Pusher: influência dos canais semicirculares laterais Posture control in Pusher syndrome: influence of lateral semicircular canals

    Directory of Open Access Journals (Sweden)

    Taiza Elaine Grespan dos Santos Pontelli

    2005-08-01

    Full Text Available A síndrome de Pusher caracteriza-se por uma alteração do equilíbrio na qual pacientes com lesões encefálicas empurram-se em direção ao lado parético utilizando o membro não-afetado. O papel do sistema vestibular na alteração postural da síndrome de Pusher ainda não foi devidamente elucidado. OBJETIVO: Neste estudo objetivamos avaliar o papel dos canais semicirculares horizontais na expressão clínica da síndrome de Pusher, através da aplicação das provas calórica e rotatória. FORMA DE ESTUDO: Observacional, clínico e prospectivo. MATERIAL E MÉTODO: Avaliamos 9 pacientes com AVC e síndrome de Pusher internados na Enfermaria de Neurologia do HCFMRP-USP. Os pacientes foram submetidos à avaliação neurológica clínica e neuropsicológica, NIHSS, Scale for Contraversive Pushing - SCP, teste calórico e teste rotatório. RESULTADOS: Foram estudados 9 pacientes (5 homens com idade média de 71,8 ± 5,9 anos e com NIHSS médio de 18.33. Três pacientes apresentaram preponderância direcional contralateral à lesão encefálica na prova calórica. Na prova rotatória, foram observados quatro pacientes com preponderância direcional na análise de velocidade da componente lenta. CONCLUSÃO: Os resultados do presente estudo indicam que a disfunção dos canais semicirculares não parece ser fundamental para a expressão da síndrome de Pusher.Pusher syndrome is an interesting disorder of balance in patients with encephalic lesions characterized by the peculiar behavior of actively pushing away from the non-hemiparetic side and resisting against passive correction, with a tendency to fall toward the paralyzed side. The role of vestibular system on the pushing behavior is not clear. AIM: To evaluate horizontal semicircular canal function in patients with Pusher syndrome, using caloric and rotation tests. STUDY DESIGN: Observational prospective. MATERIAL AND METHOD: We evaluated 9 inpatients with stroke and Pusher syndrome at the

  7. Mifepristone effects on tumor somatostatin receptor expression in two patients with Cushing's syndrome due to ectopic adrenocorticotropin secretion.

    NARCIS (Netherlands)

    Bruin, C. de; Hofland, L.J.; Nieman, L.K.; Koetsveld, P.M. van; Waaijers, A.M.; Sprij-Mooij, D.M.; Essen, M. van; Lamberts, S.W.J.; Herder, W.W. de; Feelders, R.A.

    2012-01-01

    CONTEXT: Two patients presented with Cushing's syndrome due to ectopic ACTH secretion. Initial localization studies included computed tomography, magnetic resonance imaging, and octreoscans ((111)In-pentreotide scintigraphy), which were negative in both patients. They were treated with the glucocort

  8. Letter to Editor: Carpal tunnel syndrome due to an atypical deep soft tissue leiomyoma: The risk of misdiagnosis and mismanagement

    Directory of Open Access Journals (Sweden)

    Caliandro Pietro

    2008-02-01

    Full Text Available Abstract A response to Chalidis et al: Carpal tunnel syndrome due to an atypical deep soft tissue leiomyoma: The risk of misdiagnosis and mismanagement. World J Surg Oncol 2007, 5:92.

  9. Horizontal Canal Benign Positional Vertigo

    Directory of Open Access Journals (Sweden)

    Mohtaram Najafi

    1998-03-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is a syndrome characterized by transient episodes of vertigo in association with rapid changes in head position in Dix-Halpike Maneuver. This kind of vertigo is thought to be caused by migration of otoconial debris into canals other than the posterior canal, such as the anterior or lateral canals. It is also theoretically possible for many aberrant patterns of BPPV to occur from an interaction of debris in several canals, location of debris within the canal, and central adaptation patterns to lesions. The symptoms of BPPV are much more consistent with free-moving densities (canaliths in the posterior SCC rather than fixed densities attached to the cupula. While the head is upright, the particles sit in the PSC at the most gravity-dependent position. The best method to induce and see vertigo and nystagmus in BPPV of the lateral semicircular canal is to rotate head 90°while patient is in the supine position, nystagmus would appear in the unaffected side weaker but longer than the affected side. canal paresis has been described in one third of the patients with BPPV. Adaptation which is one of the remarkable features of BPPV in PSC is rarely seen in LSC. Rotations of 270° or 360° around the yaw axis (the so-called barbecue maneuver toward the unaffected ear are popular methods for the treatment of geotropic HC-BPPV. These maneuvers consist of sequential head turning of 90° toward the healthy side while supine. With these maneuvers, the free-floating otoconial debris migrates in the ampullofugal direction, finally entering the utricle through the nonampullated end of the horizontal canal. This kind of vertigo recovers spontaneously more rapidly and suddenly.

  10. Termination of pregnancy due to Thalassemia major, Hemophilia, and Down's Syndrome: the views of Iranian physicians

    Directory of Open Access Journals (Sweden)

    Zareifar Soheila

    2008-12-01

    Full Text Available Abstract Background Genetic disorders due to kindred marriages are common medical conditions in Iran; however, the legal aspects of abortion remain controversial. This study was undertaken to determine physicians' opinions regarding the termination of pregnancy for three genetic diseases: thalassemia major, hemophilia, and Down's syndrome. Methods A questionnaire was administered to selected physicians by stratified random sampling to determine the following: age, gender, knowledge about prenatal diagnosis of diseases in high risk pregnancies, agreement with abortion, recommended gestational age for abortion, and, if opposed to abortion, the reason. Results Of 323 physicians, who participated in the study, 91.3(295, 40.6(131, and 78.6%(254 were in agreement and 8.7(28, 59.4(192, and 21.4%(69 were opposed to abortion for thalassemia major, hemophilia, and Down's syndrome, respectively. Among 289 physicians opposed to abortion in respect of each of all three conditions, the following reasons were cited: religion, 18; emotional, 10; quality of care, 23; hope to find a new treatment option in the future, 103; miscellaneous reasons, 6; and a combination of these reasons, 129. Among 680 physicians in agreement with abortion in relation to all of the diseases, 4.6%(31 were agreed with abortion in less than 12 weeks gestation, 79.2%(538 in less than 16 weeks gestation, 5.6%(38 in less than 20 weeks gestation, 2.2%(15 in less than 24 weeks gestation, and 8.4%(58 were agreed with beyond the 24 weeks of gestational age. Conclusion The majority of physicians were in agreement with abortion for thalassemia major and Down's syndrome because of the overall prognosis, but opposed to abortion for hemophilia.

  11. Refeeding syndrome in a patient with advanced Kidney failure due to Nephronophthisis

    Directory of Open Access Journals (Sweden)

    Kamel El-Reshaid

    2013-01-01

    Full Text Available Refeeding syndrome (RS is a serious and potentially fatal disorder. It is caused by a shift of fluids, sodium, potassium, magnesium and phosphorus as well changes in the metabolism of glucose, protein, fat and vitamins following the refeeding of malnourished patients, whether enterally or parenterally. RS has rarely been reported in patients with advanced kidney disease probably due to the pre-existing hyperphosphatemia, hypermagnesemia and hyperkalemia in these patients. In the following report, we present a patient with nephronophthisis type 1 deletion syndrome in whom her main previous nutrition was limited to simply rehydration to avoid renal replacement therapy. On presentation, she was cachectic and dehydrated with advanced kidney failure. She was treated with medical nephrectomy using non-steroidal anti-inflammatory drugs and then placed on maintenance hemodialysis. Percutaneous endoscopic gastrostomy was used for her initial feeding. Care was exercised during her early refeeding with regard to correction of fluids and essential electrolytes, viz. potassium, phosphorus and magnesium, as well as multivitamins to avoid the cardiovascular and neurological complications of RS. However, the changes in the gut, pancreas and liver as well as her hyperlipidemia were a clear obstacle. Fortunately, the ileus and pancreatitis she developed on refeeding improved dramatically with a decrease of the feeding dose to half; however, the liver abnormalities and hyperlipidemia were severe and slow to recover. These improved after addition of ursodeoxycholic acid and permitted successful increase of the dose of feeding subsequently.

  12. Refeeding syndrome in a patient with advanced kidney failure due to nephronophthisis.

    Science.gov (United States)

    El-Reshaid, Kamel

    2013-11-01

    Refeeding syndrome (RS) is a serious and potentially fatal disorder. It is caused by a shift of fluids, sodium, potassium, magnesium and phosphorus as well changes in the metabolism of glucose, protein, fat and vitamins following the refeeding of malnourished patients, whether enterally or parenterally. RS has rarely been reported in patients with advanced kidney disease probably due to the pre-existing hyperphosphatemia, hypermagnesemia and hyperkalemia in these patients. In the following report, we present a patient with nephronophthisis type 1 deletion syndrome in whom her main previous nutrition was limited to simply rehydration to avoid renal replacement therapy. On presentation, she was cachectic and dehydrated with advanced kidney failure. She was treated with medical nephrectomy using non-steroidal anti-inflammatory drugs and then placed on maintenance hemodialysis. Percutaneous endoscopic gastrostomy was used for her initial feeding. Care was exercised during her early refeeding with regard to correction of fluids and essential electrolytes, viz. potassium, phosphorus and magnesium, as well as multivitamins to avoid the cardiovascular and neurological complications of RS. However, the changes in the gut, pancreas and liver as well as her hyperlipidemia were a clear obstacle. Fortunately, the ileus and pancreatitis she developed on refeeding improved dramatically with a decrease of the feeding dose to half; however, the liver abnormalities and hyperlipidemia were severe and slow to recover. These improved after addition of ursodeoxycholic acid and permitted successful increase of the dose of feeding subsequently.

  13. Angelman syndrome due to paternal uniparental disomy of chromosome 15: A milder phenotype?

    Energy Technology Data Exchange (ETDEWEB)

    Bottani, A.; Robinson, W.P.; DeLoizer-Blanchet, C.D.; Engel, E.; Morris, M.A.; Schmitt, Thun-Hohenstein, L.; Schinzel, A. [Univ. of Zuerich (Switzerland)

    1994-05-15

    The Angelman syndrome (AS) is a neurological disorder characterized by severe mental retardation, absent speech, seizures, gait disturbances, and a typical age-dependent facial phenotype. Most cases are due to an interstitial deletion on the maternally inherited chromosome 15, in the critical region q11-q13. Rare cases also result from paternal uniparental disomy of chromosome 15. In a group of 14 patients with sporadic AS diagnosed in Switzerland, we found 2 unrelated females with paternal isodisomy for the entire chromosome 15. Their phenotypes were milder than usually seen in this syndrome: one girl did not show the typical AS facial changes; both patients had late-onset mild seizures; as they grow older, they had largely undisturbed gross motor functions, in particular no severe ataxia. Both girls were born to older fathers (45 and 43 years old, respectively). The apparent association of a relatively milder phenotype in AS with paternal uniparental disomy will have to be confirmed by detailed clinical descriptions of further patients. 25 refs., 2 figs., 1 tab.

  14. Recurrent Fever of Unknown Origin (FUO Due to Periodic Fever, Aphthous Stomatititis, Pharyngitis and Adenitis (FAPA Syndrome in an Adult

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    Sigridh Muñoz-Gómez

    2013-08-01

    Full Text Available FAPA syndrome (periodic fever, aphthous stomatititis, pharyngitis and adenitis is a relatively new entity described in pediatric patients. In adults, reports of FAPA are limited to rare case reports. The differential diagnosis of FAPA in adults includes Behcet’s syndrome, familial Mediterranean fever (FMF, Hyper IgD syndrome and juvenile rheumatoid arthritis (JRA, i.e., adult Still’s disease. With FAPA syndrome, between episodes patients are completely asymptomatic and serologic inflammatory markers such as erythrocyte sedimentation rate (ESR, C-reactive protein (CRP and white blood cell (WBC count are normal. The etiology of FAFA is unknown, but lack of secondary cases or clustering in close contacts, lack of seasonality, and the lack of progression for years argue against an infectious etiology. We describe an extremely rare case of an adult with a recurrent FUO with profuse night sweats and prominent chills due to FAPA syndrome.

  15. Mild Angelman syndrome phenotype due to a mosaic methylation imprinting defect.

    Science.gov (United States)

    Fairbrother, Laura C; Cytrynbaum, Cheryl; Boutis, Paula; Buiting, Karin; Weksberg, Rosanna; Williams, Charles

    2015-07-01

    Angelman syndrome (AS) is a neurogenetic disorder causing severe to profound intellectual disability, absent or very limited speech and a high risk for seizures. AS is caused by a loss of function of the maternally-derived UBE3A allele due to one of several mechanisms including imprinting defects (ImpDs). We present a girl with AS due to a mosaic ImpD who has relatively high developmental function (VABS-II composite score of 76) and communication skills (as demonstrated in supplemental video links). Given the patient's relatively mild developmental impairment, without clinical evidence of seizures, gait disturbance or inappropriate laughter, the diagnosis of AS was not initially suspected. Initial laboratory testing for AS was inconclusive but additional studies suggested mosaic ImpD and characteristic EEG findings provided further support for the clinical diagnosis. Our patient, along with other case reports of children with AS and relatively mild phenotypes, raises the question as to whether there exists an undiagnosed group of individuals with mild intellectual disability and expressive speech delays due to mosaic methylation defects of the chromosome 15q11.2-13 region. Population studies may be needed to determine if such an undiagnosed group exists. PMID:25899869

  16. Interventional Mechanism of Tongxieyao Formula on Irritable Bowel Syndrome due to Liver Depression and Spleen Deficiency

    Directory of Open Access Journals (Sweden)

    Feng Qian

    2013-09-01

    Full Text Available Objective: To investigate the efficacy and interventional mechanism of Tongxieyao Formula (TXYF on rat model with irritable bowel syndrome (IBS due to liver depression and spleen deficiency. Methods: 75 newborn SD rats were randomly divided into groups A, B, C, D and E. Except group A, the rats in other groups were treated with senna and strained stress to establish IBS models due to liver depression and spleen deficiency. Groups A and B were fed with intra-gastric normal saline, group C pinaverium bromide, groups D and E TXYF. After treatment, animals were sacrificed to excise colons, and modified toluidine blue staining was applied to observe the changes of colonic mucosal mast cell (MC count and de-granulation conditions in rats. Then the levels of 5-hydroxytryptamine (5-HT, P substance (SP, calcitonin gene-related peptide (CGRP in blood samples were detected. Results: The counts of colonic mucosal MC and de-granulation increased significantly in model control group. The levels of 5-HT, SP significantly decreased while CGRP increased in C, D and group Es. Conclusion: TXYF can play its role of improving gastrointestinal mobility and reduce visceral sensitivity so as to treat IBS through reducing the counts of colonic mucosal MC and degranulation as well as the levels of serum 5-HT and plasma SP, and increasing the level of CGRP in IBS model rats.

  17. Greater trochanteric pain syndrome due to tumoral calcinosis in a patient with chronic kidney disease.

    Science.gov (United States)

    Baek, Dongjin; Lee, Sang Eun; Kim, Woo-Jin; Jeon, Sanghoon; Lee, Kihwa; Jung, Jaewook; Joo, Hyunchul; Park, Jaehong; Kim, Yonghan; Choi, Young-gyun

    2014-01-01

    Tumoral calcinosis is a rare syndrome characterized by massive subcutaneous soft tissue deposits of calcium phosphate near the large joints. It is more prevalent in patients with chronic kidney disease undergoing dialysis. A 57-year-old woman was referred to our pain clinic with the complaint of severe pain in the left buttock and lateral hip. The patient had been suffering from chronic kidney disease for 10 years and had been undergoing peritoneal dialysis over the past 5 years. The patient's symptom was initially suspected to be of lumbar origin at the L5 level and a left L5 transforaminal epidural block was performed, but without success. Re-evaluation of the physical examination revealed severe tenderness over the left greater trochanter and piriformis muscle. On ultrasonographic evaluation, multiple mass-like lesions in the left buttock were observed. About 30 mL of fluid was aspirated from the cystic lesions, followed by 30 mL mixture of 0.08% levobupivacaine and triamcinolone 40 mg injected into the bursa under ultrasound guidance, which brought pain relief. Trochanteric bursitis was thought of as the cause of the symptoms. The patient was diagnosed with tumoral calcinosis based on the past medical history, simple plain radiographs, and hip magnetic resonance imaging (MRI). We diagnosed a case of greater trochanteric pain syndrome due to tumoral calcinosis related to chronic kidney disease in a patient whose symptoms had initially been considered to be radiating leg pain caused by lumbar spinal disease. We report our experience of symptomatic improvement following the repeated ultrasound-guided aspiration of calcific fluid and the injection of a mixture of local anesthetic and steroid. PMID:25415793

  18. Adult respiratory distress syndrome due to fat embolism in the postoperative period following liposuction and fat grafting.

    Science.gov (United States)

    Costa, André Nathan; Mendes, Daniel Melo; Toufen, Carlos; Arrunátegui, Gino; Caruso, Pedro; de Carvalho, Carlos Roberto Ribeiro

    2008-08-01

    Fat embolism is defined as mechanical blockage of the vascular lumen by circulating fat globules. Although it primarily affects the lungs, it can also affect the central nervous system, retina, and skin. Fat embolism syndrome is a dysfunction of these organs caused by fat emboli. The most common causes of fat embolism and fat embolism syndrome are long bone fractures, although there are reports of its occurrence after cosmetic procedures. The diagnosis is made clinically, and treatment is still restricted to support measures. We report the case of a female patient who developed adult respiratory distress syndrome due to fat embolism in the postoperative period following liposuction and fat grafting. In this case, the patient responded well to alveolar recruitment maneuvers and protective mechanical ventilation. In addition, we present an epidemiological and pathophysiological analysis of fat embolism syndrome after cosmetic procedures. PMID:18797748

  19. Trauma due to Self-aggression in Patient with Waardenburg Syndrome associated with Congenital Anomalies.

    Science.gov (United States)

    Marta, Sara Nader; Kawakami, Roberto Yoshio; Sgavioli, Claudia Almeida Prado Piccino; Correa, Ana Eliza; D'Árk de Oliveira El Kadre, Guaniara; Carvalho, Ricardo Sandri

    2016-01-01

    Waardenburg syndrome (WS) is an inherited autosomal dominant genetic disorder presenting variable penetrance and expressivity, with an estimated prevalence of 1:42,000. Clinical characteristics of WS include lateral displacement of the internal eye canthus, hyperplasia of the medial portion of the eyebrows, prominent and broad nasal base, congenital deafness, pigmentation of the iris and skin, and white forelock. A 24-year-old male patient, previously diagnosed with WS, was referred to the Special Needs Dental Clinic of Sacred Heart University, Bauru, Brazil. Parents reported that the patient was experiencing self-mutilation, particularly in the oral region. He presented multiple congenital anomalies, including anophthalmia, mental retardation, low-set ears, and leg deformities. Clinical oral examination revealed hypodontia, abnormalities in dental morphology, extensive dental caries, periodontal disease, and fistulae. Extensive scars on the tongue, lips, and hands caused by self-mutilation were also observed. In accordance with his family and neurologist, full-mouth extraction under general anesthesia was performed, especially considering his severe self-aggressive behavior and the necessity to be fed with soft-food diet due to his inability to chew. After the surgical procedure, a significant reduction in the patient's irritability and gain of weight were reported in the follow-ups of 30, 60, and 180 days. PMID:27659091

  20. Clinical variability in neurohepatic syndrome due to combined mitochondrial DNA depletion and Gaucher disease

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    Julie Harvengt

    2014-01-01

    Full Text Available A 1-year-old girl born to consanguineous parents presented with unexplained liver failure, leading to transplantation at 19 months. Subsequent partial splenectomy for persistent cytopenia showed the presence of foamy cells, and Gaucher disease was confirmed by homozygosity for the p.Leu483Pro mutation in the GBA gene. She was treated by enzyme replacement therapy (ERT. Clinical follow-up showed mild developmental delay, strabismus, nystagmus and oculomotor apraxia. Biochemical studies revealed multiple respiratory chain deficiencies and a mosaic pattern of deficient complex IV immunostaining in liver and fibroblast. Molecular analysis identified a mtDNA depletion syndrome due to the homozygous p.Pro98Leu mutation in MPV17. A younger sister unaffected by mtDNA depletion, presented with pancytopenia and hepatosplenomegaly. ERT for Gaucher disease resulted in visceral normalization without any neurological symptom. A third sister, affected by both conditions, had marked developmental delay, strabismus and ophthalmoplegia but no liver cirrhosis. In conclusion, intrafamilal variability occurs in MPV17-related disease. The combined pathological effect of Gaucher and mitochondrial diseases can negatively impact neurological and liver functions and influence the outcome in consanguineous families. The immunocytochemical staining of OXPHOS protein in tissues and cultured cells is a powerful tool revealing mosaic pattern of deficiency pointing to mtDNA-related mitochondrial disorders.

  1. Tolvaptan Treatment in Syndrome of Inappropriate ADH Secretion due to Small Cell Lung Cancer

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    Mucahit Gur

    2014-06-01

    Full Text Available Experience of ADH receptor antagonist (-vaptanes treatment in hyponatremia in malign patient is very limited. 68 years old male patient admitted to our department with a complain of nause, vomitting and epigastric pain. He has advanced stage of small cell lung cancer. He had treated with cisplatin and etoposide regimen 10 days ago as a first cure. We diagnosed inapropriate secretion of antidiuretic hormone syndrome (SIADH with low sodium level (118 meq/dl. Although the treatment with water restriction and 3% NaCl infusion, sodium level was not in normal. So we ordered 30 mg tolvaptan tablet. And then sodium levels were reached normal. After one month of discharge from hospital, he has hospitilized with same symptom and diagnosis. And again we ordered same treatment procedure and tolvaptane treatment. He had normal sodium (136 mEq/dl level during his follow up. This case demostrate that tolvaptane treatment is suitable aproaches in hyponatremia due to SIADH in oncologic patient.

  2. Iatrogenic Cushing's Syndrome Due to Intranasal Usage of Ophthalmic Dexamethasone: A Case Report.

    Science.gov (United States)

    Orton, Sarah; Censani, Marisa

    2016-05-01

    Iatrogenic Cushing's syndrome (ICS) is caused by exogenous corticosteroid administration with suppression of the hypothalamic-pituitary-adrenal axis. It has been commonly described with oral and topical steroid use, but scarce reports have documented intranasal steroid usage as the etiology in infancy. In this article, we describe a case of a 4-month-old infant who developed ICS after 6 weeks of intranasal dexamethasone ophthalmic solution administration for nasal obstruction. To our knowledge, this is the youngest patient reported with ICS due to intranasal use of a prescribed dose of an ophthalmic steroid. His hypothalamic-pituitary-adrenal axis recovered fully 4.5 months after steroid discontinuation. Because of the small body surface area and supine position during administration, infants are particularly susceptible to ICS. Given that intranasal steroids are commonly prescribed to infants and children for a variety of diagnoses, this case highlights the risks inherent in the use of intranasal steroid drops, particularly in young infants, for both adrenal suppression and linear growth deceleration, even with short-term use. Close monitoring of these patients' height and weight should occur while on steroid treatment, with every effort made to decrease or discontinue steroid use when possible. PMID:27244810

  3. Heart failure due to 'stress cardiomyopathy': a severe manifestation of the opioid withdrawal syndrome.

    Science.gov (United States)

    Spadotto, Veronica; Zorzi, Alessandro; Elmaghawry, Mohamed; Meggiolaro, Marco; Pittoni, Giovanni Maria

    2013-03-01

    Takotsubo cardiomyopathy (TTC) is a transient left ventricular (LV) dysfunction due to akinesia of the LV mid-apical segments ('apical ballooning') in the absence of critical coronary stenoses which can be complicated in the acute phase by heart failure, mitral regurgitation, life-threatening ventricular arrhythmias, or apical LV thrombosis. The syndrome is typically precipitated by intense emotional or physical stress; however, other causes of sympathetic overstimulation including administration of exogenous sympathomimetics or withdrawal of sympathetic antagonists can trigger TTC. We report the case of a patient who unexpectedly developed an 'apical ballooning' with severe reduction in the LV systolic function and heart failure after the withdrawal of methadone. The case supports the concept that increased sympathetic activity secondary to opioids withdrawal can trigger a stress-induced severe LV dysfunction. Physicians should be aware that the abrupt discontinuation of a long-term therapy with opioids may lead to serious cardiac complications. The administration of clonidine may be considered to prevent early clinical manifestations of addictive withdrawal, including TTC. PMID:24062938

  4. Heart failure due to ‘stress cardiomyopathy’: a severe manifestation of the opioid withdrawal syndrome

    Science.gov (United States)

    Spadotto, Veronica; Zorzi, Alessandro; ElMaghawry, Mohamed; Pittoni, Giovanni Maria

    2013-01-01

    Takotsubo cardiomyopathy (TTC) is a transient left ventricular (LV) dysfunction due to akinesia of the LV mid-apical segments (‘apical ballooning’) in the absence of critical coronary stenoses which can be complicated in the acute phase by heart failure, mitral regurgitation, life-threatening ventricular arrhythmias, or apical LV thrombosis. The syndrome is typically precipitated by intense emotional or physical stress; however, other causes of sympathetic overstimulation including administration of exogenous sympathomimetics or withdrawal of sympathetic antagonists can trigger TTC. We report the case of a patient who unexpectedly developed an ‘apical ballooning’ with severe reduction in the LV systolic function and heart failure after the withdrawal of methadone. The case supports the concept that increased sympathetic activity secondary to opioids withdrawal can trigger a stress-induced severe LV dysfunction. Physicians should be aware that the abrupt discontinuation of a long-term therapy with opioids may lead to serious cardiac complications. The administration of clonidine may be considered to prevent early clinical manifestations of addictive withdrawal, including TTC. PMID:24062938

  5. Trauma due to Self-aggression in Patient with Waardenburg Syndrome associated with Congenital Anomalies.

    Science.gov (United States)

    Marta, Sara Nader; Kawakami, Roberto Yoshio; Sgavioli, Claudia Almeida Prado Piccino; Correa, Ana Eliza; D'Árk de Oliveira El Kadre, Guaniara; Carvalho, Ricardo Sandri

    2016-01-01

    Waardenburg syndrome (WS) is an inherited autosomal dominant genetic disorder presenting variable penetrance and expressivity, with an estimated prevalence of 1:42,000. Clinical characteristics of WS include lateral displacement of the internal eye canthus, hyperplasia of the medial portion of the eyebrows, prominent and broad nasal base, congenital deafness, pigmentation of the iris and skin, and white forelock. A 24-year-old male patient, previously diagnosed with WS, was referred to the Special Needs Dental Clinic of Sacred Heart University, Bauru, Brazil. Parents reported that the patient was experiencing self-mutilation, particularly in the oral region. He presented multiple congenital anomalies, including anophthalmia, mental retardation, low-set ears, and leg deformities. Clinical oral examination revealed hypodontia, abnormalities in dental morphology, extensive dental caries, periodontal disease, and fistulae. Extensive scars on the tongue, lips, and hands caused by self-mutilation were also observed. In accordance with his family and neurologist, full-mouth extraction under general anesthesia was performed, especially considering his severe self-aggressive behavior and the necessity to be fed with soft-food diet due to his inability to chew. After the surgical procedure, a significant reduction in the patient's irritability and gain of weight were reported in the follow-ups of 30, 60, and 180 days.

  6. Sudden Cardiac Arrest due to Brugada Syndrome: a Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    R Soleimanirad

    2013-04-01

    Full Text Available Brugada Syndrome is a rare cause of sudden cardiac arrest and has a unique ECG pattern. In fact, with ST-segment elevation down sloping in the right precordial leads (v1-v3, RBBB pattern in lateral leads and J-point elevation is revealed. We must notice and avoid trigger factors of this syndrome during general anesthesia. Patient is a 39 old man who attended to emergency department with sudden cardiac arrest and resuscitate. He was transferred to ICU for management of hypoxic ischemic encephalopathy. Complementary studies concluded the diagnosis of Brugada syndrome. We must consider Brugada syndrome within patients with family history of sudden cardiac arrest. Moreover, we must avoid trigger factors of this syndrome such as fever, bradicardia and electrolyte abnormality (specialy Na, Ca abnormalities during general anesthesia and if they appear, we should treat them.

  7. Nephrotic syndrome due to immunoglobulin M mesangial glomerulonephritis preceding juvenile idiopathic arthritis.

    Science.gov (United States)

    Voyer, Luis E; Alvarado, Caupolican; Cuttica, Rubén J; Balestracci, Alejandro; Zardini, Marta; Lago, Néstor

    2013-05-21

    The association between nephrotic syndrome and juvenile idiopathic arthritis have rarely been described in pediatric patients. We report a child with steroid-responsive nephrotic syndrome, with frequent relapses, who presented with a new relapse of nephrotic syndrome associated with arthritis and uveitis at 21 months in remission after treatment with chlorambucil. Juvenile idiopathic arthritis was diagnosed and kidney biopsy examination showed mesangial glomerulonephritis with immunoglobulin M deposits. To our knowledge, only 2 cases of nephrotic syndrome preceding juvenile idiopathic arthritis have been reported, one without histopathology assessment and the other with minimal change disease. Although mesangial glomerulonephritis with nephrotic syndrome and juvenile idiopathic arthritis could have been coincidental, the immune pathogenic mechanism accepted for both diseases suggests they could be related.

  8. Root canal irrigants

    OpenAIRE

    Kandaswamy Deivanayagam; Venkateshbabu Nagendrababu

    2010-01-01

    Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are...

  9. Mifepristone effects on tumor somatostatin receptor expression in two patients with Cushing's syndrome due to ectopic adrenocorticotropin secretion

    NARCIS (Netherlands)

    C. de Bruin (Christiaan); L.J. Hofland (Leo); L.K. Nieman; P.M. van Koetsveld (Peter); A.M. Waaijers (Annet); D. Sprij-Mooij (Diana); M. van Essen (Martijn); S.W.J. Lamberts (Steven); W.W. de Herder (Wouter); R.A. Feelders (Richard)

    2012-01-01

    textabstractContext: Two patients presented with Cushing's syndrome due to ectopic ACTH secretion. Initial localization studies included computed tomography, magnetic resonance imaging, and octreoscans (111In-pentreotide scintigraphy), which were negative in both patients. They were treated with the

  10. Acute respiratory distress syndrome due to viral pneumonitis in case of varicella zoster in adult: case report

    OpenAIRE

    Anaz Binazeez; Saurabh Kothari; Dhaval Dave; Manish Pendse; Divya Lala; Smita Patil; Archana Bhate

    2015-01-01

    Chickenpox, is a highly contagious disease caused by infection with varicella zoster virus (VZV). The disease is often more severe in adults than children. Here we present a case of adult male suffering from chicken pox who presented with complication of acute respiratory distress syndrome [ARDS] due to viral pneumonitis. Due to his late presentation, despite of giving antivirals, patient had a fatal outcome. So this case highlights the necessity and importance of early administration of a...

  11. Acute Coronary Syndrome Due to Spontaneous Coronary Artery Dissection in a Middle-Aged Man

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    Davran Cicek

    2014-08-01

    Full Text Available True spontaneous coronary artery dissection (SCAD is an extremely rare but important cause of acute coronary syndrome, with only about 200 cases reported in the literature. Diagnosis is often made at autopsy. Risk factors include oral contraceptive use, atherosclerotic disease and the peripartum period. SCAD should be considered when a healthy young patient presents with the onset of acute myocardial ischemic syndrome. A timely diagnosis and intervention are mandatory as SCAD can cause sudden death. We present a case of SCAD with an uncommon clinical presentation of acute coronary syndrome and without identifiable risk factors, and successfully treated with non-invasive (medical therapy.

  12. Nonthyroidal illness syndrome in patients with subarachnoid hemorrhage due to intracranial aneurysm

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    Casulari Luiz Augusto

    2004-01-01

    Full Text Available We have previously reported that subarachnoid hemorrhage due to ruptured intracranial aneurysm (SH is associated with changes in the hormonal profile in the first 24 hours after the event. We proposed that the hormonal changes observed are due to the intense stress to which the patients are exposed. However, the thyroidal hormonal profile is indicative of the presence of a nonthyroidal illness syndrome (NTIS. In this paper, we examined whether the change in the thyroid hormone profile is compatible with a NTIS. Two groups of patients were included in the study: A 30 patients with SH (21 females and 9 males; 41.7±11.4 years and B a control group including 25 patients with benign diseases of the spine (BDS (lumbar disc hernia or stable spinal trauma (8 females and 17 males; 41.3±14.2 years. In a subgroup of eight patients of each group serum triiodothyronine (T3 and reverse T3 levels were measured. The blood samples were obtained between 8:00 and 9:00 AM. The following results were obtained: The SH group had smaller serum T3 and free T4 levels than the BDS group (p<0.05: T3 (ng/mL: SH = 58.7±1.1 and BDS = 74.5±13.9; free T4 (ng/dL: SH = 0.9±0.2 and BDS = 1.1±0.3. There was no significant difference in the serum levels of total thyroxine (T4 and thyroid-stimulating hormone (TSH between the two groups: T4 (µg/dL: SH = 6.9±1.1 and BDS = 7.4±2.1; TSH (µUI/mL: SH = 1.5±0.8 and BDS = 1.8±1,0. In the sample of eight patients of each group we had the following results: T3 (ng/mL: SH = 66.8±3.8 and BDS = 77.2±1.1 (p <0.05; reverse T3 (ng/dL: SH = 32.8±8 and BDS = 24.7±2.2 (NS; T3/ reverse T3 ratio: SH = 2.6±0.3 and BDS = 3.3±0.4 (NS. Thyreoglobulin and microsomal antibodies were not detectable, except in one patient in the SH group. In conclusion, the SH patients present serum levels of T3 and free T4 significantly lower than that of BDS patients; the thyroidal hormone profile suggests that SH patients have developed the nonthyroidal

  13. Hearing rehabilitation in Treacher Collins Syndrome with bone anchored hearing aid

    OpenAIRE

    José Fernando Polanski; Anna Clara Plawiak; Angela Ribas

    2015-01-01

    Objective: To describe a case of hearing rehabilitation with bone anchored hearing aid in a patient with Treacher Collins syndrome. Case description: 3 years old patient, male, with Treacher Collins syndrome and severe complications due to the syndrome, mostly related to the upper airway and hearing. He had bilateral atresia of external auditory canals, and malformation of the pinna. The initial hearing rehabilitation was with bone vibration arch, but there was poor acceptance due the discom...

  14. A Rare Combination: Congenital Adrenal Hyperplasia Due To 21 Hydroxylase Deficiency and Turner Syndrome

    Science.gov (United States)

    Peltek Kendirci, Havva Nur; Aycan, Zehra; Çetinkaya, Semra; Baş, Veysel Nijat; Ağladıoğlu, Sebahat Yılmaz; Önder, Aşan

    2012-01-01

    A combination of Turner syndrome (TS) and classical congenital adrenal hyperplasia (CAH) is rare. A one-day-old newborn was referred to our hospital with ambiguous genitalia. The parents were third-degree relatives. The infant’s weight was 3350g (50-75p), and the head circumference was 34.5cm (50p). The gonads were nonpalpable. Presence of a 3 cm phallus, one urogenital opening into the perineum, and incomplete labial fusion were identified. Laboratory tests revealed a classical type of CAH due to 21-hydroxylase deficiency. Karyotyping revealed a 45X0(35)/46XX(22) pattern with negative sex-determining region Y (SRY) on gene analysis. At the most recent follow-up visit, the patient appeared to be in good health - her height was 70.4 cm [-1.5 standard deviation (SD)] and her weight was 9.8 kg (0.3 SD). She was receiving hydrocortisone in a dose of 10 mg/m2/day, fludrocortisone acetate in a dose of 0.075 mg/day, and oral salt of 1 g/day. System examinations were normal. The patient’s electrolyte levels were found to be normal and she was in good metabolic control. The findings of this patient demonstrate that routine karyotyping during investigation of patients with sexual differentiation disorders can reveal TS. Additionally, signs of virilism should always be investigated at diagnosis or during physical examinations for follow-up of TS cases. [i][/i]SRY analysis should be performed primarily when signs of virilism are observed. CAH should also be considered in patients with negative [i]SRY[/i]. Conflict of interest:None declared. PMID:23261864

  15. Delayed diagnosis in patients with Prader-Willi syndrome due to maternal uniparental disomy 15.

    Science.gov (United States)

    Gunay-Aygun, M; Heeger, S; Schwartz, S; Cassidy, S B

    1997-07-11

    Prader-Willi syndrome (PWS) results from absence of the normally active paternally inherited genes on proximal 15q, due to del(15)(q11q13) or by maternal uniparental disomy (UPD) 15 in most cases. In addition to a higher frequency of hypopigmentation among deletion patients, minor phenotypic differences between deletion and UPD patients have recently been reported, including lower birth weight in the deletion group, shorter birth length in males with UPD, and shorter course of gavage feeding and later onset of hyperphagia in females with UPD. We previously reported that those with UPD had a less "typical" facial appearance, and they less often had skin picking, skill with puzzles, and high pain threshold. There were no children younger than 3.5 years of age in the UPD group, in contrast to several of them in the deletion group, suggesting a possible diagnostic delay in the UPD group. To assess this possibility and seek reasons for it, we reviewed the charts of 60 PWS patients with complete molecular testing. Mean age at diagnosis of patients with UPD was significantly higher than in the deletion group. Mean percentiles of birth weights and lengths of patients with UPD were significantly lower than in those with deletion. Mean duration of gestation, mean duration of gavage feeding, and mean age at onset of hyperphagia did not differ significantly between groups. Delay in the diagnosis of patients with UPD, which may influence the management and impact of the disorder, might be explained by a lower frequency of typical facial anomalies in this group. PMID:9215778

  16. A rare combination: congenital adrenal hyperplasia due to 21 hydroxylase deficiency and Turner syndrome.

    Science.gov (United States)

    Kendirci, Havva Nur Peltek; Aycan, Zehra; Çetinkaya, Semra; Baş, Veysel Nijat; Ağladıoğlu, Sebahat Yılmaz; Önder, Aşan

    2012-12-01

    A combination of Turner syndrome (TS) and classical congenital adrenal hyperplasia (CAH) is rare. A one-day-old newborn was referred to our hospital with ambiguous genitalia. The parents were third-degree relatives. The infant's weight was 3350g (50-75p), and the head circumference was 34.5cm (50p). The gonads were nonpalpable. Presence of a 3 cm phallus, one urogenital opening into the perineum, and incomplete labial fusion were identified. Laboratory tests revealed a classical type of CAH due to 21-hydroxylase deficiency. Karyotyping revealed a 45X0(35)/46XX(22) pattern with negative sex-determining region Y (SRY) on gene analysis. At the most recent follow-up visit, the patient appeared to be in good health - her height was 70.4 cm [-1.5 standard deviation (SD)] and her weight was 9.8 kg (0.3 SD). She was receiving hydrocortisone in a dose of 10 mg/m²/day, fludrocortisone acetate in a dose of 0.075 mg/day, and oral salt of 1 g/day. System examinations were normal. The patient's electrolyte levels were found to be normal and she was in good metabolic control. The findings of this patient demonstrate that routine karyotyping during investigation of patients with sexual differentiation disorders can reveal TS. Additionally, signs of virilism should always be investigated at diagnosis or during physical examinations for follow-up of TS cases. SRY analysis should be performed primarily when signs of virilism are observed. CAH should also be considered in patients with negative SRY. PMID:23261864

  17. Refractory rickets due to Fanconi′s Syndrome secondary to Wilson′s disease

    Directory of Open Access Journals (Sweden)

    Chitra Selvan

    2012-01-01

    Full Text Available Renal tubular disorders are an important cause of refractory rickets. Wilson′s disease, an inherited disorder of copper metabolism has varied presentations. We present a case of refractory rickets due to Fanconi′s syndrome attributable to Wilson′s disease. An adolescent girl presented with pain in the hip and knee joints and a knock-knee deformity since six years. She had received multiple doses of cholecalciferol with little improvement. There was no history of seizures, polyuria, jaundice, intake of drugs, or similar complaints in the family. Examination revealed a severely short stature with widening of the wrist joint and genu valgum. Examination of the central nervous system (CNS was normal. Skeletal radiographs showed features suggestive of rickets at the hip and knee joints. Routine biochemistry was normal, 25-hydroxyvitamin D [25(OHD] was adequate (57.1 ng/dL, with normal corrected calcium (9.24 mg/dL, low phosphate (2.76 mg/dL, elevated bone-specific alkaline phosphatase, and normal renal functions. Twenty-four-hour urine revealed phosphaturia, kaliuresis, and glucosuria with normal blood sugars and aminoaciduria. Blood gas analysis revealed normal anion gap metabolic acidosis with a urine pH of 7. Ammonium chloride (NH 4 CL challenge test revealed proximal tubular acidosis. A search for causes revealed Kayser-Fleischer rings. The diagnosis of Wilson′s disease was confirmed by low serum ceruloplasmin levels (6.5 mg/dL; normal: 18-35 mg/dL with high 24-hour urine copper levels (433 mcg; normal: 20-50 mcg. She was started on a replacement of alkali, phosphate, calcium, and vitamin D, with zinc acetate for Wilson′s disease. Rickets as a presenting feature of Wilson′s disease has been reported rarely. Recognition of this entity is important, as treatment of the primary condition may improve tubular function as well.

  18. Anton’s Syndrome due to Bilateral Ischemic Occipital Lobe Strokes

    Directory of Open Access Journals (Sweden)

    Sanela Zukić

    2014-01-01

    Full Text Available We present a case of a patient with Anton’s syndrome (i.e., visual anosognosia with confabulations, who developed bilateral occipital lobe infarct. Bilateral occipital brain damage results in blindness, and patients start to confabulate to fill in the missing sensory input. In addition, the patient occasionally becomes agitated and talks to himself, which indicates that, besides Anton’s syndrome, he might have had Charles Bonnet syndrome, characterized by both visual loss and hallucinations. Anton syndrome, is not so frequent condition and is most commonly caused by ischemic stroke. In this particular case, the patient had successive bilateral occipital ischemia as a result of massive stenoses of head and neck arteries.

  19. A Rare Case of Paraneoplastic Syndrome Presented with Severe Gastroparesis due to Ganglional Loss

    OpenAIRE

    Santosh Enaganti; Javaid Ishtiaq; Martin Peters; Argyriou, Konstantinos N.

    2012-01-01

    Paraneoplastic syndromes are rare initial manifestations of a neoplastic disorder that may precede the actual detection of an overt cancer. These syndromes can generally involve any organic system of the human body with gastroparesis being the commonest manifestation of the paraneoplastic involvement of the neuronal bodies of the gastrointestinal tract in cancer patients. Gastroparesis is the result of an autoimmune destruction of the nerve plexus of the stomach that causes nonspecific gastro...

  20. Lethal progressive thoracic insufficiency in a neonate due to jarcho levin syndrome.

    Science.gov (United States)

    Bhutia, Euden; Maria, Arti; Verma, Arushi; Sethi, Sidharth Kumar

    2014-01-01

    A rare case of Jarcho Levin syndrome (JLS) presenting as a lethal progressive respiratory insufficiency in early neonatal period is reported. The neonate had classical features of this syndrome including vertebral segmentation defects, typical costo-vertebral fusion defects and scoliosis resulting in small thoracic volume and limited chest expansion; all consistent with a clinical diagnosis of JLS with thoracic insufficiency. In addition, our case had a rare association of dextrocardia and acyanotic congenital heart disease.

  1. Sweet Syndrome due to Myelodysplastic Syndrome: Possible Therapeutic Role of Intravenous Immunoglobulin in Addition to Standard Treatment

    Directory of Open Access Journals (Sweden)

    Harry H. S. Gill

    2010-01-01

    Full Text Available We report an 82-year-old lady who developed sudden onset nodular and erythematous lesions and neutrophilia following an episode of urinary tract infection. Skin biopsy confirmed the diagnosis of Sweet syndrome. Response to the use of prednisolone alone was not satisfactory. The skin lesions however showed a sustained response to the regular use of intravenous immunoglobulin (IVIG and prednisolone was slowly weaned off. Our case highlights the possible therapeutic role of IVIG in managing this condition.

  2. Sweet Syndrome due to Myelodysplastic Syndrome: Possible Therapeutic Role of Intravenous Immunoglobulin in Addition to Standard Treatment

    OpenAIRE

    Raymond Liang; Yeung, C K; Leung, Anskar Y. H.; Trendell-Smith, N J; Harry H. S. Gill

    2010-01-01

    We report an 82-year-old lady who developed sudden onset nodular and erythematous lesions and neutrophilia following an episode of urinary tract infection. Skin biopsy confirmed the diagnosis of Sweet syndrome. Response to the use of prednisolone alone was not satisfactory. The skin lesions however showed a sustained response to the regular use of intravenous immunoglobulin (IVIG) and prednisolone was slowly weaned off. Our case highlights the possible therapeutic role of IVIG in managing thi...

  3. Canal Wall Reconstruction Mastoidectomy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To investigate the advantages of canal wall reconstruction (CWR) mastoidectomy, a single-stage technique for cholesteatoma removal and posterior external canal wall reconstruction, over the open and closed procedures in terms of cholesteatoma recurrence. Methods: Between June 2002 and December 2005, 38 patients (40 ears) with cholesteatoma were admited to Sun Yat-Sen Memorial Hospital and received surgical treatments. Of these patients, 25 were male with ages ranging between 11 and 60 years (mean = 31.6 years) and 13 were female with ages ranging between 20 and 65 years (mean = 38.8 years). Canal wall reconstruction (CWR)mastoidectomy was performed in 31 ears and canal wall down (CWD) mastoidectomy in 9 ears. Concha cartilage was used for ear canal wall reconstruction in 22 of the 31 CWR procedures and cortical mastoid bone was used in the remaining 9 cases. Results At 0.5 to 4 years follow up, all but one patients remained free of signs of cholesteatoma recurrence, i.e., no retraction pocket or cholesteatoma matrix. One patient, a smoker, needed revision surgery due to cholesteatoma recurrence 1.5 year after the initial operation. The recurrence rate was therefore 3.2% (1/31). Cholesteatoma recurrence was monitored using postoperative CT scans whenever possible. In the case that needed a revision procedure, a retraction pocket was identified by otoendoscopy in the pars flacida area that eventually evolved into a cholesteatoma. A pocket extending to the epitympanum filled with cholesteatoma matrix was confirmed during the revision operation, A decision to perform a modified mastoidectomy was made as the patient refused to quit smoking. The mean air-bone gap in pure tone threshold was 45 dB before surgery and 25 dB after (p < 0.05). There was no difference between using concha cartilage and cortical mastoid bone for the reconstruction regarding air-bone gap improvement, CT findings and otoendoscopic results. Conclusion CWR mastoidectomy can be used for

  4. Posterior reversible encephalopathy syndrome (PRES, an acute neurological syndrome due to reversible multifactorial brain edema: a case report

    Directory of Open Access Journals (Sweden)

    Camilla Cicognani

    2013-04-01

    Full Text Available Background: The essential features of Posterior Reversible Encephalopathy Syndrome (PRES are headache, mental changes, seizures, visual symptoms and often arterial hypertension. Brain RMN typically shows cortico-sottocortical parieto-occipital edema, with a bilateral and symmetric distribution. PRES develops in clinical conditions as hypertensive encephalopathy, preeclampsia/ eclampsia, autoimmune diseases, after transplantation, infections and as an adverse effect of immunosuppressive drugs or chemotherapy. It usually completely reverses with treatment, although permanent sequelae are possible in case of delayed or missed diagnosis. Case report: We describe the case of a transsexual (M!F and tetraplegic patient, admitted for neck and low back pain. She suddenly developed headache, confusion, seizures and severe hypertension with normal blood tests. RMN showed multiple cortico-sottocortical areas of vasogenic and citotoxic edema in temporo-occipital, parietal, frontal, and cerebellar regions. Soon after the beginning of the antihypertensive therapy, clinical recovery was observed, as well as the disappearance of edema at RMN. Discussion and conclusions: Although PRES is usually associated with definite pathological conditions, it is not always the case, as was for the patient here described, who had no predisposing factors in her past clinical history, and presented hypertension only in the acute phase of the syndrome. Since, moreover, PRES usually presents with acute non specific features and it can be misdiagnosed with other serious diseases, the clinician will be helped by the knowledge of this syndrome to promptly start diagnostic workup and treatments, and avoid permanent neurological deficits.

  5. Case of inappropriate ADH syndrome: hyponatremia due to polyethylene glycol bowel preparation.

    Science.gov (United States)

    Ko, Sun-Hye; Lim, Chul-Hyun; Kim, Jae-Young; Kang, Seung Hun; Baeg, Myong Ki; Oh, Hyun Jin

    2014-09-14

    Colonoscopic screening has been reported to reduce deaths from colorectal cancer. Adequate bowel preparation is essential for this and safety is an important issue in choosing the methods. Polyethylene glycol (PEG) is regarded as a safe method for cleansing, especially compared with oral sodium phosphate. Here, we present a case of hyponatremia caused by the syndrome of inappropriate antidiuretic hormone (ADH) syndrome after PEG precolonoscopic cleansing resulting in generalized tonic-clonic seizures. A 62-year-old women had ingested PEG for precolonoscopic bowel cleansing. While waiting for the colonoscopy, she developed a stuporous mentality and generalized tonic-clonic seizures, which did not correlate with brain magnetic resonance imaging. Her serum sodium level was 113 mEq per liter and laboratory analyses were consistent with inappropriate ADH syndrome. Her thyroid and adrenal functions were normal. There were no malignancies, infections, respiratory disorders or central nervous disorders and she had no history of taking either diuretics or other medications, which might have caused inappropriate ADH syndrome. She was treated with 3% hypertonic saline and showed a complete neurological recovery as her sodium levels recovered. Follow-up visits showed the patient to have a normal sodium level without neurologic deficits. This case shows that inappropriate ADH syndrome can be caused by PEG preparation, which implies that physicians have to be aware of the possible side effects of this colonic cleansing approach and mindful of the possible ensuing symptoms.

  6. 阻塞性睡眠呼吸暂停低通气综合征患者冷热试验特征分析%Feature of semicircular canal function in obstructive sleep apnea-hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    韩曦; 鲁宏华; 陈太生; 徐开旭; 林鹏; 温超; 李前伟; 程岩; 王巍

    2015-01-01

    Objective The aim of this study was to evaluate the effects of obstructive sleep apneahypopnea syndrome(OSAHS) on semicircular canal function.Methods By means of a series prospective study at Department of Otolaryngology Head and Neck Surgery of our hospital,the study was performed on 77 patients suffering from OSAHS in a period from 2012 to 2014,who underwent polysomnography(PSG) and caloric test.The maximal slow-phase velocity (SPV) and unilateral weakness (UW) were used to measure the vestibular function.Severity of OSAHS was evaluated by the lowest oxygen saturation(LSaO2) and apnea hypopnea index(AHI).The SPV after cool was signed,warm test was performed for each ear,and the sum of left ear SPV were calculated,and then,the SPV of right ear was counted as the same way.Finally,the relationships between LSaO2,AHI,age,BMI,and SPV of caloric test were analyzed.Results Caloric vestibular tests in the 77 OSAHS patients demonstrated abnormal findings in 52 patients(67.5%) and normal vestibular functions in the remaining 25 patients(32.5%).Of the 52 patients with an abnormal test result,16(20.8%)patients had unilateral vestibular hyporeflexia and 36 (46.7%)patients revealed a bilateral vestibular hyporeflexia.There was no linear relationship between AHI,age,BMI with SPV of caloric test (P > 0.05).The SPV had significant difference between Lower LSaO2 group (LSaO2 < 50%) and higher LSaO2 group (LSaO2 ≥ 80%) (P < 0.05).LSaO2 was lower in patients undertaken bilateral vestibular hyporeflexia.Conclusions OSAHS patients with long-term intermittent hypoxia can disturb the vestibular organs and reduce semicircular canal function.The heavier hypoxemia will lead to the lower reflex of semicircular canal,with the heavier degree of hypoxemia,and the bilateral horizontal semicircular canal involvement may also be higher at the same time.Due to the effect of vestibule centre compensatory,OSAHS patients lack of dizziness and symptoms from balance disturbances

  7. PERIOPERATIVE ANAESTHESIA MANAGEMENT OF A PATIENT WITH CUSHING’S SYNDROME DUE TO ADRENOCORTICAL CARCINOMA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Mukund

    2014-09-01

    Full Text Available Adrenocortical carcinoma, a rare malignancy is a rare cause of Cushing’s syndrome. Open adrenalectomy, a preferred modality for its treatment has inherent problems of difficult surgical access, bleeding, massive blood transfusion, coagulation defect, pulmonary embolism, large fluid shifts, cardiovascular collapse and postoperative complications. Cushing syndrome also poses challenge to anaesthesiologist in perioperative period, due to presence of hyper-cortisolism, volume overload, hypertension, hyperglycemia, hypokalaemia, difficult airway and difficult ventilation. We report a case of Cushing’s syndrome due to adrenocortical carcinoma in 50 year old female, who was diagnosed by her clinical presentation, blood investigations and radiological reports. During open adrenalectomy, excessive bleeding had occurred as tumour had invaded inferior vena cava. This was successfully managed with crystalloids, colloids, whole blood, fresh frozen plasma, platelet transfusion and vasopressor support. Postoperative management in PACU included mechanical ventilation, anti-hypertensive and steroids. Inferior vena cava invasion by tumour was not there in earlier CT scan images. Inadvertent inferior vena cava invasion by tumour adds not only to surgical difficulty but also to the problems of anaesthesiologist in managing Cushing syndrome. For successful outcome one has to be prepared for such an un-anticipated problem.

  8. Serotonin syndrome due to fluoxetine and tramadol in renal impaired patient

    Directory of Open Access Journals (Sweden)

    Rajnish Raj

    2014-02-01

    Full Text Available Serotonin syndrome causes confusion or altered mental status; other symptoms include myoclonus, shivering, tremors, diaphoresis, hyperreflexia, incoordination, fever and diarrhoea. Tramadol possesses dual pharmacological effects i.e., a weak opiate agonist at mu, kappa and delta opiate receptors along with reuptake inhibition of norepinephrine and serotonin. Risk associated with tramadol increases when co-administered with serotonergic antidepressants or MAOIs (monoamine oxidase inhibitors and in renal impaired. The incidence of this syndrome is less than 1% as most of the cases remain unreported. The case highlights the fact that interaction between serotonergic agents like fluoxetine and tramadol especially in the presence of co-morbid medical illness can lead to serotonin syndrome. [Int J Basic Clin Pharmacol 2014; 3(1.000: 227-229

  9. Piriformis syndrome in fibromyalgia: clinical diagnosis and successful treatment.

    Science.gov (United States)

    Siddiq, Md Abu Bakar; Khasru, Moshiur Rahman; Rasker, Johannes J

    2014-01-01

    Piriformis syndrome is an underdiagnosed extraspinal association of sciatica. Patients usually complain of deep seated gluteal pain. In severe cases the clinical features of piriformis syndrome are primarily due to spasm of the piriformis muscle and irritation of the underlying sciatic nerve but this mysterious clinical scenario is also described in lumbar spinal canal stenosis, leg length discrepancy, piriformis myofascial pain syndrome, following vaginal delivery, and anomalous piriformis muscle or sciatic nerve. In this paper, we describe piriformis and fibromyalgia syndrome in a 30-year-old young lady, an often missed diagnosis. We also focus on management of the piriformis syndrome.

  10. Piriformis Syndrome in Fibromyalgia: Clinical Diagnosis and Successful Treatment

    Directory of Open Access Journals (Sweden)

    Md Abu Bakar Siddiq

    2014-01-01

    Full Text Available Piriformis syndrome is an underdiagnosed extraspinal association of sciatica. Patients usually complain of deep seated gluteal pain. In severe cases the clinical features of piriformis syndrome are primarily due to spasm of the piriformis muscle and irritation of the underlying sciatic nerve but this mysterious clinical scenario is also described in lumbar spinal canal stenosis, leg length discrepancy, piriformis myofascial pain syndrome, following vaginal delivery, and anomalous piriformis muscle or sciatic nerve. In this paper, we describe piriformis and fibromyalgia syndrome in a 30-year-old young lady, an often missed diagnosis. We also focus on management of the piriformis syndrome.

  11. Further case of Rubinstein-Taybi syndrome due to a deletion in EP300.

    LENUS (Irish Health Repository)

    Foley, Patricia

    2012-02-01

    Rubinstein-Taybi syndrome (RSTS) is a heterogeneous disorder with approximately 45-55% of patients showing mutations in the CREB binding protein and a further 3% of patients having mutations in EP300. We report a male child with a deletion of exons 3-8 of the EP300 gene who has RSTS. He has a milder skeletal phenotype, a finding that has been described in other cases with EP300 mutations. The mother suffered from pre-eclampsia and HELLP syndrome in the pregnancy. She subsequently developed a mullerian tumor of her cervix 6 years after the birth of her son.

  12. Impotence due to external Iliac steal syndrome: Treatment with percutaneous transluminal angioplasty and stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Gur, Serkan [Sifa University, Dept. of Radiology, Izmir (Turkmenistan); Oguzkurt, Levent; Kaya, Bilal; Tekbas, Guven; Ozkan, Ugur [Baskent University, Faculty of Medicine, Dept. of Radiology, Adana (Turkmenistan)

    2013-01-15

    We report a case of erectile dysfunction caused by external iliac artery occlusion, associated with pelvic steal syndrome; bilateral internal iliac arteries were patent. The patient stated that he had experienced erectile dysfunction at similar times along with claudication, but he did not mention it before angiography. He expressed that the erectile dysfunction did not last long and that he felt completely okay after the interventional procedure, in addition to his claudication. Successful treatment of the occlusion, by percutaneous transluminal angioplasty and stent implantation, helped resolve erectile dysfunction completely and treat the steal syndrome.

  13. An infant with hyperalertness, hyperkinesis, and failure to thrive: a rare diencephalic syndrome due to hypothalamic anaplastic astrocytoma

    OpenAIRE

    Stival, Alessia; Lucchesi, Maurizio; Farina, Silvia; Buccoliero, Anna Maria; Castiglione, Francesca; Genitori, Lorenzo; de Martino, Maurizio; Sardi, Iacopo

    2015-01-01

    Background Diencephalic Syndrome is a rare clinical condition of failure to thrive despite a normal caloric intake, hyperalertness, hyperkinesis, and euphoria usually associated with low-grade hypothalamic astrocytomas. Case presentation We reported an unusual case of diencephalic cachexia due to hypothalamic anaplastic astrocytoma (WHO-grade III). Baseline endocrine function evaluation was performed in this patient before surgery. After histological diagnosis, he enrolled to a chemotherapy p...

  14. [From gene to disease; craniosynostosis syndromes due to FGFR2-mutation

    NARCIS (Netherlands)

    Ravenswaaij-Arts, C.M.A. van; Ouweland, A.M.W. van den; Hoogeboom, A.J.M.; Herbergs, J.; Pals, G.

    2002-01-01

    One of the genes involved in craniosynostosis syndromes is the fibroblast growth factor receptor 2 (FGFR2) gene, a tyrosine kinase receptor gene. Upon ligand binding the FGFR2 receptors dimerise, and this is followed by activation of the intracellular tyrosine kinase domains. This initiates a cascad

  15. An unusual presentation of Denys-Drash syndrome due to bigenic disease

    NARCIS (Netherlands)

    Eneman, B.; Mekahli, D.; Audrezet, M.P.; Lerut, E.; Damme-Lombaerts, R. van; Heuvel, L.P. van den; Levtchenko, E.N.

    2014-01-01

    We report a case of Denys-Drash syndrome (DDS) in a 3-month-old girl presenting with bilateral renal cortical cysts mimicking polycystic kidney disease. Genetic analysis revealed a de novo heterozygous missense mutation c.1186G>A (p.Asp396Asn) in the WT1 gene, confirming the diagnosis of DDS. Bec

  16. ADULT RESPIRATORY-DISTRESS SYNDROME (ARDS) DUE TO BACTEREMIC PNEUMOCOCCAL PNEUMONIA

    NARCIS (Netherlands)

    MANNES, GPM; BOERSMA, WG; BAUR, CHJM; POSTMUS, PE

    1991-01-01

    We describe a patient, who had no pre-existing disease, with bacteraemic pneumococcal pneumonia and adult respiratory distress syndrome (ARDS), a rare complication. In spite of the use of antibiotics and intensive treatment the mortality rate of this kind of infection remains high. Streptococcus pne

  17. Severe manifestation of Leber's hereditary optic neuropathy due to 11778G>A mtDNA mutation in a female with hypoestrogenism due to Perrault syndrome.

    Science.gov (United States)

    Badura-Stronka, Magdalena; Wawrocka, Anna; Zawieja, Krzysztof; Silska, Sylwia; Krawczyński, Maciej Robert

    2013-11-01

    Perrault syndrome (PS) is a rare autosomal recessive condition with ovarian dysgenesis, hearing deficit and neurological abnormalities in female patients. The molecular basis of the syndrome is heterogeneous, mutations in the HSD17B4 gene have been identified in one family and mutations in the HARS2 gene have been found in another one. We have excluded pathogenic changes in the HSD17B4 gene and in the HARS2 gene by a direct sequencing of all coding exons in a female with clinical hallmarks of PS, ataxia and mild mental retardation. In addition, the patient suffers from severe Leber's hereditary optic neuropathy (LHON) due to 11778G>A mtDNA mutation. This case is the first reported patient with PS and LHON. Possible influence of hypoestrogenism on the manifestation of optic neuropathy in this patient is discussed in the context of recent findings concerning the crucial role of estrogens in supporting the vision capacity in LHON-related mtDNA mutation carriers.

  18. Posterior semicircular canal dehiscence: a morphologic cause of vertigo similar to superior semicircular canal dehiscence

    Energy Technology Data Exchange (ETDEWEB)

    Krombach, G.A.; Schmitz-Rode, T.; Haage, P.; Guenther, R.W. [Department of Diagnostic Radiology, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); DiMartino, E. [Department of Otorhinolaryngology, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); Prescher, A. [Department of Anatomy, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); Kinzel, S. [Department of Experimental Veterinarian Medicine, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany)

    2003-06-01

    Heading Abstract.The aim of this study was to assess imaging findings of posterior semicircular dehiscence on computed tomography and to evaluate incidence of posterior and superior semicircular canal dehiscence in patients presenting with vertigo, sensorineuronal hearing loss or in a control group without symptoms related to the inner ear. Computed tomography was performed in 507 patients presenting either with vertigo (n=128; 23 of these patients suffered also from sensorineuronal hearing loss), other symptoms related to the inner ear, such as hearing loss or tinnitus (n=183) or symptoms unrelated to the labyrinth (n=196). All images were reviewed for presence of dehiscence of the bone, overlying the semicircular canals. Twenty-nine patients had superior semicircular canal dehiscence. Of these patients, 83% presented with vertigo, 10% with hearing loss or tinnitus and the remaining 7% with symptoms unrelated to the inner ear. In 23 patients dehiscence of the posterior semicircular canal was encountered. Of these patients, 86% presented with vertigo, 9% with hearing loss or tinnitus and 5% with symptoms unrelated to the inner ear. Defects of the bony overly are found at the posterior semicircular canal, in addition to the recently introduced superior canal dehiscence syndrome. Significant prevalence of vertigo in these patients suggests that posterior semicircular canal dehiscence can cause vertigo, similar to superior semicircular canal dehiscence. (orig.)

  19. Acute respiratory distress syndrome due to viral pneumonitis in case of varicella zoster in adult: case report

    Directory of Open Access Journals (Sweden)

    Anaz Binazeez

    2015-12-01

    Full Text Available Chickenpox, is a highly contagious disease caused by infection with varicella zoster virus (VZV. The disease is often more severe in adults than children. Here we present a case of adult male suffering from chicken pox who presented with complication of acute respiratory distress syndrome [ARDS] due to viral pneumonitis. Due to his late presentation, despite of giving antivirals, patient had a fatal outcome. So this case highlights the necessity and importance of early administration of antivirals, especially in adult pox, to tackle the complications of disease and get a favourable outcome. [Int J Res Med Sci 2015; 3(12.000: 3924-3927

  20. Cerebral salt wasting syndrome due to tuberculous meningitis; a case report.

    Science.gov (United States)

    Ahmad, Syed; Majid, Zain; Mehdi, Mehwish; Mubarak, Muhammed

    2016-01-01

    A 58-year-old male presented with fever, nausea, and vomiting since 15 days along with irritability and confusion since 5 days. His laboratory reports showed low serum sodium, serum osmolality and uric acid. Computerized tomography (CT) scan of brain revealed age-related changes. While on lumbar puncture (LP) and cerebrospinal fluid (CSF) examination, CSF protein, lactate dehydrogenase (LDH) and total leukocyte count (predominant lymphocytes) were all increased. On his 14th day of admission, his serum sodium was 116 mEq/l and he had a high urine output. Fluid restriction was tried in order to rule out syndrome of inappropriate antidiuretic hormone secretion (SIADH) but the patient did not respond to it. Keeping in view the above findings, a final diagnosis of tuberculous meningitis leading to cerebral salt wasting syndrome was made. The patient was started on 3% hypertonic saline, mineralocorticoids and anti-tuberculous therapy (ATT), to which he responded favorably and was later discharged.

  1. Hereditary mixed polyposis syndrome due to a BMPR1A mutation.

    LENUS (Irish Health Repository)

    O'Riordan, J M

    2010-06-01

    The conditions Juvenile Polyposis Syndrome (JPS) and Hereditary Mixed Polyposis Syndrome (HMPS) are associated with an increased risk of colorectal carcinoma. The genetic mechanisms which explain these conditions have until recently been poorly understood. Recent interest has focused on the transforming growth factor (TGF)-beta signalling pathway and, in particular, on mutations in the SMAD4 gene. However, not all cases of JPS and HMPS have mutations in SMAD4 and focus has now shifted to other components of the TGF-beta pathway to clarify the genetic mechanisms involved in these conditions. In this report, we describe the significance of a bone morphogenetic protein receptor type 1A gene mutation in an Irish family.

  2. Acute liver failure due to primary amyloidosis in a nephrotic syndrome: a swiftly progressive course.

    Science.gov (United States)

    Cardoso, Brigite Aguiar; Leal, Rita; Sá, Helena; Campos, Mário

    2016-01-01

    AL amyloidosis is a clonal plasma cell proliferative disorder characterised by extracellular tissue deposits of insoluble fibrils derived from κ or λ immunoglobulin light chains. The most common organs affected by AL amyloidosis are the kidney, presenting with nephrotic syndrome and/or progressive renal dysfunction, and the heart, with restrictive cardiomyopathy. Hepatic deposition of fibrils occurs in half the cases but the liver is rarely the predominantly affected organ. The most common presentation of hepatic amyloidosis is hepatomegaly with elevated alkaline phosphatase. Acute liver failure with cholestasis and jaundice is a rare complication, with a prevalence of approximately 5%, and is usually associated with a worse prognosis. We report a case of a 39-year-old man admitted to our nephrology department with an unusual presentation of primary amyloidosis with nephrotic syndrome and acute liver failure, complicated by obstructive cholestasis resulting in death 2 months after diagnosis. PMID:26965175

  3. The development of hemorrhagic shock encephalopathy syndrome due to child abuse a case report Case Report

    OpenAIRE

    Yalaki, Zahide; Taşar, M. Ayşin; Tıraş, Ülkü; Arıkan, İnci; Bostancı, İlknur; Dallar, Yıldız

    2009-01-01

    Child abuse neglect is a very important problem in our country as it is in the world It may be as physical sexual psychological abuse and child neglect A previously healthy baby at the age of 2 5 months was brought to the emergency service with complaints of not breathing and cyanosis Evaluation of the patient and the history obtained suggested a diagnosis of hemorrhagic shock and encephalopathy syndrome During the following period problems of spasticity and vision impairment appeared The fam...

  4. Immune reconstitution syndrome in a human immunodeficiency virus infected child due to giardiasis leading to shock.

    Science.gov (United States)

    Nandy, Sneha; Shah, Ira

    2015-01-01

    Human immunodeficiency virus (HIV)-associated immune reconstitution inflammatory syndrome has been reported in association with tuberculosis, herpes zoster (shingles), Cryptococcus neoformans, Kaposi's sarcoma, Pneumocystis pneumonia, hepatitis B virus, hepatitis C virus, herpes simplex virus, Histoplasma capsulatum, human papillomavirus, and Cytomegalovirus. However, it has never been documented with giardiasis. We present a 7-year-old HIV infected girl who developed diarrhea and shock following the initiation of antiretroviral therapy, and her stool showed the presence of giardiasis. PMID:26985424

  5. Immune reconstitution syndrome in a human immunodeficiency virus infected child due to giardiasis leading to shock

    OpenAIRE

    Nandy, Sneha; Shah, Ira

    2015-01-01

    Human immunodeficiency virus (HIV)-associated immune reconstitution inflammatory syndrome has been reported in association with tuberculosis, herpes zoster (shingles), Cryptococcus neoformans, Kaposi's sarcoma, Pneumocystis pneumonia, hepatitis B virus, hepatitis C virus, herpes simplex virus, Histoplasma capsulatum, human papillomavirus, and Cytomegalovirus. However, it has never been documented with giardiasis. We present a 7-year-old HIV infected girl who developed diarrhea and shock follo...

  6. The role of nasal CPAP in obstructive sleep apnoea syndrome due to mandibular hypoplasia.

    LENUS (Irish Health Repository)

    Miller, Stanley D W

    2012-02-01

    Melnick Needles syndrome (MNS), Treacher Collins syndrome (TCS) and Pierre Robin syndrome (PRS) are congenital abnormalities with characteristic facial appearances that include micrognathia. A 20-year-old girl with MNS, a 16-year-old boy with TCS and a 12-year-old girl with PRS attended the sleep apnoea clinic at our institution at different times. Diagnostic sleep studies were initially performed on all three patients to confirm the diagnosis of obstructive sleep apnoea syndrome (OSAS). They subsequently commenced nasal CPAP (nCPAP) treatment and their progress was followed. A limited sleep study on the patient with MNS demonstrated moderate\\/severe OSAS with an AHI of 33 events\\/h. Commencement of nCPAP resulted in symptomatic improvement. Overnight oximetry in the patient with TCS showed repeated desaturation to SpO2<90%. Subsequent treatment by nCPAP almost completely abolished the desaturation events. Overnight polysomnography in the patient with PRS demonstrated severe OSAS with an AHI of 49 events\\/h. After 3 years of nCPAP therapy, this patient requested discontinuation of treatment. Subsequent polysomnography without nCPAP revealed an AHI of <5 events\\/h. The use of nCPAP in the patients with MNS and TCS resulted in effective control of their sleep abnormalities. Mandibular growth and enlargement of the posterior airway space led to resolution of OSAS in the patient with PRS. There is a definite role for nCPAP therapy in patients with congenital micrognathia and OSAS. The use of nCPAP may obviate the need for more invasive corrective surgery for OSAS and is not necessarily a life-long requirement.

  7. Acute respiratory distress syndrome due to pulmonary involvement by neoplastic plasma cells in multiple myeloma

    OpenAIRE

    Marmor, D B; Farber, J. L.; Gottlieb, J E

    2006-01-01

    Pulmonary involvement with multiple myeloma occurs infrequently and may be difficult to distinguish from more common primary lung tumours, metastatic disease, or other pleural and parenchymal abnormalities. A patient who developed acute respiratory distress syndrome (ARDS) was subsequently found to have multiple myeloma with involvement of lung parenchyma by neoplastic plasma cells. Only one other report of ARDS in association with multiple myeloma was found, and there are no previous reports...

  8. Steven's Johnson syndrome with toxic epidermal necrolysis due to thalidomide in a case of multiple myeloma.

    Science.gov (United States)

    Das, Anupam; Sil, Amrita; Mishra, Vivek; Das, Nilay Kanti

    2014-01-01

    Thalidomide developed in 1954 for morning sickness had proven to be a teratogen and hence was withdrawn from market. Resurgence of thalidomide began as an immunomodulator when it was shown to be effective in the management of multiple myeloma and many conditions like erythema nodosum leprosum, graft versus host disease, recurrent aphthous ulcers etc. We report a case of Stevens Johnson syndrome-toxic epidermal necrolysis developing in an elderly male who was prescribed thalidomide after being diagnosed with multiple myeloma.

  9. Common Carotid Artery Stump Syndrome Due to Mobile Thrombus Detected by Carotid Duplex Ultrasonography.

    Science.gov (United States)

    Omoto, Shusaku; Hasegawa, Yuki; Sakai, Kenichiro; Matsuno, Hiromasa; Arai, Ayumi; Terasawa, Yuka; Mitsumura, Hidetaka; Iguchi, Yasuyuki

    2016-10-01

    Carotid stump syndrome is a cause of recurrent embolic stroke following occlusion of the ipsilateral internal carotid artery. The present report describes a case of recurrent cerebral embolism ipsilateral to a chronically occluded left common carotid artery (CCA), i.e., "CCA stump syndrome." Doppler color flow imaging showed anterograde flow in the left internal and external carotid arteries, which were supplied by collateral flow from the superior thyroid artery inflowing just proximal to the left carotid bifurcation. According to carotid duplex ultrasonography (CDU), a low-echoic mobile thrombus was noted at the distal stump of the occluded CCA, which presumably caused distal embolism. The low-echoic mobile thrombus dramatically changed to a homogenously high-echoic thrombus, and there was no recurrence of stroke after antiplatelet and anticoagulant therapy. This is the first report to demonstrate a CDU-verified temporal change in the thrombus at the stump in CCA stump syndrome. CDU is a noninvasive and useful technique to characterize hemodynamics, thrombus morphology, and the response to therapy. PMID:27567297

  10. Oral-facial-digital syndrome with mesoaxial polysyndactyly, common AV canal, hirschsprung disease and sacral dysgenesis: Probably a transitional type between II, VI, variant of type VI or a new type

    Directory of Open Access Journals (Sweden)

    Rabah M. Shawky

    2014-07-01

    Full Text Available We report a 4 month old male infant, the first in order of birth of healthy first cousin consanguineous parents who has many typical features of oral-facial-digital syndrome type VI (OFDS VI including hypertelorism, bilateral convergent squint, depressed nasal bridge, and wide upturned nares, low set posteriorly rotated ears, long philtrum, gum hyperplasia with notches of the alveolar borders, high arched palate, and hyperplastic oral frenula. He has mesoaxial and postaxial, polysyndactyly which is the specific feature of OFDS VI, however the cerebellum is normal on MRI brain. He has also some rare congenital anomalies including common atrioventricular canal, hirschsprung disease, and sacral dysgenesis. This patient may have a transitional type between II and VI, a variant of type VI or a new type.

  11. Watery diarrhea, hypokalemia and achlorhydria syndrome due to an adrenal pheochromocytoma

    Institute of Scientific and Technical Information of China (English)

    Shin-ichi Ikuta; Chiaki Yasui; Masahiro Kawanaka; Tsukasa Aihara; Hidenori Yoshie; Hidenori Yanagi; Masao Mitsunobu; Ayako Sugihara; Naoki Yamanaka

    2007-01-01

    Watery diarrhea, hypokalemia and achlorhydria (WDHA)syndrome caused by vasoactive intestinal polypeptide (VIP) -producing tumor only rarely occurs in patients with nonpancreatic disease. A 49-year-old woman was referred for evaluation of a right adrenal tumor incidentally diagnosed by abdominal ultrasound during the investigation of chronic watery diarrhea. Laboratory findings showed hypokalemia and excessive production of VIP and catecholamines. After surgical resection of the tumor, diarrhea subsided and both electrolytes and affected hormone levels normalized. Immunohistochemical examination confirmed a diagnosis of pheochromocytoma,which contained VIP-positive ganglion-like cells. We herein present the clinical and histogenetic implications of this rare clinical entity, with literature review.

  12. A Rare Combination: Congenital Adrenal Hyperplasia Due To 21 Hydroxylase Deficiency and Turner Syndrome

    OpenAIRE

    Peltek Kendirci, Havva Nur; Aycan, Zehra; Çetinkaya, Semra; Baş, Veysel Nijat; Ağladıoğlu, Sebahat Yılmaz; Önder, Aşan

    2012-01-01

    A combination of Turner syndrome (TS) and classical congenital adrenal hyperplasia (CAH) is rare. A one-day-old newborn was referred to our hospital with ambiguous genitalia. The parents were third-degree relatives. The infant’s weight was 3350g (50-75p), and the head circumference was 34.5cm (50p). The gonads were nonpalpable. Presence of a 3 cm phallus, one urogenital opening into the perineum, and incomplete labial fusion were identified. Laboratory tests revealed a classical type of CAH d...

  13. Ectopic Cushing’s syndrome due to retroperitoneal ACTH-producing paragangliomas

    Science.gov (United States)

    Chen, Fan; Wang, Xiangyu; Wang, Yang; Meng, Hui; Hou, Xinguo; Zhu, Yaofeng; Gao, Wei; Jiang, Xuewen; Chen, Shouzhen; Zhang, Zhaocun; Zou, Zhichuan; He, Tianyi; Yang, Yue; Zhu, Kejia; Wang, Yong; Liu, Yaxiao; Cui, Jianfeng; Shi, Benkang; Yin, Gang

    2016-01-01

    Extra-adrenal pheochromocytomas, or paragangliomas, are rare tumours that derive from extra-adrenal chromaffin cells. Cushing’s syndrome (CS) caused by paragangliomas is extremely rare. We report a 53-year-old man with hypertension, diabetes, and symptoms of hypokalemia. Computer tomography (CT) revealed two retroperitoneal masses and bilateral adrenal hyperplasia. Together with the laboratory examinations, ectopic CS caused by multiple paragangliomas was highly suspected. The patient underwent resections of retroperitoneal tumours, left kidney, and left adrenal; postoperative histopathology confirmed two paragangliomas that were both positively stained for adrenocorticotropic hormone (ACTH). He got clinical and biochemical recoveries without any recurrent evidence at the nine-month followup.

  14. Neonatal liver failure and Leigh syndrome possibly due to CoQ-responsive OXPHOS deficiency.

    Science.gov (United States)

    Leshinsky-Silver, E; Levine, A; Nissenkorn, A; Barash, V; Perach, M; Buzhaker, E; Shahmurov, M; Polak-Charcon, S; Lev, D; Lerman-Sagie, T

    2003-08-01

    CoQ transfers electrons from complexes I and II of the mitochondrial respiratory chain to complex III. There are very few reports on human CoQ deficiency. The clinical presentation is usually characterized by: epilepsy, muscle weakness, ataxia, cerebellar atrophy, migraine, myogloblinuria and developmental delay. We describe a patient who presented with neonatal liver and pancreatic insufficiency, tyrosinemia and hyperammonemia and later developed sensorineural hearing loss and Leigh syndrome. Liver biopsy revealed markedly reduced complex I+III and II+III. Addition of CoQ to the liver homogenate restored the activities, suggesting CoQ depletion. Histological staining showed prominent bridging; septal fibrosis and widening of portal spaces with prominent mixed inflammatory infiltrate, associated with interface hepatitis, bile duct proliferation with numerous bile plugs. Electron microscopy revealed a large number of mitochondria, which were altered in shape and size, widened and disordered intercristal spaces. This may be the first case of Leigh syndrome with liver and pancreas insufficiency, possibly caused by CoQ responsive oxphos deficiency. PMID:12948744

  15. Burning Mouth Syndrome due to Television Moans, an Enigma for Oral Physician: Treatment with Counseling.

    Science.gov (United States)

    Gupta, Deepak; Sheikh, Soheyl; Pallagatti, Shambulingappa; Kasariya, Kartikaya; Buttan, Amit; Gupta, Maqul

    2014-01-01

    Burning mouth syndrome (BMS) is a relatively common disease that can severely affect the quality of life of the patient. It causes chronic orofacial pain or oral burning sensation even in the absence of any detectable organic cause. The etiology of BMS is complex and multifactorial. It has been associated with menopause, trigger events and even genetic polymorphisms. Although its etiology remains unclear, there is still much evidence that psychological elements like stress, anxiety or depression do play a significant role. There are several studies in the literature which only report the association of BMS with psychological factors. But to the best of our knowledge, there is no such case reported in the literature which has actually highlighted the management of such a case with psychogenic elements involved. In this case report, apart from discussing the role of psychological factors, the treatment of BMS with emphasis on counseling is also emphasized. Further, it is of interest to know that such patients with psychologically induced burning mouth syndrome have to be evaluated to their deepest details. Even their commonly overlooked gestures and habits like watching a particular television soap opera may be involved in their disease process. It can be concluded that psychological counseling in general dental practice can provide an effective cure for chronic oral burning sensation with psychological factors involved.

  16. A Rare Case of Paraneoplastic Syndrome Presented with Severe Gastroparesis due to Ganglional Loss

    Directory of Open Access Journals (Sweden)

    Konstantinos N. Argyriou

    2012-01-01

    Full Text Available Paraneoplastic syndromes are rare initial manifestations of a neoplastic disorder that may precede the actual detection of an overt cancer. These syndromes can generally involve any organic system of the human body with gastroparesis being the commonest manifestation of the paraneoplastic involvement of the neuronal bodies of the gastrointestinal tract in cancer patients. Gastroparesis is the result of an autoimmune destruction of the nerve plexus of the stomach that causes nonspecific gastrointestinal symptoms such as intractable vomiting and abdominal discomfort that interfere with patients' quality of life and are often ascribed to psychological factors. Thus, if not suspected, it easily evades the diagnostic thought especially in those cases where the diagnostic work up has not detected any apparent cause. Consequently, it should always be considered in patients with diagnosed or suspected cancer who complain of unexplained gastrointestinal symptoms. In our report, so as to increase the clinical awareness of this rare clinical entity, we present the case of a 70-year-old Caucasian female who presented in our hospital with severe gastroparesis that was later proven to be associated with an overt small cell lung cancer (SCLC and we discuss the existing knowledge of the pathophysiology, diagnosis, and management of this disorder.

  17. Turner syndrome presented with tall stature due to overdosage of the SHOX gene

    Science.gov (United States)

    Seo, Go Hun; Kang, Eungu; Cho, Ja Hyang; Lee, Beom Hee; Choi, Jin-Ho; Kim, Gu-Hwan; Seo, Eul-Ju

    2015-01-01

    Turner syndrome is one of the most common chromosomal disorders. It is caused by numerical or structural abnormalities of the X chromosome and results in short stature and gonadal dysgenesis. The short stature arises from haploinsufficiency of the SHOX gene, whereas overdosage contributes to tall stature. This report describes the first Korean case of Turner syndrome with tall stature caused by SHOX overdosage. The patient presented with primary amenorrhea and hypergonadotropic hypogonadism at the age of 17 years. Estrogen replacement therapy was initiated at that time. She displayed tall stature from childhood, with normal growth velocity, and reached a final height of 190 cm (standard deviation score, 4.3) at the age of 30 years. Her karyotype was 46,X, psu idic(X)(q21.2), representing partial monosomy of Xq and partial trisomy of Xp. Analysis by multiplex ligation-dependent probe amplification detected a duplication at Xp22.3-Xp22.2, encompassing the PPP2R3 gene near the 5'-end of the SHOX gene through the FANCD gene at Xp22.2. PMID:26191517

  18. Myoclonic status and central fever in Angelman syndrome due to paternal uniparental disomy.

    Science.gov (United States)

    Nicita, Francesco; Garone, Giacomo; Papetti, Laura; Consoli, Federica; Magliozzi, Monia; De Luca, Alessandro; Spalice, Alberto

    2015-01-01

    Myoclonic status in nonprogressive encephalopathy (MSNE) is an early-onset, drug-resistant epileptic syndrome characterized by occurrence of continuous diffuse epileptiform abnormalities, associated with positive and/or negative phenomena and accompanied by transient and recurring motor, cognitive, and behavioral impairment. MSNE has been reported in Angelman syndrome (AS) secondary to 15q11-13 deletions or UBE3A mutations but not to paternal uniparental disomy (UPD). We describe the case of a male patient with AS caused by UPD who developed a myoclonic status (MS) associated with long-lasting fever of central origin, both promptly regressed with introduction of levetiracetam. Only three descriptions of thermal dysregulation in AS exist, and none of the previously reported cases were associated with MS or with UPD. Association of MS and central fever expands the spectrum of epileptic and non-epileptic features in UPD-related AS and provides a further evidence of hypothalamus involvement in the pathogenesis of this neurodevelopmental disorder. PMID:26559560

  19. The Dehiscent Facial Nerve Canal

    Directory of Open Access Journals (Sweden)

    Sertac Yetiser

    2012-01-01

    Full Text Available Accidental injury to the facial nerve where the bony canal defects are present may result with facial nerve dysfunction during otological surgery. Therefore, it is critical to know the incidence and the type of facial nerve dehiscences in the presence of normal development of the facial canal. The aim of this study is to review the site and the type of such bony defects in 144 patients operated for facial paralysis, myringoplasty, stapedotomy, middle ear exploration for sudden hearing loss, and so forth, other than chronic suppurative otitis media with or without cholesteatoma, middle ear tumors, and anomaly. Correlation of intraoperative findings with preoperative computerized tomography was also analyzed in 35 patients. Conclusively, one out of every 10 surgical cases may have dehiscence of the facial canal which has to be always borne in mind during surgical manipulation of the middle ear. Computerized tomography has some limitations to evaluate the dehiscent facial canal due to high false negative and positive rates.

  20. Electroacupuncture Treatment for Constipation Due to Spasmodic Syndrome of the Pelvic Floor- A Report of 36 Cases

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Thirty-six cases of constipation due to spasmodic syndrome of the pelvic floor were treated by electroacupuncture, with satisfactory therapeutic results reported as follows. Clinical Data There were 36 cases in this series, 12 males and 24 females, ranging in age from 25 to 76 years, averaging 42 years. The course of disease ranged from 6 months to 22 years, with an average of 6 years. All the 36 cases were previously treated by purgative and emollient cathartic for promoting the bowl movement.

  1. Root canal irrigants

    Directory of Open Access Journals (Sweden)

    Kandaswamy Deivanayagam

    2010-01-01

    Full Text Available Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are discussed. We performed a Medline search for English-language papers published untill July 2010. The keywords used were ′root canal irrigants′ and ′endodontic irrigants.′ The reference lists of each article were manually checked for additional articles of relevance.

  2. Syndrome of Inappropriate Antidiuretic Hormone Secretion Due to Amantadine: 3 Cases in the Literature

    Directory of Open Access Journals (Sweden)

    Akif Acay

    2014-02-01

    Full Text Available To report a patient who developed a syndrome of inappropriate antidiuretic hormone secretion (SIADH related with amantadine. A 62 year-old male, who has been followed for Parkinson%u2019s disease for 16 years. Three months ago, amantadine added to his existing treatment. About 4 weeks after the initiation of treatment, confusion, constant sleepiness, lethargy, asthenia, fatigue and muscle weakness appeared. The blood anlysis showed hyponatremia, so he was diagnosed as SIADH and amantadine treatment was stopped. Then his symptoms gradually improved and the sodium levels was turned into the normal ranges. Amantadine may cause SIADH should be used with caution in patients with Parkinson%u2019s disease.

  3. Anticholinergic syndrome due to 'Devil's herb': when risks come from the ancient time.

    Science.gov (United States)

    Piccillo, G A; Miele, L; Mondati, E; Moro, P A; Musco, A; Forgione, A; Gasbarrini, G; Grieco, A

    2006-04-01

    We describe a case of Mandragora autumnalis poisoning which occurred in a 72-year-old female patient who had eaten the venenous M. Autumnalis, picked near her home, mistaking it for the edible Borago Officinalis. M. Autumnalis is a solanaceous plant, common in the Sicilian countryside, which contains a variable concentration of solanum alkaloids, causing gastrointestinal irritation, and tropane alkaloids, with anticholinergic properties. Unluckily, M. Autumnalis is often mistaken for the edible B. Officinalis, likewise widespread in Sicilian countryside. The diagnosis of Mandragora poisoning was made on the basis of clinical symptoms and signs of anticholinergic syndrome associated with a history of vegetable meal of uncontrolled origin, moreover analysing the vegetable obtained from gastric lavage. Decontamination and symptomatic treatment were useful in our patient to control acute poisoning. PMID:16620365

  4. [Prolonged coma due to fat embolism syndrome after fracture of the femur].

    Science.gov (United States)

    Ruiz-Gimeno, J I; Ferre, M A; Napal, M T; Pelegrín, F

    2006-03-01

    A 24-year-old male came to the emergency department with a diaphyseal fracture of the femur resulting from a motorcycle accident. Neurological deterioration was progressive, although a computed tomography scan was normal. Endotracheal intubation for mechanical ventilation was necessary. His condition progressed to sepsis and multiorgan failure before resolving. Magnetic resonance images of the brain suggested a fat embolism. The presence of a patent foramen ovale was investigated. The patient remained in a state of coma vigil for 3 months after the accident. After ruling out other more likely causes of neurological deterioration after trauma with fractures, fat embolism should be suspected. The prognosis for the neurological manifestations of fat embolism syndrome are generally good. Severe cases suggest massive (paradoxical) embolization of the brain and are associated with a patent foramen ovale. Early diagnosis will identify the patient at high surgical risk. A favorable course and outcome have been reported with preoperative closure of the foramen ovale. PMID:16671262

  5. CLINICAL VARIABILITY IN TWO SISTERS WITH KEUTEL SYNDROME DUE TO A HOMOZYGOUS MUTATION IN MGP GENE.

    Science.gov (United States)

    Tüysüz, B; Cinar, B; Laçiner, S; Onay, H; Mittaz-Crettol, L

    2015-01-01

    Keutel syndrome (KS) is an autosomal recessive disease characterised by abnormal cartilage calcification, brachytelephalangism, peripheral pulmonary artery stenosis, hearing loss and midface retrusion. KS is caused by homozygous mutations in MGP, a gene encoding Matrix Gla protein which acts as a calcification inhibitor in extracellular matrix. We present two Turkish sisters (22 and 13 years old) who had abnormal cartilage calcification, brachytelephalangism, congenital heart defect and chronic asthmatic bronchitis. The patients were homozygous for c.62-2A>G (IVS1-2 A>G) mutation in MGP gene. Abnormal cartilage calcification, brachytelephalangism and midfacial retrusion are the hallmarks of KS. It was observed that the younger sister had striking cartilaginous calcifications, midfacial retrusion and severe brachytelephalangism while her older sister had mild costal cartilaginous calcifications and brachytelephalangism without any midfacial retrusion. Intrafamiliar clinical variability for KS has not been described previously. PMID:26349188

  6. RENOVASCULAR HYPERTENSION DUE TO RENAL ARTERY STENOSIS IN KLIPPEL-FEIL SYNDROME

    Directory of Open Access Journals (Sweden)

    Foyaca-Sibat H. MD.

    2003-01-01

    Full Text Available ABSTRACT We report one patient with Klippel-Feil (KFS syndrome, other associated anomalies, uncontrolled arterial hypertension, and renal artery stenosis. Because this patient underwent for surgical revascularization with unsuccessful result, all proposed way of treatments are revised, and we have hypothesized that probably for patients with KFS and unilateral renal artery stenosis, medical treatment with ACE inhibitors can provide more benefits than surgical revascularization or percutaneous transluminal angioplasty. We considered that those patients should be manage by a team of medical doctors being aware of their common associated anomalies, identifying all of them when it is possible then, making an integral evaluation of the each individual situation for establishing their medical priorities in order, and then address its treatments accordingly. If at this stage any surgical treatment is required, is important to bring those problems to the anesthesiologist’s attention for a very careful manipulation of the neck and head during induction of anesthesia. The final results will be strongly related with the capacity of management of the underlying cardio-respiratory, renal, skeletal, urogenital, and nervous system problems. . We also propose the term of Klippel-Feil syndrome "Plus" for those patients with cervical vertebral fusion and many other associated deformities rather than to add new eponyms to the long list that already exist. _____________ RESUMEN: HIPERTENSION RENOVASCULAR DEBIDO A ESTENOSIS DE LA ARTERIA RENAL EN EL SÍNDROME DE KLIPPEL-FEIL Reportamos un paciente afectado por un syndrome de Klippel-Feil, otras anormalias congenitas, hipertension arterial incontrolada y una estenosis unilateral de la arteria renal. Este paciente fue sometido a un tratamiento quirÚrgico de la estenosis de la arteria renal, cuyos resultados fueron no satisfactorios por lo que revisamos todas las alternativas de tratamiento para la estenosis

  7. Acute respiratory failure, due to severe obstructive sleep apnoea syndrome, managed with nasal positive pressure ventilation.

    Science.gov (United States)

    Sturani, C; Galavotti, V; Scarduelli, C; Sella, D; Rosa, A; Cauzzi, R; Buzzi, G

    1994-12-01

    The complications of endotracheal intubation are particularly frequent in patients with obstructive sleep apnoea syndrome (OSAS). We prospectively tested nasal ventilation in such patients admitted for acute respiratory failure. Six consecutive patients, aged 17-70 yrs, were selected for the study. All patients were confused or severely obtunded, Glasgow Coma Score (GCS) 10 (SD 2). With nasal bi-level positive airways pressure (BiPAP) all these patients improved clinical status and arterial blood gas values, avoiding intubation and invasive mechanical ventilation. The median pH increased from 7.26 (SD 0.06) to 7.36 (0.01) and to 7.43 (0.02) after, 1-3 and 24 h of nasal ventilation, respectively. Nasal ventilation lasted an average of 21 (3) h on the first day. All patients were discharged home after a median hospital stay of 28 (11) days. PMID:7711717

  8. MERRF/MELAS overlap syndrome due to the m.3291T>C mutation.

    Science.gov (United States)

    Liu, Kaiming; Zhao, Hui; Ji, Kunqian; Yan, Chuanzhu

    2014-03-01

    We report the case of a 19-year-old Chinese female harboring the m.3291T>C mutation in the MT-TL1 gene encoding the mitochondrial transfer RNA for leucine. She presented with a complex phenotype characterized by progressive cerebellar ataxia, frequent myoclonus seizures, recurrent stroke-like episodes, migraine-like headaches with nausea and vomiting, and elevated resting lactate blood level. It is known that the myoclonus epilepsy with ragged-red fibers (MERRF) is characterized by cerebellar ataxia and myoclonus epilepsy, while that the mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is characterized by recurrent stroke-like episodes, migraine-like headaches, and elevated resting lactate blood level. So the patient's clinical manifestations suggest the presence of a MERRF/MELAS overlap syndrome. Muscle biopsy of the patient showed the presence of numerous scattered ragged-red fibers, some cytochrome c oxidase-deficient fibers, and several strongly succinate dehygrogenase-reactive vessels, suggestive of a mitochondrial disorder. Direct sequencing of the complete mitochondrial genome of the proband revealed no mutations other than the T-to-C transition at nucleotide position 3291. Restriction fragment length polymorphism analysis of the proband and her family revealed maternal inheritance of the mutation in a heteroplasmic manner. The analysis of aerobic respiration and glycolysis demonstrated that the fibroblasts from the patient had mitochondrial dysfunction. Our results suggest that the m.3291T>C is pathogenic. This study is the first to describe the m.3291T>C mutation in association with the MERRF/MELAS overlap syndrome.

  9. How to bond to root canal dentin

    Science.gov (United States)

    Nica, Luminita; Todea, Carmen; Furtos, Gabriel; Baldea, Bogdan

    2014-01-01

    Bonding to root canal dentin may be difficult due to various factors: the structural characteristic of the root canal dentin, which is different from that of the coronal dentin; the presence of the organic tissue of the dental pulp inside the root canal, which has to be removed during the cleaning-shaping of the root canal system; the smear-layer resulted after mechanical instrumentation, which may interfere with the adhesion of the filling materials; the type of the irrigants used in the cleaning protocol; the type of the sealer and core material used in the obturation of the endodontic space; the type of the materials used for the restoration of the endodontically treated teeth. The influence of the cleaning protocol, of the root canal filling material, of the type of the adhesive system used in the restoration of the treated teeth and of the region of the root canal, on the adhesion of several filling and restorative materials to root canal dentin was evaluated in the push-out bond strength test on 1-mm thick slices of endodontically treated human teeth. The results showed that all these factors have a statistically significant influence on the push-out bond strength. Formation of resin tags between radicular dentin and the investigated materials was observed in some of the samples at SEM analysis.

  10. First Reported Case of Reactive Airway Dysfunction Syndrome in a Laborer Due to Porcelain Tile Dust

    Directory of Open Access Journals (Sweden)

    Tasleem Arif

    2013-06-01

    Full Text Available Reactive airway dysfunction syndrome (RADS is a type of non-immunologically mediated asthma-like disease. It usually occurs after a massive exposure to an irritating substance in the atmosphere in the form of smoke, fumes, gases, and vapor. Unlike bronchial asthma, there is no latency to the symptoms seen in RADS. A number of agents are known to cause RADS, but tile dust, as an etiological agent, has not been previously reported. We report a 45-year-old male laborer, who presented with an acute onset of cough, chest tightness, breathlessness, and audible wheeze after his first time exposure to porcelain tile dust within 5 hours of exposure. Lab tests, including, chest X-ray, electrocardiogram, air blood gas analysis, and serum IgE, were unremarkable. Spirometry showed a mild obstruction [forced expiratory volume in 1 second (FEV1=72% of predicted], while the bronchodilator reversibility test was significant(14% increase in FEV1 above the baseline.Bronchial biopsy revealed a chronic inflammatory reaction with lymphocytic and plasma cell infiltration and more importantly a striking absence of eosinophils. To the best of our knowledge, this is the first reported case of RADS as a result of exposure to tile dust (porcelain ceramics.

  11. Acute renal failure due to abdominal compartment syndrome: report on four cases and literature review

    Directory of Open Access Journals (Sweden)

    Cleva Roberto de

    2001-01-01

    Full Text Available We report on 4 cases of abdominal compartment syndrome complicated by acute renal failure that were promptly reversed by different abdominal decompression methods. Case 1: A 57-year-old obese woman in the post-operative period after giant incisional hernia correction with an intra-abdominal pressure of 24 mm Hg. She was sedated and curarized, and the intra-abdominal pressure fell to 15 mm Hg. Case 2: A 73-year-old woman with acute inflammatory abdomen was undergoing exploratory laparotomy when a hypertensive pneumoperitoneum was noticed. During the surgery, enhancement of urinary output was observed. Case 3: An 18-year-old man who underwent hepatectomy and developed coagulopathy and hepatic bleeding that required abdominal packing, developed oliguria with a transvesical intra-abdominal pressure of 22 mm Hg. During reoperation, the compresses were removed with a prompt improvement in urinary flow. Case 4: A 46-year-old man with hepatic cirrhosis was admitted after incisional hernia repair with intra-abdominal pressure of 16 mm Hg. After paracentesis, the intra-abdominal pressure fell to 11 mm Hg.

  12. Is Disturbed Transfer of Learning in Callosal Agenesis due to a Disconnection Syndrome?

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    T. Imamura

    1994-01-01

    Full Text Available Disturbed intermanual transfer of tactile learning in callosal agenesis has been interpreted as a sign of disconnection syndrome. We observed this sign in one of four acallosal patients with a conventional form-board task, and tried to elucidate the nature of the deficit. The form-board performance of the patient with disturbed transfer of learning totally depended on motor skill, while the other acallosals and normal controls executed the task based on spatial and somesthetic information. All acallosals and normals, however, failed to show transfer of learning with another tactile task which needed motor skill but not spatial-somesthetic information. These findings suggest that the task-performing strategies in form-board learning change the state of interhemispheric transfer. Unimanual learning effect is transferred if spatial-somesthetic information is acquired in the process of learning, but is not transferred if motor skill is the exclusive content of learning. We conclude that disturbed “transfer” of learning in some acallosals is not a true disconnection sign. It should be attributed to a lack of appropriate strategy, as a result of ineffective problem solving in tactile tasks.

  13. Posterior Reversible Encephalopathy Syndrome due to High Dose Corticosteroids for an MS Relapse

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    Sarah A. Morrow

    2015-01-01

    Full Text Available Increased blood pressure is a known adverse effect associated with corticosteroids but little is published regarding the risk with the high doses used in multiple sclerosis (MS. A 53-year-old female with known relapsing remitting MS presented with a new brainstem relapse. Standard of care treatment for an acute MS relapse, 1250 mg of oral prednisone for 5 days, was initiated. She developed an occipital headache and dizziness and felt generally unwell. These symptoms persisted after treatment was complete. On presentation to medical attention, her blood pressure was 199/110 mmHg, although she had no history of hypertension. MRI changes were consistent with posterior reversible encephalopathy syndrome (PRES, demonstrating abnormal T2 signal in both thalami, the posterior occipital and posterior parietal white matter with mild sulcal effacement. As her pressure normalized with medication, her symptoms resolved and the MRI changes improved. No secondary cause of hypertension was found. This is the first reported case of PRES secondary to high dose corticosteroid use for an MS relapse without a history of hypertension and with no other secondary cause of hypertension identified. This rare complication should be considered in MS patients presenting with a headache or other neurological symptoms during treatment for a relapse.

  14. Posterior Reversible Encephalopathy Syndrome due to High Dose Corticosteroids for an MS Relapse.

    Science.gov (United States)

    Morrow, Sarah A; Rana, Robina; Lee, Donald; Paul, Terri; Mahon, Jeffrey L

    2015-01-01

    Increased blood pressure is a known adverse effect associated with corticosteroids but little is published regarding the risk with the high doses used in multiple sclerosis (MS). A 53-year-old female with known relapsing remitting MS presented with a new brainstem relapse. Standard of care treatment for an acute MS relapse, 1250 mg of oral prednisone for 5 days, was initiated. She developed an occipital headache and dizziness and felt generally unwell. These symptoms persisted after treatment was complete. On presentation to medical attention, her blood pressure was 199/110 mmHg, although she had no history of hypertension. MRI changes were consistent with posterior reversible encephalopathy syndrome (PRES), demonstrating abnormal T2 signal in both thalami, the posterior occipital and posterior parietal white matter with mild sulcal effacement. As her pressure normalized with medication, her symptoms resolved and the MRI changes improved. No secondary cause of hypertension was found. This is the first reported case of PRES secondary to high dose corticosteroid use for an MS relapse without a history of hypertension and with no other secondary cause of hypertension identified. This rare complication should be considered in MS patients presenting with a headache or other neurological symptoms during treatment for a relapse. PMID:26101676

  15. Acute respiratory distress syndrome due to vivax malaria: case report and literature review

    Directory of Open Access Journals (Sweden)

    André V. Lomar

    2005-10-01

    Full Text Available Severe pulmonary involvement in malaria has been frequently reported in cases of Plasmodium falciparum infection, but rarely in vivax malaria. Among the 11 previous cases of vivax-related severe respiratory involvement described in the literature, all except one developed it after the beginning of anti-malarial treatment; these appear to correspond to an exacerbation of the inflammatory response. We report the case of a 43-year-old Brazilian woman living in a malaria-endemic area, who presented acute respiratory distress syndrome (ARDS caused by P. vivax before starting anti-malarial treatment. The diagnosis was made based on microscopic methods. A negative rapid immunochromatographic assay, based on the detection of Histidine Rich Protein-2 (HRP-2 of P. falciparum, indicated that falciparum malaria was unlikely. After specific anti-plasmodial therapy and intensive supportive care, the patient was discharged from the hospital. We conclude that vivax malaria-associated ARDS can develop before anti-malarial therapy.

  16. The Root Canal Biofilm

    NARCIS (Netherlands)

    Sluis, van der L.W.M.; Boutsioukis, C.; Jiang, L.M.; Macedo, R.; Verhaagen, B.; Versluis, M.; Chávez de Paz, E.; Sedgley, C.M.; Kishen, A.

    2015-01-01

    The aims of root canal irrigation are the chemical dissolution or disruption and the mechanical detachment of pulp tissue, dentin debris and smear layer (instrumentation products), microorganisms (planktonic or biofilm), and their products from the root canal wall, their removal out of the root cana

  17. Root canal irrigation

    NARCIS (Netherlands)

    L. van der Sluis; C. Boutsioukis; L.M. Jiang; R. Macedo; B. Verhaagen; M. Versluis

    2015-01-01

    The aims of root canal irrigation are the chemical dissolution or disruption and the mechanical detachment of pulp tissue, dentin debris and smear layer (instrumentation products), microorganisms (planktonic or biofilm), and their products from the root canal wall, their removal out of the root cana

  18. Radiofrequency treatment has a beneficial role in reducing low back pain due to facet syndrome in octogenarians or older

    Directory of Open Access Journals (Sweden)

    Shabat S

    2013-06-01

    Full Text Available Shay Shabat,1 Yossi Leitner,1 Gabriel Bartal,2 Yoram Folman31The Spine Unit, Sapir Medical Center, Kfar-Saba, Israel, and Sackler Medical School, Tel-Aviv University, Tel-Aviv, Israel; 2Department of Radiology, Sapir Medical Center, Kfar-Saba, Israel, and Sackler Medical School, Tel-Aviv University, Tel-Aviv, Israel; 3Orthopaedic Surgery Department, Hillel-Yafe Medical Center, Hadera, IsraelIntroduction: Chronic low back pain is a disabling phenomenon that can cause a severe reduction in quality of life, especially in elderly patients. Surgical treatment is sometimes a big challenge for these elderly patients. Radiofrequency (RF ablation is an increasingly popular method for treating low back pain caused by facet syndrome. The purpose of this study was to evaluate whether RF neurotomy is effective in terms of pain reduction and functional outcome in elderly patients.Patients and methods: Fifty-eight patients aged 80 years and older who had chronic mechanical low back pain were examined after they underwent RF heat lesion of the medial branch. Follow-up occurred 1, 3, 6, and 12 months after treatment. Pain was measured on the visual analog scale and functional outcome was measured using the Oswestry Disability Index.Results: After 1 month, 43 patients (74% were satisfied with the results. After 3 months, 38 patients (66% had clinically significant pain relief. After 6 months, 33 patients (57% had pain relief, and at the 1-year follow-up, 30 patients (52% showed good results while 28 patients (48% showed no effect. The Oswestry Disability Index score was substantially improved even after 1 year. Minor complications occurred in eleven patients (19%, who had transient discomfort and burning pain.Conclusion: RF is a safe and partially effective procedure for treating elderly patients with mechanical back pain due to facet syndrome.Keywords: radiofrequency, mechanical back pain, facet syndrome, elderly, octogenarians

  19. [A case of acute chronic respiratory failure due to fat embolism syndrome after the left femoral neck fracture].

    Science.gov (United States)

    Oda, Keishi; Kawanami, Toshinori; Yatera, Kazuhiro; Ogoshi, Takaaki; Kozaki, Minako; Nagata, Shuya; Nishida, Chinatsu; Yamasaki, Kei; Ishimoto, Hiroshi; Mukae, Hiroshi

    2011-09-01

    A 78 year old Japanese woman was transferred to our hospital for the treatment of a fracture of the left femoral neck in April, 2010. She had been taking oral corticosteroid (prednisolone 5 mg/day) for the treatment of idiopathic interstitial pneumonia since 2003, and had been treated by home oxygen therapy since 2007. She fell in the restroom at home and hurt herself, and was transferred to our hospital for treatment of a left femoral neck fracture in April, 2010. Her respiratory status was stable just after the transfer; however, she was transferred to the intensive care unit and started to receive mechanical ventilation due to rapidly progressive respiratory failure on the fourth day after admission. Chest X-ray and computed tomography revealed rapid progression of bilateral ground-glass attenuations, and acute exacerbation of interstitial pneumonia was clinically suspected. However, the elevation of D-dimer over time and characteristic findings of petechial hemorrhagic lesions on her palpebral conjunctivae and neck with microscopic findings of phagocytized lipid in alveolar macrophages in her endobronchial secretion led to the diagnosis of fat embolism syndrome. She was successfully treated with high-dose corticosteroid and sivelestat sodium, and she was discharged on the 21st day after admission. Although a differential diagnosis of acute exacerbation of interstitial pneumonia and fat embolism syndrome was necessary and difficult in the present case, characteristic findings of petechial hemorrhagic lesions of skin, palpebral conjunctiva and lipid-laden alveolar macrophages in endotracheal aspirate were useful for the accurate and prompt diagnosis of fat embolism syndrome. PMID:21913383

  20. Haemophilia A and cardiovascular morbidity in a female SHAM syndrome carrier due to skewed X chromosome inactivation.

    Science.gov (United States)

    Janczar, Szymon; Kosinska, Joanna; Ploski, Rafal; Pastorczak, Agata; Wegner, Olga; Zalewska-Szewczyk, Beata; Paige, Adam J W; Borowiec, Maciej; Mlynarski, Wojciech

    2016-01-01

    We have recently described a severe haemophilia A and moyamoya (SHAM) syndrome caused by Xq28 deletions encompassing F8 and the BRCC3 familial moyamoya gene. The phenotype includes haemophilia A, moyamoya angiopathy, dysmorphia and hypertension. The genetic analysis of the family of our SHAM patient demonstrated carrier state in proband's mother and sister. The patient's mother is apparently well, whereas his currently 18-years-old sister presents with mild haemophilia A, coarctation of the aorta, hypertension, and ventricular arrhythmia. We performed X chromosome inactivation assay based on HpaII methylation analysis of a polymorphic short tandem repeat (STR) in the X linked AR (androgen receptor) gene and used quantitative real-time RT PCR to measure the expression of genes from the deleted region in proband's family members. We found an extremely skewed X chromosome inactivation pattern in the female members of the family leading to preferential inactivation of the X chromosome without Xq28 deletion in patient's sister. We demonstrated differential expression of the genes from the deleted region in four members of the family, that tightly correlates with the clinical features. In conclusion, we show that the haematologic and cardiovascular morbidity and the discrepancy between patient's sister and mother despite the same genetic lesion are due to skewed X chromosome inactivation leading to clinically relevant differential expression of SHAM syndrome genes. This report highlights the role for BRCC3 in cardiovascular physiology and disease, and demonstrates that in some complex hereditary syndromes full diagnostics may require the examination of both genetic and epigenetic events. PMID:26691666

  1. Conus medullaris syndrome due to an intradural disc herniation: A case report

    Directory of Open Access Journals (Sweden)

    Chaudhary Kshitij

    2008-01-01

    Full Text Available A 70-year-old male patient developed acute paraplegia due to conus medullaris compression secondary to extrusion of D12-L1 disc. After negative epidural examination intraoperatively, a durotomy was performed and an intradural disc fragment was excised. Patient did not regain ambulatory status at two-year follow-up. Intraoperative finding of negative extradural compression, tense swollen dura and CSF leak from ventral dura should alert the surgeon for the possibility of intradural disc herniation. A routine preoperative MRI is misleading and a high index of suspicion helps to avoid a missed diagnosis.

  2. The Role of Inspiratory Muscle Training in Sickle Cell Anemia Related Pulmonary Damage due to Recurrent Acute Chest Syndrome Attacks.

    Science.gov (United States)

    Camcıoğlu, Burcu; Boşnak-Güçlü, Meral; Karadallı, Müşerrefe Nur; Akı, Şahika Zeynep; Türköz-Sucak, Gülsan

    2015-01-01

    Background. The sickling of red blood cells causes a constellation of musculoskeletal, cardiovascular, and pulmonary manifestations. A 32-year-old gentleman with sickle cell anemia (SCA) had been suffering from recurrent acute chest syndrome (ACS). Aim. To examine the effects of inspiratory muscle training (IMT) on pulmonary functions, respiratory and peripheral muscle strength, functional exercise capacity, and quality of life in this patient with SCA. Methods. Functional exercise capacity was evaluated using six-minute walk test, respiratory muscle strength using mouth pressure device, hand grip strength using hand-held dynamometer, pain using Visual Analogue Scale, fatigue using Fatigue Severity Scale, dyspnea using Modified Medical Research Council Scale, and health related quality of life using European Organization for Research and Treatment of Cancer QOL measurement. Results. A significant improvement has been demonstrated in respiratory muscle strength, functional exercise capacity, pain, fatigue, dyspnea, and quality of life. There was no admission to emergency department due to acute chest syndrome in the following 12 months after commencing regular erythrocytapheresis. Conclusion. This is the first report demonstrating the beneficial effects of inspiratory muscle training on functional exercise capacity, respiratory muscle strength, pain, fatigue, dyspnea, and quality of life in a patient with recurrent ACS. PMID:26060589

  3. The Role of Inspiratory Muscle Training in Sickle Cell Anemia Related Pulmonary Damage due to Recurrent Acute Chest Syndrome Attacks

    Directory of Open Access Journals (Sweden)

    Burcu Camcıoğlu

    2015-01-01

    Full Text Available Background. The sickling of red blood cells causes a constellation of musculoskeletal, cardiovascular, and pulmonary manifestations. A 32-year-old gentleman with sickle cell anemia (SCA had been suffering from recurrent acute chest syndrome (ACS. Aim. To examine the effects of inspiratory muscle training (IMT on pulmonary functions, respiratory and peripheral muscle strength, functional exercise capacity, and quality of life in this patient with SCA. Methods. Functional exercise capacity was evaluated using six-minute walk test, respiratory muscle strength using mouth pressure device, hand grip strength using hand-held dynamometer, pain using Visual Analogue Scale, fatigue using Fatigue Severity Scale, dyspnea using Modified Medical Research Council Scale, and health related quality of life using European Organization for Research and Treatment of Cancer QOL measurement. Results. A significant improvement has been demonstrated in respiratory muscle strength, functional exercise capacity, pain, fatigue, dyspnea, and quality of life. There was no admission to emergency department due to acute chest syndrome in the following 12 months after commencing regular erythrocytapheresis. Conclusion. This is the first report demonstrating the beneficial effects of inspiratory muscle training on functional exercise capacity, respiratory muscle strength, pain, fatigue, dyspnea, and quality of life in a patient with recurrent ACS.

  4. Therapeutic approach to "downhill" esophageal varices bleeding due to superior vena cava syndrome in Behcet's disease: a case report

    Directory of Open Access Journals (Sweden)

    Haghighi Mahshid

    2006-12-01

    Full Text Available Abstract Background One of the rare presentations of superior vena cava syndrome is bleeding of "downhill" esophageal varices (DEV and different approaches have been used to control it. This is a case report whose DEV was eradicated by band ligation for the first time. Case presentation We report a 42-year-old man who is a known case of Behcet's disease. The patient's first presentation was superior vena cava syndrome due to thrombosis followed by bipolar ulcers and arthralgia. He received warfarin, prednisolone and azathioprine. The clinical course of the patient was complicated by one episode of hematemesis without abdominal pain when the patient's PT was in therapeutic range. After resuscitation and correction of PT with fresh frozen plasma transfusion, upper gastrointestinal endoscopy was done. Prominent varices were seen in the upper third of the esophagus, tapering to the middle part without acute bleeding. Stomach and duodenum were normal. Color ultrasonography evaluation of the portal, hepatic and splenic veins was negative for thrombosis. Band ligation was done and the patient's bleeding did not recur. Conclusion Band ligation is a safe and effective method for controlling DEV bleeding in patients with uncorrectable underlying disorders.

  5. Evidence Report: Risk of Acute Radiation Syndromes Due to Solar Particle Events

    Science.gov (United States)

    Carnell, Lisa; Blattnig, Steve; Hu, Shaowen; Huff, Janice; Kim, Myung-Hee; Norman, Ryan; Patel, Zarana; Simonsen, Lisa; Wu, Honglu

    2016-01-01

    Crew health and performance may be impacted by a major solar particle event (SPE), multiple SPEs, or the cumulative effect of galactic cosmic rays (GCR) and SPEs. Beyond low-Earth orbit, the protection of the Earth's magnetosphere is no longer available, such that increased shielding and protective mechanisms are necessary in order to prevent acute radiation sickness and impacts to mission success or crew survival. While operational monitoring and shielding are expected to minimize radiation exposures, there are EVA scenarios outside of low-Earth orbit where the risk of prodromal effects, including nausea, vomiting, anorexia, and fatigue, as well as skin injury and depletion of the blood-forming organs (BFO), may occur. There is a reasonable concern that a compromised immune system due to high skin doses from a SPE or due to synergistic space flight factors (e.g., microgravity) may lead to increased risk to the BFO. The primary data available at present are derived from analyses of medical patients and persons accidentally exposed to acute, high doses of low-linear energy transfer (LET) (or terrestrial) radiation. Data more specific to the space flight environment must be compiled to quantify the magnitude of increase of this risk and to develop appropriate protection strategies. In particular, information addressing the distinct differences between solar proton exposures and terrestrial exposure scenarios, including radiation quality, dose-rate effects, and non-uniform dose distributions, is required for accurate risk estimation.

  6. Estudo neurofisiológico na síndrome miastênica congênita do canal lento: relato de caso Neurophysiological study in slow-channel congenital myasthenic syndrome: case report

    Directory of Open Access Journals (Sweden)

    Paulo José Lorenzoni

    2006-06-01

    Full Text Available A síndrome do canal lento é uma das síndromes miastênicas congênitas atribuída a desordem dinâmica do canal iônico do receptor de acetilcolina da junção neuromuscular. Descrevemos o caso de um homem de 25 anos com progressiva ptose palpebral e limitação da movimentação ocular desde infância, que evoluiu há 6 anos com piora da oftalmoparesia externa e diminuição da força muscular em ombros e mãos. O estudo da condução nervosa motora após estímulo único demonstrou duplo potencial de ação muscular composto (PAMC com desaparecimento do segundo após esforço de 30 segundos. Ao estímulo repetitivo dos nervos facial e acessório observou-se um decremento da amplitude do PAMC maior que 10% com desaparecimento do segundo potencial. O paciente fez uso de fluoxetina mostrando discreta melhora da força muscular, porém persiste com: ptose palpebral, limitação dos movimentos oculares e PAMC repetitivo ao estudo da condução nervosa motora. As características da doença são discutidas.The slow-channel syndrome is one of the congenital myasthenic syndromes attributed to inherited kinetic disorders of the ion channel of the acetylcholine receptor of the neuromuscular junction. This is a case report of 25-years-old man with progressive ptosis and limitation of ocular movements since infancy, presented a 6-years history of worse of the external ophthalmoparesis and muscular weakness in the shoulders and hands. The motor nerve conduction studies after a supramaximal single stimulus disclosed a double compound muscle action potential (CMAP that disappeared after a voluntary contraction of 30 seconds. Repetitive stimulation of facial and spinal accessory nerves showed a CMAP decrement greater than 10% with disappeared of the second potential. The patient received fluoxetine with mild improvement of muscular weakness, but persisted with: ptosis, limitation of ocular movements and repetitive CMAP in the motor nerve conduction study

  7. Three root canals in the maxillary second premolar

    Directory of Open Access Journals (Sweden)

    de Almeida-Gomes Fabio

    2009-01-01

    Full Text Available In this study, we report an endodontic treatment of the maxillary second premolar with three root canals and distinct foramens. The possibility of three root canals in this tooth is quite small; however, it must be taken into account in clinical and radiographic evaluation during endodontic treatment. Many times, their presence is noticed only after canal treatment due to continuing post-operative discomfort.

  8. [Nitric oxide inhalation as an effective therapy for acute respiratory distress syndrome due to near-drowning: a case report].

    Science.gov (United States)

    Takano, Y; Hirosako, S; Yamaguchi, T; Saita, N; Suga, M; Kukita, I; Okamoto, K; Ando, M

    1999-12-01

    A 16-year-old boy with acute respiratory distress syndrome (ARDS) due to near-drowning was admitted to our hospital. ARDS was treated with low-level nitric oxide (NO) inhalation (ranging from 4 ppm to 1 ppm) for 24 days. Oxygenation was improved and pulmonary hypertension was reduced after NO inhalation, but systemic blood pressure, heart rate, and cardiac output were not affected. PaO2 improved from 153 Torr to 354 Torr under identical ventilating conditions (F1O2 1.0), and mean pulmonary arterial pressure fell from 40 mm Hg to 27 mmHg. It has been reported that NO inhalation alleviates ventilation-flow mismatch and pulmonary hypertension. It is unclear, however, whether this therapy improves the prognosis for ARDS. In our patient, NO inhalation was effective in alleviating the oxygenation impairment and pulmonary hypertension associated with ARDS.

  9. A case report of secondary Budd-Chiari syndrome due to chronic empyema diagnosed by NMR-CT

    International Nuclear Information System (INIS)

    A 34-year-old male patient complained of general fatigue, ascites, and edema of the lower extremities. A chest x-ray film showed atelectasis of the right lung and pleural effusion of the right side. Liver ultrasonography revealed stenosis of the middle and right hepatic veins. Venacavography revealed stenosis of the inferior vena cava and collateral circulation. Finally, abdominal NMR-CT clearly visualized lunate stenosis and antero-lateral deviation of the inferior vena cava. He was diagnosed as having secondary Budd-Chiari syndrome resulting from the deviation and stenosis of the inferior vena cava due to distortion of the surrounding tissues by the thickened pleura which was caused by chronic empyema. (Namekawa, K.)

  10. Tuina Intervention and Sleep and Emotional Disorders due to Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    戴德纯; 房敏; 严隽陶; 姜淑云; 刘鲲鹏

    2009-01-01

    目的:探讨慢性疲劳综合征患者的睡眠障碍和情绪特征及推拿的调节作用.方法:将30例慢性疲劳综合征患者作为治疗组,给予推拿治疗,手法以一指禅推法、滚法和按揉法为主;部位以督脉、膀胱经、阳明经为主,主穴取风府、腰阳关、心俞、脾俞、肝俞、合谷、太溪;隔日治疗1次,共治疗10次.30例正常人为对照组,不予任何处理.借助匹兹堡睡眠质量指数(PSQI)、Hamilton焦虑量表(HAMA)、Hamilton抑郁量表(17项)(HAMD)测量工具评估两组患者的睡眠质量和精神状态,并观察推拿治疗前、后治疗组患者相应量表的积分变化.结果:治疗组治疗前PSQI总分、睡眠质量、入睡时间、睡眠效率、睡眠障碍和日间功能障碍以及HAMD和HAMA积分均显著高于对照组,差异有统计学显著性意义(P<0.01);10次推拿治疗后,治疗组PSQI总分、入睡时间、睡眠障碍和日间功能障碍4项评分及HAMD、HAMA积分有显著变化,与治疗前比较,差异有统计学意义(P<0.05).结论:慢性疲劳综合征患者存在睡眠障碍及精神心理异常;中医推拿可提高慢性疲劳综合征患者睡眠质量,调整异常精神心理状态.%Objective:To study the tuina effect on sleep disorder and emotional problems of chronic fatigue syndrome (CFS) cases.Method:Thirty CFS cases were treated in the treatment group,by applying one-thumb pushing,rolling and pressing-kneading manipulations along the Governor Vessel,Bladder and Yangming Meridians.The intended major points include Fengfu (GV 16),Yaoyangguan (GV 3),Xinshu (BL 15),Pishu (BL 20),Ganshu (BL 18),Hegu (LI 4) and Taixi (KI 3).The treatment was done once every other day;10 times constitute a course of treatment.Another 30 healthy cases were selected in the control group,without any intervention.The sleep quality and mental state in the two groups were evaluated by PSQI,HAMA and HAMD.In addition,the pre-treatment and post-treatment score changes

  11. ARCN1 Mutations Cause a Recognizable Craniofacial Syndrome Due to COPI-Mediated Transport Defects.

    Science.gov (United States)

    Izumi, Kosuke; Brett, Maggie; Nishi, Eriko; Drunat, Séverine; Tan, Ee-Shien; Fujiki, Katsunori; Lebon, Sophie; Cham, Breana; Masuda, Koji; Arakawa, Michiko; Jacquinet, Adeline; Yamazumi, Yusuke; Chen, Shu-Ting; Verloes, Alain; Okada, Yuki; Katou, Yuki; Nakamura, Tomohiko; Akiyama, Tetsu; Gressens, Pierre; Foo, Roger; Passemard, Sandrine; Tan, Ene-Choo; El Ghouzzi, Vincent; Shirahige, Katsuhiko

    2016-08-01

    Cellular homeostasis is maintained by the highly organized cooperation of intracellular trafficking systems, including COPI, COPII, and clathrin complexes. COPI is a coatomer protein complex responsible for intracellular protein transport between the endoplasmic reticulum and the Golgi apparatus. The importance of such intracellular transport mechanisms is underscored by the various disorders, including skeletal disorders such as cranio-lenticulo-sutural dysplasia and osteogenesis imperfect, caused by mutations in the COPII coatomer complex. In this article, we report a clinically recognizable craniofacial disorder characterized by facial dysmorphisms, severe micrognathia, rhizomelic shortening, microcephalic dwarfism, and mild developmental delay due to loss-of-function heterozygous mutations in ARCN1, which encodes the coatomer subunit delta of COPI. ARCN1 mutant cell lines were revealed to have endoplasmic reticulum stress, suggesting the involvement of ER stress response in the pathogenesis of this disorder. Given that ARCN1 deficiency causes defective type I collagen transport, reduction of collagen secretion represents the likely mechanism underlying the skeletal phenotype that characterizes this condition. Our findings demonstrate the importance of COPI-mediated transport in human development, including skeletogenesis and brain growth. PMID:27476655

  12. Design of canals

    CERN Document Server

    Swamee, P K

    2015-01-01

    The book presents firsthand material from the authors on design of hydraulic canals. The book discusses elements of design based on principles of hydraulic flow through canals. It covers optimization of design based on usage requirements and economic constraints. The book includes explicit design equations and design procedures along with design examples for varied cases. With its comprehensive coverage of the principles of hydraulic canal design, this book will prove useful to students, researchers, and practicing engineers. End-of-chapter pedagogical elements make it ideal for use in graduate courses on hydraulic structures offered by most civil engineering departments across the world.

  13. Intermittent Fever, Progressive Weight Gain, and Personality Changes in a Five-Year-Old Girl: Unusual Paraneoplastic Syndrome due to Presacral Ganglioneuroma

    Directory of Open Access Journals (Sweden)

    Chao Yang

    2016-01-01

    Full Text Available Ganglioneuromas are rare tumors in the neuroblastoma group. Paraneoplastic syndrome (PNS due to presacral ganglioneuromas was hardly reported in previous literature. Here, we reported that a case of a 5-year-old girl with a presacral ganglioneuroma presented with PNS, who presented with intermittent fever, progressive weight gain, and personality changes. Our report revealed intermittent fever, progressive weight gain, and personality changes may represent rare paraneoplastic syndromes in ganglioneuromas.

  14. A comparative study of verbal IQ, performance IQ and verbal IQ-performance IQ disparity among Turner syndrome patients and patients with primary amenorrhoea due to other aetiologies

    OpenAIRE

    Rahul Lakshman; Lakshman, Lakshmi R.; Vasudevan, D. M.

    2012-01-01

    Background: Assessing disparity in IQ is important in selecting an occupation and thus helping people lead a productive life. In Turner syndrome patients, this shall be more important as assessment of verbal IQ- and performance IQ disparity could be used in helping them select an occupation so that productivity and quality of life is not grossly compromised. Methods: Based on karyotyping, 30 patients with turner syndrome and 30 patients with primary amenorrhoea due to other aetiologies were s...

  15. Root canal treatment of mandibular second premolar tooth with taurodontism

    Directory of Open Access Journals (Sweden)

    Vujašković Mirjana

    2008-01-01

    Full Text Available INTRODUCTION Taurodontism is a morphoanatomical change in the shape of a tooth. An enlarged body of a tooth with smaller than usual roots is a characteristic feature. Internal tooth anatomy correlates with this appearance, which means that a taurodontal tooth has a large pulp chamber and apically positioned furcations. This dental anomaly may be associated with different syndromes and congenital discoders. CASE OUTLINE The case report presents the patient of a rare case of taurodontism in the mandibular second premolar with chronic periodontitis. Endodontic treatment was performed after dental history and clinical examination. Special care is required in all segments of endodontic treatment of a taurodontal tooth from the identification orifice, canal exploration, determining working length, cleaning and shaping and obturation of the root canal. Precurved K-file was used for canal exploration and location of the furcation. One mesial and one distal canal with the buccal position were identified in the apical third of the root canal. The working lengths of two canals were determined by radiographic interpretation with two K-files in each canal and verified with the apex locator. During canal instrumentation, the third canal was located in the disto-lingual position. The working length of the third canal was established using the apex locator. CONCLUSION Thorough knowledge of tooth anatomy and its variations can lead to lower percentage of endodontic failure. Each clinical case involving these teeth should be investigated carefully, clinically and radiographically to detect additional root canals. High quality radiographs from different angles and proper instrumentarium improve the quality of endodontic procedure.

  16. Inter ventional Mechanism of Tongxieyao Formula on Irritable Bowel Syndrome due to Liver Depression and Spleen Deifciency

    Institute of Scientific and Technical Information of China (English)

    Qian Feng; Bo Ping

    2013-01-01

    Objective:To investigate the efficacy and interventional mechanism of Tongxieyao Formula (TXYF) on rat model with irritable bowel syndrome (IBS) due to liver depression and spleen deifciency. Methods:75 newborn SD rats were randomly divided into groups A, B, C, D and E. Except group A, the rats in other groups were treated with senna and strained stress to establish IBS models due to liver depression and spleen deifciency. Groups A and B were fed with intra-gastric normal saline, group C pinaverium bromide, groups D and E TXYF. After treatment, animals were sacriifced to excise colons, and modiifed toluidine blue staining was applied to observe the changes of colonic mucosal mast cell (MC) count and de-granulation conditions in rats. Then the levels of 5-hydroxytryptamine (5-HT), P substance (SP), calcitonin gene-related peptide (CGRP) in blood samples were detected. Results:The counts of colonic mucosal MC and de-granulation increased signiifcantly in model control group. The levels of 5-HT, SP signiifcantly decreased while CGRP increased in C, D and group Es. Conclusion:TXYF can play its role of improving gastrointestinal mobility and reduce visceral sensitivity so as to treat IBS through reducing the counts of colonic mucosal MC and de-granulation as well as the levels of serum 5-HT and plasma SP, and increasing the level of CGRP in IBS model rats.

  17. Japanese case of Budd-Chiari syndrome due to hepatic vein thrombosis successfully treated with liver transplantation.

    Science.gov (United States)

    Iwasaki, Tomohiro; Kawai, Hirokazu; Oseki, Koushi; Togashi, Tadayuki; Shioji, Kazuhiko; Yamamoto, Satoshi; Sato, Yoshinobu; Suzuki, Kenji; Toba, Ken; Nomoto, Minoru; Hatakeyama, Katsuyoshi; Aoyagi, Yutaka

    2012-02-01

    A 22-year-old Japanese woman was found to have severe esophageal varices and then suffered from hepatic encephalopathy. She was diagnosed with Budd-Chiari syndrome (BCS) due to hepatic vein (HV) thrombosis accompanied by portal vein thrombosis without inferior vena cava (IVC) obstruction. Latent myeloproliferative neoplasm (MPN) lacking the JAK2-V617F mutation was considered to be the underlying disease. Liver transplantation was strikingly effective for treating the clinical symptoms attributable to portal hypertension. Although thrombosis of the internal jugular vein occurred due to thrombocythemia, which manifested after transplantation despite anticoagulation therapy with warfarin, the thrombus immediately disappeared with the addition of aspirin. Neither thrombosis nor BCS has recurred in more than 4 years since the amelioration of the last thrombotic event, and post-transplant immunosuppression with tacrolimus has not accelerated the progression of MPN. In Japan, IVC obstruction, which was a predominant type of BCS, is suggested to have decreased in incidence with recent improvements in hygiene. The precise diagnosis of BCS and causative underlying diseases should be made with attention to the current trend of the disease spectrum, which fluctuates with environmental sanitation levels. Because the stepwise strategy, including liver transplantation, has been proven effective for patients with pure HV obstruction in Western countries, this strategy should also be validated for utilization in Japan and in developing countries where HV obstruction potentially predominates.

  18. Gruber, Gradenigo, Dorello, and Vail: key personalities in the historical evolution and modern-day understanding of Dorello's canal.

    Science.gov (United States)

    Reddy, Renuka K; Reddy, Rohit K; Jyung, Robert W; Eloy, Jean Anderson; Liu, James K

    2016-01-01

    A century ago an ambitious young anatomist in Rome, Primo Dorello, who sought to understand the cause of abducent nerve palsy that often occurred in patients with severe middle ear infections, conducted intricate studies on the intracranial course of the nerve. In his findings, he identified that the abducent nerve passes through a narrow sinus near the apex of the petrous bone, which formed an osteofibrous canal. Dorello suggested that in this enclosed region the abducent nerve may be particularly vulnerable to compression due to the vascular edema accompanying the infection. Although his work was widely appreciated, it was not well received by all. Interestingly, Giuseppe Gradenigo, one of the most prominent Italian otologists of the early 20th century, who was known for his work on a triad of symptoms (Gradenigo's syndrome) that accompanies petrous apicitis, a result of severe middle ear infections, was obstinate in his criticism of Dorello's findings. Thus a scientific duel began, with a series of correspondence between these two academics-one who was relatively new to the otological community (Dorello) and one who was well reputed in that community (Gradenigo). The disagreement ultimately ebbed in 1909, when Dorello published a report in response to Gradenigo's criticisms and convinced Gradenigo to change his views. Today Dorello's canal is widely recognized as a key landmark in skull base surgery of the petroclival region and holds clinical significance due to its relation to the abducent nerve and surrounding vascular structures. Yet, although academics such as Dorello and Gradenigo are recognized for their work on the canal, it is important not to forget the others throughout history who have contributed to the modern-day understanding of this anatomical structure. In fact, although the level of anatomical detail found in Dorello's work was previously unmatched, the first description of the canal was made by the experienced Austrian anatomist Wenzel Leopold

  19. Recombinant Human Erythropoietin Therapy for a Jehovah's Witness Child With Severe Anemia due to Hemolytic-Uremic Syndrome.

    Science.gov (United States)

    Woo, Da Eun; Lee, Jae Min; Kim, Yu Kyung; Park, Yong Hoon

    2016-02-01

    Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening medical conditions due to their religious convictions. These patients require management alternatives to blood transfusions. Erythropoietin is a glycopeptide that enhances endogenous erythropoiesis in the bone marrow. With the availability of recombinant human erythropoietin (rHuEPO), several authors have reported its successful use in patients refusing blood transfusion. However, the optimal dose and duration of treatment with rHuEPO are not established. We report a case of a 2-year-old boy with diarrhea-associated HUS whose family members are Jehovah's Witnesses. He had severe anemia with acute kidney injury. His lowest hemoglobin level was 3.6 g/dL, but his parents refused treatment with packed RBC transfusion due to their religious beliefs. Therefore, we treated him with high-dose rHuEPO (300 IU/kg/day) as well as folic acid, vitamin B12, and intravenous iron. The hemoglobin level increased steadily to 7.4 g/dL after 10 days of treatment and his renal function improved without any complications. To our knowledge, this is the first case of successful rHuEPO treatment in a Jehovah's Witness child with severe anemia due to HUS. PMID:26958070

  20. Segmental overgrowth syndrome due to an activating PIK3CA mutation identified in affected muscle tissue by exome sequencing

    DEFF Research Database (Denmark)

    Rasmussen, Maria; Sunde, Lone; Weigert, Karen Petra;

    2014-01-01

    Mosaic PIK3CA-mutations have been described in an increasing number of overgrowth syndromes. We describe a patient with a previously unreported segmental overgrowth syndrome with the mutation, PIKCA3 c.3140A>G (p.His1047Arg) in affected tissue diagnosed by exome sequencing. This PIK3CA-associated......Mosaic PIK3CA-mutations have been described in an increasing number of overgrowth syndromes. We describe a patient with a previously unreported segmental overgrowth syndrome with the mutation, PIKCA3 c.3140A>G (p.His1047Arg) in affected tissue diagnosed by exome sequencing. This PIK3CA...

  1. A Gut Gone to Pot: A Case of Cannabinoid Hyperemesis Syndrome due to K2, a Synthetic Cannabinoid

    Directory of Open Access Journals (Sweden)

    Anene Ukaigwe

    2014-01-01

    Full Text Available Cannabinoid Hyperemesis Syndrome (CHS was first described in 2004. Due to its novelty, CHS is often unrecognized by clinicians leading to expensive workup of these patients with cyclical symptoms. It may take up to 9 years to diagnose CHS. CHS is characterized by cyclical nausea and vomiting, abdominal pain, and an unusual compulsion to take hot showers in the presence of chronic use of cannabinoids. Cannabicyclohexanol is a synthetic cannabinoid, popularly known as K2 spice. It is a popular marijuana alternative among teenagers and young adults since it is readily available as herbal incense. Unlike marijuana, many users know that K2 is not detected in conventional urine drug screens, allowing those users to conceal their intake from typical detection methods. Serum or urine gas chromatography mass spectrophotometry is diagnostic, though not widely available. Thus, it is imperative for clinicians to recognize CHS, even with negative UDS, to provide cost-effective care. We present a 38-year-old man with a 10-year history of cannabis, and 1-year history of K2 abuse admitted with 1-week history of episodes of nausea, vomiting of clear fluids, and epigastric discomfort. Symptoms are relieved only by hot showers. Extensive laboratory, radiologic, and endoscopic evaluation was unrevealing. CHS was diagnosed, based on proposed criteria by Simonetti et al.

  2. Case Report of Neurological Sequelae and Bilateral Optic Atrophy Developed Due to Tuberculosis Meningitis Treatment - A Rare Clinical Syndrome

    Directory of Open Access Journals (Sweden)

    M. Prasamse

    2016-06-01

    Full Text Available Tuberculosis meningitis (TBM is common CNS infection associated with neurologic sequelae and mortality if untreated. Recommended treatment regimen consists; two months of daily Isoniazide (INH, Rifampin (RIF, Pyrazinamide (PZA and either Streptomycin (SM or Ethambutol (EMB followed by 7–10 months of INH and RIF. Optic atrophy as neurologic complication may develop in TBM patients with anti TB therapy. Infection and/or drugs can be an etiologic factor also. In this case patient was diagnosed with TBM at the age of three years and was on anti TB drugs. At the age of four years he was completely cured from TBM but developed seizure as neurologic sequelae. Provisionally, child was diagnosed as known case of TBM with seizures and visual defect. Ophthalmologist revealed; bilateral optic atrophy and Neurophysician confirmed as Neurological sequelae and bilateral optic atrophy developed due to TBM treatment. A thorough patient history including past medication history is a clinical pearl to identify such rare clinical complication. In this case optic atrophy and neurological sequelae was confirmed only after thorough history and evaluation by various specialists. Not only confirmation of rare clinical syndrome is important, also identification of possible etiology and appropriate management is required for better management. Clinical pharmacists play a crucial role even in identification and reporting of such rare clinical condition as a part of health care system to create awareness among others.

  3. Cutaneous reactions simulating erythema multiforme and Stevens Johnson syndrome due to occupational exposure to a plant-growth regulator

    Directory of Open Access Journals (Sweden)

    Inamadar Arun

    2007-01-01

    Full Text Available Background: In India, hydrogen cyanamide (Dormex ® is a plant growth regulator used mainly for the bud-breaking of grapevines. The use of this chemical may result in severe cutaneous reactions simulating erythema multiforme (EM, Stevens-Johnson syndrome (SJS and toxic epidermal necrolysis (TEN. Methods: Studies were conducted on four seasonal grapevine workers who developed severe cutaneous reactions following the unprotected use of Dormex ® (hydrogen cyanamide. Results: Two of the patients had EM-like skin lesions and the other two developed SJS-TEN-like skin lesions. A latent period of 5-7 days existed between the contact with the chemical and the development of the skin lesions. The histopathological picture was suggestive of EM. All the patients responded to systemic steroids and antihistamines. Conclusions: Hydrogen cyanamide may act as a hapten, initiating cytotoxic immunological attack on keratinocytes, resulting in EM- and SJS-TEN-like clinical picture. Awareness regarding such severe cutaneous reactions due to the inappropriate handling of Dormex ® is required. The use of personal protection equipments while handling agricultural chemicals is essential.

  4. Endodontic Treatment of a Mandibular Second Premolar with Three Roots and Three Canals

    Directory of Open Access Journals (Sweden)

    Bonny Paul

    2014-01-01

    Full Text Available Complex root canal system with atypical variations is a common finding among mandibular premolars. Endodontic treatment in these teeth may not be successful due to the failure to recognise and treat multiple canals. This paper presents endodontic treatment of a mandibular second premolar with three roots and three canals.

  5. [Survival by a young woman with malnutrition due to alcoholism and eating disorders and with acute respiratory distress syndrome due to severe pneumonia who showed increased serum neutrophil elastase activity].

    Science.gov (United States)

    Nakajima, Hirokazu; Sawaguchi, Hirochiyo; Nakajima, Shigenori

    2006-11-01

    A 30-year-old woman with malnutrition due to alcoholism and eating disorders was found to have acute respiratory distress syndrome (ARDS) and sepsis due to severe Streptococcus pneumoniae pneumonia. S. pneumoniae was detected by an in vitro rapid immunochromatographic assay for S. pneumoniae antigen in urine on the day of admission and by blood culture 2 days after admission. Symptoms and laboratory findings improved after treatment with sivelestat sodium hydrate, antibiotics, and mechanical ventilation. Treatment with sivelestat sodium hydrate also decreased serum neutrophil elastase activity. This case demonstrates the usefulness of early treatment with sivelestat sodium hydrate in ARDS due to severe pneumonia.

  6. Morphometric analysis of the cervical spinal canal on MRI.

    Science.gov (United States)

    Matveeva, Niki; Janevski, Petar; Nakeva, Natasha; Zhivadinovik, Julija; Dodevski, Ace

    2013-01-01

    Two useful numerical values, called the Torg ratio and the spinal canal diameter (SC diameter) are widely accepted as reliable morphometric determinants of spinal stenosis. The aims of the study were to examine morphometric determinants of the cervical spinal canal on MRI in both sexes and analyse them as reliable indicators of spinal stenosis. Measurements were made on 50 MR images (sagittal T2 weighted images from C3 to C7) of the cervical spine of patients from the Emergency Centre who had undertaken MRI of the cervical spine in addition to CT for various diagnostic indications. Torg ratio, used in evaluation of the spinal canal stenosis on plain x-ray radiographs, cannot be used as a spinal canal stenosis indicator due to the gender differences in the vertebral bodies' width. Sagittal canal diameters were more spread out in males than in females. MRI enables the value of the space available for the spinal cord, (SAC) to be determined, by subtracting the sagittal diameter of the spinal cord from the sagittal diameter of the spinal canal. Not gender, but individual and level differences in the SAC values were evident (cervical cord enlargement). SAC values relied more on the spinal canal than on the spinal cord, so that the differences in the dimensions of the spinal cord accounted for less variability in the SAC values. MR imaging of the cervical spine provides more accurate cervical canal and spinal cord measurements that could serve as morphometric determinants of the cervical canal stenosis. PMID:24280784

  7. Canals, River Irrigation Company Canal, Published in 2002, Duchesne County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Canals dataset, was produced all or in part from Other information as of 2002. It is described as 'River Irrigation Company Canal'. Data by this publisher are...

  8. Canals, Lake Canal, Published in 2002, Duchesne County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Canals dataset, was produced all or in part from Other information as of 2002. It is described as 'Lake Canal'. Data by this publisher are often provided in...

  9. Canals, Yellowstone Feeder Canal, Published in 2002, Duchesne County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Canals dataset, was produced all or in part from Other information as of 2002. It is described as 'Yellowstone Feeder Canal'. Data by this publisher are often...

  10. Canals, Bypass Canal, Published in 2002, Duchesne County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Canals dataset, was produced all or in part from Other information as of 2002. It is described as 'Bypass Canal'. Data by this publisher are often provided in...

  11. Thalidomide for treatment of gastrointestinal bleedings due to angiodysplasia : a case report in acquired von Willebrand syndrome and review of the literature

    NARCIS (Netherlands)

    Engelen, E T; van Galen, K P M; Schutgens, R E G

    2015-01-01

    INTRODUCTION: Acquired von Willebrand syndrome is a rare bleeding disorder and treatment of the associated gastrointestinal (GI) bleeding due to angiodysplasia is challenging. AIM: The aim of this study was to present a new case on the successful use of thalidomide in a patient with acquired von Wil

  12. Ear canal cholesteatoma.

    Science.gov (United States)

    Holt, J J

    1992-06-01

    Although cholesteatomas are more commonly found in the middle ear and the mastoid, the disease can occur in the external ear canal. All cases of ear canal cholesteatoma treated by the author were reviewed. There were nine ears in seven patients, who had an average age of 62 years. The lesions ranged in size from a few millimeters to extensive mastoid destruction. Smaller lesions can be managed by frequent cleaning as an office procedure. Larger lesions require surgery, either canaloplasty or mastoidectomy. The otolaryngologist should suspect this disease in the elderly. Microscopic examination of the ear with meticulous cleaning of all wax, especially in elderly patients, is most useful in detecting early disease. Frequent applications of mineral oil to the canal should be used in the management of the disease and to prevent recurrence. PMID:1376388

  13. Sevelamer is an Effective Drug in Treating Hyperphosphatemia Due to Tumor Lysis Syndrome in Children: A Developing World Experience.

    Science.gov (United States)

    Kahlon, Dilraj Kaur; Dinand, Veronique; Yadav, Satya Prakash; Sachdeva, Anupam

    2016-03-01

    We report here a study on efficacy of sevelamer hydrochloride in treating hyperphosphatemia due to tumor lysis syndrome (TLS) in a developing world setting. Twenty one children with hyperphosphatemia due to TLS were included. All received hyper-hydration, allopurinol and sevelamer. Efficacy was assessed by decrease in serum phosphate level, calcium-phosphate product and TLS score as per Cairo Bishop definition. Four children who underwent dialysis were excluded from analysis. Among the remaining 17 patients with hyperphosphatemia, laboratory TLS was recorded in 15 patients and clinical TLS in five. Sevelamer was given according to weight, most often 400 mg twice to thrice daily. Mean phosphatemia decreased from 8.3 ± 3.0 to 6.7 ± 2.1 mg/dl within 24 h of starting sevelamer (p = 0.02), 6.0 ± 2.1 mg/dl at 48 h, 4.9 ± 1.5 mg/dl at 72 h and 4.39 ± 1.7 mg/dl at 96 h. TLS was corrected in 72 h in 14 patients, 96 h in 1 and 120 h in another patient. Mean calcium-phosphate product decreased from 63.0 ± 14.0 to 49.2 ± 9.7 mg/dl (p = 0.002) at 24 h, 46.1 ± 17.0 mg/dl at 48 h and 39.7 ± 13.5 mg/dl at 72 h. There was no mortality due to hyperphosphatemia. Sevelamer is efficacious in children with malignancy-associated hyperphosphatemia in the developing world. PMID:26855510

  14. Single-Session CT-Guided Percutaneous Microwave Ablation of Bilateral Adrenal Gland Hyperplasia Due to Ectopic ACTH Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Sarma, Asha, E-mail: ashasarma@gmail.com; Shyn, Paul B., E-mail: pshyn@partners.org [Brigham and Women’s Hospital, Department of Radiology (United States); Vivian, Mark A. [University of Manitoba, Department of Radiology (Canada); Ng, Ju-Mei [Brigham and Women’s Hospital, Department of Anesthesiology (United States); Tuncali, Kemal [Brigham and Women’s Hospital, Department of Radiology (United States); Lorch, Jorchen H. [Dana Farber Cancer Institute, Department of Medicine (United States); Zaheer, Sarah N.; Gordon, Michael S. [Brigham and Women’s Hospital, Department of Endocrinology (United States); Silverman, Stuart G. [Brigham and Women’s Hospital, Department of Radiology (United States)

    2015-10-15

    Bilateral adrenalectomy is currently the only available treatment for adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome (ectopic ACTH syndrome) that is refractory to pharmacologic therapy. We describe two patients with refractory ectopic ACTH syndrome who were treated with CT-guided percutaneous microwave ablation of both hyperplastic adrenal glands in a single session: One was not a surgical candidate, and the other had undergone unsuccessful surgery. Following the procedure, both patients achieved substantial decreases in serum cortisol, symptomatic improvement, and decreased anti-hypertensive medication requirements.

  15. Single-Session CT-Guided Percutaneous Microwave Ablation of Bilateral Adrenal Gland Hyperplasia Due to Ectopic ACTH Syndrome.

    Science.gov (United States)

    Sarma, Asha; Shyn, Paul B; Vivian, Mark A; Ng, Ju-Mei; Tuncali, Kemal; Lorch, Jorchen H; Zaheer, Sarah N; Gordon, Michael S; Silverman, Stuart G

    2015-10-01

    Bilateral adrenalectomy is currently the only available treatment for adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (ectopic ACTH syndrome) that is refractory to pharmacologic therapy. We describe two patients with refractory ectopic ACTH syndrome who were treated with CT-guided percutaneous microwave ablation of both hyperplastic adrenal glands in a single session: O ne was not a surgical candidate, and the other had undergone unsuccessful surgery. Following the procedure, both patients achieved substantial decreases in serum cortisol, symptomatic improvement, and decreased anti-hypertensive medication requirements.

  16. Behavioral features of CHARGE syndrome (Hall-Hittner syndrome) comparison with Down syndrome, Prader-Willi syndrome, and Williams syndrome.

    Science.gov (United States)

    Graham, John M; Rosner, Beth; Dykens, Elisabeth; Visootsak, Jeannie

    2005-03-15

    CHARGE syndrome, or Hall-Hitner syndrome (HHS), has been delineated as a common syndrome that includes coloboma, choanal atresia, cranial nerve dysfunction (particularly asymmetric facial palsy and neurogenic swallowing problems), characteristic ear abnormalities, deafness with hypoplasia of the cochlea and semicircular canals, genital hypoplasia, and variable heart defects, orofacial clefting, tracheo-esophageal fistula, renal anomalies, thymic/parathyroid hypoplasia, spine anomalies, short broad neck with sloping shoulders, and characteristic facial features. We conducted behavioral and personality assessments in 14 boys with HHS syndrome aged 6-21 years, and compared their characteristics with similar data from 20 age-matched boys with Down syndrome (DS), 17 boys with Prader-Willi syndrome (PWS), and 16 boys with Williams syndrome (WS). We used the Reiss Profile of Fundamental Goals and Motivation Sensitivities, the Achenbach Child Behavior Checklist (CBCL), and the Aberrant Behavior Checklist (ABC). All 14 boys with HHS were legally deaf, and 10 of the 14 were also legally blind. In comparison these other syndromes, boys with HHS had behavior that resembled autistic spectrum disorder. They were socially withdrawn, lacked interest in social contact, and manifested reduced seeking of attention from others, with hyperactivity and a need to maintain order. Though the boys with HHS showed decreased social interaction, they were not as socially impaired as in classic autism. Their language was delayed due to dual sensory impairment, cranial nerve deficits, and chronic medical problems, but their language style was not abnormal (no echolalia or jargon, no scripted phrases, and no pronoun reversal). Boys with HSS appeared frustrated, but they were not aggressive, or at risk for delinquency, manifesting few stereotypic behaviors or unusual preoccupations. They did not have a restricted repertoire of activities and interests. Their behavioral features appeared to be due

  17. Delayed diagnosis in a house of correction: Smith-Magenis syndrome due to a de novo nonsense RAI1 variant.

    Science.gov (United States)

    Yeetong, Patra; Vilboux, Thierry; Ciccone, Carla; Boulier, Kristin; Schnur, Rhonda E; Gahl, William A; Huizing, Marjan; Laje, Gonzalo; Smith, Ann C M

    2016-09-01

    We report a 25-year-old female confirmed to have Smith-Magenis syndrome (SMS) due to a de novo RAI1 variant. Her past history is significant for developmental and intellectual delay, early and escalating maladaptive behaviors, and features consistent with significant sleep disturbance, the etiology of which was not confirmed for over two decades. The diagnosis of SMS was initially suspected in 1998 (at age 12 years), but that was 5 years before the initial report of RAI1 variants as causative of the SMS phenotype; cytogenetic fluorescence in situ hybridization studies failed to confirm an interstitial deletion of 17p11.2. Re-evaluation for suspected SMS was pursued with RAI1 sequencing analysis in response to urgent parental concerns of escalating behaviors and aggression with subsequent incarceration of the subject for assault of a health professional. Genetic analysis revealed a de novo RAI1 (NM_030665.3) nonsense variant, c.5536C>T; p.Q1846X. This case illustrates the importance of confirming the SMS diagnosis, which is associated with cognitive and functional impairment, as well as significant psychiatric co-morbidities and behavioral problems. The diagnosis was particularly relevant to the legal discussion and determination of her competence to stand trial. As other similar cases may exist, this report will help to increase awareness of the possibility of a very late diagnosis of SMS, with the need for re-evaluation of individuals suspected to have SMS who were initially evaluated prior to the identification of the RAI1 gene. © 2016 Wiley Periodicals, Inc. PMID:27311559

  18. Ramsay Hunt syndrome and zoster laryngitis with multiple cranial nerve involvement.

    Science.gov (United States)

    Shinha, Takashi; Krishna, Pasala

    2015-01-01

    Ramsay Hunt syndrome is characterized by varicella zoster virus infection affecting the geniculate ganglion of the facial nerve. It typically presents with vesicles in the external auditory canal associated with auricular pain and peripheral facial nerve paralysis. Although vestibulocochlear nerve is frequently co-involved during the course of Ramsay Hunt syndrome, multiple lower cranial nerve involvement has rarely been described in the literature. In addition, laryngitis due to varicella zoster virus is a diagnostic challenge due to its unfamiliarity among clinicians. We report a case of Ramsay Hunt syndrome with laryngitis involving multiple lower cranial nerves.

  19. Ramsay Hunt syndrome and zoster laryngitis with multiple cranial nerve involvement

    Directory of Open Access Journals (Sweden)

    Takashi Shinha

    2015-01-01

    Full Text Available Ramsay Hunt syndrome is characterized by varicella zoster virus infection affecting the geniculate ganglion of the facial nerve. It typically presents with vesicles in the external auditory canal associated with auricular pain and peripheral facial nerve paralysis. Although vestibulocochlear nerve is frequently co-involved during the course of Ramsay Hunt syndrome, multiple lower cranial nerve involvement has rarely been described in the literature. In addition, laryngitis due to varicella zoster virus is a diagnostic challenge due to its unfamiliarity among clinicians. We report a case of Ramsay Hunt syndrome with laryngitis involving multiple lower cranial nerves.

  20. Papular-purpuric "gloves and socks" syndrome due to parvovirus B19: report of a case with unusual features

    Directory of Open Access Journals (Sweden)

    PASSONI Luiz Fernando C.

    2001-01-01

    Full Text Available We present a case of papular-purpuric "gloves and socks" syndrome (PPGSS in an adult male with acute parvovirus B19 infection. The patient displayed the classical features of fever, oral lesions, and purpura on hands and feet, but the purpuric lesions on the feet evolved to superficial skin necrosis, a feature not previously described in this syndrome. We believe this is the first reported case of PPGSS occurring in Brazil.

  1. Hyponatremia in aneurysmal subarachnoid hemorrhage is due to the syndrome of inappropriate antidiuresis and acute glucocorticoid deficiency

    LENUS (Irish Health Repository)

    Hannon, M J

    2011-06-01

    Hyponatraemia is the most common electrolyte abnormality following subarachnoid haemorrhage (SAH) and contributes to increased morbidity and mortality. Retrospective data suggests that the syndrome of inappropriate diuresis (SIAD) is the most common cause of hyponatraemia in SAH, though cerebral salt wasting has been postulated by some workers to be the predominant abnormality. Data which has shown acute glucocorticoid deficiency following SAH has suggested that some cases of euvolaemic hyponatraemia may also be caused by this mechanism.We prospectively studied the hormonal and haemodynamic influences involved in the development of hyponatraemia in 100 patients (61% female, median age 53 (range 16-82)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium (pNa), urea, osmolality, glucose and 0900h cortisol (PC), and urinary sodium and osmolality measured on days 1, 2, 3, 4, 6, 8, 10 and 12 following SAH. Fluid balance and haemodynamic parameters were recorded daily. Results were compared with 15 patients admitted to ITU following vascular surgery. A PC<300nmol\\/L in a patient in ITU was regarded clinically as inappropriately low.49% of patients developed hyponatraemia (pNa<135 mmol\\/L), including 14% who developed clinically significantly hyponatraemia (pNa<130 mmol\\/L). 36\\/49 (73.4%) developed hyponatraemia between days 1 and 3 post SAH. The median duration of hyponatraemia was 3 days (range 1–10 days).In 35\\/49 (71.4%), hyponatraemia was due to SIAD as defined by standard diagnostic criteria. 14% of SAH patients had at least one PC<300nmol\\/L; 5 of these (35.7%) developed hyponatraemia. In 4 patients hyponatraemia was preceded by acute cortisol deficiency and responded to hydrocortisone treatment. In contrast, all controls had PC>500 nmol\\/L on day 1, and >300 nmol on days 3–12. There were no cases of cerebral salt wasting. There was no relationship between the incidence of hyponatraemia and the defined anatomical territory or severity of

  2. A Clinical Update on the Different Methods to Decrease the Occurrence of Missed Root Canals

    Science.gov (United States)

    Mohammadi, Zahed; Asgary, Saeed; Shalavi, Sousan; V. Abbott, Paul

    2016-01-01

    One of the main causes of endodontic treatment failure is the clinician’s inability to localize all the root canals. Due to the complex anatomy of the root canal system, missed canals are not uncommon. There are several strategies to decrease the possibility of missed root canals starting with good pre-operative radiographies. In order to overcome the limitations of conventional radiographies, cone-beam computed tomography (CBCT) can be considered. A correct access cavity preparation is of pivotal importance in localizing the orifices of the root canals. Furthermore, ultrasonics are very important devices to find missed canals. Increasing magnification and illumination enhance the possibility of finding all root canals during root canal treatment. The purpose of the present paper was to review all of the above techniques and devices. PMID:27471533

  3. A maxillary central incisor with four root canals

    Directory of Open Access Journals (Sweden)

    Fábio de Almeida-Gomes

    2012-01-01

    Full Text Available The objective of the present study is to present a case report of endodontic treatment of a maxillary central incisor with 1 root and 4 root canals. The success of endodontic treatment requires knowledge of dental anatomy and its variations. This clinical article reports an unusual anatomy detected in a maxillary central incisor with 4 root canals with an associated periapical lesion. The incidence of 4 root canals in this tooth is rare. However, it must be taken into consideration, the clinical and radiographic evaluations during the endodontic treatment in order to enhance the diagnostic. Many times, the presence of a supernumerary canal is noticed only after canal treatment due to continuing post-operative discomfort or treatment failure.

  4. MANAGEMENT OF LUMBAR SPINAL CANAL STENOSIS

    Directory of Open Access Journals (Sweden)

    Mukhergee G. S

    2016-06-01

    Full Text Available BACKGROUND Spinal stenosis is one of the most common conditions in the elderly. It is defined as a narrowing of the spinal canal. The term stenosis is derived from the Greek word for narrow, which is “Stenos”. The first description of this condition is attributed to Antoine portal in 1803. Verbiest is credited with coining the term spinal stenosis and the associated narrowing of the spinal canal as its potential cause. [1-10] Kirkaldy–Willis subsequently described the degenerative cascade in the lumbar spine as the cause for the altered anatomy and pathophysiology in spinal stenosis. [11-15] If compression does not occur, the canal should be described as narrow but not stenotic. Some studies defined lumbar spinal stenosis as a “narrowing of the osteoligamentous vertebral canal and/or the intervertebral foramina causing compression of the thecal sac and/or the caudal nerve roots; at a single vertebral level, narrowing may affect the whole canal or part of it” (Postacchini 1983. This definition distinguished between disc herniation and stenosis. [16] . The most common type of spinal stenosis is caused by degenerative arthritis of the spine. Hypertrophy and ossification of the posterior longitudinal ligament which usually are confined to the cervical spine, and diffuse idiopathic skeletal hyperostosis (DISH syndrome also may result in an acquired form of spinal stenosis. Congenital forms caused by disorders such as achondroplasia and dysplastic spondylolisthesis are much less common. Congenital spinal stenosis usually is central and is evident or imaging studies. Idiopathic congenital narrowing usually involves the anteroposterior dimension of the canal secondary to short pedicles; the patient otherwise is normal. In contrast, in achondroplasia, the canal is narrowed in the anteroposterior plane owing to shortened pedicles and in lateral dimension because of diminished interpedicular distance. Acquired forms of spinal stenosis usually are

  5. Endogenous Cushing's Syndrome with Precocious Puberty in an 8-Year-Old Boy due to a Large Unilateral Adrenal Adenoma

    Science.gov (United States)

    Hossain, Muhammad Rajib; Alam, Md. Mashiul; Nabi, Junaid; Kibria, Mahzabin

    2013-01-01

    Adrenocortical tumors (ACTs) causing Cushing's syndrome are extremely rare in children and adolescents. Bilateral macronodular adrenocortical disease which is a component of the McCune-Albright syndrome is the most common cause of endogenous Cushing's syndrome. We report the case of a boy with Cushing's syndrome who presented with obesity and growth retardation. The child was hypertensive. The biochemical evaluation revealed that his serum cortisol levels were 25.80 μg/dL, with a concomitant plasma ACTH level of 10.0 pg/mL and nonsuppressed serum cortisol on high-dose dexamethasone suppression test (HDDST) to be 20.38 μg/dL. Computed tomography of the abdomen demonstrated a 8 × 6 × 5 cm left adrenal mass with internal calcifications. Following preoperative stabilization, laparotomy was carried out which revealed a lobulated left adrenal mass with intact capsule weighing 120 grams. Histopathological examination revealed a benign cortical neoplastic lesion, suggestive of adrenal adenoma; composed of large polygonal cells with centrally placed nuclei and prominent nucleoli without capsular and vascular invasion. On the seventh postoperative day, cortisol levels were within normal range indicating biochemical remission of Cushing's syndrome. On followup after three months, the patient showed significant clinical improvement and had lost moderate amount of weight and adrenal imaging was found to be normal. PMID:23533838

  6. NAA10 mutation causing a novel intellectual disability syndrome with Long QT due to N-terminal acetyltransferase impairment

    Science.gov (United States)

    Casey, Jillian P.; Støve, Svein I.; McGorrian, Catherine; Galvin, Joseph; Blenski, Marina; Dunne, Aimee; Ennis, Sean; Brett, Francesca; King, Mary D.; Arnesen, Thomas; Lynch, Sally Ann

    2015-01-01

    We report two brothers from a non-consanguineous Irish family presenting with a novel syndrome characterised by intellectual disability, facial dysmorphism, scoliosis and long QT. Their mother has a milder phenotype including long QT. X-linked inheritance was suspected. Whole exome sequencing identified a novel missense variant (c.128 A > C; p.Tyr43Ser) in NAA10 (X chromosome) as the cause of the family’s disorder. Sanger sequencing confirmed that the mutation arose de novo in the carrier mother. NAA10 encodes the catalytic subunit of the major human N-terminal acetylation complex NatA. In vitro assays for the p.Tyr43Ser mutant enzyme showed a significant decrease in catalytic activity and reduced stability compared to wild-type Naa10 protein. NAA10 has previously been associated with Ogden syndrome, Lenz microphthalmia syndrome and non-syndromic developmental delay. Our findings expand the clinical spectrum of NAA10 and suggest that the proposed correlation between mutant Naa10 enzyme activity and phenotype severity is more complex than anticipated; the p.Tyr43Ser mutant enzyme has less catalytic activity than the p.Ser37Pro mutant associated with lethal Ogden syndrome but results in a milder phenotype. Importantly, we highlight the need for cardiac assessment in males and females with NAA10 variants as both patients and carriers can have long QT. PMID:26522270

  7. Curved canals: Ancestral files revisited

    Directory of Open Access Journals (Sweden)

    Jain Nidhi

    2008-01-01

    Full Text Available The aim of this article is to provide an insight into different techniques of cleaning and shaping of curved root canals with hand instruments. Although a plethora of root canal instruments like ProFile, ProTaper, LightSpeed ® etc dominate the current scenario, the inexpensive conventional root canal hand files such as K-files and flexible files can be used to get optimum results when handled meticulously. Special emphasis has been put on the modifications in biomechanical canal preparation in a variety of curved canal cases. This article compiles a series of clinical cases of root canals with curvatures in the middle and apical third and with S-shaped curvatures that were successfully completed by employing only conventional root canal hand instruments.

  8. Jacobsen Syndrome: Surgical Complications due to Unsuspected Diagnosis, the Importance of Molecular Studies in Patients with Craniosynostosis

    Science.gov (United States)

    Linares Chávez, Etzalli P.; Toral López, Jaime; Valdés Miranda, Juan M.; González Huerta, Luz M.; Perez Cabrera, Adrian; del Refugio Rivera Vega, María; Messina Baas, Olga M.; Cuevas-Covarrubias, Sergio A.

    2016-01-01

    Jacobsen syndrome (JBS) is an uncommon contiguous gene syndrome. About 85-92% of cases have a de novo origin. Clinical variability and severity probably depend on the size of the affected region. The typical clinical features in JBS include intellectual disability, growth retardation, craniofacial dysmorphism as well as craniosynostosis, congenital heart disease, and platelet abnormalities. The proband was a 1 year/3-month-old Mexican male. Oligonucleotide-SNP array analysis using the GeneChip Human Cytoscan HD was carried out for the patient from genomic DNA. The SNP array showed a 14.2-Mb deletion in chromosome 11q23.3q25 (120,706-134,938 Mb), which involved 163 RefSeq genes in the database of genomic variation. We report a novel deletion in JBS that increases the knowledge of the variability in the mutation sites in this region and expands the spectrum of molecular and clinical defects in this syndrome. PMID:26997943

  9. The connective tissue of the adductor canal--a morphological study in fetal and adult specimens.

    Science.gov (United States)

    de Oliveira, Flavia; de Vasconcellos Fontes, Ricardo Bragança; da Silva Baptista, Josemberg; Mayer, William Paganini; de Campos Boldrini, Silvia; Liberti, Edson Aparecido

    2009-03-01

    The adductor canal is a conical or pyramid-shaped pathway that contains the femoral vessels, saphenous nerve and a varying amount of fibrous tissue. It is involved in adductor canal syndrome, a claudication syndrome involving young individuals. Our objective was to study modifications induced by aging on the connective tissue and to correlate them to the proposed pathophysiological mechanism. The bilateral adductor canals and femoral vessels of four adult and five fetal specimens were removed en bloc and analyzed. Sections 12 microm thick were obtained and the connective tissue studied with Sirius Red, Verhoeff, Weigert and Azo stains. Scanning electron microscopy (SEM) photomicrographs of the surfaces of each adductor canal were also analyzed. Findings were homogeneous inside each group. The connective tissue of the canal was continuous with the outer layer of the vessels in both groups. The pattern of concentric, thick collagen type I bundles in fetal specimens was replaced by a diffuse network of compact collagen bundles with several transversal fibers and an impressive content of collagen III fibers. Elastic fibers in adults were not concentrated in the thick bundles but dispersed in line with the transversal fiber system. A dynamic compression mechanism with or without an evident constricting fibrous band has been proposed previously for adductor canal syndrome, possibly involving the connective tissue inside the canal. The vessels may not slide freely during movement. These age-related modifications in normal individuals may represent necessary conditions for this syndrome to develop.

  10. [Congenital ectropion of the upper eyelids due to an anomaly of the eyelids in down's syndrome (author's transl)].

    Science.gov (United States)

    Hennighausen, U; Schmidt-Martens, F W; Reim, M

    1978-05-01

    A 5-months-old female baby with Down's Syndrome developed an intermittent spastic ectropion of the upper eyelids. The reasons for this are thought to be the flaccidity of the connective tissue, which is typical in Down's Syndrome, and a little anomaly of the eyelids, the tarsus was too short horizontally and very weak and the upper eyelids were somewhat larger than normal and elongated. Suturing Bangerter's lid-sheets on the upper eyelids for 15 days resulted in a scarring of the tarsus with the lax connective tissue of the upper eyelids. The ectropion disappeared and did not recur.

  11. Chronic inflammatory demyelinating polyneuropathy mimicking a lumbar spinal stenosis syndrome.

    OpenAIRE

    Ginsberg, L; Platts, A. D.; Thomas, P K

    1995-01-01

    A patient with chronic inflammatory demyelinating polyneuropathy (CIDP) established by biopsy developed cauda equina symptoms due to swelling of the nerve roots in the lumbar spinal canal. Magnetic resonance imaging of the lumbar spine showed profoundly thickened nerve roots from the level of the conus medullaris, filling the caudal thecal sac. Immunosuppressant treatment produced partial clinical and radiological resolution. This case shows that spinal compressive syndromes may occur in acqu...

  12. Hypotension due to Chemotherapy in a Patient with Small Cell Lung Cancer and Lambert-Eaton Myasthenic Syndrome Undergoing Hemodialysis: A First Case Report

    Directory of Open Access Journals (Sweden)

    Taiji Kuwata

    2012-01-01

    Full Text Available We present the first case of small cell lung cancer with Lambert-Eaton myasthenic syndrome during hemodialysis (HD. A 72-year-old male patient receiving HD experienced progressive muscle weakness. He was diagnosed with small cell lung cancer with Lambert-Eaton myasthenic syndrome due to an increased serum level of anti-voltage-gated calcium channel antibody and aspiration cytology on endobronchial ultrasonography for the swelling of a subcarinal lymph node. He received chemotherapy consisting of carboplatin (300 mg/m2 and etoposide (50 mg/m2, to which he had a partial response. However, the second therapy course could not be administered because of the unexpected development of severe hematological adverse events, which also prevented him from undergoing further HD. This case indicates that caution should be taken when using chemotherapy for such patients because of hypotension due to chemotherapy, with which it is impossible to undergo HD.

  13. Sjögren-Larsson syndrome. Impaired fatty alcohol oxidation in cultured fibroblasts due to deficient fatty alcohol:nicotinamide adenine dinucleotide oxidoreductase activity.

    OpenAIRE

    Rizzo, W B; Dammann, A L; Craft, D A

    1988-01-01

    Lipid metabolism was studied in cultured skin fibroblasts from patients with the inherited disorder, Sjögren-Larsson syndrome (SLS). Intact SLS fibroblasts incubated in the presence of [1-14C]palmitate accumulated more radioactive hexadecanol than did normal cells, whereas incorporation of radioactivity into other cellular lipids was unaltered. The hexadecanol content of SLS fibroblasts was abnormally elevated. Hexadecanol accumulation was not due to increased fatty alcohol synthesis nor its ...

  14. Posttraumatic stress due to an acute coronary syndrome increases risk of 42-month major adverse cardiac events and all-cause mortality

    OpenAIRE

    Edmondson, Donald; Rieckmann, Nina; Shaffer, Jonathan A.; Joseph E Schwartz; Burg, Matthew M.; Davidson, Karina W.; Clemow, Lynn; Shimbo, Daichi; Kronish, Ian M.

    2011-01-01

    Approximately 15% of patients with acute coronary syndromes (ACS) develop posttraumatic stress disorder (PTSD) due to their ACS event. We assessed whether ACS-induced PTSD symptoms increase risk for major adverse cardiac events (MACE) and all-cause mortality (ACM) in an observational cohort study of 247 patients (aged 25–93 years; 45% women) hospitalized for an ACS at one of 3 academic medical centers in New York and Connecticut between November 2003 and June 2005. Within 1 week of admission,...

  15. Managing curved canals

    Directory of Open Access Journals (Sweden)

    Iram Ansari

    2012-01-01

    Full Text Available Dilaceration is the result of a developmental anomaly in which there has been an abrupt change in the axial inclination between the crown and the root of a tooth. Dilaceration can be seen in both the permanent and deciduous dentitions, and is more commonly found in posterior teeth and in maxilla. Periapical radiographs are the most appropriate way to diagnose the presence of root dilacerations. The controlled regularly tapered preparation of the curved canals is the ultimate challenge in endodontics. Careful and meticulous technique will yield a safe and sufficient enlargement of the curved canals. This article gives a review of the literature and three interesting case reports of root dilacerations.

  16. ACTH overexpressing pituitary hyperplasia in a patient with ectopic ACTH-syndrome due to carcinoid of the lung

    Directory of Open Access Journals (Sweden)

    Larisa Konstantinovna Dzeranova

    2015-01-01

    Full Text Available Ectopic ACTH-syndrome is the most diagnostically challenging  variant of endogenous hypercortisolism. Particularly difficult differential diagnosis of this syndrome is from Cushing's disease (CD, as currently there is no single test sufficiently accurate to differentiate accurately ectopic ACTH production from the pituitary. The main functional tests are based on the fact that the vast majority of ectopic ACTH production is autonomous and suppresses one from pituitary. But in some cases this is not observed, and then the data obtained all necessary laboratory and instrumental research evidence in favor of central genesis of CD in a patient with ACTH ectopic secretion, which can lead to inappropriate treatment. If you confirm the ectopic ACTH-syndrome, it may take quite a long time of searching for the pathological focus, as there is no sufficiently precise imaging and diagnostic method for determining the localization of ectopic source of ACTH production. Thus, the differential diagnosis of ACTH-dependent hypercortisolism and localization of the ectopic tumor is the cornerstone of early and radical treatment of patients. We present a difficult clinical case of a patient having a pituitary hyperplasia with excessive ACTH expression with primary ectopic ACTH syndrome caused by lung carcinoid.

  17. Immunodeficiency, Centromeric instability, Facial anomalies (ICF) syndrome, due to ZBTB24 mutations, presenting with large cerebral cyst

    Science.gov (United States)

    Cerbone, Manuela; Wang, Jun; Van der Maarel, Silvère M.; d’Amico, Alessandra; d’Agostino, Antonio; Romano, Alfonso; Brunetti-Pierri, Nicola

    2012-01-01

    The Immunodeficiency, Centromeric instability, Facial anomalies (ICF) syndrome is an autosomal recessive disease presenting with immunodeficiency secondary to hypo- or agammaglobulinemia, developmental delay, and facial anomalies. Centromeric instability is the cytogenetic hallmark of the disorder which results from targeted chromosomal rearrangements related to a genomic methylation defect. We describe a patient carrying a homozygous mutation of the ZBTB24 gene, which has been recently shown to be responsible for ICF syndrome type 2. Our patient presented with intellectual disability, multiple café-au-lait spots, and a large cerebral arachnoidal cyst. Although laboratory signs of impaired immune function, such as reduced serum IgM were detected, our patient did not present clinical manifestations of immunodeficiency. Brain malformations have not been reported so far in ICF syndrome and it can be speculated that ZBTB24 mutations may alter cerebral development. Nevertheless, we cannot rule out that the presence of the cerebral cyst in the patient is coincidental. In summary, our patient illustrates that clinical evidence of immunodeficiency is not a universal feature of ICF2 syndrome type 2 and suggests that brain malformations may be present in other ICF cases. PMID:22786748

  18. Respiratory chain complex I deficiency due to NDUFA12 mutations as a new cause of Leigh syndrome

    DEFF Research Database (Denmark)

    Ostergaard, Elsebet; Rodenburg, Richard J; van den Brand, Mariël;

    2011-01-01

    This study investigated a girl with Leigh syndrome born to first-cousin parents of Pakistani descent with an isolated respiratory chain complex I deficiency in muscle and fibroblasts. Her early development was delayed, and from age 2 years she started losing motor abilities. Cerebral MRI showed...

  19. Non-syndromic hereditary gingival fibromatosis in three Chinese families is not due to SOS1 gene mutations.

    Science.gov (United States)

    Ma, Yanyan; Sun, Zheng; Hu, Ying; Liu, Yi; Jin, Lingling; Zhang, Fenqiu

    2014-12-01

    Non-syndromic hereditary gingival fibromatosis (HGF) is a rare condition, characterized by a progressive gingival hyperplasia that occurs as an isolated disease. Hitherto, only one insertion (g.126,142-126,143insC) in son-of-sevenless-1 (SOS1) gene has been associated with non-syndromic HGF in a Brazilian family. The aim of the present study was to determine if SOS1 is the causative gene of non-syndromic HGF in the Chinese population. Peripheral blood samples were collected from six affected and seven unaffected individuals from three Chinese families with history of non-syndromic HGF. Genomic DNA was extracted and SOS1 gene exons were sequenced. Neither g.126,142-126,143insC nor any other novel mutation was detected in SOS1 gene. Our results suggest that the SOS1 may not be the gene responsible for HGF in these three Chinese families and, therefore, it is possible that other genes are involved in the manifestation of HGF in these Chinese HGF families.

  20. Route Selection by Tankers(Dirty) at the Suez Canal

    Institute of Scientific and Technical Information of China (English)

    Risto Laulajainen

    2007-01-01

    <正>The Suez Canal,attached route alternatives with traffic flows and areas are described and theoretical break-even points derived. Logistically,route selection depends on relative distances,the level of spot rates and canal dues,the sensitivity to change growing with rising rate levels.The connection is diluted by the canal /pipeline owners’ price differentiation and the charterers’ capital costs;interest on cargo and change of its value during transit.Ship-owners are largely neutral to route choice as long as rates and main cost items are directly related to distance.

  1. Les pathologies du Canal Péritonio-Vaginal

    OpenAIRE

    DJAZIRI, Sihem Fatima Zohra

    2014-01-01

    Les pathologies du canal péritonéo-vaginal, sont des affections congénitales dues à la persistance du canal au delà de la naissance. Elles regroupent les hernies inguinales et inguino-scrotales, les hydrocèles communicantes ou non, et les kystes du cordon spermatique. Notre travail est une étude rétrospective portant sur 309 malades opérés de pathologies du canal péritonio-vaginal dans le service de chirurgie infantile durant la période allant d’octobre 2011 jusqu'à octobre ...

  2. Role of adrenocortical dysfunction in the pathogenesis of poisoning syndromes due to some industrial toxins (aromatic nitro compounds, lead)

    Energy Technology Data Exchange (ETDEWEB)

    Makotcenko, V.M.

    1974-10-01

    Comparative study is presented of adrenocortical dysfunction in workers chronically exposed to aromatic nitro compounds and to lead. The chronic intoxications produced by aromatic nitro compounds and by lead are characterized by a slight reduction in adrenocortical activity, which plays an important part in the pathogenesis of certain syndromes such as asthenia, gastric secretion disorders, lead anemia and lead polyneuritis. It is desirable to take measures to normalize corticosteroid formation when chronic occupational poisoning is being treated. (CIS Abstr. Vol. 2)

  3. Protein causes hyperinsulinemia: a Chinese patient with hyperinsulinism/hyperammonaemia syndrome due to a glutamate dehydrogenase gene mutation

    Institute of Scientific and Technical Information of China (English)

    CHEN Shi; XIAO Xin-hua; DIAO Cheng-ming; TONG An-li; WANG Ou; QIU Zheng-qing; YU Kang; WANG Tong

    2010-01-01

    @@ Glucose is derived from three sources: intestinal absorption, glycogenolysis, and gluconeogenesis. Hypoglycemia in child is often attributed to depletion of glycogen stores. However, recently, congenital hyperinsulinism becomes an important cause of hypoglycaemia in early infancy. Mutations in the genes encoding SUR1 and KIR6.2 are the most frequent genetic causes of hyperinsulinism followed by mutations in the glutamate dehydrogenase (GDH) gene which encodes hyperinsulinism/hyperammonaemia (HI/HA) syndrome.

  4. Ciliary Abnormalities Due to Defects in the Retrograde Transport Protein DYNC2H1 in Short-Rib Polydactyly Syndrome

    OpenAIRE

    Merrill, Amy E.; Merriman, Barry; Farrington-Rock, Claire; CAMACHO, NATALIA; Sebald, Eiman T.; Funari, Vincent A.; Schibler, Matthew J.; Firestein, Marc H.; Cohn, Zachary A; Priore, Mary Ann; Thompson, Alicia K.; Rimoin, David L.; Nelson, Stanley F.; Cohn, Daniel H.; Krakow, Deborah

    2009-01-01

    The short-rib polydactyly (SRP) syndromes are a heterogenous group of perinatal lethal skeletal disorders with polydactyly and multisystem organ abnormalities. Homozygosity by descent mapping in a consanguineous SRP family identified a genomic region that contained DYNC2H1, a cytoplasmic dynein involved in retrograde transport in the cilium. Affected individuals in the family were homozygous for an exon 12 missense mutation that predicted the amino acid substitution R587C. Compound heterozygo...

  5. Carpal tunnel syndrome due to a plexiform neurofibroma of the median nerve in a neurofibromatosis type 1 patient: clinical approach

    OpenAIRE

    Freitas, Daniel; Aido, Ricardo; Sousa, Marco; Costa, Luís; Oliveira, Vânia; Cardoso, Pedro

    2013-01-01

    The authors report the case of a 56-year-old male patient with neurofibromatosis type 1 (NF1) diagnosed during adolescence and with an insidious clinical evolution, characterised by an exuberant cutaneous involvement, referred to the orthopaedics outpatient clinic presenting with carpal tunnel syndrome secondary to a plexiform neurofibroma of the median nerve. A comprehensive clinical approach is discussed, considering the natural history of the disease and its potential complications, as wel...

  6. Comparing effects of Beractant and Poractant alfa in decreasing mortality rate due to respiratory distress syndrome in premature infants

    Directory of Open Access Journals (Sweden)

    Saeidi R

    2011-02-01

    Full Text Available "nBackground: Exogenous natural and synthetic surfactants is a rescue treatment for respiratory distress syndrome (RDS. The goals of the study were to compare the clinical response and side-effects of two frequently used surfactants, poractant alfa (Curosurf and beractant (Survanta, for the treatment of respiratory distress syndrome in preterm infants."n "nMethods: This clinical trial study was performed during a two-year period in the Neonatal Intensive Care Unit of Ghaem Hospital in Mashhad, Iran. Sample size calculated by a 95% confidence and power of 80, included 104 premature neonates, 74 in survanta and 30 in curosurf groups. The level of statistical significance was considered to be < 0.05."n "nResults: There were no statistically significant differences between the infants treated by survanta or cursurf groups regarding their mean gestational age (30.58 Vs. 29.00 weeks and birth weight (1388 Vs. 1330 g, (p=0.3 There were also no significant differences between the two groups regarding incidences of broncho- pulmonary dysplasia (BPD (40.5% Vs. 40%, intraventricular hemorrhage (IVH grades III/IV (13.5% Vs. 13.3%, pneumothorax (both 20%, patent ductus arteriosus (PDA (28/3% Vs. 20% or death (28% Vs. 26.6% on the 28th day postpartum."n "nConclusion: This study showed that survanta and curosurf had similar therapeutic effects in the treatment of neonatal respiratory distress syndrome.

  7. Facial Canal Dehiscence in Patients with Chronic Otitis Surgery

    Directory of Open Access Journals (Sweden)

    Ahmet Uluat

    2016-04-01

    Full Text Available Aim: To examine facial canal status in patients with chronic otitis media (COM surgery and to detect the relation between facial canals dehiscence (FCD with middle ear pathology in these patients. Material and Method: The surgery data of patients who were subjected to tympanoplasty with or without mastoidectomy and radical mastoidectomy due to COM were analyzed retrospectively from January 2006 to December 2012. In addition to demonstrative data of the patients, status of facial canal and preoperative diagnoses of patients, type of the operation performed, status of middle ear, number of surgeries, existence of cholesteatoma, existence of ossicular chain defect, lateral canal defect and dura defect were assessed and the relation thereof with facial canal dehiscence (FCD was analyzed statistically. Results: Seven hundred ninety six patients were included in the study. FCD was detected in 10.05% of the patients. FCD was most frequently observed in the tympanic segment. It was found out that there was a statistically significant relationship of middle ear pathology, cholesteatoma, revision surgery, lateral semicircular canal and ossicular chain defect with FCD. Discussion: COM diagnosed patients may have defect in facial canal according to their preoperative diagnoses, middle ear pathologies, number of operations and ossicular chain defects. These patients should be applied a more careful surgery and closely followed up in postoperative periods.

  8. Middle and inner ear malformations in mutation-proven branchio-oculo-facial (BOF) syndrome: case series and review of the literature.

    Science.gov (United States)

    Carter, Melissa T; Blaser, Susan; Papsin, Blake; Meschino, Wendy; Reardon, Willie; Klatt, Regan; Babul-Hirji, Riyana; Milunsky, Jeff; Chitayat, David

    2012-08-01

    Hearing impairment is common in individuals with branchio-oculo-facial (BOF) syndrome. The majority of described individuals have conductive hearing impairment due to malformed ossicles and/or external canal stenosis or atresia, although a sensorineural component to the hearing impairment in BOF syndrome is increasingly being reported. Sophisticated computed tomography (CT) of the temporal bone has revealed middle and inner ear malformations in three previous reports. We present middle and inner ear abnormalities in three additional individuals with mutation-proven BOF syndrome. We suggest that temporal bone CT imaging be included in the medical workup of a child with BOF syndrome, in order to guide management.

  9. Controversy at Love Canal.

    Science.gov (United States)

    Paigen, B

    1982-06-01

    A cancer researcher reviews the events surrounding the toxic waste contamination at Love Canal with emphasis on the political nature of the controversy about its health impact. Antagonism between the community and the New York State Department of Health was fueled by several factors: the state's awareness that it gained from delay in investigation, disagreement on health problems to be studied, control over the information gathering process, silencing of opposition opinion, and the violation of norms of scientific behavior. The author calls for the establishment of standards of ethical behavior for scientists in such situations, standards for conflict resolution, and means of appeal for those injured.

  10. Dental phenotype in Jalili syndrome due to a c.1312 dupC homozygous mutation in the CNNM4 gene.

    Directory of Open Access Journals (Sweden)

    Hans U Luder

    Full Text Available Jalili syndrome denotes a recessively inherited combination of an eye disease (cone-rod dystrophy and a dental disorder (amelogenesis imperfecta, which is caused by mutations in the CNNM4 gene. Whereas the ophthalmic consequences of these mutations have been studied comprehensively, the dental phenotype has obtained less attention. A defective transport of magnesium ions by the photoreceptors of the retina is assumed to account for the progressive visual impairment. Since magnesium is also incorporated in the mineral of dental hard tissues, we hypothesized that magnesium concentrations in defective enamel resulting from mutations in CNNM4 would be abnormal, if a similar deficiency of magnesium transport also accounted for the amelogenesis imperfecta. Thus, a detailed analysis of the dental hard tissues was performed in two boys of Kosovan origin affected by Jalili syndrome. Retinal dystrophy of the patients was diagnosed by a comprehensive eye examination and full-field electroretinography. A mutational analysis revealed a c.1312 dupC homozygous mutation in CNNM4, a genetic defect which had already been identified in other Kosovan families and putatively results in loss-of-function of the protein. The evaluation of six primary teeth using light and scanning electron microscopy as well as energy-dispersive X-ray spectroscopy showed that dental enamel was thin and deficient in mineral, suggesting a hypoplastic/hypomineralized type of amelogenesis imperfecta. The reduced mineral density of enamel was accompanied by decreased amounts of calcium, but significantly elevated levels of magnesium. In dentin, however, a similar mineral deficiency was associated with reduced magnesium and normal calcium levels. It is concluded that the c.1312 dupC mutation of CNNM4 results in mineralization defects of both enamel and dentin, which are associated with significantly abnormal magnesium concentrations. Thus, we could not disprove the hypothesis that a

  11. Steven′s Johnson syndrome with toxic epidermal necrolysis due to thalidomide in a case of multiple myeloma

    Directory of Open Access Journals (Sweden)

    Anupam Das

    2014-01-01

    Full Text Available Thalidomide developed in 1954 for morning sickness had proven to be a teratogen and hence was withdrawn from market. Resurgence of thalidomide began as an immunomodulator when it was shown to be effective in the management of multiple myeloma and many conditions like erythema nodosum leprosum, graft versus host disease, recurrent aphthous ulcers etc. We report a case of Stevens Johnson syndrome-toxic epidermal necrolysis developing in an elderly male who was prescribed thalidomide after being diagnosed with multiple myeloma.

  12. Carpal tunnel syndrome due to a plexiform neurofibroma of the median nerve in a neurofibromatosis type 1 patient: clinical approach.

    Science.gov (United States)

    Freitas, Daniel; Aido, Ricardo; Sousa, Marco; Costa, Luís; Oliveira, Vânia; Cardoso, Pedro

    2013-01-01

    The authors report the case of a 56-year-old male patient with neurofibromatosis type 1 (NF1) diagnosed during adolescence and with an insidious clinical evolution, characterised by an exuberant cutaneous involvement, referred to the orthopaedics outpatient clinic presenting with carpal tunnel syndrome secondary to a plexiform neurofibroma of the median nerve. A comprehensive clinical approach is discussed, considering the natural history of the disease and its potential complications, as well as the lack of consensus regarding standard therapeutic options for the compressive peripheral neuropathies in the NF1 disease. PMID:23853185

  13. A case of psychosis due to Fahr's syndrome and response to behavioral disturbances with risperidone and oxcarbazepine

    Science.gov (United States)

    Faye, Abhijeet Dhawalram; Gawande, Sushil; Tadke, Rahul; Kirpekar, Vivek C.; Bhave, Sudhir H.

    2014-01-01

    Calcification of basal ganglia or Fahr's syndrome is a rare disease characterized by bilateral and symmetrical intracranial deposition of calcium mainly in cerebral basal ganglia. Motor and neuropsychiatric symptoms are prominent features. We report a case presented with a few motor symptoms, features of delirium and prominent psychiatric symptoms (disorganized behavior) predominantly evident after the improvement in delirium. Radiological findings were suggestive of bilateral basal ganglia calcification. Parathyroid hormone levels were low with no significant findings in other investigations and negative family history. Patient showed significant improvement in behavioral disturbances with risperidone, low dose of lorazepam, oxcarbazepine, and memantine. PMID:24891710

  14. Successful Salvage of a Renal Allograft after Acute Renal Vein Thrombosis due to May-Thurner Syndrome

    Directory of Open Access Journals (Sweden)

    Omkar U. Vaidya

    2012-01-01

    Full Text Available A 68-year-old Caucasian female with a past medical history of a deceased donor kidney transplant four months prior was admitted with a two-day history of anuria and acute kidney injury. A renal ultrasound demonstrated thrombus in the transplanted kidney's renal vein that extended into the left iliac vein as well as into the left femoral venous system. Catheter-guided tissue thrombolytics were infused directly into the clot. Within twelve hours of initiating thrombolytic infusion, there was brisk urine output. Interval venography demonstrated decreasing clot burden. At the time of discharge her creatinine was 0.78 mg/dL, similar to her baseline value prior to presentation. The patient was noted to have May-Thurner syndrome on intravascular ultrasound (IVUS. Angioplasty followed by stent placement was done. Unique to our case report was the timing of the presentation of renal vein thrombosis (four months after transplant and the predisposing anatomy consistent with May-Thurner syndrome, which was diagnosed with IVUS and successfully treated with local thrombolytics.

  15. Carpal tunnel syndrome due to an atypical deep soft tissue leiomyoma: The risk of misdiagnosis and mismanagement

    Directory of Open Access Journals (Sweden)

    Dimitriou Christos G

    2007-08-01

    Full Text Available Abstract Background Leiomyomas of the deep soft tissue are quite uncommon and occur even more rarely in upper extremity. Case presentation A 32-year old manual laborer man presented with a two-year history of numbness, tingling and burning pain in the palmar surface of the left hand and fingers. His medical history was unremarkable and no trauma episode was reported. According to the clinical examination and the result of median nerve conduction study (NCS the diagnosis of carpal tunnel syndrome was established. Operative release of the transverse carpal ligament was subsequently performed but the patient experienced only temporary relief of his symptoms. MRI examination revealed a deep palmary located mass with well-defined margins and ovoid shape. Intraoperatively, the tumor was in continuity with the flexor digitorum superficialis tendon of the middle finger causing substantial compression to median nerve. Histopathological findings of the resected mass were consistent with leiomyoma. After two years the patient was pain-free without signs of tumor recurrence. Conclusion Despite the fact that reports on deep soft tissue leiomyoma are exceptional, this tumor had to be considered as differential diagnosis in painful non-traumatic hand syndromes especially in young patients.

  16. Digital flexion contracture and severe carpal tunnel syndrome due to tophaceus infiltration of wrist flexor tendon: first manifestation of gout.

    Science.gov (United States)

    Hernández-Cortés, P; Caba, M; Gómez-Sánchez, R; Gómez-Morales, M

    2011-11-09

    The authors report an unusual case of flexor tenosynovitis, severe carpal tunnel syndrome, and triggering at the carpal tunnel as the first manifestation of gout. A 69-year-old man presented with digital flexion contracture and severe carpal tunnel syndrome of his right hand and was treated surgically. A flexor tenosynovectomy and a median nerve neurolysis were performed through an extended carpal tunnel approach. The sublimis and the profundus tendons were involved. Partial ruptures and multiple whitish lesions suggestive of tophacceous infiltration of the flexor tendons were seen. Macroscopically, the removed synovial tissue was involved by multiple whitish nodules that were milimetric in size and was suggestive of monosodium urate crystals deposits. By light microscopy examination, numerous nonnecrotizing granulomas of different sizes were observed that were compounded by large aggregations of acellular nonpolarized material, surrounded by epithelioid histiocytes, mononuclear cells, and foreign body multinucleated giant cells. Postoperatively, the patient recovered with resolution of the median nerve symptoms and a near-to-full range of motion of the affected digits.To the authors' knowledge, this patient is the first case report with flexor tendons tophacceous infiltration as the first clinical sign of gout. Gouty flexor tenosynovitis can occur in the absence of a long history of gout. A high index of suspicion is paramount to the initiation of proper management. Operative treatment of gouty flexor tenosynovitis is mandatory to debulk tophaceous deposits, improve tendon gliding, and decompress nerves. Routine uric acid determination could be helpful in the preoperative evaluation of patients with flexor tenosynovitis.

  17. Crouzon’s Syndrome with Life-Threatening Ear Bleed: Ruptured Jugular Vein Diverticulum Treated by Endovascular Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Mondel, Prabath Kumar, E-mail: prabathmondel@gmail.com; Anand, Sunanda, E-mail: sunandaanand@gmail.com; Limaye, Uday S., E-mail: uslkem@gmail.com [Lilavati Hospital and Research Centre, Department of Interventional Neuroradiology (India)

    2015-08-15

    Crouzon’s syndrome is the commonest variety of syndromic craniosynostosis. Life-threatening ear bleed due to ruptured jugular venous diverticulum in Crouzon’s syndrome has not been described previously. In patients with syndromic craniosynostosis, definitive repair of jugular diverticulum by open surgery is fraught with high risk of bleeding, poor functional outcomes, and even death. A 24-year-old woman with Crouzon’s syndrome presented with conductive hearing loss and recurrent episodes of torrential bleeding from her left ear. On computed tomography, a defect in the roof of jugular fossa containing jugular venous diverticulum immediately inferior to the bony external auditory canal was seen. The clinical presentation, imaging features, and endovascular management of Crouzon’s syndrome due to a ruptured jugular venous diverticulum is described.

  18. Spinal canal stenosis; Spinalkanalstenose

    Energy Technology Data Exchange (ETDEWEB)

    Papanagiotou, P.; Boutchakova, M. [Klinikum Bremen-Mitte/Bremen-Ost, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Bremen (Germany)

    2014-11-15

    Spinal stenosis is a narrowing of the spinal canal by a combination of bone and soft tissues, which can lead to mechanical compression of spinal nerve roots or the dural sac. The lumbal spinal compression of these nerve roots can be symptomatic, resulting in weakness, reflex alterations, gait disturbances, bowel or bladder dysfunction, motor and sensory changes, radicular pain or atypical leg pain and neurogenic claudication. The anatomical presence of spinal canal stenosis is confirmed radiologically with computerized tomography, myelography or magnetic resonance imaging and play a decisive role in optimal patient-oriented therapy decision-making. (orig.) [German] Die Spinalkanalstenose ist eine umschriebene, knoechern-ligamentaer bedingte Einengung des Spinalkanals, die zur Kompression der Nervenwurzeln oder des Duralsacks fuehren kann. Die lumbale Spinalkanalstenose manifestiert sich klinisch als Komplex aus Rueckenschmerzen sowie sensiblen und motorischen neurologischen Ausfaellen, die in der Regel belastungsabhaengig sind (Claudicatio spinalis). Die bildgebende Diagnostik mittels Magnetresonanztomographie, Computertomographie und Myelographie spielt eine entscheidende Rolle bei der optimalen patientenbezogenen Therapieentscheidung. (orig.)

  19. A comparative study of verbal IQ, performance IQ and verbal IQ-performance IQ disparity among Turner syndrome patients and patients with primary amenorrhoea due to other aetiologies

    Directory of Open Access Journals (Sweden)

    Rahul Lakshman

    2012-12-01

    Full Text Available Background: Assessing disparity in IQ is important in selecting an occupation and thus helping people lead a productive life. In Turner syndrome patients, this shall be more important as assessment of verbal IQ- and performance IQ disparity could be used in helping them select an occupation so that productivity and quality of life is not grossly compromised. Methods: Based on karyotyping, 30 patients with turner syndrome and 30 patients with primary amenorrhoea due to other aetiologies were selected for the study. Cytogenetic analysis was done for every case using G-banding technique. Assessment of intellectual functions was done using Wechsler Adult Intelligence Scale (WAIS. Results: Mean value of PIQ of X0 (turner was 74.67 and that of XX (other amenorrhoea patients was 90.30. Mean value of VIQ of X0 (turner was 93.67 and that of XX (other amenorrhoea patients was 93.60. Mean value of VIQ and PIQ disparity of X0 (turner was 18.67 and that of XX (other amenorrhoea patients was 3. Conclusions: Turner syndrome patients have high VIQ-PIQ disparity when compared to other primary amenorrhoea patients. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000: 22-25

  20. [Posterior reversible encephalopathy syndrome due to hypocalcemia: a description of a case and an analysis of a pathogenic role of electrolyte disturbances].

    Science.gov (United States)

    Dobrynina, L A; Kalashnikova, L A; Bakulin, I S; Kremneva, E I; Krotenkova, M V; Shamtieva, K V

    2016-01-01

    Afemale patient with recurrent posterior reversible encephalopathy syndrome, severe hypocalcemia due to extirpation of the parathyroid glands is described. The disease was characterized by the acute development of headache, seizures, cognitive and behavioral disorders, mental confusion, transitory blood pressure increasing. The vasogenic edema in the posterior parts of the brain, detected by CT at the first exacerbation,was completely regressed. The residual neurological deficit and MRI changes remained after the recurrent exacerbations. Main clinical features of PRESare explained by hypocalcemia and accompanying electrolyte disturbances.The reported case shows the necessity to study blood electrolytes in patients with PRES to clarify their pathogenic role and the necessity of drug correction. PMID:27500881

  1. Repeated lung lavage with extracorporeal membrane oxygenation treating severe acute respiratory distress syndrome due to nasogastric tube malposition for enternal nutrition: a case report.

    Science.gov (United States)

    Kao, Xiaoming; Yu, Wenkui; Zhu, Weiming; Li, Ning; Li, Jieshou

    2012-01-01

    Enternal nutritional support, a frequently applied technique for providing nutrition and energy, played a pivotal role in the treatment of high risk patients. However, severe complications induced by malposition of nasogastric tube caused great danger and even death to the patients. In this case report, we present a patient with severe acute respiratory distress syndrome (ARDS) induced by bronchopleural fistula (BPF) due to malposition of nasogastric tube. Repeated lung lavage combined with extracorporeal membrane oxygenation (ECMO) was performed after transferring to the ICU of our hospital. Finally, the patient recovered and discharged 7 days after admission.

  2. Dravet syndrome with favourable cognitive and behavioral development due to a novel SCN1A frameshift mutation.

    Science.gov (United States)

    Jiang, Peifang; Shen, Jue; Yu, Yonglin; Jiang, Lihua; Xu, Jialu; Xu, Lu; Yu, Huimin; Gao, Feng

    2016-07-01

    Children with Dravet syndrome (DS) often have severe cognitive, behaviour and motor impairments. Patients with truncating mutations would logically have the more severe phenotype. Here we present a case of DS with an unusually favourable cognitive and behavioral development with a novel SCN1A frameshift mutation (c.4233-4234insAT). Under regular following up for ten years, the patient had normal expressive language and mild motor clumsiness. It is suggested that besides the type of SCN1A mutation, other mechanisms may be existed to influence the SCN1A phenotype, such as modifier genes, developmental variability, accumulation of somatic mutation in lifetime and environmental insults can all contribute to the cognitive and behavioral outcome.

  3. A case of quadriparesis due to renal tubular acidosis accompanied by vitamin D deficiency in Sjogren's syndrome

    Directory of Open Access Journals (Sweden)

    Can Huzmeli

    2016-08-01

    Full Text Available Renal tubular acidosis (RTA is metabolic acidosis disorder with a normal anion gap that occurs resulting from bicarbonate reabsorption or disorder in the hydrogen excretion from the kidney. A variety of tests are required to be administered in a stepwise fashion for the diagnosis and characterization of RTA. Correct diagnosis involves careful evaluation, including exclusion of other entities causing acidosis. The patients were treated with potassium and bicarbonate supplementation. A fifty-one years old female patient presented to the emergency department with quadriparesis dependent on hypokalemia and vitamin D deficiency, was diagnosed with distal renal tubular acidosis (dRTA combined with Sjogrens Syndrome (SS. We submitted this case in order to draw attention to the presentation of the RTA with SS. [Int J Res Med Sci 2016; 4(8.000: 3625-3628

  4. Accelerated inactivation of the L-type calcium current due to a mutation in CACNB2b underlies Brugada syndrome

    DEFF Research Database (Denmark)

    Cordeiro, Jonathan M; Marieb, Mark; Pfeiffer, Ryan;

    2009-01-01

    revealed brief episodes of very rapid ventricular tachycardia. He was also diagnosed with vasovagal syncope. Genomic DNA was isolated from lymphocytes. All exons and intron borders of 15 ion channel genes were amplified and sequenced. The only mutation uncovered was a missense mutation (T11I) in CACNB2b......Recent studies have demonstrated an association between mutations in CACNA1c or CACNB2b and Brugada syndrome (BrS). Previously described mutations all caused a loss of function secondary to a reduction of peak calcium current (I(Ca)). We describe a novel CACNB2b mutation associated with Br...... significantly faster in mutant channels between 0 and + 20 mV. Action potential voltage clamp experiments showed that total charge was reduced by almost half compared to WT. We report the first BrS mutation in CaCNB2b resulting in accelerated inactivation of L-type calcium channel current. Our results suggest...

  5. Ciliary abnormalities due to defects in the retrograde transport protein DYNC2H1 in short-rib polydactyly syndrome.

    Science.gov (United States)

    Merrill, Amy E; Merriman, Barry; Farrington-Rock, Claire; Camacho, Natalia; Sebald, Eiman T; Funari, Vincent A; Schibler, Matthew J; Firestein, Marc H; Cohn, Zachary A; Priore, Mary Ann; Thompson, Alicia K; Rimoin, David L; Nelson, Stanley F; Cohn, Daniel H; Krakow, Deborah

    2009-04-01

    The short-rib polydactyly (SRP) syndromes are a heterogeneous group of perinatal lethal skeletal disorders with polydactyly and multisystem organ abnormalities. Homozygosity by descent mapping in a consanguineous SRP family identified a genomic region that contained DYNC2H1, a cytoplasmic dynein involved in retrograde transport in the cilium. Affected individuals in the family were homozygous for an exon 12 missense mutation that predicted the amino acid substitution R587C. Compound heterozygosity for one missense and one null mutation was identified in two additional nonconsanguineous SRP families. Cultured chondrocytes from affected individuals showed morphologically abnormal, shortened cilia. In addition, the chondrocytes showed abnormal cytoskeletal microtubule architecture, implicating an altered microtubule network as part of the disease process. These findings establish SRP as a cilia disorder and demonstrate that DYNC2H1 is essential for skeletogenesis and growth.

  6. Diagnosis and treatment of effort-induced thrombosis of the axillary subclavian vein due to venous thoracic outlet syndrome.

    Science.gov (United States)

    Vemuri, Chandu; Salehi, Payam; Benarroch-Gampel, Jaime; McLaughlin, Lauren N; Thompson, Robert W

    2016-10-01

    Venous thoracic outlet syndrome (VTOS) is uncommon but most frequently occurs in young, active, healthy patients. This condition typically presents as subclavian vein (SCV) effort thrombosis, also known as Paget-Schroetter syndrome. The pathophysiology underlying VTOS is chronic repetitive compression injury of the SCV in the costoclavicular space, resulting in progressive venous scarring, focal stenosis, and eventual thrombosis. Clinical evaluation includes a history and physical examination followed by catheter-based venography, for definitive confirmation of the diagnosis and initial treatment with pharmacomechanical thrombolysis. After restoration of SCV patency, patients are maintained with anticoagulation and surgical therapy is usually planned within 4 to 6 weeks. Surgical management of VTOS can be accomplished via different protocols involving either the transaxillary, infraclavicular or paraclavicular approaches to thoracic outlet decompression. The paraclavicular approach is emphasized in this review, because it affords the surgeon the ability to safely perform complete thoracic outlet decompression (complete anterior and middle scalenectomy, removal of the entire first rib, and resection of the subclavius muscle and costoclavicular ligament), along with definitive management of the damaged SCV (external venolysis, intraoperative venography, and direct vein reconstruction, if needed, using patch angioplasty or bypass grafting), in one operative setting. After surgical therapy, interval anticoagulation and a comprehensive physical therapy and rehabilitation program are important in achieving a return to full function. Current protocols on the basis of the paraclavicular surgical approach have thereby routinely provided patients with lasting symptomatic relief, freedom from indefinite anticoagulation, and the ability to return to unrestricted upper extremity activity. PMID:27639006

  7. Interaction Between Syndromic and Non-Syndromic Factors Affecting Speech and Language Development in Treacher-Collins Syndrome

    Directory of Open Access Journals (Sweden)

    Marziyeh Poorjavad

    2011-09-01

    Full Text Available Background: Treacher-Collins syndrome is a congenital craniofacial disorder with multiple anomalies. This syndrome affects the maxilla, mandible, eyes, middle and outer ears, and soft palate. Conductive hearing loss due to the deformities of the middle and external ears is prevalent. The characteristics of this syndrome include multiple and serious threats to normal communication development in children. In this study, speech and language features of a Persian speaking child with this syndrome are presented.Case: The case was an 8-year old girl with Treacher-Collins syndrome and bilateral moderate conductive hearing loss due to atretic canal. In language and speech assessments, moderate hypernasality, numerous compensatory errors and morphosyntactic deficits were observed. There were 13 phonemes that were incorrectly produced at least in one position. Besides, she used 22 types of phonological processes that were abnormal and disappear before the age of three in normal Persian speaking children.Conclusion: Moderate hearing loss, velopharyngeal incompetency, malocclusion and dental anomalies, attention deficit/hyperactivity disorder (ADHD and environmental factors resulted in severe speech and language disorders in this case. These disorders affected her academic performance as well. Moderate hypernasality, numerous compensatory errors, and excessive and abnormal use of phonological processes were not presented as prevalent characteristics of Treacher-Collins syndrome in other resources.

  8. [General Anesthesia Using Remifentanil for Cesarean Section in a Parturient with Marfan Syndrome Associated with Heart Failure due to Severe Mitral Regurgitation].

    Science.gov (United States)

    Fujita, Masahide; Satsumae, Tsuyoshi; Tanaka, Makoto

    2016-05-01

    A 24-year-old woman with Marfan syndrome was scheduled for cesarean section in order to avoid progression of heart failure due to severe mitral regurgitation and aortic dissection during labor. Cesarean section was performed under general anesthesia using remifentanil. Anesthesia was induced and maintained with remifentanil (0.1-0.3 μg x kg(-1) x min(-1)) and continuous administration of propofol (target-controlled infusion, 2-3 ng x ml(-1)). The trachea was intubated without a significant hemodynamic change. The patient's systolic blood pressure was maintained between 90 and 120 mmHg during surgery. Intraoperatively, we conducted a transesophageal echocardiography examination, and no remarkable change was seen in the severity of mitral regurgitation and the size of an ascending aorta. An infant was delivered 6 minutes after anesthesia induction. The Apgar scores were 4 at 1 min, 5 at 5 min and 8 at 10 min. Postoperative course was uneventful. We conclude that remifentanil can be used successfully to manage cesarean section of a parturient with Marfan syndrome associated with heart failure due to severe mitral regurgitation under general anesthesia. PMID:27319100

  9. [Anesthetic Management of a Parturient with Eclampsia, Posterior Reversible Encephalopathy Syndrome and Pulmonary Edema due to Pregnancy-induced Hypertension].

    Science.gov (United States)

    Aida, Junko; Okutani, Hiroai; Oda, Yutaka; Okutani, Ryu

    2015-08-01

    A 27-year-old woman with mental retardation was admitted to a nearby hospital for an abrupt onset of seizure. Physical examination revealed remarkable hypertension and pregnancy with estimated gestational age of 28th week. Severe pulmonary edema and hypoxia led to a diagnosis of pregnancy-induced hypertension (PIH) accompanied by eclampsia. She was orotracheally intubated because of refractory seizure and hypoxemia, and transferred to our hospital for further treatment. Besides severe hypoxia and hypercapnea, an enhanced lesion was detected in the left posterior cerebrum by brain MRI. No abnormal findings were detected in the fetus, with heart rate of 150 beats x min. She was diagnosed with posterior reversible encephalopathy syndrome (PRES) caused by PIH and emergency cesarean section under general anesthesia was scheduled. A male newborn was delivered with Apgar score of 1/4 (1/5 min), followed by starting continuous infusion of nicardipine for controlling hypertension. Chest X-P on completion of surgery revealed remarkably alleviated pulmonary edema. She received intensive treatment and continued positive pressure ventilation for four days after delivery. She recovered with no neurological deficits and her child was well without any complications. PMID:26442424

  10. High fasting serum insulin level due to autoantibody interference in insulin immunoassay discloses autoimmune insulin syndrome: a case report.

    Science.gov (United States)

    Lamy, Pierre-Jean; Sault, Corinne; Renard, Eric

    2016-08-01

    Insulin-antibodies are a cause of misleading results in insulin immunoassays. They may also mediate deleterious blood glucose variations. A patient presented with overtiredness, recurrent episodes of sweating, dizziness and fainting fits. A fasting serum insulin assay performed on a Modular platform (Modular analytic E170, Roche Diagnostic, Meylan, France) showed a highly elevated value of 194.7 mIU/L, whereas on the same sample glucose and C-peptide levels were normal. Other immunometric insulin assays were performed, as well as antibodies anti-insulin radiobinding assay (RBA) and gel filtration chromatography (GFC). While complementary insulin assays yielded closer to normal fasting levels, the free insulin concentration assessed after PEG precipitation was 14.0 mIU/L and the RBA was positive. GFC revealed that most of the insulin was complexed with a 150 kDa molecule, corresponding to an immunoglobulin G (IgG). A high fasting serum insulin level in a patient with neuroglucopenic symptoms was related to a high insulin-antibody level, suggesting an insulin autoimmune syndrome. PMID:27492703

  11. Concurrent Therapy with a Low-carbohydrate Diet and Miglitol Remarkably Improved the Postprandial Blood Glucose and Insulin Levels in a Patient with Reactive Hypoglycemia due to Late Dumping Syndrome.

    Science.gov (United States)

    Hirose, Sachie; Iwahashi, Yasuyuki; Seo, Akane; Sumiyoshi, Michitaka; Takahashi, Tetsuya; Tamori, Yoshikazu

    2016-01-01

    Reactive hypoglycemia induced by late dumping syndrome is often observed after gastrectomy. However, no effective therapy has yet been fully established. We herein describe a case in which concurrent therapy with a low-carbohydrate diet using low-glycemic-index food and an alpha-glucosidase inhibitor, miglitol, very effectively ameliorated the postprandial fluctuations in the blood glucose and plasma insulin levels in a patient with reactive hypoglycemia due to late dumping syndrome following total gastrectomy. The administration of miglitol under a low-carbohydrate diet using low-glycemic-index food may therefore be an ideal treatment for reactive hypoglycemia due to late dumping syndrome. PMID:27150868

  12. Hood Canal Steelhead - Hood Canal Steelhead Supplementation Experiment

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Hood Canal Steelhead Project is a 17-year before-after-control-impact experiment that tests the effects of supplementation on natural steelhead populations in...

  13. Method for Constructing Standardized Simulated Root Canals.

    Science.gov (United States)

    Schulz-Bongert, Udo; Weine, Franklin S.

    1990-01-01

    The construction of visual and manipulative aids, clear resin blocks with root-canal-like spaces, for simulation of root canals is explained. Time, materials, and techniques are discussed. The method allows for comparison of canals, creation of any configuration of canals, and easy presentation during instruction. (MSE)

  14. End-stage kidney disease due to haemolytic uraemic syndrome – outcomes in 241 consecutive ANZDATA registry cases

    Directory of Open Access Journals (Sweden)

    Tang Wen

    2012-12-01

    Full Text Available Abstract Background The aim of this study was to investigate the characteristics and outcomes of patients receiving renal replacement therapy for end-stage kidney disease (ESKD secondary to haemolytic uraemic syndrome (HUS. Methods The study included all patients with ESKD who commenced renal replacement therapy in Australia and New Zealand between 15/5/1963 and 31/12/2010, using data from the ANZDATA Registry. HUS ESKD patients were compared with matched controls with an alternative primary renal disease using propensity scores based on age, gender and treatment era. Results Of the 58422 patients included in the study, 241 (0.4% had ESKD secondary to HUS. HUS ESKD was independently associated with younger age, female gender and European race. Compared with matched controls, HUS ESKD was not associated with mortality on renal replacement therapy (adjusted hazard ratio [HR] 1.14, 95% CI 0.87-1.50, p = 0.34 or dialysis (HR 1.34, 95% CI 0.93-1.93, p = 0.12, but did independently predict recovery of renal function (HR 54.01, 95% CI 1.45-11.1, p = 0.008. 130 (54% HUS patients received 166 renal allografts. Overall renal allograft survival rates were significantly lower for patients with HUS ESKD at 1 year (73% vs 91%, 5 years (62% vs 85% and 10 years (49% vs 73%. HUS ESKD was an independent predictor of renal allograft failure (HR 2.59, 95% CI 1.70-3.95, p  Conclusions HUS is an uncommon cause of ESKD, which is associated with comparable patient survival on dialysis, an increased probability of renal function recovery, comparable patient survival post-renal transplant and a heightened risk of renal transplant graft failure compared with matched ESKD controls.

  15. CT findings of the osteoma of the external auditory canal

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ha Young; Song, Chang Joon; Yoon, Chung Dae; Park, Mi Hyun; Shin, Byung Seok [Chungnam National University, School of Medicine, Daejeon (Korea, Republic of)

    2006-07-15

    We wanted to report the CT image findings of the osteoma of the external auditory canal. Temporal bone CT scanning was performed on eight patients (4 males and 4 females aged between 8 and 41 years) with pathologically proven osteoma of the external auditory canal after operation, and the findings of the CT scanning were retrospectively reviewed. Not only did we analyze the size, shape, distribution and location of the osteomas, we also analyzed the relationship between the lesion and the tympanosqumaous or tympanomastoid suture line, and the changes seen on the CT scan images for the patients who were able to undergo follow-up. All the lesions of the osteoma of the external auditory canal were unilateral, solitary, pedunculated bony masses. In five patients, the osteomas occurred on the left side and for the other three patients, the osteomas occurred on the right side. The average size of the osteoma was 0.6 cm with the smallest being 0.5 cm and the largest being 1.2 cm. Each of the lesions was located at the osteochondral junction in the terminal part of the osseous external ear canal. The stalk of the osteoma of the external auditory canal was found to have occurred in the anteroinferior wall in five cases (63%), in the anterosuperior wall (the tympanosqumaous suture line) in two cases (25%), and in the anterior wall in one case. The osteoma of the external auditory canal was a compact form in five cases and it was a cancellous form in three cases. One case of the cancellous form was changed into a compact form 35 months later due to the advanced ossification. Osteoma of the external auditory canal developed in a unilateral and solitary fashion. The characteristic image findings show that it is attached to the external auditory canal by its stalk. Unlike our common knowledge about its occurrence, osteoma mostly occurred in the tympanic wall, and this is regardless of the tympanosquamous or tympanomastoid suture line.

  16. Innominate vein-right atrial bypass for relief of superior vena cava syndrome due to pacemaker lead thrombosis.

    Science.gov (United States)

    Deo, Salil V; Burkhart, Harold M; Araoz, Philip A; Brady, Peter A

    2010-11-01

    We present a patient with superior vena cava (SVC) obstruction due to multiple intraluminal pacemaker leads. Previous attempts at balloon dilatation of the SVC and surgical angioplasty did not provide a long-term solution. A Gore-Tex (W. L. Gore & Associates, Flagstaff, AZ, USA) conduit interposed between the innominate vein and right atrial appendage has resulted in symptomatic relief at a follow-up of 6 months. PMID:21039859

  17. Radioiodine therapy in a patient with papillary thyroid carcinoma associated with breast uptake; hyperprolactinemia due to empty sella syndrome

    International Nuclear Information System (INIS)

    We report a 37 year-old-female patient with papillary thyroid cancer treated by surgery who demonstrated residual thyroid and bilateral breast uptake on a diagnostic I-131 whole body scan. She had an extrathyroidal extension needing I-131 ablative therapy. Her galactorrhea was investigated and treated with low doses of bromocriptine prior to I-131 therapy. Her galactorrhea was was due to the decreased secretion of PIF induced by empty sella

  18. Radioiodine therapy in a patient with papillary thyroid carcinoma associated with breast uptake; hyperprolactinemia due to empty sella syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Moon Sun; Park, Chan H.; Seo, Jung Ho [College of Medicine, Ajou Univ., Suwon (Korea, Republic of); Kim, Kyoung Rae [Yungdong Sevrance Hospital, Seoul (Korea, Republic of)

    1998-01-01

    We report a 37 year-old-female patient with papillary thyroid cancer treated by surgery who demonstrated residual thyroid and bilateral breast uptake on a diagnostic I-131 whole body scan. She had an extrathyroidal extension needing I-131 ablative therapy. Her galactorrhea was investigated and treated with low doses of bromocriptine prior to I-131 therapy. Her galactorrhea was was due to the decreased secretion of PIF induced by empty sella.

  19. The Love Canal: Beyond science?

    Science.gov (United States)

    Bell, Peter M.

    When in 1978, the New York State Department of Health issued the report, ‘Love Canal—Public Health Time Bomb,’ the serious effects of chemical waste contamination in the Love Canal area became an issue of national concern. A few ‘studies’ since then have produced results in concert with those of initial reports that described ‘conditions of acute health effects’ as being linked to hazardous wastes incorporated in landfill in the Love Canal site near Niagara Falls, New York. Now that a ‘blue ribbon’ panel of experts from the medical sciences has reviewed the problems of Love Canal, however, a different view has emerged. The ‘Report of the Governors' Panel to Review Scientific Studies and the Development of Public Policy on Problems Resulting from Hazardous Wastes,’ transmitted in October of this year, identifies the following factors about the health effects at Love Canal:

  20. Ultrasonic cleaning of root canals

    Science.gov (United States)

    Verhaagen, Bram; Boutsioukis, Christos; Jiang, Lei-Meng; Macedo, Ricardo; van der Sluis, Luc; Versluis, Michel

    2011-11-01

    A crucial step during a dental root canal treatment is irrigation, where an antimicrobial fluid is injected into the root canal system to eradicate all bacteria. Agitation of the fluid using an ultrasonically vibrating miniature file has shown significant improvement in cleaning efficacy over conventional syringe irrigation. However, the physical mechanisms underlying the cleaning process, being acoustic streaming, cavitation or chemical activity, and combinations thereof, are not fully understood. High-speed imaging allows us to visualize the flow pattern and cavitation in a root canal model at microscopic scales, at timescales relevant to the cleaning processes (microseconds). MicroPIV measurements of the induced acoustic streaming are coupled to the oscillation characteristics of the file as simulated numerically and measured with a laser vibrometer. The results give new insight into the role of acoustic streaming and the importance of the confinement for the cleaning of root canals.

  1. Bi Syndrome (Arthralgia Syndrome)

    Institute of Scientific and Technical Information of China (English)

    ZHANG En-qin

    2010-01-01

    @@ The word 'Bi' (痹) in Chinese means an obstruction.Bi Syndrome refers the syndrome characterized by the obstruction of qi and blood in the meridians due to the invasion of external pathogenic wind, cold and dampness, manifested as soreness, pain, numbness,heavy sensation, swelling of joints and limbs, limitation of movements and so on.

  2. Síndrome pulmonar por hantavirus Andes en Chile CARDIOPULMONARY SYNDROME DUE TO ANDES VIRUS IN CHILE

    Directory of Open Access Journals (Sweden)

    CONSTANZA CASTILLO H.

    2002-01-01

    Full Text Available Desde 1993 han ocurrido 204 casos de Síndrome Cardiopulmonar por Hantavirus (SCPH en Chile. Los brotes epidémicos comenzaron en el sur y avanzan hacia el norte del país. Los más afectados son varones jóvenes, obreros agrícolas o forestales. En Chile, el SCPH es causado por el virus Andes, cuyo reservorio es el Oligorizomys longicaudatus (ratón de cola larga, que se distribuye desde la III Región al sur. El cuadro clínico es similar al descrito en EE.UU., caracterizado por una fase prodrómica que simula un estado gripal o cuadro gastrointestinal febril y que agrava por la aparición de edema pulmonar agudo e inestabilidad hemodinámica (fase cardiopulmonar. Sin embargo, cursa con mayores alteraciones hemorragí-paras y compromiso renal. La mortalidad inicial fue sobre 50% y actualmente es de alrededor del 33,3%. La presente revisión incluye: historia de la enfermedad, reservorio, modos de transmisión, patogenia, cuadro clínico, diagnóstico, tratamiento y medidas de prevenciónSince 1993, 204 cases of Hantavirus cardiopulmonary syndrome (HCPS occurred in Chile. Epidemic began in the south and moved thereafter to the northern regions. The disease affected predominantly young males, who worked in agricultural labours or as timber workers. The HCPS in Chile is caused by the Andes virus. The reservoir is the wild rat Oligoryzomis longicaudatus distributed from the III to the XII Region. The clinical features are similar to those described for Sin Nombre Virus. The disease has a prodromal stage characterised by fever, muscular pain, with or without gastrointestinal manifestations, followed by the rapid onset of respiratory insufficiency and haemodynamic unstability. Andes virus courses more often with haemorrhagic disorders and overt renal failure, than Sin Nombre Virus. The initial mortality was over 50% and declined to 33,3% in the last year. History of hantavirus-diseases, reservoir, and mode of contagion, pathogenesis, clinical

  3. TREATMENT OF COMPRESSION SYNDROME OF CERVICAL POSTERIOR BRANCH BY CERVICAL NERVE BLOCK OUTSIDE VERTEBRAL CANAL AND MANIPULATION%椎管外颈神经阻滞加手法治疗颈神经后支卡压综合症

    Institute of Scientific and Technical Information of China (English)

    王希; 袁君君

    2001-01-01

    为探讨评价颈神经后支卡压综合症的诊治方法,根据YabukiS等对颈神经解剖学的研究,结合临床回顾性地分析了89例颈神经后支卡压综合症患者椎管外颈神经阻滞及手法治疗的效果。经平均6个月随访,结果47例单纯行颈神经阻滞术者,治愈38例,占80.1%;42例配合手法治疗者,全部治愈,占100%。组间比较(P<0.05),两组治愈率有明显差异。提示对病因不明及无明显神经体征的头、颈肩痛患者,应诊断为颈神经后支卡压综合症,与颈神经后支在关节突出部位的卡压有关。椎管外颈神经阻滞配合手法治疗,是一种针对性强、有效的治疗方法。%To explore the diagnostic and therapeutic methods of compressionsyndrome of cervical posterior branch, according to Yabukis'research about anatomy of cervical nerve, analyze retrospectively the therapeutic effect of compression syndrome of cervical posterior branch(89 cases) with cervical nerve block outside vertebral canal and manipulation. The average follow-up time was half a year. 38 out of 47 patients were cured with cervical nerve block and the curative rate was 80%, but other 42 patients were all cured with cervical nerve block outside vertebral canal and manipulation, the curative rate was 100%. There was a significant difference(P<0.05) in two groups. For head-neck-shoulder pain patients without clear cause and obvious nervous signs, they should be diagnosed as compression syndrome of cervical posterior branch, which related to being compressed of cervical posterior branch at the articular process. It was suggested that cervical nerve block outside vertebral canal with manipulation was a pointed and effective therapeutic method.

  4. L712V mutation in the androgen receptor gene causes complete androgen insensitivity syndrome due to severe loss of androgen function.

    Science.gov (United States)

    Rajender, Singh; Gupta, Nalini J; Chakrabarty, Baidyanath; Singh, Lalji; Thangaraj, Kumarasamy

    2013-12-11

    Inability to respond to the circulating androgens is named as androgen insensitivity syndrome (AIS). Mutations in the androgen receptor (AR) gene are the most common cause of AIS. A cause and effect relationship between some of these mutations and the AIS phenotype has been proven by in vitro studies. Several other mutations have been identified, but need to be functionally validated for pathogenicity. Screening of the AR mutations upon presumptive diagnosis of AIS is recommended. We analyzed a case of complete androgen insensitivity syndrome (CAIS) for mutations in the AR gene. Sequencing of the entire coding region revealed C>G mutation (CTT-GTT) at codon 712 (position according to the NCBI database) in exon 4 of the gene, resulting in replacement of leucine with valine in the ligand-binding domain of the AR protein. No incidence of this mutation was observed in 230 normal male individuals analyzed for comparison. In vitro androgen binding and transactivation assays using mutant clone showed approximately 71% loss of ligand binding and about 76% loss of transactivation function. We conclude that CAIS in this individual was due to L712V substitution in the androgen receptor protein.

  5. Factors Associated with Death Due to 2009 Influenza A (H1N1) Virus Infection and Acute Respiratory Distress Syndrome in Beijing, 2009-2011

    Institute of Scientific and Technical Information of China (English)

    Jin-qian; Zhang; Li-cheng; Zhang; Na; Ren; Ming; Zhang; Li-min; Guo; Xing-wang; Li; Jun; Cheng

    2012-01-01

    Objective Patients with H1N1 virus infection were hospitalized and quarantined, and some of them developed into acute respiratory failure, and were transfered to the medical intensive care unit of Beijing Ditan Hospital, Capital Medical University in Beijing, China. Methods The clinical features and preliminary epidemiologic findings among 30 patients with confirmed H1N1 virus infection who developed into acute respiratory failure for ventilatory support were investigated. Results A total of 30 patients(37.43 ± 18.80 years old) with 2009 influenza A(H1N1) related acute respiratory distress syndrome(ARDS) received treatment with mechanical ventilation, 15 cases of whom were male and 17 cases died of ARDS. Fatal cases were significantly associated with an APACHE Ⅱ score(P = 0.016), but not with PaO 2 /FIO 2(P = 0.912) and chest radiograph(P = 0.333). The most common complication was acute renal failure(n = 9). Five patients received extracorporeal membrane oxygenation(ECMO), 3 of whom died and the others survived. The major causes of death were multiple organ dysfunction syndrome(MODS)(39%), intractable respiratory failure(27%) and sepsis(20%). Conclusions Most patients with respiratory failure due to influenza A(H1N1) virus infection were young, with a high mortality, particularly associated with APACHE Ⅱ score, secondary infection of lung or type 2 diabetes mellitus.

  6. Intermittent gastric outlet obstruction due to a gallstone migrated through a cholecysto-gastric fistula: A new variant of "Bouveret's syndrome"

    Institute of Scientific and Technical Information of China (English)

    Dimitry Arioli; Mario De Santis; Fabrizio Di Benedetto; Giorgio Enrico Gerunda; Maria Luisa Zeneroli; Ivo Venturini; Michele Masetti; Elisa Romagnoli; Antonella Scarcelli; Pietro Ballesini; Athos Borghi; Alessandro Barberini; Vincenzo Spina

    2008-01-01

    Bouveret's syndrome, defined as gastric outlet obstruction due to a large gallstone, is still one of the most dramatic biliary gallstone complications. Although new radiological and endoscopic techniques have made pre-surgical diagnosis possible in most cases and the death rate has dropped dramatically, "one-stage surgery" (biliary surgery carried out at the same time as the removal of the gut obstruction) should be still considered as the gold standard for the treatment of gallstone ileus. In this case, partial gastric outlet obstruction resulted in an atypical and insidious clinical presentation that allowed us to perform the conventional one-stage laparatomic procedure that completely solved the problem, thus avoiding any further complications.

  7. [A case of X-linked alpha-thalassemia/mental retardation (ATR-X) syndrome with repeated apnea attacks due to laryngomalacia].

    Science.gov (United States)

    Ebishima, Yuko; Misaki, Takako; Owa, Kenji; Okuno, Takehiko; Wada, Takahito; Suehiro, Yutaka

    2013-01-01

    We report a case of X-linked alpha-thalassemia/mental retardation syndrome (ATR-X) with repeated apnea attacks dating from the patient's 12th year. We initially diagnosed them as obstructive apnea due to upper pharyngeal stenosis and laryngomalacia by polysomnography and laryngo-fiberscopy. However, reevaluation after one and a half years revealed that the boy had central and mixed apnea, as well as obstructive apnea. To date, few reports have been published on the causes of apnea attacks in ATR-X patients. We clinicians should therefore consider laryngomalacia as one cause of apnea attacks in ATR-X patients, and choose the appropriate therapy for a pattern of apnea that can change during its clinical course. PMID:23593745

  8. Unusual presentation of obstructive sleep apnoea syndrome due to a giant mandible osteoma: case report and literature review.

    Science.gov (United States)

    Tarsitano, A; Marchetti, C

    2013-02-01

    Osteomas are benign lesions composed of mature compact and/or cancellous bone that grow continuously. Their pathogenesis is unknown. It has been considered to be a neoplasm, a developmental or reactive osteogenic lesion resulting from muscle traction on the periosteum, or due to trauma. Herein, we report an unusual case of giant osteoma of the mandible depressing the lateral pharyngeal wall, interfering with normal respiration during the night. The uniqueness of this case is related to snoring and sleep apnoea symptoms. In fact, he presented to our Department because daytime sleepiness hindered his work, and not for the evident facial swelling. We reported our experience in diagnosis, treatment and follow-up of this uncommon disease. Polysomnography, CT scan and 3-D PAS volume analysis are useful tools to study in detail the aetiology of apnoea and assess outcomes.

  9. Syndrome-Specific Deficits of Performance and Effects of Practice on Arm Movements with Deafferentation due to Posterior Thalamic Lesion

    Directory of Open Access Journals (Sweden)

    Thomas Platz

    1997-01-01

    Full Text Available Aiming and tapping movements were analysed repeatedly over a three-week period in a patient who was hemideafferented due to an ischaemic posterior thalamic lesion. Contrasting behaviour observed in six healthy subjects, nine hemiparetic patients and one patient with hemianopic stroke, allowed the determination of behavioural deficits related to deafferentation. Finger tapping was not impaired specifically and did not improve with practice in the deafferented patient. When aiming movements were investigated, accuracy of the first, largely preprogrammed, phase of movement and timing of the late homing-in phase were impaired specifically in the deafferented patient. Practice led to a step-like change in preprogramming amplitude of the ballistic movement component, a gradual improvement of temporal efficiency of the early movement phase and a more marked improvement of the homing-in phase. Qualitatively comparable but quantitatively less marked effects of practice were documented for hemiparetic patients. These results demonstrated that deafferentation affects preprogrammed aspects of movement and those influenced by current control and that motor learning is possible with central deafferentation, even for aspects of performance that are impaired specifically. It is postulated that motor learning was mediated by changes in strategy (motor programming and improved efficiency of intact motor control processes (visuomotor control.

  10. Fatal case of hemolytic-uremic syndrome in an adult due to a rare serogroup O91 Entero hemorrhagic Escherichia coli associated with a Clostridium difficile infection. More than meets the eye

    Directory of Open Access Journals (Sweden)

    Thomas Guillard

    2015-08-01

    Full Text Available Hemolytic-uremic syndrome due to enterohemorrhagic Escherichia coli, belonging to serogroup O91 has rarely been described. We report here a case of post-diarrheal HUS due to EHEC O91 in an elderly patient for whom diagnosis was delayed given a previously diagnosed C. difficile infection. This case highlights the usefulness of Shiga-toxin detection.

  11. Fatal case of hemolytic-uremic syndrome in an adult due to a rare serogroup O91 Entero hemorrhagic Escherichia coli associated with a Clostridium difficile infection. More than meets the eye.

    Science.gov (United States)

    Guillard, Thomas; Limelette, Anne; Le Magrex-Debar, Elisabeth; Wynckel, Alain; Gouali, Malika; Mariani-Kurkdjian, Patricia; Guyot-Colosio, Charlotte; de Champs, Christophe

    2015-08-01

    Hemolytic-uremic syndrome due to enterohemorrhagic Escherichia coli, belonging to serogroup O91 has rarely been described. We report here a case of post-diarrheal HUS due to EHEC O91 in an elderly patient for whom diagnosis was delayed given a previously diagnosed C. difficile infection. This case highlights the usefulness of Shiga-toxin detection.

  12. Water losses from irrigation canals evaluation: comparison among different methodologies

    Science.gov (United States)

    Clemente, Paolo; De Luca, Domenico Antonio; Antonella Dino, Giovanna; Lasagna, Manuela

    2013-04-01

    The research investigates the field methodologies to evaluate water losses from canals, in order to find a reliable method to identify and quantify them. This study was conducted in five canal lines in Piedmont, north-western Italy, different for hydraulic, morphological, geological and hydrogeological contexts (De Luca et alii, 2012). At a regional scale, Piedmont network consists of several tens of thousands km of irrigation canals. The loss of water due to seepage from irrigation canals constitutes a substantial part of the usable water. Irrigation canals placed in natural soil or fine and coarse sediments are characterized by water losses ranging from 20 % to more than 50 %. These losses cause economic, hydrogeological and environmental consequences: water losses evaluation from irrigation canals in the basis for the sustainable water resource use and management. First, hydrogeological and hydrological characterisation of the study area and of the bottom of the irrigation canals was carried out for every investigated canal, in order to evaluate the relationships between groundwater and stream water (eg. piezometric and hydrogeochemical survey campaigns, infiltrometry tests, penetrometric tests and electrical tomographies, soil characterizations from the bottom of investigated canals). The canals seepage rates were subsequently estimated using different methodologies: empirical formulas, inflow-outflow tests and double tracer tests. The empirical formulas applied for the study underestimated the real amount of the losses probably due to the scarce number of the considered variables. Then the canals seepage rates were evaluated employing inflow-outflow tests, considered the best tool by several authors. This method allows the determination of seepage quantities measuring inflow and outflow of a canal test reach either by instruments. The canal discharge was evaluated using a current meter. This method, even if easy to apply and practical, is not efficient

  13. El Canal del Atazar I

    Directory of Open Access Journals (Sweden)

    López de Berges y de los Santos, Emilio

    1967-03-01

    Full Text Available The Atazar Canal helps to supply Madrid with water, from the rivers Lozoya, Jarama and Sorbe. The section which operates at present starts at the Torrelaguna dam and finishes at the El Goloso reservoir. Later a further section will be added, from the Atazar dam, on the Lozoya river, to link up with the control dam at Torrelaguna. The canal capacity is 16 m3/sec, and it is 43.47 km long. It has a slope of 4/10.000. The cross section is similar to that of the Jarama canal, already built. There are interconnections between this canal and the Canal Alto, which previously supplied the high and medium part of Madrid. To overcome the ground unevenness 5 syphons have been built, the most important of which is the Colmenar Goloso syphon, which is 10.88 km in length. Construction commenced on December 10, 1962, and water reached Madrid on June 15th, 1966. The initial budget for this project was 1,500 million pesetas.El canal del Atazar refuerza considerablemente el abastecimiento de aguas a Madrid, procedentes de los ríos Lozoya, Jarama y, en un próximo futuro, del Sorbe. El tramo, actualmente en funcionamiento, empieza en el salto de Torrelaguna y finaliza en los depósitos de El Goloso. Más adelante se completará su trazado mediante un nuevo tramo que partirá del embalse de Atazar, en el Lozoya, para unirse al actual en el depósito regulador de Torrelaguna. Su capacidad es de 16 m3/s; su longitud, 43,471 km, y su pendiente, 4 diezmilésimas. La sección tipo es análoga a la del canal del Jarama, de construcción anterior. Mediante la oportuna obra de transvase se realizan intercambios entre este Canal y el Canal Alto que abastecía anteriormente la parte media y alta de la capital. Para salvar los desniveles del terreno se han construido 5 sifones, siendo el más importante el de Colmenar-Goloso, con una longitud de 10,8S4 km. El comienzo de las obras tuvo lugar el 10 de diciembre de 1962, y el agua llegó a Madrid el 15 de junio de 1966. Su

  14. Groundwater quality and soil salinization in a canal command area and management options

    International Nuclear Information System (INIS)

    This study was undertaken to examine the groundwater quality and soil salinization in canal irrigated areas. Data were collected along six secondary canals (2 each at head, middle and tail end) of a main canal and nine tertiary canals (3 each at head, middle and tail) on each of the secondary canal. The farmers were also interviewed to investigate the impact of location along the irrigation channels on their crop yield and income. The results showed that groundwater quality has deteriorated from head to tail reaches of the irrigation channels i.e. the main canal, the secondary and the tertiary canals. Similarly, the soil salinization has increased with increase in distance from the head of the irrigation system along all the irrigation channels. Location of the water users along the canal irrigation system has significant impact on their crop yield as well as income and these parameters decrease with increase in distance from the head of the irrigation channels. The net income of the tail end farmers is only 43-59% of the head end farmers. The reduced canal water supply at lower reaches of the irrigation system forced the down reach water users to pump more groundwater of inferior quality resulting in many times increase in their irrigation cost. The deteriorating groundwater quality further added misery to the downstream farmers by degrading productivity of their lands due to increased soil salinity. (author)

  15. Canals - CANALS_HISTORIC_STRUCTURES_IN: Historic Canal Structures in Indiana (Bernardin-Lochmueller & Associates, Point Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — Data depicts the locations of historic structures associated with the Wabash-Erie, Central, and Whitewater Canals constructed in Indiana in from 1830-1870. Canal...

  16. Down syndrome due to a recombination of a chromosome 21 paracentric inversion in 1 of 2 cases with a review of paracentric recombinants

    Energy Technology Data Exchange (ETDEWEB)

    Jewett, T.; Rao, P.N.; Berry, M. [Wake Forest Univ., Winston-Salem, NC (United States)] [and others

    1994-09-01

    We recently identified 2 paracentric inversions (PAI) of chromosome 21. Case 1 was identified prenatally and paternally inherited: 46,XY,inv(21)(q21.2q22.13). The outcome is pending. Case 2 was a newborn male infant with clinical features of Down syndrome and an apparent inversion-duplication within chromosome 21. Parental chromosome analysis showed a maternal PAI: 46,XX,inv(21)(q21.2q22.3). The resulting child`s karyotype was: 46,XY,rec(21)(pter{yields}q21.2::q22.3{yields}q21.2::q22.3{yields}pter). Duplication of chromosome region q22.3{yields}qter was confirmed by FISH using a Down syndrome region specific probe (Cambio). Cytologically, the cornerstone of meiotic recombination from a paracentric inversion is the {open_quotes}reverse loop{close_quotes} model. In this model, a crossover event in the inversion loop results in the formation of gametes carrying either a dicentric chromatid, an acentric fragment, a normal chromatid or a chromatid with an inversion. However, a literature review of 326 PAI identified only 2 dicentrics and 15 other recombinants: 1 duplication/deletion; 6 deletions; 8 duplications. A U-type exchange model during meiosis within the inversion loop may best account for duplication/deletion recombinants. In contrast, the recombination in our case 2 would have occurred outside the loop. It is possible that no single explanation for PAI recombination may account for all outcomes. Alternative models of PAI recominational events will be presented. The literature suggests a low risk for prenatal loss due to abnormal PAI recombinants. In our review, viable offspring with recombinant chromosomes occurred in 3.8% of the PAI. Considering the potential for an increased incidence of recombination, prenatal diagnosis for all PAI carriers is warranted.

  17. Fluidmechanics of semicircular canals revisited

    Science.gov (United States)

    Obrist, Dominik

    2008-05-01

    In this work we find the exact solution for the flow field in a semicircular canal which is the main sensor for angular motion in the human body. When the head is rotated the inertia of the fluid in the semicircular canal leads to a deflection of sensory hair cells which are part of a gelatinous structure called cupula. A modal expansion of the governing equation shows that the semicircular organ can be understood as a dynamic system governed by duct modes and a single cupular mode. We use this result to derive an explicit expression for the displacement of the cupula as a function of the angular motion of the head. This result shows in a mathematically and physically clean way that the semicircular canal is a transducer for angular velocity.

  18. FGFR2 exon IIIa and IIIc mutations in Crouzon, Jackson-Weiss, and Pfeiffer syndromes: Evidence for missense changes, insertions, and a deletion due to alternative RNA splicing

    Energy Technology Data Exchange (ETDEWEB)

    Meyers, G.A.; Przylepa, K.A.; Scott, A.F. [Johns Hopkins Hospital, Baltimore, MD (United States)] [and others

    1996-03-01

    Fibroblast growth factor receptor 2 (FGFR2) mutations have been associated with the craniosynostotic conditions Crouzon, Jackson-Weiss, and Pfeiffer syndromes. Previously, mutations were described in the exons IIIa and IIIc, which form the extracellular, third immunoglobulin-like domain (IgM) and adjacent linker regions, both of which are normally involved in ligand binding. For all three conditions, mutations were found in exon IIIc. Only in Crouzon syndrome were mutations identified in exon IIIa. In this study, 39 cases with one of these three conditions were screened for exon IIIa or IIIc mutations. Eleven mutations are reported in 17 unrelated cases. Mutations in exon IIIa are identified for not only Crouzon but also Jackson-Weiss and Pfeiffer syndromes. Four mutations in either exon IIIa or exon IIIc reported only in Crouzon syndrome are present also in one of the other two syndromes. Two insertions, one in exon IIIa in a Crouzon syndrome patient and the other in exon IIIc in a Pfeiffer syndrome patient, were observed. The latter mutation has the same alternative RNA splicing effect as a reported synonymous mutation for Crouzon syndrome. A missense mutation was detected in one Pfeiffer syndrome family in which two members had craniosynostosis without limb anomalies. The inter- and intrafamilial variability in expression of FGFR2 mutations suggests that these three syndromes, presumed to be clinically distinct, are instead representative of a spectrum of related craniosynostotic and digital disorders. 16 refs., 3 figs., 1 tab.

  19. INSTRUMENTATION OF CURVED CANALS: A REVIEW

    Directory of Open Access Journals (Sweden)

    Senthil Kumar

    2013-02-01

    Full Text Available INTRODUCTION: Nature seldom draws a straight line. Nowhere is thi s more apparent than in the anatomy of teeth roots and root canal systems o f human teeth. Even teeth with straight roots can harbor severely curved canals. Canal shapi ng is a critical aspect of endodontic treatment because it influences the outcome of the subsequent phases of canal irrigation and filling and the success of the treatment itself. In fact, curved canals are the most common endodontic complexity 1 . The need for some manner of root canal preparation pri or to root canal filling has long been recognized as an essential step in endodontic t reatment. Concepts concerning the role and purpose of this canal preparation, however, have differ ed remarkably at different times in the development of endodontics and in the hands of diffe rent practitioners 2

  20. Computed tomography of the thoracic canal

    International Nuclear Information System (INIS)

    Under the adequate CT condition, thoracic canal was studied in twelve normal cases, nine cases of cervical myelopathy with developmental cervical canal stenosis and four cases of thoracic myelopathy with ossification of thoracic yellow ligament. The results were as follows. 1) The adequate condition for delineation of thoracic canal seemed to be nearly 400 EMI units in window width and 150 in level. Scanning angle was permitted within about 100. Bony thoracic canal was well scanned at the center of vertebral body. 2) The configulation of the normal thoracic canal was oval at Th1, Th2 levels and round at Th3-Th10 and large oval at Th11, Th12. The sagittal diameter was almost fixed at each level and the transverse diameter was large at upper and lower levels and small at middle levels. 3) Thoracic canal was narrowed in the cases of cervical myelopathy with developmental cervical canal stenosis especially in sagittal diameter, but not narrowed in transverse diameter. Three of four cases who had myelopathy with ossification of thoracic yellow ligament had narrow canals. 4) There was a good relation between sagittal diameter of cervical canal and thoracic canal. 5) There was a good relation between sagittal diameter of thoracic canal measured by conventional radiographs (Hattori's method) and CT scans. The author thinks that Hattori's method is useful to diagnose the thoracic canal stenosis. (author)

  1. [Piriformis syndrome].

    Science.gov (United States)

    Erauso, Thomas; Pégorie, Anne; Gaveau, Yves-Marie; Tardy, Dominique

    2010-09-20

    Sciatic pain is often misleading and establishing the link with a local muscular cause can be difficult and lead to errors, especially when faced with a young sportsman, with typical discogenic pain. Simple, specific and reproducible tests enable a better identification and treatment of a muscular cause or canal syndrome. Physiotherapy, or local infiltrations are generally very efficient, and sufficient. Surgery may be considered only in a very limited number of cases, lack of response to the first line treatment and then only if it is the absolute diagnosis, diagnosis which must remain a diagnosis of exception, more so of exclusion. PMID:21033479

  2. Contemporary root canal filling strategies

    NARCIS (Netherlands)

    A.T. Moinzadeh

    2016-01-01

    Currently, clinicians can choose from a wide range of root canal filling materials and techniques, some of which have been evaluated in this thesis. Methacrylate resin-based sealers suffer from polymerization shrinkage stresses. This limitation may partly be overcome by a two-step cementation proced

  3. Canal Water Scarcity Hits Farmers

    Institute of Scientific and Technical Information of China (English)

    张忠潮

    2007-01-01

    Acute shortage of canal water for irrigation in this district has caused resentment among the farmers.The water is being released in the various channels for just one week in a month,which is not enough to meet the irrigation needs of the farmers who are preparing their fields for paddy

  4. Dominant inhibition of Fas ligand-mediated apoptosis due to a heterozygous mutation associated with autoimmune lymphoproliferative syndrome (ALPS Type Ib

    Directory of Open Access Journals (Sweden)

    McDonald Jay M

    2007-07-01

    Full Text Available Abstract Background: Autoimmune lymphoproliferative syndrome (ALPS is a disorder of lymphocyte homeostasis and immunological tolerance due primarily to genetic defects in Fas (CD95/APO-1; TNFRSF6, a cell surface receptor that regulates apoptosis and its signaling apparatus. Methods: Fas ligand gene mutations from ALPS patients were identified through cDNA and genomic DNA sequencing. Molecular and biochemical assessment of these mutant Fas ligand proteins were carried out by expressing the mutant FasL cDNA in mammalian cells and analysis its effects on Fas-mediated programmed cell death. Results: We found an ALPS patient that harbored a heterozygous A530G mutation in the FasL gene that replaced Arg with Gly at position 156 in the protein's extracellular Fas-binding region. This produced a dominant-interfering FasL protein that bound to the wild-type FasL protein and prevented it from effectively inducing apoptosis. Conclusion: Our data explain how a naturally occurring heterozygous human FasL mutation can dominantly interfere with normal FasL apoptotic function and lead to an ALPS phenotype, designated Type Ib.

  5. Congenital myasthenic syndrome due to mutation in CHRNE gene with clinical worsening and thymic hyperplasia attributed to association with autoimmune-myasthenia gravis.

    Science.gov (United States)

    Santos, Ernestina; Moreira, Isabel; Coutinho, Ester; Gonçalves, Guilherme; Lopes, Carlos; Lopes Lima, José; Leite, M Isabel

    2015-12-01

    We report a patient with congenital myasthenic syndrome (CMS) due to mutation in CHRNE with symptoms since the age of 4; mild to moderate fatigable weakness involved mainly ocular, bulbar and limb muscles; functional impact of the disease in their development and physical activity was modest. By the age of 34, the patient experienced gradual worsening of fatigue with dyspnoea and pronounced limb weakness, requiring significant increase of pyridostigmine. Further, a remarkable and sustained clinical improvement followed thymectomy with hyperplastic thymus. Despite of the absence of detectable antibodies to acetyl-choline receptor (AChR) (including clustered-AChR), muscle-specific kinase and low-density lipoprotein receptor-related protein-4 antibodies in the serum obtained nine years after thymectomy, the clinical, genetic and histological features are in keeping with the extremely rare association of two rare neuromuscular junction disorders - CMS and myasthenia gravis (MG). The inexistence of other conditions that could potentially associate with thymic hyperplasia also supports the diagnosis of MG. PMID:26363966

  6. Unique Preservation of Neural Cells in Hutchinson- Gilford Progeria Syndrome Is Due to the Expression of the Neural-Specific miR-9 MicroRNA

    Directory of Open Access Journals (Sweden)

    Xavier Nissan

    2012-07-01

    Full Text Available One puzzling observation in patients affected with Hutchinson-Gilford progeria syndrome (HGPS, who overall exhibit systemic and dramatic premature aging, is the absence of any conspicuous cognitive impairment. Recent studies based on induced pluripotent stem cells derived from HGPS patient cells have revealed a lack of expression in neural derivatives of lamin A, a major isoform of LMNA that is initially produced as a precursor called prelamin A. In HGPS, defective maturation of a mutated prelamin A induces the accumulation of toxic progerin in patient cells. Here, we show that a microRNA, miR-9, negatively controls lamin A and progerin expression in neural cells. This may bear major functional correlates, as alleviation of nuclear blebbing is observed in nonneural cells after miR-9 overexpression. Our results support the hypothesis, recently proposed from analyses in mice, that protection of neural cells from progerin accumulation in HGPS is due to the physiologically restricted expression of miR-9 to that cell lineage.

  7. Huge bilateral ovarian cysts in adulthood as the presenting feature of Van Wyk Grumbach syndrome due to chronic uncontrolled juvenile hypothyroidism

    Directory of Open Access Journals (Sweden)

    K S Shivaprasad

    2013-01-01

    Full Text Available Juvenile primary hypothyroidism causing cystic ovaries and pseudoprecocious puberty (Van-Wyk Grumbach syndrome (VWGS is well documented in literature. There are only a few reports of primary hypothyroidism presenting as ovarian cysts in adults. Here we present a case of huge bilateral ovarian cysts in adulthood as the presenting feature of VWGS due to chronic uncontrolled juvenile hypothyroidism. Large uniloculor right ovarian cyst (119 × 81 × 90 mm and a multicystic left ovary (55 × 45 × 49 mm were detected in a 24 year lady with secondary amenorrhea, galactorrhea, and palpable abdominal mass with history of neonatal jaundice, delayed milestones, short stature, and precocious menarche at age of 7.5 years age. She had elevated levels of cancer antigen (CA-125 which normalized post levothyroxine supplementation. Elevated CA-125 may lead to misdiagnosis of ovarian carcinoma and inadvertent treatment. Bilateral ovarian cysts in adults are a rare presentation of juvenile hypothyroidism. It is necessary to screen for primary hypothyroidism in patients presenting with bilateral ovarian cysts to prevent unnecessary evaluation and treatment.

  8. Semicircular canal dehiscence: comparison of T2-weighted turbo spin-echo MRI and CT

    Energy Technology Data Exchange (ETDEWEB)

    Krombach, G.A.; Schmitz-Rode, T.; Haage, P.; Guenther, R.W. [Department of Diagnostic Radiology, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); DiMartino, E. [Department of Otorhinolaryngology, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); Prescher, A. [Department of Anatomy, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); Kinzel, S. [Department of Experimental Veterinary Medicine, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany)

    2004-04-01

    We assessed the value of MRI for delineation of dehiscence of the superior or posterior semicircular canal, as compared with CT, the current standard study for this entity. We reviewed heavily T2-weighted fast spin-echo images and high-resolution CT of the temporal bones of 185 patients independently semicircular canal dehiscence and its extent. In 30 patients (19 men, 11 women) we identified dehiscence of the bone over the superior and/or posterior semicircular canal on MRI. In 27 of these cases CT also showed circumscribed bone defects. In one patient dehiscence of the superior semicircular canal was initially overlooked on MRI, but seen on CT. MRI imaging thus had a sensitivity of 96% and specificity of 98%. Knowledge of the appearances of this entity on MRI may contribute to early diagnosis in patients with vertigo due to semicircular canal dehiscence. (orig.)

  9. Thoracic aortic aneurysm in infancy in aneurysms-osteoarthritis syndrome due to a novel SMAD3 mutation: further delineation of the phenotype

    NARCIS (Netherlands)

    Wischmeijer, A.; Laer, L. van; Tortora, G.; Bolar, N.A.; Camp, G. van; Fransen, E.; Peeters, N.; Bartolomeo, R. di; Pacini, D.; Gargiulo, G.; Turci, S.; Bonvicini, M.; Mariucci, E.; Lovato, L.; Brusori, S.; Ritelli, M.; Colombi, M.; Garavelli, L.; Seri, M.; Loeys, B.L.

    2013-01-01

    Recently, mutations in the SMAD3 gene were found to cause a new autosomal dominant aneurysm condition similar to Loeys-Dietz syndrome (LDS), mostly with osteoarthritis, called aneurysms-osteoarthritis syndrome (AOS). Our 3-year-old propositus underwent correction of an inguinal hernia at 3 months an

  10. Switch in FGFR3 and -4 expression profile during human renal development may account for transient hypercalcemia in patients with Sotos syndrome due to 5q35 microdeletions

    NARCIS (Netherlands)

    Mutsaers, H.A.M.; Levtchenko, E.N.; Martinerie, L.; Pertijs, J.C.L.M.; Allegaert, K.; Devriendt, K.; Masereeuw, R.; Monnens, L.A.; Lombes, M.

    2014-01-01

    CONTEXT: Sotos syndrome is a rare genetic disorder with a distinct phenotypic spectrum including overgrowth and learning difficulties. Here we describe a new case of Sotos syndrome with a 5q35 microdeletion, affecting the fibroblast growth factor receptor 4 (FGFR4) gene, presenting with infantile hy

  11. Autosomal dominant Carvajal plus syndrome due to the novel desmoplakin mutation c.1678A > T (p.Ile560Phe

    Directory of Open Access Journals (Sweden)

    Josef Finsterer

    2016-09-01

    Conclusion: Phenotypic manifestations of Carvajal syndrome are even broader than so far anticipated, the number of mutations in the desmoplakin gene responsible for Carvajal syndrome is still increasing, and these patients require implantation of an ICD as soon as their diagnosis is established.

  12. Mandibular Second Premolar with Four Canals

    Directory of Open Access Journals (Sweden)

    Javad Ghiasi

    2015-09-01

    Full Text Available A mandibular second premolar with four canals is an interesting example of anatomic variations. This report describes a case of a mandibular second premolar with three roots and four canals (one mesiobuccal, two distobuccal and one lingual. The canals were prepared using K-files and irrigated with NaOCl (5.25% and normal saline as the final irrigant. The canals were filled laterally with gutta percha and AH26 sealer (De Trey, Dentsply, Switzerland. This case shows a rare anatomic configuration and points out the importance of looking for additional canals.

  13. Dynamic intratubular biomineralization following root canal obturation with pozzolan‐based mineral trioxide aggregate sealer cement

    Science.gov (United States)

    Yoo, Yeon‐Jee; Baek, Seung‐Ho; Kum, Kee‐Yeon; Shon, Won‐Jun; Woo, Kyung‐Mi

    2015-01-01

    Summary The application of mineral trioxide aggregates (MTA) cement during the root canal obturation is gaining concern due to its bioactive characteristic to form an apatite in dentinal tubules. In this regard, this study was to assess the biomineralization of dentinal tubules following root canal obturation by using pozzolan‐based (Pz‐) MTA sealer cement (EndoSeal MTA, Maruchi). Sixty curved roots (mesiobuccal, distobuccal) from human maxillary molars were instrumented and prepared for root canal obturation. The canals were obturated with gutta‐percha (GP) and Pz‐MTA sealer by using continuous wave of condensation technique. Canals obturated solely with ProRoot MTA (Dentsply Tulsa Dental) or Pz‐MTA sealer were used for comparison. In order to evaluate the biomineralization ability under different conditions, the PBS pretreatment before the root canal obturation was performed in each additional samples. At dentin‐material interfaces, the extension of intratubular biomineralization was analyzed using scanning electron microscopy (SEM) and energy dispersive spectroscopy. When the root canal was obturated with GP and Pz‐MTA sealer, enhanced biomineralization of the dentinal tubules beyond the penetrated sealer tag was confirmed under the SEM observation (p cement can be used as a promising bioactive root canal sealer to enhance biomineralization of dentinal tubules under controlled environment. SCANNING 38:50–56, 2016. © 2015 The Authors. Scanning Published by Wiley Periodicals, Inc. PMID:26179659

  14. Dynamic intratubular biomineralization following root canal obturation with pozzolan-based mineral trioxide aggregate sealer cement.

    Science.gov (United States)

    Yoo, Yeon-Jee; Baek, Seung-Ho; Kum, Kee-Yeon; Shon, Won-Jun; Woo, Kyung-Mi; Lee, WooCheol

    2016-01-01

    The application of mineral trioxide aggregates (MTA) cement during the root canal obturation is gaining concern due to its bioactive characteristic to form an apatite in dentinal tubules. In this regard, this study was to assess the biomineralization of dentinal tubules following root canal obturation by using pozzolan-based (Pz-) MTA sealer cement (EndoSeal MTA, Maruchi). Sixty curved roots (mesiobuccal, distobuccal) from human maxillary molars were instrumented and prepared for root canal obturation. The canals were obturated with gutta-percha (GP) and Pz-MTA sealer by using continuous wave of condensation technique. Canals obturated solely with ProRoot MTA (Dentsply Tulsa Dental) or Pz-MTA sealer were used for comparison. In order to evaluate the biomineralization ability under different conditions, the PBS pretreatment before the root canal obturation was performed in each additional samples. At dentin-material interfaces, the extension of intratubular biomineralization was analyzed using scanning electron microscopy (SEM) and energy dispersive spectroscopy. When the root canal was obturated with GP and Pz-MTA sealer, enhanced biomineralization of the dentinal tubules beyond the penetrated sealer tag was confirmed under the SEM observation (p cement can be used as a promising bioactive root canal sealer to enhance biomineralization of dentinal tubules under controlled environment.

  15. Effect of pollution on phytoplankton in the Ashar Canal, a highly polluted canal of the Shatt al-Arab Estuary at Basrah, Iraq

    Energy Technology Data Exchange (ETDEWEB)

    Saad, M.A.H. (Alexandria Univ. (Egypt). Oceanography Dept.); Antoine, S.E.

    1983-03-01

    The effect of pollution on the phytoplankton in the Ashar Canal was studied during March and June 1976. Higher temperatures were recorded in June. The canal water was more turbid than that of the adjoining Shatt al-Arab estuary due to high algal populations and sewage disposal. The chlorosity values were remarkably high in the canal, due to sewage disposal. The flood waters in June lowered the chlorosity in both estuary and canal. Sewage disposal into the canal decreased its dissolved oxygen content. The lower oxygen values in the estuary in June were accompanied with higher temperatures. The pH values were generally higher in the estuary and were also higher in June than in March. Eighty-six algal taxa were recorded, 45 of which were diatoms. The phytoplankton in the estuary was more abundant in March, due to the increase in currents and turbidity in June. The Chlorophyta, Conjugatophyta, Myxophyta and Bacillariophyta in the estuary showed reverse seasonal trends from those of the total phytoplankton. These algae seemed to flourish during periods of high temperatures. The dense blue-green algae recorded in June is attributed to the high temperature and dissolved organic matter. The Chrysophyta recorded high populations in the estuary in March and were totally absent in June. Lower temperatures and high transparency in March might have led to their relative abundance. The total phytoplankton in the Ashar Canal followed two different seasonal trends, one resembling and the other differing from those in the estuary.

  16. Intussusception due to Peutz-Jeghers syndrome - a case report and review of the literature; Sindrome de Peutz-Jeghers e intussuscepcao - relato de um caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Grasso Filho, Luiz Eduardo; Albertotti, Flavio; Carvalho, Claudio Sobral de; Nersessian, Ana Carolina; Docema, Marcos F. Lima; Ogasawara, Aparecida M.; Peng Yong Sheng [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Centro de Diagnostico por Imagem; Costacurta, Marco Antonio [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Radiologia Geral; Albertotti, Cesar Jose [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Tomografia Computadorizada; Cerri, Giovanni Guido [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Ultra-Som

    2000-02-01

    The authors report a case of a 28-year-old woman with ileocecocolic intussusception due to Peutz-Jeghers syndrome, an autosomal dominant disorder characterized by hamartomatous polyposis of the gastrointestinal tract and mucocutaneous pigmentation. This condition frequently presents complications such as intestinal obstruction due to invagination or hemorrhage. In this patient, the diagnosis of intussusception was made preoperatively. The excised material revealed three large polyps which were considered to be the cause of the intussusception. (author)

  17. Improving the accuracy of canal seepage detection through geospatial techniques

    Science.gov (United States)

    Arshad, Muhammad

    With climatic change, many western states in the United States are experiencing drought conditions. Numerous irrigation districts are losing significant amount of water from their canal systems due to leakage. Every year, on the average 2 million acres of prime cropland in the US is lost to soil erosion, waterlogging and salinity. Lining of canals could save enormous amount of water for irrigating crops but in present time due to soaring costs of construction and environmental mitigation, adopting such program on a large scale would be excessive. Conventional techniques of seepage detection are expensive, time consuming and labor intensive besides being not very accurate. Technological advancements in remote sensing have made it possible to investigate irrigation canals for seepage sites identification. In this research, band-9 in the [NIR] region and band-45 in the [TIR] region of an airborne MASTER data has been utilized to highlight anomalies along irrigation canal at Phoenix, Arizona. High resolution (1 to 4 meter pixels) satellite images provided by private companies for scientific research and made available by Google to the public on Google Earth is then successfully used to separate those anomalies into water activity sites, natural vegetation, and man-made structures and thereby greatly improving the seepage detection ability of airborne remote sensing. This innovative technique is much faster and cost effective as compared to conventional techniques and past airborne remote sensing techniques for verification of anomalies along irrigation canals. This technique also solves one of the long standing problems of discriminating false impression of seepage sites due to dense natural vegetation, terrain relief and low depressions of natural drainages from true water related activity sites.

  18. Retention of Root Canal Posts

    DEFF Research Database (Denmark)

    Sahafi, A; Benetti, Ana Raquel; Flury, S;

    2015-01-01

    The aim of this study was to investigate the effect of the cement film thickness of a zinc phosphate or a resin cement on retention of untreated and pretreated root canal posts. Prefabricated zirconia posts (CosmoPost: 1.4 mm) and two types of luting cements (a zinc phosphate cement [DeTrey Zinc...... received tribochemical silicate coating according to the manufacturer's instructions. Posts were then luted in the prepared root canals (n=30 per group). Following water storage at 37°C for seven days, retention of the posts was determined by the pull-out method. Irrespective of the luting cement......, pretreatment with tribochemical silicate coating significantly increased retention of the posts. Increased cement film thickness resulted in decreased retention of untreated posts and of pretreated posts luted with zinc phosphate cement. Increased cement film thickness had no influence on retention...

  19. Rapidly progressive renal disease as part of Wolfram syndrome in a large inbred Turkish family due to a novel WFS1 mutation (p.Leu511Pro)

    DEFF Research Database (Denmark)

    Yuca, Sevil Ari; Rendtorff, Nanna Dahl; Boulahbel, Houda;

    2012-01-01

    Wolfram syndrome, also named "DIDMOAD" (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness), is an inherited association of juvenile-onset diabetes mellitus and optic atrophy as key diagnostic criteria. Renal tract abnormalities and neurodegenerative disorder may occur in the third...... and fourth decade. The wolframin gene, WFS1, associated with this syndrome, is located on chromosome 4p16.1. Many mutations have been described since the identification of WFS1 as the cause of Wolfram syndrome. We identified a new homozygous WFS1 mutation (c.1532T>C; p.Leu511Pro) causing Wolfram syndrome...... in a large inbred Turkish family. The patients showed early onset of IDDM, diabetes insipidus, optic atrophy, sensorineural hearing impairment and very rapid progression to renal failure before age 12 in three females. Ectopic expression of the wolframin mutant in HEK cells results in greatly reduced levels...

  20. Contemporary root canal filling strategies

    OpenAIRE

    Moinzadeh, A.T.

    2016-01-01

    Currently, clinicians can choose from a wide range of root canal filling materials and techniques, some of which have been evaluated in this thesis. Methacrylate resin-based sealers suffer from polymerization shrinkage stresses. This limitation may partly be overcome by a two-step cementation procedure. This alternative placement technique results in an increase and homogenization of the adhesion of the material to intraradicular dentin. Subsequent research should aim at developing sealers wi...

  1. Early Squamous Cell Carcinoma of the Anal Canal Resected by Endoscopic Submucosal Dissection

    Directory of Open Access Journals (Sweden)

    Yuzuru Tamaru

    2015-04-01

    Full Text Available The standard treatment approach for squamous cell carcinoma (SCC of the anal canal includes abdominoperineal resection and chemoradiotherapy. However, there are currently very few reports of early SCC of the anal canal resected by endoscopic submucosal dissection (ESD. We report 2 rare cases of SCC of the anal canal resected by ESD. In case 1, a 66-year-old woman underwent a colonoscopy due to blood in her stool, and an elevated lesion, 15 mm in size, was identified from the rectum to the dentate line of the anal canal on internal hemorrhoids. The lesion was diagnosed as an early SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. In case 2, a 71-year-old woman underwent a colonoscopy due to constipation, and an elevated lesion, 25 mm in size, was identified from the dentate line to the anal canal. The lesion was diagnosed as early-stage SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. No complications or recurrence after ESD occurred in either case.

  2. Hydrological investigation of groundwater under salt affected land in shorkot area with special emphasis on seepage from link canals

    International Nuclear Information System (INIS)

    Groundwater studies were carried out at Rechna Doab near the confluence of the rivers Chenab and Ravi, around the two link canals (HC and TSLC). The effects of canals on groundwater recharge was investigated with stable and radioactive isotope tracer technique by taking 39 spatial samples and 20 vertical profile samples at two locations. The studies show that about half of the study area receives more than 50% contribution from the canals in the groundwater recharge. The age of groundwater base flow without any contribution from the canals is more than 50 years, while the canal water component moves faster having residence time within few years. However, it seems that the hydraulic pressure due to contribution of the canals, hinders the movement of base flow coming from the northeast direction (eastern bank) and as a result, salt contents of groundwater and soil salinity increase very significantly in the area receiving little or no contribution from the canals. The study looks at horizontal and vertical extent of ground water quality at head-end of the canals. The findings of the study can help policy makers to devise policies to remove inequity due to variation in surface flow and resulting ground water quality at head and tail-ends of canal. The future studies can look at willingness to pay by low-enders for head-enders using groundwater and vice versa. (author)

  3. Budd-Chiari and inferior caval vein syndromes due to membranous obstruction of the liver veins. Successful treatment with angioplasty and transcaval TIPS

    DEFF Research Database (Denmark)

    Holland-Fischer, Peter

    2004-01-01

    -up the stents remain open and the patient is symptom free. This successful combination of stent placement and TIPS has not been described before. The case report is followed by a review of the literature on the use of angioplasty in short hepatic vein stenosis and TIPS in Budd-Chiari syndrome. It is concluded...... that angioplasty and TIPS are safe and efficient procedures to reduce liver engorgement and complications of portal hypertension in selected patients with Budd-Chiari syndrome....

  4. Shape and Deformation Analysis of the Human Ear Canal

    DEFF Research Database (Denmark)

    Darkner, Sune

    This thesis presents work on the analysis of the dynamic behavior of the human ear canal. The work is based on two studies designed during the project, a pilot study with 30 normal hearing subjects and a main study with 42 hearing impaired subjects, all hearing-aid users. The main focus is on the......This thesis presents work on the analysis of the dynamic behavior of the human ear canal. The work is based on two studies designed during the project, a pilot study with 30 normal hearing subjects and a main study with 42 hearing impaired subjects, all hearing-aid users. The main focus...... is on the extraction and analysis of the shape and deformation of the ear canal due to movements of the mandible, leaning over, and turning of the head. Methods for surface registration with focus on non-rigid registration are presented, as well as a wide range of statistical methods used for analyzing the shapes...... and deformation fields. The results show that the ear canal changes shape significantly in all subjects and that the deformation is more complicated than previously described in the literature. It is shown that the deformation at specific locations in the ear is significantly correlated to comfort issues reported...

  5. Nested Canalizing Functions and Their Networks

    CERN Document Server

    Kadelka, Claus; Adeyeye, John O; Laubenbacher, Reinhard

    2014-01-01

    The concept of a nested canalizing Boolean function has been studied over the last decade in the context of understanding the regulatory logic of molecular interaction networks, such as gene regulatory networks. Such networks are predominantly governed by nested canalizing functions. Derrida values are frequently used to analyze the robustness of a Boolean network to perturbations. This paper introduces closed formulas for the calculation of Derrida values of networks governed by Boolean nested canalizing functions, which previously required extensive simulations. Recently, the concept of nested canalizing functions has been generalized to include multistate functions, and a recursive formula has been derived for their number, as a function of the number of variables. This paper contains a detailed analysis of the class of nested canalizing functions over an arbitrary finite field. In addition, the concept of nested canalization is further generalized and closed formulas for the number of such generalized fun...

  6. Stability of guest molecules in urea canal complexes by canal polymerization

    International Nuclear Information System (INIS)

    It was found that various organic materials are attracted into urea canal by hexanediol diacrylate (HDDA) and long chain compounds. This means that materials which does not form complex by itself are induced in canal by HDDA and long chain compounds. To include with stability perfumes, insecticides, attractants and repellents in urea canal, leaf alcohol was used as a model compound for guest molecules in the canal. The leaf alcohol from the canal released gradually over many days and the release was inhibited for 15 days by long chain compounds and for 30 days by polymerized HDDA after irradiation. After releasing, the leaf alcohol in the canal remained 25 % stable for long chain compounds and 40 % for polymerized HDDA. The dose required for stabilization of leaf alcohol in the urea canal by canal polymerization of HDDA was 30 kGy. (author)

  7. Stability of guest molecules in urea canal complexes by canal polymerization

    Energy Technology Data Exchange (ETDEWEB)

    Yoshii, Fumio; Makuuchi, Keizo [Japan Atomic Energy Research Inst., Takasaki, Gunma (Japan). Takasaki Radiation Chemistry Research Establishment

    1995-03-01

    It was found that various organic materials are attracted into urea canal by hexanediol diacrylate (HDDA) and long chain compounds. This means that materials which does not form complex by itself are induced in canal by HDDA and long chain compounds. To include with stability perfumes, insecticides, attractants and repellents in urea canal, leaf alcohol was used as a model compound for guest molecules in the canal. The leaf alcohol from the canal released gradually over many days and the release was inhibited for 15 days by long chain compounds and for 30 days by polymerized HDDA after irradiation. After releasing, the leaf alcohol in the canal remained 25 % stable for long chain compounds and 40 % for polymerized HDDA. The dose required for stabilization of leaf alcohol in the urea canal by canal polymerization of HDDA was 30 kGy. (author).

  8. Canals, DMADCanals-Irrigation canals in Millard Co., Published in 2007, Millard County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Canals dataset, was produced all or in part from Other information as of 2007. It is described as 'DMADCanals-Irrigation canals in Millard Co.'. Data by this...

  9. Complicated canal morphology of mandibular first premolar

    Science.gov (United States)

    Pallavi, Vyapaka; Kumar, Janga Ravi; Mandava, Ramesh Babu; Rao, Subramanian Hari

    2015-01-01

    The aim of this article was to report an unusual anatomic variation of mandibular first premolar, with one root and three distinct canals, which leave pulp chamber and merge short of apex to exit as two separate apical foramina. The incidence of three canals existing as two apical foramina has only been documented in the literature by a few case reports. To achieve successful endodontic treatment, the clinician has to identify the different canal configurations and treat them properly. PMID:26538977

  10. The number and probability of canalizing functions

    OpenAIRE

    Just, Winfried; Shmulevich, Ilya; Konvalina, John

    2003-01-01

    Canalizing functions have important applications in physics and biology. For example, they represent a mechanism capable of stabilizing chaotic behavior in Boolean network models of discrete dynamical systems. When comparing the class of canalizing functions to other classes of functions with respect to their evolutionary plausibility as emergent control rules in genetic regulatory systems, it is informative to know the number of canalizing functions with a given number of input variables. Th...

  11. Lemierre's syndrome due to community-acquired meticillin-resistant Staphylococcus aureus infection and presenting with orbital cellulitis: a case report

    Directory of Open Access Journals (Sweden)

    Kadhiravan Tamilarasu

    2008-12-01

    Full Text Available Abstract Introduction Lemierre's syndrome is septic thrombophlebitis of the internal jugular vein leading to metastatic septic complications following an oropharyngeal infection. It is usually caused by the anaerobe, Fusobacterium necrophorum. Of late, meticillin-resistant Staphylococcus aureus is increasingly being recognised as a cause of community-acquired skin and soft tissue infections. We report a rare case of Lemierre's syndrome caused by community-acquired meticillin-resistant Staphylococcus aureus infection. Case presentation A previously healthy 16-year-old girl presented with fever of 13 days duration, painful swelling around the right eye and diplopia followed by the appearance of pulmonary infiltrates. Imaging studies confirmed the clinical suspicion of bilateral jugular venous thrombosis with septic pulmonary embolism. Meticillin-resistant Staphylococcus aureus was isolated on blood cultures. The hospital course was complicated by massive haemoptysis and pulmonary aspiration necessitating mechanical ventilation. The patient subsequently made a complete recovery. Conclusion Lemierre's syndrome, although rare, is a potentially lethal but treatable complication of head and neck sepsis. Early clinical recognition of Lemierre's syndrome and appropriate antibiotic treatment can be life-saving. One should consider the possibility of community-acquired meticillin-resistant Staphylococcus aureus infection in patients with suspected Lemierre's syndrome.

  12. Subclinical Cushing's syndrome due to unilateral or bilateral adrenal incidentalomas. Problems of diagnostic and indication to surgical treatment. Review of literature

    Directory of Open Access Journals (Sweden)

    Nikolay Sergeevich Kuznetsov

    2015-05-01

    Full Text Available Today subclinical Cushing's syndrome is the most widespread variant of hormonal activity of incidentaloma's hormonal activity. This pathology is defined as a mild intensity autonomous cortisol hypersecretion, not causing specific clinical signs of hypercorticism, but detectable biochemically as derangements of the hypothalamic-pituitary-adrenal axis function. Some clinical symptomatology of metabolic syndrome, such as obesity, impaired carbohydrate metabolism and hypertension, are peculiar to subclinical hypercorticism more than to population. As a result all these symptomatology could lead to increasing cardiovascular risk. Till now there isn't a definite opinion about the need of surgical treatment of present pathology. But there is evidence, that after removing of incidentalomas clinical symptomatology of metabolic syndrome are improving. For understanding all possible risks, connected with subclinical hypercorticism, it's necessary to study the origins of their arising and present about the most adequate screening tests. 

  13. Central Anticholinergic Syndrome due to Hypoxia-Induced Bradycardia in a Child with Difficult Intubation Undergoing Complete Dental Restoration: A Case Report.

    Science.gov (United States)

    Gharavifard, Mohamad; Razavi, Majid; Ghandehari Motlagh, Mehdi; Ziyaeifard, Mohsen

    2014-09-01

    Central anticholinergic syndrome (CAS) following general anesthesia (GA) is a well known syndrome in children and adults. Many cases of CAS have been previously reported in the literature. However, there are only two reports of post resuscitation CAS after administration of small doses of atropine. Hereby, we report a case of CAS in a child undergoing complete dental restoration under GA after receiving a small dose of atropine to reverse hypoxia induced bradycardia. Intraoperative events such as hypoxia or cardiac arrest may play a role as triggers for CAS. However, we cannot establish a causal relationship between the occurrence of CAS and such critical events.

  14. Central Anticholinergic Syndrome due to Hypoxia-Induced Bradycardia in a Child with Difficult Intubation Undergoing Complete Dental Restoration: A Case Report.

    Directory of Open Access Journals (Sweden)

    Mohamad Gharavifard

    2014-10-01

    Full Text Available Central anticholinergic syndrome (CAS following general anesthesia (GA is a well known syndrome in children and adults. Many cases of CAS have been previously reported in the literature. However, there are only two reports of post resuscitation CAS after administration of small doses of atropine. Hereby, we report a case of CAS in a child undergoing complete dental restoration under GA after receiving a small dose of atropine to reverse hypoxia induced bradycardia. Intraoperative events such as hypoxia or cardiac arrest may play a role as triggers for CAS. However, we cannot establish a causal relationship between the occurrence of CAS and such critical events.

  15. Upper esophageal web due to a ring formed by a squamocolumnar junction with ectopic gastric mucosa (another explanation of the Paterson-Kelly, Plummer-Vinson syndrome).

    Science.gov (United States)

    Weaver, G A

    1979-12-01

    A patient is presented with Barrett's esophagus (lower esophagus lined with columnar epithelium) who also has a band of columnar epithelium in the upper esophagus separated from that below by normal squamous epithelium in the midesophagus. The upper most squamocolumnar junction coincided with or formed a mucosal ring as seen at endoscopy. This ring, which was first seen on barium swallow, has the radiographic appearance of that associated with the Paterson-Kelly syndrome. This patient's unique findings may provide further insight into the etiology of upper esophageal webs or rings (Paterson-Kelly syndrome).

  16. Tethered cord syndrome: case report

    International Nuclear Information System (INIS)

    Tethered cord syndrome is one of the filum terminale congenital defects. It can coexist with anomalies of the spinal canal and column, as well as with anorectal defects. The authors present a case of tethered cord syndrome diagnosed in a 45-year-old woman. She showed typical lumbo-sacral radicular syndrome with no neurological deficits and no bowel/bladder dysfunction. The anomaly coexisted with fibrolipoma, spina bifida and Tarlov cyst. Magnetic resonance imaging is the method of choice in diagnostics of tethered cord syndrome. It provides crucial information, which is necessary for planning surgical treatment of the anomaly. (author)

  17. Application of microcomputed tomography for quantitative analysis of dental root canal obturations

    Directory of Open Access Journals (Sweden)

    Małgorzata Jaworska

    2014-03-01

    Full Text Available Introduction: The aim of the study was to apply microcomputed tomography to quantitative evaluation of voids and to test any specific location of voids in tooth’s root canal obturations. Materials and Methods: Twenty root canals were prepared and obturated with gutta-percha and Tubli-Seal sealer using the thermoplastic compaction method (System B + Obtura II. Roots were scanned and three-dimensional visualization was obtained. The volume and Feret’s diameter of I-voids (at the filling/dentine interface and S-voids (surrounded by filling material were measured. Results: The results revealed that none of the scanned root canal fillings were void-free. For I-voids, the volume fraction was significantly larger, but their number was lower (P = 0.0007, than for S-voids. Both types of voids occurred in characteristic regions (P < 0.001. I-voids occurred mainly in the apical third, while S-voids in the coronal third of the canal filling. Conclusions: Within the limitations of this study, our results indicate that microtomography, with proposed semi-automatic algorithm, is a useful tools for three-dimensional quantitative evaluation of dental root canal fillings. In canals filled with thermoplastic gutta-percha and Tubli-Seal, voids at the interface between the filling and canal dentine deserve special attention due to of their periapical location, which might promote apical microleakage. Further studies might help to elucidate the clinical relevance of these results.

  18. Narrow, duplicated internal auditory canal

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, T. [Servico de Neurorradiologia, Hospital Garcia de Orta, Avenida Torrado da Silva, 2801-951, Almada (Portugal); Shayestehfar, B. [Department of Radiology, UCLA Oliveview School of Medicine, Los Angeles, California (United States); Lufkin, R. [Department of Radiology, UCLA School of Medicine, Los Angeles, California (United States)

    2003-05-01

    A narrow internal auditory canal (IAC) constitutes a relative contraindication to cochlear implantation because it is associated with aplasia or hypoplasia of the vestibulocochlear nerve or its cochlear branch. We report an unusual case of a narrow, duplicated IAC, divided by a bony septum into a superior relatively large portion and an inferior stenotic portion, in which we could identify only the facial nerve. This case adds support to the association between a narrow IAC and aplasia or hypoplasia of the vestibulocochlear nerve. The normal facial nerve argues against the hypothesis that the narrow IAC is the result of a primary bony defect which inhibits the growth of the vestibulocochlear nerve. (orig.)

  19. Somatostatin analogues do not affect calcium metabolism in patients with acromegaly and primary hyperparathyroidism [corrected] due to MEN 1-like syndrome.

    Science.gov (United States)

    Bogazzi, F; Lombardi, M; Russo, D; Sardella, C; Raggi, F; Brogioni, S; Cetani, F; Ceccarelli, C; Mariani, G; Basolo, F; Martino, E

    2011-02-01

    Patients with clinical features of MEN 1 without mutations in the menin gene fulfill the criteria of MEN1-like syndrome. Primary hyperparathyroidism (PHP) is the most frequent clinical finding in both syndromes and is usually treated by surgery. However, PHP has been reported to respond to somatostatin analogues (SSA) in MEN 1 patients. 7 patients with PHP in the context of MEN 1-like syndrome (and absence of mutations in the menin gene) were enrolled in the study and treated with SSA for 6 months for the non-PHP disease before parathyroidectomy. Serum ionized calcium, phosphorus, and PTH concentrations, and 24-h urinary calcium and phosphorus excretion were measured before and after SSA therapy. Mean serum ionized calcium, phosphorus, and PTH concentrations did not significantly change after a 6-month course with SSA. SSA scintigraphy did not reveal uptake in the neck region corresponding to the parathyroid adenoma identified at surgery and confirmed at histology. However, immunohistochemistry revealed SS-type 2A receptor in parathyroid tissue samples of 6 out of 7 patients. SSA therapy does not affect calcium-phosphorus metabolism in patients with MEN 1-like syndrome, suggesting that the drug has no role in controlling PHP in these subset of patients.

  20. Complete androgen insensitivity syndrome due to a new frameshift deletion in exon 4 of the androgen receptor gene: Functional analysis of the mutant receptor

    NARCIS (Netherlands)

    J.M. Lobaccaro; S. Lumbroso; N. Poujol (Nicolas); V. Georget; A.O. Brinkmann (Albert); G. Malpuech (Georges); C. Sultan

    1995-01-01

    textabstractWe studied the androgen receptor gene in a large kindred with complete androgen insensitivity syndrome and negative receptor-binding activity, single-strand conformation polymorphism (SSCP) analysis and sequencing identified a 13 base pair deletion within exon 4. This was responsible for

  1. Root Canal Treatment of a Maxillary Second Premolar with Two Palatal Root Canals: A Case Report.

    Science.gov (United States)

    Golmohammadi, Maryam; Jafarzadeh, Hamid

    2016-01-01

    Accurate diagnosis of the root canal morphology and anatomy is essential for thorough shaping and cleaning of the entire root canal system and consequent successful treatment. This report describes a case of maxillary second premolar with two roots and three root canals (two mesial and distal palatal canals). The case report underlines the importance of complete knowledge about root canal morphology and possible variations, coupled with clinical and radiographic examination in order to increase the ability of clinicians to treat difficult cases. PMID:27471538

  2. Value of syndromic surveillance in monitoring a focal waterborne outbreak due to an unusual Cryptosporidium genotype in Northamptonshire, United Kingdom, June - July 2008.

    Science.gov (United States)

    Smith, S; Elliot, A J; Mallaghan, C; Modha, D; Hippisley-Cox, J; Large, S; Regan, M; Smith, G E

    2010-01-01

    The United Kingdom (UK) has several national syndromic surveillance systems. The Health Protection Agency (HPA)/NHS Direct syndromic surveillance system uses pre-diagnostic syndromic data from a national telephone helpline, while the HPA/QSurveillance national surveillance system uses clinical diagnosis data extracted from general practitioner (GP)-based clinical information systems. Data from both of these systems were used to monitor a local outbreak of cryptosporidiosis that occurred following Cryptosporidium oocyst contamination of drinking water supplied from the Pitsford Reservoir in Northamptonshire, United Kingdom, in June 2008. There was a peak in the number of calls to NHS Direct concerning diarrhoea that coincided with the incident. QSurveillance data for the local areas affected by the outbreak showed a significant increase in GP consultations for diarrhoea and gastroenteritis in the week of the incident but there was no increase in consultations for vomiting. A total of 33 clinical cases of cryptosporidiosis were identified in the outbreak investigation, of which 23 were confirmed as infected with the outbreak strain. However, QSurveillance data suggest that there were an estimated 422 excess diarrhoea cases during the outbreak, an increase of about 25% over baseline weekly levels. To our knowledge, this is the first time that data from a syndromic surveillance system, the HPA/QSurveillance national surveillance system, have been able to show the extent of such a small outbreak at a local level. QSurveillance, which covers about 38% of the UK population, is currently the only GP database that is able to provide data at local health district (primary care trust) level. The Cryptosporidium contamination incident described demonstrates the potential usefulness of this information, as it is unusual for syndromic surveillance systems to be able to help monitor such a small-scale outbreak. PMID:20738999

  3. [Upper lateral incisor with 2 canals].

    Science.gov (United States)

    Fabra Campos, H

    1991-01-01

    Clinical case summary of the patient with an upper lateral incisor with two root canals. The suspicion that there might be an anatomic anomaly in the root that includes a complex root canal system was made when an advanced radicular groove was detected in the lingual surface or an excessively enlarged cingulum. PMID:1659854

  4. 33 CFR 117.438 - Company Canal.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Company Canal. 117.438 Section 117.438 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Louisiana § 117.438 Company Canal. (a) The draw of...

  5. [Upper lateral incisor with 2 canals].

    Science.gov (United States)

    Fabra Campos, H

    1991-01-01

    Clinical case summary of the patient with an upper lateral incisor with two root canals. The suspicion that there might be an anatomic anomaly in the root that includes a complex root canal system was made when an advanced radicular groove was detected in the lingual surface or an excessively enlarged cingulum.

  6. Blending Canal Surfaces Based on PH Curves

    Institute of Scientific and Technical Information of China (English)

    Chen-Dong Xu; Fa-Lai Chen

    2005-01-01

    In this paper, a new method for blending two canal surfaces is proposed. The blending surface is itself a generalized canal surface, the spine curve of which is a PH (Pythagorean-Hodograph) curve. The blending surface possesses an attractive property - its representation is rational. The method is extensible to blend general surfaces as long as the blending boundaries are well-defined.

  7. Type III apical transportation of root canal

    Directory of Open Access Journals (Sweden)

    Shiv P Mantri

    2012-01-01

    Full Text Available Procedural accidents leading to complications such as canal transportation have been ascribed to inapt cleaning and shaping concepts. Canal transportation is an undesirable deviation from the natural canal path. Herewith a case of apical transportation of root canal resulting in endodontic retreatment failure and its management is presented. A healthy 21-year-old young male presented discomfort and swelling associated with painful endodontically retreated maxillary incisor. Radiograph revealed periradicular radiolucency involving underfilled 11 and overfilled 12. Insufficiently obturated 11 exhibited apical transportation of canal. This type III transportation was treated by periradicular surgery and repair using white mineral trioxide aggregate (MTA. Comfortable asymptomatic patient presented uneventful healing at third and fourth month recall visits. A decrease in the size of radiolucency in radiograph supported the clinical finding. In the present case, MTA is useful in repairing the transportation defect. The result of these procedures is predictable and successful.

  8. Clinical management of infected root canal dentin.

    Science.gov (United States)

    Love, R M

    1996-08-01

    Several hundred different species of bacteria are present in the human intraoral environment. Bacterial penetration of root canal dentin occurs when bacteria invade the root canal system. These bacteria may constitute a reservoir from which root canal reinfection may occur during or after endodontic treatment. The learning objective of this article is to review endodontic microbiology, update readers on the role of bacteria in pulp and periapical disease, and discuss the principles of management of infected root canal dentin. Complete debridement, removal of microorganisms and affected dentin, and chemomechanical cleansing of the root canal are suggested as being the cornerstones of successful endodontic therapy, followed by intracanal medication to remove residual bacteria, when required.

  9. The cartilage bone junction and its implications for deep canal hearing instrument fittings

    DEFF Research Database (Denmark)

    Nielsen, Claus; Darkner, Sune

    2011-01-01

    The popularity of hearing instruments deeply placed in the ear canal has been driven by their superior cosmetic characteristics. However, people fitted with these hear- ing instruments often complain about the sound qual- ity of their voice, which is typically described as being hollow, echoing......, or like talking in a barrel. This problem is caused by the occlusion effect. The effect is primarily due to vibrations of the walls in the soft part of the ear canal, which generate a sound pressure that is trapped in the cavity between the tip of the occluding hearing aid and the tympanic membrane....... If the hearing aid is fitted with a seal in the bony portion of the ear canal, preventing vibration in the soft part of the ear canal from reaching the tympanic membrane, then occlusion problems can be solved or at least reduced in most cases. 1–4 Work carried out by Garcia has shown that if the seal...

  10. TREATMENT OF SLEEP APNEA SYNDROME DUE TO ANKYLOSIS OF TMJ USING ORTHOGNATHIC SURGERY TECHNIQUE%正颌外科技术治疗TMJ后OSAS

    Institute of Scientific and Technical Information of China (English)

    于擘; 顾晓明; 张良; 门志光

    2002-01-01

    Objective To evaluate orthognathic surgery in the treatment of sleep apnea syndrome (SAS) resulted from ankylosis of TMJ. Methods Firstly, the arthroplasty was carried out to relieve the TMJ ankylosis and to open mouth according to design. The mandibles of 14 patients with SAS were advanced by "L"-osteotomy of ramus at the affected side and a sagittal split ramus osteotomy at normal side combined with TMJ arthroplasty. Results After operation, maximal mouth opening of the 14 patients reached 2.5cm-3.5cm. The follow-up 2 years later showed the maximal mouth opening was kept between 2.5cm and 3.2cm. AHI of all the patients were less than 20 postoperatively. Snoring while asleep disappeared in 12 patients and their SaO2 increased by 18.45% in average (P<0.01), which fell into the normal range. No patients were waken up by suffocation. Continuous SaO2 increased from 58% to over 95% in average. Conclusion The obstruction of the upper airway can be relieved through orthognathic surgery. Thus the hypoxemia of the patients was relieved or corrected. This technique is effective in the treatment of SAS due to TMJ ankylosis.%目的评估正颌外科技术矫治14例颞颌关节强直所致OSAS的效果.方法手术采用患侧关节成形,下颌升支、体部的"L"形半层截骨及健侧矢状截骨术,将患侧下颌升支加高固定,下颌前部整体前移.结果 14例颞颌关节强直伴OSAS患者术后张口度达2.5~3.5cm,术后2年随访张口度仍维持在2.5~3.2cm之间.所有患者的AHI指数下降了20以上,12例患者的打鼾症状消失,持续血氧饱和度平均提高了18.45%(P<0.01),达到了正常人的范围,持续血氧饱和度最低值由术前的58%提高至术后的95%以上,OSAS得以治愈.结论颞颌关节强直伴OSAS患者通过正颌外科手术可以在关节成形的同时,解决患者下颌后缩的缺陷,解除上气道狭窄,从而缓解或纠正患者的低氧血症.

  11. MRI Findings in Spinal Canal Stenosis

    Directory of Open Access Journals (Sweden)

    Maryam Barzin

    2010-05-01

    Full Text Available Spinal canal stenosis results from progressive narrowing of the central spinal canal and the lateral recesses. Primary (congenital lumbar spinal stenosis is associated with achondroplastic dwarfism. The spinal canal may become narrowed by bulging or protrusion of the intervertebral disc annulus, herniation of the nucleus pulposus posteriorly, thickening of the posterior longitudinal ligament, hypertrophy of the facet joints, hypertrophy of the ligamentum flavum, epidural fat deposition, spondylosis of the intervertebral disc margins and uncovertebral joint hypertrophy in the neck. The central canal and the neurorecess may be compromised by tumor infiltration, such as metastatic disease, or by infectious spondylitis."nAP diameter of the normal adult cervical canal has a mean value of 17-18 mm at vertebral levels C3-5. The lower cervical canal measures 12-14 mm. Cervical stenosis is associated with an AP diameter of less than 10 mm. The thoracic spinal canal varies from 12 to 14 mm in diameter in the adult. The diameter of the normal lumbar spinal canal varies from 15 to 27 mm. Lumbar stenosis results from a spinal canal diameter of less than 12 mm in some patients; a diameter of 10 mm is definitely stenotic."nSpinal MRI is the most suitable technique for the diagnosis of spinal stenosis. The examination should be performed using thin sections (3 mm and high resolution, including the axial and sagittal planes using T1-weighted, proton-density, and T2-weighted techniques. The bony and osteophytic components are seen best using a T2-weighted gradient-echo technique."nOn MRI, findings of spinal stenosis have a variable presentation depending on the specific disease. The goal of spinal imaging is to localize the site and level of disease and to help differentiate between conditions in which patients require surgery or conservative treatment."nIn this presentation, different kinds of spinal canal stenosis and their MRI findings would be discussed.

  12. Complete androgen insensitivity syndrome due to a new frameshift deletion in exon 4 of the androgen receptor gene: Functional analysis of the mutant receptor

    OpenAIRE

    Lobaccaro, J M; Lumbroso, S.; Poujol, Nicolas; Georget, V.; Brinkmann, Albert; Malpuech, Georges; Sultan, C.

    1995-01-01

    textabstractWe studied the androgen receptor gene in a large kindred with complete androgen insensitivity syndrome and negative receptor-binding activity, single-strand conformation polymorphism (SSCP) analysis and sequencing identified a 13 base pair deletion within exon 4. This was responsible for a predictive frameshift in the open reading frame and introduction of a premature stop codon at position 783 instead of 919. The deletion was reproduced in androgen receptor wildtype cDNA and tran...

  13. Non-syndromic retinitis pigmentosa due to mutations in the mucopolysaccharidosis type IIIC gene, heparan-alpha-glucosaminide N-acetyltransferase (HGSNAT)

    Science.gov (United States)

    Haer-Wigman, Lonneke; Newman, Hadas; Leibu, Rina; Bax, Nathalie M.; Baris, Hagit N; Rizel, Leah; Banin, Eyal; Massarweh, Amir; Roosing, Susanne; Lefeber, Dirk J.; Zonneveld-Vrieling, Marijke N.; Isakov, Ofer; Shomron, Noam; Sharon, Dror; Den Hollander, Anneke I.; Hoyng, Carel B.; Cremers, Frans P.M.; Ben-Yosef, Tamar

    2015-01-01

    Retinitis pigmentosa (RP), the most common form of inherited retinal degeneration, is clinically and genetically heterogeneous and can appear as syndromic or non-syndromic. Mucopolysaccharidosis type IIIC (MPS IIIC) is a lethal disorder, caused by mutations in the heparan-alpha-glucosaminide N-acetyltransferase (HGSNAT) gene and characterized by progressive neurological deterioration, with retinal degeneration as a prominent feature. We identified HGSNAT mutations in six patients with non-syndromic RP. Whole exome sequencing (WES) in an Ashkenazi Jewish Israeli RP patient revealed a novel homozygous HGSNAT variant, c.370A>T, which leads to partial skipping of exon 3. Screening of 66 Ashkenazi RP index cases revealed an additional family with two siblings homozygous for c.370A>T. WES in three Dutch siblings with RP revealed a complex HGSNAT variant, c.[398G>C; 1843G>A] on one allele, and c.1843G>A on the other allele. HGSNAT activity levels in blood leukocytes of patients were reduced compared with healthy controls, but usually higher than those in MPS IIIC patients. All patients were diagnosed with non-syndromic RP and did not exhibit neurological deterioration, or any phenotypic features consistent with MPS IIIC. Furthermore, four of the patients were over 60 years old, exceeding by far the life expectancy of MPS IIIC patients. HGSNAT is highly expressed in the mouse retina, and we hypothesize that the retina requires higher HGSNAT activity to maintain proper function, compared with other tissues associated with MPS IIIC, such as the brain. This report broadens the spectrum of phenotypes associated with HGSNAT mutations and highlights the critical function of HGSNAT in the human retina. PMID:25859010

  14. Perianal abscesses due to ingested foreign bodies

    Directory of Open Access Journals (Sweden)

    Doublali Mbarek

    2010-01-01

    Full Text Available The clinical presentation of perianal abscesses due to foreign bodies (FBs impacted in the anal canal mimics common causes of acute anal pain. The diagnosis can be established by digital rectal examination and/or proctoscopy, but may miss the presence of an FB. Incision and drainage of the abscess, along with removal of the FB, results in immediate pain relief and cure. Impacted FB must not be overlooked as an unusual cause of perianal abscess. One case of perianal abscesses due to FB impacted in the anal canal is reported.

  15. Panama Canal Watershed Experiment- Agua Salud Project

    Science.gov (United States)

    Stallard, Robert F.; Ogden, Fred L.; Elsenbeer, Helmut; Hall, Jefferson S.

    2010-01-01

    The Agua Salud Project utilizes the Panama Canal’s (Canal) central role in world commerce to focus global attention on the ecosystem services provided by tropical forests. The Canal was one of the great engineering projects in the world. Completed in 1914, after almost a decade of concerted effort, its 80 km length greatly shortened the voyage between the Atlantic and Pacific Oceans. An entire class of ships, the Panamax, has been constructed to maximize the amount of cargo that can be carried in a Canal passage. In today’s parlance, the Canal is a “green” operation, powered largely by water (Table 1). The locks, three pairs on each end with a net lift of 27 meters, are gravity fed. For each ton of cargo that is transferred from ocean to ocean, about 13 tons of water (m3) are used. Lake Gatún forms much of the waterway in the Canal transect. Hydroelectricity is generated at the Gatún dam, whenever there is surplus water, and at Madden Dam (completed in 1936) when water is transferred from Lake Alhajuela to Lake Gatún. The Canal watershed is the source of drinking water for Panama City and Colon City, at either end of the Canal, and numerous towns in between.

  16. Is the drug-induced hypersensitivity syndrome (DIHS due to human herpesvirus 6 infection or to allergy-mediated viral reactivation? Report of a case and literature review

    Directory of Open Access Journals (Sweden)

    Borgia Guglielmo

    2010-03-01

    Full Text Available Abstract Background Drug-Induced Hypersensitivity Syndrome (DIHS is a severe and rare systemic reaction triggered by a drug (usually an antiepileptic drug. We present a case of DISH and we review studies on the clinical features and treatment of DIHS, and on its pathogenesis in which two elements (Herpesvirus infection and the drug interact with the immune system to trigger such a syndrome that can lead to death in about 20% of cases. Case presentation We report the case of a 26-year old woman with fever, systemic maculopapular rash, lymphadenopathy, hepatitis and eosinophilic leukocytosis. She had been treated with antibiotics that gave no benefit. She was taking escitalopram and lamotrigine for a bipolar disease 30 days before fever onset. Because the patient's general condition deteriorated, betamethasone and acyclovir were started. This treatment resulted in a mild improvement of symptoms. Steroids were rapidly tapered and this was followed with a relapse of fever and a worsening of laboratory parameters. Human herpesvirus 6 (HHV-6 DNA was positive as shown by PCR. Drug-Induced Hypersensitivity Syndrome (DIHS was diagnosed. Symptoms regressed on prednisone (at a dose of 50 mg/die that was tapered very slowly. The patient recovered completely. Conclusions The search for rare causes of fever led to complete resolution of a very difficult case. As DIHS is a rare disease the most relevant issue is to suspect and include it in differential diagnosis of fevers of unknown origin. Once diagnosed, the therapy is easy (steroidal administration and often successful. However our case strongly confirms that attention should be paid on the steroidal tapering that should be very slow to avoid a relapse.

  17. A case of pathology-proven neuromyelitis optica spectrum disorder with Sjögren syndrome manifesting aphasia and apraxia due to a localized cerebral white matter lesion.

    Science.gov (United States)

    Sawada, Jun; Orimoto, Ryosuke; Misu, Tatsuro; Katayama, Takayuki; Aizawa, Hitoshi; Asanome, Asuka; Takahashi, Kae; Saito, Tsukasa; Anei, Ryogo; Kamada, Kyousuke; Miyokawa, Naoyuki; Takahashi, Toshiyuki; Fujihara, Kazuo; Hasebe, Naoyuki

    2014-09-01

    A woman with Sjögren syndrome manifesting as aphasia with a left deep cerebral white matter lesion tested positive for anti-aquaporin 4 (AQP4) antibody. Open biopsy of the lesion revealed active demyelination with edematous changes and the preservation of most axons, indicating a non-necrotic demyelinating lesion. Immunostaining for AQP4 was diffusely lost, whereas the loss of glial fibrillary acidic protein immunostaining was limited but with highly degenerated astrocytic foot processes in perivascular areas. These results suggested neuromyelitis optica spectrum disorder (NMOSD) pathology rather than Sjögren-related vasculitis. Only cerebral cortical symptoms with a cerebral white matter lesion could be observed in NMOSDs.

  18. Evaluation of the Number of Canals in Mandibular Canines Using Radiographic and Clearing Methods in an Iranian Population

    Directory of Open Access Journals (Sweden)

    Fateme Tajik

    2013-01-01

    Full Text Available Introduction: Lack of knowledge about root canal anatomy can cause mistakes in diagnosis, treatment planning and failure of treatment. Mandibular canine is usually single-rooted it may have two roots or more root canals. The purpose of this study was evaluating the number of root and root-canals of mandibular canine using digital radiography with different angles and comparing it with clearing method.Materials & Methods: This study was a diagnostic test. Two hundred human mandibular canine teeth were studied. Digital radiography of the teeth from mesiodistal, bacculingual and 200 mesial views were prepared. Radiographic evaluation was down by two observers (An oral radiologist and an endodontist separately. Then dental clearing was performed. Data analysis was done using SPSS.Ver.17 software and statistical tests of MC Nemar. P0.001. Findings of digital radiography in mesiodistal view showed that 180 teeth (90% were single-canal and 20 teeth (10% had two canals, which were not different from those of clearing method (P=0.25. In 200 mesial view, 192 teeth (96% were single-canal and 8 teeth (4% had two canals, which were different from those of clearing method (P=0.012.Conclusion: Despite the low prevalence of anatomical variations in mandibular canine in this in vitro study, due to the lack of significant difference of radiographic mesiodistal views compared to that of clearing technique, CBCT modality is recommended for obtaining fast and complete diagnosis of unusual root canal.

  19. 21 CFR 872.3810 - Root canal post.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Root canal post. 872.3810 Section 872.3810 Food... DEVICES DENTAL DEVICES Prosthetic Devices § 872.3810 Root canal post. (a) Identification. A root canal... of the platinum group intended to be cemented into the root canal of a tooth to stabilize and...

  20. Postmortem diagnosis of Marfan syndrome in a case of sudden death due to aortic rupture: Detection of a novel FBN1 frameshift mutation.

    Science.gov (United States)

    Wang, Yunyun; Chen, Shu; Wang, Rongshuai; Huang, Sizhe; Yang, Mingzhen; Liu, Liang; Liu, Qian

    2016-04-01

    To investigate the sudden death of a 36-year-old Chinese man, a medicolegal autopsy was performed, combining forensic pathological examinations and genetic sequencing analysis to diagnose the cause of death. Genomic DNA samples were extracted from blood and subjected to high-throughput sequencing. Major findings included a dilated aortic root with a ruptured and dissected aorta and consequent tamponade of the pericardial sac. Moreover, arachnodactyly and other skeletal deformities were noted. By sequencing the fibrillin-1 gene (FBN1), five genetic variations were found, including four previously known single nucleotide polymorphisms (SNPs) and a novel frameshift mutation, leading to the diagnosis of Marfan syndrome. The frameshift mutation (c.4921delG, p.glu1641llysFsX9) detected in exon 40 led to a stop codon after the next 8 amino acids. The four SNPs included a splice site mutation (c.3464-5 G>A, rs11853943), a synonymous mutation (p.Asn625Asn, rs25458), and two missense mutations (p.Pro1148Ala, rs140598; p.Cys472Tyr, rs4775765). Genetic screening was recommended for the relatives as it was reported that the father and brother of the deceased had died at the ages of 40 and 25, respectively, from sudden cardiac failure. The son of the deceased lacked the relevant mutations. This report emphasizes the important contribution of medicolegal postmortem analysis on the molecular pathogenesis study of Marfan syndrome and early diagnosis of at-risk relatives. PMID:26905825

  1. Excitatory synapses are stronger in the hippocampus of Rett syndrome mice due to altered synaptic trafficking of AMPA-type glutamate receptors.

    Science.gov (United States)

    Li, Wei; Xu, Xin; Pozzo-Miller, Lucas

    2016-03-15

    Deficits in long-term potentiation (LTP) at central excitatory synapses are thought to contribute to cognitive impairments in neurodevelopmental disorders associated with intellectual disability and autism. Using the methyl-CpG-binding protein 2 (Mecp2) knockout (KO) mouse model of Rett syndrome, we show that naïve excitatory synapses onto hippocampal pyramidal neurons of symptomatic mice have all of the hallmarks of potentiated synapses. Stronger Mecp2 KO synapses failed to undergo LTP after either theta-burst afferent stimulation or pairing afferent stimulation with postsynaptic depolarization. On the other hand, basal synaptic strength and LTP were not affected in slices from younger presymptomatic Mecp2 KO mice. Furthermore, spine synapses in pyramidal neurons from symptomatic Mecp2 KO are larger and do not grow in size or incorporate GluA1 subunits after electrical or chemical LTP. Our data suggest that LTP is occluded in Mecp2 KO mice by already potentiated synapses. The higher surface levels of GluA1-containing receptors are consistent with altered expression levels of proteins involved in AMPA receptor trafficking, suggesting previously unidentified targets for therapeutic intervention for Rett syndrome and other MECP2-related disorders.

  2. Use Of Noninvazive Positive Pressure Ventilation in a Case of Diffuse Alveolar Hemorrhage Due to Goodpasture%u2019s Syndrome

    Directory of Open Access Journals (Sweden)

    Bunyamin Sertogullarindan

    2014-03-01

    Full Text Available Antiglomerular basement membrane antibody disease is manifested by progressive glomerulonephritis, intraalveolar hemorrhage and antiglomerular basement membrane antibodies. It is frequently characterized by mortality. We present a case of a 18 year-old  young showing remission by early diagnosis. The patient was admitted to emergency department with symptoms and findings of atypic pneumonia with bloody sputum. Chest radiography detected patchy alveolar opacities (Figure A. An ampric antibacterial treatment was given including macrolide, and bronchodilators because of bronchospasm. The patient was suspected for goodpasture’s syndrome (GPS. Anti-glomerular basement membrane (AGBM antibodies test was send. He developed massive alveolar haemorrhage in the resolution phase of atypic pneumonia. Laboratory examination revealed proteinuria of 20 mg/ dl, anemia Hb of 8 g/dl, hematocrit of 25%, microscopic hematuria of 350 erythrocite /HPF. AGBM antibodies was found as positive. GPS was diagnosed. Early immunosuppressive treatment with pulse methylprednisolone and cyclophosphamide and plazmaferez was started. Noninvasive positive pressure ventilation (NPPV was used for severe hypoxemia. Haemolytic anemia and thrombocytopenia developed under plasmaphresis treatment. Early treatment resulted with remmission. In conclusion, the current case showed that Goodpasture’s syndrome may have a favorable prognosis with early diagnosis and proper treatments including NPPV.

  3. Postmortem diagnosis of Marfan syndrome in a case of sudden death due to aortic rupture: Detection of a novel FBN1 frameshift mutation.

    Science.gov (United States)

    Wang, Yunyun; Chen, Shu; Wang, Rongshuai; Huang, Sizhe; Yang, Mingzhen; Liu, Liang; Liu, Qian

    2016-04-01

    To investigate the sudden death of a 36-year-old Chinese man, a medicolegal autopsy was performed, combining forensic pathological examinations and genetic sequencing analysis to diagnose the cause of death. Genomic DNA samples were extracted from blood and subjected to high-throughput sequencing. Major findings included a dilated aortic root with a ruptured and dissected aorta and consequent tamponade of the pericardial sac. Moreover, arachnodactyly and other skeletal deformities were noted. By sequencing the fibrillin-1 gene (FBN1), five genetic variations were found, including four previously known single nucleotide polymorphisms (SNPs) and a novel frameshift mutation, leading to the diagnosis of Marfan syndrome. The frameshift mutation (c.4921delG, p.glu1641llysFsX9) detected in exon 40 led to a stop codon after the next 8 amino acids. The four SNPs included a splice site mutation (c.3464-5 G>A, rs11853943), a synonymous mutation (p.Asn625Asn, rs25458), and two missense mutations (p.Pro1148Ala, rs140598; p.Cys472Tyr, rs4775765). Genetic screening was recommended for the relatives as it was reported that the father and brother of the deceased had died at the ages of 40 and 25, respectively, from sudden cardiac failure. The son of the deceased lacked the relevant mutations. This report emphasizes the important contribution of medicolegal postmortem analysis on the molecular pathogenesis study of Marfan syndrome and early diagnosis of at-risk relatives.

  4. Ocean ambient sound south of Bermuda and Panama Canal traffic.

    Science.gov (United States)

    Širović, Ana; Hildebrand, John A; McDonald, Mark A

    2016-05-01

    Comparisons of current and historic ocean ambient noise levels are rare, especially in the North Atlantic. Recent (2013-2014) monthly patterns in ocean ambient sound south of Bermuda were compared to those recorded at the same location in 1966. Additionally, trends in ocean traffic, in particular, Panama Canal traffic, over this time were also investigated. One year of ocean ambient noise measurements were collected in 1966 using cabled, omnidirectional hydrophones at the U.S. Navy Tudor Hill Laboratory in Bermuda, and repeat measurements were collected at the same location from June 2013-May 2014 using a High-frequency Acoustic Recording Package. Average monthly pressure spectrum levels at 44 Hz increased 2.8 ± 0.8 dB from 1966 to 2013, indicating an average increase of 0.6 dB/decade. This low level of increase may be due to topographic shielding at this site, limiting it to only southern exposure, and the limit in the number of ship transits through the Panama Canal, which did not change substantially during this time. The impending expansion of the Canal, which will enable the transit of larger ships at twice the current rate, is likely to lead to a substantial increase in ocean ambient sound at this location in the near future.

  5. An electrokinetic model of transduction in the semicircular canal.

    Science.gov (United States)

    O'Leary, D P

    1970-09-01

    Transduction in the semicircular canal was studied by focusing an infrared beam on either side of exposed ampullae from the posterior canals of Rana pipiens. The direction of fluid movement resulting from a stimulus was inferred by observing the polarity of the change in afferent impulse mean rate relative to the spontaneous value. On the basis of the accepted functional polarization of this receptor, the results indicate that fluid moved toward the warmer side of the ampulla. Convection and thermal reception were shown to be unlikely explanations for these results. Morover, cupular displacements toward the warmer side would not be expected. Because thermo-osmosis can cause fluid to move toward the warmer side in a gelatin membrane, the results can be interpreted as evidence that thermo-osmosis occurred in the gelatinous cupula and influenced the transduction mechanism. Thermo-osmosis of liquids appears to be due to an electric field that is set up in a charged membrane; hence, the hair cells might have detected an electric field that occurred in the cupula during thermo-osmosis. Electroreception might be an important link in the transduction of physiological stimuli also. Rotational stimuli could result in weak electric fields in the cupula by the mechanoelectric effect. Cupular displacements could be important for large stimuli, but extrapolations to threshold stimuli suggest displacements of angstrom amplitudes. Therefore, electroreception by the hair cells could be an explanation of the great sensitivity that has been observed in the semicircular canal and other labyrinthine receptors. PMID:5496906

  6. Ocean ambient sound south of Bermuda and Panama Canal traffic.

    Science.gov (United States)

    Širović, Ana; Hildebrand, John A; McDonald, Mark A

    2016-05-01

    Comparisons of current and historic ocean ambient noise levels are rare, especially in the North Atlantic. Recent (2013-2014) monthly patterns in ocean ambient sound south of Bermuda were compared to those recorded at the same location in 1966. Additionally, trends in ocean traffic, in particular, Panama Canal traffic, over this time were also investigated. One year of ocean ambient noise measurements were collected in 1966 using cabled, omnidirectional hydrophones at the U.S. Navy Tudor Hill Laboratory in Bermuda, and repeat measurements were collected at the same location from June 2013-May 2014 using a High-frequency Acoustic Recording Package. Average monthly pressure spectrum levels at 44 Hz increased 2.8 ± 0.8 dB from 1966 to 2013, indicating an average increase of 0.6 dB/decade. This low level of increase may be due to topographic shielding at this site, limiting it to only southern exposure, and the limit in the number of ship transits through the Panama Canal, which did not change substantially during this time. The impending expansion of the Canal, which will enable the transit of larger ships at twice the current rate, is likely to lead to a substantial increase in ocean ambient sound at this location in the near future. PMID:27250138

  7. Sexually antagonistic epigenetic marks that canalize sexually dimorphic development.

    Science.gov (United States)

    Rice, William R; Friberg, Urban; Gavrilets, Sergey

    2016-04-01

    The sexes share the same autosomal genomes, yet sexual dimorphism is common due to sex-specific gene expression. When present, XX and XY karyotypes trigger alternate regulatory cascades that determine sex-specific gene expression profiles. In mammals, secretion of testosterone (T) by the testes during foetal development is the master switch influencing the gene expression pathways (male vs. female) that will be followed, but many genes have sex-specific expression prior to T secretion. Environmental factors, like endocrine disruptors and mimics, can interfere with sexual development. However, sex-specific ontogeny can be canalized by the production of epigenetic marks (epimarks) generated during early ontogeny that increase sensitivity of XY embryos to T and decrease sensitivity of XX embryos. Here, we integrate and synthesize the evidence indicating that canalizing epimarks are produced during early ontogeny. We will also describe the evidence that such epimarks sometimes carry over across generations and produce mosaicism in which some traits are discordant with the gonad. Such carryover epimarks are sexually antagonistic because they benefit the individual in which they were formed (via canalization) but harm opposite-sex offspring when they fail to erase across generations and produce gonad-trait discordances. SA-epimarks have the potential to: i) magnify phenotypic variation for many sexually selected traits, ii) generate overlap along many dimensions of the masculinity/femininity spectrum, and iii) influence medically important gonad-trait discordances like cryptorchidism, hypospadias and idiopathic hirsutism. PMID:26600375

  8. Comparison of Bacterial Leakage between 3 Different Root Canal Obturation Techniques in Oval Shaped Canals

    OpenAIRE

    Eshagh-ali Saberi; Shahram Shahraki; Sediqe Ebrahimipour; Anousheh Rashed Mohassel; Narjes Akbari; Majid Rezaei

    2014-01-01

    Introduction: The purpose of this study was to evaluate the sealing ability of 3 obturation techniques in oval-shaped canals by bacterial leakage assessment. Methods: Sixty mandibular incisors with oval canals were selected after providing buccolingual and mesiodistal radiographs. The teeth were sectioned at a 10 mm distance from the apex. After instrumentation, the teeth were divided into 3 groups and the canals in the three groups were obturated with lateral condensation (G1), warm vertical...

  9. Barth syndrome: cellular compensation of mitochondrial dysfunction and apoptosis inhibition due to changes in cardiolipin remodeling linked to tafazzin (TAZ) gene mutation.

    Science.gov (United States)

    Gonzalvez, François; D'Aurelio, Marilena; Boutant, Marie; Moustapha, Aoula; Puech, Jean-Philippe; Landes, Thomas; Arnauné-Pelloquin, Laeticia; Vial, Guillaume; Taleux, Nellie; Slomianny, Christian; Wanders, Ronald J; Houtkooper, Riekelt H; Bellenguer, Pascale; Møller, Ian Max; Gottlieb, Eyal; Vaz, Frederic M; Manfredi, Giovanni; Petit, Patrice X

    2013-08-01

    Cardiolipin is a mitochondrion-specific phospholipid that stabilizes the assembly of respiratory chain complexes, favoring full-yield operation. It also mediates key steps in apoptosis. In Barth syndrome, an X chromosome-linked cardiomyopathy caused by tafazzin mutations, cardiolipins display acyl chain modifications and are present at abnormally low concentrations, whereas monolysocardiolipin accumulates. Using immortalized lymphoblasts from Barth syndrome patients, we showed that the production of abnormal cardiolipin led to mitochondrial alterations. Indeed, the lack of normal cardiolipin led to changes in electron transport chain stability, resulting in cellular defects. We found a destabilization of the supercomplex (respirasome) I+III2+IVn but also decreased amounts of individual complexes I and IV and supercomplexes I+III and III+IV. No changes were observed in the amounts of individual complex III and complex II. We also found decreased levels of complex V. This complex is not part of the supercomplex suggesting that cardiolipin is required not only for the association/stabilization of the complexes into supercomplexes but also for the modulation of the amount of individual respiratory chain complexes. However, these alterations were compensated by an increase in mitochondrial mass, as demonstrated by electron microscopy and measurements of citrate synthase activity. We suggest that this compensatory increase in mitochondrial content prevents a decrease in mitochondrial respiration and ATP synthesis in the cells. We also show, by extensive flow cytometry analysis, that the type II apoptosis pathway was blocked at the mitochondrial level and that the mitochondria of patients with Barth syndrome cannot bind active caspase-8. Signal transduction is thus blocked before any mitochondrial event can occur. Remarkably, basal levels of superoxide anion production were slightly higher in patients' cells than in control cells as previously evidenced via an increased

  10. MANAGEMENT OF LUMBAR SPINAL CANAL STENOSIS

    OpenAIRE

    Mukhergee G. S; Kiran Kumar L; Manikumar C. J

    2016-01-01

    BACKGROUND Spinal stenosis is one of the most common conditions in the elderly. It is defined as a narrowing of the spinal canal. The term stenosis is derived from the Greek word for narrow, which is “Stenos”. The first description of this condition is attributed to Antoine portal in 1803. Verbiest is credited with coining the term spinal stenosis and the associated narrowing of the spinal canal as its potential cause. [1-10] Kirkaldy–Willis subsequently described the de...

  11. Pain associated with root canal treatment

    OpenAIRE

    Segura-Egea, Juan José; Cisneros Cabello, Rafael; Llamas Carreras, José María; Velasco Ortega, Eugenio

    2009-01-01

    Our purpose was to determine the pain experienced by patients during root canal treatment and to correlate with age and gender, pulpal diagnosis, previous periapical status, dental characteristics and length of treatment. One hundred and seventy-six patients (68 men and 108 women), with ages ranged from 6 to 83 years, were randomly recruited. Patients completed a 10-cm visual analogue scale (VAS) that ranked the level of pain experienced during root canal treatment. The mean pain level during...

  12. Two root canals in maxillary central incisor

    Directory of Open Access Journals (Sweden)

    Fábio de Almeida Gomes

    2011-07-01

    Full Text Available Introduction and objective: The success of endodontic treatment requires the knowledge of tooth morphology and its variations. Case report: This clinical article reports an unusual root canal configuration that was detected in a maxillary central incisor with two root canals, demonstrated by radiographic and computerized tomography exams. Conclusion: Knowledge of endodontic anatomy as well as the obtainment of both preoperative radiographs and tomography is important to detect abnormal tooth morphology.

  13. Mechanics of the Panama Canal slides

    Science.gov (United States)

    Becker, George F.

    1917-01-01

    Dr. Becker visited the Canal Zone in 1913 as a geologist of the United States Geological Survey and since that time has given the problem the benefit of his study. His appointment as a member of the committee of the National Academy of Sciences has made it appropriate for his conclusions, based upon his personal observations and already reported in part to the Canal Commission, to be stated for the benefit of his associates and other American scientists and engineers.

  14. Gastric outlet obstruction due to adenocarcinoma in a patient with Ataxia-Telangiectasia syndrome: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Hammond Sue

    2009-03-01

    Full Text Available Abstract Background Ataxia-Telangiectasia syndrome is characterized by progressive cerebellar dysfunction, conjuctival and cutaneous telangiectasias, severe immune deficiencies, premature aging and predisposition to cancer. Clinical and radiographic evaluation for malignancy in ataxia-telangiectasia patients is usually atypical, leading to delays in diagnosis. Case presentation We report the case of a 20 year old ataxia-telangiectasia patient with gastric adenocarcinoma that presented as complete gastric outlet obstruction. Conclusion A literature search of adenocarcinoma associated with ataxia-telangiectasia revealed 6 cases. All patients presented with non-specific gastrointestinal complaints suggestive of ulcer disease. Although there was no correlation between immunoglobulin levels and development of gastric adenocarcinoma, the presence of chronic gastritis and intestinal metaplasia seem to lead to the development of gastric adenocarcinoma. One should consider adenocarcinoma in any patient with ataxia-telangiectasia who presents with non-specific gastrointestinal complaints, since this can lead to earlier diagnosis.

  15. High cervical and lumbar canal stenosis of varied etiology : a case report.

    Directory of Open Access Journals (Sweden)

    Arunkumar M

    2002-01-01

    Full Text Available Developmental stenosis without any significant spondylotic changes frequently occurs at C3 vertebra or below, and typically extends to C6-C7. However, high cervical focal canal stenosis is unusual. A case of cervical canal segmental stenosis at C2-3 level in addition to a developmental stenosis of the lumbar region, in a 45 year old male, has been presented in this article. The dynamics of the spinal canal in relation to the likely pathology of such conditions are reviewed. We speculate that focal segmental stenosis in the high cervical region may be due to a possible premature fusion of the neurocentral synchondrosis of the cartilage, or due to an abnormal rotary biomechanics which can result in facetal hypertrophy.

  16. The fluid mechanics of root canal irrigation.

    Science.gov (United States)

    Gulabivala, K; Ng, Y-L; Gilbertson, M; Eames, I

    2010-12-01

    Root canal treatment is a common dental operation aimed at removing the contents of the geometrically complex canal chambers within teeth; its purpose is to remove diseased or infected tissue. The complex chamber is first enlarged and shaped by instruments to a size sufficient to deliver antibacterial fluids. These irrigants help to dissolve dying tissue, disinfect the canal walls and space and flush out debris. The effectiveness of the procedure is limited by access to the canal terminus. Endodontic research is focused on finding the instruments and clinical procedures that might improve success rates by more effectively reaching the apical anatomy. The individual factors affecting treatment outcome have not been unequivocally deciphered, partly because of the difficulty in isolating them and in making the link between simplified, general experimental models and the complex biological objects that are teeth. Explicitly considering the physical processes within the root canal can contribute to the resolution of these problems. The central problem is one of fluid motion in a confined geometry, which makes the dispersion and mixing of irrigant more difficult because of the absence of turbulence over much of the canal volume. The effects of treatments can be understood through the use of scale models, mathematical modelling and numerical computations. A particular concern in treatment is that caustic irrigant may penetrate beyond the root canal, causing chemical damage to the jawbone. In fact, a stagnation plane exists beyond the needle tip, which the irrigant cannot penetrate. The goal is therefore to shift the stagnation plane apically to be coincident with the canal terminus without extending beyond it. Needle design may solve some of the problems but the best design for irrigant penetration conflicts with that for optimal removal of the bacterial biofilm from the canal wall. Both irrigant penetration and biofilm removal may be improved through canal fluid

  17. The fluid mechanics of root canal irrigation

    International Nuclear Information System (INIS)

    Root canal treatment is a common dental operation aimed at removing the contents of the geometrically complex canal chambers within teeth; its purpose is to remove diseased or infected tissue. The complex chamber is first enlarged and shaped by instruments to a size sufficient to deliver antibacterial fluids. These irrigants help to dissolve dying tissue, disinfect the canal walls and space and flush out debris. The effectiveness of the procedure is limited by access to the canal terminus. Endodontic research is focused on finding the instruments and clinical procedures that might improve success rates by more effectively reaching the apical anatomy. The individual factors affecting treatment outcome have not been unequivocally deciphered, partly because of the difficulty in isolating them and in making the link between simplified, general experimental models and the complex biological objects that are teeth. Explicitly considering the physical processes within the root canal can contribute to the resolution of these problems. The central problem is one of fluid motion in a confined geometry, which makes the dispersion and mixing of irrigant more difficult because of the absence of turbulence over much of the canal volume. The effects of treatments can be understood through the use of scale models, mathematical modelling and numerical computations. A particular concern in treatment is that caustic irrigant may penetrate beyond the root canal, causing chemical damage to the jawbone. In fact, a stagnation plane exists beyond the needle tip, which the irrigant cannot penetrate. The goal is therefore to shift the stagnation plane apically to be coincident with the canal terminus without extending beyond it. Needle design may solve some of the problems but the best design for irrigant penetration conflicts with that for optimal removal of the bacterial biofilm from the canal wall. Both irrigant penetration and biofilm removal may be improved through canal fluid

  18. An in vitro model to investigate filling of lateral canals.

    Science.gov (United States)

    Venturi, Mauro; Di Lenarda, Roberto; Prati, Carlo; Breschi, Lorenzo

    2005-12-01

    Aims of this work were to examine lateral canals in extracted teeth, to propose a new technique to produce artificial lateral canals, and to compare two obturation techniques. Cleared roots were examined to record measure and shape of lateral canals. Artificial lateral canals were prepared on human demineralized teeth before final clearing. Specimens were divided in two groups: canals of group 1 were filled with Schilder's technique, canals of group 2 were filled with vertical compaction with apical backfilling. Stereomicroscopic analysis of lateral canal filling revealed lower filling rates in apical canals compared to coronal ones and higher filling rates with "vertical compaction with apical backfilling" compared to Schilder's group. The tested procedure appears to be a reliable technique to obtain standardized lateral canals and to compare filling procedures.

  19. Growth arrest in the ribosomopathy, Bowen-Conradi syndrome, is due to dramatically reduced cell proliferation and a defect in mitotic progression.

    Science.gov (United States)

    Armistead, Joy; Patel, Nehal; Wu, Xiaoli; Hemming, Richard; Chowdhury, Biswajit; Basra, Gagandeep Singh; Del Bigio, Marc R; Ding, Hao; Triggs-Raine, Barbara

    2015-05-01

    Bowen-Conradi syndrome (BCS) is a ribosomopathy characterized by severe developmental delay and growth failure that typically leads to death by one year of age. It is caused by a c.257A>G, p.D86G substitution in the ribosomal biogenesis protein, Essential for Mitotic Growth 1 (EMG1). We generated a knock-in of the D86G substitution in mice to characterize the effects of EMG1 deficiency, particularly in the brain, where EMG1 expression is high. Embryos homozygous for the mutation in Emg1 were small for gestational age with neural tube defects, and died between embryonic days 8.5 and 12.5. These embryos exhibited dramatically reduced cell proliferation, which we also detected in autopsy brain tissue and bone marrow of BCS patients, consistent with a requirement for high levels of EMG1 in tissues with rapid cell proliferation. In fibroblasts derived from the BCS mouse embryos, we detected a high proportion of binucleated cells, indicating that a mitotic defect underlies the growth arrest in BCS. These studies add to growing evidence of a link between ribosome biogenesis, mitotic progression, and brain development that is currently unexplored.

  20. Severe Uncompensated Metabolic Alkalosis due to Plasma Exchange in a Patient with Pulmonary-Renal Syndrome: A Clinician’s Challenge

    Directory of Open Access Journals (Sweden)

    Mohsin Ijaz

    2015-01-01

    Full Text Available Metabolic alkalosis secondary to citrate toxicity from plasma exchange is very uncommon in patients with normal renal function. In patients with advanced renal disease this can be a fatal event. We describe a case of middle-aged woman with Goodpasture’s syndrome treated with plasma exchange who developed severe metabolic alkalosis. High citrate load in plasma exchange fluid is the underlying etiology. Citrate metabolism generates bicarbonate and once its level exceeds the excretory capacity of kidneys, the severe metabolic alkalosis ensues. Our patient presented with generalized weakness, fever, and oliguria and developed rapidly progressive renal failure. Patient had positive serology for antineutrophilic cytoplasmic antibodies myeloperoxidase (ANCA-MPO and anti-glomerular basement membrane antibodies (anti-GBM. Renal biopsy showed diffuse necrotizing and crescentic glomerulonephritis with linear glomerular basement membrane staining. Patient did not respond to intravenous steroids. Plasma exchange was started with fresh frozen plasma but patient developed severe metabolic alkalosis. This metabolic alkalosis normalized with cessation of plasma exchange and initiation of low bicarbonate hemodialysis. ANCA-MPO and anti-GBM antibodies levels normalized within 2 weeks and remained undetectable at 3 months. Patient still required maintenance hemodialysis.

  1. A radiographic study of mandibular canal

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Chul; Lee, Sang Rae [Dept. of Oral Radiology, Division of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    1987-11-15

    The author invested the gonial angle, the angle of mandibular and mental canal to the lower border of the mandible, and a relationship of the position of the mandibular canal to the root apex of the posterior teeth and the cortical plate of the lower of the mandible. The materials consisted of 458 pantomograms in male and female aged 11-40 and divided into 5 groups at year intervals and subdivided into 3 groups by gonial angle. The results were as follows: 1. The gonial angle decreased with age, but slight increase occurred over 26-30 years. 2. The average angle of the mandibular canal to the lower border of the mandible was 151.6 degree and did not correlate with age. 3. The average angle of the mental canal to the lower border of the mandible was 36.9 degree and didn't correlate with age. 4. The angles of mandibular and mental canal to the lower border of mandible correlated with gonial angle. 5. The distance from the root apex of the posterior teeth to the upper wall mandibular canal was most short at the region of the distal root of the mandibular second and increased with age at the region of the mandibular second molar. 6. The distance from the lower wall of the mandibular canal to the cortical plate of the lower border of the mandibule was most short at the region of the mesial root of the mandibular first molar and didn't correlate with age.

  2. Radiological Review Studies On Ismailia Canal Ecology

    International Nuclear Information System (INIS)

    The present work is a brief review of pr-studies carried out on Ismailia Canal, Egypt, water ecosystem. Ismailia Canal water body is a bicarbonate stream with slight seasonal variations in its water chemical constituents. The canal water pH in all the stream locations are below 8.3 with low suspended matter(SM) content (22-33 mg.l-1). The mineralogical analysis of the canal bottom sediments consist mainly of quartz, smectite and kaolinite minerals. The γ- spectroscopic identification showed traces of naturally occurring radio nuclides (238U, 232Th and 40K). The average activity level of the dry samples ranged from 12 to 89 Bq.Kg-1 for the detected natural radio nuclides. Some parameters affected the sorption behaviour of radio nuclides on suspended matters and bottom sediments; such as solution pH, SM concentration, sediment grain size, carrier concentration and competing ions were studied. The reaction rates were investigated for each radionuclide studied. The distribution of the studied radio nuclides, between the liquid phase and the sediments phase was investigated, for both flowing and static systems. For both flowing and non-flowing (static), the depth penetration of the studied radio nuclides within the bottom sediment layers were found to vary from one radionuclide to the other. The total capacities of bottom sediments and the suspended matter were found to be low. As Ismailia Canal is an important source of water for public domestic uses, irrigation animals and the aquatic species; these situations have led to state that it is not recommended to release any liquid radioactive wastes to this canal. Furthermore, periodical radiometric analysis for the canal water and its components should be carried out.

  3. Proposition d’un outil d’aide au diagnostic du syndrome du canal carpien pour les acteurs de la santé au travail Proposal of a tool for diagnosis of carpal tunnel syndrome for Personal of Health at Work Proposición de una herramienta de ayuda en el diagnóstico del síndrome del túnel carpiano para los actores de la salud en el trabajo

    Directory of Open Access Journals (Sweden)

    Florence Bazzaro

    2012-05-01

    Full Text Available Les acteurs de la santé au travail sont confrontés à un manque d’outils quantitatifs de suivi et de diagnostic du syndrome du canal carpien (SCC. Pour répondre à ce manque, un outil de diagnostic du SCC est proposé dans cette communication. Il est composé de deux tests : le test de la roue qui consiste à détecter des encoches sur une roue en mouvement et le test de la poutre qui détecte un niveau de sensibilité à une force exercée sur un doigt concerné par le SCC. Deux études expérimentales ont été conduites pour valider cet appareil. La première étude montre que les mesures effectuées avec l’appareil sont répétables, la seconde vise à étudier la sensibilité et la spécificité de l’outil en comparaison avec une étude électrodiagnostique. Les résultats montrent que l’appareil de détection du SCC a un excellent pouvoir discriminant permettant d’identifier les sujets sains et les sujets atteints du SCC.People involved with occupational health at work are faced with a lack of quantitative tools to monitor and diagnose Carpal Tunnel Syndrome (CTS. In order to fill this gap, we developed a device for rapid CTS diagnosis which is composed of two complementary quantitative tests: the wheel test, which consists in detecting notches on a rotating wheel, and the beam test, which consists in detecting various forces exerted on a finger. We conducted two experimental studies to validate this device. The first one demonstrated the repeatability of the measures. The second one studied the sensitivity and specificity of our tool as compared to an electro-diagnosis test. The results show that our CTS detection device has excellent discriminatory power that allows practitioners to differentiate between healthy and CTS-affected subjects.Los actores de la salud en el trabajo se enfrentan a una falta de herramientas cuantitativas de seguimiento y de diagnóstico del síndrome del túnel carpiano (STC. Como respuesta a esa

  4. Difficulties in controlling root canal infection and a new concept of three-dimensional root canal preparation%根管感染控制的难点和三维根管预备现代理念

    Institute of Scientific and Technical Information of China (English)

    凌均棨

    2013-01-01

    根管预备是根管治疗术成功与否的关键步骤.由于根管解剖结构的复杂性和根管感染的特殊性,现有根管预备器械和技术难以达到理想的根管成形及清理效果.笔者就根管治疗中感染控制的难点、三维根管预备现代理念及其质量控制与评估作一述评.%Successful endodontic treatment depends on the effectiveness of the cleaning and shaping of the root canal system.Due to the complexity of the structure of root canal system and the particularity of root canal infections,the equipment and technology currently available for root canal preparation hinder the ability to adequately clean and shape the root canal system.In this review,we summarized the difficulties in the control of root canal infection,the new concept of three-dimensional root canal preparation,and its quality control and assessment.

  5. Síndrome de envenenamento por 2000 picadas de abelhas africanizadas. Relato de caso Poisoning syndrome due to 2,000 stings of africanized honeybees

    Directory of Open Access Journals (Sweden)

    Rita Vianna de Azevedo

    2006-03-01

    poisoning syndrome, because of the crescent number of these attacks and a few data about it. CASE REPORT: Male, 19 years old, soldier that in the course of his military training was attacked by a swarm of Africanized honeybees. CONCLUSIONS: As the Africanized honeybees are very aggressive, they attack their victims with lots of stings releasing a large quantity of venom. The reactions to the stings can vary from a local inflammatory reaction in non sensibilized people, hipersensibility reaction and anaphylactic shock in sensibilized people and poisoning syndrome when there is a big amount of inoculated venom. The medical attendance to this kind of accident must be as fast as possible. It must be done an adequate clinical support and a quick mechanical remotion of the stingers. The hemodynamic stabilization is a very important point.

  6. Mitochondrial free radical overproduction due to respiratory chain impairment in the brain of a mouse model of Rett syndrome: protective effect of CNF1.

    Science.gov (United States)

    De Filippis, Bianca; Valenti, Daniela; de Bari, Lidia; De Rasmo, Domenico; Musto, Mattia; Fabbri, Alessia; Ricceri, Laura; Fiorentini, Carla; Laviola, Giovanni; Vacca, Rosa Anna

    2015-06-01

    Rett syndrome (RTT) is a pervasive neurodevelopmental disorder mainly caused by mutations in the X-linked MECP2 gene associated with severe intellectual disability, movement disorders, and autistic-like behaviors. Its pathogenesis remains mostly not understood and no effective therapy is available. High circulating levels of oxidative stress markers in patients and the occurrence of oxidative brain damage in MeCP2-deficient mouse models suggest the involvement of oxidative stress in RTT pathogenesis. However, the molecular mechanism and the origin of the oxidative stress have not been elucidated. Here we demonstrate that a redox imbalance arises from aberrant mitochondrial functionality in the brain of MeCP2-308 heterozygous female mice, a condition that more closely recapitulates that of RTT patients. The marked increase in the rate of hydrogen peroxide generation in the brain of RTT mice seems mainly produced by the dysfunctional complex II of the mitochondrial respiratory chain. In addition, both membrane potential generation and mitochondrial ATP synthesis are decreased in RTT mouse brains when succinate, the complex II respiratory substrate, is used as an energy source. Respiratory chain impairment is brain area specific, owing to a decrease in either cAMP-dependent phosphorylation or protein levels of specific complex subunits. Further, we investigated whether the treatment of RTT mice with the bacterial protein CNF1, previously reported to ameliorate the neurobehavioral phenotype and brain bioenergetic markers in an RTT mouse model, exerts specific effects on brain mitochondrial function and consequently on hydrogen peroxide production. In RTT brains treated with CNF1, we observed the reactivation of respiratory chain complexes, the rescue of mitochondrial functionality, and the prevention of brain hydrogen peroxide overproduction. These results provide definitive evidence of mitochondrial reactive oxygen species overproduction in RTT mouse brain and

  7. MCT8 mutation analysis and identification of the first female with Allan-Herndon-Dudley syndrome due to loss of MCT8 expression.

    Science.gov (United States)

    Frints, Suzanna Gerarda Maria; Lenzner, Steffen; Bauters, Mareike; Jensen, Lars Riff; Van Esch, Hilde; des Portes, Vincent; Moog, Ute; Macville, Merryn Victor Erik; van Roozendaal, Kees; Schrander-Stumpel, Constance Theresia Rimbertha Maria; Tzschach, Andreas; Marynen, Peter; Fryns, Jean-Pierre; Hamel, Ben; van Bokhoven, Hans; Chelly, Jamel; Beldjord, Chérif; Turner, Gillian; Gecz, Jozef; Moraine, Claude; Raynaud, Martine; Ropers, Hans Hilger; Froyen, Guy; Kuss, Andreas Walter

    2008-09-01

    Mutations in the thyroid monocarboxylate transporter 8 gene (MCT8/SLC16A2) have been reported to result in X-linked mental retardation (XLMR) in patients with clinical features of the Allan-Herndon-Dudley syndrome (AHDS). We performed MCT8 mutation analysis including 13 XLMR families with LOD scores >2.0, 401 male MR sibships and 47 sporadic male patients with AHDS-like clinical features. One nonsense mutation (c.629insA) and two missense changes (c.1A>T and c.1673G>A) were identified. Consistent with previous reports on MCT8 missense changes, the patient with c.1673G>A showed elevated serum T3 level. The c.1A>T change in another patient affects a putative translation start codon, but the same change was present in his healthy brother. In addition normal serum T3 levels were present, suggesting that the c.1A>T (NM_006517) variation is not responsible for the MR phenotype but indicates that MCT8 translation likely starts with a methionine at position p.75. Moreover, we characterized a de novo translocation t(X;9)(q13.2;p24) in a female patient with full blown AHDS clinical features including elevated serum T3 levels. The MCT8 gene was disrupted at the X-breakpoint. A complete loss of MCT8 expression was observed in a fibroblast cell-line derived from this patient because of unfavorable nonrandom X-inactivation. Taken together, these data indicate that MCT8 mutations are not common in non-AHDS MR patients yet they support that elevated serum T3 levels can be indicative for AHDS and that AHDS clinical features can be present in female MCT8 mutation carriers whenever there is unfavorable nonrandom X-inactivation.

  8. The Kra Canal and Southeast Asian Relations

    Directory of Open Access Journals (Sweden)

    Rini Suryati Sulong

    2012-01-01

    Full Text Available This paper is a conceptual study that attempts to analyse the possible effects of the development of the Kra Isthmus Canal on ASEAN relations. The Kra Canal would constitute a mega-project, a passageway that would connect the Andaman Sea and the Gulf of Thailand at the Isthmus of Kra, Thailand. Although the proposed Kra Canal is projected to provide many economic and trade benefits to Thailand, and to the region as a whole, steps toward its development have yet to be taken. There has been much debate over the costs for trade, the costs for the environment, national and regional security concerns, as well as major concerns related to political and economic relations in the region. Therefore, one of the main purposes of this study is to contribute to the debate on the possible impact of the devel-opment of the Kra Canal on ASEAN’s regional relations. In particular, it proposes that the development of the Kra Canal could threaten regional solidarity as it would physically divide maritime Southeast Asia from main-land Southeast Asia, which would ultimately result in an economic, cultural and political divide of ASEAN itself.

  9. Metal Contamination In Plants Due To Tannery Effluent

    OpenAIRE

    Md.Farhad Ali; Umme Habiba Bodrun Naher; Md Mahamudul Hasan; Md. Aminul Islam

    2015-01-01

    Abstract This paper analyzes the determination of heavy metals named Chromium Lead and Cadmium deposited in soil as well as in the plants and vegetables due to the tanning industries of the area of Hazaribagh Dhaka. The tanneries discharge untreated tannery effluents which get mixed with the soil water of rivers and canals in this area. The determination of metals was performed for the soil that was collected from the land adjacent to the canals which bear untreated tannery effluents. The s...

  10. Three-dimensional vibration-induced vestibulo-ocular reflex identifies vertical semicircular canal dehiscence.

    Science.gov (United States)

    Aw, Swee Tin; Aw, Grace Elizabeth; Todd, Michael John; Bradshaw, Andrew Philip; Halmagyi, Gabor Michael

    2011-10-01

    Vertical semicircular canal dehiscence (VSCD) due to superior canal dehiscence (SCD) or posterior canal dehiscence (PCD) of the temporal bone causes vestibular and cochlear hypersensitivity to sound. This study aimed to characterize the vibration-induced vestibulo-ocular reflex (ViVOR) in VSCD. ViVORs in one PCD and 17 SCD patients, confirmed by CT imaging reformatted in semicircular canal planes, were measured with dual-search coils as binocular three-dimensional eye rotations induced by skull vibrations from a bone oscillator (B71-10 ohms) at 7 ms, 500 Hz, 135-dB peak-force level (re: 1 μN). The ViVOR eye rotation axes were computed by vector analysis and referenced to known semicircular canal planes. Onset latency of the ViVOR was 11 ms. ViVOR from VSCD was up to nine times greater than normal. The ViVOR's torsional rotation was always contraversive-torsional (the eye's upper pole rotated away from the stimulated ear), i.e. its direction was clockwise from a left and counterclockwise from a right VSCD, thereby lateralizing the side of the VSCD. The ViVORs vertical component distinguishes PCD from SCD, being downwards in PCD and upwards in SCD. In unilateral VSCD, the ViVOR eye rotation axis aligned closest to the dehiscent vertical semicircular canal axis from either ipsilateral or contralateral mastoid vibrations. However, in bilateral VSCDs, the ViVOR eye rotation axis lateralized to the ipsilateral dehiscent vertical semicircular canal axis. ViVOR was evoked in ossicular chain dysfunction, even when air-conducted click vestibulo-ocular reflex (VOR) was absent or markedly reduced. Hence, ViVOR could be a useful measurement to identify unilateral or bilateral VSCD even in the presence of ossicular chain dysfunction.

  11. Eagle syndrome

    International Nuclear Information System (INIS)

    Eagle syndrome occurs due to elongation of the styloid process or calcification of the stylohyoid ligament, which then may produce a pain sensation due the pressure exerted on various structures in the head and neck. When suspected, imaging helps in identifying the abnormally elongated styloid process or the calcified ligament. In recent years, three-dimensional CT (3DCT) has proved to be valuable in these cases. We report the case of a 62-year-old man with this syndrome in whom imaging with 3DCT conclusively established the diagnosis

  12. Uncertainty of canal seepage losses estimated using flowing water balance with acoustic Doppler devices

    Science.gov (United States)

    Martin, Chad A.; Gates, Timothy K.

    2014-09-01

    Seepage losses from unlined irrigation canals amount to a large fraction of the total volume of water diverted for agricultural use, posing problems to both water conservation and water quality. Quantifying these losses and identifying areas where they are most prominent are crucial for determining the severity of seepage-related complications and for assessing the potential benefits of seepage reduction technologies and materials. A relatively easy and inexpensive way to estimate losses over an extensive segment of a canal is the flowing water balance, or inflow-outflow, method. Such estimates, however, have long been considered fraught with ambiguity due both to measurement error and to spatial and temporal variability. This paper presents a water balance analysis that evaluates uncertainty in 60 tests on two typical earthen irrigation canals. Monte Carlo simulation is used to account for a number of different sources of uncertainty. Issues of errors in acoustic Doppler flow measurement, in water level readings, and in evaporation estimates are considered. Storage change and canal wetted perimeter area, affected by variability in the canal prism, as well as lagged vs. simultaneous measurements of discharge at the inflow and outflow ends also are addressed. Mean estimated seepage loss rates for the tested canal reaches ranged from about -0.005 (gain) to 0.110 m3 s-1 per hectare of canal wetted perimeter (or -0.043 to 0.95 m d-1) with estimated probability distributions revealing substantial uncertainty. Across the tests, the average coefficient of variation was about 240% and the average 90th inter-percentile range was 0.143 m3 s-1 per hectare (1.24 m d-1). Sensitivity analysis indicates that while the predominant influence on seepage uncertainty is error in measured discharge at the upstream and downstream ends of the canal test reach, the magnitude and uncertainty of storage change due to unsteady flow also is a significant influence. Recommendations are

  13. Panama Canal Expansion Illustrates Need for Multimodal Near-Source Air Quality Assessment

    Science.gov (United States)

    The compelling issue raised is potential major changes in goods movement due to the Panama Canal expansion and considerations for near-source air quality. Near-source air quality may be affected both at near-port areas as well as along the freight transportation corridor.

  14. Synchronous rectal adenocarcinoma and anal canal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    GU Jin; LI Jiyou; YAO Yunfeng; LU Aiping; WANG Hongyi

    2007-01-01

    It is difficult to distinguish a tectal carcinoma with anal metastases from coexistent synchronous anorectal carcinomas.The therapeutic strategy for rectal and anal carcinoma is so different that it should be clearly identified.Here,we report on the case of a 63-year-old man who presented with an upper-third rectal adenocarcinoma.Five months after resection,he developed an adenocarcinoma in the anal canal.The histological slides of both tumors were reviewed and immunohistochemical studies for cytokeratins(CKs)7 and 20 were performed.The index tumor demonstrated CK 7-/CK 20+and the second showed CK7+/CK20+.For this reason,we believe the present case had synchronous adenocarcinomas arising from anal canal and the rectum separately.It is very important to difierentiate the anorectal lesions pathologically because of the impact on the therapeutic options available,especially for the lesion arising in the anal canal.

  15. Familial co-segregation of Coffin-Lowry syndrome inherited from the mother and autosomal dominant Waardenburg type IV syndrome due to deletion of EDNRB inherited from the father.

    Science.gov (United States)

    Loupe, Jacob; Sampath, Srirangan; Lacassie, Yves

    2014-10-01

    We report an African-American family that was identified after the proposita was referred for diagnostic evaluation at 4½ months with a history of Hirschsprung and dysmorphic features typical of Waardenburg syndrome (WS). Family evaluation revealed that the father had heterochromidia irides and hypertelorism supporting the clinical diagnosis of WS; however, examination of the mother revealed characteristic facial and digital features of Coffin-Lowry syndrome (CLS). Molecular testing of the mother identified a novel 2 bp deletion (c.865_866delCA) in codon 289 of RPS6KA3 leading to a frame-shift and premature termination of translation 5 codons downstream (NM_004586.2:p.Gln289ValfsX5). This deletion also was identified in the proposita and her three sisters with a clinical suspicion of CLS, all of whom as carriers for this X-linked disorder had very subtle manifestations. The molecular confirmation of WS type 4 (Shah-Waardenburg; WS4) was not as straightforward. To evaluate WS types 1-4, multiple sequential molecular tests were requested, including Sanger sequencing of all exons, and deletion/duplication analysis using MLPA for PAX3, MITF, SOX10, EDN3 and EDNRB. Although sequencing did not identify any disease causing variants, MLPA identified a heterozygous deletion of the entire EDNRB in the father. This deletion was also found in the proposita and the oldest child. Since the heterozygous deletion was the only change identified in EDNRB, this family represents one of the few cases of an autosomal dominant inheritance of WS4 involving the endothelin pathway. Altogether, clinical evaluation of the family revealed one child to be positive for WS4 and two positive for CLS, while two children were positive for both diseases simultaneously (including the proposita) while another pair test negative for either disease. This kinship is an example of the coincidence of two conditions co-segregating in one family, with variable phenotypes requiring molecular testing to

  16. File list: His.CDV.50.AllAg.Atrioventicular_canals [Chip-atlas[Archive

    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  19. File list: Unc.CDV.50.AllAg.Atrioventicular_canals [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  20. File list: Unc.CDV.10.AllAg.Atrioventicular_canals [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  1. File list: His.CDV.10.AllAg.Atrioventicular_canals [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  2. File list: Unc.CDV.20.AllAg.Atrioventicular_canals [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  3. File list: His.CDV.20.AllAg.Atrioventicular_canals [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  4. RADIOLOGICAL DIAGNOSTIC METHODS OF SOFT-TISSUE COMPONENTS IN THE SPINAL CANAL FORMING LUMBAR STENOSIS

    Directory of Open Access Journals (Sweden)

    OTABEK ABLYAZOV

    2011-08-01

    Full Text Available The modern categorization defines the different forms of lumbar part spine stenosis, coming from anatomical and pathological of the principle. One of the varieties is a central lumbar stenosis. Compression of medulla spinalis occurs due to reduction of sizes of the spine central cannel caused either by osseous structure or softtissue of the spine canal. All softtissue components of the spinal canal can form stenos including defeat of intervertebral disk (the hernia of the disk. This work studies efficiency of Xray (at 33 patients and MRI (at 92 patients methods in diagnostics of the hernia of the disk that participates in forming lumbar part spine stenosis.

  5. Otoscopic, cytological, and microbiological examination of the equine external ear canal.

    Science.gov (United States)

    Sargent, Sandra J; Frank, Linda A; Buchanan, Benjamin R; Donnell, Robert L; Morandi, Federica

    2006-06-01

    Otoscopic examination and cytology of the equine ear would be beneficial in diseases such as head trauma, headshaking, otitis externa secondary to otitis media, vestibular disease, aural neoplasia and aural pruritus secondary to parasites. In practice, otic examinations of horses are rarely done due to the perceived difficulty in visualizing the equine external ear canal and tympanic membrane, as well as the need for chemical restraint. In this study, the proximal external ear canal was examined in live horses using a handheld otoscope and in cadaver heads using video otoscopy. Visualization of the proximal ear canal of the sedated horse could be done with a handheld otoscope, but more sedation or general anaesthesia and a video otoscope would be required to adequately visualize the tympanic membrane in the live horse. The proximal ear canals of 18 horses were examined cytologically and cultured aerobically. In three horses, both ears were sampled. No cells or organisms were seen on cytological examination of 11/21 ears. Nine of the 21 ears were sterile when cultured. Ten of the 21 ears had mixed growth with low numbers of organisms (Corynebacterium sp. being most common). Two of the 21 ears had heavy growth of a single organism (Corynebacterium sp. and Staphylococcus intermedius, respectively). Equine cadaver heads were examined in cross-section by computed tomography (CT) imaging and histopathology in order to further understand the anatomy of the equine external ear canal. Equine practitioners should be aware that otic examination is possible and may provide important diagnostic information.

  6. Frequency of enterococcus faecalis in saliva and root canals with treatment failure

    International Nuclear Information System (INIS)

    To compare the frequency of E. faecalis in the saliva and root canals of teeth associated with apical periodontitis due to endodontic treatment failure in the same patient. Study Design: Cross-sectional comparative study. Place and Duration of Study: Samples were collected from Operative Dentistry Department, AFID, while laboratory processing was done at AFIP, Rawalpindi. Study duration was one year. Patients and Methods: Fifty patients, both males and females with failed endodontic treatment were selected. Saliva and root canal samples were collected from each patient, inoculated on MacKonkey agar plate and incubated at 35-37 degree C for 48 hrs. E. faecalis colonies were identified by colony morphology, gramstain, catalase, bile asculin test, arabinose fermentation and growth in 6% NaCl nutrient broth. Results: The frequency of E. faecalis in saliva was 34% and in root canal it was 58%. Frequency between the presence of E. faecalis in root canals and saliva was found to be statistically different (p = 0.001). Conclusion: The presence of E. faecalis in root canal was not associated with their presence in saliva. (author)

  7. Stratification and enumeration of Boolean functions by canalizing depth

    Science.gov (United States)

    He, Qijun; Macauley, Matthew

    2016-01-01

    Boolean network models have gained popularity in computational systems biology over the last dozen years. Many of these networks use canalizing Boolean functions, which has led to increased interest in the study of these functions. The canalizing depth of a function describes how many canalizing variables can be recursively "picked off", until a non-canalizing function remains. In this paper, we show how every Boolean function has a unique algebraic form involving extended monomial layers and a well-defined core polynomial. This generalizes recent work on the algebraic structure of nested canalizing functions, and it yields a stratification of all Boolean functions by their canalizing depth. As a result, we obtain closed formulas for the number of n-variable Boolean functions with depth k, which simultaneously generalizes enumeration formulas for canalizing, and nested canalizing functions.

  8. Stratification and enumeration of Boolean functions by canalizing depth

    CERN Document Server

    He, Qijun

    2015-01-01

    Boolean network models have gained popularity in computational systems biology over the last dozen years. Many of these networks use canalizing Boolean functions, which has led to increased interest in the study of these functions. The canalizing depth of a function describes how many canalizing variables can be recursively picked off, until a non-canalizing function remains. In this paper, we show how every Boolean function has a unique algebraic form involving extended monomial layers and a well-defined core polynomial. This generalizes recent work on the algebraic structure of nested canalizing functions, and it yields a stratification of all Boolean functions by their canalizing depth. As a result, we obtain closed formulas for the number of n-variable Boolean functions with depth k, which simultaneously generalizes enumeration formulas for canalizing, and nested canalizing functions.

  9. Surgical endodontic management of infected lateral canals of maxillary incisors

    Science.gov (United States)

    2015-01-01

    This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment. PMID:25671217

  10. [Frequency and most common localisation of root canal curvature].

    Science.gov (United States)

    Blasković-Subat, V

    1991-01-01

    The root canal therapy of the curved canals is a complex operative procedure. Therefore 260 root canals were analysed radiologically to determine the frequency and the most common localisation of the root canal curvature. The frequency of the curved canals averaged at 59%, being greater in the sample of posterior than in the anterior teeth (p less than 0.05). The root canal curvature was most frequently localised at the apical third part (53.9%), followed by the cervical (33.3%) and the middle (12.8%) third part. The apical curvature was predominant in the sample of the anterior, while the cervical predominant (45.2%) in the sample of the posterior teeth. This study pointed out that the frequency of the curved canals is rather high. Consequently, the necessity for practising the modern root canal preparation techniques, bearing in mind their potential danger, is emphasized. PMID:1819932

  11. Peroneal nerve palsy due to compartment syndrome after facial plastic surgery Paralisia de nervo fibular devido a síndrome compartimental após cirurgia plástica da face

    Directory of Open Access Journals (Sweden)

    Clécio O. Godeiro-Júnior

    2007-09-01

    Full Text Available A 25-year-old white man, right after bilateral rhytidoplasty, presented with agitation, necessiting use of haloperidol. Some hours after, he developed severe pain in his legs and a diagnosis of neuroleptic malignant syndrome (NMS was considered. Even with treatment for NMS he still complained of pain. A diagnosis of lower limb compartment syndrome (CS was done only 12 hours after the initial event, being submitted to fasciotomy in both legs, disclosing very pale muscles, due to previous ischemia. This syndrome was not explained only by facial surgery, his position and duration of the procedure. It can be explained by a sequence of events. He had a history of pain in his legs during physical exercises, usually seen in chronic compartment syndrome. He used to take anabolizant and venlafaxine, not previously related, and the agitation could be related to serotoninergic syndrome caused by interaction between venlafaxine and haloperidol. Rhabdomyolisis could lead to oedema and ischmemia in both anterior leg compartment. This report highlights the importance of early diagnosis of compartment syndrome, otherwise, even after fasciotomy, a permanent disability secondary to peripheral nerve compression could occur.Logo após ritidoplastia bilateral, um jovem de 25 anos apresentou agitação, necessitando uso de haloperidol. Algumas horas após, desenvolveu dor intensa em membros inferiores, e o diagnóstico de síndrome neuroléptica maligna foi considerado. Mesmo com o tratamento para tal, persistiu com dor. Após 12 horas do início do quadro, foi realizado o diagnóstico de síndrome compartimental de membros inferiores e o jovem foi submetido a fasciotomia bilateral. Uma seqüência de eventos desencadeou esta síndrome, já que sua ocorrência dificilmente seria justificada pela cirurgia facial e/ou posição do paciente durante o procedimento. O jovem apresentava previamente dor em membros inferiores aos exercícios, sugerindo a ocorrência de uma s

  12. Viscoelastic assessment of anal canal function using acoustic reflectometry

    DEFF Research Database (Denmark)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J;

    2012-01-01

    Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis....

  13. Neuroacanthocytosis Syndromes

    Directory of Open Access Journals (Sweden)

    Walker Ruth H

    2011-10-01

    Full Text Available Abstract Neuroacanthocytosis (NA syndromes are a group of genetically defined diseases characterized by the association of red blood cell acanthocytosis and progressive degeneration of the basal ganglia. NA syndromes are exceptionally rare with an estimated prevalence of less than 1 to 5 per 1'000'000 inhabitants for each disorder. The core NA syndromes include autosomal recessive chorea-acanthocytosis and X-linked McLeod syndrome which have a Huntington´s disease-like phenotype consisting of a choreatic movement disorder, psychiatric manifestations and cognitive decline, and additional multi-system features including myopathy and axonal neuropathy. In addition, cardiomyopathy may occur in McLeod syndrome. Acanthocytes are also found in a proportion of patients with autosomal dominant Huntington's disease-like 2, autosomal recessive pantothenate kinase-associated neurodegeneration and several inherited disorders of lipoprotein metabolism, namely abetalipoproteinemia (Bassen-Kornzweig syndrome and hypobetalipoproteinemia leading to vitamin E malabsorption. The latter disorders are characterized by a peripheral neuropathy and sensory ataxia due to dorsal column degeneration, but movement disorders and cognitive impairment are not present. NA syndromes are caused by disease-specific genetic mutations. The mechanism by which these mutations cause neurodegeneration is not known. The association of the acanthocytic membrane abnormality with selective degeneration of the basal ganglia, however, suggests a common pathogenetic pathway. Laboratory tests include blood smears to detect acanthocytosis and determination of serum creatine kinase. Cerebral magnetic resonance imaging may demonstrate striatal atrophy. Kell and Kx blood group antigens are reduced or absent in McLeod syndrome. Western blot for chorein demonstrates absence of this protein in red blood cells of chorea-acanthocytosis patients. Specific genetic testing is possible in all NA syndromes

  14. Diagnosis and therapy of 38 Budd-Chiari syndrome due to membrance obstruction of the hepatic veins%38例肝静脉膜型布加综合征诊治分析

    Institute of Scientific and Technical Information of China (English)

    孙振阳; 芮清峰; 刘允乐

    2013-01-01

    目的 探讨肝静脉膜型布加综合征(Budd-Chiari syndrome,BCS)的诊治方法.方法 38例患者均经彩超检查,疑为BCS患者行肝静脉、下腔静脉造影明确诊断后行经皮腔内血管成形(percutaneous intraluminal angioplasty,PTA)术或/和支架置入术.结论 38例患者中16例球囊扩张成功,19例支架置入,失败3例,无1例发生严重并发症.结论经皮腔内血管成形术、支架置入术是治疗肝静脉膜型 BCS的一种操作简单、安全有效的方法.%Objective To explore diagnosis and therapy of Budd -Chiari syndrome due to membrance obstruction of the hepatic veins . Methods All of the 38 patients were detected by colour doppler flow imaging , hepatic and inferior vena cava venography. Then percutaneous in-traluminal angioplasty or intravascular stent insertion was undergone . Results 16 patients underwent therapy of percutaneous intraluminal angioplasty ,and 19 patients underwent therapy of intravascular stent insertion successfully and 3 failed. Conclusion Percutaneous intraluminal angioplasty and intravascular stent insertion are safe and effective for BCS due to membrance obstruction of the hepatic veins .

  15. Direction-fixed paroxysmal nystagmus lateral canal benign paroxysmal positioning vertigo (BPPV): another form of lateral canalolithiasis.

    Science.gov (United States)

    Califano, L; Vassallo, A; Melillo, M G; Mazzone, S; Salafia, F

    2013-08-01

    Benign paroxysmal positioning vertigo (BPPV) is the most frequent vertiginous syndrome. It is caused either by free-floating otoliths in the semicircular canals (canalolithiasis) or by otoconial debris adhering to a canal cupula (cupulolithiasis). The posterior canal is the most frequently involved (80%), while the lateral canal is involved less frequently (15%), and the rarest conditions are anterior canalolithiasis and apogeotropic posterior canalolithiasis (5%). The main diagnostic sign of lateral canal BPPV is paroxysmal horizontal bidirectional positioning nystagmus evoked through Pagnini-McClure's test (head roll in the yaw plane in supine position). In the geotropic variant, which is more frequent, the fast phase of the nystagmus is directed towards the lowermost ear, when the patient lies on the affected side or on the healthy side; in the apogeotropic variant, which is less frequent, the fast phase is directed always toward the uppermost ear, regardless of which side the patient lies on. Paroxysmal nystagmus is more intense on the affected side in the geotropic form, and more intense on the healthy side in the apogeotropic form. The authors describe five cases of another primitive and rare form of lateral BPPV, defined as "direction-fixed paroxysmal nystagmus lateral canal BPPV", which has previously been described by other authors as a transitory step observed during the transformation from an apogeotropic into a geotropic form. It is characterized by typical BPPV symptoms and diagnosed by the presence of a paroxysmal horizontal unidirectional positioning nystagmus, evoked through Pagnini-McClure's test, which is apogeotropic on the affected side and geotropic on the healthy side. In the reported cases, direction-fixed horizontal paroxysmal nystagmus was always transformed into a typical geotropic form. The clinical features and pathophysiology of direction-fixed nystagmus lateral canal BPPV are discussed.

  16. External ear canal cholesteatoma after ventilation tube insertion and mastoidectomy

    Directory of Open Access Journals (Sweden)

    Đerić Dragoslava

    2012-01-01

    Full Text Available Introduction. Etiopathogenetically, there are two types of chollesteatomas: congenital, and acquired. Numerous theories in the literature try to explain the nature of the disease, however, the question about cholesteatomas remain still unanswered. The aim of the study was to present a case of external ear canal cholesteatoma (EEC developed following microsurgery (ventilation tube insertion and mastoidectomy, as well as to point ant possible mechanisms if its development. Case report. A 16-yearold boy presented a 4-month sense of fullness in the ear and otalgia on the left side. A year before, mastoidectomy and posterior atticotomy were performed with ventilation tube placement due to acute purulent mastoiditis. Diagnosis was based on otoscopy examination, audiology and computed tomography (CT findings. CT showed an obliterative soft-tissue mass completely filled the external ear canal with associated erosion of subjacent the bone. There were squamous epithelial links between the canal cholesteatoma and lateral tympanic membrane surface. They originated from the margins of tympanic membrane incision made for a ventilation tube (VT insertion. The position of VT was good as well as the aeration of the middle ear cavity. The tympanic membrane was intact and of normal appearance without middle ear extension or mastoid involvement of cholesteatoma. Cholesteatoma and ventilation tube were both removed. The patient recovered without complications and shortly audiology revealed hearing improving. Follow-up 2 years later, however, showed no signs of the disease. Conclusion. There could be more than one potential delicate mechanism of developing EEC in the ear with VT insertion and mastoidectomy. It is necessary to perform routine otologic surveillance in all patients with tubes. Affected ear CT scan is very helpful in showing the extent of cholesteatoma and bony defects, which could not be assessed by otoscopic examination alone.

  17. Transmastoid Approach for Resurfacing the Superior Semicircular Canal Dehiscence with a Dumpling Structure

    Institute of Scientific and Technical Information of China (English)

    Xiao-Bo Ma; Rong Zeng; Guo-Peng Wang; Shu-Sheng Gong

    2015-01-01

    Background:Superior semicircular canal dehiscence (SSCD) is gradually recognized by otologists in recent years.The patients with SSCD have a syndrome comprising a series of vestibular symptoms and hearing function disorders which can be cured by the operation.In this study,we evaluated the characteristics of patients with SSCD and determined the effectiveness of treating this syndrome by resurfacing the canal via the transmastoid approach using a dumpling structure.Methods:Patients with SSCD,confirmed by high-resolution computed tomography and hospitalized at Beijing Tongren Hospital between November 2009 and October 2012,were included in the study.All of the patients underwent the unilateral transmastoid approach for resurfacing the canal,and received regular follow-up after surgery.Data from preoperative medical records and postoperative follow-up were comparatively analyzed to evaluate the effect of surgery.Results:In total,10 patients and 13 ears (three left ears,four right ears,three bilateral ears) were evaluated in the study,which included 7 men and 3 women.Different symptoms and distinctive manifestations of vestibular evoked myogenic potential were found in these patients.After surgery,4 patients had complete resolution,5 had partial resolution,and 1 patient,with bilateral SSCD,had aggravation.None of the patients suffered from serious complications such as sensorineural hearing loss,facial paralysis,cerebrospinal fluid leakage,or intracranial hypertension.Conclusions:In patients with unilateral SSCD,resurfacing the canal via the transmastoid approach using a dumpling structure is an effective and safe technique.However,more consideration is needed for patients with bilateral SSCD.

  18. Transmastoid Approach for Resurfacing the Superior Semicircular Canal Dehiscence with a Dumpling Structure

    Directory of Open Access Journals (Sweden)

    Xiao-Bo Ma

    2015-01-01

    Full Text Available Background: Superior semicircular canal dehiscence (SSCD is gradually recognized by otologists in recent years. The patients with SSCD have a syndrome comprising a series of vestibular symptoms and hearing function disorders which can be cured by the operation. In this study, we evaluated the characteristics of patients with SSCD and determined the effectiveness of treating this syndrome by resurfacing the canal via the transmastoid approach using a dumpling structure. Methods: Patients with SSCD, confirmed by high-resolution computed tomography and hospitalized at Beijing Tongren Hospital between November 2009 and October 2012, were included in the study. All of the patients underwent the unilateral transmastoid approach for resurfacing the canal, and received regular follow-up after surgery. Data from preoperative medical records and postoperative follow-up were comparatively analyzed to evaluate the effect of surgery. Results: In total, 10 patients and 13 ears (three left ears, four right ears, three bilateral ears were evaluated in the study, which included 7 men and 3 women. Different symptoms and distinctive manifestations of vestibular evoked myogenic potential were found in these patients. After surgery, 4 patients had complete resolution, 5 had partial resolution, and 1 patient, with bilateral SSCD, had aggravation. None of the patients suffered from serious complications such as sensorineural hearing loss, facial paralysis, cerebrospinal fluid leakage, or intracranial hypertension. Conclusions: In patients with unilateral SSCD, resurfacing the canal via the transmastoid approach using a dumpling structure is an effective and safe technique. However, more consideration is needed for patients with bilateral SSCD.

  19. Computed tomography of the thoracic canal. Experimental and clinical studies

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, S. (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1981-05-01

    Under the adequate CT condition, thoracic canal was studied in twelve normal cases, nine cases of cervical myelopathy with developmental cervical canal stenosis and four cases of thoracic myelopathy with ossification of thoracic yellow ligament. The results were as follows. 1) The adequate condition for delineation of thoracic canal seemed to be nearly 400 EMI units in window width and 150 in level. Scanning angle was permitted within about 10/sup 0/. Bony thoracic canal was well scanned at the center of vertebral body. 2) The configulation of the normal thoracic canal was oval at Th/sub 1/, Th/sub 2/ levels and round at Th/sub 3/-Th/sub 10/ and large oval at Th/sub 11/, Th/sub 12/. The sagittal diameter was almost fixed at each level and the transverse diameter was large at upper and lower levels and small at middle levels. 3) Thoracic canal was narrowed in the cases of cervical myelopathy with developmental cervical canal stenosis especially in sagittal diameter, but not narrowed in transverse diameter. Three of four cases who had myelopathy with ossification of thoracic yellow ligament had narrow canals. 4) There was a good relation between sagittal diameter of cervical canal and thoracic canal. 5) There was a good relation between sagittal diameter of thoracic canal measured by conventional radiographs (Hattori's method) and CT scans. The author thinks that Hattori's method is useful to diagnose the thoracic canal stenosis.

  20. 21 CFR 872.3820 - Root canal filling resin.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Root canal filling resin. 872.3820 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3820 Root canal filling resin. (a) Identification. A root canal filling resin is a device composed of material, such as methylmethacrylate,...

  1. Newer Root Canal Irrigants in Horizon: A Review

    OpenAIRE

    Prashant P. Jaju; Sushma Jaju

    2011-01-01

    Sodium hypochloride is the most commonly used endodontic irrigant, despite limitations. None of the presently available root canal irrigants satisfy the requirements of ideal root canal irrigant. Newer root canal irrigants are studied for potential replacement of sodium hypochloride. This article reviews the potential irrigants with their advantages and limitations with their future in endodontic irrigation.

  2. Newer Root Canal Irrigants in Horizon: A Review

    Directory of Open Access Journals (Sweden)

    Sushma Jaju

    2011-01-01

    Full Text Available Sodium hypochloride is the most commonly used endodontic irrigant, despite limitations. None of the presently available root canal irrigants satisfy the requirements of ideal root canal irrigant. Newer root canal irrigants are studied for potential replacement of sodium hypochloride. This article reviews the potential irrigants with their advantages and limitations with their future in endodontic irrigation.

  3. Nerve canals at the fundus of the internal auditory canal on high-resolution temporal bone CT

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Yoon Ha; Youn, Eun Kyung; Kim, Seung Chul [Sungkyunkwan Univ., School of Medicine, Seoul (Korea, Republic of)

    2001-12-01

    To identify and evaluate the normal anatomy of nerve canals in the fundus of the internal auditory canal which can be visualized on high-resolution temporal bone CT. We retrospectively reviewed high-resolution (1 mm thickness and interval contiguous scan) temporal bone CT images of 253 ears in 150 patients who had not suffered trauma or undergone surgery. Those with a history of uncomplicated inflammatory disease were included, but those with symptoms of vertigo, sensorineural hearing loss, or facial nerve palsy were excluded. Three radiologists determined the detectability and location of canals for the labyrinthine segment of the facial, superior vestibular and cochlear nerve, and the saccular branch and posterior ampullary nerve of the inferior vestibular nerve. Five bony canals in the fundus of the internal auditory canal were identified as nerve canals. Four canals were identified on axial CT images in 100% of cases; the so-called singular canal was identified in only 68%. On coronal CT images, canals for the labyrinthine segment of the facial and superior vestibular nerve were seen in 100% of cases, but those for the cochlear nerve, the saccular branch of the inferior vestibular nerve, and the singular canal were seen in 90.1%, 87.4% and 78% of cases, respectiveIy. In all detectable cases, the canal for the labyrinthine segment of the facial nerve was revealed as one which traversed anterolateralIy, from the anterosuperior portion of the fundus of the internal auditory canal. The canal for the cochlear nerve was located just below that for the labyrinthine segment of the facial nerve, while that canal for the superior vestibular nerve was seen at the posterior aspect of these two canals. The canal for the saccular branch of the inferior vestibular nerve was located just below the canal for the superior vestibular nerve, and that for the posterior ampullary nerve, the so-called singular canal, ran laterally or posteolateralIy from the posteroinferior aspect of

  4. Infrared tympanic temperature and ear canal morphology

    NARCIS (Netherlands)

    Daanen, H.A.M.

    2006-01-01

    Several publications indicate that the infrared tympanic temperature (IRTT) underestimates the core temperature of the body when the ear canal is long, curvy and narrow. In order to quantify these observations, a study was performed in 10 subjects. The IRTT was determined and compared to the oesopha

  5. The crazy project – Canal Istanbul

    Directory of Open Access Journals (Sweden)

    Seda Kundak

    2011-10-01

    Full Text Available It was late April 2011 when “the Crazy Project - Canal Istanbul” was proposed by the Prime Minister of Turkey, during his election campaign.  Although the idea of an artificial canal is not new, since it is initiated without any consensus between the people and institutions in Istanbul, the project immediately set a large number of debates. These vary from the legitimacy of decentralization of governance, to potential impacts of the canal on international politics, economy, environment and urban life.  Regarding past infrastructure projects in Istanbul, such large scale investments have caused extensive acceleration in construction sector in one hand and social and economic shifts on the other.  In this paper, the Canal Istanbul Project is evaluated according to basic motivations and claims of the PM, multi-perspective view through challenges and limitation that the project is likely to face with and speculations on implementation approach. The final discussion on the project is based on benefits/losses of Istanbul once the project will be implemented.

  6. Note on Tendipedidae of the Suez Canal

    NARCIS (Netherlands)

    Kruseman, G.

    1949-01-01

    Mr. A. C. V. VAN BEMMEL and Dr. A. DIAKONOFF of the Buitenzorg Museum (Java) collected Tendipedidae, which were attracted by artificial lights, when they passed the Suez Canal on 8-XI-1937 and 16-V-1939 respectively. This very interesting collection, containing some new species, was sent to me for d

  7. Assessment of the wetting behavior of three different root canal sealers on root canal dentin

    OpenAIRE

    Muralidhar Tummala; Veeramachaneni Chandrasekhar; A Shashi Rashmi; Kundabala, M; Vasudev Ballal

    2012-01-01

    Aim: The objective of the present study was to evaluate and compare the wetting behavior of three different root canal sealers on the root canal dentin surface treated with irrigants and their combination. Materials and Methods: Decoronation and apical third resections of 27 extracted single-rooted human mandibular premolars were done. The roots were then split longitudinally into two halves, and randomly assigned into three treatment groups (n=18). The root dentin surfaces in Group1, Gro...

  8. 根管显微镜处理阻塞根管的效果%Root Canal Microscope Blocking the Effects of Root Canal Treatment

    Institute of Scientific and Technical Information of China (English)

    陈杰

    2014-01-01

    Objective To investigate the treatment of root canal microscope blocking the ef ects of root canal. Methods The root canal microscope, combined with ultrasonic instruments, due to the three root of broken instruments, plasticizing, calcification of tube obstruction in 112 teeth (160 root canals) processing. On the basis of the causes of obstruction, different teeth, parts, comparative analysis of dif erence in the success rate of root canal dredging. Results 160 blocked canals to clear the success rate was 81.25%, because of broken instruments, plasticizing, calcification of root canal jams dredge, the success rate was 84.27%, 84.21%, 83.33%, and no significant difference between group comparison ( >0.05);the front teeth, teeth to clear the success rate was 95.56%, 72%, statistical y significant dif erences ( <0.05);roots (or curved root canal, the bending part above) fol owing root canal the success rate was 92.54%, 21.42%, there was a statistical y significant dif erence ( <0.05). Conclusion Based on the root canal microscope, obstructed root canal dredging ef ect is obvious, but the obstruction and teeth can be influenced by factors such as dredging ef ect.%目的了解根管显微镜处理阻塞根管的效果。方法采用根管显微镜,结合超声器械,对因折断器械、塑化物、钙化所致的三种根管阻塞患牙112颗(160个根管)进行处理。依据阻塞原因、牙位、部位的不同,对比分析根管疏通成功率差异。结果160个阻塞根管疏通成功率为81.25豫,因折断器械、塑化物、钙化所致的根管堵塞,其疏通成功率依次为84.27豫、84.21豫、83.33豫,组间对比差异无显著统计学意义(跃0.05);前牙、磨牙疏通成功率依次为95.56豫、72豫,差异具有显著统计学意义(约0.05);直根管(或弯曲以上根管)、弯曲部位以下根管成功率依次为92.54豫、21.42豫,差异具有显著统计学意义(约0.05)。结论基于根管显微镜下

  9. MR determination of neonatal spinal canal depth

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen, E-mail: owenarthurs@uk2.net [Centre for Cardiovascular MR, Great Ormond Street Hospital for Children, London WC1N 3JH (United Kingdom); Thayyil, Sudhin, E-mail: s.thayyil@ucl.ac.uk [Academic Neonatology, Institute for Women' s Health, London WC1E 6AU (United Kingdom); Wade, Angie, E-mail: a.wade@ucl.ac.uk [Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London (United Kingdom); Chong, W.K., E-mail: Kling.Chong@gosh.nhs.uk [Paediatric Neuroradiology, Great Ormond Street Hospital for Children, London (United Kingdom); Sebire, Neil J., E-mail: Neil.Sebire@gosh.nhs.uk [Histopathology, Great Ormond Street Hospital for Children, London WC1E 6AU (United Kingdom); Taylor, Andrew M., E-mail: a.taylor76@ucl.ac.uk [Centre for Cardiovascular MR, Cardiorespiratory Unit, Great Ormond Street Hospital for Children and UCL Institute of Cardiovascular Science, London WC1E 6AU (United Kingdom)

    2012-08-15

    Objectives: Lumbar punctures (LPs) are frequently performed in neonates and often result in traumatic haemorrhagic taps. Knowledge of the distance from the skin to the middle of the spinal canal (mid-spinal canal depth - MSCD) may reduce the incidence of traumatic taps, but there is little data in extremely premature or low birth weight neonates. Here, we determined the spinal canal depth at post-mortem in perinatal deaths using magnetic resonance imaging (MRI). Patients and methods: Spinal canal depth was measured in 78 post-mortem foetuses and perinatal cases (mean gestation 26 weeks; mean weight 1.04 kg) at the L3/L4 inter-vertebral space at post-mortem MRI. Both anterior (ASCD) and posterior (PSCD) spinal canal depth were measured; MSCD was calculated and modelled against weight and gestational age. Results: ASCD and PSCD (mm) correlated significantly with weight and gestational age (all r > 0.8). A simple linear model MSCD (mm) = 3 Multiplication-Sign Weight (kg) + 5 was the best fit, identifying an SCD value within the correct range for 87.2% (68/78) (95% CI (78.0, 92.9%)) cases. Gestational age did not add significantly to the predictive value of the model. Conclusion: There is a significant correlation between MSCD and body weight at post-mortem MRI in foetuses and perinatal deaths. If this association holds in preterm neonates, use of the formula MSCD (mm) = 3 Multiplication-Sign Weight (kg) + 5 could result in fewer traumatic LPs in this population.

  10. Beals Syndrome

    Science.gov (United States)

    ... Boards & Staff Annual Report & Financials Contact Us Donate Marfan & Related Disorders What is Marfan Syndrome? What are ... the syndrome. How does Beals syndrome compare with Marfan syndrome? People with Beals syndrome have many of ...

  11. Dorello's Canal for Laymen: A Lego-Like Presentation.

    Science.gov (United States)

    Ezer, Haim; Banerjee, Anirban Deep; Thakur, Jai Deep; Nanda, Anil

    2012-06-01

    Objective Dorello's canal was first described by Gruber in 1859, and later by Dorello. Vail also described the anatomy of Dorello's canal. In the preceding century, Dorello's canal was clinically important, in understanding sixth nerve palsy and nowadays it is mostly important for skull base surgery. The understanding of the three dimensional anatomy, of this canal is very difficult to understand, and there is no simple explanation for its anatomy and its relationship with adjacent structures. We present a simple, Lego-like, presentation of Dorello's canal, in a stepwise manner. Materials and Methods Dorello's canal was dissected in five formalin-fixed cadaver specimens (10 sides). The craniotomy was performed, while preserving the neural and vascular structures associated with the canal. A 3D model was created, to explain the canal's anatomy. Results Using the petrous pyramid, the sixth nerve, the cavernous sinus, the trigeminal ganglion, the petorclival ligament and the posterior clinoid, the three-dimensional structure of Dorello's canal was defined. This simple representation aids in understanding the three dimensional relationship of Dorello's canal to its neighboring structures. Conclusion Dorello's canal with its three dimensional structure and relationship to its neighboring anatomical structures could be reconstructed using a few anatomical building blocks. This method simplifies the understanding of this complex anatomical structure, and could be used for teaching purposes for aspiring neurosurgeons, and anatomy students. PMID:23730547

  12. Research on Canal System Operation Based on Controlled Volume Method

    Directory of Open Access Journals (Sweden)

    Zhiliang Ding

    2009-10-01

    Full Text Available An operating simulation mode based on storage volume control method for multireach canal system in series was established. In allusion to the deficiency of existing controlled volume algorithm, the improved algorithm was proposed, that is the controlled volume algorithm of whole canal pools, the simulation results indicate that the storage volume and water level of each canal pool can be accurately controlled after the improved algorithm was adopted. However, for some typical discharge demand change operating conditions of canal, if the controlled volume algorithm of whole canal pool is still adopted, then it certainly will cause some unnecessary regulation, and consequently increases the disturbed canal reaches. Therefor, the idea of controlled volume operation method of continuous canal pools was proposed, and its algorithm was designed. Through simulation to practical project, the results indicate that the new controlled volume algorithm proposed for typical operating condition can comparatively obviously reduce the number of regulated check gates and disturbed canal pools for some typical discharge demand change operating conditions of canal, thus the control efficiency of canal system was improved. The controlled volume method of operation is specially suitable for large-scale water delivery canal system which possesses complex operation requirements.

  13. Comparison of the rheological properties of four root canal sealers

    Institute of Scientific and Technical Information of China (English)

    Seok Woo Chang; Kwang Shik Bae; Young-Kyu Lee; Qiang Zhu; Won Jun Shon; Woo Cheol Lee; Kee Yeon Kum; Seung Ho Baek; In Bog Lee; Bum-Soon Lim

    2015-01-01

    The flowability of a root canal sealer is clinically important because it improves the penetration of the sealer into the complex root canal system. The purpose of this study was to compare the flowabilities of four root canal sealers, measured using the simple press method (ISO 6876), and their viscosities, measured using a strain-controlled rheometer. A newly developed, calcium phosphate-based root canal sealer (Capseal) and three commercial root canal sealers (AH Plus, Sealapex and Pulp Canal Sealer EWT) were used in this study. The flowabilities of the four root canal sealers were measured using the simple press method (n55) and their viscosities were measured using a strain-controlled rheometer (n55). The correlation between these two values was statistically analysed using Spearman’s correlation test. The flow diameters and the viscosities of the root canal sealers were strongly negatively correlated (r520.8618). The viscosity of Pulp Canal Sealer EWT was the lowest and increased in the following order:AH Plus,Sealapex,Capseal (P,0.05). All of the tested root canal sealers showed characteristic time-and temperature-dependent changes in their rheological properties. The viscosities measured using the strain-controlled rheometer were more precise than the flowabilities measured using the simple press method, suggesting that the rheometer can accurately measure the rheological properties of root canal sealers.

  14. Morphology of the mandibular canal and the angulation between the mandibular and mental canals in dry skulls

    DEFF Research Database (Denmark)

    Pálsson, S R; Kjaer, I

    2008-01-01

    -angles. In order to analyse internal morphology, a metallic pin was placed in the mental canal on the left side before radiography. The angle between the mental and the mandibular canals was termed the 'mental angle' and that expressing the curvature of the mandibular canal, the 'mandibular angle'. Spearman......-angles. The findings show that the internal courses of the mandibular and mental canals are interrelated. They also indicated that the course and morphology of the mandibular canal are interrelated with external mandibular morphology....

  15. Use of Cone Beam Computed Tomography in the Diagnosis of Superior Semicircular Canal Dehiscence

    Directory of Open Access Journals (Sweden)

    Ilson Sepulveda

    2014-01-01

    Full Text Available Superior semicircular canal dehiscence is a relatively new syndrome in the field of otology. It is of unknown etiology presenting with a variety of vestibular and auditory symptoms and radiologic findings play a crucial role in its diagnosis. Cone beam computed tomography has been shown to be a powerful tool in the field of otolaryngology. It is a three dimensional technique that uses lower radiation resulting in fewer artifacts and offers higher resolution when compared with multi-slice computed tomography. It is considered to be an excellent imaging modality for radiological exploration of the ear.

  16. Microcephaly syndromes.

    Science.gov (United States)

    Abuelo, Dianne

    2007-09-01

    The objective of this article is to review microcephaly from a genetics point of view, especially with regard to the process of identification of syndromes in which small head circumference occurs. Microcephaly can be due to either genetic or environmental causes. It can be the only positive finding or may be part of a syndrome of congenital anomalies. The genetic etiology can be caused by autosomal dominant, autosomal recessive, or X-linked genes or various types of chromosome anomalies. Some of the gene mutations have been identified recently. Syndromic microcephaly is associated with a large number of conditions. Some can be diagnosed, or at least suspected, based on their characteristic facial dysmorphism, and others can be searched for using databases of genetic disorders.

  17. Hearing rehabilitation in Treacher Collins Syndrome with bone anchored hearing aid

    Directory of Open Access Journals (Sweden)

    José Fernando Polanski

    2015-12-01

    Full Text Available Objective: To describe a case of hearing rehabilitation with bone anchored hearing aid in a patient with Treacher Collins syndrome. Case description: 3 years old patient, male, with Treacher Collins syndrome and severe complications due to the syndrome, mostly related to the upper airway and hearing. He had bilateral atresia of external auditory canals, and malformation of the pinna. The initial hearing rehabilitation was with bone vibration arch, but there was poor acceptance due the discomfort caused by skull compression. It was prescribed a model of bone-anchored hearing aid, in soft band format. The results were evaluated through behavioral hearing tests and questionnaires Meaningful Use of Speech Scale (MUSS and Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS. Comments: The patient had a higher acceptance of the bone-anchored hearing aid compared to the traditional bone vibration arch. Audiological tests and the speech and auditory skills assessments also showed better communication and hearing outcomes. The bone-anchored hearing aid is a good option in hearing rehabilitation in this syndrome.

  18. Hearing rehabilitation in Treacher Collins Syndrome with bone anchored hearing aid

    Science.gov (United States)

    Polanski, José Fernando; Plawiak, Anna Clara; Ribas, Angela

    2015-01-01

    Objective: To describe a case of hearing rehabilitation with bone anchored hearing aid in a patient with Treacher Collins syndrome. Case description: 3 years old patient, male, with Treacher Collins syndrome and severe complications due to the syndrome, mostly related to the upper airway and hearing. He had bilateral atresia of external auditory canals, and malformation of the pinna. The initial hearing rehabilitation was with bone vibration arch, but there was poor acceptance due the discomfort caused by skull compression. It was prescribed a model of bone-anchored hearing aid, in soft band format. The results were evaluated through behavioral hearing tests and questionnaires Meaningful Use of Speech Scale (MUSS) and Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS). Comments: The patient had a higher acceptance of the bone-anchored hearing aid compared to the traditional bone vibration arch. Audiological tests and the speech and auditory skills assessments also showed better communication and hearing outcomes. The bone-anchored hearing aid is a good option in hearing rehabilitation in this syndrome. PMID:26298651

  19. Enhanced MRI in patients with Ramsay-Hunt's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Yanagida, Masahiro; Ushiro, Koichi; Yamashita, Toshio; Kumazawa, Tadami (Kansai Medical Univ., Osaka (Japan). Dept. of Otolaryngology); Katoh, Tsutomu (Kansai Medical Univ., Osaka (Japan). Dept. of Radiology)

    1993-01-01

    Enhanced MRI was performed in 14 patients with Ramsay-Hunt,s syndrome to investigate the pathogenesis of this syndrome. All MRI studies were performed on a 0.5T superconductivity MRI system using a head coil with Gd-DTPA. Enhancement was observed in the areas of the distal internal auditory canal and labyrinthine segment in many patients, and was especially prominent in patients suffering from vertigo, tinnitus, and hearing loss. In some patients it involved not only the facial nerve of the internal auditory canal but also the cochlear nerve and vestibular nerves. Since histological changes of the facial nerve in patients with Ramsay-Hunt's syndrome are assumed to occur in the distal internal auditory canal and labyrinthine segment, which is more proximal than the geniculate ganglion, and the possibility is suggested that inflammation may be spread to the vestibular and cochlear nerve via the internal auditory canal. (14 refs., 2 figs.).

  20. Myofascial release of carpal tunnel syndrome.

    Science.gov (United States)

    Sucher, B M

    1993-01-01

    Current treatment for carpal tunnel syndrome may be ineffective or associated with complications or recurrence. In the case reported here, a myofascial release by the physician combined with the patient's self-stretch reduced pain and numbness and improved electromyographic results. The manipulative approach releases the transverse carpal ligament,-and "opens" or dilates the canal. The patient stretches the wrist, digits, and thumb, including myofascial components. An aggressive, conservative approach lessens the need for surgery in mild to moderate cases. Studies with magnetic resonance imaging may be helpful to document canal size before and after treatment.

  1. Water quality of the Boca Raton canal system and effects of the Hillsboro Canal inflow, southeastern Florida, 1990-91

    Science.gov (United States)

    McKenzie, D.J.

    1995-01-01

    The City of Boca Raton in southeastern Palm Beach County, Florida, is an urban residential area that has sustained a constant population growth with subsequent increase in water use. The Boca Raton network of canals is controlled to provide for drainage of excess water, to maintain proper coastal ground-water levels to prevent saltwater intrusion, and to recharge the surficial aquifer system from which the city withdraws potable water. Most of the water supplied to the Boca Raton canal system and the surficial aquifer system, other than rainfall and runoff, is pumped from the Hillsboro Canal. The Biscayne aquifer, principal hydrogeologic unit of the surficial aquifer system, is highly permeable and there is a close relation between water levels in the canals and the aquifer. The amount of water supplied by seepage from the conservation areas is unknown. Because the Hillsboro Canal flows from Lake Okeechobee and Water Conservation Areas 1 and 2, which are places of more highly mineralized ground water and surface water, the canal is a possible source of contamination. Water samples were collected at 10 canal sites during wet and dry seasons and analyzed for major inorganic ions and related characteristics, nutrients, and trace elements. All concentrations were generally within or less than the drinking-water standards established by the Florida Department of Environmental Protection. The high concentrations of sodium and chloride that were detected in samples from the Boca Raton canal system are probably from the more mineralized water of the Hillsboro Canal. Other water-quality data, gathered from various sources from 1982 through 1991, did not indicate any significant changes nor trends. The effects of the Hillsboro Canal on the water quality of the Boca Raton canal system are indicated by increased concentrations of sodium, chloride, dissolved solids, and total organic carbon. Concentrations of the constituents in the canal water generally decrease with distance

  2. Influence of the apical enlargement size on the endotoxin level reduction of dental root canals

    Directory of Open Access Journals (Sweden)

    Ariane Cassia Salustiano Marinho

    2012-12-01

    Full Text Available Gram-negative bacteria play an essential role in endodontic infections because they have virulence factors such as endotoxin. Due to its potential cytotoxic activity, special attention has been given to the removal/neutralization of this endotoxin in the root canal system. OBJECTIVE: The aim of this study was to evaluate the influence of the apical enlargement size (AES by using rotary instruments on the endotoxin level reduction of dental root canals. MATERIAL AND METHODS: Forty root canals of the mandibular premolar teeth were used. Escherichia coli endotoxin (055: B55 was inoculated into thirty root canals. Ten teeth served as the negative control group. After the incubation period, the first endotoxin samples were collected from the root canals with a sterile/apyrogenic paper point for the analysis of the endotoxin units (EU/mL present before instrumentation (S1. Specimen instrumentation was performed with the Mtwo® rotary system in the sequence 10/.04, 15/.05, 20/.06, 25/.06, 30/.05, 35/.04 and 40/.04. To monitor the effectiveness of increasing apical enlargement on endotoxin removal, the second endotoxin samples were collected from all the root canals after instrumentation with the following instruments: #25/.06- (S2; #30/.05- (S3; # 35/.04- (S4; and #40/.04- (S5. Limulus amebocyte lysate (LAL was used to quantify the levels of endotoxin. The results were statistically compared by using repeated measures of ANOVA with post hoc Tukey testing. RESULTS: Increasing levels of endotoxin removal was achieved by large sized apical enlargement: S2 (AES #25/.06- 89.2%, S3 (AES #30/.05- 95.9%, S4 (AES #35/.04- 97.8% and S5 (AES #40/.04- 98.2%. Substantial reduction of endotoxin content was obtained in S4 and S5 compared to S2 (p<0.05, however, the root canal preparation was not able to eliminate the endotoxin. CONCLUSIONS: Under the conditions of this study, it was concluded that the reduction of endotoxin levels of the dental root canals could be

  3. Anal cancer; Cancer du canal anal

    Energy Technology Data Exchange (ETDEWEB)

    Fesneau, M.; Champeaux-Orange, E. [Service de radiotherapie, Centre regional universitaire de cancerologie Henry-S.-Kaplan CHU de Tours, Hopital Bretonneau, 37 - Tours (France); Champeaux-Orange, E. [Service d' oncologie-radiotherapie, Centre hospitalier regional d' Orleans, 45 - Orleans (France); Hennequin, C. [Service de cancerologie-radiotherapie, hopital Saint-Louis, 75 - Paris (France)

    2010-07-01

    Anal canal epidermoid carcinomas represent 1.2% of digestive cancers and 6% of ano-rectal cancers. For localized diseases, the treatment is based on radiotherapy with or without chemotherapy (5-FU and cisplatin or mitomycin), according to tumour and nodal extension. The recommended treatment dose is 45 Gy in the anal canal, the mesorectum, para-rectal lymph nodes, and inguinal lymph nodes. An additional dose of 15 to 20 Gy is delivered in the initial tumour for good responders. Salvage surgery is necessary in case of poor response. The organs at risk to be considered are bladder, femur heads, small intestine and vulva. The objective of this work is to summarize the epidemiological and radio-anatomic and prognostic characteristics of this tumour. The conformal radiotherapy technique is illustrated by a case report. (authors)

  4. Ewing Sarcoma of the External Ear Canal.

    Science.gov (United States)

    Binnetoglu, Adem; Baglam, Tekin; Tokuc, Gulnur; Kecelioglu Binnetoglu, Kiymet; Gerin, Fatma; Sari, Murat

    2016-01-01

    Background. Ewing sarcoma (ES) is a high-grade malignant tumor that has skeletal and extraskeletal forms and consists of small round cells. In the head and neck region, reported localization of extraskeletal ES includes the larynx, thyroid gland, submandibular gland, nasal fossa, pharynx, skin, and parotid gland, but not the external ear canal. Methods. We present the unique case of a 2-year-old boy with extraskeletal ES arising from the external ear canal, mimicking auricular hematoma. Results. Surgery was performed and a VAC/IE (vincristine, adriamycin, cyclophosphamide alternating with ifosfamide, and etoposide) regimen was used for adjuvant chemotherapy for 12 months. Conclusion. The clinician should consider extraskeletal ES when diagnosing tumors localized in the head and neck region because it may be manifested by a nonspecific clinical picture mimicking common otorhinolaryngologic disorders. PMID:27313930

  5. Squamous cell carcinoma of the anal canal.

    LENUS (Irish Health Repository)

    Martin, F T

    2012-01-31

    Squamous cell carcinoma ofthe anal canal represents 1.5% of all malignancies affectingthe gastrointestinal tract. Over the past 20 years dramatic changes have been seen in both the epidemiological distribution of the disease and in the therapeutic modalities utilised to manage it. CLINICAL MANAGEMENT: Historically abdominoperineal resection had been the treatment of choice with local resection reserved for early stage disease. Work by Nigro et al. has revolutionised how we currently manage carcinoma of the anal canal, demonstrating combined modality chemoradiotherapy as an appropriate alternative to surgical resection with the benefit of preserving sphincter function. Surgery is then reserved for recurrent disease with salvage abdominoperineal resection. This article reviews current literature and highlights the changing therapeutic modalities with selected clinical cases

  6. Cancer of the external auditory canal

    DEFF Research Database (Denmark)

    Nyrop, Mette; Grøntved, Aksel

    2002-01-01

    . PATIENTS: Ten women and 10 men with previously untreated primary cancer. Median age at diagnosis was 67 years (range, 31-87 years). Survival data included 18 patients with at least 2 years of follow-up or recurrence. INTERVENTION: Local canal resection or partial temporal bone resection. MAIN OUTCOME......OBJECTIVE: To evaluate the outcome of surgery for cancer of the external auditory canal and relate this to the Pittsburgh staging system used both on squamous cell carcinoma and non-squamous cell carcinoma. DESIGN: Retrospective case series of all patients who had surgery between 1979 and 2000...... MEASURE: Recurrence rate. RESULTS: Half of the patients had squamous cell carcinoma. Thirteen of the patients had stage I tumor (65%), 2 had stage II (10%), 2 had stage III (10%), and 3 had stage IV tumor (15%). Twelve patients were cured. All patients with stage I or II cancers were cured except 1...

  7. Stroke due to Familial Marfan Syndrome

    Directory of Open Access Journals (Sweden)

    M.Taylan Pekoz

    2013-04-01

    Full Text Available Marfan sendromu iskelet, okuler, kardiyovaskuler, akciger, deri ve dura anormalliklerine yol acan otozomal dominant gecisli multisistem bir hastaliktir. Bu makalede Ailesel Marfan Sendromu tanisi alan ve takip periyodunda inme gelisen bir olgu sunulmustur. . [Cukurova Med J 2013; 38(2.000: 285-289

  8. Stroke due to Familial Marfan Syndrome

    OpenAIRE

    Peköz, M. Taylan; Koç, Filiz

    2013-01-01

    Marfan sendromu iskelet, oküler, kardiyovasküler, akciğer, deri ve dura anormalliklerine yol açan otozomal dominant geçişli multisistem bir hastalıktır. Bu makalede Ailesel Marfan Sendromu tanısı alan ve takip periyodunda inme gelişen bir olgu sunulmuştur. .

  9. Stroke due to Familial Marfan Syndrome

    OpenAIRE

    M.Taylan Pekoz; Filiz Koc

    2013-01-01

    Marfan sendromu iskelet, okuler, kardiyovaskuler, akciger, deri ve dura anormalliklerine yol acan otozomal dominant gecisli multisistem bir hastaliktir. Bu makalede Ailesel Marfan Sendromu tanisi alan ve takip periyodunda inme gelisen bir olgu sunulmustur. . [Cukurova Med J 2013; 38(2.000): 285-289

  10. The shape of the human lumbar vertebral canal A forma do canal vertebral lombar humano

    Directory of Open Access Journals (Sweden)

    Edmundo Zarzur

    1996-09-01

    Full Text Available Literature on the anatomy of the human vertebral column characterizes the shape of the lumbar vertebral canal as triangular. The purpose of the present study was to determine the precise shape of the lumbar vertebral canal. Ten lumbar vertebral columns of adult male cadavers were dissected. Two transverse sections were performed in the third lumbar vertebra. One section was performed at the level of the lower border of the ligamenta flava, and the other section was performed at the level of the pedicles. The shape of the lumbar vertebral canal at the level of the pedicles tends to be oval or circular, whereas the shape of the lumbar vertebral canal at the level of the lower border of the ligamenta flava is triangular. Thus, the shape of the human lumbar vertebral canal is not exclusively triangular, as reported in the literature. It is related to the level of the transversal section performed on the lumbar vertebra. This finding should be taken into consideration among factors involved in the spread of solutions introduced into the epidural space.A literatura sobre a anatomia da coluna vertebral descreve como sendo triangular o formato do canal vertebral na região lombar. O objetivo deste estudo é determinar a real forma do canal da coluna vertebral lombar.Dez colunas vertebrais de cadáveres de homens adultos foram dissecadas. Dois cortes transversais foram executados na terceira vértebra lombar. Um corte foi feito no nível das bordas inferiores de dois ligamentos amarelos vizinhos e o outro corte foi transversal, no nível dos pedículos. A forma do canal vertebral variou: no nível dos pedículos ela tende a ser oval ou circular e junto às bordas inferiores dos ligamentos amarelos passa a ser triangular. Portanto, a forma do canal vertebral lombar não é somente triangular; ela depende do nível em que se faz o corte transversal da vértebra. Estes achados devem ser levados em consideração entre os fatores envolvidos na difusão das

  11. Spinal canal narrowing during simulated frontal impact

    OpenAIRE

    Ivancic, Paul C.; Panjabi, Manohar M.; Tominaga, Yasuhiro; Pearson, Adam M.; Elena Gimenez, S.; Maak, Travis G.

    2005-01-01

    Between 23 and 70% of occupants involved in frontal impacts sustain cervical spine injuries, many with neurological involvement. It has been hypothesized that cervical spinal cord compression and injury may explain the variable neurological profile described by frontal impact victims. The goals of the present study, using a biofidelic whole cervical spine model with muscle force replication, were to quantify canal pinch diameter (CPD) narrowing during frontal impact and to evaluate the potent...

  12. Carotid canal dehiscence in the human skull

    Energy Technology Data Exchange (ETDEWEB)

    Pastor Vazquez, J.F.; Gil Verona, J.A. [Department of Anatomy, Faculty of Medicine, University of Valladolid, Ramon y Cajal, 7, E-47005 Valladolid (Spain); Garcia Porrero, M. [Department of Radiology, Faculty of Medicine, University of Valladolid (Spain)

    1999-06-01

    Abnormalities of the floor of the carotid canal have been studied in 538 skulls. These abnormalities range from a fissure to total absence of the floor. This variation may be caused by abnormalities of the internal carotid artery or deficiencies in ossification of the skull base. CT suggests that these changes should be taken into account by surgeons working on the skull base. (orig.) With 4 figs., 8 refs.

  13. Koebner phenomenon of the ear canal skin.

    LENUS (Irish Health Repository)

    Young, O

    2009-02-01

    The Koebner phenomenon originally described the appearance of psoriatic lesions in the uninvolved skin of patients with psoriasis as a consequence of trauma. We describe a case of concurrent lichen planus and sarcoidosis in the auditory canal, which represents an unusual manifestation of the Koebner phenomenon. This is the first case of concurrent lichen planus and sarcoidosis in the head and neck region and highlights the need for biopsy to allow accurate histopathological diagnosis and treatment.

  14. Root canal filling using Resilon: a review.

    LENUS (Irish Health Repository)

    Shanahan, D J

    2011-07-01

    Root canal treatment is achieved by chemo-mechanical debridement of the root canal system followed by filling. The filling material \\'entombs\\' residual bacteria and acts as a barrier which prevents the entrance of oral microorganisms and reinfection of the root canal system through microleakage. However, filling with contemporary root filling materials such as gutta-percha offers limited long-term resistance to microorganisms; as a result other materials such as Resilon have been investigated as alternatives. The aim of this review was to analyse the literature to consider whether Resilon is a suitable root canal filling material. A MEDLINE and Cochrane library search including various keyword searches identified several papers which investigated or discussed Resilon or RealSeal\\/Epiphany. Analysis of the literature demonstrated that the bulk of the literature is in vitro in nature, based largely on leakage-type studies, and demonstrates a wide variety of methodologies with conflicting findings; as a result meaningful conclusions are difficult. Within the limit of these in vitro studies Resilon appears to perform adequately in comparison to gutta-percha, however, as a result of the questionable merit of such studies, it cannot presently be considered an evidence-based alternative to the current gold standard gutta-percha. It is imperative that before Resilon is considered as a replacement material, a better understanding of the physical properties of the resin sealer and the reality of the adhesive \\'monoblock\\' are elucidated. The literature also demonstrates a paucity of quality long-term clinical outcome studies which will need to be addressed before firm conclusions can be reached.

  15. Fat herniation through the canal of Schwalbe.

    Science.gov (United States)

    Cesmebasi, A; Abel, N; Tubbs, R S; Loukas, M

    2014-11-01

    The authors report a case of fat herniation through the canal of Schwalbe noted in a female cadaver during abdominopelvic dissection. Perineal hernias are rare hernias, and herniations through the hiatus of Schwalbe represent a rare posterior lateral perineal hernia. While these hernias are extremely rare, anatomists and surgeons should be aware of them, and the clinical significance and manifestations which may occur with these hernias. PMID:25448911

  16. Koebner phenomenon of the ear canal skin.

    LENUS (Irish Health Repository)

    Young, O

    2012-02-01

    The Koebner phenomenon originally described the appearance of psoriatic lesions in the uninvolved skin of patients with psoriasis as a consequence of trauma. We describe a case of concurrent lichen planus and sarcoidosis in the auditory canal, which represents an unusual manifestation of the Koebner phenomenon. This is the first case of concurrent lichen planus and sarcoidosis in the head and neck region and highlights the need for biopsy to allow accurate histopathological diagnosis and treatment.

  17. Lesions in the external auditory canal

    Directory of Open Access Journals (Sweden)

    Priyank S Chatra

    2011-01-01

    Full Text Available The external auditory canal is an S- shaped osseo-cartilaginous structure that extends from the auricle to the tympanic membrane. Congenital, inflammatory, neoplastic, and traumatic lesions can affect the EAC. High-resolution CT is well suited for the evaluation of the temporal bone, which has a complex anatomy with multiple small structures. In this study, we describe the various lesions affecting the EAC.

  18. Comparison of Bacterial Leakage between 3 Different Root Canal Obturation Techniques in Oval Shaped Canals

    Directory of Open Access Journals (Sweden)

    Eshagh-ali Saberi

    2014-06-01

    Full Text Available Introduction: The purpose of this study was to evaluate the sealing ability of 3 obturation techniques in oval-shaped canals by bacterial leakage assessment. Methods: Sixty mandibular incisors with oval canals were selected after providing buccolingual and mesiodistal radiographs. The teeth were sectioned at a 10 mm distance from the apex. After instrumentation, the teeth were divided into 3 groups and the canals in the three groups were obturated with lateral condensation (G1, warm vertical condensation (G2 and thermoplasticized injectable gutta percha (G3. The teeth were exposed to human saliva. Observing the turbidity of the BHI broth for a period of 63 days the number of days required for the complete contamination of root canals was recorded. The data were analyzed using descriptive statistical methods and Kruskal-Wallis test with SPSS statistical software. Results: Warm vertical condensation (G2 needed a significantly greater average time for leakage than the two other methods. No significant differences were found between lateral condensations and thermoplasticized injectable G.P techniques. Conclusion: warm vertical condensation provides a better seal against bacterial leakage than lateral condensation and obtura II method in obturating oval-canals.

  19. Endoscopic posterior decompression of lumbar canal stenosis

    Directory of Open Access Journals (Sweden)

    Yad Ram Yadav

    2013-01-01

    Full Text Available Lumbar canal stenosis (LCS is quite common. Surgery is indicated when patient fails to improve after conservative treatment. Endoscopic technique can be used in LCS and lateral recess stenosis. It can be performed in degenerative canal stenosis or with disc bulges. Bilateral severe bony canal stenosis and unstable spine are the contraindications. This procedure should be avoided in patients with a history of trauma. Detailed history and thorough physical examination should be performed to find out exact level of pathology responsible for symptoms. Patient′s symptoms must correlate with radiological findings. Magnetic resonance imaging is the investigation of choice because of its superior visualization of soft-tissue. Computed tomography scan does give a more accurate and detailed picture of the bony anatomy. Although the operative time and the complication rate could be more in the initial learning curve, the results of endoscopic decompression are comparable with conventional open procedures with the additional benefit of decreased complications and lower morbidity, when sufficient experience is gained. Complications in endoscopic surgery for LCS could be dural tears, hematomas and root and facet injury. This procedure is also associated with limitations such as steep learning curve and the contra lateral decompression may not be as good as ipsilateral side. Some of the limitations of this technique can be overcome by attending live operative workshop, practice on models and hands on cadaveric dissection. Conversion to an open procedure may be required when there is disorientation, management of dural tear and for control of bleeding.

  20. Vulvar endometriosis and Nuck canal.

    Science.gov (United States)

    Mazzeo, Carmelo; Gammeri, Emanuele; Foti, Agata; Rossitto, Maurizio; Cucinotta, Eugenio

    2014-12-29

    L’endometriosi è una patologia non ancora del tutto conosciuta che colpisce il 6-10% della popolazione femminile generare e il 35-50% della popolazione femminile affetta da dolore pelvico e infertilità. La sede più frequente di malattia è rappresentata dall’ovaio e ciò sostiene l’ipotesi patogenetica della mestruazione retrograda. Viene descritto un caso di non comune localizzazione vulvare di endometriosi riscontrata in una paziente precedentemente operata per una cisti di Nuck. La donna aveva notato da qualche mese l’insorgenza di una tumefazione nella regione vulvare che le causava dolore e dispareunia che si accentuavano nel periodo mestruale. Il sospetto clinico di endometriosi non aveva avuto conferma negli esami strumentali preoperatori che non avevano evidenziato alterazioni patognomoniche, nè differenze dei reperti in fase pre mestruale e mestruale. Solo l’esame istologico della neoformazione asportata ha confermato la diagnosi. Inoltre gli Autori con la presente nota desiderano sottolineare come nella patogenesi dell’endometriosi vulvare debba essere tenuta in considerazione la presenza della pervietà del dotto peritoneovaginale o dotto di Nuck. Nel caso clinico descritto, infatti, la paziente era stata sottoposta due anni prima ad asportazione di una cisti di Nuck con obliterazione del dotto peritoneovaginale. Tuttavia già in quella fase clinica poteva essersi determinato un impianto endometriosico, che si era poi evidenziato con la formazione del nodulo in sede vulvare asportato chirurgicamente.

  1. Genetics and geometry of canalization and developmental stability in Drosophila subobscura

    Directory of Open Access Journals (Sweden)

    Iriarte Pedro

    2005-01-01

    Full Text Available Abstract Background Many properties of organisms show great robustness against genetic and environmental perturbations. The terms canalization and developmental stability were originally proposed to describe the ability of an organism to resist perturbations and to produce a predictable target phenotype regardless of random developmental noise. However, the extent to which canalization and developmental stability are controlled by the same set of genes and share underlying regulatory mechanisms is largely unresolved. Results We have analyzed the effects of clinal genetic variation (inversion polymorphism on wing asymmetry by applying the methods of geometric morphometrics in the context of quantitative genetics using isochromosomal lines of Drosophila subobscura. For the analysis of overall size, developmental stability was positively correlated with levels of heterozygosity and development at the optimal temperature. For analyses of shape, the overall comparisons by matrix correlations indicate that inter- and intraindividual variation levels were poorly correlated, a result also supported when comparing the vectors describing patterns of variation of landmark position. The lack of similarity was basically due to the discrepancy between the genetic and environmental components of the interindividual variation. Finally, the analyses have also underscored the presence of genetic variation for directional asymmetry. Conclusions The results strongly support the hypothesis that environmental canalization and developmental stability share underlying regulatory mechanisms, but environmental and genetic canalization are not functionally the same. A likely explanation for this lack of association is that natural wing shape variation in Drosophila populations is loosely related to individual fitness.

  2. Analysis of Deformation of the Human Ear and Canal Caused by Mandibular Movement

    DEFF Research Database (Denmark)

    Darkner, Sune; Paulsen, Rasmus Reinhold; Larsen, Rasmus

    2007-01-01

    Many hearing aid users experience physical discomfort when wearing their device. The main contributor to this problem is believed to be deformation of the ear and ear canal caused by movement of the mandible. Physical discomfort results from added pressure on soft tissue areas in the ear. Identif......Many hearing aid users experience physical discomfort when wearing their device. The main contributor to this problem is believed to be deformation of the ear and ear canal caused by movement of the mandible. Physical discomfort results from added pressure on soft tissue areas in the ear....... Identifying features that can predict potential deformation is therefore important for identifying problematic cases in advance. A study on the physical deformation of the human ear and canal due to movement of the mandible is presented. The study is based on laser scannings of 30 pairs of ear impressions...... for significance of the deformations for each deformation field reveals that all subjects have significant deformation at Tragus and in the canal. Furthermore, a relation between the magnitude of the deformation and the gender of the subject is demonstrated. The results are successfully validated by comparing...

  3. ROOT CANAL IRRIGANTS AND IRRIGATION TECHNIQUES: A REVIEW

    Directory of Open Access Journals (Sweden)

    Aniketh

    2015-04-01

    Full Text Available Root canal irrigation is not much emphasised in endodontic therapy. Most articles discussed are on root canal shaping and obturation not much emphasis is given for irrigation. There are many irrigation solutions which are introduced into market. The primary objective of root canal therapy is the ret ention of the pulpless or pulpally involved tooth with its associated periapical tissues in a healthy state. Achievement of this objective requires that the pulpal spaces and contents be eliminated as sources of infection. As the Enterococcus faecalis is a lso found to be the most important cause for endodontic failures, the action and efficacy of fewer irrigants against E. faecalis should also be given prime importance as of others. Therefore, the introduction of an antimicrobial endodontic irrigant during root canal therapy should be given priority in the hierarchy of root canal treatment. The purpose of this article is to analyse root canal irrigants, irrigation techniques and irrigation protocol.

  4. Utilizing geophysical methods for asessment and characterization of canal seepage in El Paso's lower valley irrigation delivery systems

    Science.gov (United States)

    Cegon, Amanda Brooke

    El Paso County Water Improvement District No. 1 (EPCWID No.1) delivers the Rio Grande water for agricultural production and urban uses through numerous networked irrigation canals. Of the nearly 86 billion gallons of water released annually for irrigation uses in Texas, billions are lost due to evaporation and seepage in unlined canals with 56 million gallons of the billions are lost in Franklin Canal annually due to improper lining and sediment variation of the canals. To characterize seepage patterns and identify areas of high seepage, Electrical Resistivity, Ground Truthing via soil sample analysis were used along three, half-mile long sectioned canals during irrigation and non-irrigation seasons. The data lines acquired were processed in EARTHIMAGER 2D to create 2D vertical resistivity inversion profiles to locate potential areas of high seepage/high resistivity. The research results will help El Paso County Water Improvement District No. 1 to develop management strategies to conserve water and improve the delivery efficiency systems which leads to economic growth in the Rio Grande Basin.

  5. Geophysical investigation of a dutch levee and canal using various seismic and GPR techniques

    NARCIS (Netherlands)

    Noorlandt, R.P.; Kleine, M.P.E. de; Kruiver, P.P.; Bakker, M.A.J.; Mesdag, C.S.; Hoogendoorn, R.M.

    2011-01-01

    A geophysical survey has been carried out on the Juliana Canal and levee in the south of the Netherlands. For a stretch of about 35 km along this canal various construction works are planned, to deepen and widen the canal. The canal is in a geological setting such that leakage from the canal to the

  6. Auriculotemporal Syndrome (Frey Syndrome).

    Science.gov (United States)

    Motz, Kevin M; Kim, Young J

    2016-04-01

    Frey syndrome is a common sequela of parotidectomy, and although it is not frequently manifested clinically, it can cause significant morbidity for those affected. Frey syndrome results from synkinetic autonomic reinnervation by transected postganglionic parasympathetic nerve fiber within the parotid gland to the overlying sweat glands of the skin. Many surgical techniques have been proposed to prevent the development of Frey syndrome. For those who develop clinical symptoms of Frey syndrome, objective testing can be performed with a Minor starch-iodine test. Some of the current methods to prevent and treat symptomatic Frey syndrome are reviewed. PMID:26902982

  7. Optimizing the chemical aspect of root canal irrigation

    OpenAIRE

    Wesselink, P.R.; Sluis, van der, J.; Versluis, A.M.; Macedo, de, R.G.

    2013-01-01

    Root canal treatment is aimed at the removal of inflamed and infected tissue present in the root canal system. It will prevent the entrance of new microorganisms or nutrients in order to maintain or create a healthy environment around the root. There is sufficient evidence that shows that traditional endodontic therapy cannot make the root canal system completely free of bacteria. Moreover, it may not always result in complete healing of apical periodontitis, highlighting the need of optimizi...

  8. Choice of root canal irrigants by Serbian dental practitioners

    OpenAIRE

    Tošić Goran; Miladinović Milan; Kovačević Milorad; Stojanović Miodrag

    2016-01-01

    Background/Aim. Root canal treatment is considered to be the one of the most important procedures in endodontic treatment. To irrigate the root canal it is most common to use sodium hypochlorite (NaOCl), chlorhexodine, ethylenediami-netetraacetic acid (EDTA), local anesthetic solution, while the most used in Serbia is hydrogen peroxide (H2O2). The aim of this survey was to reveal the preferred root canal irrigants used by general dental practitioners in Ser...

  9. ROOT CANAL IRRIGANTS AND IRRIGATION TECHNIQUES: A REVIEW

    OpenAIRE

    Aniketh; Mohamed; Geeta; Nandakishore; Gourav Kumar; Patrick Timothy; Jayson Mathew; Sahle Abdul

    2015-01-01

    Root canal irrigation is not much emphasised in endodontic therapy. Most articles discussed are on root canal shaping and obturation not much emphasis is given for irrigation. There are many irrigation solutions which are introduced into market. The primary objective of root canal therapy is the ret ention of the pulpless or pulpally involved tooth with its associated periapical tissues in a healthy state. Achievement of this objective requires that the pulpal spaces and con...

  10. Interactions between root canal irrigants, sealers and dentin

    OpenAIRE

    Neelakantan, P.

    2016-01-01

    The objective of this thesis was to determine the interactions between root filling materials and root dentin and to investigate if root canal irrigating solutions had an impact on these interactions. The following outcomes were assessed in the studies encompassed in this thesis: (i) dislocation resistance of an epoxy resin based root canal sealer and tricalcium silicate based root canal sealers, (ii) the influence of irrigation protocols on the sealing ability and chemical interactions with ...

  11. Endodontic Considerations in Three-canalled Premolars: A Practical Update

    Science.gov (United States)

    Mohammadi, Zahed; Shalavi, Sousan; Giardino, Luciano; Asgary, Saeed

    2016-01-01

    The most difficult clinical considertions in orthograde root canal treatment are generally related to the anatomy of the teeth. Three-canalled maxillary and mandibular premolars (mini-molars) have been reported in several studies. The purpose of this paper was to review various aspects of three-canalled premolars including incidence, clinical and radiographic diagnosis, racial predisposition, access cavity preparation, instrumentation and obturation. PMID:27141223

  12. Cervical spinal canal narrowing and cervical neurologi-cal injuries

    OpenAIRE

    Zhang, Ling; Chen, Hai-Bin; Wang, Yi; ZHANG Li-ying; Liu, Jing-cheng; WANG Zheng-guo

    2012-01-01

    【Abstract】Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms in-cluding neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. The mean sagittal diameter of cervical spinal canal at C 1 to C 7 ranges from 15.33 mm to 20.46 mm, ...

  13. Determining optimal transit charges: The Kiel Canal in Germany

    OpenAIRE

    Heitmann, Nadine; Rehdanz, Katrin; Schmidt, Ulrich

    2011-01-01

    The Kiel Canal in Germany connects ports on the Baltic Sea with the rest of the world and is the most-used artificial waterway in the world. Despite this fact, it generates a balance sheet loss. Revenues, which are mainly generated by the transit charge, do not cover its operating expenses. This situation raises the question: What reforms could be made to make the canal generate a balance sheet profit? In this paper, we focus solely on the canal's revenue. Because the canal is a monopoly that...

  14. [Canal infection. Ecological theory and repair with osteodentin].

    Science.gov (United States)

    Muñiz, M A; Zeberio, T

    1991-01-01

    The characteristics of the infection in the root canal are analyzed, specially its development before pulpal necrosis. It is inferred that it is an ecological infection with a function: to decompose the necrosis. Inactivating the infection in the canal by the formocresol technique, calcium hidroxide or with the conventional basic treatment in Endodontics, cleaning, washing, disinfecting and, in this case, with partial obturation of the canal, it is possible to induce a reparation with osteodentine that can cover all the free extension of the canal. PMID:1882104

  15. Nonneoplastic enhancement of internal auditory canal contents mimicking intracanalicular acoustic neuroma on MR images

    International Nuclear Information System (INIS)

    The authors present five patients with inflammation of facial and/or vestibulocochlear nerves that showed enhancement of structures in the internal auditory canal. (IAC) on MR imaging that mimic intracanalicular acoustic neuroma. MR imaging findings of four patients with unilateral sensorineural hearing loss and one with acute facial paralysis were reviewed along with the operative findings. MR imaging included pre-and postcontrast T1- and T2-weighted images. Three patients who presented with unilateral sensorineural hearing loss underwent surgery for exploration and decompression of the IAC. One patient with facial paralysis showed vesicular eruption in the external auditory canal and was diagnosed as having Ramsay Hunt syndrome (herpes zosteroticus) clinically. The fifth patient is also being followed up clinically. MR imaging findings in all five cases were similar. There was focal enhancement in the lateral portion of the IAC on postcontrast T1-weighted images with minimal mass effect. The swollen and edematous nerves were noted on surgery without any evidence of neoplasm. The patients not operated on showed no progression of symptoms. The enhancement of IAC contents on MR imaging in patients with nonspecific neuritis or Ramsay Hunt syndrome may be difficult to differentiate from a small intracanalicular neuroma, which may have important therapeutic implications

  16. In utero phthalate effects in the female rat: a model for MRKH syndrome##

    Science.gov (United States)

    Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by uterine and vaginal canal aplasia in normal karyotype human females and is a syndrome with poorly defined etiology. Reproductive toxicity of phthalate esters (PEs) occurs in rat offspring exposed in utero, a phen...

  17. In Utero Phthalate Effects in the Female Rat: A Model for MRKH Syndrome

    Science.gov (United States)

    Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by uterine and vaginal canal aplasia in normal karyotype human females and is a syndrome with poorly define etiology. Reproductive toxicity of phthlate esters (PEs) occurs in rat offspring exposed in utero. a phenome...

  18. Imaging of carcinoma of the external auditory canal: a pictorial essay

    OpenAIRE

    Ong, Cheng K.; Pua, Uei; Chong, Vincent F.H.

    2008-01-01

    Abstract Carcinoma of the external auditory canal presents a challenge in management, largely due to limited experience in treating this rare disease and the lack of a universally accepted staging system. Prognosis is most dependent on the extent of local disease at presentation, while resection margin status is also a strong determinant of survival in post-operative patients. The intent of this pictorial essay is to review the pattern of tumour spread and highlight the value of imaging, part...

  19. The use of plastic models for teaching root canal cleansing and shaping

    OpenAIRE

    Eftekhar B

    2004-01-01

    The use of root canal models in endodontics education is of high importance. So, in this article"na new method is presented that the students can produce these models with simple and low cost"ninstruments."nThese plastic models are made of polyester which is low cost, available and has the approximate cutting"nproperties of dentin. The best molds were disposable syringes due to their low cost, availability and"nproducing smooth surfaces on polyester models. A spreader...

  20. Comparison of antimicrobial substantivity of root canal irrigants in instrumented root canals up to 72 h: An in vitro study

    OpenAIRE

    M N Shahani; Subba Reddy, V. V.

    2011-01-01

    Disinfection of the root canal system is one of the primary aims of root canal treatment. This can be achieved through the use of various antimicrobial agents in the form of irrigants and medicaments. The antimicrobial substantivity of 2% chlorhexidine gluconate, 1% povidone iodine, 2.5% hydrogen peroxide followed by 2% sodium hypochlorite, and 2% sodium hypochlorite alone as irrigants was assessed in instrumented root canals. 2% chlorhexidine showed antimicrobial substantivity lasting up to ...

  1. Pre-Menstrual Syndrome in Women with Down Syndrome

    Science.gov (United States)

    Mason, Linda; Cunningham, Cliff

    2009-01-01

    Background: Prevalence of pre-menstrual syndrome (PMS) may be higher in women with Down syndrome due to syndrome specific characteristics in biochemistry, psychopathology and lifestyle. Recognition of PMS may be difficult for women with intellectual disabilities and their carers. Method: A daily diary, used to diagnose PMS with typical women, was…

  2. MODELLING OF SEDIMENTS CONCENTRATION DISTRIBUTION IN DREDGED CANALS OF THE NIGER DELTA ESTUARINE REGION, NIGERIA

    Directory of Open Access Journals (Sweden)

    Charles Chizom Dike

    2013-01-01

    Full Text Available Previous sediments concentration distributi on models used in the study of sediment characteristics of the dredged canals in the Niger-Delta estuarine region, Nigeria; did not take into consideration the lateral in flow due to tidal effects, which affects tremendously, the sediment intake into the estuarine waters. In the current research, existing models are modified by incorpora ting the missing lateral inflow parameters, which are peculiar to the Niger Delta environment, to obtain more accurate model results. Details are given herein, of the deve lopment and application of a 3-dimensional numerical model (EKU 2.8 Models to predict sediment concentration distribution (total suspended sediment & bed sediment load s in the Niger Delta estuarine canals, with Ekulama well 19 access canal as a case study. The approach in this paper involved coupling a sediment transport equation (w ith the inclusion of lateral inflow parameters, with an estuarine hydro-dy namics equation to generate a generic 3- dimensional sediment concentration distribu tion model, using deterministic approach. Predicted results using this model compar ed favorably with measured field results. Average sediment concentration of 29mg/l was obtained compared with 31mg/l measured in the field for bed sediment loads. Finally, the predicted sediment concentration distribution (TSS, when comp ared with field results, gave average correlation coefficient of 0.9.; hence, the present model will assist in generating adequate information /data on sediment ch aracteristics and transport mechanism, required for effective design of canals to redu ce rate of siltation. The application of the above knowledge/parameters generated from this model to effectively design canals to reduce siltation will be treated in subsequent articles.

  3. Revestimientos especiales para diques y canales

    Directory of Open Access Journals (Sweden)

    Zorzi, Silvano

    1964-11-01

    Full Text Available This paper summarizes the possibilities and advantages of adopting special facings for dykes and canals, and generally for all large hydraulic works, where waterproofing is of paramount importance. Technical advances in recent years have made it possible to prefabricate many facing units used in these types of works; large slabs, made in reinforced and prestressed concrete, are flexible, and watertight. Although there are many possibilities and types of facing treatments, the one described here is outstanding. It consists of narrow slabs, highly flexible, placed transversally with respect to the canal axis. They are attached with cement mortar, and the joints are finally sealed with a special mortar, called «Emboco». In this article a description is also given of a series of projects, where facing treatments have been used, which are now successfully in service. Finally some general and simple advise is given on the best procedure to apply these facing treatments in the most effective and economic manner.En este trabajo se resumen las posibilidades y ventajas que ofrecen los revestimientos especiales de diques y taludes de canales y, en general, en todas las grandes obras hidráulicas, en que la impermeabilización es de mayor importancia al tratar de conservar los caudales iniciales o la retención de aguas embalsadas, según los casos. Los progresos de las técnicas modernas, en particular la prefabricación, han permitido este tipo de revestimientos con losas de gran longitud, extremadamente flexibles e impermeables, de hormigón armado y pretensado. Aunque son muchas las posibilidades y tipos de revestimiento, destaca el que a continuación se expone: consiste en placas o losas estrechas, de gran flexibilidad, colocadas transversalmente al eje del canal sobre tongadas de mortero de cemento, y cuyas juntas se sellan, finalmente, con un mortero especial llamado «Emboco». Complementan la exposición teórica del método una serie de

  4. CAVERNOUS HEMANGIOMA OF THE INTERNAL AUDITORY CANAL

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Hekmatara

    1993-06-01

    Full Text Available Cavernous hemangioma is a rare benign tumor of the internal auditory canal (IAC of which fourteen cases have been reported so far."nTinnitus and progressive sensorineural hearing loss (SNHL are the chief complaints of the patients. Audiological and radiological planes, CTScan, and magnetic resonance image (MRI studies are helpful in diagnosis. The only choice of treatment is surgery with elective transmastoid trans¬labyrinthine approach. And if tumor is very large, the method of choice will be retrosigmoid approach.

  5. Cancer incidence in the Love Canal area.

    Science.gov (United States)

    Janerich, D T; Burnett, W S; Feck, G; Hoff, M; Nasca, P; Polednak, A P; Greenwald, P; Vianna, N

    1981-06-19

    Data from the New York Cancer Registry show no evidence for higher cancer rates associated with residence near the Love Canal toxic waste burial site in comparison with the entire state outside of New York City. Rates of liver cancer, lymphoma, and leukemia, which were selected for special attention, were not consistently elevated. Among the other cancers studied, a higher rate was noted only for respiratory cancer, but it was not consistent across age groups and appeared to be related to a high rate for the entire city of Niagara Falls. There was no evidence that the lung cancer rate was associated with the toxic wastes buried at the dump site.

  6. Water Environment Evolution along the China Grand Canal

    International Nuclear Information System (INIS)

    The China Grand Canal is one of the earliest canals in the world, having lasted for nearly 3000 years. Even its section canals have a rich history, such as the North-South Grand Canal that was established during the Sui Dynasty, whereas the Beijing-Hangzhou Canal was excavated during the Yuan Dynasty and the east line of the South-to-North Water Diversion. As one of the longest in the world, the China Grand Canal's total length is over 3500 kilometers. This length includes the navigable, unnavigable, and underground sections. Making the best use of situations and according to local conditions, the Chinese people harmoniously constructed the Beijing-Hangzhou Canal with nature. Tens of millions of workers took nearly 3000 years to complete the great shipping system. Navigable sections still exist for up to 900 kilometers and the volume of freight traffic is approximately 300 million tons. The canal remains the main logistical channel of the North-to-South Coal Transportation, South-to-North Water Diversion, and resources circulation. To date, China is promoting the success of heritage application. Part of these efforts is the declaration of the China Grand Canal as a World Cultural Heritage by 2014. In addition, the east route of the South-to-North Water Transfer project is planned to be navigable by 2016. The ancient Beijing-Hangzhou Grand Canal will usher in the new ecological civilization and cultural revival along the canal. This paper presents technical methods of water environment evolution research on the river system, river, and water quality along the Beijing-Hangzhou Canal through the integration of historical literature and modern remote sensing image data. The study carried out water environment investigation and analysis along the Beijing-Hangzhou canal by using ETM, SPOT image data, and GPS measurement data. Spatial and temporal evolution characteristics and regulations of the Beijing-Hangzhou Grand Canal regional water environment in the span of

  7. Water Environment Evolution along the China Grand Canal

    Science.gov (United States)

    Mao, F.; Wu, Y. X.; Yang, B. F.; Li, X. J.

    2014-03-01

    The China Grand Canal is one of the earliest canals in the world, having lasted for nearly 3000 years. Even its section canals have a rich history, such as the North-South Grand Canal that was established during the Sui Dynasty, whereas the Beijing-Hangzhou Canal was excavated during the Yuan Dynasty and the east line of the South-to-North Water Diversion. As one of the longest in the world, the China Grand Canal's total length is over 3500 kilometers. This length includes the navigable, unnavigable, and underground sections. Making the best use of situations and according to local conditions, the Chinese people harmoniously constructed the Beijing-Hangzhou Canal with nature. Tens of millions of workers took nearly 3000 years to complete the great shipping system. Navigable sections still exist for up to 900 kilometers and the volume of freight traffic is approximately 300 million tons. The canal remains the main logistical channel of the North-to-South Coal Transportation, South-to-North Water Diversion, and resources circulation. To date, China is promoting the success of heritage application. Part of these efforts is the declaration of the China Grand Canal as a World Cultural Heritage by 2014. In addition, the east route of the South-to-North Water Transfer project is planned to be navigable by 2016. The ancient Beijing-Hangzhou Grand Canal will usher in the new ecological civilization and cultural revival along the canal. This paper presents technical methods of water environment evolution research on the river system, river, and water quality along the Beijing-Hangzhou Canal through the integration of historical literature and modern remote sensing image data. The study carried out water environment investigation and analysis along the Beijing-Hangzhou canal by using ETM, SPOT image data, and GPS measurement data. Spatial and temporal evolution characteristics and regulations of the Beijing-Hangzhou Grand Canal regional water environment in the span of 3000

  8. Root canal filling evaluation using optical coherence tomography

    Science.gov (United States)

    Negrutiu, Meda L.; Sinescu, Cosmin; Topala, Florin; Nica, Luminita; Ionita, Ciprian; Marcauteanu, Corina; Goguta, Luciana; Bradu, Adrian; Dobre, George; Rominu, Mihai; Podoleanu, Adrian Gh.

    2010-04-01

    Endodontic therapy consists in cleaning and shaping the root canal system, removing organic debris and sealing the intra-canal space with permanent filling materials. The purpose of this study was to evaluate various root canal fillings in order to detect material defects, the marginal adaptation at the root canal walls and to assess the quality of the apical sealing. 21 extracted single-root canal human teeth were selected for this study. We instrumented all roots using NiTi rotary instruments. All canals were enlarged with a 6% taper size 30 GT instrument, 0,5 mm from the anatomical apex. The root canals were irrigated with 5% sodium hypochlorite, followed by 17% ethylenediaminetetraacetic acid (EDTA). After the instrumentation was completed, the root canals were obturated using a thermoplasticizable polymer of polyesters. In order to assess the defects inside the filling material and the marginal fit to the root canal walls, the conebeam micro-computed tomography (CBμCT) was used first. After the CBμCT investigation, time domain optical coherence tomography working in en face mode (TDefOCT) was employed to evaluate the previous samples. The TDefOCT system was working at 1300 nm and was doubled by a confocal channel at 970 nm. The results obtained by CBμCT revealed no visible defects inside the root-canal fillings and at the interfaces with the root-canal walls. TDefOCT investigations permit to visualize a more complex stratificated structure at the interface filling material/dental hard tissue and in the apical region.

  9. Síndrome séptico por Acinetobacter calcoaceticus, variedad anitratus Septic syndrome due to acinetobacter calcoaceticus var. anitratus in an infant: report of a case and review of the subject

    Directory of Open Access Journals (Sweden)

    Carmen Tulia Zapata Muñoz

    1994-04-01

    Full Text Available Se presenta un caso de síndrome séptico por Acinetobacter calcoaceticus, variedad anitratus, adquirido en la comunidad por un niño inmunocompetente. Esta combinación de circunstancias es inusitada. Se manifestó por meningitis, compromiso del pulmón izquierdo y un absceso glúteo. El niño se recuperó completamente con la antibioterapia. Se propone éste como el primer caso informado en la literatura latinoamericana que reúne las condiciones anotadas. Se hace una síntesis de las características generales de la bacteria, la patogénesis de la infección y las principales enfermedades que produce, así como los medios existentes para prevenirla.

    We report on the case of an immunocompetent infant who presented with a septic syndrome due to a community-acquired infection by Acinetobacter calcoaceticus var. anitratus. Clinical manifestations were meningitis, left Iobar pneumonia with pleural effussion and a gluteal ascess. The patient fully recovered with antibiotic therapy. This case may be the first in the Latin-American medical literature with such unusual combination of features. A review is presented on the general characteristics of Acinetobacter, the pathogenesis of the infections It produces, the main clinical presentations and the methods of prevention.

  10. Management of mandibular first molar with four canals in mesial root

    OpenAIRE

    Subbiya, Arunajatesan; Kumar, Krishnamurthy Sathish; Vivekanandhan, Paramasivam; Prakash, Venkatachalam

    2013-01-01

    Successful root canal treatment depends on adequate cleaning, shaping, and filling of the root canal system. The presence of middle mesial (MM) root canal of mandibular molars has been reported by various authors. But incidence of four canals in mesial root of mandibular molar is very rare. The aim of this case report is to present and describe the identification and management of a mandibular first molar with four canals in the mesial root and single canal in the distal root.

  11. Esophageal carcinoma extending into the spinal canal - case report and review of the literature; Carcinoma do esofago com invasao do canal medular - relato de caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Urban, Linei A.B.D.; Rogacheski, Enio; Ledesma, Jorge A. [Parana Univ., Curitiba, PR (Brazil). Hospital de Clinicas. Servico de Radiologia]. E-mail: radiohc@terra.com.br; Zaparolli, Mauricio; Duarte, Maria Cecilia B. [Parana Univ., Curitiba, PR (Brazil). Hospital de Clinicas; Sakamoto, Danielle G. [Parana Univ., Curitiba, PR (Brazil). Hospital de Clinicas. Servico de Anatomia Patologica

    2002-06-01

    The authors report the case of a 62-year-old male with a 4 month history of weight loss and a 2 day complaint of weakness and paraesthesia on the lower limbs. A computed tomography myelogram revealed a mass in the posterior mediastinum associated with destruction of the vertebral body, spinal canal extension and irregular esophageal wall thickening. The patient was later submitted to a barium esophagogram that showed an irregular filling defect. A biopsy confirmed the presence of a squamous cell carcinoma. This is the first report in the Latin-American literature (Lilacs) of a patient with an esophageal carcinoma with spinal canal extension and spinal cord compression syndrome at initial presentation. (author)

  12. The Validity of the Panoramic Radiography in Evaluating the Topographic Relationship between Mandibular Canal and Impacted Third Molars in Comparison with Cone Beam CT-scan

    Directory of Open Access Journals (Sweden)

    Taraneh Ebrahimifard

    2013-01-01

    Full Text Available Background: The purpose of this study is to compare the validity of panoramic radiography with CBCT (Cone Beam Computed Tomography in the assessment of the relationship between the mandibular third molar and the mandibular canal.Materials and Methods: In this descriptive-analytical study, 80 mandibular third molars were extracted from 48 patients. On the panoramic radiography (PR there was a close relationship between the root tooth and mandibular canal in all the teeth. The teeth were classified on the basis of six radiographic markers in panoramic radiographs (superimposition, root opacity/darkening of the roots, root deflection, diversion of the canal, interruption of the cortical border of the canal and narrowing of the canal. Then, the relationship between the markers and presence or absence of contact is CBCT was investigated. Results: The superimposition marker in the interrupted group and group with intact border was significantly higher than the group with no cortical border. The interruption of the cortical border of the canal and increased radiolucency marker were significantly higher in no-cortical border group than the other two groups. As to the other three markers (diversion of the canal, narrowing of the canal and root diversion due to the low frequency in the 80 teeth, the findings were presented in a descriptive manner.Conclusion: Presence or absence of a radiological sign in panoramic radiography will not properly predict the existence of a close relationship with third molar and it is suggested that in case of tooth-canal overlapping either as a superimposition or as other aforesaid markers, the patient should be referred for CBCT assessment regarding the additional and useful information provided by CBCT.

  13. New Technologies to Improve Root Canal Disinfection.

    Science.gov (United States)

    Plotino, Gianluca; Cortese, Teresa; Grande, Nicola M; Leonardi, Denise P; Di Giorgio, Gianni; Testarelli, Luca; Gambarini, Gianluca

    2016-01-01

    Effective irrigant delivery and agitation are prerequisites to promote root canal disinfection and debris removal and improve successful endodontic treatment. This paper presents an overview of the currently available technologies to improve the cleaning of the endodontic space and their debridement efficacy. A PubMed electronic search was conducted with appropriate key words to identify the relevant literature on this topic. After retrieving the full-text articles, all the articles were reviewed and the most appropriate were included in this review. Several different systems of mechanical activation of irrigants to improve endodontic disinfection were analysed: manual agitation with gutta-percha cones, endodontic instruments or special brushes, vibrating systems activated by low-speed hand-pieces or by sonic or subsonic energy, use of ultrasonic or laser energy to mechanically activate the irrigants and apical negative pressure irrigation systems. Furthermore, this review aims to describe systems designed to improve the intracanal bacterial decontamination by a specific chemical action, such as ozone, direct laser action or light-activated disinfection. The ultrasonic activation of root canal irrigants and of sodium hypochlorite in particular still remains the gold standard to which all other systems of mechanical agitation analyzed in this article were compared. From this overview, it is evident that the use of different irrigation systems can provide several advantages in the clinical endodontic outcome and that integration of new technologies, coupled with enhanced techniques and materials, may help everyday clinical practice. PMID:27007337

  14. Visibility of the central canal on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Petit-Lacour, M.C.; Lasjaunias, P.; Iffenecker, C.; Benoudiba, F.; Hadj Rabia, M.; Doyon, D. [Service de Neuroradiologie, Faculte de Paris Sud (France); Hurth, M. [Department of Neurosurgery, Faculte Paris Sud, Kremlin-Bicetre (France)

    2000-10-01

    The central canal of the spinal cord is present at birth and becomes progressively obliterated. Cadaver studies have shown that it may persiste partially or completely. To our knowledge, this entity has not been described on MRI. We reviewed 794 MRI studies of the spinal cord, and found 12 patients (aged 14 to 65 years) who had an intramedullary cavity. The cavity was at the junction of the ventral {sup 1}/{sub 3} and dorsal {sup 2}/{sub 3} of the spinal cord, except at the level of the lumbar enlargement, where it was central. It was filiform in most cases, although sometimes fusiform (3 to 4 mm in diameter), and had regular contours. The cavity were thoracic in 69 % of cases. The clinical features were totally unrelated to the image, and there were no anatomical factors (Chiari malformation, dysraphism) predisposing to syringomyelia. The images were perfectly compatible with a persistent central canal, which we interpret as a variant of normal anatomy. Therefore it is important to regard these findings as normal, to avoid unnecessary treatment and follow-up. (orig.)

  15. Optimizing the chemical aspect of root canal irrigation

    NARCIS (Netherlands)

    R.G. de Macedo

    2013-01-01

    Root canal treatment is aimed at the removal of inflamed and infected tissue present in the root canal system. It will prevent the entrance of new microorganisms or nutrients in order to maintain or create a healthy environment around the root. There is sufficient evidence that shows that traditiona

  16. 5 CFR 550.714 - Panama Canal Commission employees.

    Science.gov (United States)

    2010-01-01

    ...) Notwithstanding any other provisions of this subpart, an employee separated from employment with the Panama Canal... a position that meets all the following conditions: (1) The position is with the Panamanian public... below the employee's rate of basic pay as a Panama Canal Commission employee; (3) The position is...

  17. Reform in Indian canal irrigation: does technology matter?

    NARCIS (Netherlands)

    Narain, V.

    2008-01-01

    This paper examines the implications of technology - the design of canal irrigation for irrigation management reform. With reference to two different design systems in Indian irrigation - shejpali and warabandi - it shows that the potential for reform varies with the design of canal irrigation. Thre

  18. RCRA closure of the Building 3001 Storage Canal

    International Nuclear Information System (INIS)

    The 3001 Storage Canal is located under portions of Buildings 3001 and 3019 at Oak Ridge National Laboratory (ORNL) and has a capacity of approximately 62,000 gallons of water. The term canal has historically been used to identify this structure, however, the canal is an in-ground reinforced concrete structure satisfying the regulatory definition of a tank. From 1943 through 1963, the canal in Building 3001 was designed to be an integral part of the system for handling irradiated fuel from the Oak Ridge Graphite Reactor. Because one of the main initial purposes of the reactor was to produce plutonium for the chemical processing pilot plant in Building 3019, the canal was designed to be the connecting link between the reactor and the pilot plant. During the war years, natural uranium slugs were irradiated in the reactor and then pushed out of the graphite matrix into the system of diversion plates and chutes which directed the fuel into the deep pit of the canal. After shutdown of the reactor, the canal was no longer needed for its designed purpose. Since 1964, the canal has only been used to store radioisotopes and irradiated samples under a water pool for radiation protection. This report describes closure alternatives

  19. RAMSAY HUNT SYNDROME A CASE REPORT AND REVIEW OF LITERATURE

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    Balasubramanian Thiagarajan

    2013-01-01

    Full Text Available This is a case report of a rather rare disorder i.e. Ramsay Hunt syndrome. This is caused by Varicella zoster infections involving geniculate ganglion of facial nerve. This syndrome is manifested by the presence of blebs in the external auditory canal, ear ache, and lower motor neurone type of facial paralysis. This patient had excellent recovery following administration of oral steroids and acyclovir.

  20. Preparación de canales curvos y calcificados

    Directory of Open Access Journals (Sweden)

    Karen Sofia Gallego Lopez

    2013-10-01

    in curved canals and calcified due to the complexity of these, the implemented techniques, and instrumentation suitable for the preparation of pipes have been many in order to minimize errors during preparation. But any technique or instrument itself ideal in preventing these errors, it is necessary to comply with some basic principles for the preparation of these channels, such as proper preparation coronal, the continued use of irrigants and chelating agents, maintenance of the permeability, filing anticurvatura and double taper. The incorrectness of these principles leads to errors which hinder the success of endodontic treatment. The progress of science and the advent of nickel-titanium instrument, it has been facilitating both root canal treatment is no longer considered previously attributed to him was a difficult procedure, the important thing to predict the orientation and anatomy through before using or instrumental techniques, since an error in them will lead to treatment failure.Keywords: development; calcification; root canal.