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Sample records for clinically correlated anatomical

  1. Interpreting and Integrating Clinical and Anatomic Pathology Results.

    Science.gov (United States)

    Ramaiah, Lila; Hinrichs, Mary Jane; Skuba, Elizabeth V; Iverson, William O; Ennulat, Daniela

    2017-01-01

    The continuing education course on integrating clinical and anatomical pathology data was designed to communicate the importance of using a weight of evidence approach to interpret safety findings in toxicology studies. This approach is necessary, as neither clinical nor anatomic pathology data can be relied upon in isolation to fully understand the relationship between study findings and the test article. Basic principles for correlating anatomic pathology and clinical pathology findings and for integrating these with other study end points were reviewed. To highlight these relationships, a series of case examples, presented jointly by a clinical pathologist and an anatomic pathologist, were used to illustrate the collaborative effort required between clinical and anatomical pathologists. In addition, the diagnostic utility of traditional liver biomarkers was discussed using results from a meta-analysis of rat hepatobiliary marker and histopathology data. This discussion also included examples of traditional and novel liver and renal biomarker data implementation in nonclinical toxicology studies to illustrate the relationship between discrete changes in biochemistry and tissue morphology.

  2. Correlation of clinical data, anatomical site and disease stage in ...

    African Journals Online (AJOL)

    Objective: To evaluate the colorectal cancer clinical data with respect to the anatomical location and stage of disease. Design: Retrospective observational study. Setting: Kenyatta National Hospital (KNH), Nairobi, Kenya. Subjects: Two hundred and fifty three tumours were categorised as right colonic (RCC), left colonic ...

  3. Correlation of CliniCal data, anatomiCal site and disease stage in ...

    African Journals Online (AJOL)

    2008-06-01

    Jun 1, 2008 ... Objective: to evaluate the colorectal cancer clinical data with respect to the anatomical location and stage .... the tumour was palpable on digital rectal examination .... colorectal and breast cancer in urban and rural areas. Brit.

  4. Spontaneous rupture of the distal iliopsoas tendon: clinical and imaging findings, with anatomic correlations

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    Lecouvet, Frederic E.; Vande Berg, Bruno C.; Malghem, Jacques [Universite Catholique de Louvain, Department of Radiology and Medical Imaging, Saint Luc University Hospital, Brussels (Belgium); Demondion, Xavier [Centre Hospitalier Universitaire de Lille, Department of Bone Radiology and Laboratory of Anatomy, Lille (France); Leemrijse, Thibaut [Universite Catholique de Louvain, Department of Orthopedic Surgery, Saint Luc University Hospital, Brussels (Belgium); Devogelaer, Jean-Pierre [Universite Catholique de Louvain, Department of Rheumatology, Saint Luc University Hospital, Brussels (Belgium)

    2005-11-01

    We report the clinical and imaging findings in two elderly female patients with spontaneous rupture of the distal iliopsoas tendon from the lesser trochanter of the femur. We emphasize the key contribution of magnetic resonance (MR) imaging to this diagnosis and provide an anatomic correlation. Spontaneous rupture of the distal iliopsoas tendon should be kept in mind in the differential diagnosis of acute groin pain in the elderly. MR imaging enables positive diagnosis, by showing mass effect on the anterior aspect of the hip joint, proximal muscle thickening, and abnormal signal intensity, and by demonstrating interruption of the psoas tendon, whereas the distal insertion of the lateral portion of the iliacus muscle remains muscular and is preserved. (orig.)

  5. Anatomic and functional leg-length inequality: A review and recommendation for clinical decision-making. Part I, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance

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    Knutson Gary A

    2005-07-01

    Full Text Available Abstract Background Leg-length inequality is most often divided into two groups: anatomic and functional. Part I of this review analyses data collected on anatomic leg-length inequality relative to prevalence, magnitude, effects and clinical significance. Part II examines the functional "short leg" including anatomic-functional relationships, and provides an outline for clinical decision-making. Methods Online database – Medline, CINAHL and MANTIS – and library searches for the time frame of 1970–2005 were done using the term "leg-length inequality". Results and Discussion Using data on leg-length inequality obtained by accurate and reliable x-ray methods, the prevalence of anatomic inequality was found to be 90%, the mean magnitude of anatomic inequality was 5.2 mm (SD 4.1. The evidence suggests that, for most people, anatomic leg-length inequality does not appear to be clinically significant until the magnitude reaches ~ 20 mm (~3/4". Conclusion Anatomic leg-length inequality is near universal, but the average magnitude is small and not likely to be clinically significant.

  6. Mistakes in the usage of anatomical terminology in clinical practice.

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    Kachlik, David; Bozdechova, Ivana; Cech, Pavel; Musil, Vladimir; Baca, Vaclav

    2009-06-01

    Anatomical terminology serves as a basic communication tool in all the medical fields. Therefore Latin anatomical nomenclature has been repetitively issued and revised from 1895 (Basiliensia Nomina Anatomica) until 1998, when the last version was approved and published as the Terminologia Anatomica (International Anatomical Terminology) by the Federative Committee on Anatomical Terminology. A brief history of the terminology and nomenclature development is mentioned, along with the concept and contributions of the Terminologia Anatomica including the employed abbreviations. Examples of obsolete anatomical terms and their current synonyms are listed. Clinicians entered the process of the nomenclature revision and this aspect is demonstrated with several examples of terms used in clinical fields only, some already incorporated in the Terminologia Anatomica and a few obsolete terms still alive in non-theoretical communication. Frequent mistakes in grammar and orthography are stated as well. Authors of the article strongly recommend the use of the recent revision of the Latin anatomical nomenclature both in theoretical and clinical medicine.

  7. Visual agnosia and posterior cerebral artery infarcts: an anatomical-clinical study.

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    Martinaud, Olivier; Pouliquen, Dorothée; Gérardin, Emmanuel; Loubeyre, Maud; Hirsbein, David; Hannequin, Didier; Cohen, Laurent

    2012-01-01

    To evaluate systematically the cognitive deficits following posterior cerebral artery (PCA) strokes, especially agnosic visual disorders, and to study anatomical-clinical correlations. We investigated 31 patients at the chronic stage (mean duration of 29.1 months post infarct) with standardized cognitive tests. New experimental tests were used to assess visual impairments for words, faces, houses, and objects. Forty-one healthy subjects participated as controls. Brain lesions were normalized, combined, and related to occipitotemporal areas responsive to specific visual categories, including words (VWFA), faces (FFA and OFA), houses (PPA) and common objects (LOC). Lesions were located in the left hemisphere in 15 patients, in the right in 13, and bilaterally in 3. Visual field defects were found in 23 patients. Twenty patients had a visual disorder in at least one of the experimental tests (9 with faces, 10 with houses, 7 with phones, 3 with words). Six patients had a deficit just for a single category of stimulus. The regions of maximum overlap of brain lesions associated with a deficit for a given category of stimuli were contiguous to the peaks of the corresponding functional areas as identified in normal subjects. However, the strength of anatomical-clinical correlations was greater for words than for faces or houses, probably due to the stronger lateralization of the VWFA, as compared to the FFA or the PPA. Agnosic visual disorders following PCA infarcts are more frequent than previously reported. Dedicated batteries of tests, such as those developed here, are required to identify such deficits, which may escape clinical notice. The spatial relationships of lesions and of regions activated in normal subjects predict the nature of the deficits, although individual variability and bilaterally represented systems may blur those correlations.

  8. Visual agnosia and posterior cerebral artery infarcts: an anatomical-clinical study.

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    Olivier Martinaud

    Full Text Available BACKGROUND: To evaluate systematically the cognitive deficits following posterior cerebral artery (PCA strokes, especially agnosic visual disorders, and to study anatomical-clinical correlations. METHODS AND FINDINGS: We investigated 31 patients at the chronic stage (mean duration of 29.1 months post infarct with standardized cognitive tests. New experimental tests were used to assess visual impairments for words, faces, houses, and objects. Forty-one healthy subjects participated as controls. Brain lesions were normalized, combined, and related to occipitotemporal areas responsive to specific visual categories, including words (VWFA, faces (FFA and OFA, houses (PPA and common objects (LOC. Lesions were located in the left hemisphere in 15 patients, in the right in 13, and bilaterally in 3. Visual field defects were found in 23 patients. Twenty patients had a visual disorder in at least one of the experimental tests (9 with faces, 10 with houses, 7 with phones, 3 with words. Six patients had a deficit just for a single category of stimulus. The regions of maximum overlap of brain lesions associated with a deficit for a given category of stimuli were contiguous to the peaks of the corresponding functional areas as identified in normal subjects. However, the strength of anatomical-clinical correlations was greater for words than for faces or houses, probably due to the stronger lateralization of the VWFA, as compared to the FFA or the PPA. CONCLUSIONS: Agnosic visual disorders following PCA infarcts are more frequent than previously reported. Dedicated batteries of tests, such as those developed here, are required to identify such deficits, which may escape clinical notice. The spatial relationships of lesions and of regions activated in normal subjects predict the nature of the deficits, although individual variability and bilaterally represented systems may blur those correlations.

  9. Ultrasound of the rotator cuff with MRI and anatomic correlation

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    Rutten, Matthieu J.C.M. [Department of Radiology, Jeroen Bosch Hospital, Nieuwstraat 34, 5211 NL ' s-Hertogenbosch (Netherlands)]. E-mail: M.Rutten@JBZ.nl; Maresch, Bas J. [Department of Radiology, Hospital Gelderse Vallei, Willy Brandtlaan 10, 6710 HN Ede (Netherlands)]. E-mail: MareschB@zgv.nl; Jager, Gerrit J. [Department of Radiology, Jeroen Bosch Hospital, Nieuwstraat 34, 5211 NL ' s-Hertogenbosch (Netherlands)]. E-mail: G.Jager@JBZ.nl; Blickman, Johan G. [Department of Radiology, University Medical Center Nijmegen, Geert Grooteplein Zuid 18, 6500 HB Nijmegen (Netherlands)]. E-mail: J.Blickman@rad.umcn.nl; Holsbeeck, Marnix T. van [Department of Radiology, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI 48202 (United States)]. E-mail: vanholsbeeck@comcast.net

    2007-06-15

    Magnetic resonance imaging and high-resolution ultrasound (US) are frequently used for the detection of rotator cuff tears. The diagnostic yield of US is influenced by several factors as technique, knowledge of the imaging characteristics of anatomic and pathologic findings and of pitfalls. The purpose of this article is to illustrates that the standardized high-resolution US examination of the shoulder covers the entire rotator cuff and correlates with MR imaging and anatomic sections.

  10. Renal Tumor Anatomic Complexity: Clinical Implications for Urologists.

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    Joshi, Shreyas S; Uzzo, Robert G

    2017-05-01

    Anatomic tumor complexity can be objectively measured and reported using nephrometry. Various scoring systems have been developed in an attempt to correlate tumor complexity with intraoperative and postoperative outcomes. Nephrometry may also predict tumor biology in a noninvasive, reproducible manner. Other scoring systems can help predict surgical complexity and the likelihood of complications, independent of tumor characteristics. The accumulated data in this new field provide provocative evidence that objectifying anatomic complexity can consolidate reporting mechanisms and improve metrics of comparisons. Further prospective validation is needed to understand the full descriptive and predictive ability of the various nephrometry scores. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Introducing 3-Dimensional Printing of a Human Anatomic Pathology Specimen: Potential Benefits for Undergraduate and Postgraduate Education and Anatomic Pathology Practice.

    Science.gov (United States)

    Mahmoud, Amr; Bennett, Michael

    2015-08-01

    Three-dimensional (3D) printing, a rapidly advancing technology, is widely applied in fields such as mechanical engineering and architecture. Three-dimensional printing has been introduced recently into medical practice in areas such as reconstructive surgery, as well as in clinical research. Three-dimensionally printed models of anatomic and autopsy pathology specimens can be used for demonstrating pathology entities to undergraduate medical, dental, and biomedical students, as well as for postgraduate training in examination of gross specimens for anatomic pathology residents and pathology assistants, aiding clinicopathological correlation at multidisciplinary team meetings, and guiding reconstructive surgical procedures. To apply 3D printing in anatomic pathology for teaching, training, and clinical correlation purposes. Multicolored 3D printing of human anatomic pathology specimens was achieved using a ZCorp 510 3D printer (3D Systems, Rock Hill, South Carolina) following creation of a 3D model using Autodesk 123D Catch software (Autodesk, Inc, San Francisco, California). Three-dimensionally printed models of anatomic pathology specimens created included pancreatoduodenectomy (Whipple operation) and radical nephrectomy specimens. The models accurately depicted the topographic anatomy of selected specimens and illustrated the anatomic relation of excised lesions to adjacent normal tissues. Three-dimensional printing of human anatomic pathology specimens is achievable. Advances in 3D printing technology may further improve the quality of 3D printable anatomic pathology specimens.

  12. Aortic anatomic severity grade correlates with resource utilization.

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    Rasheed, Khurram; Cullen, John P; Seaman, Matthew J; Messing, Susan; Ellis, Jennifer L; Glocker, Roan J; Doyle, Adam J; Stoner, Michael C

    2016-03-01

    Potential cost effectiveness of endovascular aneurysm repair (EVAR) compared with open aortic repair (OAR) is offset by the use of intraoperative adjuncts (components) or late reinterventions. Anatomic severity grade (ASG) can be used preoperatively to assess abdominal aortic aneurysms, and provide a quantitative measure of anatomic complexity. The hypothesis of this study is that ASG is directly related to the use of intraoperative adjuncts and cost of aortic repair. Patients who undergo elective OAR and EVAR for abdominal aortic aneurysms were identified over a consecutive 3-year period. ASG scores were calculated manually using three-dimensional reconstruction software by two blinded reviewers. Statistical analysis of cost data was performed using a log transformation. Regression analyses, with a continuous or dichotomous outcome, used a generalized estimating equations approach with the sandwich estimator, being robust with respect to deviations from model assumptions. One hundred forty patients were identified for analysis, n = 33 OAR and n = 107 EVAR. The mean total cost (± standard deviation) for OAR was per thousand (k) $38.3 ± 49.3, length of stay (LOS) 13.5 ± 14.2 days, ASG score 18.13 ± 3.78; for EVAR, mean total cost was k $24.7 ± 13.0 (P = .016), LOS 3.0 ± 4.4 days (P = .012), ASG score 15.9 ± 4.13 (P = .010). In patients who underwent EVAR, 25.2% required intraoperative adjuncts, and analysis of this group revealed a mean total cost of k $31.5 ± 15.9, ASG score 18.48 ± 3.72, and LOS 3.9 ± 4.5, which were significantly greater compared with cases without adjunctive procedures. An ASG score of ≥15 correlated with an increased propensity for requirement of intraoperative adjuncts; odds ratio, 5.75 (95% confidence interval, 1.82-18.19). ASG >15 was also associated with chronic kidney disease, end stage renal disease, hypertension, female sex, increased cost, and use of adjunctive procedures. Complex aneurysm anatomy correlates with increased

  13. Benchmarking Academic Anatomic Pathologists

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    Barbara S. Ducatman MD

    2016-10-01

    Full Text Available The most common benchmarks for faculty productivity are derived from Medical Group Management Association (MGMA or Vizient-AAMC Faculty Practice Solutions Center ® (FPSC databases. The Association of Pathology Chairs has also collected similar survey data for several years. We examined the Association of Pathology Chairs annual faculty productivity data and compared it with MGMA and FPSC data to understand the value, inherent flaws, and limitations of benchmarking data. We hypothesized that the variability in calculated faculty productivity is due to the type of practice model and clinical effort allocation. Data from the Association of Pathology Chairs survey on 629 surgical pathologists and/or anatomic pathologists from 51 programs were analyzed. From review of service assignments, we were able to assign each pathologist to a specific practice model: general anatomic pathologists/surgical pathologists, 1 or more subspecialties, or a hybrid of the 2 models. There were statistically significant differences among academic ranks and practice types. When we analyzed our data using each organization’s methods, the median results for the anatomic pathologists/surgical pathologists general practice model compared to MGMA and FPSC results for anatomic and/or surgical pathology were quite close. Both MGMA and FPSC data exclude a significant proportion of academic pathologists with clinical duties. We used the more inclusive FPSC definition of clinical “full-time faculty” (0.60 clinical full-time equivalent and above. The correlation between clinical full-time equivalent effort allocation, annual days on service, and annual work relative value unit productivity was poor. This study demonstrates that effort allocations are variable across academic departments of pathology and do not correlate well with either work relative value unit effort or reported days on service. Although the Association of Pathology Chairs–reported median work relative

  14. Talocalcaneal luxation: an anatomic and clinical study

    International Nuclear Information System (INIS)

    Gorse, M.J.; Purinton, P.T.; Penwick, R.C.; Aron, D.N.; Roberts, R.E.

    1990-01-01

    Talocalcaneal luxation in dogs was studied by anatomic dissection of the talocalcaneal joint in cadavers and review of five clinical cases. The integrity of the talocalcaneal joint was maintained by two strong ligaments traversing the tarsal sinus between the two bones. The joint was found to be a low motion joint. Luxation in clinical cases was not always apparent on standard radiographic views. Three dogs were treated surgically with a screw inserted in lag fashion from talus to calcaneus. One luxation was treated surgically with figure-of-eight orthopedic wires and one was treated with external coaptation. Four dogs returned to their previous levels of function without clinically detectable lameness

  15. Correlated regions of cerebral blood flow with clinical parameters in Parkinson's disease. Comparison using 'Anatomy' and 'Talairach Daemon' software

    International Nuclear Information System (INIS)

    Yoon, Hyun Jin; Cheon, Sang Myung; Jeong, Young Jin; Kang, Do Young

    2012-01-01

    We assign the anatomical names of functional activation regions in the brain, based on the probabilistic cyto-architectonic atlas by Anatomy 1.7 from an analysis of correlations between regional cerebral blood flow (rCBF) and clinical parameters of the non-demented Parkinson's disease (PD) patients by statistical parametric mapping (SPM) 8. We evaluated Anatomy 1.7 of SPM toolbox compared to 'Talairach Daemon' (TD) Client 2.4.2 software. One hundred and thirty-six patients (mean age 60.0±9.09 years; 73 women and 63 men) with non-demented PD were selected. Tc-99m-HMPAO brain single-photon emission computed tomography (SPECT) scans were performed on the patients using a two-head gamma-camera. We analyzed the brain image of PD patients by SPM8 and found the anatomical names of correlated regions of rCBF perfusion with the clinical parameters using TD Client 2.4.2 and Anatomy 1.7. The SPM8 provided a correlation coefficient between clinical parameters and cerebral hypoperfusion by a simple regression method. To the clinical parameters were added age, duration of disease, education period, Hoehn and Yahr (H and Y) stage and Korean mini-mental state examination (K-MMSE) score. Age was correlated with cerebral perfusion in the Brodmann area (BA) 6 and BA 3b assigned by Anatomy 1.7 and BA 6 and pyramis in gray matter by TD Client 2.4.2 with p<0.001 uncorrected. Also, assigned significant correlated regions were found in the left and right lobules VI (Hem) with duration of disease, in left and right lobules VIIa crus I (Hem) with education, in left insula (Ig2), left and right lobules VI (Hem) with H and Y, and in BA 4a and 6 with K-MMSE score with p<0.05 uncorrected by Anatomy 1.7, respectively. Most areas of correlation were overlapped by two different anatomical labeling methods, but some correlation areas were found with different names. Age was the most significantly correlated clinical parameter with rCBF. TD Client found the exact anatomical name by the peak

  16. Corona mortis: an anatomical variation with clinical relevance. Case report.

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    Guillermo Adrián Rivera-Cardona

    2010-12-01

    Full Text Available The obturator artery is one of the parietal branches arising from the internal iliac artery, the anatomical variation from which this artery originates is called “The corona mortis”, generally from the external iliac artery or the inferior epigastric artery. This finding was observed bilaterally in a male cadaver during a pelvis dissection. Clinical consideration of the anatomical variation in the obturator artery, during surgical procedures, is of great importance due to the risk of pelvic hemorrhage.

  17. Correlation of bone quality in radiographic images with clinical bone quality classification

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    Kim, Hyun Woo; Huh, Kyung Hoe; Kim, Jeong Hwa; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Seoul National University, Seoul (Korea, Republic of); Park, Kwan Soo [Inje University, Seoul (Korea, Republic of)

    2006-03-15

    To investigate the validity of digital image processing on panoramic radiographs in estimating bone quality before endosseous dental implant installation by correlating bone quality in radiographic images with clinical bone quality classification. An experienced surgeon assessed and classified bone quality for implant sites with tactile sensation at the time of implant placement. Including fractal dimension eighteen morphologic features of trabecular pattern were examined in each anatomical sites on panoramic radiographs. Finally bone quality of 67 implant sites were evaluated in 42 patients. Pearson correlation analysis showed that three morphologic parameters had weak linear negative correlation with clinical bone quality classification showing correlation coefficients of -0.276, -0.280, and -0.289, respectively (p<0.05). And other three morphologic parameters had obvious linear negative correlation with clinical bone quality classification showing correlation coefficients of -0.346, -0.488, and -0.343 respectively (p<0.05). Fractal dimension also had a linear correlating with clinical bone quality classification with correlation coefficients -0.506 significantly (P<0.05). This study suggests that fractal and morphometric analysis using digital panoramic radiographs can be used to evaluate bone quality for implant recipient sites.

  18. Chronic motor cortex stimulation in the treatment of central and neuropathic pain. Correlations between clinical, electrophysiological and anatomical data.

    Science.gov (United States)

    Nguyen, J P; Lefaucheur, J P; Decq, P; Uchiyama, T; Carpentier, A; Fontaine, D; Brugières, P; Pollin, B; Fève, A; Rostaing, S; Cesaro, P; Keravel, Y

    1999-09-01

    Thirty-two patients with refractory central and neuropathic pain of peripheral origin were treated by chronic stimulation of the motor cortex between May 1993 and January 1997. The mean follow-up was 27.3 months. The first 24 patients were operated according to the technique described by Tsubokawa. The last 13 cases (eight new patients and five reinterventions) were operated by a technique including localisation by superficial CT reconstruction of the central region and neuronavigator guidance. The position of the central sulcus was confirmed by the use of intraoperative somatosensory evoked potentials. The somatotopic organisation of the motor cortex was established peroperatively by studying the motor responses at stimulation of the motor cortex through the dura. Ten of the 13 patients with central pain (77%) and ten of the 12 patients with neuropathic facial pain had experienced substantial pain relief (75%). One of the three patients with post-paraplegia pain was clearly improved. A satisfactory result was obtained in one patient with pain related to plexus avulsion and in one patient with pain related to intercostal herpes zooster. None of the patients developed epileptic seizures. The position of the stimulating poles effective on pain corresponded to the somatotopic representation of the motor cortex. The neuronavigator localisation and guidance technique proved to be most useful identifying the appropriate portion of the motor gyrus. It also allowed the establishment of reliable correlations between electrophysiological-clinical and anatomical data which may be used to improve the clinical results and possibly to extend the indications of this technique.

  19. Correlative CT and anatomic study of the sciatic nerve

    International Nuclear Information System (INIS)

    Pech, P.; Haughton, V.

    1985-01-01

    Sciatica can be caused by numerous processes affecting the sciatic nerve or its components within the pelvis including tumors, infectious diseases, aneurysms, fractures, and endometriosis. The CT diagnosis of these causes of sciatica has not been emphasized. This study identified the course and appearance of the normal sciatic nerve in the pelvis by correlating CT and anatomic slices in cadavers. For purposes of discussion, the sciatic nerve complex is conveniently divided into three parts: presacral, muscular, and ischial. Each part is illustrated here by two cryosections with corresponding CT images

  20. A team-based approach to autopsy education: integrating anatomic and clinical pathology at the rotation level.

    Science.gov (United States)

    Hébert, Tiffany Michele; Maleki, Sara; Vasovic, Ljiljana V; Arnold, Jeffrey L; Steinberg, Jacob J; Prystowsky, Michael B

    2014-03-01

    Pathology residency training programs should aim to teach residents to think beyond the compartmentalized data of specific rotations and synthesize data in order to understand the whole clinical picture when interacting with clinicians. To test a collaborative autopsy procedure at Montefiore Medical Center (Bronx, New York), linking residents and attending physicians from anatomic and clinical pathology in the autopsy process from the initial chart review to the final report. Residents consult with clinical pathology colleagues regarding key clinical laboratory findings during the autopsy. This new procedure serves multiple functions: creating a team-based, mutually beneficial educational experience; actively teaching consultative skills; and facilitating more in-depth analysis of the clinical laboratory findings in autopsies. An initial trial of the team-based autopsy system was done from November 2010 to December 2012. Residents were then surveyed via questionnaire to evaluate the frequency and perceived usefulness of clinical pathology autopsy consultations. Senior residents were the most frequent users of clinical pathology autopsy consultation. The most frequently consulted services were microbiology and chemistry. Eighty-nine percent of the residents found the clinical pathology consultation to be useful in arriving at a final diagnosis and clinicopathologic correlation. The team-based autopsy is a novel approach to integration of anatomic and clinical pathology curricula at the rotation level. Residents using this approach develop a more holistic approach to pathology, better preparing them for meaningful consultative interaction with clinicians. This paradigm shift in training positions us to better serve in our increasing role as arbiters of outcomes measures in accountable care organizations.

  1. Presence of Cognitive Deterioration and Anatomical-Clinical Topography in Patients with Epilepsy in Cienfuegos

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    Rolando Lázaro Rivera López

    2015-02-01

    Full Text Available Background: epilepsy is a pathological condition characterized by a recurrent non-provoked crisis, however, the presence of the crisis is a fraction of the global problem, patients with epilepsy develop a variety of neuropsychiatry problems, as cognitive affection, most of all, in the space of memory. Objective: evaluating the behavior of the cognitive deterioration and focalization according to anatomical- clinical topography in patients with epilepsy. Methods: a descriptive, correlational, cross-section and follow-up study of cases. The techniques used were: structured interview, the Montreal Cognitive Assessment's evaluation, and Luria´s neuropsychological exam. It was used SPDD statical parcel, version 1.5 to process the information that made possible the study of the obtained data, with the aim of expressing the results in chart of frequency and relation of variables in number and percent. Results: the 71.4 % of evaluated patients presented cognitive deterioration in any of its of measurement scales and they focalized according to neuropsychological exam. Conclusions: as the time of evolution of the disease increases, the frequency and duration of the crises, the grade of the cognitive deterioration in patients with epilepsy increases, focalizing with dysfunction majority fronto-temporary level according to anatomical-clinical topography.

  2. Radiologic-anatomic correlation of thoracic vertebrae and rib shadows in chest digital radiograph

    International Nuclear Information System (INIS)

    Yamaguchi, Isao; Itoh, Harumi

    2007-01-01

    The purpose of this study was to provide an introduction to parsing the radiologic appearance of thoracic vertebrae and ribs. In the study, the radiologic-anatomic correlation technique was applied to promote further understanding of normal chest radiographs. The thoracic vertebrae and ribs of chest radiographs were compared with each macroscopic radiologic and computed tomography (CT) image. The rib parsed the linear shadow of the body of the rib. The macroscopic and radiologic images of thoracic vertebrae and ribs were evaluated to explain their normal radiologic findings. The results of such correlation were summarized as follows: The lamina of the vertebral arch was visualized due to anterior rotation of the upper thoracic vertebrae. The density ratio of the thoracic-vertebrae shadow was almost the same in the vertebral body and vertebral arch. The linear shadow superimposed on the rib corresponded to the inferior margin of the rib. The radiologic-anatomic correlation technique was useful to evaluate normal radiologic findings, and the study was useful to radiological technologists. (author)

  3. Standardized anatomic space for abdominal fat quantification

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    Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.

    2014-03-01

    The ability to accurately measure subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) from images is important for improved assessment and management of patients with various conditions such as obesity, diabetes mellitus, obstructive sleep apnea, cardiovascular disease, kidney disease, and degenerative disease. Although imaging and analysis methods to measure the volume of these tissue components have been developed [1, 2], in clinical practice, an estimate of the amount of fat is obtained from just one transverse abdominal CT slice typically acquired at the level of the L4-L5 vertebrae for various reasons including decreased radiation exposure and cost [3-5]. It is generally assumed that such an estimate reliably depicts the burden of fat in the body. This paper sets out to answer two questions related to this issue which have not been addressed in the literature. How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? At what anatomic location do the volumes of SAT and VAT correlate maximally with the corresponding single-slice area measures? To answer these questions, we propose two approaches for slice localization: linear mapping and non-linear mapping which is a novel learning based strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. We then study the volume-to-area correlations and determine where they become maximal. We demonstrate on 50 abdominal CT data sets that this mapping achieves significantly improved consistency of anatomic localization compared to current practice. Our results also indicate that maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized.

  4. The Functional Angiosome: Clinical Implications of the Anatomical Concept.

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    Taylor, G Ian; Corlett, Russell J; Ashton, Mark W

    2017-10-01

    The angiosome is a three-dimensional block of tissue supplied by a source vessel with its boundary outlined either by an anastomotic perimeter of reduced-caliber choke vessels or by true anastomoses with no reduction of vessel caliber. This article focuses on the role of these anastomotic vessels in defining flap survival or the necrotic pattern seen in fulminating meningococcal septicemia. Experiments in pigs, dogs, guinea pigs, and rabbits over the past 46 years were reviewed, focusing on the necrosis line of flaps, the effects of various toxins in vivo, and correlating these results in the clinical setting. Experimentally, choke anastomoses are functional and control flow between perforator angiosomes. They (1) permit capture of an adjacent angiosome when the flap is raised on a cutaneous perforator in 100 percent of cases, with the necrosis line occurring usually in the next interperforator connection; (2) confine flow to the territory of the involved artery when a toxin is introduced by spasm around its perimeter; and (3) lose this property of spasm when choke vessels are converted to true anastomoses following surgical delay, or where true anastomoses occur naturally, thereby allowing unimpeded blood flow and capture of additional angiosome territories. Clinical experience supports these observations. The functional angiosome is the volume of tissue that clinically can be isolated on a source vessel. The area extends beyond its anatomical territory to capture an adjacent territory if connections are by choke anastomoses, or more if they are by true anastomoses.

  5. Anatomical Correlates of Non-Verbal Perception in Dementia Patients

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    Pin-Hsuan Lin

    2016-08-01

    Full Text Available Purpose: Patients with dementia who have dissociations in verbal and non-verbal sound processing may offer insights into the anatomic basis for highly related auditory modes. Methods: To determine the neuronal networks on non-verbal perception, 16 patients with Alzheimer’s dementia (AD, 15 with behavior variant fronto-temporal dementia (bv-FTD, 14 with semantic dementia (SD were evaluated and compared with 15 age-matched controls. Neuropsychological and auditory perceptive tasks were included to test the ability to compare pitch changes, scale-violated melody and for naming and associating with environmental sound. The brain 3D T1 images were acquired and voxel-based morphometry (VBM was used to compare and correlated the volumetric measures with task scores. Results: The SD group scored the lowest among 3 groups in pitch or scale-violated melody tasks. In the environmental sound test, the SD group also showed impairment in naming and also in associating sound with pictures. The AD and bv-FTD groups, compared with the controls, showed no differences in all tests. VBM with task score correlation showed that atrophy in the right supra-marginal and superior temporal gyri was strongly related to deficits in detecting violated scales, while atrophy in the bilateral anterior temporal poles and left medial temporal structures was related to deficits in environmental sound recognition. Conclusions: Auditory perception of pitch, scale-violated melody or environmental sound reflects anatomical degeneration in dementia patients and the processing of non-verbal sounds is mediated by distinct neural circuits.

  6. [Establishment of A Clinical Prediction Model of Prolonged Air Leak 
after Anatomic Lung Resection].

    Science.gov (United States)

    Wu, Xianning; Xu, Shibin; Ke, Li; Fan, Jun; Wang, Jun; Xie, Mingran; Jiang, Xianliang; Xu, Meiqing

    2017-12-20

    Prolonged air leak (PAL) after anatomic lung resection is a common and challenging complication in thoracic surgery. No available clinical prediction model of PAL has been established in China. The aim of this study was to construct a model to identify patients at increased risk of PAL by using preoperative factors exclusively. We retrospectively reviewed clinical data and PAL occurrence of patients after anatomic lung resection, in department of thoracic surgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, from January 2016 to October 2016. 359 patients were in group A, clinical data including age, body mass index (BMI), gender, smoking history, surgical methods, pulmonary function index, pleural adhesion, pathologic diagnosis, side and site of resected lung were analyzed. By using univariate and multivariate analysis, we found the independent predictors of PAL after anatomic lung resection and subsequently established a clinical prediction model. Then, another 112 patients (group B), who underwent anatomic lung resection in different time by different team, were chosen to verify the accuracy of the prediction model. Receiver-operating characteristic (ROC) curve was constructed using the prediction model. Multivariate Logistic regression analysis was used to identify six clinical characteristics [BMI, gender, smoking history, forced expiratory volume in one second to forced vital capacity ratio (FEV1%), pleural adhesion, site of resection] as independent predictors of PAL after anatomic lung resection. The area under the ROC curve for our model was 0.886 (95%CI: 0.835-0.937). The best predictive P value was 0.299 with sensitivity of 78.5% and specificity of 93.2%. Our prediction model could accurately identify occurrence risk of PAL in patients after anatomic lung resection, which might allow for more effective use of intraoperative prophylactic strategies.
.

  7. Posterolateral supporting structures of the knee: findings on anatomic dissection, anatomic slices and MR images

    Energy Technology Data Exchange (ETDEWEB)

    Maeseneer, M. de; Shahabpour, M.; Vanderdood, K.; Ridder, F. de; Osteaux, M. [Dept. of Radiology, Free Univ. Brussels (Belgium); Roy, F. van [Dept. of Experimental Anatomy, Free Univ. Brussels (Belgium)

    2001-11-01

    In this article we study the ligaments and tendons of the posterolateral corner of the knee by anatomic dissection, MR-anatomic correlation, and MR imaging. The posterolateral aspect of two fresh cadaveric knee specimens was dissected. The MR-anatomic correlation was performed in three other specimens. The MR images of 122 patients were reviewed and assessed for the visualization of different posterolateral structures. Anatomic dissection and MR-anatomic correlation demonstrated the lateral collateral, fabellofibular, and arcuate ligaments, as well as the biceps and popliteus tendons. On MR images of patients the lateral collateral ligament was depicted in all cases. The fabellofibular, arcuate, and popliteofibular ligaments were visualized in 33, 25, and 38% of patients, respectively. Magnetic resonance imaging allows a detailed appreciation of the posterolateral corner of the knee. (orig.)

  8. Internuclear ophthalmoplegia: MR imaging and anatomic correlation

    International Nuclear Information System (INIS)

    Atlas, S.W.; Grossman, R.I.; Savino, P.J.

    1986-01-01

    Internuclear ophthalmoplegia is a gaze disorder characterized by impaired adduction of the side of a lesion in the medial longitudinal fasciculus (MLF) with dissociated nystagmus of the abducting eye. Eleven patients with internuclear ophthalmoplegia (nine with multiple sclerosis, two with infarction) were examined with spin-echo MR imaging performed at 1.5 T. Nine of the 11 patients also underwent CT. MR imaging was highly sensitive (10 of 11 cases) and CT was of no value (0 of 9 cases) in detecting clinically suspected MLF lesions. These lesions must be distinguished from ''pseudo-MLF hyperintensity,'' which appears as a thin, strictly midline, linear hyperintensity just interior to the fourth ventricle and aqueduct in healthy subjects. True MLF lesions are nodular, more prominent, and slightly off the midline, corresponding to the paramedian anatomic site of the MLF

  9. Interactive anatomical and surgical live stream lectures improve students' academic performance in applied clinical anatomy.

    Science.gov (United States)

    Shiozawa, Thomas; Butz, Benjamin; Herlan, Stephan; Kramer, Andreas; Hirt, Bernhard

    2017-01-01

    Tuebingen's Sectio Chirurgica (TSC) is an innovative, interactive, multimedia, and transdisciplinary teaching method designed to complement dissection courses. The Tuebingen's Sectio Chirurgica (TSC) allows clinical anatomy to be taught via interactive live stream surgeries moderated by an anatomist. This method aims to provide an application-oriented approach to teaching anatomy that offers students a deeper learning experience. A cohort study was devised to determine whether students who participated in the TSC were better able to solve clinical application questions than students who did not participate. A total of 365 students participated in the dissection course during the winter term of the 2012/2013 academic year. The final examination contained 40 standard multiple-choice (S-MC) and 20 clinically-applied multiple-choice (CA-MC) items. The CA-MC items referred to clinical cases but could be answered solely using anatomical knowledge. Students who regularly participated in the TSC answered the CA-MC questions significantly better than the control group (75% and 65%, respectively; P  0.05). The CA-MC questions had a slightly higher level of difficulty than the S-MC questions (0.725 and 0.801, respectively; P = 0.083). The discriminatory power of the items was comparable (S-MC median Pearson correlations: 0.321; CA-MC: 0.283). The TSC successfully teaches the clinical application of anatomical knowledge. Students who attended the TSC in addition to the dissection course were able to answer CA-MC questions significantly better than students who did not attend the TSC. Thus, attending the TSC in addition to the dissection course supported students' clinical learning goals. Anat Sci Educ 10: 46-52. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  10. Clinical and anatomical observations of a two-headed lamb.

    Science.gov (United States)

    Fisher, K R; Partlow, G D; Walker, A F

    1986-04-01

    The clinical and anatomical features of a live-born diprosopic lamb are described. There are no complete anatomical analyses of two-faced lambs in the literature despite the frequency of conjoined twinning in sheep. The lamb had two heads fused in the occipital region. Each head had two eyes. The pinnae of the medial ears were fused. Caudal to the neck the lamb appeared grossly normal. The lamb was unable to raise its heads or stand. Both heads showed synchronous sucking motions and cranial reflexes were present. Nystagmus, strabismus, and limb incoordination were present. The respiratory and heart rates were elevated. There was a grade IV murmur over the left heart base and a palpable thrill on the left side. Each head possessed a normal nasopharynx, oropharynx, and tongue. There was a singular laryngopharnyx and esophagus although the hyoid apparatus was partially duplicated. The cranial and cervical musculature reflected the head duplications. The aortic trunk emerged from the right ventricle just to the right of the conus arteriosus. A ventricular septal defect, patent foramen ovale, and ductus arteriosus were present along with malformed atrioventricular valves. Brainstem fusion began at the cranial medulla oblongata between cranial nerves IX and XII. The cerebella were separate but small. The ventromedial structures from each medulla oblongata were compressed into an extraneous midline remnant of tissue which extended caudally to the level of T2. The clinical signs therefore reflected the anatomical anomalies. A possible etiology for this diprosopus might be the presence early in development of an excessively large block of chordamesoderm. This would allow for the formation of two head folds and hence two "heads."

  11. Technical note: Correlation of respiratory motion between external patient surface and internal anatomical landmarks

    Science.gov (United States)

    Fayad, Hadi; Pan, Tinsu; Clément, Jean-François; Visvikis, Dimitris

    2011-01-01

    Purpose Current respiratory motion monitoring devices used for motion synchronization in medical imaging and radiotherapy provide either 1D respiratory signals over a specific region or 3D information based on few external or internal markers. On the other hand, newer technology may offer the potential to monitor the entire patient external surface in real time. The main objective of this study was to assess the motion correlation between such an external patient surface and internal anatomical landmarks motion. Methods Four dimensional Computed Tomography (4D CT) volumes for ten patients were used in this study. Anatomical landmarks were manually selected in the thoracic region across the 4D CT datasets by two experts. The landmarks included normal structures as well as the tumour location. In addition, a distance map representing the entire external patient surface, which corresponds to surfaces acquired by a Time of Flight (ToF) camera or similar devices, was created by segmenting the skin of all 4D CT volumes using a thresholding algorithm. Finally, the correlation between the internal landmarks and external surface motion was evaluated for different regions (placement and size) throughout a patient’s surface. Results Significant variability was observed in the motion of the different parts of the external patient surface. The larger motion magnitude was consistently measured in the central regions of the abdominal and the thoracic areas for the different patient datasets considered. The highest correlation coefficients were observed between the motion of these external surface areas and internal landmarks such as the diaphragm and mediastinum structures as well as the tumour location landmarks (0.8 ± 0.18 and 0.72 ± 0.12 for the abdominal and the thoracic regions respectively). Worse correlation was observed when one considered landmarks not significantly influenced by respiratory motion such as the apex and the sternum. Discussion and conclusions There

  12. Anatomy of the shoulder - clinical aspects for imaging and anatomical varieties

    International Nuclear Information System (INIS)

    Vahlensieck, M.

    2004-01-01

    Knowledge of anatomic details is important for interpretation of diagnostic imaging particularly MRI and CT. New findings even in macroscopy in the last years increased our knowledge significantly. In this article the findings are summarized with emphasis on clinical aspects. (orig.) [de

  13. Computed tomography of the dog's brain: normal aspects and anatomical correlation

    International Nuclear Information System (INIS)

    Lorigados, C.A.B.; Pinto, A.C.B.F.

    2013-01-01

    Normal tomographic images of dog's heads were obtained, aimed to familiarize them with the normal aspects of the brain and correlate these findings with the relevant anatomy of the region studied. Several anatomical structures, such as the parenchyma of the frontal, parietal, temporal and occipital lobes, the longitudinal fissure, the ventricular system, the cerebellum, the olfactory bulb, the corpus callosum, diencephalon, the pons, the medulla oblongata and the chiasmatic sulcus were directly identified or were related to neighboring structures which helped in their identification. (author)

  14. Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings

    International Nuclear Information System (INIS)

    Robinson, P.; Barron, D.A.; Grainger, A.J.; O'Connor, P.J.; Parsons, W.; Schilders, E.M.G.

    2004-01-01

    To evaluate gadolinium-enhanced MR imaging in athletes with chronic groin pain and correlate with the clinical features. MR examinations performed in 52 athletes (51 male, 1 female; median age 26 years) with chronic groin pain and 6 asymptomatic control athletes (6 male; median age 29 years) were independently reviewed by two radiologists masked to the clinical details. Symptom duration (median 6 months) and clinical side of severity were recorded. Anatomical areas in the pelvis were scored for abnormality (as normal, mildly abnormal or abnormal) and an overall assessment for side distribution of abnormality was recorded, initially without post-gadolinium sequences and then, 3 weeks later (median 29 days), the post-gadolinium sequences only. Correlation between radiological and clinical abnormality was calculated by Spearman's correlation. Abnormal anterior pubis and enthesis enhancement significantly correlated with clinical side for both radiologists (both P=0.008). Abnormal anterior pubis and adductor longus enthesis oedema was significant for one radiologist (P=0.009). All other features showed no significant correlation (P>0.05). In the control cases there was no soft tissue abnormality but symphyseal irregularity was present (n=2). For both radiologists assessment of imaging side severity significantly correlated with clinical side for post-gadolinium (P=0.048 and P=0.023) but not non-gadolinium sequences (P>0.05). The extent and side of anterior pubis and adductor longus enthesis abnormality on MR imaging significantly and reproducibly correlates with the athletes' current symptoms in chronic adductor-related groin pain. (orig.)

  15. Anatomical, Clinical and Electrical Observations in Piriformis Syndrome

    Directory of Open Access Journals (Sweden)

    Assoum Hani A

    2010-01-01

    Full Text Available Abstract Background We provided clinical and electrical descriptions of the piriformis syndrome, contributing to better understanding of the pathogenesis and further diagnostic criteria. Methods Between 3550 patients complaining of sciatica, we concluded 26 cases of piriformis syndrome, 15 females, 11 males, mean age 35.37 year-old. We operated 9 patients, 2 to 19 years after the onset of symptoms, 5 had piriformis steroids injection. A dorsolumbar MRI were performed in all cases and a pelvic MRI in 7 patients. The electro-diagnostic test was performed in 13 cases, between them the H reflex of the peroneal nerve was tested 7 times. Results After a followup 1 to 11 years, for the 17 non operated patients, 3 patients responded to conservative treatment. 6 of the operated had an excellent result, 2 residual minor pain and one failed. 3 new anatomical observations were described with atypical compression of the sciatic nerve by the piriformis muscle. Conclusion While the H reflex test of the tibial nerve did not give common satisfaction in the literature for diagnosis, the H reflex of the peroneal nerve should be given more importance, because it demonstrated in our study more specific sign, with six clinical criteria it contributed to improve the method of diagnosis. The cause of this particular syndrome does not only depend on the relation sciatic nerve-piriformis muscle, but the environmental conditions should be considered with the series of the anatomical anomalies to explain the real cause of this pain.

  16. Triceps brachii tendon: anatomic-MR imaging study in cadavers with histologic correlation

    International Nuclear Information System (INIS)

    Belentani, Clarissa; Pastore, Daniel; Wangwinyuvirat, Mani; Dirim, Berna; Trudell, Debra J.; Resnick, Donald; Haghighi, Parviz

    2009-01-01

    The purpose of this cadaveric study was to describe the normal MR anatomy of the triceps brachii tendon (TBT) insertion, to correlate the findings with those seen in anatomic sections and histopathologic analysis, and to review triceps tendon injuries. Twelve cadaveric elbows were used according to institution guidelines. T1-weighted spin-echo MR images were acquired in three planes. Findings on MR imaging were correlated with those derived from anatomic and histologic study. On MR images, the TBT had a bipartite appearance as it inserted on olecranon in all specimens. The insertion of the medial head was deeper than that of the long and lateral heads and was mainly muscular at its insertion, with a small amount of the tendon blending with the muscle distally, necessitating histologic analysis to determine if there was tendon blending with the muscle at the site of insertion and if the medial head inserted together with the common tendon or as a single unit. At histopathologic analysis, the three heads of the triceps tendon had a common insertion on the olecranon. The bipartite aspect of the tendon that was identified in the MR images was not seen by histologic study, indicating that there was a union of the medial and common tendons just before they inserted into bone. TBT has a bipartite appearance on MR images and inserts on olecranon as a single unit. (orig.)

  17. Triceps brachii tendon: anatomic-MR imaging study in cadavers with histologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Belentani, Clarissa [University of California, Department of Radiology, San Diego, CA (United States); Pastore, Daniel; Wangwinyuvirat, Mani; Dirim, Berna; Trudell, Debra J.; Resnick, Donald [University of California, Department of Radiology, San Diego, CA (United States); University of California, VA Medical Center, San Diego, CA (United States); Haghighi, Parviz [University of California, VA Medical Center, San Diego, CA (United States); University of California, Department of Histology, San Diego (United States)

    2009-02-15

    The purpose of this cadaveric study was to describe the normal MR anatomy of the triceps brachii tendon (TBT) insertion, to correlate the findings with those seen in anatomic sections and histopathologic analysis, and to review triceps tendon injuries. Twelve cadaveric elbows were used according to institution guidelines. T1-weighted spin-echo MR images were acquired in three planes. Findings on MR imaging were correlated with those derived from anatomic and histologic study. On MR images, the TBT had a bipartite appearance as it inserted on olecranon in all specimens. The insertion of the medial head was deeper than that of the long and lateral heads and was mainly muscular at its insertion, with a small amount of the tendon blending with the muscle distally, necessitating histologic analysis to determine if there was tendon blending with the muscle at the site of insertion and if the medial head inserted together with the common tendon or as a single unit. At histopathologic analysis, the three heads of the triceps tendon had a common insertion on the olecranon. The bipartite aspect of the tendon that was identified in the MR images was not seen by histologic study, indicating that there was a union of the medial and common tendons just before they inserted into bone. TBT has a bipartite appearance on MR images and inserts on olecranon as a single unit. (orig.)

  18. Sinonasal anatomical variations: their relationship with chronic rhinosinusitis and effect on the severity of disease-a computerized tomography assisted anatomical and clinical study.

    Science.gov (United States)

    Kaygusuz, Ahmet; Haksever, Mehmet; Akduman, Davut; Aslan, Sündüs; Sayar, Zeynep

    2014-09-01

    The anatomy of the sinonasal area has a very wide rage of anatomical variations. The significance of these anatomical variations in pathogenesis of rhinosinusitis, which is the commonest disease in the region, is still unclear. The aims of the study were to compare the rate of sinonasal anatomical variations with development and severity of chronic rhinosinusitis patients. CT scan of paranasal sinuses images of 99 individuals were retrospectively reviewed. 65 cases of chronic rhinosinusitis (study group) who had undergone endoscopic sinus surgery were compared with 34 cases without chronic rhinosinusitis (control group). Also in study group Lund-Mackay score of the sinus disease were calculated and compared to the rate of related anatomical variations. There were 74 (74.7 %) males and 25 (25.2 %) females with ages ranging from 13 to 70 years (mean 32.2 years). The anatomical variations recorded were: Septal deviation 47 (72.3) in study and 25 (73.5 %) in control group, concha bullosa 27 (41.5 %) in study and 18 (52.9 %) in control group, overpneumatized ethmoid bulla 17 (26.1 %) in study and 14 (41.1 %) in control group, pneumatized uncinate 3 (4.6 %) in study and 3 (8.8 %) in control group, agger nasi 42 (64.6 %) in study and 19 (55.8 %) in control group, paradoxical middle turbinates 9 (13.8 %) in study and 4 (11.7 %) in control group, Onodi cell 6 (9.2 %) in study and 2 (5.8 %) in control group, Haller's cells (infraorbital ethmoid cell) 9 (13.8 %) in study and 7 (20.5 %) in control group. None of these results were statistically significant between study and control group (p > 0.05). Lund-Mackay score (which was assumed to show the severity of the disease) of the maxillary, ethmoid and frontal sinus were calculated and compared to rate of septal deviation, concha bullosa, agger nasi cells. No significant correlation was conducted (p > 0.05). The results of study showed no statistically significant correlation between sinonasal anatomical

  19. Corpus callosum and neglect syndrome: Clinical findings after meningioma removal and anatomical review

    Directory of Open Access Journals (Sweden)

    David Gomes

    2017-01-01

    Full Text Available Two types of neglect are described: hemispatial and motivational neglect syndromes. Neglect syndrome is a neurophysiologic condition characterized by a malfunction in one hemisphere of the brain, resulting in contralateral hemispatial neglect in the absence of sensory loss and the right parietal lobe lesion being the most common anatomical site leading to it. In motivational neglect, the less emotional input is considered from the neglected side where anterior cingulate cortex harbors the most frequent lesions. Nevertheless, there are reports of injuries in the corpus callosum (CC causing hemispatial neglect syndrome, particularly located in the splenium. It is essential for a neurosurgeon to recognize this clinical syndrome as it can be either a primary manifestation of neurosurgical pathology (tumor, vascular lesion or as a postoperative iatrogenic clinical finding. The authors report a postoperative hemispatial neglect syndrome after a falcotentorial meningioma removal that recovered 10 months after surgery and performs a clinical, anatomical, and histological review centered in CC as key agent in neglect syndrome.

  20. CT of Anatomic Variants of the Paranasal Sinuses and Nasal Cavity: Poor Correlation With Radiologically Significant Rhinosinusitis but Importance in Surgical Planning.

    Science.gov (United States)

    Shpilberg, Katya A; Daniel, Simon C; Doshi, Amish H; Lawson, William; Som, Peter M

    2015-06-01

    The purpose of this study was to determine the incidence of sinonasal anatomic variants and to assess their relation to sinonasal mucosal disease. A retrospective evaluation of 192 sinus CT examinations of patients with a clinical history of rhinosinusitis was conducted. The CT scans were evaluated for the presence of several anatomic variants of the sinonasal cavities, and the prevalence of each variant was calculated. Prevalences of all sinonasal anatomic variants were compared between patients who had minimal to no apparent imaging evidence of rhinosinusitis and those who had radiologic evidence of clinically significant rhinosinusitis. The most common normal variants were nasal septal deviation, Agger nasi cells, and extension of the sphenoid sinuses into the posterior nasal septum. We found no statistically significant difference in the prevalence of any of the studied anatomic variants between patients with minimal and those with clinically significant paranasal sinus or nasal cavity disease. Analysis of every routine CT scan of the paranasal sinuses obtained for sinusitis or rhinitis for the presence of different anatomic variants is of questionable value unless surgery is planned.

  1. Clinical effect of anatomical hepatectomy in treatment of intrahepatic bile duct stones

    Directory of Open Access Journals (Sweden)

    WANG Dianbei

    2017-01-01

    Full Text Available ObjectiveTo investigate the clinical effect of anatomical hepatectomy in the treatment of intrahepatic bile duct stones. Methods A retrospective analysis was performed for the clinical data of 117 patients with intrahepatic bile duct stones who underwent hepatectomy in The Affiliated Hospital of Zunyi Medical College from July 2013 to December 2015. Among these patients, 66 underwent anatomical hepatectomy (anatomical hepatectomy group and 51 underwent irregular hepatectomy (irregular hepatectomy group. The time of operation, intraoperative blood loss, volume of drainage on the day after surgery, serum levels of aspartate aminotransferase (AST, alanine aminotransferase (ALT, and total bilirubin (TBil, and length of postoperative hospital stay were recorded, as well as the patients′ general status, liver function parameters, and abdominal ultrasound, and CT or MRI findings from 2 months to 2 years after discharge, to observe the presence or absence of residual stones or stone recurrence. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsCompared with the irregular hepatectomy group, the anatomical hepatectomy group had a significantly longer time of operation (303.1±51.6 min vs 246.5±36.2 min, t=6.963, P<0.01, but it had significantly less intraoperative blood loss (467.9±80.6 ml vs 565.9±92.0 ml, t=6.026, P<0.01, a significantly lower volume of drainage on the day after surgery (212.6±54.9 ml vs 358.3±69.4 ml, t=12.682, P<0.01, a significantly lower incidence rate of complications (10.6% vs 25.5%, χ2=4.497, P=0.034, a significantly lower rate of postoperative residual stones (4.5% vs 15.7%, χ2=4.192, P=0.041, and a significantly shorter length of hospital stay (13.4±2.6 d vs 21.9±3.2 d, t=15.427, P<001. On day 3 after surgery, the anatomical hepatectomy group had significantly lower serum levels of ALT, AST, and

  2. Surgical Treatment of Carpal Tunnel Syndrome through a Minimal Incision on the Distal Wrist Crease: An Anatomical and Clinical Study

    Directory of Open Access Journals (Sweden)

    Hye Mi Yoo

    2015-05-01

    Full Text Available BackgroundAn anatomical analysis of the transverse carpal ligament (TCL and the surrounding structures might help in identifying effective measures to minimize complications. Here, we present a surgical technique based on an anatomical study that was successfully applied in clinical settings.MethodsUsing 13 hands from 8 formalin-fixed cadavers, we measured the TCL length and thickness, correlation between the distal wrist crease and the proximal end of the TCL, and distance between the distal end of the TCL and the palmar arch; the TCL cross sections and the thickest parts were also examined. Clinically, fasciotomy was performed on the relevant parts of 15 hands from 13 patients by making a minimally invasive incision on the distal wrist crease. Postoperatively, a two-point discrimination check was conducted in which the sensations of the first, second, and third fingertips and the palmar cutaneous branch injuries were monitored (average duration, 7 months.ResultsIn the 13 cadaveric hands, the distal wrist crease and the proximal end of the TCL were placed in the same location. The average length of the TCL and the distance from the distal TCL to the superficial palmar arch were 35.30±2.59 mm and 9.50±2.13 mm, respectively. The thickest part of the TCL was a region 25 mm distal to the distal wrist crease (average thickness, 4.00±0.57 mm. The 13 surgeries performed in the clinical settings yielded satisfactory results.ConclusionsThis peri-TCL anatomical study confirmed the safety of fasciotomy with a minimally invasive incision of the distal wrist crease. The clinical application of the technique indicated that the minimally invasive incision of the distal wrist crease was efficacious in the treatment of the carpal tunnel syndrome.

  3. Benchmarking Academic Anatomic Pathologists: The Association of Pathology Chairs Survey.

    Science.gov (United States)

    Ducatman, Barbara S; Parslow, Tristram

    2016-01-01

    The most common benchmarks for faculty productivity are derived from Medical Group Management Association (MGMA) or Vizient-AAMC Faculty Practice Solutions Center ® (FPSC) databases. The Association of Pathology Chairs has also collected similar survey data for several years. We examined the Association of Pathology Chairs annual faculty productivity data and compared it with MGMA and FPSC data to understand the value, inherent flaws, and limitations of benchmarking data. We hypothesized that the variability in calculated faculty productivity is due to the type of practice model and clinical effort allocation. Data from the Association of Pathology Chairs survey on 629 surgical pathologists and/or anatomic pathologists from 51 programs were analyzed. From review of service assignments, we were able to assign each pathologist to a specific practice model: general anatomic pathologists/surgical pathologists, 1 or more subspecialties, or a hybrid of the 2 models. There were statistically significant differences among academic ranks and practice types. When we analyzed our data using each organization's methods, the median results for the anatomic pathologists/surgical pathologists general practice model compared to MGMA and FPSC results for anatomic and/or surgical pathology were quite close. Both MGMA and FPSC data exclude a significant proportion of academic pathologists with clinical duties. We used the more inclusive FPSC definition of clinical "full-time faculty" (0.60 clinical full-time equivalent and above). The correlation between clinical full-time equivalent effort allocation, annual days on service, and annual work relative value unit productivity was poor. This study demonstrates that effort allocations are variable across academic departments of pathology and do not correlate well with either work relative value unit effort or reported days on service. Although the Association of Pathology Chairs-reported median work relative value unit productivity

  4. Anatomical Variations of Brachial Artery - Its Morphology, Embryogenesis and Clinical Implications

    Science.gov (United States)

    KS, Siddaraju; Venumadhav, Nelluri; Sharma, Ashish; Kumar, Neeraj

    2014-01-01

    Background: Accurate knowledge of variation pattern of the major arteries of upper limb is of considerable practical importance in the conduct of reparative surgery in the arm, forearm and hand however brachial artery and its terminal branches variations are less common. Aim: Accordingly the present study was designed to evaluate the anatomical variations of the brachial artery and its morphology, embryogenesis and clinical implications. Materials and Methods: In an anatomical study 140 upper limb specimens of 70 cadavers (35 males and 35 females) were used and anatomical variations of the brachial artery have been documented. Results: Accessory brachial artery was noted in eight female cadavers (11.43%). Out of eight cadavers in three cadavers (4.29%) an unusual bilateral accessory brachial artery arising from the axillary artery and it is continuing in the forearm as superficial accessory ulnar artery was noted. Rare unusual variant unilateral accessory brachial artery and its reunion with the main brachial artery in the cubital fossa and its variable course in relation to the musculocutaneous nerve and median nerve were also noted in five cadavers (7.14%). Conclusion: As per our knowledge such anatomical variations of brachial artery and its terminal branches with their relation to the surrounding structures are not reported in the modern medical literature. An awareness of such a presence is valuable for the surgeons and radiologists in evaluation of angiographic images, vascular and re-constructive surgery or appropriate treatment for compressive neuropathies. PMID:25653931

  5. Learning and study strategies correlate with medical students' performance in anatomical sciences.

    Science.gov (United States)

    Khalil, Mohammed K; Williams, Shanna E; Gregory Hawkins, H

    2018-05-06

    Much of the content delivered during medical students' preclinical years is assessed nationally by such testing as the United States Medical Licensing Examination ® (USMLE ® ) Step 1 and Comprehensive Osteopathic Medical Licensing Examination ® (COMPLEX-USA ® ) Step 1. Improvement of student study/learning strategies skills is associated with academic success in internal and external (USMLE Step 1) examinations. This research explores the strength of association between the Learning and Study Strategies Inventory (LASSI) scores and student performance in the anatomical sciences and USMLE Step 1 examinations. The LASSI inventory assesses learning and study strategies based on ten subscale measures. These subscales include three components of strategic learning: skill (Information processing, Selecting main ideas, and Test strategies), will (Anxiety, Attitude, and Motivation) and self-regulation (Concentration, Time management, Self-testing, and Study aid). During second year (M2) orientation, 180 students (Classes of 2016, 2017, and 2018) were administered the LASSI survey instrument. Pearson Product-Moment correlation analyses identified significant associations between five of the ten LASSI subscales (Anxiety, Information processing, Motivation, Selecting main idea, and Test strategies) and students' performance in the anatomical sciences and USMLE Step 1 examinations. Identification of students lacking these skills within the anatomical sciences curriculum allows targeted interventions, which not only maximize academic achievement in an aspect of an institution's internal examinations, but in the external measure of success represented by USMLE Step 1 scores. Anat Sci Educ 11: 236-242. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

  6. Histological-subtypes and anatomical location correlated in meningeal brain tumors (meningiomas

    Directory of Open Access Journals (Sweden)

    Abdul Rashid Bhat

    2014-01-01

    Full Text Available Context: Not enough literature is available to suggest a link between the histological subtypes of intracranial meningeal brain tumors, called ′meningiomas′ and their location of origin. Aim: The evidence of correlation between the anatomical location of the intracranial meningiomas and the histopathological grades will facilitate specific diagnosis and accurate treatment. Materials and Methods: The retrospective study was conducted in a single high-patient-inflow Neurosurgical Center, under a standard and uniform medical protocol, over a period of 30 years from December 1982 to December 2012. The records of all the operated 729 meningiomas were analyzed from the patient files in the Medical Records Department. The biodata, x-rays, angiography, computed tomography (CT scans, imaging, histopathological reports, and mortality were evaluated and results drawn. Results: The uncommon histopathological types of meningiomas (16.88% had common locations of origin in the sphenoid ridge, posterior parafalcine, jugular foramen, peritorcular and intraventricular regions, cerebellopontine angle, and tentorial and petroclival areas. The histopathological World Health Organization (WHO Grade I (Benign Type meningiomas were noted in 89.30%, WHO Grade II (Atypical Type in 5.90%, and WHO Grade III (Malignant Type in 4.80% of all meningiomas. Meningiomas of 64.60% were found in females, 47.32% were in the age group of 41-50 years, and 3.43% meningiomas were found in children. An overall mortality of 6.04% was noted. WHO Grade III (malignant meningiomas carried a high mortality (25.71% and the most common sites of meningiomas with high mortality were: The cerebellopontine angles, intraventricular region, sphenoid ridge, tuberculum sellae, and the posterior parafalcine areas. Conclusion: The correlation between the histological subtypes and the anatomical location of intracranial meningeal brain tumors, called meningiomas, is evident, but further research is

  7. High resolution ultrasound and magnetic resonance imaging of the optic nerve and the optic nerve sheath: anatomic correlation and clinical importance.

    Science.gov (United States)

    Steinborn, M; Fiegler, J; Kraus, V; Denne, C; Hapfelmeier, A; Wurzinger, L; Hahn, H

    2011-12-01

    We performed a cadaver study to evaluate the accuracy of measurements of the optic nerve and the optic nerve sheath for high resolution US (HRUS) and magnetic resonance imaging (MRI). Five Thiel-fixated cadaver specimens of the optic nerve were examined with HRUS and MRI. Measurements of the optic nerve and the ONSD were performed before and after the filling of the optic nerve sheath with saline solution. Statistical analysis included the calculation of the agreement of measurements and the evaluation of the intraobserver and interobserver variation. Overall a good correlation of measurement values between HRUS and MRI can be found (mean difference: 0.02-0.97 mm). The repeatability coefficient (RC) and concordance correlation coefficient (CCC) values were good to excellent for most acquisitions (RC 0.2-1.11 mm; CCC 0.684-0.949). The highest variation of measurement values was found for transbulbar sonography (RC 0.58-1.83 mm; CCC 0.615/0.608). If decisive anatomic structures are clearly depicted and the measuring points are set correctly, there is a good correlation between HRUS and MRI measurements of the optic nerve and the ONSD even on transbulbar sonography. As most of the standard and cut-off values that have been published for ultrasound are significantly lower than the results obtained with MRI, a reevaluation of sonographic ONSD measurement with correlation to MRI is necessary. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Behavioral and anatomical characterization of the bilateral sciatic nerve chronic constriction (bCCI) injury: correlation of anatomic changes and responses to cold stimuli

    OpenAIRE

    Datta, Sukdeb; Chatterjee, Koel; Kline, Robert H; Wiley, Ronald G

    2010-01-01

    Abstract Background Unilateral constrictive sciatic nerve injury (uCCI) is a common neuropathic pain model. However, the bilateral constrictive injury (bCCI) model is less well studied, and shows unique characteristics. In the present study, we sought to correlate effects of bCCI on nocifensive responses to cold and mechanical stimuli with selected dorsal horn anatomic markers. bCCI or sham ligation of both rat sciatic nerves were followed up to 90 days of behavioural testing. Additional rats...

  9. The posterolateral mid-forearm perforator flap: anatomical study and clinical application.

    Science.gov (United States)

    Zhuang, Yue-Hong; Lin, Jian; Fu, Fei-Huan; Cai, Zhen-De; Huang, Hui-Mei; Zheng, He-Ping

    2013-11-01

    Defects sustained at the distal forearm are common and pedicled perforator flaps have unique advantages in resurfacing it. The purpose of this study is to reappraise the anatomy of the perforator in the posterolateral aspect of the mid-forearm and present our clinical experience on using perforator flaps based on it for reconstruction of defects in the distal forearm. This study was divided into anatomical study and clinical application. In the anatomical study, 30 preserved upper limbs were used. Clinically, 11 patients with defects at the forearm underwent reconstruction with the posterolateral mid-forearm perforator flaps. The defects, ranging from 4.5 × 2.5 cm to 10.5 × 4.5 cm, were located at the dorsal aspect of the distal forearm in 6 cases and at the volar aspect of the distal forearm in 5 cases. Three patterns of the perforator were observed in the posterolateral aspect of the mid-forearm, which originated from the posterior interosseous artery, the proximal segment of the radial artery or the radial recurrent artery, and the middle segment of the radial artery, respectively. The perforator was located 11.8 ± 0.2 cm to 15.8 ± 0.4 cm inferior to the lateral humeral epicondyle. Clinically, flaps in 8 cases survived uneventfully, while the other 3 cases suffered mild marginal epidermal necrosis, which was cured with continuous dress changing. The location of the perforator at the posterolateral aspect of the mid-forearm is consistent; the posterolateral mid-forearm perforator flap is particularly suitable to cover defects in the distal one-third of the forearm. Copyright © 2013 Wiley Periodicals, Inc.

  10. The new vestibular stimuli: sound and vibration-anatomical, physiological and clinical evidence.

    Science.gov (United States)

    Curthoys, Ian S

    2017-04-01

    The classical view of the otoliths-as flat plates of fairly uniform receptors activated by linear acceleration dragging on otoconia and so deflecting the receptor hair bundles-has been replaced by new anatomical and physiological evidence which shows that the maculae are much more complex. There is anatomical spatial differentiation across the macula in terms of receptor types, hair bundle heights, stiffness and attachment to the overlying otolithic membrane. This anatomical spatial differentiation corresponds to the neural spatial differentiation of response dynamics from the receptors and afferents from different regions of the otolithic maculae. Specifically, receptors in a specialized band of cells, the striola, are predominantly type I receptors, with short, stiff hair bundles and looser attachment to the overlying otoconial membrane than extrastriolar receptors. At the striola the hair bundles project into holes in the otolithic membrane, allowing for fluid displacement to deflect the hair bundles and activate the cell. This review shows the anatomical and physiological evidence supporting the hypothesis that fluid displacement, generated by sound or vibration, deflects the short stiff hair bundles of type I receptors at the striola, resulting in neural activation of the irregular afferents innervating them. So these afferents are activated by sound or vibration and show phase-locking to individual cycles of the sound or vibration stimulus up to frequencies above 2000 Hz, underpinning the use of sound and vibration for clinical tests of vestibular function.

  11. Clinical significance of the position of dorsal root ganglia in degenerative lumbar diseases. Correlation between anatomic study and imaging study with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Masahiro; Kikuchi, Tomiichi [Fukushima Medical Coll., Matsuoka (Japan)

    1995-06-01

    In order to estimate the ralationship between the position of dorsal root ganglia (DRG) and radicular symptoms, anatomical study was done on 81 cadavers, and a clinical study with MRI was done on 20 cases of lumbar disc herniation and 20 of lumbar spondylosis with L{sub 5} radiculopathy. The position of DRG is not related to the occurrence of radicular symptoms in disc herniation, while in lumbar spondylosis proximally placed DRG are related to both of unilateral and bilateral occurrence of redicular symptoms. Unilateral occurrence of radicular symptoms is influenced by surrounding tissues of the nerve root, rather than the position of DRG. (author).

  12. Clinical significance of the position of dorsal root ganglia in degenerative lumbar diseases. Correlation between anatomic study and imaging study with MRI

    International Nuclear Information System (INIS)

    Seki, Masahiro; Kikuchi, Tomiichi

    1995-01-01

    In order to estimate the ralationship between the position of dorsal root ganglia (DRG) and radicular symptoms, anatomical study was done on 81 cadavers, and a clinical study with MRI was done on 20 cases of lumbar disc herniation and 20 of lumbar spondylosis with L 5 radiculopathy. The position of DRG is not related to the occurrence of radicular symptoms in disc herniation, while in lumbar spondylosis proximally placed DRG are related to both of unilateral and bilateral occurrence of redicular symptoms. Unilateral occurrence of radicular symptoms is influenced by surrounding tissues of the nerve root, rather than the position of DRG. (author)

  13. Determining customer satisfaction in anatomic pathology.

    Science.gov (United States)

    Zarbo, Richard J

    2006-05-01

    Measurement of physicians' and patients' satisfaction with laboratory services has become a standard practice in the United States, prompted by national accreditation requirements. Unlike other surveys of hospital-, outpatient care-, or physician-related activities, no ongoing, comprehensive customer satisfaction survey of anatomic pathology services is available for subscription that would allow continual benchmarking against peer laboratories. Pathologists, therefore, must often design their own local assessment tools to determine physician satisfaction in anatomic pathology. To describe satisfaction survey design that would elicit specific information from physician customers about key elements of anatomic pathology services. The author shares his experience in biannually assessing customer satisfaction in anatomic pathology with survey tools designed at the Henry Ford Hospital, Detroit, Mich. Benchmarks for physician satisfaction, opportunities for improvement, and characteristics that correlated with a high level of physician satisfaction were identified nationally from a standardized survey tool used by 94 laboratories in the 2001 College of American Pathologists Q-Probes quality improvement program. In general, physicians are most satisfied with professional diagnostic services and least satisfied with pathology services related to poor communication. A well-designed and conducted customer satisfaction survey is an opportunity for pathologists to periodically educate physician customers about services offered, manage unrealistic expectations, and understand the evolving needs of the physician customer. Armed with current information from physician customers, the pathologist is better able to strategically plan for resources that facilitate performance improvements in anatomic pathology laboratory services that align with evolving clinical needs in health care delivery.

  14. Variability in anatomical features of human clavicle: Its forensic anthropological and clinical significance

    Directory of Open Access Journals (Sweden)

    Jagmahender Singh Sehrawat

    2016-06-01

    Full Text Available Bones can reflect the basic framework of human body and may provide valuable information about the biological identity of the deceased. They, often, survive the morphological alterations, taphonomic destructions, decay/mutilation and decomposition insults. In-depth knowledge of variations in clavicular shape, size and its dimensions is very important from both clinical (fixation of clavicular fractures using external or inter-medullary devices, designing orthopedic fixation devices as well as forensic anthropological perspectives. Human clavicle is the most frequently fractured bone of human skeleton, possessing high degree of variability in its anatomical, biomechanical and morphological features. Extended period of skeletal growth (up to third decade in clavicle imparts it an additional advantage for forensic identification purposes. In present study, five categories of clavicular features like lengths, diameters, angles, indices and robustness were examined to explore the suitability of collarbone for forensic and clinical purposes. For this purpose, 263 pairs of adult clavicles (195 Males and 68 Females were collected from autopsied cadavers and were studied for 13 anatomical features. Gender and occupational affiliations of cadavers were found to have significant influences on anatomical dimensions of their clavicles. Product index, weight and circumference of collarbone were found the best univariate variables, discriminating sex of more than 80% individuals. The best multivariate Function-I (DF: -17.315 + 0.054 CL-L+0.196 CC-R+0.184 DM-L could identify sex and occupation of 89.4% (89.2% Male and 89.7% Female and 65.4% individuals, respectively. All clavicular variables were found bilaterally asymmetric; left clavicles being significantly longer in length, lighter in weight, smooth in texture and less curved than the right side bones. Among non-metric traits, sub-clavian groove, nutrient foramina and ‘type’ of clavicle exhibited

  15. MECHANOGENESIS AND CLINICAL-ANATOMICAL CHARACTERISTICS OF HAND CONTACT BLAST INJURY IN PEACE AND WAR TIME

    Directory of Open Access Journals (Sweden)

    N. F. Fomin

    2011-01-01

    Full Text Available Thorough research has been done on the characteristics of surgical anatomy and mechanogenesis of the explosion-related hand injuries received during military campaigns and in non-military explosion-related accidents. This research consisted of clinical, statistical and experimental-anatomical parts. 241 patient data files of the wounded during the military campaign in Afghanistan have been analysed as well as 70 patient data files of the injured in non-military explosion-related accidents. The most common, according to the patient data analysis, morphological variations of the explosion-related hand injuries were simulated during 24 in-field experiments by exploding hands of cadavers. The characteristics of the explosion-related hand injuries were analysed using radiography and precision preparation of the extremities after the in-field experiments. The correlations between the hand damage levels, the types of explosive materials, their orientation and position in hand during explosion have been identified.

  16. Clinical repercussions of Martin-Gruber anastomosis: anatomical study

    Directory of Open Access Journals (Sweden)

    Cristina Schmitt Cavalheiro

    2016-04-01

    Full Text Available OBJECTIVE: The main objective of this study was to describe Martin-Gruber anastomosis anatomically and to recognize its clinical repercussions. METHOD: 100 forearms of 50 adult cadavers were dissected in an anatomy laboratory. The dissection was performed by means of a midline incision along the entire forearm and the lower third of the upper arm. Two flaps including skin and subcutaneous tissue were folded back on the radial and ulnar sides, respectively. RESULTS: Nerve communication between the median and ulnar nerves in the forearm (Martin-Gruber anastomosis was found in 27 forearms. The anastomosis was classified into six types: type I: anastomosis between the anterior interosseous nerve and the ulnar nerve (n = 9; type II: anastomosis between the anterior interosseous nerve and the ulnar nerve at two points (double anastomosis (n = 2; type III: anastomosis between the median nerve and the ulnar nerve (n = 4; type IV: anastomosis between branches of the median nerve and ulnar nerve heading toward the flexor digitorum profundus muscle of the fingers; these fascicles form a loop with distal convexity (n = 5; type V: intramuscular anastomosis (n = 5; and type VI: anastomosis between a branch of the median nerve to the flexor digitorum superficialis muscle and the ulnar nerve (n = 2. CONCLUSION: Knowledge of the anatomical variations relating to the innervation of the hand has great importance, especially with regard to physical examination, diagnosis, prognosis and surgical treatment. If these variations are not given due regard, errors and other consequences will be inevitable.

  17. Clinical and radiological outcomes after a quasi-anatomical reconstruction of medial patellofemoral ligament with gracilis tendon autograft.

    Science.gov (United States)

    Monllau, Joan C; Masferrer-Pino, Àngel; Ginovart, Gerard; Pérez-Prieto, Daniel; Gelber, Pablo E; Sanchis-Alfonso, Vicente

    2017-08-01

    To analyse the clinical and radiological outcomes of a quasi-anatomical reconstruction of the medial patellofemoral ligament (MPFL) with a gracilis tendon autograft. Patients with objective recurrent patellar instability that were operated on from 2006 to 2012 were included. A quasi-anatomical surgical technique was performed using a gracilis tendon autograft. It was anatomically attached at the patella, and the adductor magnus tendon was also used as a pulley for femoral fixation (non-anatomical reconstruction). The IKDC, Kujala and Lysholm scores as well as Tegner and VAS for pain were collected preoperatively and at final follow-up. Radiographic measurements of patellar position tilt and signs of osteoarthritis (OA) as well as trochlear dysplasia were also recorded. Thirty-six patients were included. The mean age at surgery was 25.6 years. After a minimum 27 months of follow-up, all functional scores significantly improved (p patellofemoral surfaces at the short term, as shown by the absence of radiological signs of OA in the CT scan. The procedure has been shown to be safe and suitable for the treatment of chronic patellar instability, including in adolescents with open physis. A new effective, inexpensive and easy-to-perform technique is described to reconstruct MPFL in the daily clinical practice. Therapeutic case series, Level IV.

  18. A study of biceps brachii muscle: Anatomical considerations and clinical implications

    Directory of Open Access Journals (Sweden)

    Vaishaly Kishore Bharambe

    2015-01-01

    Full Text Available Context: Biceps brachii muscle (BBm is a very variable muscle, the variations being associated with a variety of clinical conditions. This study delves on anatomical variations in this muscle, possible phylogenic causes for their frequency and their clinical importance. Aims: The aim was to study anatomy of bicep brachii muscle, its variations and their clinical importance. Subjects and Methods: A total of 60 upper limbs preserved in 10% formalin were dissected meticulously to study anatomical details of the BBm. Results: The incidence of variation in anatomy of BBm was 15%, with incidence being 11.6% and 3.3% among male and female cadavers studied, respectively. Variation was unilateral in 10% and bilateral in 3.3%. The incidence of third head was 13.3% out of which 3.3% took origin from the capsule of the shoulder joint, 8.3% from humerus, and 1.6% from brachialis muscle. Incidence of extra bellies of insertion was found to be 1.6%. A 3.3% incidence was observed in the nerve supply. Conclusions: Variations in BBm are a reflection of its late development in human phylum. The extra bellies can cause neurovascular compression, change the kinematics at the elbow joint and be misinterpreted as tears of muscle on magnetic resonance imaging. They should be watched for in the shoulder as well as elbow joint surgeries. The authors suggest that the extra bellies of BBm instead of being labeled as third, fourth or fifth heads, can be classified as those of origin and insertion and bellies of origin be referred to clearly as capsular, humeral or brachial heads.

  19. Anatomic Boundaries of the Clinical Target Volume (Prostate Bed) After Radical Prostatectomy

    International Nuclear Information System (INIS)

    Wiltshire, Kirsty L.; Brock, Kristy K.; Haider, Masoom A.; Zwahlen, Daniel; Kong, Vickie; Chan, Elisa; Moseley, Joanne; Bayley, Andrew; Catton, Charles; Chung, Peter W.M.; Gospodarowicz, Mary; Milosevic, Michael; Kneebone, Andrew; Warde, Padraig; Menard, Cynthia

    2007-01-01

    Purpose: We sought to derive and validate an interdisciplinary consensus definition for the anatomic boundaries of the postoperative clinical target volume (CTV, prostate bed). Methods and Materials: Thirty one patients who had planned for radiotherapy after radical prostatectomy were enrolled and underwent computed tomography and magnetic resonance imaging (MRI) simulation prior to radiotherapy. Through an iterative process of consultation and discussion, an interdisciplinary consensus definition was derived based on a review of published data, patterns of local failure, surgical practice, and radiologic anatomy. In validation, we analyzed the distribution of surgical clips in reference to the consensus CTV and measured spatial uncertainties in delineating the CTV and vesicourethral anastomosis. Clinical radiotherapy plans were retrospectively evaluated against the consensus CTV (prostate bed). Results: Anatomic boundaries of the consensus CTV (prostate bed) are described. Surgical clips (n = 339) were well distributed throughout the CTV. The vesicourethral anastomosis was accurately localized using central sagittal computed tomography reconstruction, with a mean ± standard deviation uncertainty of 1.8 ± 2.5 mm. Delineation uncertainties were small for both MRI and computed tomography (mean reproducibility, 0-3.8 mm; standard deviation, 1.0-2.3); they were most pronounced in the anteroposterior and superoinferior dimensions and at the superior/posterior-most aspect of the CTV. Retrospectively, the mean ± standard deviation CTV (prostate bed) percentage of volume receiving 100% of prescribed dose was only 77% ± 26%. Conclusions: We propose anatomic boundaries for the CTV (prostate bed) and present evidence supporting its validity. In the absence of gross recurrence, the role of MRI in delineating the CTV remains to be confirmed. The CTV is larger than historically practiced at our institution and should be encompassed by a microscopic tumoricidal dose

  20. Radio-guided sentinel lymph node identification by lymphoscintigraphy fused with an anatomical vector profile: clinical applications.

    Science.gov (United States)

    Niccoli Asabella, A; Antonica, F; Renna, M A; Rubini, D; Notaristefano, A; Nicoletti, A; Rubini, G

    2013-12-01

    To develop a method to fuse lymphoscintigraphic images with an adaptable anatomical vector profile and to evaluate its role in the clinical practice. We used Adobe Illustrator CS6 to create different vector profiles, we fused those profiles, using Adobe Photoshop CS6, with lymphoscintigraphic images of the patient. We processed 197 lymphoscintigraphies performed in patients with cutaneous melanomas, breast cancer or delayed lymph drainage. Our models can be adapted to every patient attitude or position and contain different levels of anatomical details ranging from external body profiles to the internal anatomical structures like bones, muscles, vessels, and lymph nodes. If needed, more new anatomical details can be added and embedded in the profile without redrawing them, saving a lot of time. Details can also be easily hidden, allowing the physician to view only relevant information and structures. Fusion times are about 85 s. The diagnostic confidence of the observers increased significantly. The validation process showed a slight shift (mean 4.9 mm). We have created a new, practical, inexpensive digital technique based on commercial software for fusing lymphoscintigraphic images with built-in anatomical reference profiles. It is easily reproducible and does not alter the original scintigraphic image. Our method allows a more meaningful interpretation of lymphoscintigraphies, an easier recognition of the anatomical site and better lymph node dissection planning.

  1. Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle

    Directory of Open Access Journals (Sweden)

    Flavia Emi Akamatsu

    2017-01-01

    Full Text Available Myofascial pain syndrome is characterized by pain and limited range of motion in joints and caused by muscular contracture related to dysfunctional motor end plates and myofascial trigger points (MTrPs. We aimed to observe the anatomical correlation between the clinically described MTrPs and the entry point of the branches of the inferior gluteal nerve into the gluteus maximus muscle. We dissected twenty gluteus maximus muscles from 10 human adult cadavers (5 males and 5 females. We measured the muscles and compiled the distribution of the nerve branches into each of the quadrants of the muscle. Statistical analysis was performed by using Student’s t-test and Kruskal-Wallis tests. Although no difference was observed either for muscle measurements or for distribution of nerve branching among the subjects, the topography of MTrPs matched the anatomical location of the entry points into the muscle. Thus, anatomical substract of the MTrPs may be useful for a better understanding of the physiopathology of these disorders and provide basis for their surgical and clinical treatment.

  2. Cement stress predictions after anatomic total shoulder arthroplasty are correlated with preoperative glenoid bone quality.

    Science.gov (United States)

    Terrier, Alexandre; Obrist, Raphaël; Becce, Fabio; Farron, Alain

    2017-09-01

    We hypothesized that biomechanical parameters typically associated with glenoid implant failure after anatomic total shoulder arthroplasty (aTSA) would be correlated with preoperative glenoid bone quality. We developed an objective automated method to quantify preoperative glenoid bone quality in different volumes of interest (VOIs): cortical bone, subchondral cortical plate, subchondral bone after reaming, subchondral trabecular bone, and successive layers of trabecular bone. Average computed tomography (CT) numbers (in Hounsfield units [HU]) were measured in each VOI from preoperative CT scans. In parallel, we built patient-specific finite element models of simulated aTSAs to predict cement stress, bone-cement interfacial stress, and bone strain around the glenoid implant. CT measurements and finite element predictions were obtained for 20 patients undergoing aTSA for primary glenohumeral osteoarthritis. We tested all linear correlations between preoperative patient characteristics (age, sex, height, weight, glenoid bone quality) and biomechanical predictions (cement stress, bone-cement interfacial stress, bone strain). Average CT numbers gradually decreased from cortical (717 HU) to subchondral and trabecular (362 HU) bone. Peak cement stress (4-10 MPa) was located within the keel hole, above the keel, or behind the glenoid implant backside. Cement stress, bone-cement interfacial stress, and bone strain were strongly negatively correlated with preoperative glenoid bone quality, particularly in VOIs behind the implant backside (subchondral trabecular bone) but also in deeper trabecular VOIs. Our numerical study suggests that preoperative glenoid bone quality is an important parameter to consider in aTSA, which may be associated with aseptic loosening of the glenoid implant. These initial results should now be confronted with clinical and radiologic outcomes. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc

  3. Tendons in the plantar aspect of the foot: MR imaging and anatomic correlation in cadavers

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Rodrigo [University of California San Diego, Radiology, San Diego, CA (United States); Fleury Medical Center, Radiology, Sao Paulo, SP (Brazil); Aguiar, Rodrigo; Trudell, Debra; Resnick, Donald [University of California San Diego, Radiology, San Diego, CA (United States)

    2007-02-15

    The purpose of this anatomic imaging study was to illustrate the normal complex anatomy of tendons of the plantar aspect of the ankle and foot using magnetic resonance (MR) imaging with anatomic correlation in cadavers. Seven fresh cadaveric feet (obtained and used according to institutional guidelines, with informed consent from relatives of the deceased) were studied with intermediate-weighted fast-spin-echo MR imaging. For anatomic analysis, cadaveric specimens were sectioned in 3-mm-thick slices in the coronal and axial planes that approximated the sections acquired at MR imaging. The entire courses of the tendons into the plantar aspect of the foot were analyzed. The tibialis posterior tendon has a complex distal insertion. The insertions in the navicular, second, and third cuneiforms bones were identify in all cases using axial and coronal planes. A tendinous connection between the flexor hallucis longus and the flexor digitorum longus tendons was identified in five of our specimens (71%). The coronal plane provided the best evaluation. The peroneus longus tendon changes its direction at three points then obliquely crosses the sole and inserts in the base of the first metatarsal bone and the plantar aspect of the first cuneiform. MR imaging provides detailed information about the anatomy of tendons in the plantar aspect of the ankle and foot. It allows analysis of their insertions and the intertendinous connection between the flexor hallucis longus and the flexor digitorum longus tendons. (orig.)

  4. Vascularized bone graft in scaphoid fractures. Anatomical details and clinical indications. A cases series

    International Nuclear Information System (INIS)

    Vergara A, Enrique

    2007-01-01

    The fracture of scaphoid continues being a challenge for orthopedist and hand surgeons. Objective. To show the anatomical details of the bony strip from the second metacarpal in corpses injected with green latex and the results of the surgical technique in a series of patients with scaphoid pseudarthrosis. Materials and methods. We carry out an initial anatomical analysis before employing the surgical technique in clinical setting, and then we did a descriptive study of patients with pseudarthrosis of scaphoid,treated with vascularized bony graft by the first metacarpal artery. Results. All patients consolidated and improved in the pain scale, they did not have mobility deterioration or residual carpus instability, after ten years of observations. Conclusions. The vascularized graft is a useful option in the management of the pseudarthrosis of the scaphoid.

  5. A Comparative Study of Deep Neck Abscess with Regards to Anatomical Location and Age Groups Using CT and Clinical Data

    International Nuclear Information System (INIS)

    Park, Chan Ho; Han, Jong Kyu; Kim, Young Tong; Shin, Hyeong Cheol; Kim, Hyung Hwan; Jou, Sung Shick

    2012-01-01

    To evaluate differences anatomical location and age groups on CT and clinical data in deep neck abscess. This study included 200 patients who underwent CT and were diagnosed with a deep neck abscess, from December 2005 to July 2010. Patients were divided into four groups by age (children, adolescent, adult, elderly). Next, the anatomic location, location multiplicity and clinical data regarding the deep neck abscesses were analyzed retrospectively. The deep neck abscesses observed were defined as superficial or deep and partitioned into sub-groups, with further analysis of their clinical data. The incidence of the parapharyngeal abscess was more frequent in children and elderly groups (p < 0.05). The masticator abscess was only observed among patients in the elderly group (p < 0.05). Multiple locations were observed with increased frequency in children and elderly groups (p < 0.05). Swelling in the neck was more frequently observed in children and elderly groups (p < 0.05), cervical lymphadenitis was frequently seen in children and adolescent groups (p < 0.05), and the incidence of symptoms including sore throat were significantly increased in adolescent and adult groups (p < 0.05). Location multiplicity was significantly higher in parapharyngeal, retropharyngeal, submandibular, danger, visceral and masticator spaces than other spaces (p < 0.05). With regards to anatomic location, neck swelling was more frequent in superficial group and sore throat was more frequent in deep group (p < 0.05). Deep neck abscess would show significant differences with regards to the abscess location, location multiplicity, and clinical symptoms according to age. The clinical symptoms observed are dependent on the anatomic location as defined by a superficial or deep abscess.

  6. Evaluation of Mayer-Rokitansky-Kuester-Hauser syndrome with magnetic resonance imaging: Three patterns of uterine remnants and related anatomical features and clinical settings

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yue; Lu, Jingjing; Jiang, Bo; Feng, Feng; Jin, Zhengyu [Peking Union Medical College, Chinese Academy of Medical Sciences, Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Zhu, Lan; Sun, Zhijing [Chinese Academy of Medical Sciences, Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Bejing (China)

    2017-12-15

    To characterize the anatomical features and clinical settings of Mayer-Rokitansky-Kuester-Hauser (MRKH) syndrome and correlate them with patterns of uterine involvement. Pelvic magnetic resonance images and medical records of 92 MRKH patients were retrospectively reviewed. Patients were subgrouped by uterine morphology: uterine agenesis, unilateral rudimentary uterus and bilateral rudimentary uteri. Uterine volume, presence of endometrium, location of ovary, endometriosis and pelvic pain were compared among groups. The mean uterine volume was 33.5 ml (17.5-90.0 ml) for unilateral uterine remnants, and 16.1 ml (3.5-21.5 ml) for bilateral uterine rudiments (p<0.01). The incidence of presence of endometrium (100% vs. 22%, p<0.001), haematometra (56% vs. 3%, p<0.001) and ovarian endometriosis (22% vs. 3%, p<0.01) was significantly increased in the group of unilateral rudimentary uteri as compared with the group of bilateral uterine remnants. Thirty-one patients (38%) showed ectopic ovaries. Pelvic pain was more common in individuals with unilateral rudimentary uterus than those who had no (56% vs. 5%, p<0.01) or bilateral uterine remnants (56% vs. 14%, p<0.05). MRKH patients with different patterns of uterine involvement may have differentiated anatomical features and clinical settings. (orig.)

  7. Anatomic Dissection of Arachnoid Membranes Encircling the Pituitary Stalk on Fresh, Non-Formalin-Fixed Specimens: Anatomoradiologic Correlations and Clinical Applications in Craniopharyngioma Surgery.

    Science.gov (United States)

    Ciappetta, Pasqualino; Pescatori, Lorenzo

    2017-12-01

    The anatomy of the arachnoid membranes and cisternal spaces around the pituitary stalk has not been yet exhaustively described and understood. In this study, we performed a detailed anatomic study on fresh, non-formalin-fixed cadavers of the arachnoid membranes encircling the pituitary stalk and correlate our anatomic findings with magnetic resonance imaging (MRI). Ten fresh, non-formalin-fixed, non-silicon-injected adult cadaveric heads were analyzed in this study. The membrane and cisterns that were studied for our study were as follows: 1) the diaphragma sellae and its dural components; 2) the basal arachnoid membrane; 3) the Liliequist membrane with its diencephalic and mesencephalic portion; 4) the medial carotid membrane; 5) the chiasmatic cistern; and 6) the pituitary stalk. MRI examinations of the sellar region were performed in 15 healthy volunteers (9 men, mean age 40 years; and 6 women mean age, 37 years) to visualize the arachnoid membrane encircling the pituitary stalk. MRI examinations were performed with a 3-T unit. A 3-dimensional constructive interference in steady state pulse magnetic resonance sequence was used. All the membranes examined were visualized clearly in all the dissections performed. Their 3-dimensional organization around the pituitary stalk was clarified and confirmed by MRI. Our study gives a detailed description of the pituitary stalk arachnoid sheets on fresh, non-formalin-fixed cadavers. This technique allowed us to clearly identify a funnel-shaped arachnoid collar encircling the pituitary stalk and delimiting a distinct cisternal space belonging to the stalk itself. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Clinical significance of pneumatosis intestinalis - correlation of MDCT-findings with treatment and outcome

    Energy Technology Data Exchange (ETDEWEB)

    Treyaud, Marc-Olivier; Duran, Rafael; Knebel, Jean-Francois; Meuli, Reto A.; Schmidt, Sabine [Lausanne University Hospital, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Zins, Marc [Fondation Hopital St Joseph, Department of Radiology, Paris (France)

    2017-01-15

    To evaluate the clinical significance of pneumatosis intestinalis (PI) including the influence on treatment and outcome. Two radiologists jointly reviewed MDCT-examinations of 149 consecutive emergency patients (53 women, mean age 64, range 21-95) with PI of the stomach (n = 4), small (n = 68) and/or large bowel (n = 96). PI extension, distribution and possibly associated porto-mesenteric venous gas (PMVG) were correlated with other MDCT-findings, risk factors, clinical management, laboratory, histopathology, final diagnosis and outcome. The most frequent cause of PI was intestinal ischemia (n = 80,53.7 %), followed by infection (n = 18,12.1 %), obstructive (n = 12,8.1 %) and non-obstructive (n = 10,6.7 %) bowel dilatation, unknown aetiologies (n = 8,5.4 %), drugs (n = 8,5.4 %), inflammation (n = 7,4.7 %), and others (n = 6,4 %). Neither PI distribution nor extension significantly correlated with underlying ischemia. Overall mortality was 41.6 % (n = 62), mostly related to intestinal ischemia (p = 0.003). Associated PMVG significantly correlated with underlying ischemia (p = 0.009), as did the anatomical distribution of PMVG (p = 0.015). Decreased mural contrast-enhancement was the only other MDCT-feature significantly associated with ischemia (p p < 0.001). Elevated white blood count significantly correlated with ischemia (p = 0.03). In emergency patients, ischemia remains the most common aetiology of PI, showing the highest mortality. PI with associated PMVG is an alerting sign. PI together with decreased mural contrast-enhancement indicates underlying ischemia. (orig.)

  9. Behavioral and anatomical characterization of the bilateral sciatic nerve chronic constriction (bCCI) injury: correlation of anatomic changes and responses to cold stimuli.

    Science.gov (United States)

    Datta, Sukdeb; Chatterjee, Koel; Kline, Robert H; Wiley, Ronald G

    2010-01-27

    Unilateral constrictive sciatic nerve injury (uCCI) is a common neuropathic pain model. However, the bilateral constrictive injury (bCCI) model is less well studied, and shows unique characteristics. In the present study, we sought to correlate effects of bCCI on nocifensive responses to cold and mechanical stimuli with selected dorsal horn anatomic markers. bCCI or sham ligation of both rat sciatic nerves were followed up to 90 days of behavioural testing. Additional rats sacrificed at 15, 30 and 90 days were used for anatomic analyses. Behavioural tests included hindpaw withdrawal responses to topical acetone, cold plate testing, an operant thermal preference task and hindpaw withdrawal thresholds to mechanical probing. All nocifensive responses to cold increased and remained enhanced for >45 days. Mechanical withdrawal thresholds decreased for 25 days only. Densitometric analyses of immunoperoxidase staining in the superficial dorsal horn at L4-5 revealed decreased cholecystokinin (CCK) staining at all times after bCCI, decreased mu opiate receptor (MOR) staining, maximal at 15 days, increased neuropeptide Y (NPY) staining only at days 15 and 30, and increased neurokinin-1 receptor (NK-1R) staining at all time points, maximal at 15 days. Correlation analyses at 45 days post-bCCI, were significant for individual rat nocifensive responses in each cold test and CCK and NK-1R, but not for MOR or NPY. These results confirm the usefulness of cold testing in bCCI rats, a new approach using CCI to model neuropathic pain, and suggest a potential value of studying the roles of dorsal horn CCK and substance P in chronic neuropathic pain. Compared to human subjects with neuropathic pain, responses to cold stimuli in rats with bCCI may be a useful model of neuropathic pain.

  10. Behavioral and anatomical characterization of the bilateral sciatic nerve chronic constriction (bCCI injury: correlation of anatomic changes and responses to cold stimuli

    Directory of Open Access Journals (Sweden)

    Kline Robert H

    2010-01-01

    Full Text Available Abstract Background Unilateral constrictive sciatic nerve injury (uCCI is a common neuropathic pain model. However, the bilateral constrictive injury (bCCI model is less well studied, and shows unique characteristics. In the present study, we sought to correlate effects of bCCI on nocifensive responses to cold and mechanical stimuli with selected dorsal horn anatomic markers. bCCI or sham ligation of both rat sciatic nerves were followed up to 90 days of behavioural testing. Additional rats sacrificed at 15, 30 and 90 days were used for anatomic analyses. Behavioural tests included hindpaw withdrawal responses to topical acetone, cold plate testing, an operant thermal preference task and hindpaw withdrawal thresholds to mechanical probing. Results All nocifensive responses to cold increased and remained enhanced for >45 days. Mechanical withdrawal thresholds decreased for 25 days only. Densitometric analyses of immunoperoxidase staining in the superficial dorsal horn at L4-5 revealed decreased cholecystokinin (CCK staining at all times after bCCI, decreased mu opiate receptor (MOR staining, maximal at 15 days, increased neuropeptide Y (NPY staining only at days 15 and 30, and increased neurokinin-1 receptor (NK-1R staining at all time points, maximal at 15 days. Correlation analyses at 45 days post-bCCI, were significant for individual rat nocifensive responses in each cold test and CCK and NK-1R, but not for MOR or NPY. Conclusions These results confirm the usefulness of cold testing in bCCI rats, a new approach using CCI to model neuropathic pain, and suggest a potential value of studying the roles of dorsal horn CCK and substance P in chronic neuropathic pain. Compared to human subjects with neuropathic pain, responses to cold stimuli in rats with bCCI may be a useful model of neuropathic pain.

  11. Anatomic mapping of molecular subtypes in diffuse glioma.

    Science.gov (United States)

    Tang, Qisheng; Lian, Yuxi; Yu, Jinhua; Wang, Yuanyuan; Shi, Zhifeng; Chen, Liang

    2017-09-15

    Tumor location served as an important prognostic factor in glioma patients was considered to postulate molecular features according to cell origin theory. However, anatomic distribution of unique molecular subtypes was not widely investigated. The relationship between molecular phenotype and histological subgroup were also vague based on tumor location. Our group focuses on the study of glioma anatomic location of distinctive molecular subgroups and histology subtypes, and explores the possibility of their consistency based on clinical background. We retrospectively reviewed 143 cases with both molecular information (IDH1/TERT/1p19q) and MRI images diagnosed as cerebral diffuse gliomas. The anatomic distribution was analyzed between distinctive molecular subgroups and its relationship with histological subtypes. The influence of tumor location, molecular stratification and histology diagnosis on survival outcome was investigated as well. Anatomic locations of cerebral diffuse glioma indicate varied clinical outcome. Based on that, it can be stratified into five principal molecular subgroups according to IDH1/TERT/1p19q status. Triple-positive (IDH1 and TERT mutation with 1p19q codeletion) glioma tended to be oligodendroglioma present with much better clinical outcome compared to TERT mutation only group who is glioblastoma inclined (median overall survival 39 months VS 18 months). Five molecular subgroups were demonstrated with distinctive locational distribution. This kind of anatomic feature is consistent with its corresponding histological subtypes. Each molecular subgroup in glioma has unique anatomic location which indicates distinctive clinical outcome. Molecular diagnosis can be served as perfect complementary tool for the precise diagnosis. Integration of histomolecular diagnosis will be much more helpful in routine clinical practice in the future.

  12. Impact of clinical factors on the long-term functional and anatomic outcomes of osteo-odonto-keratoprosthesis and tibial bone keratoprosthesis.

    Science.gov (United States)

    De La Paz, María Fideliz; De Toledo, Juan Álvarez; Charoenrook, Victor; Sel, Saadettin; Temprano, José; Barraquer, Rafael I; Michael, Ralph

    2011-05-01

    To report the long-term functional and anatomic outcomes of osteo-odonto-keratoprosthesis and tibial bone keratoprosthesis; to analyze the influence of clinical factors, such as surgical technique, primary diagnosis, age, and postoperative complications, on the final outcome. Retrospective cohort study. setting: Centro de Oftalmología Barraquer, between 1974 and 2005. Two hundred twenty-seven patients. intervention: Biological keratoprosthesis using osteo-odonto-keratoprosthesis or tibial bone keratoprosthesis. main outcome measures: Functional survival with success defined as best-corrected visual acuity ≥0.05; anatomic survival with success defined as retention of the keratoprosthesis lamina. Osteo-odonto-keratoprosthesis and tibial bone keratoprosthesis have comparable anatomic survival at 5 and 10 years of follow-up, but osteo-odonto-keratoprosthesis has a significantly better functional success than tibial bone keratoprosthesis at the same time periods. Among the primary diagnoses, Stevens-Johnson syndrome, chemical burn, and trachoma have generally good functional and anatomic outcomes and the least favorable prognosis is for ocular cicatricial pemphigoid. Younger patients fared better than those in older age groups. The most frequent complications were extrusion (28%), retinal detachment (16%), and uncontrolled glaucoma (11%). The glaucoma group had the best anatomic success but the worst functional results, only exceeded by the retinal detachment group in terms of functional outcome. Clinical factors, such as surgical technique, primary diagnosis, age, and postoperative complications, can affect the long-term anatomic and functional successes of biological keratoprosthesis. Knowledge about the impact of each of these factors on survival can help surgeons determine the best approach in every particular case. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Mutational analysis and clinical correlation of metastatic colorectal cancer.

    Science.gov (United States)

    Russo, Andrea L; Borger, Darrell R; Szymonifka, Jackie; Ryan, David P; Wo, Jennifer Y; Blaszkowsky, Lawrence S; Kwak, Eunice L; Allen, Jill N; Wadlow, Raymond C; Zhu, Andrew X; Murphy, Janet E; Faris, Jason E; Dias-Santagata, Dora; Haigis, Kevin M; Ellisen, Leif W; Iafrate, Anthony J; Hong, Theodore S

    2014-05-15

    Early identification of mutations may guide patients with metastatic colorectal cancer toward targeted therapies that may be life prolonging. The authors assessed tumor genotype correlations with clinical characteristics to determine whether mutational profiling can account for clinical similarities, differences, and outcomes. Under Institutional Review Board approval, 222 patients with metastatic colon adenocarcinoma (n = 158) and rectal adenocarcinoma (n = 64) who underwent clinical tumor genotyping were reviewed. Multiplexed tumor genotyping screened for >150 mutations across 15 commonly mutated cancer genes. The chi-square test was used to assess genotype frequency by tumor site and additional clinical characteristics. Cox multivariate analysis was used to assess the impact of genotype on overall survival. Broad-based tumor genotyping revealed clinical and anatomic differences that could be linked to gene mutations. NRAS mutations were associated with rectal cancer versus colon cancer (12.5% vs 0.6%; P colon cancer (13% vs 3%; P = .024) and older age (15.8% vs 4.6%; P = .006). TP53 mutations were associated with rectal cancer (30% vs 18%; P = .048), younger age (14% vs 28.7%; P = .007), and men (26.4% vs 14%; P = .03). Lung metastases were associated with PIK3CA mutations (23% vs 8.7%; P = .004). Only mutations in BRAF were independently associated with decreased overall survival (hazard ratio, 2.4; 95% confidence interval, 1.09-5.27; P = .029). The current study suggests that underlying molecular profiles can differ between colon and rectal cancers. Further investigation is warranted to assess whether the differences identified are important in determining the optimal treatment course for these patients. © 2014 American Cancer Society.

  14. The clinical importance of the anatomic variations in the paranasal sinuses

    International Nuclear Information System (INIS)

    Teixeira Junior, Francisco Ribeiro; Bretas, Elisa Almeida Sathler; Madeira, Ivana Andrade; Diniz, Renata Furletti; Ribeiro, Marcelo Almeida; Motta, Emilia Guerra Pinto Coelho; Moreira, Wanderval

    2008-01-01

    The anatomic variations of the paranasal sinuses are common findings. The importance of such variations predisposing disease through the obstruction of the drainage pathway has been discussed by several authors, although it is not yet a matter of agreement. The literature was reviewed and a iconographic assay was prepared aiming the discussion of the importance of the main anatomic variations of the paranasal sinuses. The prevalence of anatomic variations of the paranasal sinuses varies largely amongst studies and its role in sinus disease is controversial. In this article, it is described the different variations associated to paranasal disease and how they relate to pathologic conditions. Most studies confirm the concept that anatomic variations of the paranasal sinuses are related to disease when they obstruct the drainage pathways. The knowledge of such alterations and its relations to pathologic conditions is expected from the general radiologist. (author)

  15. Dissecting aneurysms of posterior communicating artery itself: anatomical, diagnostic, clinical, and therapeutical considerations.

    Science.gov (United States)

    Kocak, Burak; Tureci, Ercan; Kizilkilic, Osman; Islak, Civan; Kocer, Naci

    2013-09-01

    Posterior communicating artery (PCoA) itself is an unusual location for intracranial aneurysms in that isolated dissections or dissecting aneurysms are extremely rare. In the way of correct diagnosis of dissecting aneurysms of PCoA itself, a proper understanding of (1) the anatomy of the PCoA and its perforator branches, (2) some particular diagnostic features, and (3) related clinical aspects is of significant importance. Although there are no established treatment strategies for this particular type of aneurysms, the endovascular approach might be considered as a plausible one. In this paper, our scope was to report five cases with dissecting aneurysm of the PCoA itself and to discuss this rare vascular pathology from anatomical, diagnostic, clinical, and therapeutical perspectives.

  16. Coronoid process of the ulna: paleopathologic and anatomic study with imaging correlation. Emphasis on the anteromedial ''facet''

    Energy Technology Data Exchange (ETDEWEB)

    Freitas Valle de Lemos Weber, Marcio [University of California, Department of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States); Santa Maria, Rio Grande do Sul (Brazil); Barbosa, Diogo Miranda; Belentani, Clarissa; Negrao Ramos, Pedro Miguel; Trudell, Debra; Resnick, Donald [University of California, Department of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States)

    2009-01-15

    The purpose of this study was to provide a detailed description of the anatomy of the coronoid process of the ulna and to use magnetic resonance (MR) images and anatomic correlation with cadavers to show the macroscopic configuration of this structure. Photography and high-resolution radiography were performed in 26 ulna specimens from the collection of a local museum. MR imaging of the coronoid process of 11 cadaveric elbows was performed. The images were compared with those seen on anatomic sectioning. The anteromedial rim of the coronoid process of the ulna had a regular surface, without osseous irregularities or facets in 69.2% of the specimens. In 30.8% of the specimens, the anteromedial rim was not regular and a small ridge could be identified. The insertion site of the joint capsule was onto the anterior aspect of the coronoid process, at an average distance of 5.9 mm distal to the tip. The attachment of the anterior band of the ulnar collateral ligament at the sublime tubercle was flush with the articular margin in 63.6% of the specimens. In 36.4% of the specimens, a more distal attachment, with a separation between the undersurface of the ligament and the adjacent tubercle, was seen. The brachialis tendon was attached to the coronoid process at a mean distance of 12.1 mm distal to the tip. The coronoid process of the ulna is a small osseous structure with a complex anatomy and presents some anatomical variations. (orig.)

  17. Coronoid process of the ulna: paleopathologic and anatomic study with imaging correlation. Emphasis on the anteromedial ''facet''

    International Nuclear Information System (INIS)

    Freitas Valle de Lemos Weber, Marcio; Barbosa, Diogo Miranda; Belentani, Clarissa; Negrao Ramos, Pedro Miguel; Trudell, Debra; Resnick, Donald

    2009-01-01

    The purpose of this study was to provide a detailed description of the anatomy of the coronoid process of the ulna and to use magnetic resonance (MR) images and anatomic correlation with cadavers to show the macroscopic configuration of this structure. Photography and high-resolution radiography were performed in 26 ulna specimens from the collection of a local museum. MR imaging of the coronoid process of 11 cadaveric elbows was performed. The images were compared with those seen on anatomic sectioning. The anteromedial rim of the coronoid process of the ulna had a regular surface, without osseous irregularities or facets in 69.2% of the specimens. In 30.8% of the specimens, the anteromedial rim was not regular and a small ridge could be identified. The insertion site of the joint capsule was onto the anterior aspect of the coronoid process, at an average distance of 5.9 mm distal to the tip. The attachment of the anterior band of the ulnar collateral ligament at the sublime tubercle was flush with the articular margin in 63.6% of the specimens. In 36.4% of the specimens, a more distal attachment, with a separation between the undersurface of the ligament and the adjacent tubercle, was seen. The brachialis tendon was attached to the coronoid process at a mean distance of 12.1 mm distal to the tip. The coronoid process of the ulna is a small osseous structure with a complex anatomy and presents some anatomical variations. (orig.)

  18. Alterations in Anatomical Covariance in the Prematurely Born.

    Science.gov (United States)

    Scheinost, Dustin; Kwon, Soo Hyun; Lacadie, Cheryl; Vohr, Betty R; Schneider, Karen C; Papademetris, Xenophon; Constable, R Todd; Ment, Laura R

    2017-01-01

    Preterm (PT) birth results in long-term alterations in functional and structural connectivity, but the related changes in anatomical covariance are just beginning to be explored. To test the hypothesis that PT birth alters patterns of anatomical covariance, we investigated brain volumes of 25 PTs and 22 terms at young adulthood using magnetic resonance imaging. Using regional volumetrics, seed-based analyses, and whole brain graphs, we show that PT birth is associated with reduced volume in bilateral temporal and inferior frontal lobes, left caudate, left fusiform, and posterior cingulate for prematurely born subjects at young adulthood. Seed-based analyses demonstrate altered patterns of anatomical covariance for PTs compared with terms. PTs exhibit reduced covariance with R Brodmann area (BA) 47, Broca's area, and L BA 21, Wernicke's area, and white matter volume in the left prefrontal lobe, but increased covariance with R BA 47 and left cerebellum. Graph theory analyses demonstrate that measures of network complexity are significantly less robust in PTs compared with term controls. Volumes in regions showing group differences are significantly correlated with phonological awareness, the fundamental basis for reading acquisition, for the PTs. These data suggest both long-lasting and clinically significant alterations in the covariance in the PTs at young adulthood. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Anatomical entity recognition with a hierarchical framework augmented by external resources.

    Directory of Open Access Journals (Sweden)

    Yan Xu

    Full Text Available References to anatomical entities in medical records consist not only of explicit references to anatomical locations, but also other diverse types of expressions, such as specific diseases, clinical tests, clinical treatments, which constitute implicit references to anatomical entities. In order to identify these implicit anatomical entities, we propose a hierarchical framework, in which two layers of named entity recognizers (NERs work in a cooperative manner. Each of the NERs is implemented using the Conditional Random Fields (CRF model, which use a range of external resources to generate features. We constructed a dictionary of anatomical entity expressions by exploiting four existing resources, i.e., UMLS, MeSH, RadLex and BodyPart3D, and supplemented information from two external knowledge bases, i.e., Wikipedia and WordNet, to improve inference of anatomical entities from implicit expressions. Experiments conducted on 300 discharge summaries showed a micro-averaged performance of 0.8509 Precision, 0.7796 Recall and 0.8137 F1 for explicit anatomical entity recognition, and 0.8695 Precision, 0.6893 Recall and 0.7690 F1 for implicit anatomical entity recognition. The use of the hierarchical framework, which combines the recognition of named entities of various types (diseases, clinical tests, treatments with information embedded in external knowledge bases, resulted in a 5.08% increment in F1. The resources constructed for this research will be made publicly available.

  20. Carpal height and postoperative strength after proximal row carpectomy or four-corner arthrodesis: Clinical, anatomical and biomechanical study.

    Science.gov (United States)

    Laronde, Pascale; Christiaens, Nicolas; Aumar, Aurélien; Chantelot, Christophe; Fontaine, Christian

    2016-04-01

    Proximal row carpectomy (PRC) and four-corner arthrodesis (4CA) are the two most commonly performed surgical procedures to treat wrist arthritis. Postoperative strength is one of the criteria for choosing between the two techniques. Some authors believe that strength is correlated with residual carpal height. The goal of this study was to determine if postoperative carpal height was predictive of postoperative strength. This study consisted of two parts: a clinical evaluation of grip strength after 4CA or PRC; anatomical and radiological measurements of carpal height before and after 4CA or PRC. Grip strength was better preserved after PRC (87.5%) than after 4CA (76.1%), when expressed relative to the opposite hand (P=0.053). There was a significant decrease in carpal height for the PRC group with a Youm's index of 0.37 versus 0.50 for the 4CA group (P<0.0001). Our clinical results and analysis of the literature indicate that 4CA is not superior to PRC when it comes to grip strength, whereas carpal height is significantly decreased after PRC. The decreased tendon excursion after PRC is balanced by an increase in joint stresses after 4CA. Copyright © 2016 SFCM. Published by Elsevier Masson SAS. All rights reserved.

  1. Computed tomographic, magnetic resonance imaging, and cross-sectional anatomic features of the manus in a normal American black bear (Ursus americanus).

    Science.gov (United States)

    Ober, C P; Freeman, L E

    2010-06-01

    The purpose of this study was to provide a detailed description of cross-sectional anatomic structures of the manus of a black bear cadaver and correlate anatomic findings with corresponding features in computed tomographic (CT) and magnetic resonance (MR) images. CT, MR imaging, and transverse sectioning were performed on the thoracic limb of a cadaver female black bear which had no evidence of lameness or thoracic limb abnormality prior to death. Features in CT and MR images corresponding to clinically important anatomic structures in anatomic sections were identified. Most of the structures identified in transverse anatomic sections were also identified using CT and MR imaging. Bones, muscles and tendons were generally easily identified with both imaging modalities, although divisions between adjacent muscles were rarely visible with CT and only visible sometimes with MR imaging. Vascular structures could not be identified with either imaging modality.

  2. [Anatomic rationale for clinical efficacy of intraosseous mental nerve anesthesia].

    Science.gov (United States)

    Rabinovich, S A; Vasil'ev, Yu L; Kuzin, A N

    2018-01-01

    The aim of the study was to prove the anatomical and clinical effectiveness of the modified anesthesia of mental nerve. The effectiveness of conductive anesthesia near the mental foramen was objectively evaluated using the electric pulp test (EPT) in 100 volunteers of both sexes, aged 35-43 years. Wet anterior mandible preparations obtained from 350 cadavers aged 18-74 years were also studied. EPT value after local mental anesthesia conducted according to Malamed C. using 4% articain solution of local anesthetic with vasoconstrictor concentration of 1:200.000 after 2 minutes was 93±0.82 mA, after 4 minutes - 188±1.26 mA. Yield variability indicators of intraosseous mental nerve anesthesia was slightly higher varying from 94.11 mA to 96.61 mA after 2 minutes and from 197.4 to 199.92 mA after 4 minutes survey. The study showed the efficiency and predictability of intraosseous anesthesia of the mental nerve.

  3. The maxillary second molar - anatomical variations (case report).

    Science.gov (United States)

    Beshkenadze, E; Chipashvili, N

    2015-01-01

    To be acquainted with dental anatomical specificity is of great importance for dental endodontic treatment algorithm. The subject of present publication is 2 clinical cases of upper second molars, detailed characterization of, which is considered very important for enrichment of anatomical knowledge about dental anatomical variations. In one case, the reason for admission to the clinic of a 38-year-old woman was complains as of esthetic character as well as functional misbalance (disturbance of chewing function due to the damage of orthopedic construction). The patient indicated to the existence of coronary defects of large size aesthetic discomforts, damage and discolouration of old orthopedic construction (denture) in maxillary right molar area. According to the data obtained after clinical and visiographical examinations, chronic periodontitis of 17 teeth was identified as a result of incomplete endodontic treatment. According to the data obtained after clinical and visiographical examinations, the diagnosis of chronic periodontitis of 17 teeth was identified, tooth 17 with 2 roots and 2 canals. In the second clinical case, the reason for admission to the clinic of a 39-year-old woman was severe pain in the upper right molar area. The patient indicated to the caries on the tooth 17. After completion of proper survey clinical and visiographical examinations, acute pulpitis (K04.00) - with three roots and 4 canals was diagnosed. In both cases after the proper examinations and agreement with the patients a treatment plan envisaging: 17 teeth endodontic treatment, filling of caries defects and their preparation on one hand for orthopedic construction (denture) and on the other hand for restoration of anatomical integrity by light-cured composite, was scheduled. The present study is designed to prevent complications of endodontic treatment of the second molar, to optimize diagnosis and treatment algorithm, once again proving reliable information indicating to the

  4. Standards to support information systems integration in anatomic pathology.

    Science.gov (United States)

    Daniel, Christel; García Rojo, Marcial; Bourquard, Karima; Henin, Dominique; Schrader, Thomas; Della Mea, Vincenzo; Gilbertson, John; Beckwith, Bruce A

    2009-11-01

    Integrating anatomic pathology information- text and images-into electronic health care records is a key challenge for enhancing clinical information exchange between anatomic pathologists and clinicians. The aim of the Integrating the Healthcare Enterprise (IHE) international initiative is precisely to ensure interoperability of clinical information systems by using existing widespread industry standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7). To define standard-based informatics transactions to integrate anatomic pathology information to the Healthcare Enterprise. We used the methodology of the IHE initiative. Working groups from IHE, HL7, and DICOM, with special interest in anatomic pathology, defined consensual technical solutions to provide end-users with improved access to consistent information across multiple information systems. The IHE anatomic pathology technical framework describes a first integration profile, "Anatomic Pathology Workflow," dedicated to the diagnostic process including basic image acquisition and reporting solutions. This integration profile relies on 10 transactions based on HL7 or DICOM standards. A common specimen model was defined to consistently identify and describe specimens in both HL7 and DICOM transactions. The IHE anatomic pathology working group has defined standard-based informatics transactions to support the basic diagnostic workflow in anatomic pathology laboratories. In further stages, the technical framework will be completed to manage whole-slide images and semantically rich structured reports in the diagnostic workflow and to integrate systems used for patient care and those used for research activities (such as tissue bank databases or tissue microarrayers).

  5. Anatomical variations within the deep posterior compartment of the leg and important clinical consequences.

    Science.gov (United States)

    Hislop, M; Tierney, P

    2004-09-01

    The management of musculoskeletal conditions makes up a large part of a sports medicine practitioner's practice. A thorough knowledge of anatomy is an essential component of the armament necessary to decipher the large number of potential conditions that may confront these practitioners. To cloud the issue further, anatomical variations may be present, such as supernumerary muscles, thickened fascial bands or variant courses of nerves and blood vessels, which can themselves manifest as acute or chronic conditions that lead to significant morbidity or limitation of activity. There are a number of contentious areas within the literature surrounding the anatomy of the leg, particularly involving the deep posterior compartment. Conditions such as chronic exertional compartment syndrome, tibial periostitis (shin splints), peripheral nerve entrapment and tarsal tunnel syndrome may all be affected by subtle anatomical variations. This paper primarily focuses on the deep posterior compartment of the leg and uses the gross dissection of cadaveric specimens to describe definitively the anatomy of the deep posterior compartment. Variant fascial attachments of flexor digitorum longus are documented and potential clinical sequelae such as chronic exertional compartment syndrome and tarsal tunnel syndrome are discussed.

  6. Population-based evaluation of a suggested anatomic and clinical classification of congenital heart defects based on the International Paediatric and Congenital Cardiac Code

    Directory of Open Access Journals (Sweden)

    Goffinet François

    2011-10-01

    Full Text Available Abstract Background Classification of the overall spectrum of congenital heart defects (CHD has always been challenging, in part because of the diversity of the cardiac phenotypes, but also because of the oft-complex associations. The purpose of our study was to establish a comprehensive and easy-to-use classification of CHD for clinical and epidemiological studies based on the long list of the International Paediatric and Congenital Cardiac Code (IPCCC. Methods We coded each individual malformation using six-digit codes from the long list of IPCCC. We then regrouped all lesions into 10 categories and 23 subcategories according to a multi-dimensional approach encompassing anatomic, diagnostic and therapeutic criteria. This anatomic and clinical classification of congenital heart disease (ACC-CHD was then applied to data acquired from a population-based cohort of patients with CHD in France, made up of 2867 cases (82% live births, 1.8% stillbirths and 16.2% pregnancy terminations. Results The majority of cases (79.5% could be identified with a single IPCCC code. The category "Heterotaxy, including isomerism and mirror-imagery" was the only one that typically required more than one code for identification of cases. The two largest categories were "ventricular septal defects" (52% and "anomalies of the outflow tracts and arterial valves" (20% of cases. Conclusion Our proposed classification is not new, but rather a regrouping of the known spectrum of CHD into a manageable number of categories based on anatomic and clinical criteria. The classification is designed to use the code numbers of the long list of IPCCC but can accommodate ICD-10 codes. Its exhaustiveness, simplicity, and anatomic basis make it useful for clinical and epidemiologic studies, including those aimed at assessment of risk factors and outcomes.

  7. MR neurography with multiplanar reconstruction of 3D MRI datasets: an anatomical study and clinical applications

    International Nuclear Information System (INIS)

    Freund, Wolfgang; Aschoff, Andrik J.; Stuber, Gregor; Schmitz, Bernd; Brinkmann, Alexander; Wagner, Florian; Dinse, Alexander

    2007-01-01

    Extracranial MR neurography has so far mainly been used with 2D datasets. We investigated the use of 3D datasets for peripheral neurography of the sciatic nerve. A total of 40 thighs (20 healthy volunteers) were examined with a coronally oriented magnetization-prepared rapid acquisition gradient echo sequence with isotropic voxels of 1 x 1 x 1 mm and a field of view of 500 mm. Anatomical landmarks were palpated and marked with MRI markers. After MR scanning, the sciatic nerve was identified by two readers independently in the resulting 3D dataset. In every volunteer, the sciatic nerve could be identified bilaterally over the whole length of the thigh, even in areas of close contact to isointense muscles. The landmark of the greater trochanter was falsely palpated by 2.2 cm, and the knee joint by 1 cm. The mean distance between the bifurcation of the sciatic nerve and the knee-joint gap was 6 cm (±1.8 cm). The mean results of the two readers differed by 1-6%. With the described method of MR neurography, the sciatic nerve was depicted reliably and objectively in great anatomical detail over the whole length of the thigh. Important anatomical information can be obtained. The clinical applications of MR neurography for the brachial plexus and lumbosacral plexus/sciatic nerve are discussed. (orig.)

  8. Are the anatomy textbooks wrong? A clinical patho-anatomic study of foveal vessels in the round ligament of the hip.

    Science.gov (United States)

    Barrington, John W; Sodhi, Nipun; Ali, Muzaffar; Khlopas, Anton; Sultan, Assem A; Kee, James R; Holmes, Kristopher A; Hariri, Omar; Newman, Jared M; Mont, Michael A

    2017-12-01

    The foveal vessels of the ligamentum teres are an anterior branch of the posterior division of the obturator artery, providing blood to the capitis of the femoral head. However, the basic anatomic description of foveal vasculature in the ligamentum teres of the hip is widely variable, with some studies reporting that the vessels are not patent in roughly one third of all adults. Therefore, the purpose of this study was to evaluate the status of foveal vessels in primary total hip arthroplasty (THA) patients. Specifically, we evaluated: (I) if the foveal vessels were intact; and we (II) correlated foveal vessel status with (i) patient demographics, including gender and age; as well as (ii) perioperative data, such as operative time and blood loss. The macroscopic status of the foveal vessels in the ligamentum teres femoris was documented in 266 patients at the time of primary unilateral THA performed between August 2015 and April 2017. The vessels were considered to be intact if active bleeding was directly visible from the acetabular stump of the severed ligamentum teres femoris. Demographics including age, gender, and preoperative diagnosis were collected. The perioperative outcome variables included estimated blood loss (EBL) and operative time. Foveal vessel status defined as intact or not intact, was also correlated with patient demographics and perioperative data. A student's t -test was used to compare the continuous variables and a chi square test was used for categorical variables. The foveal vessels were intact in 161 patients (61%) and not intact in 105 patients (39%). The mean age for patients with intact foveal vessels was found to be 64 years (range, 18 to 94 years) vs. 65 years (range, 29 to 94 years) (P>0.05) for not intact. No correlation was found between preoperative diagnosis, gender, operative time, and EBL and foveal vessel status. The results of this clinical patho-anatomic study of the foveal vessels in the ligamentum teres femoris of the hip

  9. Clinical Effect of Acute Complete Acromioclavicular Joint Dislocation Treated with Micro-Movable and Anatomical Acromioclavicular Plate

    Science.gov (United States)

    Liu, Qingjun; Miao, Jianyun; Lin, Bin; Guo, Zhimin

    2012-01-01

    Objectives: We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated with micro-movable and anatomical acromioclavicular plate. Methods: Open reduction and internal fixation was performed using the MAAP in 16 patients (10 males, 6 females; mean age 36 years; range16 to 63 years) with acute complete acromioclavicular joint dislocation. Radiographic evaluations were routinely conducted every 3 weeks until 3 months postoperatively. The MAAP were removed under local anesthesia after 3 months postoperatively. We evaluated the functional results by using the constant scoring system and radiological results in the last follow-up time. The mean follow up was 26 months (range 16 to 38 months). Results: The mean Constant score was 94 (range, 78 to 100). The results were excellent in 12 patients (75.0%), good in 3 patients (18.8%) and satisfactory in 1patient (6.2%). Three patients with scores of 80 to 90 had mild pain during activity, but have not affected the shoulder range of motion. One patient has both some pain and limited range of motion of shoulder joint. All patients but one have returned to their preoperative work without any limitations. Compared to the contralateral side, radiography showed anatomical reposition in the vertical plane in 14 cases, slight loss of reduction in 2 older patients. Conclusion: We recommend the MAAP fixation for surgical treatment of acute complete acromioclavicular joint dislocation as it could provide satisfactory shoulder functions and clinical results, with lower complication rate. However, it is necessary to continue to observe the clinical effects of this fixation technique. PMID:23091410

  10. Mystery of alar ligament rupture: Value of MRI in whiplash injuries - biomechanical, anatomical and clinical studies

    International Nuclear Information System (INIS)

    Bitterling, H.; Brueckmann, H.; Staebler, A.

    2007-01-01

    Purpose: Whiplash injury of the cervical spine is a frequent issue in medical expertise and causes enormous consequential costs for motor insurance companies. Some authors accuse posttraumatic changes of alar ligaments to be causative for consequential disturbances. Materials and methods: Review of recent studies on biomechanics, anatomical and clinical MR imaging. Results: Biomechanical experiments can not induce according injuries of alar ligaments. Although MRI provides excellent visualization of alar ligaments, the range of normal variants is high. (orig.)

  11. The Dentato-Rubro-Olivary Tract: Clinical Dimension of This Anatomical Pathway

    Directory of Open Access Journals (Sweden)

    Fadil Khoyratty

    2013-01-01

    Full Text Available Symptomatic palatal tremor is potentially the result of a lesion in the triangle of Guillain-Mollaret (1931 and is associated with hypertrophic olivary degeneration (HOD which has characteristic MR findings. The triangle is defined by dentate efferents ascending through the superior cerebellar peduncle and crossing in the decussation of the brachium conjunctivum inferior to the red nucleus, to finaliy reach the inferior olivary nucleus (ION via the central tegmental tract. The triangle is completed by ION decussating efferents terminating on the original dentate nucleus via the inferior cerebellar peduncle. We can demonstrate the anatomy of this anatomical triangle using a clinical case of palatal tremor presenting with bilateral subjective pulsatile tinnitus along with the pathognomonic MR findings previously described. The hyperintense T2 signal in these patients may be permanent, but the hypertrophied olive normally regresses after 4 years. The temporal relationship between the evolution of the histopathology and the development of the palatal tremor remains unknown as does the natural history of the tremor. Botox injection at the level of tensor and levator veli palatini insertion have been used to treat patients with disabling tremor synchronous tinnitus. A lesion involving the triangle can have a quite varied clinical expression.

  12. Optimization of abdominal fat quantification on CT imaging through use of standardized anatomic space: A novel approach

    Energy Technology Data Exchange (ETDEWEB)

    Tong, Yubing; Udupa, Jayaram K., E-mail: jay@mail.med.upenn.edu [Department of Radiology, Medical Image Processing Group, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6021 (United States); Torigian, Drew A. [Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6021 (United States)

    2014-06-15

    Purpose: The quantification of body fat plays an important role in the study of numerous diseases. It is common current practice to use the fat area at a single abdominal computed tomography (CT) slice as a marker of the body fat content in studying various disease processes. This paper sets out to answer three questions related to this issue which have not been addressed in the literature. At what single anatomic slice location do the areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) estimated from the slice correlate maximally with the corresponding fat volume measures? How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? Are there combinations of multiple slices (not necessarily contiguous) whose area sum correlates better with volume than does single slice area with volume? Methods: The authors propose a novel strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. The authors then study the volume-to-area correlations and determine where they become maximal. To address the third issue, the authors carry out similar correlation studies by utilizing two and three slices for calculating area sum. Results: Based on 50 abdominal CT data sets, the proposed mapping achieves significantly improved consistency of anatomic localization compared to current practice. Maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized currently for single slice area estimation as a marker. Conclusions: The maximum area-to-volume correlation achieved is quite high, suggesting that it may be reasonable to estimate body fat by measuring the area of fat from a single anatomic slice at the site of maximum correlation and use this as a marker. The site of maximum correlation is not at L4-L5 as commonly assumed

  13. Anatomic features involved in technical complexity of partial nephrectomy.

    Science.gov (United States)

    Hou, Weibin; Yan, Weigang; Ji, Zhigang

    2015-01-01

    Nephrometry score systems, including RENAL nephrometry, preoperative aspects and dimensions used for an anatomical classification system, C-index, diameter-axial-polar nephrometry, contact surface area score, calculating resected and ischemized volume, renal tumor invasion index, surgical approach renal ranking score, zonal NePhRO score, and renal pelvic score, have been reviewed. Moreover, salient anatomic features like the perinephric fat and vascular variants also have been discussed. We then extract 7 anatomic characteristics, namely tumor size, spatial location, adjacency, exophytic/endophytic extension, vascular variants, pelvic anatomy, and perinephric fat as important features for partial nephrectomy. For novice surgeons, comprehensive and adequate anatomic consideration may help them in their early clinical practice. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. CORRELATIONS BETWEEN INTER-IMPLANT DISTANCE AND CLINICAL ASPECTS IN TWO IMPLANT MANDIBULAR OVERDENTURES

    Directory of Open Access Journals (Sweden)

    Mihaela Marin

    2011-09-01

    Full Text Available The aim of this study is to assess the influence of different interimplant distances on prosthetic complications in two implant mandibular overdenture treatments, as well as the possible correlations between such complications and some anatomic and functional individual aspect of the patients. Materials and method. An observational clinical study was conducted – between October 2008 – March 2010 - in the Clinics of Dental Prosthetics of the “Carol Davila” UMF of Bucuresti – on 32 completely edentulous patients, treated with 2 implant mandibular overdentures. The patients (24 women and 8 men, with ages between 49 and 83 years were divided into 2 groups, according to the position of the implants, inserted at the level of the lateral incisor (group 1 or in posterior position versus the canine (group 2. The prosthetic aspects, the peri-implant tissues and the anchoring systems were evaluated after 6 months and, respectively, 1 year of treatment, all prosthetic or biological complications, as well as the number of visits necessary for solving them being recorded. Results. As to the general characteristics of the group of patients, the observation was made that the average age of patients was of 63.8 years, most of them demonstrated a severe resorbtion of the crest, oval in shape in the mandibular frontal area, belonging mostly to the IInd hypo or hyper-divergent skeletal class, proportionally with and without a tendency towards propulsion. For both groups of patients, a total number of 114 prosthetic complications were registered after one year, the most frequent ones being occlusal problems (23.68%, the presence of decubitus lesions (21.05% and deactivation of matrices, accompanied by reduced retention (19.29%. Lower ratios were recorded for: the necessity of prosthesis relining (14%, loss of matrices (12.28%, fracturing of the prosthesis (8.77%, presence of peri-implant gingival hyperplasies (7% and loosening of the patrix screw (5

  15. Early Results of Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction

    OpenAIRE

    Demet Pepele

    2014-01-01

    Aim: The goal in anterior cruciate ligament reconstruction (ACLR) is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our ...

  16. Brachial plexus lesions: Anatomical knowledge as an essential ...

    African Journals Online (AJOL)

    This clinical feature was in conformity with a lesion of inferior primary trunk. All diagnoses were made based on the clinical findings. These cases demonstrate the significance of a through anatomical knowledge in the clinical examination if one has to avoid confusing the signs of terminal nerves lesion with the trunk's lesion.

  17. Anatomical imaging for radiotherapy

    International Nuclear Information System (INIS)

    Evans, Philip M

    2008-01-01

    The goal of radiation therapy is to achieve maximal therapeutic benefit expressed in terms of a high probability of local control of disease with minimal side effects. Physically this often equates to the delivery of a high dose of radiation to the tumour or target region whilst maintaining an acceptably low dose to other tissues, particularly those adjacent to the target. Techniques such as intensity modulated radiotherapy (IMRT), stereotactic radiosurgery and computer planned brachytherapy provide the means to calculate the radiation dose delivery to achieve the desired dose distribution. Imaging is an essential tool in all state of the art planning and delivery techniques: (i) to enable planning of the desired treatment, (ii) to verify the treatment is delivered as planned and (iii) to follow-up treatment outcome to monitor that the treatment has had the desired effect. Clinical imaging techniques can be loosely classified into anatomic methods which measure the basic physical characteristics of tissue such as their density and biological imaging techniques which measure functional characteristics such as metabolism. In this review we consider anatomical imaging techniques. Biological imaging is considered in another article. Anatomical imaging is generally used for goals (i) and (ii) above. Computed tomography (CT) has been the mainstay of anatomical treatment planning for many years, enabling some delineation of soft tissue as well as radiation attenuation estimation for dose prediction. Magnetic resonance imaging is fast becoming widespread alongside CT, enabling superior soft-tissue visualization. Traditionally scanning for treatment planning has relied on the use of a single snapshot scan. Recent years have seen the development of techniques such as 4D CT and adaptive radiotherapy (ART). In 4D CT raw data are encoded with phase information and reconstructed to yield a set of scans detailing motion through the breathing, or cardiac, cycle. In ART a set of

  18. The hamatolunate facet: characterization and association with cartilage lesions - magnetic resonance arthrography and anatomic correlation in cadaveric wrists

    Energy Technology Data Exchange (ETDEWEB)

    Pfirrmann, C.W.A. [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States); Orthopedic University Hospital Balgrist, Department of Radiology, Forchstrasse 340, 8008 Zurich (Switzerland); Theumann, N.H.; Chung, C.B.; Trudell, D.J.; Resnick, D. [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States)

    2002-08-01

    The objective of this study was to characterize the appearance of the hamatolunate facet using high-resolution magnetic resonance (MR) arthrography in cadavers and to correlate the presence of this anatomic variant with the presence of osteoarthritis in the wrist. High-resolution MR images of 22 cadaveric wrist specimens were obtained after tri-compartmental arthrography. Two readers in consensus analyzed the MR images and recoded the presence or absence of a hamatolunate facet. Geometric characteristics and cartilage and ligament integrity were analyzed. A third reader, who was blinded to the purpose of the study, recorded cartilage lesions of all the bones of the proximal and distal carpal rows. A hamatolunate facet was present in 11 of 22 wrists (50%). The mean coronal size of the lunate facet at the lunate (type II lunate) was 4.5 mm (range, 2-6 mm). The highest frequencies of cartilage lesions were seen in the scapho-trapezio-trapezoid joint (45.5%) and at the proximal pole of the hamate (54.4% and 40.9% for consensus reading/blinded reading, respectively). In cases with a hamatolunate facet, the frequency of cartilage lesions in the proximal pole of the hamate was 81.8% and 63.6% versus 27.3% and 18.2% without such a facet (chi-squared, P=0.01/P=0.03). No correlation of the presence of a hamatolunate facet with interosseous ligament tears or lesions of the triangular fibrocartilage was seen. In conclusion, the hamatolunate facet is a very common anatomic variant. The presence of a hamatolunate facet is associated with cartilage damage in the proximal pole of the hamate. (orig.)

  19. Cardiac abnormalities in the acquired immunodeficiency syndrome. A prospective study with a clinical-pathological correlation in twenty-one adult patients

    Directory of Open Access Journals (Sweden)

    Herdy Gesmar Volga Haddad

    1999-01-01

    Full Text Available OBJECTIVE - To evaluate the cardiac abnormalities and their evolution during the course of the acquired immunodeficiency syndrome, as well as to correlate clinical and pathological data. METHODS - Twenty-one patients, admitted to the hospital with the diagnosis of acquired immunodeficiency syndrome, were prospectively studied and followed until their death. Age ranged from 19 to 42 years (17 males. ECG and echocardiogram were also obtained every six months. After death, macro- and microscopic examinations were also performed. RESULTS - The most frequent causes of referral to the hospital were: diarrhea or repeated pneumonias, tuberculosis, toxoplasmosis or Kaposi sarcoma. The most frequent findings were acute or chronic pericarditis (42% and dilated cardiomyopathy (19%. Four patients died of cardiac problems: infective endocarditis, pericarditis with pericardial effusion, bacterial myocarditis and infection by Toxoplasma gondii. CONCLUSION - Severe cardiac abnormalities were the cause of death in some patients. In the majority of the patients, a good correlation existed between clinical and anatomical-pathological data. Cardiac evaluation was important to detect early manifestations and treat them accordingly, even in asymptomatic patients.

  20. Anatomical masking of pressure footprints based on the Oxford Foot Model: validation and clinical relevance.

    Science.gov (United States)

    Giacomozzi, Claudia; Stebbins, Julie A

    2017-03-01

    Plantar pressure analysis is widely used in the assessment of foot function. In order to assess regional loading, a mask is applied to the footprint to sub-divide it into regions of interest (ROIs). The most common masking method is based on geometric features of the footprint (GM). Footprint masking based on anatomical landmarks of the foot has been implemented more recently, and involves the integration of a 3D motion capture system, plantar pressure measurement device, and a multi-segment foot model. However, thorough validation of anatomical masking (AM) using pathological footprints has not yet been presented. In the present study, an AM method based on the Oxford Foot Model (OFM) was compared to an equivalent GM. Pressure footprints from 20 young healthy subjects (HG) and 20 patients with clubfoot (CF) were anatomically divided into 5 ROIs using a subset of the OFM markers. The same foot regions were also identified by using a standard GM method. Comparisons of intra-subject coefficient of variation (CV) showed that the OFM-based AM was at least as reliable as the GM for all investigated pressure parameters in all foot regions. Clinical relevance of AM was investigated by comparing footprints from HG and CF groups. Contact time, maximum force, force-time integral and contact area proved to be sensitive parameters that were able to distinguish HG and CF groups, using both AM and GM methods However, the AM method revealed statistically significant differences between groups in 75% of measured variables, compared to 62% using a standard GM method, indicating that the AM method is more sensitive for revealing differences between groups. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Relationship between external anal sphincter atrophy at endoanal magnetic resonance imaging and clinical, functional, and anatomic characteristics in patients with fecal incontinence

    NARCIS (Netherlands)

    Terra, Maaike P.; Deutekom, Marije; Beets-Tan, Regina G. H.; Engel, Alexander F.; Janssen, Lucas W. M.; Boeckxstaens, Guy E. E.; Dobben, Annette C.; Baeten, Cor G. M. I.; de Priester, Jacobus A.; Bossuyt, Patrick M. M.; Stoker, Jaap

    2006-01-01

    PURPOSE: External anal sphincter atrophy at endoanal magnetic resonance imaging has been associated with poor outcome of anal sphincter repair. We studied the relationship between external anal sphincter atrophy on endoanal magnetic resonance imaging and clinical, functional, and anatomic

  2. Phrenic Nerve Palsy and Regional Anesthesia for Shoulder Surgery: Anatomical, Physiologic, and Clinical Considerations.

    Science.gov (United States)

    El-Boghdadly, Kariem; Chin, Ki Jinn; Chan, Vincent W S

    2017-07-01

    Regional anesthesia has an established role in providing perioperative analgesia for shoulder surgery. However, phrenic nerve palsy is a significant complication that potentially limits the use of regional anesthesia, particularly in high-risk patients. The authors describe the anatomical, physiologic, and clinical principles relevant to phrenic nerve palsy in this context. They also present a comprehensive review of the strategies for reducing phrenic nerve palsy and its clinical impact while ensuring adequate analgesia for shoulder surgery. The most important of these include limiting local anesthetic dose and injection volume and performing the injection further away from the C5-C6 nerve roots. Targeting peripheral nerves supplying the shoulder, such as the suprascapular and axillary nerves, may be an effective alternative to brachial plexus blockade in selected patients. The optimal regional anesthetic approach in shoulder surgery should be tailored to individual patients based on comorbidities, type of surgery, and the principles described in this article.

  3. Deformable meshes for medical image segmentation accurate automatic segmentation of anatomical structures

    CERN Document Server

    Kainmueller, Dagmar

    2014-01-01

    ? Segmentation of anatomical structures in medical image data is an essential task in clinical practice. Dagmar Kainmueller introduces methods for accurate fully automatic segmentation of anatomical structures in 3D medical image data. The author's core methodological contribution is a novel deformation model that overcomes limitations of state-of-the-art Deformable Surface approaches, hence allowing for accurate segmentation of tip- and ridge-shaped features of anatomical structures. As for practical contributions, she proposes application-specific segmentation pipelines for a range of anatom

  4. Comparative radiographic analysis on the anatomical axis in knee osteoarthritis cases: inter and intraobserver evaluation.

    Science.gov (United States)

    Matos, Luiz Felipe; Giordano, Marcos; Cardoso, Gustavo Novaes; Farias, Rafael Baptista; E Albuquerque, Rodrigo Pires

    2015-01-01

    To make a comparative inter and intraobserver analysis on measurements of the anatomical axis between panoramic radiographs of the lower limbs in anteroposterior (AP) view with bipedal weight-bearing, on short film. An accuracy study comparing radiographic measurements on 47 knees of patients attending the knee surgery outpatient clinic due to osteoarthritis. The radiographic evaluation used was as standardized for the total knee arthroplasty program, including panoramic AP views of the lower limbs and short radiographs of the knees in AP and lateral views, all with bipedal weight-bearing. Following this, the anatomical axis of the lower limbs or the femorotibial angle was measured by five independent examiners on the panoramic and short AP radiographs; three of the examiners were considered to be more experienced and two, less experienced. All the measurements were made again by the same examiners after an interval of not less than 15 days. The statistical analysis was performed using the intraclass correlation coefficient, in order to evaluate the inter and intraobserver concordance of the anatomical axis measurements. From the statistical analysis, it was observed that there was strongly significant concordance between the anatomical axis measurements on the panoramic and short radiographs, for all the five examiners and for both measurements. Under the conditions studied, short radiographs were equivalent to panoramic radiographs for evaluating the anatomical axis of the lower limbs in patients with advanced osteoarthritis. The measurements used also showed high rates of inter and intraobserver concordance and reproducibility.

  5. Anatomical planes: are we teaching accurate surface anatomy?

    Science.gov (United States)

    Mirjalili, S Ali; McFadden, Sarah L; Buckenham, Tim; Wilson, Ben; Stringer, Mark D

    2012-10-01

    Anatomical planes used in clinical practice and teaching anatomy are largely derived from cadaver studies. Numerous inconsistencies in clinically important surface markings exist between and within anatomical reference texts. The aim of this study was to reassess the accuracy of common anatomical planes in vivo using computed tomographic (CT) imaging. CT scans of the trunk in supine adults at end tidal inspiration were analyzed by dual consensus reporting to determine the anatomy of five anatomical planes: sternal angle, transpyloric, subcostal, supracristal, and the plane of the pubic crest. Patients with kyphosis, scoliosis, or abnormal lordosis, distorting space-occupying lesions, or visceromegaly were excluded. Among 153 thoracic CT scans (mean age 63 years, 53% female), the sternal angle was most common at T4 (females) or T4/5 (males) vertebral level, and the tracheal bifurcation, aortic arch, and pulmonary trunk were most often below this plane. In 108 abdominal CT scans (mean age 60 years, 59% female), the subcostal and supracristal planes were most often at L2 (58%) and L4 (69%), respectively. In 52 thoracoabdominal CT scans (mean age 61 years, 56% female), the transpyloric plane was between lower L1 and upper L2 (75%); in this plane were the superior mesenteric artery (56%), formation of the portal vein (53%), tip of the ninth rib (60%), and the left renal hilum (54%), but the right renal hilum and gallbladder fundus were more often below. The surface anatomy of anatomical planes needs revising in the light of results from living subjects using modern imaging techniques. Copyright © 2012 Wiley Periodicals, Inc.

  6. Students perception about the clinico-anatomical conferences as a teaching methodology

    International Nuclear Information System (INIS)

    Saeed, K.; Baptist, M.; Mukhtar, F.

    2015-01-01

    Anatomy has always been considered as an essential basis for clinical sciences. In recent decades there has been an increased trend towards incorporation of clinical problems in the teaching of anatomy. To promote clinical knowledge clinico-anatomical conferences have been conducted in our department for the last five years. This study has been undertaken to determine perception of medical students regarding these conferences and to formulate recommendations for their improvement based on feedback obtained from students. Method: A cross-sectional study was conducted from December 2013 to January 2014 at the Lahore Medical and Dental College (LMDC), Lahore. A sample of 200 students of first and second year MBBS classes was selected for the study through convenience sampling technique. A 5-point Likert scale ranging from 1 (strongly agree) to 5 (strongly disagree) was used to determine students perception about clinic-anatomical conferences, using a self-administered questionnaire. Data was analysed using SPSS-19.0. Results: Out of total 144 (72%) students were of the opinion that clinico-anatomical conferences were a good source of clinical knowledge, 126 (63%) opined that these conferences promoted understanding rather than memorization, 122 (61%) found them interesting, and 15 (30%) found improvement in their grades in the subject of anatomy after attending the conferences. Conclusion: The clinico-anatomical conferences were found interesting and reported to be a good source of clinical knowledge. It is recommended that these conferences should be conducted frequently, made interactive and patients should be presented as case studies during the conferences. (author)

  7. Neural Correlates of Intolerance of Uncertainty in Clinical Disorders.

    Science.gov (United States)

    Wever, Mirjam; Smeets, Paul; Sternheim, Lot

    2015-01-01

    Intolerance of uncertainty is a key contributor to anxiety-related disorders. Recent studies highlight its importance in other clinical disorders. The link between its clinical presentation and the underlying neural correlates remains unclear. This review summarizes the emerging literature on the neural correlates of intolerance of uncertainty. In conclusion, studies focusing on the neural correlates of this construct are sparse, and findings are inconsistent across disorders. Future research should identify neural correlates of intolerance of uncertainty in more detail. This may unravel the neurobiology of a wide variety of clinical disorders and pave the way for novel therapeutic targets.

  8. Clinical Correlations as a Tool in Basic Science Medical Education

    Directory of Open Access Journals (Sweden)

    Brenda J. Klement

    2016-01-01

    Full Text Available Clinical correlations are tools to assist students in associating basic science concepts with a medical application or disease. There are many forms of clinical correlations and many ways to use them in the classroom. Five types of clinical correlations that may be embedded within basic science courses have been identified and described. (1 Correlated examples consist of superficial clinical information or stories accompanying basic science concepts to make the information more interesting and relevant. (2 Interactive learning and demonstrations provide hands-on experiences or the demonstration of a clinical topic. (3 Specialized workshops have an application-based focus, are more specialized than typical laboratory sessions, and range in complexity from basic to advanced. (4 Small-group activities require groups of students, guided by faculty, to solve simple problems that relate basic science information to clinical topics. (5 Course-centered problem solving is a more advanced correlation activity than the others and focuses on recognition and treatment of clinical problems to promote clinical reasoning skills. Diverse teaching activities are used in basic science medical education, and those that include clinical relevance promote interest, communication, and collaboration, enhance knowledge retention, and help develop clinical reasoning skills.

  9. Anatomically Plausible Surface Alignment and Reconstruction

    DEFF Research Database (Denmark)

    Paulsen, Rasmus R.; Larsen, Rasmus

    2010-01-01

    With the increasing clinical use of 3D surface scanners, there is a need for accurate and reliable algorithms that can produce anatomically plausible surfaces. In this paper, a combined method for surface alignment and reconstruction is proposed. It is based on an implicit surface representation...

  10. Functional and anatomical correlates of word-, sentence-, and discourse-level integration in sign language

    Directory of Open Access Journals (Sweden)

    Tomoo eInubushi

    2013-10-01

    Full Text Available In both vocal and sign languages, we can distinguish word-, sentence-, and discourse-level integration in terms of hierarchical processes, which integrate various elements into another higher level of constructs. In the present study, we used magnetic resonance imaging and voxel-based morphometry to test three language tasks in Japanese Sign Language (JSL: word-level (Word, sentence-level (Sent, and discourse-level (Disc decision tasks. We analyzed cortical activity and gray matter volumes of Deaf signers, and clarified three major points. First, we found that the activated regions in the frontal language areas gradually expanded in the dorso-ventral axis, corresponding to a difference in linguistic units for the three tasks. Moreover, the activations in each region of the frontal language areas were incrementally modulated with the level of linguistic integration. These dual mechanisms of the frontal language areas may reflect a basic organization principle of hierarchically integrating linguistic information. Secondly, activations in the lateral premotor cortex and inferior frontal gyrus were left-lateralized. Direct comparisons among the language tasks exhibited more focal activation in these regions, suggesting their functional localization. Thirdly, we found significantly positive correlations between individual task performances and gray matter volumes in localized regions, even when the ages of acquisition of JSL and Japanese were factored out. More specifically, correlations with the performances of the Word and Sent tasks were found in the left precentral/postcentral gyrus and insula, respectively, while correlations with those of the Disc task were found in the left ventral inferior frontal gyrus and precuneus. The unification of functional and anatomical studies would thus be fruitful for understanding human language systems from the aspects of both universality and individuality.

  11. Posterolateral Corner Reconstruction using the Anatomical Two-Tailed Graft Technique: Clinical Outcomes in the Multiligament Injured Knee.

    Science.gov (United States)

    Woodmass, Jarret M; Sanders, Thomas L; Johnson, Nick R; Wu, Isabella T; Krych, Aaron J; Stuart, Michael J; Levy, Bruce A

    2018-02-14

    Injury to the posterolateral corner (PLC) of the knee can lead to both varus and rotational instability. Multiple PLC reconstruction techniques have been described, including one-tailed graft (fibula-based constructs) or two-tailed graft (combined fibula- and tibia-based constructs). The purpose of our study was to evaluate the clinical outcomes of anatomical two-tailed graft reconstruction of the PLC in the setting of multiligament knee injuries (MKLIs) with grade III varus instability. Patients were identified through a prospective MLKI database between 2004 and 2013. Patients who received fibular collateral ligament and PLC reconstructions using a two-tailed graft and had a minimum follow-up of 2 years were included. Patients were assessed for clinical laxity grade, range of motion, and functional outcomes using Lysholm and International Knee Documentation Committee (IKDC) scores. Twenty patients (16 male, 4 female) with a mean age of 30.7 (range: 16-52) and a mean follow-up of 52.2 months (range: 24-93 months) were included. Knee dislocation (KD) grades included: 4 KD-1, 10 KD 3-L, 5 KD-4, and 1 KD-5. No patients had isolated PLC injuries. Mean IKDC and Lysholm score were 73.1 ± 25.8 and 78 ± 26, respectively. Mean range of motion was -1.1 to 122.8. In full extension, two patients (10%) had grade 1 laxity to varus stress. In 30 degrees of knee flexion, five (25%) patients had grade 1 laxity, and two (10%) had grade 2 laxity. Anatomical two-tailed PLC reconstruction can reliably restore varus stability when performed on patients with MLKIs and type C posterolateral instability with hyperextension external rotation recurvatum deformity. Satisfactory functional outcome scores were achieved in the majority of patients. This study supports the use of an anatomical two-tailed PLC reconstruction in the multiligament injured knee. The level of evidence is IV, case series. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Anatomical terminology and nomenclature: past, present and highlights.

    Science.gov (United States)

    Kachlik, David; Baca, Vaclav; Bozdechova, Ivana; Cech, Pavel; Musil, Vladimir

    2008-08-01

    The anatomical terminology is a base for medical communication. It is elaborated into a nomenclature in Latin. Its history goes back to 1895, when the first Latin anatomical nomenclature was published as Basiliensia Nomina Anatomica. It was followed by seven revisions (Jenaiensia Nomina Anatomica 1935, Parisiensia Nomina Anatomica 1955, Nomina Anatomica 2nd to 6th edition 1960-1989). The last revision, Terminologia Anatomica, (TA) created by the Federative Committee on Anatomical Terminology and approved by the International Federation of Associations of Anatomists, was published in 1998. Apart from the official Latin anatomical terminology, it includes a list of recommended English equivalents. In this article, major changes and pitfalls of the nomenclature are discussed, as well as the clinical anatomy terms. The last revision (TA) is highly recommended to the attention of not only teachers, students and researchers, but also to clinicians, doctors, translators, editors and publishers to be followed in their activities.

  13. Extra-Anatomic Revascularization of Extensive Coral Reef Aorta.

    Science.gov (United States)

    Gaggiano, Andrea; Kasemi, Holta; Monti, Andrea; Laurito, Antonella; Maselli, Mauro; Manzo, Paola; Quaglino, Simone; Tavolini, Valeria

    2017-10-01

    Coral reef aorta (CRA) is a rare, potential lethal disease of the visceral aorta as it can cause visceral and renal infarction. Various surgical approaches have been proposed for the CRA treatment. The purpose of this article is to report different extensive extra-anatomic CRA treatment modalities tailored on the patients' clinical and anatomic presentation. From April 2006 to October 2012, 4 symptomatic patients with extensive CRA were treated at our department. Extra-anatomic aortic revascularization with selective visceral vessels clamping was performed in all cases. Technical success was 100%. No perioperative death was registered. All patients remained asymptomatic during the follow-up period (62, 49, 25, and 94 months, respectively), with bypasses and target vessels patency. The extra-anatomic bypass with selective visceral vessels clamping reduces the aortic occlusion time and the risk of organ ischemia. All approaches available should be considered on a case-by-case basis and in high-volume centers. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Correlating Intravital Multi-Photon Microscopy to 3D Electron Microscopy of Invading Tumor Cells Using Anatomical Reference Points

    Science.gov (United States)

    Karreman, Matthia A.; Mercier, Luc; Schieber, Nicole L.; Shibue, Tsukasa; Schwab, Yannick; Goetz, Jacky G.

    2014-01-01

    Correlative microscopy combines the advantages of both light and electron microscopy to enable imaging of rare and transient events at high resolution. Performing correlative microscopy in complex and bulky samples such as an entire living organism is a time-consuming and error-prone task. Here, we investigate correlative methods that rely on the use of artificial and endogenous structural features of the sample as reference points for correlating intravital fluorescence microscopy and electron microscopy. To investigate tumor cell behavior in vivo with ultrastructural accuracy, a reliable approach is needed to retrieve single tumor cells imaged deep within the tissue. For this purpose, fluorescently labeled tumor cells were subcutaneously injected into a mouse ear and imaged using two-photon-excitation microscopy. Using near-infrared branding, the position of the imaged area within the sample was labeled at the skin level, allowing for its precise recollection. Following sample preparation for electron microscopy, concerted usage of the artificial branding and anatomical landmarks enables targeting and approaching the cells of interest while serial sectioning through the specimen. We describe here three procedures showing how three-dimensional (3D) mapping of structural features in the tissue can be exploited to accurately correlate between the two imaging modalities, without having to rely on the use of artificially introduced markers of the region of interest. The methods employed here facilitate the link between intravital and nanoscale imaging of invasive tumor cells, enabling correlating function to structure in the study of tumor invasion and metastasis. PMID:25479106

  15. The test-retest reliability of anatomical co-ordinate axes definition for the quantification of lower extremity kinematics during running.

    Science.gov (United States)

    Sinclair, Jonathan; Taylor, Paul John; Greenhalgh, Andrew; Edmundson, Christopher James; Brooks, Darrell; Hobbs, Sarah Jane

    2012-12-01

    Three-dimensional (3-D) kinematic analyses are used widely in both sport and clinical examinations. However, this procedure depends on reliable palpation of anatomical landmarks and mal-positioning of markers between sessions may result in improperly defined segment co-ordinate system axes which will produce in-consistent joint rotations. This had led some to question the efficacy of this technique. The aim of the current investigation was to assess the reliability of the anatomical frame definition when quantifying 3-D kinematics of the lower extremities during running. Ten participants completed five successful running trials at 4.0 m·s(-1) ± 5%. 3-D angular joint kinematics parameters from the hip, knee and ankle were collected using an eight camera motion analysis system. Two static calibration trials were captured. The first (test) was conducted prior to the running trials following which anatomical landmarks were removed. The second was obtained following completion of the running trials where anatomical landmarks were re-positioned (retest). Paired samples t-tests were used to compare 3-D kinematic parameters quantified using the two static trials, and intraclass correlations were employed to examine the similarities between the sagittal, coronal and transverse plane waveforms. The results indicate that no significant (p>0.05) differences were found between test and retest 3-D kinematic parameters and strong (R(2)≥0.87) correlations were observed between test and retest waveforms. Based on the results obtained from this investigation, it appears that the anatomical co-ordinate axes of the lower extremities can be defined reliably thus confirming the efficacy of studies using this technique.

  16. Correlation between anatomic foot and ankle movement measured with MRI and with a motion analysis system.

    Science.gov (United States)

    Marquez-Barrientos, C; Liu, X C; Lyon, R; Tassone, C; Thometz, J; Tarima, S

    2012-07-01

    Several studies have attempted to measure how well external markers track internal bone movement using pins drilled into the foot, but this is too invasive for the pediatric population. This study investigated how well a six segment foot model (6SFM) using external markers was able to measure bone movement in the foot compared to MRI measurements. The foot was moved into different positions using a plastic foot jig and measurements were taken with both systems. The aims were to: (1) Look at the correlation between movement tracked with an Electronic Motion Tracking System (EMTS) and by measurements derived from MRI images, specifically the principal intercept angles (PIAs) which are the angles of intersection between principal axes of inertia of bone volumes. (2) To see how well external motion measured by the 6SFM could predict PIAs. Four bone pairs had their movement tracked: Tibia-Calcaneus, Calcaneus-Cuboid, Navicular-1st Metatarsal, and 1st Metatarsal-Hallux. The results showed moderate correlation between measured PIAs and those predicted at the Tibia-Calcaneus, Navicular-1st Metatarsal, and 1st Metatarsal-Hallux joints. Moderate to high correlation was found between the PIA and movement in a single anatomic plane for all four joints at several positions. The 6SFM using the EMTS allows reliable tracking of 3D rotations in the pediatric foot, except at the Calcaneus-Cuboid joint. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Early Results of Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Demet Pepele

    2014-03-01

    Full Text Available Aim: The goal in anterior cruciate ligament reconstruction (ACLR is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our clinic between June 2009 and March 2010, performed the anatomic double bundle ACLR with autogenous hamstring grafts 20 patients were evaluated prospectively with Cincinnati, IKDC and Lysholm scores and in clinically for muscle strength and with Cybex II dynamometer. Results: The mean follow-up is 17.8 months (13-21 months. Patients%u2019 scores of Cincinnati, IKDC and Lysholm were respectively, preoperative 18.1, 39.3 and 39.8, while the post-op increased to 27.2, 76.3 and 86.3. In their last check, 17 percent of the patients according to IKDC scores (85% A (excellent and B (good group and 3 patients took place as C (adequate group. The power measurements of quadriceps and hamstring muscle groups of patients who underwent surgery showed no significant difference compared with the intact knees. Discussion: Double-bundle ACL reconstruction is a satisfactory method. There is a need comparative, long-term studies in large numbers in order to determine improving clinical outcome, preventing degeneration and restoring the knee biomechanics better.

  18. Coronoid process of the ulna: paleopathologic and anatomic study with imaging correlation. Emphasis on the anteromedial ''facet''

    Energy Technology Data Exchange (ETDEWEB)

    Freitas Valle de Lemos Weber, Marcio [University of California, Department of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States); Santa Maria, Rio Grande do Sul (Brazil); Barbosa, Diogo Miranda; Belentani, Clarissa; Negrao Ramos, Pedro Miguel; Trudell, Debra; Resnick, Donald [University of California, Department of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States)

    2009-01-15

    The purpose of this study was to provide a detailed description of the anatomy of the coronoid process of the ulna and to use magnetic resonance (MR) images and anatomic correlation with cadavers to show the macroscopic configuration of this structure. Photography and high-resolution radiography were performed in 26 ulna specimens from the collection of a local museum. MR imaging of the coronoid process of 11 cadaveric elbows was performed. The images were compared with those seen on anatomic sectioning. The anteromedial rim of the coronoid process of the ulna had a regular surface, without osseous irregularities or facets in 69.2% of the specimens. In 30.8% of the specimens, the anteromedial rim was not regular and a small ridge could be identified. The insertion site of the joint capsule was onto the anterior aspect of the coronoid process, at an average distance of 5.9 mm distal to the tip. The attachment of the anterior band of the ulnar collateral ligament at the sublime tubercle was flush with the articular margin in 63.6% of the specimens. In 36.4% of the specimens, a more distal attachment, with a separation between the undersurface of the ligament and the adjacent tubercle, was seen. The brachialis tendon was attached to the coronoid process at a mean distance of 12.1 mm distal to the tip. The coronoid process of the ulna is a small osseous structure with a complex anatomy and presents some anatomical variations. (orig.)

  19. Peroneal nerve injury in three patients with knee trauma: MR imaging and correlation with anatomic findings in volunteers and anatomic specimens

    Energy Technology Data Exchange (ETDEWEB)

    Trappeniers, Laurence; Osteaux, Michel [Department of Radiology, Vrije Universiteit Brussels, Brussels (Belgium); De Maeseneer, Michel [Department of Radiology, Vrije Universiteit Brussels, Brussels (Belgium); Department of Radiology, AZ VUB, Laarbeeklaan 101, 1090, Jette (Belgium); Van Roy, Peter [Department of Experimental Anatomy, Vrije Universiteit Brussels, Brussels (Belgium); Chaskis, Christo [Department of Neurosurgery, Vrije Universiteit Brussels, Brussels (Belgium)

    2003-07-01

    The aim of this article is to report on three patients with injuries of the peroneal nerve along the posterolateral aspect of the knee. Injuries in this area are less common than the injuries occurring at the level of the fibular head. In this article we report on three patients with posterolateral knee trauma who had peroneal nerve dysfunction. To better understand the precise location of the nerve on MR images, we performed MR imaging in five volunteers, and studied the position of the nerve on anatomic dissection (n=1) and anatomic slices (n=1). The common peroneal nerve is easily depicted on MR images and has a typical location along the posterior margin of the biceps tendon. Non-visualisation of the peroneal nerve at the posterolateral aspect of the knee, as seen on MR images, is consistent with nerve injury. Scar tissue at the posterolateral aspect of the knee indicates injury of this specific area, and involvement of the peroneal nerve is likely. (orig.)

  20. Recent advances in standards for collaborative Digital Anatomic Pathology

    Science.gov (United States)

    2011-01-01

    reports that are interoperable at an international level. The use of machine-readable format of APSR supports the development of decision support as well as secondary use of Anatomic Pathology information for epidemiology or clinical research. PMID:21489187

  1. Comparative radiographic analysis on the anatomical axis in knee osteoarthritis cases: inter and intraobserver evaluation

    Directory of Open Access Journals (Sweden)

    Luiz Felipe Matos

    2015-06-01

    Full Text Available OBJECTIVE: To make a comparative inter and intraobserver analysis on measurements of the anatomical axis between panoramic radiographs of the lower limbs in anteroposterior (AP view with bipedal weight-bearing, on short film.METHODS: An accuracy study comparing radiographic measurements on 47 knees of patients attending the knee surgery outpatient clinic due to osteoarthritis. The radiographic evaluation used was as standardized for the total knee arthroplasty program, including panoramic AP views of the lower limbs and short radiographs of the knees in AP and lateral views, all with bipedal weight-bearing. Following this, the anatomical axis of the lower limbs or the femorotibial angle was measured by five independent examiners on the panoramic and short AP radiographs; three of the examiners were considered to be more experienced and two, less experienced. All the measurements were made again by the same examiners after an interval of not less than 15 days. The statistical analysis was performed using the intraclass correlation coefficient, in order to evaluate the inter and intraobserver concordance of the anatomical axis measurements.RESULTS: From the statistical analysis, it was observed that there was strongly significant concordance between the anatomical axis measurements on the panoramic and short radiographs, for all the five examiners and for both measurements.CONCLUSIONS: Under the conditions studied, short radiographs were equivalent to panoramic radiographs for evaluating the anatomical axis of the lower limbs in patients with advanced osteoarthritis. The measurements used also showed high rates of inter and intraobserver concordance and reproducibility.

  2. Measuring the nose in septorhinoplasty patients: ultrasonographic standard values and clinical correlations.

    Science.gov (United States)

    Stenner, Markus; Koopmann, Mario; Rudack, Claudia

    2017-02-01

    Although septorhinoplasty is the most commonly performed operation in plastic surgery, and the surgical plan as well as its outcome is directly related to the configuration of the anatomical structures in the nose, these are not routinely assessed preoperatively. The aim of our study was to evaluate the nasal soft tissue and cartilaginous structures by means of high-resolution ultrasonography to set up clinical correlations and standard values. We examined 44 patients before septorhinoplasty by high-resolution ultrasonography in noncontact mode. All pictures were quantitatively evaluated by measuring 13 lengths and 4 ratios. All patients underwent a rhinomanometry measuring the nasal air flow. Besides others, men as well as older patients have a significantly thicker alar cartilage. Patients with thinner alar cartilages have a significantly smaller interdomal distance as well as significantly thinner upper lateral cartilages. The soft tissue above the bony dorsum was significantly thicker in older patients. Younger patients have significantly thicker soft tissue in relation to their cartilage. Patients with thicker soft tissue and thinner cartilage have a smaller tip. The interdomal distance and the thickness of the cartilaginous septum significantly correlated with the nasal air flow. We set up standard values of nasal structures in septorhinoplasty patients which can be used as reference values. By judging cartilage and soft tissue characteristics preoperatively, relevant factors for distinct procedures could be analyzed and the surgical steps can be better planned. Visualization by ultrasonography enables the surgeon to achieve treatment goals in a more predictable fashion.

  3. Distal insertions of the semimembranosus tendon: MR imaging with anatomic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Maeseneer, Michel de [Universitair Ziekenhuis Brussel, Department of Radiology, Jette, Brussels (Belgium); Vrije Universiteit Brussel, Department of Experimental Anatomy, Brussels (Belgium); Shahabpour, Maryam; Milants, Annemieke; Ridder, Filip de; Mey, Johan de [Universitair Ziekenhuis Brussel, Department of Radiology, Jette, Brussels (Belgium); Lenchik, Leon [Wake Forest University, Department of Radiology, Winston-Salem, NC (United States); Cattrysse, Erik [Vrije Universiteit Brussel, Department of Experimental Anatomy, Brussels (Belgium)

    2014-06-15

    The purpose of this study is to investigate the distal insertions of the semimembranosus tendon with MR imaging, correlated with findings in cadavers. Four fresh cadaveric specimens were studied with 3-T MR imaging. Sequences included proton density (PD) sequences (TE, 13; TR, 4957; FOV, 170 x 170; matrix, 424 x 413; NA, 2; slice thickness, 2.5 mm) in the axial, coronal, and sagittal planes and 3D fast field echo (FFE) sequences (TR 9.4; TE 6.9; FOV, 159 x 105; matrix, 200 x 211; NA, 2; slice thickness, 0.57 mm). One specimen was dissected and three specimens were sectioned with a bandsaw in the axial, coronal, and sagittal plane. The sections were photographed and correlated with MR images. To standardize the analysis, the semimembranosus muscle and tendon were assessed at seven levels for the axial sections, and at three levels for the coronal and sagittal sections. Anatomic dissection revealed six insertions of the distal semimembranosus tendon: direct arm, anterior arm, posterior oblique ligament extension, oblique popliteal ligament extension, distal tibial expansion (popliteus aponeurosis), and meniscal arm. Axial MR images showed five of six insertions: direct arm, anterior arm, oblique popliteal ligament extension, posterior oblique ligament extension, and distal tibial expansion. Sagittal MR images showed four of six insertions: direct arm, anterior arm, oblique popliteal ligament arm, and distal tibial expansion. Sagittal MR images were ideal for showing the direct arm insertion, but were less optimal than the axial images for showing the other insertions. The anterior arm was seen but volume averaging was present with the gracilis tendon. Coronal MR images optimally revealed the anterior arm, although magic angle artifact was present at its posterior aspect. The common semimembranosus tendon and meniscal arm were also well depicted. The division in anterior arm, direct arm, and oblique popliteal ligament arm was poorly seen on coronal images due to

  4. Variability amongst radiographers in the categorization of clinical acceptability for digital trauma radiography

    Science.gov (United States)

    Decoster, Robin; Toomey, Rachel; Smits, Dirk; Mol, Harrie; Verhelle, Filip; Butler, Marie-Louise

    2016-03-01

    Introduction: Radiographers evaluate anatomical structures to judge clinical acceptability of a radiograph. Whether a radiograph is deemed acceptable for diagnosis or not depends on the individual decision of the radiographer. Individual decisions cause variation in the accepted image quality. To minimise these variations definitions of acceptability, such as in RadLex, were developed. On which criteria radiographers attribute a RadLex categories to radiographs is unknown. Insight into these criteria helps to further optimise definitions and reduce variability in acceptance between radiographers. Therefore, this work aims the evaluation of the correlation between the RadLex classification and the evaluation of anatomical structures, using a Visual Grading Analysis (VGA) Methods: Four radiographers evaluated the visibility of five anatomical structures of 25 lateral cervical spine radiographs on a secondary class display with a VGA. They judged clinical acceptability of each radiograph using RadLex. Relations between VGAS and RadLex category were analysed with Kendall's Tau correlation and Nagelkerke pseudo-R². Results: The overall VGA score (VGAS) and the RadLex score correlate (rτ= 0.62, pscore. The reproduction of spinous processes (rτ=0.67, pscore. Conclusion: RadLex scores and VGAS correlate positively, strongly and significantly. The predictive value of bony structures may support the use of these in the judgement of clinical acceptability. Considerable inter-observer variations in the VGAS within a certain RadLex category, suggest that observers use of observer specific cut-off values.

  5. Correlation between anatomical characteristics of ethanol organosolv pretreated Buddleja davidii and its enzymatic conversion to glucose.

    Science.gov (United States)

    Hallac, Bassem B; Ray, Michael; Murphy, Richard J; Ragauskas, Arthur J

    2010-12-01

    Buddleja davidii is a unique biomass that has many attractive agroenergy features, especially its wide range of growth habitat. The anatomical characteristics of B. davidii were investigated before and after ethanol organosolv pretreatment (one of the leading pretreatment technologies) in order to further understand the alterations that occur to the cellular structure of the biomass which can then be correlated with its enzymatic digestibility. Results showed that the ethanol organosolv pretreatment of B. davidii selectively removes lignin from the middle lamella (ML), which does not significantly disrupt the crystalline structure of cellulose. The removal of ML lignin is a major factor in enhancing enzymatic cellulose-to-glucose hydrolysis. The pretreatment also causes cell deformation, resulting in cracks and breaks in the cell wall. These observations, together with characterization analysis of the cell wall polymer material, lend support to the hypothesis that the physical distribution of lignin in the biomass matrix is an important structural feature affecting biomass enzymatic digestibility. © 2010 Wiley Periodicals, Inc.

  6. Anatomic variability of the vascularized composite osteomyocutaneous flap from the medial femoral condyle: an anatomical study

    Directory of Open Access Journals (Sweden)

    Trung-Hau Le Thua

    2014-12-01

    Full Text Available Aim: The anatomical study and clinical application for the vascularized corticoperiosteal flap from the medial femoral condyle have been performed and described previously. Although prior studies have described the composite osteomyocutaneous flap from the medial femoral condyle, a detailed analysis of the vascularity of this region has not yet been fully evaluated. Methods: This anatomical study described the variability of the arteries from the medial femoral condyle in 40 cadaveric specimens. Results: The descending genicular artery (DGA was found in 33 of 40 cases (82.5%. The  superomedial genicular artery (SGA was present in 10 cases (25%. All 33 cases (100% of the DGA had articular branches to the periosteum of the medial femoral condyle. Muscular branches and saphenous branches of the DGA were present in 25 cases (62.5% and 26 cases (70.3%, respectively. Conclusion: The current study demonstrates that the size and length of the vessels to the medial femoral condyle are sufficient for a vascularized bone flap. A careful preoperative vascular assessment is essential prior to use of the vascularized composite osteomyocutaneous flap from the medial femoral condyle, because of the considerable anatomical variations in different branches of the DGA.

  7. Clinical and Anatomical Correlates of Apraxia of Speech

    Science.gov (United States)

    Ogar, Jennifer; Willock, Sharon; Baldo, Juliana; Wilkins, David; Ludy, Carl; Dronkers, Nina

    2006-01-01

    In a previous study (Dronkers, 1996), stroke patients identified as having apraxia of speech (AOS), an articulatory disorder, were found to have damage to the left superior precentral gyrus of the insula (SPGI). The present study sought (1) to characterize the performance of patients with AOS on a classic motor speech evaluation, and (2) to…

  8. Anatomical study of the popliteal artery perforator-based propeller flap and its clinical application.

    Science.gov (United States)

    Onishi, Tadanobu; Shimizu, Takamasa; Omokawa, Shohei; Sananpanich, Kanit; Kido, Akira; Mahakkanukrauh, Pasuk; Tanaka, Yasuhito

    2018-05-30

    There is lack of anatomical information regarding cutaneous perforator of the popliteal artery and its connections with the descending branch of the inferior gluteal and profunda femoris arteries. We aimed to evaluate the anatomical basis of popliteal artery perforator-based propeller flap from the posterior thigh region and to demonstrate our experience utilizing this flap. Ten fresh cadaveric lower extremities were dissected following injection of a silicone compound into the femoral artery. We investigated the number, location, length, and diameter of cutaneous perforators of the popliteal artery. Based on the results, we treated three cases with a large soft tissue defect around the knee using popliteal artery perforator-based propeller flap. We found a mean of 1.9 cutaneous perforators arising from the popliteal artery with a mean pedicle length of 6 cm and a mean arterial internal diameter of 0.9 mm, which were located at an average of 4 cm proximal to the bicondylar line. The most distal perforator consistently arose along the small saphenous vein and connected proximally with concomitant artery of the posterior femoral cutaneous nerve, forming a connection with perforating arteries of the profunda femoris artery. A mean of 4.5 cutaneous perforators branched from the arterial connection sites. All clinical cases healed without any complications. The popliteal artery perforator-based propeller flap is reliable for reconstruction of soft tissue defects around the knee. The flap should include the deep fascia and concomitant artery along with the posterior femoral cutaneous nerve for maintaining the blood supply.

  9. Quantitative renal scintigraphy: anatomo-clinical and biological correlation (concerning 51 mercury 197 renal scintigraphs)

    International Nuclear Information System (INIS)

    Pinganaud, J.-M.

    1976-01-01

    To find out whether the renal mercury uptake measurement in urology is a satisfactory way to judge the separate functional value of the kidneys the records of 51 patients were examined. The exploration took place as follows: - injection of 300 μCi 197 HgCl 2 , - measurement of the radioactivity fixed on each kidney, three days later, by means of a gamma camera. Of these 51 uptake measurements only one result appears inconsistent by excess. All the others agree perfectly with comparative observations. On the whole a close correlation is found between the renal mercury uptake measurement and the various clinical, urographic and anatomical data obtained on this group of patients. The method seems to be ideal because reliable, harmless and repeatable. Where dosimetry is concerned an injected dose of 300μCi delivers 9mrad to each kidney, 6mrad to the ovaries. By way of comparison it is interesting to note that an intraveinous urograph with 5 exposures delivers 500mrad to the ovaries. It is considered safe to repeat the examination 3 to 4 times on one patient [fr

  10. Single versus double-row repair of the rotator cuff: does double-row repair with improved anatomical and biomechanical characteristics lead to better clinical outcome?

    Science.gov (United States)

    Pauly, Stephan; Gerhardt, Christian; Chen, Jianhai; Scheibel, Markus

    2010-12-01

    Several techniques for arthroscopic repair of rotator cuff defects have been introduced over the past years. Besides established techniques such as single-row repairs, new techniques such as double-row reconstructions have gained increasing interest. The present article therefore provides an overview of the currently available literature on both repair techniques with respect to several anatomical, biomechanical, clinical and structural endpoints. Systematic literature review of biomechanical, clinical and radiographic studies investigating or comparing single- and double-row techniques. These results were evaluated and compared to provide an overview on benefits and drawbacks of the respective repair type. Reconstructions of the tendon-to-bone unit for full-thickness tears in either single- or double-row technique differ with respect to several endpoints. Double-row repair techniques provide more anatomical reconstructions of the footprint and superior initial biomechanical characteristics when compared to single-row repair. With regard to clinical results, no significant differences were found while radiological data suggest a better structural tendon integrity following double-row fixation. Presently published clinical studies cannot emphasize a clearly superior technique at this time. Available biomechanical studies are in favour of double-row repair. Radiographic studies suggest a beneficial effect of double-row reconstruction on structural integrity of the reattached tendon or reduced recurrent defect rates, respectively.

  11. Alexia without agraphia: Clinical-computed tomographic correlations

    International Nuclear Information System (INIS)

    Weisberg, L.A.; Wall, M.; Charity Hospital, New Orleans, LA; Veterans Administration Hospital, New Orleans, LA

    1987-01-01

    Four patients with alexia without agraphia had CT lesions which correlated with the clinical findings. All lesions were vascular; two were spontaneous intracerebral hematomas and two were ischemic infarctions in the posterior cerebral artery distribution. The lesions were located in the posterior portion of the dominant hemisphere. The location of the lesion correlated with the presence or absence of visual field abnormalities. (orig.)

  12. Computerized Tomographic Study on the Anatomic Variation of the Paranasal Sinus

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sun Kyung; Lim, Sug Young; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology and Institute of Oral Bio Science, College of Dentistry, Chonbuk National University, Chonju (Korea, Republic of); Park, Mi Ju [Dept. of Prosthodontics, School of Denstistry, Chonbuk National Universty, Chonju (Korea, Republic of)

    1999-08-15

    To evaluate the anatomic variations of the paranasal sinuses on computed tomographs. The author examined the CT images of the paranasal sinuses retrospectively in 500 patients who visited Chonbuk National University Hospital between January 1996 and December 1997. The highest incidence of anatomic variation of the paranasal sinuses in bilateral structures was agger nasi cell (73.2%), followed by concha bullosa (31.1%), Onodi cell (24.0%), Haller cell (19.8%), maxillary sinus septum (13.0%), paradoxical middle turbinate (2.5%), pneumatized uncinate process (2.0%), and bent uncinate process. The highest incidence of anatomic variation in midline structures was nasal septum deviation(53.2%), followed by nasal septumaerated (29.4%), bulla galli (24.7%) asymmetric intersphenoid septum (22.3%), and nasal septum spur (13.8%). The correlation between anatomic variation and paranasal sinusitis was not found. The results of this study will aid in the diagnosis and treatment of paranasal sinus diseases, especially in the treatment planning before functional endoscopic surgery.

  13. Computerized Tomographic Study on the Anatomic Variation of the Paranasal Sinus

    International Nuclear Information System (INIS)

    Choi, Sun Kyung; Lim, Sug Young; Koh, Kwang Joon; Park, Mi Ju

    1999-01-01

    To evaluate the anatomic variations of the paranasal sinuses on computed tomographs. The author examined the CT images of the paranasal sinuses retrospectively in 500 patients who visited Chonbuk National University Hospital between January 1996 and December 1997. The highest incidence of anatomic variation of the paranasal sinuses in bilateral structures was agger nasi cell (73.2%), followed by concha bullosa (31.1%), Onodi cell (24.0%), Haller cell (19.8%), maxillary sinus septum (13.0%), paradoxical middle turbinate (2.5%), pneumatized uncinate process (2.0%), and bent uncinate process. The highest incidence of anatomic variation in midline structures was nasal septum deviation(53.2%), followed by nasal septumaerated (29.4%), bulla galli (24.7%) asymmetric intersphenoid septum (22.3%), and nasal septum spur (13.8%). The correlation between anatomic variation and paranasal sinusitis was not found. The results of this study will aid in the diagnosis and treatment of paranasal sinus diseases, especially in the treatment planning before functional endoscopic surgery.

  14. SU-C-207B-02: Maximal Noise Reduction Filter with Anatomical Structures Preservation

    Energy Technology Data Exchange (ETDEWEB)

    Maitree, R; Guzman, G; Chundury, A; Roach, M; Yang, D [Washington University School of Medicine, St Louis, MO (United States)

    2016-06-15

    Purpose: All medical images contain noise, which can result in an undesirable appearance and can reduce the visibility of anatomical details. There are varieties of techniques utilized to reduce noise such as increasing the image acquisition time and using post-processing noise reduction algorithms. However, these techniques are increasing the imaging time and cost or reducing tissue contrast and effective spatial resolution which are useful diagnosis information. The three main focuses in this study are: 1) to develop a novel approach that can adaptively and maximally reduce noise while preserving valuable details of anatomical structures, 2) to evaluate the effectiveness of available noise reduction algorithms in comparison to the proposed algorithm, and 3) to demonstrate that the proposed noise reduction approach can be used clinically. Methods: To achieve a maximal noise reduction without destroying the anatomical details, the proposed approach automatically estimated the local image noise strength levels and detected the anatomical structures, i.e. tissue boundaries. Such information was used to adaptively adjust strength of the noise reduction filter. The proposed algorithm was tested on 34 repeating swine head datasets and 54 patients MRI and CT images. The performance was quantitatively evaluated by image quality metrics and manually validated for clinical usages by two radiation oncologists and one radiologist. Results: Qualitative measurements on repeated swine head images demonstrated that the proposed algorithm efficiently removed noise while preserving the structures and tissues boundaries. In comparisons, the proposed algorithm obtained competitive noise reduction performance and outperformed other filters in preserving anatomical structures. Assessments from the manual validation indicate that the proposed noise reduction algorithm is quite adequate for some clinical usages. Conclusion: According to both clinical evaluation (human expert ranking) and

  15. SU-C-207B-02: Maximal Noise Reduction Filter with Anatomical Structures Preservation

    International Nuclear Information System (INIS)

    Maitree, R; Guzman, G; Chundury, A; Roach, M; Yang, D

    2016-01-01

    Purpose: All medical images contain noise, which can result in an undesirable appearance and can reduce the visibility of anatomical details. There are varieties of techniques utilized to reduce noise such as increasing the image acquisition time and using post-processing noise reduction algorithms. However, these techniques are increasing the imaging time and cost or reducing tissue contrast and effective spatial resolution which are useful diagnosis information. The three main focuses in this study are: 1) to develop a novel approach that can adaptively and maximally reduce noise while preserving valuable details of anatomical structures, 2) to evaluate the effectiveness of available noise reduction algorithms in comparison to the proposed algorithm, and 3) to demonstrate that the proposed noise reduction approach can be used clinically. Methods: To achieve a maximal noise reduction without destroying the anatomical details, the proposed approach automatically estimated the local image noise strength levels and detected the anatomical structures, i.e. tissue boundaries. Such information was used to adaptively adjust strength of the noise reduction filter. The proposed algorithm was tested on 34 repeating swine head datasets and 54 patients MRI and CT images. The performance was quantitatively evaluated by image quality metrics and manually validated for clinical usages by two radiation oncologists and one radiologist. Results: Qualitative measurements on repeated swine head images demonstrated that the proposed algorithm efficiently removed noise while preserving the structures and tissues boundaries. In comparisons, the proposed algorithm obtained competitive noise reduction performance and outperformed other filters in preserving anatomical structures. Assessments from the manual validation indicate that the proposed noise reduction algorithm is quite adequate for some clinical usages. Conclusion: According to both clinical evaluation (human expert ranking) and

  16. Laryngeal spaces and lymphatics: current anatomic concepts

    International Nuclear Information System (INIS)

    Welsh, L.W.; Welsh, J.J.; Rizzo, T.A. Jr.

    1983-01-01

    This investigation evaluates the anatomic concepts of individual spaces or compartments within the larynx by isotope and dye diffusion. The authors identified continuity of spaces particularly within the submucosal planes and a relative isolation within the fixed structures resulting from the longitudinal pattern of fibroelastic tissues, muscle bands, and perichondrium. The historical data of anatomic resistance are refuted by the radioisotope patterns of dispersion and the histologic evidence of tissue permeability to the carbon particles. There is little clinical application of the compartment concept to the perimeter of growth and the configuration of extensive endolaryngeal cancers. The internal and extralaryngeal lymphatic network is presented and the regional associations are identified. The normal ipsilateral relationship is distorted by dispersion within the endolarynx supervening the anatomic midline. The effects of lymphatic obstruction caused by regional lymphadenectomy, tumor fixation, and irradiation-infection sequelae are illustrated; these result in widespread bilateral lymphatic nodal terminals. Finally, the evidence suggests that the internal network is modified by external interruption to accommodate an outflow system in continuity with the residual patent lymphatic channels

  17. [Development and clinical application of a new type of anatomical locking plate for sternoclavicular joint fracture and dislocation].

    Science.gov (United States)

    Sun, Yuanlin; Yang, Yunkang; Ge, Jianhua; Yang, Kun; Xiang, Feifan; Zhou, Ju; Liang, Jie

    2018-03-01

    To report a new type of anatomical locking plate for sternocalvicular joint, and investigate its effectiveness in treatment of sternoclavicular joint fracture and dislocation. A new type of anatomical locking plate for sternoclavicular joint was developed, which accorded with the anatomical features and biomechanical characteristics of Chinese sternoclavicular joint. By adopting the method of clinical randomized controlled study, 32 patients with the sternoclavicular joint fracture and dislocation who met the selection criteria between June 2008 and May 2015 were randomly divided into groups A and B ( n =16), and the patients were treated with new anatomic locking plate and distal radial T locking plate internal fixation, respectively. There was no significant difference between 2 groups in gender, age, injured side, body mass index, cause of injury, type of injury, the time from injury to operation, and preoperative Rockwood grading score ( P >0.05). The operation time, intraoperative blood loss, incision length, hospitalization time, and postoperative complications in 2 groups were recorded, and the effectiveness was evaluated by Rockwood grading score. The operations of 2 groups completed successfully. The operation time, intraoperative blood loss, and hospitalization time in group A were significantly less than those in group B ( P case of sternoclavicular joint pain and 2 cases of wound infection; in group B, there were 1 case of sternoclavicular joint pain, 1 case of internal fixation loosening, and 1 case of sternoclavicular joint re-dislocation; there was no significant difference in complication incidence between 2 groups ( P =1.000). The Rockwood grading scores at each time point after operation in 2 groups were significantly higher than those before operation. At 1 month after operation, the Rockwood grading score in group A was significantly higher than that in group B ( t= 2.270, P =0.031); but there was no significant difference in the Rockwood

  18. Evolution of the Anatomical Theatre in Padova

    Science.gov (United States)

    Macchi, Veronica; Porzionato, Andrea; Stecco, Carla; Caro, Raffaele

    2014-01-01

    The anatomical theatre played a pivotal role in the evolution of medical education, allowing students to directly observe and participate in the process of dissection. Due to the increase of training programs in clinical anatomy, the Institute of Human Anatomy at the University of Padova has renovated its dissecting room. The main guidelines in…

  19. Chronic ankle instability: Arthroscopic anatomical repair.

    Science.gov (United States)

    Arroyo-Hernández, M; Mellado-Romero, M; Páramo-Díaz, P; García-Lamas, L; Vilà-Rico, J

    Ankle sprains are one of the most common injuries. Despite appropriate conservative treatment, approximately 20-40% of patients continue to have chronic ankle instability and pain. In 75-80% of cases there is an isolated rupture of the anterior talofibular ligament. A retrospective observational study was conducted on 21 patients surgically treated for chronic ankle instability by means of an arthroscopic anatomical repair, between May 2012 and January 2013. There were 15 men and 6 women, with a mean age of 30.43 years (range 18-48). The mean follow-up was 29 months (range 25-33). All patients were treated by arthroscopic anatomical repair of anterior talofibular ligament. Four (19%) patients were found to have varus hindfoot deformity. Associated injuries were present in 13 (62%) patients. There were 6 cases of osteochondral lesions, 3 cases of posterior ankle impingement syndrome, and 6 cases of peroneal pathology. All these injuries were surgically treated in the same surgical time. A clinical-functional study was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. The mean score before surgery was 66.12 (range 60-71), and after surgery it increased up to a mean of 96.95 (range 90-100). All patients were able to return to their previous sport activity within a mean of 21.5 weeks (range 17-28). Complications were found in 3 (14%) patients. Arthroscopic anatomical ligament repair technique has excellent clinical-functional results with a low percentage of complications, and enables patients to return to their previous sport activity within a short period of time. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Anatomically-specific intratubular and interstitial biominerals in the human renal medullo-papillary complex.

    Directory of Open Access Journals (Sweden)

    Ling Chen

    Full Text Available Limited information exists on the anatomically-specific early stage events leading to clinically detectable mineral aggregates in the renal papilla. In this study, quantitative multiscale correlative maps of structural, elemental and biochemical properties of whole medullo-papillary complexes from human kidneys were developed. Correlative maps of properties specific to the uriniferous and vascular tubules using high-resolution X-ray computed tomography, scanning and transmission electron microscopy, energy dispersive X-ray spectroscopy, and immunolocalization of noncollagenous proteins (NCPs along with their association with anatomy specific biominerals were obtained. Results illustrated that intratubular spherical aggregates primarily form at the proximal regions distant from the papillary tip while interstitial spherical and fibrillar aggregates are distally located near the papillary tip. Biominerals at the papillary tip were closely localized with 10 to 50 μm diameter vasa recta immunolocalized for CD31 inside the medullo-papillary complex. Abundant NCPs known to regulate bone mineralization were localized within nanoparticles, forming early pathologic mineralized regions of the complex. Based on the physical association between vascular and urothelial tubules, results from light and electron microscopy techniques suggested that these NCPs could be delivered from vasculature to prompt calcification of the interstitial regions or they might be synthesized from local vascular smooth muscle cells after transdifferentiation into osteoblast-like phenotypes. In addition, results provided insights into the plausible temporal events that link the anatomically specific intratubular mineral aggregates with the interstitial biomineralization processes within the functional unit of the kidney.

  1. Impact of the clinical ultrasound elective course on retention of anatomical knowledge by second-year medical students in preparation for board exams.

    Science.gov (United States)

    Kondrashov, Peter; Johnson, Jane C; Boehm, Karl; Rice, Daris; Kondrashova, Tatyana

    2015-03-01

    Ultrasound has been integrated into a gross anatomy course taught during the first year at an osteopathic medical school. A clinical ultrasound elective course was developed to continue ultrasound training during the second year of medical school. The purpose of this study was to evaluate the impact of this elective course on the understanding of normal anatomy by second-year students. An anatomy exam was administered to students enrolled in the clinical ultrasound elective course before the start of the course and after its conclusion. Wilcoxon signed ranks tests were used to determine whether exam scores changed from the pre-test to the post-test. Scores from two classes of second-year students were analyzed. Students who took the elective course showed significant improvement in the overall anatomy exam score between the pre-test and post-test (P students with an important review of key anatomical concepts while preparing them for board exams. Our results suggested that more emphasis should be placed on head and neck ultrasound to improve student performance in those areas. Musculoskeletal, abdominal, and heart ultrasound labs were more successful for retaining relevant anatomical information. © 2014 Wiley Periodicals, Inc.

  2. Return-to-activity after anatomical reconstruction of acute high-grade acromioclavicular separation.

    Science.gov (United States)

    Saier, T; Plath, J E; Beitzel, K; Minzlaff, P; Feucht, J M; Reuter, S; Martetschläger, F; Imhoff, Andreas B; Aboalata, M; Braun, S

    2016-04-02

    To evaluate return-to-activity (RtA) after anatomical reconstruction of acute high-grade acromioclavicular joint (ACJ) separation. A total of 42 patients with anatomical reconstruction of acute high-grade ACJ-separation (Rockwood Type V) were surveyed to determine RtA at a mean 31 months follow-up (f-u). Sports disciplines, intensity, level of competition, participation in overhead and/or contact sports, as well as activity scales (DASH-Sport-Module, Tegner Activity Scale) were evaluated. Functional outcome evaluation included Constant score and QuickDASH. All patients (42/42) participated in sporting activities at f-u. Neither participation in overhead/contact sports, nor level of activity declined significantly (n.s.). 62 % (n = 26) of patients reported subjective sports specific ACJ integrity to be at least the same as prior to the trauma. Sporting intensity (hours/week: 7.3 h to 5.4 h, p = .004) and level of competition (p = .02) were reduced. If activity changed, in 50 % other reasons but clinical symptoms/impairment were named for modified behavior. QuickDASH (mean 6, range 0-54, SD 11) and DASH-Sport-Module (mean 6, range 0-56, SD 13) revealed only minor disabilities at f-u. Over time Constant score improved significant to an excellent score (mean 94, range 86-100, SD 4; p < .001). Functional outcome was not correlated with RtA (n.s.). All patients participated in sporting activities after anatomical reconstruction of high-grade (Rockwood Type V) ACJ-separation. With a high functional outcome there was no significant change in activity level (Tegner) and participation in overhead and/or contact sports observed. There was no correlation between functional outcome and RtA. Limiting, there were alterations in time spent for sporting activities and level of competition observed. But in 50 % those were not related to ACJ symptoms/impairment. Unrelated to successful re-established integrity and function of the ACJ it should be considered that

  3. Magnetic resonance imaging of the menisci of the knee. Normal images. Pitfalls. Meniscus degeneration. Anatomical correlation

    International Nuclear Information System (INIS)

    Helenon, O.; Laval-Jeantet, M.; Bastian, D.

    1989-01-01

    The results of a study on 5 knees of fresh corpses explored with magnetic resonance imaging are reported, including 1 examined before and after intraarticular contrast injection, and on 15 asymptomatic subjects examined with the same procedure. A very thorough study of the menisci and of their attachment, ie. The tibial insertion of the menisceal horns, the transverse ligament, and the meniscofemoral ligament, is possible with T1-weighted MR sequences. The T2-weighted sequences, either following intraarticular contrast injection or in cases of articular effusion, allow analyzing the capsular attachments of the posterior horn of the lateral meniscus and its relationships with the tendon of the popliteal muscle. Five misleading images must be known for the exploration of the menisci, in order to avoid a number of interpretation problems. Images of type I and II initial meniscus degeneration are observed in 47% of all cases (control group). One case of menisceal cyst developing in the anterior horn of the lateral meniscus, with anatomical correlation, is also reported [fr

  4. Anatomical Modularity of Verbal Working Memory? Functional Anatomical Evidence from a Famous Patient with Short-Term Memory Deficits.

    Science.gov (United States)

    Paulesu, Eraldo; Shallice, Tim; Danelli, Laura; Sberna, Maurizio; Frackowiak, Richard S J; Frith, Chris D

    2017-01-01

    Cognitive skills are the emergent property of distributed neural networks. The distributed nature of these networks does not necessarily imply a lack of specialization of the individual brain structures involved. However, it remains questionable whether discrete aspects of high-level behavior might be the result of localized brain activity of individual nodes within such networks. The phonological loop of working memory, with its simplicity, seems ideally suited for testing this possibility. Central to the development of the phonological loop model has been the description of patients with focal lesions and specific deficits. As much as the detailed description of their behavior has served to refine the phonological loop model, a classical anatomoclinical correlation approach with such cases falls short in telling whether the observed behavior is based on the functions of a neural system resembling that seen in normal subjects challenged with phonological loop tasks or whether different systems have taken over. This is a crucial issue for the cross correlation of normal cognition, normal physiology, and cognitive neuropsychology. Here we describe the functional anatomical patterns of JB, a historical patient originally described by Warrington et al. (1971), a patient with a left temporo-parietal lesion and selective short phonological store deficit. JB was studied with the H 2 15 O PET activation technique during a rhyming task, which primarily depends on the rehearsal system of the phonological loop. No residual function was observed in the left temporo-parietal junction, a region previously associated with the phonological buffer of working memory. However, Broca's area, the major counterpart of the rehearsal system, was the major site of activation during the rhyming task. Specific and autonomous activation of Broca's area in the absence of afferent inputs from the other major anatomical component of the phonological loop shows that a certain degree of

  5. Construction of a 3-D anatomical model for teaching temporal lobectomy.

    Science.gov (United States)

    de Ribaupierre, Sandrine; Wilson, Timothy D

    2012-06-01

    Although we live and work in 3 dimensional space, most of the anatomical teaching during medical school is done on 2-D (books, TV and computer screens, etc). 3-D spatial abilities are essential for a surgeon but teaching spatial skills in a non-threatening and safe educational environment is a much more difficult pedagogical task. Currently, initial anatomical knowledge formation or specific surgical anatomy techniques, are taught either in the OR itself, or in cadaveric labs; which means that the trainee has only limited exposure. 3-D computer models incorporated into virtual learning environments may provide an intermediate and key step in a blended learning approach for spatially challenging anatomical knowledge formation. Specific anatomical structures and their spatial orientation can be further clinically contextualized through demonstrations of surgical procedures in the 3-D digital environments. Recordings of digital models enable learner reviews, taking as much time as they want, stopping the demonstration, and/or exploring the model to understand the anatomical relation of each structure. We present here how a temporal lobectomy virtual model has been developed to aid residents and fellows conceptualization of the anatomical relationships between different cerebral structures during that procedure. We suggest in comparison to cadaveric dissection, such virtual models represent a cost effective pedagogical methodology providing excellent support for anatomical learning and surgical technique training. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Investigations of Anatomical Variations of the Thorax and Heart, and Anatomical Knowledge for First Year Medical Dental and Podiatry Students

    Science.gov (United States)

    Verenna, Anne-Marie

    2013-01-01

    The universal presence of anatomy in healthcare professions is undeniable. It is a cornerstone to each of the clinical and basic sciences. Therefore, further expansion of current anatomical knowledge and effective methods to teach anatomy is essential. In this work, the relationship of the dorsal scapular artery with the trunks of the brachial…

  7. Clinical applications of the superior epigastric artery perforator (SEAP) flap: anatomical studies and preoperative perforator mapping with multidetector CT.

    Science.gov (United States)

    Hamdi, Moustapha; Van Landuyt, Koenraad; Ulens, Sara; Van Hedent, Eddy; Roche, Nathalie; Monstrey, Stan

    2009-09-01

    Pedicled superior epigastric artery perforator (SEAP) flaps can be raised to cover challenging thoracic defects. We present an anatomical study based on multidetector computerized tomography (MDCT) scan findings of the SEA perforators in addition to the first reported clinical series of SEAP flaps in anterior chest wall reconstruction. (a) In the CT scan study, images of a group of 20 patients who underwent MDCT scan analysis were used to visualise bilaterally the location of musculocutaneous SEAP. X- and Y-axes were used as landmarks to localise the perforators. The X-axis is a horizontal line at the junction of sternum and xyphoid (JCX) and the Y-axis is at the midline. (b) In the clinical study, seven pedicled SEAP flaps were performed in another group of patients. MDCT images revealed totally 157 perforators with a mean of 7.85 perforators per patient. The dominant perforators (137 perforators) were mainly localised in an area between 1.5 and 6.5 cm from the X-axis on both sides and between 3 and 16 cm below the Y-axis. The calibre of these dominant perforators was judged as 'good' to 'very good' in 82.5% of the cases. The average dimension of the flap was 21.7x6.7 cm. All flaps were based on one perforator. Mean harvesting time was 110 min. There were no flap losses. Minor tip necrosis occurred in two flaps. One of them was treated with excision and primary closure. Our clinical experience indicates that the SEAP flap provides a novel and useful approach for reconstruction of anterior chest wall defects. CT-based imaging allows for anatomical assessment of the perforators of the superior epigastric artery (SEA).

  8. Demonstration of the proliferation marker Ki-67 in renal biopsies: correlation to clinical findings.

    Science.gov (United States)

    Nabokov, A; Waldherr, R; Ritz, E

    1997-07-01

    Assessment of cell proliferation in renal biopsy samples is a potentially promising analytical tool to evaluate disease activity. So far no information is available on the correlation between proliferative activity in different anatomic compartments of the kidney and clinical symptoms. To elucidate this issue, we examined renal biopsy specimens from 20 patients with systemic vasculitis (15 Wegener's granulomatosis, five microscopic polyangiitis), 20 patients with immunoglobulin (Ig) A nephropathy (IgAN), 13 patients with minimal-change disease (MCD), 11 patients with tubulointerstitial nephritis, and five patients with diabetes mellitus. The streptavidin-biotin-peroxidase complex technique was applied to autoclave-pretreated, formalin-fixed, paraffin-embedded tissue sections to label different cell types with the antibody MIB1 directed against the Ki-67 antigen. Proliferation index (PI) was estimated as the number of positively stained nuclei per glomerular cross-section or per square millimeter section area. The interstitial cells were discriminated by additional staining of Ki-67-processed samples with specific immune markers. In patients with vasculitis, PI was considerably elevated in the extracapillary glomerular compartment (0.86), in proximal tubules (6.24), and in the interstitium (8.62). High proliferative activity was also noted in interstitium (3.98) and proximal tubules (1.35) of patients with IgAN. Of particular interest was the increased interstitial proliferative activity (15.0) in diabetic patients. Resident renal cells, but not infiltrating cells, seemed to constitute the majority of the proliferating cell population in the interstitium. In systemic vasculitis, clinical disease activity was significantly correlated to endocapillary (r(s) = 0.58), extracapillary (r(s) = 0.67), proximal tubular (r(s) = 0.67), and interstitial PI (r(s) = 0.61). By multiple linear regression analysis, proximal tubular PI was correlated to the presence of hematuria

  9. Surface anatomy and anatomical planes in the adult turkish population.

    Science.gov (United States)

    Uzun, C; Atman, E D; Ustuner, E; Mirjalili, S A; Oztuna, D; Esmer, T S

    2016-03-01

    Surface anatomy and anatomical planes are widely used in education and clinical practice. The planes are largely derived from cadaveric studies and their projections on the skin show discrepancies between and within anatomical reference textbooks. In this study, we reassessed the accuracy of common thoracic and abdominopelvic anatomical planes using computed tomography (CT) imaging in the live adult Turkish population. After patients with distorting pathologies had been excluded, CT images of 150 supine patients at the end tidal inspiration were analyzed. Sternal angle, transpyloric, subcostal, supracristal and pubic crest planes and their relationships to anatomical structures were established by dual consensus. The tracheal bifurcation, azygos vein/superior vena cava (SVC) junction and pulmonary bifurcation were usually below the sternal angle while the concavity of the aortic arch was generally within the plane. The tip of the tenth rib, the superior mesenteric artery and the portal vein were usually within the transpyloric plane while the renal hila and the fundus of the gallbladder were below it. The inferior mesenteric artery was below the subcostal plane and the aortic bifurcation was below the supracristal plane in most adults. Projectional surface anatomy is fundamental to medical education and clinical practice. Modern cross-sectional imaging techniques allow large groups of live patients to be examined. Classic textbook information regarding anatomy needs to be reviewed and updated using the data gathered from these recent studies, taking ethnic differences into consideration. © 2015 Wiley Periodicals, Inc.

  10. Absence of the musculocutaneous nerve: a rare anatomical variation with possible clinical-surgical implications

    Directory of Open Access Journals (Sweden)

    José Humberto Tavares Guerreiro Fregnani

    Full Text Available CONTEXT: The musculocutaneous nerve is one of the terminal branches of the lateral fasciculus of the brachial plexus, and is responsible for innervation of the flexor musculature of the elbow and for skin sensitivity on the lateral surface of the forearm. Its absence has been described previously, but its real prevalence is unknown. CASE REPORT: A case of absence of the musculocutaneous nerve that was observed during the dissection of the right arm of a male cadaver is described. The area of innervation was supplied by the median nerve. From this, three branches emerged: one to the coracobrachialis muscle, another to the biceps brachii muscle and the third to the brachialis muscle. This last branch continued as a lateral antebrachial cutaneous nerve. This is an anatomical variation that has clinical-surgical implications, considering that injury to the median nerve in this case would have caused unexpected paralysis of the flexor musculature of the elbow and hypoesthesia of the lateral surface of the forearm.

  11. The Science and Politics of Naming: Reforming Anatomical Nomenclature, ca. 1886-1955.

    Science.gov (United States)

    Buklijas, Tatjana

    2017-04-01

    Anatomical nomenclature is medicine's official language. Early in their medical studies, students are expected to memorize not only the bodily geography but also the names for all the structures that, by consensus, constitute the anatomical body. The making and uses of visual maps of the body have received considerable historiographical attention, yet the history of production, communication, and reception of anatomical names-a history as long as the history of anatomy itself-has been studied far less. My essay examines the reforms of anatomical naming between the first modern nomenclature, the 1895 Basel Nomina Anatomica (BNA), and the 1955 Nomina Anatomica Parisiensia (NAP, also known as PNA), which is the basis for current anatomical terminology. I focus on the controversial and ultimately failed attempt to reform anatomical nomenclature, known as Jena Nomina Anatomica (INA), of 1935. Discussions around nomenclature reveal not only how anatomical names are made and communicated, but also the relationship of anatomy with the clinic; disciplinary controversies within anatomy; national traditions in science; and the interplay between international and scientific disciplinary politics. I show how the current anatomical nomenclature, a successor to the NAP, is an outcome of both political and disciplinary tensions that reached their peak before 1945. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Visualisation of bony and vascular structures via digital subtraction images upon the amount of anatomic background

    International Nuclear Information System (INIS)

    Hinz, A.; Scholz, A.; Zwicker, C.

    1992-01-01

    We examined the loss of contrast leaving a part of the anatomic background in digital subtraction angiography by visual analysis and densitometry. We observed a greater loss of the quality at the representation of the bone below than above an amount of anatomic background of 60%. The loss of quality at the representation of the vessels decreases more above than below an anatomical background of 45%. We think that, depending on the clinical problem, an anatomical background between 15 and 30% should be left. (orig.) [de

  13. Local Anatomic Changes in Parotid and Submandibular Glands During Radiotherapy for Oropharynx Cancer and Correlation With Dose, Studied in Detail With Nonrigid Registration

    International Nuclear Information System (INIS)

    Vasquez Osorio, Eliana M.; Hoogeman, Mischa S.; Al-Mamgani, Abrahim; Teguh, David N.; Levendag, Peter C.; Heijmen, Ben J.M.

    2008-01-01

    Purpose: To quantify the anatomic changes caused by external beam radiotherapy in head-and-neck cancer patients in full three dimensions and to relate the local anatomic changes to the planned mean dose. Methods and Materials: A nonrigid registration method was adapted for RT image registration. The method was applied in 10 head-and-neck cancer patients, who each underwent a planning and a repeat computed tomography scan. Contoured structures (parotid, submandibular glands, and tumor) were registered in a nonrigid manner. The accuracy of the transformation was determined. The transformation results were used to summarize the anatomic changes on a local scale for the irradiated and spared glands. The volume reduction of the glands was related to the planned mean dose. Results: Transformation was accurate with a mean error of 0.6 ± 0.5 mm. The volume of all glands and the primary tumor decreased. The lateral regions of the irradiated parotid glands moved inward (average, 3 mm), and the medial regions tended to remain in the same position. The irradiated submandibular glands shrank and moved upward. The spared glands showed only a small deformation (∼1 mm in most regions). Overall, the primary tumors shrank. The volume loss of the parotid glands correlated significantly with the planned mean dose (p <0.001). Conclusion: General shrinkage and deformation of irradiated glands was seen. The spared glands showed few changes. These changes were assessed by a nonrigid registration method, which effectively described the local changes occurring in the head-and-neck region after external beam radiotherapy

  14. Anatomic variables affecting interdental papilla

    Directory of Open Access Journals (Sweden)

    Swapna A. Mahale

    2013-01-01

    Full Text Available Aim: The aim of this study is to evaluate the anatomic variables affecting the interdental papilla. Materials and Methods: Thirty adult patients were evaluated. Papilla score (PS, tooth form/shape, gingival thickness, crest bone height and keratinized gingiva/attached gingiva were recorded for 150 inter proximal sites. Data were analyzed using SPSS software package (version 7.0 and the significance level was set at 95% confidence interval. Pearson′s correlation was applied to correlate the relationship between the factors and the appearance of the papilla. Results: Competent papillae (complete fill interdentally were associated with: (1 Crown width (CW: length ≥0.87; (2 bone crest-contact point ≤5 mm; and (3 inter proximal gingival tissue thickness ≥1.5 mm. Gingival thickness correlated negatively with PS (r = −0.37 to −0.54 and positively with tissue height (r = 0.23-0.43. Tooth form (i.e., CW to length ratio correlated negatively with PS (r = −0.37 to −0.61. Conclusion: Gingival papilla appearance was associated significantly with tooth form/shape, crestal bone height and interproximal gingival thickness.

  15. Software Designation to Assess the Proximity of Different Facial Anatomic Landmarks to Midlines of the Mouth and Face

    Directory of Open Access Journals (Sweden)

    Moshkelgosha V

    2014-12-01

    Full Text Available Statement of Problem: Recognition and determination of facial and dental midline is important in dentistry. Currently, there are no verifiable guidelines that direct the choice of specific anatomic landmarks to determine the midline of the face or mouth. Objectives: The purpose of this study was to determine which of facial anatomic landmarks is closest to the midline of the face as well as that of the mouth. Materials and Methods: Frontal full-face digital images of 92 subjects (men and women age range: 20-30 years in smile were taken under standardized conditions; commonly used anatomic landmarks, nasion, tip of the nose, and tip of the philtrum were digitized on the images of subjects and aesthetic analyzer software used for midline analysis using Esthetic Frame. Deviations from the midlines of the face and mouth were measured for the 3 clinical landmarks; the existing dental midline was considered as the fourth landmark. The entire process of midline analysis was done by a single observer and repeated twice. Reliability analysis and 1-sample t- tests were conducted. Results: The Intra-class correlation coefficients (ICCs for reliability analysis of RFV and RCV measures made two times revealed that the reliabilities were all acceptable. The results indicated that each of the 4 landmarks deviated uniquely and significantly (P<.001 from the midlines of the face as well as mouth in both males and females. Conclusions: There was a significant difference between the mean ratios of the chosen anatomic landmarks and the midlines of the face and mouth. The hierarchy of anatomic landmarks closest to the midline of the face is: (1 midline of the commissures, (2 nasion , (3 tip of philtrum,(4 dental midline, and (5 tip ofthe nose. The closest anatomic landmarks to the mouth midline are: (1 tip of philtrum, (2 dental midline, (3 tip of nose, and (4 nasion.

  16. MR findings of transverse myelitis and its clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Seung; Chang, Kee Hyun; Na, Dong Gyu; Han, Moon Hee; Choi, Choong Gon; Kim, Ji Hye [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1995-02-15

    The purpose of this study is to correlate the MR findings with clinical stage and clinical outcome, and to describe the evolutional changes of abnormal MR findings of transverse myelitis. Medical records and spinal MR images of 23 patients with both clinical and radiological diagnosis of transverse myelitis were retrospectively reviewed. MR findings were correlated with clinical stages including interval between MR imaging and full development of clinical symptoms, and compared with the clinical outcome. Diffuse high signal intensity of the spinal cord on T2-weighted image with mild cord bulging (67%) and focal contrast enhancement of the cord (75%) were observed within the first four weeks after full development of clinical symptoms. The findings decreased in extent or vanished later than four weeks on either initial or follow-up MR images. Most patients with either cord atrophy or focal hemorrhage within the cord lesion had poor clinical outcome. The MR findings of transverse myelitis are nonspecific, which may be seen in a variety of diseases. Serial MRIs, especially follow-up examination over at least one month after full development of clinical symptoms are useful in the diagnosis of transverse myelitis and predicting its prognosis.

  17. Anatomic variations of the cerebral arteries and their embryology: a pictorial review

    International Nuclear Information System (INIS)

    Okahara, Mika; Kiyosue, Hiro; Mori, Hiromu; Tanoue, Shuichi; Sainou, Michihumi; Nagatomi, Hirohumi

    2002-01-01

    In the embryonic period, several developmental anomalies of the cerebral arteries occur. The knowledge of these anatomic variations of the cerebral artery is important to avoid the unnecessary surgery and to undergo surgery or interventional radiology with safety. We reviewed 3000 MR angiographies and 700 cerebral angiographies of the previous 5 years to assess cerebral arterial system, and to illustrate the embryological development, imaging findings, occurrence, and clinical significance of the anatomic variation of the cerebral arteries. The normal development and variations of the cerebral arteries are depicted. Knowledge of the anatomic variations is important since it can influence surgical and interventional procedure. (orig.)

  18. Dopaminreceptorscintigraphy in Parkinson's disease - Clinical correlation

    International Nuclear Information System (INIS)

    Riklund Aahlstroem, K.E.; Hietala, S.-O.; Johansson, F.

    2002-01-01

    Parkinson's disease is a severe, progressive neuro degenerative disorder which is characterised by a degeneration of the dopamine containing cells and loss of dopamine transporters (DA) in substantia nigra. Earlier 123 I-β-CIT SPECT studies have demonstrated this loss of DA content in Parkinson's disease. Recently a new radioligand 123 I-FP-CIT, with faster kinetics than b-CIT became available for imaging of the DA transporter. The applicability of this radioligand was tested in a large clinical material with early and advanced Parkinson's disease using a one day protocol. 123 I-FP-CIT uptake was decreased in patients with Parkinson's disease and this was seen three hours after injection of the radioligand. In the Parkinson's disease group the uptake in the putamen was reduced more than in the caudate nucleus. Specific to non-specific striatal uptake ratios correlated with the Hoehn and Yahr stage. It appeared that 123 I-FP-CIT SPECT allows a significant discrimination between patients with Parkinson's disease and other movement disorders. The scintigraphic observations were correlated to clinical findings. The results will be presented and discussed

  19. Diagnosis of cystocele--the correlation between clinical and radiological evaluation.

    Science.gov (United States)

    Altman, Daniel; Mellgren, Anders; Kierkegaard, Jonas; Zetterström, Jan; Falconer, Christian; López, Annika

    2004-01-01

    In patients with genital prolapse involving several compartments simultaneously, radiologic investigation can be used to complement the clinical assessment. Contrast medium in the urinary bladder enables visualization of the bladder base at cystodefecoperitoneography (CDP). The aim of the present study was to evaluate the correlation between clinical examination using the Pelvic Organ Prolapse Quantification system (POP-Q) and CDP. Thirty-three women underwent clinical assessment and CDP. Statistical analysis using Pearson's correlation coefficient ( r) demonstrated a wide variability between the current definition of cystocele at CDP and POP-Q ( r=0.67). An attempt to provide an alternative definition of cystocele at CDP had a similar outcome ( r=0.63). The present study demonstrates a moderate correlation between clinical and radiologic findings in patients with anterior vaginal wall prolapse. It does not support the use of bladder contrast at radiologic investigation in the routine preoperative assessment of patients with genital prolapse.

  20. A systematic review of studies on anatomical position of electrode contacts used for chronic subthalamic stimulation in Parkinson's disease.

    Science.gov (United States)

    Caire, François; Ranoux, Danièle; Guehl, Dominique; Burbaud, Pierre; Cuny, Emmanuel

    2013-09-01

    The dorso-lateral part of the subthalamic nucleus (STN) is considered as the usual target of deep brain stimulation for Parkinson's disease. Nevertheless, the exact anatomical location of the electrode contacts used for chronic stimulation is still a matter of debate. The aim of this study was to perform a systematic review of the existing literature on this issue. We searched for studies on the anatomical location of active contacts published until December 2012. We identified 13 studies, published between 2002 and 2010, including 260 patients and 466 electrodes. One hundred and sixty-four active contacts (35 %) were identified within the STN, 117 (25 %) at the interface between STN and the surrounding structures, 184 (40 %) above the STN and one within the substantia nigra. We observed great discrepancies between the different series. The contra-lateral improvement was between 37 and 78.5 % for contacts located within the STN, between 48.6 and 73 % outside the STN, between 65.3 and 66 % at the interface. The authors report no clear correlation between anatomical location and stimulation parameters. Post-operative analysis of the anatomical location of active contacts is difficult, and all the methods used are debatable. The relationship between the anatomical location of active contacts and the clinical effectiveness of stimulation is unclear. It would be necessary to take into account the volume of the electrode contacts and the diffusion of the stimulation. We can nevertheless assume that the interface between dorso-lateral STN, zona incerta and Forel's fields could be directly involved in the effects of stimulation.

  1. Wilson's disease: cranial MRI observations and clinical correlation

    International Nuclear Information System (INIS)

    Sinha, S.; Taly, A.B.; Prashanth, L.K.; Venugopal, K.S.; Arunodaya, G.R.; Swamy, H.S.; Ravishankar, S.; Vasudev, M.K.

    2006-01-01

    Study of MRI changes may be useful in diagnosis, prognosis and better understanding of the pathophysiology of Wilson's disease (WD). We aimed to describe and correlate the MRI abnormalities of the brain with clinical features in WD. MRI evaluation was carried out in 100 patients (57 males, 43 females; mean age 19.3±8.9 years) using standard protocols. All but 18 patients were on de-coppering agents. Their history, clinical manifestations and scores for severity of disease were noted. The mean duration of illness and treatment were 8.3±10.8 years and 7.5±7.1 years respectively. MRI of the brain was abnormal in all the 93 symptomatic patients. The most conspicuous observations were atrophy of the cerebrum (70%), brainstem (66%) and cerebellum (52%). Signal abnormalities were also noted: putamen (72%), caudate (61%), thalami (58%), midbrain (49%), pons (20%), cerebral white matter (25%), cortex (9%), medulla (12%) and cerebellum (10%). The characteristic T2-W globus pallidal hypointensity (34%), ''Face of giant panda'' sign (12%), T1-W striatal hyperintensity (6%), central pontine myelinosis (7%), and bright claustral sign (4%) were also detected. MRI changes correlated with disease severity scores (P<0.001) but did not correlate with the duration of illness. MRI changes were universal but diverse and involved almost all the structures of the brain in symptomatic patients. A fair correlation between MRI observations and various clinical features provides an explanation for the protean manifestations of the disease. (orig.)

  2. INFLUENCE OF ANATOMICAL FEATURES AND EXTRACTIVES CONTENT WOOD OF Eucalyptus grandis W. Hill ex Maiden IN QUALITY BONDING

    Directory of Open Access Journals (Sweden)

    Vanessa Cristina do Sacramento Albino

    2012-12-01

    Full Text Available http://dx.doi.org/10.5902/198050987561The study aimed to anatomically characterize and to quantify the total extractives in different positions of the log of Eucalyptus grandis W. Hill ex Maiden with 18 years of age and to assess their influence on the shear strength and percentage of wood failure in adhesive bonded joints with thermosetting resorcinol-formaldehyde. Histological slides were prepared for an anatomical study and determined the total extractive content. The preparation of bonded joints was made according to ASTM D 2339-98(2000. It was used the correlation coefficient of Pearson, 1% probability by t test to evaluate the correlation between the anatomical and extractives content with the quality of the glued joints. It was found that there was a correlation between the shear strength with the following characteristics: vessel diameter, wall width, length and width of the fiber, the width of the radius and total extractives content. For the percentage of wood failure, there was a correlation between this with the following characteristics: the frequency of vessels, thickness of the heat of fiber, and high frequency of lightning. Both the radial direction as in the longitudinal direction of the logs there was change in the values found for the measurement of the anatomical elements, the total amount of extractives, the shear test strength and the percentage of wood failure.

  3. CORRELATION BETWEEN OBESITY, SAGITTAL BALANCE AND CLINICAL OUTCOME IN SPINAL FUSION

    Directory of Open Access Journals (Sweden)

    Marcel Machado da Motta

    2015-09-01

    Full Text Available Objective:To correlate obesity with radiographic parameters of spinal and spinopelvic balance in patients undergoing spinal arthrodesis, and to correlate obesity with clinical outcome of these patients.Methods:Observational retrospective study including patients who underwent spinal arthrodesis, with minimum follow-up period of three months. We measured waist circumference, as well as height and weight to calculate body mass index (BMI and obtained radiographs of the total column. The clinical parameters studied were pain by visual analog scale (VAS and the Oswestry questionnaire (ODI. Obesity correlated with radiographic parameters of the sagittal and spinopelvic balance and postoperative clinical parameters.Results:32 patients were analyzed. The higher the BMI, the greater the value of VAS found, but without statistical significance (p=0.83. There was also no correlation between BMI and the ODI questionnaire. Analyzing the abdominal circumference, there was no correlation between the VAS and ODI. There was no correlation between BMI or waist circumference and the radiographic parameters of global spinopelvic sagittal alignment. Regarding the postoperative results, there was no correlation between the mean BMI and waist circumference and the postoperative results for ODI and VAS (p=0.75 and p=0.7, respectively.Conclusions:The clinical outcomes of patients who undergone spinal fusion were not affected by the BMI and waist circumference. Also, there was no correlation between radiographic parameters of spinal and spinopelvic sagittal balance with obesity in patients previously treated with arthrodesis of the spine.

  4. Computed tomography of the dog's brain: normal aspects and anatomical correlation; Tomografia computadorizada do encefalo do cao: aspectos da normalidade e correlacao anatomica

    Energy Technology Data Exchange (ETDEWEB)

    Lorigados, C.A.B., E-mail: clorigados@usp.br [Faculdades Metropolitanas Unidas (UniFMU), Sao Paulo, SP (Brazil); Pinto, A.C.B.F. [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina Veterinaria e Zootecnia

    2013-06-15

    Normal tomographic images of dog's heads were obtained, aimed to familiarize them with the normal aspects of the brain and correlate these findings with the relevant anatomy of the region studied. Several anatomical structures, such as the parenchyma of the frontal, parietal, temporal and occipital lobes, the longitudinal fissure, the ventricular system, the cerebellum, the olfactory bulb, the corpus callosum, diencephalon, the pons, the medulla oblongata and the chiasmatic sulcus were directly identified or were related to neighboring structures which helped in their identification. (author)

  5. Neural correlates of intolerance of uncertainty in clinical disorders

    NARCIS (Netherlands)

    Wever, Mirjam; Smeets, Paul; Sternheim, Lot

    2015-01-01

    Intolerance of uncertainty is a key contributor to anxiety-related disorders. Recent studies highlight its importance in other clinical disorders. The link between its clinical presentation and the underlying neural correlates remains unclear. This review summarizes the emerging literature on the

  6. Neural Correlates of Intolerance of Uncertainty in Clinical Disorders

    NARCIS (Netherlands)

    Wever, M.; Smeets, P.A.M.; Sternheim, L.

    2015-01-01

    Intolerance of uncertainty is a key contributor to anxiety-related disorders. Recent studies highlight its importance in other clinical disorders. The link between its clinical presentation and the underlying neural correlates remains unclear. This review summarizes the emerging literature on the

  7. Prefrontal-Thalamic Anatomical Connectivity and Executive Cognitive Function in Schizophrenia.

    Science.gov (United States)

    Giraldo-Chica, Monica; Rogers, Baxter P; Damon, Stephen M; Landman, Bennett A; Woodward, Neil D

    2018-03-15

    Executive cognitive functions, including working memory, cognitive flexibility, and inhibition, are impaired in schizophrenia. Executive functions rely on coordinated information processing between the prefrontal cortex (PFC) and thalamus, particularly the mediodorsal nucleus. This raises the possibility that anatomical connectivity between the PFC and mediodorsal thalamus may be 1) reduced in schizophrenia and 2) related to deficits in executive function. The current investigation tested these hypotheses. Forty-five healthy subjects and 62 patients with a schizophrenia spectrum disorder completed a battery of tests of executive function and underwent diffusion-weighted imaging. Probabilistic tractography was used to quantify anatomical connectivity between six cortical regions, including PFC, and the thalamus. Thalamocortical anatomical connectivity was compared between healthy subjects and patients with schizophrenia using region-of-interest and voxelwise approaches, and the association between PFC-thalamic anatomical connectivity and severity of executive function impairment was examined in patients. Anatomical connectivity between the thalamus and PFC was reduced in schizophrenia. Voxelwise analysis localized the reduction to areas of the mediodorsal thalamus connected to lateral PFC. Reduced PFC-thalamic connectivity in schizophrenia correlated with impaired working memory but not cognitive flexibility and inhibition. In contrast to reduced PFC-thalamic connectivity, thalamic connectivity with somatosensory and occipital cortices was increased in schizophrenia. The results are consistent with models implicating disrupted PFC-thalamic connectivity in the pathophysiology of schizophrenia and mechanisms of cognitive impairment. PFC-thalamic anatomical connectivity may be an important target for procognitive interventions. Further work is needed to determine the implications of increased thalamic connectivity with sensory cortex. Copyright © 2017 Society of

  8. Cadaveric dissection as an educational tool for anatomical sciences in the 21st century.

    Science.gov (United States)

    Ghosh, Sanjib Kumar

    2017-06-01

    Anatomical education has been undergoing reforms in line with the demands of medical profession. The aim of the present study is to assess the impact of a traditional method like cadaveric dissection in teaching/learning anatomy at present times when medical schools are inclining towards student-centered, integrated, clinical application models. The article undertakes a review of literature and analyzes the observations made therein reflecting on the relevance of cadaveric dissection in anatomical education of 21st century. Despite the advent of modern technology and evolved teaching methods, dissection continues to remain a cornerstone of anatomy curriculum. Medical professionals of all levels believe that dissection enables learning anatomy with relevant clinical correlates. Moreover dissection helps to build discipline independent skills which are essential requirements of modern health care setup. It has been supplemented by other teaching/learning methods due to limited availability of cadavers in some countries. However, in the developing world due to good access to cadavers, dissection based teaching is central to anatomy education till date. Its utility is also reflected in the perception of students who are of the opinion that dissection provides them with a foundation critical to development of clinical skills. Researchers have even suggested that time has come to reinstate dissection as the core method of teaching gross anatomy to ensure safe medical practice. Nevertheless, as dissection alone cannot provide uniform learning experience hence needs to be complemented with other innovative learning methods in the future education model of anatomy. Anat Sci Educ 10: 286-299. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  9. Double incision iso-anatomical ACL reconstruction: the freedom to place the femoral tunnel within the anatomical attachment site without exception.

    Science.gov (United States)

    Arnold, Markus P; Duthon, Victoria; Neyret, Philippe; Hirschmann, Michael T

    2013-02-01

    The present paper describes the rationale behind the surgical technique and the clinical results of the iso-anatomical, single bundle bone patellar-tendon bone anterior cruciate ligament (ACL) reconstruction. Using a second incision on the distal lateral femur an outside-in femoral tunnel is drilled. Guided by a special aiming device it is possible to place the femoral tunnel in the centre of the ACL footprint in every single case. Since every crucial step of the procedure is under visual control, the technique is safe and reliable, which is mirrored by good clinical results.

  10. Feature-based morphometry: discovering group-related anatomical patterns.

    Science.gov (United States)

    Toews, Matthew; Wells, William; Collins, D Louis; Arbel, Tal

    2010-02-01

    This paper presents feature-based morphometry (FBM), a new fully data-driven technique for discovering patterns of group-related anatomical structure in volumetric imagery. In contrast to most morphometry methods which assume one-to-one correspondence between subjects, FBM explicitly aims to identify distinctive anatomical patterns that may only be present in subsets of subjects, due to disease or anatomical variability. The image is modeled as a collage of generic, localized image features that need not be present in all subjects. Scale-space theory is applied to analyze image features at the characteristic scale of underlying anatomical structures, instead of at arbitrary scales such as global or voxel-level. A probabilistic model describes features in terms of their appearance, geometry, and relationship to subject groups, and is automatically learned from a set of subject images and group labels. Features resulting from learning correspond to group-related anatomical structures that can potentially be used as image biomarkers of disease or as a basis for computer-aided diagnosis. The relationship between features and groups is quantified by the likelihood of feature occurrence within a specific group vs. the rest of the population, and feature significance is quantified in terms of the false discovery rate. Experiments validate FBM clinically in the analysis of normal (NC) and Alzheimer's (AD) brain images using the freely available OASIS database. FBM automatically identifies known structural differences between NC and AD subjects in a fully data-driven fashion, and an equal error classification rate of 0.80 is achieved for subjects aged 60-80 years exhibiting mild AD (CDR=1). Copyright (c) 2009 Elsevier Inc. All rights reserved.

  11. Assessment of Anatomical Knowledge and Core Trauma Competency Vascular Skills.

    Science.gov (United States)

    Granite, Guinevere; Pugh, Kristy; Chen, Hegang; Longinaker, Nyaradzo; Garofalo, Evan; Shackelford, Stacy; Shalin, Valerie; Puche, Adam; Pasley, Jason; Sarani, Babak; Henry, Sharon; Bowyer, Mark; Mackenzie, Colin

    2018-03-01

    Surgical residents express confidence in performing specific vascular exposures before training, but such self-reported confidence did not correlate with co-located evaluator ratings. This study reports residents' self-confidence evaluated before and after Advanced Surgical Skills for Exposure in Trauma (ASSET) cadaver-based training, and 12-18 mo later. We hypothesize that residents will better judge their own skill after ASSET than before when compared with evaluator ratings. Forty PGY2-7 surgical residents performed four procedures: axillary artery (AA), brachial artery (BA), femoral artery exposure and control (FA), and lower extremity fasciotomy (FAS) at the three evaluations. Using 5-point Likert scales, surgeons self-assessed their confidence in anatomical understanding and procedure performance after each procedure and evaluators rated each surgeon accordingly. For all the three evaluations, residents consistently rated their anatomical understanding (p < 0.04) and surgical performance (p < 0.03) higher than evaluators for both FA and FAS. Residents rated their anatomical understanding and surgical performance higher (p < 0.005) than evaluators for BA after training and up to 18 mo later. Only for third AA evaluation were there no rating differences. Residents overrate their anatomical understanding and performance abilities for BA, FA, and FAS even after performing the procedures and being debriefed three times in 18 mo.

  12. MRI anatomical mapping and direct stereotactic targeting in the subthalamic region: functional and anatomical correspondence in Parkinson's disease

    International Nuclear Information System (INIS)

    Lemaire, Jean-Jacques; Coste, Jerome; Ouchchane, Lemlih; Hemm, Simone; Derost, Philippe; Ulla, Miguel; Durif, Franck; Siadoux, Severine; Gabrillargues, Jean; Chazal, Jean

    2007-01-01

    Object Relationships between clinical effects, anatomy, and electrophysiology are not fully understood in DBS of the subthalamic region in Parkinson's disease. We proposed an anatomic study based on direct image-guided stereotactic surgery with a multiple source data analysis. Materials and Methods A manual anatomic mapping was realized on coronal 1.5-Tesla MRI of 15 patients. Biological data were collected under local anesthesia: the spontaneous neuron activities and the clinical efficiency and the appearance of adverse effects. They were related to relevant current values (mA), the benefit threshold (bt, minimal current leading an clear efficiency), the adverse effect threshold (at, minimal current leading an adverse effect) and the stimulation margin (sm = at - bt); they were matched with anatomy. Results We found consistent relationships between anatomy and biological data. The optimal stimulation parameters (low bt + high sm) were noted in the dorsolateral STN. The highest spontaneous neuron activity was found in the ventromedial STN. Dorsolateral (sensorimotor) STN seems the main DBS effector. The highest spontaneous neuron activity seems related to the anterior (rostral) ventromedial (limbic) STN. Conclusion 1.5 Tesla images provide sufficiently detailed subthalamic anatomy for image-guided stereotactic surgery and may aid in understanding DBS mechanisms. (orig.)

  13. Clinical correlates of loss of insight in bipolar depression

    Directory of Open Access Journals (Sweden)

    Rafael de Assis da Silva

    Full Text Available Abstract Introduction Affective state may influence insight, especially regarding mania. Nevertheless, studies have so far suggested that depression seems not to significantly impair insight. To the best of our knowledge, this study pioneers the evaluation of how insight variations in bipolar depression correlate with clinical variables. Method A group of 165 bipolar patients, 52 of whom had depressive episodes according to DSM-5 criteria, were followed during a year. All patients underwent clinical assessment, and insight was evaluated through the Insight Scale for Affective Disorders (ISAD. Repeated-measures ANOVA was calculated comparing scores on the four ISAD factors (insight into symptoms, the condition itself, self-esteem and social relationships in order to investigate differences in insight according to different objects. Correlational analysis explored which clinical symptoms were linked to reduced insight. Results Worse total insight correlated with suicide attempt/ideation and fewer subsyndromal manic symptoms such as mood elevation, increased energy and sexual interest. Worse self-esteem insight was associated with not only suicide ideation/attempt but also with activity reduction and psychomotor retardation. Worse symptom insight also correlated with psychomotor retardation. Better insight into having an affective disorder was associated with more intense hypochondria symptoms. Finally, worse insight into having an illness was associated with psychotic episodes. Conclusion Our study found that symptoms other than psychosis – suicide ideation, psychomotor retardation and reduction of activity and work – correlate with insight impairment in bipolar depression.

  14. Do craniopharyngioma molecular signatures correlate with clinical characteristics?

    Science.gov (United States)

    Omay, Sacit Bulent; Chen, Yu-Ning; Almeida, Joao Paulo; Ruiz-Treviño, Armando Saul; Boockvar, John A; Stieg, Philip E; Greenfield, Jeffrey P; Souweidane, Mark M; Kacker, Ashutosh; Pisapia, David J; Anand, Vijay K; Schwartz, Theodore H

    2018-05-01

    OBJECTIVE Exome sequencing studies have recently demonstrated that papillary craniopharyngiomas (PCPs) and adamantinomatous craniopharyngiomas (ACPs) have distinct genetic origins, each primarily driven by mutually exclusive alterations: either BRAF ( V600E), observed in 95% of PCPs, or CTNNB1, observed in 75%-96% of ACPs. How the presence of these molecular signatures, or their absence, correlates with clinical, radiographic, and outcome variables is unknown. METHODS The pathology records for patients who underwent surgery for craniopharyngiomas between May 2000 and March 2015 at Weill Cornell Medical College were reviewed. Craniopharyngiomas were identified and classified as PCP or ACP. Patients were placed into 1 of 3 groups based on their genomic mutations: BRAF mutation only, CTNNB1 mutation only, and tumors with neither of these mutations detected (not detected [ND]). Demographic, radiological, and clinical variables were collected, and their correlation with each genomic group was tested. RESULTS Histology correlated strongly with mutation group. All BRAF tumors with mutations were PCPs, and all CTNNB1 with mutations and ND tumors were ACPs. Preoperative and postoperative clinical symptoms and radiographic features did not correlate with any mutation group. There was a statistically significant relationship (p = 0.0323) between the age group (pediatric vs adult) and the mutation groups. The ND group tumors were more likely to involve the sella (p = 0.0065). CONCLUSIONS The mutation signature in craniopharyngioma is highly predictive of histology. The subgroup of tumors in which these 2 mutations are not detected is more likely to occur in children, be located in the sella, and be of ACP histology.

  15. Probabilistic anatomical labeling of brain structures using statistical probabilistic anatomical maps

    International Nuclear Information System (INIS)

    Kim, Jin Su; Lee, Dong Soo; Lee, Byung Il; Lee, Jae Sung; Shin, Hee Won; Chung, June Key; Lee, Myung Chul

    2002-01-01

    The use of statistical parametric mapping (SPM) program has increased for the analysis of brain PET and SPECT images. Montreal neurological institute (MNI) coordinate is used in SPM program as a standard anatomical framework. While the most researchers look up Talairach atlas to report the localization of the activations detected in SPM program, there is significant disparity between MNI templates and Talairach atlas. That disparity between Talairach and MNI coordinates makes the interpretation of SPM result time consuming, subjective and inaccurate. The purpose of this study was to develop a program to provide objective anatomical information of each x-y-z position in ICBM coordinate. Program was designed to provide the anatomical information for the given x-y-z position in MNI coordinate based on the statistical probabilistic anatomical map (SPAM) images of ICBM. When x-y-z position was given to the program, names of the anatomical structures with non-zero probability and the probabilities that the given position belongs to the structures were tabulated. The program was coded using IDL and JAVA language for the easy transplantation to any operating system or platform. Utility of this program was shown by comparing the results of this program to those of SPM program. Preliminary validation study was performed by applying this program to the analysis of PET brain activation study of human memory in which the anatomical information on the activated areas are previously known. Real time retrieval of probabilistic information with 1 mm spatial resolution was archived using the programs. Validation study showed the relevance of this program: probability that the activated area for memory belonged to hippocampal formation was more than 80%. These programs will be useful for the result interpretation of the image analysis performed on MNI coordinate, as done in SPM program

  16. Anatomical Modularity of Verbal Working Memory? Functional Anatomical Evidence from a Famous Patient with Short-Term Memory Deficits

    Directory of Open Access Journals (Sweden)

    Eraldo Paulesu

    2017-05-01

    Full Text Available Cognitive skills are the emergent property of distributed neural networks. The distributed nature of these networks does not necessarily imply a lack of specialization of the individual brain structures involved. However, it remains questionable whether discrete aspects of high-level behavior might be the result of localized brain activity of individual nodes within such networks. The phonological loop of working memory, with its simplicity, seems ideally suited for testing this possibility. Central to the development of the phonological loop model has been the description of patients with focal lesions and specific deficits. As much as the detailed description of their behavior has served to refine the phonological loop model, a classical anatomoclinical correlation approach with such cases falls short in telling whether the observed behavior is based on the functions of a neural system resembling that seen in normal subjects challenged with phonological loop tasks or whether different systems have taken over. This is a crucial issue for the cross correlation of normal cognition, normal physiology, and cognitive neuropsychology. Here we describe the functional anatomical patterns of JB, a historical patient originally described by Warrington et al. (1971, a patient with a left temporo-parietal lesion and selective short phonological store deficit. JB was studied with the H215O PET activation technique during a rhyming task, which primarily depends on the rehearsal system of the phonological loop. No residual function was observed in the left temporo-parietal junction, a region previously associated with the phonological buffer of working memory. However, Broca's area, the major counterpart of the rehearsal system, was the major site of activation during the rhyming task. Specific and autonomous activation of Broca's area in the absence of afferent inputs from the other major anatomical component of the phonological loop shows that a certain

  17. Acromioclavicular joint dislocations: radiological correlation between Rockwood classification system and injury patterns in human cadaver species.

    Science.gov (United States)

    Eschler, Anica; Rösler, Klaus; Rotter, Robert; Gradl, Georg; Mittlmeier, Thomas; Gierer, Philip

    2014-09-01

    The classification system of Rockwood and Young is a commonly used classification for acromioclavicular joint separations subdividing types I-VI. This classification hypothesizes specific lesions to anatomical structures (acromioclavicular and coracoclavicular ligaments, capsule, attached muscles) leading to the injury. In recent literature, our understanding for anatomical correlates leading to the radiological-based Rockwood classification is questioned. The goal of this experimental-based investigation was to approve the correlation between the anatomical injury pattern and the Rockwood classification. In four human cadavers (seven shoulders), the acromioclavicular and coracoclavicular ligaments were transected stepwise. Radiological correlates were recorded (Zanca view) with 15-kg longitudinal tension applied at the wrist. The resulting acromio- and coracoclavicular distances were measured. Radiographs after acromioclavicular ligament transection showed joint space enlargement (8.6 ± 0.3 vs. 3.1 ± 0.5 mm, p acromioclavicular joint space width increased to 16.7 ± 2.7 vs. 8.6 ± 0.3 mm, p acromioclavicular joint lesions higher than Rockwood type I and II. The clinical consequence for reconstruction of low-grade injuries might be a solely surgical approach for the acromioclavicular ligaments or conservative treatment. High-grade injuries were always based on additional structural damage to the coracoclavicular ligaments. Rockwood type V lesions occurred while muscle attachments were intact.

  18. [State and developmental trends of urogenital tuberculosis--20 years clinical and pathologic-anatomical experiences].

    Science.gov (United States)

    Köhler, H; Haenselt, V; Endmann, P

    1978-10-01

    On the basis of own experiences of twenty years and taking into consideration the knowledge of other authors the developmental tendency in the treatment of the urogenital tuberculosis is demonstrated, the indications to nephrectomy, resection of the kidney, and epididymectomy are reified as well as kind and sequelae of errors in chemotherapy analysed. From 1958 to 1977 2,868 patients with urogenital tuberculosis were hospitalized in the Central Clinic Bad Berka. Of them about 41% had to undergo an operation. A decrease of the quantity of operations can be observed only in the renal resections, whereas the nephrectomy rate is unchangedly high (16.3% of the own patients) and even shows an increasing tendency since 1975. Comparative examinations show that the pathologo-anatomical picture of the ectomized kidneys has not changed during the period of observation. The knowledge of the symptom-poor course obliges also further on differential-diagnostically to take into consideration the urogenital tuberculosis. Only on this way the still large number of organ endangering complications may be encountered in time.

  19. Anatomical Variations in the Sinoatrial Nodal Artery: A Meta-Analysis and Clinical Considerations.

    Directory of Open Access Journals (Sweden)

    Jens Vikse

    Full Text Available The sinoatrial nodal artery (SANa is a highly variable vessel which supplies blood to the sinoatrial node (SAN. Due to its variability and susceptibility to iatrogenic injury, our study aimed to assess the anatomy of the SANa and determine the prevalence of its anatomical variations.An extensive search of major electronic databases was performed to identify all articles reporting anatomical data on the SANa. No lower date limit or language restrictions were applied. Anatomical data regarding the artery were extracted and pooled into a meta-analysis.Sixty-six studies (n = 21455 hearts were included in the meta-analysis. The SANa usually arose as a single vessel with a pooled prevalence of 95.5% (95%CI:93.6-96.9. Duplication and triplication of the artery were also observed with pooled prevalence of 4.3% (95%CI:2.8-6.0 and 0.3% (95%CI:0-0.7, respectively. The most common origin of the SANa was from the right coronary artery (RCA, found in 68.0% (95%CI:55.6-68.9 of cases, followed by origin from the left circumflex artery, and origin from the left coronary artery with pooled prevalence of 22.1% (95%CI:15.0-26.2 and 2.7 (95%CI:0.7-5.2, respectively. A retrocaval course of the SANa was the most common course of the artery with a pooled prevalence of 47.1% (95%CI:36.0-55.5. The pooled prevalence of an S-shaped SANa was 7.6% (95%CI:2.9-14.1.The SANa is most commonly reported as a single vessel, originating from the RCA, and taking a retrocaval course to reach the SAN. Knowledge of high risk anatomical variants of the SANa, such as an S-shaped artery, must be taken into account by surgeons to prevent iatrogenic injuries. Specifically, interventional or cardiosurgical procedures, such as the Cox maze procedure for atrial fibrillation, open heart surgeries through the right atrium or intraoperative cross-clamping or dissection procedures during mitral valve surgery using the septal approach can all potentiate the risk for injury in the setting of high

  20. Anatomically ordered tapping interferes more with one-digit addition than two-digit addition: a dual-task fMRI study.

    Science.gov (United States)

    Soylu, Firat; Newman, Sharlene D

    2016-02-01

    Fingers are used as canonical representations for numbers across cultures. In previous imaging studies, it was shown that arithmetic processing activates neural resources that are known to participate in finger movements. Additionally, in one dual-task study, it was shown that anatomically ordered finger tapping disrupts addition and subtraction more than multiplication, possibly due to a long-lasting effect of early finger counting experiences on the neural correlates and organization of addition and subtraction processes. How arithmetic task difficulty and tapping complexity affect the concurrent performance is still unclear. If early finger counting experiences have bearing on the neural correlates of arithmetic in adults, then one would expect anatomically and non-anatomically ordered tapping to have different interference effects, given that finger counting is usually anatomically ordered. To unravel these issues, we studied how (1) arithmetic task difficulty and (2) the complexity of the finger tapping sequence (anatomical vs. non-anatomical ordering) affect concurrent performance and use of key neural circuits using a mixed block/event-related dual-task fMRI design with adult participants. The results suggest that complexity of the tapping sequence modulates interference on addition, and that one-digit addition (fact retrieval), compared to two-digit addition (calculation), is more affected from anatomically ordered tapping. The region-of-interest analysis showed higher left angular gyrus BOLD response for one-digit compared to two-digit addition, and in no-tapping conditions than dual tapping conditions. The results support a specific association between addition fact retrieval and anatomically ordered finger movements in adults, possibly due to finger counting strategies that deploy anatomically ordered finger movements early in the development.

  1. [Clinical study of post-stroke speech apraxia treated with scalp electric acupuncture under anatomic orientation and rehabilitation training].

    Science.gov (United States)

    Jiang, Yujuan; Yang, Yuxia; Xiang, Rong; Chang, E; Zhang, Yanchun; Zuo, Bingfang; Zhang, Qianwei

    2015-07-01

    To compare the differences in the clinical efficacy on post-stroke speech disorder between scalp electric acupuncture (EA) under anatomic orientation combined with rehabilitation training and simple rehabilitation training. Sixty patients of post-stroke speech apraxia were randomized into an observation group and a control group, 30 cases in each one. In the observation group, under anatomic orientation, the scalp EA was adopted to the dominant hemisphere Broca area on the left cerebrum. Additionally, the speech rehabilitation training was combined. In the control group, the speech rehabilitation training was simply,used. The treatment lasted for 4 weeks totally. The speech movement program module in the psychological language assessment and treatment system of Chinese aphasia was used for the evident of efficacy assessment. The scores of counting, singing scale, repeating phonetic alphabet, repeating monosyllable and repeating disyllable were observed in the patients of the two groups. The assessment was done separately on the day of grouping and 4 weeks after treatment. In 4 weeks of treatment, the scores of counting, singing scale, repeating phonetic alphabet, repeating monosyllable and repeating disyllable were all improved as compared with those before treatment in the two groups (all Pspeech rehabilitation training obviously improves speech apraxia in stroke patients so that the speech disorder cani be relieved. The efficacy is better than that in simple rehabilitation training.

  2. Using LEAN principles to improve quality, patient safety, and workflow in histology and anatomic pathology.

    Science.gov (United States)

    Serrano, Leo; Hegge, Pamela; Sato, Brendon; Richmond, Barbara; Stahnke, Lennis

    2010-05-01

    Histology and anatomic pathology have historically been slow to accept many of the process changes that have been widely accepted in the clinical laboratory. In this article, we describe the application of the Toyota Production System (LEAN) to histology and anatomic pathology as implemented at the Avera McKennan Hospital laboratory. Avera McKennan is the flagship hospital of the Avera Health System, a faith based, not for profit healthcare system based in South Dakota. Comprised of 235 hospitals, clinics, and physicians, with over 12,000 employees, Avera Health is one of the largest healthcare systems in the region. Beginning in 2004, Avera McKennan's laboratory began its "LEAN journey" and in the intervening years has expanded it throughout all areas of the laboratory. Following the example set by the laboratory, many other areas of the hospital have joined in the LEAN Process Improvement journey. In January 2009, the Avera McKennan Laboratory became the first hospital laboratory in the US to achieve the CAP ISO-15189 accreditation in both clinical and anatomic pathology.

  3. Degenerative lumbar spinal stenosis: correlation with Oswestry Disability Index and MR Imaging

    OpenAIRE

    Sirvanci, Mustafa; Bhatia, Mona; Ganiyusufoglu, Kursat Ali; Duran, Cihan; Tezer, Mehmet; Ozturk, Cagatay; Aydogan, Mehmet; Hamzaoglu, Azmi

    2008-01-01

    Because neither the degree of constriction of the spinal canal considered to be symptomatic for lumbar spinal stenosis nor the relationship between the clinical appearance and the degree of a radiologically verified constriction is clear, a correlation of patient’s disability level and radiographic constriction of the lumbar spinal canal is of interest. The aim of this study was to establish a relationship between the degree of radiologically established anatomical stenosis and the severity o...

  4. Reducing 4D CT artifacts using optimized sorting based on anatomic similarity.

    Science.gov (United States)

    Johnston, Eric; Diehn, Maximilian; Murphy, James D; Loo, Billy W; Maxim, Peter G

    2011-05-01

    Four-dimensional (4D) computed tomography (CT) has been widely used as a tool to characterize respiratory motion in radiotherapy. The two most commonly used 4D CT algorithms sort images by the associated respiratory phase or displacement into a predefined number of bins, and are prone to image artifacts at transitions between bed positions. The purpose of this work is to demonstrate a method of reducing motion artifacts in 4D CT by incorporating anatomic similarity into phase or displacement based sorting protocols. Ten patient datasets were retrospectively sorted using both the displacement and phase based sorting algorithms. Conventional sorting methods allow selection of only the nearest-neighbor image in time or displacement within each bin. In our method, for each bed position either the displacement or the phase defines the center of a bin range about which several candidate images are selected. The two dimensional correlation coefficients between slices bordering the interface between adjacent couch positions are then calculated for all candidate pairings. Two slices have a high correlation if they are anatomically similar. Candidates from each bin are then selected to maximize the slice correlation over the entire data set using the Dijkstra's shortest path algorithm. To assess the reduction of artifacts, two thoracic radiation oncologists independently compared the resorted 4D datasets pairwise with conventionally sorted datasets, blinded to the sorting method, to choose which had the least motion artifacts. Agreement between reviewers was evaluated using the weighted kappa score. Anatomically based image selection resulted in 4D CT datasets with significantly reduced motion artifacts with both displacement (P = 0.0063) and phase sorting (P = 0.00022). There was good agreement between the two reviewers, with complete agreement 34 times and complete disagreement 6 times. Optimized sorting using anatomic similarity significantly reduces 4D CT motion

  5. Registration of prone and supine CT colonography scans using correlation optimized warping and canonical correlation analysis

    International Nuclear Information System (INIS)

    Wang Shijun; Yao Jianhua; Liu Jiamin; Petrick, Nicholas; Van Uitert, Robert L.; Periaswamy, Senthil; Summers, Ronald M.

    2009-01-01

    Purpose: In computed tomographic colonography (CTC), a patient will be scanned twice--Once supine and once prone--to improve the sensitivity for polyp detection. To assist radiologists in CTC reading, in this paper we propose an automated method for colon registration from supine and prone CTC scans. Methods: We propose a new colon centerline registration method for prone and supine CTC scans using correlation optimized warping (COW) and canonical correlation analysis (CCA) based on the anatomical structure of the colon. Four anatomical salient points on the colon are first automatically distinguished. Then correlation optimized warping is applied to the segments defined by the anatomical landmarks to improve the global registration based on local correlation of segments. The COW method was modified by embedding canonical correlation analysis to allow multiple features along the colon centerline to be used in our implementation. Results: We tested the COW algorithm on a CTC data set of 39 patients with 39 polyps (19 training and 20 test cases) to verify the effectiveness of the proposed COW registration method. Experimental results on the test set show that the COW method significantly reduces the average estimation error in a polyp location between supine and prone scans by 67.6%, from 46.27±52.97 to 14.98 mm±11.41 mm, compared to the normalized distance along the colon centerline algorithm (p<0.01). Conclusions: The proposed COW algorithm is more accurate for the colon centerline registration compared to the normalized distance along the colon centerline method and the dynamic time warping method. Comparison results showed that the feature combination of z-coordinate and curvature achieved lowest registration error compared to the other feature combinations used by COW. The proposed method is tolerant to centerline errors because anatomical landmarks help prevent the propagation of errors across the entire colon centerline.

  6. The Anatomical Correlation between the Internal Venous Vertebral System and the Cranial Venae Cavae in Rabbit.

    Science.gov (United States)

    Mazensky, David; Petrovova, Eva; Danko, Jan

    2013-01-01

    The aim of this study was to describe the possible variations in the connection between the internal venous vertebral system and the cranial vena cava in rabbit using corrosion technique. The study was carried out on 40 adult New Zealand white rabbits. The venous system was injected by using Batson's corrosion casting kit number 17. We found the connection between the internal venous vertebral system and the cranial vena cava by means of the vertebral veins and the right azygos vein. The vertebral vein was present as independent tributary in 36 cases (90%). In the rest of the cases, it was found as being double, being triple, or forming a common trunk with other veins. The azygos vein was present as independent tributary of the cranial vena cava in 39 cases (97.5%). We found also a common trunk formed by the junction of the deep cervical vein, the right vertebral vein, and the azygos vein in one case (2.5%). The azygos vein received 6, 7, 8, or 9 pairs of dorsal intercostal veins. Documenting the anatomical variations in the rabbit will aid in the planning of future experimental studies and determining the clinical relevance on such studies.

  7. The Integral Theory System Questionnaire: an anatomically directed questionnaire to determine pelvic floor dysfunctions in women.

    Science.gov (United States)

    Wagenlehner, Florian Martin Erich; Fröhlich, Oliver; Bschleipfer, Thomas; Weidner, Wolfgang; Perletti, Gianpaolo

    2014-06-01

    Anatomical damage to pelvic floor structures may cause multiple symptoms. The Integral Theory System Questionnaire (ITSQ) is a holistic questionnaire that uses symptoms to help locate damage in specific connective tissue structures as a guide to reconstructive surgery. It is based on the integral theory, which states that pelvic floor symptoms and prolapse are both caused by lax suspensory ligaments. The aim of the present study was to psychometrically validate the ITSQ. Established psychometric properties including validity, reliability, and responsiveness were considered for evaluation. Criterion validity was assessed in a cohort of 110 women with pelvic floor dysfunctions by analyzing the correlation of questionnaire responses with objective clinical data. Test-retest was performed with questionnaires from 47 patients. Cronbach's alpha and "split-half" reliability coefficients were calculated for inner consistency analysis. Psychometric properties of ITSQ were comparable to the ones of previously validated Pelvic Floor Questionnaires. Face validity and content validity were approved by an expert group of the International Collaboration of Pelvic Floor surgeons. Convergent validity assessed using Bayesian method was at least as accurate as the expert assessment of anatomical defects. Objective data measurement in patients demonstrated significant correlations with ITSQ domains fulfilling criterion validity. Internal consistency values ranked from 0.85 to 0.89 in different scenarios. The ITSQ proofed accurate and is able to serve as a holistic Pelvic Floor Questionnaire directing symptoms to site-specific pelvic floor reconstructive surgery.

  8. The Diagnostic Reproducibility of Tomosynthesis for the Correlation between Acromiohumeral Distance and Rotator Cuff Size or Type.

    Science.gov (United States)

    Song, Yoonah; Lee, Seunghun; Lee, Bong Gun; Joo, Young Bin; Song, Soon-Young

    2018-01-01

    To correlate the acromiohumeral distance (AHD) using tomosynthesis and rotator cuff (RC) pathology and various anatomical indices and to assess the diagnostic reproducibility of tomosynthesis for the evaluation of subacromial impingement. A retrospective review of 63 patients with clinically suspected subacromial impingement was conducted. Two musculoskeletal radiologists independently measured the following quantitative data: the AHD on plain radiographs and the AHD at three compartments (anterior, middle, and posterior) using tomosynthesis, computed tomography (CT) arthrography, or magnetic resonance (MR) arthrography. To investigate the association between the AHD and RC pathology and various anatomical indices, we reviewed the arthroscopic operation record as the referenced standard. The size of rotator cuff tear (RCT) in full-thickness tears displayed a significant inverse correlation with the middle and the posterior tomosynthetic AHDs ( p tomosynthesis, and CT or MR arthrography ( p tomosynthesis is reproducible compared with other modalities.

  9. Analyzing functional, structural, and anatomical correlation of hemispheric language lateralization in healthy subjects using functional MRI, diffusion tensor imaging, and voxel-based morphometry.

    Science.gov (United States)

    James, Jija S; Kumari, Sheela R; Sreedharan, Ruma Madhu; Thomas, Bejoy; Radhkrishnan, Ashalatha; Kesavadas, Chandrasekharan

    2015-01-01

    To evaluate the efficacy of diffusion fiber tractography (DFT) and voxel-based morphometry (VBM) for lateralizing language in comparison with functional magnetic resonance imaging (fMRI) to noninvasively assess hemispheric language lateralization in normal healthy volunteers. The aim of the present study is to evaluate the concordance of language lateralization obtained by diffusion tensor imaging (DTI) and VBM to fMRI, and thus to see whether there exists an anatomical correlate for language lateralization result obtained using fMRI. This is an advanced neuroimaging study conducted in normal healthy volunteers. Fifty-seven normal healthy subjects (39 males and 18 females; age range: 15-40 years) underwent language fMRI and 30 underwent direction DTI. fMRI language laterality index (LI), fiber tract asymmetry index (AI), and tract-based statistics of dorsal and ventral language pathways were calculated. The combined results were correlated with VBM-based volumetry of Heschl's gyrus (HG), planum temporale (PT), and insula for lateralization of language function. A linear regression analysis was done to study the correlation between fMRI, DTI, and VBM measurements. A good agreement was found between language fMRI LI and fiber tract AI, more specifically for arcuate fasciculus (ArcF) and inferior longitudinal fasciculus (ILF). The study demonstrated significant correlations (P based statistics, and PT and HG volumetry for determining language lateralization. A strong one-to-one correlation between fMRI, laterality index, DTI tractography measures, and VBM-based volumetry measures for determining language lateralization exists.

  10. CLINICAL CASE OF PERFORMING A TWO-ST AGE LOVER RESECTION BY TYPE ALPPS IN PATIENT WHO PREVIOUSLY UNDERWENT ANATOMIC RESECTION OF THE RIGHT LOBE OF THE LIVER

    Directory of Open Access Journals (Sweden)

    D. V. Sidorov

    2015-01-01

    Full Text Available Abstract:One of the variants for the surgical treatment of patients with bilobal liver metastases is to perform two-stage anatomic resections. Thus, at least in a quarter of the patients it is impossible to perform the second stage of intervention because of absence of hypertrophy of the remaining liver parenchyma or progression of disease during standby. The most modern and promising way of overcoming this obstacle is to perform the so-called ALPPS (Associating Liver Partition and Portal vein Ligation for Staged hepatectomy or «in situ slit» liver resections. In this article we present a clinical case of performing a two-stage hepatectomy by type ALPPS in patients with metastatic colorectal cancer liver, who previously undergone the anatomic bisegmentectomy SVI-SVII. The present observation is the first in the available literature, evidence of justification perform repeated liver resections in patients with metastatic colorectal cancer and demonstrates the possibility of ALPPS techniques when performing extensive anatomical liver resections in patients who have undergone previous removal of the parenchyma of the right lobe.

  11. Anatomical study of terminal peroneal artery perforators and their clinical applications

    Directory of Open Access Journals (Sweden)

    Rajendran Purushothaman

    2013-01-01

    Full Text Available Introduction: Peroneal artery gives off plenty of perforators that pass through fascial septum to supply skin and tenosynovium of peroneal muscles. Aim: The aim of this study was to study the anatomical basis of perforators from terminal part of peroneal artery axiality and to make use of this knowledge in reconstructing defects of posterior heel with the advantage of reducing the morbidity of conventional flaps. Materials and Methods: Our study was conducted at Department of Plastic surgery, Madras Medical College and Rajiv Gandhi Government General Hospital, India. We have carried out eleven cadaver dissections (from six cadavers-four fresh cadavers and two preserved cadavers and delineated all septocutaneous and septosynovial perforators of distal peroneal axis and studied their relation with short saphenous vein (SSV and sural nerve. Using this anatomical knowledge we have fashioned perforator based flaps in 13 patients (three propeller, four V-Y advancement, six tenosynovial flaps for reconstruction of defects over tendo achilles and pericalcaneal region . Results: In all cases, SSV and sural nerve were preserved and donor site was closed primarily. No total flap loss was noted. Conclusion: Perforator based flaps from distal most part of peroneal artery provide a good and reliable method for reconstruction of pericalcaneal and tendo achilles region defects with preservation of SSV and sural nerve. It also avoids contour deformity of the grafted donor site of the classical lateral calcaneal artery axial flap.

  12. A case of hemorrhagic pineal cyst: MR/CT correlation

    International Nuclear Information System (INIS)

    Osborn, R.E.

    1989-01-01

    A 30-year-old male had headache pain for one month and was evaluated with both computed tomography (CT) and magnetic resonance (MR). These scans demonstrated an obstructing pineal cyst containing layered acute and subacute blood products by MR criteria. The concurrent scans allowed correlation between CT and MR findings in this rare complication of an unusual entity, explained his headache (and the development of later upward gaze paresis), provided a precise surgical/anatomic approach, and gave a good final clinical result. The report illustrates appropriate CT and MR images and pathological specimen. (orig.)

  13. Longitudinal retention of anatomical knowledge in second-year medical students.

    Science.gov (United States)

    Doomernik, Denise E; van Goor, Harry; Kooloos, Jan G M; Ten Broek, Richard P

    2017-06-01

    The Radboud University Medical Center has a problem-based, learner-oriented, horizontally, and vertically integrated medical curriculum. Anatomists and clinicians have noticed students' decreasing anatomical knowledge and the disability to apply knowledge in diagnostic reasoning and problem solving. In a longitudinal cohort, the retention of anatomical knowledge gained during the first year of medical school among second-year medical students was assessed. In May 2011, 346 medical students applied for the second-year gastro-intestinal (GI) tract course. The students were asked to participate in a reexamination of a selection of anatomical questions of an examination from October 2009. The examination consisted of a clinical anatomy case scenario and two computed tomography (CT) images of thorax and abdomen in an extended matching format. A total of 165 students were included for analysis. In 2011, students scored significantly lower for the anatomy examination compared to 2009 with a decline in overall examination score of 14.7% (±11.7%). Decrease in knowledge was higher in the radiological questions, compared to the clinical anatomy cases 17.5% (±13.6%) vs. 7.9% (±10.0%), respectively, d = 5.17. In both years, male students scored slightly better compared to female students, and decline of knowledge seems somewhat lower in male students (13.1% (±11.1%) vs. 15.5% (±12.0%), respectively), d = -0.21. Anatomical knowledge in the problem-oriented horizontal and vertical integrated medical curriculum, declined by approximately 15% 1.5 year after the initial anatomy course. The loss of knowledge in the present study is relative small compared to previous studies. Anat Sci Educ 10: 242-248. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  14. Athletic groin pain (part 1): a prospective anatomical diagnosis of 382 patients--clinical findings, MRI findings and patient-reported outcome measures at baseline.

    Science.gov (United States)

    Falvey, É C; King, E; Kinsella, S; Franklyn-Miller, A

    2016-04-01

    Athletic groin pain remains a common field-based team sports time-loss injury. There are few reports of non-surgically managed cohorts with athletic groin pain. To describe clinical presentation/examination, MRI findings and patient-reported outcome (PRO) scores for an athletic groin pain cohort. All patients had a history including demographics, injury duration, sport played and standardised clinical examination. All patients underwent MRI and PRO score to assess recovery. A clinical diagnosis of the injured anatomical structure was made based on these findings. Statistical assessment of the reliability of accepted standard investigations undertaken in making an anatomical diagnosis was performed. 382 consecutive athletic groin pain patients, all male, enrolled. Median time in pain at presentation was (IQR) 36 (16-75) weeks. Most (91%) played field-based ball-sports. Injury to the pubic aponeurosis (PA) 240 (62.8%) was the most common diagnosis. This was followed by injuries to the hip in 81 (21.2%) and adductors in 56 (14.7%) cases. The adductor squeeze test (90° hip flexion) was sensitive (85.4%) but not specific for the pubic aponeurosis and adductor pathology (negative likelihood ratio 1.95). Analysed in series, positive MRI findings and tenderness of the pubic aponeurosis had a 92.8% post-test probability. In this largest cohort of patients with athletic groin pain combining clinical and MRI diagnostics there was a 63% prevalence of PA injury. The adductor squeeze test was sensitive for athletic groin pain, but not specific individual pathologies. MRI improved diagnostic post-test probability. No hernia or incipient hernia was diagnosed. NCT02437942. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Imaging diagnosis in relapsing polychondritis and correlation with clinical and serological data

    International Nuclear Information System (INIS)

    Thaiss, W.M.; Nikolaou, K.; Horger, M.; Spengler, W.; Xenitidis, T.; Henes, J.; Spira, D.

    2016-01-01

    We hypothesize that imaging findings from CT and MRI correlate better with clinical markers for assessment of disease activity in patients with the rare relapsing polychondritis (RPC) than with serological inflammatory markers. Retrospective database search at our institution identified 28 patients (13 females; age 49.0 years ± 15.0 SD) with RP between September 2004 and March 2014. Institutional review board approval was obtained for this retrospective data analysis. All patients had clinically proven RPC with at least two episodes of active disease. Of those, 18 patients were examined with CT- and MRI and presented all morphologic features of RPC like bronchial/laryngeal/auricular cartilage thickness, contrast enhancement, increased T2-signal intensity. Imaging data was subsequently correlated with corresponding clinical symptoms like fever, dyspnea, stridor, uveitis, pain, hearing impairment as well as with acute-phase-inflammatory parameters like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The clinical parameters were in good agreement with imaging findings and clinical symptoms such as tracheal wall thickening and dyspnea (r =0.65 p = 0.05), joint synovitis on MRI and a higher McAdam score (r = 0.84 p < 0.001). No correlations were found between inflammatory laboratory markers, imaging findings and clinical features. Imaging diagnosis in RPC using CT and/or MRI delivers information about the degree of disease activity that correlates better with clinical features than unspecific inflammatory laboratory markers. Additionally, clinically unapparent cartilage involvement can be assessed adding value to the clinical diagnosis and therapy planning in this rare disease. (orig.)

  16. Imaging diagnosis in relapsing polychondritis and correlation with clinical and serological data

    Energy Technology Data Exchange (ETDEWEB)

    Thaiss, W.M.; Nikolaou, K.; Horger, M. [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Tuebingen (Germany); Spengler, W.; Xenitidis, T.; Henes, J. [Eberhard Karls University, Department of Internal Medicine II, Tuebingen (Germany); Spira, D. [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Tuebingen (Germany); University Medical Center Heidelberg, Diagnostic and Interventional Radiology, Heidelberg (Germany)

    2016-03-15

    We hypothesize that imaging findings from CT and MRI correlate better with clinical markers for assessment of disease activity in patients with the rare relapsing polychondritis (RPC) than with serological inflammatory markers. Retrospective database search at our institution identified 28 patients (13 females; age 49.0 years ± 15.0 SD) with RP between September 2004 and March 2014. Institutional review board approval was obtained for this retrospective data analysis. All patients had clinically proven RPC with at least two episodes of active disease. Of those, 18 patients were examined with CT- and MRI and presented all morphologic features of RPC like bronchial/laryngeal/auricular cartilage thickness, contrast enhancement, increased T2-signal intensity. Imaging data was subsequently correlated with corresponding clinical symptoms like fever, dyspnea, stridor, uveitis, pain, hearing impairment as well as with acute-phase-inflammatory parameters like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The clinical parameters were in good agreement with imaging findings and clinical symptoms such as tracheal wall thickening and dyspnea (r =0.65 p = 0.05), joint synovitis on MRI and a higher McAdam score (r = 0.84 p < 0.001). No correlations were found between inflammatory laboratory markers, imaging findings and clinical features. Imaging diagnosis in RPC using CT and/or MRI delivers information about the degree of disease activity that correlates better with clinical features than unspecific inflammatory laboratory markers. Additionally, clinically unapparent cartilage involvement can be assessed adding value to the clinical diagnosis and therapy planning in this rare disease. (orig.)

  17. Force of habit: shrubs, trees and contingent evolution of wood anatomical diversity using Croton (Euphorbiaceae) as a model system.

    Science.gov (United States)

    Arévalo, Rafael; van Ee, Benjamin W; Riina, Ricarda; Berry, Paul E; Wiedenhoeft, Alex C

    2017-03-01

    Wood is a major innovation of land plants, and is usually a central component of the body plan for two major plant habits: shrubs and trees. Wood anatomical syndromes vary between shrubs and trees, but no prior work has explicitly evaluated the contingent evolution of wood anatomical diversity in the context of these plant habits. Phylogenetic comparative methods were used to test for contingent evolution of habit, habitat and wood anatomy in the mega-diverse genus Croton (Euphorbiaceae), across the largest and most complete molecular phylogeny of the genus to date. Plant habit and habitat are highly correlated, but most wood anatomical features correlate more strongly with habit. The ancestral Croton was reconstructed as a tree, the wood of which is inferred to have absent or indistinct growth rings, confluent-like axial parenchyma, procumbent ray cells and disjunctive ray parenchyma cell walls. The taxa sampled showed multiple independent origins of the shrub habit in Croton , and this habit shift is contingent on several wood anatomical features (e.g. similar vessel-ray pits, thick fibre walls, perforated ray cells). The only wood anatomical trait correlated with habitat and not habit was the presence of helical thickenings in the vessel elements of mesic Croton . Plant functional traits, individually or in suites, are responses to multiple and often confounding contexts in evolution. By establishing an explicit contingent evolutionary framework, the interplay between habit, habitat and wood anatomical diversity was dissected in the genus Croton . Both habit and habitat influence the evolution of wood anatomical characters, and conversely, the wood anatomy of lineages can affect shifts in plant habit and habitat. This study hypothesizes novel putatively functional trait associations in woody plant structure that could be further tested in a variety of other taxa. Published by Oxford University Press on behalf of the Annals of Botany Company 2017. This work is

  18. Brain anatomical network and intelligence.

    Directory of Open Access Journals (Sweden)

    Yonghui Li

    2009-05-01

    Full Text Available Intuitively, higher intelligence might be assumed to correspond to more efficient information transfer in the brain, but no direct evidence has been reported from the perspective of brain networks. In this study, we performed extensive analyses to test the hypothesis that individual differences in intelligence are associated with brain structural organization, and in particular that higher scores on intelligence tests are related to greater global efficiency of the brain anatomical network. We constructed binary and weighted brain anatomical networks in each of 79 healthy young adults utilizing diffusion tensor tractography and calculated topological properties of the networks using a graph theoretical method. Based on their IQ test scores, all subjects were divided into general and high intelligence groups and significantly higher global efficiencies were found in the networks of the latter group. Moreover, we showed significant correlations between IQ scores and network properties across all subjects while controlling for age and gender. Specifically, higher intelligence scores corresponded to a shorter characteristic path length and a higher global efficiency of the networks, indicating a more efficient parallel information transfer in the brain. The results were consistently observed not only in the binary but also in the weighted networks, which together provide convergent evidence for our hypothesis. Our findings suggest that the efficiency of brain structural organization may be an important biological basis for intelligence.

  19. Anatomical curve identification

    Science.gov (United States)

    Bowman, Adrian W.; Katina, Stanislav; Smith, Joanna; Brown, Denise

    2015-01-01

    Methods for capturing images in three dimensions are now widely available, with stereo-photogrammetry and laser scanning being two common approaches. In anatomical studies, a number of landmarks are usually identified manually from each of these images and these form the basis of subsequent statistical analysis. However, landmarks express only a very small proportion of the information available from the images. Anatomically defined curves have the advantage of providing a much richer expression of shape. This is explored in the context of identifying the boundary of breasts from an image of the female torso and the boundary of the lips from a facial image. The curves of interest are characterised by ridges or valleys. Key issues in estimation are the ability to navigate across the anatomical surface in three-dimensions, the ability to recognise the relevant boundary and the need to assess the evidence for the presence of the surface feature of interest. The first issue is addressed by the use of principal curves, as an extension of principal components, the second by suitable assessment of curvature and the third by change-point detection. P-spline smoothing is used as an integral part of the methods but adaptations are made to the specific anatomical features of interest. After estimation of the boundary curves, the intermediate surfaces of the anatomical feature of interest can be characterised by surface interpolation. This allows shape variation to be explored using standard methods such as principal components. These tools are applied to a collection of images of women where one breast has been reconstructed after mastectomy and where interest lies in shape differences between the reconstructed and unreconstructed breasts. They are also applied to a collection of lip images where possible differences in shape between males and females are of interest. PMID:26041943

  20. Disruption of brain anatomical networks in schizophrenia: A longitudinal, diffusion tensor imaging based study.

    Science.gov (United States)

    Sun, Yu; Chen, Yu; Lee, Renick; Bezerianos, Anastasios; Collinson, Simon L; Sim, Kang

    2016-03-01

    Despite convergent neuroimaging evidence indicating a wide range of brain abnormalities in schizophrenia, our understanding of alterations in the topological architecture of brain anatomical networks and how they are modulated over time, is still rudimentary. Here, we employed graph theoretical analysis of longitudinal diffusion tensor imaging data (DTI) over a 5-year period to investigate brain network topology in schizophrenia and its relationship with clinical manifestations of the illness. Using deterministic tractography, weighted brain anatomical networks were constructed from 31 patients experiencing schizophrenia and 28 age- and gender-matched healthy control subjects. Although the overall small-world characteristics were observed at both baseline and follow-up, a scan-point independent significant deficit of global integration was found in patients compared to controls, suggesting dysfunctional integration of the brain and supporting the notion of schizophrenia as a disconnection syndrome. Specifically, several brain regions (e.g., the inferior frontal gyrus and the bilateral insula) that are crucial for cognitive and emotional integration were aberrant. Furthermore, a significant group-by-longitudinal scan interaction was revealed in the characteristic path length and global efficiency, attributing to a progressive aberration of global integration in patients compared to healthy controls. Moreover, the progressive disruptions of the brain anatomical network topology were associated with the clinical symptoms of the patients. Together, our findings provide insights into the substrates of anatomical dysconnectivity patterns for schizophrenia and highlight the potential for connectome-based metrics as neural markers of illness progression and clinical change with treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. [Establishment of anatomical terminology in Japan].

    Science.gov (United States)

    Shimada, Kazuyuki

    2008-12-01

    The history of anatomical terminology in Japan began with the publication of Waran Naikei Ihan-teimŏ in 1805 and Chŏtei Kaitai Shinsho in 1826. Although the establishment of Japanese anatomical terminology became necessary during the Meiji era when many western anatomy books imported into Janan were translated, such terminology was not unified during this period and varied among translators. In 1871, Tsukumo Ono's Kaibŏgaku Gosen was published by the Ministry of Education. Although this book is considered to be the first anatomical glossary terms in Japan, its contents were incomplete. Overseas, the German Anatomical Society established a unified anatomical terminology in 1895 called the Basle Nomina Anatomica (B.N.A.). Based on this development, Kaibŏgaku Meishŭ which follows the BNA, by Buntarŏ Suzuki was published in 1905. With the subsequent establishment in 1935 of Jena Nomina Anatomica (J.N.A.), the unification of anatomical terminology was also accelerated in Japan, leading to the further development of terminology.

  2. [Clinical and anatomical features of congenital microphthalmia and anophthalmia in children and conservative methods of rehabilitation].

    Science.gov (United States)

    Sudovskaya, T V; Filatova, I A; Kiseleva, T N; Bobrovskaya, Yu A; Kokoeva, N Sh

    2016-01-01

    To develop a comprehensive classification system of distinctive clinical and anatomical features of congenital microphthalmia and anophthalmia in children and to specify indications, contraindications, and optimal timing of the primary and subsequent prosthetic treatment. A total of 70 patients with congenital micro- or anophthalmia aged from 1 month to 12 years were examined. Besides the routine ophthalmic examination, all patients underwent eye and orbit ultrasound (axial length measurement and B-scan), computed tomography of the orbits and skull, and immunological tests for infectious diseases (enzyme-linked immunosorbent assays). Basing on the examination we have determined the common types of congenital micro- and anophthalmia in children. We have also developed a stepwise prosthetic treatment aimed at better cosmetic rehabilitation. Indications and contraindications for the use of ocular prostheses in children with congenital micro- and anophthalmia have been identified. The proposed method of stepwise prosthetics is the principal option for conservative rehabilitation of children with congenital micro- or anophthalmia.

  3. Systematic reviews: I. The correlation between laboratory tests on marginal quality and bond strength. II. The correlation between marginal quality and clinical outcome.

    Science.gov (United States)

    Heintze, Siegward D

    2007-01-01

    An accepted principle in restorative dentistry states that restorations should be placed with the best marginal quality possible to avoid postoperative sensitivity, marginal discoloration, and secondary caries. Different laboratory methods claim to predict the clinical performance of restorative materials, for example, tests of bond strength and microleakage and gap analysis. The purpose of this review was twofold: (1) find studies that correlated the results of bond strength tests with either microleakage or gap analysis for the same materials, and (2) find studies that correlated the results of microleakage and/or gaps with the clinical parameters for the same materials. Furthermore, influencing factors on the results of the laboratory tests were reviewed and assessed. For the first question, searches for studies were conducted in the MEDLINE database and IADR/AADR abtracts online with specific search and inclusion criteria. The outcome for each study was assessed on the basis of the statistical test applied in the study, and finally the number of studies with or without correlation was compiled. For the second question, results of the quantitative marginal analysis of Class V restorations published by the University of Zürich with the same test protocol and prospective clinical trials were searched that investigated the same materials for at least 2 years in Class V cavities. Pearson correlation coefficients were calculated for pooled data of materials and clinical outcome parameters such as retention loss, marginal discoloration, marginal integrity, and secondary caries. For the correlation of dye penetration and clinical outcome, studies on Class V restorations published by the same research institute were searched in MEDLINE that examined the same adhesive systems as the selected clinical trials. For the correlation bond strength/microleakage, 30 studies were included into the review, and for the correlation bond strength/gap analysis 18 studies. For both

  4. Clinical applications of PET/CT

    International Nuclear Information System (INIS)

    Le Ngoc Ha

    2011-01-01

    The purpose of this article is to review the evolution of PET, PET/CT focusing on the technical aspects, PET radiopharmaceutical developments and current clinical applications as well. The newest technologic advances have been reviewed, including improved crystal design, acquisition modes, reconstruction algorithms, etc. These advancements will continue to improve contrast, decrease noise, and increase resolution. Combined PET/CT system provides faster attenuation correction and useful anatomic correlation to PET functional information. A number of new radiopharmaceuticals used for PET imaging have been developed, however, FDG have been considered as the principal PET radiotracer. The current clinical applications of PET and PET/CT are widespread and include oncology, cardiology and neurology. (author)

  5. Brain neuroimaging of domestic cats: correlation between computed tomography and cross-sectional anatomy

    International Nuclear Information System (INIS)

    Nepomuceno, A.C.; Zanatta, R.; Chung, D.G.; Costa, P.F.; Feliciano, M.A.R.; Avante, M.L.; Canola, J.C.; Lopes, L.S.

    2016-01-01

    Computed tomography of the brain is necessary as part of the diagnosis of lesions of the central nervous system. In this study we used six domestic cats, male or female, aged between one and five years, evaluated by Computed Tomography (CT) examination without clinical signs of central nervous system disorders. Two euthanized animals stating a condition unrelated to the nervous system were incorporated into this study. The proposal consisted in establishing detailed anatomical description of tomographic images of normal brain of cats, using as reference anatomical images of cross sections of the stained brain and cranial part, with thicknesses similar to the planes of the CT images. CT examinations were performed with and without intravenous iodinated contrast media for live animals. With one euthanized animal, the brain was removed and immediately preserved in 10% formalin for later achievement in cross-sectional thickness of approximately 4mm and staining technique of Barnard, and Robert Brown. The head of another animal was disarticulated in the Atlanto-occipital region and frozen at -20 deg C then sliced to a thickness of about 5mm. The description of visualized anatomical structures using tomography is useful as a guide and allows transcribing with relative accuracy the brain region affected by an injury, and thus correlating it with the clinical symptoms of the patient, providing additional information and consequent improvement to veterinarians during the course of surgical clinic in this species. (author)

  6. Brain neuroimaging of domestic cats: correlation between computed tomography and cross-sectional anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Nepomuceno, A.C. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Zanatta, R. [Universidade de Cuiaba, MT (Brazil); Chung, D.G.; Costa, P.F.; Feliciano, M.A.R.; Avante, M.L.; Canola, J.C., E-mail: marcusfeliciano@yahoo.com.br [Faculdade de Ciencias Agrarias e Veterinarias, Jaboticabal, SP (Brazil); Lopes, L.S. [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil)

    2016-09-15

    Computed tomography of the brain is necessary as part of the diagnosis of lesions of the central nervous system. In this study we used six domestic cats, male or female, aged between one and five years, evaluated by Computed Tomography (CT) examination without clinical signs of central nervous system disorders. Two euthanized animals stating a condition unrelated to the nervous system were incorporated into this study. The proposal consisted in establishing detailed anatomical description of tomographic images of normal brain of cats, using as reference anatomical images of cross sections of the stained brain and cranial part, with thicknesses similar to the planes of the CT images. CT examinations were performed with and without intravenous iodinated contrast media for live animals. With one euthanized animal, the brain was removed and immediately preserved in 10% formalin for later achievement in cross-sectional thickness of approximately 4mm and staining technique of Barnard, and Robert Brown. The head of another animal was disarticulated in the Atlanto-occipital region and frozen at -20 deg C then sliced to a thickness of about 5mm. The description of visualized anatomical structures using tomography is useful as a guide and allows transcribing with relative accuracy the brain region affected by an injury, and thus correlating it with the clinical symptoms of the patient, providing additional information and consequent improvement to veterinarians during the course of surgical clinic in this species. (author)

  7. Clinical applications of SPECT/CT in imaging the extremities

    International Nuclear Information System (INIS)

    Huellner, Martin W.; Strobel, Klaus

    2014-01-01

    Today, SPECT/CT is increasingly used and available in the majority of larger nuclear medicine departments. Several applications of SPECT/CT as a supplement to or replacement for traditional conventional bone scintigraphy have been established in recent years. SPECT/CT of the upper and lower extremities is valuable in many conditions with abnormal bone turnover due to trauma, inflammation, infection, degeneration or tumour. SPECT/CT is often used in patients if conventional radiographs are insufficient, if MR image quality is impaired due to metal implants or in patients with contraindications to MR. In complex joints such as those in the foot and wrist, SPECT/CT provides exact anatomical correlation of pathological uptake. In many cases SPECT increases the sensitivity and CT the specificity of the study, increasing confidence in the final diagnosis compared to planar images alone. The CT protocol should be adapted to the clinical question and may vary from very low-dose (e.g. attenuation correction only), to low-dose for anatomical correlation, to normal-dose protocols enabling precise anatomical resolution. The aim of this review is to give an overview of SPECT/CT imaging of the extremities with a focus on the hand and wrist, knee and foot, and for evaluation of patients after joint arthroplasty. (orig.)

  8. Clinical applications of SPECT/CT in imaging the extremities

    Energy Technology Data Exchange (ETDEWEB)

    Huellner, Martin W. [University Hospital Zurich, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Strobel, Klaus [Lucerne Cantonal Hospital, Department of Nuclear Medicine and Radiology, Lucerne (Switzerland)

    2014-05-15

    Today, SPECT/CT is increasingly used and available in the majority of larger nuclear medicine departments. Several applications of SPECT/CT as a supplement to or replacement for traditional conventional bone scintigraphy have been established in recent years. SPECT/CT of the upper and lower extremities is valuable in many conditions with abnormal bone turnover due to trauma, inflammation, infection, degeneration or tumour. SPECT/CT is often used in patients if conventional radiographs are insufficient, if MR image quality is impaired due to metal implants or in patients with contraindications to MR. In complex joints such as those in the foot and wrist, SPECT/CT provides exact anatomical correlation of pathological uptake. In many cases SPECT increases the sensitivity and CT the specificity of the study, increasing confidence in the final diagnosis compared to planar images alone. The CT protocol should be adapted to the clinical question and may vary from very low-dose (e.g. attenuation correction only), to low-dose for anatomical correlation, to normal-dose protocols enabling precise anatomical resolution. The aim of this review is to give an overview of SPECT/CT imaging of the extremities with a focus on the hand and wrist, knee and foot, and for evaluation of patients after joint arthroplasty. (orig.)

  9. Semantic Dementia and Persisting Wernicke's Aphasia: Linguistic and Anatomical Profiles

    Science.gov (United States)

    Ogar, J. M.; Baldo, J. V.; Wilson, S. M.; Brambati, S. M.; Miller, B. L.; Dronkers, N. F.; Gorno-Tempini, M. L.

    2011-01-01

    Few studies have directly compared the clinical and anatomical characteristics of patients with progressive aphasia to those of patients with aphasia caused by stroke. In the current study we examined fluent forms of aphasia in these two groups, specifically semantic dementia (SD) and persisting Wernicke's aphasia (WA) due to stroke. We compared…

  10. Awareness in dementia: a review of clinical correlates

    NARCIS (Netherlands)

    Aalten, Pauline; van Valen, Evelien; Clare, Linda; Kenny, Geraldine; Verhey, Frans

    2005-01-01

    This article provides a review of the literature on clinical correlates of awareness in dementia. Most inconsistencies were found with regard to an association between depression and higher levels of awareness. Dysthymia, but not major depression, is probably related to higher levels of awareness.

  11. Clinical anatomy of the subserous layer: An amalgamation of gross and clinical anatomy.

    Science.gov (United States)

    Yabuki, Yoshihiko

    2016-05-01

    The 1998 edition of Terminologia Anatomica introduced some currently used clinical anatomical terms for the pelvic connective tissue or subserous layer. These innovations persuaded the present author to consider a format in which the clinical anatomical terms could be reconciled with those of gross anatomy and incorporated into a single anatomical glossary without contradiction or ambiguity. Specific studies on the subserous layer were undertaken on 79 Japanese women who had undergone surgery for uterine cervical cancer, and on 26 female cadavers that were dissected, 17 being formalin-fixed and 9 fresh. The results were as follows: (a) the subserous layer could be segmentalized by surgical dissection in the perpendicular, horizontal and sagittal planes; (b) the segmentalized subserous layer corresponded to 12 cubes, or ligaments, of minimal dimension that enabled the pelvic organs to be extirpated; (c) each ligament had a three-dimensional (3D) structure comprising craniocaudal, mediolateral, and dorsoventral directions vis-á-vis the pelvic axis; (d) these 3D-structured ligaments were encoded morphologically in order of decreasing length; and (e) using these codes, all the surgical procedures for 19th century to present-day radical hysterectomy could be expressed symbolically. The establishment of clinical anatomical terms, represented symbolically through coding as demonstrated in this article, could provide common ground for amalgamating clinical anatomy with gross anatomy. Consequently, terms in clinical anatomy and gross anatomy could be reconciled and compiled into a single anatomical glossary. © 2015 Wiley Periodicals, Inc.

  12. Anatomical sciences: A foundation for a solid learning experience in dental technology and dental prosthetics.

    Science.gov (United States)

    Bakr, Mahmoud M; Thompson, C Mark; Massadiq, Magdalena

    2017-07-01

    Basic science courses are extremely important as a foundation for scaffolding knowledge and then applying it in future courses, clinical situations as well as in a professional career. Anatomical sciences, which include tooth morphology, oral histology, oral embryology, and head and neck anatomy form a core part of the preclinical courses in dental technology programs. In this article, the importance and relevance of anatomical sciences to dental personnel with no direct contact with patients (dental technicians) and limited discipline related contact with patients (dental prosthetists) is highlighted. Some light is shed on the role of anatomical sciences in the pedagogical framework and its significance in the educational process and interprofessional learning of dental technicians and prosthetists using oral biology as an example in the dental curriculum. To conclude, anatomical sciences allow dental technicians and prosthetists to a gain a better insight of how tissues function, leading to a better understanding of diagnosis, comprehensive treatment planning and referrals if needed. Patient communication and satisfaction also increases as a result of this deep understanding of oral tissues. Anatomical sciences bridge the gap between basic science, preclinical, and clinical courses, which leads to a holistic approach in patient management. Finally, treatment outcomes are positively affected due to the appreciation of the macro and micro structure of oral tissues. Anat Sci Educ 10: 395-404. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  13. Marginal space learning for medical image analysis efficient detection and segmentation of anatomical structures

    CERN Document Server

    Zheng, Yefeng

    2014-01-01

    Presents an award winning image analysis technology (Thomas Edison Patent Award, MICCAI Young Investigator Award) that achieves object detection and segmentation with state-of-the-art accuracy and efficiency Flexible, machine learning-based framework, applicable across multiple anatomical structures and imaging modalities Thirty five clinical applications on detecting and segmenting anatomical structures such as heart chambers and valves, blood vessels, liver, kidney, prostate, lymph nodes, and sub-cortical brain structures, in CT, MRI, X-Ray and Ultrasound.

  14. Anatomical knowledge retention in third-year medical students prior to obstetrics and gynecology and surgery rotations.

    Science.gov (United States)

    Jurjus, Rosalyn A; Lee, Juliet; Ahle, Samantha; Brown, Kirsten M; Butera, Gisela; Goldman, Ellen F; Krapf, Jill M

    2014-01-01

    Surgical anatomy is taught early in medical school training. The literature shows that many physicians, especially surgical specialists, think that anatomical knowledge of medical students is inadequate and nesting of anatomical sciences later in the clinical curriculum may be necessary. Quantitative data concerning this perception of an anatomical knowledge deficit are lacking, as are specifics as to what content should be reinforced. This study identifies baseline areas of strength and weakness in the surgical anatomy knowledge of medical students entering surgical rotations. Third-year medical students completed a 20-25-question test at the beginning of the General Surgery and Obstetrics and Gynecology rotations. Knowledge of inguinal anatomy (45.3%), orientation in abdominal cavity (38.8%), colon (27.7%), and esophageal varices (12.8%) was poor. The numbers in parentheses are the percentage of questions answered correctly per topic. In comparing those scores to matched test items from this cohort as first-year students in the anatomy course, the drop in retention overall was very significant (P = 0.009) from 86.9 to 51.5%. Students also scored lower in questions relating to pelvic organs (46.7%), urogenital development (54.0%), pulmonary development (17.8%), and pregnancy (17.8%). These data showed that indeed, knowledge of surgical anatomy is poor for medical students entering surgical clerkships. These data collected will be utilized to create interactive learning modules, aimed at improving clinically relevant anatomical knowledge retention. These modules, which will be available to students during their inpatient surgical rotations, connect basic anatomy principles to clinical cases, with the ultimate goal of closing the anatomical knowledge gap. © 2014 American Association of Anatomists.

  15. Development of a patient-specific anatomical foot model from structured light scan data.

    Science.gov (United States)

    Lochner, Samuel J; Huissoon, Jan P; Bedi, Sanjeev S

    2014-01-01

    The use of anatomically accurate finite element (FE) models of the human foot in research studies has increased rapidly in recent years. Uses for FE foot models include advancing knowledge of orthotic design, shoe design, ankle-foot orthoses, pathomechanics, locomotion, plantar pressure, tissue mechanics, plantar fasciitis, joint stress and surgical interventions. Similar applications but for clinical use on a per-patient basis would also be on the rise if it were not for the high costs associated with developing patient-specific anatomical foot models. High costs arise primarily from the expense and challenges of acquiring anatomical data via magnetic resonance imaging (MRI) or computed tomography (CT) and reconstructing the three-dimensional models. The proposed solution morphs detailed anatomy from skin surface geometry and anatomical landmarks of a generic foot model (developed from CT or MRI) to surface geometry and anatomical landmarks acquired from an inexpensive structured light scan of a foot. The method yields a patient-specific anatomical foot model at a fraction of the cost of standard methods. Average error for bone surfaces was 2.53 mm for the six experiments completed. Highest accuracy occurred in the mid-foot and lowest in the forefoot due to the small, irregular bones of the toes. The method must be validated in the intended application to determine if the resulting errors are acceptable.

  16. Anatomical specificity of vascular endothelial growth factor expression in glioblastomas: a voxel-based mapping analysis

    Energy Technology Data Exchange (ETDEWEB)

    Fan, Xing [Capital Medical University, Department of Neurosurgery, Beijing Tiantan Hospital, Beijing (China); Wang, Yinyan [Capital Medical University, Department of Neurosurgery, Beijing Tiantan Hospital, Beijing (China); Capital Medical University, Department of Neuropathology, Beijing Neurosurgical Institute, Beijing (China); Wang, Kai; Ma, Jun; Li, Shaowu [Capital Medical University, Department of Neuroradiology, Beijing Tiantan Hospital, Beijing (China); Liu, Shuai [Chinese Academy of Medical Sciences and Peking Union Medical College, Departments of Neurosurgery, Peking Union Medical College Hospital, Beijing (China); Liu, Yong [Chinese Academy of Sciences, Brainnetome Center, Institute of Automation, Beijing (China); Jiang, Tao [Capital Medical University, Department of Neurosurgery, Beijing Tiantan Hospital, Beijing (China); Beijing Academy of Critical Illness in Brain, Department of Clinical Oncology, Beijing (China)

    2016-01-15

    The expression of vascular endothelial growth factor (VEGF) is a common genetic alteration in malignant gliomas and contributes to the angiogenesis of tumors. This study aimed to investigate the anatomical specificity of VEGF expression levels in glioblastomas using voxel-based neuroimaging analysis. Clinical information, MR scans, and immunohistochemistry stains of 209 patients with glioblastomas were reviewed. All tumor lesions were segmented manually and subsequently registered to standard brain space. Voxel-based regression analysis was performed to correlate the brain regions of tumor involvement with the level of VEGF expression. Brain regions identified as significantly associated with high or low VEGF expression were preserved following permutation correction. High VEGF expression was detected in 123 (58.9 %) of the 209 patients. Voxel-based statistical analysis demonstrated that high VEGF expression was more likely in tumors located in the left frontal lobe and the right caudate and low VEGF expression was more likely in tumors that occurred in the posterior region of the right lateral ventricle. Voxel-based neuroimaging analysis revealed the anatomic specificity of VEGF expression in glioblastoma, which may further our understanding of genetic heterogeneity during tumor origination. This finding provides primary theoretical support for potential future application of customized antiangiogenic therapy. (orig.)

  17. Anatomical specificity of vascular endothelial growth factor expression in glioblastomas: a voxel-based mapping analysis

    International Nuclear Information System (INIS)

    Fan, Xing; Wang, Yinyan; Wang, Kai; Ma, Jun; Li, Shaowu; Liu, Shuai; Liu, Yong; Jiang, Tao

    2016-01-01

    The expression of vascular endothelial growth factor (VEGF) is a common genetic alteration in malignant gliomas and contributes to the angiogenesis of tumors. This study aimed to investigate the anatomical specificity of VEGF expression levels in glioblastomas using voxel-based neuroimaging analysis. Clinical information, MR scans, and immunohistochemistry stains of 209 patients with glioblastomas were reviewed. All tumor lesions were segmented manually and subsequently registered to standard brain space. Voxel-based regression analysis was performed to correlate the brain regions of tumor involvement with the level of VEGF expression. Brain regions identified as significantly associated with high or low VEGF expression were preserved following permutation correction. High VEGF expression was detected in 123 (58.9 %) of the 209 patients. Voxel-based statistical analysis demonstrated that high VEGF expression was more likely in tumors located in the left frontal lobe and the right caudate and low VEGF expression was more likely in tumors that occurred in the posterior region of the right lateral ventricle. Voxel-based neuroimaging analysis revealed the anatomic specificity of VEGF expression in glioblastoma, which may further our understanding of genetic heterogeneity during tumor origination. This finding provides primary theoretical support for potential future application of customized antiangiogenic therapy. (orig.)

  18. Multimodal Investigation of Network Level Effects Using Intrinsic Functional Connectivity, Anatomical Covariance, and Structure-to-Function Correlations in Unmedicated Major Depressive Disorder.

    Science.gov (United States)

    Scheinost, Dustin; Holmes, Sophie E; DellaGioia, Nicole; Schleifer, Charlie; Matuskey, David; Abdallah, Chadi G; Hampson, Michelle; Krystal, John H; Anticevic, Alan; Esterlis, Irina

    2018-04-01

    Converging evidence suggests that major depressive disorder (MDD) affects multiple large-scale brain networks. Analyses of the correlation or covariance of regional brain structure and function applied to structural and functional MRI data may provide insights into systems-level organization and structure-to-function correlations in the brain in MDD. This study applied tensor-based morphometry and intrinsic connectivity distribution to identify regions of altered volume and intrinsic functional connectivity in data from unmedicated individuals with MDD (n=17) and healthy comparison participants (HC, n=20). These regions were then used as seeds for exploratory anatomical covariance and connectivity analyses. Reduction in volume in the anterior cingulate cortex (ACC) and lower structural covariance between the ACC and the cerebellum were observed in the MDD group. Additionally, individuals with MDD had significantly lower whole-brain intrinsic functional connectivity in the medial prefrontal cortex (mPFC). This mPFC region showed altered connectivity to the ventral lateral PFC (vlPFC) and local circuitry in MDD. Global connectivity in the ACC was negatively correlated with reported depressive symptomatology. The mPFC-vlPFC connectivity was positively correlated with depressive symptoms. Finally, we observed increased structure-to-function correlation in the PFC/ACC in the MDD group. Although across all analysis methods and modalities alterations in the PFC/ACC were a common finding, each modality and method detected alterations in subregions belonging to distinct large-scale brain networks. These exploratory results support the hypothesis that MDD is a systems level disorder affecting multiple brain networks located in the PFC and provide new insights into the pathophysiology of this disorder.

  19. Multimodal Investigation of Network Level Effects Using Intrinsic Functional Connectivity, Anatomical Covariance, and Structure-to-Function Correlations in Unmedicated Major Depressive Disorder

    Science.gov (United States)

    Scheinost, Dustin; Holmes, Sophie E; DellaGioia, Nicole; Schleifer, Charlie; Matuskey, David; Abdallah, Chadi G; Hampson, Michelle; Krystal, John H; Anticevic, Alan; Esterlis, Irina

    2018-01-01

    Converging evidence suggests that major depressive disorder (MDD) affects multiple large-scale brain networks. Analyses of the correlation or covariance of regional brain structure and function applied to structural and functional MRI data may provide insights into systems-level organization and structure-to-function correlations in the brain in MDD. This study applied tensor-based morphometry and intrinsic connectivity distribution to identify regions of altered volume and intrinsic functional connectivity in data from unmedicated individuals with MDD (n=17) and healthy comparison participants (HC, n=20). These regions were then used as seeds for exploratory anatomical covariance and connectivity analyses. Reduction in volume in the anterior cingulate cortex (ACC) and lower structural covariance between the ACC and the cerebellum were observed in the MDD group. Additionally, individuals with MDD had significantly lower whole-brain intrinsic functional connectivity in the medial prefrontal cortex (mPFC). This mPFC region showed altered connectivity to the ventral lateral PFC (vlPFC) and local circuitry in MDD. Global connectivity in the ACC was negatively correlated with reported depressive symptomatology. The mPFC–vlPFC connectivity was positively correlated with depressive symptoms. Finally, we observed increased structure-to-function correlation in the PFC/ACC in the MDD group. Although across all analysis methods and modalities alterations in the PFC/ACC were a common finding, each modality and method detected alterations in subregions belonging to distinct large-scale brain networks. These exploratory results support the hypothesis that MDD is a systems level disorder affecting multiple brain networks located in the PFC and provide new insights into the pathophysiology of this disorder. PMID:28944772

  20. New semiquantitative assessment of 123I-FP-CIT by an anatomical standardization method

    International Nuclear Information System (INIS)

    Takada, Seiko; Yoshimura, Mana; Shindo, Hiroaki; Saito, Kazuhiro; Koizumi, Kiyoshi; Utsumi, Hiroya; Abe, Kimihiko

    2006-01-01

    We evaluated a new semiquantitative procedure to more easily and objectively estimate the striatal uptake of 123 I-FP-CIT in patients with Parkinsonian syndrome (PS) and essential tremor (ET), using an anatomical standardization method, the Neurostat. Eleven patients with PS and 8 with ET were examined by clinical assessment and 123 I-FP-CIT SPECT imaging. The modified Hoehn and Yahr Staging Scale and Unified Parkinson's Disease Rating Scale (UPDRS) were used to assess the stage and severity of the disease. The co-registered MR and SPECT images were created with fusion software included in Neurostat. On the cross section, which shows the largest area of striate, irregular shaped regions of interest corresponding to the striate and occipital cortex were drawn. Then the ratio of specific striatal uptake to non-specific occipital cortex, V3''(F), was calculated. Another calculation was done by VOIClassic, which is a software included in Neurostat to estimate the counts per voxel of anatomically defined regions such as caudate nucleus, putamen, occipital cortex, and total cortex. Using these count data, the ratio of specific striatal uptake to non-specific occipital cortex, V3''(OC), and total cortex, V3''(TC), was calculated. A fair linear correlation was observed between V3''(OC) and V3''(F) (y=1.53x+1.40; r=0.756; p s =-0.816). However, V3''(OC) and V3''(TC) correlated less with UPDRS (r s =-0.667 and -0.645, respectively). Semiquantitative parameters, V3''(OC) and V3''(TC), calculated by VOIClassic including the Neurostat system are useful and easily calculable parameters as well as V3''(F) for the differential diagnosis of PS from ET. (author)

  1. Anatomical and physical changes in leaves during the production of tamales.

    Science.gov (United States)

    Angeles, Guillermo; Lascurain, Maite; Davalos-Sotelo, Raymundo; Zarate-Morales, Reyna Paula; Ortega-Escalona, Fernando

    2013-08-01

    Tamale preparation has a long tradition in Mexico. To understand which material properties have been considered important for this purpose throughout the years, a study was conducted of the anatomical, chemical, and mechanical properties of the leaves of four plant species used in tamale preparation in Veracruz, Mexico: Calathea misantlensis, Canna indica, Musa paradisiaca, and Oreopanax capitatus. Four cooking treatments were considered: fresh (F), roasted (soasado, R), steamed (S), and roasted plus steamed (R/S). Chemical, anatomical, and mechanical analyses were conducted before and after each treatment. Leaf samples were tested for tensile strength at both parallel and perpendicular orientation relative to the fibers. Musa paradisiaca had the highest proportion of cellulose, while the remaining species shared similar lower proportions. Leaves were stronger and stiffer in the longitudinal direction of the fibers. Musa paradisiaca leaves had higher values of mechanical strength than the other species. The cooking process that most affected the mechanical properties was steaming. The chemical constituents of the leaves are closely correlated with their physical properties. The treatment that caused the greatest decrease in leaf physical integrity was steaming, while the combination of roasting and steaming showed similar results to those of steaming alone. No evident anatomical changes are produced by any of the treatments. This is one of the few studies comparing physical, chemical, and anatomical characteristics of leaves used for human consumption, before and after cooking.

  2. The Anatomical Correlation between the Internal Venous Vertebral System and the Cranial Venae Cavae in Rabbit

    Directory of Open Access Journals (Sweden)

    David Mazensky

    2013-01-01

    Full Text Available The aim of this study was to describe the possible variations in the connection between the internal venous vertebral system and the cranial vena cava in rabbit using corrosion technique. The study was carried out on 40 adult New Zealand white rabbits. The venous system was injected by using Batson's corrosion casting kit number 17. We found the connection between the internal venous vertebral system and the cranial vena cava by means of the vertebral veins and the right azygos vein. The vertebral vein was present as independent tributary in 36 cases (90%. In the rest of the cases, it was found as being double, being triple, or forming a common trunk with other veins. The azygos vein was present as independent tributary of the cranial vena cava in 39 cases (97.5%. We found also a common trunk formed by the junction of the deep cervical vein, the right vertebral vein, and the azygos vein in one case (2.5%. The azygos vein received 6, 7, 8, or 9 pairs of dorsal intercostal veins. Documenting the anatomical variations in the rabbit will aid in the planning of future experimental studies and determining the clinical relevance on such studies.

  3. Acetabular fractures: anatomic and clinical considerations.

    Science.gov (United States)

    Lawrence, David A; Menn, Kirsten; Baumgaertner, Michael; Haims, Andrew H

    2013-09-01

    Classifying acetabular fractures can be an intimidating topic. However, it is helpful to remember that there are only three basic types of acetabular fractures: column fractures, transverse fractures, and wall fractures. Within this framework, acetabular fractures are classified into two broad categories: elementary or associated fractures. We will review the osseous anatomy of the pelvis and provide systematic approaches for reviewing both radiographs and CT scans to effectively evaluate the acetabulum. Although acetabular fracture classification may seem intimidating, the descriptions and distinctions discussed and shown in this article hopefully make the topic simpler to understand. Approach the task by recalling that there are only three basic types of acetabular fractures: column fractures (coronally oriented on CT images), transverse fractures (sagittally oriented on CT images), and wall fractures (obliquely oriented on CT images). We have provided systematic approaches for reviewing both conventional radiographs and CT scans to effectively assess the acetabulum. The clinical implications of the different fracture patterns have also been reviewed because it is critically important to include pertinent information for our clinical colleagues to provide the most efficient and timely clinical care.

  4. Does the anatomical localization of lower extremity venous diseases affect the quality of life?

    Science.gov (United States)

    Sadikoglu, Ganime; Ozcakir, Alis; Ercan, Ilker; Yildiz, Caner; Sadikoglu, Yurtkuran

    2006-11-01

    To investigate the effects of venous diseases at different anatomical localizations on the qualities of life of patients with varicose veins. The study included 354 cases, which was referred to a private vascular and interventional radiology center in Bursa, Turkey between January 2005 to January 2006. The cases were diagnosed with visual inspection and were clinically indicative of varicose veins. Color Doppler ultrasonography was used to radiologically examine the varicose veins. All cases were accepted as class II criteria according to the Clinical, Etiologic, Anatomic, Pathophysiologic classification. The generic Short Form Health Survey-36 (SF-36) was used to measure physical and mental quality of life (QOL). High scores indicated good QOL. The Statistical Package for Social Sciences version 13.0 program was used for the statistical evaluation. When the life SF-36 quality parameters of cases with different anatomical localizations of the varicose veins were examined, only the mental health scores were found to differ in different groups (pemotional role scores among the mental state determinants. When females and males with deep vein disease were compared, significant differences were found among both physical and mental health determinants. Anatomical localization of lower extremity varicose veins can be accepted as a predictive factor in determining the life qualities of patients with varicosities in their lower limb, and should be used to regulate their therapy and follow up protocols.

  5. Estimation of lung tumor position from multiple anatomical features on 4D-CT using multiple regression analysis.

    Science.gov (United States)

    Ono, Tomohiro; Nakamura, Mitsuhiro; Hirose, Yoshinori; Kitsuda, Kenji; Ono, Yuka; Ishigaki, Takashi; Hiraoka, Masahiro

    2017-09-01

    To estimate the lung tumor position from multiple anatomical features on four-dimensional computed tomography (4D-CT) data sets using single regression analysis (SRA) and multiple regression analysis (MRA) approach and evaluate an impact of the approach on internal target volume (ITV) for stereotactic body radiotherapy (SBRT) of the lung. Eleven consecutive lung cancer patients (12 cases) underwent 4D-CT scanning. The three-dimensional (3D) lung tumor motion exceeded 5 mm. The 3D tumor position and anatomical features, including lung volume, diaphragm, abdominal wall, and chest wall positions, were measured on 4D-CT images. The tumor position was estimated by SRA using each anatomical feature and MRA using all anatomical features. The difference between the actual and estimated tumor positions was defined as the root-mean-square error (RMSE). A standard partial regression coefficient for the MRA was evaluated. The 3D lung tumor position showed a high correlation with the lung volume (R = 0.92 ± 0.10). Additionally, ITVs derived from SRA and MRA approaches were compared with ITV derived from contouring gross tumor volumes on all 10 phases of the 4D-CT (conventional ITV). The RMSE of the SRA was within 3.7 mm in all directions. Also, the RMSE of the MRA was within 1.6 mm in all directions. The standard partial regression coefficient for the lung volume was the largest and had the most influence on the estimated tumor position. Compared with conventional ITV, average percentage decrease of ITV were 31.9% and 38.3% using SRA and MRA approaches, respectively. The estimation accuracy of lung tumor position was improved by the MRA approach, which provided smaller ITV than conventional ITV. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  6. Nodule detection in digital chest radiography: Effect of anatomical noise

    International Nuclear Information System (INIS)

    Baath, M.; Haakansson, M.; Boerjesson, S.; Hoeschen, C.; Tischenko, O.; Kheddache, S.; Vikgren, J.; Maansson, L. G.

    2005-01-01

    The image background resulting from imaged anatomy can be divided into those components that are meaningful to the observers, in the sense that they are recognised as separate structures, and those that are not. These latter components (referred to as anatomical noise) can be removed using a method developed within the RADIUS group. The aim of the present study was to investigate whether the removal of the anatomical noise results in images where lung nodules with lower contrast can be detected. A receiver operating characteristic (ROC) study was therefore conducted using two types of images: clinical chest images and chest images in which the anatomical noise had been removed. Simulated designer nodules with a full-width-at-fifth-maximum of 10 mm but with varying contrast were added to the images. The contrast needed to obtain an area under the ROC curve of 0.80, C0.8, was used as a measure of detectability (a low value of C0.8 represents a high delectability). Five regions of the chest X ray were investigated and it was found that in all regions the removal of anatomical noise led to images with lower C0.8 than the original images. On average, C0.8 was 20% higher in the original images, ranging from 7% (the lateral pulmonary regions) to 41% (the upper mediastinal regions). (authors)

  7. Noninvasive study of anatomic variations of the bile and pancreatic duct using magnetic resonance cholangiopancreatography

    International Nuclear Information System (INIS)

    Fernandez, E.; Falco, J.; Campo, R.; Martin, J.; Brullet, E.; Espinos, J.

    1999-01-01

    To identify anatomic variations of the bile duct and pancreatic duct and papillary anomalies by means of magnetic resonance cholangiopancreatography (MRCP) and determine their correlation with endoscopic retrograde cholangiopancreatography (ERCP) findings. Eighty-five patients were selected by means of a prospective study comparing MRCP and ERCP. Coronal and axial HASTE images and coronal and oblique coronal RARE images were acquired in all the patients. Four of the studies (6%) were excluded because of poor technical quality. Anatomic variations were observed in 26 cases (30.5%), including trifurcation (n=7; 27%), right hepatic duct draining into left hepatic duct (n=2, 7.7%), right hepatic duct draining into common bile duct (n=4; 15.4%), extrahepatic confluence (n=2; 7.7%), medial cystic duct (n=2; 7.7%), parallel cystic duct (n=3; 11.5%), juxtapapillary duodenal diverticulum (n=3; 11.5%) and pancreas divisum (n=3; 11.5%). A good correlation was observed between the MRCP and ERCP findings. The introduction of MRCP into the noninvasive study of biliary disease may be useful in the detection of anatomic variations relevant to laparoscopic surgery and other endoscopic and interventional techniques. (Author) 11 refs

  8. Frequency of palmaris longus absence and its association with other anatomical variations in the Egyptian population.

    Science.gov (United States)

    Raouf, Hoda Abdel; Kader, Ghada Abdel; Jaradat, Ahmed; Dharap, Amol; Fadel, Raouf; Salem, Abdel Halim

    2013-07-01

    The palmaris longus (PL) is one of the most variable muscles in the human body. Racial differences in its variation have been documented. Several studies have attempted to correlate PL absence with other anatomical variations. This study was conducted to determine the prevalence of absence of PL, correlate it with gender and body side and to determine its association with other anatomical variations in the Egyptian population. The presence of PL was clinically determined in 386 Egyptians using the standard technique. All subjects were examined for the presence of the flexor digitorum superficialis (FDS) to the fifth finger. Allen's test was done to assess the completeness of the superficial palmar arch (SPA). The overall prevalence of absence of the PL in Egyptian subjects was 50.8%. There was no significant difference in PL absence with regard to the body side but a significant difference was seen as regards gender and when bilateral absence of PL was compared to its unilateral absence. Absence of FDS tendon to the fifth finger was seen in 1.3% subjects. There was no association between the absence of the FDS tendon to the fifth finger and either presence or absence of PL and also between the absence of PL and the incompleteness of SPA in both genders. In conclusion, the prevalence of absence of PL in the Egyptian population represents one of the highest rates of absence to be reported for this muscle, which is significantly different from that in other ethnic groups. Copyright © 2013 Wiley Periodicals, Inc.

  9. MR patterns of rotator cuff impingement lesions and histopathologic correlation of cadaver tendons

    International Nuclear Information System (INIS)

    Rafii, M.; Firooznia, H.; Minkoff, J.; Sherman, O.; Schinella, R.; Weinreb, J.C.; Golimbu, C.; Zazlav, K.

    1989-01-01

    This paper reports shoulder MR examinations of 250 patients retrospectively evaluated and correlated with surgical/arthrographic results in 68 patients and with clinical data in all for assessment of the signal pattern and the configuration of rotator cuff lesions. MR-histopathologic evaluation of the supraspinatus tendon of 8 cadaver shoulders was also correlated with these findings. MR imaging had a sensitivity of 92% in the diagnosis of cuff tears. The most common and accurate criterion for a tear was a tendinous defect, characterized by intense signal on T2-weighted images; less often the torn region consisted of an extremely degenerated and attenuated tendon or was obscured by scar. Presence of secondary findings was mandatory for diagnosis in the latter group. Signal pattern associated with tendonitis varied, and in some simulated that of tendon degeneration (fatty infiltration and fibrillation) or cellular proliferation observed on anatomic specimens. Associated tendinous enlargement and subacromial-subdeltoid bursitis in these patients best correlated with the severity of clinical and surgical findings

  10. Pediatric eosinophilic esophagitis: radiologic findings with pathologic correlation

    International Nuclear Information System (INIS)

    Binkovitz, Larry A.; Lorenz, Emily A.; Di Lorenzo, Carlo; Kahwash, Samir

    2010-01-01

    Eosinophilic esophagitis is increasingly recognized as a cause of dysphagia or food impaction in pediatric patients. It has a high male predominance and is often associated with a history of allergy or asthma. To correlate fluoroscopic findings in eosinophilic esophagitis with the endoscopic and histologic findings. We retrospectively reviewed the upper gastrointestinal (UGI) findings of eosinophilic esophagitis and correlated them with the clinical, endoscopic and histologic findings in a series of 17 children (12 boys, 5 girls). UGI findings were normal in 12 children, including 4 who had a normal UGI exam after endoscopic disimpaction for an obstructing food bolus. Five children had strictures identified on UGI: one was demonstrated with endoscopy. This suggests that the impactions and strictures were due to an esophageal dysmotility rather than a fixed anatomic abnormality. Because the UGI findings are frequently normal in eosinophilic esophagitis, radiologists need to have a high index of suspicion for this disease. In children with a strong clinical history, especially impaction in the absence of an esophageal stricture, endoscopy and biopsy are indicated for further evaluation. (orig.)

  11. Pediatric eosinophilic esophagitis: radiologic findings with pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Binkovitz, Larry A. [Nationwide Children' s Hospital, Columbus, OH (United States); Mayo Clinic, Division of Pediatric Radiology, E-2, Rochester, MN (United States); Lorenz, Emily A. [Nationwide Children' s Hospital, Columbus, OH (United States); Di Lorenzo, Carlo [Nationwide Children' s Hospital, Department of Gastroenterology, Columbus, OH (United States); Kahwash, Samir [Nationwide Children' s Hospital, Department of Pathology, Columbus, OH (United States)

    2010-05-15

    Eosinophilic esophagitis is increasingly recognized as a cause of dysphagia or food impaction in pediatric patients. It has a high male predominance and is often associated with a history of allergy or asthma. To correlate fluoroscopic findings in eosinophilic esophagitis with the endoscopic and histologic findings. We retrospectively reviewed the upper gastrointestinal (UGI) findings of eosinophilic esophagitis and correlated them with the clinical, endoscopic and histologic findings in a series of 17 children (12 boys, 5 girls). UGI findings were normal in 12 children, including 4 who had a normal UGI exam after endoscopic disimpaction for an obstructing food bolus. Five children had strictures identified on UGI: one was demonstrated with endoscopy. This suggests that the impactions and strictures were due to an esophageal dysmotility rather than a fixed anatomic abnormality. Because the UGI findings are frequently normal in eosinophilic esophagitis, radiologists need to have a high index of suspicion for this disease. In children with a strong clinical history, especially impaction in the absence of an esophageal stricture, endoscopy and biopsy are indicated for further evaluation. (orig.)

  12. An Anatomically Validated Brachial Plexus Contouring Method for Intensity Modulated Radiation Therapy Planning

    International Nuclear Information System (INIS)

    Van de Velde, Joris; Audenaert, Emmanuel; Speleers, Bruno; Vercauteren, Tom; Mulliez, Thomas; Vandemaele, Pieter; Achten, Eric; Kerckaert, Ingrid; D'Herde, Katharina; De Neve, Wilfried; Van Hoof, Tom

    2013-01-01

    Purpose: To develop contouring guidelines for the brachial plexus (BP) using anatomically validated cadaver datasets. Magnetic resonance imaging (MRI) and computed tomography (CT) were used to obtain detailed visualizations of the BP region, with the goal of achieving maximal inclusion of the actual BP in a small contoured volume while also accommodating for anatomic variations. Methods and Materials: CT and MRI were obtained for 8 cadavers positioned for intensity modulated radiation therapy. 3-dimensional reconstructions of soft tissue (from MRI) and bone (from CT) were combined to create 8 separate enhanced CT project files. Dissection of the corresponding cadavers anatomically validated the reconstructions created. Seven enhanced CT project files were then automatically fitted, separately in different regions, to obtain a single dataset of superimposed BP regions that incorporated anatomic variations. From this dataset, improved BP contouring guidelines were developed. These guidelines were then applied to the 7 original CT project files and also to 1 additional file, left out from the superimposing procedure. The percentage of BP inclusion was compared with the published guidelines. Results: The anatomic validation procedure showed a high level of conformity for the BP regions examined between the 3-dimensional reconstructions generated and the dissected counterparts. Accurate and detailed BP contouring guidelines were developed, which provided corresponding guidance for each level in a clinical dataset. An average margin of 4.7 mm around the anatomically validated BP contour is sufficient to accommodate for anatomic variations. Using the new guidelines, 100% inclusion of the BP was achieved, compared with a mean inclusion of 37.75% when published guidelines were applied. Conclusion: Improved guidelines for BP delineation were developed using combined MRI and CT imaging with validation by anatomic dissection

  13. Changes of wood anatomical characters of selected species of Araucaria- during artificial charring - implications for palaeontology

    Directory of Open Access Journals (Sweden)

    Isa Carla Osterkamp

    2017-11-01

    Full Text Available ABSTRACT Charcoal is widely accepted as evidence of the occurrence of palaeo-wildfire. Although fossil charcoal remains have been used in many studies, investigation into the anatomical changes occurring during charring are few. The present study analyses changes in selected anatomical characters during artificial charring of modern wood of three species of the genus Araucaria (i.e. Araucaria angustifolia, Araucaria bidwillii and Araucaria columnaris. Wood samples of the studied species was charred under controlled conditions at varying temperatures. Measurements of anatomical features of uncharred wood and artificial charcoal were statistically analysed. The anatomical changes were statistically correlated with charring temperatures and most of the parameters showed marked decreases with increasing charring temperature. Compared to the intrinsic variability in anatomical features, both within and between growth rings of an individual plant, the changes induced by temperature account only for a comparatively small percentage of the observed variability. Regarding Araucaria charcoal, it seems possible that at least general taxonomic and palaeoenvironmental implications can be drawn from such material. However, it is not clear so far whether these results and interpretations based on only three taxa, can be generalized for the entire family and anatomically similar fossil taxa or not.

  14. Mental health and clinical correlates in lesbian, gay, bisexual, and queer young adults

    DEFF Research Database (Denmark)

    Grant, Jon E; Odlaug, Brian Lawrence; Derbyshire, Katherine

    2014-01-01

    This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students.......This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students....

  15. Correlation of salivary immunoglobulin A against lipopolysaccharide of Porphyromonas gingivalis with clinical periodontal parameters

    Directory of Open Access Journals (Sweden)

    Pushpa S Pudakalkatti

    2015-01-01

    Full Text Available Background: A major challenge in clinical periodontics is to find a reliable molecular marker of periodontal tissue destruction. Aim: The aim of the present study was to assess, whether any correlation exists between salivary immunoglobulin A (IgA level against lipopolysaccharide of Porphyromonas gingivalis and clinical periodontal parameters (probing depth and clinical attachment loss. Materials and Methods: Totally, 30 patients with chronic periodontitis were included for the study based on clinical examination. Unstimulated saliva was collected from each study subject. Probing depth and clinical attachment loss were recorded in all selected subjects using University of North Carolina-15 periodontal probe. Extraction and purification of lipopolysaccharide were done from the standard strain of P. gingivalis (ATCC 33277. Enzyme linked immunosorbent assay (ELISA was used to detect the level of IgA antibodies against lipopolysaccharide of P. gingivalis in the saliva of each subject by coating wells of ELISA kit with extracted lipopolysaccharide antigen. Statistical Analysis: The correlation between salivary IgA and clinical periodontal parameters was checked using Karl Pearson′s correlation coefficient method and regression analysis. Results: The significant correlation was observed between salivary IgA level and clinical periodontal parameters in chronic periodontitis patients. Conclusion: A significant strong correlation was observed between salivary IgA against lipopolysaccharide of P. gingivalis and clinical periodontal parameters which suggest that salivary IgA level against lipopolysaccharide of P. gingivalis can be used to predict the severity of periodontal destruction in chronic periodontitis patients.

  16. The impact of case specificity and generalisable skills on clinical performance: a correlated traits-correlated methods approach.

    Science.gov (United States)

    Wimmers, Paul F; Fung, Cha-Chi

    2008-06-01

    The finding of case or content specificity in medical problem solving moved the focus of research away from generalisable skills towards the importance of content knowledge. However, controversy about the content dependency of clinical performance and the generalisability of skills remains. This study aimed to explore the relative impact of both perspectives (case specificity and generalisable skills) on different components (history taking, physical examination, communication) of clinical performance within and across cases. Data from a clinical performance examination (CPX) taken by 350 Year 3 students were used in a correlated traits-correlated methods (CTCM) approach using confirmatory factor analysis, whereby 'traits' refers to generalisable skills and 'methods' to individual cases. The baseline CTCM model was analysed and compared with four nested models using structural equation modelling techniques. The CPX consisted of three skills components and five cases. Comparison of the four different models with the least-restricted baseline CTCM model revealed that a model with uncorrelated generalisable skills factors and correlated case-specific knowledge factors represented the data best. The generalisable processes found in history taking, physical examination and communication were responsible for half the explained variance, in comparison with the variance related to case specificity. Conclusions Pure knowledge-based and pure skill-based perspectives on clinical performance both seem too one-dimensional and new evidence supports the idea that a substantial amount of variance contributes to both aspects of performance. It could be concluded that generalisable skills and specialised knowledge go hand in hand: both are essential aspects of clinical performance.

  17. Acute traumatic central cord syndrome: analysis of clinical and radiological correlations.

    Science.gov (United States)

    Miranda, P; Gomez, P; Alday, R

    2008-12-01

    In patients with traumatic spinal cord injury, several studies correlate neurological impairment and radiological findings. However, little information is available about this correspondence in the particular group of acute traumatic central cord syndrome. The object of the present work was to describe the clinical and radiological features of a series of patients presenting with acute traumatic central cord syndrome and to analyze clinical and radiological correlations on admission and at last follow-up. Retrospective review of 15 patients diagnosed of acute traumatic central cord syndrome between 1995 and 2005. Global motor score and motor score in upper extremities were determined on admission and at last follow-up (6 months-4 years, mean 16 months). Plain films, cervical computed tomography and magnetic resonance (MR) were performed in every patient and retrieved for the study. In seven patients, serial MR studies were performed during follow-up. Clinical and radiological correlations were statistically analyzed with non-parametric tests. Cervical spondylosis appeared associated with older age, falls, and absence of fracture. Spinal cord edema was the most common finding in MR studies but hemorrhage was also observed. The length of spinal cord edema significantly correlated with initial motor score. The decrease in T2-weighted hyperintensity in serial MR studies correlated with the gain of motor power in upper limbs at last follow-up. Elderly patients with more degenerated cervical spines commonly develop acute traumatic central cord syndrome after incidental falls. Length of spinal cord edema correlates with neurological impairment on admission and may provide significant prognostic information.

  18. ArthroBroström Lateral Ankle Stabilization Technique: An Anatomic Study.

    Science.gov (United States)

    Acevedo, Jorge I; Ortiz, Cristian; Golano, Pau; Nery, Caio

    2015-10-01

    Arthroscopic ankle lateral ligament repair techniques have recently been developed and biomechanically as well as clinically validated. Although there has been 1 anatomic study relating suture and anchor proximity to anatomic structures, none has evaluated the ArthroBroström procedure. To evaluate the proximity of anatomic structures for the ArthroBroström lateral ankle ligament stabilization technique and to define ideal landmarks and "safe zones" for this repair. Descriptive laboratory study. Ten human cadaveric ankle specimens (5 matched pairs) were screened for the study. All specimens underwent arthroscopic lateral ligament repair according to the previously described ArthroBroström technique with 2 suture anchors in the fibula. Three cadaveric specimens were used to test the protocol, and 7 were dissected to determine the proximity of anatomic structures. Several distances were measured, including those of different anatomic structures to the suture knots, to determine the "safe zones." Measurements were obtained by 2 separate observers, and statistical analysis was performed. None of the specimens revealed entrapment by either of the suture knots of the critical anatomic structures, including the superficial peroneal nerve (SPN), sural nerve, peroneus tertius tendon, peroneus brevis tendon, or peroneus longus tendon. The internervous safe zone between the intermediate branch of the SPN and sural nerve was a mean of 51 mm (range, 39-64 mm). The intertendinous safe zone between the peroneus tertius and peroneus brevis was a mean of 43 mm (range, 37-49 mm). On average, a 20-mm (range, 8-36 mm) safe distance was maintained from the most medial suture to the intermediate branch of the SPN. The amount of inferior extensor retinaculum (IER) grasped by either suture knot varied from 0 to 12 mm, with 86% of repairs including the retinaculum. The results indicate that there is a relatively wide internervous and intertendinous safe zone when performing the Arthro

  19. Comparison of computer tomographic and patho-anatomic pathomorphology of the hypernephroid renal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Jaschke, W.; Moeller, P.; Palmtag, H.; Kaick, G. van

    1980-11-01

    Knowledge of the patho-anatomic variants of the hypernephroid renal carcinoma as well as of its computertomographic correlate facilitates diagnosis and prevents fatal diagnostic errors. Measurements of density by computer tomography, as well as on-target application of contrast medium, are of great importance for arriving at the correct diagnosis.

  20. Determination of anatomic landmarks for optimal placement in captive-bolt euthanasia of goats.

    Science.gov (United States)

    Plummer, Paul J; Shearer, Jan K; Kleinhenz, Katie E; Shearer, Leslie C

    2018-03-01

    OBJECTIVE To determine the optimal anatomic site and directional aim of a penetrating captive bolt (PCB) for euthanasia of goats. SAMPLE 8 skulls from horned and polled goat cadavers and 10 anesthetized horned and polled goats scheduled to be euthanized at the end of a teaching laboratory. PROCEDURES Sagittal sections of cadaver skulls from 8 horned and polled goats were used to determine the ideal anatomic site and aiming of a PCB to maximize damage to the midbrain region of the brainstem for euthanasia. Anatomic sites for ideal placement and directional aiming were confirmed by use of 10 anesthetized horned and polled goats. RESULTS Clinical observation and postmortem examination of the sagittal sections of skulls from the 10 anesthetized goats that were euthanized confirmed that perpendicular placement and firing of a PCB at the intersection of 2 lines, each drawn from the lateral canthus of 1 eye to the middle of the base of the opposite ear, resulted in consistent disruption of the midbrain and thalamus in all goats. Immediate cessation of breathing, followed by a loss of heartbeat in all 10 of the anesthetized goats, confirmed that use of this site consistently resulted in effective euthanasia. CONCLUSIONS AND CLINICAL RELEVANCE Damage to the brainstem and key adjacent structures may be accomplished by firing a PCB perpendicular to the skull over the anatomic site identified at the intersection of 2 lines, each drawn from the lateral canthus of 1 eye to the middle of the base of the opposite ear.

  1. Age dependent physical and anatomical Indian data for application in internal dosimetry

    International Nuclear Information System (INIS)

    Dang, H.S.; Jaiswal, D.D.; Parameswaran, M.; Krishnamony, S.

    1996-01-01

    The data on physical, anatomical, physiological and metabolic human characteristics of the Indian population in various age groups were obtained for application in internal dosimetry. Only the physical and anatomical characteristics of the Indian population in age groups 0, 1, 5, 10, 15 y and adult are considered here. A comparison of the adult Indian data with that of ICRP Reference Man, clearly showed that with the exception of a few smaller organs, the body size as well as the organ weights of Indian subjects are, in general, smaller. With the exception of brain, a statistically significant linear correlation (p < 0.01) was observed between the body weights and the corresponding organ weights of Indian subjects in different age groups. (author)

  2. Anatomic Correlation of the Mini-Mental State Examination: A Voxel-Based Morphometric Study in Older Adults.

    Science.gov (United States)

    Dinomais, Mickael; Celle, Sebastien; Duval, Guillaume T; Roche, Frederic; Henni, Samir; Bartha, Robert; Beauchet, Olivier; Annweiler, Cedric

    2016-01-01

    The clinical utility of the Mini-Mental State Examination (MMSE) and its shorter version (SMMSE) is still debated. There is a need to better understand the neuroanatomical correlates of these cognitive tests. The objective of this cross-sectional study was to determine whether lower MMSE and SMMSE scores correlated with focal brain volume reduction in older adults. Participants from the GAIT study (n = 207; mean, 70.9±5.9 years; 57% female; mean MMSE 26.2±3.9; mean SMMSE 5.1±1.1) were evaluated using the MMSE and SMMSE and received a 1.5-Tesla MRI scan of the brain. Cortical gray and white matter subvolumes were automatically segmented using Statistical Parametric Mapping. Age, gender, education level, and total intracranial volume were included as potential confounders. We found correlations between the MMSE score and specific cortical regions of the limbic system including the hippocampus, amygdala, cingulate gyrus, and parahippocampal gyrus, independently of the diagnostic category (i.e., mild cognitive impairment or Alzheimer disease or controls). Regarding correlations with the SMMSE score, only one cluster in the left hippocampus was identified, which overlapped with the cluster that was positively correlated with the MMSE score. There were no correlations with the volume of white matter. In conclusion, worse MMSE and SMMSE scores were associated with gray matter atrophy mainly in the limbic system. This finding highlights that atrophy of specific brain regions are related to performance on the MMSE and the SMMSE tests, and provides new insights into the cognitive function probed by these tests.

  3. The anatomic basis for the acquisition of speech and obstructive sleep apnea: evidence from cephalometric analysis supports The Great Leap Forward hypothesis.

    Science.gov (United States)

    Davidson, Terence M; Sedgh, Jacob; Tran, Duyen; Stepnowsky, Carl J

    2005-11-01

    We previously postulated how evolutionary changes in man's upper respiratory tract to facilitate speech, a phenomenon Jared Diamond calls The Great Leap Forward, have predisposed man to obstructive sleep apnea (OSA) [Diamond J. The Third Chimpanzee: the evolution and future of the human animal. New York: HarperCollins Publishers; 1992. p. 21, 23, 32-54, 54-6; Davidson TM. The Great Leap Forward: the anatomic evolution of obstructive sleep apnea. Sleep Medicine 2003;4:185-94]. We grouped these anatomic changes into four categories: klinorynchy, laryngeal descent, craniobase angulation and supralaryngeal vocal tract (SVT) ratio of SVT(H):SVT(V). This study was designed to investigate the relationship between cephalometric measures corresponding to these anatomic changes and OSA. One hundred and twenty-three male subjects presenting with symptoms of OSA underwent unattended multi-channel home sleep studies. We obtained cephalometric measurements from standard lateral cephalograms. Pearson correlation coefficients were calculated between cephalometrics and apnea-hypopnea index (AHI), age, and body mass index (BMI). Our results showed significant correlation between AHI and klinorynchy, laryngeal descent, and craniobase angulation. Overall, our data supports the theory that evolutionary anatomic changes to facilitate speech correlate with OSA severity. The cumulative changes in each cephalometric category trended in the directions hypothesized and support the Great Leap theory of OSA evolution.

  4. Stenting is improving and stabilizing anatomical results of coiled intracranial aneurysms

    International Nuclear Information System (INIS)

    Lubicz, Boris; Bandeira, Alexandra; Baleriaux, Danielle; Bruneau, Michael; Witte, Olivier de; Dewindt, Aloys

    2009-01-01

    Stent-assisted coiling (SAC) is an alternative to surgical clipping for the treatment of wide-necked intracranial aneurysms (IA). However, little information is available concerning the long-term results of this treatment. The aim of this study was to report the long-term clinical and anatomical findings in 32 patients with 34 wide-necked IA treated by SAC. A retrospective review of our prospectively maintained database identified all patients followed up for wide-necked IA treated by SAC. The clinical charts, procedural data, and angiographic results were reviewed. Thirty-two patients with 34 IA were identified including 25 asymptomatic patients, four with cranial nerve palsies, two with a subarachnoid hemorrhage, and one with transient ischemic attacks. Mean aneurysm size was 10.2 mm (range 3.5 to 26 mm). Embolization was successful in all patients and no procedure-related neurological morbidity or mortality was observed. Immediate anatomical results included nine complete occlusions (26.5%), two neck remnants (6%), and 23 incomplete occlusions (67.5%). Mean imaging follow-up of 20 months showed 18 further thrombosis (53%) and 16 stable results (47%). Finally, 27 aneurysms were completely occluded (79%), three had a neck remnant (9%), and four were incompletely occluded (12%). Asymptomatic and nonsignificant in-stent stenosis occurred in seven patients (22%). SAC is safe and effective for the treatment of wide-necked IA. Despite unsatisfying immediate aneurysm occlusion, the adjunctive effect of the stent is stabilizing or significantly improving long-term anatomical results. (orig.)

  5. Three-Dimensional Anatomic Evaluation of the Anterior Cruciate Ligament for Planning Reconstruction

    Directory of Open Access Journals (Sweden)

    Yuichi Hoshino

    2012-01-01

    Full Text Available Anatomic study related to the anterior cruciate ligament (ACL reconstruction surgery has been developed in accordance with the progress of imaging technology. Advances in imaging techniques, especially the move from two-dimensional (2D to three-dimensional (3D image analysis, substantially contribute to anatomic understanding and its application to advanced ACL reconstruction surgery. This paper introduces previous research about image analysis of the ACL anatomy and its application to ACL reconstruction surgery. Crucial bony landmarks for the accurate placement of the ACL graft can be identified by 3D imaging technique. Additionally, 3D-CT analysis of the ACL insertion site anatomy provides better and more consistent evaluation than conventional “clock-face” reference and roentgenologic quadrant method. Since the human anatomy has a complex three-dimensional structure, further anatomic research using three-dimensional imaging analysis and its clinical application by navigation system or other technologies is warranted for the improvement of the ACL reconstruction.

  6. MRI Anatomical Correlates of Reading and Language Deficits

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-12-01

    Full Text Available Neuroanatomical correlates of developmental dyslexia (DD, defined by isolated reading deficits, and specific language impairment (SLI, defined by poor receptive and expressive language skills, were examined using MR imaging in a heterogeneous sample of 14 boys and 8 girls (11-16 yers of age with learning disabilities, in a study at University of Florida; Georgetown University, Washington, DC; and other centers.

  7. Designing learning spaces for interprofessional education in the anatomical sciences.

    Science.gov (United States)

    Cleveland, Benjamin; Kvan, Thomas

    2015-01-01

    This article explores connections between interprofessional education (IPE) models and the design of learning spaces for undergraduate and graduate education in the anatomical sciences and other professional preparation. The authors argue that for IPE models to be successful and sustained they must be embodied in the environment in which interprofessional learning occurs. To elaborate these arguments, two exemplar tertiary education facilities are discussed: the Charles Perkins Centre at the University of Sydney for science education and research, and Victoria University's Interprofessional Clinic in Wyndham for undergraduate IPE in health care. Backed by well-conceived curriculum and pedagogical models, the architectures of these facilities embody the educational visions, methods, and practices they were designed to support. Subsequently, the article discusses the spatial implications of curriculum and pedagogical change in the teaching of the anatomical sciences and explores how architecture might further the development of IPE models in the field. In conclusion, it is argued that learning spaces should be designed and developed (socially) with the expressed intention of supporting collaborative IPE models in health education settings, including those in the anatomical sciences. © 2015 American Association of Anatomists.

  8. The anatomical diaspora: evidence of early American anatomical traditions in North Dakota.

    Science.gov (United States)

    Stubblefield, Phoebe R

    2011-09-01

    The current focus in forensic anthropology on increasing scientific certainty in ancestry determination reinforces the need to examine the ancestry of skeletal remains used for osteology instruction. Human skeletal remains were discovered on the University of North Dakota campus in 2007. After recovery, the osteological examination resulted in a profile for a 33- to 46-year-old woman of African descent with stature ranging from 56.3 to 61.0 in. The pattern of postmortem damage indicated that the remains had been prepared for use as an anatomical teaching specimen. Review of the American history of anatomical teaching revealed a preference for Black subjects, which apparently extended to states like North Dakota despite extremely low resident populations of people of African descent. This study emphasizes the need to examine the ancestry of older teaching specimens that lack provenience, rather than assuming they are derived from typical (i.e., Indian) sources of anatomical material. © 2011 American Academy of Forensic Sciences.

  9. Correlation between clinical severity and type and degree of pectus excavatum in twelve brachycephalic dogs.

    Science.gov (United States)

    Hassan, Elham A; Hassan, Marwa H; Torad, Faisal A

    2018-05-18

    The aim of the study was to correlate the clinical severity of pectus excavatum with its type and degree based on objective radiographic evaluation. Twelve brachycephalic dogs were included. Grading of the clinical severity was done based on a 6-point grading score. Thoracic radiographs were used to calculate the frontosagittal and vertebral indices at the tenth thoracic vertebra and the vertebra overlying the excavatum. Correlation between the clinical severity score and frontosagittal and vertebral indices was evaluated using Pearson's correlation coefficient. Typical pectus excavatum was recorded in the caudal sternum in seven dogs, with a mean clinical severity score of 1.7 ± 1.4, whereas in five dogs, atypical mid-sternal deviation was recorded with a mean clinical severity score of 3.8 ± 0.7. A strong correlation (r=0.7) was recorded between the clinical severity score and vertebral index in the atypical form, whereas a weak correlation (r=0.02) was recorded in the typical form (Pcorrelated (r=0.3) in the typical form of pectus excavatum, whereas it was strongly correlated (r=0.9) in the atypical form. Pectus excavatum in dogs is associated with compressive cardiopulmonary dysfunction, which depends mainly on the site/type of deviation rather than the degree of deviation.

  10. Correlative Studies in Clinical Trials: A Position Statement From the International Thyroid Oncology Group.

    Science.gov (United States)

    Bible, Keith C; Cote, Gilbert J; Demeure, Michael J; Elisei, Rossella; Jhiang, Sissy; Ringel, Matthew D

    2015-12-01

    Patients with progressive thyroid cancer in distant metastatic sites represent a population with a need for new therapeutic options. Aspiring to improve the treatment of such patients, the objective of this position statement from the International Thyroid Oncology Group (ITOG) is to clarify the importance of incorporating high-quality correlative studies into clinical trials. ITOG was formed to develop and support high-quality multicenter and multidisciplinary clinical trials for patients with aggressive forms of thyroid cancer. The Correlative Sciences Committee of the ITOG focuses on the quality and types of correlative studies included in ITOG-associated clinical trials. This document represents expert consensus from ITOG regarding this issue based on extensive collective experience in clinical and translational trials informed by basic science. The Correlative Studies Committee identified an international writing group representative of diverse specialties, including basic sciences. Drafts were reviewed by all members of the writing group, the larger committee, and the ITOG board. After consideration of all comments by the writing group and modification of the document, the final document was then approved by the authors and the ITOG board. High-quality correlative studies, which include variety in the types of correlates, should be intrinsic to the design of thyroid cancer clinical trials to offer the best opportunity for each study to advance treatment for patients with advanced and progressive thyroid cancer.

  11. Comparison of computer tomographic and patho-anatomic pathomorphology of the hypernephroid renal carcinoma

    International Nuclear Information System (INIS)

    Jaschke, W.; Moeller, P.; Palmtag, H.; Kaick, G. van; Heidelberg Univ.

    1980-01-01

    Knowledge of the patho-anatomic variants of the hypernephroid renal carcinoma as well as of its computertomographic correlate facilitates diagnosis and prevents fatal diagnostic errors. Measurements of density by computer tomography, as well as on-target application of contrast medium, are of great importance for arriving at the correct diagnosis. (orig.) [de

  12. 21 CFR 320.28 - Correlation of bioavailability with an acute pharmacological effect or clinical evidence.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Correlation of bioavailability with an acute pharmacological effect or clinical evidence. 320.28 Section 320.28 Food and Drugs FOOD AND DRUG ADMINISTRATION... Correlation of bioavailability with an acute pharmacological effect or clinical evidence. Correlation of in...

  13. Fingertip replantation at the eponychial level with venous anastomosis: an anatomic study and clinical application.

    Science.gov (United States)

    Cheng, L; Chen, K; Chai, Y-M; Wen, G; Wang, C-Y

    2013-11-01

    We present an anatomic study of the vein distribution at the eponychial level, in order to standardize outpatient fingertip replantation. The cross sectional anatomy of 100 fingers was studied by dissection following dye injection. The distribution of the veins >0.3 mm was recorded on a pie-chart. Thirty fingers in 27 patients with fingertip amputations at the eponychial level were replanted by anastomosis of the palmar subcutaneous veins, to reconstruct the venous reflux of the amputated digits. The operations were aided by the anatomical study and confirmed that the palmar area is the preferred site for venous anastomosis Following a distal finger amputation at the level of the eponychial fold we propose starting the search for veins between the 3 to 5 o'clock or 7 to 9 o'clock positions, as these are the areas where there are most likely to be suitable veins.

  14. Wilson's disease: cranial MRI observations and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Sinha, S.; Taly, A.B.; Prashanth, L.K.; Venugopal, K.S.; Arunodaya, G.R.; Swamy, H.S. [National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neurology, Bangalore (India); Ravishankar, S.; Vasudev, M.K. [National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neuroimaging and Interventional Radiology, Bangalore (India)

    2006-09-15

    Study of MRI changes may be useful in diagnosis, prognosis and better understanding of the pathophysiology of Wilson's disease (WD). We aimed to describe and correlate the MRI abnormalities of the brain with clinical features in WD. MRI evaluation was carried out in 100 patients (57 males, 43 females; mean age 19.3{+-}8.9 years) using standard protocols. All but 18 patients were on de-coppering agents. Their history, clinical manifestations and scores for severity of disease were noted. The mean duration of illness and treatment were 8.3{+-}10.8 years and 7.5{+-}7.1 years respectively. MRI of the brain was abnormal in all the 93 symptomatic patients. The most conspicuous observations were atrophy of the cerebrum (70%), brainstem (66%) and cerebellum (52%). Signal abnormalities were also noted: putamen (72%), caudate (61%), thalami (58%), midbrain (49%), pons (20%), cerebral white matter (25%), cortex (9%), medulla (12%) and cerebellum (10%). The characteristic T2-W globus pallidal hypointensity (34%), ''Face of giant panda'' sign (12%), T1-W striatal hyperintensity (6%), central pontine myelinosis (7%), and bright claustral sign (4%) were also detected. MRI changes correlated with disease severity scores (P<0.001) but did not correlate with the duration of illness. MRI changes were universal but diverse and involved almost all the structures of the brain in symptomatic patients. A fair correlation between MRI observations and various clinical features provides an explanation for the protean manifestations of the disease. (orig.)

  15. Anatomical correlates of cognitive functions in early Parkinson's disease patients.

    Directory of Open Access Journals (Sweden)

    Roberta Biundo

    Full Text Available Cognitive deficits may occur early in Parkinson's disease (PD but the extent of cortical involvement associated with cognitive dysfunction needs additional investigations. The aim of our study is to identify the anatomical pattern of cortical thickness alterations in patients with early stage PD and its relationship with cognitive disability.We recruited 29 PD patients and 21 healthy controls. All PD patients performed an extensive neuropsychological examination and 14 were diagnosed with mild cognitive impairment (PD-MCI. Surface-based cortical thickness analysis was applied to investigate the topographical distribution of cortical and subcortical alterations in early PD compared with controls and to assess the relationship between cognition and regional cortical changes in PD-MCI.Overall PD patients showed focal cortical (occipital-parietal areas, orbito-frontal and olfactory areas and subcortical thinning when compared with controls. PD-MCI showed a wide spectrum of cognitive deficits and related significant regional thickening in the right parietal-frontal as well as in the left temporal-occipital areas.Our results confirm the presence of changes in grey matter thickness at relatively early PD stage and support previous studies showing thinning and atrophy in the neocortex and subcortical regions. Relative cortical thickening in PD-MCI may instead express compensatory neuroplasticity. Brain reserve mechanisms might first modulate cognitive decline during the initial stages of PD.

  16. Pituitary fossa: a correlative anatomic and MR study

    International Nuclear Information System (INIS)

    Mark, L.; Pech, P.; Daniels, D.; Charles, C.; Williams, A.; Haughton, V.

    1984-01-01

    This study characterizes the normal appearance of the pituitary fossa in partial saturation magnetic resonance (MR) images. In sagittal images, the pituitary fossa appears inhomogeneous. Correlation of sagittal MR images in normal subjects with sagittal cryomicrotomic images in cadavers suggests that the highest intensity signal from the posterior-inferior pituitary fossa is due to a fat pad. This conclusion was supported by MR images and postmortem cryotome sections obtained in normal subhuman primates

  17. Radiological diagnostics of abdomen and thorax. Image interpretation considering anatomical landmarks and clinical symptoms; Radiologische Diagnostik Abdomen und Thorax. Bildinterpretation unter Beruecksichtigung anatomischer Landmarken und klinischer Symptome

    Energy Technology Data Exchange (ETDEWEB)

    Krombach, Gabriele A. [Universitaetsklinikum Giessen (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Mahnken, Andreas H. (ed.) [Universitaetsklinikum Marburg (Germany). Diagnostische und Interventionelle Radiologie

    2015-07-01

    The book on radiological diagnostics of abdomen and thorax - image interpretation considering anatomical landmarks and clinical symptoms - includes three chapters: (1) imaging of different parts of the body: thorax and abdomen. (II) Thorax: head and neck; mediastinum; heard and pericardium; large vessels; lungs and pleura; mamma. (III) Abdomen: liver; gall bladder and biliary tract; pancreas; gastrointestinal tract; spleen and lymphatic system; adrenal glands; kidneys and urinary tract; female pelvis; male pelvis.

  18. Anatomic atlas for computed tomography in the mesaticephalic dog: head and neck

    International Nuclear Information System (INIS)

    George, T.F. II; Smallwood, J.E.

    1992-01-01

    The purpose of this study was to produce a comprehensive anatomic atlas of CT anatomy of the dog for use by veterinary radiologists, clinicians, and surgeons. Whole-body CT images of two mature beagle dogs were made with the dogs supported in sternal recumbency and using a slice thickness of 13 mm. The head was scanned using high-resolution imaging with a slice thickness of 8 mm. At the end of the CT session, each dog was euthanized, and while carefully maintaining the same position, the body was placed in a walk-in freezer until completely frozen. The body was then sectioned at 13-mm (head at 8-mm) intervals, with the cuts matched as closely as possible to the CT slices. The forzen sections were cleaned, photographed, and radiographed using xeroradiography. Each CT image was studied and compared with its corresponding xeroradiograph and anatomic section to assist in the accurate identification of specific structures. Intact, sagittally sectioned, and disarticulated dog skulls were used as reference models. Clinically relevant anatomic structures were identified and labeled in the three corresponding photographs (CT image, xeroradiograph, and anatomic section). In this paper, the CT anatomy of the head and neck of the mesaticephalic dog is presented

  19. A correlation of clinical, MRI and brain SPECT in dementia

    International Nuclear Information System (INIS)

    Shelley, S.; Indirani, M.; Gokhale, S.; Anirudhan, N.; Sivakumar, M.R.; Jaganathan, K.

    2004-01-01

    Background: Dementia is a clinical syndrome characterised by acquired impairment in multiple neuropsycologic and behavior domains including memory, language, speech, visuospatial ability, cognition and mood/personality. Dementia produces deficits in perfusion reflecting decreased metabolic needs. Neuroimaging techniques help in determining whether the cognitive symptoms are organic and in which pattern of cognitive loss the patient may evolve. AIM: To differentiate various types of Dementia, based on the regional perfusion abnormalities seen in Brain SPECT and correlate this with Clinical and MRI findings. Material and methods: Patients suffering from memory impairment and memory loss were referred to our department for Brain SPECT as a part of work up for Dementia. They had undergone a detailed clinical examination, psychometry, mini mental status examination (MMSE), memory/cognitive testing and an MRI. Brain SPECT was done after injecting Tc 99m ECD (Ethylene Cysteinate Dimer ) and imaging after 45 minutes. The images obtained were reconstructed in a conventional way. The various patterns of perfusion abnormalities seen in the SPECT images was studied and correlated with MRI and clinical findings. The patients were thus classified as having Multi Infarct Dementia, Alzheimer's disease, Fronto-Temporal Dementia and Mixed variety. Results: Twenty One Patients were included in our study from February 2003 to February 2004. The mean age of the patients was 73 years ( 37 to 81). 15 were males and 6 were females. Out of 21 patients, 12 had Multi Infarct Dementia, 4 had Alzheimer's disease, 1 had Fronto- Temporal Dementia and 4 had Mixed variety. Conclusion: Brain SPECT aids in substantiating the clinical findings and in correlation with MRI helps in distinguishing various types of Dementia and thus has prognostic implications and helps in instituting early appropriate treatment to the patient. In our study, the majority of the patients have Multi Infarct Dementia

  20. Anatomic atlas for computed tomography in the mesaticephalic dog: caudal abdomen and pelvis

    International Nuclear Information System (INIS)

    Smallwood, J.E.; George, T. II.

    1993-01-01

    The purpose of this study was to produce a comprehensive anatomic atlas of CT anatomy of the dog for use by veterinary radiologists, clinicians, and surgeons. Whole-body CT images of two mature beagle dogs were made with the dogs supported in sternal recumbency and using a slice thickness of 13 mm. At the end of the CT session, each dog was euthanized, and while carefully maintaining the same position, the body was frozen. The body was then sectioned at 13-mm intervals, with the cuts matched as closely as possible to the CT slices. The frozen sections were cleaned, photographed, and radiographed using xeroradiography. Each CT image was studied and compared with its corresponding xeroradiograph and anatomic section to assist in the accurate identification of specific structures. Clinically relevant anatomic structures were identified and labeled in the three corresponding photographs (CT image, xeroradiograph, and anatomic section). In previous papers, the head and neck, and the thorax and cranial abdomen of the mesaticephalic (beagle) dog were presented. In this paper, the caudal part of the abdomen and pelvis of the bitch and male dog are presented

  1. Isolated lipoma of filum terminale in adults: MRI findings and clinical correlation

    International Nuclear Information System (INIS)

    Al-Omari, Ma'moon H.; Qudseih, Hana' M.; Al-shinag, Mohammad K.; Eloqayli, Haytham M.

    2011-01-01

    Fat within the filum terminale is frequently seen on routine magnetic resonance imaging (MRI) of the lumbosacral spine (LSS), with prevalence of 1–5%. The objective of this study was to determine the prevalence and MRI features of isolated lipoma of filum terminale (LFT) in adult population and its correlation with the patient clinical presentations. Prospective analysis of all lumbosacral MRI performed at King Abdullah University Hospital during a 21-month period. A total of 37 patients with LFT were included. Patients were divided into two groups. Group A patients have neurological deficit manifested by either motor, sensory or sphincter abnormality. Group B patients have normal neurological examination. Clinical findings were correlated with: A: thickness of LFT, B: length of LFT, C: distance of LFT from conus medullaris (CM), D: age of the patient. The prevalence of isolated LFT in our study was 3.2%. There was no significant correlation between the thickness or length of LFT and the presence of neurological deficit. The distance of LFT from CM was also not correlated with the patient clinical presentation. No significant difference in the age between the two groups. LFT in adult likely represent an incidental finding on routine lumbosacral MRI. Special attention for LFT in children is mandatory as it may indicate clinical tethering in otherwise normal appearing LSS.

  2. A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment

    DEFF Research Database (Denmark)

    Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm

    2017-01-01

    are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer......This paper discusses methods for assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology...... to properly reveal the clinical value. The paper exemplifies the methodology using recent studies of Synthetic Aperture Sequential Beamforming tissue harmonic imaging....

  3. Medial depression with bony dehiscence of lamina papyracea as an anatomic variation: CT evaluation

    International Nuclear Information System (INIS)

    Na, Sun Young; Lee, Young Uk; Youn, Eun Kyung; Suh, Sang Gyung; Kim, Dong Hyun

    1994-01-01

    To evaluate the incidence and CT findings of the medial depression and bony dehiscence of lamina papyracea as an anatomic variation. 1472 PNS CTs of the patients with symptoms of chronic sinusitis were retrospectively evaluated. The total incidence of depressed lamina papyracea as an anatomic variation was 3.5%(52/1472) on PNS CT. There was a statistically significant correlation between the increasing age and the incidence of depressed lamina papyracea. Depression of lamina papyracea anterior to the basal lamella were more common than those of the posterior depression. Associated findings were herniation of adjacent fatty tissue in all cases and the medial bowing and hypertrophied configuration of the medial rectus muscle without significant herniation in 19 cases(34%). Nontraumatic, asymptomatic depression with bony dehiscence of lamina papyracea as an anatomic variation is not uncommon with the incidence of 3.5%. Recognition of its existence and degree may be helpful in avoiding various ocular complication during ethmoid surgery

  4. Neurovascular Content of the Mandibular Canal and Its Clinical Relevance: A Literature Review of the Related Anatomical and Radiological Studies

    Directory of Open Access Journals (Sweden)

    Eliades Apostolos N.

    2014-11-01

    Full Text Available In literature, anatomical variations of the inferior alveolar nerve branches (infratemporal, extraosseous and intraosseous are reported and their importance in clinical practice is discussed too. The spatial vessels’ position in relationship with the nerve in the mandibular canal was explored, which is of clinical significance in impacted third molar and implant surgery. It is believed that the neurovascular content of the main mandibular canal follows any variations of the mandibular canal i.e. bifid mandibular, retromolar and accessory mental canals. Retrospective studies and case reports reported the presence of multiple foramina on the medial surface of the ramus, near the main mandibular foramen. In some cases, one supplementary mandibular foramen was found to be connected with the lower third molar, which is called “temporal crest canal”. Others found an accessory mandibular foramen that led into a second mandibular canal which joined the main mandibular canal (double anteriorly. The bony canals contained a terminal branch of the anterior trunk of the mandibular nerve or a branch of inferior alveolar nerve before it entered the mandibular foramen.

  5. Extra-anatomic transplantations in autologous adult cell therapies aiding anatomical regeneration and physiological recovery – An insight and categorization

    Directory of Open Access Journals (Sweden)

    Editorial

    2015-12-01

    Full Text Available Autologous mature adult cells as well as stem cells, which are not considered pluripotent, have been reported to be safe and efficacious in clinical applications for regenerating cartilage [1] and corneal epithelium [2]. Use of primary autologous cells and stem cells expanded in number from cartilage and corneal epithelial tissues have shown abilities to reconstruct and regenerate tissues, de novo. It is to be noted that in both these cases, the source of the cells that have been used for transplantation into the cornea and cartilage have been from the same organ and tissue. The replacement cells for regeneration have also been sourced from the same germ layer, as that of the cells of the target tissue; corneal epithelial tissue embryologically originating from the ectoderm has been replaced with corneal limbal stem cells that are also of ectodermal origin from the unaffected healthy eye of the same individual. Similarly, the cartilage which developmentally is from the mesoderm has been replaced with mature chondrocytes from the non-weight bearing area of the cartilage, again of the same individual. Figure 1: Autologous, in vitro cultured, adult cell based therapies; An overview and categorization. (Click here for High Resol. Image The proceedings of the IIDIAS session published in this issue have described two novel cell therapies, where cells taken from a tissue or organ, after normal in vitro expansion, have been clinically applied to aid the regeneration of a different tissue or organ, i.e skeletal myoblasts having been used for myocardial regeneration and buccal mucosal epithelium having been used for corneal epithelial regeneration heralding the birth of a new paradigm called ‘extra-anatomic cell therapy’. The myocardium is a specialized muscle in that it works as an electrical synctitium with an intrinsic capacity to generate and propagate action potentials (involuntary as opposed to the skeletal muscles that are dependent on neuronal

  6. Clinical radiological correlation in E200K familial Creutzfeldt-Jakob disease.

    Science.gov (United States)

    Cohen, Oren S; Chapman, Joab; Korczyn, Amos D; Siaw, Oliver L; Warman-Alaluf, Naama; Nitsan, Zeev; Appel, Shmuel; Kahana, Esther; Rosenmann, Hanna; Hoffmann, Chen

    2016-12-01

    The use of diffusion MRI improved the accuracy of diagnosis in Creutzfeldt-Jakob disease (CJD) and expanded our knowledge of the changes occurring in the brain during the disease. The aim of this study was to test whether in patients with E200K familial CJD (fCJD) the clinical severity correlates with the disease burden as reflected by the extent of cortical involvement in DWI MRI. Consecutive fCJD patients were examined by a neurologist who performed several tests including the CJD neurological scale (CJD-NS), MiniMental status examination (MMSE), Frontal Assessment Battery (FAB), NIH Stroke Scale (NIHSS), and the expanded disability status scale (EDSS). A simultaneously acquired MRI was analyzed by measuring the extent of cortical involvement in the DWI axial sequence. Correlations were tested for using Pearson test. Fifty-two fCJD patients (35 males, mean age 59.4 ± 5.7 years) were recruited to the study. Significant negative correlation was found between the extent of cortical involvement and the cognitive performance of the patients as reflected by their MMSE and FAB scores. In addition, a significant positive correlation was found between the MRI and the clinical disease severity scales CJD-NS and EDSS. The correlation between clinical scales of severity and cognitive dysfunction and the disease burden confirms the reliability of the CJD-NS scale. Further studies are warranted to examine whether MRI may serve not only for diagnosis but also as a biomarker for follow-up of disease progression and the efficacy of potential treatments.

  7. Analysis of anatomic variability in children with low mathematical skills

    Science.gov (United States)

    Han, Zhaoying; Fuchs, Lynn; Davis, Nikki; Cannistraci, Christopher J.; Anderson, Adam W.; Gore, John C.; Dawant, Benoit M.

    2008-03-01

    Mathematical difficulty affects approximately 5-9% of the population. Studies on individuals with dyscalculia, a neurologically based math disorder, provide important insight into the neural correlates of mathematical ability. For example, cognitive theories, neuropsychological studies, and functional neuroimaging studies in individuals with dyscalculia suggest that the bilateral parietal lobes and intraparietal sulcus are central to mathematical performance. The purpose of the present study was to investigate morphological differences in a group of third grade children with poor math skills. We compare population averages of children with low math skill (MD) to gender and age matched controls with average math ability. Anatomical data were gathered with high resolution MRI and four different population averaging methods were used to study the effect of the normalization technique on the results. Statistical results based on the deformation fields between the two groups show anatomical differences in the bilateral parietal lobes, right frontal lobe, and left occipital/parietal lobe.

  8. Cardiac Conduction System: Delineation of Anatomic Landmarks With Multidetector CT

    Directory of Open Access Journals (Sweden)

    Farhood Saremi

    2009-11-01

    Full Text Available Major components of the cardiac conduction system including the sinoatrial node (SAN, atrioventricular node (AVN, the His Bundle, and the right and left bundle branches are too small to be directly visualized by multidetector CT (MDCT given the limited spatial resolution of current scanners. However, the related anatomic landmarks and variants of this system a well as the areas with special interest to electrophysiologists can be reliably demonstrated by MDCT. Some of these structures and landmarks include the right SAN artery, right atrial cavotricuspid isthmus, Koch triangle, AVN artery, interatrial muscle bundles, and pulmonary veins. In addition, MDCT has an imperative role in demarcating potential arrhythmogenic structures. The aim of this review will be to assess the extent at which MDCT can outline the described anatomic landmarks and therefore provide crucial information used in clinical practice.

  9. The Fibularis (Peroneus Tertius Muscle in Humans: A Meta-Analysis of Anatomical Studies with Clinical and Evolutionary Implications

    Directory of Open Access Journals (Sweden)

    Kaissar Yammine

    2017-01-01

    Full Text Available Being considered an exclusive human structure for a long time, fibularis tertius (FT is believed to have a secondary function of foot dorsiflexion and eversion. This study is an attempt to approach the issue from an anatomical perspective. A systematic literature search identified 35 studies (7601 legs which met the inclusion criteria. The weighted results of FT presence were as follows: an “adult cadaveric” frequency of 93.2% and a clinical frequency of 80%. The most common FT origin and insertion sites were the distal half of fibula and the base of the 5th metatarsal, respectively. In 95% of cases, an accessory fibular muscle was detected when FT was lacking. We demonstrated that the discrepancy found between the adult cadaveric and clinical frequency values would point out a probable bias in interpreting previous kinesiological results. On an evolutionary level, comparative anatomy demonstrated a very low FT prevalence among monkeys while reaching a frequency of 30% in gorillas, the only non-human apes having an almost exclusive terrestrial locomotion. The consistent prevalence among humans and the presence of similar functional muscles when it is missing would support an essential role of FT during the phylogenetic development of the erect bipedal posture and probably during gait.

  10. Personality in Parkinson's disease: Clinical, behavioural and cognitive correlates.

    Science.gov (United States)

    Santangelo, Gabriella; Piscopo, Fausta; Barone, Paolo; Vitale, Carmine

    2017-03-15

    Affective disorders and personality changes have long been considered pre-motor aspects of Parkinson's disease (PD). Many authors have used the term "premorbid personality" to define distinctive features of PD patients' personality characterized by reduced exploration of new environmental stimuli or potential reward sources ("novelty seeking") and avoidance behaviour ("harm avoidance") present before motor features. The functional correlates underlying the personality changes described in PD, implicate dysfunction of meso-cortico-limbic and striatal circuits. As disease progresses, the imbalance of neurotransmitter systems secondary to degenerative processes, along with dopamine replacement therapy, can produce a reversal of behaviours and an increase in reward seeking, laying the foundations for the emergence of the impulse control disorders. Personality disorders can be interpreted, therefore, as the result of individual susceptibility arising from intrinsic degenerative processes and individual personality features, in combination with extrinsic factors such as lifestyle, PD motor dysfunction and drug treatment. For a better understanding of personality disorders observed in PD and their relationship with the prodromal stage of the disease, prospective clinical studies are needed that correlate different personality profiles with other disease progression markers. Here, we review previous studies investigating the clinical, cognitive and behavioural correlates of personality traits in PD patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Anatomical traces of vocabulary acquisition in the adolescent brain.

    Science.gov (United States)

    Lee, HweeLing; Devlin, Joseph T; Shakeshaft, Clare; Stewart, Lauren H; Brennan, Amanda; Glensman, Jen; Pitcher, Katherine; Crinion, Jenny; Mechelli, Andrea; Frackowiak, Richard S J; Green, David W; Price, Cathy J

    2007-01-31

    A surprising discovery in recent years is that the structure of the adult human brain changes when a new cognitive or motor skill is learned. This effect is seen as a change in local gray or white matter density that correlates with behavioral measures. Critically, however, the cognitive and anatomical mechanisms underlying these learning-related structural brain changes remain unknown. Here, we combined brain imaging, detailed behavioral analyses, and white matter tractography in English-speaking monolingual adolescents to show that a critical linguistic prerequisite (namely, knowledge of vocabulary) is proportionately related to relative gray matter density in bilateral posterior supramarginal gyri. The effect was specific to the number of words learned, regardless of verbal fluency or other cognitive abilities. The identified region was found to have direct connections to other inferior parietal areas that separately process either the sounds of words or their meanings, suggesting that the posterior supramarginal gyrus plays a role in linking the basic components of vocabulary knowledge. Together, these analyses highlight the cognitive and anatomical mechanisms that mediate an essential language skill.

  12. [Verrucous pastern dermatitis syndrome in heavy draught horses. Part II: Clinical findings].

    Science.gov (United States)

    Geburek, F; Deegen, E; Hewicker-Trautwein, M; Ohnesorge, B

    2005-07-01

    In the present field study the skin of the feet of 37 heavy draught horses of different breeds showing verrucous pastern dermatitis was examined clinically. Included were the degree of severity of the disease and the prevalence of anatomically normal structures associated with the skin: fetlock tufts of hair ("feathering"), ergots, chestnuts, bulges in the pastern region, cannon circumference. Each horse was examined for Chorioptes sp. skin mites. Information was also collected on the development of the skin alterations and housing conditions and feeding. These individual data were correlated with the clinical degree of severity of verrucous pastern dermatitis, which was evaluated using a numerical code (scoring system). In addition, punch biopsies were taken from the diseased skin of the feet and from healthy skin of the neck for comparative patho-histological examination (see Part III). Verrucous pastern dermatitis is a chronic disease which can be divided into four groups: scaling (group I), hyperkeratotic and hyperplastic plaque-like lesions (group II), tuberous skin masses (group III), and verrucous skin lesions with rugged surfaces (group IV). No correlation was found between the clinical degree of severity of the skin lesions and sex, breed, amount of work, use of stallions for breeding, grooming condition of the hair, white markings in the foot region, or Chorioptes sp. infestation. In regard to feeding it was found that the amount of maize and oats fed had some influence on the clinical degree of severity. Statistical analysis revealed a significant correlation between the clinical degree of severity and the age, the grooming condition of the hooves, and the mean cannon circumference. The prevalence of fetlock tufts of hair, chestnuts, ergots, and anatomically normal bulges in the pastern region also increased significantly with the clinical degree of severity. Furthermore the study revealed that the clinical degree of severity depended on the hygienic

  13. Anatomic Variation of the Median Nerve Associated with an Anomalous Muscle of the Forearm.

    Science.gov (United States)

    Atoni, Atoni Dogood; Oyinbo, Charles Aidemise

    2017-03-01

    Documented anatomical variations are important not only for the study of the subject of anatomy, but also in clinical situation. This knowledge would aid surgeons in planning a preoperative strategy for surgical procedures and reconstructive surgery. The right forearm of a 35-year-old embalmed male cadaver present a splitting of the median nerve in the proximal 1/3 of the forearm to form medial and lateral divisions that accommodate an anomalous muscle. The split median nerve reunites at the distal 1/3 and continues as a single nerve. The anomalous muscle arises by muscle fibers from flexor digitorum superficialis and inserted by tendon into flexor digitorum profundus. There was no such variation in the left forearm. The knowledge of such anatomical variations is important to clinicians and surgeons in interpreting atypical clinical presentations and avoiding unusual injury during surgery.

  14. Anatomic Variation of the Median Nerve Associated with an Anomalous Muscle of the Forearm

    Directory of Open Access Journals (Sweden)

    Atoni Atoni Dogood

    2017-03-01

    Full Text Available Documented anatomical variations are important not only for the study of the subject of anatomy, but also in clinical situation. This knowledge would aid surgeons in planning a preoperative strategy for surgical procedures and reconstructive surgery. The right forearm of a 35-year-old embalmed male cadaver present a splitting of the median nerve in the proximal 1/3 of the forearm to form medial and lateral divisions that accommodate an anomalous muscle. The split median nerve reunites at the distal 1/3 and continues as a single nerve. The anomalous muscle arises by muscle fibers from flexor digitorum superficialis and inserted by tendon into flexor digitorum profundus. There was no such variation in the left forearm. The knowledge of such anatomical variations is important to clinicians and surgeons in interpreting atypical clinical presentations and avoiding unusual injury during surgery.

  15. Right Hemisphere Cognitive Functions: From Clinical and Anatomic Bases to Brain Mapping During Awake Craniotomy Part I: Clinical and Functional Anatomy.

    Science.gov (United States)

    Bernard, Florian; Lemée, Jean-Michel; Ter Minassian, Aram; Menei, Philippe

    2018-05-12

    The nondominant hemisphere (usually the right) is responsible for primary cognitive functions such as visuospatial and social cognition. Awake surgery using direct electric stimulation for right cerebral tumor removal remains challenging because of the complexity of the functional anatomy and difficulties in adapting standard bedside tasks to awake surgery conditions. An understanding of semiology and anatomic bases, along with an analysis of the available cognitive tasks for visuospatial and social cognition per operative mapping allow neurosurgeons to better appreciate the functional anatomy of the right hemisphere and its relevance to tumor surgery. In this article, the first of a 2-part review, we discuss the anatomic and functional basis of right hemisphere function. Whereas part II of the review focuses primarily on semiology and surgical management of right-sided tumors under awake conditions, this article provides a comprehensive review of knowledge underpinning awake surgery on the right hemisphere. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Correlation of quantitative sensorimotor tractography with clinical grade of cerebral palsy

    International Nuclear Information System (INIS)

    Trivedi, Richa; Gupta, Rakesh K.; Agarwal, Shruti; Rathore, Ram K.S.; Shah, Vipul; Goyel, Puneet; Paliwal, Vimal K.

    2010-01-01

    The purpose of this study was to determine whether tract-specific diffusion tensor imaging measures in somatosensory and motor pathways correlate with clinical grades as defined using the Gross Motor Function Classification System (GMFCS) in cerebral palsy (CP) children. Quantitative diffusion tensor tractography was performed on 39 patients with spastic quadriparesis (mean age = 8 years) and 14 age/sex-matched controls. All patients were graded on the basis of GMFCS scale into grade II (n = 12), grade IV (n = 22), and grade V (n = 5) CP and quantitative analysis reconstruction of somatosensory and motor tracts performed. Significant inverse correlation between clinical grade and fractional anisotropy (FA) was observed in both right and left motor and sensory tracts. A significant direct correlation of mean diffusivity values from both motor and sensory tracts was also observed with clinical grades. Successive decrease in FA values was observed in all tracts except for left motor tracts moving from age/sex-matched controls to grade V through grades II and IV. We conclude that white matter tracts from both the somatosensory and the motor cortex play an important role in the pathophysiology of motor disability in patients with CP. (orig.)

  17. Correlation of quantitative sensorimotor tractography with clinical grade of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Trivedi, Richa; Gupta, Rakesh K. [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Radiodiagnosis, Lucknow (India); Agarwal, Shruti; Rathore, Ram K.S. [Indian Institute of Technology, Department of Mathematics and Statistics, Kanpur (India); Shah, Vipul [Bhargava Nursing Home, Pediatric Orthopedic Surgery unit, Lucknow (India); Goyel, Puneet [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Anesthesiology, Lucknow (India); Paliwal, Vimal K. [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Neurology, Lucknow (India)

    2010-08-15

    The purpose of this study was to determine whether tract-specific diffusion tensor imaging measures in somatosensory and motor pathways correlate with clinical grades as defined using the Gross Motor Function Classification System (GMFCS) in cerebral palsy (CP) children. Quantitative diffusion tensor tractography was performed on 39 patients with spastic quadriparesis (mean age = 8 years) and 14 age/sex-matched controls. All patients were graded on the basis of GMFCS scale into grade II (n = 12), grade IV (n = 22), and grade V (n = 5) CP and quantitative analysis reconstruction of somatosensory and motor tracts performed. Significant inverse correlation between clinical grade and fractional anisotropy (FA) was observed in both right and left motor and sensory tracts. A significant direct correlation of mean diffusivity values from both motor and sensory tracts was also observed with clinical grades. Successive decrease in FA values was observed in all tracts except for left motor tracts moving from age/sex-matched controls to grade V through grades II and IV. We conclude that white matter tracts from both the somatosensory and the motor cortex play an important role in the pathophysiology of motor disability in patients with CP. (orig.)

  18. Correlation between MRI and clinical profiles of periventricular leukomalacia in children

    International Nuclear Information System (INIS)

    Fan Xiaoying; Xiao Jiangxi; Jiang Xuexiang; Tang Guangjian

    2003-01-01

    Objective: To study the relationship between MRI and clinical profiles of periventricular leukomalacia (PVL) in children. Methods: The clinical and MRI findings in 34 cases with PVL were retrospectively analyzed. Results: (1) Periventricular hyperintensity on T 2 WI was more prominent in the preterm-group than that in the term-group, and P value was 0.000; (2) Cortical lesion and subcortical leukomalacia was seen in 9 of 19 cases in the children with PVL born at term, but detected in only 1/15 in the preterm-group. P value was 0.020; (3) Seizure was common in term children. P value was 0.036; (4) The degree of reduction of periventricular white matter correlated with motor impairment and mental retardation in all children, and P values were 0.002 and 0.000, respectively. The thinning of the corpus callosum also correlated with mental retardation and P value was 0.012. The degree of reduction of periventricular white matter correlated with visual impairment in preterm-group. Conclusion: The end-stage PVL can been clearly displayed by MRI, and gestational age and clinical manifestation were closely related to the findings of MRI

  19. Prostatome: A combined anatomical and disease based MRI atlas of the prostate

    Energy Technology Data Exchange (ETDEWEB)

    Rusu, Mirabela; Madabhushi, Anant, E-mail: anant.madabhushi@case.edu [Case Western Reserve University, Cleveland, Ohio 44106 (United States); Bloch, B. Nicolas; Jaffe, Carl C. [Boston University School of Medicine, Boston, Massachusetts 02118 (United States); Genega, Elizabeth M. [Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215 (United States); Lenkinski, Robert E.; Rofsky, Neil M. [UT Southwestern Medical Center, Dallas, Texas 75235 (United States); Feleppa, Ernest [Riverside Research Institute, New York, New York 10038 (United States)

    2014-07-15

    yielded a central gland Dice similarity coefficient (DSC) of 90%, and prostate DSC of 88%, while the misalignment of the urethra and verumontanum was found to be 3.45 mm, and 4.73 mm, respectively, which were measured to be significantly smaller compared to the alternative strategies. As might have been anticipated from our limited cohort of biopsy confirmed cancers, the disease atlas showed that most of the tumor extent was limited to the peripheral zone. Moreover, central gland tumors were typically larger in size, possibly because they are only discernible at a much later stage. Conclusions: The authors presented the AnCoR framework to explicitly model anatomic constraints for the construction of a fused anatomic imaging-disease atlas. The framework was applied to constructing a preliminary version of an anatomic-disease atlas of the prostate, the prostatome. The prostatome could facilitate the quantitative characterization of gland morphology and imaging features of prostate cancer. These techniques, may be applied on a large sample size data set to create a fully developed prostatome that could serve as a spatial prior for targeted biopsies by urologists. Additionally, the AnCoR framework could allow for incorporation of complementary imaging and molecular data, thereby enabling their careful correlation for population based radio-omics studies.

  20. Prostatome: A combined anatomical and disease based MRI atlas of the prostate

    International Nuclear Information System (INIS)

    Rusu, Mirabela; Madabhushi, Anant; Bloch, B. Nicolas; Jaffe, Carl C.; Genega, Elizabeth M.; Lenkinski, Robert E.; Rofsky, Neil M.; Feleppa, Ernest

    2014-01-01

    yielded a central gland Dice similarity coefficient (DSC) of 90%, and prostate DSC of 88%, while the misalignment of the urethra and verumontanum was found to be 3.45 mm, and 4.73 mm, respectively, which were measured to be significantly smaller compared to the alternative strategies. As might have been anticipated from our limited cohort of biopsy confirmed cancers, the disease atlas showed that most of the tumor extent was limited to the peripheral zone. Moreover, central gland tumors were typically larger in size, possibly because they are only discernible at a much later stage. Conclusions: The authors presented the AnCoR framework to explicitly model anatomic constraints for the construction of a fused anatomic imaging-disease atlas. The framework was applied to constructing a preliminary version of an anatomic-disease atlas of the prostate, the prostatome. The prostatome could facilitate the quantitative characterization of gland morphology and imaging features of prostate cancer. These techniques, may be applied on a large sample size data set to create a fully developed prostatome that could serve as a spatial prior for targeted biopsies by urologists. Additionally, the AnCoR framework could allow for incorporation of complementary imaging and molecular data, thereby enabling their careful correlation for population based radio-omics studies

  1. [Occlusion and posture: is there evidence of correlation?].

    Science.gov (United States)

    Michelotti, A; Manzo, P; Farella, M; Martina, R

    1999-11-01

    The observation that the masticatory system and the postural body regulating system are anatomically and functionally related, has led to postulate several hypotheses of correlation between occlusal and postural disturbances. In the last decade, these arguments have gained a great social impact, also because they have been broadly spread by the mass-media. As a consequence, there has been a growing number of patients seeking concomitant occlusal and postural treatments. The aim of this study was to review critically the current evidence of correlation between the two systems; this in order to address clinical issues for the management of patients. Methodology of the studies reviewed has been evaluated according to the criteria suggested by Storey and Rugh 20 rif. Although there are some evidences of correlation between occlusion and posture, this appears limited to the cranio-cervical tract of the column and tends to disappear when descending in cranio-caudal direction. On the basis of this review of the literature, it's not advisable to treat postural imbalance by means of occlusal treatment or vice versa, particularly if the therapeutic modalities are irreversible.

  2. Medical students call for national standards in anatomical education.

    Science.gov (United States)

    Farey, John E; Sandeford, Jonathan C; Evans-McKendry, Greg D

    2014-11-01

    The diminishing number of hours dedicated to formal instruction in anatomy has led to a debate within medical education as to the level required for safe clinical practice. We provide a review of the current state of anatomical education in Australian medical schools and state the case for national standards. In light of the review presented, council members of the Australian Medical Students' Association voted to affirm that consideration should be given to developing undergraduate learning goals for anatomy, providing a codified medical student position on the teaching of anatomy in Australian medical schools. Crucially, the position states that time-intensive methods of instruction such as dissection should be a rite of passage for medical students in the absence of evidence demonstrating the superiority of modern teaching methods. We believe the bodies with a vested interest in the quality of medical graduates, namely the Australian Medical Council, Medical Deans Australia & New Zealand, and the postgraduate colleges should collaborate and develop clear guidelines that make explicit the core knowledge of anatomy expected of medical graduates at each stage of their career with a view to safe clinical practice. In addition, Australian universities have a role to play in conducting further research into contemporary learning styles and the most efficacious methods of delivering anatomical education. © 2014 Royal Australasian College of Surgeons.

  3. [Sacroiliac joint injury treated with oblique insertion at anatomical points: a randomized controlled trial].

    Science.gov (United States)

    Kuang, Jiayi; Li, Yuxuan; He, Yufeng; Gan, Lin; Wang, Aiming; Chen, Yanhua; Li, Xiaoting; Guo, Lin; Tang, Rongjun

    2016-04-01

    To compare the effects of oblique insertion at anatomical points and conventional acupuncture for sacroiliac joint injury. Eighty patients were randomly divided into an observation group and a control group, 40 cases in each one. In the observation group, oblique insertion therapy at anatomical points was used, and the 9 points of equal division (anatomical points) marked by palpating the anatomical symbol were treated as the insertion acupoints. In the control group, conventional acupuncture was applied, and perpendicular insertion was adopted at Huantiao (GB 30), Zhibian (BL 54) and Weizhong (BL 40), etc. In the two groups, the! treatment was given once a day and 5 times per week. Ten treatments were made into one course and two courses were required. The clinical effects, the changes of visual analogue scale (VAS) and Oswestry dysfunctional index. (ODI) before and after treatment were observed in the two groups. The total effective rate of the observation group was 90.0% (36/40), which was better than 72.5% (29/40) of the control group (P sacroiliac joint injury is superior to that of conventional acupuncture, which can effectively relieve pain and improve the disfunction.

  4. TIBIAL LANDMARKS IN ACL ANATOMIC REPAIR

    Directory of Open Access Journals (Sweden)

    M. V. Demesсhenko

    2016-01-01

    Full Text Available Purpose: to identify anatomical landmarks on tibial articular surface to serve as reference in preparing tibial canal with respect to the center of ACL footprint during single bundle arthroscopic repair.Materials and methods. Twelve frozen knee joint specimens and 68 unpaired macerated human tibia were studied using anatomical, morphometric, statistical methods as well as graphic simulation.Results. Center of the tibial ACL footprint was located 13,1±1,7 mm anteriorly from posterior border of intercondylar eminence, at 1/3 of the distance along the line connecting apexes of internal and external tubercles and 6,1±0,5 mm anteriorly along the perpendicular raised to this point.Conclusion. Internal and external tubercles, as well as posterior border of intercondylar eminence can be considered as anatomical references to determine the center of the tibial ACL footprint and to prepare bone canals for anatomic ligament repair.

  5. Consensus guidelines for the uniform reporting of study ethics in anatomical research within the framework of the anatomical quality assurance (AQUA) checklist.

    Science.gov (United States)

    Henry, Brandon Michael; Vikse, Jens; Pekala, Przemyslaw; Loukas, Marios; Tubbs, R Shane; Walocha, Jerzy A; Jones, D Gareth; Tomaszewski, Krzysztof A

    2018-05-01

    Unambiguous reporting of a study's compliance with ethical guidelines in anatomical research is imperative. As such, clear, universal, and uniform reporting guidelines for study ethics are essential. In 2016, the International Evidence-Based Anatomy Working group in collaboration with international partners established reporting guidelines for anatomical studies, the Anatomical Quality Assurance (AQUA) Checklist. In this elaboration of the AQUA Checklist, consensus guidelines for reporting study ethics in anatomical studies are provided with in the framework of the AQUA Checklist. The new guidelines are aimed to be applicable to research across the spectrum of the anatomical sciences, including studies on both living and deceased donors. The authors hope the established guidelines will improve ethical compliance and reporting in anatomical research. Clin. Anat. 31:521-524, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

  6. Anatomical landmarks of radical prostatecomy.

    Science.gov (United States)

    Stolzenburg, Jens-Uwe; Schwalenberg, Thilo; Horn, Lars-Christian; Neuhaus, Jochen; Constantinides, Costantinos; Liatsikos, Evangelos N

    2007-03-01

    In the present study, we review current literature and based on our experience, we present the anatomical landmarks of open and laparoscopic/endoscopic radical prostatectomy. A thorough literature search was performed with the Medline database on the anatomy and the nomenclature of the structures surrounding the prostate gland. The correct handling of puboprostatic ligaments, external urethral sphincter, prostatic fascias and neurovascular bundle is necessary for avoiding malfunction of the urogenital system after radical prostatectomy. When evaluating new prostatectomy techniques, we should always take into account both clinical and final oncological outcomes. The present review adds further knowledge to the existing "postprostatectomy anatomical hazard" debate. It emphasizes upon the role of the puboprostatic ligaments and the course of the external urethral sphincter for urinary continence. When performing an intrafascial nerve sparing prostatectomy most urologists tend to approach as close to the prostatic capsula as possible, even though there is no concurrence regarding the nomenclature of the surrounding fascias and the course of the actual neurovascular bundles. After completion of an intrafascial technique the specimen does not contain any periprostatic tissue and thus the detection of pT3a disease is not feasible. This especially becomes problematic if the tumour reaches the resection margin. Nerve sparing open and laparoscopic radical prostatectomy should aim in maintaining sexual function, recuperating early continence after surgery, without hindering the final oncological outcome to the procedure. Despite the different approaches for radical prostatectomy the key for better results is the understanding of the anatomy of the bladder neck and the urethra.

  7. Broad Anatomical Variation within a Narrow Wood Density Range—A Study of Twig Wood across 69 Australian Angiosperms

    Science.gov (United States)

    Ziemińska, Kasia; Westoby, Mark; Wright, Ian J.

    2015-01-01

    Objectives Just as people with the same weight can have different body builds, woods with the same wood density can have different anatomies. Here, our aim was to assess the magnitude of anatomical variation within a restricted range of wood density and explore its potential ecological implications. Methods Twig wood of 69 angiosperm tree and shrub species was analyzed. Species were selected so that wood density varied within a relatively narrow range (0.38–0.62 g cm-3). Anatomical traits quantified included wood tissue fractions (fibres, axial parenchyma, ray parenchyma, vessels, and conduits with maximum lumen diameter below 15 μm), vessel properties, and pith area. To search for potential ecological correlates of anatomical variation the species were sampled across rainfall and temperature contrasts, and several other ecologically-relevant traits were measured (plant height, leaf area to sapwood area ratio, and modulus of elasticity). Results Despite the limited range in wood density, substantial anatomical variation was observed. Total parenchyma fraction varied from 0.12 to 0.66 and fibre fraction from 0.20 to 0.74, and these two traits were strongly inversely correlated (r = -0.86, P area to sapwood area ratio, and modulus of elasticity (0.24 ≤|r|≤ 0.41, P area to sapwood area ratio (0.47 ≤|r|≤ 0.65, all P area spectrum. The fibre-parenchyma spectrum does not yet have any clear or convincing ecological interpretation. PMID:25906320

  8. Broad Anatomical Variation within a Narrow Wood Density Range--A Study of Twig Wood across 69 Australian Angiosperms.

    Science.gov (United States)

    Ziemińska, Kasia; Westoby, Mark; Wright, Ian J

    2015-01-01

    Just as people with the same weight can have different body builds, woods with the same wood density can have different anatomies. Here, our aim was to assess the magnitude of anatomical variation within a restricted range of wood density and explore its potential ecological implications. Twig wood of 69 angiosperm tree and shrub species was analyzed. Species were selected so that wood density varied within a relatively narrow range (0.38-0.62 g cm-3). Anatomical traits quantified included wood tissue fractions (fibres, axial parenchyma, ray parenchyma, vessels, and conduits with maximum lumen diameter below 15 μm), vessel properties, and pith area. To search for potential ecological correlates of anatomical variation the species were sampled across rainfall and temperature contrasts, and several other ecologically-relevant traits were measured (plant height, leaf area to sapwood area ratio, and modulus of elasticity). Despite the limited range in wood density, substantial anatomical variation was observed. Total parenchyma fraction varied from 0.12 to 0.66 and fibre fraction from 0.20 to 0.74, and these two traits were strongly inversely correlated (r = -0.86, P area to sapwood area ratio, and modulus of elasticity (0.24 ≤|r|≤ 0.41, P area to sapwood area ratio (0.47 ≤|r|≤ 0.65, all P area spectrum. The fibre-parenchyma spectrum does not yet have any clear or convincing ecological interpretation.

  9. Anatomical Features and Early Outcomes of Endovascular Repair of Abdominal Aortic Aneurysm from a Korean Multicenter Registry.

    Science.gov (United States)

    Kwon, Hyunwook; Lee, Do Yun; Choi, Soo Jin Na; Park, Ki Hyuk; Min, Seung-Kee; Chang, Jeong-Hwan; Huh, Seung; Jeon, Yong Sun; Won, Jehwan; Byun, Seung Jae; Park, Sang Jun; Jang, Lee Chan; Kwon, Tae-Won

    2015-09-01

    To introduce a nation-based endovascular aneurysm repair (EVAR) registry in South Korea and to analyze the anatomical features and early clinical outcomes of abdominal aortic aneurysms (AAA) in patients who underwent EVAR. The Korean EVAR registry (KER) was a template-based online registry developed and established in 2009. The KER recruited 389 patients who underwent EVAR from 13 medical centers in South Korea from January 2010 to June 2010. We retrospectively reviewed the anatomic features and 30-day clinical outcomes. Initial deployment without open conversion was achieved in all cases and procedure-related 30-day mortality rate was 1.9%. Anatomic features showed the following variables: proximal aortic neck angle 48.8±25.7° (mean±standard deviation), vertical neck length 35.0±17.2 mm, aneurysmal sac diameter 57.2±14.2 mm, common iliac artery (CIA) involvement in 218 (56.3%) patients, and median right CIA length 34.9 mm. Two hundred and nineteen (56.3%) patients showed neck calcification, 98 patients (25.2%) had neck thrombus, and the inferior mesenteric arteries of 91 patients (23.4%) were occluded. Anatomical features of AAA in patients from the KER were characterized as having angulated proximal neck, tortuous iliac artery, and a higher rate of CIA involvement. Long-term follow-up and ongoing studies are required.

  10. A functional-anatomical approach to the spine-pelvis mechanism: interaction between the biceps femoris muscle and the sacrotuberous ligament.

    Science.gov (United States)

    van Wingerden, J P; Vleeming, A; Snijders, C J; Stoeckart, R

    1993-10-01

    Summary. Sacroiliac joint dysfunction is often overlooked as a possible cause of low back pain. This is due to the use of reductionistic anatomical models. From a kinematic point of view, topographic anatomical models are generally inadequate since they categorize pelvis, lower vertebral column and legs as distinct entities. This functional-anatomical study focuses on the question whether anatomical connections between the biceps femoris muscle and the sacrotuberous ligament are kinematically useful. Forces applied to the tendon of the biceps femoris muscle, simulating biceps femoris muscle force, were shown to influence sacrotuberous ligament tension. Since sacrotuberous ligament tension influences sacroiliac joint kinematics, hamstring training could influence the sacroiliac joint and thus low back kinematics. The clinical implications with respect to 'short' hamstrings, pelvic instability and walking are discussed.

  11. Anatomical Basis and Clinical Application of Synovial Flaps in the Wrist and Distal Forearm.

    Science.gov (United States)

    Colen, David L; Yeh, Jiun-Ting; Colen, Lawrence B

    2017-05-01

    Neuropathic symptoms after median nerve repair at the wrist or secondary to refractory carpal tunnel syndrome may become debilitating. These symptoms develop because of perineural adhesions, intraneural fibrosis, and fixation of the nerve to the transverse carpal ligament after surgery, and often require neurolysis. Interposition of vascularized soft tissue over the median nerve at the time of neurolysis prevents recurrence of such adhesions. The synovial flap, fashioned from the synovial lining of the flexor tendon sheath, is an ideal tissue for this purpose. Previous authors have described the surgical technique of the synovial flap, but the anatomical basis and design of the flap have not been previously discussed. Twenty fresh cadaver upper extremities were injected with Microfil to analyze the arterial anatomy, flap dimensions, and arc of rotation of the flexor tendon synovium mobilized as a flap suitable for coverage of the median nerve at the wrist. The authors determined that both radial and ulnar-based flaps are clinically useful for providing coverage in the wrist and distal forearm. This flap was used in 18 patients with complicated median nerve lesions in this region. All patients had an uncomplicated postoperative course. Of 13 patients treated for posttraumatic median nerve neuromas, all but two had significant resolution of symptoms. When used as a vascularized flap, the flexor tendon synovium provides adequate protection of the median nerve. Flap dimensions and vascularity of this tissue make it an ideal local flap option when performing reoperative surgery on the median nerve.

  12. Deterioration of abstract reasoning ability in mild cognitive impairment and Alzheimer's disease: correlation with regional grey matter volume loss revealed by diffeomorphic anatomical registration through exponentiated lie algebra analysis

    International Nuclear Information System (INIS)

    Yoshiura, Takashi; Hiwatashi, Akio; Yamashita, Koji; Takayama, Yukihisa; Kamano, Norihiro; Honda, Hiroshi; Ohyagi, Yasumasa; Kira, Jun-ichi; Monji, Akira; Kawashima, Toshiro

    2011-01-01

    To determine which brain regions are relevant to deterioration in abstract reasoning as measured by Raven's Colored Progressive Matrices (CPM) in the context of dementia. MR images of 37 consecutive patients including 19 with Alzheimer's disease (AD) and 18 with amnestic mild cognitive impairment (aMCI) were retrospectively analyzed. All patients were administered the CPM. Regional grey matter (GM) volume was evaluated according to the regimens of voxel-based morphometry, during which a non-linear registration algorithm called Diffeomorphic Anatomical Registration Through Exponentiated Lie algebra was employed. Multiple regression analyses were used to map the regions where GM volumes were correlated with CPM scores. The strongest correlation with CPM scores was seen in the left middle frontal gyrus while a region with the largest volume was identified in the left superior temporal gyrus. Significant correlations were seen in 14 additional regions in the bilateral cerebral hemispheres and right cerebellum. Deterioration of abstract reasoning ability in AD and aMCI measured by CPM is related to GM loss in multiple regions, which is in close agreement with the results of previous activation studies. (orig.)

  13. Clinical application of calculated split renal volume using computed tomography-based renal volumetry after partial nephrectomy: Correlation with technetium-99m dimercaptosuccinic acid renal scan data.

    Science.gov (United States)

    Lee, Chan Ho; Park, Young Joo; Ku, Ja Yoon; Ha, Hong Koo

    2017-06-01

    To evaluate the clinical application of computed tomography-based measurement of renal cortical volume and split renal volume as a single tool to assess the anatomy and renal function in patients with renal tumors before and after partial nephrectomy, and to compare the findings with technetium-99m dimercaptosuccinic acid renal scan. The data of 51 patients with a unilateral renal tumor managed by partial nephrectomy were retrospectively analyzed. The renal cortical volume of tumor-bearing and contralateral kidneys was measured using ImageJ software. Split estimated glomerular filtration rate and split renal volume calculated using this renal cortical volume were compared with the split renal function measured with technetium-99m dimercaptosuccinic acid renal scan. A strong correlation between split renal function and split renal volume of the tumor-bearing kidney was observed before and after surgery (r = 0.89, P volumetry had a strong correlation with the split renal function measured using technetium-99m dimercaptosuccinic acid renal scan. Computed tomography-based split renal volume measurement before and after partial nephrectomy can be used as a single modality for anatomical and functional assessment of the tumor-bearing kidney. © 2017 The Japanese Urological Association.

  14. Automatic extraction analysis of the anatomical functional area for normal brain 18F-FDG PET imaging

    International Nuclear Information System (INIS)

    Guo Wanhua; Jiang Xufeng; Zhang Liying; Lu Zhongwei; Li Peiyong; Zhu Chengmo; Zhang Jiange; Pan Jiapu

    2003-01-01

    Using self-designed automatic extraction software of brain functional area, the grey scale distribution of 18 F-FDG imaging and the relationship between the 18 F-FDG accumulation of brain anatomic function area and the 18 F-FDG injected dose, the level of glucose, the age, etc., were studied. According to the Talairach coordinate system, after rotation, drift and plastic deformation, the 18 F-FDG PET imaging was registered into the Talairach coordinate atlas, and then the average gray value scale ratios between individual brain anatomic functional area and whole brain area was calculated. Further more the statistics of the relationship between the 18 F-FDG accumulation of every brain anatomic function area and the 18 F-FDG injected dose, the level of glucose and the age were tested by using multiple stepwise regression model. After images' registration, smoothing and extraction, main cerebral cortex of the 18 F-FDG PET brain imaging can be successfully localized and extracted, such as frontal lobe, parietal lobe, occipital lobe, temporal lobe, cerebellum, brain ventricle, thalamus and hippocampus. The average ratios to the inner reference of every brain anatomic functional area were 1.01 ± 0.15. By multiple stepwise regression with the exception of thalamus and hippocampus, the grey scale of all the brain functional area was negatively correlated to the ages, but with no correlation to blood sugar and dose in all areas. To the 18 F-FDG PET imaging, the brain functional area extraction program could automatically delineate most of the cerebral cortical area, and also successfully reflect the brain blood and metabolic study, but extraction of the more detailed area needs further investigation

  15. Volumetric Nephrogram Represents Renal Function and Complements Aortic Anatomic Severity Grade in Predicting EVAR Outcomes.

    Science.gov (United States)

    Balceniuk, Mark D; Trakimas, Lauren; Aghaie, Claudia; Mix, Doran; Rasheed, Khurram; Seaman, Matthew; Ellis, Jennifer; Glocker, Roan; Doyle, Adam; Stoner, Michael C

    2018-07-01

    Chronic kidney disease (CKD) is a predictor of poor outcomes for patients undergoing endovascular aortic aneurysm repair (EVAR). Anatomic severity grade (ASG) represents a quantitative mechanism for assessing anatomical suitability for endovascular aortic repair. Anatomic severity grade has been correlated with repair outcomes and resource utilization. The purpose of this study was to identify a novel renal perfusion metric as a way to assist ASG with predicting EVAR outcomes. Retrospective review of a prospectively maintained database identified elective infrarenal aortic aneurysm repair cases. Anatomic grading was undertaken by independent reviewers. Using volumetric software, kidney volume, and a novel measure of kidney functional volume, the volumetric nephrogram (VN) was recorded. Systematic evaluation of the relationship of kidney volume and VN to CKD and ASG was undertaken using linear regression and receiver-operator statistical tools. A total of 386 cases with patient and anatomic data were identified and graded. Mean age was 72.9 ± 0.4 years. Renal volume renal volume (AUC = .628; P ≤ .0001) and VN (AUC = .628; P ≤ .0001). Regression analysis demonstrated a strong, inverse relationship between ASG and VN ( R 2 = .95). These data demonstrate that VN is a strong predictor of CKD in a large database of patients undergoing elective aneurysm repair. We demonstrate an inverse relationship between renal function and ASG that has not been previously described in the literature. Additionally, we have shown that VN complements ASG as a model of overall cardiovascular health and atherosclerotic burden. Outcomes in patients with poor renal function may be related to anatomical issues in addition to well-described systemic ramifications.

  16. Correlation between the clinical presentation and DSA of intracranial aneurysms

    International Nuclear Information System (INIS)

    Fang Chun; Hua Jia; Chen Kemin; Yin Yan; Ge Xin; Ying Yiping

    2001-01-01

    Objective: To evaluate the correlation between the clinical presentation and cerebral angiographic features of intracranial aneurysms. Methods: The authors retrospectively analyzed the relationship between the size, location and shape of 48 patient's cerebral aneurysms and their clinical presentations. Results: Clinical symptoms of cerebral aneurysms were related with their size, location and shape. Aneurysms in different location or at same location may cause similar symptoms or different symptoms. Rotation DSA is a useful examination supplemented to conventional DSA. Conclusions: The relationship between the location and the presentation of intracranial aneurysms is not specific. Rotation DSA plays important role in showing the characteristics of the cerebral aneurysms

  17. Anatomical aspects of the gastrocnemius muscles: A study in 47 fresh cadavers.

    Science.gov (United States)

    Andjelkov, Katarina; Atanasijevic, Tatjana C; Popovic, Vesna M; Sforza, Marcos; Atkinson, Connor J; Soldatovic, Ivan

    2016-08-01

    This study offers objective dimensions of the gastrocnemius muscle and analyzes correlations between dimensional variables, with a view to providing guidance on the proportions of a healthy gastrocnemius muscle for both genders. This anatomical study was conducted at the Institute of Forensic Medicine Faculty of Medicine University of Belgrade, Serbia, from May until November 2014. We included 47 fresh cadavers (up to 12-h postmortem interval) both male and female. The inclusion criteria were absence of any trauma or degenerative findings in lower limbs, normally weighed, and age between 18 and 60 years. The exclusion criteria were significant difference in dimensions between legs and overweighed cadavers. After statistical analysis of gathered data, we were able to define the exact shape and average measures of the medial and lateral head of gastrocnemius muscle in male and female. Factors affecting muscle dimensions are also defined in this study. The method of dissection that we applied could be recommended for exploration of different anatomical structures of calf region. The reported dimensions and correlations are useful guide in planning cosmetic and reconstructive procedures with high accuracy. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. CT of the external auditory canal: Correlation with clinical otoscopy

    International Nuclear Information System (INIS)

    Shankar, L.; Hawke, M.; Leekam, R.N.

    1987-01-01

    CT is the modality of choice in the assessment of external auditory canal abnormalities. Disorders of the complex structures within the ear that may be difficult to define clinically are well visualized on high-resolution CT. This exhibit illustrates various external auditory canal abnormalities and correlates these with color illustrations from clinical otoscopy. Congenital lesions of the external auditory canal - microtia, temporo-bandibular joint herniation, and fistulas - and various acquired lesions - traumatic, inflammatory, and neoplastic - are reviewed in this exhibit

  19. From medical imaging data to 3D printed anatomical models.

    Directory of Open Access Journals (Sweden)

    Thore M Bücking

    Full Text Available Anatomical models are important training and teaching tools in the clinical environment and are routinely used in medical imaging research. Advances in segmentation algorithms and increased availability of three-dimensional (3D printers have made it possible to create cost-efficient patient-specific models without expert knowledge. We introduce a general workflow that can be used to convert volumetric medical imaging data (as generated by Computer Tomography (CT to 3D printed physical models. This process is broken up into three steps: image segmentation, mesh refinement and 3D printing. To lower the barrier to entry and provide the best options when aiming to 3D print an anatomical model from medical images, we provide an overview of relevant free and open-source image segmentation tools as well as 3D printing technologies. We demonstrate the utility of this streamlined workflow by creating models of ribs, liver, and lung using a Fused Deposition Modelling 3D printer.

  20. The current and ideal state of anatomic pathology patient safety.

    Science.gov (United States)

    Raab, Stephen Spencer

    2014-01-01

    An anatomic pathology diagnostic error may be secondary to a number of active and latent technical and/or cognitive components, which may occur anywhere along the total testing process in clinical and/or laboratory domains. For the pathologist interpretive steps of diagnosis, we examine Kahneman's framework of slow and fast thinking to explain different causes of error in precision (agreement) and in accuracy (truth). The pathologist cognitive diagnostic process involves image pattern recognition and a slow thinking error may be caused by the application of different rationally-constructed mental maps of image criteria/patterns by different pathologists. This type of error is partly related to a system failure in standardizing the application of these maps. A fast thinking error involves the flawed leap from image pattern to incorrect diagnosis. In the ideal state, anatomic pathology systems would target these cognitive error causes as well as the technical latent factors that lead to error.

  1. Serial headache drawings by children with migraine: correlation with clinical headache status.

    Science.gov (United States)

    Stafstrom, Carl E; Goldenholz, Shira R; Dulli, Douglas A

    2005-10-01

    Children's artistic self-depictions of headache provide valuable insights into their experience of pain and aid in the diagnostic differentiation of headache types. In a previous study, we compared the clinical diagnosis (gold standard) and artistic diagnosis of headaches in 226 children. In approximately 90% of cases, the drawing predicted the clinical diagnosis of migraine versus nonmigraine headache correctly. In the present study, we explored whether headache drawings correlate with clinical improvement after treatment in children with migraine headaches followed longitudinally. Children seen in the Pediatric Neurology Clinic with the chief complaint of headache were asked to draw a picture of what their headache feels like. On subsequent clinic visits, children with the clinical diagnosis of migraine were asked to draw another picture depicting their current headache. The two drawings were compared to assess whether there was improvement; this "artistic response" was then correlated with the child's clinical status (ie, whether the headaches were improved clinically). One hundred eleven children (66 girls, 45 boys) participated in the study, with a mean interval of 5.3 +/- 2.3 (standard error of the mean) months between the first and second visits. The mean age at the first visit was 11.6 +/- 3.1 years. The raters agreed that serial drawings were both improved or both not improved in 99 of the 111 cases (89%; interrater reliability kappa score of 0.767). Fifty-three children had improvements in their headaches and drawings, 3 children had an improved drawing but no clinical headache improvement, 32 children had no improvement in either their drawing or clinical headaches, and 11 children had improved headaches but no improvement in their drawing. The sensitivity of the drawings for clinical improvement was 0.83, and the specificity was 0.91. The predictive value of an improved headache drawing for an improved clinical response was 0.946. There was no

  2. Cluster-based upper body marker models for three-dimensional kinematic analysis: Comparison with an anatomical model and reliability analysis.

    Science.gov (United States)

    Boser, Quinn A; Valevicius, Aïda M; Lavoie, Ewen B; Chapman, Craig S; Pilarski, Patrick M; Hebert, Jacqueline S; Vette, Albert H

    2018-04-27

    Quantifying angular joint kinematics of the upper body is a useful method for assessing upper limb function. Joint angles are commonly obtained via motion capture, tracking markers placed on anatomical landmarks. This method is associated with limitations including administrative burden, soft tissue artifacts, and intra- and inter-tester variability. An alternative method involves the tracking of rigid marker clusters affixed to body segments, calibrated relative to anatomical landmarks or known joint angles. The accuracy and reliability of applying this cluster method to the upper body has, however, not been comprehensively explored. Our objective was to compare three different upper body cluster models with an anatomical model, with respect to joint angles and reliability. Non-disabled participants performed two standardized functional upper limb tasks with anatomical and cluster markers applied concurrently. Joint angle curves obtained via the marker clusters with three different calibration methods were compared to those from an anatomical model, and between-session reliability was assessed for all models. The cluster models produced joint angle curves which were comparable to and highly correlated with those from the anatomical model, but exhibited notable offsets and differences in sensitivity for some degrees of freedom. Between-session reliability was comparable between all models, and good for most degrees of freedom. Overall, the cluster models produced reliable joint angles that, however, cannot be used interchangeably with anatomical model outputs to calculate kinematic metrics. Cluster models appear to be an adequate, and possibly advantageous alternative to anatomical models when the objective is to assess trends in movement behavior. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Correlation between self-reported and clinically based diagnoses of bruxism in temporomandibular disorders patients.

    Science.gov (United States)

    Paesani, D A; Lobbezoo, F; Gelos, C; Guarda-Nardini, L; Ahlberg, J; Manfredini, D

    2013-11-01

    The present investigation was performed in a population of patients with temporomandibular disorders (TMD), and it was designed to assess the correlation between self-reported questionnaire-based bruxism diagnosis and a diagnosis based on history taking plus clinical examination. One-hundred-fifty-nine patients with TMD underwent an assessment including a questionnaire investigating five bruxism-related items (i.e. sleep grinding, sleep grinding referral by bed partner, sleep clenching, awake clenching, awake grinding) and an interview (i.e. oral history taking with specific focus on bruxism habits) plus a clinical examination to evaluate bruxism signs and symptoms. The correlation between findings of the questionnaire, viz., patients' report, and findings of the interview/oral history taking plus clinical examination, viz., clinicians' diagnosis, was assessed by means of φ coefficient. The highest correlations were achieved for the sleep grinding referral item (φ = 0·932) and for the awake clenching item (φ = 0·811), whilst lower correlation values were found for the other items (φ values ranging from 0·363 to 0·641). The percentage of disagreement between the two diagnostic approaches ranged between 1·8% and 18·2%. Within the limits of the present investigation, it can be suggested that a strong positive correlation between a self-reported and a clinically based approach to bruxism diagnosis can be achieved as for awake clenching, whilst lower levels of correlation were detected for sleep-time activities. © 2013 John Wiley & Sons Ltd.

  4. Computed tomography of the vesicular glands: anatomical animal model (Oryctolagus cuniculus)

    International Nuclear Information System (INIS)

    Dimitrov, R.; Stamatova-Yovcheva, K.; Hamza, S.; Toneva, Y.

    2014-01-01

    Spiral CT is a non-invasive imaging method of choice for animal anatomical studies. The aim of the study was to establish the imaging anatomical features of the vesicular glands in the rabbit. Eight sexually mature healthy clinically male New Zealand rabbits of 18 months of age with body weight from 2.8 kg to 3.2 kg were used. The animals were anesthetized. As contrast medium Opti-ray350 was administrated. The computed tomography scan was complied with certain bone and soft tissue markers. For this purpose, a whole body multi-slice spiral computed tomography scanner was used. The both soft tissue glands were heterogeneous and relatively hyperdense structures, and defined in detail from the adjacent soft tissues. The urinary bladder neck was ventrally to the glands. Both vesicular glands were better differentiated each other when the rabbit is examined in abdominal recumbence. In dorsal recumbence the shape of the transversal image of the glandular finding was oval. In abdominal recumbence both the left and right soft tissue vesicular gland were defined. Transversal anatomical computed tomographic investigation of the rabbit vesicular gland is a detailed and definitive method, to study the normal morphology of these glands. Key words: Vesicular Gland. Helical Computed Tomography. Anatomy. Rabbit

  5. Correlating metabolic and anatomic responses of primary lung cancers to radiotherapy by combined F-18 FDG PET-CT imaging

    Directory of Open Access Journals (Sweden)

    Grills Inga

    2007-05-01

    Full Text Available Abstract Background To correlate the metabolic changes with size changes for tumor response by concomitant PET-CT evaluation of lung cancers after radiotherapy. Methods 36 patients were studied pre- and post-radiotherapy with18FDG PET-CT scans at a median interval of 71 days. All of the patients were followed clinically and radiographically after a mean period of 342 days for assessment of local control or failure rates. Change in size (sum of maximum orthogonal diameters was correlated with that of maximum standard uptake value (SUV of the primary lung cancer before and after conventional radiotherapy. Results There was a significant reduction in both SUV and size of the primary cancer after radiotherapy (p Conclusion Correlating and incorporating metabolic change by PET into size change by concomitant CT is more sensitive in assessing therapeutic response than CT alone.

  6. Knee Osteochondral Autologous Transplantation: Long-term MR findings and clinical correlations

    International Nuclear Information System (INIS)

    Tetta, Cecilia; Busacca, Maurizio; Moio, Antonio; Rinaldi, Raffaella; Delcogliano, Marco; Kon, Elizaveta; Filardo, Giuseppe; Marcacci, Maurilio; Albisinni, Ugo

    2010-01-01

    We evaluated long-term magnetic resonance imaging (MRI) features of Knee Osteochondral Autologous Transplantation (OAT)-Mosaicplasty and correlated MRI findings and clinical outcome. Twenty-four patients (mean age 29.9 ± 8.7, 70.8% male) undergoing arthroscopic OAT between 1997 and 2000 were prospectively enrolled. The International Cartilage Repair Society (ICRS)/International Knee Documentation Committee (IKDC) scores and Tegner scores were employed for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) was utilized for description and assessment of the repair tissue. Median follow up was 113 months (interquartile range [IQR] 106-122). MRI showed good survival of grafted cartilage in 62.5% of patients. The integration of the graft was complete in 75% of cases, while the repaired tissue was intact in 62.5% and had an homogeneous structure in 70.8%. The MOCART score significantly correlated with objective and subjective scores (p = 0.003 and p = 0.002). Contrastingly, overall MOCART showed no correlation with the Tegner score. MRI revealed to be a powerful tool for non-invasive long-term assessment of OAT.

  7. The Correlation between Chronic Periodontitis and Oral Cancer.

    Science.gov (United States)

    Krüger, Maximilian; Hansen, Torsten; Kasaj, Adrian; Moergel, Maximilian

    2013-01-01

    Infections are increasingly considered as potential trigger for carcinogenesis apart from risk factors like alcohol and tobacco. The discussion about human papilloma virus (HPV) in oral squamous cell carcinoma (OSCC) points at a general role of infection for the development of oral carcinomas. Furthermore, first studies describe a correlation between chronic periodontitis and OSCC, thus, characterizing chronic inflammation as being a possible trigger for OSCC. In front of this background, we present four well-documented clinical cases. All patients showed a significant anatomical relation between OSCC and clinical signs of chronic periodontitis. The interindividual differences of the clinical findings lead to different theoretical concepts: two with coincidental appearance of OSCC and chronic periodontitis and two with possible de novo development of OSCC triggered by chronic inflammation. We conclude that the activation of different inflammatory cascades by chronic periodontitis negatively affects mucosa and bone. Furthermore, the inflammatory response has the potential to activate carcinogenesis. Apart from a mere coincidental occurrence, two out of four patients give first clinical hints for a model wherein chronic periodontitis represents a potential risk factor for the development of OSCC.

  8. The Correlation between Chronic Periodontitis and Oral Cancer

    Directory of Open Access Journals (Sweden)

    Maximilian Krüger

    2013-01-01

    Full Text Available Infections are increasingly considered as potential trigger for carcinogenesis apart from risk factors like alcohol and tobacco. The discussion about human papilloma virus (HPV in oral squamous cell carcinoma (OSCC points at a general role of infection for the development of oral carcinomas. Furthermore, first studies describe a correlation between chronic periodontitis and OSCC, thus, characterizing chronic inflammation as being a possible trigger for OSCC. In front of this background, we present four well-documented clinical cases. All patients showed a significant anatomical relation between OSCC and clinical signs of chronic periodontitis. The interindividual differences of the clinical findings lead to different theoretical concepts: two with coincidental appearance of OSCC and chronic periodontitis and two with possible de novo development of OSCC triggered by chronic inflammation. We conclude that the activation of different inflammatory cascades by chronic periodontitis negatively affects mucosa and bone. Furthermore, the inflammatory response has the potential to activate carcinogenesis. Apart from a mere coincidental occurrence, two out of four patients give first clinical hints for a model wherein chronic periodontitis represents a potential risk factor for the development of OSCC.

  9. THE AZYGOS VENOUS SYSTEM AND ITS ANATOMICAL VARIATIONS

    Directory of Open Access Journals (Sweden)

    Madiki Sudhakara Rao

    2016-06-01

    Full Text Available AIMS AND OBJECTIVES Azygos veins are important cavocaval and portacaval junctions, which form a collateral circulation in caval vein occlusion and in portal hypertension, cirrhosis of liver. The unpaired azygos venous system consists of azygos vein, hemiazygos vein and accessory azygos vein. This system of veins, along with its mediastinal, bronchial and oesophageal tributaries drains most of the body wall of trunk, namely posterior abdominal and thoracic wall. Anatomical variations of this unpaired azygos venous system are clinically important. AIMS To study and report the occurrence of anatomical variations of the unpaired azygos venous system in the region of East Godavari District, Andhra Pradesh (India. METHODS The present study was carried out in the Department of Anatomy, KIMS & RF, Amalapuram and G.S.L. Medical College, Rajahmundry over a period of 2 years. The present study was conducted on 60 cadavers (irrespective of age and sex. The entire course of the azygos venous system in these 60 cadavers was carefully observed and documented. RESULTS Anatomical variations were present in 16.66% of cases, out of which three distinct types were identified. 6.6% exhibited two separate azygos venous systems with no communications, 5% with communication between the left brachiocephalic vein and the azygos vein and 5% presence of post-aortic venous channels. CONCLUSION Variations of azygos venous system may be wrongly dubbed as aneurysm, lymphadenopathy or other abnormalities while reporting a CT scan of mediastinum. Venous anomalies are also detected only during surgery. The most troublesome intraoperative hazard is haemorrhage, which is mainly of venous origin. To avoid such situations is to have an awareness and knowledge of the expected venous anomalies.

  10. MR findings of cerebral palsy and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Ho; Kim, In One; Kim, Woo Sun; Yeon, Kyung Mo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-04-01

    To demonstrate MR findings of cerebral palsy (CP), correlation with clinical findings, and differences between the full-term and pre-term group. Brain MRI of 94 patients with cerebral palsy (CP) were reviewed. The frequency of each MR finding, statistical correlation with clinical findings including type, severity and extent of CP, and differences between the full-term and pre-term group were analyzed. Abnormal MR findings were found in 83 patients(88%), and were as follows : diffuse brain atrophy(30%); periventricular leukomalacia(PVL)(28%); infarction(11%), basal ganglia abnormality(11%); delayed myelination(10%); nonspecific tissue loss or encephalomalacia(9%); and cortical dysplasia(7%). Hemiplegia was the most common condition among patients with infarction, and was found in 80% of this group; diplegia was found in 50% of cases with diffuse brain atrophy, while paraplegia was found in 36% of those with normal MR findings (p < .05). Mild symptoms were dominant in patients with normal MR findings(82%) and in those with infarctions(90%)(p < .05). PVL was the dominant finding in the pre-term group (65%) whereas findings in the full-term group varied; in this group, 38% of MR findings suggested prenatal insults. Possible causative factors were found in 66% of the full-term and 80% of the pre-term group. Perinatal factors were dominant in the pre-term group(81%), whereas prenatal and postnatal factors showed relatively higher frequencies in the full-term group(30% and 24%, respectively). Diffuse brain atrophy and PVL were the most common MR findings. The extent of CP the pre-term correlated well with MR findings. PVL and perinatal factors were dominant in the pre-term group, whereas variable MR findings and relatively higher frequencies of pre- and postnatal factors were found in the full-term group.

  11. MR findings of cerebral palsy and clinical correlation

    International Nuclear Information System (INIS)

    Kim, Sun Ho; Kim, In One; Kim, Woo Sun; Yeon, Kyung Mo

    1997-01-01

    To demonstrate MR findings of cerebral palsy (CP), correlation with clinical findings, and differences between the full-term and pre-term group. Brain MRI of 94 patients with cerebral palsy (CP) were reviewed. The frequency of each MR finding, statistical correlation with clinical findings including type, severity and extent of CP, and differences between the full-term and pre-term group were analyzed. Abnormal MR findings were found in 83 patients(88%), and were as follows : diffuse brain atrophy(30%); periventricular leukomalacia(PVL)(28%); infarction(11%), basal ganglia abnormality(11%); delayed myelination(10%); nonspecific tissue loss or encephalomalacia(9%); and cortical dysplasia(7%). Hemiplegia was the most common condition among patients with infarction, and was found in 80% of this group; diplegia was found in 50% of cases with diffuse brain atrophy, while paraplegia was found in 36% of those with normal MR findings (p < .05). Mild symptoms were dominant in patients with normal MR findings(82%) and in those with infarctions(90%)(p < .05). PVL was the dominant finding in the pre-term group (65%) whereas findings in the full-term group varied; in this group, 38% of MR findings suggested prenatal insults. Possible causative factors were found in 66% of the full-term and 80% of the pre-term group. Perinatal factors were dominant in the pre-term group(81%), whereas prenatal and postnatal factors showed relatively higher frequencies in the full-term group(30% and 24%, respectively). Diffuse brain atrophy and PVL were the most common MR findings. The extent of CP the pre-term correlated well with MR findings. PVL and perinatal factors were dominant in the pre-term group, whereas variable MR findings and relatively higher frequencies of pre- and postnatal factors were found in the full-term group

  12. Nutrient Canals of the Alveolar Process as an Anatomical Feature for Age and Gender Determination

    Directory of Open Access Journals (Sweden)

    Prashant Gupta

    2017-01-01

    Full Text Available Introduction: Nutrient canals are anatomic structures of the alveolar bone through which neurovascular elements transit to supply teeth and supporting structures. Dental identification using nutrient canal of the mandibular alveolar process as the most compelling anatomic feature for antemortem–postmortem radiographic comparison can be potentially used in forensic identification. Aim: The aim of the present study was to investigate the correlation between the appearance of nutrient canals as a potential clue to age and gender determination. Materials and Methods: One hundred and twenty patients, 60 males and 60 females, were selected in the 11–60-year age group. Systemic disease, especially hypertension, was ruled out in the patients. Periapical radiographs were taken from mandibular anterior cuspid central incisor region because nutrient canals are commonly observed in this area. Data obtained was analyzed by SPSS software and various statistical analysis were carried out. Results: Study revealed nutrient canals to be commonly seen in females compared to males. Males had maximum canals in the age group of 21–30-year whereas females in the age group of 31–40 years had the maximum canals. Conclusion: Significant correlation was seen between the gender and nutrient canals whereas no significant correlation existed between the age and presence of nutrient canals.

  13. Correlation Between Screening Mammography Interpretive Performance on a Test Set and Performance in Clinical Practice.

    Science.gov (United States)

    Miglioretti, Diana L; Ichikawa, Laura; Smith, Robert A; Buist, Diana S M; Carney, Patricia A; Geller, Berta; Monsees, Barbara; Onega, Tracy; Rosenberg, Robert; Sickles, Edward A; Yankaskas, Bonnie C; Kerlikowske, Karla

    2017-10-01

    Evidence is inconsistent about whether radiologists' interpretive performance on a screening mammography test set reflects their performance in clinical practice. This study aimed to estimate the correlation between test set and clinical performance and determine if the correlation is influenced by cancer prevalence or lesion difficulty in the test set. This institutional review board-approved study randomized 83 radiologists from six Breast Cancer Surveillance Consortium registries to assess one of four test sets of 109 screening mammograms each; 48 radiologists completed a fifth test set of 110 mammograms 2 years later. Test sets differed in number of cancer cases and difficulty of lesion detection. Test set sensitivity and specificity were estimated using woman-level and breast-level recall with cancer status and expert opinion as gold standards. Clinical performance was estimated using women-level recall with cancer status as the gold standard. Spearman rank correlations between test set and clinical performance with 95% confidence intervals (CI) were estimated. For test sets with fewer cancers (N = 15) that were more difficult to detect, correlations were weak to moderate for sensitivity (woman level = 0.46, 95% CI = 0.16, 0.69; breast level = 0.35, 95% CI = 0.03, 0.61) and weak for specificity (0.24, 95% CI = 0.01, 0.45) relative to expert recall. Correlations for test sets with more cancers (N = 30) were close to 0 and not statistically significant. Correlations between screening performance on a test set and performance in clinical practice are not strong. Test set performance more accurately reflects performance in clinical practice if cancer prevalence is low and lesions are challenging to detect. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  14. A general XML schema and SPM toolbox for storage of neuro-imaging results and anatomical labels.

    Science.gov (United States)

    Keator, David Bryant; Gadde, Syam; Grethe, Jeffrey S; Taylor, Derek V; Potkin, Steven G

    2006-01-01

    With the increased frequency of multisite, large-scale collaborative neuro-imaging studies, the need for a general, self-documenting framework for the storage and retrieval of activation maps and anatomical labels becomes evident. To address this need, we have developed and extensible markup language (XML) schema and associated tools for the storage of neuro-imaging activation maps and anatomical labels. This schema, as part of the XML-based Clinical Experiment Data Exchange (XCEDE) schema, provides storage capabilities for analysis annotations, activation threshold parameters, and cluster and voxel-level statistics. Activation parameters contain information describing the threshold, degrees of freedom, FWHM smoothness, search volumes, voxel sizes, expected voxels per cluster, and expected number of clusters in the statistical map. Cluster and voxel statistics can be stored along with the coordinates, threshold, and anatomical label information. Multiple threshold types can be documented for a given cluster or voxel along with the uncorrected and corrected probability values. Multiple atlases can be used to generate anatomical labels and stored for each significant voxel or cluter. Additionally, a toolbox for Statistical Parametric Mapping software (http://www. fil. ion.ucl.ac.uk/spm/) was created to capture the results from activation maps using the XML schema that supports both SPM99 and SPM2 versions (http://nbirn.net/Resources/Users/ Applications/xcede/SPM_XMLTools.htm). Support for anatomical labeling is available via the Talairach Daemon (http://ric.uthscsa. edu/projects/talairachdaemon.html) and Automated Anatomical Labeling (http://www. cyceron.fr/freeware/).

  15. Anatomical eponyms - unloved names in medical terminology.

    Science.gov (United States)

    Burdan, F; Dworzański, W; Cendrowska-Pinkosz, M; Burdan, M; Dworzańska, A

    2016-01-01

    Uniform international terminology is a fundamental issue of medicine. Names of various organs or structures have developed since early human history. The first proper anatomical books were written by Hippocrates, Aristotle and Galen. For this reason the modern terms originated from Latin or Greek. In a modern time the terminology was improved in particular by Vasalius, Fabricius and Harvey. Presently each known structure has internationally approved term that is explained in anatomical or histological terminology. However, some elements received eponyms, terms that incorporate the surname of the people that usually describe them for the first time or studied them (e.g., circle of Willis, follicle of Graff, fossa of Sylvious, foramen of Monro, Adamkiewicz artery). Literature and historical hero also influenced medical vocabulary (e.g. Achilles tendon and Atlas). According to various scientists, all the eponyms bring colour to medicine, embed medical traditions and culture to our history but lack accuracy, lead of confusion, and hamper scientific discussion. The current article presents a wide list of the anatomical eponyms with their proper anatomical term or description according to international anatomical terminology. However, since different eponyms are used in various countries, the list could be expanded.

  16. [Anatomical study and clinical application of a leg flap pedicle-included with cutaneous nerve and its concomitant vessels].

    Science.gov (United States)

    Liu, B; Hao, X; Goan, M

    2000-05-01

    To investigate the blood supply patterns and the clinical liability of a leg flap pedicle-included with cutaneous nerve and its concomitant vessels. Fresh cadaver legs with thirty-two in infants and two in adults were anatomically examined after the intravenous injection of the red Chlorinated Poly Vingl Choride (CPVC). Five patients with the soft tissue defects were selected for the treatment with the flap pedicle-included with the cutaneous nerve and its concomitant vessels. Four main cutaneous nerves were found in the leg after they perforated the deep fascia out. They were companioned with their concomitant vessels with different blood-supply pateeerns, which the upper part of the leg was in an axial pattern and the lower part was in a "chain-type anastomosing" pattern. Following the above-mentioned findings, five cases were successfully treated with this led flap. The leg flap should be designed along the cutaneous nerve and its concomitant vessels. When the flap is applied in the area of blood supply with "chain-type anastomosing" pattern, the deep fascia should also be included in the flap.

  17. The dorsal thoracic fascia: anatomic significance with clinical applications in reconstructive microsurgery.

    Science.gov (United States)

    Kim, P S; Gottlieb, J R; Harris, G D; Nagle, D J; Lewis, V L

    1987-01-01

    The anatomic distribution and potential arterial flow patterns of the circumflex scapular artery were investigated by Microfil injection. These studies demonstrated that the circumflex scapular artery lies within the dorsal thoracic fascia, which plays a significant role in the circulation of the overlying skin and subcutaneous tissue. We conclude that scapular/parascapular flaps are fasciocutaneous flaps, the dorsal thoracic fascia can be transferred as a free flap without its overlying skin and subcutaneous tissue, and intercommunication exists between the myocutaneous perforators of the latissimus dorsi myocutaneous flap and the vascular plexus of the dorsal thoracic fascia. We present microvascular cases in which the vascular properties of the dorsal thoracic fascia facilitated wound closure with free fascia flaps or expanded cutaneous or myocutaneous flaps.

  18. Femoral rotation unpredictably affects radiographic anatomical lateral distal femoral angle measurements

    DEFF Research Database (Denmark)

    Miles, James Edward

    2016-01-01

    Objective: To describe the effects of internal and external femoral rotation on radiographic measurements of the anatomical lateral distal femoral angle (a-LDFA) using two methods for defining the anatomical proximal femoral axis (a-PFA). Methods: Digital radiographs were obtained of 14 right...... femora at five degree intervals from 10° external rotation to 10° internal rotation. Using freely available software, a-LDFA measurements were made using two different a-PFA by a single observer on one occasion. Results: Mean a-LDFA was significantly greater at 10° external rotation than at any other...... rotation. The response of individual femora to rotation was unpredictable, although fairly stable within ±5° of zero rotation. Mean a-LDFA for the two a-PFA methods differed by 1.5°, but were otherwise similarly affected by femoral rotation. Clinical significance: If zero femoral elevation can be achieved...

  19. CLINICAL-RADIOGRAPHIC CORRELATION OF DEGENERATIVE CHANGES OF THE SPINE - SYSTEMATIC REVIEW

    Directory of Open Access Journals (Sweden)

    Emiliano Neves Vialle

    Full Text Available ABSTRACT Systematic review of the literature on the evaluation of images of degenerative changes of the spine and its clinical correlation. A systematic literature review was conducted, and the results evaluated for the presence of clinical correlation, as well as the type of imaging method used. The search terms were "Intervertebral Disc Degeneration", "Intervertebral disc", "Classification", "Anulus fibrosus", "Nucleus pulposus", "Lumbar spine", "Degenerative disc disease", "Degeneration", "Zygapophyseal Joint". We also assessed whether there were inter- and intraobserver agreement in the selected works and possible guidelines regarding the treatment and prognosis of patients. Of the 91 reviewed abstracts, 31 articles were selected that met the inclusion criteria. Six articles were related to the cervical spine, 13 to the lumbar spine and 12 were about changes not related specifically to a single segment of the spine. Articles that determined limiting values considered normal were also included, since variations were considered signs of degeneration or pathology. It was not possible to establish the relationship between the changes identified in imaging and the clinical history of patients, either define treatment and prognosis guidelines.

  20. Anatomical location of metastatic lymph nodes: an indispensable prognostic factor for gastric cancer patients who underwent curative resection.

    Science.gov (United States)

    Zhao, Bochao; Zhang, Jingting; Zhang, Jiale; Chen, Xiuxiu; Chen, Junqing; Wang, Zhenning; Xu, Huimian; Huang, Baojun

    2018-02-01

    Although the numeric-based lymph node (LN) staging was widely used in the worldwide, it did not represent the anatomical location of metastatic lymph nodes (MLNs) and not reflect extent of LN dissection. Therefore, in the present study, we investigated whether the anatomical location of MLNs was still necessary to evaluate the prognosis of node-positive gastric cancer (GC) patients. We reviewed 1451 GC patients who underwent radical gastrectomy in our institution between January 1986 and January 2008. All patients were reclassified into several groups according to the anatomical location of MLNs and the number of MLNs. The prognostic differences between different patient groups were compared and clinicopathologic features were analyzed. In the present study, both anatomical location of MLNs and the number of MLNs were identified as the independent prognostic factors (p location of MLNs was considered (p location of MLNs had no significant effect on the prognosis of these patients, the higher number of MLNs in the extraperigastric area was correlated with the unfavorable prognosis (p location of MLNs was an important factor influencing the prognostic outcome of GC patients. To provide more accurate prognostic information for GC patients, the anatomical location of MLNs should not be ignored.

  1. [Application of the anatomic plate and trapezoid plate in comminuted intertrochanteric fracture combined with trochanteric coronal position fracture: a controlled clinical trial].

    Science.gov (United States)

    Zhen, Ping; Liu, Xing-Yan; Gao, Ming-Xuan; Tian, Qi

    2010-05-01

    To investigate the therapeutic effect and operative characteristic of the anatomic plate and trapezoid plate for treament of the comminuted intertrochanteric fracture combined with trochanteric coronal position fracture. From Jan. 1998 to Mar. 2007, 57 patients suffered from comminuted intertrochanteric fracture combined with trochanteric coronal position fracture were randomly divided into two groups, 21 patients in trapezoid plate group were treated with the trapezoid compression plate, included 11 males and 10 females with an average age of 41.8 years; and 36 patients in anatomic plate group were treated with the anatomic plate, included 17 males and 19 females with an average age of 42.1 years. All of the 57 fractures were A3 type according to AO classification. The functions of hip joints were evaluated according to the Harris hip functional standard score. All 57 patients were followed-up for 5 months to 9 years and 3 months with an average of 4.8 years. The healing time of the fractures was from 8 to 20 weeks with an average of 12.8 weeks. The results of Harris scoring showed the pain scores of the anatomic plate group were higher than that of the trapezoid plate group (P 0.05). In unstable comminuted intertrochanteric fracture combined with trochanteric coronal position fracture, the lateral wall of trochanteric is often destroyed. The anatomic plate and the trapeziod compression plate can provide effective internal fixation, while many othere internal fixation methods were limited in this kind of fracture. As compared with the anatomic plate fixation, the trapezoid compression plate fixation of comminuted intertrochanteric fracture combined with trochanteric coronal position fracture have several advantages, such as fewer complications, faster union of fracture and earlier recovery of joint functions.

  2. Clinical-pathological-angiographic correlations following transluminal atherectomy

    International Nuclear Information System (INIS)

    Althaus, S.J.; Maynar, M.; Reyes, R.; Pulido-Duque, J.M.; Casal, G.; Hunter, D.W.; Castaneda-Zuniga, W.R.; Amplatz, K.

    1989-01-01

    Following percutaneous atherectomy, arterial and catheter diameter relationships were correlated with angiographic and ankle-arm index results. There was a greater amount of tissue removed, improved luminal reconstitution, and ankle-arm index in lesions where the catheter and arterial diameters were equal or within 0.5 mm. Excluding lesions requiring angioplasty, 77% of our lesions had less than 30% residual stenosis; including lesions requiring concomitant angioplasty, the initial overall patency was 93%, with a 1-year patency rate of 92.5%. This study indicates that adequate matching of the atherectomy catheter diameter to the arterial diameter is necessary to optimize tissue removal and clinical results

  3. CONDUCTO ALVEOLAR INFERIOR. CORRELATO ANATOMO-IMAGENOLOGICO E IMPLICANCIA EN LOS PROCEDIMIENTOS QUIRURGICOS DE MANDIBULA. Inferior alveolar canal. Imaginological anatomical correlation and implication in jaw surgical procedures

    Directory of Open Access Journals (Sweden)

    Andrés C Limardo

    2016-03-01

    Full Text Available Introducción: Las lesiones iatrogénicas del nervio dentario inferior son complicaciones documentadas de diversos procedimientos quirúrgicos en la mandíbula. Debido a ello se justifica una descripción más detallada con referencias morfométricas de dicho conducto, como así también una correlación con imágenes. Materiales y métodos: Se realizó un estudio descriptivo observacional con una muestra de 44 hemimandíbulas secas y 100 tomografías computadas de mandíbulas de pacientes al azar. Se realizaron mediciones del foramen mandibular y mentoniano con respecto a bordes mandibulares. Se hicieron cortes en la rama y el cuerpo con sus respectivas mediciones. Se utilizaron Tomografías Computadas Cone Beam 3D de 100 pacientes las cuales fueron procesadas por el programa Compudent Navigator 3D®. Utilizando este programa se pudieron realizar las mismas mediciones que en los preparados anatómicos, como así también la reconstrucción del conducto. En una segunda etapa se realizó una correlación entre los valores morfométricos del estudio anatómico y se comparó con los estudios por imágenes (TC con reconstrucción 3D Dental Scan. Resultados: Se expresaron en tablas con diversas variables. Discusión: Los textos clásicos de anatomía y los libros de cirugía de la especialidad describen en detalle el recorrido y las relaciones del CAI, y presentan datos morfométricos pero no lo hacen en poblaciones locales. Como conclusión podemos afirmar que, tomando como punto de partida la anatomía y correlacionándola con la imagenologia, podemos llegar a evitar lesiones del nervio alveolar inferior en el transcurso de diversos procedimientos realizados en la mandíbula. Introduction: Iatrogenic inferior alveolar nerve injuries are documented complications of different surgical procedures in the jaw. It should justify a more detailed description with morphometric references of the duct and a correlation with images. Materials and method: A

  4. Complex distal insertions of the tibialis posterior tendon: detailed anatomic and MR imaging investigation in cadavers

    Energy Technology Data Exchange (ETDEWEB)

    Pastore, Daniel; Cerri, Giovanni G. [University of Sao Paulo, Department of Radiology, Sao Paulo, Sao Paulo (Brazil); VA Medical Center, University of California, Department of Radiology, San Diego, CA (United States); Dirim, Berna; Wangwinyuvirat, Mani; Belentani, Clarissa L.; Trudell, Debra J.; Resnick, Donald L. [VA Medical Center, University of California, Department of Radiology, San Diego, CA (United States); Haghighi, Parviz [VA Medical Center, University of California, Department of Radiology, San Diego, CA (United States); VA Medical Center, University of California, Department of Histology, San Diego, CA (United States)

    2008-09-15

    The purpose of this report was to demonstrate the normal complex insertional anatomy of the tibialis posterior tendon (TPT) in cadavers using magnetic resonance (MR) imaging with anatomic and histologic correlation. Ten cadaveric ankles were used according to institutional guidelines. MR T1-weighted spin echo imaging was performed to demonstrate aspects of the complex anatomic distal insertions of the TPT in cadaveric specimens. Findings on MR imaging were correlated with those derived from anatomic and histologic study. Generally, the TPT revealed a low signal in all MR images, except near the level of the medial malleolus, where the TPT suddenly changed direction and ''magic angle'' artifact could be observed. In five out of ten specimens (50%), a type I accessory navicular bone was found in the TPT. In all cases with a type I accessory navicular bone, the TPT had an altered signal in this area. Axial and coronal planes on MR imaging were the best in identifying the distal insertions of the TPT. A normal division of the TPT was observed just proximal to the insertion into the navicular bone in five specimens (100%) occurring at a maximum proximal distance from its attachment to the navicular bone of approximately 1.5 to 2 cm. In the other five specimens, in which a type I accessory navicular bone was present, the TPT directly inserted into the accessory bone and a slip less than 1.5 mm in thickness could be observed attaching to the medial aspect of the navicular bone (100%). Anatomic inspection confirmed the sites of the distal insertions of the components of the TPT. MR imaging enabled detailed analysis of the complex distal insertions of the TPT as well as a better understanding of those features of its insertion that can simulate a lesion. (orig.)

  5. Unilateral Duplication Of Parotid Duct. A Rare Anatomical Variation

    Directory of Open Access Journals (Sweden)

    Humberto Ferreira Arquez

    2017-11-01

    Full Text Available Background: The paired parotid glands are the largest of the major salivary glands and produces mainly serous secretions. The secretion of this gland reaches the oral cavity through single parotid duct (Stensen’s duct. The parotid duct begins at the anterior border of the gland, crosses the masseter muscle, and then pierces the buccinator muscle to reach the mucosa lining the mouth at the level of the cheek. The purpose of this study is determine the morphologic features of the parotid duct and describe an anatomical variation until now unreported. Methods and Findings: A total of 17 cadavers were used for this study in the Morphology Laboratory at the University of Pamplona. In a cadaver were findings: The main parotid duct originated two conducts: Left superior parotid duct and Left inferior parotid duct, is observed the criss-cross of the ducts, and then perforated the buccinator muscle and entered the oral cavity at a double parotid papilla containing a double opening, separated from each other in 0,98 mm. In the remaining  33 parotid regions (97.06% the parotid duct is conformed to the classical descriptions given in anatomical textbooks. Conclusions: The parotid duct anatomy is important for duct endoscopy, lithotripsy, sialography and trans-ductal facial nerve stimulation in the early stage of facial palsy in some cases. The anatomical variations also has clinical importance for parotid gland surgery and facial cosmetic surgery. To keep in mind the parotid duct variation will reduce iatrogenic injury risks and improve diagnosis of parotid duct injury.

  6. Interfractional Variations in Patient Setup and Anatomic Change Assessed by Daily Computed Tomography

    International Nuclear Information System (INIS)

    Li, X. Allen; Qi, X. Sharon; Pitterle, Marissa; Kalakota, Kapila; Mueller, Kevin; Erickson, Beth A.; Wang Dian; Schultz, Christopher J.; Firat, Selim Y.; Wilson, J. Frank

    2007-01-01

    Purpose: To analyze the interfractional variations in patient setup and anatomic changes at seven anatomic sites observed in image-guided radiotherapy. Methods and Materials: A total of 152 patients treated at seven anatomic sites using a Hi-Art helical tomotherapy system were analyzed. Daily tomotherapy megavoltage computed tomography images acquired before each treatment were fused to the planning kilovoltage computed tomography images to determine the daily setup errors and organ motions and deformations. The setup errors were corrected before treatment and were used, along with the organ motions, to determine the clinical target volume/planning target volume margins. The organ motions and deformations for 3 representative patient cases (pancreas, uterus, and soft-tissue sarcoma) and for 14 kidneys of 7 patients are presented. Results: Interfractional setup errors in the skull, brain, and head and neck are significantly smaller than those in the chest, abdomen, pelvis, and extremities. These site-specific relationships are statistically significant. The margins required to account for these setup errors range from 3 to 8 mm for the seven sites. The margin to account for both setup errors and organ motions for kidney is 16 mm. Substantial interfractional anatomic changes were observed. For example, the pancreas moved up to ±20 mm and volumes of the uterus and sarcoma varied ≤30% and 100%, respectively. Conclusion: The interfractional variations in patient setup and in shapes, sizes, and positions of both targets and normal structures are site specific and may be used to determine the site-specific margins. The data presented in this work dealing with seven anatomic sites may be useful in developing adaptive radiotherapy

  7. Internal respiratory surrogate in multislice 4D CT using a combination of Fourier transform and anatomical features

    International Nuclear Information System (INIS)

    Hui, Cheukkai; Suh, Yelin; Robertson, Daniel; Beddar, Sam; Pan, Tinsu; Das, Prajnan; Crane, Christopher H.

    2015-01-01

    Purpose: The purpose of this study was to develop a novel algorithm to create a robust internal respiratory signal (IRS) for retrospective sorting of four-dimensional (4D) computed tomography (CT) images. Methods: The proposed algorithm combines information from the Fourier transform of the CT images and from internal anatomical features to form the IRS. The algorithm first extracts potential respiratory signals from low-frequency components in the Fourier space and selected anatomical features in the image space. A clustering algorithm then constructs groups of potential respiratory signals with similar temporal oscillation patterns. The clustered group with the largest number of similar signals is chosen to form the final IRS. To evaluate the performance of the proposed algorithm, the IRS was computed and compared with the external respiratory signal from the real-time position management (RPM) system on 80 patients. Results: In 72 (90%) of the 4D CT data sets tested, the IRS computed by the authors’ proposed algorithm matched with the RPM signal based on their normalized cross correlation. For these data sets with matching respiratory signals, the average difference between the end inspiration times (Δt ins ) in the IRS and RPM signal was 0.11 s, and only 2.1% of Δt ins were more than 0.5 s apart. In the eight (10%) 4D CT data sets in which the IRS and the RPM signal did not match, the average Δt ins was 0.73 s in the nonmatching couch positions, and 35.4% of them had a Δt ins greater than 0.5 s. At couch positions in which IRS did not match the RPM signal, a correlation-based metric indicated poorer matching of neighboring couch positions in the RPM-sorted images. This implied that, when IRS did not match the RPM signal, the images sorted using the IRS showed fewer artifacts than the clinical images sorted using the RPM signal. Conclusions: The authors’ proposed algorithm can generate robust IRSs that can be used for retrospective sorting of 4D CT data

  8. Internal respiratory surrogate in multislice 4D CT using a combination of Fourier transform and anatomical features

    Energy Technology Data Exchange (ETDEWEB)

    Hui, Cheukkai; Suh, Yelin [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Robertson, Daniel; Beddar, Sam, E-mail: abeddar@mdanderson.org [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 and Department of Radiation Physics, The University of Texas Graduate School of Biomedical Sciences, Houston, Texas 77030 (United States); Pan, Tinsu [Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 and Department of Imaging Physics, The University of Texas Graduate School of Biomedical Sciences, Houston, Texas 77030 (United States); Das, Prajnan; Crane, Christopher H. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States)

    2015-07-15

    Purpose: The purpose of this study was to develop a novel algorithm to create a robust internal respiratory signal (IRS) for retrospective sorting of four-dimensional (4D) computed tomography (CT) images. Methods: The proposed algorithm combines information from the Fourier transform of the CT images and from internal anatomical features to form the IRS. The algorithm first extracts potential respiratory signals from low-frequency components in the Fourier space and selected anatomical features in the image space. A clustering algorithm then constructs groups of potential respiratory signals with similar temporal oscillation patterns. The clustered group with the largest number of similar signals is chosen to form the final IRS. To evaluate the performance of the proposed algorithm, the IRS was computed and compared with the external respiratory signal from the real-time position management (RPM) system on 80 patients. Results: In 72 (90%) of the 4D CT data sets tested, the IRS computed by the authors’ proposed algorithm matched with the RPM signal based on their normalized cross correlation. For these data sets with matching respiratory signals, the average difference between the end inspiration times (Δt{sub ins}) in the IRS and RPM signal was 0.11 s, and only 2.1% of Δt{sub ins} were more than 0.5 s apart. In the eight (10%) 4D CT data sets in which the IRS and the RPM signal did not match, the average Δt{sub ins} was 0.73 s in the nonmatching couch positions, and 35.4% of them had a Δt{sub ins} greater than 0.5 s. At couch positions in which IRS did not match the RPM signal, a correlation-based metric indicated poorer matching of neighboring couch positions in the RPM-sorted images. This implied that, when IRS did not match the RPM signal, the images sorted using the IRS showed fewer artifacts than the clinical images sorted using the RPM signal. Conclusions: The authors’ proposed algorithm can generate robust IRSs that can be used for retrospective

  9. CT findings of transfusional hemosiderosis in patients with chronic renal failure : clinical correlation

    International Nuclear Information System (INIS)

    Park, Tae Joon; Lee, Hae Kyung; Hong, Hyun Sook; Kim, Gun Woo; Kim, Hyung Hwan; Choi, Gyo Chang; Kwon, Kui Hyang; Choi, Deuk Lin

    1997-01-01

    The purpose of this study is to evaluate whether there is any correlation between the CT features of hemosiderosis and clinical findings in patients with chronic renal failure who have received multiple blood transfusion. Among chronic renal failure patients who had undergone long-tern dialysis and received multiple blood transfusions, CT findings in 16 cases in which increased liver attenuation was seen on images obtained for other purpose, were analyzed by three radiologic specialists. The attenuation values of liver, spleen and pancreas compared with that of back muscle were correlated with the amount and duration of transfusion, and blood ferritin level. There is no correlation between the CT features of hemosiderosis and clinical findings. In patients with chronic renal failure and no clinical symptoms, the status of iron overload was relatively easily detected on CT. Close observation of CT findings is thus thought to prevent significant permanent functional deformity of organs in patients with chronic renal failure who have received multiple blood transfusions. (author). 14 refs., 1 tab., 1 fig

  10. Incidence and correlates of delirium in a West African mental health clinic

    OpenAIRE

    Ola, B.A.; Crabb, J.; Krishnadas, R.; Erinfolami, A.R.; Olagunju, A.

    2010-01-01

    Objective:\\ud \\ud \\ud To determine the incidence of delirium in those patients presenting to a psychiatric clinic in Nigeria and to examine if any demographic or clinical variables were correlated with this diagnosis.\\ud \\ud \\ud Method \\ud \\ud \\ud A prospective survey design; 264 consecutive new referrals to a psychiatric clinic in Nigeria were assessed for the presence of delirium using a standardised diagnostic scale. Data was analysed for normality and appropriate statistical test employed...

  11. Correlation between clinical fetal head station and sonographic angle of progression during the second stage of labor.

    Science.gov (United States)

    Perlman, Sharon; Kivilevitch, Zvi; Moran, Orit; Katorza, Eldad; Kees, Salim; Achiron, Reuven; Gilboa, Yinon

    2017-08-04

    To investigate the correlation between the angle of progression and the clinical fetal head station (FHS) during the second stage of labor, and to build reference range. A prospective, observational study was conducted. Women carrying singleton term pregnancies were enrolled during the second stage of labor. FHS was assessed manually by a senior obstetrician, while the angle of progression (AOP) was assessed by transperineal ultrasound (TPU). Both examiners were blinded to each others results. The correlation between the sonographic AOP and the clinical FHS was analyzed. Seventy patients comprised the study group. Clinical FHS demonstrated an excellent correlation with the sonographic measurement of AOP (Pearson's Correlation 0.642, p correlation was best described by a cubic regression according to the formula: 123.800 + 10.290 × FHS -2.889 * FHS +0.910, (r 2  = 0.423, p correlation between the clinical FHS and the TPU measured AOP. These standardized sonographic values may serve the obstetrician as a reliable, objective auxiliary tool for the evaluation of the FHS during the second stage of labor.

  12. Clinical experience does not correlate with the perceived need for cardiopulmonary resuscitation training.

    Science.gov (United States)

    Lunz, Dirk; Brandl, Anita; Lang, Klaus; Weiss, Berthold; Haneya, Assad; Pühler, Thomas; Graf, Bernhard M; Zausig, York A

    2013-02-01

    The efficiency of cardiopulmonary resuscitation (CPR) training is dependent upon different influencing factors, such as the presented concepts, the participants' willingness to learn, and the interval between training sessions. However, the optimal interval for refreshing CPR training is less clear. We evaluated the perceived need of simulator-based CPR training for nurses and correlated it with their clinical experience. The 60 invited nurses were trained in simulator-based CPR. Knowledge about adult advanced life support was evaluated using a questionnaire after training, and participants rated their desired individual frequency of simulator-based training as well as the value of the presented training using a six-point Likert scale. The same questions were asked again after 1 year. All participants agreed about the usefulness of this type of simulator-based training. The average number of correct answers about typical facts in adult advanced life support showed an almost bell-shaped distribution, with the highest point at 6-15 years of clinical experience and the lowest points at≤5 and≥21 years. The desired training-frequency need was inversely correlated with clinical experience. There is a high interest in CPR training among nursing staff. Self-assessment about the training-frequency need was inversely correlated with clinical experience. However, the average number of correct answers on resuscitation questions decreased with clinical experience. Therefore, the training effectiveness seems to be extremely dependent on clinical experience, and therefore, training experienced senior nurses might be more challenging than training novice nurses. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Quantifying agreement between anatomical and functional interhemispheric correspondences in the resting brain.

    Directory of Open Access Journals (Sweden)

    Hang Joon Jo

    Full Text Available The human brain is composed of two broadly symmetric cerebral hemispheres, with an abundance of reciprocal anatomical connections between homotopic locations. However, to date, studies of hemispheric symmetries have not identified correspondency precisely due to variable cortical folding patterns. Here we present a method to establish accurate correspondency using position on the unfolded cortical surface relative to gyral and sulcal landmarks. The landmark method is shown to outperform the method of reversing standard volume coordinates, and it is used to quantify the functional symmetry in resting fMRI data throughout the cortex. Resting brain activity was found to be maximally correlated with locations less than 1 cm away on the cortical surface from the corresponding anatomical location in nearly half of the cortex. While select locations exhibited asymmetric patterns, precise symmetric relationships were found to be the norm, with fine-grained symmetric functional maps demonstrated in motor, occipital, and inferior frontal cortex.

  14. Anterior joint capsule of the normal hip and in children with transient synovitis: US study with anatomic and histologic correlation

    NARCIS (Netherlands)

    S.G.F. Robben (Simon); M.H. Lequin (Maarten); A.F.M. Diepstraten (Ad); J.C. den Hollander (Jan); C.A. Entius; M. Meradji

    1999-01-01

    textabstractPURPOSE: To study the anatomic components of the anterior joint capsule of the normal hip and in children with transient synovitis. MATERIALS AND METHODS: Six cadaveric specimens were imaged with ultrasonography (US) with special attention to the anterior

  15. Defining the spatial relationships between eight anatomic planes in the 11+6 to 13+6 weeks fetus: a pilot study.

    Science.gov (United States)

    Abu-Rustum, Reem S; Ziade, M Fouad; Abu-Rustum, Sameer E

    2012-09-01

    Our study aims at investigating the spatial relationships between eight anatomic planes in the 11+6 to 13+6 weeks fetus. This is a retrospective pilot study where three-dimensional and four-dimensional stored data sets were manipulated to retrieve eight anatomic planes starting from the midsagittal plane of the fetus. Standardization of volumes was performed at the level of the transverse abdominal circumference plane. Parallel shift was utilized and the spatial relationships between eight anatomic planes were established. The median and the range were calculated for each of the planes, and they were evaluated as a function of the fetal crown-rump length. P planes were found to adhere to normal distribution curves, and most of the planes were in a definable relationship to each other with statistically significant correlations. To our knowledge, this is the first study to describe the possible spatial relationships between eight two-dimensional anatomic planes in the 11+6 to 13+6 weeks fetus, utilizing a standardized approach. Defining these spatial relationships may serve as the first step for the potential future development of automation software for fetal anatomic assessment at 11+6 to 13+6 weeks. © 2012 John Wiley & Sons, Ltd.

  16. Anatomical location differences between mutated and wild-type isocitrate dehydrogenase 1 in low-grade gliomas.

    Science.gov (United States)

    Yu, Jinhua; Shi, Zhifeng; Ji, Chunhong; Lian, Yuxi; Wang, Yuanyuan; Chen, Liang; Mao, Ying

    2017-10-01

    Anatomical location of gliomas has been considered as a factor implicating the contributions of a specific precursor cells during the tumor growth. Isocitrate dehydrogenase 1 (IDH1) is a pathognomonic biomarker with a significant impact on the development of gliomas and remarkable prognostic effect. The correlation between anatomical location of tumor and IDH1 states for low-grade gliomas was analyzed quantitatively in this study. Ninety-two patients diagnosed of low-grade glioma pathologically were recruited in this study, including 65 patients with IDH1-mutated glioma and 27 patients with wide-type IDH1. A convolutional neural network was designed to segment the tumor from three-dimensional magnetic resonance imaging images. Voxel-based lesion symptom mapping was then employed to study the tumor location distribution differences between gliomas with mutated and wild-type IDH1. In order to characterize the location differences quantitatively, the Automated Anatomical Labeling Atlas was used to partition the standard brain atlas into 116 anatomical volumes of interests (AVOIs). The percentages of tumors with different IDH1 states in 116 AVOIs were calculated and compared. Support vector machine and AdaBoost algorithms were used to estimate the IDH1 status based on the 116 location features of each patient. Experimental results proved that the quantitative tumor location measurement could be a very important group of imaging features in biomarker estimation based on radiomics analysis of glioma.

  17. Neurocysticercosis: Correlative pathomorphology and MR imaging

    International Nuclear Information System (INIS)

    Lotz, J.; Hewlett, R.; Alheit, B.; Tygerberg Hospital, Stellenbosch; Bowen, R.

    1988-01-01

    CT and MR images of 32 patients with neurocysticercosis were correlated with pathomorphology. Gross morphological features of cystic larvae, complex arachnoid cysts, granulomatous abscesses, basal meningitis and mineralised nodules correlated closely with the images obtained, especially on MR, where resolution permitted visualisation of larval protoscolices. Our material indicates three forms of the natural history of neurocysticercosis related chiefly to anatomic location, and provides details of the evolution of large, complex arachnoid cysts. (orig.)

  18. Neurocysticercosis: Correlative pathomorphology and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lotz, J.; Hewlett, R.; Alheit, B.; Bowen, R.

    1988-02-01

    CT and MR images of 32 patients with neurocysticercosis were correlated with pathomorphology. Gross morphological features of cystic larvae, complex arachnoid cysts, granulomatous abscesses, basal meningitis and mineralised nodules correlated closely with the images obtained, especially on MR, where resolution permitted visualisation of larval protoscolices. Our material indicates three forms of the natural history of neurocysticercosis related chiefly to anatomic location, and provides details of the evolution of large, complex arachnoid cysts.

  19. Correlation between spinal cord MRI and clinical features in patients with demyelinating disease

    International Nuclear Information System (INIS)

    Papadopoulos, A.; Gatzonis, S.; Gouliamos, A.; Trakadas, S.; Kalovidouris, A.; Sgouropoulos, P.; Vlachos, L.; Papavasiliou, C.

    1994-01-01

    Localisation of spinal cord lesions by MRI was correlated with neurological symptoms and signs in 16 patients with clinical and laboratory evidence of multiple sclerosis. There was good correspondence between spinal cord lesions and motor tract signs. On the other hand, superficial or deep sensory disturbances correlated with spinal cord lesions in only about a quarter of the patients. MRI of the spinal cord appeared to explain the myelopathy in 11 patients, while in 3 there was strong clinical evidence of more extensive demyelinating lesions. In 7 of the 16 patients MRI of the brain was normal. (orig.)

  20. Anatomical Basis for the Cardiac Interventional Electrophysiologist

    Directory of Open Access Journals (Sweden)

    Damián Sánchez-Quintana

    2015-01-01

    Full Text Available The establishment of radiofrequency catheter ablation techniques as the mainstay in the treatment of tachycardia has renewed new interest in cardiac anatomy. The interventional arrhythmologist has drawn attention not only to the gross anatomic details of the heart but also to architectural and histological characteristics of various cardiac regions that are relevant to the development or recurrence of tachyarrhythmias and procedural related complications of catheter ablation. In this review, therefore, we discuss some anatomic landmarks commonly used in catheter ablations including the terminal crest, sinus node region, Koch’s triangle, cavotricuspid isthmus, Eustachian ridge and valve, pulmonary venous orifices, venoatrial junctions, and ventricular outflow tracts. We also discuss the anatomical features of important structures in the vicinity of the atria and pulmonary veins, such as the esophagus and phrenic nerves. This paper provides basic anatomic information to improve understanding of the mapping and ablative procedures for cardiac interventional electrophysiologists.

  1. Normal feline brain: clinical anatomy using magnetic resonance imaging.

    Science.gov (United States)

    Mogicato, G; Conchou, F; Layssol-Lamour, C; Raharison, F; Sautet, J

    2012-04-01

    The purpose of this study was to provide a clinical anatomy atlas of the feline brain using magnetic resonance imaging (MRI). Brains of twelve normal cats were imaged using a 1.5 T magnetic resonance unit and an inversion/recovery sequence (T1). Fourteen relevant MRI sections were chosen in transverse, dorsal, median and sagittal planes. Anatomic structures were identified and labelled using anatomical texts and Nomina Anatomica Veterinaria, sectioned specimen heads, and previously published articles. The MRI sections were stained according to the major embryological and anatomical subdivisions of the brain. The relevant anatomical structures seen on MRI will assist clinicians to better understand MR images and to relate this neuro-anatomy to clinical signs. © 2011 Blackwell Verlag GmbH.

  2. Anatomical background and generalized detectability in tomosynthesis and cone-beam CT

    International Nuclear Information System (INIS)

    Gang, G. J.; Tward, D. J.; Lee, J.; Siewerdsen, J. H.

    2010-01-01

    Purpose: Anatomical background presents a major impediment to detectability in 2D radiography as well as 3D tomosynthesis and cone-beam CT (CBCT). This article incorporates theoretical and experimental analysis of anatomical background ''noise'' in cascaded systems analysis of 2D and 3D imaging performance to yield ''generalized'' metrics of noise-equivalent quanta (NEQ) and detectability index as a function of the orbital extent of the (circular arc) source-detector orbit. Methods: A physical phantom was designed based on principles of fractal self-similarity to exhibit power-law spectral density (κ/f β ) comparable to various anatomical sites (e.g., breast and lung). Background power spectra [S B (f)] were computed as a function of source-detector orbital extent, including tomosynthesis (∼10 deg. - 180 deg.) and CBCT (180 deg. +fan to 360 deg.) under two acquisition schemes: (1) Constant angular separation between projections (variable dose) and (2) constant total number of projections (constant dose). The resulting S B was incorporated in the generalized NEQ, and detectability index was computed from 3D cascaded systems analysis for a variety of imaging tasks. Results: The phantom yielded power-law spectra within the expected spatial frequency range, quantifying the dependence of clutter magnitude (κ) and correlation (β) with increasing tomosynthesis angle. Incorporation of S B in the 3D NEQ provided a useful framework for analyzing the tradeoffs among anatomical, quantum, and electronic noise with dose and orbital extent. Distinct implications are posed for breast and chest tomosynthesis imaging system design--applications varying significantly in κ and β, and imaging task and, therefore, in optimal selection of orbital extent, number of projections, and dose. For example, low-frequency tasks (e.g., soft-tissue masses or nodules) tend to benefit from larger orbital extent and more fully 3D tomographic imaging, whereas high-frequency tasks (e

  3. Broad Anatomical Variation within a Narrow Wood Density Range--A Study of Twig Wood across 69 Australian Angiosperms.

    Directory of Open Access Journals (Sweden)

    Kasia Ziemińska

    Full Text Available Just as people with the same weight can have different body builds, woods with the same wood density can have different anatomies. Here, our aim was to assess the magnitude of anatomical variation within a restricted range of wood density and explore its potential ecological implications.Twig wood of 69 angiosperm tree and shrub species was analyzed. Species were selected so that wood density varied within a relatively narrow range (0.38-0.62 g cm-3. Anatomical traits quantified included wood tissue fractions (fibres, axial parenchyma, ray parenchyma, vessels, and conduits with maximum lumen diameter below 15 μm, vessel properties, and pith area. To search for potential ecological correlates of anatomical variation the species were sampled across rainfall and temperature contrasts, and several other ecologically-relevant traits were measured (plant height, leaf area to sapwood area ratio, and modulus of elasticity.Despite the limited range in wood density, substantial anatomical variation was observed. Total parenchyma fraction varied from 0.12 to 0.66 and fibre fraction from 0.20 to 0.74, and these two traits were strongly inversely correlated (r = -0.86, P < 0.001. Parenchyma was weakly (0.24 ≤|r|≤ 0.35, P < 0.05 or not associated with vessel properties nor with height, leaf area to sapwood area ratio, and modulus of elasticity (0.24 ≤|r|≤ 0.41, P < 0.05. However, vessel traits were fairly well correlated with height and leaf area to sapwood area ratio (0.47 ≤|r|≤ 0.65, all P < 0.001. Modulus of elasticity was mainly driven by fibre wall plus vessel wall fraction rather than by the parenchyma component.Overall, there seem to be at least three axes of variation in xylem, substantially independent of each other: a wood density spectrum, a fibre-parenchyma spectrum, and a vessel area spectrum. The fibre-parenchyma spectrum does not yet have any clear or convincing ecological interpretation.

  4. Correlations of theory of mind deficits with clinical patterns and quality of life in schizophrenia

    Directory of Open Access Journals (Sweden)

    Mathieu eUrbach

    2013-05-01

    Full Text Available Background: Numerous studies have demonstrated the existence of theory of mind (ToM impairments in patients with schizophrenia. The clinical consequences of these impairments are currently under debate. Accumulated evidence suggests that ToM deficits are linked to negative and disorganization symptoms, but direct correlations are lacking. Moreover, it is unclear whether ToM deficits are related to reduced quality of life (QoL. Methods: To extend the understanding of objective (i.e., clinical symptoms and subjective (QoL correlates of impaired ToM, we assessed 206 patients with schizophrenia based on performance of an ecological task (Versailles-Situational Intention Reading, V-SIR, a Communication Disorders Scale (SCD, the Positive and Negative Syndrome Scale (PANSS, the Clinical Global Impression rating, and a QoL questionnaire (S-QoL. Statistical inferences were drawn from correlations analyses considering both factors/subscales aggregates and single items.Results: ToM performance was negatively correlated to disorganization and negative PANSS factors. Poor V-SIR performance was correlated with conceptual disorganization, difficulties in abstract thinking and apathy/social withdrawal. The SCD was correlated with negative, disorganization, and anxiety/depression PANSS factors. The S-QoL total score was not significantly correlated with ToM performance. Only the item difficulties in expressing feelings was significantly correlated with poorer V-SIR performance. Conclusions: We discuss the intriguing paucity of the results and what they reveal about the difficulties faced by psychiatrists with patients not expressing complaints about lack of social skills.

  5. Non tumoral intracranial expansive processes: clinical tomographic correlation

    International Nuclear Information System (INIS)

    Campos, P.; Herrera, G.; Valneica, F.

    1991-01-01

    Presentation of clinical-tomographic correlation in 111 cases of non tumoral intracranial expansive processes seen between 1984-1988 in the Hospital Cayetano Heredia (Lima, Peru). Emphasis is given fundamentally to: the importance of establishing the organicity of partial and late epilepsy; the high incidence rate of inflammatory infectious processes with CNS compromise in under developing countries; the necessity of making public the importance of two parasitic diseases in the differential diagnosis of non tumoral intracranial expansive processes: free living amebiasis, and toxoplasmosis (especially in association with AIDS). (author)

  6. Normal or abnormal?, That is the question. Anatomical Osteomuscular Variants in Pediatric Radiology

    International Nuclear Information System (INIS)

    Ferreira, Hugo H; Garcia, Carlos A

    2009-01-01

    The objective is to describe some normal radiological variants that can cause diagnostic errors being interpreted as abnormal. Method: Its present some radiologic cases from San Ignacio Hospital and Reina Sofia Clinic of some patients with different clinical scenarios, in whom a simple radiograph was obtained. The radiologic findings are described. Results: Radiologic findings observed in these patients are normal anatomic variants, there were confirmed by a literature review. Conclusion: There are innumerable radiologic variants in the human body anatomy. It is important to know them, in order to prevent diagnostic errors and unnecessary studies.

  7. Incorporating Topic Assignment Constraint and Topic Correlation Limitation into Clinical Goal Discovering for Clinical Pathway Mining

    Directory of Open Access Journals (Sweden)

    Xiao Xu

    2017-01-01

    Full Text Available Clinical pathways are widely used around the world for providing quality medical treatment and controlling healthcare cost. However, the expert-designed clinical pathways can hardly deal with the variances among hospitals and patients. It calls for more dynamic and adaptive process, which is derived from various clinical data. Topic-based clinical pathway mining is an effective approach to discover a concise process model. Through this approach, the latent topics found by latent Dirichlet allocation (LDA represent the clinical goals. And process mining methods are used to extract the temporal relations between these topics. However, the topic quality is usually not desirable due to the low performance of the LDA in clinical data. In this paper, we incorporate topic assignment constraint and topic correlation limitation into the LDA to enhance the ability of discovering high-quality topics. Two real-world datasets are used to evaluate the proposed method. The results show that the topics discovered by our method are with higher coherence, informativeness, and coverage than the original LDA. These quality topics are suitable to represent the clinical goals. Also, we illustrate that our method is effective in generating a comprehensive topic-based clinical pathway model.

  8. TH-E-17A-06: Anatomical-Adaptive Compressed Sensing (AACS) Reconstruction for Thoracic 4-Dimensional Cone-Beam CT

    International Nuclear Information System (INIS)

    Shieh, C; Kipritidis, J; OBrien, R; Cooper, B; Kuncic, Z; Keall, P

    2014-01-01

    Purpose: The Feldkamp-Davis-Kress (FDK) algorithm currently used for clinical thoracic 4-dimensional (4D) cone-beam CT (CBCT) reconstruction suffers from noise and streaking artifacts due to projection under-sampling. Compressed sensing theory enables reconstruction of under-sampled datasets via total-variation (TV) minimization, but TV-minimization algorithms such as adaptive-steepest-descent-projection-onto-convex-sets (ASD-POCS) often converge slowly and are prone to over-smoothing anatomical details. These disadvantages can be overcome by incorporating general anatomical knowledge via anatomy segmentation. Based on this concept, we have developed an anatomical-adaptive compressed sensing (AACS) algorithm for thoracic 4D-CBCT reconstruction. Methods: AACS is based on the ASD-POCS framework, where each iteration consists of a TV-minimization step and a data fidelity constraint step. Prior to every AACS iteration, four major thoracic anatomical structures - soft tissue, lungs, bony anatomy, and pulmonary details - were segmented from the updated solution image. Based on the segmentation, an anatomical-adaptive weighting was applied to the TV-minimization step, so that TV-minimization was enhanced at noisy/streaky regions and suppressed at anatomical structures of interest. The image quality and convergence speed of AACS was compared to conventional ASD-POCS using an XCAT digital phantom and a patient scan. Results: For the XCAT phantom, the AACS image represented the ground truth better than the ASD-POCS image, giving a higher structural similarity index (0.93 vs. 0.84) and lower absolute difference (1.1*10 4 vs. 1.4*10 4 ). For the patient case, while both algorithms resulted in much less noise and streaking than FDK, the AACS image showed considerably better contrast and sharpness of the vessels, tumor, and fiducial marker than the ASD-POCS image. In addition, AACS converged over 50% faster than ASD-POCS in both cases. Conclusions: The proposed AACS algorithm

  9. TH-E-17A-06: Anatomical-Adaptive Compressed Sensing (AACS) Reconstruction for Thoracic 4-Dimensional Cone-Beam CT

    Energy Technology Data Exchange (ETDEWEB)

    Shieh, C; Kipritidis, J; OBrien, R; Cooper, B; Kuncic, Z; Keall, P [The University of Sydney, Sydney, New South Wales (Australia)

    2014-06-15

    Purpose: The Feldkamp-Davis-Kress (FDK) algorithm currently used for clinical thoracic 4-dimensional (4D) cone-beam CT (CBCT) reconstruction suffers from noise and streaking artifacts due to projection under-sampling. Compressed sensing theory enables reconstruction of under-sampled datasets via total-variation (TV) minimization, but TV-minimization algorithms such as adaptive-steepest-descent-projection-onto-convex-sets (ASD-POCS) often converge slowly and are prone to over-smoothing anatomical details. These disadvantages can be overcome by incorporating general anatomical knowledge via anatomy segmentation. Based on this concept, we have developed an anatomical-adaptive compressed sensing (AACS) algorithm for thoracic 4D-CBCT reconstruction. Methods: AACS is based on the ASD-POCS framework, where each iteration consists of a TV-minimization step and a data fidelity constraint step. Prior to every AACS iteration, four major thoracic anatomical structures - soft tissue, lungs, bony anatomy, and pulmonary details - were segmented from the updated solution image. Based on the segmentation, an anatomical-adaptive weighting was applied to the TV-minimization step, so that TV-minimization was enhanced at noisy/streaky regions and suppressed at anatomical structures of interest. The image quality and convergence speed of AACS was compared to conventional ASD-POCS using an XCAT digital phantom and a patient scan. Results: For the XCAT phantom, the AACS image represented the ground truth better than the ASD-POCS image, giving a higher structural similarity index (0.93 vs. 0.84) and lower absolute difference (1.1*10{sup 4} vs. 1.4*10{sup 4}). For the patient case, while both algorithms resulted in much less noise and streaking than FDK, the AACS image showed considerably better contrast and sharpness of the vessels, tumor, and fiducial marker than the ASD-POCS image. In addition, AACS converged over 50% faster than ASD-POCS in both cases. Conclusions: The proposed AACS

  10. Clinical applications of SPECT-CT

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadzadehfar, Hojjat; Biersack, Hans-Juergen (eds.) [University Hospital Bonn (Germany). Dept. of Nuclear Medicine

    2014-06-01

    Covers the full spectrum of clinical applications of SPECT/CT in diagnosis of benign and malignant diseases. Includes chapters on the use of SPECT/CT for dosimetry and for therapy planning. Completely up to date. Many helpful illustrations. SPECT/CT cameras have considerably improved diagnostic accuracy in recent years. Such cameras allow direct correlation of anatomic and functional information, resulting in better localization and definition of scintigraphic findings. In addition to this anatomic referencing, CT coregistration provides superior quantification of radiotracer uptake based on the attenuation correction capabilities of CT. Useful applications of SPECT/CT have been identified not only in oncology but also in other specialties such as orthopedics and cardiology. This book covers the full spectrum of clinical applications of SPECT/CT in diagnosis and therapy planning of benign and malignant diseases. Opening chapters discuss the technology and physics of SPECT/CT and its use for dosimetry. The role of SPECT/CT in the imaging of a range of pathologic conditions is then addressed in detail. Applications covered include, among others, imaging of the thyroid, bone, and lungs, imaging of neuroendocrine tumors, cardiac scintigraphy, and sentinel node scintigraphy. Individual chapters are also devoted to therapy planning in selective internal radiation therapy of liver tumors and bremsstrahlung SPECT/CT. Readers will find this book to be an essential and up-to-date source of information on this invaluable hybrid imaging technique.

  11. Injury patterns of medial patellofemoral ligament after acute lateral patellar dislocation in children: Correlation analysis with anatomical variants and articular cartilage lesion of the patella

    International Nuclear Information System (INIS)

    Zhang, Guang-ying; Ding, Hong-yu; Zheng, Lei; Ji, Bing-jun; Shi, Hao; Feng, Yan

    2017-01-01

    To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. (orig.)

  12. Injury patterns of medial patellofemoral ligament after acute lateral patellar dislocation in children: Correlation analysis with anatomical variants and articular cartilage lesion of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Guang-ying; Ding, Hong-yu [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Ultrasonography, Jinan (China); Zheng, Lei; Ji, Bing-jun [Shandong Provincial Corps Hospital of Chinese People' s Armed Police Force, Department of Radiology, Jinan (China); Shi, Hao [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Radiology, Jinan (China); Feng, Yan [Affiliated Hospital of Binzhou Medical College, Department of Radiology, Binzhou (China)

    2017-03-15

    To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. (orig.)

  13. Anatomical and palynological characteristics of Salvia willeana ...

    African Journals Online (AJOL)

    In this study, anatomical and palynological features of the roots, stems, petiole and leaves of Salvia willeana (Holmboe) Hedge and Salvia veneris Hedge, Salvia species endemic to Cyprus, were investigated. In the anatomical characteristics of stem structures, it was found that the chlorenchyma composed of 6 or 7 rows of ...

  14. Transfusional hemosiderosis; correlation of MR findings with clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mi Ok; Kim, Ju Heon; Jeon, Woo Jin; Lee, Sung Moon; Kim, Hong; Suh, Soo Jhi [School of Medicine, Keimyung University, Taegu (Korea, Republic of)

    1994-08-15

    Parenchymal iron deposition occurs in hemochromatosis, while iron is deposited in reticuloendothelial cells after blood transfusions(Hemosiderosis). We studied correlation between MR finding and clinical findings(serum ferritin, TSI, LFT, disease duration) of hemosiderosis. 12 patients with chronic renal failure and one patient with aplastic anemia, who have received multiple transfusion, were performed MRI with a 2.0 Tesla unit. In all of 13 patients(17 cases), the liver revealed low signal intensity equal to background noise. In 4 of 17 cases whose serum ferritin level was below 1000 ng/ml, pancreas, gastric wall, adrenal gland were involved in 1 case. In 4 cases with serum ferritin level between 1000 and 1500, pancreas was involved in 2 cases, and other organ was involved in 1 case. In 9 cases with serum ferritin level above 1500ng/ml, pancreas was involved in 9 cases, and other origin 4 cases. The MR findings are well correlated with serum ferritin level whereas the TSI, LFT, disease duration are not correlated with involved organ on MR.

  15. Correlation of clinical predictions and surgical results in maxillary superior repositioning.

    Science.gov (United States)

    Tabrizi, Reza; Zamiri, Barbad; Kazemi, Hamidreza

    2014-05-01

    This is a prospective study to evaluate the accuracy of clinical predictions related to surgical results in subjects who underwent maxillary superior repositioning without anterior-posterior movement. Surgeons' predictions according to clinical (tooth show at rest and at the maximum smile) and cephalometric evaluation were documented for the amount of maxillary superior repositioning. Overcorrection or undercorrection was documented for every subject 1 year after the operations. Receiver operating characteristic curve test was used to find a cutoff point in prediction errors and to determine positive predictive value (PPV) and negative predictive value. Forty subjects (14 males and 26 females) were studied. Results showed a significant difference between changes in the tooth show at rest and at the maximum smile line before and after surgery. Analysis of the data demonstrated no correlation between the predictive data and the surgical results. The incidence of undercorrection (25%) was more common than overcorrection (7.5%). The cutoff point for errors in predictions was 5 mm for tooth show at rest and 15 mm at the maximum smile. When the amount of the presurgical tooth show at rest was more than 5 mm, 50.5% of clinical predictions did not match the clinical results (PPV), and 75% of clinical predictions showed the same results when the tooth show was less than 5 mm (negative predictive value). When the amount of presurgical tooth shown in the maximum smile line was more than 15 mm, 75% of clinical predictions did not match with clinical results (PPV), and 25% of the predictions had the same results because the tooth show at the maximum smile was lower than 15 mm. Clinical predictions according to the tooth show at rest and at the maximum smile have a poor correlation with clinical results in maxillary superior repositioning for vertical maxillary excess. The risk of errors in predictions increased when the amount of superior repositioning of the maxilla increased

  16. An anatomic transcriptional atlas of human glioblastoma.

    Science.gov (United States)

    Puchalski, Ralph B; Shah, Nameeta; Miller, Jeremy; Dalley, Rachel; Nomura, Steve R; Yoon, Jae-Guen; Smith, Kimberly A; Lankerovich, Michael; Bertagnolli, Darren; Bickley, Kris; Boe, Andrew F; Brouner, Krissy; Butler, Stephanie; Caldejon, Shiella; Chapin, Mike; Datta, Suvro; Dee, Nick; Desta, Tsega; Dolbeare, Tim; Dotson, Nadezhda; Ebbert, Amanda; Feng, David; Feng, Xu; Fisher, Michael; Gee, Garrett; Goldy, Jeff; Gourley, Lindsey; Gregor, Benjamin W; Gu, Guangyu; Hejazinia, Nika; Hohmann, John; Hothi, Parvinder; Howard, Robert; Joines, Kevin; Kriedberg, Ali; Kuan, Leonard; Lau, Chris; Lee, Felix; Lee, Hwahyung; Lemon, Tracy; Long, Fuhui; Mastan, Naveed; Mott, Erika; Murthy, Chantal; Ngo, Kiet; Olson, Eric; Reding, Melissa; Riley, Zack; Rosen, David; Sandman, David; Shapovalova, Nadiya; Slaughterbeck, Clifford R; Sodt, Andrew; Stockdale, Graham; Szafer, Aaron; Wakeman, Wayne; Wohnoutka, Paul E; White, Steven J; Marsh, Don; Rostomily, Robert C; Ng, Lydia; Dang, Chinh; Jones, Allan; Keogh, Bart; Gittleman, Haley R; Barnholtz-Sloan, Jill S; Cimino, Patrick J; Uppin, Megha S; Keene, C Dirk; Farrokhi, Farrokh R; Lathia, Justin D; Berens, Michael E; Iavarone, Antonio; Bernard, Amy; Lein, Ed; Phillips, John W; Rostad, Steven W; Cobbs, Charles; Hawrylycz, Michael J; Foltz, Greg D

    2018-05-11

    Glioblastoma is an aggressive brain tumor that carries a poor prognosis. The tumor's molecular and cellular landscapes are complex, and their relationships to histologic features routinely used for diagnosis are unclear. We present the Ivy Glioblastoma Atlas, an anatomically based transcriptional atlas of human glioblastoma that aligns individual histologic features with genomic alterations and gene expression patterns, thus assigning molecular information to the most important morphologic hallmarks of the tumor. The atlas and its clinical and genomic database are freely accessible online data resources that will serve as a valuable platform for future investigations of glioblastoma pathogenesis, diagnosis, and treatment. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

  17. Enhancement of anatomical learning and developing clinical competence of first-year medical and allied health profession students.

    Science.gov (United States)

    Keim Janssen, Sarah A; VanderMeulen, Stephane P; Shostrom, Valerie K; Lomneth, Carol S

    2014-01-01

    Hands-on educational experiences can stimulate student interest, increase knowledge retention, and enhance development of clinical skills. The Lachman test, used to assess the integrity of the anterior cruciate ligament (ACL), is commonly performed by health care professionals and is relatively easy to teach to first-year health profession students. This study integrated teaching the Lachman test into a first-year anatomy laboratory and examined if students receiving the training would be more confident, competent, and if the training would enhance anatomical learning. First-year medical, physician assistant and physical therapy students were randomly assigned into either the intervention (Group A) or control group (Group B). Both groups received the course lecture on knee anatomy and training on how to perform the Lachman test during a surface anatomy class. Group A received an additional 15 minutes hands-on training for the Lachman test utilizing a lightly embalmed cadaver as a simulated patient. One week later, both groups performed the Lachman test on a lightly embalmed cadaver and later completed a post-test and survey. Students with hands-on training performed significantly better than students with lecture-only training in completing the checklist, a post-test, and correctly diagnosing an ACL tear. Students in Group A also reported being more confident after hands-on training compared to students receiving lecture-only training. Both groups reported that incorporating clinical skill activities facilitated learning and created excitement for learning. Hands-on training using lightly embalmed cadavers as patient simulators increased confidence and competence in performing the Lachman test and aided in learning anatomy. © 2013 American Association of Anatomists.

  18. [Morphogenetic processes and seasonal changes in the anatomic and histological organization of the Barents Sea sponge Halichondria panicea (Pallas)].

    Science.gov (United States)

    Ivanova, L V

    1978-10-01

    As a result of histological investigations of seasonal dynamics in the anatomical-tissue organization of the litoral sponge Halichondria panicea (Pallas), morphogenetical processes during different periods of its life cycle are described in detail. Correlations between different phases of sexual reproduction and conditions of anatomical and tissue organization in the maternal organism are stated. It is noted that tissue reduction of the definitive sponge Halichondria panicea during autumn--winter season is a natural phenomenon, regularly repeating in the life of the litoral sponge investigated, as a result of the maternal organism's "exhaustion" in the period of sexual embryogenesis.

  19. Correlation between the reason for referral, clinical, and objective assessment of the risk for dysphagia.

    Science.gov (United States)

    Mancopes, Renata; Gonçalves, Bruna Franciele da Trindade; Costa, Cintia Conceição; Favero, Talita Cristina; Drozdz, Daniela Rejane Constantino; Bilheri, Diego Fernando Dorneles; Schumacher, Stéfani Fernanda

    2014-01-01

    To correlate the reason for referral to speech therapy service at a university hospital with the results of clinical and objective assessment of risk for dysphagia. This is a cross-sectional, observational, retrospective analytical and quantitative study. The data were gathered from the database, and the information used was the reason for referral to speech therapy service, results of clinical assessment of the risk for dysphagia, and also from swallowing videofluoroscopy. There was a mean difference between the variables of the reason for the referral, results of the clinical and objective swallowing assessments, and scale of penetration/aspiration, although the values were not statistically significant. Statistically significant correlation was observed between clinical and objective assessments and the penetration scale, with the largest occurring between the results of objective assessment and penetration scale. There was a correlation between clinical and objective assessments of swallowing and mean difference between the variables of the reason for the referral with their respective assessment. This shows the importance of the association between the data of patient's history and results of clinical evaluation and complementary tests, such as videofluoroscopy, for correct identification of the swallowing disorders, being important to combine the use of severity scales of penetration/aspiration for diagnosis.

  20. Vaginismus and its correlates in an Iranian clinical sample.

    Science.gov (United States)

    Farnam, F; Janghorbani, M; Merghati-Khoei, E; Raisi, F

    2014-01-01

    Although vaginismus is a relatively common female sexual dysfunction in Iran, there are scant studies reporting on its clinical and social features. The aim of the present study was to compare the social and clinical characteristics of women with vaginismus with those of healthy women. The study comprises 22 patients with vaginismus and 22 healthy controls who presented to the health clinics of Tehran University of Medical Sciences, Iran. We used three assessment tools: interview, a (34-item) questionnaire for demographic and clinical characteristics of vaginismus and a 13-item questionnaire of Female Sexual Distress Scale-Revised (FSDS-R) for sexual distress. The majority (73%) of women with vaginismus had primary vaginismus (unconsummated marriage). These women demonstrated significant higher phobia than healthy women, including fear of genital pain and penetration, fear of bleeding during intercourse, height phobia, aversion to looking or touching the genitalia, fear of vaginal disproportion and also disgust of semen. Compared with the healthy women, these women displayed a significantly higher sexual distress score, defecation or urination problems, general anxiety, higher education levels and lower self-esteem. Our findings suggest that there is a strong correlation between vaginismus, phobia and anxiety.

  1. Clinical Correlations With Lewy Body Pathology in LRRK2-Related Parkinson Disease

    Science.gov (United States)

    Kalia, Lorraine V.; Lang, Anthony E.; Hazrati, Lili-Naz; Fujioka, Shinsuke; Wszolek, Zbigniew K.; Dickson, Dennis W.; Ross, Owen A.; Van Deerlin, Vivianna M.; Trojanowski, John Q.; Hurtig, Howard I.; Alcalay, Roy N.; Marder, Karen S.; Clark, Lorraine N.; Gaig, Carles; Tolosa, Eduardo; Ruiz-Martínez, Javier; Marti-Masso, Jose F.; Ferrer, Isidre; de Munain, Adolfo López; Goldman, Samuel M.; Schüle, Birgitt; Langston, J. William; Aasly, Jan O.; Giordana, Maria T.; Bonifati, Vincenzo; Puschmann, Andreas; Canesi, Margherita; Pezzoli, Gianni; De Paula, Andre Maues; Hasegawa, Kazuko; Duyckaerts, Charles; Brice, Alexis; Stoessl, A. Jon; Marras, Connie

    2015-01-01

    IMPORTANCE Mutations in leucine-rich repeat kinase 2 (LRRK2) are the most common cause of genetic Parkinson disease (PD) known to date. The clinical features of manifesting LRRK2 mutation carriers are generally indistinguishable from those of patients with sporadic PD. However, some PD cases associated with LRRK2 mutations lack Lewy bodies (LBs), a neuropathological hallmark of PD. We investigated whether the presence or absence of LBs correlates with different clinical features in LRRK2-related PD. OBSERVATIONS We describe genetic, clinical, and neuropathological findings of 37 cases of LRRK2-related PD including 33 published and 4 unpublished cases through October 2013. Among the different mutations, the LRRK2 p.G2019S mutation was most frequently associated with LB pathology. Nonmotor features of cognitive impairment/dementia, anxiety, and orthostatic hypotension were correlated with the presence of LBs. In contrast, a primarily motor phenotype was associated with a lack of LBs. CONCLUSIONS AND RELEVANCE To our knowledge, this is the first report of clinicopathological correlations in a series of LRRK2-related PD cases. Findings from this selected group of patients with PD demonstrated that parkinsonian motor features can occur in the absence of LBs. However, LB pathology in LRRK2-related PD may be a marker for a broader parkinsonian symptom complex including cognitive impairment. PMID:25401511

  2. Ascitic microbiota composition is correlated with clinical severity in cirrhosis with portal hypertension.

    Directory of Open Access Journals (Sweden)

    Geraint B Rogers

    Full Text Available Identification of pathogenic bacteria in ascites correlates with poor clinical outcomes. Ascites samples are commonly reported culture-negative, even where frank infection is indicated. Culture-independent methods have previously reported bacterial DNA in ascites, however, whether this represents viable bacterial populations has not been determined. We report the first application of 16S rRNA gene pyrosequencing and quantitative PCR in conjunction with propidium monoazide sample treatment to characterise the viable bacterial composition of ascites. Twenty five cirrhotic patients undergoing paracentesis provided ascites. Samples were treated with propidium monoazide to exclude non-viable bacterial DNA. Total bacterial load was quantified by 16S rRNA Q-PCR with species identity and relative abundance determined by 16S rRNA gene pyrosequencing. Correlation of molecular microbiology data with clinical measures and diagnostic microbiology was performed. Viable bacterial signal was obtained in 84% of ascites samples, both by Q-PCR and pyrosequencing. Approximately 190,000 ribosomal pyrosequences were obtained, representing 236 species, including both gut and non gut-associated species. Substantial variation in the species detected was observed between patients. Statistically significant relationships were identified between the bacterial community similarity and clinical measures, including ascitic polymorphonuclear leukocyte count and Child-Pugh class. Viable bacteria are present in the ascites of a majority of patients with cirrhosis including those with no clinical signs of infection. Microbiota composition significantly correlates with clinical measures. Entry of bacteria into ascites is unlikely to be limited to translocation from the gut, raising fundamental questions about the processes that underlie the development of spontaneous bacterial peritonitis.

  3. Correlating lesion size and location to deficits after ischemic stroke: the influence of accounting for altered peri-necrotic tissue and incidental silent infarcts

    Directory of Open Access Journals (Sweden)

    Black Sandra E

    2010-01-01

    Full Text Available Abstract Background Investigators frequently quantify and evaluate the location and size of stroke lesions to help uncover cerebral anatomical correlates of deficits observed after first-ever stroke. However, it is common to discover silent infarcts such as lacunes in patients identified clinically as 'first-ever' stroke, and it is unclear if including these incidental findings may impact lesion-based investigations of brain-behaviour relationships. There is also debate concerning how to best define the boundaries of necrotic stroke lesions that blend in an ill-defined way into surrounding tissue, as it is unclear whether including this altered peri-necrotic tissue region may influence studies of brain-behaviour relationships. Therefore, for patients with clinically overt stroke, we examined whether including altered peri-necrotic tissue and incidental silent strokes influenced either lesion volume correlations with a measure of sensorimotor impairment or the anatomical localization of this impairment established using subtraction lesion analysis. Methods Chronic stroke lesions of 41 patients were manually traced from digital T1-MRI to sequentially include the: necrotic lesion core, altered peri-necrotic tissue, silent lesions in the same hemisphere as the index lesion, and silent lesions in the opposite hemisphere. Lesion volumes for each region were examined for correlation with motor impairment scores, and subtraction analysis was used to highlight anatomical lesion loci associated with this deficit. Results For subtraction lesion analysis, including peri-necrotic tissue resulted in a larger region of more frequent damage being seen in the basal ganglia. For correlational analysis, only the volume of the lesion core was significantly associated with motor impairment scores (r = -0.35, p = 0.025. In a sub-analysis of patients with small subcortical index lesions, adding silent lesions in the opposite hemisphere to the volume of the index

  4. Analysis on correlation between overall classification on color doppler ultrasound and clinical stages of atherosclerosis obliterans

    International Nuclear Information System (INIS)

    Zhang Dongmei; Liu Meihan; Shi Weidong; Chen Enqi; Li Xinying; Lin Yu

    2010-01-01

    Objective: To investigate the correlation and the clinical significance between the overall classification on color Doppler ultrasound and the clinical stages of atherosclerosis obliterans (ASO), and evaluate the extent of arterial lesions comprehensively. Methods: 125 patients of ASO, who were divided into three groups of mild, moderate and severe with Color Doppler ultrasound according to differences of occlusion, quantity, degree of stenosis and collateral number, were analyzed with clinical stages, then their associations were studied with Spearman rank analysis. Results: The clinical manifestations of ASO patients who were divided into three groups of mild, moderate and severe according to overall classification on color Doppler ultrasound were respectively gradually serious, which had positive correlations with the stages of I, II and III according to clinical stages. Spearman rank analysis showed that the correlation coefficients (rs)was 0.797 2 between two groups (P<0.01), there was good consistency between the overall classification on color Doppler ultrasound and the clinical stagesof ASO. Conclusion: The overall classification of ASO on color Doppler ultrasound has considered impact of many other factors on the clinical symptoms,such as the level of the local narrow, narrow scope, segments of occlusion and collateral arteries, which divides the lesions more objectively, shows good consistency with the clinical stages. (authors)

  5. Early fetal anatomical sonography.

    LENUS (Irish Health Repository)

    Donnelly, Jennifer C

    2012-10-01

    Over the past decade, prenatal screening and diagnosis has moved from the second into the first trimester, with aneuploidy screening becoming both feasible and effective. With vast improvements in ultrasound technology, sonologists can now image the fetus in greater detail at all gestational ages. In the hands of experienced sonographers, anatomic surveys between 11 and 14 weeks can be carried out with good visualisation rates of many structures. It is important to be familiar with the normal development of the embryo and fetus, and to be aware of the major anatomical landmarks whose absence or presence may be deemed normal or abnormal depending on the gestational age. Some structural abnormalities will nearly always be detected, some will never be and some are potentially detectable depending on a number of factors.

  6. [ADVANCES IN ANATOMICAL REPAIR OF CHRONIC LATERAL ANKLE INSTABILITY].

    Science.gov (United States)

    Zhang, Yan; Liang, Xiaojun

    2016-12-08

    To summarize the current status and progress of the treatment of chronic lateral ankle instability (CLAI). The literature about the anatomical repair of CLAI at home and abroad was reviewed and summarized. Broström and its modified operations are the most common surgical treatment of CLAI. The operations showed satisfactory clinical outcomes in the short-, medium-, and long-term follow-up and low complication rate. Suture anchor technique and arthroscopic techniques are gradually used in Broström and its modified operations with satisfactory short-term effectiveness, but long-term effectiveness needs further observation because of the limitation of the short clinical application time. Broström and its modified operations are effective, convenient, and safe to treat CLAI. Based on the researches of biomechanics and dynamic anatomy, the more personalized design of the rehabilitation program is the further research direction.

  7. Soluble CD30 correlates with clinical but not subclinical renal allograft rejection.

    Science.gov (United States)

    Hirt-Minkowski, Patricia; Roth, Michèle; Hönger, Gideon; Amico, Patrizia; Hopfer, Helmut; Schaub, Stefan

    2013-01-01

    Soluble CD30 (sCD30) has been proposed as a promising noninvasive biomarker for clinical renal allograft rejection, but its diagnostic characteristics regarding detection of subclinical rejection have not been assessed. We investigated sCD30 in 146 consecutive kidney allograft recipients under tacrolimus-mycophenolate-based immunosuppression having 250 surveillance biopsies at 3 and 6 months as well as 52 indication biopsies within the first year post-transplant. Allograft histology results were classified as (i) acute Banff score zero or interstitial infiltrates only, (ii) tubulitis t1, (iii) tubulitis t2-3 and (iv) isolated vascular compartment inflammation. sCD30 correlated well with the extent of clinical (P sCD30, histological groups were assigned to two categories: no relevant inflammation (i.e. acute Banff score zero and interstitial infiltrates only) versus all other pathologies (tubulitis t1-3 and isolated vascular compartment inflammation). For clinical allograft inflammation, AUC was 0.87 (sensitivity 89%, specificity 79%; P = 0.0006); however, for subclinical inflammation, AUC was only 0.59 (sensitivity 50%, specificity 69%; P = 0.47). In conclusion, sCD30 correlated with clinical, but not subclinical renal allograft rejection limiting its clinical utility as a noninvasive rejection screening biomarker in patients with stable allograft function receiving tacrolimus-mycophenolate-based immunosuppression. © 2012 The Authors Transplant International © 2012 European Society for Organ Transplantation.

  8. Clinical correlates of resilience factors in geriatric depression.

    Science.gov (United States)

    Laird, Kelsey T; Lavretsky, Helen; Paholpak, Pattharee; Vlasova, Roza M; Roman, Michael; St Cyr, Natalie; Siddarth, Prabha

    2018-01-16

    Traditional perspectives conceptualize resilience as a trait and depression as resulting from resilience deficiency. However, research indicates that resilience varies substantially even among adults who are clinically depressed, as well as across the lifespan of an individual. Few studies have investigated resilience in depression, and even fewer have examined resilience in depressed older adults. Three hundred thirty-seven adults ≥60 years with major depressive disorder completed the Connor-Davidson Resilience Scale (CD-RISC) and measures of mental health, quality of life (QOL), and medical comorbidity. Exploratory factor analysis was used to explore the factor structure of the CD-RISC. Correlations and general linear models were used to examine associations between resilience and other variables. The rotated component matrix indicated a four-factor model. Sorting of items by highest factor loading revealed constructs associated with (1) grit, (2) active coping self-efficacy, (3) accommodative coping self-efficacy, and (4) spirituality. Resilience was significantly correlated with increased age, lower cognitive functioning, greater cerebrovascular risk, and greater medical comorbidity. Resilience was negatively associated with mental health symptoms (depression, apathy, and anxiety) and positively associated with QOL. The final optimal model identified less depression, less apathy, greater medical comorbidity, higher QOL, and minority (non-White) race as factors that significantly explained variability in resilience. Resilience was significantly associated with a range of mental health constructs in a sample of older adults with depression. Future clinical trials and dismantling studies may help determine whether interventions targeting grit, active coping, accommodative coping, and spirituality can increase resilience and help prevent and treat depression in older adults.

  9. Is anatomic complexity associated with renal tumor growth kinetics under active surveillance?

    Science.gov (United States)

    Mehrazin, Reza; Smaldone, Marc C; Egleston, Brian; Tomaszewski, Jeffrey J; Concodora, Charles W; Ito, Timothy K; Abbosh, Philip H; Chen, David Y T; Kutikov, Alexander; Uzzo, Robert G

    2015-04-01

    Linear growth rate (LGR) is the most commonly employed trigger for definitive intervention in patients with renal masses managed with an initial period of active surveillance (AS). Using our institutional cohort, we explored the association between tumor anatomic complexity at presentation and LGR in patients managed with AS. Enhancing renal masses managed expectantly for at least 6 months were included for analysis. The association between Nephrometry Score and LGR was assessed using generalized estimating equations, adjusting for the age, Charlson score, race, sex, and initial tumor size. Overall, 346 patients (401 masses) met the inclusion criteria (18% ≥ cT1b), with a median follow-up of 37 months (range: 6-169). Of these, 44% patients showed progression to definitive intervention with a median duration of 27 months (range: 6-130). On comparing patients managed expectantly to those requiring intervention, no difference was seen in median tumor size at presentation (2.2 vs. 2.2 cm), whereas significant differences in median age (74 vs. 65 y, P anatomic tumor complexity at presentation and renal masses of LGR of clinical stage 1 under AS may afford a clinically useful cue to tailor individual patient radiographic surveillance schedules and warrants further evaluation. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Hierarchical anatomical brain networks for MCI prediction: revisiting volumetric measures.

    Directory of Open Access Journals (Sweden)

    Luping Zhou

    Full Text Available Owning to its clinical accessibility, T1-weighted MRI (Magnetic Resonance Imaging has been extensively studied in the past decades for prediction of Alzheimer's disease (AD and mild cognitive impairment (MCI. The volumes of gray matter (GM, white matter (WM and cerebrospinal fluid (CSF are the most commonly used measurements, resulting in many successful applications. It has been widely observed that disease-induced structural changes may not occur at isolated spots, but in several inter-related regions. Therefore, for better characterization of brain pathology, we propose in this paper a means to extract inter-regional correlation based features from local volumetric measurements. Specifically, our approach involves constructing an anatomical brain network for each subject, with each node representing a Region of Interest (ROI and each edge representing Pearson correlation of tissue volumetric measurements between ROI pairs. As second order volumetric measurements, network features are more descriptive but also more sensitive to noise. To overcome this limitation, a hierarchy of ROIs is used to suppress noise at different scales. Pairwise interactions are considered not only for ROIs with the same scale in the same layer of the hierarchy, but also for ROIs across different scales in different layers. To address the high dimensionality problem resulting from the large number of network features, a supervised dimensionality reduction method is further employed to embed a selected subset of features into a low dimensional feature space, while at the same time preserving discriminative information. We demonstrate with experimental results the efficacy of this embedding strategy in comparison with some other commonly used approaches. In addition, although the proposed method can be easily generalized to incorporate other metrics of regional similarities, the benefits of using Pearson correlation in our application are reinforced by the experimental

  11. The linguistic roots of Modern English anatomical terminology.

    Science.gov (United States)

    Turmezei, Tom D

    2012-11-01

    Previous research focusing on Classical Latin and Greek roots has shown that understanding the etymology of English anatomical terms may be beneficial for students of human anatomy. However, not all anatomical terms are derived from Classical origins. This study aims to explore the linguistic roots of the Modern English terminology used in human gross anatomy. By reference to the Oxford English Dictionary, etymologies were determined for a lexicon of 798 Modern English gross anatomical terms from the 40(th) edition of Gray's Anatomy. Earliest traceable language of origin was determined for all 798 terms; language of acquisition was determined for 747 terms. Earliest traceable languages of origin were: Classical Latin (62%), Classical Greek (24%), Old English (7%), Post-Classical Latin (3%), and other (4%). Languages of acquisition were: Classical Latin (42%), Post-Classical Latin (29%), Old English (8%), Modern French (6%), Classical Greek (5%), Middle English (3%), and other (7%). While the roots of Modern English anatomical terminology mostly lie in Classical languages (accounting for the origin of 86% of terms), the anatomical lexicon of Modern English is actually much more diverse. Interesting and perhaps less familiar examples from these languages and the methods by which such terms have been created and absorbed are discussed. The author suggests that awareness of anatomical etymologies may enhance the enjoyment and understanding of human anatomy for students and teachers alike. Copyright © 2012 Wiley Periodicals, Inc.

  12. Is intrathoracic tracheal collapsibility correlated to clinical phenotypes and sex in patients with COPD?

    Directory of Open Access Journals (Sweden)

    Camiciottoli G

    2015-04-01

    Full Text Available Gianna Camiciottoli,1 Stefano Diciotti,2 Francesca Bigazzi,1 Simone Lombardo,3 Maurizio Bartolucci,4 Matteo Paoletti,1 Mario Mascalchi,3 Massimo Pistolesi1 1Section of Respiratory Medicine, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy; 2Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi,” University of Bologna, Cesena, Italy; 3Radiodiagnostic Section, Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy; 4Department of Diagnostic Imaging, Careggi University Hospital, Florence, Italy Abstract: A substantial proportion of patients with chronic obstructive pulmonary disease (COPD develops various degree of intrathoracic tracheal collapsibility. We studied whether the magnitude of intrathoracic tracheal collapsibility could be different across clinical phenotypes and sex in COPD. Intrathoracic tracheal collapsibility measured at paired inspiratory–expiratory low dose computed tomography (CT and its correlation with clinical, functional, and CT-densitometric data were investigated in 69 patients with COPD according to their predominant conductive airway or emphysema phenotypes and according to sex. Intrathoracic tracheal collapsibility was higher in patients with predominant conductive airway disease (n=28 and in females (n=27. Women with a predominant conductive airway phenotype (n=10 showed a significantly greater degree of collapsibility than women with predominant emphysema (28.9%±4% versus 11.6%±2%; P<0.001. Intrathoracic tracheal collapsibility was directly correlated with inspiratory–expiratory volume variation at CT and with forced expiratory volume (1 second, and inversely correlated with reduced CT lung density and functional residual capacity. Intrathoracic tracheal collapsibility was not correlated with cough and wheezing; however, intrathoracic tracheal collapsibility and clinical phenotypes of COPD

  13. T1- Thresholds in Black Holes Increase Clinical-Radiological Correlation in Multiple Sclerosis Patients.

    Science.gov (United States)

    Thaler, Christian; Faizy, Tobias; Sedlacik, Jan; Holst, Brigitte; Stellmann, Jan-Patrick; Young, Kim Lea; Heesen, Christoph; Fiehler, Jens; Siemonsen, Susanne

    2015-01-01

    Magnetic Resonance Imaging (MRI) is an established tool in diagnosing and evaluating disease activity in Multiple Sclerosis (MS). While clinical-radiological correlations are limited in general, hypointense T1 lesions (also known as Black Holes (BH)) have shown some promising results. The definition of BHs is very heterogeneous and depends on subjective visual evaluation. We aimed to improve clinical-radiological correlations by defining BHs using T1 relaxation time (T1-RT) thresholds to achieve best possible correlation between BH lesion volume and clinical disability. 40 patients with mainly relapsing-remitting MS underwent MRI including 3-dimensional fluid attenuated inversion recovery (FLAIR), magnetization-prepared rapid gradient echo (MPRAGE) before and after Gadolinium (GD) injection and double inversion-contrast magnetization-prepared rapid gradient echo (MP2RAGE) sequences. BHs (BHvis) were marked by two raters on native T1-weighted (T1w)-MPRAGE, contrast-enhancing lesions (CE lesions) on T1w-MPRAGE after GD and FLAIR lesions (total-FLAIR lesions) were detected separately. BHvis and total-FLAIR lesion maps were registered to MP2RAGE images, and the mean T1-RT were calculated for all lesion ROIs. Mean T1 values of the cortex (CTX) were calculated for each patient. Subsequently, Spearman rank correlations between clinical scores (Expanded Disability Status Scale and Multiple Sclerosis Functional Composite) and lesion volume were determined for different T1-RT thresholds. Significant differences in T1-RT were obtained between all different lesion types with highest T1 values in visually marked BHs (BHvis: 1453.3±213.4 ms, total-FLAIR lesions: 1394.33±187.38 ms, CTX: 1305.6±35.8 ms; p1500 ms (Expanded Disability Status Scale vs. lesion volume: rBHvis = 0.442 and rtotal-FLAIR = 0.497, p<0.05; Multiple Sclerosis Functional Composite vs. lesion volume: rBHvis = -0.53 and rtotal-FLAIR = -0.627, p<0.05). Clinical-radiological correlations in MS patients are

  14. Anatomical influences on internally coupled ears in reptiles.

    Science.gov (United States)

    Young, Bruce A

    2016-10-01

    Many reptiles, and other vertebrates, have internally coupled ears in which a patent anatomical connection allows pressure waves generated by the displacement of one tympanic membrane to propagate (internally) through the head and, ultimately, influence the displacement of the contralateral tympanic membrane. The pattern of tympanic displacement caused by this internal coupling can give rise to novel sensory cues. The auditory mechanics of reptiles exhibit more anatomical variation than in any other vertebrate group. This variation includes structural features such as diverticula and septa, as well as coverings of the tympanic membrane. Many of these anatomical features would likely influence the functional significance of the internal coupling between the tympanic membranes. Several of the anatomical components of the reptilian internally coupled ear are under active motor control, suggesting that in some reptiles the auditory system may be more dynamic than previously recognized.

  15. Multivariate pattern analysis reveals anatomical connectivity differences between the left and right mesial temporal lobe epilepsy.

    Science.gov (United States)

    Fang, Peng; An, Jie; Zeng, Ling-Li; Shen, Hui; Chen, Fanglin; Wang, Wensheng; Qiu, Shijun; Hu, Dewen

    2015-01-01

    Previous studies have demonstrated differences of clinical signs and functional brain network organizations between the left and right mesial temporal lobe epilepsy (mTLE), but the anatomical connectivity differences underlying functional variance between the left and right mTLE remain uncharacterized. We examined 43 (22 left, 21 right) mTLE patients with hippocampal sclerosis and 39 healthy controls using diffusion tensor imaging. After the whole-brain anatomical networks were constructed for each subject, multivariate pattern analysis was applied to classify the left mTLE from the right mTLE and extract the anatomical connectivity differences between the left and right mTLE patients. The classification results reveal 93.0% accuracy for the left mTLE versus the right mTLE, 93.4% accuracy for the left mTLE versus controls and 90.0% accuracy for the right mTLE versus controls. Compared with the right mTLE, the left mTLE exhibited a different connectivity pattern in the cortical-limbic network and cerebellum. The majority of the most discriminating anatomical connections were located within or across the cortical-limbic network and cerebellum, thereby indicating that these disease-related anatomical network alterations may give rise to a portion of the complex of emotional and memory deficit between the left and right mTLE. Moreover, the orbitofrontal gyrus, cingulate cortex, hippocampus and parahippocampal gyrus, which exhibit high discriminative power in classification, may play critical roles in the pathophysiology of mTLE. The current study demonstrated that anatomical connectivity differences between the left mTLE and the right mTLE may have the potential to serve as a neuroimaging biomarker to guide personalized diagnosis of the left and right mTLE.

  16. Perceptions of science. The anatomical mission to Burma.

    Science.gov (United States)

    Sappol, Michael

    2003-10-10

    Until the 1830s, most Americans were unfamiliar with the images of anatomy. Then a small vanguard of reformers and missionaries began to preach, at home and around the world, that an identification with the images and concepts of anatomy was a crucial part of the civilizing process. In his essay, Sappol charts the changes in the perception of self that resulted from this anatomical evangelism. Today, as anatomical images abound in the arts and the media, we still believe that anatomical images show us our inner reality.

  17. Anatomical measurements of the gastric cardia in obese patients.

    Science.gov (United States)

    Hindle, A Katherine; Gonzalez, Florencia; Brody, Fred

    2009-11-01

    Currently, surgeons implant a variety of laparoscopic adjustable gastric bands. However, there is little data to guide the selection process. This study aims to determine the relationship between a patient's body mass index (BMI), height, and weight and the anatomical measurements of the gastric cardia in morbidly obese patients undergoing laparoscopic adjustable gastric band (LAGB) surgery. A total of 67 morbidly obese patients undergoing LAGB surgery were studied. Intraoperative measurements of the gastric cardia were obtained. The relative circumference and posterior diameter of the gastric cardia were measured along with the patient's height, weight, and BMI. Pearson's correlation coefficient was used to measure the relationship between the circumference and posterior diameter of the gastric cardia and the BMI, height, and weight. A p < 0.05 was considered significant. No correlation exists between a patient's BMI or weight and the circumference or diameter of the gastric cardia. A correlation exists between a patient's height and the posterior diameter of the gastric cardia (p = 0.02). Of note, there is a correlation between the relative circumference and the posterior diameter of the gastric cardia for each patient (p = 0.05). Our unique data show no significant correlation between a patient's BMI and weight and the measurements of the gastric cardia. There was a correlation between a patient's height and the posterior diameter of the gastric cardia. These intraoperative measurements may help surgeons objectively select the appropriate band for each respective patient undergoing LAGB surgery. This may potentially decrease postoperative dysphagia.

  18. [Clinical aspects and classification of echinococcosis].

    Science.gov (United States)

    Nabokov, Sh A; Vasil'ev, R Kh

    1978-04-01

    350 cases of alveococcosis were examined with the use of clinical and generally available methods of laboratory analysis. This study helped to find out the characteristic symptoms of the disease and their incidence rate. A clinico-anatomical classification of alveoccoccosis, based on local and general manifestations, localization of a primary focus, anatomic form of the growth of an alveococcal node and the degree of its propagation in the liver parenchima, has been developed. The suggested classification promotes a correct construction of a detailed clinical diagnosis and complete solution of the problems of therapeutic tactics.

  19. Uniportal anatomic combined unusual segmentectomies.

    Science.gov (United States)

    González-Rivas, Diego; Lirio, Francisco; Sesma, Julio

    2017-01-01

    Nowadays, sublobar anatomic resections are gaining momentum as a valid alternative for early stage lung cancer. Despite being technically demanding, anatomic segmentectomies can be performed by uniportal video-assisted thoracic surgery (VATS) approach to combine the benefits of minimally invasiveness with the maximum lung sparing. This procedure can be even more complex if a combined resection of multiple segments from different lobes has to be done. Here we report five cases of combined and unusual segmentectomies done by the same experienced surgeon in high volume institutions to show uniportal VATS is a feasible approach for these complex resections and to share an excellent educational resource.

  20. Clinical correlates of first episode early onset psychosis in KwaZulu ...

    African Journals Online (AJOL)

    Background: The study of first episode early onset psychosis can yield many clues to understanding the early development of psychosis and guide interventions to decrease psychosis risk and improve outcome. The aim of the study was to investigate the socio-demographic profile and clinical correlates in early onset ...

  1. [Non-metastatic clear cell renal cancer: dependence of the tumour stage on clinico-anatomic and morphologic factors; prognostic value of macro- and karyometric characteristics].

    Science.gov (United States)

    Iurin, A G

    2010-01-01

    Non-metastatic clear-cell renal cancer: dependence of the tumour stage on clinico-anatomic and morphologic factors; prognostic value of macro- and karyometric characteristics Sankt Peterburg Pathology Bureau, Sankt Peterburg It was shown based on multivariate regression analysis that pT1a3bN0MO stages of non-metastatic clear-cell renal cancer significantly correlate not only with the tumor size and invasion into the fatty tissue and/or renal vein but also with the invasion into the renal capsule and with the mean maximum diameter and mean nucleus area of tumor cells. There was no correlation of clear-cell renal cancer stages with tumor proliferative activity, gene p53 mutation, oncosuppressor gene PTEN expression, fraction of tumour clear-cell component, and such clinical characteristics as patients' sex, age, and body mass index. Taking into account statistically significant differences between the patients' survival rates, the regression equations developed in this work may be used for the prediction of disease outcome.

  2. Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. Pt. 1. The intramedullary cartilage tumors

    International Nuclear Information System (INIS)

    Brien, E.W.; Mirra, J.M.; Kerr, R.

    1997-01-01

    We reviewed 845 cases of benign and 356 cases of malignant cartilaginous tumors from a total of 3067 primary bone tumors in our database. Benign cartilaginous lesions are unique because the epiphyseal plate has been implicated in the etiology of osteochondroma, enchondroma (single or multiple), periosteal chondromas and chondroblastoma. In the first part of this paper, we will review important clinical, radiologic and histologic features of intramedullary cartilaginous lesions in an attempt to support theories related to anatomic considerations and pathogenesis. (orig.). With 44 figs., 2 tabs

  3. Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. Pt. 1. The intramedullary cartilage tumors

    Energy Technology Data Exchange (ETDEWEB)

    Brien, E.W. [Orthopaedic Oncology Service, Orthopaedic Hospital, Los Angeles, CA (United States)]|[Musculoskeletal Tumor Service, Orthopaedic Hospital, Los Angeles, CA (United States); Mirra, J.M. [Orthopaedic Oncology Service, Orthopaedic Hospital, Los Angeles, CA (United States); Kerr, R. [Orthopaedic Oncology Service, Orthopaedic Hospital, Los Angeles, CA (United States)

    1997-06-01

    We reviewed 845 cases of benign and 356 cases of malignant cartilaginous tumors from a total of 3067 primary bone tumors in our database. Benign cartilaginous lesions are unique because the epiphyseal plate has been implicated in the etiology of osteochondroma, enchondroma (single or multiple), periosteal chondromas and chondroblastoma. In the first part of this paper, we will review important clinical, radiologic and histologic features of intramedullary cartilaginous lesions in an attempt to support theories related to anatomic considerations and pathogenesis. (orig.). With 44 figs., 2 tabs.

  4. Diffusion tensor imaging for anatomical localization of cranial nerves and cranial nerve nuclei in pontine lesions: initial experiences with 3T-MRI.

    Science.gov (United States)

    Ulrich, Nils H; Ahmadli, Uzeyir; Woernle, Christoph M; Alzarhani, Yahea A; Bertalanffy, Helmut; Kollias, Spyros S

    2014-11-01

    With continuous refinement of neurosurgical techniques and higher resolution in neuroimaging, the management of pontine lesions is constantly improving. Among pontine structures with vital functions that are at risk of being damaged by surgical manipulation, cranial nerves (CN) and cranial nerve nuclei (CNN) such as CN V, VI, and VII are critical. Pre-operative localization of the intrapontine course of CN and CNN should be beneficial for surgical outcomes. Our objective was to accurately localize CN and CNN in patients with intra-axial lesions in the pons using diffusion tensor imaging (DTI) and estimate its input in surgical planning for avoiding unintended loss of their function during surgery. DTI of the pons obtained pre-operatively on a 3Tesla MR scanner was analyzed prospectively for the accurate localization of CN and CNN V, VI and VII in seven patients with intra-axial lesions in the pons. Anatomical sections in the pons were used to estimate abnormalities on color-coded fractional anisotropy maps. Imaging abnormalities were correlated with CN symptoms before and after surgery. The course of CN and the area of CNN were identified using DTI pre- and post-operatively. Clinical associations between post-operative improvements and the corresponding CN area of the pons were demonstrated. Our results suggest that pre- and post-operative DTI allows identification of key anatomical structures in the pons and enables estimation of their involvement by pathology. It may predict clinical outcome and help us to better understand the involvement of the intrinsic anatomy by pathological processes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Mucocutaneous Manifestations of HIV and the Correlation with WHO Clinical Staging in a Tertiary Hospital in Nigeria

    Directory of Open Access Journals (Sweden)

    Olumayowa Abimbola Oninla

    2014-01-01

    Full Text Available Skin diseases are indicators of HIV/AIDS which correlates with WHO clinical stages. In resource limited environment where CD4 count is not readily available, they can be used in assessing HIV patients. The study aims to determine the mucocutaneous manifestations in HIV positive patients and their correlation with WHO clinical stages. A prospective cross-sectional study of mucocutaneous conditions was done among 215 newly diagnosed HIV patients from June 2008 to May 2012 at adult ART clinic, Wesley Guild Hospital Unit, OAU Teaching Hospitals Complex, Ilesha, Osun State, Nigeria. There were 156 dermatoses with oral/oesophageal/vaginal candidiasis (41.1%, PPE (24.4%, dermatophytic infections (8.9%, and herpes zoster (3.8% as the most common dermatoses. The proportions of dermatoses were 4.5%, 21.8%, 53.2%, and 20.5% in stages 1–4, respectively. A significant relationship (using Pearson’s Chi square with P value <0.05 was obtained between dermatoses and WHO clinical stages. Pearson’s correlation coefficient showed a positive correlation between the number of dermatoses and the WHO clinical stages. Dermatoses can therefore serve as diagnostic and prognostic markers in resource limited settings to initiate HAART in clinical stages 3 and 4.

  6. Network of anatomical texts (NAnaTex), an open-source project for visualizing the interaction between anatomical terms.

    Science.gov (United States)

    Momota, Ryusuke; Ohtsuka, Aiji

    2018-01-01

    Anatomy is the science and art of understanding the structure of the body and its components in relation to the functions of the whole-body system. Medicine is based on a deep understanding of anatomy, but quite a few introductory-level learners are overwhelmed by the sheer amount of anatomical terminology that must be understood, so they regard anatomy as a dull and dense subject. To help them learn anatomical terms in a more contextual way, we started a new open-source project, the Network of Anatomical Texts (NAnaTex), which visualizes relationships of body components by integrating text-based anatomical information using Cytoscape, a network visualization software platform. Here, we present a network of bones and muscles produced from literature descriptions. As this network is primarily text-based and does not require any programming knowledge, it is easy to implement new functions or provide extra information by making changes to the original text files. To facilitate collaborations, we deposited the source code files for the network into the GitHub repository ( https://github.com/ryusukemomota/nanatex ) so that anybody can participate in the evolution of the network and use it for their own non-profit purposes. This project should help not only introductory-level learners but also professional medical practitioners, who could use it as a quick reference.

  7. Correlation of abdominopelvic computed tomography with clinical manifestations in methamphetamine body stuffers.

    Science.gov (United States)

    Bahrami-Motlagh, Hooman; Hassanian-Moghaddam, Hossein; Zamini, Hedieh; Zamani, Nasim; Gachkar, Latif

    2018-02-01

    Little is known about methamphetamine body stuffers and correlation of clinical manifestations with imaging studies. Current study was done to determine abdominopelvic computed tomography findings and clinical manifestations in methamphetamine body stuffers. In an IRB-approved routine data base study, demographic characteristics, clinical findings, and CT results of 70 methamphetamine body stuffers were retrieved. According to the clinical manifestations, the patients were categorized into either benign- or severe-outcome group. Also, they were determined to have positive or negative CT results. In the group with positive results, number and place of the baggies were determined, as well. Results of the CT were compared between the two groups. Almost 43% of the patients had positive abdominopelvic CT results. Mean density of the packs was 176.2 ± 152.7 Hounsfield unit. Based on the clinical grounds, 57% of the patients were in the benign- and 33% were in the severe-outcome group. In the benign group, 45% of the patients had positive CTs while in the severe-risk group, this was 40% (p > 0.05). Except variables defined as severe outcome (seizure, intubation, creatinine level, aspartate aminotransferase level, creatine phosphokinase and troponin level), agitation, on-arrival pulse rate, lactate dehydrogenase, bicarbonate, base excess, loss of consciousness and hospitalization period were correlating factors. But in regression analysis, we could not find a significant variable that prognosticate severe outcome. It seems that there is no relationship between the CT findings and clinical manifestations of the methamphetamine body stuffers. Severe outcomes may be observed even in the face of negative CTs.

  8. Anatomically-aided PET reconstruction using the kernel method.

    Science.gov (United States)

    Hutchcroft, Will; Wang, Guobao; Chen, Kevin T; Catana, Ciprian; Qi, Jinyi

    2016-09-21

    This paper extends the kernel method that was proposed previously for dynamic PET reconstruction, to incorporate anatomical side information into the PET reconstruction model. In contrast to existing methods that incorporate anatomical information using a penalized likelihood framework, the proposed method incorporates this information in the simpler maximum likelihood (ML) formulation and is amenable to ordered subsets. The new method also does not require any segmentation of the anatomical image to obtain edge information. We compare the kernel method with the Bowsher method for anatomically-aided PET image reconstruction through a simulated data set. Computer simulations demonstrate that the kernel method offers advantages over the Bowsher method in region of interest quantification. Additionally the kernel method is applied to a 3D patient data set. The kernel method results in reduced noise at a matched contrast level compared with the conventional ML expectation maximization algorithm.

  9. Correlations Between Clinical Judgement and Learning Style Preferences of Nursing Students in the Simulation Room.

    Science.gov (United States)

    Hallin, Karin; Haggstrom, Marie; Backstrom, Britt; Kristiansen, Lisbeth Porskrog

    2015-09-28

    Health care educators account for variables affecting patient safety and are responsible for developing the highly complex process of education planning. Clinical judgement is a multidimensional process, which may be affected by learning styles. The aim was to explore three specific hypotheses to test correlations between nursing students' team achievements in clinical judgement and emotional, sociological and physiological learning style preferences. A descriptive cross-sectional study was conducted with Swedish university nursing students in 2012-2013. Convenience sampling was used with 60 teams with 173 nursing students in the final semester of a three-year Bachelor of Science in nursing programme. Data collection included questionnaires of personal characteristics, learning style preferences, determined by the Dunn and Dunn Productivity Environmental Preference Survey, and videotaped complex nursing simulation scenarios. Comparison with Lasater Clinical Judgement Rubric and Non-parametric analyses were performed. Three significant correlations were found between the team achievements and the students' learning style preferences: significant negative correlation with 'Structure' and 'Kinesthetic' at the individual level, and positive correlation with the 'Tactile' variable. No significant correlations with students' 'Motivation', 'Persistence', 'Wish to learn alone' and 'Wish for an authoritative person present' were seen. There were multiple complex interactions between the tested learning style preferences and the team achievements of clinical judgement in the simulation room, which provides important information for the becoming nurses. Several factors may have influenced the results that should be acknowledged when designing further research. We suggest conducting mixed methods to determine further relationships between team achievements, learning style preferences, cognitive learning outcomes and group processes.

  10. Alterations in white matter volume and its correlation with clinical characteristics in patients with generalized anxiety disorder

    International Nuclear Information System (INIS)

    Moon, Chung-Man; Jeong, Gwang-Woo

    2015-01-01

    Only a few morphological studies have focused on changes in white matter (WM) volume in patients with generalized anxiety disorder (GAD). We evaluated alterations in WM volume and its correlation with symptom severity and duration of illness in adults with GAD. The 44 subjects were comprised of 22 patients with GAD (13 males and nine females) diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and 22 age-matched healthy controls (13 males and nine females). High-resolution magnetic resonance imaging (MRI) data were processed by voxel-based morphometry (VBM) analysis based on diffeomorphic anatomical registration using the exponentiated Lie algebra (DARTEL) algorithm in SPM8. Patients with GAD showed significantly reduced WM volume, particularly in the dorsolateral prefrontal cortex (DLPFC), anterior limb of the internal capsule (ALIC), and midbrain. In addition, DLPFC volume was negatively correlated with GAD-7 score and illness duration. ALIC volume was negatively correlated with GAD-7 score. Female patients had significantly less orbitofrontal cortex volume compared to that in male patients. The findings demonstrate localized changes in WM volume associated with cognitive and emotional dysfunction in patients with GAD. The finding will be helpful for understanding the neuropathology in patients with GAD. (orig.)

  11. Alterations in white matter volume and its correlation with clinical characteristics in patients with generalized anxiety disorder

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Chung-Man [Chonnam National University Hospital, Research Institute for Medical Imaging, Gwangju (Korea, Republic of); Jeong, Gwang-Woo [Chonnam National University Hospital, Research Institute for Medical Imaging, Gwangju (Korea, Republic of); Chonnam National University Medical School, Department of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2015-11-15

    Only a few morphological studies have focused on changes in white matter (WM) volume in patients with generalized anxiety disorder (GAD). We evaluated alterations in WM volume and its correlation with symptom severity and duration of illness in adults with GAD. The 44 subjects were comprised of 22 patients with GAD (13 males and nine females) diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and 22 age-matched healthy controls (13 males and nine females). High-resolution magnetic resonance imaging (MRI) data were processed by voxel-based morphometry (VBM) analysis based on diffeomorphic anatomical registration using the exponentiated Lie algebra (DARTEL) algorithm in SPM8. Patients with GAD showed significantly reduced WM volume, particularly in the dorsolateral prefrontal cortex (DLPFC), anterior limb of the internal capsule (ALIC), and midbrain. In addition, DLPFC volume was negatively correlated with GAD-7 score and illness duration. ALIC volume was negatively correlated with GAD-7 score. Female patients had significantly less orbitofrontal cortex volume compared to that in male patients. The findings demonstrate localized changes in WM volume associated with cognitive and emotional dysfunction in patients with GAD. The finding will be helpful for understanding the neuropathology in patients with GAD. (orig.)

  12. A Proposed Set of Metrics to Reduce Patient Safety Risk From Within the Anatomic Pathology Laboratory.

    Science.gov (United States)

    Banks, Peter; Brown, Richard; Laslowski, Alex; Daniels, Yvonne; Branton, Phil; Carpenter, John; Zarbo, Richard; Forsyth, Ramses; Liu, Yan-Hui; Kohl, Shane; Diebold, Joachim; Masuda, Shinobu; Plummer, Tim; Dennis, Eslie

    2017-05-01

    Anatomic pathology laboratory workflow consists of 3 major specimen handling processes. Among the workflow are preanalytic, analytic, and postanalytic phases that contain multistep subprocesses with great impact on patient care. A worldwide representation of experts came together to create a system of metrics, as a basis for laboratories worldwide, to help them evaluate and improve specimen handling to reduce patient safety risk. Members of the Initiative for Anatomic Pathology Laboratory Patient Safety (IAPLPS) pooled their extensive expertise to generate a list of metrics highlighting processes with high and low risk for adverse patient outcomes. : Our group developed a universal, comprehensive list of 47 metrics for patient specimen handling in the anatomic pathology laboratory. Steps within the specimen workflow sequence are categorized as high or low risk. In general, steps associated with the potential for specimen misidentification correspond to the high-risk grouping and merit greater focus within quality management systems. Primarily workflow measures related to operational efficiency can be considered low risk. Our group intends to advance the widespread use of these metrics in anatomic pathology laboratories to reduce patient safety risk and improve patient care with development of best practices and interlaboratory error reporting programs. © American Society for Clinical Pathology 2017.

  13. Glutaric aciduria type 1: neuroimaging features with clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Mohammad, Shaimaa Abdelsattar; Ahmed, Khaled A. [Ain-Shams University, Department of Radiodiagnosis, Faculty of Medicine, Cairo (Egypt); Abdelkhalek, Heba Salah; Zaki, Osama K. [Ain-Shams University, Medical Genetics Unit, Pediatric Department, Faculty of Medicine, Cairo (Egypt)

    2015-10-15

    Glutaric aciduria type 1 is a rare neurometabolic disease with high morbidity. To describe the MR imaging abnormalities in glutaric aciduria type 1 and to identify any association between the clinical and imaging features. MRI scans of 29 children (mean age: 16.9 months) with confirmed diagnosis of glutaric aciduria type 1 were retrospectively reviewed. Gray matter and white matter scores were calculated based on a previously published pattern-recognition approach of assessing leukoencephalopathies. Hippocampal formation and opercular topography were assessed in relation to the known embryological basis. MRI scores were correlated with morbidity score. The most consistent MRI abnormality was widened operculum with dilatation of the subarachnoid spaces surrounding underdeveloped frontotemporal lobes. Incomplete hippocampal inversion was also seen. The globus pallidus was the most frequently involved gray matter structure (86%). In addition to the central tegmental tract, white matter abnormalities preferentially involved the central and periventricular regions. The morbidity score correlated with the gray matter abnormality score (P = 0.004). Patients with dystonia had higher gray matter and morbidity scores. Morbidity is significantly correlated with abnormality of gray matter, rather than white matter, whether secondary to acute encephalopathic crisis or insidious onset disease. (orig.)

  14. [The nerves of the face: anatomical sample in wax in the Delmas-Orfila-Rouvière Museum in Paris].

    Science.gov (United States)

    Drifi, F; Le Floch-Prigent, P

    2009-01-01

    The aim of the study was to check the anatomical veracity of the model of wax no. 262, from the Delmas, Orfila and Rouvière museums, 45, rue des Saints Pères, Paris 6th, made by Tramond M.D., entitled "nerves of the face". We successively took several numerical photographs with several view angles; anatomically described the nerves of the face as they were represented on this model; correlated the anatomical veracity of this representation with the classical, textbooks' data; approached the technical bases of fabrication; and collected successive photographs of the model every 5 degrees , all along 180 degrees , thus allowing an animated rotation on computer, using the QuickTime Virtual Reality program. The oversize of the model excluded a set on a real human skeleton. The building technique of the model was deduced from known data but could not be completely reported. The anatomical veracity of the sample was excellent. The difficulties of realization in wax of an oversized model of the nerves of the human face were solved in the late 19th century, in Paris by Tramond's factory. They remained unequalled.

  15. Time-resolved diffuse optical tomographic imaging for the provision of both anatomical and functional information about biological tissue

    Science.gov (United States)

    Zhao, Huijuan; Gao, Feng; Tanikawa, Yukari; Homma, Kazuhiro; Yamada, Yukio

    2005-04-01

    We present in vivo images of near-infrared (NIR) diffuse optical tomography (DOT) of human lower legs and forearm to validate the dual functions of a time-resolved (TR) NIR DOT in clinical diagnosis, i.e., to provide anatomical and functional information simultaneously. The NIR DOT system is composed of time-correlated single-photon-counting channels, and the image reconstruction algorithm is based on the modified generalized pulsed spectral technique, which effectively incorporates the TR data with reasonable computation time. The reconstructed scattering images of both the lower legs and the forearm revealed their anatomies, in which the bones were clearly distinguished from the muscles. In the absorption images, some of the blood vessels were observable. In the functional imaging, a subject was requested to do handgripping exercise to stimulate physiological changes in the forearm tissue. The images of oxyhemoglobin, deoxyhemoglobin, and total hemoglobin concentration changes in the forearm were obtained from the differential images of the absorption at three wavelengths between the exercise and the rest states, which were reconstructed with a differential imaging scheme. These images showed increases in both blood volume and oxyhemoglobin concentration in the arteries and simultaneously showed hypoxia in the corresponding muscles. All the results have demonstrated the capability of TR NIR DOT by reconstruction of the absolute images of the scattering and the absorption with a high spatial resolution that finally provided both the anatomical and functional information inside bulky biological tissues.

  16. Design and use of numerical anatomical atlases for radiotherapy

    International Nuclear Information System (INIS)

    Commowick, O.

    2007-02-01

    The main objective of this thesis is to provide radio-oncology specialists with automatic tools for delineating organs at risk of a patient undergoing a radiotherapy treatment of cerebral or head and neck tumors. To achieve this goal, we use an anatomical atlas, i.e. a representative anatomy associated to a clinical image representing it. The registration of this atlas allows us to segment automatically the patient structures and to accelerate this process. Contributions in this method are presented on three axes. First, we want to obtain a registration method which is as independent as possible from the setting of its parameters. This setting, done by the clinician, indeed needs to be minimal while guaranteeing a robust result. We therefore propose registration methods allowing a better control of the obtained transformation, using rejection techniques of inadequate matching or locally affine transformations. The second axis is dedicated to the consideration of structures associated with the presence of the tumor. These structures, not present in the atlas, indeed lead to local errors in the atlas-based segmentation. We therefore propose methods to delineate these structures and take them into account in the registration. Finally, we present the construction of an anatomical atlas of the head and neck region and its evaluation on a database of patients. We show in this part the feasibility of the use of an atlas for this region, as well as a simple method to evaluate the registration methods used to build an atlas. All this research work has been implemented in a commercial software (Imago from DOSIsoft), allowing us to validate our results in clinical conditions. (author)

  17. Tissue factor activated thromboelastography correlates to clinical signs of bleeding in dogs

    DEFF Research Database (Denmark)

    Wiinberg, Bo; Jensen, Asger Lundorff; Rozanski, Elizabeth

    2009-01-01

    The ability of a laboratory assay to correlate to clinical phenotype is crucial for the accurate diagnosis and monitoring of haemostasis and is therefore challenging with currently used routine haemostasis assays. Thromboelastography (TEG) is increasingly used to evaluate haemostasis in humans...... and may well be of value in the workup of dogs suspected of having a haemostatic disorder. This study was undertaken to evaluate prospectively how tissue factor (TF) activated TEG correlated to clinical signs of bleeding in dogs, compared to a routine coagulation profile. A prospective case-control study...... was performed over a 2 year period from 2004-2006. Eligible dogs were those where the primary clinician requested a coagulation profile to evaluate haemostasis. The dogs were simultaneously evaluated with a TF-activated TEG assay. Twenty-seven dogs, characterised as hypo-coagulable based on the TEG parameter G...

  18. Correlation of kidney biopsy findings and clinical manifestations of primary focal and segmental glomerulosclerosis.

    Science.gov (United States)

    Taheri, Diana; Chehrei, Ali; Samanianpour, Pargol; Hassanzadeh, Amar; Sadrarhami, Shohreh; Seyrafian, Shiva

    2009-05-01

    To evaluate the correlation of clinical, laboratory, and pathological features at pre-sentation of focal segmental sclerosis (FSGS), we reviewed in a cross sectional study the pathological findings of kidney biopsies in 64 cases of primary FSGS, and correlated them with the clinical and laboratory data obtained at the time of the biopsies. The data included blood pressure, glomerular filtration rate (GFR), serum albumin, and the level of proteinuria. The mean level of serum creatinine was significantly higher in the biopsies' findings of synechiae (adhesions) in the Bowman's capsule, interstitial fibrosis, and global scars (PBowman's capsule in their biopsies.

  19. [Correlation of medial compartmental joint line elevation with femorotibial angle correction and clinical function after unicompartmental arthroplasty].

    Science.gov (United States)

    Zhang, Zhan-Feng; Wang, Dan; Min, Ji-Kang

    2017-04-25

    To study the correlation of postoperative femorotibial angle with medial compartmental joint line elevation after unicompartmental arthroplasty(UKA), as well as the correlation of joint line elevation with the clinical function by measuring radiological joint line. A retrospective study of 56 patients from July 2012 to August 2015 was performed. The mean body mass index (BMI) was 23.5 (ranged, 18.3 to 30.1). The standing anteroposterior radiographs of these patients were assessed both pre-and post-operatively, and the knee function was evaluated according to HSS grading. The correlation between postoperative femorotibial angle(FTA) and joint line elevation was analyzed as well as the correlation between joint line elevation and the clinical function. The mean medial joint line elevation was (2.2±2.0) mm(ranged, -3.3 to 7.0 mm), and the mean FTA correction was (2.3±3.0)°(ranged, -4.5° to 9.6°). The mean follow-up period was 12.2 months. There was a significant correlation between in joint line elevation and FTA correction( P clinical function( P >0.05). There was a significant correlation between medial compartmental joint line elevation and FTA correction after UKA, and the proximal tibial osteotomy was critical during the procedure. There was no significant correlation between joint line elevation and the clinical function, which may be related to the design of UKA prosthesis.

  20. Movement disorders associated with focal midbrain lesion: correlation with clinical and I-123 IPT SPECT findings

    International Nuclear Information System (INIS)

    Kang, Ji Hoon; Im, Joo Hyuk; Kim, Jae Seung; Lee, Myoung Chong

    2001-01-01

    Midbrain lesion may produce a variety of movement disorders including tremor, dystonia, and parkinsonism. The anatomical and functional basis of the movement disorder associated with the midbrain lesion is still unclear. The purpose of this study was to correlate focal midbrain lesions with clinical and I-123 IPT SPECT findings. Five patients (aged 25 to 69 years, 3 men and 2 women) who presented with movement disorder associated with discrete focal midbrain lesion on the brain MRI were included. We reviewed the clinical characteristics of movement disorders and the brain MRI findings in all patients. I-123 IPT SPECT was performed in all patients and 9 normal controls to evaluate the integrity of the nigrostriatal dopaminergic system and specific binding ratios were also calculated. Patients consisted of 2 with parkinsonism, 1 with midbrain tremor, 1 with hemidystonia, and 1 with micrographia as the only manifestation. In all patients, movement disorders were confined to the limbs contralateral to the focal midbrain lesions. The causes of midbrain lesion were trauma (n=2), rupture of AVM (n=1), cerebral infarction (n=1), and encephalitis (n=1). The latency between the midbrain injury and the onset of movement disorder varied from 1.5 months to 2 years (mean 6.7 months). Specific binding ratios of ipsilateral striatum (1.6±1.4) were significantly lower than that of contralateral side (3.3±0.99) and normal control (3.5±0.5)(p<0.05). All of six patients had lesions involving substantia nigra on MRI and two of these with resting tremor had also lesions involving the red nucleus. Bradykinesia and rigidity were mild or absent in these two patients, despite severely decreased specific binding ratios (mean 0.55) of ipsilateral striatum. Movement disorders associated with focal midbrain lesion were partially related to the damage in the nigrostriatal dopaminergic system. However, the severity and nature of movement disorder were variable and not directly related to the

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  2. Extended Endoscopic Endonasal Approaches for Cerebral Aneurysms: Anatomical, Virtual Reality and Morphometric Study

    Directory of Open Access Journals (Sweden)

    Alberto Di Somma

    2014-01-01

    Full Text Available Introduction. The purpose of the present contribution is to perform a detailed anatomic and virtual reality three-dimensional stereoscopic study in order to test the effectiveness of the extended endoscopic endonasal approaches for selected anterior and posterior circulation aneurysms. Methods. The study was divided in two main steps: (1 simulation step, using a dedicated Virtual Reality System (Dextroscope, Volume Interactions; (2 dissection step, in which the feasibility to reach specific vascular territory via the nose was verified in the anatomical laboratory. Results. Good visualization and proximal and distal vascular control of the main midline anterior and posterior circulation territory were achieved during the simulation step as well as in the dissection step (anterior communicating complex, internal carotid, ophthalmic, superior hypophyseal, posterior cerebral and posterior communicating, basilar, superior cerebellar, anterior inferior cerebellar, vertebral, and posterior inferior cerebellar arteries. Conclusion. The present contribution is intended as strictly anatomic study in which we highlighted some specific anterior and posterior circulation aneurysms that can be reached via the nose. For clinical applications of these approaches, some relevant complications, mainly related to the endonasal route, such as proximal and distal vascular control, major arterial bleeding, postoperative cerebrospinal fluid leak, and olfactory disturbances must be considered.

  3. Breast abscess after nipple piercing: sonographic findings with clinical correlation.

    Science.gov (United States)

    Leibman, A Jill; Misra, Monika; Castaldi, Maria

    2011-09-01

    The purpose of this series was to review the spectrum of clinical and sonographic features associated with infection after nipple piercing. Between 2002 and 2010, 6 patients presented to our breast center with a breast abscess after nipple piercing. A retrospective analysis of the imaging findings was performed with clinical and pathologic correlation. Patients with breast infections after nipple piercing tend to be young, and the timing since piercing varies from 2 weeks to 17 months. Sonography showed a complex or hypoechoic mass in 5 of 6 patients. Treatment of breast abscesses included surgical incision and drainage, percutaneous drainage, and antibiotic therapy. Surgical evacuation is commonly performed; however, sonographically guided aspiration may be an appropriate management strategy.

  4. Unification of Sinonasal Anatomical Terminology

    Directory of Open Access Journals (Sweden)

    Voegels, Richard Louis

    2015-07-01

    Full Text Available The advent of endoscopy and computed tomography at the beginning of the 1980s brought to rhinology a revival of anatomy and physiology study. In 1994, the International Conference of Sinus Disease was conceived because the official “Terminologia Anatomica”[1] had little information on the detailed sinonasal anatomy. In addition, there was a lack of uniformity of terminology and definitions. After 20 years, a new conference has been held. The need to use the same terminology led to the publication by the European Society of Rhinology of the “European Position Paper on the Anatomical Terminology of the Internal Nose and Paranasal Sinuses,” that can be accessed freely at www.rhinologyjournal.com. Professor Valerie Lund et al[2] wrote this document reviewing the anatomical terms, comparing to the “Terminology Anatomica” official order to define the structures without eponyms, while respecting the embryological development and especially universalizing and simplifying the terms. A must-read! The text's purpose lies beyond the review of anatomical terminology to universalize the language used to refer to structures of the nasal and paranasal cavities. Information about the anatomy, based on extensive review of the current literature, is arranged in just over 50 pages, which are direct and to the point. The publication may be pleasant reading for learners and teachers of rhinology. This text can be a starting point and enables searching the universal terminology used in Brazil, seeking to converge with this new European proposal for a nomenclature to help us communicate with our peers in Brazil and the rest of the world. The original text of the European Society of Rhinology provides English terms that avoided the use of Latin, and thus fall beyond several national personal translations. It would be admirable if we created our own cross-cultural adaptation of this new suggested anatomical terminology.

  5. Mystery of alar ligament rupture: Value of MRI in whiplash injuries - biomechanical, anatomical and clinical studies; Mysterium Ligamentum alare Ruptur: Stellenwert der MRT-Diagnostik des Schleudertraumas - biomechanische, anatomische und klinische Studien

    Energy Technology Data Exchange (ETDEWEB)

    Bitterling, H.; Brueckmann, H. [Abt. fuer Neuroradiologie, Klinikum der LMU, Muenchen (Germany); Staebler, A. [Radiologische Praxis, Radiologie in Muenchen, Harlaching (Germany)

    2007-11-15

    Purpose: Whiplash injury of the cervical spine is a frequent issue in medical expertise and causes enormous consequential costs for motor insurance companies. Some authors accuse posttraumatic changes of alar ligaments to be causative for consequential disturbances. Materials and methods: Review of recent studies on biomechanics, anatomical and clinical MR imaging. Results: Biomechanical experiments can not induce according injuries of alar ligaments. Although MRI provides excellent visualization of alar ligaments, the range of normal variants is high. (orig.)

  6. Suicide During Perinatal Period: Epidemiology, Risk Factors and Clinical Correlates

    Directory of Open Access Journals (Sweden)

    Laura Orsolini

    2016-08-01

    Full Text Available Perinatal period may pose a great challenge for the clinical management and treatment of psychiatric disorders in women. In fact, several mental illnesses can arise during pregnancy and/or following childbirth. Suicide and infanticide have been considered relatively rare events during the perinatal period. However, in some mental disorders (i.e. postpartum depression, bipolar disorder, postpartum psychosis, etc. have been reported a higher risk of suicidal ideation, suicide attempt or suicide. Therefore, a complete screening of mothers’ mental health should also take into account thoughts of suicide and thoughts about harming infants as well. Clinicians should carefully monitor and early identify related clinical manifestations, potential risk factors and alarm symptoms related to suicide. The present paper aims at providing a focused review about epidemiological data, risk and protective factors and an overview about the main clinical correlates associated with the suicidal behaviour during the pregnancy and postpartum period.

  7. Mammographic density in asymptomatic menopausal women: correlation with clinical and sonographic findings

    Directory of Open Access Journals (Sweden)

    Beatriz Regina Alvares

    2012-06-01

    Full Text Available OBJECTIVE: To evaluate mammographic breast density in asymptomatic menopausal women in correlation with clinical and sonographic findings. MATERIALS AND METHODS: Mammograms and clinical and sonographic findings of 238 asymptomatic patients were retrospectively reviewed in the period from February/2022 to June/2006. The following variables were analyzed: mammographic density patterns, sonographic findings, patients' age, parity, body mass index and use of hormone replacement therapy. RESULTS: Age, parity and body mass index showed a negative correlation with breast density pattern, while use of hormone replacement therapy showed a positive correlation. Supplementary breast ultrasonography was performed in 103 (43.2% patients. Alterations which could not be visualized at mammography were found in 34 (33% of them, most frequently in women with breast density patterns 3 and 4. CONCLUSION: The authors concluded that breast density patterns were influenced by age, parity, body mass index and time of hormone replacement therapy. Despite not having found any malignant abnormality in the studied cases, the authors have observed a predominance of benign sonographic abnormalities in women with high breast density patterns and without mammographic abnormalities, proving the relevance of supplementary ultrasonography to identify breast lesions in such patients.

  8. Perioperative vitamin D levels correlate with clinical outcomes after ankle fracture fixation.

    Science.gov (United States)

    Warner, Stephen J; Garner, Matthew R; Nguyen, Joseph T; Lorich, Dean G

    2016-03-01

    Hypovitaminosis D is common in patients undergoing orthopaedic trauma surgery. While previous studies have shown that vitamin D levels correlate with functional outcome after hip fracture surgery, the significance of vitamin D levels on outcomes after surgery in other orthopaedic trauma patients is unknown. The purpose of this study was to determine if vitamin D levels correlated with outcomes in ankle fracture patients. We reviewed a prospective registry of patients who underwent operative treatment for ankle fractures from 2003 to 2012. Preoperative serum 25-hydroxyvitamin D (25[OH]D) levels were measured, and the primary and secondary outcomes included foot and ankle outcome scores (FAOS) and ankle range of motion. Data were also collected on patient comorbidities, articular malreductions, and wound complications. Included patients had at least 12 months of clinical outcome data. Ninety-eight patients operatively treated for ankle fractures met our inclusion criteria. Of these 98 patients, 36 (37%) were deficient in vitamin D (ankle fractures, preoperative vitamin D deficiency correlated with inferior clinical outcomes at a minimum of 1 year follow-up. Our study suggests that deficient vitamin D levels may result in worse outcomes in orthopaedic trauma patients recovering from fracture fixation.

  9. Deterioration of abstract reasoning ability in mild cognitive impairment and Alzheimer's disease: correlation with regional grey matter volume loss revealed by diffeomorphic anatomical registration through exponentiated lie algebra analysis

    Energy Technology Data Exchange (ETDEWEB)

    Yoshiura, Takashi; Hiwatashi, Akio; Yamashita, Koji; Takayama, Yukihisa; Kamano, Norihiro; Honda, Hiroshi [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan); Ohyagi, Yasumasa; Kira, Jun-ichi [Kyushu University, Department of Neurology, Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan); Monji, Akira; Kawashima, Toshiro [Kyushu University, Department of Neuropsychiatry, Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan)

    2011-02-15

    To determine which brain regions are relevant to deterioration in abstract reasoning as measured by Raven's Colored Progressive Matrices (CPM) in the context of dementia. MR images of 37 consecutive patients including 19 with Alzheimer's disease (AD) and 18 with amnestic mild cognitive impairment (aMCI) were retrospectively analyzed. All patients were administered the CPM. Regional grey matter (GM) volume was evaluated according to the regimens of voxel-based morphometry, during which a non-linear registration algorithm called Diffeomorphic Anatomical Registration Through Exponentiated Lie algebra was employed. Multiple regression analyses were used to map the regions where GM volumes were correlated with CPM scores. The strongest correlation with CPM scores was seen in the left middle frontal gyrus while a region with the largest volume was identified in the left superior temporal gyrus. Significant correlations were seen in 14 additional regions in the bilateral cerebral hemispheres and right cerebellum. Deterioration of abstract reasoning ability in AD and aMCI measured by CPM is related to GM loss in multiple regions, which is in close agreement with the results of previous activation studies. (orig.)

  10. Brain functional networks. Correlation analysis with clinical indexes in patients with diabetic retinopathy

    Energy Technology Data Exchange (ETDEWEB)

    Dai, Hui; Zhang, Yu; Hu, Su; Wang, Ximing; Li, Yonggang; Hu, Chunhong [The First Affiliated Hospital of Soochow University, Department of Radiology, Suzhou, Jiangsu (China); Lai, Lillian [LAC+USC Medical Center, Department of Neuroradiology, Los Angeles, CA (United States); Shen, Hailin [Suzhou Kowloon Hospital, Shanghai Jiao Tong University Medical School, Department of Radiology, Suzhou, Jiangsu (China)

    2017-11-15

    The relationship between parameters of brain functional networks and clinical indexes is unclear so far in patients with diabetic retinopathy (DR). This paper is to investigate this. Twenty-one patients with different grades of DR and 21 age- and sex-matched healthy controls were enrolled from August 2012 to September 2014. The clinical indexes recorded included DR grade, duration of diabetes, HbA1c, diabetic foot screen, fasting plasma glucose, insulin, Homa-β, Homa-IR, insulin sensitive index (ISI), Mini-Mental State Examination (MMSE), and patient sex and age. Subjects were scanned using 3-T MR with blood-oxygen-level-dependent and 3D-FSPGR sequences. MR data was analyzed via preprocessing and functional network construction, and quantified indexes of network (clustering coefficient, characteristic path length, global efficiency, degree distribution, and small worldness) were evaluated. Statistics consisted of ANOVA and correlation. There were significant differences between patients and controls among clustering coefficient, characteristic path length, degree distribution, and small worldness parameters (P < 0.05). MMSE scores negatively correlated with characteristic path length, and Hb1Ac negatively correlated with small worldness. MMSE, duration of diabetes, diabetic foot screen, fasting plasma glucose, insulin, Homa-β, Homa-IR, ISI, DR grade, and patient age, except from Hb1Ac, correlated with degree distribution in certain brain areas. Brain functional networks are altered, specifically in the areas of visual function and cognition, and these alterations may reflect the severity of visual weakness and cognitive decline in DR patients. Moreover, the brain networks may be affected both by long-standing and instant clinical factors. (orig.)

  11. Brain functional networks. Correlation analysis with clinical indexes in patients with diabetic retinopathy

    International Nuclear Information System (INIS)

    Dai, Hui; Zhang, Yu; Hu, Su; Wang, Ximing; Li, Yonggang; Hu, Chunhong; Lai, Lillian; Shen, Hailin

    2017-01-01

    The relationship between parameters of brain functional networks and clinical indexes is unclear so far in patients with diabetic retinopathy (DR). This paper is to investigate this. Twenty-one patients with different grades of DR and 21 age- and sex-matched healthy controls were enrolled from August 2012 to September 2014. The clinical indexes recorded included DR grade, duration of diabetes, HbA1c, diabetic foot screen, fasting plasma glucose, insulin, Homa-β, Homa-IR, insulin sensitive index (ISI), Mini-Mental State Examination (MMSE), and patient sex and age. Subjects were scanned using 3-T MR with blood-oxygen-level-dependent and 3D-FSPGR sequences. MR data was analyzed via preprocessing and functional network construction, and quantified indexes of network (clustering coefficient, characteristic path length, global efficiency, degree distribution, and small worldness) were evaluated. Statistics consisted of ANOVA and correlation. There were significant differences between patients and controls among clustering coefficient, characteristic path length, degree distribution, and small worldness parameters (P < 0.05). MMSE scores negatively correlated with characteristic path length, and Hb1Ac negatively correlated with small worldness. MMSE, duration of diabetes, diabetic foot screen, fasting plasma glucose, insulin, Homa-β, Homa-IR, ISI, DR grade, and patient age, except from Hb1Ac, correlated with degree distribution in certain brain areas. Brain functional networks are altered, specifically in the areas of visual function and cognition, and these alterations may reflect the severity of visual weakness and cognitive decline in DR patients. Moreover, the brain networks may be affected both by long-standing and instant clinical factors. (orig.)

  12. Rare anatomical variation of the musculocutaneous nerve - case report

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    Sergio Ricardo Rios Nascimento

    2016-06-01

    Full Text Available ABSTRACT The clinical and surgical importance of anatomical knowledge of the musculocutaneous nerve and its variations is due to the fact that one of the complications in many upper-limb surgical procedures involves injury to this nerve. During routine dissection of the right upper limb of a male cadaver, we observed an anatomical variation of this nerve. The musculocutaneous nerve originated in the lateral cord and continued laterally, passing under the coracobrachialis muscle and then continuing until its first branch to the biceps brachialis muscle. Just after this, it supplied another two branches, i.e. the lateral cutaneous nerve of the forearm and a branch to the brachialis muscle, and then it joined the median nerve. The median nerve followed the arm medially to the region of the cubital fossa and then gave rise to the anterior intermediate nerve of the forearm. The union between the musculocutaneous nerve and the median nerve occurred approximately at the midpoint of the arm and the median nerve. Given that either our example is not covered by the classifications found in the literature or that it fits into more than one variation proposed, without us finding something truly similar, we consider this variation to be rare.

  13. Effect of anatomical variability in brain on transcranial magnetic stimulation treatment

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    Syeda, F.; Magsood, H.; Lee, E. G.; El-Gendy, A. A.; Jiles, D. C.; Hadimani, R. L.

    2017-05-01

    Transcranial Magnetic Stimulation is a non-invasive clinical therapy used to treat depression and migraine, and shows further promise as treatment for Parkinson's disease, Alzheimer's disease, and other neurological disorders. However, it is yet unclear as to how anatomical differences may affect stimulation from this treatment. We use finite element analysis to model and analyze the results of Transcranial Magnetic Stimulation in various head models. A number of heterogeneous head models have been developed using MRI data of real patients, including healthy individuals as well as patients of Parkinson's disease. Simulations of Transcranial Magnetic Stimulation performed on 22 anatomically different models highlight the differences in induced stimulation. A standard Figure of 8 coil is used with frequency 2.5 kHz, placed 5 mm above the head. We compare cortical stimulation, volume of brain tissue stimulated, specificity, and maximum E-field induced in the brain for models ranging from ages 20 to 60. Results show that stimulation varies drastically between patients of the same age and health status depending upon brain-scalp distance, which is not necessarily a linear progression with age.

  14. Theory of mind correlates with clinical insight but not cognitive insight in patients with schizophrenia.

    Science.gov (United States)

    Zhang, Qi; Li, Xu; Parker, Giverny J; Hong, Xiao-Hong; Wang, Yi; Lui, Simon S Y; Neumann, David L; Cheung, Eric F C; Shum, David H K; Chan, Raymond C K

    2016-03-30

    Research on the relationship between insight and social cognition, in particular Theory of Mind (ToM), in schizophrenia has yielded mixed findings to date. Very few studies, however, have assessed both clinical insight and cognitive insight when examining their relationships with ToM in schizophrenia. The current study thus investigated the relationship between clinical insight, cognitive insight, and ToM in a sample of 56 patients with schizophrenia and 30 healthy controls. Twenty-seven patients were classified as low in clinical insight according to their scores on the 'insight' item (G12) of the Positive and Negative Syndrome Scale (PANSS). Moreover, cognitive insight and ToM were assessed with the Beck Cognitive Insight Scale (BCIS) and the Yoni task, respectively. The results indicated that patients with poor clinical insight performed worse on tasks of second-order cognitive and affective ToM, while the ToM performance of patients with high clinical insight was equivalent to that of healthy controls. Furthermore, while clinical insight was correlated with ToM and clinical symptoms, cognitive insight did not correlate with clinical insight, ToM, or clinical symptoms. Clinical insight thus appears to be an important factor related to ToM in schizophrenia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Reappraising the functional implications of the primate visual anatomical hierarchy.

    Science.gov (United States)

    Hegdé, Jay; Felleman, Daniel J

    2007-10-01

    The primate visual system has been shown to be organized into an anatomical hierarchy by the application of a few principled criteria. It has been widely assumed that cortical visual processing is also hierarchical, with the anatomical hierarchy providing a defined substrate for clear levels of hierarchical function. A large body of empirical evidence seemed to support this assumption, including the general observations that functional properties of visual neurons grow progressively more complex at progressively higher levels of the anatomical hierarchy. However, a growing body of evidence, including recent direct experimental comparisons of functional properties at two or more levels of the anatomical hierarchy, indicates that visual processing neither is hierarchical nor parallels the anatomical hierarchy. Recent results also indicate that some of the pathways of visual information flow are not hierarchical, so that the anatomical hierarchy cannot be taken as a strict flowchart of visual information either. Thus, while the sustaining strength of the notion of hierarchical processing may be that it is rather simple, its fatal flaw is that it is overly simplistic.

  16. Multivariate pattern analysis reveals anatomical connectivity differences between the left and right mesial temporal lobe epilepsy

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    Peng Fang

    2015-01-01

    Full Text Available Previous studies have demonstrated differences of clinical signs and functional brain network organizations between the left and right mesial temporal lobe epilepsy (mTLE, but the anatomical connectivity differences underlying functional variance between the left and right mTLE remain uncharacterized. We examined 43 (22 left, 21 right mTLE patients with hippocampal sclerosis and 39 healthy controls using diffusion tensor imaging. After the whole-brain anatomical networks were constructed for each subject, multivariate pattern analysis was applied to classify the left mTLE from the right mTLE and extract the anatomical connectivity differences between the left and right mTLE patients. The classification results reveal 93.0% accuracy for the left mTLE versus the right mTLE, 93.4% accuracy for the left mTLE versus controls and 90.0% accuracy for the right mTLE versus controls. Compared with the right mTLE, the left mTLE exhibited a different connectivity pattern in the cortical-limbic network and cerebellum. The majority of the most discriminating anatomical connections were located within or across the cortical-limbic network and cerebellum, thereby indicating that these disease-related anatomical network alterations may give rise to a portion of the complex of emotional and memory deficit between the left and right mTLE. Moreover, the orbitofrontal gyrus, cingulate cortex, hippocampus and parahippocampal gyrus, which exhibit high discriminative power in classification, may play critical roles in the pathophysiology of mTLE. The current study demonstrated that anatomical connectivity differences between the left mTLE and the right mTLE may have the potential to serve as a neuroimaging biomarker to guide personalized diagnosis of the left and right mTLE.

  17. Creating vascular models by postprocessing computed tomography angiography images: a guide for anatomical education.

    Science.gov (United States)

    Govsa, Figen; Ozer, Mehmet Asim; Sirinturk, Suzan; Eraslan, Cenk; Alagoz, Ahmet Kemal

    2017-08-01

    A new application of teaching anatomy includes the use of computed tomography angiography (CTA) images to create clinically relevant three-dimensional (3D) printed models. The purpose of this article is to review recent innovations on the process and the application of 3D printed models as a tool for using under and post-graduate medical education. Images of aortic arch pattern received by CTA were converted into 3D images using the Google SketchUp free software and were saved in stereolithography format. Using a 3D printer (Makerbot), a model mode polylactic acid material was printed. A two-vessel left aortic arch was identified consisting of the brachiocephalic trunk and left subclavian artery. The life-like 3D models were rotated 360° in all axes in hand. The early adopters in education and clinical practices have embraced the medical imaging-guided 3D printed anatomical models for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between the anatomical structures. Printed vascular models are used to assist in preoperative planning, develop intraoperative guidance tools, and to teach patients surgical trainees in surgical practice.

  18. Live Donor Renal Anatomic Asymmetry and Post-Transplant Renal Function

    Science.gov (United States)

    Tanriover, Bekir; Fernandez, Sonalis; Campenot, Eric S.; Newhouse, Jeffrey H.; Oyfe, Irina; Mohan, Prince; Sandikci, Burhaneddin; Radhakrishnan, Jai; Wexler, Jennifer J.; Carroll, Maureen A.; Sharif, Sairah; Cohen, David J.; Ratner, Lloyd E.; Hardy, Mark A.

    2014-01-01

    Background Relationship between live donor renal anatomic asymmetry and post-transplant recipient function has not been studied extensively. Methods We analyzed 96 live-kidney donors, who had anatomical asymmetry (>10% renal length and/or volume difference calculated from CT angiograms) and their matching recipients. Split function differences (SFD) were quantified with 99mTc-DMSA renography. Implantation biopsies at time-zero were semi-quantitatively scored. A comprehensive model utilizing donor renal volume adjusted to recipient weight (Vol/Wgt), SFD, and biopsy score was used to predict recipient estimated glomerular filtration rate (eGFR) at one-year. Primary analysis consisted of a logistic regression model of outcome (odds of developing eGFR>60ml/min/1.73 m2 at one-year), a linear regression model of outcome (predicting recipient eGFR at one-year, using the CKD-EPI formula), and a Monte Carlo simulation based on the linear regression model (N=10,000 iterations). Results In the study cohort, the mean Vol/Wgt and eGFR at one-year were 2.04 ml/kg and 60.4 ml/min/1.73m2, respectively. Volume and split ratios between two donor kidneys were strongly correlated (r=0.79, p-value10%) were not different (p=0.190). On multivariate models, only Vol/Wgt was significantly associated with higher odds of having eGFR>60ml/min/1.73 m2 (OR=8.94, 95% CI 2.47–32.25, p=0.001) and had a strong discriminatory power in predicting the risk of eGFRrenal anatomic asymmetry, Vol/Wgt appears to be a major determinant of recipient renal function at one-year post-transplantation. Renography can be replaced with CT volume calculation in estimating split renal function. PMID:25719258

  19. Inexpensive anatomical trainer for bronchoscopy.

    Science.gov (United States)

    Di Domenico, Stefano; Simonassi, Claudio; Chessa, Leonardo

    2007-08-01

    Flexible fiberoptic bronchoscopy is an indispensable tool for optimal management of intensive care unit patients. However, the acquisition of sufficient training in bronchoscopy is not straightforward during residency, because of technical and ethical problems. Moreover, the use of commercial simulators is limited by their high cost. In order to overcome these limitations, we realized a low-cost anatomical simulator to acquire and maintain the basic skill to perform bronchoscopy in ventilated patients. We used 1.5 mm diameter iron wire to construct the bronchial tree scaffold; glazier-putty was applied to create the anatomical model. The model was covered by several layers of newspaper strips previously immersed in water and vinilic glue. When the model completely dried up, it was detached from the scaffold by cutting it into six pieces, it was reassembled, painted and fitted with an endotracheal tube. We used very cheap material and the final cost was euro16. The trainer resulted in real-scale and anatomically accurate, with appropriate correspondence on endoscopic view between model and patients. All bronchial segments can be explored and easily identified by endoscopic and external vision. This cheap simulator is a valuable tool for practicing, particularly in a hospital with limited resources for medical training.

  20. Palmaris Longus Muscle's Prevalence in Different Nations and Interesting Anatomical Variations: Review of the Literature.

    Science.gov (United States)

    Ioannis, Dimitriou; Anastasios, Katsourakis; Konstantinos, Natsis; Lazaros, Kostretzis; Georgios, Noussios

    2015-11-01

    The prevalence of the palmaris longus (PL) muscle varies more than any other muscle in the human body. Its absence across the world ranges between 1.5% and 63.9%. It presents with many different anomalies, discovered either clinically, intraoperatively or after anatomical examination of cadavers. This paper includes recent studies and reports about the presence and variations of the PL muscle, thereby illustrating the differences between ethnic groups, as well as emphasizing the different ways of finding it, during daily clinical and surgical practice.

  1. May–Thurner syndrome: Correlation between digital subtraction and computed tomography venography

    Directory of Open Access Journals (Sweden)

    Ying-Sheng Kuo

    2015-04-01

    Conclusion: The cross-sectional area ratio and diameter ratio in CTV correlate with the reflux start-up time in DSV. For May–Thurner syndrome, both CTV and DSV provide essential information for diagnosis and evaluation of the disease. The positive correlation between anatomical and hemodynamic properties corresponds with the underlying pathophysiology.

  2. The forearm complex: anatomy, biomechanics and clinical considerations.

    Science.gov (United States)

    LaStayo, Paul C; Lee, Michael J

    2006-01-01

    The forearm complex is comprised of the proximal radioulnar joint, middle radioulnar joint/interosseous membrane, and the distal radioulnar joint. These three areas function in a coordinated manner to rotate the hand in space and allow performance of functional tasks. If a structure or structures in one of these three areas is disrupted, this can adversely affect the function at any of the other two remaining areas. Surgical intervention focuses on restoring anatomical alignment to preserve the function of the forearm complex. Rehabilitation is guided by the relationships between the three areas of the forearm complex and the awareness of clinical signs, symptoms, and complications. The purposes of this paper are to 1) describe the anatomy and biomechanical function of the forearm complex and 2) discuss clinical correlates pertaining to select forearm injuries (excluding peripheral nerve injuries) that may affect forearm function.

  3. Anatomically contoured plates for fixation of rib fractures.

    Science.gov (United States)

    Bottlang, Michael; Helzel, Inga; Long, William B; Madey, Steven

    2010-03-01

    : Intraoperative contouring of long bridging plates for stabilization of flail chest injuries is difficult and time consuming. This study implemented for the first time biometric parameters to derive anatomically contoured rib plates. These plates were tested on a range of cadaveric ribs to quantify plate fit and to extract a best-fit plating configuration. : Three left and three right rib plates were designed, which accounted for anatomic parameters required when conforming a plate to the rib surface. The length lP over which each plate could trace the rib surface was evaluated on 109 cadaveric ribs. For each rib level 3-9, the plate design with the highest lP value was extracted to determine a best-fit plating configuration. Furthermore, the characteristic twist of rib surfaces was measured on 49 ribs to determine the surface congruency of anatomic plates with a constant twist. : The tracing length lP of the best-fit plating configuration ranged from 12.5 cm to 14.7 cm for ribs 3-9. The corresponding range for standard plates was 7.1-13.7 cm. The average twist of ribs over 8-cm, 12-cm, and 16-cm segments was 8.3 degrees, 20.6 degrees, and 32.7 degrees, respectively. The constant twist of anatomic rib plates was not significantly different from the average rib twist. : A small set of anatomic rib plates can minimize the need for intraoperative plate contouring for fixation of ribs 3-9. Anatomic rib plates can therefore reduce the time and complexity of flail chest stabilization and facilitate spanning of flail segments with long plates.

  4. Correlations between Clinical Judgement and Learning Style Preferences of Nursing Students in the Simulation Room

    Science.gov (United States)

    Hallin, Karin; Häggström, Marie; Bäckström, Britt; Kristiansen, Lisbeth Porskrog

    2016-01-01

    Background: Health care educators account for variables affecting patient safety and are responsible for developing the highly complex process of education planning. Clinical judgement is a multidimensional process, which may be affected by learning styles. The aim was to explore three specific hypotheses to test correlations between nursing students’ team achievements in clinical judgement and emotional, sociological and physiological learning style preferences. Methods: A descriptive cross-sectional study was conducted with Swedish university nursing students in 2012-2013. Convenience sampling was used with 60 teams with 173 nursing students in the final semester of a three-year Bachelor of Science in nursing programme. Data collection included questionnaires of personal characteristics, learning style preferences, determined by the Dunn and Dunn Productivity Environmental Preference Survey, and videotaped complex nursing simulation scenarios. Comparison with Lasater Clinical Judgement Rubric and Non-parametric analyses were performed. Results: Three significant correlations were found between the team achievements and the students’ learning style preferences: significant negative correlation with ‘Structure’ and ‘Kinesthetic’ at the individual level, and positive correlation with the ‘Tactile’ variable. No significant correlations with students’ ‘Motivation’, ‘Persistence’, ‘Wish to learn alone’ and ‘Wish for an authoritative person present’ were seen. Discussion and Conclusion: There were multiple complex interactions between the tested learning style preferences and the team achievements of clinical judgement in the simulation room, which provides important information for the becoming nurses. Several factors may have influenced the results that should be acknowledged when designing further research. We suggest conducting mixed methods to determine further relationships between team achievements, learning style preferences

  5. Anatomical variants of lister's tubercle; A new morphological classification based on magnetic resonance imaging

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    Chan, Wan Ying; Chong, Le Roy [Dept. of Radiology, Changi General Hospital, Singapore (Singapore)

    2017-11-15

    Lister's tubercle is used as a standard anatomical landmark in hand surgery and arthroscopy procedures. In this study, we aimed to evaluate and propose a classification for anatomical variants of Lister's tubercle. Between September 2011 and July 2014, 360 MRI examinations for wrists performed using 1.5T scanners in a single institution were retrospectively evaluated. The prevalence of anatomical variants of Lister's tubercle based on the heights and morphology of its radial and ulnar peaks was assessed. These were classified into three distinct types: radial peak larger than ulnar peak (Type 1), similar radial and ulnar peaks (Type 2) and ulnar peak larger than radial peak (Type 3). Each type was further divided into 2 subtypes (A and B) based on the morphology of the peaks. The proportions of Type 1, Type 2, and Type 3 variants in the study population were 69.2, 21.4, and 9.5%, respectively. For the subtypes, the Type 1A variant was the most common (41.4%) and conformed to the classical appearance of Lister's tubercle; whereas, Type 3A and 3B variants were rare configurations (6.4% and 3.1%, respectively) wherein the extensor pollicis longus tendon coursed along the radial aspect of Lister's tubercle. Anatomical variations of Lister's tubercle have potential clinical implications for certain pathological conditions and pre-procedural planning. The proposed classification system facilitates a better understanding of these anatomical variations and easier identification of at-risk and rare variants.

  6. Anatomical study of middle cluneal nerve entrapment

    Directory of Open Access Journals (Sweden)

    Konno T

    2017-06-01

    Full Text Available Tomoyuki Konno,1 Yoichi Aota,2 Tomoyuki Saito,1 Ning Qu,3 Shogo Hayashi,3 Shinichi Kawata,3 Masahiro Itoh3 1Department of Orthopaedic Surgery, Yokohama City University, 2Department of Spine and Spinal Cord, Yokohama Brain and Spine Center, Yokohama City, 3Department of Anatomy, Tokyo Medical University, Tokyo, Japan Object: Entrapment of the middle cluneal nerve (MCN under the long posterior sacroiliac ligament (LPSL is a possible, and underdiagnosed, cause of low-back and/or leg symptoms. To date, detailed anatomical studies of MCN entrapment are few. The purpose of this study was to ascertain, using cadavers, the relationship between the MCN and LPSL and to investigate MCN entrapment. Methods: A total of 30 hemipelves from 20 cadaveric donors (15 female, 5 male designated for education or research, were studied by gross anatomical dissection. The age range of the donors at death was 71–101 years with a mean of 88 years. Branches of the MCN were identified under or over the gluteus maximus fascia caudal to the posterior superior iliac spine (PSIS and traced laterally as far as their finest ramification. Special attention was paid to the relationship between the MCN and LPSL. The distance from the branch of the MCN to the PSIS and to the midline and the diameter of the MCN were measured. Results: A total of 64 MCN branches were identified in the 30 hemipelves. Of 64 branches, 10 (16% penetrated the LPSL. The average cephalocaudal distance from the PSIS to where the MCN penetrated the LPSL was 28.5±11.2 mm (9.1–53.7 mm. The distance from the midline was 36.0±6.4 mm (23.5–45.2 mm. The diameter of the MCN branch traversing the LPSL averaged 1.6±0.5 mm (0.5–3.1 mm. Four of the 10 branches penetrating the LPSL had obvious constriction under the ligament. Conclusion: This is the first anatomical study illustrating MCN entrapment. It is likely that MCN entrapment is not a rare clinical entity. Keywords: middle cluneal nerve, sacroiliac joint

  7. [Expression and correlation of Fra-1 and HMGA1 in laryngeal squamous cell carcinoma].

    Science.gov (United States)

    Zhang, Y L; Song, X F; Duan, Y J; Zhao, R L

    2017-12-07

    Objective: To investigate the expressions of Fra -1 and HMGA 1 in laryngeal squamous cell carcinoma and their correlation . Methods: Immunohistochemistry and reverse transcription-polymer chain reaction (RT-PCR) were used to detect the expressions of HMGA 1 and Fra -1 in laryngeal squamous carcinoma tissues in 47 cases and para - carcinoma tissues in 21 cases ( the First Hospital of Shijiazhuang ). The relationship between the gene expressions in carcinoma tissues and clinopathological parameters such as pathological grade, clinical stage, lymph metastasis, age and anatomic site and the relevance of the two gene expressions were analyzed . SPSS 13.0 software was used to analyze the data . Results: The positive expression rates of Fra-1 and HMGA1 proteins in laryngeal squamous cancer tissue were 48.9% and 53.2%, which were respectively higher than the rates of 19.0% for Fra-1 (χ(2)=5.416, P 0.05). The expression of HMGA 1 gene was correlation with pathological grade, clinical stage, lymph metastasis and age (t values were -1.112, -1.065, -1.009 and -1.066, all P0.05). The expressions of Fra -1 and HMGA 1 gene were positively correlation (r=0.672, P<0.05). Conclusions: In laryngeal squamous cancer, Fra -1 and HMGA 1 are excessive expression, with a positive correlation between the expressions of both genes .

  8. UNMASKING MASKED HYPERTENSION: PREVALENCE, CLINICAL IMPLICATIONS, DIAGNOSIS, CORRELATES, AND FUTURE DIRECTIONS

    Science.gov (United States)

    Peacock, James; Diaz, Keith M.; Viera, Anthony J.; Schwartz, Joseph E.; Shimbo, Daichi

    2014-01-01

    ‘Masked hypertension’ is defined as having non-elevated clinic blood pressure (BP) with elevated out-of-clinic average BP, typically determined by ambulatory BP monitoring. Approximately 15–30% of adults with non-elevated clinic BP have masked hypertension. Masked hypertension is associated with increased risks of cardiovascular morbidity and mortality compared to sustained normotension (non-elevated clinic and ambulatory BP), which is similar to or approaching the risk associated with sustained hypertension (elevated clinic and ambulatory BP). The confluence of increased cardiovascular risk and a failure to be diagnosed by the conventional approach of clinic BP measurement makes masked hypertension a significant public health concern. However, many important questions remain. First, the definition of masked hypertension varies across studies. Further, the best approach in the clinical setting to exclude masked hypertension also remains unknown. It is unclear whether home BP monitoring is an adequate substitute for ambulatory BP monitoring in identifying masked hypertension. Few studies have examined the mechanistic pathways that may explain masked hypertension. Finally, scarce data are available on the best approach to treating individuals with masked hypertension. Herein, we review the current literature on masked hypertension including definition, prevalence, clinical implications, special patient populations, correlates, issues related to diagnosis, treatment, and areas for future research. PMID:24573133

  9. Connecting imaging mass spectrometry and magnetic resonance imaging-based anatomical atlases for automated anatomical interpretation and differential analysis.

    Science.gov (United States)

    Verbeeck, Nico; Spraggins, Jeffrey M; Murphy, Monika J M; Wang, Hui-Dong; Deutch, Ariel Y; Caprioli, Richard M; Van de Plas, Raf

    2017-07-01

    Imaging mass spectrometry (IMS) is a molecular imaging technology that can measure thousands of biomolecules concurrently without prior tagging, making it particularly suitable for exploratory research. However, the data size and dimensionality often makes thorough extraction of relevant information impractical. To help guide and accelerate IMS data analysis, we recently developed a framework that integrates IMS measurements with anatomical atlases, opening up opportunities for anatomy-driven exploration of IMS data. One example is the automated anatomical interpretation of ion images, where empirically measured ion distributions are automatically decomposed into their underlying anatomical structures. While offering significant potential, IMS-atlas integration has thus far been restricted to the Allen Mouse Brain Atlas (AMBA) and mouse brain samples. Here, we expand the applicability of this framework by extending towards new animal species and a new set of anatomical atlases retrieved from the Scalable Brain Atlas (SBA). Furthermore, as many SBA atlases are based on magnetic resonance imaging (MRI) data, a new registration pipeline was developed that enables direct non-rigid IMS-to-MRI registration. These developments are demonstrated on protein-focused FTICR IMS measurements from coronal brain sections of a Parkinson's disease (PD) rat model. The measurements are integrated with an MRI-based rat brain atlas from the SBA. The new rat-focused IMS-atlas integration is used to perform automated anatomical interpretation and to find differential ions between healthy and diseased tissue. IMS-atlas integration can serve as an important accelerator in IMS data exploration, and with these new developments it can now be applied to a wider variety of animal species and modalities. This article is part of a Special Issue entitled: MALDI Imaging, edited by Dr. Corinna Henkel and Prof. Peter Hoffmann. Copyright © 2017. Published by Elsevier B.V.

  10. Dental Pulp: Correspondences and Contradictions between Clinical and Histological Diagnosis

    Science.gov (United States)

    Giuroiu, Cristian Levente; Căruntu, Irina-Draga; Lozneanu, Ludmila; Melian, Anca; Vataman, Maria; Andrian, Sorin

    2015-01-01

    Dental pulp represents a specialized connective tissue enclosed by dentin and enamel, the most highly mineralized tissues of the body. Consequently, the direct examination as well as pathological evaluation of dental pulp is difficult. Within this anatomical context, our study aimed to evaluate the correlation between dental pulp lesions and clinical diagnosis. Pulpectomies were performed for 54 patients with acute and chronic irreversible pulpitides and for 5 patients (control group) with orthodontic extractions. The morphological features were semiquantitatively assessed by specific score values. The clinical and morphological correspondence was noted for 35 cases (68.62%), whereas inconsistency was recorded for 16 cases (31.38%). The results of the statistical analysis revealed the correlations between clinically and pathologically diagnosed acute/chronic pulpitides. No significant differences were established between the score values for inflammatory infiltrate intensity, collagen depositions, calcifications and necrosis, and acute, respectively chronic pulpitides. We also obtained significant differences between acute pulpitides and inflammatory infiltrate and calcifications and between chronic pulpitides and inflammatory infiltrate, collagen deposition, and calcifications. On the basis of the predominant pathological aspects, namely, acute and chronic pulpitis, we consider that the classification schemes can be simplified by adequately reducing the number of clinical entities. PMID:26078972

  11. Automatic anatomically selective image enhancement in digital chest radiography

    International Nuclear Information System (INIS)

    Sezan, M.I.; Minerbo, G.N.; Schaetzing, R.

    1989-01-01

    The authors develop a technique for automatic anatomically selective enhancement of digital chest radiographs. Anatomically selective enhancement is motivated by the desire to simultaneously meet the different enhancement requirements of the lung field and the mediastinum. A recent peak detection algorithm and a set of rules are applied to the image histogram to determine automatically a gray-level threshold between the lung field and mediastinum. The gray-level threshold facilitates anatomically selective gray-scale modification and/or unsharp masking. Further, in an attempt to suppress possible white-band or black-band artifacts due to unsharp masking at sharp edges, local-contrast adaptivity is incorporated into anatomically selective unsharp masking by designing an anatomy-sensitive emphasis parameter which varies asymmetrically with positive and negative values of the local image contrast

  12. CT following US for possible appendicitis: anatomic coverage

    Energy Technology Data Exchange (ETDEWEB)

    O' Malley, Martin E. [University of Toronto, Princess Margaret Hospital, 3-920, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Alharbi, Fawaz [University of Toronto, Toronto General Hospital, NCSB 1C572, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Qassim University, Department of Medical Imaging, Buraydah, Qassim (Saudi Arabia); Chawla, Tanya P. [University of Toronto, Mount Sinai Hospital, Room 567, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Moshonov, Hadas [University of Toronto, Joint Department of Medical Imaging, Toronto, Ontario (Canada)

    2016-02-15

    To determine superior-inferior anatomic borders for CT following inconclusive/nondiagnostic US for possible appendicitis. Ninety-nine patients with possible appendicitis and inconclusive/nondiagnostic US followed by CT were included in this retrospective study. Two radiologists reviewed CT images and determined superior-inferior anatomic borders required to diagnose or exclude appendicitis and diagnose alternative causes. This ''targeted'' coverage was used to estimate potential reduction in anatomic coverage compared to standard abdominal/pelvic CT. The study group included 83 women and 16 men; mean age 32 (median, 29; range 18-73) years. Final diagnoses were: nonspecific abdominal pain 50/99 (51 %), appendicitis 26/99 (26 %), gynaecological 12/99 (12 %), gastrointestinal 9/99 (10 %), and musculoskeletal 2/99 (2 %). Median dose-length product for standard CT was 890.0 (range, 306.3 - 2493.9) mGy.cm. To confidently diagnose/exclude appendicitis or identify alternative diagnoses, maximum superior-inferior anatomic CT coverage was the superior border of L2-superior border of pubic symphysis, for both reviewers. Targeted CT would reduce anatomic coverage by 30-55 % (mean 39 %, median 40 %) compared to standard CT. When CT is performed for appendicitis following inconclusive/nondiagnostic US, targeted CT from the superior border of L2-superior border of pubic symphysis can be used resulting in significant reduction in exposure to ionizing radiation compared to standard CT. (orig.)

  13. CT following US for possible appendicitis: anatomic coverage

    International Nuclear Information System (INIS)

    O'Malley, Martin E.; Alharbi, Fawaz; Chawla, Tanya P.; Moshonov, Hadas

    2016-01-01

    To determine superior-inferior anatomic borders for CT following inconclusive/nondiagnostic US for possible appendicitis. Ninety-nine patients with possible appendicitis and inconclusive/nondiagnostic US followed by CT were included in this retrospective study. Two radiologists reviewed CT images and determined superior-inferior anatomic borders required to diagnose or exclude appendicitis and diagnose alternative causes. This ''targeted'' coverage was used to estimate potential reduction in anatomic coverage compared to standard abdominal/pelvic CT. The study group included 83 women and 16 men; mean age 32 (median, 29; range 18-73) years. Final diagnoses were: nonspecific abdominal pain 50/99 (51 %), appendicitis 26/99 (26 %), gynaecological 12/99 (12 %), gastrointestinal 9/99 (10 %), and musculoskeletal 2/99 (2 %). Median dose-length product for standard CT was 890.0 (range, 306.3 - 2493.9) mGy.cm. To confidently diagnose/exclude appendicitis or identify alternative diagnoses, maximum superior-inferior anatomic CT coverage was the superior border of L2-superior border of pubic symphysis, for both reviewers. Targeted CT would reduce anatomic coverage by 30-55 % (mean 39 %, median 40 %) compared to standard CT. When CT is performed for appendicitis following inconclusive/nondiagnostic US, targeted CT from the superior border of L2-superior border of pubic symphysis can be used resulting in significant reduction in exposure to ionizing radiation compared to standard CT. (orig.)

  14. Quantitative evaluation of anatomical noise in chest digital tomosynthesis, digital radiography, and computed tomography

    International Nuclear Information System (INIS)

    Lee, D.; Kim, D.; Choi, S.; Kim, H.-J.; Choi, S.; Lee, H.

    2017-01-01

    Lung cancer is currently the worldwide leading cause of death from cancer. Thus, detection of lung cancer at its early stages is critical for improving the survival rate of patients. Chest digital tomosynthesis (CDT) is a recently developed imaging modality, combining many advantages of digital radiography (DR) and computed tomography (CT). This method has the potential to be widely used in the clinical setting. In this study, we introduce a developed CDT R/F system and compare its image quality with those of DR and CT, especially with respect to anatomical noise and lung nodule conspicuity, for LUNGMAN phantoms. The developed CDT R/F system consists of a CsI scintillator flat panel detector, X-ray tube, and tomosynthesis data acquisition geometry. For CDT R/F imaging, 41 projections were acquired at different angles, over the ± 20° angular range, in a linear translation geometry. To evaluate the clinical effectiveness of the CDT R/F system, the acquired images were compared with CT (Philips brilliance CT 64, Philips healthcare, U.S.) and DR (ADR-M, LISTEM, Korea) phantom images in terms of the anatomical noise power spectrum (aNPS). DR images exhibited low conspicuity for a small-size lung nodule, while CDT R/F and CT exhibited relatively high sensitivity for all lung nodule sizes. The aNPS of the CDT R/F system was better than that of DR, by resolving anatomical overlapping problems. In conclusion, the developed CDT R/F system is likely to contribute to early diagnosis of lung cancer, while requiring a relatively low patient dose, compared with CT.

  15. Quantitative evaluation of anatomical noise in chest digital tomosynthesis, digital radiography, and computed tomography

    Science.gov (United States)

    Lee, D.; Choi, S.; Lee, H.; Kim, D.; Choi, S.; Kim, H.-J.

    2017-04-01

    Lung cancer is currently the worldwide leading cause of death from cancer. Thus, detection of lung cancer at its early stages is critical for improving the survival rate of patients. Chest digital tomosynthesis (CDT) is a recently developed imaging modality, combining many advantages of digital radiography (DR) and computed tomography (CT). This method has the potential to be widely used in the clinical setting. In this study, we introduce a developed CDT R/F system and compare its image quality with those of DR and CT, especially with respect to anatomical noise and lung nodule conspicuity, for LUNGMAN phantoms. The developed CDT R/F system consists of a CsI scintillator flat panel detector, X-ray tube, and tomosynthesis data acquisition geometry. For CDT R/F imaging, 41 projections were acquired at different angles, over the ± 20° angular range, in a linear translation geometry. To evaluate the clinical effectiveness of the CDT R/F system, the acquired images were compared with CT (Philips brilliance CT 64, Philips healthcare, U.S.) and DR (ADR-M, LISTEM, Korea) phantom images in terms of the anatomical noise power spectrum (aNPS). DR images exhibited low conspicuity for a small-size lung nodule, while CDT R/F and CT exhibited relatively high sensitivity for all lung nodule sizes. The aNPS of the CDT R/F system was better than that of DR, by resolving anatomical overlapping problems. In conclusion, the developed CDT R/F system is likely to contribute to early diagnosis of lung cancer, while requiring a relatively low patient dose, compared with CT.

  16. Correlation between clinical and histopathological diagnoses in periapical inflammatory lesions.

    Science.gov (United States)

    Diegues, Liliane Lopes; Colombo Robazza, Carlos Roberto; Costa Hanemann, João Adolfo; Costa Pereira, Alessandro Antônio; Silva, Cléverson O

    2011-08-01

      The purpose of the present study was to evaluate the correlation between clinical and histopathological diagnoses of periapical inflammatory lesions, focusing mainly on cystic conditions.   Files dating from 1998 to 2006 at the Oral Pathology Laboratory, School of Dentistry, Alfenas Federal University, Brazil, were reviewed to identify cases with histopathological diagnoses of periapical inflammatory lesions. A total of 1788 files were analyzed, and 255 cases were identified with clinical diagnoses of periapical inflammatory lesions.   The most prevalent clinical diagnosis was apical periodontal cyst (59%), followed by periapical granuloma (20%), and dentoalveolar abscess (2%). After histopathological analysis, 53% of the cases represented apical periodontal cyst, 42% periapical granuloma, and 5% dentoalveolar abscess.   The outcomes of the present study show a high prevalence of periapical cysts among periapical inflammatory lesions. Moreover, this study highlights the importance of histopathological evaluation for the correct diagnosis of periapical inflammatory lesions. © 2011 Blackwell Publishing Asia Pty Ltd.

  17. Exploring brain function from anatomical connectivity

    Directory of Open Access Journals (Sweden)

    Gorka eZamora-López

    2011-06-01

    Full Text Available The intrinsic relationship between the architecture of the brain and the range of sensory and behavioral phenomena it produces is a relevant question in neuroscience. Here, we review recent knowledge gained on the architecture of the anatomical connectivity by means of complex network analysis. It has been found that corticocortical networks display a few prominent characteristics: (i modular organization, (ii abundant alternative processing paths and (iii the presence of highly connected hubs. Additionally, we present a novel classification of cortical areas of the cat according to the role they play in multisensory connectivity. All these properties represent an ideal anatomical substrate supporting rich dynamical behaviors, as-well-as facilitating the capacity of the brain to process sensory information of different modalities segregated and to integrate them towards a comprehensive perception of the real world. The result here exposed are mainly based in anatomical data of cats’ brain, but we show how further observations suggest that, from worms to humans, the nervous system of all animals might share fundamental principles of organization.

  18. The Correlation Between Q-angle (Clinical and TTTGdistance (Axial Computed thomography in Firuzgar Hospital, 2008

    Directory of Open Access Journals (Sweden)

    Ali Yeganeh

    2010-02-01

    Full Text Available Background:The purpose of this study was to evaluate the significance of the Q angle with respect to the patella position. We assess the correlation between the Q angles(calculated by clinical exam in different positions and CT indices (with more impression on TTTG.Method: Atotal number of 68 knee joints of 50 cases entered the study. Clinical examination was used to measure Q angle (in 3 positions of sitting, standing and supine. CT scan performed in 2 axial view of proximal tibia, and distal femor for   measurement of Tibial tuberosity-trochlear groove distance (TTTG and other CT   indices. Correlation between main variables calculated.and analysed with spss.Results: Supine Q angle were strongly correlated with standing Q angles and moderately with sitting Q angle.Sitting Q angle was moderately correlated with supine and standing Q angle and weakly with PTA.we found no other significant correlation between Q angle and CT indexes.Discussion: Our findings suggest that Q angle is not a valuable index for predicting the presence of patelofemoral malalignment.  

  19. NHS Trusts' clinical research activity and overall CQC performance - Is there a correlation?

    Science.gov (United States)

    Jonker, L; Fisher, S J

    2015-11-01

    Since the late 2000's, the creation of the National Institute for Health Research (NIHR) has transformed clinical research activity in the United Kingdom. This study sought to establish if there is a link between clinical research activity and overall NHS Trust performance. Retrospective cohort study. Data for NHS Trust performance were obtained from public databases, namely the Care Quality Commission (CQC) 2013 risk rating for overall performance, and 2012-13 NIHR records for clinical research activity. Applying Spearman's rank analysis, none of the Trust categories showed a correlation with CQC risk rating: small hospitals, r = -0.062 (P = 0.76; n = 27); medium, r = -0.224 (P = 0.13; n = 47); large, r = -0.008 (P = 0.96; n = 57); academic, r = -0.18 (P = 0.41; n = 24). Similar results were observed when CQC risk rating was compared with the number of different clinical research studies conducted per Trust. The degree of NIHR National Portfolio clinical research activity is not significantly related to CQC risk rating, used as an indicator of overall NHS Trust performance. Other studies have previously shown that increased research activity correlates with improved mortality rates, one component of CQC risk rating scores. Alternative tools may have to be explored to evaluate the impact of clinical research on NHS Trusts and its patients. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Clinical correlation of radiological spinal stenosis after standardization for vertebral body size

    International Nuclear Information System (INIS)

    Athiviraham, A.; Yen, D.; Scott, C.; Soboleski, D.

    2007-01-01

    Aim: To determine the relationship between the degree of radiographic lumbar spinal stenosis, adjusted with an internal control for vertebral body size, and disability from lumbar stenosis. Materials and methods: one hundred and twenty-three consecutive patients with clinical and radiological confirmation of neural impingement secondary to lumbar stenosis were enrolled prospectively. Thecal sac anteroposterior (AP) diameter (TSD) and cross-sectional area (CSA), and vertebral body AP dimension (VBD) were determined. These parameters were then correlated with patients' symptoms using the modified Roland-Morris questionnaire (RMQ) disability score. Results: No statistically significant inverse correlation was found between the TSD and RMQ score (p = 0.433), between the CSA and RMQ score (p = 0.124), or between the TSD:VBD ratio and RMQ score (p = 0.109). There was a significant positive correlation between the CSA:VBD ratio and RMQ score (p = .036), and therefore, there was no statistical support for an inverse relationship between the two. There was a significant difference in mean RMQ scores when the patients were divided into those with CSA greater than or equal to 70 mm 2 and those less than 70 mm 2 , with T = -2.104 and p = 0.038. Conclusion: The degree of radiographic lumbar spinal stenosis, even with the use of an internal control of vertebral body size and standardized disability questionnaires, does not correlate with clinical symptoms. However, patients with more severe stenosis below a CSA critical threshold of 70 mm 2 , have significantly greater functional disability

  1. [Project HRANAFINA--Croatian anatomical and physiological terminology].

    Science.gov (United States)

    Vodanović, Marin

    2012-01-01

    HRANAFINA--Croatian Anatomical and Physiological Terminology is a project of the University of Zagreb School of Dental Medicine funded by the Croatian Science Foundation. It is performed in cooperation with other Croatian universities with medical schools. This project has a two-pronged aim: firstly, building of Croatian anatomical and physiological terminology and secondly, Croatian anatomical and physiological terminology usage popularization between health professionals, medical students, scientists and translators. Internationally recognized experts from Croatian universities with medical faculties and linguistics experts are involved in the project. All project activities are coordinated in agreement with the National Coordinator for Development of Croatian Professional Terminology. The project enhances Croatian professional terminology and Croatian language in general, increases competitiveness of Croatian scientists on international level and facilitates the involvement of Croatian scientists, health care providers and medical students in European projects.

  2. Demographic and Clinical Correlates of Autism Symptom Domains and Autism Spectrum Diagnosis

    Science.gov (United States)

    Frazier, Thomas W.; Youngstrom, Eric A.; Embacher, Rebecca; Hardan, Antonio Y.; Constantino, John N.; Law, Paul; Findling, Robert L.; Eng, Charis

    2014-01-01

    Demographic and clinical factors may influence assessment of autism symptoms. This study evaluated these correlates and also examined whether social communication and interaction and restricted/repetitive behavior provided unique prediction of autism spectrum disorder diagnosis. We analyzed data from 7352 siblings included in the Interactive…

  3. An anatomical study of the proximal aspect of the medial femoral condyle to define the proximal-distal condylar length

    Directory of Open Access Journals (Sweden)

    Chia-Ming Chang

    2017-01-01

    Full Text Available Objective: Despite its possible role in knee arthroplasty, the proximal-distal condylar length (PDCL of the femur has never been reported in the literature. We conducted an anatomic study of the proximal aspect of the medial femoral condyle to propose a method for measuring the PDCL. Materials and Methods: Inspection of dried bone specimens was carried out to assure the most proximal condylar margin (MPCM as the eligible starting point to measure the PDCL. Simulation surgery was performed on seven pairs of cadaveric knees to verify the clinical application of measuring the PDCL after locating the MPCM. Interobserver reliability of this procedure was also analyzed. Results: Observation of the bone specimens showed that the MPCM is a concavity formed by the junction of the distal end of the supracondylar ridge and the proximal margin of the medial condyle. This anatomically distinctive structure made the MPCM an unambiguous landmark. The cadaveric simulation surgical dissection demonstrated that the MPCM is easily accessed in a surgical setting, making the measurement of the PDCL plausible. The intraclass correlation coefficient was 0.78, indicating good interobserver reliability for this technique. Conclusion: This study has suggested that the PDCL can be measured based on the MPCM in a surgical setting. PDCL measurement might be useful in joint line position management, selection of femoral component sizes, and other applications related to the proximal-distal dimension of the knee. Further investigation is required.

  4. Kinematic measures for upper limb robot-assisted therapy following stroke and correlations with clinical outcome measures: A review.

    Science.gov (United States)

    Tran, Vi Do; Dario, Paolo; Mazzoleni, Stefano

    2018-03-01

    This review classifies the kinematic measures used to evaluate post-stroke motor impairment following upper limb robot-assisted rehabilitation and investigates their correlations with clinical outcome measures. An online literature search was carried out in PubMed, MEDLINE, Scopus and IEEE-Xplore databases. Kinematic parameters mentioned in the studies included were categorized into the International Classification of Functioning, Disability and Health (ICF) domains. The correlations between these parameters and the clinical scales were summarized. Forty-nine kinematic parameters were identified from 67 articles involving 1750 patients. The most frequently used parameters were: movement speed, movement accuracy, peak speed, number of speed peaks, and movement distance and duration. According to the ICF domains, 44 kinematic parameters were categorized into Body Functions and Structure, 5 into Activities and no parameters were categorized into Participation and Personal and Environmental Factors. Thirteen articles investigated the correlations between kinematic parameters and clinical outcome measures. Some kinematic measures showed a significant correlation coefficient with clinical scores, but most were weak or moderate. The proposed classification of kinematic measures into ICF domains and their correlations with clinical scales could contribute to identifying the most relevant ones for an integrated assessment of upper limb robot-assisted rehabilitation treatments following stroke. Increasing the assessment frequency by means of kinematic parameters could optimize clinical assessment procedures and enhance the effectiveness of rehabilitation treatments. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

  5. Live Donor Renal Anatomic Asymmetry and Posttransplant Renal Function.

    Science.gov (United States)

    Tanriover, Bekir; Fernandez, Sonalis; Campenot, Eric S; Newhouse, Jeffrey H; Oyfe, Irina; Mohan, Prince; Sandikci, Burhaneddin; Radhakrishnan, Jai; Wexler, Jennifer J; Carroll, Maureen A; Sharif, Sairah; Cohen, David J; Ratner, Lloyd E; Hardy, Mark A

    2015-08-01

    Relationship between live donor renal anatomic asymmetry and posttransplant recipient function has not been studied extensively. We analyzed 96 live kidney donors, who had anatomical asymmetry (>10% renal length and/or volume difference calculated from computerized tomography angiograms) and their matching recipients. Split function differences (SFD) were quantified with technetium-dimercaptosuccinic acid renography. Implantation biopsies at time 0 were semiquantitatively scored. A comprehensive model using donor renal volume adjusted to recipient weight (Vol/Wgt), SFD, and biopsy score was used to predict recipient estimated glomerular filtration rate (eGFR) at 1 year. Primary analysis consisted of a logistic regression model of outcome (odds of developing eGFR>60 mL/min/1.73 m(2) at 1 year), a linear regression model of outcome (predicting recipient eGFR at one-year, using the chronic kidney disease-epidemiology collaboration formula), and a Monte Carlo simulation based on the linear regression model (N=10,000 iterations). In the study cohort, the mean Vol/Wgt and eGFR at 1 year were 2.04 mL/kg and 60.4 mL/min/1.73 m(2), respectively. Volume and split ratios between 2 donor kidneys were strongly correlated (r = 0.79, P 10%) were not different (P = 0.190). On multivariate models, only Vol/Wgt was significantly associated with higher odds of having eGFR > 60 mL/min/1.73 m (odds ratio, 8.94, 95% CI 2.47-32.25, P = 0.001) and had a strong discriminatory power in predicting the risk of eGFR less than 60 mL/min/1.73 m(2) at 1 year [receiver operating curve (ROC curve), 0.78, 95% CI, 0.68-0.89]. In the presence of donor renal anatomic asymmetry, Vol/Wgt appears to be a major determinant of recipient renal function at 1 year after transplantation. Renography can be replaced with CT volume calculation in estimating split renal function.

  6. Anatomic, Clinical, and Neuropsychological Correlates of Spelling Errors in Primary Progressive Aphasia

    Science.gov (United States)

    Shim, HyungSub; Hurley, Robert S.; Rogalski, Emily; Mesulam, M.-Marsel

    2012-01-01

    This study evaluates spelling errors in the three subtypes of primary progressive aphasia (PPA): agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S). Forty-one PPA patients and 36 age-matched healthy controls were administered a test of spelling. The total number of errors and types of errors in spelling to dictation of regular words,…

  7. Linking retinotopic fMRI mapping and anatomical probability maps of human occipital areas V1 and V2.

    Science.gov (United States)

    Wohlschläger, A M; Specht, K; Lie, C; Mohlberg, H; Wohlschläger, A; Bente, K; Pietrzyk, U; Stöcker, T; Zilles, K; Amunts, K; Fink, G R

    2005-05-15

    Using functional MRI, we characterized field sign maps of the occipital cortex and created three-dimensional maps of these areas. By averaging the individual maps into group maps, probability maps of functionally defined V1 or V2 were determined and compared to anatomical probability maps of Brodmann areas BA17 and BA18 derived from cytoarchitectonic analysis (Amunts, K., Malikovic, A., Mohlberg, H., Schormann, T., Zilles, K., 2000. Brodmann's areas 17 and 18 brought into stereotaxic space-where and how variable? NeuroImage 11, 66-84). Comparison of areas BA17/V1 and BA18/V2 revealed good agreement of the anatomical and functional probability maps. Taking into account that our functional stimulation (due to constraints of the visual angle of stimulation achievable in the MR scanner) only identified parts of V1 and V2, for statistical evaluation of the spatial correlation of V1 and BA17, or V2 and BA18, respectively, the a priori measure kappa was calculated testing the hypothesis that a region can only be part of functionally defined V1 or V2 if it is also in anatomically defined BA17 or BA18, respectively. kappa = 1 means the hypothesis is fully true, kappa = 0 means functionally and anatomically defined visual areas are independent. When applying this measure to the probability maps, kappa was equal to 0.84 for both V1/BA17 and V2/BA18. The data thus show a good correspondence of functionally and anatomically derived segregations of early visual processing areas and serve as a basis for employing anatomical probability maps of V1 and V2 in group analyses to characterize functional activations of early visual processing areas.

  8. Relevancia de la anatomía humana en el ejercicio de la medicina de asistencia primaria y en el estudio de las asignaturas de segundo ciclo de la licenciatura en medicina Relevance of Gross Human Anatomy in health primary care and in clinical disciplines of medical studies

    Directory of Open Access Journals (Sweden)

    Blanca Mompeó

    2003-03-01

    Full Text Available El objetivo de este trabajo fue conocer la relevancia y la necesidad que de conocimientos en Anatomía macroscópica tenían los médicos de asistencia primaria y los alumnos del segundo ciclo de la licenciatura en Medicina. También nos interesó saber cual era su opinión sobre esta disciplina del curriculum médico. Para ello, médicos de asistencia primaria de los Centros de Salud de la provincia de las Palmas y alumnos de 6º curso de la Licenciatura en Medicina de la U.L.P.G.C., cumplimentaron un cuestionario en el que se valoraron los aspectos referidos. Ambos grupos consideraron que la Anatomía era fundamental para la exploración física y para la interpretación de técnicas de imagen. Los conocimientos más necesarios a la hora de su aplicación a la práctica y al estudio de las asignaturas clínicas fueron los de sistema nervioso y aparato locomotor. Modificarían la docencia que recibieron, incrementando el número de clases prácticas y dándole un mayor enfoque clínico. Los tres objetivos fundamentales de aprendizaje propuestos por los profesionales en ejercicio fueron: 1. Conocer las estructuras anatómicas y relaciones entre ellas 2. Reconocer estructuras anatómicas mediante técnicas de imagen y 3. Ser capaz de describir las bases anatómicas de la patología.The aim of this work was to highlight the relevance and necessity about gross anatomy knowledge had on family physicians and clinical-courses medical students. We also wanted to know their suggestions about the discipline Human Anatomy in Medical studies. To obtain our objective, physicians of Health Centres in Las Palmas and last-year medical students of U.L.P.G.C. were asked to fill a questionnaire. In this questionnaire the referred items were considered. The data obtained showed that both groups thought that Gross Anatomy was fundamental in the physical exploration and the image techniques interpretation. They considered that anatomical knowledge more necessary for

  9. High-resolution CT of the lungs: Anatomic-pathologic correlation

    International Nuclear Information System (INIS)

    Stein, M.G.; Webb, W.R.; Finkbeiner, W.; Gamsu, G.

    1986-01-01

    The interpretation of thin-section (1.5-mm), high-resolution CT scans of the lungs has been limited by lack of direct radiologic and pathologic correlation. The author scanned fresh inflated isolated lungs from ten healthy and five diseased subjects using thin-section, high-resolution techniques. The lungs were then fixed by inflation with endobronchial Formalin. Gough sections (1 mm thick) were obtained at the same levels as the CT scans. In healthy subjects, secondary lobules were identified by the presence of visible interlobular septa and central arterioles. In some patients with disease, septal thickening was visible. In patients with honeycombing cystic areas of destroyed lung were seen, along with areas of fibrosis. Emphysema was well evaluated. Thin-section, high-resolution CT can define lung architecture and may resolve mild changes of the interstitium

  10. Anatomic study of the pelvis in carcinoma of the uterine cervix as related to the box technique

    International Nuclear Information System (INIS)

    Zunino, Silvia; Rosato, Otilio; Lucino, Sergio; Jauregui, Esteban; Rossi, Luis; Venencia, Daniel

    1999-01-01

    Purpose: To review the radiation therapy 'box' technique for cancer of the cervix by means of magnetic resonance imaging (MRI), lymphangiography, and anatomic studies on cadavers. Methods and Materials: From 1993 to 1996, the anatomic borders of the 'box' technique used at our Radiation Oncology Department--the superior border of the AP-PA fields at the inferior edge of L4; the inferior border at the inferior edge of the ischium; the lateral borders placed 2.5 cm outside of the bony pelvis rim; the anterior border of the lateral fields over the anterior edge of the pubic symphysis; and the posterior at the S2-S3 interspace - were reviewed in 35 sagittal MRI and 10 lymphangiographies of patients with FIGO IB (6), IIA (6), IIB (19), IIIB (3), and IVA (1). An anatomic revision was conducted on 30 cadavers to identify aortic bifurcation, lymphatic nodes, and uterus flexion. Results: In 50% of the patients with FIGO IB, the posterior border of the lateral field was inadequate to encompass the planning target volume (PTV), and in 67% with Stage IIA. In IIB, the anterior border was inadequate in 1 patient, and the posterior in 8 (42%). In IIB and IVA patients, the PTV was not encompassed. When correlating the anterior and posterior borders of the lateral field and the treatment volume in the 35 sagittal MRIs, the posterior border of the lateral field was inadequate in 49%, and the anterior border in 9% of the cases. According to the lymphangiography, the portals encompassed the external iliac nodes. Dissected female pelvises revealed that the aortic bifurcation occurred at the level of the inferior L4 edge in 80% of the cadavers. There was no correlation between uterus flexion in MRIs and in cadavers. Conclusion: The design of the lateral fields of the four-field technique for the irradiation of the uterine cervix based on anatomic bone references failed to encompass the planning-target volume in a significant number of patients

  11. Social, dietary and clinical correlates of oedema in children with severe acute malnutrition

    DEFF Research Database (Denmark)

    Rytter, Maren Johanne Heilskov; Namusoke, Hanifa; Babirekere-Iriso, Esther

    2015-01-01

    BACKGROUND: Severe acute malnutrition is a serious public health problem, and a challenge to clinicians. Why some children with malnutrition develop oedema (kwashiorkor) is not well understood. The objective of this study was to investigate socio-demographic, dietary and clinical correlates...... of oedema, in children hospitalised with severe acute malnutrition. METHODS: We recruited children with severe acute malnutrition admitted to Mulago Hospital, Uganda. Data was collected using questionnaires, clinical examination and measurement of blood haemoglobin, plasma c-reactive protein and α1-acid...... glycoprotein. Correlates of oedema were identified using multiple logistic regression analysis. RESULTS: Of 120 children included, 77 (64%) presented with oedematous malnutrition. Oedematous children were slightly older (17.7 vs. 15.0 months, p = 0.006). After adjustment for age and sex, oedematous children...

  12. Correlation of Traditional Point a With Anatomic Location of Uterine Artery and Ureter in Cancer of the Uterine Cervix

    International Nuclear Information System (INIS)

    Wang, K.-L.; Yang, Y.-C.; Chao, K. S. Clifford; Wu, M.-H.; Tai, H.-C.; Chen, T.-C.; Huang, M.-C.; Chen, J.-R.; Su, T.-H.; Chen, Y.-J.

    2007-01-01

    Purpose: Point A, used for dose specification for intracavitary brachytherapy for cervical cancer, is the point at which the uterine artery and ureter cross. This study assessed compatibility of commonly used traditional point A (TPA) and actual anatomic point A (APA). Methods and Materials: We visualized and placed radiopaque clips at the APA during pelvic and paraaortic lymphadenectomy in 11 patients with cervical carcinoma. Orthogonal and oblique radiographs were obtained after insertion of brachytherapy applicators. We measured the distance between the TPA and APA and estimated the brachytherapy dose to each of the two points. Results: A total of 64 brachytherapy treatments were performed. The mean distances between the TPA and APA were 5.2 ± 1.0 cm on the right and 5.4 ± 1.1 cm on the left. The estimated brachytherapy doses delivered to the APA as a percentage of the presumed 500-cGy fraction size to the TPA were 35.2% (176.6 ± 59.0 cGy) on the right and 30.0% (150.2 ± 42.9 cGy) on the left. The marked discrepancy in the position of the two points was not related to individual kinetic variations during brachytherapy treatment, tumor size, or bladder filling. Conclusions: The conventional TPA does not provide an accurate estimate of the APA determined during lymphadenectomy, indicating a need to reevaluate the current practice for determining the brachytherapy prescription for cervical cancer. ( (ClinicalTrials.gov) Identifier, NCT00319462)

  13. Double uterus with obstructed hemivagina and ipsilateral renal agenesis: pelvic anatomic variants in 87 cases.

    Science.gov (United States)

    Fedele, L; Motta, F; Frontino, G; Restelli, E; Bianchi, S

    2013-06-01

    What are the anatomic variants (and their frequencies) of double uterus, obstructed hemivagina and ipsilateral renal agenesis? Most cases examined (72.4%) were of the classic anatomic variant of the Herlyn-Werner-Wunderlich syndrome (with didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis) but the 27.6% of cases are of a rare variant of the syndrome (with uterus septum or cervical agenesis), showing relevant clinical and surgical implications. The extreme variability of anatomic structures involved in this syndrome (both uterus, cervico-vaginal and renal anomalies) is well known, even if a complete and uniform analysis of all its heterogeneous presentations in a large series is lacking. This is a retrospective study with 87 patients referred to our third level referral center between 1981 and 2011. We analyzed the laparoscopic and chart records of 87 women, who referred to our institute with double uterus, unilateral cervico-vaginal obstruction and ipsilateral renal anomalies. Sixty-three of 87 patients had the more classic variant of didelphys uterus with obstructed hemivagina; 10/87 patients had septate bicollis uterus with obstructed hemivagina; 9/87 patients had bicornuate bicollis uterus with obstructed hemivagina; 4/87 patients had didelphys uterus with unilateral cervical atresia; 1/87 patients had bicornuate uterus with one septate cervix and unilateral obstructed hemivagina. This is a retrospective study with a long enrolling period (30 years). New insights in the anatomic variants of this rare syndrome with their relevant surgical implications.

  14. Morpho-anatomical investigations on Momordica charantia L. (Cucurbitaceae

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    İlham Eröz Poyraz

    2016-05-01

    Full Text Available Momordica charantia L. (Cucurbitaceae used for some medicinal purposes like antidiabetic, anticancer, antiviral and treat to gastritis was investigated. Morphological studies were supported by morphometric measurements and drawings of male and female flowers, fruit and seeds of the species. In anatomical studies, cross sections of stem and leaf, upper and lower surface sections of leaves were evaluated. It was detected that the stem with typical anatomical properties of a climbing dicotyl plant. The leaves were amphistotamic and with lots of cyctoliths on the lower surface of leaves. Stomata are anomocytic and situated much more at the lower surface of leaves. Morpho-anatomical investigations on Momordica charantia L. (Cucurbitaceae*

  15. Functional and anatomical connectivity abnormalities in left inferior frontal gyrus in schizophrenia.

    Science.gov (United States)

    Jeong, Bumseok; Wible, Cynthia G; Hashimoto, Ryu-ichiro; Kubicki, Marek

    2009-12-01

    Functional studies in schizophrenia demonstrate prominent abnormalities within the left inferior frontal gyrus (IFG) and also suggest the functional connectivity abnormalities in language network including left IFG and superior temporal gyrus during semantic processing. White matter connections between regions involved in the semantic network have also been indicated in schizophrenia. However, an association between functional and anatomical connectivity disruptions within the semantic network in schizophrenia has not been established. Functional (using levels of processing paradigm) as well as diffusion tensor imaging data from 10 controls and 10 chronic schizophrenics were acquired and analyzed. First, semantic encoding specific activation was estimated, showing decreased activation within the left IFG in schizophrenia. Second, functional time series were extracted from this area, and left IFG specific functional connectivity maps were produced for each subject. In an independent analysis, tract-based spatial statistics (TBSS) was used to compare fractional anisotropy (FA) values between groups, and to correlate these values with functional connectivity maps. Schizophrenia patients showed weaker functional connectivity within the language network that includes left IFG and left superior temporal sulcus/middle temporal gyrus. FA was reduced in several white matter regions including left inferior frontal and left internal capsule. Finally, left inferior frontal white matter FA was positively correlated with connectivity measures of the semantic network in schizophrenics, but not in controls. Our results indicate an association between anatomical and functional connectivity abnormalities within the semantic network in schizophrenia, suggesting further that the functional abnormalities observed in this disorder might be directly related to white matter disruptions. 2009 Wiley-Liss, Inc.

  16. TissueCypher™: A systems biology approach to anatomic pathology

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    Jeffrey W Prichard

    2015-01-01

    Full Text Available Background: Current histologic methods for diagnosis are limited by intra- and inter-observer variability. Immunohistochemistry (IHC methods are frequently used to assess biomarkers to aid diagnoses, however, IHC staining is variable and nonlinear and the manual interpretation is subjective. Furthermore, the biomarkers assessed clinically are typically biomarkers of epithelial cell processes. Tumors and premalignant tissues are not composed only of epithelial cells but are interacting systems of multiple cell types, including various stromal cell types that are involved in cancer development. The complex network of the tissue system highlights the need for a systems biology approach to anatomic pathology, in which quantification of system processes is combined with informatics tools to produce actionable scores to aid clinical decision-making. Aims: Here, we describe a quantitative, multiplexed biomarker imaging approach termed TissueCypher™ that applies systems biology to anatomic pathology. Applications of TissueCypher™ in understanding the tissue system of Barrett's esophagus (BE and the potential use as an adjunctive tool in the diagnosis of BE are described. Patients and Methods: The TissueCypher™ Image Analysis Platform was used to assess 14 epithelial and stromal biomarkers with known diagnostic significance in BE in a set of BE biopsies with nondysplastic BE with reactive atypia (RA, n = 22 and Barrett's with high-grade dysplasia (HGD, n = 17. Biomarker and morphology features were extracted and evaluated in the confirmed BE HGD cases versus the nondysplastic BE cases with RA. Results: Multiple image analysis features derived from epithelial and stromal biomarkers, including immune biomarkers and morphology, showed significant differences between HGD and RA. Conclusions: The assessment of epithelial cell abnormalities combined with an assessment of cellular changes in the lamina propria may serve as an adjunct to conventional

  17. Towards anatomic scale agent-based modeling with a massively parallel spatially explicit general-purpose model of enteric tissue (SEGMEnT_HPC).

    Science.gov (United States)

    Cockrell, Robert Chase; Christley, Scott; Chang, Eugene; An, Gary

    2015-01-01

    Perhaps the greatest challenge currently facing the biomedical research community is the ability to integrate highly detailed cellular and molecular mechanisms to represent clinical disease states as a pathway to engineer effective therapeutics. This is particularly evident in the representation of organ-level pathophysiology in terms of abnormal tissue structure, which, through histology, remains a mainstay in disease diagnosis and staging. As such, being able to generate anatomic scale simulations is a highly desirable goal. While computational limitations have previously constrained the size and scope of multi-scale computational models, advances in the capacity and availability of high-performance computing (HPC) resources have greatly expanded the ability of computational models of biological systems to achieve anatomic, clinically relevant scale. Diseases of the intestinal tract are exemplary examples of pathophysiological processes that manifest at multiple scales of spatial resolution, with structural abnormalities present at the microscopic, macroscopic and organ-levels. In this paper, we describe a novel, massively parallel computational model of the gut, the Spatially Explicitly General-purpose Model of Enteric Tissue_HPC (SEGMEnT_HPC), which extends an existing model of the gut epithelium, SEGMEnT, in order to create cell-for-cell anatomic scale simulations. We present an example implementation of SEGMEnT_HPC that simulates the pathogenesis of ileal pouchitis, and important clinical entity that affects patients following remedial surgery for ulcerative colitis.

  18. The correlation between anti phospholipase A 2 specific IgE and clinical symptoms after a bee sting in beekeepers

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    Jan Matysiak

    2016-06-01

    Full Text Available Introduction: Beekeepers are a group of people with high exposure to honeybee stings and with a very high risk of allergy to bee venom. Therefore, they are a proper population to study the correlations between clinical symptoms and results of diagnostic tests. Aim: The primary aim of our study was to assess the correlations between total IgE, venom- and phospholipase A 2 -specific IgE and clinical symptoms after a bee sting in beekeepers. The secondary aim was to compare the results of diagnostic tests in beekeepers and in individuals with standard exposure to bees. Material and methods: Fifty-four individuals were divided into two groups: beekeepers and control group. The levels of total IgE (tIgE, venom-specific IgE (venom sIgE, and phospholipase A 2 -specific IgE (phospholipase A 2 sIgE were analyzed. Results: Our study showed no statistically significant correlation between the clinical symptoms after a sting and tIgE in the entire analyzed group. There was also no correlation between venom sIgE level and clinical symptoms either in beekeepers or in the group with standard exposure to bees. We observed a statistically significant correlation between phospholipase A 2 sIgE level and clinical signs after a sting in the group of beekeepers, whereas no such correlation was detected in the control group. Significantly higher venom-specific IgE levels in the beekeepers, as compared to control individuals were shown. Conclusions : In beekeepers, the severity of clinical symptoms after a bee sting correlated better with phospholipase A 2 sIgE than with venom sIgE levels.

  19. Use of regularized principal component analysis to model anatomical changes during head and neck radiation therapy for treatment adaptation and response assessment

    International Nuclear Information System (INIS)

    Chetvertkov, Mikhail A.; Siddiqui, Farzan; Chetty, Indrin; Kumarasiri, Akila; Liu, Chang; Gordon, J. James; Kim, Jinkoo

    2016-01-01

    Purpose: To develop standard (SPCA) and regularized (RPCA) principal component analysis models of anatomical changes from daily cone beam CTs (CBCTs) of head and neck (H&N) patients and assess their potential use in adaptive radiation therapy, and for extracting quantitative information for treatment response assessment. Methods: Planning CT images of ten H&N patients were artificially deformed to create “digital phantom” images, which modeled systematic anatomical changes during radiation therapy. Artificial deformations closely mirrored patients’ actual deformations and were interpolated to generate 35 synthetic CBCTs, representing evolving anatomy over 35 fractions. Deformation vector fields (DVFs) were acquired between pCT and synthetic CBCTs (i.e., digital phantoms) and between pCT and clinical CBCTs. Patient-specific SPCA and RPCA models were built from these synthetic and clinical DVF sets. EigenDVFs (EDVFs) having the largest eigenvalues were hypothesized to capture the major anatomical deformations during treatment. Results: Principal component analysis (PCA) models achieve variable results, depending on the size and location of anatomical change. Random changes prevent or degrade PCA’s ability to detect underlying systematic change. RPCA is able to detect smaller systematic changes against the background of random fraction-to-fraction changes and is therefore more successful than SPCA at capturing systematic changes early in treatment. SPCA models were less successful at modeling systematic changes in clinical patient images, which contain a wider range of random motion than synthetic CBCTs, while the regularized approach was able to extract major modes of motion. Conclusions: Leading EDVFs from the both PCA approaches have the potential to capture systematic anatomical change during H&N radiotherapy when systematic changes are large enough with respect to random fraction-to-fraction changes. In all cases the RPCA approach appears to be more

  20. Use of regularized principal component analysis to model anatomical changes during head and neck radiation therapy for treatment adaptation and response assessment

    Energy Technology Data Exchange (ETDEWEB)

    Chetvertkov, Mikhail A., E-mail: chetvertkov@wayne.edu [Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, Michigan 48201 and Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan 48202 (United States); Siddiqui, Farzan; Chetty, Indrin; Kumarasiri, Akila; Liu, Chang; Gordon, J. James [Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan 48202 (United States); Kim, Jinkoo [Department of Radiation Oncology, Stony Brook University Hospital, Stony Brook, New York 11794 (United States)

    2016-10-15

    Purpose: To develop standard (SPCA) and regularized (RPCA) principal component analysis models of anatomical changes from daily cone beam CTs (CBCTs) of head and neck (H&N) patients and assess their potential use in adaptive radiation therapy, and for extracting quantitative information for treatment response assessment. Methods: Planning CT images of ten H&N patients were artificially deformed to create “digital phantom” images, which modeled systematic anatomical changes during radiation therapy. Artificial deformations closely mirrored patients’ actual deformations and were interpolated to generate 35 synthetic CBCTs, representing evolving anatomy over 35 fractions. Deformation vector fields (DVFs) were acquired between pCT and synthetic CBCTs (i.e., digital phantoms) and between pCT and clinical CBCTs. Patient-specific SPCA and RPCA models were built from these synthetic and clinical DVF sets. EigenDVFs (EDVFs) having the largest eigenvalues were hypothesized to capture the major anatomical deformations during treatment. Results: Principal component analysis (PCA) models achieve variable results, depending on the size and location of anatomical change. Random changes prevent or degrade PCA’s ability to detect underlying systematic change. RPCA is able to detect smaller systematic changes against the background of random fraction-to-fraction changes and is therefore more successful than SPCA at capturing systematic changes early in treatment. SPCA models were less successful at modeling systematic changes in clinical patient images, which contain a wider range of random motion than synthetic CBCTs, while the regularized approach was able to extract major modes of motion. Conclusions: Leading EDVFs from the both PCA approaches have the potential to capture systematic anatomical change during H&N radiotherapy when systematic changes are large enough with respect to random fraction-to-fraction changes. In all cases the RPCA approach appears to be more

  1. ANATOMIC STRUCTURE OF CAMPANULA ROTUNDIFOLIA L. GRASS

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    V. N. Bubenchikova

    2017-01-01

    Full Text Available The article present results of the study for a anatomic structure of Campanula rotundifolia grass from Campanulaceae family. Despite its dispersion and application in folk medicine, there are no data about its anatomic structure, therefore to estimate the indices of authenticity and quality of raw materials it is necessary to develop microdiagnostical features in the first place, which could help introducing of thisplant in a medical practice. The purpose of this work is to study anatomical structureof Campanula rotundifolia grass to determine its diagnostic features. Methods. Thestudy for anatomic structure was carried out in accordance with the requirements of State Pharmacopoeia, edition XIII. Micromed laboratory microscope with digital adjutage was used to create microphotoes, Photoshop CC was used for their processing. Result. We have established that stalk epidermis is prosenchymal, slightly winding with straight of splayed end cells. After study for the epidermis cells we established that upper epidermis cells had straight walls and are slightly winding. The cells of lower epidermishave more winding walls with prolong wrinkled cuticule. Presence of simple one-cell, thin wall, rough papillose hair on leaf and stalk epidermis. Cells of epidermis in fauces of corolla are prosenchymal, with winding walls, straight or winding walls in a cup. Papillary excrescences can be found along the cup edges. Stomatal apparatus is anomocytic. Conclusion. As the result of the study we have carried out the research for Campanula rotundifolia grass anatomic structure, and determined microdiagnostic features for determination of raw materials authenticity, which included presence of simple, one-cell, thin-walled, rough papillose hair on both epidermises of a leaf, along the veins, leaf edge, and stalk epidermis, as well as the presence of epidermis cells with papillary excrescences along the edges of leaves and cups. Intercellular canals are situatedalong the

  2. Anatomically standardized statistical mapping of 123I-IMP SPECT in brain tumors

    International Nuclear Information System (INIS)

    Shibata, Yasushi; Akimoto, Manabu; Matsushita, Akira; Yamamoto, Tetsuya; Takano, Shingo; Matsumura, Akira

    2010-01-01

    123 I-iodoamphetamine Single Photon Emission Computed Tomography (IMP SPECT) is used to evaluate cerebral blood flow. However, application of IMP SPECT to patients with brain tumors has been rarely reported. Primary central nervous system lymphoma (PCNSL) is a rare tumor that shows delayed IMP uptake. The relatively low spatial resolution of SPECT is a clinical problem in diagnosing brain tumors. We examined anatomically standardized statistical mapping of IMP SPECT in patients with brain lesions. This study included 49 IMP SPECT images for 49 patients with brain lesions: 20 PCNSL, 1 Burkitt's lymphoma, 14 glioma, 4 other tumor, 7 inflammatory disease and 3 without any pathological diagnosis but a clinical diagnosis of PCNSL. After intravenous injection of 222 MBq of 123 I-IMP, early (15 minutes) and delayed (4 hours) images were acquired using a multi-detector SPECT machine. All SPECT data were transferred to a newly developed software program iNeurostat+ (Nihon Medi-physics). SPECT data were anatomically standardized on normal brain images. Regions of increased uptake of IMP were statistically mapped on the tomographic images of normal brain. Eighteen patients showed high uptake in the delayed IMP SPECT images (16 PCNSL, 2 unknown). Other tumor or diseases did not show high uptake of delayed IMP SPECT, so there were no false positives. Four patients with pathologically proven PCNSL showed no uptake in original IMP SPECT. These tumors were too small to detect in IMP SPECT. However, statistical mapping revealed IMP uptake in 18 of 20 pathologically verified PCNSL patients. A heterogeneous IMP uptake was seen in homogenous tumors in MRI. For patients with a hot IMP uptake, statistical mapping showed clearer uptake. IMP SPECT is a sensitive test to diagnose of PCNSL, although it produced false negative results for small posterior fossa tumor. Anatomically standardized statistical mapping is therefore considered to be a useful method for improving the diagnostic

  3. [Cellular subcutaneous tissue. Anatomic observations].

    Science.gov (United States)

    Marquart-Elbaz, C; Varnaison, E; Sick, H; Grosshans, E; Cribier, B

    2001-11-01

    We showed in a companion paper that the definition of the French "subcutaneous cellular tissue" considerably varied from the 18th to the end of the 20th centuries and has not yet reached a consensus. To address the anatomic reality of this "subcutaneous cellular tissue", we investigated the anatomic structures underlying the fat tissue in normal human skin. Sixty specimens were excised from the surface to the deep structures (bone, muscle, cartilage) on different body sites of 3 cadavers from the Institut d'Anatomie Normale de Strasbourg. Samples were paraffin-embedded, stained and analysed with a binocular microscope taking x 1 photographs. Specimens were also excised and fixed after subcutaneous injection of Indian ink, after mechanic tissue splitting and after performing artificial skin folds. The aspects of the deep parts of the skin greatly varied according to their anatomic localisation. Below the adipose tissue, we often found a lamellar fibrous layer which extended from the interlobular septa and contained horizontally distributed fat cells. No specific tissue below the hypodermis was observed. Artificial skin folds concerned either exclusively the dermis, when they were superficial or included the hypodermis, but no specific structure was apparent in the center of the fold. India ink diffused to the adipose tissue, mainly along the septa, but did not localise in a specific subcutaneous compartment. This study shows that the histologic aspects of the deep part of the skin depend mainly on the anatomic localisation. Skin is composed of epidermis, dermis and hypodermis and thus the hypodermis can not be considered as being "subcutaneous". A difficult to individualise, fibrous lamellar structure in continuity with the interlobular septa is often found under the fat lobules. This structure is a cleavage line, as is always the case with loose connective tissues, but belongs to the hypodermis (i.e. fat tissue). No specific tissue nor any virtual space was

  4. Automatic, anatomically selective, artifact-free enhancement of digital chest radiographs

    International Nuclear Information System (INIS)

    Sezan, M.I.; Tekalp, A.M.; Schaetzing, R.

    1988-01-01

    The authors propose a technique for automatic, anatomically selective, artifact-free enhancement of digital chest radiographs. Anatomically selective enhancement is motivated by the different enhancement requirements of the lung field and the mediastinum. A recent peak detection algorithm is applied to the image histogram to automatically determine a gray-level threshold between the lung and mediastinum fields. The gray-level threshold facilitates anatomically selective gray-scale modification and unsharp masking. Further, in an attempt to suppress possible white-band artifacts due to unsharp masking at sharp edges, local-contrast adaptivity is incorporated into anatomically selective unsharp masking by designing an anatomy-sensitive emphasis parameter that varied asymmetrically with positive and negative values of the local image contrast

  5. Correlation of structure and function of the macula in patients with retinitis pigmentosa.

    Science.gov (United States)

    Battu, R; Khanna, A; Hegde, B; Berendschot, T T J M; Grover, S; Schouten, J S A G

    2015-07-01

    To correlate the structure of the macula, as measured by spectral-domain optical coherence tomography (SD-OCT) and function, as measured by microperimetry (MAIA) in patients with retinitis pigmentosa (RP) and relatively good visual acuity. Prospective, cross-sectional, non-intervention study. Patients with RP. Thirty patients with RP and good central visual acuity were identified. Each patient underwent SD-OCT of the macula and microperimetry. The images were overlaid using the custom-designed software. The retinal sensitivity by microperimetry was correlated with corresponding retinal thickness, as measured by the SD-OCT. ELM, COST, and IS/OS junction were scored as intact, disrupted, or absent. Comparing the retinal sensitivity on the MAIA with various measurements on the SD-OCT. The retinal sensitivity on the MAIA showed a significant correlation with total retinal thickness and outer retinal thickness on the SD-OCT. There was no association with either the inner retinal thickness or the choroidal thickness. ORT showed a statistically significant correlation with the anatomical classification of ELM (r=-0.76, Pmacula in patients with RP. These studies are important to establish surrogate markers that can be used as end points for various tests in future therapeutic clinical trials.

  6. Burst fracture of the thoracolumbar spine: correlation between kyphosis and clinical result of the treatment

    Directory of Open Access Journals (Sweden)

    Rodrigo Arnold Tisot

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the correlation between kyphosis due to burst fractures of thoracic and lumbar spine and clinical outcome in patients undergoing conservative or surgical treatment.METHODS: A retrospective, cross-sectional study was conducted with 29 patients with thoracolumbar burst fractures treated by the Spine Group in a trauma reference hospital between the years 2002 and 2011. Patients were followed-up as outpatients for a minimum of 24 months. All cases were clinically evaluated by Oswestry and SF-36 quality of life questionnaires and the visual analogue scale (VAS of pain. They were also evaluated by X-ray examinations and CT scans of the lumbosacral spine at the time of hospitalization and subsequently as outpatients by Cobb method for measuring the degree of kyphosis.RESULTS: There was no statistically significant correlation between the degree of initial kyphosis and clinical outcome measured by VAS and by most of the SF-36 domains in both patients treated conservatively and the surgically treated. The Oswestry questionnaire showed benefits for patients who received conservative treatment (p=0.047 compared to those surgically treated (p=0.335. The analysis of difference between initial and final kyphosis and final kyphosis alone in relation to clinical outcome showed no statistical correlation in any of the scores used.CONCLUSION: The clinical outcome of treatment of the thoracic and lumbar burst fractures was not influenced by a greater or lesser degree of initial or residual kyphosis, regardless of the type of treatment.

  7. Intersection syndrome: MR imaging with anatomic comparison of the distal forearm

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    Lima, Jose E. de; Kim, Hyun-Jin; Albertotti, Flavio; Resnick, Donald [University of California, San Diego, VA San Diego Healthcare System, San Diego (United States)

    2004-11-01

    To correlate the anatomic and MR imaging characteristics of the area of intersection of the first and the second dorsal extensor tendon compartments (DETC) in the distal forearm in an attempt to improve the design of MR imaging protocols used for the evaluation of intersection syndrome. Ten forearms of nine cadavers underwent MR imaging in the axial and sagittal-oblique planes before and after tenography with direct injection of a gadolinium-containing contrast agent into the first DETC in four forearms, the second DETC in four forearms, and both compartments in the remaining two forearms. The area of intersection between the first and second DETC was identified in each case as well as its distance from Lister's tubercle. Subsequently all forearms were sectioned in the axial (8 forearms) or sagittal-oblique planes (2 remaining forearms) to parallel the imaging planes. Detailed examination of each of the anatomic slices was performed in a search for anatomic variations and for possible anatomic connections of the tendons sheaths. One forearm was dissected to identify the area of intersection. The area of intersection between the first and second DETC occurred between 3.5 cm and 4.8 cm (mean 4.18 cm) proximal to Lister's tubercle. After tenography, gadolinium solution was noted in the third DETC in two of four specimens in which the second DETC was injected and in one of two specimens in which both the first and second DETC were injected. Extension of the gadolinium solution between the first and second DETC was noted during isolated injections of either compartment, although this finding may have related to iatrogenic injection effects. The axial plane was the most valuable for assessment of the area of intersection of the first and second DETC. MR imaging is a noninvasive method that can be used for the evaluation of distal forearm and wrist pain. Standard wrist protocols do not include the area of intersection between the first and second DETC and, in

  8. Intersection syndrome: MR imaging with anatomic comparison of the distal forearm

    International Nuclear Information System (INIS)

    Lima, Jose E. de; Kim, Hyun-Jin; Albertotti, Flavio; Resnick, Donald

    2004-01-01

    To correlate the anatomic and MR imaging characteristics of the area of intersection of the first and the second dorsal extensor tendon compartments (DETC) in the distal forearm in an attempt to improve the design of MR imaging protocols used for the evaluation of intersection syndrome. Ten forearms of nine cadavers underwent MR imaging in the axial and sagittal-oblique planes before and after tenography with direct injection of a gadolinium-containing contrast agent into the first DETC in four forearms, the second DETC in four forearms, and both compartments in the remaining two forearms. The area of intersection between the first and second DETC was identified in each case as well as its distance from Lister's tubercle. Subsequently all forearms were sectioned in the axial (8 forearms) or sagittal-oblique planes (2 remaining forearms) to parallel the imaging planes. Detailed examination of each of the anatomic slices was performed in a search for anatomic variations and for possible anatomic connections of the tendons sheaths. One forearm was dissected to identify the area of intersection. The area of intersection between the first and second DETC occurred between 3.5 cm and 4.8 cm (mean 4.18 cm) proximal to Lister's tubercle. After tenography, gadolinium solution was noted in the third DETC in two of four specimens in which the second DETC was injected and in one of two specimens in which both the first and second DETC were injected. Extension of the gadolinium solution between the first and second DETC was noted during isolated injections of either compartment, although this finding may have related to iatrogenic injection effects. The axial plane was the most valuable for assessment of the area of intersection of the first and second DETC. MR imaging is a noninvasive method that can be used for the evaluation of distal forearm and wrist pain. Standard wrist protocols do not include the area of intersection between the first and second DETC and, in those cases

  9. Cockayne's syndrome: correlation of clinical features with cellular sensitivity of RNA synthesis to UV irradiation

    International Nuclear Information System (INIS)

    Lehmann, A.R.; Thompson, A.F.; Harcourt, S.A.

    1993-01-01

    Cockayne's syndrome (CS) is a rare autosomal recessive disorder with dwarfism, mental retardation, and otherwise clinically heterogeneous features. In cultured CS fibroblasts, the failure of RNA synthesis to recover to normal rates after UV-C irradiation provides a useful and relatively simple diagnostic test. We have measured post-UV-C RNA synthesis in 52 patients for whom a clinical diagnosis of CS was considered a possibility. Twenty-nine patients showed the defect characteristic of CS cells, and 23 had a normal response. We have attempted to correlate the cellular diagnosis with the different clinical features of the disorder. Clinical details of the patients were obtained from referring clinicians in the form of a questionnaire. Our results show that, apart from the cardinal features of dwarfism and mental retardation, sun sensitivity correlated best with a positive cellular diagnosis. Pigmentary retinopathy, gait defects, and dental caries were also good positive indicators, although several patients with a positive cellular diagnosis did not have these features. (Author)

  10. Correlation of Diffusion and Metabolic Alterations in Different Clinical Forms of Multiple Sclerosis

    Science.gov (United States)

    Hannoun, Salem; Bagory, Matthieu; Durand-Dubief, Francoise; Ibarrola, Danielle; Comte, Jean-Christophe; Confavreux, Christian; Cotton, Francois; Sappey-Marinier, Dominique

    2012-01-01

    Diffusion tensor imaging (DTI) and MR spectroscopic imaging (MRSI) provide greater sensitivity than conventional MRI to detect diffuse alterations in normal appearing white matter (NAWM) of Multiple Sclerosis (MS) patients with different clinical forms. Therefore, the goal of this study is to combine DTI and MRSI measurements to analyze the relation between diffusion and metabolic markers, T2-weighted lesion load (T2-LL) and the patients clinical status. The sensitivity and specificity of both methods were then compared in terms of MS clinical forms differentiation. MR examination was performed on 71 MS patients (27 relapsing remitting (RR), 26 secondary progressive (SP) and 18 primary progressive (PP)) and 24 control subjects. DTI and MRSI measurements were obtained from two identical regions of interest selected in left and right centrum semioval (CSO) WM. DTI metrics and metabolic contents were significantly altered in MS patients with the exception of N-acetyl-aspartate (NAA) and NAA/Choline (Cho) ratio in RR patients. Significant correlations were observed between diffusion and metabolic measures to various degrees in every MS patients group. Most DTI metrics were significantly correlated with the T2-LL while only NAA/Cr ratio was correlated in RR patients. A comparison analysis of MR methods efficiency demonstrated a better sensitivity/specificity of DTI over MRSI. Nevertheless, NAA/Cr ratio could distinguish all MS and SP patients groups from controls, while NAA/Cho ratio differentiated PP patients from controls. This study demonstrated that diffusivity changes related to microstructural alterations were correlated with metabolic changes and provided a better sensitivity to detect early changes, particularly in RR patients who are more subject to inflammatory processes. In contrast, the better specificity of metabolic ratios to detect axonal damage and demyelination may provide a better index for identification of PP patients. PMID:22479330

  11. Reorganization of Anatomical Connectome following Electroconvulsive Therapy in Major Depressive Disorder

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    Jinkun Zeng

    2015-01-01

    Full Text Available Objective. Electroconvulsive therapy (ECT is considered one of the most effective and fast-acting treatment options for depressive episodes. Little is known, however, about ECT’s enabling brain (neuroplasticity effects, particular for plasticity of white matter pathway. Materials and Methods. We collected longitudinal diffusion tensor imaging in the first-episode, drug-naïve major depressive disorder (MDD patients n=24 before and after a predefined time window ECT treatment. We constructed large-scale anatomical networks derived from white matter fiber tractography and evaluated the topological reorganization using graph theoretical analysis. We also assessed the relationship between topological reorganization with improvements in depressive symptoms. Results. Our investigation revealed three main findings: (1 the small-worldness was persistent after ECT series; (2 anatomical connections changes were found in limbic structure, temporal and frontal lobes, in which the connection changes between amygdala and parahippocampus correlate with depressive symptom reduction; (3 significant nodal strength changes were found in right paralimbic network. Conclusions. ECT elicits neuroplastic processes associated with improvements in depressive symptoms that act to specific local ventral frontolimbic circuits, but not small-world property. Overall, ECT induced topological reorganization in large-scale brain structural network, opening up new avenues to better understand the mode of ECT action in MDD.

  12. Patho-radiologic correlation of invasive pulmonary aspergillosis in the compromised host.

    Science.gov (United States)

    Orr, D P; Myerowitz, R L; Dubois, P J

    1978-05-01

    The autopsy findings and antemortem radiographic abnormalities were correlated in 20 patients with invasive pulmonary aspergillosis to define typical radiographic patterns, their progression and anatomic basis. Sixteen (80%) patients had radiographic abnormalities due to aspergillosis. Fifty-nine percent of the specific radiographic abnormalities seen in these patients were caused by anatomic lesions of asperigillosis and 67% of such anatomic lesions were radiographically definable. The most common initial radiographic pattern was a patchy density (single or multifocal) or a well defined nodule. The densities remained stable in half the patients but progressed, over several weeks to either diffuse consolidation or cavitation in the others. Most anatomic lesions were categorized as either nodular ("target") lesions (1-3 cm in diameter) or hemorrhagic infarctions (5-10 cm in diameter), both due to vascular invasion causing thrombosis and ischemic necrosis. Unlike pulmonary candidiasis, which is usually radiographically undetectable, invasive pulmonary asperigillosis frequently caused radiographically visible lesions.

  13. Anatomical basics, variations, and degenerative changes of the shoulder joint and shoulder girdle

    Energy Technology Data Exchange (ETDEWEB)

    Prescher, Andreas E-mail: dkeyserlingk@post.klinikum.rwth-aachen.de

    2000-08-01

    This paper summarizes the anatomical basics of the shoulder, their variations, and precise definitions, including differential diagnoses. It also describes the characteristic degenerative changes caused by aging. A typical variation (7-15%) is the os acromiale, which forms the triangular epiphysis of the scapular spine. This abnormality must be differentiated from a fracture of the acromion or a pseudarthrosis. Because ossification of the acromion is complete after age 25, the os acromiale should be diagnosed only after this age. The shape of the acromion is a further important feature. In a recent anatomical study, the following frequencies of the Bigliani-types of the acromial shape were anatomically determined - type 1 (flat), 10.2% and type 2 (curved), 89.8%. Type 3 (hooked) was not observed, which indicates that this type is probably a misinterpretation of the so-called acromial spur. Minor dehiscences and perforations in the infraspinate or supraspinate fossa should not be confused with malignant osteolyses. The scapula has three ligaments of its own, (1) the coracoacromial ligament and its osseous fixations form an osteofibrous arch above the shoulder joint, which plays a part in impingement syndrome; (2) the superior transverse scapular ligament or its ossified correlate arches the scapular incisure and can cause a typical compression syndrome of the suprascapular nerve; (3) the inferior transverse scapular ligament is of no great clinical importance. Two intraarticular structures (glenoid labrum and tendon of the long bicipital head) must be mentioned. The glenoid labrum consists of dense connective tissue and surrounds the margin of the glenoid cavity. Two areas exhibit specialized conditions, cranial at the supraglenoid tubercle an intimate relationship exists to the tendon of the long bicipital head and in about 55% of cases, the labrum is stretched over the glenoid rim at the ventral side. At the area of the biceps-tendon-labrum complex, so-called SLAP

  14. Whole-body MRI in patients with Non-bacterial Osteitis: Radiological findings and correlation with clinical data

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    Arnoldi, A.P.; Geyer, L.L. [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich (Germany); Schlett, C.L.; Weckbach, S. [University Hospital Heidelberg, Diagnostic and Interventional Radiology, Heidelberg (Germany); Douis, H. [University Hospital Birmingham, Department of Radiology, Birmingham (United Kingdom); Voit, A.M.; Bleisteiner, F.; Jansson, A.F. [Dr. von Hauner Children' s Hospital, Ludwig-Maximilians-University, Department of Rheumatology and Immunology, Munich (Germany)

    2017-06-15

    To correlate clinical findings of Non-bacterial Osteitis (NBO) with whole-body MRI (WB-MRI) findings and determine a radiologic index for NBO (RINBO) which allows standardized reporting of WB-MRI. In a prospective study, 40 patients with diagnosis of NBO underwent clinical examination and WB-MRI in which STIR- and T1- weighted images were assessed for NBO-typical lesions. Parameters of interest for RINBO were: number of radiologically active lesions (RAL), size of the patients' maximum RAL presence of extramedullary and spinal involvement. Results were tested for statistical agreement of clinical and MR-based lesion detection. RINBO was tested for correlation with clinical activity. 62/95 clinically/radiologically active lesions were found in 30/33 patients. In 45 % of the cohort, more active lesions were detected by WB-MRI than by clinical examination. RINBO was a significant predictor for the presence of clinically active lesions. WB-MRI is a powerful diagnostic tool for patients with NBO which can reveal asymptomatic disease activity. With RINBO a standardized evaluation approach is proposed which helps assessing radiologic disease burden and predicts clinical disease activity. (orig.)

  15. Clinical Correlates of Diarrhea and Gut Parasites among Human Immunodeficiency Virus Seropositive Patients

    Directory of Open Access Journals (Sweden)

    Elvis Bisong

    2017-09-01

    Full Text Available Cluster differentiation 4 (CD4 count estimation, which is not readily available in most resource poor settings in Nigeria, is an important indexdetermining commencement of antiretroviral therapy (ART. It is imperative for physicians who come in contact with these patients in such settings to recognize other parameters to evaluate these patients. The clinical correlates of diarrhea and gut parasites among human immunodeficiency virus (HIV-seropositive patients attending our special treatment clinic were studied. Three hundred and forty consenting HIV-positive adult subjects were enrolled. Their stool and blood specimens were collected for a period of three months. Stool samples were analyzed for the presence of diarrhea and gut parasites. The patients were clinically evaluated by physical examination for the presence of pallor, dehydration, oral thrush, wasting lymphadenopathy, dermatitis, skin hyperpigmentation, and finger clubbing. Participants with diarrhea represented 14.1% of the population, while 21.5% harbored one or more parasites. In the subjects with diarrhea, 14.6% harbored gut parasites. The presence of diarrhea was associated with a low CD4 count. Clinically, oral thrush, wasting, and rashes were more reliable predictors of low CD4 count levels; whereas, the presence of pallor, dehydration, wasting, and rashes correlated with the presence of diarrhea. HIV patients presenting with pallor, dehydration, wasting, and rashes should be evaluated for the presence of diarrhea. The clinical variables associated with low CD4 count in this study may guide commencing antiretroviral therapy in resource poor settings.

  16. Correlation of areca habit, clinical grading, anorexia, and fatique in oral submucous fibrosis

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    Rashmi S Sathe

    2015-01-01

    Full Text Available Aim: The aim was to correlate the habit index (HI, clinical grading with anorexia, and fatigue in oral submucous fibrosis (OSMF. Settings and Design: Hospital-based study including a total of 60 individuals, out of which 30 patients were with OSMF, (27 males and 3 females. A group of 30 individuals, with areca chewing habit but without any oral lesions were selected as a control group. Subjects and Methods: Detailed case history was recorded. Height and weight measurements were made to assess body mass index (BMI. Fatigue and anorexia scores were calculated using structured questionnaires. Clinical staging of OSMF was done according to Khanna JN and Andrade NN (1995 classification. The information related to the type of habit, site of placement of areca nut, and duration was recorded using HI. Statistical Analysis Used: Statistical analysis was done using Pearson's correlation and Student's t-test. Results: A statistically significant difference was found between anorexia in both the groups (P = 0.01 and a highly significant difference was seen in HI (P = 0.001. However, the comparison between other parameters was found to be statistically not significant. The correlation of HI, anorexia, and fatigue score in Grade I, Grade II, Grade III, and Grade IV OSMF within each group was not significant statistically. However, in Grade IV a strong correlation was found between BMI and anorexia score (P = 0.0188. Conclusion: The merits of this study include a positive correlation between anorexia and fatigue with disease progression and a congruent relation of HI with the grades of OSMF.

  17. Correlation of kidney biopsy findings and clinical manifestations of primary focal and segmental glomerulosclerosis

    International Nuclear Information System (INIS)

    Taheri, Diana; Chehrei Ali; Samanianpour, Pargol; Hassanzadeh, Amar; Sadrarhami, Shohreh; Shiva, Seyrafian

    2009-01-01

    To evaluate the correlation of clinical, laboratory, and pathological features at presentation of focal segmental sclerosis (FSGS), we reviewed in a cross sectional study the pathological findings of kidney biopsies in 64 cases of primary FSGS, and correlated them with the clinical and laboratory data obtained at the time of the biopsies. The data included blood pressure, glomerular filtration rate (GFR), serum albumin, and the level of proteinuria. The mean level of serum creatinine was significantly higher in the biopsies' findings of synechiae (adhesions) in the Bowman's capsule, interstitial fibrosis, and global scars (P< 0.05), and mean level of GFR was significantly lower with the presence of interstitial fibrosis (P< 0.05). Furthermore, there was a positive correlation between the level of serum creatinine and global sclerosis (r= 2.21, P= 0.04), and a negative correlation between the level of GFR and global sclerosis(r= 2.01, P= 0.02). All the patients with renal insufficiency had interstitial fibrosis in their biopsies in comparison of only the 24 patients (48%) of the group without renal insufficiency (P< 0.05). There was no significant difference between patients with and without hypertension and nephritic-ranged proteinuria. We conclude that we found a correlation of renal insufficiency in primary FSGS patients with interstitial fibrosis, global scars and the synechiae of Bowman's capsule in their biopsies. (author)

  18. The clinical and genetic correlates of MRI findings in myotonic dystrophy

    International Nuclear Information System (INIS)

    Bachmann, G.; Damian, M.S.; Koch, M.; Schilling, G.; Fach, B.; Stoeppler, S.

    1996-01-01

    Amplification of an unstable CTG trinucleotide repeat sequence in a protein kinase gene on chromosome 19 has recently been recognised as the molecular basis of myotonic dystrophy (DM), a multisystem disorder with a wide spectrum of muscular and extramuscular manifestations. The CTG expansion of 40 patients was assessed by direct genotype analysis of the white blood cell DNA and correlated with MRI of the brain and muscles, and with functional clinical data. Cerebral pathology on MRI consisted of diffuse atrophy (68 %), subcortical white matter lesions (65 %), wide Virchow-Robin spaces (38 %) and thickening of the skull (35 %). Cerebral atrophy and extent of white matter disease correlated significantly with mental retardation, duration of disease and CTG fragment amplification. MRI of the muscular system showed fatty degeneration of different degrees in neighbouring muscles causing a mosaic pattern of the thigh in 38 % and the calf in 44 %. Muscular changes on MRI were strongly correlated with muscular impairment but less strongly with CTG expansion. Changes on MRI reflect the stage of development of tissue pathology in DM, modified by defect of the DM gene. Pathology on MRI is strongly correlated with functional deficits. (orig.). With 8 figs., 3 tabs

  19. Canine intrahepatic vasculature: is a functional anatomic model relevant to the dog?

    Science.gov (United States)

    Hall, Jon L; Mannion, Paddy; Ladlow, Jane F

    2015-01-01

    To clarify canine intrahepatic portal and hepatic venous system anatomy using corrosion casting and advanced imaging and to devise a novel functional anatomic model of the canine liver to investigate whether this could help guide the planning and surgical procedure of partial hepatic lobectomy and interventional radiological procedures. Prospective experimental study. Adult Greyhound cadavers (n = 8). Portal and hepatic vein corrosion casts of healthy livers were assessed using computed tomography (CT). The hepatic lobes have a consistent hilar hepatic and portal vein supply with some variation in the number of intrahepatic branches. For all specimens, 3 surgically resectable areas were identified in the left lateral lobe and 2 surgically resectable areas were identified in the right medial lobe as defined by a functional anatomic model. CT of detailed acrylic casts allowed complex intrahepatic vascular relationships to be investigated and compared with previous studies. Improving understanding of the intrahepatic vascular supply facilitates interpretation of advanced images in clinical patients, the planning and performance of surgical procedures, and may facilitate interventional vascular procedures, such as intravenous embolization of portosystemic shunts. Functional division of the canine liver similar to human models is possible. The left lateral and right medial lobes can be consistently divided into surgically resectable functional areas and partial lobectomies can be performed following a functional model; further study in clinically affected animals would be required to investigate the relevance of this functional model in the dog. © Copyright 2014 by The American College of Veterinary Surgeons.

  20. Neurovascular structures of the mandibular angle and condyle: a comprehensive anatomical review.

    Science.gov (United States)

    Yang, Hun-Mu; Won, Sung-Yoon; Kim, Hee-Jin; Hu, Kyung-Seok

    2015-11-01

    Various surgical interventions including esthetic surgery, salivary gland excision, and open reduction of fracture have been performed in the area around the mandibular angle and condyle. This study aimed to comprehensively review the anatomy of the neurovascular structures on the angle and condyle with recent anatomic and clinical research. We provide detailed information about the branching and distributing patterns of the neurovascular structures at the mandibular angle and condyle, with reported data of measurements and proportions from previous anatomical and clinical research. Our report should serve to help practitioners gain a better understanding of the area in order or reduce potential complications during local procedures. Reckless manipulation during mandibular angle reduction could mutilate arterial branches, not only from the facial artery, but also from the external carotid artery. The transverse facial artery and superficial temporal artery could be damaged during approach and incision in the condylar area. The marginal mandibular branch of the facial nerve can be easily damaged during submandibular gland excision or facial rejuvenation treatment. The main trunk of the facial nerve and its upper and lower distinct divisions have been damaged during parotidectomy, rhytidectomy, and open reductions of condylar fractures. By revisiting the information in the present study, surgeons will be able to more accurately prevent procedure-related complications, such as iatrogenic vascular accidents on the mandibular angle and condyle, complete and partial facial palsy, gustatory sweating (Frey syndrome), and traumatic neuroma after parotidectomy.

  1. The right atrium: gateway to the heart--anatomic and pathologic imaging findings.

    Science.gov (United States)

    Malik, Sachin B; Kwan, Damon; Shah, Amar B; Hsu, Joe Y

    2015-01-01

    Knowledge of right atrial anatomic and pathologic imaging findings and associated clinical symptoms is important to avoid false-positive diagnoses and missed findings. Complete evaluation of the heart often requires a multimodality approach that includes radiography, echocardiography, computed tomography (CT), magnetic resonance (MR) imaging, and invasive angiography. In general, CT provides the highest spatial resolution of these modalities at the cost of radiation exposure to the patient. Echocardiography and MR imaging offer complementary and detailed information for functional evaluation without added radiation exposure. The advantages and disadvantages of each modality for the evaluation of right atrial anatomic structure, size, and pathologic findings are discussed. Cardiac MR imaging is the reference standard for evaluation of right atrial size and volume but often is too time consuming and resource intensive to perform in routine clinical practice. Therefore, established reference ranges for two-dimensional transthoracic echocardiography are often used. Right atrial pathologic findings can be broadly categorized into (a) congenital anomalies (cor triatriatum dexter, Ebstein anomaly, and aneurysm), (b) disorders of volume (tricuspid regurgitation, pathologic mimics such as a pseudoaneurysm, and atrial septal defect), (c) disorders of pressure (tricuspid stenosis, restrictive cardiomyopathy, and constrictive pericarditis), and (d) masses (pseudomasses, thrombus, lipomatous hypertrophy of the interatrial septum, lipoma, myxoma, sarcoma, and metastatic disease). Familiarity with each pathologic entity and its treatment options is essential to ensure that appropriate imaging modalities are selected. Online supplemental material is available for this article. RSNA, 2015

  2. Correlation Between Clinical and Radiological Outcomes After Matrix-Induced Autologous Chondrocyte Implantation in the Femoral Condyles.

    Science.gov (United States)

    Ebert, Jay R; Smith, Anne; Fallon, Michael; Wood, David J; Ackland, Timothy R

    2014-08-01

    Matrix-induced autologous chondrocyte implantation (MACI) is an established technique for the repair of knee chondral defects, although the correlation between clinical and radiological outcomes after surgery is poorly understood. To determine the correlation between clinical and radiological outcomes throughout the postoperative timeline to 5 years after MACI. Cohort study (diagnosis); Level of evidence, 3. This retrospective study was undertaken in 83 patients (53 male, 30 female) with complete clinical and radiological follow-up at 1, 2, and 5 years after MACI. The mean age of patients was 38.9 years (range, 13-62 years), with a mean body mass index (BMI) of 26.6 kg/m(2) (range, 16.8-34.8 kg/m(2)), mean defect size of 3.3 cm(2) (range, 1-9 cm(2)), and mean preoperative duration of symptoms of 9.2 years (range, 1-46 years). Patients indicated for MACI in this follow-up were 13 to 65 years of age, although they were excluded if they had a BMI >35 kg/m(2), had undergone prior extensive meniscectomy, or had ongoing progressive inflammatory arthritis. Patients were assessed clinically using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Magnetic resonance imaging (MRI) was used to evaluate the graft using a 1.5-T or 3-T clinical scanner; the MRI assessment included 8 parameters of graft repair (infill, signal intensity, border integration, surface contour, structure, subchondral lamina, subchondral bone, and effusion) based on the magnetic resonance observation of cartilage repair tissue (MOCART) score as well as an MRI composite score. The degree of an association between the MRI parameters and the KOOS subscales at each postoperative time point was assessed with the Spearman correlation coefficient (SCC), and significance was determined at P correlations over time and statistically significant associations at 5 years with KOOS-Pain (SCC, 0.25; P = .020), KOOS-Activities of Daily Living (SCC, 0.26; P = .018), and KOOS-Sport (SCC, 0.32; P = .003). Apart

  3. NCI Workshop Report: Clinical and Computational Requirements for Correlating Imaging Phenotypes with Genomics Signatures

    Directory of Open Access Journals (Sweden)

    Rivka Colen

    2014-10-01

    Full Text Available The National Cancer Institute (NCI Cancer Imaging Program organized two related workshops on June 26–27, 2013, entitled “Correlating Imaging Phenotypes with Genomics Signatures Research” and “Scalable Computational Resources as Required for Imaging-Genomics Decision Support Systems.” The first workshop focused on clinical and scientific requirements, exploring our knowledge of phenotypic characteristics of cancer biological properties to determine whether the field is sufficiently advanced to correlate with imaging phenotypes that underpin genomics and clinical outcomes, and exploring new scientific methods to extract phenotypic features from medical images and relate them to genomics analyses. The second workshop focused on computational methods that explore informatics and computational requirements to extract phenotypic features from medical images and relate them to genomics analyses and improve the accessibility and speed of dissemination of existing NIH resources. These workshops linked clinical and scientific requirements of currently known phenotypic and genotypic cancer biology characteristics with imaging phenotypes that underpin genomics and clinical outcomes. The group generated a set of recommendations to NCI leadership and the research community that encourage and support development of the emerging radiogenomics research field to address short-and longer-term goals in cancer research.

  4. Foot reconstruction using a free proximal peroneal artery perforator flap: Anatomical study and clinical application.

    Science.gov (United States)

    Han, Hyun Ho; Lee, Yeon Ji; Moon, Suk-Ho

    2018-02-22

    When a small, thin, and durable flap is required for coverage of the foot, the proximal peroneal artery perforator (PPAP) free flap may be a novel option. However, few clinical results and anatomical studies on the PPAP flap have been published. A total of 24 PPAP flaps used in 22 patients from January 2013 to December 2016 were analyzed. All flaps were elevated in the subfascial plane based on a single perforator from the peroneal artery between the soleus and peroneus muscles. The average harvested flap size was 18.9 cm 2 (range, 9-40 cm 2 ), pedicle length was 4.3 cm (range, 3.1-5.5 cm), and pedicle artery diameter was 1.1 mm (range, 0.8-1.5 mm). Twenty-three of the 24 PPAP flaps survived. Average time to harvest the flap was 35 minutes (range, 20-55 minutes). Perforator location (ratio by fibula length) was confirmed at the 0.32 site (standard deviation, ±0.04) from the fibular head. Percentages of septocutaneous and musculocutaneous types were 42% (10/24) and 58% (14/24), respectively, for perforator vessel course; average intramuscular course was 1.3 cm (range, 0.7-2.4 cm). Vessel graft was conducted in four cases, with an average length of 2.2 cm (range, 1.5-3.0 cm). The PPAP flap is one of the thinnest flaps available and is relatively easy to elevate. Moreover, it can be elevated in the same operative field as the foot, and primary closure is available for the donor site. Thus, the PPAP flap may be a good surgical option for soft tissue coverage of the foot. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. The Depressive Experiences Questionnaire: validity and psychological correlates in a clinical sample.

    Science.gov (United States)

    Riley, W T; McCranie, E W

    1990-01-01

    This study sought to compare the original and revised scoring systems of the Depressive Experiences Questionnaire (DEQ) and to assess the construct validity of the Dependent and Self-Critical subscales of the DEQ in a clinically depressed sample. Subjects were 103 depressed inpatients who completed the DEQ, the Beck Depression Inventory (BDI), the Hopelessness Scale, the Automatic Thoughts Questionnaire (ATQ), the Rathus Assertiveness Schedule (RAS), and the Minnesota Multiphasic Personality Inventory (MMPI). The original and revised scoring systems of the DEQ evidenced good concurrent validity for each factor scale, but the revised system did not sufficiently discriminate dependent and self-critical dimensions. Using the original scoring system, self-criticism was significantly and positively related to severity of depression, whereas dependency was not, particularly for males. Factor analysis of the DEQ scales and the other scales used in this study supported the dependent and self-critical dimensions. For men, the correlation of the DEQ with the MMPI scales indicated that self-criticism was associated with psychotic symptoms, hostility/conflict, and a distress/exaggerated response set, whereas dependency did not correlate significantly with any MMPI scales. Females, however, did not exhibit a differential pattern of correlations between either the Dependency or the Self-Criticism scales and the MMPI. These findings suggest possible gender differences in the clinical characteristics of male and female dependent and self-critical depressive subtypes.

  6. The spontaneous spinal epidural hematoma : A clinical and anatomical study with correlations to the morphology of the internal vertebral venous plexus

    NARCIS (Netherlands)

    Groen, Rob

    1997-01-01

    This thesis concerns a clinical study of the spontaneous spinal epidural hematoma (SSEH) and a study of the vascular anatomy of the spinal epidural space. In particular the morphology of the internal vertebral venous plexus is studied, in an attempt to find an explanation for the etiology of this

  7. The Anatomical Institute at the University of Greifswald during National Socialism: The procurement of bodies and their use for anatomical purposes.

    Science.gov (United States)

    Alvermann, Dirk; Mittenzwei, Jan

    2016-05-01

    This is the first comprehensive account of body procurement at the Anatomical Institute at Greifswald University during National Socialism (NS). As in all other German anatomical departments, the bodies received during this period included increasing numbers of victims of the NS regime. Prior to 1939, 90% of all bodies came from hospitals, state nursing homes and mental institutions (Heil- und Pflegeanstalten), but dropped to less than 30% after 1941. While the total catchment area for body procurement decreased, the number of suppliers increased and included prisons, POW camps, Gestapo offices and military jurisdiction authorities. Among the 432 documented bodies delivered to the institute, 132 came from state nursing homes and mental institutions, mainly from Ueckermünde. These were bodies of persons, who probably were victims of "euthanasia" crimes. The Anatomical Institute also procured 46 bodies of forced laborers, of whom at least twelve had been executed. Other groups of victims included 21 bodies of executed Wehrmacht soldiers and 16 Russian prisoners of war from the camp Stalag II C in Greifswald, who had died of starvation and exhaustion. From 1941 onwards, the number of bodies delivered from prisons and penitentiaries greatly increased. In total, 60 bodies of prisoners, mainly from the penitentiary in Gollnow, were delivered to the Anatomical Institute. Greifswald Anatomical Institute was not just a passive recipient of bodies from all of these sources, but the anatomists actively lobbied with the authorities for an increased body supply for teaching and research purposes. Copyright © 2016 Elsevier GmbH. All rights reserved.

  8. Anatomical Cystocele Recurrence: Development and Internal Validation of a Prediction Model.

    Science.gov (United States)

    Vergeldt, Tineke F M; van Kuijk, Sander M J; Notten, Kim J B; Kluivers, Kirsten B; Weemhoff, Mirjam

    2016-02-01

    To develop a prediction model that estimates the risk of anatomical cystocele recurrence after surgery. The databases of two multicenter prospective cohort studies were combined, and we performed a retrospective secondary analysis of these data. Women undergoing an anterior colporrhaphy without mesh materials and without previous pelvic organ prolapse (POP) surgery filled in a questionnaire, underwent translabial three-dimensional ultrasonography, and underwent staging of POP preoperatively and postoperatively. We developed a prediction model using multivariable logistic regression and internally validated it using standard bootstrapping techniques. The performance of the prediction model was assessed by computing indices of overall performance, discriminative ability, calibration, and its clinical utility by computing test characteristics. Of 287 included women, 149 (51.9%) had anatomical cystocele recurrence. Factors included in the prediction model were assisted delivery, preoperative cystocele stage, number of compartments involved, major levator ani muscle defects, and levator hiatal area during Valsalva. Potential predictors that were excluded after backward elimination because of high P values were age, body mass index, number of vaginal deliveries, and family history of POP. The shrinkage factor resulting from the bootstrap procedure was 0.91. After correction for optimism, Nagelkerke's R and the Brier score were 0.15 and 0.22, respectively. This indicates satisfactory model fit. The area under the receiver operating characteristic curve of the prediction model was 71.6% (95% confidence interval 65.7-77.5). After correction for optimism, the area under the receiver operating characteristic curve was 69.7%. This prediction model, including history of assisted delivery, preoperative stage, number of compartments, levator defects, and levator hiatus, estimates the risk of anatomical cystocele recurrence.

  9. Clinical correlates of the restless legs syndrome

    Directory of Open Access Journals (Sweden)

    Luis Fabiano Marin

    2012-07-01

    Full Text Available OBJECTIVE: To determine the clinical correlates of the restless legs syndrome (RLS in a Brazilian sleep disorders center. METHODS: We retrospectively studied 118 patients with RLS from January, 2004, to December, 2010. The analyzed variables were: age at disease onset, gender, race, years of school instruction, primary and secondary RLS, and treatment options. RESULTS: Among the studied patients, 83.9% were women with a female/male sex ratio of 5:1. Mean age of the patients at symptom onset ± standard deviation was 41.7±17.9 years-old. The primary RLS was found in 85% of patients. The other 15% remainders consisted of secondary forms, and they were associated with neuropathy, iron deficiency anemia, end-stage renal disease, or Parkinson's disease. Drug therapy for RLS was introduced in 67% of patients. CONCLUSIONS: Most patients presented primary RLS with an early disease onset. Further epidemiological studies are welcomed to provide better information on secondary RLS in Brazil.

  10. The relationship between the numbers of reflux episodes with anatomic changes of the esophagus in children under one year with gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    HamidrezaTalari

    2016-07-01

    Full Text Available Gastroesophageal reflux is the most common gastrointestinal disorder in the neonatal period, and the main reason for it is the lack of development in the first months of an infant's digestive system and it gets improved with the aging of baby and development of the digestive system. Some studies have shown that there is a relationship between characteristics of anatomic and esophageal reflux. This study aimed to determine the relationship between the characteristics and frequency of reflux in infants under one year old with gastroesophageal reflux disease. This study is a cross-sectional study that was conducted in 2015 in the hospital of martyr Beheshti. In this study, a group of 120 children with reflux in three age groups less than one month, 1-6 months and 6-12 months were choses and the relationship between reflux episodes with esophagus anatomic characteristics, including distal esophagus distention, Hiss angle, internal angle and length of esophagus were examined. The data were analyzed using the SPSS software and the relationship between the characteristics was compared with the number of reflux in three groups. According to the results, the frequency of reflux and extent of distention of the distal esophageal, Hiss angle, Internal Gastro esophageal angle and length of the esophagus, there was a statistically significant correlation (P <0.001. The correlation between reflux episodes and four parameters, are respectively, 0/95, 0/97, 0/71 and -0/79/. Also there was a direct relation between the frequency of reflux and extent of distention of the distal esophageal, Hiss angle, Internal Gastro esophageal angle and an inverse relation with length of the esophagus. The correlation between the frequency of reflux and esophageal characteristics in separation between all three age groups showed a statistically significant relationship exists between anatomical esophageal characteristics and reflux frequency. Based on the results of this study it

  11. Googling in anatomy education: Can google trends inform educators of national online search patterns of anatomical syllabi?

    Science.gov (United States)

    Phelan, Nigel; Davy, Shane; O'Keeffe, Gerard W; Barry, Denis S

    2017-03-01

    The role of e-learning platforms in anatomy education continues to expand as self-directed learning is promoted in higher education. Although a wide range of e-learning resources are available, determining student use of non-academic internet resources requires novel approaches. One such approach that may be useful is the Google Trends © web application. To determine the feasibility of Google Trends to gain insights into anatomy-related online searches, Google Trends data from the United States from January 2010 to December 2015 were analyzed. Data collected were based on the recurrence of keywords related to head and neck anatomy generated from the American Association of Clinical Anatomists and the Anatomical Society suggested anatomy syllabi. Relative search volume (RSV) data were analyzed for seasonal periodicity and their overall temporal trends. Following exclusions due to insufficient search volume data, 29 out of 36 search terms were analyzed. Significant seasonal patterns occurred in 23 search terms. Thirty-nine seasonal peaks were identified, mainly in October and April, coinciding with teaching periods in anatomy curricula. A positive correlation of RSV with time over the 6-year study period occurred in 25 out of 29 search terms. These data demonstrate how Google Trends may offer insights into the nature and timing of online search patterns of anatomical syllabi and may potentially inform the development and timing of targeted online supports to ensure that students of anatomy have the opportunity to engage with online content that is both accurate and fit for purpose. Anat Sci Educ 10: 152-159. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  12. Lacrimal Gland Pathologies from an Anatomical Perspective

    Directory of Open Access Journals (Sweden)

    Mahmut Sinan Abit

    2015-06-01

    Full Text Available Most of the patients in our daily practice have one or more ocular surface disorders including conjucntivitis, keratitis, dry eye disease, meibomian gland dysfunction, contact lens related symptoms, refractive errors,computer vision syndrome. Lacrimal gland has an important role in all above mentioned pathologies due to its major secretory product. An anatomical and physiological knowledge about lacrimal gland is a must in understanding basic and common ophthalmological cases. İn this paper it is aimed to explain the lacrimal gland diseases from an anatomical perspective.

  13. [Planning of esthetic oral rehabilitation according to correlative analysis of clinical and morphological features of the marginal gingiva].

    Science.gov (United States)

    Stafeev, A A; Zinov'ev, G I; Drozdov, D D

    2015-01-01

    The orthopedic restoration and related to its clinical stages (preparation, gingival retraction, impression) is often associated with complications which arise from the marginal gingiva. The technology of indirect ceramic restoration requires an assessment of the clinical and morphological parameters of periodontal tissues. The study outlines correlation between the type of periodontal histhology and inflammatory and degenerative complications that has been established after the analysis of morphofunctional state of periodontal tissue. Results of clinical studies and correlation analysis of clinical and morphological parameters of marginal gingiva has shown that important parameter influencing the choice of manufacturing technology are the position of restoration margin relatively to marginal gingiva and periodontal morphotype.

  14. THERMAL REGULATION OF THE BRAIN -AN ANATOMICAL AND PHYSIOLOGICAL REVIEW FOR CLINICAL NEUROSCIENTISTS

    Directory of Open Access Journals (Sweden)

    Huan (John eWang

    2016-01-01

    Full Text Available Humans, like all mammals and birds, maintain a nearly constant core body temperature (36 -37.5°C over a wide range of environmental conditions and are thus referred to as endotherms. The evolution of the brain and its supporting structures in mammals and birds coincided with this development of endothermy. Despite the recognition that a more evolved and complicated brain with all of its temperature-dependent cerebral circuitry and neuronal processes would require more sophisticated thermal control mechanisms, the current understanding of brain temperature regulation remains limited. To optimize the development and maintenance of the brain in health and to accelerate its healing and restoration in illness, focused and committed efforts are much needed to advance the fundamental understanding of brain temperature. In order to effectively study and examine brain temperature regulation, it is critical to first understand the relevant anatomical and physiological properties in the head-neck regions.

  15. Influence of anatomic location of lidocaine patch 5% on effectiveness and tolerability for postherpetic neuralgia

    Directory of Open Access Journals (Sweden)

    Nalamachu S

    2013-06-01

    Full Text Available Srinivas Nalamachu,1 Matthew Wieman,2 Leah Bednarek,2 Surya Chitra21International Clinical Research Institute, Overland Park, KS, 2Endo Pharmaceuticals Inc, Malvern, PA, USAPurpose: Lidocaine patch 5% is recommended as a first-line therapy for postherpetic neuralgia pain in neuropathic pain guidelines. Postherpetic neuralgia can occur anywhere on the body but often follows acute herpes zoster occurring in trigeminal and brachial plexus dermatomes. An analysis was conducted to determine whether the anatomic location of lidocaine patch 5% is associated with variations in effectiveness or tolerability in patients with postherpetic neuralgia.Methods: This was a post hoc analysis by anatomic site of patch placement (head [including neck], trunk [chest, abdomen, back, hips], and extremities [arm, leg] of a 4-week, multicenter, open-label study that enrolled patients with persistent pain following herpes zoster infection. Effectiveness was measured by Brief Pain Inventory (BPI average pain intensity (0 [no pain] to 10 [worst imaginable pain] and the BPI subscale for pain relief (0% [no relief] to 100% [complete relief]. Tolerability was assessed on the basis of patient-reported adverse events.Results: Of 332 enrolled patients (59.6% women [n = 198]; 92.5% white [n = 307]; mean [standard deviation] age, 71.2 [13.9] years, those (n = 203 who applied lidocaine patch 5% to a single anatomic site only and had baseline and postbaseline pain score data were analyzed (trunk, n = 130; head, n = 41; extremities, n = 32. The frequency of adverse events differed significantly by anatomic location, with significantly more adverse events reported with patch placement on the head versus the extremities (P = 0.006 or trunk (P = 0.02. BPI average pain improved significantly from baseline in each of the three anatomic areas (mean score decrease, 1.50–2.04; P ≤ 0.002, with no significant difference in effectiveness by patch location.Conclusion: Lidocaine 5% patch was

  16. CLINICAL PHARMACOLOGY OF DIURETICS

    Directory of Open Access Journals (Sweden)

    I. V. Soldatenko

    2014-06-01

    Full Text Available Clinical pharmacology of diuretics in the international system of ATC (anatomic-therapeutic-chemical is presented. Classification of this group by the action mechanism and caused effects is provided. Pharmacokinetics and pharmacodynamics features, indications and principles of diuretics usage in clinics are considered. Contraindications, side effects and interaction with other drugs of this group are discussed in detail.

  17. Correlation between the distribution of 3H-labelled enkephalin in rat brain and the anatomical regions involved in enkephalin-induced seizures.

    Science.gov (United States)

    Haffmans, J; Blankwater, Y J; Ukponmwan, O E; Zijlstra, F J; Vincent, J E; Hespe, W; Dzoljic, M R

    1983-08-01

    The correlation between the distribution of the intraventricularly (i.v.t.) administered delta agonist [3H](D-ala2,D-leu5)-enkephalin ([3H]DADL) and the anatomical regions involved in enkephalin-induced seizures has been studied in rat by using an autoradiographic method and recording of the electromyogram (EMG) and the electroencephalogram (EEG). The results indicate that within 10 min, the radioactivity of the intraventricularly administered drug reached all parts of the ventricular system, including the central canal of the spinal cord. However, within 2.5 min after the intraventricular administration of [3H]DADL, which corresponds to the onset of DADL-induced seizures, the substance appeared mainly in the left lateral ventricle and occasionally in the third ventricle. During the first 2.5 min the substance penetrated regularly into the surrounding periventricular tissue of the striatum, septum and hippocampus to a depth of about 100 microns. The most intensive and long-lasting epileptic discharges, exceeding 30 min were observed in the hippocampus, in contrast to the mild and short-lasting electrophysiological responses of the septum and corpus striatum. The experiments suggest that the short onset of enkephalin-induced excitatory phenomena is due to the rapid distribution and penetration of the substance in the surrounding periventricular tissue. According to these data, it is proposed that activation of delta opiate receptors, localized within the first 100 microns of the periventricular tissue, mainly in the hippocampus, is essential for the triggering of endorphin-induced seizure activity.

  18. 16 CFR Figure 1 to Part 1203 - Anatomical Planes

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Anatomical Planes 1 Figure 1 to Part 1203 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR BICYCLE HELMETS Pt. 1203, Fig. 1 Figure 1 to Part 1203—Anatomical Planes ER10MR98.001 ...

  19. Specification and estimation of sources of bias affecting neurological studies in PET/MR with an anatomical brain phantom

    Science.gov (United States)

    Teuho, J.; Johansson, J.; Linden, J.; Saunavaara, V.; Tolvanen, T.; Teräs, M.

    2014-01-01

    Selection of reconstruction parameters has an effect on the image quantification in PET, with an additional contribution from a scanner-specific attenuation correction method. For achieving comparable results in inter- and intra-center comparisons, any existing quantitative differences should be identified and compensated for. In this study, a comparison between PET, PET/CT and PET/MR is performed by using an anatomical brain phantom, to identify and measure the amount of bias caused due to differences in reconstruction and attenuation correction methods especially in PET/MR. Differences were estimated by using visual, qualitative and quantitative analysis. The qualitative analysis consisted of a line profile analysis for measuring the reproduction of anatomical structures and the contribution of the amount of iterations to image contrast. The quantitative analysis consisted of measurement and comparison of 10 anatomical VOIs, where the HRRT was considered as the reference. All scanners reproduced the main anatomical structures of the phantom adequately, although the image contrast on the PET/MR was inferior when using a default clinical brain protocol. Image contrast was improved by increasing the amount of iterations from 2 to 5 while using 33 subsets. Furthermore, a PET/MR-specific bias was detected, which resulted in underestimation of the activity values in anatomical structures closest to the skull, due to the MR-derived attenuation map that ignores the bone. Thus, further improvements for the PET/MR reconstruction and attenuation correction could be achieved by optimization of RAMLA-specific reconstruction parameters and implementation of bone to the attenuation template.

  20. Correlation of kidney biopsy findings and clinical manifestations of primary focal and segmental glomerulosclerosis

    Directory of Open Access Journals (Sweden)

    Taheri Diana

    2009-01-01

    Full Text Available To evaluate the correlation of clinical, laboratory, and pathological features at pre-sentation of focal segmental sclerosis (FSGS, we reviewed in a cross sectional study the patholo-gical findings of kidney biopsies in 64 cases of primary FSGS, and correlated them with the clinical and laboratory data obtained at the time of the biopsies. The data included blood pressure, glome-rular filtration rate (GFR, serum albumin, and the level of proteinuria. The mean level of serum crea-tinine was significantly higher in the biopsies′ findings of synechiae (adhesions in the Bowman′s capsule, interstitial fibrosis, and global scars (P< 0.05, and mean level of GFR was significantly lower with the presence of interstitial fibrosis (P< 0.05. Furthermore, there was a positive correlation between the level of serum creatinine and global sclerosis (r= 2.21, P= 0.04, and a negative correlation between the level of GFR and global sclerosis(r= 2.01, P= 0.02. All the patients with renal insufficiency had interstitial fibrosis in their biopsies in comparison of only the 24 patients (48% of the group without renal insufficiency (P< 0.05. There was no significant difference bet-ween patients with and without hypertension and nephritic-ranged proteinuria. We conclude that we found a correlation of renal insufficiency in primary FSGS patients with interstitial fibrosis, global scars and the synechiae of Bowman′s capsule in their biopsies.